HomeMy WebLinkAbout95-5362
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BUILDING PERMIT-
CITY OF ZEPHYRHILLS Permit IT!
(813) 788-6611
ni362 p
Date
JI-~-9~
,
EL~--
~- Sewer Conn
Water Conn:
NO OCCUPANCY BEFORE C.O.
Water Meter:
Property Owner:
Job Address:
Parcel I. D. #
Zoning:
Description of Work
T.I.F.'s:
l\~#~
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
FINAL
C.O.
Valuation or "2 - ~
Contract Price ~A () .
Permit Fee c;-,
Signature
Company
Address
Telephone#
City License Registration # ------
ertified License# ~
.-
/
BUILDING
Ftr.
Pre SL
Lintel
,,,~,..,~'
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Driveway
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
C. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
OWNER
"R C.lTY OF ZRPIIIRlULLS BU.lLU.lNG DRPARTHBNT
\ . ..J( ~ RC).0~A ~()J0PS
~'5' 9 -3 '-I I 't +~ ~+ r-~ L J2~r- ~~ \l & '-}L~L
/ I -,J (, - ;. J - 001 () - 6't5ob - oObD
JOB LOCATION
P/\RCEL I.D. #
7frS -383L
335'YO
SHOW ALL EXISTING & PROPOSED STRUCTURES GIVING DIMENSIONS & SETBACKS.
.
/\LLEYWAY ACCESS FOR
G/\RAGE OR CARPORT -
15 FOO'I' SETBACK
REQUIRED.
<- (I'D Sf f' ...:r-
Woed -1t.AAJ~ ~
1~
r
r
FRONT PROPERTY LINE
UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MA'l'ION.
"J
I q-lh STREET
r -- . -<-J------+--__--J
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'. .
APPLICATION FOR PERKlT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER'S NAME fJeLiJ/ CLhJ t:?onriCi.... .j00 e.-S PHONE lF8 - .<,R..3~
OWNER'S ADDRESS fj'13 Lj I q fu S+'('-e_~~ 2~rhyr~ :lls FL I 3<.5-Ljo
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S){..u~ 5) t. ), ,q~LOCK "IS SUBDIVISION
PARCEL 1. D.' I J - d" . d J - 00 J () - 0 r..L1on - (> D bO (OBTAIN FROH PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition -^lteration _Repair /' Install
_Sign.
_Hove
_Demolish
PROPOSED USE: LSiogle Faaily
_H/F
_, of Units _H/H
_C~ercial
_Indust.
_Swi.. Pool ___Other
_Restaurant & Health Department Approval
DESCRIPTION OF WORK: T" () S~ cJ I .\\{'\l" 6' \. .u onJ ~r\ t@(" rt. t _ fJ
BUILDING SIZE: X , ~() Square Feet,-LHeight
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
_BUILDING
';:350. ()~
PERMITS REOUESTED
Valuation of Total Construction
_ELEC'l"RICAL
AMP Service
Florida Power Corp.
W.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLtJMBING GAS ROOFING
SPECIALTY
TYPE OF CONSTRUcrION: _Block _FrDe _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
CONTRACTOR SeIPN-
BUILDER - ./' . COMPANY ~..P to-('~../)
~ ~ State Ger<. or Regist. .
Signature ... ... . , ~City License Registration'
*******~*********************************
ELECTRICIAN COMPANY
State Cert. or Regist. #
Sim~ture City License Registration t
******************************************
PLUMBER COMPANY
State Cert. or Regist. ,
Signature City License Registration .
******************************************
MECHANICAL COMPANY
State Cert. or Regist. *
Signature City License Registration ,
******************************************
OTHF.R COMPANY
State Cert. or Regist. ,
Signature City License Registration ,
******************************************
APPLICATION APPROVED BY PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit lay be subject to "deed restrictions" which lay be lOre restrictive than City
regulations. The undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they lay be required to be licensed in accordance with
state and local regulations. If the contractor is not licensed as required by law, botb the owner and contractor lay be
cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requirelents lay apply for tbe intended work, they are advised to contact tbe City of Zepbyrbills Building Departlent, (813)
788-6611.
FurtherlOre, if the owner has hired a contractor or contractors, he is advised to have tbe contractor(s) sign portions of tbe
"Contractor Sections" of this application for wbich they will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign
as contractor that lay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN LAW (ClffiPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, tbe applicant, bave been provided with a copy of "Florida's Construction Lien Law - HOIeOWDer's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleone other than the
"owner", I certify that I have obtained a copy of the above described docUlent and prolise in good faith to deliver it to the
"owner" prior to couencelent.
E. CONTRACTOR'SjOWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has cOllenced prior to issuance of a perlit and that all work will be perfofled to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
certify tbat I understand tbat the regulations of otber governlental agencies lay apply to tbe intended wort, and tbat it is
IY responsibility to identify wbat actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to:
A Departlent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands,
Water/Wastewater Treatlent
A Southwest Florida Water Hanagelent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
A ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
A Departlent of Health & Rehabilitative Services, EnviroDlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
A US EnviroDlental Protection Agency - Asbestos abatelent
I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
addressing a "colpensating volUle" will be sublitted which is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A perlit issued sball be construed to be a license to proceed witb tbe work and not as autbority to violate, cancel alter, or
set aside any provisions of tbe tecbnical codes, nor shall issuance of a perlit prevent the Building Official frOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued sball becOle invalid
unless the work authorized by sucb perlit is cOllenced within six IOnths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six IOnths after the tile tbe work is cOIIenced. One 90 day extension of tile, laY be
allowed for tbe perlit with ,fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection lust be logged during each six IOnth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A Nor ICE OF COKHENCKHBNT HAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMKKTS TO YOUR
PROPERTY. .IF YOU IIflRND TO OBTAIN FINANCING, CONSULT WITH YOUR LEIDER OR AN ATTORRRY BIlFORE RIlCORDING YOUR NOTICE OF
COMHIlNCIlMIlIfl. JOBS UNDIlR $2,500 IN VALUIl 00 NOT NIlIlD TO RIlCORD AND POST A "NOTICIl OF COMHHNCIlMBNT".
~ OR~od.,,- pr,',A SIGNATURE: aJIlIRACIOR
STATIl OF FLORIDA
COUNTY OF
The foregoing instrument was acknDwledged
before me this , 19____ by
STATIl OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
before me this , 19_____ by
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
(Signature)
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC