HomeMy WebLinkAbout95-5393
BUILDING PERMII-
CITY OF ZEPHYRHILLS Permit ]I!
(813) 788-6611
j-539U5
Date
I/-Ib-(?S-
, r
~
Valuation or ~ C,.)
Contract Price ~ -::1/0'
City License Registration # I~I ;
State Certified License#
Property Owner:
Job Address:
Parcell.D. #
Zoning:
Description of Work
~t ~'
9,,<:r; 181ft'. '7lf {l~.
ME~wer Conn
Water Conn:
Water Meter:
T.I.F.'s:
FINAL
C.O.
DATE
DATE
~~:S~ &~
IL~I -- -~ ~: L_
PLU~
~ -
MECJ:IANIEAL
~
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
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.
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT
M, \ ~n;'
Cn\i\ <'-\YI 1 ( ~ .;) Y\. \ Vl'-
.
~j) \ J :D~cl-e (\ iu ' FL 33525" PHONE
( ,
Me (AbC
'1U41~7- ttD4,
ADDRESS 15~1' l J . <.,
OWNER ,\)Wl\ ~ V\~_I R\ \ \\ "
JOB LOCATION 50..,>+ - I~~lrl ~ty,,'t't-
LOT SIZE
x
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUbDIVISION
PARCEL I.D.~;
1\ .?&.' 2...\. DO 10' L'S()l). Dl))ir\)
WORK PROPOSED:____New Construction ----Addition ----Alteration
!:~ - U--
~epair ____Install
____Sign/Temp.
____S 19n
_Move
-Demolish
PROPOSED USE: _Single Family
--.-HI F
____4; of Uni ts
.-.-M/H
-Acommercial
____Indus t .
____Swim. Pool
Other
----Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Fee t .
Height
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.**
**COPY OF CONTRACT REQUIRED.
PERMITS REOUESTED
2S.-BUILDING
$ Z I :1 10 IOU
Valuation of Total Construction
____ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
---HECHANICAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ____Block ____Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
CONTRACTOR SECTION
Company
State Cert. or Regist. #
City License Registration #
******************************************
BUILDER
Signature
Silltlature
Company
State Cert. or Regist. #
City License Registration #
******************************************
ET.ECTRICIAN
Company
State Cert. or Regist. #
City License Registration #
******************************************
PLUMBER
Signature
Company
Sta~e Cert. or Regist. #
City License Registration #
******************************************
MECHANICAL
Signature
Signature
Comp"ny -.n1d"Kar (~~(,;tr'Afh()Y\1 \\I\L.
State Cert. or Regist. # K( I)OSSUS'
City License Registration # ~~
OTHER
******************************************
APPLICATION APPROVED BY
PERMIT OFFICER.
~. NOTICE OF DEED RESTRICTIONS
lhe undersigned understands that this perlit lay be subject to .deed restriction~" which lay be lore re~trictive than r.i~y
regulations. The undersigned assUleS responsibility for cOlpliance .ith any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the o.ner has hired a contractor or contractors to undertake .ork, they lay be required to be licensed in accordance I.ith
state and local regulations. If the contractor is not licensed as required by laM, both the OMner and contractor lay b~
cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensilg
requirelents lay apply for the intended .ork, they are advised to contact the City of 2ephyrhills Building Departlent, 11~13}
788-6611.
Furtherlore, if the owner has bired a contractor or contractors, he is advised to have the contractorls} sign portions of the
"Coatractor Sections" of this application for which they .ill be responsible. If you, as the owner sign as the contract~r,
you are indicating that you, rather than the contractor, are responsible for the work. If the contractor .ishes 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
tity of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
1 certify that I, the applicant, have been provided .ith a copy of 'Florida's Construction Lien Law - HOltowner's Prot:ection
6uide. prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant i~ sOleone other than the
.o.ner., I certify that I have obtained a copy of the above described doculent and prolise in good faith to deliver it; to the
.oltntr. prior to COllence.nt.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in tbis application is accurate and that all work wi 11 be done in co.pliance lIith ilU
applicable laws regulatiog construction, zoning, and land develop..nt.
Application is hereby lade to obtain a perlit to do ItGrk and installation as indicated. 1 certify that no work or
installation has cOI.enced prior to issuance of a per.it and that all work lIill be perforled to leet standards of all lilWS
regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction. I alsl~
certify that 1 understand that the regulations of other governlental agencies lay apply to the intended work, and that it is
IY responsibility to identify what actions I lUst take to be in cOlpliance. Such agencies include but are not liaited 'to:
f DeDartaent of Environaental ReauIation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treataent
I Southwest Florida Water "anaaeaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
I ArlY CorDS of Enaineers - Seawalls, Docks, Navigable Waterways
I DeDartlent of Health 1 Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
f US Environaental Protection Aaency - Asbestos abateaent
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 "coapensating volule" will be subaitted which is prepared by a professional engineer registered in the State of
Florida prior to perait issuance.
A perait issued shall be construed to be a license to proceed lIith the work and not as authority to violate, cancel illter, or
set aside any provisions of the technical codes, nor shall issuance of a perait prevent the Building Official frol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall bee Oil! invalid
unless the 1I0rk authorized by such perlit is cOlaenced within six aonths of issuance, or if Nork authorized by the pl!r.it is
suspended or abandoned for a period of six lonths after the tile the work is cOllenced. One 90 day extension of till!, lay be
allowed for the perait 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 aonth period, or the project Nill be considered abandoned.
WARMING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COKKENCEKENT KAY RESULT IN YOUR PAYING TWICE FOR IKPROYEKENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER DR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
7:[;;;;~ 00 ~T ~ED TO REamD ~DZTI7;;:;(
SIGNATURE: OWNER OR AGENT, SIGNATURE: CONTRACTOR
v
STATE OF FlORl~
COUITY OF ' ~f' / j
The fDregoing ins~~nt
before me this J& d.
was acknowledged
, 19'7 Y by
STATE OF FLORI~
COUNTY OF ",J:}~~&)
The foregDing instrument
before me th i s JVou It 'fi'
was acknowledged
, 19 <91" by
o me or who ha~
me or whD has
d/did not
GAil Y. GRINDLE
tJnt!lry PlIhllc ~tatB of Florida
(Name Typed, P~OI'X.'~' 1998
NOTARY PUBLIC Comm. No. CO 368560
GAil Y. GRINDLE
~eliYjYMPD~.1 flodda
(Name Typed, Pr y com . exp r ' . ~5. 19Q5
NOTARY PUBLIC Comm. No. CC 368580
..-'
~
l~rllpU!ial
Page No.
of
~a,ges;
'\,
".
Member of the Florida
Rooting and Sheet Metal
Association
~
"i<'''~ ",t " J
hHioar ,-,ons rucucn, inC.
',: .'l!- '~'11ttH":-:
~l, ,(leI itl..-uC023221
U.5, Intee Certified
Platinum Installer
#5204
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PROPOSAL SUBMITTED TO
Creative ~jorld ;;clix)l
s~ltetn: (;.:11'1 .larth~1 /BILLIE
5U34 - Litl ,,::~- .:~C
CITY, STATE AND ZIP CODE
PHONEB13/963_3445
; -: ~ ,/ ~i '~ ) ~.; ;
~] DATE
,:I:1/'J'l
II. 2"~2 i . 0010 ~
002C4~
J' JJ..)J~"1'\4_,
JOB
NttY3/264-7266 Fax
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JOB LOCATION
::'~:'>; prrl1i 1 L,
ARCHITECT
t'L 33540
~~ "j ,J _.
, " ~.~, "_ . t:
JOB PHONE
DA TE OF PLANS
We hereby submit specificatIOns and estimates for:
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mE JfrDJlDSE hereby to furnish material and labor - complete in accordance with above specifications, for the sum of:
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