HomeMy WebLinkAbout95-5411
BUILDING PERMITJl!- i-5411, t?
CITY OF ZEPHYRHILLS Permit- ,{...)
(813) 788-6611 _ C
Date /I-~ 7--S-
e ELECTRICAL PLUMBING MECHANICAL
::::,::~e$rfZt~ !J/:i:;J7 ~ I3LvJ
Parcel 1.0, #
Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
Zoning: Energy Code.
r- J ~
Description of Work k. _0 A
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
-'1 -)
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Valuation or
Contract Price
-S~d.- 0 b, ()D
./
City License Registration # ~
State Certified License#
k/)-- 9~9- (,/56/
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BUILDING ELECTRICAL
PLUMBING
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
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.
APPLICAnON FOR PERKIT
CITY OF ZEPBYRBILLS
BUILDING DEPAImfENT
OWNER'S tu.HE /~I?"}/VGE BIDSS {)fr; I?R-NC'It fj.d~e PHONE 7ffJ'-()t)O?
OWER'S ADDRESS /()SSOm i/d. ZE II /hIS )ft. J3 /
JOB ADDRESS 'It 00 / iff//J02 ) ~c:;-s-t "s:s-g 8 /t)~~m .8 } lid Z F;PHY ~ If; //S - 3.3.51-1 /
~ r
/J/ / 11
PARCEL LD.'
LEGAL DESCRlP'1'lON: LOT(S)
NIl; ,
BLOClL--SUBDIVISION
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:~ew Construction --.....Addition --..Alteration ~pair _Install
_Sign
--.-JIove
->>eaolish
PROPOSED USE: _Single Faaily
~/F ..!:L.. of Units __JI/B
_ec-ercial
_Indust. _Swia. Pool _OtJ;1er
Restaurant &: Bealth Departaent Approval
DESCRlP'1'lOJl OF WOBK: / /0 li'e roo ~ uJr/J... ;L;.:J.er- ~/-9 ,;,,5 , JA,.>.-,;A....>
(
),/00
BUILDING SIZE:
x
Square Feet.
Height
RESIDEIITIAL: ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET DERGY FORKS.
COMKERCIAL: ATtACH (3) SETS OF BUILDING PLANS &: (1) SET EllERGY FORKS.
PROPERTY SURVEY REQUIRED FOR ALL NEW COJlSTRUCTION.
-BUILDING
..,-M P PERMITS REOUESTED
$ L) ,p (Q eQ. Valuation of Total Construction
_ELEcrRICAL
AHP Service
Florida Power Corp.
W.R.E.C.
---lIECllAlJICAL
.-PLUMBING
$
Valuation of Hechaaica1 Installation
GAS
~ ROOFING
SPECIALTY
TYPE 9F COIIS'l'RucrIOJl: ---..81oc1t _Fraae _Steel
Other
FIIIISBED PI.OOR ELEVAnOJlS:
Fl.
IS PROJECI' IN FLOOD ZONE AREA?
YES NO
..........................................
CONTRACTOR SECTION
BIITT.nm
mHPAIIY
State Cert. or Regtst. .
City License Registration .
..........................................
Signature
R1.RCTRTCIAR
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
Signature
PUllBER
OOHPANY
State Cert. or Regist. .
City License Registration .
..........................................
Signature
tlECBANICAL
COMPANY
State Cert. or Regist. 'J-
City License Registration .
..........................................
Signature
COMPANY Y;w-<-fl> Ifoof,,,? J'o-fJ C" ~~< II
State Cert. or Regist:' KC ~S.5-/S-
City License Registration' g-~
..........................................
OTRRR
Signature
PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
'l'be undersigned understands that this penit lilY be subject to Ideed restrictions' wbich lilY be lOre restrictive than City
regulations. !he undersigned assUJeS responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the OlDer bas bired a contractor or contractors to undertake lIOrt, they I8Y be required to be licensed in accordance with
state and local regulations. If the contractor is not licensed as required by law, both the 0IIJler and contractor 181 be
cited for a lisdeJeallor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requireJellts I8Y apply for the intended wort, they are advised to CQJltact the City of Zepbyrhills Building Departlent, (813)
788-6611.
FurtheIlOre, if the OlDer bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
RContractor Sections I of this application for wbich they will be responsible. If you, as the OlDer sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the wort. If the contractor wisbes you to sign
as contractor that I8Y be an indication that be is not properly licensed and is not entitled to peIJitting privileges in the
City of Zepbyrbills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, bave been provided with a copy of IPlorida's Construction Lien Law - BoIeolmer's Protection
GuideR prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs. If the applicant is SOIl!OIle other than the
RovnerR, I certify that I bave obtained a copy of the above described c10cUIent and prcmse in good faith to deliver it to the
lownerl prior to co.encel8Jlt.
E. CONTRACTOR' S/OWNER 's AFFIDAVIT
I certify that all the infOIlation in this application is accurate and that all work will be done in CDlpliance with all
applicable laws regulating construction, zoning, and land developlleDt.
Application is bereby lade to obtain a peIlit to do 1IOrk and installation as indicated. I certify that no IfOrt or
installation bas CDlenced prior to issuance of a perlit and that all wort will be perfoIJed to _t stancJards of all lil1f8
regulating construction, City codes, zoning regulations, and land c1evelopleDt regulations in the jurisdiction. I also
certify that I understand that the regulations of other gDVeI1II8Iltal agencies lilY apply to the intended vort, and that it is
If responsibility to identify what actions I lUSt take to be in COIpliance. Such agencies include but are not luited to:
I DepartJent of InvirOl1l8lltal Regulation - Cypress Baybeads, Wetland Areas and InvirODll!lltally Sensitive Lands,
Water/llaste1rater 'l'reatJent
I SoutlNest Florida Water ManaQeMIlt District - Wells, Cypress Baybeads, Wetland Areas, Altering watercourses
I ArIy Corps of Engineers - Seawalls, Docks, lavigable Watenays
I DepartJent of Health & Rehabilitative Services, BnviIODl8Dtal Health Unit - Wells, Wastewater 'l'reatlent, Septic !ants
I US InviIODl8Dtal Protection Agency - Asbestos abatl!ll!llt
I also certify that, if fill Hterial is to be used in Flood ZOne IAI or IA,etc. R, it is understood that a drainage plan -
addressing a ICOllpeDSating volutel will be sublitted wbich is prepared by a professional engineer registered in the State of
Florida prior to peIlit issuance.
A ~it issued shall be construed to be a license to proceed with the IfOrt and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official fIOl thereafter'
requiring a correction of errors in plans, construction, or violations of any coele. Ivery perlit issued shall beCCIIe invalid
unless the wort authorized by such perlit is co.enced within sillOIltbs of issuance, or if wort autboriled by the perlit is
suspended or abandoned for a period of sil IOIltbs after the tile the vort is co.enced. One 90 day extension of tile, I8Y be
al101led for the perlit with fee charge of $15.00. 'l'be extension shall be requested in writing to the Building Official. An
approved inspection lUSt be logged during each sil IODth period, or the project will be considered abandoned.
mHING '1'0 OIlIER: YOUR FAILURI !O RlCORD A IO'I'ICE OF cmatDCIIIIIC'I' MAY RlSULf III YOUR PAYlIIG !IIICE FOR lMPROVIIID'I'S !O YOUR
PROPIR'I'Y. IP YOU IJ'I'BJID !O OB'l'AlJI PIJlAllCUG, CONSUL'I' WI'I'H YOUR LlllDIR OR All A'I"I'OIIDY BEFORE RBCORDIJIG YOUR ROIICE OF
COMMINClHBtlt'. JOBS UllDBR' $2,500 IN VALUE 00 JIO'I' mD '1'0 RECORD AID POS'I' A 'JIO'I')CB;OP
//
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SIGlllf : (IIJIIR OR AGItlt'
S'l'Afl OF FLORIDA
coum OF Pd5ClJ
The foregoing instrument was acknowledged
before me this ~1.//Jf!!....;7O? , 19li- by
-1h&re.r~' /77. 'l}~'
who is personally known to me or Mh8 has
..pradeeed
aa id&Rtifi~atiQR aD~who did/did Aot
~A7~~
--~atu:l,
-e/7 /On/? A"e/~ --#(JL!.Jhf?~'J
(Rame Typed, Printed or S ed)
ROTARY --PUBLIC
S'l'AD OP FLORIDA
COUN'I'Y 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 o~th.
(Signature)
(RaDle Typed, Printed or StilllPed)
ROTARY PUBLIC
NOl'.AItY I'OII.ICsrA'Dl OPI'I.OmQ\
Y\'~IDlP.DIiC 1'_
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