HomeMy WebLinkAbout95-5430
BUILDING PERMIT--
CITY OF ZEPHYRHILLS Permit l\T!.
(813) 788-6611
~ -- 5430 .e
Date I~ -/ ~9 ~-
~INi0
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
",operty Owne, }/ :s-~~
Job Address:d 7' b ,.... < - ---:t3 ~
Parcell.D. # ~ -db -;1..1 - c') /s6 - D CJ CJ CJ <:J -..... 06> D
Water Meter:
T.I.F.'s:
Zon;n. ~En2 Code
:;t,::::' .." .." .. /~ -
2don G:U
'&' (/. A-t h7 -
&<Ih1- ~M,r
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
DATE
Valuation or
Contract Price
DATE
es.
& tJcTo. cr-o
...,
City License Registration #
State Certified License#
c2.-.b
J!r. y lJt ~
BUILDING
Ftr. Il-{o-t{ '> :gilL
Pre SLB II- -&-05" j31u...-
Lintel
ELECTRICAL
PLUMBING
MECHANICAL
Driveway
12--104) rJ l~
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
FRM.
Insul. CL
WL
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
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 PERKIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
a~ Itls3-~.
OWNER'S NAME H4K \Y\\-e.\'..---,h+~ ~ PHONE ,?j3-7~.~-d-d../G
OWNER'S ADDRESS 3~ ~ G;7 ~L0 i ~Lf W l -c'+-
JOB ADDRESS 37CeLj-S-~aAD \),. Lo, Loj
LEGAL DESCRIPTION: LOT(S) /J1v 1 () BLOCKD()nOCSUBDIVISION Ze> f Ay ~~H, 'n 91:-
PARCEL I.D.' .3-;)& -;).1 - OJ ~o - DoO()() - 6(07 b (OBTAIN FROH PROPERTY TAX NOTICE)
WORK PROPOSEDLNew Construction _Addition --...Alteration _Repair _Install
_Sign
_Hove
_Deaolish
PROPOSED USE: _Single Faaily
_H/F
_' of Units _H/H
_~ercial
_Indust.
_Swia. Pool _Other
_Restaurant Ii Health Departaent Approval
DESCRIPTION OF WORK: ('oN
BUILDING SIZE:
x
Square Feet.
Height
RESIDENTIAL :
COMMERCIAL :
ATTACH (2) PLOT PLANS Ii (2) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
~LDING
PERKITS REOUESTED
$~;)(~i 00
Valuation of Total Construction
_ELECTRICAL
AKP Service
Florida Power Corp.
W.R.E.C.
_MECllAlfICAL
$
Valuation of Hechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fraae _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
Signature
4;. &t.
CONTRACTOR SECTION
COHPANYB+/I 11'7 f?5o /-.1/Z(r(lC=iJ lE/V/ / IV G .
State Cert. or Regis . .
City License Registration' c){....
******************************************
BlJII.DER
ELECTRICIAN COMPANY
State Cert. or Regist. .
SignAture City License Registration .
******************************************
PLUMBER COMPANY
State Cert. or Regist. ,
Signature City License Registration t
******************************************
MECHANICAL COMPANY
State Cert. or Regist. t
Signature City License Registration .
******************************************
OTHRR COMPANY
State Cert. or Regist. .
Signature City License Registration #
******************************************
APPLICATION APPROVED BY PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A" NOTICE OF DEED RESTRICTIONS
Tbe undersigned understands tbat this pertit lay be subject to "deed restrictions" wbich tay be lOre restrictive than City
regulations. Tbe undersigned assUles responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas bired 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, both the owner and contractor lay be
cited for a lisdel8anor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requirelents tay apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departtent, (813)
788-6611.
Furtheraore, if the owner bas bired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
"Contractor Sections" of this application for which they will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, rather tban the contractor, are responsible for the work. If the contractor wishes you to sign
as contractor that tay be an indication that be is not properly licensed and is not entitled to peraitting 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, have been provided with a copy of "Florida's Construction Lien Law - Hoaeowner's Protection
Guide" prepared by the Florida Departtent of Agriculture and Consuaer Affairs. If the applicant is soaeone other than the
.owner", I certify that I bave obtained a copy of the above described docuaent and prOlise in good faith to deliver it to the
"owner" prior to cOlleDcelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforaation in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, loning, and land developleDt.
Application is bereby lade to obtain a pertit to do wort and installation as indicated. I certify that no work or
installation bas COIIeDced prior to issuance of a pertit and that all work will be perforted to teet standards of all laws
regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other goveI1llental agencies tay apply to the intended wort, and that it is
If responsibility to identify wbat actions I lust take to be in cotpliance. Such agencies include but are not lilited to:
· Departtent of Environaental Regulation - Cypress Baybeads, lIetland Areas and Envirolllentally Sensitive Lands,
lIater/llastewater 'Ireattent
· Southwest Florida Water Hanagelent District - lIells, Cypress Baybeads, lIetland Areas, Altering lIatercourses
· Arty Corps of Engineers - Seawalls, Docks, Navigable Waterways
· Departtent of Health & Rehabilitative Services, EnvirODlental Health Unit - Wells, lIastewater 'Ireattent, Septic Tanks
· US EnvirODlental Protection Agency - Asbestos abatelent
I also certify that, if fill taterial is to be used in Flood ZOne "A. or "A, etc. ., it is understood that a drainage plan
addressing a .cQlPeDsating volute" will be subtitted wbich is prepared by a professional engineer registered in the State of
Florida prior to pertit issuance.
A perlit issued sball be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor sball issuance of a pertit prevent the Building Official frOt thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall beCOle invalid
unless tbe work authorized by such pertit is cOllenced within sillOnths of issuance, or if work authorized by the pertit is
suspended or abandoned for a period of sillOntbs after the tite the work is COlleDCed. One 90 day 81tension of tile, tay be
allowed for the pertit with fee charge of $15.00. 'Ibe 81tension sball be requested in writing to the Building Official. An
approved inspection lUst be logged during each six aonth period, or the project will be considered abandoned.
WARlfIHG '1'0 0IIlfER: YOUR FAILURE TO RECORD A NOTICE OF COHHEJICEJlElft' HAY RESULT IN YOUR PAYING DICE FOR IHPROVEHElft'S '10 YOUR
PROPERTY. IF YOU Ilft'EIID TO OmAIN FlIIAICING, CONSULT 1I1'IH YOUR LINDER OR D AftORIfEY BEFORE RECORDUm YOUR NOTICE OF
COMHENCEHElft'. JOBS UNDER $2,500 IN VALUE 00 NOT HEED '10 RECORD AIID POST A "NOTICE OF COHMENCEIIEN'I".
SIGNATURE: OWIIER OR AGE1ft'
SIGHA'IURE: COlft'RAC'IOR
STATE OF FLORIDA
COUlft'Y OF
The foregoing instrument was acknowledged
before me this , 19____ by
STArE OF FLORIDA
COUlft'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 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
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STA.NDAl~l) F()Rl\1. OF AGREEMENT
CC)NTRACl'OR AI\.JD OWI'IER
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:: : March 8. 1996 : ::
S \ No. CC185307 i ::
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DATE: IJ-r)-7)~
CITY OF ZEPHYRHILLS - BUILDING DEPARTMENT
RIGHT-OF-WAY USE PERMIT
PERMIT /I
No construction under ground or above ground of any facility shall be accomplished on any
City Rights of Way without written approval froln the City Building lJepartment. Any application
for approval of construction operations on any City owned nights of Way shall furnish a detailed
.drawing showing the.complet.e scope of the proposed work in triplicate to the office of the Build-
ing Official for approval prior to the commencement of any work. A copy of this permit is to be
kept readily available at the site of the work at all times.
See No.
City noad
Date
LOCATION (Legal Description) s 37(/-/5'" '~/9i)D bl2 '/011-;7 Ze L)A-./,.!?(& ~
I I
'. 3 -;~ e;;) / - () /3C - (xxx::x; ~ ()/r; -7 0
G REq .gee-dcE:
I
and maintenance of
subject to the fallowing conditions:
. 1. The construction and maintenance of such utility shall not interfere with be property
and rights of a prior occ~pant.
2. All work shall be done in keeping with the standards of the City Streets Department and
under the supervision of the City Building Official, who will be notified.at least one day prior
to commencement of construction.
3. All materials andeq~ipment shall be subject to inspection by the City Building Official.
4. During construction all safety regulations of the State Road Department shall be observed
and tqe City shall be relieved of all responsibility from damage of any nature arising from this
permit: Subject to the same terms and conditions, the permit holder may take such safety measures,
inclUding placing and display of caution sign9, as it may deem necessary in conduct of construction
and maintenance work hereunder.
S. All private and all City property shall be restored to its original condition as far as
practical in the opinion of the City Building Official.
6~ All underground C1:Qssing installations shall be laid at su.:h depth as may be specified
by the City Building Official.
7. The sketch covering the details of this installation shall be made a part of this permit.
This permit is granted with the understanding that the applicant has notified all other utility
users in the area covered by the permit and takes full responsibility for any damage incurred by
prior installations as a result of his operations in order that they may safe guard their interests.
B. It is expressly stipulated that this permit is a license for permissive use only and
that the placing of ~~~ilities upon public property pursuant to this permit shall not operate to
'create or to vest any property right in said holder.
9. Whenever the City decides to further exploit the City Rights of Way, any or all of said
poles, ~ire., pip,s, cables, or other facilities and appurtenances authorized hereunder, shall be
immediately removed frOm said Rights of Way, or reset or relocated thereon as required by the City
B~i1ding Official at the expense of the holder of this permit.
10. The holder shall save and keep the City harmless from any and all damages, claims, or
injuries that may ocgur by:reason of the construction, maintenance, and operation of said facility.
11. ' The holder shall complete the requested work within days or this permit shall
become null and void. In the event the work requested is not completed upon the expiration date
of this permit, the City shall have the right to complete such work and to charge the holder of
the permit for all costs incurred in completi~g said work.
. 12. The holder shall post a cash or surety bond with the City Manager in the sum of $
dollars to guarantee performance of the Obligations herein~and to guarantee maintenance of the
right-of-way described herein for a period of one (1) year following completion of the requested
,installation. In the event a surety bo.lc1 is posted, the said surety bond shall be made payable to
the City and shall obligate the surety to hold the City harmless in the event the holder of this
permit should fail to'meet any of its obligations hereunder. The bond shall also indemnify ~le
City for all court costs and reasonabl~ attorneys fees in the event legal action is required to
collect on said bond'7fN1 /J7~jS6tV1c!Iy{~1J1E:AJT/V~
APPROVED BY I SUBMITTED BY: Gf{.'6"C;&?3I'f F
lpermittee)
~ / / -
Date ~~J ^,1k:~Llrqnj~~ t~ ~l(/Le5
)JL/9LJ -~bfqIC si. &e-t.04sv,j!c F/
Address 9't; (p! Lf
~~
/
SITE PLAN
(RESIDENTIAL USE ONLY)
rARCEL I.D,
2-
SEe
20
TWl'
~I
RNG
60 X I ~o
~/3d
SUlllJ
PROPEHT'i MEASUREMENT
CUIUtENT OWNEHS
u ~ e rjl/-r[t2-STAT~
d{JO~{J
BLOCK
tJI;;70
LOT
DATE
1/-7-9.)
All drawings sball be drawn to scale for all parcels or lots five acres or less.
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Notice to all contractors concerned with concrete for the design,
fabrication, and erection of Aluminum Structures Onl~.
Patio Slab's: Minimum 8"x12" footer w/211 5 rebar.
Effective November 15, 1990 concrete shall be installed as required
in detail below.
.
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