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HomeMy WebLinkAbout95-5476 BUILDING PERMIT-- CITY OF ZEPHYRHILLS P~rmit IV! (813) 788-6611 !~5476i5 Date /2 -/ f~' 9-s- . c;L~I~ Zoning: Description of Work ~- P~ ::~::;::~., il1j~ ~~~~aw~ ParceII.D.# /:;J.- -_ _-__ 0- ~_~o- _9t) ~ ,. U/P~ M~C.^.L St:wer Conn Water Conn: Water Meter: T.I.F.'s: Energy Code: 7<(/)4. /R1 ~ado~ G~r ~ 6 IL ~J. NO OCCUPANCY BEFORE C.O. FINAL~' . C.O. -q'::J DATE Complete Plans. Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. DATE City License Registration # 7'-) State Certified License# Permit Fee Signature Company Address Telephone# Valuation or Contract Price /; I~!' ELECT PLU MI;!;I-l^~IICAL Ftr. Pre SLB Lintel /' FRM. l Insul. CL WL Tp. Servo 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. SITE PLAN (RESIDENTIAL USE ONLY) PARCEL 1.0. ,?- SEe :;2-( .,.L~ 03/0 OD660 o b 9 D' RNG 5~ )-~ SUBO R. ffo v) It- BLOCK LOT TWl' PROPEHTY MEASUREMENT C~ CURRE.NT OWNEHS C Iff/? CLS- i3KiJGK. DATE All drawings shall be drawn to Beale for all parccls or lots five acrcs or less. .. t"'1/ 5 tl,u (1 ;.,k 't-( ~ EY6Tr~ ~_ o ~ 100 L. I .t;O ~',"",", ,/--- ~ ~ (c) (NS'l.(..c.... /,)\ '1> -; (2- i f(.~ FIfr3 i 5 rf~t) \ \ ) // \ \ I 1& SHOW ALL EXISTING AND PROPf)SED STRUCTURES GIVING DIMENSIONS AND SETBACKS. ALSO, INDICATE M"Y BODIES OF WATER AND ROADWAYS (INCLUDING NAMES) ADJACENT TO THE PROPEHl'Y. INDICATE THE SIZE, YEAR, AND NAME OF MOBILEi SUCH AS 121 x 601.1981. FLEETWOOD. All "EASEMENTS", "RIGHT-OF-WAY" and "JURISDICTIONAL LINES" must be shown on all site plans. DO NOT F'~lrROAr" T"J'l'() HI,. F~ fT'1.'1'" " "", 11 " ' , ~ " i APPLICATION POR PERKIT . CITY OP ZEPBYRBILLS BUILDING DEPARTMENT OWNER'S NAKE . . c tIitR <-f-. S 5(, .).- ~:::L ~1H'1~ () Zo CK r<..fkAJ j) 4 PHONE 78~ VA ~~ . OWNER' S ADD~S CK( JOB ADDUSS LEGAL DESCRIPTION: LOT(S) BLOClL.-SUBDIVISION ~& ~(_ _~ 064D' PARCEL LD.' I~ ~ ~ D<..//O OOOo() tOBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction ---...Addition --.-.A1teration --.Jlepair ~Install _Sign -.JIove _Deaolish PROPOSED USE: _Single F_i1y --It/F _' of Units -.JI/H _eo..ercial _Indust. _Swia. Pool _Other _Restaurant air Health Departaent Approval DESCRIPTION OF WORK: 7u IIJS~ ~ ~ CttrJ,z.. <?yr)- tu F/ff;> S~j) BUILDING SIZE: cr; X /0 , 90 Square Feet, I <3 Height RESIDEHTIAL: AttACH (2) PLOT PLANS air (2) SEtS OF BUILDING PLANS air (1) SET ENERGY FORMS. COMKERCIAL: ATTACH (3) SETS OF BUILDIMG PLANS Ie (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. " PERMITS REQUESTED 1(;).. ,.- Cf Valuation of Total Construction $ _BUILDING ____ELECTRI.CAL AIIP Service Florida Power Corp. W.R.E.C. ---1IECIIAIflCAL $ Valuation of Kecbanica1 Installation ~UKBING GAS RooPING SPECIALTY TYPE OP CORSTRUCTlON: _Block _Pr_e _Steel Other FlRISBBD FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO .......................................... IlIJTI.Dm CONTRACTOR SECTI.ON . ---:..-_:~;~=::--::> -S'UtJS'Tlh-lt..- /k-u/Y /AJu'i We- ;.------- ) ..,-.".,..--.:..:/ '/ alKPANY /-//~~ -. -- State Cert. or Regist. . City License Registration' '71 t.......................... Signa ILG2 COMPANY State Cert. or Regist. t &.wm City License Registration . ~.......................... ~ COMPANY State Cert. or Regist. . Sigm City License Registration' .......................................... KECBABICAL COMPANY State Cert. or Regist. . Signature City License Registration . .......................................... OTRF.R COKPANY State Cert. or Reaist. . Signature -.-' City License Registration f .......................................... APPLICATION APPROVED B1 PERKIT OPFICER. . CONOITIONS OF PERMIT AFFIDAVIT A. NO'l'LCEOF J)gED ltESTRICTIONS 'fbeundersigned understands that this pertit lay be subject toBdeed resttictiOIl8. .bid!Iil' be'lIOteretttictive than City regulations.. fbe undersigned assUles responsibility for COIpliance with any applicable deed reatrictions. B. ORLICElfSEb ' CONTRA'C*I'OltS, ,AND CONTRACTOR .RESPONSIBILIT1ES. IftbeOlller bas hired a. contractor or contractors to undertake wort,. they lay. be . required to.be licenaed. inaccordal1cettitb state aDd loeal regulations. If the contractor.18 notliC8b8ed as l'IlQuirlrllbtlav,bOthtbeOllD8t.iIJ1dconttldm'laYbt ci ted for a lisdeleaoor violation under state law. If the OlDer at intended cOntrattor are Ulleettainas to .t UC8118!ng requiruentalayapply for the intended work, they are advised to contact the City afZepbyrbiU8 Building De~, (813) 788-6611. Pllttbetlorflt . if tbeiJlftletJias hired acontrmr or COlltractot1, be ill adfi'setftohDe tlIecoatractor(8) sign portiOllS of the BContractorSe'ctionsB of this application for which they will be reaponsible. If you, astH 0IfJler sign as, tile contractor, you are indicating that you, rather than the contractor, are responsible for the trOtt. If the conttactor wishes you to sign as COIltractor that .Iilybe an indication that be is. notpropetly licensed and is not entitled. to petlitting privileges ill the City of Zepbyrhillt. C. TRANSPORTATIONIMPAC'I' . FEES MIl UTILITY ,'. COHNECTIONFEES D. CONSTRUCTION . LIEN . LAW (CHAPTER 713, FLORIOASTATtJ'tES,AS AH8RDED) 1 l:ertlfy that I, the applicant, have been.provided witb a copy of B'lorida'sCOIlS'ttUctionLien Law _ lkIIeoIaler's Protection Guide. prepared by the Florida Departlent of Agricaltureand Cons_Affairs. If the applicantl. '8ClIeone other than the -owner., 1 certify that I have obtained a copy of the above delcribed ~t and pl'Olise in gOo'dfaith tadelivlr it to the -owner'prior to COlleDCeHnt. E. CON'l'RAC'l'Olt'S/OWNEH 'S .AFIi"tDAVIT I certify that all. .the infOrltiltion in this application is accurate and tbatillllfOtkwiU bedCmeiJr COIpliance withal1 applicable laws regulatiDgconstructiiJn, JOlJing, ana landdwelopnm. APPllciltlon isllerebyJade to Obtaill. it per.it to ao worlandioatallaUOIl as indicated. 1 cettify that tIO 110ft or installation haa ClMntel1 prior to>iSSuanceof aplrlit and that . allllOl'iliUbepetf(JtlldtollltataJldardaOf aU. 1M regulating COIl8tructiml, .Cftreodes, ..loningregUl.tions, ..and '. lancl.c1evelopleDt regulatiOll8 In, the.. judsdiction. I also certifytbat I understamltbat the. regulations ofotbel' gOflmliebtalagencll8aey.pplytotlie intended work, aDd that it ia If. respOnSibility to idelltify what . actions IlUIt tate to be in COIp1iance. Such_cia include but are not lilitedto: t Departleb.t.of Envi~talRewlatiOD - typreaaBayIlead8,Mlandlreasandln,irODleJrtllly SeII8tUft Lands, . . Ifater/lastewater treatleDt t 'SOUtble&t FloridaWatetHiihlQtfettt.Dilttict.. Vellst CypteBa aaYbea4r,.lfetlaDdAteas,Altering, watercourses t.ArayCorPs of Engineers.. seawalls,> Docb,'avigilblelatenrQ8 . .. '. . . tDeP8I'tlentofHealth. iRl!habilltatiJe~ Senu.,lnYirODll8Du,I,llealth .Ullit ... ileUs, IUtllatetfreatlellt, Septic tants .. us InvitoDlentalProtection Agency-.Asbestos abateaent I also certify that, H fill aaterial,fsto be t1sedinPlOOd%One"A., or Bl,ete.B'iitia Ulfder&tood that<a4taiDageplu addressing a B~till9 VOl.- lill be 'BUbiittet1wbich i8 preparedbyaprofesaional engineer registetecl in the State of Floridapdor tOperlit iIIS1Il1lce. Apenit issuedshlUbe CODstruedtobe a license to,proceecl,ith the wort and Ilot as autlbdttto 'iolate" cance1alter, or set aside any provilions of the teclmical codes, nor shall issuanceofapertlt preventthe Buildill90ffieialfrOlthereafter reqttiringa correctional errors. in. plans, construction, Or .violations of any COde.. Every perait issued aIla11 betGIe.. invalid unless the wortauthodzeclby sUehperait is ~ed withih all IODths..of issuance, or if IOtt.authoriJed bftbe.petlit is sl1spemleclor abandoned fora .periodofsiiGtha after the tile. the 1IOI't Is~. .0J1e 90 day utenaiouof tiae,Ia, be allOled for the pertit with fee chatgeof,15.00. tbe eltensi.OD allan ,berequl8tedin.writing to .tD... Bui1dillg Official. All approveditllpettiOil at be logg~duringeachsil 81th pedod,<or the project wiUbe. considered abandoned. WIfUIIKG to .(MfBR : YOUR. FIlLURE YO RECORDA. KOfICE.' OF CCIIuClllDf MlY RlSULt II YOOR P1YIIfG. twICE POl .DIPROVIIIDrsro YOUR PROPIRfY. .. .IFloo IIfDD 'YO()8'fl1H FIIIMCIHC, COJfSlJtr ."IDYooR..... OR 111 .JftORDYBlPOJIIlICOfU)llIG.YOUR ..leBOF ~. DllIIIDBR IZ.~~~~IO IlI.lIlD JID Rm I 'IlllIl'Il~~~~ . . ..-"-~~~::~:;~~.,.~?// .,J3f[~~-~- SIGJlAfURE~iaMi'; '. . sHimmr:~bR StAft; dPPOORl:OI. . . ,?) coum o~ /45"( a The.foregOing .instl'UDlent .was ackoowledtted befOre me this _11 Ir-;).- .. ,19~ by , sYAflOFF'OOIttOl ,.' ~. COUNIY OF ...' .. .... 4-$>C2> , Tbe, foregoing. in. s. tZ2i..... ..t.was aC~ledged before me this . II. ~)..-.... j 19 9~, by wbo is personally known to me or who has prOdUced, as identi,ficationand who did/did. not We.aI1 ....th. 'Jft2ff.. ..~~ (Signature) who is personally known to .eor wbo bas produCed as identification and who did/did not tilkean O.tb~X:A-( ~~ (Signature) (Name.Typed, pr tfOt'ARY' PUBLIc ......- Ji;i'F'IA _ :~'~. 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