HomeMy WebLinkAbout96-5570
BUILDING PERMIT--
CITY OF ZEPHYRHILLS Permit II!
(813) 788-6611
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Pmperty Owne" ?v{~ 2 ,ft '-fr/:
Job Address: ~ / 3' ..
Parcel 1.0. # /1- ()6 -dJ - t)(JJ 0 - ~ YR-OtJ -
Date t:2 ~-- -7.6
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
tJCJ'1b
Zoning: Energy Code:
Description of Work ~~a-~--9--
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Radon Gas:
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NO OCCUPANCY BEFORE C,O,
FINAL
Complete Plans, Specifications and Fee Must Accompany Application. C,O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Permit Fee ))?, ~ .'v
Signature ~A~ (" :I~";;::?;)
Company
Address
Telephone#
Valuation or ()
Contract Price ~ ~ t)7) , &v
City License Registration #
State Certified License#
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BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
-
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Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Lintel
FRM. ?-I'1-~ t5~L.L
Insul. CL
WL
Driveway '}... 1'1- 911 t:i....t
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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.
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PUV'tlT LD'lA-l- 77 ~ SD
I4N 6,.J 6ft ~
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BUILDING DEPARTKERT
OWRER'S IWIE t>>IUr+e.D v.J P'IAJ( Fe.e. -:Ie., t SJ,;dey {'(\ FEr
OWRER'S ADDRESS 5Blt:3 "9th ~+. Z(?fh~""I-f,"}I.r F/v-..
JOB ADDRESS S AfY1 c a ~ a. b'Z>l,) tE'
fht. SooM J.;; of' L,qf- !L 4/1 O+.AAJd) .
LEGAL DESCRIPTION: LOT(S~l! ,Of fJ B~SUBDIVISION
Q~~~,_~_~_~~ 11 - 24:, - 2 I - 00 I 0 - 04800 - 009 CJ (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:~ew Construction .-X.Addition -KAIteration ____epair LInstall
PHONE 813 -78Z -2Z4y.
33S-<-/o
_Sign
----.JIove
_DeIIolish
PROPOSED USE: ~Single Faaily
_ec-ercial
----KIF _, of Units ---.Jt/H
_Indust. _Swia. Pool _Other
____estaurant & Health Departaent Approval
DESCRIPTION OF WORK: (Add ;t1S CCAr-- foe-+ ~ P,2,'uEJt ~ F+'.oCOYlc.
BUILDING SIZE: 3D' Xbl'tt-': 9l/D Square Feet, 8' Height pevk....a.IM\>sf 1-"
RESIDEI1TI.AL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ERERGY FOIUIS.
COMKERClAL: A'nACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
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PERKI.TS REQUESTED
RI.RCTlUCAL
AIIP Service
Florida Power Corp.
W.ll.E.C.
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--K..BUILDING
$ .s-c8 7 Z ,'->0
Valuation of Total Construction
--lIECIfABlCAL
$
Valuation of Kecbanica1 Installation
-PL1JlIBIliG
GAS
X ROOFING
SPECIALTY
TYPE OF COIISTRUcnOR: ---B1oclt .,XFraae _Steel
(CO()C)
Other
PIIJISIIED PLOOJl ELEVAfiOIlS: Fr. IS PROJEct IIi FLOOD ZORE AREA!
(8 'A f2..,0vc f<() tit)) 54""'~ I/.> I-bv.s e YES
..........................................
CONTRACTOR SECTION
BIITT.DRR COlIPAIIY
;:ii&, . ~ State Cert. or Jle&ist. .
Sigoature ~.d'~~____ City License Registration .
.. ....................................
RI.RC'l'RTCIAR
SiGnAture
COtIPAIlY
State Cert. or :Regist. f
City License :Registration f
..........................................
OTRRR RtJ1II,:'/A.J& COMPANY
. ~ State Cert. or _ist. .
Sigoature ~..v~~ ~ J City License :Registration f
- .... ....................................
PLDMBER
Sigoature
COlIPANY
State Cert. or :Reaist. f
City License :Registration f
..........................................
KECllARICAL
Sigoature
COMPANY
State Cert. or :Reaist. f
City License :Registration'
..........................................
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APPLICAfiON APPROVED BY PERKlT OFP1ca;a.
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CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
!be undersigned understands that this perI1t JIilY be subject to "deed restrictions" wbieb JIily be lOre restricti"ethan City
regulations. !he undersigned assUleS responsibility for cmpliance with any applicable deed restrictioos. ; .
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES . ....
If the OWDer has hired a contractor or contractors to undertake work, they lilY be required to be licensed: iJl~i.ith,
state and local regulaticms. If the contractor is not licensed as required by law, both the 0III1er and cqn~~~l't">
cited for a lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to ~tU.i~8D,~ipg,.
requireJellts JIilY apply for the intended work, they are advised to contact the City of Zepbyrbills Build,lng ~t,i (81. '" ~)
788-6611. . ..' '"
Furtberlore, if the owner has hired a contractor or contractors, he is advised to have the contractor(8).~i9't~.f1PJ"0!~;~;
"Contrac~or. Se~ons" of this application for 1fbieb they will be res~ible. If JOU, as the OIfDer sign ij18 'u.,~~~~~~~~;~. .'
you are Indicating that you, rather than the contractor, are responsible for the work. If the COIltractor.~1!Oii~.tolligpF\;'~'f~.,~
as contractor that .Iily be an indication that he is not properly licensed and is not entitled to peraittiDg P9,iWwI..~;tJit,gii:~.;<~~
City of Zepbyrhills. . :
TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
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D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS ~~.I;),)" . ~':
I certify that I, the applicant, have been provided with a copy of "Plorida's COnstruction Lien Law .:. ~~f:'PJ;o~OD . ,~\' ,.
Guide' prepared by the Florida Departlent of Agriculture and ConsuIer Affairs. If the applicant is .... ~rJ~ftlae:)~!e~
'owner", I certify that I have obtained a copy of the above described docuIent and prOlise in good faith to. de1iv8r"it:tQ tIIoe~ ,:. '~
'OWDer' prior to COIIeI1CeJe1lt. "( .,' ': :7 .~' ':', ;f,
E. CONTRACTOR' SlOWER'S AFFIDAVIT ,."Y'!'
I certify that all the infomtion in this application is accurate and that all work will be done in COIplianceJlfith'all{'i:;;
applicable laws regulating construction, zoning, and land develO{Elt.;" ~t~'~>~
Application is hereby lade to obtain a perait to do work and installation as indicated. I certify that ,110 _t.ior'L,}Ar;:.~;:;;
~ ., ,.' ':.,' "... -"',-";,,., "" '\ "".'t.l(,'~'\-',"><~:"'_:'
installation has cc.enced prior to issuance of a pmit and that. all work .ill be perf OIled :to ..tiS~;9fEall.~JiP!IIi~i;2';':'i:;
regulating construction, City codes, loning regulations, and land develOllEt reguIati~in~~;i~' ',."';"';'::~f,;~,:i,;~~,;'f;~;
certify that I understand that the regulations of other goverJllBDtal agencies JIilf apply totl!e4.D~ec1, ," .~~. .
If responsibility to identify what actions I lUSt take to be in COIpliance. Such agenciesinc:'~~~t~;J:lP, .,~,~
t DepartJent of BnvirODlelltal Regulation - Cypress Bayheads, Wetland Areas and BnvirolllelltalIY!SeMiijve"'!'M",~t,i.;\,fj(1
Water/waste1fater !reatlent. l : 'i: '{ ,',i;~;/;;~~~',:'
t Southwest Florida Water Hanagl!ll!llt District - IIells, Cypress Bayheads, Wetland Areas, Altering Watercourses, ,.~;
t lIlY Corps of Ingineers - Seawalls, Docks, Mavigable Waterways ;". .!~ ';~'
t DepartJent of Health' Rehabilitative Services, InvirODlBDtal Health Unit - Wells, Wastewater !rea...t,~,~ ' .;;,.'
t US InviIOllleJltal Protection )qency - Asbestos abatelt!Jlt" '. ;, .>/.,
I also certify that, if fill JIilterial is to be used in Flood Zone 'A' or "I,etc.', it is understood that adt~epl1J1:,:..;, ';~,!
Faddressl 'd ing, a 'CGlpeDSto ~ttin', g VolUle' will be subaitted wbieb is prepared by a professional engineerregistered{~,~.~~tO~"':.'i:....:......'...;.t.'<':,."
OIl a prIor peIlI Issuance. .' '. " .' ..... ~,:
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A pmit issued shall be construed to be a license to proceed with the work and not as authority to viOl$,,~al~,Q,r;+;'-:~{
set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building;Off~fj,I~;.~~~,~4~~'''/;Z!i
requiring a correction of errors in plans, construction, or violations of any code. Ivery perait;,is8ut!4~.;~".~' .;'.~;;
unless the work authoriled by su~ peIli~ is COIIeI1ced within sillODths of issuance, or if work autbor~~~*~P,It~i~,J~;;'Y:rt;,.;~:;,
suspended or abandoned for a perIod of SlllOIlths after the tile the work is COIIeDced. One 90 daY;~I:enOOI,lf()f)tU!e';>~J!~'fX't'f:t"~r:
allow~ f~r the ~it with fee charge, of $15.00: !he elt~ion shall be r~es~ in wri~ to the ~'~~,c;l.~~i~1q"r '" \;'l~
approved lDSpection lUSt be logged dUIlng eaeb Sll IODth perIod, or the proJect WIll be CODS1dered~", + i >:;'>:.+:-.;~j
IfIRIING !O (JDR: YOOR FAILURE ro RECORD I MO!ICI OF aIIMDCIIIIn' lilY RESUL! IN' YOOR PIYIlGDICI POB,~fO::JCIlRli,;;;;~'tt'~l'
PROPER!Y IF YOU umm !O 0Bf1U PDlUCING COJISOL! 1fI!II YOOR LODER OlIN IftOJIIIY BIFOIBIICOJIDDGYOOIJOrlCBOli~~i;;,/i('~t::
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a>>IHERCEMBRf. JOBS ORDER $2,500 1M VALUE DO MO! REED ro RECORD AND POS! A 'MO!ICE OF aJIIIDCBIIII!'. ' '. .:)i;~
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SIGRA!ORI: (JfJIU 01 AGIII! t::/
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SIGJfA!URE: COIDACTOR ,.
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S!AtE OF FLORIDA
coom OF
The foregoing instrument was acknOWledged
before me this , 19____ by
srAn: OF FLORIDA ,'''i
coum OF .... .... '. ,. \"::
The foregoing instI'WDelltwas af:,~~~\!'~%;~t~
before me this , 19 '. "~~Y};1';:'J/" . :e' 'f!\.,
;~,,'jt"f:'~:'~,l:"~;!l"'\" ::.:';t),~,~.:,,-,:, ;\;~i
. . ,'< 1('. ~ .".; .... . ..i'l'i'\~~0
who is personally known.to .~Pf~1II:l9'>,'~~:f:;:\,.t,k:";i.i&;':
produced . . . '. .t?,:~:i",':it4;;);::;'0.';~~U'jJ"~/'
as identification and,:.who d.icJi'4ii~,'AQt!'l';"",";:,~:I;:y:<:!:r'
take an oct.th .... "'jl.'fi;;.f:;;~:"":i~';'::1?
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(::"llBY ~i.I~riDted orSt;uIped) T" ;j~:;;~~
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t~,: ,:
(Signature)
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
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