HomeMy WebLinkAbout96-5582
BUILDING PERMIT--
1ft j"--5582E
CITY OF ZEPHYRHILLS Permit. ..
(813) 788-6611 Date :1- 9- '-b
. .
~
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
:b
Pcop,rty Own", -; ~ ~
Job Address: -5 -.2. A ./L
Parcell.D. # I LJ ~ cJ...b .-;;)../~ 1/ C) f) 0 - "6? / LJ n - CJ & Cf7 D
Water Meter:
T,I.F.'s:
Zon;n" ~"
Oeso,;pt;O(Jt~ ~ ;..z~~
Radon Gasj
_.d~~~~~..J~
NO OCCUPANCY BEFORE C.O.
FINAL ;> -
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
~~~
Address
Telephone#
Valuation or
Contract Price
J~37_pv
..,"
City License Registration # 7 0
State Certified License#
,,-L~ -Y;;.L:z
BUILDING
ELECTRICAL
PLUMBING
-
MECHANICAL
Ftr.
Pre SLB
Lintel
FRM.
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.
APPLICATION FOR PERKIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
c) ..
,
PHONElt)~ - ~~
OWNER'S NAME ~~f.,.S:> ~N}....
OWNER'S ADDRESS '5l d.::\ ~\'L~~~f\.
:SO~
"5\,'
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION
PARCEL LD.' (i). U,..- z..., - oa~t::l ~ C>~ I \)(j - Cf~b ~ (OBTAIN FROH PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction ~Addition _Alteration _Repair _Install
_Sign
_Hove
_DeJlolish
PROPOSED USE: )(: Single Faaily
_H/F
_, of Units _H/H
_C~ercial
_Indust.
_Swim. Pool ___Other
_Restaurant & Health Department Approval
DESCRIPTION OF WORK: ~\\.....D ~ ~)4"")
BUILDING SIZE:
x
Square Feet.
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.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
_BUILDING
$
I? ~l ~
PERMITS REOUESTED
Valuation of Total Construction
_ELECTRICAL
AtIP Service
Florida Power Corp.
W.R.E.C.
.--JfEGllANICAL
$
Valuation of Mechanical Installation
_PLUKBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fralle _Steel
Other
FIRISUED FLOOR ELEVATIONS:
FT.
IS PROJECI' IN FLOOD ZONE AREA?
..........................................
YES NO
yONTRACI'OR SECTION
BUILDER ~~~~ COMPANY 5:uA) 5"~re:
6~";'~:::~~7~ .-' - // State Cert. or Regist.' .
Signature-L--,,-- ", City License Registration ,
~---_.- .,...- .--'- ..........................................
/fLvlf/v'i.,iJ(.
7V
ELECTRICIAN
COMPANY
State Cert. or Regist. #
City License Registration ,
..........................................
SiQllature
PLUKBER
COMPANY
State Cert. or Regist. ,
City License Registration #
..........................................
Signature
KEGHANI~
COMPANY
State Cert. or Regist. ,
City License Registration ,
..........................*.*..*..*.*..*..
Signature
"
!)THF.R
COMPANY
State Cert. or Regist. ,
City License Registration #
..........................................
Signa ture -
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Tbe undersigned understands that this pertit lay be subject to Ddeed restrictionsD wbieb lay be lOre restrictive than City
regulations. The undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired 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 lisdeieanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building DepartJent, (813)
788-6611.
FurtherlOre, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
DContractor 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 than the contractor, are responsible for the work. If the contractor wishes 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
City of Zephyrhills.
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 - HOIeOIDer's Protection
GuideD prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleOne other than the
'owner", I certify that I have obtained a copy of the above described docUlent and prOlise in good faith to deliver it to the
"ownerD prior to cOllencl!IeIlt.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforaation in tbis application is accurate and that all work will be done in cOIpliance with all
applicable laws regulating construction, loning, and land developaent.
Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation bas cOllenced prior to issuance of a pertit and that all work will be perfoIled to !eet standards of all laws
regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other gDveI1lftl1tal agencies laY apply to the intended work, and that it is
Iy responsibility to identify wbat actions I lUst take to be in cOlpliance. Sueb agencies include but are not lulted to:
* Departlent of EnvironJental Regulation - Cypress Bayheads, Wetland Areas and EnvironJentally Sensitive Lands,
Vater/Wastewater Treatlent
* Southwest Florida Water ManageJent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
* Arly Corps of Engineers - Seawalls, Docks, Navigable Waterways
* Departlent of Health & Rebabilitative Services, EnvironJental Health Unit - Wells, Vastewater Treatlent, Septic Tanks
* US EnvironJental Protection Agency - Asbestos abatelent
I also certify that, if fill laterial is to be used in Flood Zone DAD or DA,etc.D, it is understood that a drainage plan
addressing a .cOlpensating volUleD will be sublitted wbieb is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A pertit issued sball be construed to be a license to proceed with tbe work.and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor sball issuance of a perlit prevent the Building Official frOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall becOla invalid
unless the work authorized by sueb perlit is COIIeDced within six IOnths of issuance, or if work authorized by the pertit is
suspended or abandoned for a period of six IOnths after the till! the work is cOllenced. One 90 day extension of tile, laY be .
allowed for the pertit with fee ebarge of $15.00. Tbe extension sball be requested in writing to the Building Official. An
approved inspection lUst be logged during eaeb six IOnth period, or the project will be considered abandoned.
WARNING TO OWliER: YOUR FAILURE TO RECORD A NOTICE OF COMMKJfCKllEIft' MAY RESULT IN YOUR PAYING 'fIUCH FOR IMPROVEIIKIft'S TO YOUR
PROPERTY. IF YOU IIft'EW TO OBTAIN FINAIICING, CONSULT WITH YOUR LEWER OR AM ATTORNEY BEFORE RECORDING YOUR NOTICH OF
COMMKNCEMKHT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AMD POST A "NOfICE OF COMMENCEMKIft'".
~~' -~ ~
sfQ.~rii; MOR AGE1ft' ---~
--~:~~- - :;5~
/-~~- - - -- . -'--
S~WR - ~ - - efeR ~-- ----. ---
STATE OF FLORIDA !/~ <:"o./" _
couny OF f :;) L-- 0
The foregoing inst~ent was acknowledged
before me this ;J, I 7 ' 192b.. by
STATE OF FLORIDA jJ
coum OF I /1-5' C. (1
The foregoing inst.rum~t was a~~Wledged
before me this :,J--/ 7 ' 19 by
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.~J'~ a-~__e-
(Signature),)!""" ~ /""' n [) 2:
~4 ({. T 0 0 r.....r-ct A
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
who is personally known to me or who has
produced
as identification and who did/did not
take an oath. /7' /L:/ a.. _ .
eA.- /T . J~--<-Q-
(Signature) ~" f C"I..,...,...,
IL-. E iT! /uK.)~ --'"\,
(Name Typed, Printed or StillDDedl
NOTARY PUBL... ~~..".. KEITH CORREIA
l!!~''''~ MY COMMISSION' OC 41141'
~. I EXPIRES: May is. 1.
...... 1/' Bonded Thru NoeIIY I'UIlIo tJndllIWIltn
'" '
KEITH CORREIA
MV COMMISSION II CC 411416
EXPIRES: May 13. 1999
Bonded lbm NotarY N* lJndoIWllltIS
RECYCLED PAPER
Contents: 40% Pre-Consumer. 10% Post-Consumer
'roposal
Page No.
of
Pages
SUN STATE AlUM!NlJMr INC.
37528 State Road 54 West
ZEPHYRHILlS, FL 33541
(813) 788-1308
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JOB LOCATION
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ARCHITECT
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DATE OF PLANS
JOB PHONE
We hereby submit specifip.ations and estimates ~or:
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me 'ropose hereby to furnish material and labor - complete in accordance ~atwve specifications, for the sum of:
~ (, ---<\. , {. \ ~~~ '\ " \> ~\ \---:-\, /" ~~~. \ "'I L ----, ~
..... .->1.. " '-__ ~, -' ' . \ ><>-.".1. '- ,I ~ \. . \ -"dollars ($ CIItti...~ I ').
Payment to be made as follows: ~
...
All material is guaranteed to be as specified. All work to be completed in a workmanlike
manner according to standard practices. Any alteration or deviation from above specifications
involving extra costs will be executed only upon written orders, and wiil become an extra
charge over and above the estimate. All agreements contingent upon strikes, accidents
or delays beyond our control. Owner to carry fire, tornado and other necessary insurance.
Our workers are fully covered by Workman's Compensation Insurance.
Authorized
Signature .
NO'~ /" n;lposal may be
withdrawn by us if not ,accepted within
-,-~
~~~~~~.
days.
Acceptance of 'roposal - The above prices. specifications
and conditions are satisfactory and are hereby accepted. You are authorized
to do the work as specified. Payment will be made as outlined above.
~i ~. ," .'\
,.. --'---\--C--'~ (\
Signature ~ 1-. 7 \'!r{.A .(,J
. /f
,:/
Signature
Date of Acceptance:
OWNER
~j
CITY OF ZEPHYRHILLS BUILDING DEPART'HENT
l\ N) '- So b\~
~J;::Lq ~~'D0')\J-a ~
-
JOB LOCATION
PARCEL LD. # \
SHOW ALL EXISTING & PROPOSED STRUC"l"lJRES GIVING DIMENSIONS & SETBACKS.
4J
l'l
~
ALLEYWAY ACCESS ~OR
GARAGE OR CARPORT -
15 FOOT SETBACK
REQUIRED.
UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
(NOTE EXAMPLES 1 & 2)
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FRONT P
STREET
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1. SETBACKS FOR R1f R2 ZONING
60'
2. SETBACKS FOR R3 ZONING
60'
10'
P E-
R X
0 I
10' P S 10'
0 T
S I
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D G
20'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30 'DUPLEX
1 0'
1 0'
FRONT PROPERTY LINE
FRONT PROPERTY LINE
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