HomeMy WebLinkAbout96-5631
BUILDING PERMIT--
CITY OF ZEPHYRHILLS Permit ]I!. i - 5631A
(813) 788-6611 Date ;;. _;}?---- 7' b
~~ ELECTRICAL PLUMBING MECHANICAL
P<aporty Own" J1! ~ -f l::;L:;jyr
JObAddress:..3V~ g,------'_ _.__ _ 31
Parcel I. D. #
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning: Energy Code:
Description of Work_ ~.A..e..PA'l. ~
Radon Gas:
FINAL
(.,
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
Perm;' Fee ~ 0-iJ
Signatur0-;7. A~4~~
Company
Address
Telephone#
Valuation or
Contract Price
6'bC)'P7)
City License Registration #
State Certified License#
h .J'YV2/'I_
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
-
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
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
--;; // --:;>'
ra,w F7~'~-
PHONE (8 (3) 7? 2, ~ () /y Z L-
;t;:t t:P< ? I
OWNER'S IWIE M c::;ty){ ~ Ve Ya !\e r ~1..rt.. W'
OIIIIEIl.'S ADDIlBSS j 9' 7 tJ ;; ,V C~~ / A"cf.
JOB ADDRESS JY~~--e-P
LEGAL DESCRIPI'ION: LOT(S)
PARCEL 1. D. f
WORK PROPOSED:_New Construction Pcklition ----1U.teration ~pair _Install
_Sign
--Hove
_Deaolish
PROPOSED USE: _Single Faaily
--H/F
_, of Units _K/B
Swia. Pool Other
- 1-1;/'/ I ~'~~
_Restaurant &: Health Departaent Approval _A--!!'~ I" inn" "'/1; I r
(, (J l:A /~. /,7,~:r /1. d tn
DESCRIPTION OF NORK: ~~V\P,/X:/ ./Z"t.~ 0.. ~ _,_
BUlLDIRG SIZE: >( /f X / J If
_ec-ercial
_Indust.
Square Feet.
Beight
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUlLDIRG PLANS &: (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERKITS REQUESTED
-----BUlLDIRG
$
Valuation of Total Construction
_ELECTRICAL
AKP Service
Florida Power Corp.
N.R.E.C.
----"ECllAlfICAL
$
Valuation of Kecbanical Installation
_PLUHBIRG GAS ROOFING
SPECIALTY
TYPE OF COIJSTRUCTION: _Block _Fralle _Steel
Other
FIlJISBED FLOOR ELEVAfiOIJS:
FT.
IS PROJEct IR FLOOD ZONE AREA?
YES NO
..........................................
CONTRActOR SECTION
Signature
't.J.Ava~
-
COKPANY
~ State Cert. or Regist. f
}~..M'-4.! City License Registration f
..................................*.**.*..
BIJTTJlER,
RI.RCTRICIAN COKPARY
State Cert. or Regist. f
SianAture City License Registration f
.....*.*.....*...*...............*.*......
PLUMBER COKPARY
State Cert. or Regist. f
Signature City License Registration f
...................................*......
IlECBANlCAL COKPARY
State Cert. or Regist. .
Signature City License Registration f
...............*.....................*.*..
OTRRR COKPARY
State Cert. or Regist. f
Signature City License Registration ,
.................*........................
APPLICATION APPROVED BY PERKIT OFFICER.
';"',
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
'l'he undersigned understands that this pertit lay be subject to Ideed restrictions" which lily be lOre restrictive than City
regulations. the undersigned assUles responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they JaY 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 lilY be
cited for a lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requirelents lilY apply for the intended work, they are advised to contact the City of Zephyrhills Building DepartJent, (813)
788-6611.
Furthel'lOre, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
IContractor Sectionsl 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 lilY be an indication that he is not properly licensed and is not entitled to peraitting 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 - HOIllOW.Iler's Protection
Guide" prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs. If the applicant is SOJeOne other than the
"owner", I certify that I have obtained a copy of the above described dOCUJent and pnmise in good faith to deliver it to the
"owner" prior to COlleDCeJeDt.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infoIlition in this application is accurate and that all work will be done in COIpliance with all
applicable laws regulating construction, zoning, and land develo~ent.
Application is hereby lade to obtain a pertit to do work and installation as indicated. I certify that no work or
installation bas ~ced prior to issuance of a pmi t and that all IIOrk will be perforJed to Ieet standards of all laws
regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. lalso
certify that I understand that the regulations of other governJental agencies lilY apply to the intended work, and that it is
If responsibility to identify what actions I lust take to be in colpliance. Such agencies include but are not Haited to:
I DepartJent of Environaental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
Water/llastewater !reatJent
I Southwest Florida lIater Hanagelent District - lIells, Cypress Bayheads, lIetland Areas, Altering lIatercourses
I ArtY Corps of Engineers - Seawalls, Docks, Navigable lIaterways
t DepartJent of Health i Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater 'l'reatlent, Septic lants
t US Envil'ODlental Protection Agency - Asbestos abatl!leDt
I also certify that, if fill Jaterial is to be used in Flood Zone "AI or "A,etc.", it is understood that a drainage plan
addressing a "COJpenSating volllle" will be subaitted wbich is prepared by a professional engineer registered in the State of
Florida prior to pertit issuance.
A pertit issued shall 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 frOJ thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perait issued shall beCOle invalid
unless the work authorized by such perlit is COllellCed within sillOnths of issuance, or if IIOrk authorized by the pertit is
suspended or abandoned for a period of six IOntbs after the tiae the IIOrk is COIIeDced. One 90 day l!Itension of tile, lay be
allowed for the perIIit with fee charge of $15.00. 'l'be l!Itension shall be requested in writing to the Building Official. An
approved inspection lUSt be logged during each sixlODth period, or the project will be considered abandoned.
WAlUfING '1'0 0IIlfER: YOUR FAILURE '1'0 RECORD A NOTICE OF COHMDCEIID'I' HAY RESUL'I' IN YOUR PAYING NICE FOR DlPROVIIIDl'S '1'0 YOUR
PROPERTY. IF YOU IIl'fBIID !O OB'l'AIN FINANCING, CONSUL'I' WI'I'H YOUR LINDER OR AN AftORNEY BEFORE RECORDIXG YOUR 1I0UCK OF
COMMENCEHRlft'. JOBS UNDER $2,500 IN VALUE DO NOT NEED fO RECORD AND POS'I' A "NOTICE OF COMMENCEMEII'I'''.
SIGlAIURE: OVIIER OR AGEIf'I'
SIGlA'I'URE: COIf'l'BAC'I'OR
SfA'I'E OF FLORIDA
COUIf'I'Y OF
The foregoing instrument was acknowledged
before me this , 19____ by
S'I'AfE OF FLORIDA
COUNTY 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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