HomeMy WebLinkAbout96-5702
BUILDING PERMIT -.-
CITY OF ZEPHYRHILLS Permit 1f!
(813) 788-6611
-;-5702 ~
Dale
'/-3-76
~ ELECTRICAL PLUMBING MECHANICAL
::~:::,~,:~.J ~~~: :ztr.~:/
Parcell.D. # c-3 - ~ 6 ... d--I . ?) / h 0 - c.J - /}~ '--7 D
Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
Zoning: Energy Code:
Description of Work ~A.-P ~A--J A'.A~A.
- - -
Radon Gas:
FINAL
4
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
P~rmit Fee~cZ O. ~IVJ
Slgnature~ ~
Company
Address
Telephone#
Valuation or
Contract Price
(, 9')1. c7?J
/~6-3
City License Registration # _ /
State Certified License#
(l!~~ ~
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 ZEPHYImILLS
BUILDING DEPARTMENT
, d -7~0
~ -:? -{).&s
OWNER'S. NANE ;<~h ~ mONE
OWNER's ADDIlIlSS - - - _ ~ ~_ r ~j?/t
JOB ADDRESS 3'7 J {", f!;~' /~I
LEGAL DESCRIPTION: LOT(S) c:::; ~ BWCK SUBDIVISION
PARCEL I.D.' ~ ~ 2(" - 2/
Pf/ .7S~ 6
SL~ [)~
bl~O
.-@- D <5:'1 cJ (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install
_Sign
_Move
_DeJIOlish
PROPOSED USE: _Single FOIily
_H/F
_' of Units _M/H
_eo..ercial
_Indust.
_Swia. Pool _Other
----Restaurant & Health Depar..en~~roval
DESCRIPTION OF WORK: S~ ~
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 REQQlRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTED
_BUILDING
$
(,q'1 ,g;-o
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
_MECHAlUCAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _FrOle _Steel
Other
FlIUSBED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
..................................********
YES NO
BUILDER
CONTRACTOR SECTION _
./l/r~ tI - 7d: ;(/tJt! /111 t/U
State Cert. or Regist. ,
City License Registration ,
*.**...*.****...*******..*....***********
COMPANY
Signature
/410 "':?,
F.T .RCTRIClAN
COMPANY
State Cert. or Regist. .
City License Registration .
**..**..*.*.****...**....*..*..******.***.
SignAture
PLUMBER
COMPANY
State Cert. or Regist. .
City License Registration .
**..*.*...******................*...******
Signature
MECHANICAL
COMPANY
State Cert. or Regist. ,
City License Registration f
..*******.**.**.*.****.****.*.**....**...*
Signature
OTRRR
COMPANY
State Cert. or Regist. I
City License Registration I
.***.....*.*.*******.**.******.***********
Signature
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit lay be subject to "deed restrictions" whieb lay be lOre restrict~ve than City
regulations. Tbe 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 lisdeteanor 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 Zepbyrhills.Building Departlent, (813)
188-6611.
FurtherlOre, if the owner bas bired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the
"Contractor Sections II of this application for wbicb 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 be 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 - HOIl!OWJler's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is SOIeOne other than the
"owner", I certify that I bave obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
"owner" prior to cOlleIlcelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has cOlleDced prior to issuance of a perlit and that all work will be perforled to leet 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 goveIDIeDtal agencies laY apply to the intended work, and that it is
IY responsibility to identify what actions I lUst take to be in cOlpliance. Sucb agencies include but are not lilited to:
* Departlent of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
Water/Wastewater Treatlent
t Southwest Florida W~ter Managetent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
* Departlent of Health & Rebabilitative Services, EnvirODlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
t US EnviroDlental Protection Agency - Asbestos abatelent
I also certify that, if fill laterial is to be used in Flood Zone "A" or "A, etc. ", it is understood that a drainage plan
addressing a uCOlpensating volUle" will be subtitted which is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A perlit issued sball be construed to be a license to proceed witb the work and not as authority to violate, cancel alter, or
set aside any provisions of tbe technical codes, nor shall issuance of a perlit prevent the Building Official frOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued sball becOle invalid
unless the work authorized by such perlit is cOllenced within six IOnths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six IOnths after the tile the work is co.enced. One 90 day eltension of tile, laY be
allowed for the perlit with fee cbarge of $15.00. Tbe extension shall be requested in writing to the Building Official. An
approved inspection lust be logged during eacb six IOnth period, or the project will be considered abandoned.
WARHHlG TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR P !WlCE FOR IMPROVEMENTS TO YOUR
PROPERTY. IF YOU IIfTBlm TO 0 FIMAlCING, CONSULT WITH YOUR LENDER OR AI ATTO EFO RECORDING YOUR NOTICE OF
COMMENCEMENT. JOBS UNDER N VALUE DO NOT NEED TO RECORD AND POST A "NOTICE F NCHMENT" .
STATE OF
COUNTY OF
The foregoing instrument was acknowledged
before me this , 19_____ by
srATE 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
ALUM- TER
9635 Gray Fox Lane
Port Richey, FL 34668
1-813-845-0465
LICENSED
BONDED
INSUAED
Order No.
Sheet No,
Aluminum Co.
Date
STREET
PHO~I/ -7~~-'?(~
JOB NAME
Iv
"- _..._---,.._--------~---_.
JOB }OC'IOfJr" -C;'
[t"/ oil
DATEL,.
c./ - Z-
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6?
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(.( '0('( ~)
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3&, P,JI. R)'-' \ .
- ",\) It:V/t:!""'\dCU'
DATE ~ ~&_, t~L
BUILDING DEPT AP ----
'. PROVEO
Payment to be made as follows:
.e 'rupuse hereby to furnish material and labor - complete in accordance with above specifi~ti r the sum of:
dollars ($ f;7rl. ,m )
!,reepinnre of 'ropoenl _
The above prices, speclficBtions and conditions are satisfactory and are hereby ac-
cepted. You are lIuthorized to do the work 3S specified. Payment will be rnads 8S
outlined above, After 90 daYI a (IS) Fifteen Dollar lervice charge, plul material.
will b. charged for service work.
AnV alterllltions or devi8tion from above specifications involving extra costs yvill be
executed only upon written orders and will become an extra charge over and above
the estimate. All egreementl contingent upon strikes, accidents or delAYS beyond
our control.
Authorized
Signature
Note: This proposal may be
withdrawn by us if not accepted within
days.
Date of Acceptan
Work Accepted
x
Signature
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RERO \LE D-.-P R+N T- RED tj IftE b-
~-:;'~::""'" 0 l~ JOB S (T E
A1UM- TEK
9635 Gray Fox Lane
Port Richey, FL 34668
1-813-845-0465
LICENSED
BONDED
INSURED
Order No.
Sheet No.
AI"uminum CO.
Date
STREET
PHO>>d
,/'1'/-7366
JOB NAME
t"
JOB .7V.1 C~l'id C-/
?-t;// "5'1
DATEL..
c-/---z
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i!9
:'""') .,d ,
2> -,
'-S L L-~~V
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(l. ,icCA- ~ /it-~ <-))
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Payment to be made as follows:
;BIe 'ropo.e hereby to furnish material and labor - complete in accordance with above specifications, for the sum of:
dollars ($ (91.ru )
!\rreptanre uf Jrupui5al _
The above prices, specificlJtions and conditions are satisfactory and are hereby ae.
cepted. You are authorized to do the work 85 specified. Payment will be made as
outlined above. After 90 days 8 (15) Fifteen Dollar service charge, plus materials
will be chllrged for service work.
Any alterations or deviation from above specifications involving extra costs will be
executed only upon written orders and will become an extra charge over and above
the estimate. All agreements contingent upon strikes, accidents or delays beyond
our control.
j\ ~"
Authorized
Signature
Note: This proposal may be
withdrawn by us if not accepted within
[J I
. '..
days.
0... of A~
1:0" AOC~~~d /
I
~._/
/I~
Signature
Signatu re