HomeMy WebLinkAbout96-5747
BUILDING PERMII-h
CITY OF ZEPHYRHILLS permit]l!
(813) 788-6611
-;-574711
. -
Date
~ -/ ,f--7-b
BUILDING
c:2. (). vD
ELECTRICAL
PLUMBING
...?" ~ en>
MECHANICAL
Sewer Conn
Water Conn:
",aperty Owne" ~~
Job Address: h/ ' , ./If #
Parcel I. D. #
Water Meter:
T.I.F.'s:
Zoning: Energy Code:
Description of Work '-Il J4. -0 11 G
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
~
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
~b
Valuation or
Contract Price :J... Y tlV" v-v
/"
.~
City License Registration #
State Certified License#
l-s -- '1/
Signau.lr
Company
Address
Telephone#
~
fi7Z/ Md.~'y
~4~"~~ 'I G.IJ
BUILDING
ELECTRICAL
PLUMBING
-
MECHANICAL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final~L ,]01>
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
SLB
Tub Set
Water
Sewer
Final
~
Breakers
Ducts Insl.
com~
Final ~ L.
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 PEKKIT
CITY OF ZEPHYRBILLS
BUILDING DEPARTMENT
OWNER'S NAIIIl :;;~c:r~
OWNER'S ADDRESS tlf/4- P!~A-<::;MT S'"7
JOB ADDRESS t I c/ fe /)I87kA-/llr &; T
PHONE
7P:~- 5t/3P
2-h~
z-l~
SUBDIVISION &c:: / J'l)ti I4f I/-
LEGAL DESCRIPTION: LOT(S)
BLOCK
PARCEL 1. D. t
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition ~teration _Repair _Install
_Sign _Move _Deaolish
PROPOSED USE: _Single Faaily _KIF _' of Units _K/H
_eo..ercial _Indust. _Swia. Pool _Other
_Restaurant & Health Department Approval
DESCRIPTION OF WORK:
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL:
COMKERGIAL
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.
PERMITS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
AKP Service
Florida Power Corp.
W.R.E.C.
~GHAlO.CAL
$ ~ f/ (}?) . tJD
Valuation of Mechanical Installation
_PLUKBING GAS ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fraae _Steel
Other
FIRISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
CONTRACTOR SECTION
BUTIJ1ER COMPANY
State Cert. or Regist. t
Signature City License Registration t
=IAR~ ~ .................::Pdii7l~
S~ate Cert. or Regist. :f E!CcJc~d( ~ r;,;i?
_ _ _e Q.. C1ty License Registration t ')V
******************************************
PLUMBER COKPANY
State Cert. or Regist. t
Signature City License Registration .
******************************************
KEGHANICAL~VC COIIPANY SJ(e: cJL- rJJg +C-I;? Mr<:{~
State Cert. or Regist. .
Signature C City License Registration t I",s - '7
******************************************
OTRF.R COKPANY
State Cert. or Regist. t
Signature City License Registration #
******************************************
APPLICATION APPROVED BY PEKKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that tbis perlit lay be subject to "deed restrictions" which lay be lOre restrictive tban City
regulations. !he undersigned assUles responsibility for cOlpliance witb any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If tbe owner bas hired a contractor or contractors to undertake work, tbey .ay be required to be licensed in accordance witb
state and local regulations. If tbe contractor is not licensed as required by law, botb tbe owner and contractor JaY be
cited for a lisdl!leanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requireleDts lay apply for tbe intended work, tbey are advised to contact tbe City of Zepbyrbills Building Departlent, (813)
188-6611.
FurtbeClOre, if tbe owner bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of tbe
"Contractor Sections" of tbis application for wbich tbey will be responsible. If you, as tbe owner sign as tbe contractor,
you are indicating that you, ratber tban tbe contractor, are responsible for tbe work. If tbe contractor wisbes yoo to sign
as contractor tbat Jay be an indication tbat be is not properly licensed and is not entitled to perlitting privileges in the
City of Zepbyrbills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify tbat I, tbe applicant, bave been provided witb a copy of .Florida's Construction Lien Law _ BoIeov.ner's Protection
Guide" prepared by the Florida Departlent of Agriculture . and ConsUJer Affairs. If the applicant is SOftQne otber than tbe
"owner", I certify tbat I bave obtained a copy of tbe above described docUleDt and pro.ise in good faitb to deliver it to tbe
"owner" prior to cOllencl!lent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforJation in tbis application is accurate and that all work will be done in cOlpliance witb all
applicable laws regulating construction, zoning, and land developllent,
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify tbat no work or
installation bas cOllenced prior to issuance of a perlit and that all work will be perf oIled to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developllent regulations in the jurisdiction. I also
certify tbat I understand that tbe regulations of otber goveI1llental agencies Jay apply to tbe intended work, and tbat it is
Iy responsihility to identify wbat actions I lUst take to be in COIpliance. Sucb agencies include bot are not li.ited to:
t Departlent of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
Water/Vastewater rreatlent
t Southwest Florida Water HanageleDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
t ArlY Corps of Engineers - Seawalls, Docks, lavigable Waterways
t Departlent of Healtb & Rehabilitative Services, EnvirODlental Healtb Unit - Wells, Wastewater rreatlent, Septic ranks
t US EnvirODleDtal Protection Agency - Asbestos abatelent
I also certify that, if fill .aterial is to be used in Flood Zone "A" or "A,etc.", it is understood tbat a drainage plan
addressing a "cQlpensating volUle" will be sublitted wbich is prepared by a professional engineer registered in tbe State of
Florida prior to perlit issuance.
A perlit issued sball be construed to be a license to proceed witb tbe work and not as authority to violate, cancel alter, or
set aside any provisions of tbe technical codes, nor sball issuance of a perlit prevent tbe Building Official fro. tbereafter
requiring a correction of errors in plans, construction, or violations of any code. Every petlit issued shall beCOle invalid
unless tbe work autborized by such per.it is cDllenced witbin six IOntbs of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six IOntbs after tbe tile tbe work is c~ced. One 90 day l!Itension of tile, lay be
allowed for tbe perlit witb fee charge of $15.00. The l!Itension sball be requested in writing to tbe Building Official. An
approved inspection lUst be logged during each six IOntb period, or tbe project will be considered abandoned.
WARHING TO 0IiN1R: YOUR FAILURE TO RECORD A NOTICE OF COHHERCENIIfT MAY RESULT IN YOUR PAYIIG TWICE FOR I.MPROVIMmS TO YOUR
PROPERTY. IF YOU IH'lEIiD TO OBrAIH FIIlAHCIHG, COISULT WITH YOUR LIIiDIR OR AH Anomy BEFORE RlCORDIIG YOUR NOTICE OF
COHHENCKHEH'l. JOBS UIiDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COHHENCm:H'l".
SIGJfATURE: OWNER OR AGEH'l
SIGIArURE: COH'lRACTOR
srATE OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before me this , 19____ by
STATE OF FLORIDA
coum 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)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
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