HomeMy WebLinkAbout96-5752
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Parcel 1.0. # /~-::Jh'" t'I. /- ~ tJ. A 0', Co
BUILDING PERMIT-
CITY OF ZEPHYRHILLS Permit lI!
(813) 788-6611
t-~-575~t?
~- /9-?~
Date
M~'Sewer Conn
Water Conn:
Water Meter:
T,I.F,'s:
Zoning:
Description of Work
FINAL
'S' '3 q \..
DATE
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.
Valuation or '#- ' Ov
Contract Price . ~ I tJ () ..-.-
Permit Fee
Signature V
Company
Address
Telephone#t/ 5'/3 ~ 7/'5""- 19 <?
Inspector
Ftr.
Pre SLB
Lintel
City License Regist,.';on # ><--;-
State Certified License#
(fJ1lJ>fluJ ....-
ELECT~
c..----
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
BUILDING
PLU~' MECH~L
.......-- - ~
Breakers
Ducts Insl.
Compressor
Final
FRM.
Insul. CL
WL
SLB
Tub Set
Water
Sewer
Final
t ~ ry~-th
AI! J,;P
~ -0
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 PERMIT
CITY OF ZEPHYRBILLS
BUILDING DEPARTMENT
OWNER'S NAKE .~ be-rT Cf'- G-o (J oe--I....-L
OWNER'S ADDRESS .3931 ~ J~~ ~ A Vc-
JOB ADDRESS ~
LEGAL DESCRl~~,!~~O!TI ~'~ ~ .i'or- tUJCK .;)..
PARCEL 1.D.' O. f?-, I ts.8 c/ PG- 08' 7 & fJ--\\T \\o,k: b'
PHONE ~/3 7/ ~ 19{ ~
SUBDIVISION 2-~p Ii '/ R
H j;;.1 <!rH T.s
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:____New Construction ____Addition ----^lteration ____Repair ____Install
____Sign
--"ove
____Deaolish
PROPOSED USE: -It-S ingle F8IIily
--,,'F
____' of Units --"/H
____~ercial
____Indus t.
____Swim. Pool ___Other
~estaurant & Health Department Approval
, ~~!L.~.AJ
DESCRIPTION OF WORK: '~
BUILDING SIZE: ? X/O, ~o
~
Square Feet,
'7
Height
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS.
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERKlTS REOUESTED
V;UILDING
$ I, / trD . en;>
Valuation of Total Construction
____ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
--"ECllANlCAL
$
Valuation of Mechanical Installation
____PLUKBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ____Block ____Fraae ____Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREAY
YES NO
******************************************
CONTRACTOR SECTION
BUIWER
COMPANY
rfl.~ J. ~ State Cert. or Regist. ·
A"'/. City License Registration'
******************************************
Signature
SiROAture
COMPANY
State Cert. or Regist. .
City License Registration .
******************************************
ELECTRlCIAR
COMPANY
State Cert. or Regist. t
City License Registration .
******************************************
PLUKBER
Signature
Signature
COMPANY
State Cert. or Regist. .
City License Registration .
******************************************
MECHANICAL
COMPANY
State Cert. or Regist. t
City License Registration t
******************************************
OTHER
Signature
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perJit lay be subject to "deed restrictions" whicb 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 tbe contractor is not licensed as required by law, both the owner and contractor aay be
cited for a lisdeteanor violation under state law, If the owner or intended contractor are uncertain as to what licenSing
requirelents lay apply for the intended work, they are advised to contact tbe City of Zepbyrhills Building Departlent, (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
"Contractor Sections" of this application for wbich tbey will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, rather than tbe contractor, are responsible for tbe 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 Zephyrbills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. ~ONSTRUCTION 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 - HoIeowner's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If tbe applicant is sOleone other than the
"owner", I certify tbat I have obtained a copy of tbe above de~cribed docUlent and prolise in good faith to deliver it to the
"owner" prior to coaencelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infor.ation in this application is accurate and that all work will be done in co.pliance witb all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby .ade to obtain a per.it to do work and installation as indicated. I certify that no work or
installation has cOllenced prior to issuance of a per.it and that all work will be perf oIled to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
certify tbat I understand that the regulations of otber governtental agencies aay apply to the intended worl, and that it is
IY responsibility to identify what actions I lust take to be in co.pliance. Such agencies include but are not li.ited to:
t Departlent of HnvirODlental Regulation - Cypress Bayheads, Wetland Areas and Hnvironaentally Sensitive Lands,
Water/Wastewater Treatlent
t Southwest Florida Water Hanagetent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
· Ar., Corps of Engineers - Seawalls, Docks, Navigable Waterways
t Departlent of Health & Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater Treallent, Septic ranls
t US HnviroDlental Protection Agency - Asbestos abatetent
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 "colpensating volUle" will be sublitted which is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A per.it 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 shall issuance of a per.it prevent the Building Official frOl,thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perJit issued sball beCOle invalid
unless the work authorized by such perlit is coaenced witbin six IOnths of issuance, or if worl authorized by the per.it is
suspended or abandoned for a period of six IOnths after the ti.e the work is cOlleDced. One 90 day utension of tile, laY be
allowed for the perlit with fee cbarge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection lust be logged during each sil IOntb period, or the project will be considered abandoned.
WARNING TO OIINER: YOUR FAILURE TO RHCORD A NOTICH OF COHHEICEMlHT MAY RBSULT IN YOUR PAYING rlflCE FOR IHPROVKIIKJTS TO YOUR
PROPERTY. IF YOU IHTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LHIDER OR AN ATTORIEY BEFORB RBCORDING YOUR HO'lICE OF
COMHHNCEtmNT. JOBS UNDER $2,500 IN VALUE 00 NOT NEED TO RECORD AND POST A "NOTICE OF COHHENCKllEHT".
SIGNATURE: OWNER OR AGRNJ
SIGNATURE: CONTRACTOR
STATH OF FLORIDA
COUHTY OF
The foregoing instrument
before me this
was acknowledged
, 19_ by
STATE 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
CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
tf ~ I~ ~rL' c< 4et"t'zJ2d-/
{/ . t/
OWNER
JOB LOCATION
PARCEL 1. D, #
SHOW ALL EXISTING Ii: PROPOSED STRUC'l'URES GIVING DIMENSIONS Ii: SETBACKS.
ALLEYWAY ACCESS FOR
GARAGE OR CARPORT -
15 FOOT SETBACK
REQUIRED,
UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
(NOTE EXAMPLES 1 & 2)
{'1 (..:',
S' ..... ""'"
, -,
P:>cr lA) ; I'f
I I CJ
FRONT PROPERTY LINE
STREET
1. SETBACKS FOR R1, R2 ZONING
60'
2. SETBACKS FOR R3 ZONING
60'
10'
P E-
R X
0 I
10' P S 10'
0 T
S I
E N
D G
20'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30'DUPLEX
1 0'
1 0'
FROIft" PROPERTY LIME
FRONT PROPERTY LINE