HomeMy WebLinkAbout96-5766
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BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit ]I!
(813) 788-6611
j-5766LS
Date
,/-;JS..7t
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning: Energy Code:
Description of Work ~.M..tI./ ~ 0 J A---1~ ~
/
Radon Gas:
FINAL
J-
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.
DATE
Inspector
City License Registration #
State Certified License#
Permit Fee Y ,s........." ~
Signature
Company
Address
Telephone#
Valuation or
Contract Price
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t7'h.JVul A
0)" /'v1 LA
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Ftrn-'l -q lLJ g~g
Pre SLB
Lintel
FRM. JZ-::S -crt, ~D(3
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 ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
C. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
APPLICATION FOR PERKIT
CITY OF ZEPllYRHILLS
BUILDING DEPARTMENT
OWNER'S NAME /7lJ1Jnu r F. /fJAI/J Sf/9!rv /')
OWNER'S ADDRESS S ~ s", t 7ft- ~ 7:-
JOB ADDRESS ') t j (J 6.L:J;t- S T'
)~N~L'/( .>
2. -Jllt-t$'
2 ~ll / L4...S
PHONE 7R~.~l.- V)
LEGAL DESCRIPTION: LOT(S) I~_ 2.(")
BLOCK '3 SUBDIVISION L /7 Yo' '2 - II IL LS
,
PARCEL I. D.' / I "2.. (. L I 0010 IJ S ~ tJ() Q I g tJ (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:..LNew Construction _Addition ~teration _Repair _Install
_Sign
-'love
/Deaolish
PROPOSED USE: _Single FUlily
Veo..ercial
_KIF
_' of Units _K/H
_Indust.
_Swia. Pool _Other
_Restaurant
& Health DepartJllent Approval
~, /j6A~_ AJ~ ~ ~
I' .
~,.-n.
,
DESCRIPTION OF WORK: r. ~
R' X /9 '
BUILDING SIZE:
I ,S- 'L
Square Feet,
Height
RESIDENTIAL:
COMMERCIAL
ATTACH (2) PLOT PLARS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS.
ATTACH (3) SETS OF BUILDING PLARS & (1) SET ENERGY FORKS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
JBUILDING
PERMITS REOUESTED
$ '<-sop, IJ v
_ELECTRICAL
AtIP Service
Valuation of Total Construction
/' Florida Power Corp.
W.R.E.C.
_MECHANICAL
$
Valuation of Kechanical Installation
_PLuttBING GAS ROOFING
TYPE OF CONSTRUCTION: _Block ~8IIe _Steel
SPECIALTY
Other
FIlIISHED FLOOR ELEVATIONS:
'"
FT.
IS PROJECT IN FLOOD ZONE AREA? ~
YES NO
.................................*********
CONTRACTOR SECTION
BUILDER
~ aMPARY
~ State Cert. or Regist. .
City License Registration .
*.*****************.*******.*.***********
Signature
RUO:CTRICIAN COMPANY
~ ~ State Cert. or Regist. .
SignAture~' City License Registration .
* *********.******************************
PLUMBER COMPANY
State Cert. or Regist. .
Signature City License Registration .
*****.*****.******************************
MEGHABICAL COMPANY
State Cert. or Regist. .
Signature City License Registration .
.***.****.*****************..*************
OTRRR COMPANY
State Cert. or Regist. #
Signature City License Registration #
*.****.***********************************
APPLICATION APPROVED BY PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Tbe undersigned understands tbat tbis pertit lay be subject to "deed restrictions" wbieb lay be lOre restrictive than City
regulations. Tbe undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas bired 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 lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requireaents aay apply for the intended work, they are advised to contact tbe City of Zepbyrbills Building DepartJent, (Dt3)
788-6611.
FurtberlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
"Contractor Sections. of this application for wbieb 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 tbe contractor wishes you to sign
as contractor that JaY be an indication that be is not properly licensed and is not entitled to pertitting 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 that I, the applicant, bave been provided with a copy of .Plorida's Construction Lien Law - HOIeOWDer's Protection
Guide" prepared by the Florida DepartJent of Agriculture . and Consuter Affairs. If the applicant is sOJeone other than the
Downer", I certify that I bave obtained a copy of the above described docUlent and prOJise in good faith to deliver it to the
"owner II prior to cOllenceaent.
E. CONTRACTOR'SjOWNER'S AFFIDAVIT
I certify tbat all the inforaation 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 pertit and that all work will be perforted to teet standards of all laws
regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also
certify that I understand that the regulations of other governaental agencies JaY apply to the intended work, and that it is
IY responsibility to identify what actions I lUst take to be in cOlpliance. Sueb agencies include but are not litited to:
* DepartJent of Environaental Regulation - Cypress Bayheads, Wetland Areas and Environaentally Sensitive Lands,
Water/Wastewater TreatJent
t Southwest Florida Water Hanageaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
* Arty Corps of Engineers - Seawalls, Docks, Navigable Waterways
t DepartJent of Health & Rebabilitative Services, Environaental Health Unit - Wells, Wastewater TreatJent, Septic Tanks
t US Environaental Protection Agency - Asbestos abateaent
I also certify that, if fill laterial is to be used in Flood Zone "AD or .A,etc.", it is understood that a drainage plan
addressing a uCOlpensating volute" will be subtitted whieb 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 perlit prevent the Building Official frOJ thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued sball becote invalid
unless the work authorized by such per.it is COIIeJlced within six IOnths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six IOntbs after the tite the work is co.enced. One 90 day extension of tite, JaY be
allowed for the pertit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection lUst be logged during each six IOnth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COIIHENCEHEM'f MAY RESULT IN YOUR PAYING TWICE FOR IHPROVBMmS TO YOUR
PROPERTY. IF YOU IM'fBHD TO OB'l'AIM PIJfAIICING, COMSULT WITH YOUR LBIIDER OR All AftOlIDY BEFORE RECORDING YOUR HO'fICE OF
COHMENCEMEM'f. JOBS UlfDER $2,500 IN VALUE 00 NOT NEED TO RECORD AIfD POST A "NOTICE OF COIIIEHCEMEIf'l".
44-~
' SIGIlATURE: om:RR GEN1'
SIGHATURE: CON1'RAC'fOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
before me this , 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
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:,~Ili) Picl~ i n,~view Approval
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rt,is BIs day 01
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