HomeMy WebLinkAbout96-5779
BUILDING PERMIT--
CITY OF ZEPHYRHILLS Permit ]I!
(813) 788-6611
J 5779;t1
BUILDING
:2lJ, o-u
G~ECTRIC~
PLUMBING
31), o-v
~~sewerconn
Water Conn:
Date /f-;2 7 - 9 b
Pmperty own.~I!~';/;!~
Job Address: 1/ 17<-$0 0Jt;;~ ..:::.
Parcel I. D. #
Zoning: F Energy _Co~:
Description of Work --41 L (:R' ~ If!
Water Meter:
T.I.F.'s:
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
,,-/-( 7V.-- ~
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
City License Registration #
State Certified License#
-
/d; ?..s
,
Permit Fee ~ tTV
Sign.,",~ :~-,~~
Com pan
Address
Telephone#
Valuation or
Contract Price
2;- tf1) ,. vo
,/
BUILDING
~""-^-< J · </~ ~
ELECTRICAL
,,~~ ~ R!.dk:eI4~
PLUMBING
MECHANICAL
Ftr.
Pre SLB
Lintel
FRM.
InsuJ. CL
WL
Tp.Serv.
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 ZEPHYRBILLS
BUILDING DEPARTMENT
OWNER'S NAME {~ ! Ii-? e.....
OWNER'S ADDRESS '-1630 v-; , '? Ie YO, y:L
JOB ADDRESS t-I h3 () Wi' :::; t~Y' "y:}-
Ae1r/~
PHONE 7lf3 - h I IFb
Or
iJv
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I.D.'
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install
_Sign _Move _DeJIOlish
PROPOSED USE: ~ogle Faaily _KIF _, of Units _M/H
_eo..ercial _Indust. _SwiIB. Pool _Other
_Restaurant & Health Department Approval
DESCRIPTION OF WORK: ~/ ~
GeL/I)/} t&/'~~.p (9u t
~6- fd-"
BUILDING SIZE:
x
Square Feet.
Height
RESIDENTIAL :
COKKERCIAL
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
Y MECHANICAL
AMP Service
Florida Power Corp.
W.R.E.C.
$ ,J." 'it/9t' ;J~
Valuation of Mechanical Installation
_PLUMBING GAS ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fralle _Steel
Other
FINISHED FLOOR ELEVATIONS:
F'f .
IS PROJEC1' IN FLOOD ZONE AREA?
..........................................
YES NO
CONTRAC1'OR SECTION
BITTI.DER
COMPANY
State Cert. or Regist. ,
City License Registration ,
..........................................
Signature
~ tih ~~ COIIPANY lIe?1r! /Ja..e z:
,c_'. State Cert. or Regist. #
- !: . ~ (J __ City License Registration .
..........................................
EIeC.?/;
,/ ,\- .::L
PLUMBER
COMPANY
State Cert. or Regist. t
City License Registration ,
........................................*.
Signature
MECHANICAL COMPANY A tJ(i ---11 ! e..r fR~' ) b-~'C/l-'t 3
~/14 / ~ / / State Cert. or Regist. t q- -/ (
Signature U/i ~..c.- City License Registration' /bl~
Z1 .*.*..*......*.*.***.*.*****...*.*..***.**
OTRF.R COMPANY
State Cert. or Regist. #
Signature City License Registration #
......*....*....*..*.**......***.*..*.**.*
APPLICATION APPROVED BY PERKIT OFFICER.
.,:
~
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this peIlit lay be subject to 'deed restrictions' wbicb 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 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 lisdl!leanor violation under state law. If the olfller or intended contractor are uncertain as to what licensing
requirelents lay apply for tbe intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
788-6611.
FurtheIlOre, if the owner bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
.Contractor Sections" 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 wisbes you to sign
as contractor that laY be an indication that be is not properly licensed and is not entitled to peIlitting privileges in the
City of Zepbyrhills.
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 'Florida's Construction Lien Law - BOIeowner's Protection
Guide" prepared by the Florida Departlent of Agriculture ,and ConsUler Affairs. If tbe applicant is sOleone other tban 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 COIleDCl!lellt.
E. CONTRACTOR'SjOWNER'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, loning, 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 peIlit and that all work will be perforJed to leet standards of all laws
requlating construction, City codes, loning 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 wbat actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
* Departlent of EnviroOlental Regulation - Cypress Bayheads, Wetland Areas and EnviroOlentally Sensitive Lands,
Water/Wastewater Treatlent
t Southwest Florida Water Managl!lellt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
* ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
t Departlent of Health & Rebabilitative Services, EnvirODl9Dtal Health Unit - Wells, Wastewater Treatlent, Septic Tanks
t US EnviroOlental Protection Agency - Asbestos abateJeDt
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 wbich 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 with tbe 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 tbe Building Official frOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perait issued shall becoae invalid
unless the work authorized by such perlit is cOlleDced 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 c_enced. One 90 day extension of tile, laY be
allowed for the peIlit with fee charge of $15.00. Tbe extension shall be requested in writing to the Building Official. An
approved inspection lUst be logged during each sixlOntb period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMEJfCEMElft' MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMEIfTS TO YOUR
PROPERTY. IF YOU IN'l'IND TO OB!AIN FINANCING, CONSUL! WITH YOUR LIXDIR OR AM AnOmy BlFORE RECORDIHG YOUR HOTICH OF
COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCHMEN'l'".
9~~
SIGNAtURE: OVIfIlR OR AGENT
STATE OF FLORIDA
COUN'l'Y OF
The foregoing instrument was acknowledged
before me this , 19____ by
STATI OF FLORI~
COUNTY OF ~
The foregoing instrument was aCknowledged
before me this 11 - r2 9 , 19~ by
o me or who has
L _.s3-asy-(J
as identification and who id/did not
take~tb. a .?1z::j
ISignature~ . / A . /1 tJ p
(Name Typed, prin~ or Stamped) 7
NOTARY PUBLIC
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
NIIICY A. Moody
'OMM/SSION II CC53480B EXPIRES
Februa!y 21, 2000
IiUNDEO THRU TROY FAIN INSURANCE, INC.
EiY.t'MEHT ",eOIFICATIONS: ~
FURNAOE/AIA HANDLER EXJSTfNG D NEW DRAIN LINE
OONDeNSER UNIT exISTING 0 NEW . CONDENSATE PUMP
eVAPORA10Fl COIL EXISTING g.."NEW SLAB'
LINe 8ETexISTINGi'~N&W Cl OTHER___._..__,_
REMOVE OLD &QUIPMENT FROM ;SITUtf LEAVE ON SITE [""J
-~~~::J?~~~~:~:~~~:~T~UCTION.]~~r~.~I~TING-r~~~p ~~~~~:~~=;:~-~~;' ,
..:~~~TEA' ,. L~E EXISTJNQ ~ NEW ~ ~~'~~~~L :'O~~.MC.fd"tt{.<1'.~::::=:;;~;;;;;~~;;;;:
~P"'~gIAb.tti'-TJ:l.l~.9..TJ~ %":.;0).+-11 X~"'J'nQ"'e.. ..~ -,Ie,..., C';""~~;"Z:7' I t';Jlr ~.~~ WI";'"
l~;I<W ,p1iP.~ -I~~ C, h't"'~"'I'- ~1("fff'h"'~TI;".!J -I-~ ~"..s"'/;""2 c:/(.JC:~* J 7lJ.6./.h-!fl
"" ," eI tin.""" 11..,..$. WI,.,.. t:' ",., d ~$-e.- ~ :!!' "''-''''~. -.:: ?'''' -.1 I;" !1'" N' ~I!:. ;
II?..s-lQII new R'1.5CCJ<1",tPC+- J:>e..)I' I;, .R.,I.,II,e; -/'0..- t/.7/,.- ;At:.7,..,d1er. ~vl
(-:il~lo. r "Inf fl'fM',Pl'nte,,""" ~ncl l1?e, -A!r.,...IQ Is. Per""/~.s ","'; c-It..'d tft'cI .
:~..,,...b'e,Jjt.$~~~/'.9 heeQ'.s -,Ie be. ~hrd~~.c~ ..,t.c QI/~w ~;;. hahdlt.'r
'~,/,/c;re/)t,.n"'.. WIll r"'I!/.lJ-ttJ$,J-C1/1 i:1;k:r new vn/r I.s I;" r/~c-c:;.....
A P R - 2 4 - -;. Eo ~.,j E D 1 '2-:-1~'~'-'S eo 0. t~"==. HIP S # 4:3 7 Eo
na=A f'l'n.iIl...VVL..rnll co liMA' I: ANU "'MUI"'VOAL.
SEARS, ROeBUCK AND co.
:INS'AL~iF.l;COPY ~!~;.
5ATioF esfiMA\lr' '"l:oRe'A"f>'6RlSS-01TV -, STATe -- ZIP OOOf PIo40NE
.4~M.~P'~. . .' , .~#S,~$)'.-,Jh ~r:I. j l.VI.~~ .Ff1.d<'" /f"o/M"'- ,JH~'<fhO-'!>N~l"9&........ "F1P1.......!.LE.IS:t:.t.L.?2
OUSTOMER'S NA""a n .. " ~ .. ""......,_
&'~ol. 1;''- ,I ~."'."""".,'!n. 0'.'....." 7f,:a~~~.B12. ,.._..... '...._.__........._._. ..,..,.._.
..AaOAe-ai:..'.'O;" 'lr. 4..c~1Ier' IT STA"E' ltp,COOe
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...~..aQ.--~f.I.l.A~.~.l.~_.~.*.............~~~b! /,/..'$ ..E.~''''''"'_''_'._ . . . ~.
IN.STA'wnoN AC1D'RIl:H.l.,lSimRENT (!if.r: STArE"..., ' f,..,O
.~.~'.!.??'?~::r ...'!:f:!!~.r:!.'::!.......~.L.~!?.!..':1_..'!:A., U~.~._(EJ/~ ~., .9fJ 9" ? ($';;'... ........... ._.,_... '.u_.._.._...,.._.._._
,~Y~~fJA.1 t.l!T~
60 L;tN.Q .. .~..J2___$StR,Lt~<' .___ I-tEATING___....... .', AFUE 1#____
---'.'.'."" ',. '.'...'.'. ..." . '....,.'....' ,............."....-., ..'.. .."'.'...",,......... .... ..............,......""4..__.........--. ---..-........... "..... .. , '. . ..", . .'. I.' ........... ..._._....., '" .__..,.,....._,_....,.......,.
ggYIPMENT 1t9.Qi:.!S: FLlt~..V~,.,lM~,Q1QJ! CHI Mt4EY:
PUANACEtAIFt "'ANDLERtI ~a2..., T.STAT EXISTING 0 NEW#II?r~_. USE EXISTING VENT OR CHIMNEY 0 REPLAOe FLUE 0
CONDENSER Ut~IT" ~..iJf2.::J..._... OOOL&F1" ,., ..... _.~_... INSTALL NEW CHIMNEY LINE~ 0 S~E-<-...._...._._,
PAOI(~GE UNIT" ._. BOILER" __.__________. _.... _ PVC VENT PIPE FOR HI"E FURNAOEHOFU!: CI VERT 0
eVAPORATOR COIL If .-......., ......... ." OTHEFl # 6.15.W h -A::t..~ COMBUSTION AIR [J EXI$TINOO UOOIFY 0
'..' . '.'........"'....-.-.-,--.--,...---..,.........,."....,.-- ~flD ....., 1 PIPE INSTALLATION 0 2 PIPE INSTA4LATIONCl
I' RETURN AIR 0 EXISlINCH:J iiMOOIF.YCl ','.'
',' .-..... .' ""'''' '" . . '.,..' '.'. '.., 1 I..I..~~...~. ..M........................,.., ..........,..._......._... ........ ....~...,
EXIST/NG V NEW tJ
EXIS1'ING [-l."J-IEW [J
EXISTING V' NEW 0 8IZ&:__._._._.......____
EXISTING [l NEW 0
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P _"0 1
NO. .............,,__ ..... _.,..:....
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C<:)I!'EA,S ;'If tl.-L PA Rr..s.
A.N J;> <'.'f'OR
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5t:?V7"/.f ",;: ..5fr J .8$r~.i= .Bal O;::/="' 'e" Sl'1:?5E'r
\j;; L '/~~~? ( r 'St-V1l ~ ~
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.. .." ......,.,.... .-"!'.... ........ ''''.'''''''~'''''''''.!' ............-...............-,-....---.. '..,
'CONTRACTOR, '" ~_.."_......._'.J....;...~J.o. ......~-"_,~..;,.. ....,............_ , .. ._~,_"_. PHONE /I
ADDRess _.......... ..._'......____ _._'.................____.. .._..._........... ,..........,
~jijJiiQNT.AiOTiQi~llflCtubQ:-."~--...-..... ...,... ..,.--..,..,.,. '.. ,..---..,....-- " ..... ...'..'.....--'...-..-.'..__...._..."...._
..-. YEA,. MAIN'-eNANOE' AGJ.':tEEM E! NT 'pct.(J, -1c...-.-.1 _ ASBESTOS ABATEMENT,
e yeAR AEPAIA '-LAN ~_ ~-'_.._._.. 1'HI$ el:lrlMATE Ai'll> PI'lOfiOl,AI MlSlIMEi" NO ASBli8TO& WILL 8E OISruAef-O 'N
NP$ eODe~W~/~,^~e. THE Pl'~'ORMANCIi OF WO'l!\ I,. 1I1'ON I'UWlHER 'N8P80T.ION'e.'\' CONfl1AC1TOIIr
1'!,.6"ioI\UI::. 'J!t .AIll" !r!' ".".~",L, ~'O: T 1. ;.;......, .....1..'.11: "..... 'NV IIXllT!N.......O....'VIOL..'A. Of'l CnHtRt. All61Ii$TC/$ HAil 10 &11 lJU,tUAIUlO to,P"fllfQ$M' WDflK,~litiOMQA
~.u.!.:lI"~ -..,... I., Ill" n.t..... - "'" .. , ..... '" MUST AMANGE "NO,.... Y FOM "'-"'Yflot&Nt OP' ACfII~ 'KIOA fIlOlf"dllT AWl" QIl
TION' OR ""1.lllllT' ca CQNDmONS OF ANY DUC'l'WOAlC.ItII1ING, ILllCTAlr.Al. SU"I.IES CONTINUATION Or WO~K. ,I- t:US"OMEiR PAILS TO ARAANGoG 'OR "'.Ol8$A,",
0" lIOUlf'MINT NOT ""NO "........010 AT THI* TIMI.III lll)OlTl<'INAI WC'I~K II "IlOUI"IO. 4$8&$TO$ ABATlll\Al!:NT WIlHfN T"'lrllY j30l "Ava;, lUoAM ~~ ~NQ'" .'Hl~ PRo."
11' WILL II' TNI Cl/1'10MEA', AllPoNSUIILltV. ANY AUDITION"L CHA"OI!S Will, I! POS"\' UPON WRITTiN NOTICli 'ro CJOOTOMEI'l. , J
QlJOTIO AND APPI'lO\110 IIJIIIOA TO THlITART OF AODITIONAI. WORK.
.... r J
"HIi VI'O"IC WtLL .fAR t'''fIIOxthlATI,-V · _ ANO WlL~ .. IUIITANTlALL ~ COMPt.ITID 8'1
""JlltGltIMATILV TWUIlU.,...A.. AIJLI.~" Te!> t':W"'"U'll ...,. "WI "'UII '!'WI! f'!1'\1>J,....",. ,..
.". .......__,............,...".........,..,.,~-.,............,.. .'It
'.. ...~.__.._ LICENSi';.;.;...._..;....-.....,.._
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· UNMMT AND TH4T THIS IS ONL V .11I !STI""ATf DATI "NO I Wll.\;
~!i:.S1P"!~~<::!~.~.~~O" TO TI1IS DAT& ra SCHmuU THl "ervA"