HomeMy WebLinkAbout96-5782
BUILDING PERMIT'-
CITY OF ZEPHYRHILLS Permit :II!
(813) 788-6611
J~5782A
Date
/;/- ;1..9-9&
c9 ELECTRICAL PlUMBING MECHANICAL
::::''':::~.y h ~A~ ~ q ..
Parcel 1.0. # )Y-d.-b -~..... O;;L61J.- /)/)oc) 0 - 190VU
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning: ~~ode: Radon Gas:
L~ r
Description of Work _ '--> d.."><
NO OCCUPANCY BEFORE C.O.
FINAL
~ q (,.
ATE
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#
Permit Fee ~O~:2:
Signature r-: 6.A
Company
Address
Telephone#
~~40'
Valuation or....
Contract Price /;;l-..s - ()"-o
~
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 Ins!.
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 ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER · S NAKE
PHONE
OWNER' S ADDRESS
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 1.D.'
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition --.fllteration _Repair _Install
_Sign
----"ove
_Deaolish
PROPOSED USE: _Single Faaily
----"/ F
_' of Units _M/H
_eo..ercial
_Indust.
_Swia. Pool _Other
_Restaurant & Health Department Approval
DESCRIPTION OF WORK:
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 REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
AKP Service
Florida Power Corp.
W.R.E.C.
_HECHARICAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fraae _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
CONTRACTOR SECTION
BunnER ~ COMPANY
/19/ ~'l d '\. State Cert. or Regist. .
Signature //( u~~r/ .:b ~ - City License Registration'
****************************************
ELECTRICIAR COMPANY
State Cert. or Regist. .
SiQDAture City License Registration ,
******************************************
PLUMBER COMPANY
State Cert. or Regist. .
Signature City License Registration .
******************************************
MECHANICAL 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
The undersigned understands that this perlit lay be subject to "deed restrictions" whieb 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 tbe 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 JaY be
cited for a lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requireJents lay apply for tbe intended work, they are advised to contact the City of Zepbyrbills Building DepartJent, (813)
788-6611.
FurtberlOre, if the owner bas hired a contractor or contractors, he is advised to bave 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 tbat 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 he 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 tbat I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law - HOJeowner's Protection
Guide" prepared by tbe Florida DepartJent of Agriculture and ConsUler Affairs. If tbe applicant is sOleone otber than the
"owner", I certify that I have obtained a copy of the above described docUlent and prolise ,in good faith to deliver it to the
"owner" prior to coaenceJent.
E. CONTRACTOR'SjOWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work will be done in cOJpliance 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 cOIIenced 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 developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other goverDIental agencies lay apply to the intended work, and that it is
IY responsib~lity to identify what actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to:
A DepartJent of EnviroDlental Regulation - Cypress Baybeads, Netland Areas and EnvironJentally Sensitive Lands,
Nater/Nastewater TreatJent
t Southwest Florida Nater Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
t DepartJent of Health i Rehabilitative Services, EnviroDlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
t US EnvirODlental Protection Agency - Asbestos abateJent
I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood tbat 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 perlit 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 frOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall 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 tbe tile the work is cOllenced. One 90 day eltension of tile, JaY be
allowed for the perljtwith fee charge of $15.00. Tbe extension sball be requested in writing to the Building Official. An
approved inspectionj'ust be logged during eaeb sillOnth period, or the project will be considered abandoned.
NARNING TO OWNER: YOIlR FAILURE TO RECORD A NOTICE OF COMMENCEMEIft' MAY RESULT IN YOUR PAYING TWICH FOR IHPROVBMElft'S TO YOUR
PROPERTY. IF YOU IIft'END TO OBTAIN FINANCING, CONSULT NITH YOUR LENDER OR AN AnORNEY BEFORE RECORDING YOUR HOIICH OF
COMHENCKHENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED to RECORD AND POST A "NOTICE OF COMMENCEMEHT".
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
was acknowledged
, 19_ by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
before me this , 19_____ by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument
before me this
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
? ~. CJ'"Y ~~IL~ BUILDING DEPARTMENT
OWNER~4-d~~~_______,-
7"6~-:S ~~~
JOB LOCATION
PARCEL I.D. # /'1-:26 - d-/ - Od-bO - 00 DOO -- 00 Yo
SHOW ALL EXISTING & PROPOSED STRUCTURES GIVING DIMENSIONS & SETBACKS.
ALLEYWAY ACCESS FOR
GARAGE OR CARPORT -
15 FOOT SETBACK
REQUIRED.
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UTILITY SUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
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FRONT PROPERTY LINE
(NOTE EXAMPLES 1 & 2)
STREET
1. SETBACKS FOR R1f R2 ZONING
60'
10'
P E-
R X
0 I
10' P S 10'
0 T
S I
E N
D G
20'
FRONT PROPERTY LDIIJ:
2. SETBACKS FOR R3 ZONING
60'
1 0'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30 'DUPLEX
1 0'
FRONT PROPERTY LINE