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BUILDING PERMIT -",
CITY OF ZEPHYRHILLS permit:.!
(813) 788-6611
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M~erConn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
Description of Work
NO OCCUPANCY BEFORE C.O.
FINAL ?; ( U-~
DATE
C.O. \
DATE
Inspector €
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances.
Valuation o~ 0./02 / 9,;(' yo
Contract Prrce ) ~
P 'F srI. Q..Q.
ermlt ee V , of/.
Signature v7~7 ( ~
Company
Address
Telephone# t/"J '71"..::z ~ <is' ~
City License Registration If-... _
State Certified License# _ ~
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BUILDING ELECTRICAL
PLU~
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ME~'CAL
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Ftr.
Pre SLB
Lintel
FRM.
Insul. 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.
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INVOICE
INDUSTRIES INC
SOLD TO
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1061 HWY. 92, W.
AUBURN DALE, FL 33823
(813) 665-3767
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OUR ORDER NO.
MANUFACTURERS OF THE'
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YOUR ORDER NO.
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QUANTITY QUANTITY
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STOCK NUMBER/DESCRIPTION
UNIT PRICE UNIT
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"IF IT'S SMITHBIL T ... IT'S BIL T TO LAST,"
APPLICATION FOR PERKIT
CITY OF ZEPBYRHILLS
BUILDING DEPARTMENT
OIiIlER'S IWl1l ~~ ~ ,
OWNER'S ADDRESS CJ 3 L/ - 7' Jt<.~
JOB ADDRESS ~ 03 jI--- ~ Y-<- ~
PHONE '? ~~ ';).. ~ ~ ')
LEGAL DESCRlP'l'ION: LOT(S) BLOCK SUBDIVISION
C~~~~.~-.';'.-~--P-d..G,-J/-(:)OIO-;)..I;lOC - (0 ISO (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED: V"New Construction _Addition _Alteration _Repair _Install
_Sign
_Move
_Deaolish
PROPOSED USE: _Single Faaily
_KIF
_' of Units _K/H
_eo..ercial
_Indust.
_Swia. Pool _Other
_Restaurant Ii Health Department Approval
DESCRIPTION OF WORK: ~ Q. ~~ I \ a..)l ~C:>
BUILDING SIZE: ) & X \.l-G . ~4 ~
\)~\\..i~ ~t-\EI) ~....(;,.
, -,,?,
Square Feet.~ Height
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RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS Ii (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
AtIP Service
Florida Power Corp.
W.R.E.C.
_MECHANICAL
$
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
BIITI.DER. COMPANY
State Cert. or Regist. ,
Signature City License Registration f
..........................................
F.I.F.CTRICIAN COMPANY
State Cert. or Regist. ,
SianAture City License Registration ,
..........................................
PLUMBER COMPANY
State Cert. or Regist. f
Signature City License Registration .
..........................................
MECHANICAL COMPANY
State Cert. or Regist. .
Signature City License Registration .
..........................................
OTHRR COMPANY
State Cert. or Regist. .
Signature City License Registration f
..........................................
APPLICATION APPROVED BY PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit lay be subject to udeed restrictions" wbich lily be lOre restrictive than City
regulations. !be 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 laY be
cited for a lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requireJents lilY apply for tbe intended work, they are advised to contact tbe City of Zepbyrbills Building Departlent, (813)
788-6611.
FurtberlOre, if tbe 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 wbich 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 tbe 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 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 that I, the applicant, bave been provided with a copy of 'Florida's Construction Lien Law - HOJeOWDer's Protection
Guide" prepared by the Florida DepartJent of Agriculture and ConsUleI' Affairs. If the applicant is sOlleane other than the
"owner", I certify that I bave obtained a copy of the above described docUJeDt and prOllise in good faith to deliver it to the
"owner" prior to cOlleDceJent.
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 bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation bas COIIenced prior to issuance of a perlit and that all work will be perforJed 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 governJental agencies lilY apply to the intended work, and that it is
If responsibility to identify wbat actions I lUst take to be in cOlpliance. Such agencies include but are not luited to:
I DepartJent of EnviroDl8Dtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
Water{Nastewater !reatlent
I Soutbwest Florida Water ManageJent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
I ArlY Corps of En!iineers - Seawalls, Docks, Navigable Waterways
I Departlent of Health & Rebabilitative Services, EnvirODJental Health Unit - Wells, Wastewater !reatlent, Septic ranks
I US EnvirODlental Protection Agency - Asbestos abatBlent
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 .cOllpensating volUJeu will be subJitted 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 witb the work and not as autbority to violate, cancel alter, or
set aside any provisions of the technical codes, nor sball issuance of a pertit prevent the Building Official frOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall beCOle invalid
unless the work authorized by such pertit is COllellced within sillOnths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of Sil IOnths after the tile the work is cOIIenced. One 90 day extension of tile, laY be
allowed for the peI'l,it with fee charge of $15.00. !be extension sball be requested in writing to the Building Official. An
approved inspection lUst be logged during eacb sillOnth period, or the project will be considered abandoned.
WARNING '1'0 0IfKEIl: YOUR FAILURE !O RECORD A NO!ICE OF COHMDCEIlENt' MAY RESUL! IN YOUR PAYING !NICE FOR IMPROVEIIEIft'S TO YOUR
PROPERTY. IF YOU INt'END TO OB!AIK FIIfAIICING, COKSULT WITH YOUR LBNDBR OR AK AftOIlMBY BBFORE RECORDIKG YOUR KO'rICE OF
COMMENCEMENt' . JOBS UlfDBR $2,500 IN VALUE 00 NO! NBED '1'0 RECORD AND POST A "NO'rICE OF COMMBNCEIlEN1'''.
SIGNA'IURB: OIfIfER OR AGENt'
SIGKATURE: CONt'RACTOR
S!ATE OF FLORIDA
COUK'lY OF
The foregoing instrument was acknowledged
before me this , 19____ by
S!A'I'E OF FLORIDA
COUN1'Y 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 DEPARTHEN'J."
OWNER ~~ ~1j
JOB LOCATION '5.o3.y- ~~~. :;?~ -.;2;1
PARCEL LD. # 11-;)"~-:J.J-OOI6- J-r;;"'60'-615 <5
SHOW ALL EXISTING & PROPOSED STRUCTURES GIVING DIMENSIONS & SETBACKS.
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ALLEYWAY ACCESS FOR
GARAGE OR CARPORT -
15 FOOT SETBACK
REQUIRED.
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UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
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FRONT PROPERT
LINE
(NOTE EXAMPLES 1 & 2)
STREET
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1. SETBACKS FOR Rl, R2 ZONING
60'
10'
P E-
R X
0 I
10' P S 10'
0 T
S I
E N
D G
20'
-
2. SETBACKS FOR R3 ZONING
60'
1 0'
10'
10' EXISTING 10'
PROPOSED ~
20'SGL FAM 30 ' DUPLEX
1 0'
FRONT PROPERTY LINE
FRONT PROPERTY LINE
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SMITHBILT INDUSTRIES, INC. "
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. ANCHORS I
PORTABLE BUILDING
BUILDING ANCHOR SCHEDULE
NO. OF ANCH. @ NO, OF A NCH. @ TOTAL ANCH.
BUlWING SIZE END OF BLDG. SIDE OF BLDG. PER BLDG,
8',10'& 14' WIDE TO 24' LONG 4 - 4
48' 4 2 6
.. ;
50' 4 4 8
I'
20',22'&24' WIDE TO 24' LONe 8 - 8 'I fl
,I
Ii .I
48' 8 2 10 .,
, 1I
;
50' 8 4 12
,
BUILDING ANCHOR DATA
;
MODEL BAR EYE HELIX UPLIFT CAPACITf
NUMBER LENGTH DIAMETER DIAMETER DIAMETER IN NORMAL SOIL
. 36SHEJ4 30' !/2' 1!/2' 4' 2500 Ibs. ;
NOTE: i
J
SIDING "\ THESE ANCHORS MEET THE WIND REQUIREMENTS OF THE
1994 STANDARD 8U1LDING CODE AND THE AMERICAN
SOCIE7Y OF CIVIL ENGINEERS STANDARD CODE ANSVASCE -93.
~
... 2x4 WALL STUD '"
/ %'~x4' LAG 80LT &: LEAD
SHEILD @ 6'-0' O. C. I
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TYP. CONN. TO CONC. 0
BOLT THRU ANCH. &: 2x6 ~
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w/ %'~ x 4' LAG BOLT
r SIDE ANCH. 8
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ENDANCH, ANCHO~ SPACIN; PLAN' , ~' - ~CAL ANCHOR
- . illl{ '15
sou NONE: DATE lOCAnON OF JOII m>ICAL PORTAJJtE BVIUJI//C ANCHORS i
ONl,," 11'I' 0.11<:. I
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