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Home My WebLink About96-5832 BUILDING PERMIT 0 CITY OF ZEPHYRHILLS permitN. (813) 788-6611 -~5832J3 Date -.5--/ </- Y.b G~~ ELECTRICAL PLUMBING MECHANICAL Sewer Conn Water Conn: P"'pertyOwne" - ~~,~. J;t:;~ Job Address: --..s s--- ,_ __ _ _ Parcel 1.0. # Zoning: Energy Code: Description of Work----;? ~ ~J Water Meter: T,I.F.'s: Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL Complete Plans. Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. Inspector Valuation or ::> / c-. ~" Contract Price ~ ~ C/ '-/ Permit Fee ~{J _ o-D /t~ ~~ a.~~ City License Registration # State Certified License# Signature Company Address Telephone# 0)A.lY\. .o.A--- 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 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 ($15.001 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 1 8 ~- G, (" II OWNER'S N PHONE ~ f' ,J- b 9 j .j OWNER'S ADDRESS JOB ADDRESS ....1- Y ,.;} J'- ~ /'/2 (' 7' LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I. D. t (OBTAIN FROK PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition _Alteration "'x"Repair _Install _Sign _Kove _Deaolish PROPOSED USE: _Single Faaily _KIF _' of Units _K/H _<=<-ercial _Indust. _Swia. Pool _Other _Restaurant & Health Department Approval DESCRIPTION OF WORK: f?~I'5"~ f'/~u~a .e,~ /5"-/;7' .5~~ ~e_e..e<.,dst:' of uJ..../t', Pi€~64_ , 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. _BUILDING PERMITS REOUESTED ~'j .' 1'/ ,,' ,,'<" -1",: ,. :;:..., O. 0 ,,) ,,5,q ,.,1 q I ,5" ~ () =- 3 ~S", ;'.:) $ 13.( 0,-/<. 50.7 ~) Valuation of Total Construction _ELEGTRlCAL AMP Service Florida Power Corp. W.R.E.C. _KECHAlllCAL $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUGTION: _Block _Fraae _Steel Other FDnSBED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** CONTRACTOll SE~ COMPANY ( ,~e t2hJ-YP~) State Cert. or Regist. . City License Registration t ****************************************** BUn.DER Signature F.T.Ji:GTRlCIAN COMPANY State Cert. or Regist. t City License Registration , ****************************************** SianAture PLUMBER COMPANY State Cert. or Regist. t City License Registration f ****************************************** Signature MECHANICAL COMPANY State Cert. or Regist. f City License Registration f ****************************************** Signature OTRRR COMPANY State Cert. or Regist. I City License Registration , ****************************************** Signature APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Tbe undersigned understands tbat tbis perJit lay be subject to "deed restrictions" wbieb tay 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 lisdeteanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requiretents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813) 788-6611. FurtherlOre, 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 which 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 tay be an indication that be is not properly licensed and is not entitled to perJitting 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 that I, the applicant, bave been provided with a copy of 'Florida's Construction Lien Law - HOIIe01IDer's Protection Guide" prepared by the Florida Departlent of Agriculture and Consuter Affairs. If the applicant is sllleone other than the uowner", I certify that I bave obtained a copy of the above described docuteJlt and prlllise in good faith to deliver it to the "owner" prior to cOlllencl!lel1t. E. CONTRACTOR'SjOWNER'S AFFIDAVIT I certify that all the infortation in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land developllent. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation bas CDIIeDced prior to issuance of a perJit and that all work will be perforJed to teet standards of all laws regulating construction, City codes, zoning regulations, and land developtent regulations in the jurisdiction. I also certify that I understand that the regulations of other governtental agencies tay apply to the intended wort, and that it is IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not It.ited to: t Departlent of HnviroDlental Regulation - Cypress Baybeads, Wetland Areas and HnviroDlentally Sensitive Lands, Water/Wastewater Treatlent t Southwest Florida Water Hanagetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways t Departtent of Health & Rebabilitative Services, EnvirODlental Health Unit - Wells, Wastewater Treattent, Septic Tanks t US EnvirODlental Protection Agency - Asbestos abatetent I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.I', it is understood that a drainage plan addressing a UcOlpeDsating volute" will be sublitted whieb is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A pertit 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 frill 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 perJit is COllenced within six IOnths of issuance, or if work authorized by the perJit is suspended or abandoned for a period of six IOnths after the tite the work is co.enced. One 90 day extension of tite, tay be allowed for the pe~t with fee charge of $15.00. Tbe extension sbal1 be requested in writing to the Building Official. An approved inspection lUst be logged during eacb six IOI1th period, or the project will be considered abandoned. WARlHNG TO OWNER: YOUR FAILURE '1'0 RECORD A NO'I'ICE OF COHHEHCEHElft' HAY RESULT IN YOUR PAYING TWICE FOR IHPROVEMElft'S TO YOUR PROPERTY. IF YOU Ilft'BHD TO OBTAIN FINAKCING, CONSULT WITH YOOR LINDER OR AN AftORIIEY BEFORE RECORDING YOUR NO'I'ICE OF COMHENCHHElft'. JOBS UNDHR $2,500 IN VALUE DO NO'I' NEED '1'0 RECORD AND POST A "NO'I'ICE OF COMMENCEMBlft'''. ~- \d~ 'L J( S~~."T - '~:C SIGNATURE: COlft'RAC'I'OR STATH OF FLORIDA coum OF The foregoing instrument was acknowledged before me this s-/r 3 , 19 1'- by STATH OF FLORIDA COUlft'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 . California All-Purpose Acknowledgment State of California SANTA CLARA County of On MAY /3; /99~ DATE personally appeared, tJ I!( C//lJ (If o personally known to me- OT- r.......t...l....~~~~~.~~~~l.l.l gj8 COMM,1971482 i rr:' NOTARY PU8UC. CALFOANII'. l:J SANTA CLARA COUNTY r!t+-^u.. ~~::=:::;:.:~;=.J s before me, LEROYGORE NAME OF NOTARY PUBUC A L DI<JCII NAME(S) OF SIGNER(S} ~ proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowl- edged to me that he / Gf;) executed the same in his ;(f!iij authorized capacity , and that by his /(f!ii) signature on the instrument the person or the entity upon behalf of which the person acted, executed the instrument. Witness my hand and official al. I Though the information below is not required by law, it may prove valuable to persons relying on the document and prevents fraudulent reattachment of this form. Type or Title of Document II ffL/ CA7/oA/ P &1\ fiE IZ MZ; 'lTI'LE OR TYPE OF DOCUMENT Number of pages: ;2 Date of Document: .5// j / 9 ~ Signer(s) Other Than Named Above: Form 901.294 Capacity Claimed By Signer Zl Individual(s) ---' Corporate -.J 'lTI'LE(S} I Partner(s) ..................... [~ General .............. ... .................... [J Limited Attorney-in-Fact Guardian/ Conservator Trustee(s) Other: --.J ---, --.J Signer is Representing: Name of Person(s} or EtIlity(u,s} OWNER l/ I I? fI ;' n ,'a...- -~ --- JOB LOCATION .,j ~;'l s.; CITY OF ZEPHYRHILLS BUILDING DEPARTMENT /j I / , / fA / rt I? I C. "7 {llfGS I PARCEL I. D. # S/ -l1};n/~~ _7 , ./___--~ --n ~(-; ~~.. //' U -"-. '-/' ./~ "-?~~. , / . _ .."ft/ L/ ~:ffl/? SHOW ALL EXISTING & PROPOSED STRUCTURES GIVING DIMENSIONS & SETBACKS. .1. ALLEYWAY ACCESS FOR GARAGE OR CARPORT - 15 FOOT SETBACK REQUIRED. ~~ ,~ ~~ ~'\ :; ("'" , ~., . \., ",; , ~ t, "t I.' ~ -: , )1;, ~~ , ()o :) I ~.. ",> UTILITY SUILDINGS MUST SHOW SIZE & FOUNDATION INFOR- MATION. .1'1;'.-. '., JArf '- r:<l 'If .... "( C. \ \ \~ 1< ~, 1) t" " , Ai . I ... i i "~ ! " ' 'J I}j '",:> ~ ...., . ,- X ~'t. ilJ '\\, 'V ... '''', ,. I .: . I). -'-? FRONT PROPERTY LINE (NOTE EXAMPLES 1 & 2) STREET ,;::: / Ii' ". ]'" " -r If ~ e -1 1. SETBACKS FOR R1, R2 ZONING 60' 10' P E R X 0 I 10' P S 10' 0 T 1 0' S I E N D G 20' FRONT PROPERTY LINE 2. SETBACKS FOR R3 ZONING 60' 10' 10' EXISTING 10' PROPOSED 20'SGL FAM 30 ' DUPLEX 1 0' FRONT PROPERTY LINE