HomeMy WebLinkAbout96-5853
BUILDING PERMIT 0
CITY OF ZEPHYRHILLS permitN.
(813) 788-6611
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Job Address:.3 "3 / Y ~
Date
J --.2J} ~ 7'--4
02-0 - o-v
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Parcell.D. #
Zoning:
Description of Work
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
ps~rmit Fee ~ ~ <<9---
Ignature ~ _ __
Company
Address
Telephone#
Valuation or
Contract Price
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City License Registration #
State Certified License#
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BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
-
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
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.
/).. CITY OF
OWNER l:/ { () h ~~ /LJ J
JOB LOCATION ? ~~ ~~3
ZEPHYRHILLS BUILDING DEPARTMBNT
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PARCEL 1.0. #
SHOW ALL EXISTING &: PROPOSED STRUCTURES GIVING DIHENSIORS &: SBTBACKS.
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ALLEYWAY ACCESS FOR
GARAGE OR CARPORT -
15 FOOT SETBACK
REQUIRED.
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FRONT PROPERTY LINE
UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
(NOTE EXAMPLES 1 & 2)
STREET
1. SETBACKS FOR Rl, R2 ZONING
60'
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2. SETBACKS FOR R3 ZONING
60'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30'DUPLEX
10'
p E-
R X
0 I
10' P S 10'
0 T
S .. I
E N
0 G
20'
1 0'
FROIft" PROPERTY LINE
FRONT PROPERTY LINE
1 0'
APPLICAnON FOR PBlUlIT
CITY OF ZEPHYImIU.S
BUILDING DBPAR'11tERT
OWNER' S tWlBQ I c~h ~ 12.. <:.t
OWNER' S ADDDSS ,-~ Ii' < 5 =:3
JOJ' ADDRESS ~
LEGAL DESCRIPTION: LOT(S) 7 -./ i) B~SUBDIVISION
PARCEL I.D.' V 11-..11---.J.,-o (if 'i)-a 1 , a l> - 0 0"7 I (OBTAIN FROM PROPERTY TAX NOTICE)
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PHONE 713 7 F,S J.."7 J-f
WORK PROPOSED:~ew CQnstruction ---Addition ----..Alteration ---Repair ..1::::::::'Insta11
_Sign
--.JIove
_Deaolish
PROPOSED USE: _Single Faaily
_ec-ercial
---1.t/F _, of Units ---1.t/U
_Indust. ~Swia. Pool _Other
---Restaurant it Health Departaent Approval
DESCRIPTION OF wou..:.Ih'}sTn/1 ?)boJe C;-AOu. 'VeL Po 0 I
/f (
BUILDING SIZE:
x
.
Square Feet,
Height
RESIDEIITIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS it (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUILDING PLANS it (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTED
~UILDING
$ ~':: ~- (/"77
Valuation of Total Construction
RI.RcrRI:CAL
AIIP Service
Florida Power Corp.
W.R.E.C.
--1fECIWII.c&L
~1JHBIRG
$.
Valuation of lIechanical Installation
GAS
ROOFIRG
SPECIALTY
TYPE OF OOIIS'l'RucnON: -Block -"raae _Steel
Other
FDIISIIED .FI.OOll BLEVAnOIfS:
Fl.
IS PROJECT IN FLOOD ZONE AREA!
YES NO
..........................................
CONTRACTOR SECTION'
BUJIJ1RR COIIPARY
.-/2 J n L?, State Cert. or Regist. .
Signature \./ ~~~ __ City License Registration ,
..........................................
:.-:::::~u~
COMPANY
State Cert. or Regist. ,
City License Registration'
..........................................
PLUMBER
. ~ t /)
Signature ;; .~ - t:
COMPANY
_ State Cert. or Regist. ,
-- . - - * _ -== City License Registration .
........... ..............................
IlEClWlI.CAL
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
Signature
OTRRR
COMPANY
State Cert. or Regist. .
City License Registration t
..........................................
Sigoature
APPLICAnON APPROVED BY
PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
fbe undersigned understands that tbis perltt JaY be subject to Ideed restrictions I wbieb laY be lOre restrictive than City
regulations. !be UDc1ersigned asSUIe& responsibility for capllance witb any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the OIIIler bas blred a contractor or contractors to undertake IIOrt, tbey Jay be reguired to be licensed in accordance witb
state and local regulations. If tbe contractor is not licensed as required by law, botb tbe 0IIIler and contractor JaY be
cited for a lisdeJeallOr violation under state law. If tbe OIfIler or intended contractor are uncertain as to wbat licensing
reguiruenu JaY apply for the intended IIOrt, they are advised to contact tbe City of Zepbyrbi1ls Building Departlent, (813)
-788-6611.
PurtbeIlOre, if the OIfIler bas bired a contractor or contractors, be is advised to bave tbe contractor(s) sign portions of tbe
IContractor Sections I of tbis application for wbieb tbey will be responsible. If you, as tbe OIIner sign as the contractor,
you are indicating that you, ratber than tbe contractor, are responsible for tbe wort. If tbe contractor wisbes you to sign
. as contractor tbat JaY be an indication that be is not properly licensed and is not entitled to perIltting 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 witb a copy of IFlorida's Construction Lien Law - lkIIemmer's Protection
Guidel prepared by tbe Florida Departlent of Agriculture and ConsUEl' Affairs. If tbe applicant is 8OMOIle otber tban the
10000erl, I certify tbat I bave obtained a copy of the above described c10cuIent and pmUse in good faitb to deliver it to tbe
lOIfIlerl prior to co.eDC8IeIlt.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infollation in tbis application is accurate and that all IIOrt will be done in COIpliance witb all
applicable IDS regulating construction, loning, and land develolllent.
Application is hereby Jade to obtain a perait to do lort and installation as indicated. I certify that no IOrt or
installation bas ~ced prior to issueDce of a perIlt and that all1101't will be perfOIJecl to _t standards of all 188
regulating construction, City codes, loning regulations, and land developEDt regulations in the jurisdiction. I also
certify tbat I understand tbat tbe regulations of other gDYerDI8Jltal agencies JaY apply to tbe intendec1lOrt, and that it is
IY responsibility to identify Ibat actions I lust tate to be in COIpliance. Sueb ag!!Jlcies include but are not lilitec1 to:
t Departlent of EnYil'Ollll!Dtal Regulation - Cypress Baybeads, IIetland Areas and Envirolllelltally Sensitive Lands,
IIater/lfastnater freat:lent
t Soutbwest Florida IIater Manage.unt District - IIells, Cypress Baybeac1s, IIetland Areas, Altering IIatercourses
t AllY Corps of Engineers - Sealalls, Dods, laVIgable Vaterways
t DepartJent of Healtb , Rehabilitative Senices, InYirOllll!lltal Healtb Unit - IIells, Wastewater freallent, Septic rants
t us EnYifOllll!Jltal Protection Agency - Asbestos abatuent
I also certify that, if fill IIterial is to be used in Flood Zone IAI or IA,etc.l, it is understood tbat a drainage plan
addressing a lCOIp8II8ating VOIUleI will be sublitted wbieb 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 tbe IIOrt and not as authority to violate, cancel alter, or
set aside any provisions of tbe tecbnical codes, nor shall issuance of a perlit prevent the Building Official frOl thereafter
reguiring a correction of errors in plans, construction, or violations of any code. Jvery perIlt issued shall becme invalid
unless tbe IOrt authoriled by sueb perlit is COB8Ilced witbin sillOllths of issuance, or if wort authoriled by the perait is
suspended or abandoned for a period of sil IODtbs after tbe tile the 1I01't is ~ced. One 90 day atension of tile, IIY be
allowed for tbe perait with fee charge of $15.00. !he atension shall be requested in lriting to the Building Official. An
approved inspection lUSt be logged during eaeb sil IODtb period, or the project will be considered abandoned.
WARJIIIG ro (JfIIR: YOUR FAILURE ro 'RICORD A lorICI OF CCllMllCIIIIIT JIIY RlSULr II YOUR PAYDfG DICE FOR DIPROVIIIIIIS 'fO YOUR
PHOPIIm'. IF YOU IIlmD ro OBfm FIIIIICIIG, COIISULf WID YOUR LIIDIIl OR IIlftORDY BIFORI RECORDIIG YOUR DICE OF
CCIDIIffCIMDI. JOBS UIDIR $2,500 II VALUJ DO lIor ffIID to RECORD lID POSf A IlorICI OF aJINIffCIIIIIIf'.
SIGlAfURI: CMIIR OR AGDr
SIGUfURI: COII!IIAC'fOR
SrArJ OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before me this t 19____ by
SfAR OF FLORIDA
coum 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 oi'f,th.
(Signature)
(Hue Typed, Printed or Stamped)
NOTARY PUBLIC
(Signature)
(Haile Typed, Printed or Stamped)
HOTARY PUBLIC
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..:.\;:::If:!.~!.....NAME, r< 1<: tWJ) C O~MI fer KJ
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/' THE POOL PROPOSED FOR CONSTRUCTION AT THE ABOVE ADDRESS
DOES NOT CONFLICT WITH ANY UNDERGROUND OR OVERHEAD FACILITIES OF
FLORIDA POWER CORPORATION, PROVIDED THAT THE POOL IS INSTALLED IN
THE LOCATION SHOWN ON THE ATTACHED SITE PLAN PROVIDED TO US BY
THE POOL CONTRACTOR. ...
~
THE POOL PROPOSED FOR CONSTRUCTION AT THE ABOVE ADDRESS
DOES CONFLICT WITH OIH UIG FACILITIES OF FLORIDA POWER
CORPORA TI ON.
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ARRANGEMENTS HA VE BEEN MADE WITH US FOR RELOCATION OF THE
FACILITIES SO AS TO CLEAR THE POOL AREA SHOWN ON THE ATTACHED SITE
PLAN.
FLORIDA POWER CORPORA nON
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STEPHEN F. BUNNER o/tJ/1~
DISTRIBUTION ENGINEERING
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ZEPHYRHILLS OPERATION CENTER: 36453 GOlgor Road' Zophyrhilll' Flollde 33541, (8131 783.0H4
A Rruid' PrOV"u Comp,ny
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