HomeMy WebLinkAbout96-5888
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(813) 788.6611
Date
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Job Address:<-5 , 'I I
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Parcell.D. #
Zoning:
Description of Work
J Energy Code: .-/ ~n Gas: ~ _
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NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
7-'3o-Q
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Permit Fee
Signature
Company
Address
Telephone#
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Valuation or
Contract Price
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City License Registration #
State Certified License#
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BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
-
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Serv.
Rough In
Meter Can
Const. Pole
Pool
.Pre-Meter
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 ($15.001 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.
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V<:E POOL PROPOSED FOR CONSTRUCTION AT THE AIlO~E 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 WlTH O/H UIG FACILITIES OF FLORIDA POWER
CORPORATION.
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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.
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FLORIDA POWER CORPORA nON
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STEPHEN F. BUNNER
DISTRlBUTION ENOlNEERlNG
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ZEPHYRHILLS OPERATION CENTER: 36453 Gelller ROI!J . ZephYlhill.. Flo/l!Ja 33541, (8131 7e3'O~~4
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APPLICATION FOR PERKIT
CITY OF ZEPBYRHILLS
BUILDING DEPARTMENT
OWNER'S NAKE
DEN,..,; ~
"3'7~(1
S~f4
I <..( 'f-to\
AN
PHONE 81 '3 ???:J... S ~ '74
2~((\('"
OWNER'S ADDRESS
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 1. D.'
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition _Alteration -Repair _Install
_Sign
----..JIove
_Deaolish
PROPOSED USE: _Single Faaily
_M/F
_, of Units _M/H
_ec:-ercial
_Indust.
_Swia. Pool _Other
_Restaurant &: Health Departaent 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
_MEGHAIIiCAL
AMP Service
Florida Power Corp.
W.R.E.C.
$
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
BUILDER
GOHPANY
Q 'I ~ State Cert. or Regist. .
~ - - ~ ~ City License Registration'
L: ~~**************************************
Signature
F.T .RGTRlCIAN
SisrnAture D1/..4t. ;
COMPANY
~ State Cert. or Regist. .
~ ~ City License Registration ,
*~********************************
PLUMBER
GOKPANY
State Cert. or Regist. ,
City License Registration .
******************************************
Signature
MECHANICAL
COMPANY
State Cert. or Regist. f
City License Registration ,
***********~******************************
Signature
OTRF.R
COMPANY
State Cert. or Regist. f
City License Registration f
******************************************
Signature
APPLICATION APPROVED BY
PERKIT OFFICER.
, . -
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit lay be subject to "deed restrictions" which JaY 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 tbe contractor is not licensed as required by law, both the owner and contractor lay be
cited for a lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requireJents lay apply for the intended work, they are advised to contact the City of Zepbyrbills Building DepartJent, (813)
788-6611.
FurtheflOre, if the owner bas hired a contractor or contractors, be is advised to have 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 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 tbat I, the applicant, bave been provided with a copy of .Florida's Construction Lien Law - HOJeowner's Protection
Guide" prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs. If the applicant is so.teone 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 cOJJellceJent.
E. CONTRACTOR'SjOWNER'S AFFIDAVIT
I certify that all the inforaation in tbis application is accurate and that all work will be done in cOlpliance witb 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 couenced prior to issuance of a perlit and that all work will be perfofled 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 govefDIental agencies JaY apply to the intended work, and that it is
IY responsibility to identify what actions I .ust take to be in co.pliance. Such agencies include but are not li.ited to:
* DepartJent of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and Environaentally Sensitive Lands,
Water/Wastewater Treatlent
* Soutbwest Florida Water HanageJent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
* AllY Corps of Engineers - Seawalls, Docks, Navigable Waterways
t DepartJent of Health & Rebabilitative Services, Environaental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
t US EnvirODlental Protection Agency - Asbestos abateJent
I also certify that, if fill .aterial 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 which is prepared by a professional engineer registered in the State of
Florida prior to per.it issuance.
A peflit 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 tbe technical codes, nor shall issuance of a perlit prevent the Building Official frOJ thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every peflit issued sball beCOle invalid
unless tbe work authorized by such per.it iscouenced .ithin six IOnths of issuance, or if .ork authorized by the perlit is
suspended or abandoned for a period of six IOntbs after the tile the .ork is coaenced. One 90 day extension of tile, lilY be
allowed for the peflit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection lUst be logged during each six IOnth period, or the project .ill be considered abandoned.
WARNING TO 0WlfBR: YOUR FAILURE TO RECORD A NOTICH OF COMHEIICHHDT HAY RESULT IN YOUR PAYING TWICE FOR IMPROVEIIEMTS TO YOUR
PROPERTY. IF YOU IIfTEIfD TO OBTAIJf FINAIICING, CONSULT WITH YOOR LENDER OR All AnOIlDY BEFORE RECORDING YOUR JlO'IICB OF
COMMENCEMKKT. JOBS UNDER $2,500 IN VALUE 00 NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGIIATURE: omR OR AGENT
SIGNATURE: COIfTRACTOR
STATK OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
before me this , 19~ by
STATE OF FLORIDA
COUNTY 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