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Home My WebLink About96-5922 BUILl?!~9HY~L~RM!!N~ ~-5922p (813) 788-6611 Date (0 - 1:3- 96 --~ ~ Property Owner: Job Address: Parcel 1.0. # Zoning: Description of Work MEGMANICAL Sewer Conn Water Conn: Water Meter: T.J.F.'s: 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. DATE Valuation or ~ Contract Price ~ {J () Permit Fee Signature Comparo Address Telephone# hY..--n. ..J?" City License Registration # _________ St rtified License# _______ - Tp. SeN. Rough In Meter Can Const. Pole Pool Pre-Meter Final BUILDING Ftr. Pre SLB Lintel FRM. Insul. CL WL SLB Tub Set Water Sewer Final Breaker Ducts lnsl. 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 ($15.00) shall be made for each trip for each trade: a. Wrong Address b. Condemned work resulting from faulty construction. c. Repairs or corrections not made when inspection called. d. Work not ready for inspection when called. e. Permit not posted on job site. f. Plans not at job site. g. Work not accessible. The payment of inspection fees shall be made before any further permits will be issued to the person owning same. OWNER <h /n~.s CITY OF ZEPHYRHILLS BUILDING DEPAR"l"MENT lk ..y" 6 c. 1,1 <P.- 'y? e 11 :;g"7/tJ LtZ1(~/'nf ~--' JOB LOCATION PARCEL 1.0. # SHOW ALL EXISTING ,. PROPOSED S"l'RUCI'lJRES GIVIHG DIMENSIONS ,. SETBACKS. ~~~.~ ~ ~ '-. _~.J~ au 1?~~ lle~ ~~'tA' '~_.-"\ ~~~~JAC-~-n ;;~ ~~~~~ ~ <7~ ~"4144~ ~, ~ ~~'~~~, ~~~ ALLEYWAY ACCESS FOR GARAGE OR CARPORT - 15 FOOT SETBACK REQUIRED. ,if.. I . .Jt." fA' f1"'~ e::- l:t' ---4- ~\~~~ /11./, ><r AI.,wI:$ /Y4 G-/~;> / W,nld.lV? ~I 1 I ~~ 1 ~.l ~-<~ ,IJ '- ~ UTILITY SUILDINGS MUST SHOW SIZE & FOUNDATION INFOR- MATION. -.--, I I j i . t- FRONT PROPERTY LINE (NOTE EXAMPLES 1 & 2) STREET 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 0 G 20' FROII'I' PROPERTY LIRE 2. SETBACKS FOR R3 ZONING 60' 10' 10' EXISTING 10' PROPOSED 20'SGL FAM 30 'DUPLEX 1 0' FRO1ft' PROPERTY LIRE " . " . APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER'S NAME ~1~ If1 f7 .5 (;:>--r J C l u e --r e. n OWNER'S ADDRESS ! j ?J ?)O !-- t0n<-~,)1,f C1 i/~ JOB ADDRESS .3?? I 0 J- Q.. n bilL. t C~ t/ e, PHONE LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL L D.' _Sign ~ PlllU'~ TAll NOTICEI ~iUO . tera. --1lepeir _Inatall ---'love _Deaolish WORK PROPOSED:_New Construction _eo..ercial ~- _Indust. _, of Units _K/H PROPOSED USE: VSingle Fu.ily _Swia. Pool _Other _Restaurant & Health Departaent Approval . - ~IST P DESCRIPTION OF WORK: S eye e i? f~d ~ ti~~(!".t _ 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 AMP Service Florida Power Corp. W.R.E.C. ---'lECHAlUCAL $ Valuation of Kechanical Installation _PLUKBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FIliISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? ~ YES NO ****************************************** BUILDER / Sigoat~.fW ~NTBAcrOA SB~ ) / i . COMPANY -- - ~ LH' ~ >711-1 /0 . -~ State Cert. or Regist. . 1JU7_<<uc.k:~ City License Registration I ****************************************** RI.RGTRICIAN COMPANY State Cert. or Regist. . City License Registration . ****************************************** SianAture PLUKBER COMPANY State Cert. or Regist. I City License Registration f ****************************************** Signature MECHANICAL COMPANY State Cert. or Regist. , City License Registration I ***********~****************************** Signature OTRRR COMPANY State Cert. or Regist. f City License Registration # ****************************************** Signature APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Tbe undersigned understands tbat this perlit lay be subject to "deed restrictions" wbich lay be lOre restrictive tban 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, tbey 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 requirelents laY apply for the intended work, they are advised to contact the City of Zepbyrbills Building DepartJent, (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 wbicb 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 wishes 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 tbat I, tbe applicant, bave been provided with a copy of "Florida's Construction Lien Law - HOIeOWDer's Protection Guide" prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs. If the applicant is sOleone other than the Rowner", I certify that I bave obtained a copy of the above described docUlent and prolise in good faith to deliver it to the "owner" prior to couencelent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforlation 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 cOlleDced prior to issuance of a perlit and that all work will be perfoIJed to leet 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 goveIDJelltal agencies laY apply to the intended work, and that it is IY responsibility to identify wbat actions I lust take to be in cOlpliance. Such agencies include but are not li.ited to: t DepartJent of Environtental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands, Vater/Wastewater TreatJent t Southwest Florida Water Managetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses t Arty Corps of Engineers - Seawalls, Docks, Navigable Waterways t DepartJent of Health & Rehabilitative Services, EnvirODlental Health Unit - Wells, Wastewater Treattent, Septic Tanks t US EnviroDlental Protection Agency - Asbestos abatelent I also certify that, if fill laterial is to be used in Flood Zone "AU or "A,etc.", it is understood tbat a drainage plan addressing a uCOlpensating volUleR will be sublitted 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 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 couenced within six IOnths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six IOntbs after the tile the work is cOllenced. One 90 day extension of tile, laY be allowed for the perlit with fee charge of $15.00. Tbe extension sball be requested in writing to the Building Official. An approved inspection lUst be logged during each six IOnth period, or the project will be considered abandoned. WARMING TO OWNER: YOUR FAILURE TO RECORD A NOrICE OF CCllMElfCEMENT MAY RESULT IN YOUR PAYING rwla FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OB!AIN FINANCING, CONSUL! WI!H YOUR LENDER OR AN A!!ORNEY BEFORE RECORDING YOUR NOTICI OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NElD TO RECORD AND POS! A uNOTICE OF COMMENCEMENT". SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this , 19~ by STATE 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 oath. (Signature) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC