HomeMy WebLinkAbout96-6059
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BUILDING
BUILDING PERMIT 0
CITY OF ZEPHYRHILLS Permit N. 6059 I
(813) 788-6611 Date ~ ~d ~ - 90
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
PmpertyOwne, Q~lM fl. <\ ~tQ .~D.t-l
Job Address: 3C1 'cd. ~ T.k.l Cl.N-e-.
Parcell.D. # J d'" d to -.a) - 00 "30- ~e:> 30 C> - 0>0 ~O
Water Conn:
Water Meter:
T.I.F.'s:
Zoning: Energy Code: Radon Gas:
DescriPtionofWOrk~^.:X ..1\.tJ\.O~~ il'h-t=n.. ~~~~
NO OCCUPANCY BEFORE C.O.
FINAL
DATE
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
Contract Price
~B-
City License Registration #
State Certified License#
Permit Fee 11..26 -;, ~ ~.1 J n
Signatu~e ~ /f-<.AA i.. ~ ;.f; Up!' U Vr
Company
Address
Telephone#
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 ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
C. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
:~LC!..O~ ~- /0~7~
OIiIlER'S IIAIlI\ aAtJZ~ r;J cI !!f;;;$# ?!t:-doNE ; 9&;3 -//O?
OWNER'S ADDRESS ,,_
--.3 9./t)Q -~~II a~_.
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S) BLOCIL.-SUBDIVISION Z
PARCEL 1.D.' /:<-,"210- ,2,J-()D3Q- 00-31/) -DtJ6UcOBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install
_Sign
_Move
_DeJIOlish
PROPOSED USE: _Single Faaily
_M/F
_, of Units _M/H
_<=<-ercial
_Indust.
_Swia. Pool _Other
_Res-7ant & Health Departaent Approval .
DESCRIPTION OF WOPJ(I.~ -1- /:).'" / 2. ~,4... "rh.iiM 1 /f7f)/)d -<Ad;
o ~ 1~ hOo-n-- v
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.
_MECllANICAL
$
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
******************************************
BIJIIJlER ~
Signature /ff-?<.
~C{OR SE~~ )
2 COMPANY .. , ~L2v~
~tate Gert. or Regist. t .
>> . City License Registration .
*****~***** ***************************
F.T .RCTRICIAN
COMPANY
State Cert. or Regist. t
City License Registration t
******************************************
SignAture
PLUMBER
COMPANY
State Cert. or Regist. .
City License Registration t
******************************************
Signature
,.
MECHANICAL
COMPANY
State Cert. or Regist. t
City License Registration .
******************************************
Signature
OTRRR
COMPANY
State Cert. or Regist. ,
City License Registration ,
******************************************
Signature
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit JaY be subject to Ideed restrictions" which tay be lOre restrictive than City
regulations. fbe undersigned assUJes responsibility for coapliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has bired a contractor or contractors to undertake work, they JaY 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 tay be
cited for a lisdeaeanor violation under state law. If the olDer or intended contractor are uncertain as to what licensing
requireaents lay apply for the intended work, they are advised to contact the City of Zephyrbills Building Departaent, (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
IContractor 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 the 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 pertitting 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 IFlorida's Construction Lien Law - HOteOlIJler's Protection
Guide" prepared by the Florida Departlent of Agriculture and Consuaer Affairs. If the applicant is SOteOne other than the
lowner", I certify that I bave obtained a copy of the above described docuaent and prOlise in good faith to deliver it to the
lowner" prior to cOllBDcelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforaation in this application is accurate and that all work will be done in coapliance with all
applicable laws regulating construction, zoning, and land developaent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation bas ~ced prior to issuance of a perli t and that all work will be perforaed to teet standards of all laws
regulating construction, City codes, zoning regulations, and land developaent regulations in the jurisdiction. I also
certify that I understand that the regulations of other governJental agencies JaY apply to the intended wort, and that it is
IY responsib,ility to identify .bat actions I lUst take to be in cOJpliance. Such agencies include but are not litited to:
* DepartJent of Environaental Regulation - Cypress Baybeads, Wetland Areas and Environaentally Sensitive Lands,
Water/Wastewater 'I'reatJent
* Southwest Florida Water Hanageaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
* Arty Corps of Engineers - Seawalls, Docks, Kavigable Waterways
* DepartJent of Health & ~ebabilitative Services; Environaental Health Unit - Wells, Wastewater freattent, Septic !ants
* US EnvirODlental Protection Agency - Asbestos abateaent
I also certify that, if fill laterial is to be used in Flood Zone HAil or HA,etc.", it is understood that a drainage plan
addressing a ICOlpensating volute" will be subtitted which is prepared by a professional engineer registered in the State of
Florida prior to pertit. 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 sball issuance of a per.it prevent the Building Official frOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perait issued shall beCOle invalid
unless the work authorized by such perlit is cOllenced within sillOnths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of silaontbs after the tite the wort is c.enced. One 90 day extension of Ute, tay be
allowed for the perll.t 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 sillOnth period, or the project will be considered abandoned.
WARKING TO OWKER: YOUR FAILURE TO RECORD A KO'I'ICE OF COMMDCBHEKT HAY RESULT IN YOUR PAYING !VICB FOR IMPROVEMmS !O YOUR
PROPER'l'Y. IF YOU IKTEKD TO OB'I'AIN FINAHCIKG, cOKSUL! WI!H YOUR LBHDER OR AK AnORIIY BBFORE RECORDING YOUR DICE OF
cOMMDcEHBN'l'. JOBS ORDER $2,500 IK VALUE DO KO'I' HEED TO RECORD AND POST A "NOTICE OF c(JUfEHCBHEKTI.
SIGKA'l'URE: OWKER OR AGEKT
SIGKATURE: COKTRACIOR
STATE OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before me this , 19 by
--
STATE OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before me this , 19_____ by
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
(Signature)
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
CITY OF ZEPHYRBILLS BUILDING DEPARTMEN"l"
OWNER A riA iJ r D, i E U~24 k,h 1: ~ Ba'\'-P;"€J d
JOB LOCATION ,"1 q I 0 .l.. - S;"-r;g. Clt.;z.
PARCEL I.D. #
SHOW ALL EXISTING IE PROPOSED STRUCf'tJRES GIVING DDlEHSIOHS IE SETBACKS.
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ALLEYWAY ACCESS FOR
GARAGE OR CARPORT -
15 FOOT SETBACK
REQUIRED.
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UTILITY SUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
~ou.-$~
FRONT PROPERTY LINE
(NOTE EXAMPLES 1 & 2)
STREET
1. SETBACKS FOR R1, R2 ZONING
60'
2. SETBACKS FOR R3 ZONING
60'
10'
P E-
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1 0'
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