HomeMy WebLinkAbout96-6064
BUILDING PERMIT 0
CITY OF ZEPHYRHILLS Permit N.
(813) 788-6611
6064 (3
Date
Y~c2b ~7'-h
~) ELECTRICAL PLUMBING MECHANICAL
Pmperty Owne' Ilk Iff JY ~
Job Address: 'I __ - ~ _ ~
Parcell.D. #
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning: Energy Code:
Description of Wor;;:- 1"(:./ /?; /1 ./)~
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
jc>--3'P - ]J
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
If L.. L
c2.f/:;;t
Permit Fee ....?6." t?12.,
Signature~~
Company
Address
Telephone#
Valuation or
Contract Price ~ rtTlJ. o---v
City License Registration #
State Certified License#
_ ~/~.-t (h'~
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
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.
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RESIDENTIAL & COMMERCIAL
Reglstered Builolng Contractor RB 0032524
Reglstered Roofing Contractor RC 0056763
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11250 South Highway 98, Dade City, Florida
Phone # (352)567-8580
Bonded and Insured
33525
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Or~E PLy Tlll;u r DOWhl ROOF SYSTEM
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- CITr/COUNTY PERMIT 08TAINED
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APPLICATION FOR PERKIT
CITY OF ZEPHYRBILLS
BUILDING DEPARTMENT
l) r :J C-<.-lf- K"\.<;"se I ) PHONE '7 B l~r:J7 80
OIlIIER'S ADIlRESS '-( j L\ I L-I 11-- S+ Z. f 1t"'1 ~ I II oS '
M~lclq rY\-w~ C lLMl C
OWNER' S NAKE
JOB ADDRESS
2:> c;. IAr-e.- -
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 1. D. f /4 - ol,lP ~ a I ~ VOIO... f) I .:>.00 - 00 I 0
(OBTAIN FROH PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition --Alteration _Repair _Install
_Sign --'love _Deaolish
PROPOSED USE: _Single Faaily _H/F _, of Units _H/H
_eo..ercial _Indust. _Swia. Pool _Other
_Restaurant & Health Departaent Approval
DESCRIPTION OF WORK: JZr2-pfA tJ of roo-F
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.
PERKITS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
AtIP Service
Florida Power Corp.
W.R.E.C.
_MECllAlUCAL
$
Valuation of Mechanical Installation
_PL~ING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fraae _Steel
Other
FlBISHED FLOOR ELEVATIONS:
F1" .
IS PROJECT IN FLOOD ZONE AREA?
YES NO
..............................*****.******
CONTRACTOR SECTION
BIITIllER
COMPANY
State Cert. or Regist. .
City License Registration .
******..*.**************...**..***********
Signature
F.l.RCTRICIAN
COMPANY
State Cert. or Regist. f
City License Registration f
.......*************.*****.*..*.****.***.*
SionAture
PLUMBER
COMPANY
State Cert. or Regist. ,
City License Registration t
**..******.**.****..**.*.***..************
Signature
~
MECHANICAL
COMPANY
State Cert. or Regist. f
City License Registration .
..**..*...***************.*..*..********.*
Signature
OTRRR
COlfPMfY ~~I ~~ r-z~~k
State Cert. or Regist.' LLOO .
City License Registration' ;;rild-.
.*.***.***.******.*******..*************
Signature
APPLICATION APPROVED BY
PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Tbe undersigned understands that this peIlit lay be subject to Ddeed restrictions" wbicb lay be lOre restrictive than City
regulations. 'he undersigned assutes responsibility for coapliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired 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 lisdeteanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requireaents lay apply for the intended work, they are advised to contact the City of Zephyrbills Building Departaent, (813)
788-6611.
FurtherJOre, if the owner has bired a contractor or contractors, he 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 OlDer sign as the contractor,
you are indicating that you, ratber 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 peraitting 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 that I, the applicant, bave been provided with a copy of 'Florida's Construction Lien Law - Hoteowner's Protection
Guide" prepared by the Florida Departlent of Agriculture and consuter Affairs. If the applicant is sOleone other than the
'owner", I certify tbat I bave obtained a copy of the above described docutent and prOlise in good faith to deliver it to the
"owner" prior to cOlleDceaent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infortation 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 COIIeDced prior to issuance of a perlit and that all work will be perforaed 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 goveI1llelltal agencies tay apply to the intended work, and that it is
ty responsibility to identify wbat actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
t DepartJent of Environaental Regulation - Cypress Baybeads, Wetland Areas and Environaentally Sensitive Lands,
Water/Wastewater TreatJent
i Southwest Florida Water Hanageaent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
--t-A Cor s of En ineers - Seawalls, Docks, Navigable Waterways
of Health & Rehabilitative Services Environaental Health Unit - Wells, Wastewater 'I'reataent, Septic 'I'anks
~/ t US EnvirDnrental_Protection Agency - Asbestos abateaent
I also certify-tbat;1f fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
addressing a "cOlpensating volute" will be subtitted which is prepared by a professional engineer registered in the State of
Florida p'rior to peIlit. issuance.
A perlit issuedsball be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
Bet aside any provisions of the technical codes, nor shall issuance of a pertit prevent the Building Official frOl thereafter
requiring i!- orrection of errors in plans, construction, or violations of any code. Every peIlit issued shall beCOle invalid
unless the wor au'tforized by such perlit is cOllenced within sillOnths of issuance, or if work authorized by the perlit is
suspended or do~ for a period of sillOntbs after the tite the work is coaenced. One 90 day extension of tite, tay be
allowed for tbe erlit~th fee charge of $15.00. Tbe extension sbaU be requested in writing to the Building Official. An
approved~nspect n lUst ibe logged during each six IOntb period, or the project will be considered abandoned.
WARNIHG TO _R: YOUR FAILURE TO RECORD A KO'lICE OF COJIHEIICEHEKT HAY RESULT IK YOUR PAYIKG !VICE FOR IMPROVIMD'l'S TO YOUR
PROPERTY. IF YOU EID TO OBTAIH FlNAHCIKG, COKSULT WI'I'H YOUR LEIDER OR AK A'l"l'ORHEY BEFORE RECORDING YOUR KO'I'ICE OF
COMMENcEMEKT. JOBS ER $2,500 IN VALUE DO KO'l NEED '1'0 RECORD AND POST A "KO'I'IcE OF COHHEHCEMEKT'.
Q
AfORE: OWlIER OR AGEKT
:t:t:-
~ ~J 50 5frQ C~ ')g)
STATE OF FLO~ D
coum OF o...sC
The foregoing instrument was acknowledged
before me this ~/rt' , 19-2.t. by
~l\.iiiordUJ~
who is per nally known to me or wile bas
pr6du(.~d
as identification
take an oa
.....
SIGKA'I'URE: cOKTRAC'l'OR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
before me this , 19_____ by
(Signature
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed,
NOTARY PUBLII ~
);.u\
nr
JUDITH L SCHAPER
Notary PublIc. stat. of FIoIlcIa
My Comm. Exp. J\.N 6.1997
No. CC 292357