HomeMy WebLinkAbout96-6271
BUILDING PERMIT N~
CITY OF ZEPHYRHILLS PermIt
(813) 788-6611
'.
..
6271.
Date
j/...:J.o-9fo
Property Owner:
Job Address:
Parcel I. D. #
ELE7
.
ME7
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
Description of Work
Energy Code: Radon Gas:
:u~ ~ J\.JI..O,..\...~,~
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Perm;. Fee ~- <?) 0 ~
Signature'V' ~~ .(-,0../
Company Jj ~ ~X.
Address
Telephone#
Valuation or
Contract Price
Pen; , cTiJ
City License Registration # 30 5
State Certified License#
Ftr.
Pre SLB
Lintel
FRM.
tnsul. CL
WL
Tp. Ser
Rough In
Meter Can
Canst. Pole
Pool
Pre-Meter
Final
SLB
TUD Set
Water
Sewer
Final
Bre
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 PERKIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER IS NAKE
MS. SHIRLEY LANIER
OWNER I S ADDRESS
6433 BRENTWOOD DR.
783-6108
PHONE
SILVER OAKS ZEPHYRHILLS FL. 33540
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S) 4&5
SAME AS ABOVE
BLOCK
SUBDIVISION
SILVER OAKS
PARCEL 1.D.'
3-26-21-12-0-415
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction ...!.-Addition _Alteration _Repair _Install
_Sign
_Move
_Deaolish
PROPOSED USE: ~Single Faaily
_M/F
_' of Units _M/H
_<=<-ercial
_Indust.
_Swia. Pool _Other
_Restaurant & Health Department Approval
DECK ON REAR OF NEW HOME
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
-1L-BUILDING
$
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
_MECHAIilCAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ~Block 2-Fraae _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
******************************************
YES NO
CONTRACTOR SECTION
BIITI.DER
COMPANY ~. L. ~ 7E:.-Y~
U\ - I I Vf.' 1~ State Cert. or Regist. ,
~ .~ City License Registration'
~*****************************************
Co DoS. t.
Signature
"
.,30s;
ELECTRICIAN
COMPANY
State Cert. or Regist. ,
City License Registration ,
******************************************
SionAture
PLUMBER
COMPANY
State Cert. or Regist. t
City License Registration ,
******************************************
Signature
MECHANICAL
COMPANY
State Cert. or Regist. *
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 peIlit lay be subject to 'deed restrictions" which lay be lOre restrictive than City
regulations. The undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they 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 what licensing
requiretents laY apply for the intended work, they are advised to contact the City of Zephyrbills Building Departlent, (813)
788-6611.
FurtherlOre, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
"Contractor Sections" of this application for which 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 he is not properly licensed and is not entitled to peIlitting 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, have been provided with a copy of "Florida's Construction Lien Law - HOIeowner's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleone otber than the
"owner", I certify that I bave obtained a copy of the above described docutent and prOlise in good faith to deliver it to the
"owner" prior to couencetent.
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 hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has cOllenced 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 developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other governtental agencies laY apply to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
* Departlent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands,
Water/Wastewater Treatlent
* Southwest Florida Water Hanagetent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
* ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
* Departlent of Health & Rehabilitative Services, Environtental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
* US EnviroDlental Protection Agency - Asbestos abatetent
I also certify that, if 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 sublitted which is prepared by a professional engineer registered in the State of
Florida prior to perlit. issuance.
A peIlit 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 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 peIlit issued shall becOle invalid
unless the work authorized by such perlit is cOllenced within six IOnths of issuance, or if work authorized by the pertit is
suspended or abandoned for a period of six IOntha after the tile the work is coaenced. One 90 day eztension of tite, lay be
allowed for the peIlit with fee charge of $15.00. The 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.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCEJIENT MAY RESULT IN YOUR PAYING TWICE FOR IHPROVEMEIft'S TO YOUR
PROPERTY. IF YOU IH'l'EHD TO OBTAIN FINANCING, CONSULT. WITH YOUR LENDER OR AN AnORREY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COIOIHN~".
SIGNA'fURI: OWNER OR AGENT
SIGNATURE: CONTRACTOR
STATE 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)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
r2eIUJEC .
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