HomeMy WebLinkAbout96-6301
BUILDING PERMIT
Permit N!
CITY OF ZEPHYRHILLS
(813) 788-6611
6301 E
BUILDING
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PLUMBING
MECHANICAL
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Property Owner: .. ~..d
Job Address:...:f:.. .~
Parcell.D. #
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q:/nA(J -JR /
Zoning:
Description of Work
?L~gy ;:ode:
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Radon Gas:
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NO OCCUPANCY BEFORE C.O.
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FINAL
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DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
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. Servo
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 ($15.001 shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
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APPLICATION FOR PERKIT
CITY OF ZEPHYRBILLS
BUILDING DEPARTMENT
OWNER'S ADDRESS
g~Vi\"1.,t&~r he..flcS"",
:$ q L. ~u C "'" n L <'l/
,
SA. f"VV-e:-
Vi t'\ t-c""
PHONE
OWNER'S NAME
Ro... J
~ 5'" 'f
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
_Move
_Deaolish
PROPOSED USE: _Single Faaily
_M/F
_, of Units _M/H
_eo..ercial
_Indust.
_swta. 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
~ELEC1'RICAL
$
Valuation of Total Construction
( C'~
AMP Service
Florida Power Corp.
W.R.E.C.
_MECHAIr.lCAL
$
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
COMPANY
State Cert. or Regist. .
City License Registration f
******************************************
Signature
::~~~~
COMPANY~ ~ r- ~
State Cert. or Re~is t. f ; 0 ~ e/ /) 61
City License Registration' 1~7
******************************************
PLUMBER COMPANY
State Cert. or Regist. ,
Signature City License Registration ,
******************************************
MECHANICAL COMPANY
State Cert. or Regist. ,
Signature City License Registration .
***********~******************************
OTHF.R COMPANY
State Cert. or Regist. I
Signature City License Registration I
******************************************
APPLICATION APPROVED BY PERMIT OFFICER.
.... .. '.," ".-
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Tbe undersigned understands that this pertit 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 JaY be
cited for a lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requireJents JaY apply for the intended work, they are advised to contact the City of Zephyrhills Building DepartJent, (813)
788-6611.
FurtheflOre, if the owner has hired a contractor or contractors, be 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 wishes you to sign
as contractor that lay be an indication that he is not properly licensed and is not entitled to perlitting 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 nFlorida'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
"owner", I certify that I have obtained a copy of the above described docUJent and prOlise in good faith to deliver it to the
"owner" prior to cOlJeDceJent.
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 COJJenced prior to issuance of a perlit and that all work will be perforted to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developaent regulations in t~e jurisdiction. I also
certify that I understand that the regulations of other goverDJental agencies JaY 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 liJited to:
t Departlent of EnviroDJental Regulation - Cypress Bayheads, Wetland Areas and EnviroDJentally Sensitive Lands,
Water/Wastewater TreatJent
t Southwest Florida Water ManageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t Arty Corps of Engineers - Seawalls, Docks, Navigable Waterways
t DepartJent of Health & Rehabilitative Services, EnvirODlental Health Unit - Wells, Wastewater TreatJent, Septic Tanks
t US BnvirODlental Protection Agency - Asbestos abateJent
I also certify that, if fill laterial is to be used in Flood Zone "AU or nA,etc.", it is understood that a drainage plan
addressing a .cOlpensating volUJe" will be sublitted which is prepared by a professional engineer registered in the State of
Florida prior to perlit. issuance.
. A perlit 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 is~uance of a perlit prevent the Building Official frOJ thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall becOJe invalid
unless the work authorized by such perlit is cOllenced within six IOnths of issuance, or if work authorized by the peflit is
suspended or abandoned for a period of six IOnths after the tile the work is cOBenced. One 90 day extension of tile, JaY be
allowed for the pertit 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 will be considered abandoned.
WARMING TO OVNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEllENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINAlfCING, CONSULT WITH YOUR LENDER OR AN AnORMEY BEFORE RECORDING YOUR MOTICE OF
COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
STATE OF FLORIDA
coum 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