HomeMy WebLinkAbout96-6343
BUILDING PERMIT
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Permit
CITY OF ZEPHYRHILLS
(813) 788-6611
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Date 1:2- /~.- 70
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c PlUl'vrBlNG
MECH 'UJICAL
::ieWer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
FINAL
J-f- g-
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Permit Fee
Signature
Company
Address
Telephone#
Valuation or ~ ' ~
Contract Price ~ 0 t> 0
City License Registration # .~
State Certified License# _
CO,r,mfA)
BUILDING
~~,t?P6 &;75. .
LECTRICAL.,# 9~ P~
./
~
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.
DISCLOSURE STATEMENT FOR OWNER
CITY OF ZEPBYRHILLS BUILDING DEPARTHENT
I,/4&~e~
to the provisions of this instrument."
have read and fully understand and agree
The undersigned states and affirms
renovating, adding to or reroofing
occupy, or will occupy by
sale. That he or she shall comply
that he or she is desirous of constructing,
his or her own domiCile, that he or she actually
said domicile, and same is not for rent, lease or
with the follOWing conditions:
1. That the owner and he or she alone shall act as the builder for all phases
of construction.
2. That the owner will comply with all provisions of the City of Zephyrhills
ordinances and codes pertinent to the bUilding.
3. That in the event various phases of construction are subcontracted, he will
engage only properly licensed subcontractors and will personally supervise
such work. .
4. That in the event the Building Inspector shall require corrections to be
made, the owner will assume full responsibility to insure they are made, and
upon completion will call for a reinspection before proceeding with the
building.
5. That the owner shall assume full responsibility for the construction and
will not expect supervision of his work from the City of Zephyrhills
Building Department.
6. That prior to final inspection any additional fees, including reinspection
fees, must be paid in full. A written request from this office shall
constitute an official notice to pay additional fees.
7. That the owner shall comply with all City, State and Federal laws in regard
to social security, workman's compensation, lien laws, etc., where
applicable.
8. That'the owner shall comply with all the safety codes issued by the Florida
Industrial Commission.
9. State law requires construction to be done by licensed contractors. You
have applied for a permit under an exemption to that law, The exemption
allows you, as the owner of your property, to act as your own contractor
even though you do not have a license. You must supervise the construction
yourself. You may build or improve a one-family or tWO-family residence or
a farm outbUilding. You may also build or improve a commercial bUilding at
a cost of $25,000 or less. The building must be for your own use and
occupancy. It may not be built for sale or lease. If you sell or lease
more than one bUilding you have built yourself within 1 year after the
construction is complete, the law will presume that you built it for sale or
lease, which is a Violation of this exemption. You may not hire an
unlicensed person as your contractor. Your construction must be done
according to building codes and zoning regulations. It is your
responsibility to make sure that people employed by you have licenses
required by state law and by county or municipal licensing ordinances.
DATE: fJ .M__I' I 5 . / 99 {p.
::::::::9::: ~ ~;;:;
PERMIT #
DATE:
/J-/.s-:"'~b
~C~,!/
OWNER:
ADDRESS: .:??/..?~ /p~p' ,P~
ZE 'pif''fff:;I,u..s /-e- PH: ?' c:f .5 - h 7 V :/
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER'S NAKE Rol-Jert c. 31ann
PHONE (P 1 3) 7 R 3 -;) 71+0
OWNER'S ADDRESS 37132 F'oxrlln Place, Zephyrhills, F'Y 33541
JOB ADDRESS Sa 1"'1 e
LEGAL DESCRIPTION: LOT(S) 40 BLOCK
PARCEL LD.' c"))-26-21-0 120-00000-0400
SUBDIVISION ~ i 1 IT erG a 1< s
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition _Alteration _Repair ~Install
_Sign _Hove _Deaolish
PROPOSED USE: 2-Single FOlily _H/F _' of UnUs _M/H
_ec-ercial _Indust. _Swia. Pool ___Other
_Restaurant & Health Department Approval
DESCRIPTION OF WORK: Install ,,,indows in openings of present screen porch.
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
-LBUILDING
$~ 1 , 000
Valuation of Total Construction
-2-ELEC'J'RICAL
AMP Service
.,r
h
Florida Power Corp.
W.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBING GAS ROOFING
SPECIALTY
TYPE OF CONSTRUC'l'ION: _Block _FrOle _Steel
Other
FlNISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
******************************************
YES NO
CONTRACTOR SECTION
BUILDER
Signature /~ c:: ~
COMPANY
State Cert. or Regist. #
City License Registration .
******************************************
=L\R ~ANY'L.-l"\'U-""> e'-f~\ ..
ate Cert. or Regis t.' 0 0 d ;:l-. t G k-
m _ e ~ City License Registration t OZ'"'
** **** ** ******************************
PLUMBER COMPANY
State Cert. or Regist. ,
Signature City License Registration ,
******************************************
MECHANICAL COMPANY
State Cert. or Regist. ,
Signature City License Registration'
***********~******************************
OTRRR COMPANY
State Cert. or Regist. ,
Signature City License Registration f
******************************************
APPLICATION APPROVED BY PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this petlit lay be subject to -deed restrictions" wbicb laY be lOre restrictive than City
regulations. !be 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, 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 wbat licensing
requirelents lay apply for tbe intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
788-6611.
FurtherlOre, if the owner has bired a contractor or contractors, be 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 owner sign as the contractor,
you are indicating that you, rather than tbe contractor, are responsible for tbe 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 petlitting privileges in the
City of Zephyrbills.
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 - HOJeOw.Der's Protection
Guide" prepared by the Florida Departlent of Agriculture and Conslller Affairs. If the applicant is sOleOne otber than the
"owner", I certify that I have obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
"owner" prior to cOllellcelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify tbat all the inforlation in tbis application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, zoning, and land develo.-ent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation bas COIIenced prior to issuance of a petlit and that all work will be perfotled to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developlent regulations in th~ jurisdiction. I also
certify that I understand that the regulations of other goveIDIeDtal agenCies laY apply to the intended work, and that it is
IY responsibility to identify wbat actions' I lust take to be in coapliance. Sucb agencies include but are not lilited to:
t Departlent of EnviroDleDtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDleDtally Sensitive Lands,
Water/Wastewater Treatlent
t Southwest Florida Water Managelent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
t ArlY Corps of Engineers - Seawalls, Docks, Ravigable Waterways
t DepartJent of Health & Rebabilitative Services, EnvirODJental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
t US EnvirODJental Protection Agency - Asbestos abateleDt
I also certify that, if fill laterial is to be used in Flood Zone "Aa or "A,etc.", it is understood that a drainage plan
addressing a .cOlpensating volUle" will be sublitted which is prepared by a professional engineer registered in the State of
Florida prior to perlit. issuance.
. A petlit issued sball be construed to be a license to proceed with tbe work and not as authority to violate, cancel alter, or
set aside any provisions of tbe technical codes, nor sball issuance of a perlit prevent the Building Official frOJ thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every peIlit issued shall beCOle invalid
unless tbe work authorized by such perlit is cOllenced within six IOntbs of issuance, or if work authorized by the petlit is
suspended or abandoned for a period of six IOnths after the tile the work is cOlleDced. One 90 day extension of tile, laY be
allowed for the petlit 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.
WARNIRG TO OWRER: YOUR FAILURE TO RECORD A ROTICE OF COMMERCEIlBtI1' MAY RESULT IR YOUR PAYIKG TWICE FOR IMPROVEMEn'S TO YOUR
PROPERTY. IF YOU ItI1'EHD TO OBIAIK FIHAlfCIRG, CORSULT WITH YOUR LBllDIR OR AM AftORHEY BEFORE RECORDIKG YOUR IfOTICE OF
COMMERCEMEtI1'. JOBS ORDER $2,500 IR VALUE DO lOT REED TO RECORD AIfD POST A "NOTICE OF COMMEHCEMEtI1'".
I~C~
SIGJlA'fURE: OWNER OR AGBtI1'
SIGKATURE: COtl1'RAC'fOR
STATE OF FLORIDA P
coum OF _~
The foregoing i~trument was acknowledged
before me this ~ ,.. / ~ , 19!11z.. by
PDB13~T r, (JL:JrVj)
who is personally known to me or who has
produced ~
as identification and who did id not
take~ OAth. J to ~
~ C' C'!f-'All -
(Signature)
STATE OF FLORIDA
COUtI1'Y 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.
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
...\\':i.VI~""
l4}~~. ..~~ ROBERT !. EPPERS
~;. E.~ MY COMMISSION' CC426867 EXPIRES
""J.if.....~f,:-~ February 15 1999
',P.r.,ft!- BONDED THRU TROY FAIN INSURANCE,INC.