HomeMy WebLinkAbout97-6399
CITY OF ZEPHYRHILLS
(813) 788-6611 __
,3 0 Date
~ E~, ~~~~~::;~:~~.
:=::::::~O, ~#)f6~oAJc~~::'- ;~:~:,~eto'
BUILDING PERMIT ~!
Permit
- --- 6399 If(
/ - I 7 -97
Parcell.D. #
Zoning:
Description of Work
FINAL
C.O.
DATE
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Valuation or "-f. ~ -- tlZJ.
Contract Price d..L/,5'-
,
Permit Fee
Signature
Company
Address
Telephone#
.'
,
City license Registration # IS 7
State Certified license# f! .4 {! D S7~1 /
BUI
ICAl
El
P
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Insl.
Compressor
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.
- .
APPLICATION FOR PERKIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER'S NAKE
(",..€(Jv5e- (Vt ~rl~llt'
(;r;r 7 YJS(e--- C. ~ .
5~VV'.e.. ~S" y:). ~ ~
PHONE
OWNER'S ADDRESS
JOB ADDRESS
~
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I. D. t
(OBTAIN FROK PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install
_Sign
_Kove
_DeJIOlish
.
PROPOSED USE: _Single Faaily
_KIF
_' of Units _K/H
_eo..ercial
_Indust.
_Swia. Pool _Other
_Restaurant & Health DepartJIent Approval
DESCRIPTION OF WORK: GZey Itcrc~~A- of I-J 0. v4 . L.
5tJ~Skv---
BUILDING SIZE:
x
Square Feet.
Height
RESIDENTIAL :
COMMERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS.
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELEG.TRICAL
~~CAL
$
AMP Service Florida Power Corp.
0.. \.{ cr S-- · Va1uation of Mechanical Installation
W.R.E.C.
_PLUHBING GAS ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fr8lle _Steel
Other
FDlISHED FLOOR ELEVATIONS:
Fr.
IS 'PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
CONTRACTOR SECTION
BUTI.DER
COMPANY
State Cert. or Regist. ,
City License Registration t
******************************************
Signature
RT.F.GTRICIAN
COMPANY
State Cert. or Regist. ,
City License Registration ,
******************************************
SilmAture
PLUKBER
COMPANY
State Cert. or Regist. ,
City License Registration .
****************************
Signature
COHPANYv...<5, ) {Jer.'o""- He 14-+- + Coo)f.'f .
ate Cert. or Regist.' CYt- c..o ~/.r I /
City License Registration' t..----- /j7
* *********~**~***************************
OTRRR COMPANY
State Cert. or Regist. ,
Signature City License Registration t
******************************************
APPLICATION APPROVED BY PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Tbe undersigned understands tbat tbis pertit lay be subject to "deed restrictions" wbicb Jay be lOre restrictive than City
regulations. 'be undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTQR.RESPONSIBILITIES
If the owner bas bired 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 JaY be
cited for a lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requireJents laY apply for the intended work, they are advised to contact the City of Zepbyrbills Building DepartJent, (813)
788-6611. .
FurtbeIlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
"Contractor Sections" of this application for whieb 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 pertitting privileges in the
City of Zepbyrbills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN ~AW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law - HOIeOw.Der's Protection
Guide" prepared by the Florida DepartJent of Agriculture and Conslller Affairs. If the applicant is sOftone otber than the
"owner", I certify that I have obtained a copy of the above described dOCUJeDt and prOlise in good faith to deliver it to the
"owner" prior to cOllenCeJent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify tbat 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 developaent.
Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has cOlleDced prior to issuance of a pertit and that all work will be perfoIJed to teet standards of all laws
regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also
certify that I understand that the regulations of other goverDJental agencies laY apply to the'intended wort, 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:
t DepartJent of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDleDtally Sensitive Lands,
Water/Wastewater rreatJent
t Southwest Florida Water HanageJent 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 rreattent, Septic rants
t US EnvironJental Protection Agency - Asbestos abateJent
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 RcDlpeDsating volUleR will be subJitted whieb is prepared by a professional engineer registered in the State of
Florida prior to perlit. issuance.
A pertit 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 perlit prevent the Building Official frOJ thereafter
requiring a correction of errors in plans, construction, or Violations of any code. Every petlit issued shall beCOle invalid
unless the work authorized by sucb perlit is cOllenced within six IOntbs of issuance, or if wort authorized by the pertit is
suspended or abandoned for a period of six IOntbs after the tile the work is couenced. One 90 day extension of tile, lilY be
allowed for the pertit with fee cbarge of $15.00. Tbe extension sball be requested in writing to the Building Official. An
approved inspection lust be logged during eacb sixlOnth period, or the project will be considered abandoned.
WARHING TO OWNER: YOUR FAILURE TO RECORD A NOTICH OF COMMENCENBNt' HAY RESULT IN YOUR PAYING TlUCH FOR IMPROVENBNt'S TO YOUR
PROPERTY. IF YOU nmnm ro OBTAIN FINAJlCING, CONSULT WITH YOUR LE.NDER OR AN AnORREY BEFORE RBCORDIMG YOUR MOTICE OF
COHHEMCEHBIfT. JOBS UNDER $2,500 IN VALUE DO MOT NEED TO RECORD AND POST A bNOTICE OF COHHBMCBHBNt'''.
SIGMArURE: OIflfER OR AGENt'
SIGMATURE: CONt'RACrOR
STATR OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before me this , 19____ by
STATR 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
~ lr'-\ l-- ~-,.
\ 0: ::<
.............o~ ~ ~ 8
ill ~ I \ I~t;~-'D
OJ ~ I~ ~ ~ ~ ~
~""-- i'j""-- fS\~ o. . I 0: ~ 1:: 0: u;
o '" ~~ I -< 0 lJJ 0 W
UJ W :l.. I3:':OC/)ZO::
~ ~ \,} 1000000
---~'.TT
I~ I
IN
I :::!'
I \\'\ ;
I '" 'l w
I if)
- I
co
OJ
C--
c----
~
V
:z:
0.. "<t
(V)
1J")"<t(Y)-o
o.."<tNCO
o..,?~,
O"<t'O
I IJ") CO "<t
0.. CO CO-o
r--.. -0
(Y) 0
I:10
<{l? 0 a;>
I-::)o..~
00
V'l~0..u.J
<{OOU
~COIJ")-
<{:Jr--..l:t
V'l....J'O
I-(V)
ICOu.J
ttll,....,1-
~V'l0~
zSuO
<{....JV'lo..
<LU<{~
<Zo..O
Q.
..
....:
~
:E
c.: ~
O:z:
--
CII::-I
LLlO
a.. 0
=u
V")
~
~
:z:
i=
<C
LLI
:c
'.
.-
....
l/\
.-
l/\
0
U
<(
U
%:
~ z
OC 0
0
~ t=
<(
u
u:
i=
~
w
U
w
I-
<(
l-
V')
.s~ ~~
O.g ~ 0
-~ :s.9
~ l"tI c: W
~ 15 :s-6~
~:; 1,1) ~';j
~~ ~=~
~ ~ ... ~ =
J -05 :B~~
== ~~ oG,)2'
; 0; ~a.fi
CI) ~c5 i~.3
~~ ~~~ ~2~
~-E ~~-g ~~~
a: ~ .~~.~ 8'~~
~:~:Ju~ o~i
3:;<a9:CJ...- ...: Co
~ ~ ~ ~ ~ ~ ~ ~ :.~
~ ~i~ 1U'5~~~.!
0..00:( cn...Jt: gg~;:-8
'- ~ ~
-~ ~ ~' ,:J
",- '. ~.. ~. t~
: .\N. * \~ ~
\f<(" \I~
~>~ \~.~~\.
\:', ,V-J !'" t:~
'.'" \ ' ,
'.:l. ''(.~ \
',- .~
~~'
~,~
~-~~ i~
~ ~ ~
~ ~ "t
~.ci~' ~
S::-'-"i~. .\...
~'--- . '-I' ,'v
'\ I". I "v' - '.
. '\J ~ '~\~'~
f"'-.. , . r~ r.\
'~~\kJ ~ ~1 .'V
\\~ ~ ~, :~\~,.
: '" '~ ~. '<\0 "
. ' , . '\;.
Lijl _
IJJ LlJ
:; :::!'
;: ~
~ I~
C) 10"
~ i ~
I-
:J) i (fl I
~ I ~,ft' !:
I IfE
~::.~U
I~
..
II
'e
'"
I::
;- C.D-'..~
~...(!~O~
~
~
o
m
~
~
'"
E
~
~
c: LL Ll- . I
cni.i5fi: ~~ f2 ""1 z ffi CJ)(j)~
a..a...:;;: 01 len t='O C/)<{ 0 ('Jill a: t-a:~
<((/)Z 0 ZZ:...J::E-1 ,<(CL w Za: UJ Cl.8Ul W
t5<..J~ W O<{~o1l_~a:l~W~~ ~ <(~ UJo.. :;0' U
-WZ_LL CJa: i=~I-U)OLLO>a:<c<{ ..J I(() 30 o<{~:5
t;dQo~CJ a:OcnfrloU)~(.)[5~t9<iS6 ~ >=~UJ ~LLI~ ,,~w fri Ul
a: ~o/j5(.)fil~~~I-~ZOCl~a:a::LU...J~WZZ O:w(/)W!f>-Wc6ge;! w'-'8g:~a: ~
g S ~ S ffi ~ ~ ~ ~ ~ <tIS ~ ~ ~ ~ ~ ~I ~I ~ ~ ~ lQ O~ ~ ~ ~ ~ ~ ~ ~ ~ e- g 50 0 ~ 0 ~
ffl <i~o/}~6Iw c ~~(U~~6 Z~~~r~C)<<I&~a~~iwi1if-a: ~o ~ >
a:z ~GLdwo" z a:t>j:...J'OUa:la:lWG0...JtjG:~t5~<(~a::JUJ::iI8~(()g:E (3 ~
o..Q (/JI-~~CZ a: <((/)I-~[Ga..~os:C1UJwU:~ t-Z~b'~~~~59=a:(.)~a:a: 0 I-
:s t; ~ ~ &3 z ...J Z ~ I- u.. ~ Z ~ ~ Z Z ill <( W I- I- Z B; 55 a: W <( ~ ~ ~'~ a: ~ 3 ;: g: tt w uj ~ w ~ u:i l
o ~ ~ ~ uj 8 6 0 d ~ w ~ <( ~ u:l 8 it G > d ~ dj 0 ~ ~ - d ~ en ~ 0.. U. 0.. U. CD cr, ~ 0 ~ a: 0 ~ ~ a:
UOoOooOuOOa:OU.OoOOO WOOD UOOO<l:O OOoOooOoOLJOr~OD,_UD
o 000 00,' U..J
.__.. _ __ ._._ _______~_____.__m__.. . _.._ __... ____ J._
Sf;09-vf;S (SOC:) 'VL^J'V8'Vl'lt NI
III
--I-~--
--r-I
I
I
I
u.i-
I
UJ
0.."
-a:
a:<(
I-:r
C,)
Q...J...Jt-oa:u.:
(/)=~Ot--Oo
O~5~~~~
~ffi~;:Qt3~
z::f:r::za:..Jt-
c{u..!:I)W ~
. :::.:::(/)z~UJa:...J
a:L1Ja:~~~~
~~~i:wo~
w~;i~~uj~
~~a:~J:J:
. ~Q~~::j~~
w :E<"~jt-
J: a::wU)-:E
f- o~ ~o
f-::l:ffiococ
z ..JUJU-
~..J..J
w...JCl
~ U)~~
S::l: w~
~ W~I-J:~
a:o ~ ~ w
0!il1<(f- ZOC
:r:JOww<cn
~1-~..Ja:L1JL1J
<:JW~~::l:Cl
wO..Jo <(<
~~~CJ~~~
wffi:;:~UJ~o
~o~<O::l:>
J:a:wZ<CUJZ
_OociL::l:oc<
f-
Z
lI.l
:l:
z
o
ex:
>
z
lI.I
x
~
---
W
II:
:0
~
Cl
iii
o
!!j
~
5
<
I
~
o
D~ DOO~ D~
D~ DO~D~ D~
o
~ ~
f- a:
".
o
W
II
W
>
o
u
w
II
0'" W
". ". f-:::;: ...J
0 OW ro
0 w wf- ...J < ...J
W :::;: zCJ) < w <
...J CJ) CJ) CJ)
u 3 ~~I 0 :J 0
>- CL Z CL
U U 1-- CJ) 0 CJ)
w W WI 0 0
OC OC OCf- Z
.--.-----
@ @ e @
"-a:fBfoiV~4'~ ' .ii.tf:
II II,
a:
W ;!; ~
C)
il'i
...I
~
'" 0
~ w
~ CD , :1 >< >< "
~ e- -' Z I- -' a:
> a: w 0 oc "" 0..<
~a: weE ;;:w ~ I- a::r
::;Ow g:~ Z 0
_0: >=0 w rn I- 1-0
e-<<
/::)
a: w u.
A3"no 'S OlVNOO lBS I G
OS6G'SS9 (008) ~ 33tJ.:lllOl. llVO
C"IAlUr..J ~C'.."II u-:Jnur.-:Ju r..