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Home My WebLink About97-6467 BUILDING PERMIT N! Permit CITY OF ZEPHYRHILLS (813) 788-6611 --6467/3 Date :; -/ ? -1 'l ~ ELECTRICAL PLUMBING ::::::,~.:~e6/.16A~ MECHANICAL Sewer Conn Water Conn: Water Meter: T,I.F.'s: Parcel 1.0, # Zoning: Description of Work /) J~erg-W:-ode: ~~ t7 X.' I tJ Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL 3- /) - 7 DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. c.o. DATE Inspector~ City License Registration # State Certified License# Permit Fee ;Lo . t:/7..",) Signa~ /)n"-'/4 Camp . y Address Telephone# Valuation or Contract Price ? CJ7J - cro o\"'..I'Y"l a..Il-- BUILDING ELECTRICAL PLUMBING MECHANICAL Ftr. Pre SLB Lintel FRM. Insul. CL WL Tp. Servo Rough In Meter Can Canst. 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. APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT tt,~~~%tl t PHONE 7 (r o~ /:1. 7 rY J' ..e f'~p 71..) Jj f LJ J , r; :;r- L/ ...i3 .5 y{) {...... ., ..... OWNER t S NAKE . ,.) tt .'::;; 1'1 I rl. OWNER t S ADDRESS b I :S-O JOB ADDRESS 6! i:) I- J } /(1 LEGAL DESCRIPTION: LOT(S) ( . ; / /1' BLOCK SUBDIVISION PARCEL 1. D.' (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition ----Alteration _Repair _Install _Sign _Move _Deaolish PROPOSED USE: _Single Fuaily ~M/F _, of Units _M/H _eo..ercial _Indust. _Swia. Pool _Other _Restaurant & Health Department Approval DESCRIPTION OF WORK: BUILDING SIZE: I 7 I' X ?rJ , 'J{) ... Square Feet. ,7 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. V');UILDING ~"U -LL'WCTRlCAL $ $ to () f tJ 0 PERMITS REOUESTED Valuation of Total Construction NIP Service Florida Power Corp. W.R.E.C. _KECllAliIGAL . $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF COHSTRUCTIOH: _Block _Fruae _Steel Other FlHISBED FLOOR ELEVATIOHS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO .......................................... CONTRAC1:llII s~ COMPANY .i~~OJJ7VA) State Cert. or Regist. . City License Registration , ..............*....*****..***..*********** l;OMPANY ('1~ ~p 1.) State Cert. or eg S . City License Registration , ***.**.**********..**..*..**************** BUILDER. Signaturei/ F.T.RC'f'RTC~ ---~---- SiooJ!lture {/" PLUMBER. COMPANY State Cert. or Regist. , City License Registration f .***.**.********************************** Signature MECHANICAL COMPANY State Cert. or Regist. t City License Registration f ****.*******~***********.******.*********. Signature OTRF.R COMPANY State Cert. or Regist. # City License Registration I ****************************************** Signature APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS fhe undersigned understands that this perlit .ay be subject to "deed restrictions" which aay 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 .ay be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the 01fller and contractor aay be cited for a .isdeaeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requireaents .ay apply for the intended work, they are advised to contact the City of Zephyrhills 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 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 'Florida's Construction Lien Law - HOIeOW:Der's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is SOIeone other than the "01fller", I certify that I have obtained a copy of the above described docl1ll!Ilt and prOllise in good faith to deliver it to the "owner" prior to cOlleIlceaent. 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 cOllpliance with all applicable laws regulating construction, zoning, and land developaent. Application is hereby .ade to obtain a per.it to do work and installation as indicated. I certify that no work or installation has cOllenced prior to issuance of a per.it and that all work will be perfOIJed to leet standards of all laws regulating construction, City codes, zoning regulations, and land developaent regulations in t4e jurisdiction. I also certify that I understand that the regulations of other goveIDIeDtal agencies aay apply to the intended work, and that it is If responsibility to identify what actions I lUst take to be in co.pliance. Such agencies include but are not lilited to: t Departlent of EnviroDleDtal Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater freatJent t Southwest Florida Water Hanageaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways t Departlent of Health & Rebabilitative Services, EnvirODlental Health Unit - Wells, Wastewater !reatJent, Septic tanks t US EnvirODlental Protection Agency - Asbestos abatetent I also certify that, if fill .aterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addressing a .cOllpensating volute" will be subtitted which is prepared by a professional engineer registered in the State of Florida prior to perlit. issuance. A per.it 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 perlit issued shall beCOJe invalid unless the work authorized by such per.it is cOlIBnced within six IOnths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six IOntha after the tile the work is c~ced. One 90 day l!Itension of tile, JaY be allowed for the perlit with fee charge of $15.QO. 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 OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHMDCEIlEMT HAY RESULT IN YOUR PAYING !WICE FOR IHPROVBHHIlt'S TO YOUR PROPERTY. IF YOU IIIt'END TO OBTAIN FINANCING, COlfSULf WITH YOUR LINDER OR AN AnOIlREY BEFORE RECORDING YOUR IIO'I'ICE OF COMMENCEMBIfT. JOBS UlfDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POSf A "NOTICE OF COHHENCEMElff". SIGNATURE: OWIfER OR AGElit' SIGlfAfURE: CON1'RACfOR STATE OF FLORIDA COUlf1'Y OF The foregoing instrument was acknowledged before me this , 19____ by SfA!E 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 OWNER CITY OF ZEPHYRHILLS BUILDING DEPARTMENT .... . .... JOB LOCATION PARCEL 1. D. # SHOW ALL EXISTING & PROPOSED STRUCTURI!:S GIVING DIMENSIONS & SETBACKS. ffiolt! r -I()~ g-- J:J. ALLEYWAY ACCESS FOR GARAGE OR CARPORT - 15 FOOT SETBACK REQUIRED. l. ~ \) Q. ~ ~ U -J'"- c:f::. ~~6 UTILITY BUILDINGS MUST SHOW SIZE & FOUNDATION INFOR- MATION. ~ ~ ""<. ........... ~ ~ (NOTE EXAMPLES 1 & 2) FRONT PROPERTY LINE STREET 1. SETBACKS FOR Rl, R2 ZONING 60' 10' P E- R X 0 I 10' P S 10' 0 T S I E N D G 20' 1 0' FRORT PROPERTY LIME 2. SETBACKS FOR R3 ZONING 60' 10' 10' EXISTING 10' PROPOSED 20'SGL FAM 30 'DUPLEX 1 0' FRONT PROPERTY LINE