HomeMy WebLinkAbout97-6532
BUILDING PERMIT N!
Permit
CITY OF ZEPHYRHILLS
(813) 788-6611
.6532/5
r-
liS
Date
g-~ - 97
{
--------..
~ ,_ E.~-- ~- MECHANICAL Sewer Conn
(? ,Q/I Q __ ? ~ _ Water Conn:
:=:::,~.:;e;fi-~ 7r/<:t.;--::~:::::, CiC.:JJ;u< ?~;,.:e:.~ete'
Parcell.D. #
Zoning:
Description of Work
NO OCCUPANCY BEFORE C.O.
FINAL
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
City License Registration #
State Certified License#
<i? Flu
Inspector
Valuation or ~ $- . ~
Contract Price' . ~-g 1'0
c!0~;:~~€- (s cr~AL
Pl~."
MC(;nANICAL
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Serv.
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 ($15.001 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.
APPLICATION FOR PERKIT
CITY OF ZEPIIYRHILLS
"BUILDING DEPARTMENT
OWNER · S NAKE Or/) I....,/(;I ~- g /0 j S () ,'>'/ /l."9./Jc ~ c-....k/ ..0
/
OWNER'S ADDRESS Y'&/> LJ/.r;5 5'o~
JOB ADDRESS l.f,s-SO iJ/05" So"..-}
LEGAL DESCRlFl'ION: LOT(S)
IJ/t/ci ~ ot","'#
il/cf# S-
PHONE? cr f'~ Ot? [)7
J.JSY/'
a.
BLOCK
SUBDIVISION
PARCEL 1. D.'
(OBTAIN FROM PROPERTY TAX NOTICE)
.."
WORK PROPOSED:_New Construction _Addition -^Iteration ~Repair _Install
..
_Sign _Move _Deaolish
. --x""M/F
PROPOSED USE: _Single Faaily _, of Units _M/H
~,
_Co..ercial _Indust. _Swia. Pool _Other
_Restaurant Ii Health Departaent Approval
DESCRIFl'ION OF WORK:
BUILDING SIZE:
x
~oo Square Feet, ./0 Height
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS Ii (2) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTED
_BUILDING
('>(.')
$ s;- J 9'0 .-
Valuation of Total Construction
_ELEC'l'RICAL
AKP Service
Florida Power Corp.
W.R.E.C.
_MECllAlfICAL
$
Valuation of Mechanical Installation
_Pl.UHBING
GAS
K ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fraae _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT"
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
CONTRACTOR SECTION
BIJTI.DER
COMPANY
State Cert. or Regist. .
City License Registration .
******************************************
Signature
RI.RCTRIClAN
SignAture
COMPANY
State Cert. or Regist. .
City License Registration .
*************************************....*
PLUMBER
COMPANY
State Cert" or Regist. .
City License Registration t
*..*.*****..***********.*.*.**..**...*.*.*
Signature
MECHANICAL
COMPANY
State Cert. or Regist. f
City License Registration .
*.*.*.*.***~**.....**...******...*......**
COMPANY T..'''/V ,.lUrJc;1 /):}/.;I
State Cert. or Regist. . He 003.. ~'>/!>-
City License Registration # Jl90
.*.**...*..*.*.*..*.*.*..***..*.***......
Signature
OTRRR Fool";;'
Signature
PERHIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A" NOTICE OF DEED RESTRICTIONS
Tbe undersigned understands tbat this peI1lit laY be subject to "deed restrictions" wbieb laY be lOre restrictive than City
regulations. fhe undersigned assUles responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas hired a contractor or contractors to undertake wort, 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 owner and contractor IlaY be
cited for a .isdeieanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requir9ents laY apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
788-6611.
FurtherlOre, if the owner bas bired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the
"Contractor Sections" of this application for wbieb they will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, rather tban the contractor, are responsible for the work. If the contractor wishes you to sign ".r
as contractor that lay be an indication that be is not properly licensed and is not entitled to perlitting privileges in the
City of Zepbyrbills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN iaAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law - HOIeOIfDer's Protection
Guide" prepared by the Florida Departlent of Agriculture and Conslller Affairs. If the applicant is &DEone- ather than the
"owner", I certify that I bave obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
"owner" prior to COIleDCgent.
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 developaent.
Application is hereby .ade to obtain a per.it to do work and installation as indicated. I certify that no work or
installation bas COIIeDced prior to issuance of a per.it and that all work will be perf oIled to leet standards of all laws
regulating construction, City codes, zoning regulations, and land develop.ent regulations in the 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 wbat actions I .ust take to be in cOlpliance. Sueb agencies include but are not li.ited to:
* Departlent of EnviroDleDtal Regulation - Cypress Baybeads, Wetland Areas and BnviroDlentally Sensitive Lands,
Water/Wastewater Treatlent
* Southwest Florida Water HanageJeDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
* ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
* Departlent of Health & Rebabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater Treatlent, Septic Tanks
* US EnvirODleDtal Protection Agency - Asbestos abat9ent
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 uCOlpensating volUleu will be subtitted whieb is prepared by a professional engineer registered in the State of
Florida prior to per.it, 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 sball issuance of a peI1lit prevent tbe Building Official frOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every peIlit issued shall becoIe invalid
unless the work authorized by such per.it is cOllenced within six IOnths of issuance, or if work authorized by the peIlit is
suspended or abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day extension of tile, lilY be
allowed for the peI1lit with fee ebarge 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 OIflfER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEHEn' MAY RESULT IN YOUR PAYING DICE FOR IHPROVEMDl'S TO YOUR
PROPERTY. IF YOU IJft'ElfD TO NANCING, CONSULT WIfH YOUR LBHDER OR All A BB NG YOUR JOTICE OF
COMHBNCEHBJft' . 088 ,-DIN I VALUE DO NOT TO RECORD AIID POST A "NOTI
' )
~
/'
~~/
&;/ c----..
n: OF FLORIDA '-, J _/
COUNTY OF - /9 5(1l)
he foregoing i;nrum~t was acknowledged
before me this 'v9d , 19~ by
c::__c;-J /'} riA) (2, ~ / L)/:' ~
who is pers~l~ known to .me . or who has
produced o//'1JA.5 ~.
as ide ification and who did/did not
ta~{C an . t " ')
F
(Name Typed, Printed
NOTARY PUBLIC
""l'tlt'wo..
.<j.\r. :~ Bobble S. SWetland
f1/"1,~ !*~ ~ COMMISSION # CC534927 FY"'.
<)"'4~: FebrualY 22. 2O(Ji)
~ '9n~~ BONDED THRU TRO'! cAIN IN~"" .
3Th TE or: FL01ilQ,I\
CO!Ji'HY or: Pf\,')J:'~)
Ii!/:) !~; [:) tCfllf'( H1P,iiHl: rnl't[l~(lmG IS ^
IHU[ i\f,lf) C01<Rfl:; ('(Wi C[ Y!lf- r"n~t!Mr:~:, tiN rll.E
(1~.~ fir PUIi'!r, I,r'." "'f, Ir' THIS wr::',;: '/,I' I'W~S '-IY
.l!'~" ~ . '>,. I~.,..:-:.!;~j'" rtr"~f!1 'I.";' ''l-.'{j} .;l.~~, I. .
~~~~.al1lL_::~'," ;~'~.1~~tL-'"' ll~\ OF
Jro~J. l!1'" II' """"" roll",
BY at . lc-r':d41,C,
11111111111I11111 11111 11111 11111 1111111111 IIllll1i
97024751
NOTICE OF COMMENCEMENT
Rept: 137183 Ree:
DS: 0.00 IT:
03/06/97
6.00
0.00
Dpty Clerlr
County of
/'.
)/ ~ J c; c/
TUB lmnERSIGNED hereby gives notice that improvement will be made to c~rtain
real property, and in accordance with Chapter 713, Florida Statutes, the
following information is provided in this Notice of Commencement:
~ 1.
Description of Property: Parcel No. I)-:/~- ,z/- ()(lJ(). 06.300.. OO/(J
tJM,./t.)-/v..w;I.> ~iJ(p ,
'-Is-. 0 - 9.>"":5.....1. - lISi/,. ,- t.-, If/{)s ('.") IJ/./r/
(Legal descrlptlon of t e property and street address If,avallable)
2.
General Description o~ Improvement
R ~ ~O() ,"-
JED PITT"'N, PASCO COUNTY CLERI
03/06/97 02:41p. 1 OfJ..1558
OR OK 3707 PG
3. Owner Information: Name O'''~lv'fJr:. /J/VS.Jorr' )JQVt:.( 4.$..5&'>"
.
1\ddress yt/> J)/o~.h'n JJlv tI,
C i t Y -:J. P,I' Hj, y4 J.I,. f/.s
State R. J'JS'7'/
Interest in Pr.operty:
Name of Fee Simple Titleholder: A/Il
(If other th~n owner)
Address
I
/l/~
City
/V~
State /)/6'
4'
Contractor: Name x: /'\./..- Iff' Ifr.,of.......;
, /
Address ~~ ~() 011 c;)JJrC'!d {"'HI! .-.I, City
Surety: Name ,A/ /9
,J'C.'~~
J.. (J ~
{'. X;l-' C
(/
StateF..(. Jy~ J9'
5.
Address
/VA
City
IV1-
State /t//j
Amount of Bond: $ ^/~
6.
Lender: Name
/V~
Address
rv'9-
City
A//)..
State /V~
7. Persons within the State of Florida designated by Owner upon whom
notices or other documents may be served as provided by Section
713.13(1)(a)(7), Florida Statutes:
Name
/V'9
Address
/v'/}
City
/\/rJ-.
State ,,--,,4
8.
In addition to himself, Owner designates
/V" 13
of j....- 19--- to receive a copy of the
Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes.
9. E:xpl.rl1t..ion dat.e or NotIce ot Conlrnencement. (t.he expIration date is 1 year
fr?m the date of recording unless a different date is specified.)
Iv/-l
>f Signature of Owner\.Z'&A'J'.u.!/ h7. ad!t. (~{f)/flar)
Sworn to and subscribed before' me this J(l )i/} day of P.6='~7
1917
,
Notary Public:
-;--~ - --~."":' -. . T~7-;-'-r-r)"
BR:"i\IDA -\Ni\l KEllY
NOTARY P~lD~.IC STATE OF FLORIDA
MYCOMMlssION EXP. DEe. 181m
My Commission Expires:
,ltHO(' 1I1H d Fh~I)ll11
IC(~ 19b4
SUIJM" TO
_ Or/l,..,.J..e. !1)OS.SOIYl /f~^lcJ...
SIRII I
'1ft: 1>- /J /0 5~ o,r') .J /i/J,
_:~; / ~p "l:r .J .3 5"" ~ I
,,^'f:.' Ji, leby Sl illt sp"~clflca'lOnS al1d I;StH11,-,h:5 h
ar of f old roof.
II, plaCtl all roUtHl IUIJIIJur at (j,
i/___li''l in roof with. ) _ --ph 15-
i/ II place alllflad tHII)tS: Size .'V-);/
~f(. place UI1Jb.1I RfItr,e!~al ~
::::.._Ji. tl1aee.____.J""' in, Eav.;
Ii place valillY JII", "
I tall ~ Oy/"
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7,
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__~., ,'Ilylus wllIlJe b 'I.; iI.~d lU III,
V C "t holH and instilll I~ 0 t,
h ;ilt up rooll~l\J
I in ,,~ith 43 Ill, !>,.it! :,1 ,,~t!t
1".1 rnc>p 3 ply fibtl ~11i.l::;J Iell '.
___-1 "feh apply 1 ply III"dilled It,
__h, placl~__ _ .__ III Hdlit: rTWl "
( at d(~ck with alulJ IIIlUII] IOu i
.5' ,K 7-! /I e- :) j f ^"" <"( .:.,r
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(
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[
dn 1'1) all haul o'."dY all lid:
,I rna,jllel arOlllld jlJb to IJjl .
'11u...tI~e Wid p'~I,II" illlllHh
.5
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All,"rr"", I
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PilvnWl11
Dill.-
Ie as lollows:
l.il'pUt,it uf $
1I~.l~ (01 II Inofirl~\/or~ lilt' ,I: .
t l'jS ", .'" '<I frpri .lsht",I,)', 1'1,11' Iii.
II .llld.r qU~\< I'"
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,..' '.dll~l, .,V HILI I dIP hl'r,,!>1" ",
.11"1 rndth outlil1' J ahovl' H~" ,-I,. !"! I""
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Ilu)Nt DATE
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W. 'Ii II ~,II lNF JOB'
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,"lj /,111 'IU"SS
J ~ON1ACT ;;ER~.
.-f'-. SCt::-_IJJ;../O~____.
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/'--:;'1 II $ "!'~____~ per full sheet vi'; Y2 ineh plywo .d
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LJro~~ f'di'lled Sleel
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lie . IIY...-e 10 t~)L
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'110" P,..o ....,~ I", pful,wr ventilation
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,,[, ," ,.: "',LHKe With :ltlO\le ';I.'ti'iflcal,,.,,,,., 1.)r th., sum of'
,)(>11.11 ~ ($ .s- 3 Slo 2.!!.. .._..___) ~llIS .:IIIY III fiber cha'~
S"J YO ~
.___.._.due upon completion.
1l"I,lllce ol:}
/\1,. I' ",: I ',II I,(ll 1',11'1 III' 'II l.omplot.Ofl 01 I"(} wllllxt subJ!l'T 10 a 18,*, j(!ltlhlt't II pCfc."r ; I APR on Ufll\
HlrlH)!1 ,dl:d ~l;-jd\' All matorllil i~ lJuaranteed to bo as specifi,>d.' All 1\I'I,k to I . cqmpleted ill
'I('r "1(,l'llIinU to S!i1rHlatd pJm:ticus AIi~' dheratioll 'lr dOVI,,'I.ln filii' ,lhovo speciti
,1"'1 l~ .........11 I,., fllC,(tculctf nfll~.. upon wlittan Ofth!l:". and WIll btH.:Ofl" HI exlr,1 j,harge o\l'er ur
I;,. 1""I"I".j AU 1,;II~I:nlml1s <HI' ':lltlli'I\Wlllupon ,;111"',:S. nc:t:Irtl:llls 01 ,j,'j.l)l!' tll!" dId our conlra,
.Illy 1.1". IOllrddll itI1d other IIl;!LC5sary insura'll'f!~ Our w(Jr~llrs art~ l<JdY COVI'II~t1 bV Workmill
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