HomeMy WebLinkAbout97-6550
BUILDING PERMIT
Ii'!
Permit
CITY OF ZEPHYRHILLS
(813) 788-6611
- 655~
Date
,~.; /.2 - 97
~::JI'I~~
ELECl.BJ-C.Al
PL~
MErl-l^NICAL - Sewer Conn
:~~::,~:~e' ~~O ~:t::i;'-~jJ
Parcell.D. # ,::2 Jf - :J (17 .- ~ I -
Zoning:
Description of Work
Water Conn:
Water Meter:
_ ~tJT.-S-/'f.I.F:s:
,
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
~-l3- q
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
P..m;t Fee ~ r
Signature i..---' I .,' ~ .J.
Company
Address
Telephone#
Valuation or
Contract Price
15 / /f r?9 i!5!-
G-rr~c
City License Registration # "7D
State Certified License#
c;;/~~UvD {~
MEC~CAL
Brea~
Ducts Insl.
Compressor
Final
BUILDING
ELECTRIC~
..--------
Tp. Se,,,:/
Rough In
Meter Can
Con st. Pole
Pool
Pre-Meter
Final
PLUM~
..-/
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.
/
.I
/
APPLICATION FOR PERMIT
CITY OF ZEPIIYRHILLS
BUILDING DEPARTMENT
/1
OWNER'S NAME
G~y
-.. .I
OWNER'S ADDRESS ,3;3 CD
ch>/ 51
JOB ADDRESS
;( uT1fV!- RJR)J
~dmU U5'/ <]) ,
b7 I ' ~
~ o/.V-r-.
PHONE
7~~ ~ Ifl
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
WORK PROPOSED:_New Construction _Addition
(OBTAIN FROH PROPERTY TAX NOTICE)
_Alteration _Repair ~nstall
PARCEL LD.I
_Sign
-.Jlove
_Deaolish
PROPOSED USE: _Single Family
_H/F
_# of Units _H/H
_Commercial
_Indust.
_Swim. Pool ___Other
_Restaurant & Health Department Approval
DESCRIPTION OF WORK: 75 / AJ S77f1C It ~ ~
BUILDING SIZE: -Lx(() , /, Square Feet,
ry/o
,
~
St3/W
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.
_BUILDING
$
PERMITS REOUESTED
I Cf' f;tj . d'l) Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
_HECHAHICAL
$
..
Valuation of Mechanical Installation
"
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fr8Jlle _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT,
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
BUILDER
CONTRACTOR SECTION
~ COMPANY 9c1,u577t7-S
~../ / / //~ . - - ~~"'> State Cert. or Regist. .
, ..- ..--
_//' City License Registration'
******************************************
4-Lu If ('/(/ i/f7
70'
Signature
"
ELECTRICIAN COMPANY
State Cert. or Regist. #
Sianature City License Registration #
******************************************
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. #
Signature City License Registration #
******************************************
APPLICATION APPROVED BY PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit 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 lay be
cited for a lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requirements lay apply for the intended work, they are advised to contact the City of Zephyrhills Building DepartJent, (813)
788-6611.
Furthermore, 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 !s 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 _ HOIeowner's Protection
Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is sOleone other than the
'owner", I certify that I have obtained a copy of the above described document and prolise in good faith to deliver it to the
"owner" prior to couencl!llent.
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 compliance with all
applicable laws regulating construction, zoning, and land developtent.
Application is hereby lade to obtain a perlit 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 perforled to teet standards of all laws
regulating construction, City codes, zoning regulations, and land development regulations in th~ jurisdiction. I also
certify that I understand that the regulations of other governlental agencies lay apply to the intended work, and that it is
IY responsibility to identify what actions I must take to be in compliance. Such agencies include but are not lilited to:
* Department of Environmental Regulation - Cypress Bayheads, Wetland Areas and Envirolllentally Sensitive Lands,
Water/Wastewater Treatlent
* Southwest Florida Water HanageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
* ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
* Departlent of Health & Rehabilitative Services, Environmental Health Unit - Wells, Wastewater TreatJent, Septic Tanks
* US Envirofilental Protection Agency - Asbestos abatement
I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understoOC that a drainage plan
addressing a .cQlpensating volUle" 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 issuance of a permit prevent the Building Official frOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every per.it issued shall becOle invalid
unless the work authorized by such perlit is cOllenced within six months of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six months after the tile the work is cOllenced. One 90 day extension of tile, aay be
allowed for the permit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection lust be logged during each six .onth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCEMENT HAY RESULT IN YOUR PAYING TWICE FOR IHPROVEMENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COHHENCKHENT. JOBS m1DHR VALUB DO HO' HEBU '0 RECORD AND~. "HOT:::,:, ~~
-" ~
: CONTRACTOR
STATE OF FLORIDA ~
COUH1Y OF rlf S Co
The foregOing inst~ent was acknowledged
before me this .:?f-J I , 19-ilby
STATE OF FLORIDA ~
COUNTY OF /' ~S Co
The foregOing inst~ent was acknowledged
before me this 2f- f/ ,19-2:2. by
who is personally known to me or who has
produced
as identification and W~~id/did not
take an oath. ~,Lf' ~
(Signature)
who is personally known to me or who has
produced
as identification and who did/did not
take an oath. ~~ ~
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC CORREIA
.,........ KEITH 1416
;'~;r.v.r~\ MY COMMISSION' CC 46 l
i"tin EXPIRES: May 13, 1999 11 \
~;", Ii Bonded T11Iu NolIIY PubIc lJnd8IWI\lll <l
"r"Rr.",'"
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
---;::;..!/.rU..... KEITH CORREIA
g"/J;,~r;~ MY COMMISSION' CC 461416
'~"~'~~ EXPIRES: May 13, 1999
'.~Rf.,\~~~_. Bonded TImI Notary PublIc UndeIWItteIl
SITE PLAN
(RESIDENTIAL USE ONLY)
/
PARCEL I.D~
RNG SUllU
,,(J~ H,RA
3) 7 ' bto:&j)
BLOCK
LOT
SEe
1"1<1' fWlIf
~/
Pol Jr
PROPEHTY HEASUREMr:NT
CUlmENT OWtmnS
DATE
L_ drawn to scale for nll parcels or lots five acres or less.
All drawings shall uc
5/
Ie) INS77K-G
.- ~ jf?J CffO /(. r
5'
c; '//0 /P--Lhffl 511€b
'.
Er($ /(,J0
:;; cA-i?
SHOW ALL EXISTING AND PROPOSED STRUCTURES GIVING DlliE.NSIONS AND SETBACKS. ALSO, INDICATE
ANY BODIES OF WATER AND ROADWAYS (INCLUDING NAMES) ADJACENT TO THE PHOPEHTY. INDICATE
THE SIZE, y~~, ~~D N~~E OF MOBILE; SUCH AS 12' x 60'. 1981. FLEETwOOD.
All "EASEMENTS", "RIGHT-OF-WAY" and "JURISDICTIONAL LINES" must be shown on all site plans.