HomeMy WebLinkAbout97-6571
BUILDING PERMIT N!
Permit
CITY OF ZEPHYRHILLS
(813) 788-6611
- 6571 JZ
Dale -.3'- /0 - 7' J
BUILDING
~
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
p,opertYown~:f ~~l,d
Job Address: ~ ~
Parcell.D. # . . ~p
J1Jk~;tL
Water Meter:
T.I.F.'s:
Zoning: ~rgy Code:
Description of Work!~ It' ~
,
lJk~A-~Jtr/-9'7 /1:yo)1111
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
3-2-
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Valuation or
Contract Price
~//*
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Jp-7
Permit Fee
Signature
Company
Address
Telephone#
:1.~ - ~
~.~ o(.~
City License Registration #
State Certified License#
o p; av.._
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
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: J
a. Wrong Address Wci--S -t-- a3.t..4;f;jln4J1. 0> _
b. Condemned work resulting from faulty construction. 3 -;,7~ "9/,
c. Repairs or corrections not made when inspection called. r .3 '-~ -.S ~ 917
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
LOT
OWNER'S NAME
OWNER'S ADDRESS
fY\ aL C.OfY) 1.s~EV'
L D-\- ~~ (no
SAme..
PHONE
q ..f 0{ (' e. S-S
'1 'S.s..: j .... <e.- J
y~t-)
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
'~-3.
BLOCK
SUBDIVISION
PARCEL I.D.#
(OBTAIN FROK PROPERTY TAX NOTICE)
WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install
____Sign
~ove
____Demolish
PROPOSED USE: _Single Family
____KIF
_' of Units ____K/B
____Comaercial
_Indust.
____Swilll. Pool _Other
____Restaurant & Health Department Approval
DESCRIPTION OF WORK:
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTED
_BUILDING
$
Valuation of Total Construction
~ELECTRICAL
100
AMP Service
Florida Power Corp.
_W.R.E.C.
_MECHAHICAL
$
Valuation of Mechanical Installation
_PLUKBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block. ____Frame ____S teel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
CONTRACTOR SECTION
BUILDER
Signature
COMPANY
State Cert. or Regist. #
City License Registration f
******************************************
:=IAN~~~ COMPANY)( t:la Ct~ r etif
State Cert. or Regist. ,f:.-SoC'Oc6Ii
ex, J 62?.t.P City License Registration # )&7
******************************************
PLUKBER COMPANY
State Cert. or Regist. I
Signature City License Registration #
******************************************
MECHANICAL COMPANY
State Cert. or Regist. #
Signature City License Registration f
***********~******************************
OTHER 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 perait 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 lisdeaeanor 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.
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 tbe contractor wishes you to sign
as contractor that lay be an indication that be 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 - HOJeowner's Protection
Guide" prepared by the Florida Department of Agriculture and ConsUler Affairs. If the applicant is sOleone other tban the
"owner", I certify that I bave obtained a copy of the above described docUlent and prolise in good faith to deliver it to the
"owner II prior to couenceaent.
E. CONTRACTOR'SjOWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance witb all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a perlit to do work and instailation as indicated. I certify that no work or
installation bas cOllenced prior to issuance of a perlit and that all work will be perforaed to leet standards of all laws
regulating construction, City codes, loning regulations, and land developlent regulations in tqe jurisdiction. I also
certify that I understand that the regulations of other goverDIental agencies lay apply to the intended work, and that it is
IY responsibility to identify wbat actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to:
t Department of Environlental Regulation - Cypress Baybeads, Wetland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treatment
t Southwest Florida Water Manageaent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
t ArlY Corps of Engineers - Seawalls, Docks, Navigable,Waterways
t Department of Health & Rehabilitative Services, EnviroDlental Healtb Unit - Wells, Wastewater TreatJent, Septic Tanks
t US EnviroDlental Protection Agency - Asbestos abatement
I also certify that, if fill laterial is to be used in Flood Zone "All or IIA,etc.lI, it is understood that a drainage plan
addressing a ucolpensating volUlell 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 witb the work and not as authority to violate, cancel alter, or
set aside any provisions of tbe technical codes, nor sball is~uance of a perlit prevent the Building Official frOJ tbereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perait issued shall becOJe invalid
unless the work authorized by such perlit is cOllenced within six lontbs of issuance, or if work autborized by the perlit is
suspended or abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day extension of tile, JaY be
allowed for the perlit with fee charge of $15.00. The extension sball be requested in writing to tbe Building Official. An
approved inspection lust be logged during each six IOnth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT KAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FIHANCING, CONSULT WITH YOUR LEHDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE: OVNER OR AGENT
SIGNATURE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
before me this , 19____ by
STATE OF FLORIDA
COUHTY 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