HomeMy WebLinkAbout97-6631
BUILDING PERMIT HI! -- 663113
CITY OF ZEPHYRHILLS Permit '
(813) 788-6611 Date .If-tf- - ~ 'J
~O;J
Pmperty Own." ~
Job Add,..., ,;>~'-_' -=-- _ _--I
Parcel 1.0. # \
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
.~~~
Water Meter:
T,I.F.'s:
~.r1-a
Radon Gas:
fl~~
}'
Zoning:
Description of Work
4- E.nergy Cc:de:
J /t.l:i: (f
NO OCCUPANCY BEFORE C,Q.
FINAL
C.O.
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
Permit Fee OL <? eo o"'V
~;:;-D. ~
City License Registration #
State Certified License#
Signature
Company
Address
Telephone#
~
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
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 PERMIT
CITY OF ZEPHYRBILLS
BUILDING DEPARTMENT
OWNER'S NAME
~f)
v
g~S7(J W
,
~.J Of" 4 u tf'V L
~
2- C f/rJ Y/t.. /r/I L L;
b..r-
PHONE
OWNER'S ADDRESS
L .-rl tV EC
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I. D. #
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install
_Sign
_Move
_Deaolish
PROPOSED USE: _Single Fsaily
_KIF
_' of Units _K/H
_~ercial
_Indust.
_Swia. Pool _Other
_Restaurant & Health Department Approval
DESCRIPTION OF WORK:
BUILDING SIZE:
x
Square Feet,
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.
PERMITS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
-.JIECllAlfICAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUcrION: _Block _Frsae _Steel
Other
FDUSHED FLOOR ELEVATIONS:
FT.
IS PROJEcr IN FLOOD ZONE AREA?
******************************************
YES NO
CONTRAcrOR SECTION
BUILDER
COMPANY
~ State Cert. or Regist. .
~, . ity License Registration .
, . ****~************************
Signature
RT.RCTRICIAR COMPANY
State Cert. or Regist. f
Sianature City License Registration f
******************************************
PLUMBER COMPANY
State Cert. or Regist. t
Signature City License Registration .
******************************************
MECHANICAL COMPANY
State Cert. or Regist. ,
Signature City License Registration t
************~*****************************
OTHRR COMPANY
State Cert. or Regist. f
Signature City License Registration t
******************************************
APPLICATION APPROVED BY PERMIT OFFICER.
CONDITIONS OF PEUMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit 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 CON'l'RAC'l'OU 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 aay be
cited for a lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requirelents lay 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. CONSTRUC'l'ION LIEN unw (CHAPTER 713, FLORIDA STA'l'UTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - HOIeOIDer's Protection
Guide" prepared by the Florida Deparllent of Agriculture and ConsUler Affairs, If the applicant is sOIeone other than the
"owner", I certify that I have obtained a copy of the above described docUlent and prolise in good faith to deliver it to the
"owner" prior to conencelent.
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 lawB regulating construction, loning, and land developlent,
, \
Application is hereby lade to obtain a perlit to do work and instailation as indicated. I certify that no worl or
installation has cOllenced prior to issuance of a perlit and that all work will be perforaed to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other goverDlental agencies laY apply to the intended worl, 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 Deparllent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroRJentally Sensitive Lands,
Vater/Vastewater Treallent
t Southwest Florida Water Hanagelent District - VeIls, Cypress Bayheads, Vetland Areas, Altering Watercourses
t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
t DepartJent of Health & Rehabilitative Services, EnviroDlental Health Unit - Wells, Wastewater TreatleRt, Septic Janks
t US EnvirODlental Protection Agency - Asbestos abatelent
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 "colpensating 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 tbe work and not as authority to violate, cancel alter, or
set aside any provisions of tbe technical codes, nor shall is~u~nce of a perlit prevent the Building Official frOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every peflit issued aball beCOle invalid
unless the work authorized by such perlit is cOllenced within sil IOnths of issuance, or if work authorized by the peflit is
suspended or abandoned for a period of sil IOnths after the tile the worl is cOllenCed. One 90 day eatension of tile, lay be
allowed for the perlit 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 sil IOntb period, or the project will be considered abandoned.
WARMING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCRHRNT HAY RESULT IN YOUR PAYING !VICE FOR IHPROVEllBNlS '1'0 YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORRRY BEFORE RECORDING YOUR IfOTICB OF
COHHENCRHENT. JOBS UNDER $2,500 IN VALUR DO NOT NERD TO RKCORD AND POST A "NOTICK OF COHHRNCBHENI".
, I
SIGNATURE: OWNBR OR AGBNT
SIGNATURE: CONTRACTOR
STATB OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
before me this , 19____ by
STATK 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
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llFiii'7&.o 'IHE LOAD REQUIREMENTS
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ATTACHED COVER8 ,OF sS~...o LOADS AND PROVISIONS
2. BOCA NA1lONAl. IIUlDINO CODE 1913
3. 'ItXAS DEPAR'IIolENT OF INSURANCE W1NOSTORM
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PORT ORANCE, HORIDA J2119
TELlJ'IIONE: (904) 161-4714
fAX: (904) J67-6~~6
FREESTANDING COVERS
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or THE rou.OWNG COOES:
" STANDARD BUILDING COIlE '004 ED. CHAPTfR I,
~CLJ1.Pc~~ ts"rt;lIfo"!~~ WND LOADS AND PRO\1 S
2. /JOCA IIAnONAL OUII.OII1G COOf 199J
J. 11:"'5 OfPA'''UUH Of 'HSURAHCf ""4051'0111"
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