HomeMy WebLinkAbout97-6632
BUILDING PERMIT N!
Permit
CITY OF ZEPHYRHILLS
(813) 788-6611
6632)1
BUILDING
:;L (}, 0-0
Gc,:~
PLUMBING
..:? C) .. 0-0
~HAN~
Date
7 - 9 -7'1
Sewer Conn
P<opertyOwne, ~~ )/~
Job Address: d / ;;L c:J - b ~
Water Conn:
Water Meter:
T.IF.'s:
Parcell.D, #
Zoning:
Description of Work
Energy Code: ~
Ale (~ (-><-
Radon Gas:
FINAL
NO OCCUPANCY BEFORE C,O.
Complete Plans, Specifications and Fee Must Accompany Application, C.O,
All work shall be performed in accordance with City Codes and Ordinances,
Inspector
~
DATE
Permit Fee
Signature
Company
Address
Telephone#
7()
Valuation or
Contract Price
:2 f- 7 -s '- (.It:)
"
City License Registration # / 6.:L
State Certified License#
-
rAAlM jJl 7::L
BUILDING
ELECTRICAL
PLUMBING
J(~~~'p
MECHANICAL
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 ($15.00) 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 ZEPBYRHILLS
BUILDING DEPARTMENT
OWNER'S NAKE
J / ~ 1/4., <; !-o....;
57/~ 60~R
5' s-4-A.1,.e,
PHONE )),~.;z - 9 C) ., '7
OWNER r S ADDRESS
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 -Hove _Deaolish
.
PROPOSED USE: _Single Family _KIF _' of Units _K/H
_eo..erciaI _Indust. _Swia. Pool _Other
_Restaurant & Health Departaent Approval
DESCRIPTION OF WORK: ;z -; ...,. dxJ 4Y'C c Iz c7:7 ~.
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
AKP Service
Florida Power Corp.
W.R.E.C.
_MECHANICAL
t)-v
$ ..2 ~ ? 5:-:;:-I"JV Valuation of Mechanical Installation
l
_PLUMBING GAS ROOFING
SPECIALTY
'typE OF CONSTRUCTION: _Block _Frame _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS 'PROJECT IN FLOOD ZONE AREA?
*********************************..*****.*
YES NO
CONTRACTOR SECTIOli
BUILDER
COMPANY
State Cert. or Regist. ,
City License Registration ,
*.**.***..********************.**.*******.
Signature
,
RT.RCTRIClAR COMPANY~'" ~€ (N/I/I/I) A-L { FLEe flr,~,f L (c...ft;
, tl - State Cert. or Regist. #
SiQQAture/~c~( ( {eL~ u...ef City License Registration' (J 70<.
*..**********..***********.****.*********.
PLUMBER
COMPANY
State Cert. or Regist. #
City License Registration I
****.***************.**.******.***********
Signature
MECHANICAL
Signature
K:'.vC;-<!7 C~~
State Cert. or Reglst. # cJ cf) ~.::z
City License Registration I ,
*.*.*********.***********.....*******.*.*.
COMPANY
OTHF;R
COMPANY
State Cert. or Regist. I
City License Registration #
**********.****************************..*
Signature
",.-,.."..
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Tbe undersigned understands tbat this perlit lay be subject to "deed restrictions" wbicb laY be lOre restrictive than City
regulations. !be 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 work, tbey 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 lisdeleanor 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 Zepbyrbills Building Departlent, (813)
788-6611.
FurtherlOre, if the owner has hired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
RContractor Sections" of this application for wbicb 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 wisbes 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 ~AW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of RFlorida's Construction Lien Law - HOIeowner's Protection
GuideR prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleOne other than the
'owner", I certify tbat I bave obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
"owner" prior to coaenCl!Ient,
E. CONTRACTOR'SjOWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work will be done in cDlpliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation bas COIIenced prior to issuance of a perlit and that all work will be perf oIled 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 governleDtal agenCies laY apply to the 'intended work, and that it is
IY responsibility to identify wbat actions I lust take to be in cOlpliance. Such agencies include but are not li1ited to:
t Departlent of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
Water/Wastewater !reatlent
t Southwest Florida Water ManageleDt District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
t Departlent of Healtb & Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater Treatlent, Septic Tanks
t US EnviroDleDtal Protection Agency - Asbestos abateleDt
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 wbich is prepared by a professional engineer registered in the State of
Florida prior to perlit. issuance.
A perlit issued sball 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 perlit prevent the Building Official frOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becOle invalid
unless the work authorized by such perlit is cOlIBnced within six IQnths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six IOntbs after the tile the work is c-.mced. One 90 day extension 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 six IODth period, or the project will be considered abandoned.
WARMING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHMBRCEMBlft' MAY RESULT IN YOUR PAYING !VICE FOR IHPROVEMElft'S TO YOUR
PROPERTY. IF YOU Ilft'EID TO OBTAIN FINANCING, CONSULT WITH YOUR LEIDER OR All A!!ORNEY BEFORE RECORDING YOUR MOTICR OF
COMMEMCEMBlft'. JOBS UIDER $2,500 1M VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENC lft'''
STATE OF FLO~ ~
coum OF ~
The fore.g.oing i~~~tf. as ~~owledged
before me this~, 19LL.- by
~~. --/~
wQiYis P~~~lliJl1l' known to me or who has
produced
as identification
ta e a h
C?
(s;!4-aYTJ/;!zE/V' //-. Cll-P'
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
'I'
KATtLEEN A. CAP
Sate of Florl:!a
tJiC:Ol'lln.Ext :", ',' 1~:3
Cor!\m.;Ie ;'::T,
r--.
/
/
S OF FLORIDA
C m 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 o~th.
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
NOTICE OF COMMENCEMENT
-
kept: 144886 Ree: 6.00
DS: 0.00 IT: 0.00
04/08/97 Dpty Clerk
JED PITT"A., PASCO COUITY CLERK
04/08/97 02:08p. 1 of 1 ~
OR OK 3723 PG .16~O
11111111111I11111 1111111I1111111111111111111111111
97038418
State of
~(.
County of
p.AJ S C' G)
THB tmoERSIGNED 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.
"
(Lega
( ,;< -:26 -till ... OO.S'CJ- (9
escr~pt~on 0 t e property
2. General Description of Improvement
.:2...f~ 7....... ~ C-
ava~lable)
3.
-
Owner Information: Name J ; ~
Interest in Property:
c!fJ ~ ""'..P r
;I~s~
.2-pA,/yl.; -/k
r
State
Fc
Address ? 5' /;;J....o h'" A-v..J2.. City
4.
Name of Fee Simple Titleholder:
(If other th~n owner)
Address ~~~
I
Contractor: Nam~ K- ~ c::; 2.....
Address ? ) r~~ ?7-' /(, .-v5-
Surety: Nilme ~~
Address
7-6?
City
State
5.
C'~ir~
City ZpAL.-; J~/t'<
,/
State /7'
-3!l
City
State
Amount of Bond: $
6.
Lender: Name
~~
Address
City
State
7.
Persons within the State of Florida
notices or other documents may be
713.13(1)(a)(7), Florida Statutes:
l I:) Name .,{, ~", ~ C-'.~
~ I:'lAddress ~t), 4 -<..2.07
designated by Owner upon whom
served as provided by Section
of
Lienor's Not~ce a
In addition to himself,
jL/
City -<'phc/<,-,(t;
/
Owner designates
5< S-?7-.;(~'
StateR
.
8.
to receive a copy of the
~n Sect~on 7 3.13(1)(b), Florida Statutes.
9. Explrat..Lon dnte ot NotIce or Commencement (the expIratIon date is 1 year
fr0m the date of recording unless a different date is specified.)
Signature of Owner:~
Q/2-~f
/
,
Sworn to and subscr
19.92.
Notary Public:
My Commi.ssion Expires:
PC93053048
Kinsey Central
H_t&AIr~, '.~
7718 Fort King H~~., ~'{ 2209
Zephyr-hills, florida ...,
(813) 782-230tr~76y..<'_ 9 f) ? ?
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AIlORESS 6 .- APARTMENT
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IIAllE /_l /RllIAI. 110, IkrESTlMATE
NATURE OF r::> o CASH
SERVICE o CHARGE
REQUEST
OUAN. PART NO. DESCRIPTION PRICE AMOUNT
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TECHNICIAN
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