HomeMy WebLinkAbout97-6681
BUILDING PERMIT N!
Permit
CITY OF ZEPHYRHILLS
(813) 788-6611
668175
Date
r-.v--7)
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BUILDING
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ELECTRICAL
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PLUMBING
MECHANICAL
Water Conn:
Sewer Conn .:."5 I '7.....s -V
lr !/ . .!i 'z)
::":'::'::~d~~~E~
Parcell.D. #
Water Meter:
T.I.F.'s:
Zoning: Energy ~e:
Description of Work '-/J./..,t-J \. :;.-l~
~Gas:
),l,
NO OCCUPANCY BEFORE C.O.
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
City License Registration #
State Certified License#
77
.
p.rm;~ .-S
Signa ur ~.~~.r~/----
Company
Address
Telephone#
Valuation or
Contract Price
/. tf" u-v. (ri.)
c.,~~. 0"-
BUILDING
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tJ; ~J7~ A~ /7
ELECTRICAL
PLUMBING MECHANICAL
~ /}.J/q) '8
Breakers
Ducts Insl.
Compressor
Final
Tp. Servo
Rough In '-I/J.~/q? &~
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Ftr.
Pre SLB
Lintel
FRM. '1/2>/~ 1 iLL
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 PERKIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
A I - C ~
OWNER'S NAKE .AJ kLc= ~ F-oal ~IU JElL
OWNER'S ADDRESS S3S'-J bALLntvi .JJ:. '1 f S?
JOB ADDRESS ~ ArM. ~
PHONE ~ ( 3 - -z- '54.... l..J 1 'f 7
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I.D.' (OBTAIN FROK PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction -^ddition ~lteration ~epair _Install
_Sign
_Kove
_Deaolish
PROPOSED USE: _Single Faaily
_KIF _' of Units _K/H
_eo..ercial
_Indust. _Swia. Pool _Other
_Restaurant & Health Department Approval
DESCRIPTION OF WORK:
...\~ -=t-ItA-l\ ~ wA-llb
BUILDING SIZE:
x
Square F~et,
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.
v~ BUILDING
VELECI'RlCAL
~Gwu.J.CAL
j.,~UMB~NG
$
~
1.8(90
,
PERMITS REOUESTED
Valuation of Total Construction
AMP Service
Florida Power Corp.
W.R.E.C.
$
Valuation of Kechanical Installation
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION:
_Block
_Fraae _Steel
Other
FIllISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
BIITI.DER
******************************************
CONTRACTl!I\ s~ ;/.~
COMPANY LlAJ AJ/A1&HAIl-C. COtJ s1etlL1ld\\.\
'77
COMPANY SA~ ANN 17L'~0Ttl) e-
State Cert. or Regist. .
City License Registration .
****************************************
State Cert. or Regist. .
City License Registration .
***********************************
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/
PLUMBER : i COMPANY NOs.{~s DA~'EIL
...... LJ J. State Cert. or Regist. .
Signature 7Jit.l>'-V.A... ( g-:l!'~ City License Registration t
/ ******************************************
/'1
/
Signature
NJr
COMPANY C2:,1l\AJ--A,NJ -SLt::-er,U L
State Cert. or Regist. .
City License Registration .
************~*****************************
KEGBANICAL
OTRF.R
COMPANY
State Cert. or Regist. f
City License Registration #
******************************************
Signature
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT 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 assOles 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 QWDer 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 Zephyrhills Building DepartJent, (813)
788-6611.
FurtberlOre, if the owner has hired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
"Contractor Sections" of this application for wllicb they wiU be responsible. If you, as the OIfDer sign as the contractor,
you are indicating that you, ratber tllan the contractor, are responsible for the work. If tbe contractor wishes you to sign
as contractor tbat lay be an indication tbat be is not properly licensed and Is not entitled to perlitting priVileges in the
City of Zephyrbills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES I~
D. ~ONSTRucrlrION LIEN fA\W (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law _ HOIeONDer's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If tbe applicant is sOleone 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 COllenCelent.
E. CONTRACTOR I S/OWNER I S AFFIDAVI'l'
I certify that all the inforlation in tbis application is accurate and tbat all work will be done in cOlpliance with all
applicable laws regUlating construction, loning, and land developlent.
1(
Application is hereby lade to obtain a perlit to do work and instailation as indicated. I certify that no worl or
. installation bas cOllenced prior to issuance of a perlit and that all work will be perf OIled to Jeet standards of all laws
regulating construction, City codes, loning 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 wort, 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 Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
Water/Wastewater Treallent
t Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t ArlY Corps of Engineers - Seawalls, Docks, Navigable WateClfays
t Deparllent of Health & Rehabilitative Services, EnviroDlental Health Unit - Wells, Wastewater Treallent, Septic lanks
t US InviroDlental Protection Agency - Asbestos abatelent
I also certify that, if fill lateriaI is to be used in Flood Zone "A" or "A,etc.", it is understood tbat a drainage plan
addressing a "colpensating volOle" 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 sball issuance of a perlit prevent the Building Official frOl thereafter
requiring a correction of errors in plans, construction, or vioiations of any code. Ivery per.it issued shall heCOle invalid
unless the work authorized by sucb perlit is cOllenced within six IOntbs of issuance, or if work authorized by the perJit is
suspended or abandoned for a period of six IOntbs after the tile the work is cOllenced. One 90 day 81tension of tile, lIy be
allowed for the perlit wIth fee cbarge of $15.00. Tbe extension shall be requested in writing to the Building Official. An
approved inspection lust be logged during eacb six IOnth period, or the project will be considered abandoned.
WARNING TO OIINIR: YOUR FAILURE TO RECORD A NOTICE OF COHHENCRHENT HAY RBSULT IN YOUR PAYING TlUCI FOR IHPROVEJIDIS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CO~SULT WITH YOUR LENDER OR AN AnOMEY BEFORB RBCORDING YOUR JfOlICB OF
COHMHNCBHENT. JOBS UNDER $2,500 IN VALUE DO NOT NEBD TO RBCORD AND POST A "NOTICE OF COHIIBNCHMKNT".
SIGNATURE: OIIIlER OR AGENT
, I
SIGNATURE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument
before me this
was aCknowledged
, 19_ by
STATE 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 Dot
take an oath.
(Signature)
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
ftN f(L.-L J rc~ f
C~J -r if-.
CITY OF ZEPHYRHILLS CONNECTION FEES TABLE A - WORKSHEET
ORD. #395/RESOLUTIONS 312/372 WATER $1.75/GALLON SEWER $6.39/GALLON
RESIDENTIAL (Each Lot or Unit)
.
Residence $ 350.00 $1,278.00
Travel Trailer Park 131.25 479.25
COMMERCIAL (PER FIXTURE)
Sinks 87.50 319.50
Water Closet 131 . 25 479.2~
Urinal 87.50 319.50
Lavatory 43.75 159.75
Tub/Shower 87.50 319':.50
Washing Machines-Commercial Size 350.00 1,278.00
Washing Machines-Domestic Size 87.50 319.50
Dishwasher - Limited Use 87.50 319.50
FOOD SERVICE - Dishwasher 700.00 2,556.00
Sinks (3 Compartment) 175.00 639.00
Car Wash (Per Stall) 1 , 000 . 00 6,390.00
FIXTURE G.P.D. # WATER SEWER TOTAL PER FIXTURE
Sinks 50
Water Closets 75
Uri na Is 50
Lavatories 25
Tubs/Showers 50
Wash. Mach.Com. 200
Wash. Mach.Dom. 50 ~71 )D 3lq -0 1107. DO
.'"l
Dishwasher-Comm 400
Di shw.Limt .Use 60
Sinks-3 Comprt 100
Car Wash-p/st. 1 , 000
17, /0 :~),q I 50 ttc I' ~-:-
.)
..
WATER t1ETER
MIA
4u7~ .~~~
GRAND TOTAL
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97043829
Rcpt: 147984 Rec:
DS: 0.00 IT:
04/22/97
.
6.00
0.00
Dpty Clerk
Permi t No.
State of
FLORIDA
HOTJ:CB OF COHMBHCBHBNT
County of
PASCO
TUB UNDERSIGN'SD hereby gives notioe that improvement will be made to CtJt'taih
real property, and in accordanoe with Chapter 713, Florida Statut~81 the i
following information is provided in this Notice of CommenCOIncllt.
~ ..........._~~~,v
1.
~esoription of Property. Parael Ho. 11-26-21.-0010-15400-0050
(Lega
'. ", '. .', J I
2. GttlltU, al DescJ:'!vtion of Improvomcnt Office Interior Renova tions
;
J.
Owner Information. Name Wayne Tanner
; /1 ta./ '0-....:>.'\..1 tL.,. .
Address ~A-L~ \.-Jl-.V \) C.a..J-4'L City ?-ef'~ !2j\J.l ~
Interest in Property. Weinman Trustee
JED PITTMAN, PASCO COUNTY CLERI\..... r
8~/22/97 10:49a8 1 of l:j
BK 3730 PG aao 'il
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Name of Fee Simple Titleholder.
(If other thIn owner)
Address City State.
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Stat~~ '1
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Oontractor. Name Cunningham Construction, (GTady Cunningham)
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Address 12152 Fo:rt
King
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Rd.
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Dade Ci t}l\ 3 35Z ~State . Fl.
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Surety. Name
City
STATE OF FLORIDA
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Amount of Bond. $
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Address City
Persons within the State of Flo~ida
notices or other document. naay be
713.13(1)(a)(7), Fl~rida Statutest
Name
BY
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served
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Lender. Name
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as provided by Seatioh
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In addition to himself, owner designates
State
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of . to, receive e ccpy , . of 'the
' Li'!hor' e Notice ee provided in Section 713 . 13 (111 b,. Florida statut...
~rK~mh "tit i (Jdll Ut"LO fur HOLlduio or clollunouoodlUlUfllfL (Lho eX(Jlraitloll date i8 1 y.ar, J.;~
~. ~ ae a e 0 recor ng un eS8 a erent date s specified.) ~
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Si9na:ureof OWner/bent · ~~,
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Sworn 'to and subscribed before me this ~# day of
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