HomeMy WebLinkAbout97-6845
BUILDING PERMIT
b}U.
c;ECTRIC~
CITY OF ZEPHYRHILLS
(813) 788-6611
gt2.::
(~LUMBIN~
Permit
tl!
. 6845~
.....,
/';:1)
~
Date
7-/5"- 97
Property Owner:
Job Address:
~..Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
NO OCCUPANCY BEFORE C.O.
FINAL
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Permit Fee
Signature /'
Company
Address
Telephone# /"t?/3 ' C} f, 2.- o~ "/ y
Valuation or )L () GJ
Contract Price ?f-' d?; ;2 0 t) '" ~
~
SLB 1,111 ,q? eLg
Tub Set
Water
Sewer
Final
M~
Break: ~
Ducts Insl.
Compressor
Final
BUILDING
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Driveway
~ ~11-~1 ~
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
3~ 'l/dS-Ql ~
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.001 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 ZEPBYRBILLS
BUILDING DEPARTMENT
~0/P~~
OWNER · S NAHE
3-1\ v-'\,~.\. .; 0c/lfl< (?..h"~6B
~ /0 7 ,Uo~" ~L'C K
PHONE
OWNER' S ADDRESS
~ )D) 1~~l)(K~ ~/C
LEGAL DESCRIPTION: LOT(S) q BLOCK SUBDIVISION sr ~h c:./^...J:S ~ A.J AI
SI / t.J ell CJ1 J::s
PARCEL 1.0.' D S. Gk. .2/- 01 )U. 0Cfl:.X) 'CC>; 0 (OBTAIN FROM PROPERTY TAX NOTICE)
JOB ADDRESS
WORK PROPOSED:_New Construction ~tion --.Alteration _Repair _Install
_Sign --.Hove _Deaolish
PROPOSED USE: _Single Faaily --.H/F _' of Units --.H/H
_eo..ercial _Indust. ~im. Pool _Other
_Restaurant & Health Department Approval
DESCRIPTION OF WORK:
S~\~~\",-\ ~~ S b~, t
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.
~ e.9.
J-1, ;JOO
~.
PERMITS REOUESTED
_BUILDING
Valuation of Total Construction
_ELEC'fRI.CAL
_MEClWiIGAL
AMP Service
Florida Power Corp.
W.R.E.C.
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fralle _Steel
Other
FIRISBED FLOOR ELEVAnONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
BUlI.J)ER
YES NO
..........................................
, tP(j,UW
CONTRACTOR SECTION ~ ~ 01 '" . J
COMPANY U, II D Pc:u{ S 7' ...:>c. CflVL 1<-,5, P ~ff ~
State Cert. or Regist.' C PC.JOI ~R ~
City License Registration' 1/
..........................................
Signature
omRR
Signature 0:
COMPANY.J:tA t.U/(., 11 S cl e.c:trl CA.. ~ Sf V .
State Cert. or Regist. , E~~~""Z-~L
City License Registration . /alL-
.........::...f,~:.P:;,i;( ~ elL" P. ~7Y )
State Cert. or Regist. ,
City License Registration' II J
..............................tt ~........... '. ,-
COMPANf=.-- k0. ro fr,,-..-j,,-- ((~~ 4 .i~5 /~ ~c7?iC )
~
State Cert. or Regist. ,
City License Registration ,
...........~..............................
COMP -::>>7~. r:J:i7rlC;Y ~,,),;.lA/C./""<JA~.
ate Cert. or Regist. .
City License Registration ,
...........................
ELECTRICIAB
PLUMBER
Signature
MECHANICAL
Signature
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undetsigned 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 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 lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requirelents lay apply for tbe intended work, they are advised to contact tbe City of Zepbyrbills Building Departlent, (813)
788-6611.
FurtberlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
"Contractor Sections" of this application for whicb 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 Zepbyrbills.
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 - HOIeOWDer's Protection
Guide" prepared by tbe Florida DepartJent 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 docOlent and prOlise in good faith to deliver it to the
"owner- prior to couencelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in tbis 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 installation as indicated. I certify that no work or
installation bas cOlleDced prior to issuance of a perlit and that all work will be perforled to teet standards of all laws
regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also
certify that I understand that the regulations of otber goveIDJeDtal agencies lay apply to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to:
A DepartJent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDJentally Sensitive Lands,
Water/Wastewater TreatJent
* Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
* ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
* DepartJent of Health & Rebabilitative Services, EnvirODJeDtal Health Unit - Wells, Wastewater TreatJent, Septic Tanks
A US BnvirODlental Protection Agency - Asbestos abatetent
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 volOle- will be subtitted whicb 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 perlit prevent the Building Official frOJ thereafter
requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall becOle invalid
unless the work authorized by such perlit is cOlleDced within sil IOnths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of sillOnths after the tite the work is co.enced. One 90 day extension of tite, Jay 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 JODtb period, or the project will be considered abandoned.
WARlHNG TO OVID: YOUR FAILURE TO RECORD A IIOTICE OF COMMENCHHHIIT HAY RESULT IN YOUR PAYING TWICE FOR IHPROVHHHRTS TO YOUR
PROPERTY. IF YOU IIITBND TO OBTAIN FINANCING, COIISULT WUH YOUR LBJlDBR OR AN ATTOIIDY BBFORH RECORDING YOUR MorICE OF
COHHEIICEHBNT. $2,500 IN VALUE DO NOT NIID TO RBCORD AND POST A "NOTI COMMENCHHHIIT" .
~&-
S
STATB OF FLORIDA ~J
CmmnOF ~O~~/
The foregoing inst~ent was acknowledged
before me this ~--I~ , 19~ by
STATB OF FLORIDA ~ i ~
COUNTY OF (~J.....) 9'
The foregoing instrument was acknowledged
before me this ~'-/S , 19 ~7 by
-/I -
/.J/i . \ . () ~_ ,--- _
~.~e..AL.S 'I .\C~~ u~
who ~rsonallY ~W9 to me or who has
produ ...
as identification and who did/did not
take.~ &
~ . 41fi~~
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
ABOBBIK.BLVMENBERG
~~~!!bIIc. Stlte of FIoridl
~1 """"". e.".r.. 1/2:J12000
No. CC 121702
Bonae! Thru lIfltNr )(atxrt ~t
1-(800) 723.0121 I
"
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
ABOBBIK.BLVMENBERG
Notary Public. Stale of Florida
My COmm. Ellpires 1/2312000
No. CC 121702
Bonded Thru tlfftNl )('atlrrv ~z
1-(800) 723-0121
."-"1 wi 'I\lil V" 1"lliliVj.I.l.lil IV"V I, w \/1' 14.w'/
wlwU'tIVIIV't
, li I ww\lV..v..
'.
POOL ENCLOSURE AFFIDAVIT
,
It'is understood and aareed that the OWNER will comply with the 'folloWing
resulations conceminl pool enclosurel:
1. That immediately upon completion of pool construction the OWNER shalll
"
a. Construct around the pool a four foot hlah fenc~ with self latchin,' ,:'", ':','
aates with no openinal larae enough to admit 8 ff)ur inch sphere, or, ',',
b. Construct a screen enclosure around the pool which i. permitted by the
Pasco County C~Dtral P.rmitting Division.
2. That one of the enclosures described above will be completed prior to final'
inspection of the pool. '
'3. That the OWNER will require his pool contractor and screen enclosure
'contractor (if applicable) to call to~ . final inspection immediately
follo~ln8 the structures completion. '
4. If the following conditions are found on the property, it lhall compri.e
presumptive evidence that the OWNER ia in violation of Section 315 of the
Standard SW~inl Pool Code and Section 530.4-0 of the Pasco County Land
Development leaulational
a. More than seven days have passed since all work wal completed on the
pool st~cture except for a final inspection, and"
1) A fence or pool enclosure as described above is,not in place, or
.
:
2) Work to build a fence or pool enclosure a8 described above has not
commenced and is proceeding in good faith, or .
b., The pool is being used for swlmmina or bathing purposes without a fence
or screen enclosure, as described above.
S. That a violation of Section 315 of the Standard Swimmina Pool Code or
Section 530.4.D of the Pasco County Land Development Regulations ,hall
reeult in the issuance of 8 "Notice of Violation" to the OWNER by the Pasco
County Building Official, and may result in a fine not to exceed $500 for
each ~ythat the violation exiets.
6. If the lignature of the OWNER'S AGENT appears below, the AGENT promises in
good faith to make the OWNER aware of the above described requirelDents lillrl
penalties before commencing construction.
~,
"-"'<::.....-
.~~~~~
OR AGENT" SIGNATURE
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PLtASg TYPE OR PRINT NAM€ ABo
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/' THE POOL PROPOSED FOR CONSTRUCTION AT 1'HE AilOVE ADDRESS
DOES NOT CONFLICT WITH ANY UNDERGROUND OR OVERHEAD FACILITIES OF
FLORIDA POWER CORPORATION. PROVIDED THAT THE POOL IS INSTALLED IN
THE LOCA1"ION SHOWN ON 'fHe Al"ACHED SITE PLAN PROVIDED TO US Uj'
THB POOL CONTRACTOR. ...
,
. THE POOL PROPOSED FOR CONSTRUCTION AT TJ-m AlJOVE ADDRESS
DOES CONFLICT WlTH OIH U/O FACIUTIES OF 'FLORIDA J>OWU<
COIUJORAnON.
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ARRANGEMENTS HAVE BEEN MADE WITH US FOR RELOCATION OF THE
FACi"LI11ES SO AS TO CLEAR THIl POOL AREA SHOWN ON THE A1TACHED SITE
PLAN.
~. ~. ....
. 0' NoTE.:'. YDU Af6 fMs./~ EI &ur Pole. G.ft.uAl'- S.&M1SWI JtJ~ s~ 0/4(S ~ fl~
0,". AU:,
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FLORIDA POWER COJU>QRA TION
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':.: :.;.....
, ~ I. ~ tJ o/i-rtfl
Sl"~'{EN F. DUNNER
DISTRiBUTION ENGINEERING
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APPLICATION FOR PERKIT
CITY OF ZEPHYRBILLS
BUILDING DEPARTMENT
<(i6
. 0 ~91
7-f
OWNER'S NAKE C___halA..~~
OWNER'S ADDRESS L, i- () -=t- "-.)
JOB ADDRESS Srirr..p_
LEGAL DESCRIP'l'ION: LOT(S)-.:)
PHONE
L d 'Le \) f .
~~.~ Gk.r, ~
BLOCK SUBDIVISION Si \ve<' L'd jLe....
PARCEL I.D.' 03 -:;l.lp - Z. ( - 0 lSo - 00000 - 00<(0 (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:-X-New Construction _Addition ---.Alteration _Repair _Install
_Sign
_Hove
_Deaolish
PROPOSED USE: _Single Faaily
_H/F
_' of Units ~H/H
_Swia. Pool XOther ~
_<=<-ercial
_Indust.
_Restaurant &: Health DeparUlent Approval
DESCRIPTION OF WORK: C~-* O-Q.~. ~ ~. ~ ...L4C.
~p~
BUILDING SIZE: 3/' X 33', / 02 ~ Square Feet. Height
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORKS.
ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORKS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERKITS REOUESTED
LBUILDING
$
Valuation of Total Construction
_ELECTRICAL
AIIP Service
Florida Power Corp.
W.R.E.C.
~GBAliICAL
$
Valuation of Mechanical Installation
_PLUHBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fraae _Steel
A-lu.rYl ·
Other
FIlIISBED FLOOR ELEVATIONS:
Fl' .
IS PROJECT IN FLOOD ZONE AREA?
YES NO
..................................**..****
CONTRACTOR SECTION
BUTIJ)ER
~ V ~ COMPANY
. . State Cert. or Regist. . -P~D~-=t-4'-t3
-- Hr'". C"O.......~(.Ac.-fi 0<\ City License Registration' 14--:rz..
**..*...*.***************.*.*.************
Signature
RJ.RCTRTGIAN
COMPANY
State Cert. or Regist. .
City License Registration .
.*.*..*.*.*..*.**********....*.***********
SiRQAture
PLUKBER
COMPANY
State Cert. or Regist. .
City License Registration .
*...*....*.*..****..****.***..************
Signature
KEGBANICAL
COMPANY
State Cert. or Regist. f
City License Registration .
.*..*..**.*..***********.*.*.*..********.*
Signature
OTRRR
COMPANY
State Cert. or Regist. .
City License Registration .
.....*....*..***********........**********
Signature
APPLICATION APPROVED BY
PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this per.it lay be subject to "deed restrictions" which lay be lOre restrictive than City
regulations. The undersigned assUles responsibility for co.pliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they .ay be required to be licensed in accordance with
state and local regulations. If the contractor is not licensed as required by law, both the ONner and contractor JaY 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 tbe intended work, they are advised to contact the City of Zephyrhills Building DepartJent, (813)
788-6611.
Furtberlore, if the ONner has hired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
"Contractor Sections" of this application for whicb they will be responsible. If you, as the OlDer sign as the contractor,
you are indicating that you, ratber than the contractor, are responsible for the work. If tbe contractor wishes you to sign
as contractor that lay be an indication tbat 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 "t'
D. CONSTRUC'l'ION LIEN L'.AW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, tbe applicant, bave been provided with a copy of "Florida's Construction Lien Law - HOIeOMDer's Protection
Guide" prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs. If the applicant i8 BOIeOne other than the
"owner", I certify that I bave obtained a copy of the above described ducu.ent and pro.ise in good faith to deliver it to the
"owner" prior to coaenceJIent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all tbe inforlation in this application is accurate and that all work will be done in COIpliance with all
applicable laws regulating construction, loning, and land developlent.
I
Application is hereby lade to obtain a per.it to do work and instailation as indicated. I certify that no worl or
installation has cOIIenced prior to issuance of a perlit and that all work will be perf OIled to Jeet standards of all lars
regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I al80
certify tbat I understand tbat tbe regulations of otber governlental agencies laY apply to the intended worl, and that it is
IY responsibility to identify what actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to:
* DepartJent of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
Water/Wastewater TreatJent
* Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
* AllY Corps of Engineers - Seawalls, Docks, lavigable Waterways
* DepartJent of Healtb , Rehabilitative Services, EnviroDlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
* US EnviroDlental Protection Agency - Asbestos abateJIent
I also certify that, if fIll .aterial is to be used in Flood Zone "An or nA,etc.", it is understood that a drainage plan
addressing a "cOIpensating volUle" will be sub.itted wbicb is prepared by a professional engineer registered in the State of
Florida prior to per.it. 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
Bet aside any provisions of tbe technical codes, nor shall is~u~nce of a per.it prevent the Building Official frOJ thereafter
requiring a correction of errors in plans, construction, or violations of any code. Ivery petlit issued &ball beCOle invalid
unless the work authoriled by such perlit is cOlIBnced within sil IOntbs of issuance, or if worl autboriled by the petlit is
suspended or abandoned for a period of sillOntbs after the tile the work is cc.enced. One 90 day Bltension of tile, Jay be
allowed for the per.it with fee charge of '15.00. The extension shall be requested in writing to the Building Official. An
approved inspection .ust be logged during each sillOntb period, or tbe project will be considered abanc1oned.
WARMIIG TO OWIIR: YOUR FAILURE TO RECORD A 10TlCE OF COMMEICRHRIT HAY RESULT II YOUR PAYlIG niCE POR IHPROVIIIIIIS TO YOUR
PROPERTY. IF YOU INTEID TO OBTAII PlIAICIHG, CONSULT WITH YOUR LEIDER OR AN AnORIKY BIFORB RBCORDIBG YOUR 1IO'fICB OF
COMHKICEHKIT. JOBS UIDER '2,500 II VALUE DO lOT IEED TO RECORD AID POST A "IOTICE OF COHHRICKHiMT".
: I
SIGIAtURE: ONNER OR AGEIT
SIGIATURE: COITRACTOR
STATE OF FLORIDA
COUITY OF
The foregoing instrument
before me this
was acknowledged
, 19_ by
STATE OF FLORIDA
COUITY 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 bas
produced
as identification and who did/did not
take an oatb.
(Signature)
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