HomeMy WebLinkAbout97-6885
BUILDING PERMIT N~
Permit
CITY OF ZEPHYRHILLS
(813) 788-6611
68851S
Date
.'1- ,3 t!J ~
r7
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
:::::::~e' ~yf~;$t~
Parcell.D. # J / -:J..L -;)..j- t9 % -- t!'J Y J.-o 0 - 0/ b 0
Water Meter:
T,I.F.'s:
Zoning: Ene~
Description of Work ~ ~ / h X-I)
Radon Gas:
-I- t;7~
/3 X /'-S-
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.
FINAL
DATE
City License Registration # 7 V
State Certified License#
Inspector
P~rmit Fee ~~ ~
Signature ~~ ~
Company
Address
Telephone#
:1
Valuation or
Contract Price
..2 3..s.~, ?TV
"
._~~"ft
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
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 ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER t S NAKE
(70 rfV S C.II et( 1'1- V/If;e..
v
:3 <67V() A./h1L77f /rl/E
,5 /H( L
PHONE
, 7g()
9.3C/~
OWNER'S ADDRESS
JOB ADDRESS
LEGAL DESCRIP'l'ION: LOT(S)
BLOCK
SUBDIVISION
Olf,o
PARCEL 1. D.'
~
WORK PROPOSED:_New Construction _Addition _Alteration _Repair
_Sign
_Move
_Deaolish
PROPOSED USE: _Single Faaily
_KIF
_' of Units _K/H
_~ercial
_Indust.
_Swia. Pool _Other
_Restaurant & Health Department Approval
DESCRIPTION OF WORK: 7iJ I1iJ5'TJttc
If;, '117 ~fol!..T ~ I'3V/~ Ce6ef?a;L(.
,
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL:
COtlMERCIAL :
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.
_BUILDING
$d-~
'0'0
PERMITS REOUESTED
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
--"ECllARICAL
$
Valuation of Mechanical Installation
_PLUMBING GAS ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fraae _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
CONTRACTOR SECTION
RUTU)ER.
~(-f
COMPANY <;;uiJ 8T1/Tl!' i4t.'.J;"1/1() I) ''I
State Cert. or Regist. ,
City License Registration t
******************************************
~L-<-'C
~
~C
Signature
to
F.T.F.CTRICIAN
COMPANY
State Cert. or Regist. ,
City License Registration ,
******************************************
Sig-lUature
PLUMBER
COMPANY
State Cert. or Regist. ,
City License Registration ,
******************************************
Signature
MECHANICAL
COMPANY
State Cert. or Regist. t
City License Registration .
***********~******************************
Signature
OTRF.R
COMPANY
State Cert. or Regist. f
City License Registration f
******************************************
Signature
APPLICATION APPROVED
B~~
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Tbe undersigned understands that this peClit lay be subject to "deed restrictions" wbich lay be lOre restrictive than City
regulations. Tbe undersigned assUles responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has bired 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
requireJents lay apply for the intended work, they are advised to contact the City of Zepbyrbills Building DepartJent, (813)
788-6611.
FurtherlOre, if the owner has bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
"Contractor 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 wishes you to sign
as contractor that laY be an indication that he is not properly licensed and is not entitled to peClitting 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, bave been provided with a copy of .Florida's Construction Lien Law - HOJeowoer's Protection
Guide" prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs. If tbe applicant is sOleone other tban the
.owner", I certify that I bave obtained a copy of the above described dOCUJeDt and prolise in good faith to deliver it to the
"owner" prior to coaenceJent.
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 laws regulating construction, zoning, and land developllent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation bas COIIeDced prior to issuance of a perlit and that all work will be perfoIJed to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developllent regulations in the jurisdiction. I also
certify that I understand that the regulations of other govel1lleDtal agencies laY apply to the intended work, 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:
* DepartJent of BnviroDlental Regulation - Cypress Bayheads, Wetland Areas and InviroDlentally Sensitive Lands,
Water/Wastewater TreatJent
t Southwest Florida Water HanageJent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
* AllY Corps of Engineers - Seawalls, Docks, Navigable Waterways
* DepartJent of Health & Rebabilitative Services, EnvirODlental Health Unit - Wells, Wastewater TreatJent, Septic Tanks
* US EnvirODlental Protection Agency - Asbestos abateJent
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 volUJe" will be sublitted wbicb is prepared by a professional engineer registered in the State of
FlorIda prior to peClit. 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 peClit prevent the Building Official frOJ thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every peClit issued shall beCOle invalid
unless the work authorized by such peClit is COlleDced within six IOnths of issuance, or if work authorized by the peClit is
suspended or abandoned for a period of six IOnths after the tile the work is coaenced. One 90 day extension of tile, laY be
allowed for the peClit 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 IOnth period, or the project will be considered abandoned.
WARNING TO OWNBR: YOUR FAILURE TO RECORD A NO'I'ICE OF COMHENCEMENT HAY RESULT IN YOUR PAYING TWICE FOR IHPROVIHElft'S TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN AT'rORMEY BEFORE RECORDING YOUR NO'I'ICB OF
COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NO'I' NEED '1'0 RECORD AND POST A "NO'I'ICE OF COMMENCEMENT..
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
before me this , 19____ by
STATB 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
(n.t:.Srn!!1~'r1JJ.:. USR ONLY)
rARCEL L D.
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MI' BOVIES OF WATER AND ROAl)WAYS (INCLUDING NAffES) ADJACENT TO TilE PHOPEHTY. INUICATE
1ltE SJZE, yEft..R, "~"l!) Nf_'iEOF MOBILE; SUCH AS 12' ^ 60', In!. FLEETwOOD.
All "EASEMENTS", "RIGHT-Of-WAY" and "JURISDICTIONAL LINES" must be sho\.lll on all site plans.
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A TT AOHED OOVERS . . ~ sS..o~ IIND LOADS AND PRO."SIONS
2. BOCA NA'IlOHAl. IIUIl.IlINO COllE '993
3. 1PAS DEPAR1IIEHT CW "SURANCE WlNOSTORII
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TELEI't10NE: (90.) 767-4"17'
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IIIE DESIGNS AIm SPANS StIOI'oH ON THESE
DRAVoINGS AilE BASED ON nlE LOAD IlEOU,REUE
or THE rOUOVolNG COOES,
I. STANDARD BUILDING COOE 100. ED, CHAPTER I,
fREEST ANDING COVERS ~CLJI.fl!~ ts"rti-'fo'..e~~ VoIND LOADS AND 1'110\15
7, DOCA NAnONAL OUII.D'NO CDOE 199J
J.IOAS OEP""'UWI Of "'svll....n .....051011...
IIES'5''''ICE GIJ'IlE 6-89
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proposal
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V~)8 State r~0ad 54 We<::.t
l['-'HYRfNLS, FL 33C>41
(813) 788.7308
PR?I".CJ~f.J..S.l.l{lMITTED TO
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DATE OF PLANS
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ARCHiTECT
We hereby,.submil specifications and estimates for:
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JOB NAME
JOB LOCATION
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hereby; t~ furnish material and lab~r - cOr11plete in accordance with above specifications, for the sum of:
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Payment to be made as follows:
All material is guaranteed to be as specified. All work to be completed in a workmanlike
manner according to standard practices. Any alteration or deviation from above specifications
involving extra costs will be executed only upon written orders, and will become an extra
charge over and above the estimate. All agreements contingent upon strikes, accidents
or delays beyond our control. Owner to carry fire, tornado and other necessary insurance.
Our workers are fully covered by Workman's Compensation Insurance.
Acceptance of 'roposal- The above prices, specifications
and conditions are satisfactory and are hereby accepted. You are authorized
to do the work as specified. Payment will be made as outlined above,
Date of Acceptance:
Authorized
Signature
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Note: This proposal may be
withdrawn by us if not accepted within
Signature
Signature
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