HomeMy WebLinkAbout97-7010
BUILDING PERMIT
7010
f3
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
Date.
1-30.-1 ~
~ ELECTRICAL
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Parcel I. D. #
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
(JA~
T.I.F.'s:
Zoning:
.--
Energy Code:
KJ2 ~
Radon Gas:
Description of Work
FINAL
//- /9- '1
DATE
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.
DATE
City license Registration #
State Certified license#
t128-:L
Permit F
Signat re
Compan
Address
Telephone#
Valuation or
Contract Price ~ t.j ()?;) . ~
xt~~F --
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
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 ($~) shall be made for each trip for each trade:
,;J...-.6-'t?V
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.
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Phone # (352'567-8580
Bonded and Insured I
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APPLICATION FOR PERKIT
CITY OF ZEPIIYRHILLS
BUILDING DEPARTMEHT
OWNER'S NAME
C-rf/6L
3}?~.3?
.')
15 .1k"~f
/1//;OM /
PHOHE
;7//-c?C:;3;(
OWNER'S ADDRESS
/71/6
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S) BLOCK
PARCEL I.D.' (j;?- db - ;;'/-()(J;;<(J-aJ500- {)ot..fl
SUBDIVISION
(OBTAIH FROM PROPERTY TAX HOTICE)
WORK PROPOSED:_Hew Construction _Addition --..Alteration ~epair _Install
_Sign
~ove
_DeIIOlish
PROPOSED USE: _Single Faaily
_KIF
_' of Units _K/H
_~ercial
_Indust.
_Swia. Pool
_Other
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.(.
DESCRIPTIOH OF WORK:
_Restaurant & Health Departaent Approval
MKuoP {5F &5!{X;A/cE
BUILDING SIZE:
x
Square!Feet,
Height
RESIDEHTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUlLDIHG PLANS & (1) SET EHERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL HEW CONSTRUCTIOH.
_BUlLDIHG
$
PERKITS REOUESTED
03 10(),.. ~ Valuation of Total Construction
. . 1
_ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
--1IEGIIAIO.CAL
$
Valuation of ttechanical Installation
_PLUttBIHG GAS . ROOFING
SPECIALTY
TYPE OF CORSTRUGTION: _Block _Fraae _Steel
Other
FDlISBED FLOOR ELEVAnOHS:
Fr.
IS PROJECT IH FLOOD ZOHE AREA?
******************************************
YES NO
RIJTI.DER
COHTRACTOR SECTIOH
GOKPAHY l- j~HAP6te 2(]()F' AJ (;
, State Cert. or Regist. .
City License Registration .
~,~ ***************************************-
fUr 'kt:; K OJ H
COMPANY
State Cert. or Regist. .
City License Registration .
******************************************
Signature
RI.RGTRIGIAII
Sian,.ture
PLUMBER
COMPANY
State Cert. or Regist. .
City License Registration .
******************************************
Signature
KEGBARICAL
COMPANY
State Cert. or Regist. .
City License Registration .
******************************************
Signature
OTRRR
COMPANY
State Cert. or Regist. t
City License Registration t
******************************************
Signature
APPLICATIOH APPROVED BY
PERKIT 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 OlDer and contractor laY be
cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
reguirelents lay apply (or 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 ot the
"Contractor Sections" of this application (or which they will be responsible. If you, as the OlDer 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 per.itting privileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNKCTIONFEES
{
{
D. CONSTRUCTION LIEN L~W (ClffiPTER 713, FLORIDA STATUTES~ AS AMENDED)
I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law - HoIeoIDerts Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsOler Affairs. If the applicant is sOIeone other than the
"owner", I certify that I have obtained a copy of the above described doeulent and prolise in good faith to deliver,At bfthe
"owner" prior to COllenCelent.
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, loning, and land dev~~oplent.
Application is hereby lade to obtain a perlit to do work and instailation as indicated. I certify that no work or
installation has cOIIenced prior to issuance of a perlit and that all work will be perforJed to leet 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 otber goverDlental 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:
t Departlent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroRleRtally Sensitive Lands,
Water/Wastewater Treallent
t Southwest Florida Water Hanagelent District - Wells, Cypress Biyheads, Wetland Areas, Altering Watercourses
· 'Ar.y Corps of Engineers - Seawalis, Docks, Navigable Waterways"
· Departlent of Health' Rehabilitative Services, InviroDlental Health Unit - Wells, Wastewater Treatlent, Septic Tants
· US InviroDlental 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 "cOlpeDsating volOle" will be sublitted which 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 the work and not as autbority to ,iolate, cancel alter, or
Bet aside any provisions of the technical codes, nor shall is~u~ce of a perlit prevent the Building Official trOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every plrJit issued &ball beCDII Invalid
unless the work authorized by such perlit is cOll9nced within Sil IOnths of issuance, or if work autboriled by the petitt is
suspended or abandoned for a period of sillOnths after the tile the work is cu.enced. One 90 da, utension of tille, ., be
allowed for the perlit with fee charge of $15.00. The I!Itension shall be requested in writing to the Building Official. An
approved inspection lUSt be logged during each sil IOnth period, or the project will be considered abaodoDed.
NAMING TO OIfIIER: YOUR FAILURB TO RBCORD A NOTICB OF COINICIHINT MAY RESULT IN YOUR PAYING "'ICE FOR IHPROVIIIIIIS TO lOOK
PROPERTY. IP YOU INTI TO OBTAIN FINANCING, CONSULT WITH YOUR LENDBR OR AN ATTORlIY BIFOHl RBCORDIIG YOUR IOnCE OF
COMMBNCIHBNT. J NO $2 500 I L DO NOT NEBD TO RBCORD AND POST A "NOTlC CIHIIfT" . . )?
~
~f Gf.f'1f
STATI OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
before me this , 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 not
take an oath.
(Signature)
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC