HomeMy WebLinkAbout97-7106
BUILDING PE.RM!! 7100
CITY OF ZEPHYRHILLS
(813) 788-6611
Date /l) ~ ..:2/- 9.7
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ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcel I. D. #
cYz;- W~~,tj1~
~ . . Water Meter:
( b'J'1 b;::;.. T.1. F .' s :
Zoning:
Description of Work
Energy Code: 1
~. Rd-Y
Radon Gas:
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.
Permit Fee
Signature v-;
Company
Address
Telephone#
ATE
Inspector
Valuation or
Contract Price
~ J./ 40' ti.2-
City License Registration # 1.1/ 7
State Certified License#
ELECTRICAL
PLUMBING
MECHANICAL
Ftr.
Pre SLB 11- b-97 /ZL~
Lintel
FRM.
Insul. CL
WL
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Driveway j/., ~ - (j 7 ,eLf(
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:
2~-;tlV
Wrong Address
Condemned work resulting from faulty construction.
Repairs or corrections not made when inspection called.
Work not ready for inspection when called.
Permit not posted on job site.
Plans not at job site.
Work not accessible.
a.
b.
c.
d.
e.
f.
g.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
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,5000 ('5 r Fo OT.t:::!R. v...'/ REBI1rf: f IA-I JI\F
/2- -i~()
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT
..:J11Vl
t1 fit? )J/J
AD T 1)/
C tP1 EI?J7J.,D jJ D/;Ur
ADDRESS
PHONE
OWNER
JOB LOCATION
.LeT 'II
[:,IYlE/U1J.D fJOltYr- LOT SIZs..?C X 68 AREA SQ.FT. JLOD
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I.D.4~
Z 0)( "-0 ,5LJ1B
WORK PROPOSED:~New Construction ----Addition ----Alteration ____Repair ____Install
c
~emolish
_Sign/Temp.
_Sign ____Move
PROPOSED USE: _Single Family
~/F _# of Units
.-M/H
____Commercial
~Indust. . ____Swim. Pool
Other
_Restaurant & Health Department Approval
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.**
**COPY OF CONTRACT REQUIRED. '
PERMITS REOUESTED
____BUILDING
$ z.--r~V, cO
Valuation of Total Construction
~ELECTRICAL
AMP Service
Florida Power Corp.
_W.R.E.C.
____MECHANICAL
$
Valuation of Mechanical Installation
____PLUMBIN"G
.-
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ____Block ____Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
CONTRACTOR SECTION I --
.tlll.om i755 C" /1/5 ~ Company 0-':[5 c. v A/S .I
/") ..L-.L, State Cert. or Regist. 4F C~ eo '33~Z.J
Signature Lu~ . City License Registration # /-1')
..........................................
El.ECTRTCIAN
Company
State Cert. or Regist. #
City License Registration #
******************************************
SilZnature
Company
State Cert. or Regist. #
City License Registration #
******************************************
PLUMBER
Signature
.
Company
State Cert. or Regist. #
City License Registration #
******************************************
MECHANICAL
Signature
Company
State Cert. or Regist. #
City License Registration #
OTHER
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 restricti~ns' which- lay be lore res\rictive than City
regulations. The undersigned assuIIIT'lpDnsibiliv,/of 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 tay be required to be licensed in accordance with
state and local regulations. If the contractor il 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 tay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
788-6611. '
Furthertore, if the owner has hired a contractor or contractors, he is advised to have the contractorls) sign portions of the
'Contractor Sections" of this application for which they will be responsible. If y~u, as the ~wner 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 t~ perlitting privileges in the
City of Zephyrhills.
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 C~nstruction Lien Law - HOleowner's Protection
Guide" prepared by the Florida Depart.ent of Agriculture and Consuler Affairs. If the applicant is SOleone other than the
'owner", I certify that I have obtained a copy of the above described doculent and pr~.ise in g~od faith to deliver it to the
'owner" prior to cOllencelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all w~rk will be done in cOlpliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby aade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has cotlenced prior to issuance of a perait and that all work will be perf~rmed to leet standards of all laMS
regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdicti~n. I also
certify that I understand that the regulations of other govern.ental agencies lay apply t~ the intended work, and that it is
ty responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include bllt <11 e 110t lilited to:
I Departltnt of Envitonlental ReQulation - Cypress Bayheads, Wetland Areas and Envir~nlentally Sensitive lands,
Water/Wastewater Treataent .
I Southwest Florida Water "anaaelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
I Departlent of Health L Rehabilitative Services. Environlental Health Unit - W~lls, Wastewater Tr~at.ent. Septic Tanks
I US Environ.ental Protection Aaency - Asbestos abatelent
I also certify that, if fill laterial is to be used in Flood Zone 'A" or "A,etc.", it is understood th~t a drainage plan
addressing a "colpensating volute" will be sub.itted which is prepared by a pr~fessional engineer reqistered in the State of
Florida prior to perlit issu~nce.
A perlit issued shall be construed to be a license to proceed with the w~rk and not as authority to vi~13te, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official fr~. thereafter
requiring a correction of errors in plans, construction, or violations ~f. any c~de. Every permit iss\l~d ;hall becOle invalid
unless the work authorized by such perlit is cOllenced within six lonths ~f issuance, or if work authol lIed by the perlit is
suspended or abandoned for a period of six lonths after the tile the work is commenced. One 90 day e~t~nsiou of tile, lay be
all~wed for the permit 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 lonth period, Dr the pr~ject will be considered dbdlldoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE__________________________________
OWNER OR AGENT
SIGNATURE______________________________
CONTRACTOR
MY COMMISSION EXPIRES______________________
DATE___________________________________
NOTARY AS TO
CONTRACTOR_____________________________
MY COMMISSION EXPIRES
------------------
DATE_______________________________________
NOTARY AS TO
OWNER OR AGENT_____________________________