HomeMy WebLinkAbout97-7314
BUILDING PERMIT 7314
Permit
CITY OF ZEPHYRHILLS
(813) 788-6611
13
Date /;;>. - 9 - c; ?
'10. H
BUILDING
..3 ~ -... tI'b
ELECTRICAL
~--, tiV
PLUMBING
;L.S ---. lJ1)
MECHANICAL
Sewer Conn
Water Conn:
Pmperty Owna" ~
Job Address: 3.. ~ (J .~ J>?L
p."all.D. . ,;2.1 ~- . -~. _ _. - - - t:J 0/ (J 0 - r?--
Zoning: Enej9Y Code: Radon Gas:
DescriPtion of W~ R LJL /Jt. ~d,..{J ~7 ~
Water Meter:
T.I.F.'s:
NO OCCUPANCY BEFORE C.O.
FINAL I)
C.O. /:1-1
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
City License Registration #
State Certified License#
:;t~()
:~;~~:~~
Company
Address
Telephone#
Valuation or
Contract Price
/!~n~
BUILDING
fkq In
~~ o>cUo
PLUMBING
Il..-A d ~
ELECTRICAL
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:
.;1.,.5-- trO
a.
b.
c.
d.
e.
f.
g.
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.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
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APPLICATION FOR PERKlT
CITY OF ZEPHYRBILLS
BUILDING DEPARTMENT
a/fl
I ')-./ I
0IlIlER' S MAIlE t! 1hti'J. eO. *' At.!e7lLy C!.&ft7Ee.. PHONE (/1.3 ) 1ft1-/pS5 Jt 110 h';L-
OWNER'S ADDRESS 356~ Ee-/<i L J.. /9 AJ~
JOB ADDRESS SI9 ftf €
LEGAL DESCRIPTION: LOT(S) -1/ cf .;:J... BLOCK SUBDIVISION
.
PARCEL 1. D.' ~ 1- ,;2t.:.- 02/- /f'n-tJ - n / trtJ (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install
_Sign
--Hove
_Deaolish
PROPOSED USE: L./'Single Fallily
_M/F
_' of Units _M/H
_ec-ercial
_Indust.
_Swia. Pool _Other
_Restaurant lie Health Departaent Approval
DESCRIPTION OF WORK:
PArd; Jl10deL .seT-if
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL :
COMMERCIAL :
ATTACH (2) PLOT PLANS lie (2) SETS OF BUILDING PLANS lie (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUILDING PLANS lie (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTED
~UlLDIRG
$
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
_MECllABl.CAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fr8lle _Steel
Other
FI.RISBED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
BllTl.DER ~ rolifRA::;ECrIO~ o(~
~~ ,,~_ I~ State Cert. or Regist.' --U
Signature 1..1 YC /f.lJ,.e..u City License Registration' cJ.~ 0
************ * ************************** . -
F.1.F.CTRICIAR COMPANY ... --Llee- f!&~
~/ f),() /)/) State Cert. or Regist. t
Signature <. ~ V.:J...e.-evOUfl- City License Registration 1 / Y 7'
******************************************
PLUMBER COMPANY .~ ~~
State Cert. or Regist. 1 - 0
Signature City License Registration f ;J. ::J .30
*************************
/} O/J ~.
COMPANY .1a-~ ~
State Cert~or Regist. 1
City License Registration ,
******************************************
7-S
MECHAIUCAL
Signature ~ IS $ C7tUZ-
OTRF.R COMPANY
State Cert. or Regist. .
Signature City License Registration ,
******************************************
APPLICATION APPROVED BY PERMIT OFFICER.
-.........
- CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RES'rRICTIONS
lb. undor.igool und...laod. lhal Ihi. perall lOy he .ubjocl to 'd.oI ['.I[iclioo.' whieb lOy be IO[. restricli.. than Cily
regulations. rhe undersigned assUles responsibility for co.pliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CON'l'RAC'l'OH RESPONSIBILITIES
if the ....r has hlrol · contr.ctor or conlr'clor. to underlak. ..rl, Ih.y lOy he required to be ii....ed io 'ccordaoca wilb
.1.1. and iocal regul.lion.. If Ih. conlr.clo[ i. nol lic.n..d as [eQoi[ed by I.w, bolb tbe ..... and contractor .., be
clled for · .i.d.....or ,iul.lion und.r .1.1. I.w. If Ih. own.r or inlended conlr,clor .r. uncerlalo as 10 wbal Ilc...tng
r.goir....tv "y .pply for lhe inl.nd.d oorl, Ib.y .r. .d.i..d to conlacl th. Cily of &epbyrbill. Boildlog Departo,ol, (813]
788-6611.
Forlh....r., ii Ih. ....r has bired · conlr'ctor or conlr'Clor., be I. .d.i.ed 10 ha.. the contractor(.) .igo porlioos of lbe
'Cootraclor Socii....' of Ibi. .pplicallon for whieb lhey will he res/lotlSibl.. If 1'00, as lbe "'or olIO as the oootractor,
you are indicaliog 1101 roo, r.ther lion the conlr.clor, .r. r"/lotlSibl. ior th. ..rl. If the contractor wiahes roo 10 .i9O
.. contr.clorlbal ..y he .n iodic'lion 1101 h. i. .01 Properly licensed and i. nol ..Iilied 10 PlIJdtliog pri'ii.... i. lb.
City of Zephyrhills.
C. 'rRANSPORTATION IMPAC'r FEES AND U1'ILITY CONNECTION FEES ""
D. CONSTRUCTION LIEN LAW (CIIAPTER 713, FLORIDA STATUTES. AS AMENDED)
I cerlify thaI I, lb. .ppiicanl, ba.. beeo provided with. copy .f 'Florid.'s Coo.lrocli.. Li.. Law _ 80000w0er'. Proteclion
Goid.' prepared by the Fiorid. Deparloenl of Agricullu[. .nd Coo..... Iff.i... If lbe .ppiicant i. ....... olber than lbo
....or', I cerlify 1101 I ba.. obl.i.oI · copy of the .bo" described doco,,"1 .nd P[OlIi.. I. good f.1th to dell", it 10 th.
"owner" prior to COalenceaent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I c.[llfy 1101 .Ii lb. info[..lloo in Ibi. .pplic'llon i. .ccor.t. and lhal .il ..[1 will be done is coopll.... wilb all
applicable laws regulating construction, zoning, and land develop.ent.
I
Application is hereby .ade to obtain a per.it to do work and installation as indicated. I certify that no worl or
i..I.II.li.. bas ....enced prior 10 i.....c. of . ",.it and that .11 ..rl will be perforooi 10 ...t .looIaoIs of all I...
regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction. I also
corllfy tb'l I nod.r.t.od lhal the r.,ol'lio.. of olbor got......I.1 ....ci.. lOr 8pplr to the lolended ...1, sod that it is
.y responSibility to identify what actions I .ust take to be in co.pliance. Such agencies include but are not li.ited to:
t DepartJent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and BnviroDlentally Sensitive Lands,
Water/Wastewater rreatlent
t Southwest Florida Water HanageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t Ar., Corps of Bngineers - Seawalls, Docks, Havigable Waterways
t DepartJent of Health & Rehabilitative Services, BnviroDlental Health Unit - Wells, Wastewater freatJent, Septic fanks
t US InviroDlental Protection Agency - Asbestos abate.ent
1.180 c.rllfy th.l, If fill ..I.rl.1 is 10 be 0Bed io Flood Zon. '1' or '1,.lc.', il i. ooIerslood!lol. dr.iooge pi..
odd....i.g · 'CUlpOOBaliog ..I.... will be .obollled .bieb I. pr.pared by . prof...I...1 englo"" regi.tered in 1Io Slate of
Florida prior to per.it. issuance.
. I penlit issoed shall be conslroed 10 b. . liceos. 10 proceed wilb the ..rl and oot .. aullority to 'iol.te, canoel alter, .r
..t ..id. .ny pr..I.i... .f !be tecboicai cod", nor .hall is,u,"" of . penlit pr....t the Building Official froo tIoreolter
requiring · "'recti.. .f err.r. io plan., construcli.., or ,i.I.II... of any cole. Every peroit losoed &ball becooe invalid
unl... the ..rl .othorl"" by such POlOil i. ......ced wilbin .i. ...Ib. .f issuance, .r if ..rl aotIori.ed by tie peroit I.
.o&peoded .r .baodooed for · period of .1. ...tbs .ft.r !be tloe the ..rl i. """,,cod. Doe 90 day ..t...l.. of lioe, lOr 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 six IOntb period, or the project will be considered abandoned.
WARHIHG TO ONHIR: YOUR FAILURI TO RECORD A HOnCK OF COHHIHClHKHT HAY RISULT IH YOUR PAYIHG 'fIIICE FOR IMPROVIIIDrS TO YOUR
PHOPIRn. IF YOU IH1'IHD ro OBTAIH FIHANCIHG, COHSULr WIrH YOUR LIHDBR OR AH ArTOMIY BIFOM RECORDING YOUR HarICE OF
COHHIHCEHBHT. JOBS UNDIR $2,5001N VALUI DO HOr NIED TO RECORD AlfD POST A "HOTICI OF COHHIlfCIHlJf1'".
SIGHArURI: OWNIR OR AGIHT
. I
SIGHATURE: COHrRACrOR
STATI OF FLORIDA
COUlt1'Y OF
The foregOing instrument
before me this
was acknowledged
, 19_ by
STATB OF FLORIDA
COUHn OF
The foregOing instrument
before me this
was aCknowledged
, 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