HomeMy WebLinkAbout97-7346
BUILDING PERMIT 734611
Permit
CITY OF ZEPHYRHILLS
(813) 788~6611
Date
/J.-;)3- ?~
BUILDING
ELECTRICAL
PLUMBING
GCHANI~ Sewer Conn
Water Conn:
i ~
Property Owner: ~
Job Add,.." ci'~; L __ ~ ~ ~-..., ./
Parcell.D. # 61-:l6 -d../ o.:L IlS_ t/ 0 F ()O- c:rD / l)
Water Meter:
T.LF_'s:
Zoning: Energy Code'
Description of Work -AI L- (;~fJ 0
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
b '6
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
DE
Permit Fee ~,... p-o .
Signature ~~~
Company
Address
Telephone#
Valuation or
Contract Price
3/1 gr.3, d()
,
City License Registration # oL;t ?-I
State Certified License#
'-~~.~
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Tp. Servo
Rough In
Meter Can
Con st. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
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 ($ +5:"00) shall be made for each trip for each trade:
~ -"0'0
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.
FLA. 1977 l^WB
F. 713.'3
SEMINOLE FORM 408
NOTICE OF COMMENCEMENT
~:a~~t:f o~lorida } IPR~PARE IN DUPLICATE' 1I111'1I11'1I!~~~~~~11111II1I1111I111I111
The undersigned hereby informs all concerned that improvements will be made to certain real property. and in accordance
with section 713.13 of the Florida Statutes. the following information Is stated In this NOTICE OF COMMENCEMENT.
Description of property _. _1!1I:~.~l:i...# (!?~ 2~ ~(.<?~ I t? ~ Et!P. .t?"P/(?............
Rcpt: 203950 Rec: 6.00
OS: 0.00 IT: 0.00
12/23/97 Dpty Clerk
JED PITTMAN, PASCO COUNTY CLER"
12/23/97 01:46p. 1 of 1
General description of improvements ...................................., _ . . . . . . _ _ . . . . ~~. .~_ . ~~.=?~, . . . . . . .~. . . . . . _ . ~ :3
Owner,..,.. _. k.t!;;; Ift/?.. ~ g;. ~T#................ _ _ _....,.................... _'" _...... _ _........
Add,... ~:2 ff?J 1.a?777;/J/.~<</.t!7? ,~J. /?,. ~. ?-7"/~ r A0-~ ~ ~ ~ ~. .
Owner's interest in site of the improvement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ _ _ . . . . . _ . _ . . _ . . . _ _ . . . . . . . . . . . . . . . . . . . . . . . . . .
Fee Simple Title holder (if other than owner)
Name ....... .__,..__._____. ._____._.___._...,............ ...__........._...__.____.._.... .... ._......_.____._.__..._......_,...
Address _ _ . . _ _ . _ _ . _ . . _ . _ _ _ . . . . _ _ _ . _ _ _ . _ _ . . _ . . . . . . . . . . . . . _ . . . . . _ . . . . , . . _ . . . . . _ _ _ . , . _ _ _ _ , _ . _ _ _ _ _ , _ . . _ _ . . . _ . . . . . . . . . . . . . , _ . . . , . . . . .
..... .~. ".
.Ron"ac,o,.. ~.,2 ?P?7:'::> ~ ~ ~54wli::?~ ~ ~...... ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~.. ~ ~. ~ ~ ~. ~ ~.. ~ ~. ~ ~ ~ ~. ~ ~.
'~" dd,... /{)//-<&!'/~k:c/IMdH~1f~H3~dc22HH
Surety (if any) _.... _ _ _ _ . _ _ _ _ . _ _ _ . _ . . . , _ _ . . . . . . . . . . . . . . . _ . , . . . . . . . _ . _ . _ , . . . . . _ _ . . . . _ . . . _ _ . . _ _ _ . . _ _ . _ _ _ . . . . . _ _ . . . . . . . . . . , _ . . . . . . . .
Address _..... _ _.. _. _ _ _. _.. _ _ _......,..... _................................. _. _.... _ _ _ _ _.... _ _Amount of bond $ ........ _ _.....
Any person making a loan for the construction of the improvements:
Name __._.____..__..._....___.__..._......,......................,........__.........___.__.._......._..,.......................
Address _ _ . . . . . . . . . _ _ . _ . _ _ _ . . . _ . . . . . _ _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ _ . . . _ . . . . . . . . . _ . . . . . . . . . . . . . . . . . . . _ . . . . . . . . _ . . . . . . .
Person within the State of Florida designated by owner upon whom notices or other documents may be served:
Name ...__.__....,.._._..._._.__ .__.._......"._.................__..._._....,__.._._..._....__..__......._..............._....
Address ,'.... _ _ . _ _ _ . . _ _ . . . , _ . . . _ _ . . . . . . , . _ _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . _ _ . . . . . . . . . . _ . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
In addition to himself, owner designates the following person to receive a copy of the lienor's Notice as provided in Section
713.13 (1) (hI. Florida Statutes. (Fill in at Owner's option).
Name
..""""...""..." ..--..."".""."""".... ..-,..--...-"."."..."".""........""".."."""."""""."".".".........."."..".............""...."..
Address . _ , _ _ . _ _ _ _ _ . _ _ _ _ _ _ _ . . . . _ _ _ . _ . _ , . . _ _ _ _ _ . . . . . . . . . _ . _ . . . . _ . . . _ . . . . _ _ . '_.' --'? _ _ _ . . . . . . _ _ _ . . . _ _ _ _ . _ _ _ _ _ _ . _ _ _ . _ . _ _ _ _ . . _ . _ . . . _ . , _
THIS SPACE FOR RECORDER'S USE ONLY
::>TATE OF FLORIDA
cour-n:.v OF PASCO
nllS is ro CCmFY .HI"T TNE FOREGOING IS A
mu(: MoD C0?iLCT coPY ,*C THE l){)('.UMf.:r~T GN FILE
0::: or rUJUC riECOffD iN THIS CfFlCE_ WiTNESS ~,1Y
H[;;;n,lj;! U;FICIAVS~L Hi!S d.3- DAY OF
yL/fJ~19D
JED PiTTMAN, C.lER~IRCUIT C RT
D.C.
/- /j," /:? ~
..~/U-6{--L.~~-'-.-,.-....
Sworn to and subscribed before me this ....... _ , . _ _ . _ . , . _ . _ . . . _ . , . . . . _ ,
~~~~~~~~~.~.~~~~~~.~~~.~...~...~~~~~..~~~~~...~.~~....~~~...~19..~}
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APPLICATION FOR PERKIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTKENT
OWNER'S NAKE Et/C#Z ,5//'1/77/
OWNER'S ADDRESS 33"'70/ GtY 77lJ,v /t/f/7JJ /i:
PHONE ?~~~~30Y-
2~~"<?$@ /C: _
33,-syC
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION
PARCEL 1.0.' 02 2. h2 /1") .:z/cJ oo"..c c+vc41':';;ki'a FRllH PROPERTY T~""l
WORK PROPOSED:_New Construction _Addition _Alteration _Repair Install
_Sign
_Kove
_Deaolish
PROPOSED USE: _Single Faaily
_KIF
_' of Units _K/H
_ec:-ercial
_lndust.
_Swia. Pool _Other
_Restaurant & Health Departllent Approval
DESCRIPTION OF WORK:
BUILDING SIZE:
x
Square Feet.
Height
RESIDENTIAL:
COMKERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS 1& (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUILDING PLANS 1& (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERKlTS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
AKP Service
Florida Power Corp.
W.R.E.C.
-"ECIIANlCAL
$
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
BunnER
COKPANY
State Cert. or Regist. .
City License Registration .
******************************************
Signature
ELECTRICIAN
COKPANY
State Cert. or Regist. t
City License Registration .
******************************************
SionAture
PLUMBER
COMPANY
State Cert. or Regist. t
City License Registration .
******************************************
r "
~ COKPANY s-a//-S ,5~~C/5/
~~) State Cert. or Regist. .
- v / C/" City License Registration' e<;;;;lcZ/
******************************************
Signature
HECBANI~
Signature >
OTRF.R
COKPANY
State Cert. or Regist. .
City License Registration ,
******************************************
Signature
APPLICATION APPROVED BY
PERKlT 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 assUles responsibility Cor cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CON'!'RAC'!'On 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 owner and contractor aay be
cited for a lisde.eanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
788-6611.
Further.ore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
"Contractor Sections" of this application for which they will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, rather tllan 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 CONNECTION FEES
I"
,
D. CONS'l'RUC'!'ION LIEN L1\W (CUAPTER 713, FLOIUDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law _ Hoaeowner's Protection
Guide" prepared by the Florida Departlent 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 docu.ent and pro.ise in good 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 work will be done in co.pliance with all
applicable laws regulating construction, loning, and land develop.ent.
I
Application is hereby lade to obtain a perlit to do work and instailation as indicated. I certify that no worl or
installation has cOllenced prior to issuance of a per.it and that all worl will be perf oIled to aeet 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 other goverDlental agencies aay apply to the intended worl, and that it is
IY responsibility to identify what actions I .ust take to be in cOlpliance. Such agencies include but are not liaited to:
· Departlent of Environaental Regulation - Cypress Barheads, Wetland Areas and EnviroDlentally Sensitive Lands,
Water/Wastewater Treataent
· Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
· Ar.y Corps of Engineers - Seawalls, Docks, Navigable Waterways
· Departaent of Health' Rehabilitative Services, BnvironaeDtal Health Unit - Wells, Wastewater Treatlent, Septic Tanks
· US BnviroDlental 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 .colpensating volUle" will be sublitted which is prepared by a professional engineer registered in the State of
Florida prior to per.it. issuance.
, A per.it 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 is~u~nce of a per.it prevent the Building Official frOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall becOII invalid
unless the work authorized by such per.it is cOllenced within six IOnths of issuance, or if worl authorized by the perlit is
suspended or abandoned for a period of six IOnths after the ti.e the worl is cOllenced. One 90 day eltension of tile, lay 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 lust be logged during each six IOnth period, or the project will be considered abandoned.
WARNING TO OWNBR: YOUR FAILURB TO RBCORD A NOTICB OF COKHBNCBHBNT HAY RBSULT IN YOUR PAYING rwlCK FOR IHPROVEHHIrS TO YOUR
PROPBRTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LBNDBR OR AN ATTORNBY BIFORE RECORDING YOUR NOTICK OF
ClIIIIIIICIIlm. JOIIS UIlDIR 12.500 IN VAW! DO NOI Nm ro IIICfJRD AlID POSr A ?/.... C ~.. .~/
. ~ ~/~/~;(
SIGNATURIl: ONNBR OR AGIlNT SI NATURE: ONTRACTOR
STATI OF FLORIDA
COUNTY OF
The foregoing instrument
before me this
was acknowledged
, 19 by
STATE OF FLORIDA
COUNTY 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 bas
produced
as identification and who did/did not
take an o~th.
(Signature)
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC