HomeMy WebLinkAbout98-7516
BUILDING PE"RMIT 7516
Permit
CITY OF ZEPHYRHILLS
(813) 788-6611
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Pmperty owne'~~ Qo-<lliJ_. <0 .
Job Address: __~ \~
Parcell.D. # .;;J4-C;H::J-dJ- C)noO-6JCJJOO - a>Z~(]
Zoning: Energy Code: Radon Gas:
'?i I ~ ~r~_
Date
~~ d3-98
EL~
PL~
MsPi~
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
DescriPtion of Work
NO OCCUPANCY BEFORE C.O.
FINAL ~
DATE
C.O.
DATE
Inspector '/1
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Valuation or :If
Contract Price '/3 I ~. 00
Pe'm;t Fee ~}"P2:-T-r-C'"
City License Registration #
State Certified License#
70
Signature
Company
Address
Telephone#
f~~
BUILDING
ELECT~L
/
PLUM~G
MECH~AL
Ftr.
Pre SLB
Lintel
FRMo
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 ($16.0&1 shall be made for each trip for each trade:
,:L.!:,-. i7V
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.
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER'S NAKE
;Rlk-Pff
LAr tP 'l
,
5' fflt:.
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PHONE
t:/AJ r
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OWNER'S ADDRESS_.
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
BLOCK.
SUBDIVISION
PARCEL I. D. f C?-C(.:2~ d.-( ~<:0 6 () I () () t'J.?-W (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ~Install
____Sign
-",ove
____De.olish
PROPOSED USE: ____Single F8IIily
____M/F
____, of Units ____M/8
____C~ercial
____Indust.
____Swia. Pool _Other
____Restaurant & Health Department Approval
DESCRIPTION OF WORK: /0 1~5?;f-(L
BUILDING SIZE: CZ X / i) , 50
i:j5(ro Ike~ S;/I€l>
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.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
I?;I rt .a)
PERMITS REOUESTED
____BUILDING
$
Valuation of Total Construction
____ELECTRICAL
AKP Service
Florida Power Corp.
W.R.E.C.
____MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUGTION: _Block ____Fr8JIe ____Steel
Other
FIRISHED FLOOR ELEVATIONS:
FT.
IS PROJEGT IN FLOOD ZONE AREA?
YES NO
..........................................
CONTRAGTOR SECTION
BUilllER/;::~~ =~ert. ~D~~:: f
Signat~ (~!::. ....-- ~_. City License Registration f
-.-........ ... ............. ... .................. .....
;Ie: CI /( IIf.! t/!( ~
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ELECTRICIAR COMPANY
State Cert. or Regist. ,
SiRDature City License Registration t
..........................................
PLUMBER COMPANY
State Cert. or Regist. f
Signature City License Registration t
..........................................
MECHANICAL COMPANY
State Cert. or Regist. t
Signature City License Registration .
..........................................
OTHRR COMPANY
State Cert. or Regist. ,
Signature City License Registration .
..........................................
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 restrictions" which .ay be lOre restrictive than City
regulations. The undersigned assu.es 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 ONner and contractor tal be
cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requiretents lay apply (or the intended work, they are advised to contact the City of Zephyrbills 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 of the
DContractor 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 than the contractor, are responsible for the work. If tbe contractor wishes you to sign
as contractor tbat lay be an indication tbat be is not properly licensed and is not entitled to perlitting priVileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
I ~I
,
D. CONSTRUC'I'ION LIEN L1\W (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - HoIeoIner's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is SOleoDe other than the
"owner", I certify that I have obtained a copy of the above described doculent and prolise in good faith to deliver it to the
DownerD prior to COllenCelent'
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infor.ation in this application is accurate and that all work will be done in cotpliance with all
applicable laws regulating construction, Joning, and land developlent.
I
Application is hereby lade to obtain a perlit to do work and instailation as indicated. I certify that DO wor1 or
installation bas COIIenced prior to issuance of a perlit and that all work will be perfofl8d to teet standards of all laws
regulating construction, City codes, Joning regulations, and land developtent regulations in the jurisdiction. I also
certify that I understand that the regulations of otber goverDlental agencies .ay apply to tbe intended worl, and that it is
IY responsibility to identify what actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to:
t Departlent of Environtental Regulation - Cypress Bafbeads, Vetland Areas and Bnvironaentall, Sensitive Lands,
Vater/Vastewater Treatlent
t Southwest Florida Vater Hanagetent District - VeIls, Cypress Bayheads, Wetland Areas, Altering Vatercourses
t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
t DepartJent of Healtb & Rehabilitative Services, BnvirODlental Health Unit - VeIls, Vastewater freattent, Septic lanks
· 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 voluteD will be sublitted which is prepared by a professional engineer registered in the State of
Florida prior to perlit. issuance.
. A perlit issued shall be construed to be a license to proceed witb the work and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall is~u~ce of a perlit prevent the Building Official frOt thereafter
requiring a correction of errors in plans, construction, or violations of any code. Bvery perlit issued shall beCOle invalid
unless the work authorized by such perlit is cOllenced witbin six IOnths of issuance, or if IOrk authorized by the perlit is
suspended or abandoned for a period of six IOnths after the tite the worl is cOllenced. One 90 day 81tension of tite, lay be
allowed for the perlit with fee charge of '15.00. Tbe extension shall be requested in writing to the Building Official. An
approved inspection lust be logged during each six IOntb period, or the project will be considered abandoned.
WARMING TO OIlIER: YOUR FAILURE TO RECORD A NOTlCR OF COHHBNCIHBNf HAY RESULT IN YOUR PAYING !VICE FOR D1PROV111BIIS TO YOOR
PROPERTY. IF YOU INTHND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN AnORIBY BEFORB RBCORDING YOUR KOIICI OF
COHHENCEHRNT. JOBS UNDER U,500 IN VALUR DO NOT NEED TO RECORD AlfD POST A 'NOTICB OF COHHBNCBMiNT".
SIGlAIURK: ~~~~,~ SI_:~~~EIA I
STATE OF FLORIDA f;;
COUNTY OF S CO
The foregOing instr~ent.was acknowledged
before me this ~ )-0 , 19 ~ by
(
STATE OF FLORIDA 0
COUNTY OF r ~O;J .
The foregoing instrument was aCknowledged
before me this , 19_____ by
who is personally known to me or who has
produced
as identification .~nd w~id/dld nnt
take an oa~~ ~~
(Signature) ( .
who is personally known to me or who bas
produced
as identification ~~o
take an oath. ~~
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLTr
.......... KEITH CORREIA
l~~~>!\..f~~ MY COMMISSION' CC 451416
:*: :*~ EXPIRES' May 13 1999
~.. ;J: .,
..~ OF ~~~~., Bonded TIvu NolIIy PubIlc lJnderwritlll
"Ilftt'"
(Name Typed,
NOTARY PUB
). MY COMMISSION' CC 451418
~} EXPIRES: May 13. 1999
s.l BondId Thru NoIIIy PublIc ~
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SUN STATE ALUMINUM, INC.
37528 State Road 54 West
ZEPHYRHILLS, FL 33541
(813) 788-7308
CUSTOMER'S pRDER NO.
NAME
PHONE () _ ~ ;Z ;;-s
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SOLD BY
PAID OUT
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RECEIVED BY
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All claims and eturne goods must be accompanied by this bill.
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B PRODUCT 61
L
I Ness J To Reorder Call
1-800-225-6380
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