HomeMy WebLinkAbout98-7636
BUILDING PERMIT
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7636
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Property Owne' Z.t < ~
Job Address: Y ~ . r( ~ _ .p-
~ Radon G:/Jj.l
~l A-rf<
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
Date J-s/-9~
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Parcell.D, #
Zoning:
Ener~
L~ --V
DescriPtion of Work
NO OCCUPANCY BEFORE C.O.
FINAL
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
- I fATE
p~'m;'Fe~~
Signature --'--------'-~
Company
Address
Telephone#
Valuation or
Contract Price
.3. g-~ rzro
/
City License Registration #
State Certified License#
py..~
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Tp, Serv,
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
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 ($ ~l shall be made for each trip for each trade:
r1..~';PV
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
.1), (.\<- -A-~~V\.S
175.'5 1<DJ /J!h:S c5~+-
LJ i ~eY-~ Yqy- k
PHONE
;7 '33 -It) ~q3
OWNER · S ADDRESS
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I.D.' (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED: ~w Construction _Addition _Alteration _Repair _Install
_Sign
PROPOSED USE: ~ingle Faaily
_Move
_Deaolish
_M/F
_, of Units _M/H
_~ercial
_Indust.
_Swia. Pool _Other
_Restaurant & Health Departaent Approval
DESCRIPTION OF WORK:
o~ Vi15e-';:L
BUILDING SIZE: X .10 .
diD
Square Feet,
3'
Height ~1- 0 I~ J'f)~ '7Y1tl
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.
~LDING
00
$ '-1 %00-
PERMITS REOUESTED
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
---1fECIlAIITCAL
$
Valuation of Mechanical Installation
_PLUKBING GAS ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fraae _Steel
Other
FIlIISBED FLOOR ELEVAnONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
..........................................
BUILDER
-OONTRACTOR SECTION
~~. lDIPARY CWftJE42
~ -
. State Cert. or Regist. ,
, r City License Registration .
..........................................
Signature
F.1.RCTRICIAR
COMPANY
State Cert. or Regist. t
City License Registration .
......................................***.
SiimAture
PLUKBER
COMPANY
State Cert. or Regist. .
City License Registration .
*....*....*..*.**.*.***.*.......*********.
Signature
MECHANICAL
COMPANY
State Cert. or Regist. ,
City License Registration .
...........**.***.**.*.........**.***.*.*.
Signature
OTRRR
;""."._~""",.,
COMPANY
State Cert.
City Licens
.............**...........*.
Signature
or Regist. t
Y4.,tJ..QJl t .
*.*...**....
'...... "",,~... ~'''f'~'~
~
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APPLICATION APPROVED BY
p
PERMIT OFFlcER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
ThB undersigned understands that this per.it .ay be subject to "deed restrictions" which lay be lOre restrictive than City
regulations. The undersigned assUles 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 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 lay apply for the intended work, they are advised to contact the City of Zepbyrhills 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
.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 than the contractor, are responsible for the work. If the contractor wisbes you to sign
as contractor that lay be an indication that he is not properly licensed and is not entitled to perlitting priVileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
" ~'
D. CONSTRUC'I'ION LIEN LftW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of .Florida's Construction Lien Law _ HDIeOWDer'. Protection
Guide" prepared by the Florida DepartJent of Agriculture and ConsUler Affairs. If the applicant is sOleDne 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
"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 developlent.
I
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no worl or
installation has cOllenced prior to issuance of a perlit and that all work 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 goverDlentaI agencies lay apply to the intended worl, 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 OepartJent of EnviroDleDtal Regulation - Cypress Bayheads, Wetland Areas and InviroDlentally Sensitive Lands,
Water/Wastewater TreatJent
t Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
t Departlent of Health & Rehabilitative Services, InviroDlental Health Unit - Wells, Wastewater TreatJent, Septic tanks
t US EnviroDlental 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 perlit. issuance.
. A perlit 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 tbereafter
requiring a correction of errors in plans, construction, or violations of any code. Bver,'perJit issued sball becOIe invalid
unless the work authoriled by such per.it is cOllenced within sil IOnths of issuance, or if work authorized b, the perJit is
suspended or abandoned for a period of sil IOnths after the tile the work is cOlleRced. One 90 day 8Itension of tile, 18' be
allowed for the perlit 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 sil IOnth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCEHlNT HAY RESULT IN YOUR PAYING flfICE FOR IHPROVIIIIII8 '10 YOUR
PROPERTY. IF INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENOIR OR AN ORIIIY BEFORE RECORDING YOUR MICE OF
ClIIIIEIICIIIIl, T I IN lIIl 00 HOT IIIiIlD TO RRCOlIIJ AIID roSf ~ ~~ . . I
CONT CTORD{-1t -A3:J.-5 - ')33'- Shlo-47o
STATI OF FLORIDA ~ .
COUNTY OF ~ ()
The foregoing :~~t .a. ~~iedged
before me this , 19 by
STATE OF FLORIDA ~
COUNTY OF rq Scv
The foregoing i.ns~ent
before me thiS.~
was aC~ledged
, 19-U.:. by
who is personally known to me or who has
produced
as identification and who did/did not
take an oa~_ yV)Dn!1t .
(Signature) . h~
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.0nlA~ fV)011b:tArll....
(Signature) W:Y I
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
-
CARRIE MONBARREN
Not",,,. Public - State of Florida
My CC'mmi~s'on Expires Apr 23, 2lO1
C0m"Tllsslon # CC64()Ijl42
-
CARRIE MONBARREN
N('lt~~' Pu~f1c - State of FIorIdO
Mv C("~~^'^"on ExpIres Apr 23, 2001
('r ~"T11sslon # CC640942 .
........-
OWNER '. ( ')IL'/~ /1 }i</f/'c~
JOB LOCATION 'l 7 ~;.- S'-- " /-, I C \ L: (//'I c ' ) '7:
, .
PARCEL 1.0. I
SHOW ALL EXISTING. PROP081D STRUCTURIS-GIVING DIMBNSIONS , SETBACKS.
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FRONT PROrlRTY LINK
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U~ILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
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(NOTE EXAMPLES 1 , 2)
STUIT
1. SETBACKS FOR Rl, R2 ZONING
60'
2. SIT8ACKS rOR R3 ZONING
60'
10'
p E-
R X
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10~ P S 10'
0 T
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D G
20'
1 O'
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10' BXISTING' 10'
1 0
PROPOSID
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20,' SGL rAM 30'DUPLEX
'. . t:RONT PROPERTY LINK
fRONT PROPiRTV'LINS
FQR CARpORTS OR L~~I ~T~UCTVRE~ PL~A~E.CO~pLET~ TUE rQL~OWIUP.
( 1 ) DESCRIBE WHAT TYPE: ,: fRBS' STANDING O~ (CIRCLli ONI).
(2) IF ATTACHED, HOW IS IT TO BE FASTENED TO STRUCTURE?
A'7T/.,(/-lEO T"o l?"ITf--:'TIAiG' r)",TI() 1~e>:.::;)I:
-
(3) DESCRIBS POST SPACING' FASTININO (IF TO CONCRBTC, IN WHAT HANNIR?)
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Notllry Pllblic
Stlltp of Floridll nL L/1r,~..
~Iy Cornndssioll Expir('s:
_._-----------~---_._--
Print, Type, or Stnmp Commissioned
NAme of Notnry PubJir:
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Personi11 lv Known
or Produr:p.ci ldpl1tificAt.ion ~;
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CARRIE MeN
Notel'v PUblic BA~EN
My CO"''1''1''Slon E- State Of FIortdo
C .' lCplres Ap .....
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36 X 80 OOOR
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