HomeMy WebLinkAbout98-7646
BUILDING PE_RMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
7646 !3
Date
J.j-~-7~
e ELECTRICAL PLUMBING MECHANICAL
"'operty Own., !Ii ~tf. Q~-
Job Address: ;S ~ '- d!- <;IJ ~ ~ S-
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Parcel J. D, #
Zoning: --r-jnergv. Code:
Descriotion of Work ......,d.,( t7 :I ___'? X 0
Radon Gas:
FINAL
~-
NO OCCUPANCY BEFORE C,O,
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances.
c.o.
DATE
Inspector
City License Registration #
State Certified License#
Permit Fee ~ t7-I)
Signature ~ r b7'1.. !~'~4
, /
Company
Address
Telephone#
Valuation or
Contract Price
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d)..-. .Nl..t;7./L....
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Ftr.
Pre SLB
Lintel
FRM,
Insul. CL
WL
Tp, Servo
Rough In
Meter Can
Con st. 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 ($.1-5-:00) shall be made for each trip for each trade:
~-: c:7Z)
a, Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called,
d, Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site,
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
CITY OF ZKPHYRHILLS BUILDING DEPARTMENT
OWNER
JOB LOCATION
PARCEL I.D.' #
SIIOW ALL EXISTING & PROPOSED STRUCTURES GIVING DIHENSIONS & SETBACKS.
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UTILITY UILDINGS
MUST S OW SIZE &
FOUN ATION INFOR-
MATION.
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(NOTE EXAMpt~ s 1 Or 2 )
- - ---:-:-~:,::.~_:__..-
STRE"ET
-'
1, SETBACKS FOR Rl, R2 ZONING
60'
10'
P E-
R X
0 I
10' P S 10'
0 T
S I
E N
D G
20'
2, SETBACKS FOR R3 ZONING
60'
1 0'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30'DUPLEX
1 0'
FRONT PROPERTY LINK
FRONT PROPERTY LINE
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER'S NAKE ;t1 / L T cJAJ C-
OWNER' S ADDRESS .387;'-/ Cfi- E
./J~
,
~A YVES
X~45
PHONE 5'/3 - 785'- 8~6cf
~ c:7~J5~
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
s-
BLOCK
SUBDIVISION
PARCEL 1. D.'
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction ~ddition ----..Alteration _Repair _Install
_Sign
_Move
_Deaolish
...--:
PROPOSED USE: _Single Faaily
_M/F
_, of Units _M/H
_ec-ercial
_Indust.
_Swia. Pool _Other
DESCRIPTION OF WORK:
srle,4D
BUILDING SIZE: 3
_Restaurant & Health Departaent Approval
~)~ />2)/ ~c2..
3x~
x~,
JJ.~""7
,
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,
PERMITS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
W,R.E.C.
--"ECHARICAL
$
Valuation of Mechanical Installation
_PLUKBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fraae _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
******************************************
YES NO
CONTRACTOR SECTION
BIJTI.DER
COMPANY
f~ c? State Cert. or Regist. ,
~ City License Registration t
/ * ****************************************
Signatur~~
ELECTRICIAN
COMPANY
State Cert. or Regist. ,
City License Registration ,
******************************************
SiimAture
PLUKBER
COMPANY
State Cert. or Regist. ,
City License Registration t
******************************************
Signature
KECHANlCAL
COMPANY
State Cert. or Regist. ,
City License Registration ,
******************************************
Signature
OTHF.R
COMPANY
State Cert. or Regist. ,
City License Registration ,
******************************************
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 restrictions" which lay be lOre restrictive than City
regulations. The undersigned assWles responsibility for cOlpliance with allY applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CON'l'RAC'l'On 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 IaN, If the owner or intended contractor are uncertain as to wbat licensing
reguirelents lay apply for the intended work, they are advised to contact the City of Zephyrbills Building Departlent, (813)
788-6611.
Furtberlore, if the ONner has Ilired a contractor or contractors, he is advised to have tile 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, ratller than the contractor, are responsible for the work. If the contractor wisbes you to sigo
as contractor that lay be an indication that he is not properly licensed and is not entitled to perlittiog privileges in the
City of Zephyrhills,
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES ~,
D. CONSTRUC'I'ION LIEN L1\W (CHAPTER 713, FLOIUDA STA'fUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - HOI801Oer's Protection
Guid~" prepared by the Florida Departlent of Agriculture and ConsWler Affairs, If the applicant is sOl8One 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 lhis application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, zoning, and land developlent.
I
Application is hereby lade to obtain a perlit to do work and instailation as indicated. I certify that no work or
installation has cOllenced prior to issuance of a perlit and that all work will be perfolled to teet standards of all laws
regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other goverDlenlal agencies lay apply to the intended work, and that it is
IY responsibility lo identify what actions I lust lake lo be in cOlpliance, Such agencies include but are not lilited to:
* Departlent of EnviroDlental RegUlation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands,
Water/Wastewater Treallent
* Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
* ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
* Deparllent of Health & Rehabilitative Services, EnviroDlental Health Unit - Wells, Wastewater Treallent, Septic Tanks
* 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 tbat a drainage plan
addressing a "colpensating volOle" 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 perlit prevent the Building Official frOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every per.it issued shall beCOlB invalid
unless the work authorized by such perlit is cOllenced within six IOnths of issuance, or if work authorized by the per.it is
suspended or abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day 81tension of tite, iiI 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 six IOnth period, or the project will be considered abandoned.
WARNING TO OWIER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCKHEIT MAY RESULT IN YOUR PAYING twICH FOR IHPROVEMHITS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORIEY BEFORB RECORDING YOUR MOIICH OF
COHHEICHHENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AID POST A "NOTICE OF COKKKICKMKNT".
. I
SIGNATURE: OWNER OR AGENT
-SIGIATURE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument
before me this
was acknowledged
, 19 by
STATE OF FLORIDA
COUITI 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