HomeMy WebLinkAbout98-7654
BUILDING PE,RMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
7654 Iv?
BUILDING
~--;d7;)
~EC~~I~ PLUMBING
"'operty Own., b~
Job Address: (, / () ~ ' ..~
Parcell.D, # -S -:;2..6 -.J./ - tJo/ 0 ... / /d-()O - tJ 0 Y I
<3 t!J ' iro
~HANIC~sewer Conn
Water Conn:
Date
'1- g--? y
Water Meter:
T,I.F.'s:
Zoning: Energy Code:
Description of Work ~./.4 A-") .+ / c
Radon Gas:
FINAL
C,Q,
q/q.-Pt
DATE
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.
DATE
City License Registration #
State Certified License#
Inspector
Permit Fee e-' U7:J
Signature - / .cf -<....
Company /
Address
Telephone#
Valuation or
Contract Price
t r2-5-: c.rv
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BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Ftr,
Pre SLB
Lintel
FRM.
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 ($ ~ S.OOI shall be made for each trip for each trade:
~--'OZJ
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 PERKIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER'S NAME IIlr EI/J1~r C{))(
OWNER'S ADDRESS 1:>/07 ~"I"e t ~
.
5/Tme
PHONE
0Ne~res i:
($13) 7t!K~ 7/~1
mHP
,.- . ~
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION
PARCEL 1.0.' tJ~ -;2(,-:lI- ,t}t!J/O" //;J/JO-CdI/cOBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition _Alteration _Repair V Install
_Sign
_Move
_D~olish
PROPOSED USE: ./' Single Faaily
_M/F
_' of Units _M/H
_<=<-ercial
_Indust.
_Swia, Pool _Other
_Restaurant & Health Departaent Approval
DESCRIPTION OF WORK: /1/-,.. 6 (),udl t,;~".jer INS-br1119-66N
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS,
COHH.ERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
AMP Service
, Florida Power Corp.
W.R.E,C.
~CBARlCAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fraae _Steel
Other
FlHISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
CONTRACTOR SECTION
BIITI.Dg
COMPANY
State Cert. or Regist. .
City License Registration f
******************************************
Signature
ELECTRICIAN COMPANY /?t Dh kit.. tJ (/<~/V.o If t: c... ~{r cr-;f:/ c/iL CO/l/l!
f;1 / # ~ n_ _~ State Cert. or Regist. t
SignAture j~ LA. a~/><U--<--f City License Registration' 0 '7;z,
, ******************************************
PLUH.BER
COMPANY
State Cert. or Regist. t
City License Registration t
******************************************
Signature
Signature
f?~
/ /
COMPANY ~,..,;e:S rl26;1'1- ~ ~ ~ .e..1/C
State Cert. or Regist. f C.A CoP '/:rcr y.g>
City License Registration t / 7
******************************************
MECHANICAL
OTRRR
COMPANY
State Cert. or Regist. f
City License Registration f
******************************************
Signature
APPLICATION APPROVED BY
PERKIT OFFI~,
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 for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CON'l'RAC'l'OH RESPONSIBILITIES
If the owner bas 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 nol licensed as required by Jaw, 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
require.ents lay apply Cor the intended work, they are advised to contact the City of Zephyrhills Building DepartJent, (813)
188-6611,
FurtherlOre, if the owner has 'Ii red a contractor or contractors, he is advised to have the contractor(s) sign portions of the
.Contractor Sections" of this application for wbich ,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 Zephyrbills,
C. TRANSPORTATION IMPACT FEES AND U'l'ILITY CONNECTION FEES ,,!
D. CONSTRUCTION LIEN Lnw (CImPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify tbat 1, the applicant, bave been provided with a copy of "Florida's Construction Lien Law _ HDIeOWDer's Protection
Guid," prepared by the Florida DepartJent of Agriculture and ConSUler Affairs, If the applicant i8 sOleone 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 couence.enL
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 witb 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 bas cOllenced prior to issuance of a perlit and that all work will be perforJed to Jeet standards of all laws
regulating construction, City codes, Boning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations oC other goverDlental agencies lay apply to the intended work, 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:
· Departlent of HnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands,
Water/Nastewater Treallent
· Southwest Florida Water Hanage.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
· ArlY Corps of Engineers - Seawalls, Docks, Ravigable Waterways
· DepartJent of Health & Rehabilitative Services, EnvironJental Health Unit - Wells, Wastewater TreatJent, Septic Tanks
· US EnvironJental Protection Agency - Asbestos abate.ent
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 tbe 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 frUl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued sball beCOle invalid
unless the work authorized by such perlit is cOllenced within sil IOnths of issuance, or if worl authorized by the perlit is
suspended or abandoned for a period of six IOnths after tbe tile the work is cOllenced. One 90 day 91tension of tile, Jay 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.
WARRiRG TO ONRER: YOUR FAILURB TO RECORD A NOTICB OF COHHHRCBHBRY KAY RBSULT IR YOUR PAYIRG TWICE FOR IHPROVEHlNrS TO YOUR
PROPERTY. IF YOU IRTERD TO OBTAIR FIRARCIRG, CORSULT WITH YOUR LERDER OR AN ATTORREY BEFORE RBCORDIHG YOUR NOTICE OF
COHHERCEHERT. JOBS URDBR $2,500 IN VALUB DO NOT REED TO RBCORD AND POST A "NOTICB OF COHHBRCBHKNYft.
SIGRATURE: OWHBR OR AGRRY
. I
SIGNATURE: CORTRACTOR
STATE OF FLORIDA
COUNn OF
The foregOing instrument
before me this
was acknowledged
, 19_ by
STATE OF FLORIDA
COURTY 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 oath.
{Signature}
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
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