HomeMy WebLinkAbout98-7669
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
766913
Permit
Date
~-13-7R
Vo.f!lo
BUILDING
~S-r th>
ELECTRICAL
3S';. tTP
PLUMBING
;;l!:, -: tTb
MECHANICAL
Sewer Conn / ;J. 9 Y < PU
Water Conn: -3~ 'z';, ru
Water Meter: /8'0, 0--0
T.I.F.'s: ~ 'I P1J . tt-iJ
P,"perty Owne, J/ -7? o.i._~\
Job Address: ...] 7 ~ ;;;J.:L .11../~ ;t )/L
Parcel 1.0. # J -;2~ ~_o-3/ 0 I)-bt)~ n - 0 d-6-0
Zoning: ~co~
Descriotion of Work JJt .'
z)'=?
)v i? EA- -5--/.3-9~ ~ 4J~ ~3~~ )/ ""-
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.
-.!.>-
DATE
Inspector
City License Registration # L/ r
State Certified License#
Permit Fee
Signature
Company
Address
Telephone#
tJ~ ~~
Valuation or
Contract Price
Lj I, ..s-cr-o
r
1I...i:t:"f:M
BUILDING
~f~ 1')0
ELECTRICAL
13~~f'~1
PLUMBING
13~ / 7
MECHANICAL
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Canst. 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 ($-t'!t:'Ot)) shall be made for each triP.for each trade: ~ . _<;;r./
~~~ ~ _.1_ 7 ~~~
a. Wrong Address 7/~ ~
b. Condemned work resulting from faulty construction. A S __ If --'18"
c. Repairs or corrections not made when inspection called. /J--dI.
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.
APPLICATION FOR PERKIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER'S NAKE II-./-- R T f/'fer&iltf~ /41oiJ/le /foI11U PHONE
OWER'S ADDII1lSS 35;U 7 flw 5l( 0. - 2r""r/J.lls
JDB ADDRESS ~of 'IF;),8 7effrr ~'fJe.. (
LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION
PARCEL I.D.' eJ1- d.&; - J (- 63 10 - OOOO()- O~O (OBTAIN FROM PROPERTY TAX NOTICE)
FI-:S -7f~:l- ~a'7~
335/
WORK PROPOSED:_New Construction _Addition ---lU.teration _Repair _Install
_Sign / _Hove _Deaolish
Z F_lty
PROPOSED USE: _H/F _' of Units _HIH
_eo..ercial _Indust. _Swia. Pool _Other
_Restaurant & Health Departaent Approval
DESCRIPTION OF WORK: Lslt+1! l1efJ..J I11AI1{/I~ciJr-eJ hOMt2..
BUILDING SIZE: 02~ I x~O: 1'500 Square Feet. Height
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
_BUILDING
$ '/~ bOO
PERMITS REOUESTED
Valuation of Total Construction
_ELECTRICAL
/ {7J AMP Service
/ q~{)
Florida Power Corp.
~W.R.E.C.
----1fECllARICAL
$
Valuation of Hechanical Installation
_PLUHBING
GAS
ROOFING
SPECIALTY
FINISHED FLOOR ELEVATIONS: FT .
IS PROJECT IN FLOOD ZONE AREA?
~.
YES NO
TYPE OF CONSTRUCTION: _Block
_Fralle _Steel Other
............******.**.*****.*****.********
:.::~
CONTRACTOR SECTION
COMPANY i5rtfer€ed /V106;/e f/ome 5;r V;C-€-
State Cert. or Regist. ,
City License Registration , ~
***************************************
~ CllIIPAlIY (}/I/rertu 3rdAfl
State Cert. or Regist. ,
~ City License Registration' l70
*.***. ****.****.*****.***.**.***********
BUILDER
Signature
PLUHBER
~~~
COMPANY
State Cert. or Regist. ,
City License Registration .
*****.**.**********.***********..*********
Signature
HEGHANICAL
COMPANY fJ-; *' ^ r IJ'I 1e r sfft,fe f11 If,
State Cert. or Regist. I
City License Registration' ;). 7~
.**.***.*.*~..**.*****.*.*.*.*..**********
Signature
CO/fPAlIY it! b,. S P""illl/l. a -+1\ Iflld
State Cert. or Regi .,
City License Registration' 117
..........***.**.*..*.***...**..*.*******.
A~
.'
OTRRR
Signature
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PEI~IT AFFIDAVIT
A. NOTICE OF DEED RES'j'IUC'l'IONS
The undersigned understands that this perlit lay be subject to "deed restrictions" wbich lay be lOre restrictive than City
regulations. The undersigned assUles respollsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRAC'l'ORS AND CON'1'UAC'l'OR UESPONSIBILl'j'IES
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 tbe owner and contractor lay be
cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requirelents lay apply for 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 bave the contractor(s) sign portions of the
"Contractor Sections" of tllis application for wbich they will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, ratfler than 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 perlitting privileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
, ~~'
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D. CONSTRUC'j'ION LIEN LftW (CIIAP1'ER 713, FLOIUDA STA'rU'l'ES, AS AMENDED)
I certiiy that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law - HOIeowDer's Protection
Guide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If tbe applicant is 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 co..encelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in thi8 application i8 accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, loning, and land developlent.
I \
Application i8 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 perlit and that all work will be perfoCled to lOet standards of all laws
regulating con8truction, City code8, loning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of otber goverDlental agencies lay apply to tbe intended work, and that it is
IY re8ponsibility to identify what actions I IU8t take to be in cOlpliance. Such agencies include but are not Iillted to:
· Deparllent at EnviroRlental Regulation - Cypre88 Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands,
Water/Wastewater Treatlent
· Southwest Florida Water Hanagelent District - We118, Cypress Bayheads, Wetland Area8, Altering Watercourses
· ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
· Departlent of Health & Rehabilitative Services, InviroDlental Heallh Unit - Wells, Wastewater Treallent, Septic Tanks
· US InviroDlental Protection Agency - Asbe8t08 abatelent
I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is under8tood that a drainage plan
addressing a "colpen8ating volUle" will be sublitted which i8 prepared by a professional engineer registered in the State of
Florida prior to perlit. i88uance.
. A perlit iS8ued shall be construed to be a license to proceed with tbe work and not as authority to violate, cancel alter, or
set aside any provi8ions of tbe technicai 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, Ivery per.it issued sball hecOIB invalid
unless the work authorized by such per.it is cOllenced within Sil IOntha of issuance, or if worl authorized by the per.it is
suspended or abandoned for a period of six IOnths after tbe tile the work is cOllenced. One 90 day eatension of tile, IaJ 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 IOntb period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCEHENT HAY RESULT IN YOUR PAYING nUCR FOR IHPROVKllKnS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORH RBCORDING YOUR NOIICH OF
COHHENCEHENT. JOBS UNDER $2,5 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COHHENCBHKNT".
~~, .1
.-fIGNATURE: CONTRACTOR
and who
nnt-
STATE OF FLORIDA 0
COUNTY OF c..Q 4 (! (')
The foregoing instrument was acknowledged
before me this ~~ 14 . 19 1J'il by
tI.p I~()n A__o 11
who is personally kAQWn to me or who has
produced
as i n ification
ta oath.
twas a~OWledged
, 19q by
me or who has
(S1 re)
Christina M. Cone
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
( . gnature),
Christina M. Cone:
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
..,.},,~.y rv",'S CHRISTINA M. CONE
~: ~;r<" tv'Y cm.Jl'..:.ON # CC 530210
"")'l' OF';\.t:..... EXPIRES. February 13,2000
1-800-3-NGi"ARY Fla ~~otary Service & Bonding Co.
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<< ,~~~frj~;
,-;Joe- cr \\.\).
1..'10'.;.3-NOT AR!
CHRISTINA M. CONE
MY Cm'M::;SiON # CC 530210
EXPIRES: February 13,2000
Fla Nota'Y SefV100 & Bonding Co
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