HomeMy WebLinkAbout98-8035
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
8035 11
BUILDING
~-. OV
~ECT~~
PLUMBING
.30.Ob
CECHAN~ewer Conn
Water Conn:
Date It; -/~-- 9 k
Pmperty Owne' ~"Z~ ~ ~ t]
Job Add'..., 60 - _ _- ~_ - <( ';;;.e-<--I <?A -
Parcel I. D. # 3 - Q.. b '" J./ - (!1 t:J / 0- / I :J.. tJ (J 00'-11
Water Meter:
T.I.F.'s:
Zoning: Energy Code:.
Description of Work Cfl-"........> A/ C-
Radon Gas:
FINAL
DATE
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application, C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
(?Db
Permit Fee
Signature
Company
Address
Telephone#
~'~
//A
-
Valuation or
Contract Price
I ? ~ s, CY-b
,I
City License Registration #
State Certified License#
(J.a;At L, -tf 7::J..
~(?i4- /7
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp, Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Ftr,
Pre SLB
Lintel
FRM,
Insul. CL
WL
Driveway
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons. a
charge of Fifteen and 00/100 Dollars ($ 25,001 shall be made for each trip for each trade:
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,
.. ~
APPLICATION FOR PERKIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
~ / .,,-. .
OWNER'S NAME JtJ..V) I-OSblU"J
OWNER'S ADDRESS hl):l7 {!,res.-bAi
JOB ADDRESS 1,(),;J7 (!re~J.l
PHONE rf;V. 7i'l- 75"1-~
LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION
PARCEL 1.D.' LJ3-d&-~/-I;{)/~-II:;<<'>-tJO~1 (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction ~ddition ----Alteration _Repair VInstall
_Sign
~ove
_Deaolish
PROPOSED USE: ~ingle Faaily
_M/F
_' of Units _M/H
_eo..ercial
_Indust.
_Swia. Pool _Other
_Restaurant {( Health Departaent Approval
DESCRIPTION OF WORK: NeoJ HIJII ~ 5ys ten) /N5W/ed
BUILDING SIZE:
x
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.
PERKITS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
----1fECBANICAL
$
Valuation of Mechanical Insta11ation
_PLUKBING
GAS
ROOFING
SPECIALTY
TYPE OF GONSTRUGTION: _Block _Fraae _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
CONTRACTOR SECTION
COMPANY
State Cert. or Regist. .
City License Registration t
******************************************
BIITIJ)ER
Signature
ELECTRICIAN COMPANY!ftc:,{MIJ u/}fV1/U L Fud7f/~A-L ccJN'T/?k 1'tf~
/! /) /' ().. /J State Cert. or Regist. ,
SimlAtur~/Lk~ GL~. City License Registration' Co 7;;2...
******************************************
Signature
COMPANY
State Cert. or Regist. .
City License Registration .
******************************************
PLUMBER
MECHANICAL COMPANYAeihr's ;+OPITNe Gns f 1J;f F~ .
~ J /" // State Cert. or Regist. f
Signature P./ ~ ---<....... City License Registration' /7
~ ********~A&.*************************** .
OTHF.R COMPANY
State Cert. or Regist. .
Signature City License Registration #
******************************************
APPLICATION APPROVED BY PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
7he under.igned und.r.tands that tbis per.it .ay b. subject to 'd..d restrictioos' .bleb say be sor. r..tricti.. !boo City
regulations. The undersigned assUles responsibility for co.pliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CON'!'RACTOn RESPONSIBILITIES
II !be ....r ban bired a cootractor or contractor. to undertai. oorl, tb.y say be r.gulred to be liceosed 10 accordance .itl
.tat. and local r.gulatlon,. II lb. cWltractor I. oot lic....d an requir.d by la., botb lb. ..... and cootractor say be
cited (or a .I.d....oor .Iolatioo und.r stat. law. II tbe 08o.r or Intended cootractor ar. uncertain a. to Ibat liceaslng
regulr....t. .ay apply lor tb. lot.nded oorl, tb.y ar. advl..d to contact lb. City o( Z.pbyrbill. Building Dopartsent, (813)
788-6611.
Further.ore, if the owner has hired a contractor or contractors, he is advised to have tIle contractor(s) sign portions of the
'Contractor S.ctlon.' o( Ibi. application (or wbicb Ib.y will be respon.ibl.. I( you, as !be ..... .ign as lb. cootractor,
,OU are indicating that you, ratb.r tban lb. cootractor, are responsibl. (or lb. oorl. If !be contractor .iobes ,.. to .i9O
as contractor that .ay be an indication that he is not properly licensed and is not entitled to per.itting privileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPAC'f FEES AND U'!'ILI'fY CONNECTION FEES ~"
D. CONSTRUCTION LIEN Lnw (ClffiPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law _ HOJeOWDer's Protection
Guid~" prepared by the Florida DepartJent of Agriculture and ConSUler Affairs. If tbe applicant is sOIeone otber than the
"owner", I certify tbat I have obtained a copy of the above described docu.ent and pro.ise in good faith to deliver it to the
"owner" prior to couenCeJent.
E. CONTRACTOR' S/OWNER' S AFFIDAVI'!'
I certify that all the infor.ation in this application is accurate and tbat all work will be done in cOlpliance with all
applicable laws regulating construction, Joning, and land develop.ent.
I
Application is hereby .ade to obtain a per.it to do work and instailation as indicated. I certify that no worl or
installation has cOllenced prior to issuance of a per.it and that all work will be perfofled to aeet standards of all laws
regulating construction, City codes, Joning regulations, and land develop.ent regulations in the jurisdiction. I also
certify that I understand that the regulations of otber goverOlental agencies .ay apply to the intended work, and that it is
'Y responsibility to identify what actions I .ust take to be in co.pliance. Such agencies include but are not li.ited to:
· DepartJent of EnviroDlental Regulation - Cypress Bayheads, Netland Areas and EnviroDlentally Sensitive Lands,
. Nater/Nastewater rreatJent
· Southwest Florida Nater HanageJent District - NeIls, Cypress Bayheads, Netland Areas, Altering Natercourses
· Ar.y Corps of Engineers - Seawalls, Docks, Navigable Naterways
· De artJent of Health & Rehabilitative Services EnviroDlental Health Unit - NeIls, Wastewater rreatlent, Septic Tanks
t US EnviroOlental Protection Agency - Asbestos abateJent
I also certify that, if fill .aterial is to be used in Flood Zone "A" oc "A,etc.", it is understood that a drainage plan
addressing a "co.pensating volUle" will be sub.itted whicb is prepared by a professional engineer registered in the State of
Florida prior to per.it. issuance.
. A per.it 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 frOJ thereafter
requiring a correction of errors in plans, construction, or violations of any code, Ivery per.it issued shall beCOle 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 eztension of tile, Jay be
allowed for the per.it with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection .ust be logged during each six IOntb period, or the project will be considered abandoned.
NARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COKHENCKHRNT HAY RESULT IN YOUR PAYING 'fIIICE FOR IHPROVEllBns TO YOUR
PROPBRTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT NITH YOUR LENDER OR AN ATTORHEY BEFORE RECORDING YOUR JOTIC! OF
COKHENCKHENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COKHKNCEIliHT".
SIGNATURE: ONNER OR AGENT
. I
SIGNATURE: CONTRACTOR
STArE OF FLORIDA
COUNTY OF
The foregOing instrument
before me this
was acknowledged
, 19_ by
STATE OF FLORIDA
COUNTY 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 oilth.
(Signature)
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
I~~ ~II I' I, ~ 12 I
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