HomeMy WebLinkAbout98-7889
BUILDING PERMIT
CITY OF ZEPHYRHILLS
, (813) 788-6611
:;J... S-".,Ii) . h"~ AFTER HOURS PHONE NUMBER
~V~ (813) 788-528.
BUILDING .--J PLUMBING MECHANICAL
Permit
7889 (;
.
Date
8"- I f) -ye-
Sewer Conn
~~ -
Property Owner:
JObAdd,e,,-4~.~ ~~, r
Parcel 1.0. #
Water Conn:
Water Meter:
T.I.F.'s:
Zoning: Energy Code:
De",;pt;on of Wo<k , ..;{; '"
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
DATE
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
City License Registration #
State Certified License#
J '7?-..s
-
Permit Fee
Signature
Company
Address
Telephone#
!J~?~
Valuation or
Contract Price /l..C} --.s-O. o-v
/'
~2v/J.;7 {~7~/J ~l~~
BUILDING ELECTRICAL
loh,/C,i eD\o
PLUMBING
MECHANICAL
Ftr.
Pre SLB
Lintel
Tp. Servo
Rough In
Meter Can
Canst. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
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 ($1--5.001 shall be made for each trip for each trade:
~-;(/'1)
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.
".
Design
Manufacturing
Service
Installation
Property Owner Authorization Form
For Sign Permit Applications
I,
f? () b~R.1
S I ( 1/-rP1C
,
EljJ I...;? k s: , property owner or agent of
o A- k ~ (\ (l /Yl1Jll U A/ I ( V .4, )' ~ A.J../
/
do hereby give permission to West Central Signs, Inc. to erect a sign
at the above location.
/(0 73 E~ r- E P/PF:ic \'
Property Owner (Please Type or Print)
f-o,
//6~
Mailing Address
T~~?) N::'!~ ~ d 29 7
-;; // rf/7J
I I
Date
~...." '11.<. SHARON THOMPSON -
~ fi ~ My ComrnlMiOn CC463676
*JiiilJ * Expires May. 14, 1990
q1. ~ Bonded by HAl
~.... o~.,. 800-422-1555
." OF f\,
was acknowledged before me this \ ~ day of
19~byK()\~,-\, I .1~p~h
~""c::.'0-. <:Ji~} l-, r r-
Notary Public (Signed)
~~ -'
"---') \\ ,,' \: \" \ \\c'\ \0.r\ps,C) \\
Notary Public Name Printed
The foregoing instrument
-s~~}.
j
Personally Known X
Produced Identification
Type:
7720 U.S. 301 N,
Tampa, FL 33637.
State Cert: #ES-87
(813) 980-6763
Fax (813) 980-6857
SilCOX ENGINEERING, INC.
Post Office Box 8574
TAMPA, FLORIDA 33674-8574
(813) 238.9755
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SilCOX ENGINEERING, INC.
Post Office Box 8574
TAMPA, FLORIDA 33674-8574
(813) 238.9755
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PASCO CClUhlTY' BU I LD H.JG FEFd-i! IT:;
": -5 FOR PROPERTY ID: 03 ~b
[,;}TE ~ (.i.; ../(f=: ./~2
c:.:: 1.
1.__I(}I._.II,__f 4'~'91->(.' (1(.1:::5(1
PARCEL IS LOCATED IN CITY SC TF RG SUBD BLOCK LOT
1\ , _ _.::J _ ',l'EF.: OAK~ L' !1M' ,;J _ 'y' h.lA!1E 2: I !'JC
ST LN1: 2204 FOUi'H(';Ii'~ F.:D ST U'JE:
CITY: ZEPHYRHILLS STATE: FL ZIP: 33541- TI~ZN: c
-------------LEGAL DESCRIPTIClN FOR PROPERTY---------------------------------
THAT PART OF ZEPHRYHILLS BY- PASS WEST PCL 144 LYING IN PD
R j(.J DED I Ct'ITED ~OF.: p,p I 'v'?HE USE P'ER P'LAT OF ':; IL\/EF: OA~::S PH?:j'3E
ONE PB 26 PG 46 INACTIVE-COMB WiO-499-13
NEXT-FUNCTION: LD
r==-DR
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APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
71r e,'J ~ & 7 b .3 1. ~.
7;~_--/J A ~,fbLej
~-r ~-.s-_C; 1.-.-
DATE RECEIVED ,7 c:r
PLANS REVIEW FEE
JOB ADDRESS
511{/~v OA1.;5" /.l,'--1~ CwJE;,-5
C:c:{~~ / Pc~ + StlV~r CJ(J'=-S
;Jssoc-
tJy
PHONE
__. l'
1<63 - J.L.ql )
OWNER'S NAME
SUBDIVISION S>lv<;.r 0./)/<..5
LEGAL DESCRIPTION: LOT(S)
BLOCK
PARCEL ID #
O~2r: 2..1
(OBTAIN FROM PROPERTY TAX NOTICEl
WORK PROPSED: DNEW CONSTRUCTION
o ADDITION
DALTERATION
o REPAIR
o INSTALL
~IGN
o MOVE
o DEMOLISH
\
PROPOSED USE: DSGL FAMILY DWELLING
o COMMERCIAL
DMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBI LE HOME
~THER
DESCRIPTION OF WORK
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
~1~<"+ .A/1~U./l"l~ ~ SL 6-.,)
BUILDING SIZE
SQUARE FOOTAGE
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 REQUESTED
cYBUILDING
$ ,.1, CJ -.5.0 . 0-0
/
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o FLORIDA POWER
o W.R.E.C.
o PLUMBING
o MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES
o NO
SIGNATURE
~/e~
COMPANY w~7 ~Y{"Q<- 5/~..J..S'
STATE CERT OR REGIST # c;;:~ A Cad t!) P' ~
CITY PROCESSING # / 77~
v
BUILDER
******************************************************************
SIGNATURE
~..
- COMPANY W~:sT C~.v"Pt.D1 slc,.J..f V
~. ~ STATE CERT OR REGIST # ~S~~~c'>c:J fl'/
c::'"~ CITY PROCESSING # J I' \-
ELECTRICIAN
******************************************************************
PLUMBER
SIGNATURE
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
* * * * * * * * * * *.* * * * * ** * * * * * * ** * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * *** **
MECHANICAL
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
OTHER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictions" which
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they may 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 may be cited for a misdemeanor
violation under state law. If the owner or intended contractor are uncertain as to what
licensing requirements may apply for the intended work, they are advised to contact the
City of Zephyrhills Building Department, 813-788-6611.
Furthermore, 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 signs as the contractor, you are indicating that
you, rather than the contractor, are responsible for the work. If bhe contractor wishes
you to sign as contractor that may be an indication that he is not properly licensed and is
not entitled to permitting privileges in the City of Zephyrhills.
C. TRANSPORTATION IM~CT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction
lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "owner", I cerify that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the "owner" prior to commencement.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all work will
be done in compliance with all applicable laws regulating construction, zoning, and land
development.
Application is hereby made to obtain a permit to do work and installation as indicated. I
certify that no work or installation has commenced prior to issuance of a permit and that
all work will be performed to rneet standards of all laws regulating construction, City
codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other governmental agencies may apply to
the intended work, and that it is my responsibility to identify what actions I must take to
be in compliance. Such agencies include but are not limited to: *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment
*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone "A" or "A, etc.", it is
understood that a drainage plan addressing a "compensating volume" will be submitted which
is prepared by a professional engineer registered in the State of Florida prior to permit
issuance.
A permit 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 issuance of a permit prevent the Building Official from thereafter requiring a
correction of errors in plans, construction, or violations of any code. Every permit
issued shall become invalid unless the work authorized by such permit is commenced within
six months of issuance, or if work authorized by the permit is suspended or abandoned for a
period of six months after the time the work is commenced. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be requested
in writing to the Building Official. An approved inspection must be logged during each six
month period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
$2,500 IN VALUE DO NOT NEED TO CORD AND POS'l' A "N':::;:F CO~
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
acknowledged
19_
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____day of
by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by
acknowledged
19
(name of person acknowledged)
Dwho is personally known to me, or
(name of person acknowledged)
[1ho is personally known to me, or
of identification)
take an oath.
Dwho has produced
(type of identification)
and who Ddid []:iid not take an oath
Dwho has produced
(type
and whoD did Ddid not
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
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