HomeMy WebLinkAbout98-7740
BUILDING PEeRM!! 7740 ~
CITY OF ZEPHYRHILLS
(813) 788-6611
Date --S - - t,- 9' K"
--S7). VD ~ '-" cnJ
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Pmperty Own.' W Jl y/'.d
Job Address:S . ~
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
Parcell.D, #
Zoning: ~ergy Code:
Description of Work \..~~ _"'A~
Radon Gas:
FINAL' q (
DATE
C.O. ~-) ~?rs-
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.
Inspector
Pe,m;tF..p ~-
S;gnatu<. /". Z ee
Company ,.
Address
Telephone#
Valuation or
Contract Price ~ tJ7)-7J . t:FV
City License Registration # / L:. :2.. ,
State Certified License#
~~~ ,13(~~U&A
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.....,
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Tp. Serv,
Rough In 5-1>>-q;r ;2~
Meter Can
Canst. Pole
Pool
Pre-Meter
Final
Ftr.
Pre SLB
Lintel
FRM. S- I S, ~ ~ eL';:(
Insul. CL
WL
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 ($~) shall be made for each trip for each trade:
c2.:!J '; crv
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.
SOUTHERN BUILDERS
5233 GALL BLVD.
SQ. FEET PRICE
MAIN OR LIVING AREA - $ 40.00
OTHER AREA UNDER ROOF - $ 15.00
OTHER - $ 0.85
VALUATION $ -
FEE SHEET $ -
ADDRESS $ -
DRIVEWAY $ -
BUILDING: $ 50.00
ELECTRICAL: $ 25,00
PLUMBING: $ -
MECHANICAL: $ -
RADON: $ -
CREDIT: $ -
TOTAL $ 75,00
SEWER'I $
WATER: $
TOTAL: $
I
3/4" WATER METER:I $
TIF ~~I :
TOTAL: $
75.00
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APPLICATION FOR PERMIT
CITY OF ZEPHYRBILLS
BUILDING DEPARTMENT
I ,- 1ct
~/
OWNER' S NAKE
;P! 3. JJl).- ~ J-9~f
[, t- 37j~Y I
OWNER'S ADDRESS
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 1. D."
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction --..Addition --..Alteration _Repair _Install
_Sign _Move _Deaolish
PROP9SED USE: _Single Faaily _M/F _, of Units _M/H
Leo..erCial _Indust. _Swia. Pool _Other
_Restaurant & Health Department Approval
DESCRIPTION OF WORK:
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.
PERMITS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
_MEGllAlUGAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF. CONSTRUCTION: _Block _Fraae _Steel
Other
FINISHED FLOOR ELEVATIONS:
F1' .
IS PROJECT IN FLOOD ZONE AREA? ~
YES NO
******************************************
BmlJlER
CONTRACTOR SECTION
GOMP~L'.J~/?.--J [S}. (cP.-e/? s
State Cert. or Regist. ,
City License Registration" /6.;z. 7
******************************************
~
~
Signature
ELECTRICIAN ~ COMPANY ,'-j'~
~ State Cert. or Regist. #
Silm~ture k{ P!/ ~ ~ a City License Registration'
************~***************************
/&?4
PLUMBER COMPANY
State Cert. or Regist. ,
Signature City License Registration ,
******************************************
MEGBAHI~ COMPANY
State Cert. or Regist. ,
Signature City License Registration ,
******************************************
OTRRR COMPANY
State Cert. or Regist. ,
Signature City License Registration ,
******************************************
APPLICATION ,APPROVED BY PERMIT OFFICER.
CONDI'rIONS OF PEUMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
rb. ~rslgned uDd.,.taeds thet tbi. persit lOy be .ubj.ct to 'deed ,..t,iclio..' whieb lOy be .... restriclive lhon Clt,
regulatlons. The undersigned assDles responsibility for co.pliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the ..... has hi'ed · conl,aclo, or contr'clo,. to uoderlale "'I, lb., 10, be '"Iui'ed 10 he Ilc,",", io accordi0c8 with
.1.1. and loc.1 regul.li.... If lhe conl'acto, I, 001 IIc....d as regui'ed by law, both the ..... aod controctor IO, he
cIted lor · .i&deoe.oo, viol.lion usd., .1.1. ION. II the ...., 0' lnl"ded cont'aclo, .,. uscertal. .. 10 MIot Iiceooi.g
'""i'....I. IO, .pply fo, the int..ded ..'I, Ib.y .,. advi.ed 10 cootact the Cil, 01 Z.phyrbiII. BoIIdlDg Deparllent. (BIl)
788-6611.
Fu'the,..,.. If the OInor b.. hired · cont"clor ., conl,act.,s, be i. .dvised t. ba,. the cont,actor(.) sign portl... of the
'Cont,.ctor Sectl.... .f thi. .pplicatlon f., whicb they will be ,espuooibl.. II roo, as the ..... .ign as the contractor.
roo ". iDdicatiog th.t you, ,.tb., tban lb. cont,.cto" ar. '''pon.lbl. fo, the "'I. If the contracto, wiobes ,.. to .Ign
.. contr.ct., that IO, he '0 i.dic.tion that b. i. oot P'.pe,I, licen'ed .Dd I. oot entitled 10 peroittiDg prl,111gOI in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND U'l'ILI'rY CONNECTION FEES
"
, '
D. CONSTRUCTION LIEN Lftw (CIIAPTER 713, FLORIDA STATUTES, AS AMENDED)
I c.,tif, that I. the .pplicant. h.,. been p,.'ided with. copy 01 'FI.rld.', COOItroctloo Li.. Law _ Booeowoer'. Protectioo
~uIde' prepa'ed by tb. FI.,ida DeP"lIent .f 8g,Icultu,. aod Cons..., Iff.irs. If the .pplicast i. ....... otIor than the
....or.., I ce,tify that I bate obl.lned · copy .f lh. .bo" described doc....t .Dd P'..Is. 10 good f.ith 10 dell..r It to the
"owner" prior to co..ence.ent.
E. CONTRACTOR'S/OWNER'S AFFIDAVI'l'
I c.,tify that .11 the 10fo'lOtioo i. this .ppllc.tioo is .ceu,.t. .nd tb.t .11 ..rl will he done i. CDlpllaoce with all
applicable laws regUlating construction, loning, and land develop.ent.
I
Application is hereby .ade to obtain a per.it to do wort and instailation as indicated. I certify that DO worl or
leotall.tius has C08IeOoed prio, to i..uaoc. of . pe,.it ..d that .11 ",I will he perf,",", to lOOt 'looIordo of all I...
regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other govern.ental agencies .ay apply to the intended vork, and that it is
.y responsibility to identify what actions I .ust take to be in co.pliance. Such agencies include but are not Iiaited to: ,_.
· Deparllent of BnviroDlental Regulation - Cypress Bayheads, Wetland Areas and Bnvironaentally Sensitive Lands,
Water/Wastewater Treat.ent
· Southwest Florida Water Hanage.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
· Ar.y Corps of Engineers - Seawalls, Docks, Navigable Waterways
· De arLaent of Health & Rehabilitative Services Envirou.ental Health Unit - Wells, Wastewater Treat.ent, Septic lan.s
· US Envirou.ental Protection Agency - Asbestos abate.ent
I also certify that, if fill .aterial is to be used in Flood Zone "A" or "A,etc.., it is understood tbat a drainage plan
addressing a "Co.pensating volu.e" will be sub.itted which is prepared by a professional engineer registered in the State of
Florida prior to per.it. issuance.
. I pe,.it I.sued .hall be DOOOt,ued to 10 . lice... to p'oceed lith the "'I and eot as .uthorit, to 'ioloto, caocel a1ler. or
..t ..ide .n, p,o,l.i... of the t.chnlClI cod", eor .hall i.,","," of 0 penlll prevent the Bulldiog Offlclll f... lIoreofler
requirlog · eo,rectios of .rro,. In pi.... con.tructiDO, 0' ,iol.tl... of '0' cod.. S"" PIIIIt Iooued ~I becooo IeoaIld
onl... tb. ..'I ..thorlled by ouch polIlt i. ......coi Iltbln .11 ""tho of i......., 0' If "'I autboriled by the PIIIIt I.
suspended or abandoned for a period of six IOnths after the tile the wor. is cOIIenced. One 90 day eatension of tiae, 181 he
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 IOnth period, or the project will he considered abandoned.
WARNING TO ONNER: YOlIR FAILURE TO RECORD A NOTICB OF COHHBNCBHBNT HAY RBSULT IN YOUR PAYIftG TWICE FOR IHPHOVKHDrS TO YOUR
PHOPBRfY'. IF YOlI UTEND TO OBTAIN FIIfANCING, CONSULT WUH YOUR LBNDBR OR All ArrORlKY BEFORB RBCORDIHG YOlIR NOIICE OF
COHHEHCIHENT. JOBS UNDER $2,500 IN VALUE 00 NOT NBED TO RECORD AND POST A "NOTlCB OF COtIHBHCIHIiN1'-.
~~~~.i ~ tE~~----
SIGHATURB: ONNER OR AGENT (/
STATE OF FLORIDA ~
COUny OF ~
The foregOing instrument
before me this ~A_~~O
was acknowledged
, 19~ by
-SIGNATURE: CONTRACTOR
STATB 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.
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
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