HomeMy WebLinkAbout99-8977
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
8977
1( I ~ /7 r
11o.~ ~o.~ \
BUILDING ELECTRICAL PLUM~NG
Property Owner: T 5 kv \); v( G . ~ '
Job Address: 4;) I..( , 1(y d; v~ L r\ .
Parcell.D. #
Date
MECH~NICAL
Sewer Conn
Water Conn:
Water Meter:
TI.F.'s:
Zoning:
Description of Work
Energy Code:
(){.(.:,-..e d- s +01'4 Cj q
Radon Gas;
~ reO I J"\
~~v
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
bO
DATE
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#
~gnature
Compan
Address
-Telephone#
Inspector
~R.
Valuation or ').....
Contract Price ~O 00
BUILDING
ELECTRICAL
Ftr.
Pre SLB
Lintel
FRM. / J, IO~ Q't S',c-l-
Insul. CL
WL
Tp. Servo
Rough In J/-/~~YKfJ~
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
ME HANICAL
Breakers
Ducts Ins!.
Compresso
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 ($ 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 PERMIT
CITY or ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER'S NAME
DAV l t)
tfZ'-It
HftYss (REs>)
SIZ<(f)IVE l N '
;~,~. - ,:_~:
DATE RECEIVED {O-;j 9-9~
PLANS REVXEW,m~'''':
11 '3 '- '6 ~?'(j ~t!!l-, U....
PHONE "[33: -"-13/ <; ,
JOB ADDRESS
i r~ ''It ~" 1 .
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID #
o SIGN
~ ADDITION
o MOVE
,-" , .' id .~.,~ . J',y
(OBTAIN FROM PROPERTY TAX NOTICE\
; ,
WORK PROPSED: ONEW CONSTRUCTION
OALTERATION
o REPAIR
" .'
D.INSTALL ','
,",' , ..'
o DEMOLISH
, 'el
:; .J
,0.:
PROPOSED USE: OSGL FAMILY DWELLING OMULTI-FAMILY
~OMMERCIAL ~INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o M~BILE HOME
o OTHER" "
"""1'
BUILDING SIZE
STC>f2..A-GE.... ~ (N
SQUARE FOOTAGE ~ 7 00 ...s~ F-r:
HEIGHT
I[ I
7/~')
DESCRIPTION OF WORK
RESIDENTIAL:
COMMERCIAL:
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORt?!i-i,
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
'.
PERMITS REQUESTED
, ,
~ BUILDING $ 2..t). 00 CJ
,
l&i: ELECTRICAL (f)(?
o PLUMBING tJ(f+
o MECHANICAL $ AliA
o GAS o ROOFING o SPECIALTY
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
!tf)f)IT(DN
W FLORIDA POWER
'0 EJ<.('5t/NG
o
W.R.E.C.
VALUATION OF MECHANCIAL INSTALLATION
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
l::i!' FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES . 0 NO
BUZmBR ~
SIGNATUR~ I .
COMPANY -F&.EffftL~
STATE CERT OR REGIST
CITY PROCESSING #
Ei'\P R-E5S" '/.ltr~.~ "
#' ':-,,'" '. """, ",
\-.
I
***************************************************************~**
L1H";:'!
:."0 ?
JIlLECTRICIAN
SIGNATURE ~~ ~ 12,
COMPANY PEE..- f-ttt-riU. c:-- ': '
STATE CERT OR REGIST #
CITY PROCESSING #_1 <Xo
J.-,...
; .; \. .. i~
, L ,: .~<
******************************************************************
PLUMBER
COMPANY.
STATE CERT OR REGIST #
CITY PROCESSING #
~'I "
SIGNATURE
MECHANICAL
***********,*******************************************************
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
. :1 .
~ - (:t
SIGNATURE
,-"r.-_,
*****************************************************************
, 1 ;-r~~f" j
OTHER
SIGNATURE
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
************************A**************************************.*
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 misdemean,or
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 the 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 IMPACT 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 wo~kwil~
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 indicat~d. I
certify that no work or installation has commenced prior to issuance of a permit 'and that
all work will be performed to meet 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
$~ 7lJ NOT~E~ TO RECORD AND POST A "NOTV;~
~TURE?! -~!::;( AGENT SIGNATURE: CONTRACTOR
acknowledged
19_
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____day of
by
l J
STATE OF FLORIDA
COUNTY OF
The foregoing, instrument was
Before me this _____ day of
by
acknowledged
, 19-:...
_1'''', jt~ "jot;" Ii;
(name of person acknowledged)
Dwho is personally known to me, or
(name of person acknowledged)
C1ho is personally known to me, or
o who has produced
(type
and whoD did Ddid not
of identification)
take an oath.
Dwho has produced
(type of identifica~~on)
and who Ddid []:lid not take an oath'~'
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
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If, 2.. 1ft' skit., i v'/,-- LN'
SQ. FEET PRICE
MAIN OR LIVING AREA
OTHER AREA UNDER ROOF
OTHER
BUILDING: lb /20. c~
ELECTRICAL: J 5< ~
o.
PLUMBING: ,JIPr
MECHANICAL: tJlPr
RADON: jJ)fr
CREDIT: ,Jl/f
SEWER: !JIlT W-f)1T1 ~
WATER:
~..
TOTAL:
~
I
T.I.F1Sl AJ/ft ~
-cj/114L- /70 . v~
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