HomeMy WebLinkAbout99-9089
BUILDING PERMIT
Permit 09089
Date / J l II??
,
CITY OF ZEPHYRHILLS
(813) 788-6611
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BUILDING ELECT~L
Property Owner: U4 "Z~l 6 (. ~
'"'I' ~
Job Address: '3" 0 3 ., --
Parcell.D, # (I-lb-- 21- Do 10 ,. IJ 5"' 00 - 01( 0
PL~G
MECHAN~L
Sewer Conn
Water Conn:
Water Meter:
Zoning:
Descriotion of Work
Energy Code:
401 {)t Pr:tlc.( y
T,I.F.'s:
Radon Gas:
Pe-. (' {1
NO OCCUPANCY BEFORE C.O.
FINAL 5" - <1,.. <PO
DATE
C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances,
Valuation or
Contract Price
Q:Il2.
.-.
I~()
City License Registration #
State Certified License#
("
DATE
Inspector ,9..1(
P...m;t Fee ~9It ~
~Signature. .- ~/
Company
-J- Address
TelePhone#(.1 ~-'l. ) l.fZ4-6~'-7 D
6,
BUILDING
Ftr,
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Driveway
PLUMB NG
MECH NICAL
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
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 PEmfiT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
DATE RECEIVED
PLANS REVIEW FEE
JI;f2~L b/~t-
7 -6k. ~uC
LEGAL DESCRIPTION: LOT (S) /I- /1 BLOCK /25'
C~~_.i~~L..~D~~/1 Zb 2/ DOlO /25' 00 0110
WORK PROPSED: ONEW CONSTRUCTION 0 ADDITION
'-?WN~~~
(;c_.~?~~QE.ESS~ :;s 9 i 0 '3
PHONEGn")~b 7- 1744
z&P Yf?{ffLL 5
SUBDIVISION
(OBTAIN FROM PROPERTY TAX NOTICE)
OALTERATION
o REPAIR
o INSTALL
o SIGN
o MOVE
o DEMOLISH
PROPOSED USE: OSGL FAMILY DWELLING
o COMMERCIAL
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
D RESTAURANT & HEALTH DEPARTMENT APPROVAL
~<;~!.~_'r.~~~.?~!'1.9j3.K) .US' ni '- L.
BUILDING SIZE
il'
,0
~(::-
PR/flrlC,-(
FE tvcG
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.
~ING
~..
?StJ
~~
PE~ITS REQUESTED
-, )
Y~UATION OF TOTAL CONSTRUCTION
o ELECTRICAL
o PLUMBING
AMP SERVICE
o FLORIDA POWER
o W.R.E.C.
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 AREAO YES
o NO
BUILDER .
SIGNATUREI~L/c:d~
COMPANY /! ~J4I-1t4-(/I-f Cb.A..J,5 T7! tic. r ( O..AJ
STATE CERT OR REGIST # cl? coS7770
CITY PROCESSING # GG5f, .
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SIGNATURE
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
ELECTRICIAN
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COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
PLUMBER
SIGNATURE
**********~*******************************************************
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
MECHANICAL
SIGNATURE
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COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
OTHER
SIGNATURE
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CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be
may be more restrictive than City regulations. The
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 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 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 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 ~AH 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
$_:~~ :~ VAL: =~NEED TO RECORD AND POST A ~~CEMENTH'
SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR
-
subject to ~deed restrictions" which
undersigned assumes responsibility for
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.
o who has produced
(type of identification)
and who Ddid DUd not take an oath
Dwho has produced
(type
and whoD did 0 did not
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
BUILDING DEPARTHENT
OWNER
//+ 2{; L
JOB LOCA'I'ION
3 )/10'
2~;-?'-1/11-1( {>-
/~L
PARCEL 1.0." ff
1/ 2(P "'21 ()C>/6
I 25'
QO 0/10
SIION ALL EXISTUIG & PROPOSED STRUCTURES GIVING DIHENSI0NS & SETBACKS.
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UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION,
\
FRONT PROPERTY LINE
(NOTE EXAMPLES 1 & 2)
S'l'REE'l'
1, SETBACKS FOR Rl, R2 ZONING
60'
2. SETBACKS FOR R3 ZONING
60'
10'
P E-
R X
0 I
10' P S 10'
0 T
S I
E N
D G
20'
1 0'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30'DUPLEX
1 0'
FRONT PROPERTY LINE
FRONT PROPBRTY LINB
F/ r1 ":;...;,,.,,,,-~,..
./ ';'(4,":~ 1'/ lL~- .'
-)~ (......
I.t .: _..f: f
PROPOSAL
r :< ~.::;1 -.... l
No,
(: .
i Date /ql...- / 3
~h'" No.
Work To Be Performed At:
I'
f '{
./
Pro osal Submitted To:
"i
Name
J ;
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7
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Street
""7 ..-;: lr.: -<
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/1- -:./ .:;;-.
Street
City [': ///'/L"'j; q (, -"
State
/~L
City
State
Phone
51:.7
--. --I "I' ( l
I -. r
Date of Plans
Architect
We hereby propose to furnish the materials and perform the labor necessary for the completion of
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E~:,.':..... T ,'/-;1c': (,/ L '7' i c.' j,jC' i: ~,,~..J AIo,<ilft.// ); Cr i(_~{/ t:".lC a j-'
~~</Jt ,1-' /1'
/(:'T//(:,I'.."-' T
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r ,;:,J
/iL {[ '1'.
All material is
specifications
guaranteed to be as specified, and the above
subf!1_~tted . for; above ,work anp ~col1lpleted
.5 ~~-i.--'~ .....'l_' .'--t. f../_.,4..',~; t\: c. U'- i It r 1
with payments to be made as follows: V/;;,,/u C<:;t.-'AI'::~ (;, T (",; .1'.1
work to be performed in accordance with the drawings and
in a substantial workmanlike manner for the sum of
Dollars [$ :~~-(" ..~";.., 1
Any alteration or deviation from above specifications involving extra
costs, will be executed only upon written orders, and will become an
extra charge over and above the estimate, All agreements contingent
upon strikes, accidents or delays beyond our control. Owner to carry
fire, tornado and other necessary insurance upon above work, Work.
men's Compensation and Public liability Insurance on above work to be
taken out by
Respectfully submitted
/"7 / /
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/. ./;._./ ~;/--t:.-
;:,... l
Per
Note-This proposal may be withdrawn by us if not accepted
within days,
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are satisfactory and are hereby accepted, You are authorized to do the work as specified,
Payment will be made as outlined above, / /J./ l " ~
Signature /'<YA.A..:2t:.{/J A /V1--(.,
Date
/2.. /.?
7 I
Signature
~ FORM 3850
TRIPLICATE
MAOE IN U,S,A