HomeMy WebLinkAbout00-9261
BUILDING PERMIT
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CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
09261
2}23POOO
Date
ELE~'CAL
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Property Owner' ,e, err. ~ ' .:l .(,p
Job Address: 41? 0 2D~ S.f.
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PLUMBING
ME.\NICAL
Sewer Conn
Water Conn:
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~d; {c.,
Water Meter:
T.I.F.'s:
Parcell.D, #
Zoning: Energy Code: Radon Gas:
k f)e "b ' feA'"t..D r'''ero.X. "7011 s.r
Descriotion of War I'- ~Q.... CT r I"'" ~ t-- ._'
GJ."\ (.re'~
o-f €'/G:.5+ ~ ----,
NO OCCUPANCY BEFORE C.O.
FINAL .3- 2-3 -- 8
DATE
Complete Plans, Specifications and Fee Must Accompany Application, C.O.
All work shall be performed in accordance with City Codes and Ordinances,
DATE
Inspector
~
Valuation or ',. ~ ~
Contract Price .LO ~ f ?i1 0, -
City License Registration # :2? 1 2
State Certified License#
Permit Feef
_Signature
Company
Address
- Telephone#
697 - 3'f.g~
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BUILDING
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Breakers
Ducts Insl.
Compressor
Final
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Tp, Serv,
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
FRM,
Insul. CL
WL
Driveway
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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.
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SQ. FEET PRICE
MAIN OR LIVING AREA
OTHER AREA UNDER ROOF
OTHER
.
':>;:, BUILDING:
ELECTRICAL:
PLUMBING:
MECHANICAL:
RADON:
CREDIT: -
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SEWER: JAJ/It-
WATER: f
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APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
~;TE -REC2IVED G2 - /g -' f) i)
PLlUIS RBVI"" ~ sryJ-
813.783.1959
OWNER'S NAME THR PERRRIER GROUP OF AMERICA
JOB ADDRESS 4330 20th STREET, ZEPHYRHILLS, FL 33540
PHONE
LEGAL DESCRIPTION: LOT(S)
BLOCK
PARCEL 10 1#
SUBDIVISION
WORK PROPSED: ONEW CONSTRUCTION
Ol\lJlJITION
fiALTERA'fION
(OR'('ATN FROM PROPF.RTY TAX NOTTCEI
Os I GN
PROPOSED USE: OSGL FAMILY DWELLING
o COMMERCIAL
o REPAIR
o INSTALL
o MOVE
o DEMOLI SH
OMULTI-FAMILY
lj8&NDUSTRIAL
01# OF UNITS
o SWIMMING POOL
o MOBI LE HOME
o OTHER
DESCRIPTION OF WORK
o RESTAURANT & HEALTH DEPARTMENT APPROVAL
RRMOVR & REPLACE APPROX. 11,700 sf. OF EXISTING CONCRETE
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
RESIDENTIAL:
COMMERCIAL:
ATTACH (2) PLo'r PLANS & (2) SETS OF BUILDING PLANs, .(1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. ...
PROPERTY SURVEY REQUIRED EDR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
[] BUILDING
$ 204,298.00
VALUATION OF TO'l'AL CONSTRUCTION
[] ELECTRICAL
AMP SERVICE
[] FLORIDA POWER
[] W.R.E.C.
xu PLUMBING
~ECHANICAL
$ 17,500.00
VALUATION OF MECIIANCIAL INSTALLATION
[] GAS
[] ROOFING
[] SPECIALTY
[] OTHER
TYPE OF CONSTRuc'nON: H BLOCK
FINISHED FLOOR ELEVATIONS
o F'HJ\ME
o S'l'EEL
[] OTHER
IS PROJECT IN FLOOD ZONE AREA[J YES
[J NO
BUILDER
SIGNATURE
COMPANY KEENi~ CON~'T'RTTr.'T'CO~~~1j
STl\'l'E CERT OR REGIST 1#
CJ.'l'Y PROCESSING II ~ -tl CO2 ./
,t... -:..............
************..*.****************************
SIGNATURE
COMPANY
STATE CERT OR REGIST 1#
CITY PROCESSING 1#
PLUMBER .f'17
SIGNA'rURE' ~~ 4.-zt~/hfJ~
*****************.************************************************
ALDERMAN PLUMBING, INC.
COMPANY
STATE CERT OR REGIST II
CITY PROCESSING 1#
MECHANICAL
**********~*****************.*************************************
COMPANY
STATE CERT OR REGIST 1#
CITY PROCESSING 1#
SIGNATURE
**.*..**.********************************************************
OTHER
SIGNATURE
COMPANY
STATE CERT OR REGIST 1#
CITY PROCESSING II
***************************************************..**.****..***
..
CO/WIT,I UIIS OF' FERMiT AI"F'IDAVI'l'
A.' No'ricE OF DEED HF:STIUC'!'10NS
'I'he undersigned understands that this permit may be subject to "deed restrictions" which
may be more restrictive than City regulations. The undersigned asswnes responsibility for
compliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTHJ\CTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they may be required
to be licensed in accordance with stale and 10Cil1 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 (or: the intended work, they are advised to contact the
City of Zephyrhills Building Department, 013-780-6611. '
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 pr,operly 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 '113, 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 conmlencement.
E. CONTRACTOR' S/OWNER' S AF'FIDAVIT
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 penult to do work and installation as indicated. I
certify that no work or installation has conunenced 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 Enviromnentally 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 cer.tify that, if rill milter-lilt .is lo he used In F'lood Zone "A" or "A,etc.", it is
understood that a drainage plan addressing a "compensat.ing 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 Dul1d.lng Official from thereafter requiring a
correction of errors in plans, construction, or violations of any code. Every per.mit
issued shall become invalid unless the work authorized by such permit is conunenced 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 cOlmnenced. 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 PROPE~rY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
$2,500 IN VALU DO NOT NEED '1'0 RECORD AND POST ^ "NOTI OF CO NCEMENT".
STAT OF FLO);IDA
COUN 0 F t.J(
The oregoing instrument was acknowledged
Before me this t,!1::f- day of J1/:Jruar"l. ' ~Jrro
by JFlC'K K~eAJ ~,Jt',
l1J (name of person acknowledged)
,zTWho is personally known to me, or
STATE 0 FLORIDA f}
COUNT F ~~
'I'he fo goIng instrument was acknowled9~d ~
Before me this g,1:J:- iay of .~~bnltlr/., t8' of IUt)
by _ JIraK j(FEIi / J. , .
OJ J (name of person acknowledged)
~ is personally known to me, or
o who has produced
tJ../ (type of identification)
and Wh~id( ~dld not ~ake an oath.
C;a~Jt:'!Jp dJJ}~
Signature of person taking acknowledgement
Jl;141~ j;. A ItltaJ.:;t.:
Name typed, printed or stamped
o who has produced
~ (type of identification)
and who ~~/J DiJ.,' d no~ take an oath
r!o~~/~
Signature of person taking acknowledgment
JfJI-J I ~ ;.,. jJp // lj) tV sf,'
Name typed, printed or stamped
.' .....\l::!... JAMIE L POPLAWSKI
{.f1~:""f..\ MY COMMISSION II CC 732207
~. : ff EXPIRES: April 8, 2002
""-~iII1o\: l' Bonded Thru Notary PIIbli<: Undenitit8nl
"'i"'III".'
~~'f.::.". JAMIE L POPLAWSKI
I-f'J:~:\ MY COMMISSION II CC 7322.07
hi: . . EXPIRES: April 8, 2002
Bonded Thru Notary PuIlIic Underwrilers
..
Feb-21-00 04:14P
, 2-2'-200~ 4:41PM
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Keener Construction Inc 1-863-686-0764
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