HomeMy WebLinkAbout00-9352
BUILDING PERMIT
Permit 09352
Date S/JV to
CITY OF ZEPHYRHILLS
(813) 788-6611
~... DU
BU'~~'NG ELE~ICAL PLU~ING MECH~ICAL
Pmperty Owne" 5kv ~ &eu ~
Job Address: ~7 "> '"$ Y q~e .
ParceII.O,# /2, Jb-2,-OJDO > OQOoo" 03'7)
Zoning: Energy Code: Radon Gas:
(llv Of ,Cld-J
Oescriotion of Work ~ ~ Q . d~~Qt
Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
NO OCCUPANCY BEFORE C.O.
FINAL .Lf-/f'--O' 6)
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances,
C,O.
DATE
"b.-
70
Inspector
~ :~~s.::..:.-S::?
Company
Address
-- Telephone# -I/~~) - ") ~\fe ~
~
Valuation or
Contract Price
9DO.~
City License Registration #
State Certified License#
~",,5-k~
BUILDING
EL CTRICAL
Pl
MEC
Ftr.
Pre SLB
Lintel
FRM,
Insul. CL
WL
Tp. Serv,
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
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 ($ 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.
APPLICA~ION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTME1~T
DATE RECEIVED
PLANS REVIEW FEE
~
\
"
OWNER'S NAME STl::..t/e
.JOB ADDRESS ;3[2 _3 C;
B~ -r-i7 A(,
(1<- If-Jc-
PHONE 7<(;0
?77'?
LEGA,J, DESCRT PTION: LOT (S)
BLOCK
SUBDIVISION
PARCEL 10 #
Ie>- ;2..c;.. ~r 6 300
066 () 0
O~6 0' (OBTAIN FROM PROPERTY TAX NOTICEl
vJORK PROPSED: ONEW CONSTRUCTION
o ADDITION
OALTERATION
.0 REPAIR
d'INSTALL
o SIGN
o MOVE
o DEMOLI;:,H
o COMMERCIAL
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
PROPOSED USE: OSGL FAMILY DWELLING
DESCRIPTION OF WORK
D RESTAURANT & HEALTH DEPARTMENT APPROVAL
To (,.J5'7?l-C-c
6.t 7111/ CHoL
~;c.f. r f(.rt j::1f-8
{,rf
S'1fU1
'ill
BUILDING SIZE
~~.
SQUARE FOOTAGE
HEIGHT
RESIDENTIAL:
COMHERCIAL:
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
[J BUILDING
0 ELECrl'RICAL
0 PLUiJIBING
0 HECHANICAL
$
9 () (;) roJ
VALUATION OF TOTAL CONSTRUCTION
ANP SERVICE
o FLORIDA POWER
o ~v , P.. E . C ,
$
VALUATION OF MECfUillCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR n,EVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES
o NO
L_
SIGNATURE
4:l It ~~C-
90~'+'MC'+'QR"~;m(z.'+'J;Q~
5' 01./ S T1t-7 L. I'f Lv H (,v J J-f ---:z;j c..
COMPANY
~n'ATE CERI' OR REGIST #
CITY PROCESSING # 70 t
BUILDER
*~*************,********************~******************************
SIGNATURE
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
ELECTRICIAN
********~*********************************************************
PLUMBER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
********~************~********************************************
SIGNATURE
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
MECHANICAL
***~*************k*k*********************************************
SIGNATURE
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
OTHER
*****k*******~************~*~******************k*****************
CONDITIONS OF PEPJ-lIT l-\E'FIDAVIT
A. NOTICE OF DEED RESTRICTIONS
. The.. undersigned understands that this permit. may be
may be more r~strictive than City regulatIons. The
~mpliance with any applicable deed restrict.~.Qns.
B, UNLICENSED CONTRACTORS AND CONTRJ'.CTOR RESPONSIBILITIES
If the owner has hired a contractor or contrc.\ctors 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 contracto.t, 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 contr~ctor 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, f'LORIDA STATUTES, AS AHENDED)
I certify that I, the applicant, have been provided with i.I copy of "r'lorida's Construction
lien Law - Homeowner's Protection Guide" prepared by the i'~lorida Department of Agriculture
and Consumer Affairs, If the applicant is someone ether that the "owner", I cerify that I
have obtained a copy of the above descd,bed dOC\E1lent and promise in good faith to deliver
it to the "owner" prior to couunencement.
E, CONTRACTOR' S/OWNER' S AFFIDAVIT
I certify that all the infor~,tion in this aflpl;cation 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 .i.nstallati.on as indicated,
certify that no work or installation has crnm~nced prior to issuance of a permit and that
all work will be performed to meet: standi'trds of all la\v5 regulating construction, City
codes, zoning regulations, and land development regulations in the jurisdiction, I also
certify that I understand that the regulatio~s of other governmental agencies may apply to
the intended work, and that it is my responsibility to identify what. actions I must take 1',0
be in compliance, Such agencies inclUde but are not li.m! ted to: "'Department of
Environmental Regulation-Cypress Bayheads, vletland A,\:'eas and Environmern:ally Sensitive
Lands, WaterfWastewater Treatment
*Southwest Florida Water Management District"Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of Health & RehabLU.tative Services, Environmental Health Un:L~-~>Jells,
Wastewater Treatment, Septic Tanks
*U, S, Environmental Protection Agenc:y'-A:3best()s aba.ternent
I also certify that, if fill material is to be used in flood Zone "A" or "A,etc.", lC is
understood that a drainage plan add!:essinq a "compensating volume" will be submitted which
is prepared by a professional engineer.: regJ.s\ered in t.-he State of Florida prior to permit
issuance.
A permit issued shall be COilS trued 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 1".1"\(-'. Eu] Iding Official f.rom thereafter' requiring a
correction of errors in plans, construction, or violations of any code. Every permit
issued shall become invalid unless t,he ,vork authorized by such permit is commenced 'vi thin
six months of issuance, or if work authorized by the pe.rmit 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 Off,icial. An approved inspection l'lUst be logged dur-Lng each six
month period, or the project will be considered abandoned,
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OE' COMMENC~MENT HAY RESULT IN YOUR
PAYING T~lICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOLT INTEND TO OBTATN FINANCING, CONSULT
WITH YOUR LEI'WEE OR AN ATTORNEY BEFORE RECORDHJG YOUR NOTICE OF COMMENCEMENT. JOBS UNDEH
$2, SOD IN 4:/0a:O:RE:_~D AND FaST :~_NO'llC";;:;EM~_~__
SIGNATURE: m>JNER OR ENT SIGNATURE: CON'I'Rl\.CTOR
ST,ATE OF FLO. RIDA /). /1 /1 ./)..r-J S'l'ATr~ OF' I"LOHID1\ ~/J/1/O
COUNTY OF , LWL~ . CDUNTY. OF ~._-~~------_...
The foregoing instr~nt was~~1~;0ged Tl~~ f~Te?oin? ~i:1 t~L' e~tr,~~' at ~ ~OO
Before th'is t/l?"d'ay of ~~;1 ~ BE j orl. rr h.ls __ a ~ . _.__
by ,______.___ by --"7 - ----
}((" ( ~ (lame of peL'son Clckno\vIedgedJ
~~WhO ~o is personally known to me, or
o who has produced_______..._ 0 who has produced__,___.______..____
(type of identification) (eype of jdentification)
'd at take a~ oath. not take an oath
,~,lIbject to "deed restrict:Lons" Vlhich
undersigned assumes responsibility fer
I
Signature
_L.
;,jaITle
C, DE STEFANO
MY COMMISSION 1/ CC 72930,')
EXPIRES: May 4, 2002
Banded Thru Notary Public UndeIwril8ts
l~*"~. C. DE STEFANO
. :*~ MY COMMISSION 1/ CC 739300
.,;,1j EXPIRES: May 4, 2002
. ", Banded Thru Notary Public Underwriters
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All drawings shall be drawn to scale for nil parcels or lots five acres or less.
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