HomeMy WebLinkAbout00-9444
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
09444
5 / c.t /0'0
.
Pll~NG
Property Owner: ~Wo..rJ I.... S'~ r.~k
Job Address: 5113 b~ Sf.
Parcel I. D. # 1f'.2" - '2 I - 00 'o~ l.g b 00 - () 0 ~ 0
s-o.aQ
ELECTRICAL
Date
~7.~
BUILDING
ME~NICAl
Sewer Conn
Water Conn:
Water Meter:
T,I.F:s:
Zoning: Energy Code:
Descriotion of Work ~., do S ,'on CJ
Radon Gas:
LC:V- fort
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
c, ~ Z-2~<:D---O
DATE
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Valuation or
cOOD,C>I!"
Contract Price ~,
,
Permit Fee
~7.-
'Y0~r
~k~~t
City license Registration #
State Certified license#
_ Signature
Company
Address
- Telephone# JJ/rJJtJI-
l
61r f? 7 - 6'5J<P
O,"".'1~r
I') ,-",1\ e.r
Ftr.
Pre SLB
lintel
FRM. ..t't -/.f-OO 5 ~
Insul. CL
WL 6-/1'-l} IJ 2 R
Tp. serv.~
Rough In 'd -8--00 ~
Meter Can
Con st. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
BUILDING
ELECTRICAL
Driveway
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($ 25.00) 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 OF ZEPRYRHILLS
BUILDING DEPARTMENT
DATE RECEIVED Jj - ~ 7-0 D
PLANS REVIEW FEE
PHONE 9frf rP{t!7}lIf:34
'"P. 3J..rI(
OWNER'S NAME
Edt~ ~Iue/l
-6 n:r. - J~ 6f&~ r
JOB ADDRESS ..:fil ?J
LEGAL DESCRIPTION: LOT(S) ~~~~LOCK
C-~J.>~~~~_~i)-o /1-2' -2/- 00/0 - l~C.oo." 00<../0
-'_-~""-'--:~':~~-:-":'::':'-.- --: - .-" ::;- ,-.,..~-~~
WORK PROPSED: DNEW CONSTRUCTION 0 ADDITION AALTERATION
o SIGN 0 MOVE 0 DEMOLISH
SUBDIVISION
(OBTAIN FROM PROPERTY TAX NOTICE)
o REPAIR
o INSTALL
PROPOSED USE: DSGL FAMILY DWELLING
o COMMERCIAL
DMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
o
DESCRIPTION OF WORK t?~~~
3ft It'
RESTAURANT & HEALTH DEPARTMENT APPROVAL
erfS rf.,~f C<$v
SQUARE FOOTAGE
~
f
BUILDING SIZE
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.
~BUILDING
~ ELECTRICAL
o PLUMBING
o MECHANI CAL
$
PERMITS REQUESTED
1000 !!fl.--
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
o FLORIDA POWER
o
W.R.E.C.
$
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 AREAD YES
o NO
COMPANy,I_~
STATE CERT OR REGIST #
CITY PROCESSING #
BUILDER a // ~ ;-::;..... P'
SIGNATURE~ ~
******************************************************************
SIGNATURE
(~
~)
COMPANY tk-~
STATE CERT OR REGIST #
CITY PROCESSING #
ELECTRICIAN
******************************************************************
PLUMBER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
**********~*******************************************************
MECHANICAL
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
OTHER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
CONDITIONS OF PERMIT AFFIDAVIT
A. . NOTI€E 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 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 ~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
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A ~NOTICE OF COMMENCEMENT".
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
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)
Owho is personally known to me, or
(name of person acknowledged)
[1ho is personally known to me, or
o who has produced
(type
and whoO did 0 did not
of identification)
take an oath.
Owho has produced
(type of identification)
and who Odid [):lid not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
~f~
~J-
:(-- i;: u :.A.Y\t1-O ,:> \"'~1\11:;"!S ~
' (~<J.P-- :5/l-? G;J ~ <-;,t:
)~ 7 ~ I> 100
SQ. FEET PRICE
MAIN OR LIVING AREA ZS6 Z-f). ~~
OTHER AREA UNDER ROOF
OTHER
.
[J:::t) . :::> ":::,.
BUILDING: o 7~ s 0
ELECTRICAL: 5"6. 0 ~
PLUMBING: NY1
MECHANICAL: AJ
RADON: Nf.
CREDIT: N
SEWER: !JIlt
WATER:
TOTAL: ~
I
T.1.F'sl fJlfr I
~ ~ . -tie/I 7. 5"0
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:\'i,LIIOf(1 fOl/,l-)l(i'O~ 68902 U)
allTtJl")tWrntuft, .'nud. It.;..
March
19 82, Itlulftn
12th
doy "I
ELIZ/>J3tTH TALLWi, /l. ,'.'1dO"<l and autviving apouee of f\MBRCSE TALLEY,
decenseJ.
~l Ih. CouMy of Pas<.:o S,,,,t. 01 Florida 9ro~tor', o~d
1,1.,-..
(-: <: i;A C. r-;" :......"i' .,;.
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GOJGJOC~i 4.nO CA
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:J\vok 1 y:"' s~. ~'~-:t~C. PO~1~iac.
'j\ lh., COvMy qi
Oai<lanc!
Hichigun 48055
gro....t'O.~,
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_ _ _ _ _ _ _ _ _ _" - - - - - - - - " - - - - - - - - - GIFT - - - - - . - - - - ~ - - - - - - - - - - - - - - - - - - - - - 0011<""
f:1rd othC'f (lQod OM! \(ulvobi.. ,tdaH='tfOfi";'.#,} to \.U,d Qr~f\tO. 1/"1 h()lld poid l;iy ,old 91ontee, ,he- rfc.ipl w~.re-of h htreby
Q(~I'IQ......ledQ.dl no\ Qf{H,ted. ~OfQo;l"Ie~ Cr':; l~ld 10 1r.~ ~olQ fJfcn1~.. and \)f-ontelC"~ ~.ir' ofld o\\i~HH ior~\lor. to. follow,n9
d~l{rib.d IOr'ld. )11Vol;" !yiT\9 0"''' ~~;'1l} 1(\ P"18CO Coynty, Florida, to.......il:
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t~t 4 nnd the North 11 feet and 8 incihes of
the Yest 24 f~Gt and 4 inches of Lot 5, BLock
186, City of Zephyrhille, a6 per plat th@Leof
of :;h(; rO\m OF ZEi'HYRHILLS, recorded in Ph t
~ook 1, page 54, Pub11c Records of Palco
County, Florida.
Including furnicure. fixtures and equipmenc
located in tha homs a!tuated on said lande.
RC8~rv~ng unto GrantJr a Life Estate in ~nd to
1:1",2 above-descr:l.bed real and personal property,
includi~g ch~ righ~ to rentG and procseds thereof,
C1nd ,old IIronlor doe' i,.,.toy "/:,; '.,v,'CO'" H,. "~,to ~o ,old :o^d, ond .,.,ill delt~d f~. ,omt o9Q.ml ,II. Icw'vl ,k,''''1 ef 011
P1HW..,\ "",~,onl!.-OOYer.
. '(",rOI"lI(,..l'" (lr"lQ '~".Jol"" 0'''' v...d jVI "n'<il'Jlor t>/ phJroi. 0' tonte.. "~quite,
C;:.., :,:;f hOI hf'rttlJnlo.") ~...r ';'unI0('t hQrlO ond ~af fn. dQY .o('ld YfO' fir1f ceo.... writtlfn.
ffJ! ,~?'f~ ..
eLlz1f!~ TALLE~ '.c ::::
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Sr,o,TE O~ Florida N,~ :>.>
COUNTY Of Pas co ~ ~ .;;0 ~
I HHf8Y CfR1IF'/ I~~' on Ihi. d~'1 I..Ie,. m., o~ oHic.' O"'r Q"oli'l.d 'II .ok. "(.nOwle~Qm.nh. P."o*'I ~ rtJ:: 0;,
nIZABETH TALLEY :E 3 0-
· ::Ill C1'>
e'.",db.,l I" o~d ,...~o ...,,,I.d Ih. loreooinQ i~lt'um..~' ond IIc.nowl~.~.'ore ~e ,he.
10 ""'. kno,,",,^ 10 b.f f"', p.rt.ol'l
S h. u"vltd I~t .('me,
WITNESS my .,hR';d' ~,.d. Q(f~,,\.',.,'i In 'K> L ovo'Y ood 510"
1982 .""t>, f'. C,. ',..
/,.:~.-:..,. . .. .:.r,,~!,~p';~'K' S;J\' of ~ru.o
My co",~i,'lltvi'.~O:1~R y'1(,o~. ..~ ~';X:~l j,\.iy ~. 1m
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10" oior.'~'iI 12th d.,y oi March,
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