HomeMy WebLinkAbout00-9965
BUILDING PERMIT
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CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
09965
Date
1.2- ~-o 0
.
Property Owner:
Job Address:
Parcell.D. #
E~AL P~'
C? .J.d. ~O~~
4? O.tl.l/ ,- 10 ~ ST.
M~'- Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
Zoning:
Descriotion of Work
Energy Co?e:
Jt; X
.
} /
&,
.
~2GZ.
~J t1
FINAL
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
y
Valuation or
Contract Price
....-------
~ 99/2-
Permit Fee
~
mpany
Address
~
City License Registration # ____
C":)e,m;ed ucense~________
1J-n(1
BUILDING
ELE~-
-----
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
PLUMBJHCf
---
MEC~-
--
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
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 ($ 25.00) 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 I'OR PBRMIT
CITY or ZBPHYRBILLS
BU:ILDING DBPAR'DdBNT
DATI: RBCJlIVBD
PLANS RBVID I'JDI
i2-?--DU
~ OWNER'S NAME ~~ ~ kJ~
.:x JOB ADDRESS M -~ J ~ ~ !o!i SA-,
LEGAL DESCRIPTION: LOT (S) . ~ o:z.1
PHONE f':<~
b:lV f
BLOCK
SUBDIVISION
y PARCEL ID #-
WORK PROPSED: 40NEw CONSTRUCTION
OSIGN
(OBTAIN FROM PROPERTY TAX NOTICE}
o ADDITION
OALTERATION
o REPAIR
o INSTALL
o MOVE
o D~OLISH
PROPOSED USE: OSGL FAMILY DWELLING
o COMMERCIAL
OMULTI-FAMILY
o INDUSTRIAL
O#- OF UNITS
o SWIMMING POOL
o M:OBILE HOME
o OTHER
...)( DESCRIPTION OF WORK
D RESTAURANT & HEALTH DEPARTMENT APPROVAL
I 2 Y I~ Shed
BUILDING SIZE
.;
SQUARE FOOTAGE
19~
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.
~
~ILDING
o ELECTRICAL
o PLUMBING
o MECHANICAL
~ 9r;~
SltQ6
po
PERMITS REQUESTED
d$
VALUATION .OF TOTAL CONSTRUCTION
AMP SERVICE
o FLORIDA POWER
o
W.R.E.C.
$
o GAS
o ROOFING
o SPECIALTY
VALUATION OF MECHANCIAL INSTALLATION
o OTHER
TYPE OF CONSTRUCTION: 0 B~OCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES 0 NO
BUILDER
4IGNATURE ~j~
~D~
COMPANY
STATE CERT OR REGIST
CITY PROCESSING #-
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BLBCTlUCIAH
SIGNATURE
COMPANY
STATE CERT OR REGIST #-
CITY PROCESSING #-
I
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PLUYBBR
COMPANY
STATE CERT OR REGIST #-
CITY PROCESSING #-
SIGNATURE
MBCllAHlCAL
** * * * * *** * *.** * * ** * * * * * * * * **** * * * * ** * *** * ** * * * * * * * * **'* * * * * * * * * * * * * *
COMPANY.
STATE CERT OR REGIST #-
CITY PROCESSING #-
SIGNATURE
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OTBBR
SIGNATURE
COMPANY
STATE CERT OR REGIST #-
CITY PROCESSING #-
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CONDITIONS OF PERMIT AFFIDAVIT
A~ NOT~CE 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.
Furthennore, 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 infonnation 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 perfonned to meet standards of all laws regulating construction, City
codes, zoning regulations, and land development regulations in the jur!sdiction. 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
ackI,lowledged
, 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 of identification)
and whoO did Odid not take an oath.
o who has produced
(type of identification)
and who Odid Diid not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
OWNER
JOB LOCATION
PARCEL I. D . . #
SHON ALL EXISTING & PROPOSED STRUCTURES GIVING DIMENSIONS & SETBACKS.
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UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
FRONT PROPERTY LINE
(NOTE EXAMPLES 1 & 2)
STREET
I (J 7.tf .s lit
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 1 0'
S I
E N
D G
20'
FRONT PROPERTY LINE
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30 'DUPLEX
1 0'
FRORT PROPERTY LINE