HomeMy WebLinkAbout01-0556
BUILDING PERMIT ~~
0556
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
Date
9 / ,e, /0 I
,
/ 00
lD 0...--
BUILDING
ELECT~CAL
PLUM~NG
MECH~NICAL
Sewer Conn
Water Conn:
Property Owner: Lv!.. \\-
Job Address: '3 (" () S
Parcell.D. # ;).If. - -:2 ~ -1. -
') o~ , .h,,~
A~~,v . ....~
00 to -OVO~~tI-
Water Meter:
(.,J
C)1:~
T.I.F,'s:
Energy Code:
~ L-.re ~.... a.. 0 o.."...-'\.
Radon Gas:
Zoning:
Description of Work
NO OCCUPANCY BEFORE C.O.
FINAL
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
C.O.
DATE
Inspector
City License Registration #
State Certified License#
Permit Fee
;X Signature
Company
Address
~.Telephone#
Valuation or 75 Dc #::.-v
Contract Price .:>
~
0'-)~-J2~Y
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
BUILDING
Driveway
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Twenty Five 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.
I
. . ~
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CITY OF ZEPHYRHILLS PERMIT APPLICATION h9I ~to
PL 33540
BUILDING DBPARTMENT 5335 Bth STREET ZEPHYRHILLS,
Phone:B13-7BO-0020 Pax:B13-7BO-0021
DATE RECEIVED 7'~ /7-0 I
PLANS REVIEW PBE
::':::.N:RE~{t5"1j:l!~;/He tt/~)/
LEGAL DESCRIPTION: LOT(S);( )I BLOCK ~~ SUBDIVISION
PHONE CONTACT
.2)
PARCEL ID # ;(
WORK PROPSED: [JNEW CONSTRUCTION
-(}6ldt7LJ __ otf;G D (OBTAIN FROM PROPERTY TAX NOTICE)
~ITION [JALTERATION [J REPAIR [J INSTALL
[J SIGN
[J MOVE
[J DEMOLISH
PROPOSED USE: [JSGL FAMILY DWELLING
[JMULTI-FAMILY
[J# OF UNITS
[J MOBILE HOME
[J OTHER
[J COMMERCIAL
[J INDUSTRIAL
[J SWIMMING POOL
D
DESCRIPTION OF WORK 5" C r t2 e t1
/<J )( )Ip
. .
RESTAURANT & HEALTH DEPARTMENT APPROVAL
~c:J t4?
BUILDING SIZE
SQUARE FOOTAGE
x
.
p!- II
HEIGHT ,-
& (1) SET ENERGY FORMS.
FORMS.
RESIDENTIAL:
COMMERCIAL:
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
lid ;)o~
[J BUILDING
~
PERMITS REQUESTED
,~9tJ tJ, & 0
VALUATION OF TOTAL CONSTRUCTION
[J ELECTRICAL
AMP SERVICE
o
FLORIDA POWER
o w.R6'~~/f~)-1
INSTALLATION 1/ f
[J PLUMBING
o MECHANICAL
$
VALUATION OF MECHANCIAL
[J GAS
o ROOFING
o SPECIALTY
[J OTHER
TYPE OF CONSTRUCTION: [J BLOCK
o FRAME
[J STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT
AREA[J YES
o NO
BUILDER
~ COMPANY
/ /J ~. . STATE CERT OR REGIST #. 0 20 Ir 'J'!;;
~'. CITY PROCESSING # ,jR.F97 -x: ;Vi
.................................................................. ' ,,~
BLECTRICIAN
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
******************************************************************
PLUMBBR
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.' NOTICE 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 Zephyrhil1s.
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 TICE OF COMM EMENT MAY RESULT IN YOUR
PAYING TWI FOR IMPROVEMENTS TO YOU OPERT. IF YOU T D TO OBTAIN FINANCING, CO U
WITH YO NDER OR AN ATTORNEY BORE RECO ING YOUR T E OF COMME CEMENT. JOBS NDE
$2,500 I VALUE D NEED TO CORD AND ST A OF COMME C
OR AGENT
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 [~iid not take an oath
o who 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
1111111111111111111I11111111111I1111111111111111111111111111
2001130359
NOTICE OF COMMENCEMENT
state of F7L> /"/~ County of .Ol!f c ()
I /
TUB lmOERSIGNED hereby gives notice that improvement will be made to c~rtain
real property, and in accordance with Chapter 713, Florida Statutes, the
follo~ing infor~ation is provided in this Notice of Commencemcnt:
2. General Description of Improvement
j()T~??
,~cree 1/\
3.
6 t6vo..rcn;/)()
a,mer Information: Name 'uJ.(//~ ~c !nl1~
llddress 'J~tJ ~~ ~ ~?- ,II;/ls
Interest in Property: 0 t1 p r R t 5
cp: 29817
DS: 0.00
llame of Fee Simple Titleholder: 09/19/01
(If other th~n owner)
State E
Rec: 6.00
IT: 0 . 00
Dpty Clerk
Address
City
State
.,- .. .
. ")'
l~". A
\1 ijo:!. ".
Contractor: N.:lme 1l7D;Z ll/trU/l
Address /.2 rio f) t!{r .,j/faity l4l{cl5~ tA
, e, ICL~ Lt:tj(e f);
5 .~S rety: N.:lrne
/V(
1\ddress
State A
~
City
State
Amount of Bond: $
JED PITTMANA PASCO COUNTY CLERK
09/19/01 0~:01Pm 1 of 1
OR BK 4724 PG 1973
6 .
Lender: llame
Address
City
Statc
7. Persons within the State of Florida designated by Owner upon whcm
notices or o~her documents may be served as provided by Section
713.13(1)(a)(7), Florida Statutes:
t l,; me $d1 tH:i:' -'
Address
City
State
8. In addition to himself, Owner designates
4;r.1;f to receive a copy of t:.c
f~Lienorls Notice as prov~ded ~n Section 713.13(1)(b), Florlda Statutes.
<J. f"xp.ir/11 ..!.',n d~t~ n! !!CJt.lce of ~O:1It'ii~nCemeiit. (t.he explratiun date is 1 ye.:1r
ir?m the d.:ltc of recording unless a different date is specified.)
~ot<lry
PC93053048/A
-- -- -- - ,~~:;~-- ----- -- -- --- ---- --- --- -- -- - ---.
~ropo~al
Page #
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We hereby:$Jbmit specifications and estimates for:
Job Name
f'
Proposal Submitted To:
Address
-~~.
.' -,.- --~/k::) /
i.(.. / . .1'<' "'
Phone #' /
l-/
~:Z!~=3_CZ;Z2:j.:er!
. .:7Z!!-QZZ .?:~. .K~~ 5'3-~z~~-:~:;~f:::~:;
Z-<;?)ti;1;;<<i2=I1t?'~~::l;~:-:jZ;ZZ2.~!1.:r!-~~::
&~. ._-'<-(~~~_..~~ ~~ =st..
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Any alteration or deviation from above specifications involving extra costS\ill be
executed only upon written order, and will become an extra charge over and
above the estimate. All agreements contingent upon strikes, accidents, or delays
beyond our control.
Respectfully
submitted X
"' Dollars
6M/Je12
~-/ //
~~-L.-o< "' ...//
==
with payments to be made as follows:
Note - this proposal may be withdrawn by us if not accepted within
days.
~tttptant~ of ~roPoS'~t 1 (1/: /J f
The above prices, specifications and conditions are satisfactory and are Signature X l~ U uJ!5fi., /!.ft-t)lJ~~
hereby accepted. You are authorized to do the work as specified.
Payments will be made as outlined above.
Date of Acceptance 'f Signature X
air NC3819 MADE IN USA
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