HomeMy WebLinkAbout02-0895
BUILDING PERMIT~~
0895
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
B~G
,/
ELECTRICAL
PL~.~'G
Bz"-z Br(~
.4v~ '
t?25'/o7J
MECHANICAL
Date / - tF - () ~
I
Property Owner:
Job Address:
Parcel I. D, #
f1 II Nc fAtJs i
3 ?'CfltS S'-A
Sewer Conn
Water Conn:
Water Meter:
T.LF.'s:
Zoning:
Descriotion of Work
Energy Code:
K;+C~ ~d
Radon Gas:
v~-f;.{~t'O'h S'fSt-~
FINAL
C.O.
0(.
DATE
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances,
DATE
Valuation or
Contract Price
~~o
(}O
Inspector
Permit Fee ,;25"' p.o
pignature flJ- f I..~
Company
Address
)(f elephone #~;] '75".J. -.2 ( I r
City License Registration #
State Certified License#
~
Rd- p 5"/~~-I
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
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
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.
APPLICATION FOR PERMIT
CITY OFZEPHYRHILLS
BUILDING DEPARTMENT
/ UQJ.<-ti 1, 7 - 0). ~'
.~_.---
APPLICANT
R -rR. SHEer
7700 f7;~T klw6<"
t1 EntL
Rei
PHONE
7~2-";).t If
ADDRESS
OWNER
Jon LOCATION 37i'l'/S 6-14 live
LEGAL DESCRIPTION: LOT(S) ~fA-/~ Jo'&-~BLOCK
LOT SIZE_X
AREA SQ. FT.
SUBDIVISION
~
PARCEL 1. D. f1
WORK PROPOSED:_New Construction____Addition ____Alteration ____Repair _Install
_Sign/Temp.
____Sign
_I-Iove
_Demolish
PROPOSED USE: ____Single Family
____M/F
____f~ of Uni ts
._r-I/ll
_Commercial
~Indust.
_Swim. Pool
Other
_Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Pee t,
Height
RESIDENTIAL:
COr-frIERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY PORI-IS. H
**COPY OF CONTRACT REQUIRED.
PERMITS REQUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL AMP Service
LMECHANICAL $ Ir:(oo ~.
Krr"f1G"~ }f~i'JD UE:vncArl()"/ 5Y.57C~
_PLmmIN"G ,.... - GAS
TYPE OF CONSTRUCTION: ~Block
Florida Power Corp,
_H.R.E.C.
Valuation of Mechanical Installation
IIV 5 r tft;tA-1/ " ,..I
ROOFING
SPECIALTY
_Frame
_Sr.eel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
CONTRACTOR SECTION
Company
State Cert. or Regist, 0
City License Registration il
******************************************
BUILDER
Signature
ELECTRTCTAN
Company
State Cert. or Regist. "
City License Registration 0
******************************+.***********
Si!:'n::\ture
Company
State Cert. or Regist. 0
City License Rcgistration 0
******************************************
PLUMBER
i<S
Signature
Signature
K ~ R 5" /l&eT /J1 CT'71L
~ Company
Cl I _, _ 191/ State Cert. or Regis t, to T<t5 oo.:l'l,f-S-fI
~{[ ~ City License RCGistration 1; 0"<''1
********************************~~~**~**~*
N~tJt#d.uwf-
I ..Ap
l-IECHANTCAL
Company
State Cert. or-Rcgist, 0
City License Registration f~
OTHER
Signature
******************************************
APPLICATION APPROVED BY
PERHIT OFFICER.
:it'
i'-Ii' ,
~
~ONDITIONS OF PERMIT AFFIDAVIT
PI ..: NOT I ItE OF DEED RESTR I CT IONS ;', , .
Th, """"," ......t"" th.t th\' ".,\. .~ b. ~bl..t .. -.... ............. ,h'" .., b. ".. ..."."... 'h.. CI"
regulation,. The undersigned aSSUlel relponsib~l~'~ fo~ cOMpliance with any applicable oeed restrictions.
. .:. I :.~' ~., ~ ".. '
. "\' ~~..~.~ ',' .
UNLICENSED CONTRACTORS AN '~ONTRACTOR RESPONSIBILITIES
B.
If th. ,.... h.. hI..' . .,....,.,. ,. "....,.,.. ., ..,...." "", 'h'y "y .. "".,.. .. b, ,.....'. .. .,.,....,. ....
..... ... ".., ,.,.,.",... If th. .,.t,..t" I. .,t """" .. ,~".'. by I.., b,'h .h. "." ... ......,.., .., b'
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City ~f Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
CONSTRUCTION LIEN LAW
(CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
D.
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.o~ner. pri~r to cOi~encement.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I ,.,\'f, \h.1 .., Ih' ....,.,Ii,. .. \h" ,ppll,.tl" ., ,."".. ..d Ih.1 ,II ..,\ ,'11 b. d," .. ...,1"'" ..1' .11
applicable laws regulating c~nstructi~n, z~ning, and land development.
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Water/Waste~ater Treatment
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I Armv C~ros of EnQi~eers - Sea~a\ls, Docks, Havigable Waterways
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I US EnvirDnoental Pr~tecti~n AQenci - Asbestos abatement
I .... ",Iify \h", if fill .....i., I, to.b' ."d i. FI..' 'IP' .,. .. ","c', " ;. "o",lc,.' "", · .".".,. pI"
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."....d . ..,or Ii ,.. ..., b, ..",d ..d.g mh ,Ix ...1 h "d.d, .. \h, ,,,;... · ill ., "". 10m' ,b ...M. pOd .
WARNING TO OWNER. YOUR FAI(URE 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. J08S UNDER $2,500 ,N VALUI
DO NOT NEED TO RECORD AN POST A "NOTICE OF COMMENCEMENT".
SIGNAT SIGNATURE____~-~-----------
CONTRACTOR
DATE
-----------------------------------
/)..-17-61
DATE_~~~~~J2~---------------~------
NOTARY AS TO " ~ ,:' ,
OWNER OR AGENT__~~1~---[t~--~i~Jt~3-~---
""1-::,,1,/,..1 y:) fY',. ~,tc',(;: ,'..1
MY COMMISSION EXPIRES_~~~Q~--L~~-l~~-~----
NOTARY AS TO ,': ~!~' k
,/ )f c.-/ ~'"..,
CONTRACTOR G~\V,"'" ~ (\ . -" . -
. ___~j~;;~-~:~-AZ7cej-~~-
MY COMt'lISS10N ExPIRES_:::l~[l?-L:tL~~~~~--
(j DONNA M. BACKES
, MY COMMISSION II DD 014597
EXPIRES: June 18.2005
l.ero3-NOTARV Fl ~ ~1.1!OndIf'IO, tnc.
~ DONNA M. BACKES
. MY COMMISSION # DO 014597
EXPIRES: June f8. 2005_
1-8l>>3-NOTARY Fl NolatY SefVice & Bondin9rIAc.
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