HomeMy WebLinkAbout02-1125
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N!
1125
(813) 780-0020
Date
1/- ,;2-0~
~ ~C' P~'- ~~
p.opertVowne'~~ V~ ~ ·
Job Address: __ G~~/ - ~
Parcel 1.0. #
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
OescriDtion of Work
,.-1--- %/ ;:2.
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.
c.o.
Inspector
DATE
RL c;
Permit Fee
~~
Company
Address
~e~ g 1'3-1-'lS"- +17~
Valuation or
Contract Price
600
City license Registration #
State Certified liS'nse#
If?PLC .;uGV
~ /l1.LJ J) /.11;- {! 0 ~
/40
BUilDING
ElECTBteAC-
..---
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
------
PlUMBI~
~
M!'CRANICAl
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 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.
Tl J2e)
PLV5"
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
~o'j I-(:;Z -0 ~
PHONE 7'2 7-~ - '372-7
C.~RWATezFL.
I
OWNER'S ADD~OU
JOB ADDRESS S' 2 +0
OWNER'S NAKE MOf2-6AfJ TlfZe, ClJrz-~
<; lJ N "l'{ 1:> ALE g\j O.
GALL rJ \/D .. I
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 1. D. f
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition _Alteration _Repair ~Install
-X-Sign _Move _DeIIOlish
PROPOSED USE: _Single Fallily _M/F _, of Units _M/H
,
~eo..ercial _Indust. _Swia. Pool _Other
Restaurant & Health Depar~ent Approval
- , I ;;:'\
DESCRIPTION OF WORK: \NC>'ALL- 5 ')<. 20 ~l6N ON INAU-~AC IN& 3o.!;
BUILDING SIZE:
x
Square Feet.
Height
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMMERCIAL ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTED
_BUILDING
$
(,,00.00
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBING GAS ROOFING
SPECIALTY
TYPE OF CONSTRUGTION: _Block _Fralle _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJEGT IN FLOOD ZONE AREA?
******************************************
YES NO
OONTRAGTOR SECTION
BUTI.Dm
COMPANY
State Cert. or Regist. ,
City License Registration f
******************************************
Signature
F.l.RGTRICIAN
COMPANY
State Cert. or Regist. t
City License Registration ,
******************************************
SiQllAture
PLUMBER
COMPANY
State Cert. or Regist. f
City License Registration ,
******************************************
Signature
KEGBANIGAL
COMPANY
State Cert. or Regist. ,
City License Registration ,
************~*****************************
Signature
~ ~ ~ =~~~~~is;l~r~J~-f
Signature City License Registration t ~
.......................................... V 0 fL
APPLICATION. APPROVED BY PERMIT OFFICER.
OTRRR
t.f)~
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS .
Tbe undersigned understands tbat tbis perait lay be subject to "deed restrictions" wbieb lay be lOre restrictive than City
regulations. Tbe undersigned assUles responsibility for colpliance with any applicable deed restrictions.
B. UNLIC,NSED ~O~~RACTORS AND CONTRAc.wOR RESPONSIUrtiTiES.
If the Owner baa bired a contractor or contractors to undertake work, they lay be required to be licensed in accordance with
state,'and local regul~tiPRel.. \If~~ cqn~aj:ti>r is .not U~ed as:~requiredjbl t'aw/ tio\:h the owjlet.iUl(ij contractor laY be
cited for a lisdeteanor violation under state law. If the owner or int~ded contractor are uncertain as to _hat licensing
reguirelents lay apply for the intended work, they are advised to contact the City of,Zepbytbills Building Departlent, (813)
788-6611.
FurtherlOre, if tbe owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
"Contractor Sections" of this application for wbieb they will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, rather tban the contractor, are responsible for the work. If the contractor wishes you to sign
as contractor that lay be an indication that be is not properly licensed and is not entitled to peraitting privileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify tbat I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - HOIeOWDer's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is SOletH)e other tban the
"owner", I certify that I have obtained a copy of the above described docUlBIlt and prOlise in good faith'to deliver it to the
"owner" prior to couencelent.
E. CONTRACTOR'S/OWNER"iS,~~FF:{D~VIT '.,:J ~ . ."\ ..... .
, I certify tbat all the inforlafion in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a perait to do work and installation as indicated. I certify that no work or
installation has cOllenced prior to issuance of a perait and that all work will be perforaed to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developlent regulations in t4e jurisdiction. I also
certify that I understand that the regulations of other goveI1llental agencies laY apply to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to:
* Departlent of EnvironJental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands,
Water/Wastewater Treatlent
* Soutbwest Florida Water ManagelBnt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
* ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
* Departlent of Health & Rehabilitative Services, Environaental Health Unit - Wells, Wastewater Treablent, Septic Tanks
* US EnviroDlental Protection Agency - Asbestos abatelent
I also certify that, ,if fill laterial is to be used in Flood Zone RA" or "A,etc.", it is understood tbat a drainage plan
addressing a UcOlpensating volUleR will be sublitted wbieb is prepared by a professional engineer registered in the State of
Florida prior to perait. issuance.
A perlit issued sball 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 is~uance of a perait prevent the Building Official frQI thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perJit issued sball beCOle invalid
unless the work authorized by such perait is cOllenced within six IOnths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six IOntbs after tbe tile the work is Co.eDced. One 90 day eJtension of tiM, laY be
allowed for the perait with fee cbarge of $15.00. The eJtension shall be requested in writing to the Building Official. An
approved inspection lust be logged during eacb six IOnth period, or the project will be considered abandoned.
WARMING T HER: YOUR FAILURE TO RECORD A NOTICE OF COMMEIICEMENT MAY RESULT IN YOUR PAYING 'NICE FOR IIIPROVIIIDTS TO YOUR
PH . IF INTEND TO OB! INAIICING, CONSULT WITH YOUR LBJlDER OH All AnoRIEY BEFORE RECORDING YOUR MOTICE OF
C NCEMBNT. J S $2,5 VALUE 00 NOT NEED TO RECORD AIID POST A uNOTICE OF COMMENCEMENT".
SI~ ·
STATE OF FLORI~
coum OF E.~
The foregoing instrument was acknowledged
before me this c2.~ or-R- l(9c.:tolP-by
Y'A-\AL ~ r M A-
w~o is personally known to me or who has
produced
as identification and who did/did not
~~UtaI- .
'..J_'~ l0ILC~
(Name Typed~ Printed' or Stamped)
NOTARY' PUBLIC "
STATE OF FLORI~
coum OF ~
The foregoing instrument was acknowledged
before me this ~~f ~ ' i,9~CbL: by
rRAt...\Q\ S ~,L ''''H~.lt
who is personally known...to me or who has
.... --
produced
as ide..ntificati~n/~d ,jPo did/did not
::::!;/flJMf/~
19nat'lire) .
. .' MAA~ 1.01 LL.~ lL
( ame Typed, Printed or Stamped)
NOTARY PUBLIC
,,',-:;"~n:.:" R. Mark Willett
g:r'Ji.'"'f;".; MY COMMISSION # CCS80m EXPIRES
~\~.:~i December 8, 2003
~'1.t ~ \;.~ &ONDED THRU '!IOY FAIN INSURANCE, ilK
""ht'~\
,1ii:!/~ R. Mark Willett
l*rX'1l:~ MY COMMISSION # CC880695 EXPIRES
~,~jt! December 8, 2003
"''.:iif.:r.-cr.;,' BONDED THRU TROY FAIN lNSUtlANCE,lNc.
MORGAN TIRE & AUTO, Inc.
Execuave Offices. Store Support Center. (727) 441-3727 . Fax (727) 461-7709
2021 Sunnydale Boulevard, Clearwater, Florida 33765
If!ft~!!~!:'L
TIlis letter authorizes Apple Sign & Awning, Inc. to install site and building SigIlage at
~2-+0 t,AU- BJ-'\J D. . . Mr. Paul Lima is authorized to act
as owner/agent on our behalf to obtain permits.
Sincerely,
MORGAN TIRE & AUTO, INe.
dba Olson Tire - Total Car Care
ce~ (OJ1(~
Larry C. Morgan
ChaimlaIl and Chief Executive Officer
7~
LCM/vlo
AGeNT
~."""ffl
",~...'IIv.~ R. Mark Willett
r*tiA'\<1 MY COMMISSION # CC880695 EXPIRES
~~~~~.o December 8, 2003
'.,r ::,.~~it' SON[/ED THRU TlIOV FAIN INIUlIANCUC
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