HomeMy WebLinkAbout02-1126
BUILDING PERMIT 0
CITY OF ZEPHYRHILLS Permit. N_
(813) 780-0020
BUilDING
elECTRICAL
PLUMBING
MECHANICAL
P,opertyOwne, 1!o6Mr ~;y
Job Address: 3 ~ 0 3> <6 1.,( fI"< .
1126
Date
..y - Jl- t1 ;;2..
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Parcel 1.0. ,
Zoning:
OescriDtion of Work
j-
Radon Gas:
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Address
\-Telephone# ? r,z - ., y tP s;-
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.
Valuation or
Contract Price
t(~fYV ( ~
-
FINAL
C.O.
DATE
DATE
Inspector
City License Registration #
State Certified License#
1) r) i'\i/f
BUilDING
SlB
Tub Set
Water
Sewer
Final
Ftr.
Pre SLB I t/-5~O:t. ilL". f(JJ
.
Lintel
FRM.
Insul. CL
Wl
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Driveway
ANICAl
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of twenty-five and 00/100 Dollars ($25.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
9TH AVENUE
40' Platted R/W
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OWNER'S NAME et3~/L1 ~Jwl'
JOB SITE ADDRESS 3Cfog S Cf"ff,.... Ac.)e.
OfO 'Xf!:l. C,c:I
LEGAL DESCRIPTION: LOT(S) ~O ~K
V)"fi. . \
~ 0--'- - it;), 100
CITY OF ZEPaYRHILLS PERMIT APPLICA~~
BUILDING DBPART~ 5335 B~ STRBBT ZBPRYRRILLS, PL 33540
Phone: 813-780-0020 Pax:813-780-0021. L/::'/_ /J /} .
DATB IlBCBIVBD L (/ ~
PLANS RBVIBW FBB
...
PHONE CONTACT lei?- - <=1 '-f {p S-
2-3
SUBDIVISION
Y /tv'] L. '^~
PARCEL ID # '.Z -;z..t. -;< - oo~ 4 - (!)7{ 300 -00 10 (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: ONEW CONSTRUCTION J(ADDITION o ALTERATION 0 REPAIR 0 INSTALL
OSIGN 0 MOVE 0 DEMOLISH
PROPOSED USE:)8$GL FAMI~Y DWELLING
o COMMERCIAL
DMULTI-FAMILY
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
o INDUSTRIAL
o RESTAURANT & HEALTH DEPARTMENT APPROVAL
I?ESCRIPTION OF WORK I/St)D' Qt9rv<!rd-e.. O~fD Gll"'\,..':h A Cf'lIZ. ;.J;/-..Lb
I
9'1'/ Z. SQUARE FOOTAGE
108
/iM.;C1 IPS c.c. ". IE
9'
HEIGHT
BUILDING SIZE
RESIDENTIAL:
COMMERCIAL:
~TTACH (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.
f. ~ ,!!-
/~()O
PBRMITS RBQU.STBD
~DING
~LECTRICAL
$
VALUATION OF TOTAL CONSTRUCTION
/00
.
AMP SERVICE
)kf FLORIDA POWER
o
W.R.E.C.
o PLUMBING
o MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
~RAME
o STEEL
o OTHER
TYPE OF CONSTRUCTION: 0 BLQCK
FINISHED FLQOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES jJ('NO
BUILDBR~~
STATE CERT OR REGIST #
SIGNATUR J CITY PROCESSING 1#
******************************~********************************'***
'VI
BLBCTIlI~IAH . . COMPANY{Y 1....77U/J/
.. STATE CERT. OR REGIST 1#
SIGNATUR', . CITY PROCESSING 1#
*.*********************.*.*.*..****.*..****.****.*.*******.******.
COMPANY
PLUllBBR
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING # .
'~, "
SIGNATURE
IOICHAHICAL
....*...*.**....*..*.*.**.*********.*****************.*...*.*.....
COMPANY
STATE CERT OR REG 1ST #
CITY PROCESSING #
SIGNATURE
**.************************.****.***.*********.******.**********.
OTHBR
SIGNATURE
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
***********************************************************..****
CONDITI0NS 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 resportsi~ility-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 roay 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 uowner" prior to commencement.
E. CONTRACTOR' S/OWNER' B 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 UA" or uA,etc.", it is
understood that a drainage plan addressing a ucompensating volume" will be submitted which
is prepared by a professional engineer registered in the State of Florida prior to pe~t
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 pe~t 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 pe~t is commenced within
six months of issuance, or if work authorized by the pe~t 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 pe~t 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 uNOTICE OF COMMENCEMENT".
~~ . SIGHAruRE: CONTRACTOR
STATE OF FLO~ .) STATE OF FLORIDA
COUNTY OF 1dt.--,-5 C!<? COUNTY OF .
The foregoing instrument ~as~c~n~wledged The foregoing instrument was acknowledged
Before me this ----L.2.7day of li.. t::k.. , ~Before me this _day of , 19
by by
(name of person ackno~ledged)
~ho is personally known to me, or
o who has
(name of person acknowledged)
[Lho is personally known to me, or
an
o who. has produced
(type of identification)
~id not take an oath
and who Ddid
Signature of person taking acknowledgment
Name t
Name typed, printed or stamped