HomeMy WebLinkAbout02-1137
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N~
1137
(813) 780-0020
Date -f -tff"~t? ;(
BUilDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Property Owner: ~ P'~A po ~ ? ~
Job Address: l 191tf"3 //~ RI/e.
Water Conn:
Water Meter:
T.I.F.'s:
Parcel I. D, /I
Zoning:
Descriotion of Work
Energy Code:
&~JP-rk~
Radon Gas:
~/~cp~
NO OCCUPANCY BEFORE C.O.
FINAL
Complete Plans. Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
FRM.
Insul. Cl
Wl
BUilDING
ELECTRICAL
Inspector
Permit Fee .5~ ' tt:JO
~ignature C;,~, ( e:
Company
. Address
"'>Telephone # '7 C( J...... if J (., V
~~~ \1)/1 I./<:? COM4.;,/2
PLUMBING MECHANICAL
Valuation or ______
Contract Price
City license Registration #
State Certified license#
.(,3
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SlB Breakers
Tub Set Ducts Insl.
Water . Compressor
Sewer .//.1-10 -0"- ;2ot;1/7(J Final
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.
OWNER'S NAMB p; 'f!l. !l-e
CITY OF ZEPgYRHILLS PBRMIT APPLICATION
BUILDING DBPART~ 5335 8~ STRBBT ZBPRTRB.ILLS, PL 33540
Phone.813-780-0020 Pax.813-780-0021. LI O_/'J V)
DATB .BCB:IVBD . r - L V "-
PLANS RBVIIIIf rBII .
,~1 /4 ~
(J / 't -I -/.~
i I +-.0- A iJfvvu~
JOB SITE ADDRESS
PHONE CONTACT
LEGAL DESCRIPTION. LOT(S)
BLOCK
PARCBL ID #
SUBDIVISION
WORK PROPSED: ONEW CONSTRUCTION
(OBTAIN FROM PROPBRTY TAX NOTICE)
o ADDITIO~
o ALTERAT ION
o REPAIR
o INSTALL
OSI<JN
PROPOSED USE: ~ FAMI~Y DWELLING
o MOVE
o DEMOLISH
OMULTI - FAMILY
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
o COMMERCIAL
o INDUSTRIAL
PESCRIPTION OF WORK
CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL
SeWf'tL Lr'..ve.-
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
RESIDENTIAL:
COMMERCIAL:
~TTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUILDING PLANS & (1) SET BNERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PBRNITS RBaUa~TBD
o BUILDING
$
VALUATION OF TOTAL CONSTRUCTION
o ELBCTRICAL
~MBING
AMP SERVICE
o FLORIDA POWER
o W.R.E.C.
o MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLQCK
o FRAME
o STEEL
o OTHER
FINISHED FLQOR ELEVATIONS
IS PROJBCT IN FLOOD ZONE AREAO YES 0 NO
BUILDBR
SIGNATURB.
COMPANY
STATE CBRT.OR REGIST #
CITY PROCESSING #
BLBCTR.IC.IAH
~**********A******************************************************
SIGNATURE
COMPANY
STATE CERTOR REGIST #
CITY PROCESSING #
PLUJlBBR
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?lu~'~J
~ ~l
, "
SIGNATURE
/~e
COMPANy. (r4/;J~ S~1y 5
STATE CERT ORR GIST #
CITY PROCESSING #
IOICIIAHICAL.
******************************************************************
COMPANY
STATB CERT OR RBGIST. #
CITY PROCESSING #
SIGNATURE
*****************************************************************
OTHBR
SIGNATURE
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
*****************************************************************
CONDITI0NS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Tile und.ers.igned understands t~at 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, 813-788-66~1.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the UContractor 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 priyileges in the City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTEa, ASAMENDBD)
.1 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 uowner", 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, zonin~ 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 addressin9 a ucompensating 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 1s 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 uNOTICE OF COMMENCEMENT".
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRl\.CTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by
acknowledged
, 1!L-
STATE OF FLORIDA
COUNTY OF .
The foregoing instrument was
Before me this ~ay of
by
a clf.nowl edged
, 19
(name of person ackno~ledged)
.0 who is personally known to me, or
Dwho has produced
(type
and whoO did Odid not
of identification)
take an oath.
(name of person acknowledged)
CLho is personally known to me, or
o who. has produced
(type of identification)
and who Odid [}lid not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped