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BUILDING PERMIT
Permit N2
3.----- u"o
t)'
ELECTRICAL
CITY OF ZEPHYRHILLS
(813) 780-0020
i1- So
PLUMBING
1212
JLf7 <~?J
BUILDING
c... /7 - O~
Date J' - /
MECHANICAL
Sewer Conn
Parlii81 I g. "
Water Conn:
Property Owner:
Job Address: .
Water Meter:
T,I.F.'s:
Zoning:
Descriotion of Work
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
-L(--tJ2.
DATE
- . ~() d--.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
RL
DATE
j/JO
/
-I'.
City license Registration #
State Certified license#
.2517
p~rmit Fee J1~tJ.5. r-
~nature~ j4P-c- .
Company
Address
:Yfelephone#
Valuation or
Contract Price
:<. O} f-OO
.
BUILDING
Ftr. /', - ).5--0"2- P-L Y
Pre SLB /~<Z5"()2.. RL ~
lintel
FRM. ./ li-Il(-t7 2 B ~
Insul. CL
WL
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.
CITY OF
ZEPHYRHILLS
"NOTICE"
OF ADD.ITION OR CORRECTION
BUILDING
DEPARTMENT
DO NOT REMOVE
ADD?", s7; !o 2- P,;'; ~ I
THIS JOB HAS NOT BEEN COMPLETED. T~e following additiqns or corrections shall be made before the job
will be accepted,
Need /0 I () + ?'f 5) ur{). }J 0 WGt-k',y'" I '" p. (J<? .
I
II Is unlawful for any Corpenler, Conlroctor, Builder, or olher persons, 10
cover or couse 10 be covered, any part of Ihe work with flooring, 10lh, earth
or olher mOlerlol, unlllthe proper Inspeclor has hod omple lime 10 approve
Ihe Inslollollon.
. AFTER CORRECTIONS ARE MADE CAlL
788-6611 R RE-INSPECTION
OfFICE HOURS 8 - 5 MON.-FRI.
INSPECTOR
I ~..tl(}/7)1/ . r -{J;J ~l
CITY OF ZEPHYRHILLS PERMIT APPLICA~~~' 3":J, ~j
BUILDING DBPARTMENT 5335 8~ STREBT ZBPHYRHILLS, PL 33540
PhoneaB13-7BO-0020 Pax:B13-780-0021 /J- /} J _ I~
DATB RECEIVED ~.?<..~ O~
PLANS REVIEW PBB
OWNER'S NAME
,PHONE CONTACT
JOB SITE ADDRESS
~ ~I!-O "?-
.$1 IS--
(OBTAIN FROM PROPERTY TAX NOTICE)
LEGAL DESCRIPTION:
PARCEL ID #
WORK PROPSED: ~ CONSTRUCTION
o ADDITION
o ALTERATION
o REPAIR
o INSTALL
DSIGN
o MOVE
o DEMOLISH
PROPOSED USE: DSGL FAMILY DWELLING
DMULTI-FAMILY
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
o COMMERCIAL
o INDUSTRIAL
DESCRIPTION OF WORK
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
j41t1~~ 4, y
BUILDING SIZE
/2,'/ 7t3
SQUARE FOOTAGE ) J...s-~
,
I (
HEIGHT /3/&
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.
PERMITS REQUESTED
& (1) SET ENERGY FORMS.
FOll~ ptJ~
o BUILDING
$ ;;)r{/<jOD
,
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o FLORIDA POWER
o W_R.E.C.
o PLUMBING
o MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT
o NO
BUILDBR
COMPANY
STATE CERT OR REGIST
CITY PROCESSING #
SIGNATURE
******************************************************************
COMPANY ~~iY)
STATE CERT OR REGIST #
CITY PROCESSING #
'M~
BLBCTRICIAN
PLUMBER
**************************************************************
~ COMPANY B!I/6 ,fJ!ttVU,J;;6
~ / ~.) _ ~.' '. STATE CERT OR REGIST #
~~~_~-_________ CITY PROCESSING #
SIGNATURE
MECHANICAL
******************************************************************
COMPANY
STATE CERT OR REG 1ST #
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 roay 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, 813-788-661l.
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 ~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 r the project will be considered abandoned.
WARNING TO R: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN
PAYING IC IMPROVEMENTS TO UR PROPERTY. IF YOU END TO BTAIN FINANC G,
WITH Y R ATTORNEY EFORE RECORDING YOUR T CE OF 0 NCEMENT. JOBS
$2,50~N NEED TO ECORD AND POST A ~NOT OF CO ENT".
SIGNATURE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by
acknowledged
1L-
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
o who has produced
(type
and whoD did Ddid not
of identification)
take an oath.
(name of person acknowledged)
[1ho is personally known to me, or
o who has produced
(type of identification)
and who Ddid Oiid not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
,
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J.N3N3:lHBJlWO:l dO 3:lI.t.ON
CITY OF
ZEPHYRHILLS
"NOTICE"
OF ADD.ITION OR CORRECTION
BUILDING
DEPARTMENT
DO NOT REMOVE
1/5S
ADDRESS DATE PERMIT +
'3912. ~-2~ -az.... /C/~
THIS JOB HAS NOT BEEN COMPLETED The fo I wing additiqns or corrections sholl be mode before the job
. will be accepted,
,
)t~i.~~W~~
:f--.E_.~ ~- \~ ~ 0v.If0'~
1111 unlowful tor ony Corpent.r, Controctor, Build.r, or olh.r peraonl, 10
cov.r or COUM 10 be cov.red, ony port ot Ih. work with flooring, loth, earth
or oth.r moterlol, unllllh. proper Inlpector hOI had ompl. 11m. to opprov.
Ih. Inllollollon.
, AFTER CORRECTIONS ARE MADE CALL
788-6611 FOR RE-INSPECTION
INSPECTOR C-- ~~
OFFICE HOURS 8 - 5 MON.-FRI.
CITY OF
Z-EPHYRHILLS
"NOTICE"
OF ADDITION OR CORRECTION
BUILDiNG
DEPARTMENT
DO NOT REMOVE
Yivy>
ADDRESS
DATE
PERMIT .",
9'72 5"" -0 L '2/
THIS JOB HAS NOT BEEN COMPLETED. T~e folio I 9 additiqns or corrections sholl be mode before the job
will be accepted,
,
It il unlawful for any Corpent.r, Contractor, Bulld.r, or oth.r pe~nl, 10
cov.r or couae to be cov.red, any port of the work with flooring, loth, earth
or oth.r material, unlll the proper Inlpector hOI hod ompl. 11m. to opprov.
In. Inllollollon.
, AFTER CORRECTIONS ARE MADE CAlL
78~1J.,CT, ION
INSPECTOR
OFFICE HOURS 8 - 5 MON,-FRI.