HomeMy WebLinkAbout02-1235
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N2
(813) 780-0020
BUILDING
Property Owner:
Job Address:
Parcell.D. ,
1235
Date
{"'-4 (- 0 t5(
ELECTRICAL
MECHANICAL
Sewer Conn
PLUMBING
t<~t~ A/~
V13Q .2o~ 51".
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
Description of Work
Energy Code:
:2 .'/iN
Radon Gas:
r~~JZ. (ntf
/J /c:
I
FINAL
C.O.
NO OCCUPANCY BEFORE C.O.
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Valuation or
Contract Price
City License Registration #
State Certified License#
BUILDING
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
DATE
3,~/5'O~
,
(~.~
Inspector
Permit Fee~' p.o _
yS;gnaMe _ -?A L,r~
Company _ _
Addres( /
)l8lePho~# 7/-1:2,.02 300
I
,} /k;L
r /J/~ if
ELECTRICAL
PLUMBING
MECHANICAL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Ins!.
Compressor
Final
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.
Kinsey Central
Heat & Air-Conditioning, Inc.
P.O. Box 2209 ~
Zephyrhills, Florida 33539-2209 7Z;
(813) 782-2300 RA0056288
DATE PROMISED
ADDRESS
APARTMENT
c
LN<>.
NATURE OF Q
SERVICE
REQUEST
o ESTIMATE
o CASH
o CHARGE
. ,
:... .,
QUAN:' ;PART NO,
.~ 7#}A.J
PRICE
q- .. .p" ?"JA. ~
SERVICE PERFORMED
TOTAL
MATERIAL
TECHNICAL
SERVICE TIllE
TAX
7~ toJ
DATE COMPlETED
CASH ~~MPlET1ON _ TOTAl
TECHNICIAN
CUSTOMER'S SIGNATURE
OHNBR'S NAME !:q c L e1?
JOB SITE ADDRESS i '9 3 7
LBGAL DESCRIPTION: LOT(S)
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUl:LDIRG DEPUTJImno 5335 Sth 8nBJIT ZBPRYRBl:LL8. I'L- 33540
Phon..S13-7S0-0020 l'ax.813-780-0021'
DATE RBCEl:VBD
PLAH8 RBYIJIK I'EB
;u~~
'If"".~' ')
~b jr:r-
PHONE CONTACT
BLOCK
PARCEL ID #
SUBDIVISION
WORK PROPSBD: ONEW CONSTRUCTION
(OBTAIN FROM PROPERTY TAX NOTICE)
o ADDITION
D ALTERATION
D REPAIR
o INSTALL
DSIGN
D MOVE
o DEMOLISH
PROPOSED USE: DeGL FAMILY DW.&;LLING
o COMMERCIAL
o MULTI - FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
DESCRIPTION OF WORK
CJ RESTAURANT & HEALTH
r2 16;v .~
DEPARTMENT APPROVAL
BUILDING SIZE
c /z 0 ""Y
e &l~rI--
SQUARE FOOTAGE
HEIGHT
RESIDENTIAL:
COMMERCIAL:
ATTACH (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.
PBRNITS. RBQUBSTBD
o BUILDING
$
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 OTHRR
TYPE OF CONSTRUCTION I 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJBCT IN FLOOD ZONE ARBAO YES' 0 NO
*********'*********** *****************************'**************
:~
COMPANY f'v\.O\.{"'+\~ ?..xO ~~c;./ I :Jh.c-
STATE CERT OR REGIST # b (Zoo /3 c./L/ q
CITY PROCESSING # Q'1
*******************************.***********************
PLUllBER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING *
SIGNATURE
MBC.llAHICAL
COMPANY
STATB CBRT OR
CITY PROCESSING
/,-8 2
**********************.***************************************
OTRBR
COMPANY
STATB CERT OR REGIST *
' CITY PROCOSSING * ~
********************************************.********~~<. *******
SIGNATURE
A. NUTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictions" which
may be ~ore restrictive than City regulations. The undersigned ass~es responsibi~ity for
compliance with any applicable deed restrictions.
B. UNLICENSED CONT~CTORS AND CONTRACTOR RESfONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they may be required
to be licensed in accordance with st~te 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. It 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, 813-188-6611.
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 contraptor that may be an indication that he is not properly licensed and is
not entitleq to permitting privileges in the City of Zephyrhills"
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTUION LIEN LAW (CHAPTER 113, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction
lien Law - Homeowner's frotection 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
code~, 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, CypEess 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 Offic!al from thereafter requiring a
correction of errors in plans, construction, or violations of any code. Every permit
issued shall become invalid unless the work author~zed by such permit is commence~ 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, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEHENTMAY 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 "NOTICE OF COMMENCEMENT".
SIGNATURE: OWNER OR AGENT'
SIGNATURE: CONTRACTOR
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
acknowledged
19
(name of person ackno~ledged)
'0 who is personally known to me, or
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 DUd not take an oath
Signature of perspp taking acknowledgement
:'A"'
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped