HomeMy WebLinkAbout02-1268
BUilDING
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N!
(813) 780-0020 ;16 -- Date 10 - :;--(jJ~
.-~. ...- ...... ........._~
~HAN~~V Sewer Conn
-. Water Conn:
1268
--
Property Owner:
Job Address:
Parcell.D. "
pj
GLfCIBJC~
~~-~
_ Lf7. -_
-J1 - / EL-~
PLUMBING
Water Meter:
T,I.F.'s:
Zoning:
Descriotion of Work
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p ~ I /
. ~... '.(! C'.... C,
FINAL
C.O.
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.
DATE
'nspector _
Valuation or
Contract Price
-
PerrnitFee -
~,.. .~.~
Company
Address
cTIii~#~$JS- 7RZ- - 5'0/3
~ ~rY:~
PlUM9+Ntr- ~Oc..-.~ ~Ea~~
--
c:2, S ~o
City license Registration #
State Certified license#
/7
-_...-
BUI~-
---
~ ~R;?07;z.
Breakers
Ducts Insl.
Compressor
FinalJL.
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
pre-M~
Fina~ -~" .PQ /2L7'
SlB
Tub Set
Water
Sewer
Final
Ftr.
Pre SlB
lintel
FRM.
Insul. Cl
Wl
Driveway
FP II: t(~ /&rl#t ~
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.
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APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT
ADDRESS .5 3~ 7
OWNER
JOB LOCATION S?~ 7 J3M
/2 ~ Sf
.
PHONE
76"~- CJCJ6,?'
5/-,
LOT SIZE_X
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION
PARCEL 1. D. # / / ' Q /.;.,- 1 (- 00 ) 0 - I 713 0 () - 0 I <f 6
WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install
____Sign/Temp.
____Sign
____Move
____Demolish
PROPOSED USE: ____Single Family
____M/F
____# of Units
,____M / H
____Commercial
____Indust.
____Swim. Pool
Other
____Restaurant & Health Department Approval
~
BUILDING SIZE:
x
Square Feet,
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.**
**COPY OF CONTRACT REQUIRED.
PERMITS REOUESTED
____BUILDING
$
c5(, ~;20
JSO
AMP Service
Valuation of Total Construction
>\ Florida Power Corp.
_W.R.E.C.
____ELECTRICAL
____MECHANICAL
$
Valuation of Mechanical Installation
____PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ____Block
____Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
CONTRACTOR SECTION
Company
State Cert. or Regist. #
City License Registration #
******************************************
BUILDER
Signature
::::::::~ Company ~;<.i.A.rJ (l r.., JJ. {j E'~dr;<-
. State Cert. or Regist. #
- -. - - ~.......~:;~.;:;;~~;.~;~~~;~:;;~~ i/ 0 n
PLUMBER
Signature
Company
State Cert. or Regist. #
City Licebse Registration #
******************************************
Signature
Company 13/~#.e ~ htJ/JAA/z 0..4-> fJ~'#~
State Cert. or Regist. # CAC,~ Y:J 9 Y.f> /
City License Registration # I 7
******************************************
OTHER
Company
State Cert. or Regist. #
City License Registration #
Signature
******************************************
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this pertit tay be subject to "deed restrictions" which may be lore restrictive than City
regulations. The undersigned assutes responsibility for cotpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they tay 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 lay be
cited for a .isdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requiretents tay apply for the intended work, they are advised to contact the City of Zephyrhills Building Department, (BI3}
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 sign 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.
CONSTRUCTION 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 - HOleowner's Protection
Guide" prepared by the Florida Departtent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the
"owner", I certify that I have obtained a copy of the above described doculent and promise in good faith to deliver it to the
"owner" prior to cotmencelent.
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 cospliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a pertit to do work and installation as indicated. I certify that no work or
installation has cOltenced prior to issuance of a pertit 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 lay apply to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in cOlllpliance. Such agencies include bllt ~if! not lilllited to:
* Departlent of Environ.ental ReQuIation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive lands,
Water/Wastewater Treatlent
* Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
* ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
* Deoarttent of Health ~ Rehabilitative Services. Environ.ental Health Unit - Wells, Wastewater Treatlllent. Septic Tanks
* US Environ.ental Protection AQency - Asbestos abate.ent
I also certify that, if fill aaterial is to be used in Flood Zone "A" or "A,etc.", it is understood tllat a dl.ainage plan
addressing a "cotpensating volUMe" will be sublitted which is prepared by a professional engineer registe,cd in the State of
FIDrida prior to permit issuance.
A perlit issued shall be construed to be a license to proceed with the work and not as authority to vioi~te, cancel alter, or
set aside any provisions of.. the ~~chnical codes, nor shall issuance of a pH.it prevent the Building Official frc'lfI thereafter
requiring a correction Df ernrsin plans, constructic.n, [.r violations of any code. Every perillit isslll!d~hdll bec['le invalid
unless the work authorized by such per.it is cO.lenced within six tonths of issuan~e, or if work authol lzed by the perMit is
suspended or abandoned for a peric.d of six tonths after the tile the work is cOlimenced: . One 90 day l'~t;:iisioll uftile, 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 lonth period, or the project will be considered dbilildoned.
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 A1TORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE
SIGNATURE
------------------------------
----------------------------------
OWNER OR AGENT
CONTRACTOR
DATE
DATE
-----------------------------------
---------------------------------------
NOTARY AS TO
OWNER OR AGENT
NOTARY AS TO
CONTRACTOR
-----------------------------
-----------------------------
MY COMMISSION EXPIRES
MY COMMISSION EXPIRES
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