HomeMy WebLinkAbout02-1384
BUILDING PERMIT
Permit N!!
CITY OF ZEPHYRHILLS
(813) 780-0020
1384
Date
7r-('-O;;'
BUilDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcel I. O. /I
~rA 5~~
.)t!13 5-(1.. rr
Water Meter:
T.I.F.'s:
Zoning:
OescriDtion of Work
Energy n:
/9 J' I I ,)...C 1
Radon Gas:
-
I-oUr ~
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Permit Fee
,)Signature
Company
Address
..-\::1""elephone#
~~
;{/ j)---
City License Registration" J 99 .s-
State Certified license#
Valuation or
Contract Price
"'.13- 77~- ~33J
IIlkltp~ F~ce
Tp.Serv.
Rough In
Meter Can
Canst. Pole
Pool
Pre-M
Fina
PLUMBING
Ftr.
Pre SlB
lintel
FRM.
Insul. Cl
Wl
SlB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl
Com ssor
Final
BUILDING
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.
CITY OF ZEPHYRHILIAS PERMIT APPLICA'rION
BUILDINCl DEPARTMENT 5335 8th STREE'r ZEPlIYRHILLS, FL 33540
PhoneI813-780-0020 FaxI813-780-0021 _
DATB RBCBIVJlID _____
PLANS RBVIBW FBE
I OWNER'S NAME LJU 0 V.5' J-! E It. PHONE CONTACT'&)3 tyg -.52.22.
JOB SITE ADDRESS 52f3? ~5tlJ ,St-, 2LP/lYf~c-L.s -8 33S-l{2
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 10 #
WORK PROPSED; ONEW CONSTRUCTION
DADDITION
o ALTERATION
(OBTAIN FROM PROPERTY TAX NOTICE)
~NSTALI,
D REPAIR
DSIGN
D MOVE
o DEMOLISH
PROPOSED USE; ~L FAMILY DWELLING
DMULTI - F'AMIL Y
D# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
o COMMERCIAL
D INDUSTRIAL
DESCRIPTION OF WORK
o RESTAURANT & HEALTH DEPARTMEN'f APPROVAL
_7/11sf;4/1
9' { ,
I if -1~ PT?
BUILDING SIZE
SQUARE FOOTAGE
iJ?/ vfJCv PENCE-.
/ '
HEIGHT 6" i
RESIDENTIAL:
COMMERCIAL:
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUnDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
D BUILDING
$
PERMITS REQUESTED
1/' <:)'7 &.00
~ 0-r6. -1-_ VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o FI,ORIDA POWER
o W.R.E.C.
D PLUMB ING
o MECHANICAL
$
o GAS
o ROOFING
o SPECIALTY
VALUATION OF MECHANCIAL INSTALI,ATION
~THER
TYPE OF CONSTRUCTION: 0 BLOCK
D FRAME
o STEEL
D OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES 0 NO
BUILDBR
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
******************************************************************
BLBCTRICIAN
S IGNA'l'URE
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
******************************************************************
PLUMBER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
MECHANICAL
******************************************************************
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
OTHER --.L!E/t/ (" E r-T,v s 7'iI//"E ;<:?,
SIGNATURE 7~4=/,O~
*****************************************************************
COMPANY /J ~Ac TlO/V FErvC#E
STATE CERT OR REGIST # _ GOZ.05"~900i 9'&'
CITY PROCESSING #
;;( 9rs-
CONDITIONS O~ PERM~~ ^FFIDAVI~
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictionsN which
may be more restrictive than City regulations. T]le undersigned assumes responsibility for
'compTiance with any applicable deed restrictions.
B. UNLICENSED CONTR1\CTORS AND CON'l'RACTOFl RESPONSIIHLITU:S
If the owner has hired a contractor or contract.orl~ to undert1!ke work, t.hey may be required
to be licensed in accordance with state and local regulat.ions. 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 \-lOrk, they are advised to contact the
City of Zephyrhills Building Department, 813-78B-6611.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor SectionsN 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 U,!'ILITY CONNEC'rION FEES
D. CONSTRUC'rUION LIEN LAW (CHAP'l'ER 713, FLORIDA S'rATUTES, 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 ced.fy 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
*lJepartment of Health & Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.S. Environmental Protection Agency-ASbestos abatement
I also certify that, i~ fill material is to be used in Flood Zone "AN or "A,etc.N, it is
understood that a drainage plan 'addressing a "compensating volume" will be submitted ",hich
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
iseued shall become invalid unless the work authorized by such permit is commenced within
SiK months of issuance, or if work authorized by the permit is suspended or abandoned for a
period of SiK months after the time the work is commenced. One 90 day extension of tJrtte
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 'fa OWNER: YOUR FAII,URE TO RECORD A NO'!'ICE OF COMMENCEMENT MAY RESUI.T IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR I,ENDER OR AN AT'l'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. ,JOBS UNDER
$2,500 IN VALUE DO NOT NEED fro RECORD AND POS'!' A "NOTICE OF COMMENCEMENT".
SIGNATURE: OWNER OR AGENT
SIGNNfURE: CONTRACTOR
STATE OF FLORIDA
COUNfry OF
The foregoing instrument was
Before me this _ day of
by
acknmdedged
, 19_
STATE OF FLORIDA
COUN'rY 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 whoO did Odid not
(name of person acknowledged)
[1ho is personally known to me, or
of identification)
take an oath.
Dwho has produced
(type of identification)
and who Ddid D:l.id not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment'
Name typed, printed or stamped
Name typed, printed or stamped
.
~v
~.
J
A ACTION
.r--y-ENCE CO.
Your Fence Company
8327 Jacqueline Ct. · Zephyrhills, FL 33541
(813) 779-4331
.'.
Name: ~'rw 1/1/ 5' ffF,4
Address: 5 L/~3 J 5- t:f 5~
2~~1yrA,.//j ~L 33S-~L
Phone: 7lf8 -322. z.
Sunshine State One Call (1-800-432-4770)
Reference # ).. ( ~ L DOc;. ,
Date:
'7- 3 1- ~., <-
FENCE SPECIFICATIONS
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Customer agrees to furnish and be responsible for property lines. This quotation does not include compressor for digging in underlying rock. A Action Fence will not be
liable for any underground wiring, pipes, or other conditions not known to us at time of installation. Customer agrees to be responsible for all building code and home
owner association code restrictions that may apply to the erecting of a fence on their property.
A Action Fence: ,c:.A2./ _____/
By: ~.
We hereby propose to furnish labor and materials complete
in accordance with the above specifications, for the sum of
C' ,I
$ ~ Y'2f -
With payment to be made as follows: S- 0 ~ 70 7'f/lr/
d.ld wA~~? Cb"o/Rk~,.
Accepted:
By:
We Accept Visa & MasterCard
Warranty: One year on materials and workmanship unless
extended manufacturer's warranty is noted.