HomeMy WebLinkAbout02-1398
BUILDING PERMIT
Permit N~
CITY OF ZEPHYRHILLS
(813) 780-0020
1398
Date
f' - / t2 - O~
BUllDI~~i_.._~~~CTRI~~0 P~----- MECHANICAl
._._.~.,-,_....--------
::::::~.,~ 3 6'lA1~#~ ~~MJ
Parcel 1.0. /I
Zoning:
Descriotion of Work
C::"\(\/er Conn
Water Conn:
Water Meter:
T.I.F.'s:
~
1-& 2-
DATE
FINAL
NO OCCUPANCY BEFORE C.O.
Complete Plans. Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
City license Registration #
State Certified license#
l-P- ~ 7
Permit Fee
~
Company
Address. . '91 /f
,
elephone#
Y3siu
Inspector
Valuation or
Contract Price
ELECTRICAL
Pl
Tp. Servo
Rough In
Meter Can
Canst. Pole
Pool
Pre-Meter
Final,/ f5 r 2/. ()2
Breakers
Ducts Ins/.
Compressor
Final
SlB
Tub Set
Water
Sewer
Final
Ftr.
Pre SlB
lintel
FRM.
Insul. Cl
Wl
Driveway
RL~ i/ro
fP f-;2.I-o~ j,'J!1 Alt$S;t\ U
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.
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
-# 131!'
DA.TE RECEIVED
PLANS REVIEW FEE
OWNER'S NAME
fY e'J/~a, /1/1;1 T1 J-Fr
6~/ ;2 '1 ~~4,.,<~ee/- 2e.I'A-yrh/ils
PHONE
? 79. '1,2 J 3
JOB l\DDRESS
1=-;' .3 3 5-$11
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID # 1C;-...2/,.- 2/, O~ <11)- IC?t:J<j~tJ- O~..2tJ
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: ONEW CONSTRUCTION o ADDITION OALTERATION o REPAIR ffi"INSTALL
D SIGN o MOVE 0 DEMOLISH
PROPOSED USE: ~GL FAMILY DWELLING OMULTI-FAMILY 0# OF UNITS o MOBILE HOME
o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER
o REST1,URANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK ~1'/TcI~ -/c; ~tJol'/'"""f Cru-/./?'OI'Seo/l"Ce
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
RESIDENTIAL:
COI-111ERC IAL :
I"\TTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUILDING PLANS & (I) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
o BUILDING
-s~
$ /Yk5.
VALUATION OF TOTAL CONSTRUCTION
D ELECTRICAL
01 c;tzJ
AMP SERVICE
~FLORIDA POWER
D W.R.E.C.
o PLUHBING
o MECHANICAL
$
VALUATION O~ MECHANCIAL INSTALL~TIGN
o GAS
[]ROOFING
D SPECIALTY
D OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
D FRAME
o STEEL
D OTHER
FlUI SHED FLOOR ELEVATIONS
[::; PROJECT IN FLOOD ZONE AREAD YES
D NO
CQN'l.'~C'l.'QR',SEC'l'ION
BUILDER
SIGNATURE
COMPANY
STATE CERT OR REGIST #
CITY PRqCESSING #
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ELECTRICIAN
~~~.
SIGNATURE
COMPANY ~./T..& e,,'~;.~.
STATE CERT OR REGIST #
CITY PROCESSING #,~:?;t
********************'k*********************************************
c0:-rzrL
.,
PLUMBER
COMPANY
STATE CERT OR RE
CITY PROCESSIN
SIGNATURE
**************************************
MECllANICAL
COMPANY
STATE CErn OR REGJ ST II
CITY PROCESSING 1/
SIGNATURE
*****************************************************************
OTHER
CCMP ANY.
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
CO"'1DIT::ONS 0'" ?E"UV'_~':':' A."''''='JAV!_'.~
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands tha~ this permit may be s~~ject to "deed restrictions" which
may be more restrictive than City regulations. The undersiqned assumes responsibility for
compliance with any applicable deed restricti:>r1s.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSII3ILITIE:S
If the owner has hired a contractor or contractors to under~ake 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-'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 th~ 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 corrunencement.
E. CONTRACTOR'S/O~NER'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 ~o work or installation has corrunenced 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 developrnent 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 perrnit 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 corrunenced within
six months of issuance, or if work authorized by the permit is suspended or abandoned for a
period of six months a~ter the time the work is corrunenced. 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 "NOTICE OF COMMENCEMENT".
~~:hiJ~'
SIGNA URE: OWNER OR AGENT
~ .~.kJ~
SI~URE: CONTRACTOR
...
acknowledged
19_
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____day of
by
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
(name of person acknowledged)
Qho is personally known to me, or
of identification)
take an oath.
Dwho has produced
(type of identification)
and who D did Q:.iid not take an oath
Dwho has produced
(type
and whoD'did Ddid not
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped