HomeMy WebLinkAbout02-1409
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N!
Property Owner:
Job Address:
Parcell.D. II
Zoning: Energy Code:
Description of Work ~ '\ ~ D 't( e. (. .
BUilDING
1409
(813) 780-0020
Date
~- 026 --C/ ;;J..
ELECTRICAL
MECHANICAL
Sewer Conn
Water Conn:
PLUMBING
T~&'4
sv;).4
f:;J;:- 51- .
Water Meter:
T,I.F.'s:
Radon Gas:
IV'\ lox / ~
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
-- 0 2-
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
DATE
Inspector
Perm;' Fo. ~' ...,
/(Signature ~ \..+~
Company
Address
City license Registration #
State Certified license#
)ielephone#
,?I::J- '/'Y;;-J-,C)So
.
BUilDING
Ftr.
Pre SlB
lintel
FRM.
Insul. Cl
Wl
Driveway
tJt,../ /1.bY'
ELECTRICAL
Tp. Servo /%-3C// d..ell~lB
Rough In Tub Set
Meter Can Water
Const. Pole Sewer
Pool Final
pre-Meytr .
Final"; '1-- I <6 r 02. f2- ('1
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final
REINSPECTlON 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
BUILI>INC:I
OF ZEPaYRHILL8 PERMIT APPLICATION 1t/&/(7
UBPARTMBNT 5335 8th STREE'r ZBPHYRHILLS, PL 33B40
P hart. I 8 13 - '18 () - 0 0 2 0 po ax I 813 - 7 80 - 0 0 21 9-
DATa RIOBIvan _~_ -:1:o_--t?:<.
PLANS RBVIaw rIB
JOB BITBl
~1t
NAME~. ' ~
ADDRIlIBB - 7 ' .~
, OWNER'S
PHONIll CONTACT
Sf I
-----.------
LBlGAL DBlSCRIPTIONI LOT (B)
BLOCK
SUBDIVISION
PARCEL ID #
WORK PROPSED I 0 NEW CONSTRUCTION
(OBTAIN P'ROM PROPERTY TAX NOTICE)
(] ADDITION
(]AUfERATION
(]REPAIR
[J INS'I'AJ,I,
DSIGN
(] MOVE
o DEMOLISH
PROPOSED USE' [JSGL FAMILY DWELLING
o COMMERCIAl,
OMlJLTI - FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
[] MOB I LE HotlJBI
[JOTHER
o RESTAURANT & HEALTH DEPARTMEN'f APPROVAL
DESCRIPTION OF WORK ~ OLC~ e-r~/\..- ~ -J f~~ R gf)
BUILDING SIZE / 6 X /,;:). SQUARE FOOTAGE HEIGHT
RESIDENTIAL.
COMMER(!IALI
ATTACH (2) PLOT PLANS & (2) SE'fS OF BUIl,DING PL~8 & (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUIJ,DING PLANS & (1., SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUmSTED
o BUU,DING
$
VAI,uATION OF TO'fAl, COnS1.'RUCTION
o ELEC1'RICAL
AMP SERVICE
(] FI,ORIDA POWER
o W.R.E.C.
(J PLUMB TNG
[J MECHAJHCAL
1)1
VALUATION OF MECHANCIAr~ IN8TAIJl,ATION
o GAS
[J ROOFINf1
(] SPECIALTY
o OTHER
'l'YPE OF CONS'l'RUCTlON I 0 BLOCK
o FRAME
(] S'l'EEL
(] o'mER
FINISHED FI,QOR ELEVATIONS
IS PROJECT IN FLOOD ZONE ARBlAO YIlIS (] NO
BUILDBR
COMPANY
STATE CERT OR REGIST #
CITY PROCE88ING #
8 IGNA'fUREl
******************************************************************
BLICTRIOIAN COMPANY [)~~
, n_ ~ d STATEl CER'f OR REGtST #
SIGNA'l'UR~ ~ ~ ,+.fLR. CITY PROCESSING #
..******** *********.********************************************
PLUHBIR
COMPANY
STATE CERT OR REG 1ST #
CITY PROCESSING #
Sl GNA 'l'UREl
MaCHANICAL
******************.***************************************~******.
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****.***********************************************************
OTHIlR
SIGNATURE
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
*****************************************************************
CONDITIONS OF PERMI1' AFFIDAVIT
A. NOnCE OR' DEED RESTRIC'I'IONB
'l'he undersigned understands that this permit may be subj eat to "deed restrictions" whioh
may be "mre restrictive than City regulations. The ullderslgned assumes responsibility for
oomplianoe uith any applicable deed restrlctions.
B. UNLICENSED CONTRACTORS AND CON'l'RAC'l'OP: RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they may be required
to be licensed in accordance with state and local regulations. If the contractor is not
licensed as required by lau, both the owner and contractor may be aited for a misdemeanor
violation under state law. If the owner or intended contractor are uncertain as to wllat
licensing requirements may apply for the intended \wrk, they are advised to contact the
City of Zephyrhills Building Department, 013-788-6611.
Furthermore, if the owner has hired a contractor or contractors, he is advlsed to have the
oontraotor(s) sign portions of the "Contractor SectionsH of this applioation for which they
will be responsible. If you, as the owner signs as the contractor, you are indicating tllat
you, rather than the contractor, are responsible for the work. If the contractor w1shes
you to sign as contractor that may be an indication tllat he 1s not properly licensed and is
not entitled to permitting privileges in the City of Zephyrhills.
C. 'l'RANBPOR'l'A'I'ION IMPAC'r FEES AND U'l'ILITY CONNEC'l'ION FEES
D. CONBTRIJC'PUION J,!EN LAW (CIfAP'I'ER 713, FLORIDA S'fATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construotion
Ibm Law -- Homeowner's Protection Guide" prepared by the E'lorida Department of Agriculture
and COllsumer Affairs. If the applJ.cant is someone other that the "owner", I oerify that I
have obtained a copy of the above described ~ocument and promise in good faith to deliver
it to the "owner" prior to commencement.
E. CON'l'RAc'rOR' a/OWNER'S AFIl'IDAVIT
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.
AppHoation is henby m~de to obtain a permit to do work and installation as indioated. I
certlfy that no work or installation has oommenced pripr to issuance of a permit and that
all work will be performed to meet standards of all laws regulating construation, City
codes, zonlng regulations, and land development regulations in the jurisd:lction. I also
certify that! understand that the regulations of other governmental agencies may apply to
the intended work, and that it is my r~sponaibiH.ty 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 'rreatment
*Southwest Florida Water Management District-Wells, CYPEess Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Departmenl of Health iii Rehabilitative Services, Environmental Health Unit-Wella,
Wastewater Treatment, Septic Tanks
*u. S. EnvJronrnental I?rotelOtion 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" wl11 be submitted which
is prepared IlY a professional engineer reg:lstered in the State of Florida prior to permit
issuance.
A permit issued shall be construed to be a license to proceed with ~he work and not as
authority to violate, oancel, alter, or set aside any provisions of the technical codes,
nor shall issuance of a permit prevent the Building Official from thereafter requiring a
correation of errors in plans, constructioj}, or violations of any oode. B1very permih
lsllIued shall become invalid unle.. the worJcauthor:ized by llIuoh permit is oommenced withln
.iK months of iSllIuanoe, or if work authorJzed by the permit is suspended or ahandoned for a
period of six months after the time the work is conunenced. One 90 day extension of ti.llle
may be allowed for the permit with fee charge of $15.00. The extension shall be Eequested
in writing to the Building Offioial. An approved inspection must be logged durlng each six
month period, or the project will be considered abandoned.
WARNING '1'0 OWNER: YOUR FAIWRE TO RECORD A NO'!'ICE OF COMMENCEMENT MAY RI!lSUJ/l' IN YOUR
PAYING 'l'WH~E U'OR IMPROVEMEN'rS TO YOUR PROI?ER'rY. IF YOU IN'l'END 'l'0 OB'I'AIN FINANCING, CONSUL'l'
WI'I'lI YOUR 1,I!lNDER OR AN A'r'l'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'l'. ,JOB/3 UNDER
$2,500 IN VAI.UE DO NO'l' NEED '1'0 RECORD AND 1?0S'l' A "NOnCE OF COMMENCEMEN'I'fI.
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
S'l'A'l'E Ol!' FJ~ORlUA
COUN'rY OF
'Jlhe forego.ing instrument was
Before lIIe this ____ day of_
by
acknowledged
, 1 !l.-
BTM'E OF FI,ORIUA
COUN'fY OF
The foregoing instrument was
Before me this _J.iay of
by
acknowledged
19
(name of person acknoWledged)
rJ who is personally known to me, or
[J who has p roduoed
(type
and wholJ did Ddid not
of identification)
take an oath.
(name of person acknOWledged)
C1ho is personally known to me, or
o who has produced .
(type of ldentifioation)
and who Ddid DUd not take an oath
Signature of person taking acknowledgement
Signature of person taking aoknouledgment1
Name typed, printed or stamped
Name typed, printed or stamped