HomeMy WebLinkAbout02-1424
ILDING PERMIT
Permit N2
CITY OF ZEPHYRHILLS
(813) 780-0020
tfD
PLUMBING
1424
Date
~- ~g-D:L
bO
BUILDING
10
ELECTRICAL
M~
Sewer Conn
Water Conn:
:::::~.:~"~;;:fj ~:~",~::r.)
Water Meter:
T.I.F.'s:
Parcell.D. #
Zoning:
Descriotion of Work
~code: .
A~~~
CjY~R'don G.lY}
1) AJJ~Z--
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
Valuation or
Contract Price
Inspector
City license Registration # $0/ i
State Certified license# ~ -# OOa.:>.5"/ D
Comp
A~~
((T8lePhon'e;) t'1?- 7'1'/- 11 </r
ELECTRICAL V~
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final /IP.-28'-t'J~ ~(.y
I-An
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Ftr.
Pre SLB
lintel
FRM.
Insul. CL
WL
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 ZEPHYRHILLS PERMIT APPLICATION
BUILDING DBPART~NT 5335 8~ STREET ZEPHYRHILLS, FL 335.0
PhoneI813-780-0020 FaxI813-780-0021
DATE RBCEIVBD ~ -;z. 8-'0':<-
PLANS RBVIBW PBE
OWNER'S NAME ~ e ef ~~.ArZ: V,-- Cot It 4'~
/
JOB SITE ADDRESS <; 7S-3' Z?R'()~4?oc.);t'-<-
PHONE CONTAC~Lr~~-/7~~
LEGAL DESCRIPTION: LOT(S)
BLOCK SUBDIVISION
PARCEL ID #
- 'e:>O() (.}.- 0 01 ~ _t!:J C d 0 (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: [JNEW CONSTRUCTION
[J ADDITION
[J ALTERATION
[J DEMOLISH
[JREPAIR
D INSTALL
[JSIGN
[JMOVE
PROPOSED USE: DSGL FAMILY DWELLING
OMULTI - FAMILY
D# OF UNITS
D SWIMMING POOL
~ILE HOME
D COMMERCIAL
D INDUSTRIAL
o OTHER
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK 1 ~1' {",. CJL-,*~r ~ d,-c... ttd.,~
BUILDING SIZE /~ K ~J7 SQUARE FOOTAGE .J'R"u
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.
PERMITS REQUESTED
D BUILDING
$ /530
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
/dl
AMP SERVICE
o FLORIDA POWER
o W.R.E.C.
o PLUMBING
D MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: D BLOCK
o FRAME
o STEEL
D OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES
D NO
~/
SIGNAWR -~ce~
~*****************************************************************
- ')
E~ COMPANY 1=e.-e:. E.L:E.~l<"'"
. 1'/' J 0 STATE CERT OR REGIST # ER-0004b4o
SIG ATURE ~Lcr- (}' ~~ CITY PROCESSIV \exo
******************************************************************
COMPANY <;:r-_4/;A....-.::s. Z",I4c>~: t... ~"~t~
STATE CERT OR REGIST # I'}; otJov S/a
CITY PROCESSING # //3 D / I
V C
~
SIGNA
COMPANY S:T~...(.__ ..J'. :?~..-4<. ::t=""'~~<-/I...
STATE CERT OR REGIST #::t:H ab-,~ I ()
CITY PROCESSING #
MBCHANICAL
******************************************************************
SIGNATURE /p; ~ .D g "- "'-' ;'""tJ
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
*****************************************************************
OTHER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictions" which
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR 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 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, 813-768-6611.
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 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 aocument 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 penmit and that
all work will be perfonmed 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
*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 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 commenced 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 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".
SIGNATURE: CONTRACTOR
OWNER OR
STATE OF FLORIDA:-j") "
COUNTY OF --m..5~ 0
The foregoing ins~Fpment was apknowledged
Before me this~day OfJul'( ,.aC!.D.~
by
(name of person acknowledged)
Dwho is personally known to me, or
[i;(who has produced4rH'e"~ JJCelJS e.
(type of identification)
whoD did 0 ot take an oath.
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this -----Pay of
by
acknow~edged
19
Name
(name of person acknowledged)
C1ho is personally known to me, or
Owho has produced
(type of identification)
and who Ddid DUd not take an oath
owledgement
Signature of person taking acknowledgment
ed
Name typed, printed or stamped
CITYOF II N OT ICE" BUILDING
.ZEfJHYRHILLS DEPARTMENT
OF ADD.ITION OR CORRECTION
DO NOT REMOVE
I ADDRESS 8~ DATE PERMIT.. I
. '5'153 ~_ . JO~2?-(!)'L ~NJY
THIS JOB HAS NOT BEEN COMPLETED The following additiqns or corrections shall be made before the job
. will be accepted.
,
~t\~~JJ~tc:~~..~~~
~,;~~~'~~t~TI:::
II II unlawful tor any Corpenter, Contraclar. Builder. or arher peraonl, to
cover or caUM 10 be covered. any port of the work wllh flooring, loth, earth
or other marerlal. unlllthe proper Inspector has hod ample time 10 approve
'he Installation.
. AFTER CORRECTIONS ARE MADE CAlL
788-6611 FOR RE-INSPECTION
OfFICE HOURS 8 - 5 MON.-FRI.
INSPECTOR
o~
CITY or ZBfHfRHIL1S BUILDING DIPARTHIHt
OWNBR _7fiE€:.~.l:d4^,# _~/IAg~
JOB LOCATION S ? S.3 131'0 AP./!U;i1L...._~r4T-I-
-
PARCEL I. D. . II /{} - ~tJ ..2-1 -:Q~.~C?.-=-qJ2L~_o - Cooo
-...--__-.c,___
SUON l'.LL XXISi'ING 6: PROPOSED STRUCTURES GIVING DIMBMS:IONS . SB'1'BACKS.
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UTIL:IT'~' BUILDINGS
MUST SHOW SIZB <<
FOUNDATION TNFOR-
MATION.
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1. SETBACKS FOR Rl, R2 ZONING
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2. SETBACKS FOR R3 ZONING
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I PROPOSB~
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I, 2tl. S;JL $J'~'!I 30 I D~il.i:X I .
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ifklORl' ~m'.IiL'.i"~ .J.D.&:
PERMIT #I
Monu,s / MAI~u'F^CrVIlfD HOME SET.UP
PERMIT APPLICATION sU'n"LEMENT
APPIiClnt:z;i;-G ~r _101/111$ ~
Address -ff.'S'3 8NfJ1ADMu/"t!l6lAceT-
- -
Manufacturer's Name LLfiL,#t.__
Roof Zone _:::Ir. _ Wind Zone ..;;J;t;:-_
Nu.mb~r of Sections -L_ Wldth ~_ Len,m .:l.. i-'
Manufacnarcd date -LY-C ~
Inst3llation'tandard used (check one): Manufacturer's manual ___
Year 1 77 "'--
lSC.} '1~~_
SITE PREP ARA TION:
Under-home (ride cleaned of all vegetation and organic material Y
Sloped for proper drain.,e ~L
Distance (approx.) between finished Ifade and bonom of I-beam(s) (Y); m /311
FOUNDATION:
Load bearing soil densit) · / S CJ(J assumed 1,000 psf __
· (Attach penetrometer test results per the requirement on the back of this form)
Ma.inrail frame blo<:ks: Size //'J(/(p Placement OC ~_
Perimeter bl(Xkini: Size .,~ Number !/ Locarion DD!?Bj
Ridae beam support: Size}( Number _L- Location X
Center line blo<:king: Size)( Num~r _ X_ Location --L-..
Anchors (type); 6,000 ______ 4,725 ~~_
Anale of strap LJo - !;o...Q.e~
Number of frame tie. .1. tf'. Spacini 5. L/ OC
Number of sidewall anchors -LL-- /'IUM lUA of LOi'll"~D/,.1 77.'....B.-
Number of centerline anl:hors ~._ Number of stabilizers __~_
1n...Ueror Enllineer~~___.______
State LH;;en..'.O.Q..Q.t:J..5.1D..__ .______
REQUIRED ATTACHMENTS
1. FOUNDA nON PLAN, TO S<:ALE. SHOWINO
SC'PPLEMENT AL INFORMA.TJON.
2. SITE PLAK (2 COPIES), TO SCALE.
..'a\m~.trr'\I~"'" (re~l_ July l. ! 91>>9)
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