HomeMy WebLinkAbout02-1448
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N~
1448
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G~~~-~~I~U.
(813) 780-0020
Date
9-//-o~
-
Property Owner:
Job Address:
Parcel I. D. ,
ME~'.
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
Descriotion of Work
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
Valuation or ~-
Contract Price
!gnature
Company
Address
~~t.~(~) 1~.ln;AOd-
City license Registration # / 0 ~
State Certified license#
./lb / 'I '-II
v~
'-"-
BUilDING
(/ ~E.cTR~lj
Tp. Servo SlB
Rough In /1 - / 2. '-()2 Rt.JTub Set
Meter Can Water
Const. Pole Sewer
Pool Final
Pre-Meter
Final
PlUMawa---' ."
-
~l
Ftr.
Pre SlB
lintel
FRM.
Insul. Cl
Wl
Breakers
Ducts Insl.
Compressor
Final
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 ($25.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction,
c. Repairs or corrections not made when inspection called,
d. Work not ready for inspection when called,
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
, OHI1BJR I 8 11jU1EI___~/n~_==u__~~ _ _~.____._ ___..____.______
,JOB SI'l'BJ ADDRB:88 -."e..t:l$.----~~~-t.i~----.__.___.._______.___
CITY OF ZElPUYRHIIJIIS PERM!'l' APPI.IICA'l'ION
BUII.1>IllIJ IJIllPAR'l'MHlN'l' 5335 8th STREB'!' ZBlPIIYRHILI,e, FI, 3J540
PhoneI813-180-0020 FaxI813-780-0021
IJA'rm RllldBIVBlD _____:',,______
InANe RBlVIIllW FBlIll
PHONE CON'I'ACT
. ----...------.-----..,--.---.
LIlJGAL DIJJS(!RI P '1'1 011 I [,C)'I' (S)
.-------- "-'- .-- ------.. _.~ .--_._.... 0___. ____-..._____
BLO(!K ~
SUBDIVISION ~~_~_~___.___.__.__._
--'~~----------- -...-.--.--.
PARCBlL HI #
WORK PROPSIJJD I [JNBlN conSTRUCTION
~---~..--------.--'------------..-.----.---------..-----__._.n._.___,___,..,_
(OBTAIN FRO!'l PROPElRTY ,[,AX. NO'l'lC!I1l)
[J ADllI'1'IOll
I] AI,'1'ERA'I'ION
[J REPAIR
~ IlISTAI,I,
[]8HnT
LJ (\J(JV III
[J UHlHOI"ISII
PROP08HlD USE i [JStH., F'AMII,Y DWHlI,LJNG
IJfvlULTI - F'AtHT,Y
IJ# OF uln'!'s
[] HOB:rr.El IIUI/IHJ
[] CUI,1MBlRCIAI,
n INDUSTRIAlJ
[.J SNJl.1t1TNG Porn,
[] O'I'IIER
C=-J REJS'l'AURAH'l' & HEJAUl'II DEJPAR'l'MHlN'l' APPROVAl,
IJBlS(!IU P'l'lOH OP' I'll mK .--.:Z(.i!!!...--_cf€L_.___...i:,~_ __._.~__._. ____________..._____._...____________
BlJIl,DING BIZHl
'-_.. -.----,.- ---~._-------_._----
SQIJAREl FOOTl\Cm
RBIS IDflJN'l'IAT.:
c;OMl\lEJRC I IU, :
._------..~--_.__._--
IIElJHm'l'
A'l"l'ACII (2) P['O'l' P[,AllS & (:2) SElTS OF BllII,Dum PI.ANa & (J) SEl'I' ElIIElRGY FORMS.
A'1"I'ACII (3) SElTS OF BUlf,lHIW PLANS & (l) SET EJNElRGY FORMS.
PRoPER'ry SURVEY RBlQUIRED F'OR AI,I, HEM COU8TRtJ(!T IOU.
-- ----.-- --.-- "'----'-
l?B:RMI'l'8 RBlnUl!lS'I'ED
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o BlJu'IlT IIG
"W EI,EJC1'R J:(~A I,
$
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:xJ
VAI,uATIOH OF TOTAL COlIS'l'RIICTION
---~----'-----,----_..-
At.1P 8EJHVICEJ
~
P'I,uRlfJA POImR
[J
I^I.R.EJ.r~.
I"" I PI/UlilB r 1Il3
LJ HEiCHAlHCJ\1J
[J (~A8
LJ ROOF ING
$....---------------- VAI.,UATIOH OF' IvlECHANCIAJ. IHSTAl,I,A'nON
IJ SPECIAI/l'~
IJ OTHER
'l'YlJIlJ OF COlIS'l'RlIC'l'lON: /] 8WCK
[J FRANEJ
CJ 8TEW1"
[J O'fllElR
F llHSIlEn B'IDOR EI,ElVA'1'JON8
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IS PRCltJE)C''I' IN FLOof) zemEl AIUilALJ YElS
CI NO
BUlI.IJBR /"N
81(~NA'l'URlll~f:..-/~~~._______,_._,_______.___
lIJLBC'l'RW1A~H %" . a ~~~,~~H,;ii'"~Ei;il9~'<:~.....-.~
S 1C1l11\'J'IJREl' ~ ' " '" 'r: # J--..---..'------- ___u__..
' - -------,,- ,,--- --' ==-L____ 01 Y PRUCES8JN 1 _.____ -0(0_____ ___
""*""'1* **'**********'******'*******"*********'*"**'**1*'
"'*""*"*'***'*"'*'***"**"*"*'****'**'**'**'**'*.,**,******
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81 I.El R RBl HSl II ___________________...._,_____..
C I'ry PROCEl881Nr~ l/ e..., ~
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Ji'1~UMSBJR
---_._-~-----_._~._._~-----_._-------_._~--
C{)tI[P ANY --_______._______________._.___ _,._,_____
STATE: CERT OR RHl<H8'1' II _____~___.___..____.~_.
CITY PROCEJSSIlm II
8 JGl1ATtJREJ
MlIUHAUICAI,
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---.... .-.---- --....--------------.--.--
-----------------.--.---..---..--.-.--.---..--
COl\1P JINY ---___ m______.______.__ ___._____
8'I'A'1'8 CB:R'1' OR RElG I ST if
CITY PRUCB:SSINn II
--------..--- ...---..-.- --.----. .--.- ------.- ---.--...
8 WIIJI'!'lJRIlI
O'l'HBJR
***************.*************.***********************************
---------.----~--_._-_.._.._.- ,,- ---_...___n.__
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C'OI\IPAN'{
STATE: (~ER'I' OR RH:GJ-ST'"..#...----....------.--------.-...~-....-...---..-
CI'l'Y PROCESSING # --._.__.____._.._._...__________
------..-----
SIGNATURE
A'*A************'*'*******A**********A*********..***..t*t*'***A..
- ~.- -.. --. --..---_____._._n_._ . _ ,__ ___._ __'_. .
1\, IIO'l'lCF, OIJ' DIl:FJD HEB'l'RIC'I'IONS
Tbe llndersJgned understands that: t.hJs pe:nnll: Ill~\' IH: s',lb)e:~Jt. 1:0 "deed resl:r.jntjons" Hhlch-
lIlay be lIIore resl:r.ictlve than City t'egl1l::,t:ioils. 'l'h", \'l!Id':;lslqned aSSllmes respollslb.llJl:y ror.
compliance Hj t:h any appl..i.callJe de€.d [<3strletio:IS.
. B. lrlH.J CH:NSIl:D CON'l'Hi\C'1'OnS AND COj'J'l'HI\C'l\lR RiTIS !?'):IE TIn [, L'l'IE,:J
If the (Hillel: has hir.ed a contr.aotor OJ: ~:CJntl:a,;l-.:)U3 tOlllICI-3J:take Hork, Uley may be regH:1 red
\:0 be licensed .ill auuordauoe I-l1th stal:e and 10,:::,,1 J:eglllatlolls. If t.he c:ontl:autor .Is lIot
licensed as re(jllJred by lSH, both tile o'..mer: alld contrac.:t:Ol: Hlay be oJt:ed for a lid adellnSi:lllnr.
I)'JulaLinn lIuder state laH. If the OHIISl or intended contractor aLe l\IIner'taJn as to HIla\"
I juemd lHj requlr€:lllents lIIay apply tor the lntended Iwrk, they are advi sed to nonLact the
I:.lly of Zepllyrldl.ls BuJldlng Depart:menL, fl13-'/88.6611.
li'ulLlIsl:Illor::e, if the O\'lller has lLi.J~ed a contl'acl:o,l: or contractors, lie Js advlsed to have the
(J()ntranlcn(s) sign port.lol1S of l:be "COl1l:ractor Sections" of tll1s app.Ucation for 111110h they
1/1.11 be I:esponsi hie. 1 f YOII, as the CHlnet s.lgns as I:he conL.r:actol:, you a,r:e indl eal:ing tha t:
you, raLber than the contnwtor, are responsible for I:lle vsotk. If the oonl1:anhn vsJshes
ynll 1:0 s.lyn as contr:actor that lIIay be an .lncJJcatjon that lie Js not: properly Licensed and is
lIot anti t:led to penllt.LUng privileges In the CJty of 2'.ephyrhJ116.
c. 'L'RlINSPon'I'A'I' [ON lt1PAC'1' FEHlS ,AIID U'l'1 LITY CONIIEC'I'ION Jj'EES
n. COHS'1'RllC'I'1I10N ],TEN IJAW (Clli\P'l'ER 'll3, FlnRlDA ,'3']'A'l'U'I'IDS, AS AHEHDED)
I eel:t.! fy thaI: I, the iOIpplJcant, have bean provided Ht\:h a copy of "Ii'lod.da's Constt"lHJtJon
1lell ],all .,. lIolllE:c)\"IT\sr's Protection GuIde" prepared by the E'lorida Department: of Agcl.nult.ut"!!l
and Consumer A1:fajxs. If the applIcant: is SOIO~one other that. the "oHnet.", I ceclfy that 1
have uhtaJned a copy of the above descr1bed aOCll1ll8nt: and p1'omJse 111 good 'FaJth to deliver
it. tn t.he "ol.mer" pr:\,or to comrnencelLlenl:.
H:, COH'I'Hl\C'I'OH' S/OWHH:H' S AFE'1DAVl'l'
I nerU.fy Lhal: a]J the 1nformation in thts appl.lcaUoll Is accurate and thal: aU 110dt III]]
he done .l.n compl:\auce III Lh aU. <lpplJcable lavls regula U.ng construction, zon.lng, and laud
development:.
Appl.lcaUon :Is hereby made to obtain a permJt to do work and installatJon as Jnd:loated. I
cetU fy thaI: no Hork or instal.lation has oomrnenoed pr.tor to isauallce of a pell:ml.\', awi tbat:
all 110rlt HU.l be performed to lIIeet st:andards of all 1a\18 regulat.ing UOllsl:nlOtlol1, C\ ty
codes, zonJng reglllal:j,olla, alld land development regll.l.atJons In the Jlll.JscUct.jon. 1 also
ced:lfy Lila\: I IInderst:and that the l:eglllat.JoIIS of other goveullllent:al. agendes may apply \:0
Llle .Intended wnk, and that it is my !'eaponsibi1lty to ldentL fy l'lhat aeU OilS I IIIlIst take 1:0
be In cOlllpll.allCe. SlIclI a\]encles inc.lude b\l1: are not limited to: ~Deparl:!lIellt: of
H:n v i r'Olllnen l:a 1 Regula l'.ion'-Cypress Bayheads, We t1 and Are as and n:n vi l' 0 I1l1\e1\ 1:a 1.1 l' S ens 1. 1'..1 ve
l,allds, ~"Ja ter-;Wasl:e~la I:er 'l'lea l:ment
ABouLlll/es\: E'},oJ:ida \"Jater Hanagement Distr.tct'-Wel1s, CYP.li:ess Baylleads, Wel:landl\reas,
AJt:Bdllg WateroOlu:ses
-I. THIllY Corps of ffillglneers-Sea\olslls, Docks, Navlgable WaterI'Jays
~)lepa1.l:lllenl: of Health & RehabLUtative Servioes, H:nvirOlllnelll:a111ealth lInlt'-Wells,
WasteHater 'j'l:eatmenl:, SeptJc 'Pa1\les
-All. B. ElnvJ lOlllnelltal I:' rotection Agency-Asbestos aba temen I:
1 also ceLLI fy that, if fill material :Ls to be used .In lJ'lood Zone "A" or' "A,el:c.//, Jt is
undel:sl:ood Lhat a dralnage plan addressing a "cQll\pensaLl.ng vollllne// 1-11.11 be subml tted IIIIJeh
.Is prepared hy a professional eng.l.neer: reg.l.stered in the state of E'lodda pdot" to perml.\:
lsBllanue.
A permJt Jsslled shaLl he construed to be a llcense to proceed Hith the Hork \!Ind not as
authorj Ly t.o vJolate, cancel, alter, or set: aside any provisions of the te()lllllcaJ codes,
nor shall issllance of a permit: prevent: the BI\.U.dJng ()ffloial from thereClfter reqll.1.dng a
con:ecL.lon of errors in plans, const.ruatlon, or violations of any aode, IIlvery permlt
issued sha.11 baDome invalid unless the work authol::ized uy slIoh permit. ls OOllllllenced H.H:ld n
fiiu lllouths of lss1l8noe, OJ:" if \'ior.k allthod.zed hy Lhe perm.!.t is sllspended or abandoned for a
ped,od of eht months after the U.me the l-wr}, is commenced. One 90 day e.Ktensioll of t.lme
lIIav be a:l lOlled tor the tJennlt "lith te~ oharge of $15.00. '['he extens.1oll shaU be I.eqllesl:ad
l.n Hritillg 1.0 the Building Offio1a1, An approved .inspection mllst be logged dlld ng each al){
month ped.od, or: the project Idll be consi.dered abandoned.
WAIUIJlIG ',1'0 OvlNElRI YOUR li'AII,ORE '1'0 Hi'JCORD A NOT [eF, OF COMNENCEHl:!lN'l' MAY HIr.SUJil' 111 YOtlR
PAYHIG TWICE ll'OH UIPROVEHI!JN'I'S '1'0 YOUR PROPgR'!'Y. IE' YOU IH'I'EHD 1,'0 Ofl'1'AItI F.'JNAIIClIH3, COlHJlIW'
W1'1'lI YOIJR I,ElIIJER on AN A'I"l'ORNfl~Y BEIfORa~ RECORDING Youn NOTICE OF Cm'1I'1ENCHlt1EH'I'. ,lOBS l1HnR',H
$2,5()() 111 VALli!!: DO 110'1' HIl:ED '1'0 RHlCOHD AND POS']' A "NO'l'ICID OF COHMIDI'ICEMH:JoI'l'''.
f,.,l.).r) :J .:'_ '.*.1 ~l~ U,~! f::' () .~.... ,,? ~~ ~1\..\~ .~~ I!\ 1\:T ~l'~: ;) AV} ~J.l
51 G1IA'l'UHH: lOWliER UR lI.GEN'1'
-......_-~--'-~-_.~._--_._-~--...---~.__. ..-..-, "-'---~'" ..-~ .-._-~--,-"_._---_.
SIGNA']'IIRn:: CON'l'RI\.C'l'OH
S'l'A']'Hl Oil' l:!'UlRl DA
C01JN'I'Y o Ii' .-----.._~_._._________.___._____.__._
'J'he foreyolng .1nsl:rlllnent lias acknolrl1 edged
Befol:e !lIe tllJs -on__'._ day of,._.______, l.~_._
b V ......_.,__."" __.__ .., _._._._.._ .___________..____,.___,_._.__...
(name of persall Bclmow1edged)
[) I~ho is peJ:6onally ItnoHIl to !lie, or
[I Hila has prodllced____._____.____._,_..____
(type of identifJcatJon)
and IJho(] cUd [lei ld !lot tab: all oath.
fl'I'A'j'!:!: OF FLORIDA
em J N'j'Y () j!" ___.________._.__.__..__________._.__.__
'l'he fa Lego.ing JI1 s l: rlllnen t I/!':l S a elwol-sledged
Bafore !lie tIlls ___Jiay of-----....,---,--, 19
b V .'..___'_._._..______.__...__.,___,__..,_____....., ,_,_..,...
(name of person BcknoHledyed)
[1ho ls personally known to me, or
[] Vlho has prodllc'ild___.....__.___.._______._.
(type of I dSIlt.i Eieat. lOTI)
and vdlO [ldl d I.]Ud 1I0t take an oath
--. .' .-.-.-.--.------~...~--.~--.---~-_..-.._-----~-__.__ _~._.______~..__ ___._M'___
SJ gna\:\Ire of persoll tak.ing ackllovlledgement
Signature of persoll taklng aaknollledgmentf
_."... .. .......' ._._~.._,..w. ,_._
Hallie typed,
printed 01: stamped
Hallie typed, pl)lIted or sl:ampBd