HomeMy WebLinkAbout02-1453
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N!
1453
(813) 780-0020
Date
9../ I~ -oP _
~ E~L ~ ~AL
PmpertyOwne, Y& ~ riit~
Job Address: _ __ _ _-
Parcell.D. # II - :2..10-:/- 001 v- 67/m-o/7r'J
Zoning: Code:
DescriDtion of Work
Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
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
&a:fJ ' ~!:J-
Permit Fee -::S:-" ~
~~~~~/~ fl:-,,~
Company
Address
.-.......-...........-----
~~__=Yi';3 -7/5-7.7-$.3
City License Registration #
ertified License#
BUILDING
EL~".
----
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
PLUM~''''
~
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
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 Z8PHYRHTJ.l.S BUll..DING DKPARTHENT
OWNER
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JOB LOCATION
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PARCEL I.D."
SHOIf ALL EXISTDIG << PROPOSED STRUCTURES GIVING DIHKHSIONS << SE"l'BACXS.
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UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
FRONT PROPERTY LINE
(NOTE EXAMPLES 1 & 2)
STREET
//':/' ~ '7
, ~
1. SETBACKS FOR Rl, R2 ZONING
60'
10'
r-P E-
R X
0 I
10' p S 10'
0 T
S I
E N
D G
20'
2. SETBACKS FOR R3 ZONING
60'
1 0'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAH 30 'DUPLEX
1 0'
FROIIr PROPERTY LIRE
FRORT' PROPBIl"J'Y .L.:INB
CITY OF ZEPHYRHIIJLS PERMrf APPLICA'l'ION
BUILUINI:! DlllPAR'l'MBlN'f 5335 8th 8TREE'f ZlllPIIYRHILL8, PL 33540
PhoneI813-780-0020 FaxI813-780-0021 l'
DATE RHClllIVlllD -2:....L~_=fL"?-_
PLANS REVIHW FHH
, OWNER f S NAME ~ /Jill{ fLJ~-I?~(Xn >-_ __~____ _____ PHONE ('ONTACT
,JOB 81'1'8 ADDRESS -~...J36---I-2-ff--i!----u2..fJ1Lf~/JJI/s-____ _ ___ ______ ________ _____________
LEGAL DElSCRIP'l'lON: LOT(S) CJ!f) /Cf;,2,Q_ BLOCK __~_... SUBDIVISION '_______
# (OBTAIN F'ROM PROPERTY TAX NOTICE)
PARCElL ID / I';' 16--' 2 / ... 0 (! / 17 -'" 07/ Of) - O-LZd_ '_______
WORK PROPSED: ONEW CONSTRUCTION L1 ADDITION []ALTERATION [] REPAIR [] INSTALl,
[JSIGN
rJ MOVE:
rJ DEMOLISH
PROPOSED USE: L1SGI., FAMH,Y DWELLING
[Jr'1lJLTI - F'AtHLY
[J# OF' UNITS
[J MOBILE HOt-1El
[] OTHER
DCOl1MERCIAL
n INDUSTRIAL
rJ SWIMMING POOl,
D RESTAURANT & HElALTH DElPAR'l'MElN'l' APPROVAl,
DESCRIP'l'ION OF' WORK -(/}A...~'/~g-~~_'7i!? Q ;:::;-,q
Bun/DING SIZE
-----------
SQUARE FOOTAGE
HEIGHT
RES IDElN'I'IAL:
COMI\1ERCIAI~ :
A'I"I'ACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
A'I"I'ACII (3) SETS OF BUIJ,DHm PLAllS & (1) SET ENERGY FORMS,
PROPElRTY SURVEY REQUIRED FOR ALl. NEW CONSTRUCTION.
~,BUII,DnlG
[] ELEC'l'RICAI,
PERMlr~REQUESTED
$
. . ,oG
Lo~5:D'-
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
o Fr.~RIDA POWER
[J W.R.E.C.
[] PI,UMB ING
LJ IvJECHANICAL
$
--- VALUATION OF' MECHANCIAL INSTAI,I.AT ION
[J (~AS
LJ ROOF ING
[] SPECIAI/l'Y
[J OTHER
'l'Yl-'E OF CONSTRUe'l'lON: [] BLOCK
[J FRAME
[] STEEl"
[J OTHER
FIlHSHED FLOOR EIJEVATIONS
IS PRO,JECT IN FLOOD ZONE AREA[] YES
[] NO
BUILDHR
COMPAtlY ~
STATE CEJRT OR REGIS'!' It _...____
CITY PROCESSING #
SIGNATURE ~~ ~ /Z-, t:.L-.--1'_g. RP
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ELBC'!'RICIAN
SIGNA'l'lJRE
COMPANY ______,......_____
STATE CERT OR REGlST #
CllY PROCESSING #
---_..__.._----.~_.._-
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---_._-~------"-,---.
PLUMBER
COMPANY- '_____'___
STATE CERT OR REGIST #
Cl'l'Y PROCESSING #
S 1 GNA'I'LJRE
MECHANICAl.
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COMPANY
STATE CERT OR REGrST #
CITY PROCESSING #
---------
S IGN1~TUREl
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OTHER
SIGNATURE
COMPANY
STATE CERT OR REGIST #
CI1Y PROCESSING #
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CO\'t;J!r~1.1l0NS 0:-: p~n,\1I'~\ I\FW"JDAVIT
A. NO'l'ICE OB' DJlJED RES'l'RIC'I'IONS
'l'he undersJgned understands that tiLLs penn1 t Il13Y hl3 s',lb.l eutl~o "deed restrJctions" Hldch-
r.~3'y bt'more restrJct.:ive than City t'13qulatio'IS. 'J'he und'3t:signed assumes responsib,t lity for
compliance Hi th any applicable deE,dcestd,cl:iotls.
B. UNl,ICENSED CON'l'R1\C'I'ORS AND COnTHi\CTOn RIllS p:mSIBIL,ITIES
I f the (J~'1ner has hired a contractor or cont r:a,:::tot's to undertake work, they may be requl red
i to be 11censed in accordance wltlJ state and local reglllatJolls. If the contractor 1s not
l..1.censed as required by laH, both theol^lTler and contt:,'1ctor may be cited for a lid sdemeanor
violation under state law, If the' OHner or i.ntended :contractor are l1ncertaln as to Hhat
Ucensing requirements may apply for the intended Iwrk, they are advised to contact the
City of Zephyrhills Building Department, 013-'788-6611.
B'urtherlllore, if the owner has h.il:ed a contract:or or contractors, he is advised to have the
contractor (s) sign portions of the "Contractor Sections" of this app,U.cation for Hhleh they
Hill be responsible. If you, as the OHner signs ~s the contractor, you are indicating that
you, rather than the contractor, are responsible for the Hork. If the contractor Hishes
you to sign as contractor that may be an lndicatlon that he is not properly licensed and 1s
lIot entitled to permitting privileges ill the City of Zephyrhills.
C. 'l'RAHSPOR'l'A'l'ION IMPAC'l' FEES AND UTILI'I'Y CONHEC'l'ION FEES
D. CONS'rRtJC'rtJION LIEN LAW (CHAPTI!:R '71.3, FI.oRIDA S'l'A'l'UTES, AS AMENDED)
J certify that I, the appLicant, have been provided Hlth a copy of "B'lorida's Constrllction
lien LaH - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and ConSllmer Affairs. If the applJcant is someone other that the "oHner", I cerj,fy that I
have obtained a copy of the above described Clocument and promise in good faith to deliver
it to t.he "owner" prior to conunencement.
E:, CON'I'H1\C'rOH' S/oWNEH' S AFI!'IDAVl'l'
r cerU,fy that all the information in Ud.s application is accurate and that all vlOrk ~'dl.l
be clone ,i,ll compU,ance ~dth ali applicable laHs regulatillg const.ruction, zonlng, and land
development.
1\ppl.lcatlon .is he):ehy made to obtain a perroJt to do work and installation as indicated. I
certify thaI: no Hork or instal.lation has conunenced pr.i.or to issuallce of a permit: and that
all Hark Hili be performed to meet standards of all laHs regulating constructJon, City
codes, 'zoning regulatlons, and land development: regll.latlons in the jur.l.sd.l.ct10n. I also
certify tllat I understand that the regulations of other governmental agencies may appl.y to
t.he ill tended Hork, and that it is my responsibility to identify \-That act.lons I mllst: take [:0
be in complJance. SlIch agencies include but are not limited to: *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensit1ve
l.ands, Water:/WasteHal:er 'I'reatment:
"'Southwesl: Flor:ida Water Management Distrlct-Wells, Cypress Bayheads, Wetland Areas,
1\1 ted,llg Wa tercourses
"Army Corps of Ellgilleers-SeaHaIls, Docks, Navlgable WaterNays
"Department: of Health & Rehabilitative Services, Environmental Health Unlt-Wells,
Wastewater Treatment, Septlc 'ranks
"U.S. Ellviromnental Prot.ectioll Agency-Asbestos abatement
I also cer.tLf.y that, if fi.llmaterlal is to be used in I!'lood Zone "A" or \\A,etc.", it 1s
understood that a drainage plan addressing a "compensat:lng volume" Hill be submJtted Hld.ch
is prepared I)y a professional engineer registered in the State of Florida prior to permit
issuance.
A permit jasued shall be construed to be a license to proceed with the Hork and not as
authority t.o violate, cancel, alter, ar set aside any provlsions of the technical codes,
nor shall issuance of a permit prevent.: the BuJ..lding Official from thereafter requlring a
con:eution of errors in plans, construction, or violations of any code. Every permit
issued shall become invalld unless the work authorized by such permit is commenced' w:Uhin
sl}( months of issuance, or if \'1ork authorized hy the permlt is suspended or abandoned f.or a
period of six months after the time the work 15 commenced. One 90 day extensioll of time
may be allowed for tile permit with fee charge of $15.00. 1~e extension shall be requested
ill writing to the Building Official. An approved inspection mllst be logged during each allC
month ped,od, or the project Hill be considered abandoned.
WARNING '1'0 OWNER: YOUR FAII,URE TO RECORD A NOTICE OF COMMENCEMEN'l' M1\Y RESULT IN YOUH
PAYING TWICE B'OR IMPROVEMENTS '1'0 YOUR PROPER'ry. IE' YOU IN1'END '1'0 OB'I'AIN FINANCHIG, CONSU!!!'
WITH YOUR LENDER OR AN A'r'l'ORNEY BEFORE RECORDING YOUR NOT;ICE OF COMMENCENEH'I'. ,JOBS UNDER
$2,500 IN VALliE DO NO'!, NEED '!'O RECORD AND POST A "NO'rICE OF COMMENCEME'.N'l"'.
-...._-------~--_._---~._----_._._.
SIGNATURE: OWNER OR AGENT
SIGNA'I'URE: CON'l'R1\CTOH
S'l'A'l'E OF FLORIDA
COUN'l'Y OF'..
'J'he forego:lng instrument Has acknowledged
Before me this _.._____ day of..._____._, l!:t_,...
by ____.____ ___
(name of person acknowledged)
[] ~'1ho is personally known to me, or
[] Hho has produced
(type
and Hha[) dld [Jdld not
STATE OF FLORIDA
COUN'I'Y OF
'l'he foregoing instr\1ment Has aclmo'tTledged
Before me this _..._...slay of------...--, 19_~
by
(name of person acknowledged)
[1ho is personally known to me, or
of identlfication)
take an oath.
o who has prodl1ced__,__________
(type of identification)
and "lho Ddid Diid not talc.;: an oath
Signature of person taking acknoHledgement
Signature of person taklng acknOHledgment'
N~~~~-t~Yr;;ci~--p~i;;l ed --;;~-;"'t~-~I;;;;-----"----"
Name typed, pr\.nted or
s l:amped