HomeMy WebLinkAbout02-1497
8UILDING PERMIT
Permit N2
CITY OF ZEPHYRHILLS
(813) 780-0020
1497
Date
9-;2S;- ~d--
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Zoning:
Description of Work
/\ JJ ~ Water Conn:
~ S' ~ :] W.... Met."
~:qSO l( ~~;' . (&~ ~/~r T.I.F.'s:
. Lo-fl3Y
. Energy Code: Rado? Gasn
~ I lJ,,-s~ f~rr,.( S~ d-
Property Owner:
Job Address:
Parcel J.D. "
~eJ-
FINAL
- 3- D 2-
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Valuation or
Contract Price
Ii tfMJO
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~
Pe,m;tFee ~'1 ~
)c!ignature' -L ...,,- J
Company
City License Registration #
State Certified License#
Addres~ ........ _. . __.
yelePhon~5 / Y-!3 y/ r;
~~~h":16~
/111.: '8 -
PLUM IN ~II MECHANICAL
Breakers
Ducts Insl
Compr
Fi
~r R.JCQ 6"lec.
ff;:L 7'3j"
BUILDING ELECTRICAL
L ..7/ . "7/. ""-0 t J/~ /21.. '(
Ftr.' (~V ~~ Tp.Serv. SLB
Pre SLB ./ 'j-:ztJ/ tJ'Z,-p"l'lc2L-Rbugh In ~/lI-IS~tt?'i A2~Tub Sett/'/; (~-4Z. Ji['q.,
Lintel Meter Can Water
FRM. ,../ /1-1 s r O"l ,2 ~ Canst. Pole Sewer
Insul. CL Pool Finalb-/71-j....-c 1- (tt'1
WL Pre-Meter t--I jcJ
Final~/!~ - 1- 0;2. I?~
I 0
/l-ro -z /J I U ;'r'Aj.
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.
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
DATE RECEIVED
PLANS REVIEW FEE.
q-It'-t'~
OWNER'S NAME dd~ (/ -5 ~
JOB ADDRESS '35 () L( tHll / q c h j re
PHONE.S36- ;Z~/'" 6313
)1Pf-73{
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
EurerCt/d fJ(~~
PARCEL ID #
WORK PROPSED: ~ONSTRUCTION
(OBTAIN FROM PROPERTY TAX NOTICEl
~ITION
o ALTERATION
o REPAIR
o INSTALL
DSIGN
o MOVE
o DEMOLI SH
PROPOSED USE: DSGL FAMILY DWELLING
o COMMERCIAL
DMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
BUILDING SIZE
D RESTAURANT & HEALTH DEPARTMENT APPROVAL ~ / /
..4blltltn / ttkder ~RHI / 6 r pttf7- '..51&
( t. . q. / I II
, ;2 'f ) R SQUARE FOOTA E 2 / ~ HEIGHT 7 ~
DESCRIPTION OF WORK
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
o BUILDING
$
J rtJtJ{),~'j)
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o FLORIDA POWER
o W.R.E.C.
o PLUMBING
o MECHANICAL
$
VALUATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT
BUILDER
SIGNATURE
COMPANY L-
STATE CERT OR REGIST # 872-bt;/~r r
CITY PROCESSING # )"'~~cf
******************************************************* ,
PLUMBER ~ COMPANY ~ ~)Gt/l111's LJ;/kah15
/. STATE CERT OR REGIST #
SIGNATURE- . " CITY PROCESSING # ~ 1~'!AtJ
~. ~**:* ~*******************************************
MECHANICAL
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
OTHER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
CONDITIONS OF PERMI~ 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. Thl: -.l::ldersigned assumes responsibility for
compliqnce with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBLLITIES
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, 813-788-6611.
Furtheumore, 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 peumitting 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 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 permit and that
all work will be perfoumed 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
*Aumy 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
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
acknowledged
19_
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____day of
by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____ day of
by
acknowledged
19
(name of person acknowledged)
Dwho is personally known to me, or
(name of person acknowledged)
C1ho is personally known to me, or
D who has produced
(type
and whoD did D did not
of identification)
take an oath.
Dwho has produced
(type of identification)
and who Ddid [}:lid not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
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A TO Z ALUMINUM, INC.
P.o. Box 192. ZEPHYRHILLS. FL. 33539
Z'HILLS(813)715-7523-HUDSON(727)857-1234
.>-6
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4& .
Pl;7 b
Other Address:
{
Street
.~ .
State
Date of Plans
Architect
e Hereby PrqlOSe to furnish the materials and perform the labor necessary for the car rptetiu I cl:
'OtJo, IJ<.
I Material is quaratteed to be as specified. 1nl the abow wOO< to be perlom led in accorda1ce with the drawings 1nl
. submitted for abow wOO< 1nl co IIpleted in substantia worI<rna IIike manner for the SIm cI
DoIlars($
payments to be ma:ie as fdloNs:
eX8CUllld only upon WIillIIn orders. and WII become lII1 exInI ch8tge ~
- !he ntim'""". AN agrMm_ cot'Ilingent upon _, aCCldllnt8 or
ya beyond 0lM" conIrol. Ow".,.. to carry fire. tornado and ~ neceuary
upon - worl<. WOlken C"",,* oOooliu. , and Public Uabllity
on__tobetai< out
Respectfully submitted
Per
This prq:Ja1aI may be withdrawn by us if net accepted
within days.
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are satisfactory and are hereby accepted.
to do the worIc: as specified. Payment 'Mil be made as outlined above.
K
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Yau are
Signature
Date
Signature
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" . . ',:I:? 'Sl~1:iJ U'I H:AT THE FOREGOING IS A
l::il( A,~" "OHP1:C ( : :1](.1. OF THE DOCUMENT ON FILE
OM I)~ r."II1L i,.C "'.':U;O;W '.1' THIS~~ESS MY
H',f'ifJ "Nl! Oi:~IC.r1iL SE.I"L THIS. DAY OF
- ,.. . L-=-_ 2 :;z
,JEU F'Yrn~VL.' " C,-~RK OF CIRCUIT COURT
! ( / . A~ .../.0'~
, ""'-.. ~;.' /"/L~';r, DEPUTY CLERK NOTICE OF COMMENCEMENT
State of ~ County of ~~5ct:J
, I
THB lmDERSIGNED hereby gives notice that improvement will be made to c~rtain
real property, and in accordance with Chapter 713, Florida Statutes, the
following information is provided in this Notice of Commencement:
1IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIlIIIIIIIIIII.1I
2002148595
Rcpl: 620600
OS: 0.00
09/25/02
Rec: 6.00
IT : 0 . 00
Dpty Clerk
1. Description of Property: Parcel No. ;;?j/-/t:. - 2/- OvfLtJ-C/c:/o.?>~).-13 Yc:J
(Legal description
3.
Owner Information:
of the prop~rty and street address .j'f available)
Improvement 1)!CJom J -) J-jeJ ~.5'~/' I:otrl
( JEO PITTMA~ PASCO COUNTY CLERK
09/25/02 10:41am 1 of 1
OR BK 5079 PG 1168
~~ U 5crl ~~
~-- State ~.
2.
General Description of
Address 3 SCJ
Interest in Property:
Name of Fee Simple Titleholder:
(If other th~n owner)
4.
Address City State
Contractor: Name 11-'#2 ;Jk~ /foci. jj-t<--
Address .!:{), i&?:I fl2 City 2.- ii/Is State!2 3$~'-31
5. Surety: Name
Address
City
State
Amount of Bond: $
6. Lender: Name
Address
City
State
7. Persons within the State of Florida designated by Owner upon whom
notices or other documents may be served as provided by Section
713.13(1~(/)(7), Florida Statutes:
Name {!fu4!/ cf dI~1
Address go () rf ;Jf~l2.._ City ~-;J/)...LPL Stat;::;~ 3Jnct
8. In addition to himself, Owner designates
of to receive a copy of the
Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes.
9.
EXp~r?~~on date at Notlc~ or Commencem~nt (the expIratIon date is 1 year
fr~m~ne date of record~ng unless a d~fferent date is specified.)
Sworn to and
day of
,
f- Signature of Owner:
19 c9r1N ~
llotary PUblic:. ~ldnmafl( )
CARY lISTERMAN
, Commission Expires: 5 -;)5 /'Ih ~otary Pu~ljc:, Macomb County, MI
~~ &.If f"".nmm..Rlnft S:Yp;~. 512II.2OQ'
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