HomeMy WebLinkAbout02-1545
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N2
1545
(813) 780-0020
Date
/0-- /f)-tJ.:L
, e
1~-
BUILDING
Property Owner:
Job Address:
Parcell.D. #
Zoning:
DescriPtion of Work
EL~CAL PL~BfN(r ME~C
T1f:/t~!1<1{j!~~~
Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
Energy Code:
b
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
FINAL
C.O.
DATE
NO OCCUPANCY BEFORE C.O.
DATE
Permit Fee
~i.natur
Company'
Addres.l
~~~~n~V
Inspector
. ~
Valuation or
Contract Price
o ~fob'
City License Registration' 7 t)
State Certified License'
7?g-- 531 '-I
Q~A1 ,$ ~h/ !1~b~.
~~UILDINJV ~kT~l
Ftr. #ni?~.::7{)-15-0P-/-IJ'?p. Servo
Pre SLB Rough In
Lintel Meter Can
FRM. Const. Pole
Insul. CL Pool
WL Pre-Meter
Final
~P~G
M~-"
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
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.
C~TY OF ZEPHYRHILLS PERMIT APPLICATION
SUll,DING DBPARTMBlNT 5335 81:11 S'l'RBlBl'f ZBlPHYRHILI.S, Fl, 33840
Phonill 813 ~ 780 - 0,,0 2 0 Fax I 813 -780 - 0021 -LA'! _/"_(/ /)
DA'n RBOBlIVIID CI ~
'--.-' -_.,__.....-..~.......,._~w
PI,ANS RBlVUlW i'JUI______._____
PASCO PERMIT SERVICE
miNBlR' 8 HANEI--1'1.ich<.t.eL_. D ( mitxi._______ PHONEl CON'l'ACT_____..81a:.ZB.a:5314
.JOB ElI'l'Bl ADDRBlSS _3~~51 :Gtrr '[2(". ., Z4bv-r:.b~_EL 335'fo _______"..__~
R~IIL-Ta..l M.H. Pa.rk
LEGAL J'}8l8CRIPTION I LOT (8) BI,OCK SUBDIVISION
I?ARUBlL ID #_3.5::~5"- ~1:QQLO_~_LL5120- 0000__
WORK PRO!?SBl[J I []NEW CONS'l'RtJCTION
(OBTAIN B'ROM I?ROPlilR'1'Y TAX NO'I'TflBl)
[J SIGN
j
IJ ADDI'rION o AUrE:RATION o REPAIR o INS'I'M.I,
{] Jl10VE 0 DEMOIJI 811
OMUl,'I'I - FAMIl.1 0# OF UN I'1'S f] MOBH,Bl 110MB
o INDU13'l'RIAJ, o SWIMMING POOl, Il orfllBlJ\
I?RO!:'D8ElIl USElI DQ..sC:l1, FAMII,Y nWELI,um
fJ cot-1MBlRC fAI,
D RESTAURANT & HEI}\W'II DBlPARTMElNT AI?PROVAL
DESCRIPTION OF WORK _free....sh-.nd,.!._~t__.___
BlJII.,PING SnE ~O' X ;2...0~_____ SQUARE p'oO'rAGE _.lfoo ____
I I
HEHUIT .._~__~JP,_.__
RBIS IDBlHTIAL I A'1"l'ACH (;a) PL.OT PI"AllS & (J) BElTS OF BUU,IJING PLANS & (1) SBl'r IlINElRQ'I F()RMS,
120MMBlRCIALI A~rACH (3) SETS OF BUI~PING PLANS & (1) SElT ENERGY FORMS.
PROPERTY SURVEY RBlQUIRBlD FOR ALL NEW CONSTRUCTION.
flllJU.1ITS REQI1Jl1ITJm
\L{ BlI II.lHNl~
Ll BlLBlC'I'RICAL
$__31 ~~. (X)
VALUATION OF TOTAL CONSTRUC'PION
AMI? /3E1RVWEl
o
FLORIDA POWER
[]
W.R,E.fL
[) Pr.ot1BING
U II1BJUHAJ:HUAI.
$
VALUATION OF MECHANCIAI, INSTAI,LATION
o OAB
rJ ROOFING
[J SI?EOIAL'fV
o OTHER
TYPE OF C(n~SrRtJCTIONI [J BI~CK
[) FRANE:
[J STEEl,
5!. OTHER ttlL.U4Un~
FINISHHlIJ FU)OR BlI,EVATION8
IS !:'ROdElCT IN Fl.OOD ZONE ARElAO YBlS
D NO
BUILn.. ~
SmHATURm _ ~
COt-1I?ANY ~LO\. 6t~~l"'~
STA'I'E CEJR'!" OR REGIST # ________
CITY PROCESSING # jil?
******************************************************************
BI.lldTIUCIAN
COfil PAN Y_____
errATE: CEJRT OR RECHS'!, #
CITY PROCElBSING #
8 J C:lHATIJREJ ___'________._____
........-...-----.-'--------..-.---..--
*****************************************************.************
~LUMSIIR
---_._"------"-~----------~---
COMI?ANY-- ______.._.._.____
STATE CH:RT OR ftEJGlS'r ,. _______,___________
CITY PROCESSING #
8IGNA'1'IIRIil
-_._._--.._-_.._----~-
MBlClHANICAI,
""'*'********'***'**"*'**'**"'**'*""*"**'****"'*"*"'*'*'
COMPANY _____________.____________._ __..___._
STATE CHlR'r OR REGIST # _..___~_______.______
CI'l'Y I?ROCIil8SIHG #
SHH'IATliRB
'**'****'*****'**"*'*'**'*****'**'*'*~**'*'*'****"******"'*'**
OTHia
~.....---._----_._~_.
COII1PANY
STATE CERT OR RE~I8T #
CITY PROCESSING #
13 llJHATURE:
--------.....-'..--~'---.-...-~--_..-.-
"****'**""'***'***"*'*"*"'*'***'*'******'**"*"***"***'*'
"'---~--..._---.-_--------._-----
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 CONTRAC'I'ORS 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 contaot the
City of Zephyrhills Building Department, 813-788-6611.
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. CONBTRUCTUION 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 performed 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
slx 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 Y BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
$2,500 IN V '1'0 BCDRD AND POST ~~
S G~ - NTRACTOR
STATE OF FLORIDA 'D
COUNTY OF r a..$Lo
The foregoing instrument wa~ a~~ledged
Before me .:!;.h.is ~ay .of ~ ~r, 1" t2€0~
by "..ta&.J.--rL>r r ~l c--
~ (name of person acknowledged)
~o is personally known to me, or
STATE OF FLORIDA ~
COUNTY OF ~~
The foregoing instrument was acknowledged
Before ~this&-;~ay of ~t-~r llIt;lOO~
b y &A...l l "-'
~__, (name of person acknowledged)
~ho is personally known to me, or
Dwho
Dwho has produced
(type of identification)
~id not ta an oath
Si
rson taking acknowledgment
Name typed,
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pr ~~"f;:te~F")l!Iibmilpe'dC~ 79?817
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