HomeMy WebLinkAbout02-1590
1590
(po
BUilDING
lie)
ELECTRICAL
(813) 780-0020
'Ii) ~~
PLUMBING MECHANICAL
Date
Zoning:
DescriPtion of Work
(~~
NO OCCUPANCY BEFORE C.O.
FINAL
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
City License Registration #
State Certified License#
11
Permit Fee
Signature
Company
Address
Telephone#
Inspector
/ .~
w c.;.-- B: A I.. /-t.~
Valuation or
Contract Price
9- ")..:;1 .>''''S~ ",
ELECTRICAL
MECHANICAL/7
Breakers
Ducts Insl.
Compressor
Finall.../'/O....lS-...cP2 ($~
SLB
Tub Set
Water
Sewer
Final/IO-Z:$""... t!'Z t6-6
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final /;0 - 25 ~" 2. l13
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
Wl
Driveway
F fJ /O-:JP-O':l- Ill: 3 u EfIu! /C~
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.
L:..l'J.''t OF ZEl?HYRHILLS PERMIT APprJICATI01~
BUILDING DSPARTMlllN'I' 5335 ~th S'l'RlllEl'I' ZlllPH'lRHILLS, FL 3354.0
Pbon~1813-780-~020 F&KI813-780-0021
DA'l'Bl RBCilIVBlD ~___~__.__
PI.Al'lS RBlVnlW FJiBl________
OHNI1:R I S NAI'1E 19 c::... ) At;" PHONE CON'l'AC'!,
,JOB SITE ADDRESS ~c.~ ;:J 1__~_~5-i!..I'.:.. __o/lK~________
LEGAL DESCRIPTION: LOT IS)
SUBDIVISION k1~:5"'<-'oF~ eJAI;~
BI-,OCK
PARCEL ID #
(OBTAIN Ii'ROM I?ROI?ER'l''l TAX Nfl'l'fCE)
WORK PROk"SED: ONEW CONS'I'RUCTION
o ADDITION
[J ALTERA T I ON
o REPAIR
D lm3T~I,II
DSWN
[J MOVE
[] DEI"1OlIISH
I?ROl?OSED USE: OSGL FAMILY DWELLING
[]MUL'l'I - FAMILY
0# OF UlU'l'S
[]SWIMMING POOL
f3lvJOBH.E HOME
D O'rtUilR
o COMMERCIAl,
[] INDUS'l'RIAI~
D RESTAURANT &< HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK
P,M-
BUILDING SIZE
SQUARE li'OOTAGE
HEIGH'I'
RESIDENTIAL:
COIYJMERCIAL:
ATTACH (2) PLOT PLANS &< (2) SETS OF BUII,DIliG PLAl\JS ~ (1) SlilT l1lNiilJtqy F'ORMS.
A'l"l'ACH (3) SETS OF BUILDlW3 I?LANS &< (1) SET ENERGY FORMS,
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
~E~IT~ REOUE~TED
o BUILDING
rJ iilLElC'!'RlCAL
$
VALUATION OF TOTAL CONs'I'RUC'l'ION
AMI? ~ERVICE
o FLORIDA POWER
o W.R.lil,e.
[J l?WlvlBING
o Jo1ECHANICAL
$
VALUATION OF MECHANCIAL INs'I'AI,LA'l'HJN
[] GAS
D ROOFING
[] SI?ECIALTY
o O'l'HlilR
'l'YPE OF CONS'l'RUCTION: 0 BLOCK
o FRAlY1E
o STEEL
o OTHER
FlNISHEP H{JOR EI,EVATIONS
I S PROJECT IN !<'LOOf) ZONE AREA 0 YES
D NO
CQti\PANY p~V
STATE CERcI' OR REGIS'l' # ______
CITY PROCESSING #
BUILDIIlR
SIGNATURE _ 0-J'::;r- I!J~
*"***"'.t***.**..*...*..*.**...*.*.....***...**...**t*****......
COl1PAHY ~,4~J..... ((
STAT~ CERT OR REGIST #
CITY PROCESSING #
111l,BlCT1U ClAN
8mnA'm.> __~
._-----....-~......_-
***t***.*********.**.*.***.*..***************.*******.**..*.**.,..
JilLUMBIIlR
SIGNATIJRE
cJ~~p
COMPANY -r: ~
STATE CERT OR f{EGIST if__
CITY PROCESSING #
SIGNATURE
.****.**...****.*****.*****..*.**.***....********..,******''It***.*
COMI?ANY j'J AAA
STATE CERT OR RElGIST #
t.-l' ~ p~/ CITY PROCESSING If
*******.***.**************************~**.****************'tt****
MIIlCHANICAIJ
OTHJilR
S rrmATURE
COl>1PAHY
S'l'A'l'EJ CEJRT OR REGIST #
cI'ry PROCESSING # -----__~.---
***********~***************.....***..**.******.*******...***.....
--------.....~~~
I
1 I
n
.JOo
CONDITIONS OF PERMIT AfFIDAVIT
A~ NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictionsn 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 ~ay 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.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor Sectionsn of this application for which they
will be responsible. If you" as the owner signs as the contractor, you are indicating that
you, rather thah 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 Guiden prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "ownern, I cerify that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the "ownern prior to conunencement.
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 "An or "A,etc.n, it is
understood that a drainage plan addressing a "compensating volumen 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, constructiont or violations of any code. mvery permit
issu~d 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
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
acknowledged
, 19_
(name of person acknowledged)
C1ho is personally known to me, or
(name of person acknowledged)
Dwho is personally known to me, or
Dwho has produced
(type
and whoD did Ddid not
Dwho has produced
(type of identification)
and who Ddid O:Hd not take an oath
of identification)
take an oath.
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
MAJESTIC OAKS
LOT: 31
40'
.. ~
6'
I
SCREEN RM
ON SLAB
12 X 18
V"
PARK
MODEL
12 x 42
8 '
8 ' -
- - - ...
- -
CARPORT
12 X 24
ON EXIST.
SLAB
h
EXISTING
DRIVEWAY
22'
J \ "
STREET
70'