HomeMy WebLinkAbout02-1714
BUILDING PERMIT
Permit N~
CITY OF ZEPHYRHILLS
(813) 780-0020
1714
Date ~-17- t1 f1..
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Property Owner: o! '1 r ~
Job Address: ~f f' ~ It ~
Parcell.D, #
~
ST.
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
DescriPtion of Work
E'J!ty Code:
~~
Radon Gas:
FINAL
C.O.
DATE
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Permit Fee -3...5-. P<1
~ignature ct;;th~c4L,-{ ~
Company
Address
~elephone# "f / J - 7 77 - '9' / ~ ~
Valuation or
Contract Price
{-1thJ ' &-0
City License Registration #
State Certified License#
tLN/Y
BUILDING
Ftr,
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
MECHANICAL
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) shaH 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.
OWNB.'. IIAME ,L.c.h"'-Ci'" ~ ~0J e PHONm mN'1'A"'1'
,TO. · ITE AU";B.":-7i<J fdZ_ =--Zl;,'5=-sz.;'~l-==-=_ __u _ ____
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUIllDING DBPA'RTMElN'r 5335 8~h S'rRI!IE'r ZIlIPHYRHII.IJS, rt 331540
PhoheI813-780-~020 'axI813-780-0021
IJA'rBl RBOl!lIVJllb '--"'--->"-,L ;.~""',
PI.ANS 'RHlV!BlW II'JlJII__'_,d_,-,"IL__.___
IJBlll1\L DBlSURTPTIONI I~OT(S)
B UK' K
SUBlJIVISlON
-~_._--_.__._--
PARC'ElIJ In #
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...._~---------_..._-_._-~------_..__._-_._-~._-----_.~-----...--.- _._._~._------.__..._-~.~--
(OBTAIN FROM PROPERTY TAX NO'l'WEI)
~~URI< PRnPBEIll [J NElN CONSTRUCTION
[JSHm
o ADDITION [] AI/I'ElRA'I'ION [g RBlPAIR IJ J NeTAlJ!'
[J MOVE: 0 DElMot,ISII
Ch1Uw'r. FAI"IIl,Y 0# OF t1NIT8 (] MOBTlrm II or1 III
[] INDtJS1'RIAL [] SNIMMING POOL (]OTHBlR
PROl?OSEI1 USE: I [JSGI. FAMILY nWELI.nm
[J cm1MBlRc! IAI,
11EJBCRIP'rWN OF NORK
o RaJ8TAtJRANT & HElAI.TIf DEiPARTt.1ElNT APPROVAL
__ If c: ro~______
-----.---.'-_.4_._'--______~_____._~,__:..__.._ _.____
BUIr,nrN(l ElIZEl
SQUARE! FOOTAGE
RElSIIJI!JN'rrATJ I
CO~'MI!JR(!IAJJ I
If El! fUn ..:___.~_-"____
A'f'rl\CH (2) Pi,OT PIJAllS .& (2) BElTS OF BUI! ,IJIN<) PLANS & (1) 881T I!JNElRO'l FORMS,
A'rti1\CH (J) sslTs OF BU!LDING PLANS & (1) SElT ENElRClY FORMS,
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION,
(] BtIILIJINc~
$__i9Q~ ~
R!~ITS REQUESTED
VALUATION OF TOTAIJ COHS'rRlJCTION
L1 B1LSlCTRWAI,
-----.~-~
AMP ~E1RVrcEJ
[)
FI.oRIDA POWER
[1
W.R,B1,(),
(] P I.tlt1B I NG
o JIJBlCH1\.NWAIJ
[] (JAB
[]ROOFING
r
$----
(] SPElotAI/l'Y
. VAIJUATION OF MECHAHCIAI, nlSTAr.iJATTON
[) OTHER
'l'YPE OF (~ON8'I'RU(!TIDN l [J eWCR
(] FRANE!
(] STERlI,
[] OTHER
FINIBHElIl nUOR ElIJEVATIOHS
18 PRO,JEC'f IN FLOOD ZONE! ARE!A 0 YBlS
[J No
BUI LfJlllJil ;;b COtlJPANY _____~__ _____.._______________
r ~ ~.A ~ STA'I'B1 CElRT OR RElCHS'!' ## ____________...______.__...-'--____.__
a l<JNATUR El -a1t.L2.1::&_-'-_~_~_____ CITY PROCESS ING fl__________________.___..__._____
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IIIf.B10TU C IAN
S] <mATURE ___.._.
.._ _v..___ _____.__.__________.__ __._._ ____.__'_._____~_
COHP ANY ____.__.____ ____ .______._.___________ ___.._._
STATE CERT OR RE~TST #
CITY PROCESSING #
----- -_. -~'-..~_._._--_.__..._-_."-".__...._. ---
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---_._~-- ---.-- _. ----~..-.__._._.----._-------_.
PJJt1MBBlR
-~""'___---'4""""'~""'_"_"""",,,,_ _.
<~OMPANY ---_____._________._____.________.._
STATE CEJRT OR REGIST # _____.~_.__.__
CITY PROCESSING #
SWNA'l'I1RIll
MBlCHANICAl,
~*****************************************************************
.---.--.,-..-.___4________"..__._~~____
CoMPANY__..
STATE: 0EJRT OR REGIST #
CITY PROCESSING #
"_._-_..-.--_._._-~--~------ _..__.._~--- '.---._-
8 HJNA1'tl1U!l
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**************************************~**************************
------~._-----
OTHBlR
Cot1PANY
S'I'J\TEl CElRT OR REcnST W-------.-----------.---
CITY PROCESSING # --.--___._______
.--..-....-.........---------......-.----
8 WHA'l'1JR El
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~"---"'---. -'----------~----"----~-....._-...-_.
COHDl'rIONS OF PERMIT AFFIDAVIT
A, N011CE OF DEED RESTRICTIoNS
The undersigned understands th~t thi~ p~rmit ~ay b~ s~b1ect to "deed reatriotionsH which
m~y be more restrictive than City regulations. The undersigned assumes responsibility for
oomplianoe with any applicable deed restrictiolHl.
B. UNLICENSED CON'l'RAC'l'ORS AND CON'l'RAC'l'OR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they may be required
to be li censed in accordance ~dth state and local regulations, If the contractor is not
licensed as required by law, both the owner and contractor may be cited for a misdemeallor
violation ullder state law. If the owner or intended contractor are uncertain as to what
U censing requi rements may apply for the intf:lnded work, . they are advised to contaot the
city of Zephyrhills Building Department, 613-766-6611,
Furthermo}::e, if the owner has hired a contractor or contractors, he is advised to have the
contractor(a) sign portions of the "Contractor SectionsU of this application far whiell they
will be responsible. If you, as the owner signs <IS the contractor, YQl,\ are indicating that
you, rather than the contractor, are responsible for the work, If the contractor wislles
you to sign as contractor that may be an indication that he is not properly licensed and is
not entitled to permitting privil~ges in the City of Zephyrhills.
C. 'I'RANSPOR'l'ATION IMPACT FEES AND UTILITY CONNECTION FEES
V. CONS1RUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that 1, the applicant, have been provided with a copy of "florida's Construction
lien Law - Homeowner's Protection GuideH prepared by the Florida Department of Agriculture
and Consumer Affairs, If the applicant is SOmeone other th~t the "ownerU, 1 cerify that I
llave obtained a copy of the above described document and promise in good faith to deliver
it to the "owneru prior to commencement.
E, CON'rRAC'l'OR' S/OWNER' S AFIfIDAVI'l'
I certify that all the information in this application is accurate alld that all work will
be done in compliance with all appU.cable laws regulating construction, zoning, and land
dev&;llopment.
Application is hereby made to obtain a permit to do work and installation as indicated. I
ce.j:tify that no work or installation has commenced prior to isauance of a permit and that
all work v/ill be performed to meet standards of all laws regulati.ng construotion, City
codea, 2:oning regulations, and land development regulations in the jurisdiotion, J also
certify that'I understand that th~ 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 I *Department e)f
Environmental Regulatipn-Cypress Bayheads, Wetland Areas and I!:nvironmentally SensJ.tive
Lands, Water/Wastewater Treatment
*Soutllwest Wlorida Water Management District-Wells,CYPEess Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Uepartn~nt of Health & Rehabilitative Services, Environmental Healtll Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.S. Environmental J:rotection Agency-Asbestos abatement
1 also certify that, if fill material is to be used in Flood Zone ~Au or "A,eto,H, it is
understood that a drai.nage plan addressing a "compensating volume" "will be submitted v/hioh
is prepared by a professional engineer registered in the State of rlorida 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 technioal codes,
nor shall issuance of a permit prevent the Building Official from thereafter requi.ring a
correction of errors in plans, construction, or viol~tions of any oode. ivary p@r~it
is/lued ahall beoome invalid unleas the work authori~ed by auoh permit is oOllulumaed within
six' months of issuance, or if \vork authorized by the permit is suspended or abandolletd 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 extensi.on shall be tequea~ed
in writing to the Building Official. An approved inapeation must be logged during each ala
month period, or the project Hill be considered abandoned. .
WARNING TO OWNERI YOUR Ii'AILURE 'fO RECORD A NOTICE Oli' COMMENCEMENT MAy RESUL'l' IN YOUR
J:AYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF you INTEND TO OBTAIN FINANqINq, ~'~iUL1
WI'rH YOUR LENDER OR AN A'r'TORNEY BEIi'ORE RECORDING YOUR NonCE OF COMMENCEMIilN'f. JOBS uNDER
$2,500 IN VALUI!l DO NOT Nti:ED '1'0 RECORD AND POS'l' A "NOTICE OF COMMENCEMEN'r".
S IGNA'l'URE I OWN iR OR AGENT
SIGNA'rUREI CONTRACTOR
a cknmvl edged
, 19_
STA'rE OF FLORIDA
COUNTY OF
The foregcin9 instrument w~a acknowledged
Before me this ------J.iay of---, IS-.:._
by
(name of person aoknowledged)
[1ho il3 perl30nally known to me, or
Dwho has produced
(type of identifioation)
and Hho Odid DUd not t.ake an oilth
a'rA'l'E Oli' FLORIDA
COUNTY OF
The foregoing instrument was
Before me this __._ day of
by~
(name of peraon aaknowl~dged)
Dwho is personally known to me, or
o who has produced
(type
and who[] did []did not
of identification)
take an oath.
Signature of person taking acknowledgement
Signature of person taking aoknow~edgment
Name typed, printed or stamped
Name typed, printed or stamped