HomeMy WebLinkAbout02-1716
BUILDING PERMIT
Permit N2
CITY OF ZEPHYRHILLS
(813) 780-0020
1716
-
Date ./-~- /3-0<..;
Jf5
Property Owner:
Job Address:
Parcel I. 0 0 "
E~Al P~G
~~-~'~L;;~.
~:._-- Sewer Conn
Water Conn:
BUILDING
Water Meter:
T.I.F.'s:
Zoning:
DescriDtion of Work
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
City license Registration #
State Certified license#
J/~
,
(;:1:3
Company
Address
~~~V S;7-5D3 c;
-
Valuation or ~ e:2 ~ c-
Contract Price ...;;;d
,.,.---
_.~.~_.--.
BUilDING
PLUMBI
~_.~_.
.L.
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
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) 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 ZEPHYRHILLS PERMIT APPLICATION
BUILDING DBlI?ARTMlllN'r 5335 8th S'rRlllllJ'r ZllJI?HYRHIr,IJS, ris 33Ei40,
PhoneI813-780-~020 'a~1813-780-0021
W\.'fm RBCHlIIVJllb ..............~"-.:..~.i&C" ______
li'IJANS R!llV I BlW J'SI_,-,-, ~_"__ L' Hq_____.
OI'lNEJR I S HM1El &1 ? ~~ c:: U 61[ <:F r?;~ PHONHl CON'l'Ar~'~_________~_~~:.c _____-'
-._---._-_..~-_._..- .._----~._---_._--_._--_...,'-_._..__.__.~.-------_._---------..-.. --------
,JOB BITBl ADIJRBl88___::J.ip.:J_l_ ---12=__I!l~G_:..__________________ ________ ----------___H___________
LBJ~AL DBJSURTP'1'IONI LO'1'(S)
-.-.--.-----
BUKlK
811BJJIV I S ION
PAR(~ElII III #
_.._..._--~--_..- - ., '---...----- ._-,-.- ----.-
---.-------~._---~.--.-----------.-..---.---~...~----.----_._.....u _.__._.,_________.~_
(OBTAIN FROM PROPERTY '!'A){ NO'l'WEJ)
WURK PRnpSElIJ I [J NEW CONs'rRUC'T ION
[J UW1MBlRt!IAI,
n ADDITION o AL'rERA'rION [1 RIllPAIR I.J IN8TAlJl1
o MOVE 0 DEf-10I,ISII
Ch1Ut/n - FAMIl.V 0# OF llNITS lJ MOB lItm 1I0f-1E
rJ INDUS1'RIAJJ [J SHIMMING POUL U OTHER
[j 8 IGN
PROI:JUI3EJJJ USE: r [~FAMILY DWELr,IW-~
D Rl!l8TAURJ\HT & HEAlmr DElPARTt,1EN'r APPROVAL
nEBeRr onON OF WORK .____IZ~ _I!Q~..'! ?_~______~___ ____..________~___~_.__.___
BUn,nrNt~ SIZE
-------..- .
SQUARBl FOOTAGE
R!llBIlHllNTIATJ r
COMMBlIWI AT,I
HEJJ~H'r .,_~__,_______
A'r'I'l\CH (;]) PI,O,!, PI"AllS & (2) SElTS OF BUIl,DIl'l(l PLANS & (1) SElT E1NBJROY FORMS,
A'r'tA(~H (.J) SETS OF Butr.rnNG PLANS & (1) SElT ElNERclY FORMS,
PROPBlR'I'V SURVEY REQUIRElD FOR ALL NElW CONSTRUCTION.
[] BllILIJINc1
RERMITS REQUESTED
$1u'?s D'"J
-_----....._~~_._.-
.-/
VALUATION OF TOTAL CONs'nWCTION
L1 BlLBlCTRWAT,
[J PI.llMBING
--------
AMP ~ElRVWBJ
o
FLOR IDA POWER
[J
N.R.Bl.C.
I.] IIJBlUH1\N WAIJ
[J W\8 [~OFIN(J
j-
$------
-- VAIJUATION OF MH:C'!IAHCIAr, INS'I'AI,lJATTON
LJ 8PElCltAI/l'V
[) OTHER
TVPE OF (lONS'I'RUc!'rWN I [J Br.oCK
o FRAJ.1E!
[) 8'I'ElElI,
[) OTHER
FINISHBlIJ Fr.cJOR IllIJEVATIONS
-------~._-~
r S PROIJElCT IN FLoon ZONE! ARElA [1 VEla
o No
I!H1UnIllR
-----------..--------..
.~------~-~._---
Cor1P ANY_______,_______________________ ______ ___________
STATE CElRT OR REGIS'!' # _______________________,_______
CITY PROCESSING L_______________________________________._
810NATlJREl
B1UIClTRICIAN
****"'****'**"'*""'***'*'**********'*"'*******'**'*'*"****'*
COt1PANY ______ ________ _________________________ __.____
STATE <'BRT OR REGIST #
SWI1ATlJREi -------.--'-----------.--__________________________ CITY PROCESSING #
-----.--.-......-... --.----..--.-.--..--.....-- -._. --_.
PIJUMBBJR
"*'**'*"'A"""'""***",**"**,,,,,*,*******,****'**'*****"*
----- ---.---.-..--. ~.-_..- -.,...- --->---.,__..a.____.
_._~----~--._..._--------- -.
-----.----
(~OM PAN Y ------________.____________________.._____.__________ ._____.___
STATE CBR'I' OR RBGIST # _________________________..
CITY PROCESSING #
S WNA'l'lJR III
MBlCHANICAl.
~'*******'*************************************'*'****'*'***'**'**
--.--....-.----.---...--------.--
COlvJPANY _______
STATE nERT OR REGIST #
CI'I'Y PROCESSING #
------."....-..-- -------._._.._-._."_.~.._--
SIGNA1'lJ~El
---..-----.-...-
----.--.-.--..----.-..--.------..-.
OT'.R ----j!~tf!I?_~~ ~ I4coh.c/?
8WNA'r'lJREJ _ ~__IJM: __
*'**********'***********'********'****~**'***'**********'**"****
-----.-----...------
t /J '
COMPANY t:-1'It//lt/ K O()//~6-
S'I'A1'El CElRT OR REGIST # 0 ~ l)olt~J~ ,-------
CITY PROCESSING # ~ _+----_______
--Il_'~.____._________._____________
***********************************'*****************************
CONDITIONS OF PERNI'I' AFFIDAVIT
A. NO~ICE OF DEED RESTRICTIONS
The undersigned understands thijt this p~rmit may be subject to "deed restriotions" which
may be more restrictive than City regulations. The undersigned assumes responsibility for
complir.H1ce with any applicable deed restrictions.
B. UNLICENSED CONTRAC'l'ORS AND CON'l'RAC'l'OR RESPONSIBII,I'l'IES
If tile owner has hired a contractor or contractors to undertake work, they May be required
to be Ii ceused in accordance with state aud local regl!lations. If the contractor ia not
Ii censed as reqUired Ly law, both the ol-mer and contri:lctor may be cited for a ndademeanor
violation under state law. If the owner or intended contractor are uncertain as to wllat
li censing requi rementa may apply for the intEHlded work, they are advised to oontaot the
City of Zephyrhills Building Department, 813-768-6611.
Furtllecnore, 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 Ule owner signs ~s the contractor, YQ4 are indioating that
you, rather than the contractor, are responsible for the WOl'k. If the contractor wishes
you to sign as contractor that may be an indiCation that he is not properly licensed arid is
not entitled to permitting privil~ges in the City of Zephyrhills.
C. 'rRANSI?OR'l'ATION IMPAC'l' Ii'E;ES AND U'I'lLI'I'Y CONNECTION rEES
D. CONB'fRllC'rUION LIEN LAW (CHAP'I'ER 713, FLORIDA S'l'ATU'rES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of MFlorida's Construction
lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affaira. If the applicant is someone other that the "ownerU, I cerify that I
have obtaineq a copy of the above described document and promise in good faith to deliver
it to the "owneru prior to commencement.
E. CONTRAC'l'OR' S/OWNER' S AFFIDAVI'r
I certify that all the information in this application is accurate and that all work will
be done in oompliance with all applicable laws regulating construction, zoning, and land
development.
Application is hereby made to obtain a permit to do work and installation as indioated. I
ceJ:tify 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 construotion, City
codes, zoning regulations, and land development regulations in the jllrisdiotion. J also
certify that I understand that th~ regulations of other governmental agencies lnay apply to
the intended work, and that it is my responsibility to identify what aationa J llIuat take to
be in compliance. Such agencies include but are not limited tOI *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Bnvironmentally Sens~tive
Landa, Water/Wastewater Treatment
*Boutllwest rlorida Water Management District-Wells,Cypress Bayheads, Wetland Areas,
Altering W~teroourses
*Acny Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of Health & Rehabilitative Services, Environmental Health \Jnit-Wella,
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 ~Au or "A,ete.", it is
understood that a drainage plan addressing a "compensating volume" 'will be submitted which
is prepared by a professional engineer registered in tile State of rlorida prior to permit
iasuance.
A permit issued shall be conatrued 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 coclea,
nor shall issuance of a perndt prevent the Building Official from thereafter requiring a
cor,r:ect1on of errors in plans, con~truotion~ or vio,l.ations of any code. EVtiry p(u:mH
iSliu~d ~hall become invalid unless th~ Hork authorized by auch permit is cOl\ulIenced within
slxmonths of issuance, or if Hork authorized by the permit is suspended or abandoqfild for a
period of slx months after the time the work is commenced. One 90 day extenaion of time
may be allowed for the permit with fee charge of $15.00. 'rhe extenaion shall be teq~ea~ed
in writing to the Building Official. An approved inlilpection mUlilt be logged during each SiK
month period, or the project will be considered abandoned.
WARNING TO OWNIilRI YOUR rAILURE 'fO RECORD A NOTICE OE' COMMENCEMENT MAY RESUW' IN YOUR
PAYING 'l'WICE; E'OR IMPROVEMHlN'I'S TO YOUR E'ROE'ER'rY. IF you INTEND TO OB'rAIN l!'INAN qr<<'i, -~'~NiUL'f
WITH YOUR LENDER OR AN A'I''l'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'f. JOBS UNDER
~2, 500 IN VALUE DO NOT N)!:ED 'l'0 RECORD AND POST A "NO'rrCE OF COMMENCILMEN'r".
SIGNA'l'URE: OWNER OR AGENT
SIGNATURE; CONTRACTOR
acknowledged
_,19_
STATE OF FLORIDA
COUNTY OF
'fhe foregoin9 instrument w~a aoknowledged
Before me this ------pay of---, 19 ~,_
by
(name of person acknowledged)
C1ho ia pex:sonally known to me, or
Dwho haa produced ,
(type of identifioat~on)
and vlho Ddid DUd not t,ake an oath
5'rA'fE or E'LORIDA
COUNTY OF
'l'he foregoing instrument was
Before mE! this __ day of
by~
(name of person acknowledged)
Dwho is personally known to me, or
o who haa proQuced
(type
and whoD did Odid not
of identification)
take an oath.
Signature of person taking acknowledgement
Signature of person taking aoknowledgment
Name typed, printed or stamped
Name typed, printed or- stamped