HomeMy WebLinkAbout02-1723
BUILDING
Property Owner:
Job Address:
Parcell.D. #
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N!
1723
(813) 780-0020
Date
1 J- -;2 ,3- 0 :;(
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
-Acc,u~ --r-Y\5,.
3 'i) a?>'d- S o/h. fV~,
Water Meter:
T.I.F.'s:
Zoning:
DescriDtion of Work
~ergy Code: ~
IAJUlA.M(j-
s, :;on~.,?&€.,
FINAL
~ /CJ - [) 3
DATE
NO OCCUPANCY BEFORE C.O.
Complete Plans. Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
I-/Jb
Inspector
Permit Fee ...3.5' t!>-C
~ignature -; ~.~ D<L:.e. . 0
Company
Address
Ylelephone# *\~ q~')- L-[3') I..(
Valuation or ______
Contract Price
City license Registration #
State Certified license#
~/6~o
BUILDING .
Ftr.
Pre SLB
lintel
~ bier .
ELECTRICAL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
pre-M7r
Final ~ / - 10 - tJ -'
SLB
Tub Set
Water
Se
Fi al
A-'~r
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 ZEPHYRHILL8 PERMIT APPLICATION
Burr,DING DEPARTMENT 5335 8th S'rREJll'r Zl!JPHYRHII,I,S, P'L 3.Hi40
PhoneI813-780-n020 FaXI813-780-0021
!lA'rs RBeJllIVJl!o _.__ ".__~"=.
PJ,ANS R!IIVIIIlW II'IlIBi_,--~_.~ l1- ___..
Dl'lNBJR f 8 HANE___~e._.~~c:,I1v.::",,"~~_.____________.____ PHONE CON'l'J\.(~'~_________.._.._.__.___.
.JOB SITE A.DDRBl88 ....~~?-- ?~-_5~-~~~'-----__,_____u'_"_____'_'__h'_______. ._nu...._.
LEGA.L DESCRIPTION, LOT(S)
BU)CK
SUBDIVISION
~~_.__.._---------
_.._------_.~,._-_..~----._-,.__.-
PARCEll, ILl #
HURl{ PRnpSBltJ I LJ NBlH CONSTRlJCTION
~.
_.._--_._.-----~.~.__.._--_._---_.._----_._~--------_._--------.--.- --~_._-~~-----~--~..~-
(OBTAIN FROM PROPER'rv 'I'1\!{ Nfl'I'WEl)
[] ADlJI'l'ION
o AUl'ERATION
o DElrJJot,IslI
[] RElPAIR
Ll INSTAl,I,
o MOVE:
PROPOSEIl USE, [JSCH, FAMILY DWELfJIllG
r~1MBlR(!IAr,
[]~1tJI/l'I.. FAr",rLV
0# UF UlnTS
[JSWHilMING poorJ
[J MOB Il,El lfor11lJ
o INDUS'l'RIAIJ
/] OTflHlR
ImSCRIPTION OF WORK
o ReISTAURAN'l' & HEAUl'!I DHlPAR'I'tilENT APPROVAL
LJ ~ ~ V\.~u) __.
--------.-~- .-.---------.---~_. -"-..-.___.0.0. _~___"_4
BUILfHN(J SIZE
----..--..-
SQUAREl Foo'rAGE
RESIDBlNTlJUJ I
COMMER(!IA.IJ:
lIEI TGHT
....:4___...__. _ __ _~~4___
A'I'T1\CH (;3) PLOT PIJAl1S & (;3) 8ElT8 OF Burr ,[)IN<1 PLANS & (1) 8El'I' ElNElRrJY FORMS,
A'!"IiA.C!H (.3) SE'rs OF BUtLDING PLANS & (1) SEl'r ElNERGY FORMS,
PROPERTY 8URVHlY RElQUIRElD FOR ALL NEW CON,9TRUC'l'ION.
~aRMITS REQUESTED
[] BlJIr.IJIN(~
$ ---"---.
---ALA_-"-
---~_.--.;.
VALUATION OF TOTAL COHs'rRUC'I'ION
IJ ElLElCTRlCAl,
AMP gElRVICEJ
o FU)RHJA POWElR
o
W . R , El . () .
f] PIJ{JtilBING
U J.1B1CHANH!Af,
[] (~A.8
[J ROOFING
,
$- .--.-------- VAI,UATION OF r..,ECHA.NCIAI, UISTAIJIJA'I'TON
[J SPE(!tA.Ul'V
[) OTHER
'l'YPEl OF' (~0118'I'Rt1C!'I'IDN: [J BLOCK
[J FRAHEJ
[] STEEL
[J OTHElR
FINI8HElV FI,OOR IlIIJElVATIONS
-------
IS PRlXJEC'I' IN FLoon ZONEI AREA. 0 vms
o NU
BUIJJfJllIR
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cor.., PAN Y___._______._ _______... __.__ ________.___.__
STATE CElRT OR REGreT # _____._.__.__._____.___-'______
C!TV PROCBl88ING L_..____._____________________._.__
81GNA.TlJREl
-_.._-_._----.__._-~_.._------------------_.._---
tIIl,!l(1'fRICI.I\U
131 GNA.'1'IJREJ _...._~~ ~~__________
COI'1PANY ~.-l2.ee~LGl<QL~~.~.._.______u_ ____
STATE C'E:R'I' OR RElGT8'!' #-~C_t~.cH~~._.____._.__
CITY PROCESSING #
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--~_._..__.-.._+._-~-_.._.._. --.------..-.-------
PI,UMSBJR
._._-........_..-.....~-~'"...-......_-- ---.
COM PAN Y -.--.._._.___.__________..._____. .___.._____..______._
STATE: e'ER'!' OR REGIST # __________._.___.___.
CITY PROCESSING #
SIlJHA'I'tlRE
MIIICHANICAI.
******************************************************************
----.~~._--._._-~._---_._-----,-
-----~--~_....._---._--
COMPA.NV.______________.._.__..______._____
STATE CElRT OR REGIST #
CITY PROCElS8ING #
-'--.-.,-.+--~-+____.__u____,___+_.......__ _'., '.___.._
e TGNA.'I'UREl
**************************************~*******************~******
-----+._--~-,--_._--- ----..------
OTlIlIlR
-'-~--~...,--_-...-......_---------------
-------_._~
(~()rvIPA.NY
STATE e'ERT OR REG 1ST #
CITY PROCESSING #
S WHA'I'1JRE
----_._---_.._._+-~._-._._... ._~,- '-
-_.~-- -- '_.._._-_.._-----~--.~
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------~----,.---~._----~...__...__4..__._
CONDI'l'IONS OF PERMIT AE'f!"IDAVIT
A. NOTICE or DEED RESTRICTIONS
The undersigned understands thijt lhi~ permit may be subject to "deed restrictions" which
, may be more restri cti ve than City H!gula tions. '1'1\1:: 11l1ch::rsigned assumes responsibili ty for
oompliance with any applicable deE:Q restrictions.
B. UNLICENSED CONTRAC'I'ORS AND CON'l'HACTOR RESPONSI:BII,[TIES
If the owner has hired a contractor or contractors to undertake work, they nlay be required
to be licensed in accordance with scate and local regulations. If the contractor is not
licensed as required by law, both the o~mer and contractor may be cited for a miademeanor
v~olation under state law. If the owner or intended contractor are uncertain as to what
Ucensing requirements may apply for the intended work, they are advised to aontaot the
City of Zephyrhills Building Department, 813-788-6611.
FurtherlllOl::e, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor SectionsU of this applioation for which they
will be responsible. If you, as.the owner signs as the contraotor, YQ4 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. 'l'RANSE'ORtl'ATION IMPAC'l' FEES AND U'l'ILITY CONNECTION FEES
D. CONS'l'RUCTUION LIEN LAvl (CHAP'l'ER 713, rl,ORIDA STATUTES, AS AMENDED)
1 certify that I, the applicant, have been provided with a copy of "rlorida's Constrllction
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 aocument and promise in good faith to dellver
it to the "ownerU prior to commencement.
E. CON'rRACtl'oR' S/OWNER' S AFFIDAVI'l'
I certify that all the information in this application is accurate and that all work will
be done in compliance with all appU_cable laws regulating construction, zoning, and land
devf?lopment.
Application is hereby made to obtain a permit to do work and installation as lndioatlid. I
certify that no work or installation has commenced prior to issuance of a permit and that
all work Vlill be performed to meet standards of all laws regulating construction, City
codes, zoning regulations, and land development regulations in the jurisdiction. I also
aertify 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 llIllSt Lake to
be in compliance. Such agencies include but are not limited to: *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Envlronmentally Sensitive
Landa, Water/Wastewater Treatment
*Soutllwest ilorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
'Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of Health & Rehabl1itative Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.S. Environmental 1?rotection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone ~A" or "A, eta.", it is
under:stood that a drainage plan addressing a "compensating volume" 'will be submitted whioh
is prepared by a professional engineer registered in the state of Wlorida prior to permit
issuance.
A permit issued shall be oonstrued to be a license to proceed with the work and not as
authority to violate, cancel, alteL', or set aside any provisions of the tealmical codes,
nor shall issuance of a permit prevent the Building Official from thereafter requirlng a
oorrection of errors in plans, pon~truotion1 or vio~a~ions of any oode. Every p&,mit
issu~d shall beoome invalid unless the work authori:z;ed by such permit is oOllunenced ~/ithin
SiK months of issllance, or if work authori:z;ed by the permlt is suspended or abandoqliild for a
period of aix 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 reques~ed
in writing to the Building Official. An approved lnspection must be logged during each six
month period, or the project will be considered abandoned.
WARNING TO OWNER; YOUR rAIWRE '1'0 RECORD A NOTICE or COMMENCEMENT MAY RESULt!, IN YOUR
PAYING 'l'WICE FOR IMPROVEMENTS 'I'O YOUR PROPERTY. IF YOU IN'l'END TO OB'!'AIN lnNANqINq, ,~9N~UI!r'
WI'l'H YOUR LENDER OR AN A'rTORNEY BEFORE RECORDING YOUR NOTICE or COMMENCEMENT. JOBS UNDER
$2,500 IN VAWE DO NOrl' NEED 'l'O RECORD AND POST A "NOTICE OF COMMENCEMEN'l'''.
S lGNA'l'URE; OWNER OR AGENT
SIGNATURE: CONTRACTOR
o who has produoed
(type
and who[] did Ddid not
of identification)
take an oath.
STA'l'E OF nORIDA
COUNTY or
The foregoing instrument WqB aoknowledged
Before me this ---Pay uf-- I 1~ ......:..._
by
(name of person aoknowledged)
[1ho .is personally known to me, or
o who has produced______________
. (type of identifioation)
and Hho Odid DUd not t,ake an oath
f:l'rAtl'E Qjj' FLORIDA
COUNTY or
The foregoing instrument was acknowledged
Before me this __ day of , l~
by ~__
(name of person acknOWledged)
Dwho is personally known to me, or
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped