HomeMy WebLinkAbout02-1726
BUILDING PERMIT
Permit N~
CITY OF ZEPHYRHILLS
(813) 780-0020
1726
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Parcell.D. II ___
Zoning: Energy Code: )
Descriotion of Work (~ /'-hU---
....
Date
/~ - :21'- 0::0
ME~-Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Radon Gas:
a.~
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
-tl3
Complete Plans. Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Ll( ;-fl-J"O
Permit Fee
0s;~natYLJ
Company
Address
~~ -35-:/-79'7-/$-:.73 C1-(C(
Valuation or ...di . ;Z-
Contract Price ~ r f /)0
City License Registration # c5?71)
State Certified License#
PlUMBI MECH
BUilDING
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
.c::;.------
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
Driveway
REINSPECTlON 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.
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"1') 17 ~ ?L1 tW-e:f ~
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(~U (2-/1,0;:<
ir
SQ.FT
Main
Other Area
Under Roof
Valuation:
PRICE
Building:
/Dt 0'0
'~w- C C
, ).
Electric:
Plumbing:
I/\!} I tit
;Jfn
IV' I;/}-
Mechariical:
Radon:
School Impact A \ I\/l
Fees: IV I\- r-
Connection ~ J /
Fees: IV I v1-
Trans. Impact JA II
Fees: IV {Ii
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7
CITY OF ZEPHYRHILLS PERMIT APPLICATION
aUILDItW DBlI?ARTMBlN'r 5335 8th B'fRBlBJ'f ZBJPHYRHII.IJS, vi.. 33~40 .
I?honaI813-780-D;020 FaXI813-780-.0021,.,' '. I, .1).., ._/1 'f
IJATBl RBOBlIVIIJD "'""-.....I~2L2~ _12~
I?IJANS RmV!BJW I'Jl1t'--'",_.".LL____'n.
ONNBlR' 8 ITAHEl f Ior(c4 f}; eclr Jell ("\ Ie' PHoNE CON'!'AC!'!'_._)--,S:.,__~ _(,~,
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lTOB S I'fBl ADDRESS 3_~-L~--J!LCf.LjLd__5frY'EL'-f______-5efky._____~___. ._______.__ '______
IJEI!J1\L DmSCRIPTIOtlr LO'f(S)
BLOCK
8UBfJIVI8 JON
~-_._--_._------
PARC!ElIJ I n it
--_.~-_.__.-----.--.+"'._.,-_.,-.~--
WfJRK PROPSElD I [JNBlN C!ONElTRUCTION
~N
-------------.------ -----------~--_..__._------~------_._._-_._------_..-
(OBTAIN FROM PROPERTY 'I'1\!( NOTICE)
[] Cm1MBlRC JAt,
o AODITICHl CJALTERA'rION [) REPAIR IJ INSTAlJ!l
o MOVE 0 DEMar/ISlI
[J~1tJI/l'r - FA1'1I1.Y On UF tJNITS LJ M08U,i:n Hor1Bl
o INDUS1'RIATJ [J SNr~1MINa POOL I] OTHBlR
PRO!?D8EI1 USEll CJSGH, FAMILY DWELf,UTt]
))ElSCRIPTIOl--l OF NORK
CJ R~8TAURAN'r &
~ 5'91'
/
-1--7..2______
HEAIml DBlPARn.1ENT APPROVAL
BtJn,nrN(~ SUIlI
~f (c.,tlLL~L__t._~o _0-~_____________.___ _______
HEllaHT _,. ~6_~__-,-__
SQUARE FOOTAGE
RBlBI1H!lNTIALI )\'fTACH (2) pr,OT PIJAHS & (2) 8ElTS OF BUII,IJINt1 PLANS & (1) SElT ElNElROlJ FORMS.
(~OMMBlRC!IAT, I A'!'1;J\r!H (3) SE'fS OF BUtLIJ!NG PLANS & (1) Sill'!' ElNERnv FORMS,
PROPERTY SURVEY REQUIRED FOR AtJL NEW CONS'I'RUCTION.
[] 8tlII.IJINC3
~~~ PERMITS RBOUBSTED
$- .--_" VALUATION OF TOTAL CONS'rFHJCTION
.,,--- -~-_..
----------~ AMP SERVICE 0 nORmA POWElR [) W, R , 8. (l.
C1 BJU1CTRlCAI,
[] P!,{J~1B INC3
o I>1Bl(JHI\.NWATJ
,.
$-- --.
- VALUATION OF MEC'HAHCIAI, UIS1'AI,IJATH1N
fJ (JAs
LJ ROOFING
[J ElPEJC1tAurv
[J OTHER
'J'Y'Plll OF (~ON8'1'RtJC!TroN I [J BLOCK
o FRAt1EJ
[] STElElI;
[] OTIIElR
. -~\ 17'1-1723
(J) / 4f,i~
FINIBHElIJ Fl,(JOR: ElIJElVATIONS
--------
I8 PROtTElC"f IN FLoon ZONm ARElA 0 yms 0 NO
BuunlllR
810NATtJRE
-'"-~._-~--..._-~
---------.-----
CO~-1 PAN y____..___~_____. __._____ ______.___...____________.
STATE CElRT OR RE(HST # __________________________,_._______
CITY PROCB1SSING L_____________~__.____..______.
'*"*""*"'**'**"""""*"""*""**"*"""'""**"'*""
mtJIllClTRIOIAN
s mlTA'1'IJRE _____
0... ______ _____.___.____..___.~_..___.._,_.__~_______
Cm-1PANY -.--------------------.-__c___.___
STATE CERT OR REGTS'!' #
CITY PROCESSING #
'---'--. --.------------------ ."- -.----- _..-...-
*""""*"""""*"'*'*"""'**"'***""'*""*'"'**'***'"
-----.- ---.------.-- "---,._--._.._-~---
PJ,UMBBlR
._.-....-._----~..~..._-_....._.-.--._-
COMPANY-.._________________________.__________
STATE CERT OR REareT # _________,_________.
CITY PROCESSING #
S WNA'l'tlREl
MBlrJHANI CAli
**"*'*'**'**'****'**'*'*******'*'**'*******'****'****"'*'**'*'**
-.-.-...----------------..-.-__.._M._
----....._-_._~..,---
CO~1PANY __._________,.___________ ________. ___.
STATE (IERT OR REGt8'f # ---.-~-----------------__u__
CITY PROCESSINa #
e IGNA1'tJREl
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0.... 5J6'd~ckr CO"PAtlyhl'/'7 S;-2':I1~_.__~._._..___
/- S'l'ATEJ CElRT !%:-RElGIST '#-,c: ~a:>
SWNA'I'tJREl_ ~~ __ CITY PROCBlSSING # _ --<1.1-L_________
...................................................;~~~:~~~;~~~
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------~-_._-_._-- -_._---~_.,---~
cmlDI':'.'IONS 0:: PERMIT A::FIDAVI'J'
A. NOnCE OF DEED RES'l'RICTIONS
Th~ undersigned understands thijt thi~ parmit may be subject to "deed restrictionsH which
m~y be more restrictive than City regulations. The undersigned assumes responsibility for
oonlplicmoe with any applicable deedrest:l:ictL:JlH;.
B. UNLICENSED CON'l'RAC'l'ORS AND CONl'RAC'l'OR RESP~)NS LBII,II'IE:S
If the owner lias hired a contr~ctor or contractora to u~dertake work, they may be required
to be licensed in ~ccordaIlce with sti~te and L:lC<t] reglll,:itiuns. If the (lontractor is lIot
licensed as required by law, both lh,= ovmer and contrOlctor may be cited for a ndademeanor
violation under state law. If the owner or intended contractor are uncertain as to wllat
licensing requirements may apply for the intE:lnded work, they are advised to contact the
City of Zephyrhills Building Department, 613-768-6611.
Furtllermore, if the owner has hired a contractor or contractors, he is advised to hav~ the
contraotor(s) sign portions of the "Contractor SectionsH of this application for which they
will be responsible. If you, as the owner signs IS tile oontractor, YQY 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 lioensed and is
not entitled to permitting privil~ges in the City of Zephyrhills.
C. 'I'RANSPOR'l'ATION IMPACT FEES AND U'l'ILI'I'Y CONNECTION FEES
D. CONB'l'RUc'rUION LIEN LAW (CHAP'l'ER '713, E'l,ORIDA STATUTES, AS AMENDED)
r certify that I, 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 Affail:'s. If the appliciant is someone other that the "owner", I cerify that I
have obtained a copy of the above described document and promise in good faitll to deliver
it to the "owner" prior to cOlTunencement.
E, CONTRAC'l'OR' a/OWNER'S AFli'lDAVI'l'
I certify that all the information in this application is accurate and that all work will
be done in compliance with all appli_cable laws regulati.ng construction, zoning, and land
devljllopment.
Application is hereby made to obtain a permtt to do work and installation as indioattild. I
ce~tify that no vwrk or installation has commenced prior to iaauance of a permit and that
all work will be performed to meet standards of all laws regulating construotion, City
codes, ~oninQ regulations, and land development regulations in the jurisdiction. I also
certify that I understand that th~ regulations of other governmental agencies may apply to
the intended work, and that it is my reaponalbility to identify what aotiona I must take to
be in compliance. Such agencies inolude but are not limited tOI *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and J!:nvironmentally SensJ.tive
Lands, Water/Wastewater Treatment
*Southwest Florida Water Management District-Wells, 'Cypress Bayheadfi, Wetland Areas,
Alteri.ng Wateroourses
"'ArlilY Corps of Engineers-SeawCllls, Docks, Navigable WaterHays
*Uepartu~nt of Health & Rehabilitative Services, Environmental Healtll 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 qA" or "A,ete.H, it is
understood that a drai.nage plan addressing a "compensating volume" "will be submitted Hhich
is prepared by a professional engineer registered in the State of florida prior to permit
iasuance.
A permit issued ahall be construed to be a license to proceed with the work and not as
authority to violate, cancel, alte:t:, or set aside any provisions of the technioal codes,
nor shall issuallce of a permit prevent the Building Official from thereafter requiring a
correotion of errors in plans, con~truction, or vio~~tiona of any Dode. every p@twit
i/iiaued /iihall become invalid unless the work authodzed by suoh permit is oOllullenoed within
six'month/ii of issuance, or if \vork authorized by the permit is suspended or abandol1tild for a
period of eix months after the time the work is commenced. One 90 day eKtenaion of time
may be allowed for the permit with fee charge of $15.00. The extension ~hall be requea~ed
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 'fO RECORD A NO'nCE Ob' COMMENCEMENT MAY RESUL'I' IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF you INTEND TO OBTAIN FINANqINq, ~QN'ULT
W!'l'H YOUR LENDER OR AN A'l"l'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'l'. JOBS UNDER
.2,500 IN VALUE UO NOT NEED TO RECORD AND pas" A "NOTICE OF COMM~~~N'r" /
,:#----~
S~TUREI OWNER OR AGENT SIGNA~'UREI CONTRhCTOR
acknowledged
,19_
STA'l'E OF FLORIDA
COUNTY OF
The foregoin9 instrument W~/ii aoknowledged
Before me this -----5.iay of---, 19.....:._
by
(name of person acknowledged)
Qho is personally known to me, or
Owllo has produced
(type of identification)
and Vlho Odid DUd not t.ake an oath
fj'rA'rJ!; mf FLORIDA
COUN'rY OF
The foregoing instrument was
Before me this _ day of
by~
(name of person aoknoWledged)
Owho is personally known to me, or
o who has produced
(type
and who[] 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
.
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