HomeMy WebLinkAbout03-1734
BUilDING
Property Owner:
Job Address:
Parcell.D. ,
BUILDING PERMIT
, NO
Permit -
1734
CITY OF ZEPHYRHILLS
(813) 780-0020
I - d ~() '3
Date
ELECTRICAL
MECHANICAL
PLUMBING
Sewer Conn
fJ/6erT
~gly'7
Water Conn:
-5 J'k\ ~~~ S
C;~ Ave,
Water Meter:
T.I.F.'s:
Zoning:
Descriotion of Work
Energy Code :
(Y /{""5Yl~?A-f 0
Radon Gas:
FINAL
-e2/-0
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.
Valuation or
Contract Price
DATE
Inspector
o
~.-
Pe,m;t Fee ~~
YSignatur
Company -. % ~ - C- cJ;<- CU. F (-
Address /09 rk'o<./"g/tf D(~@C ;(JtJ...
J<J TelePhone#f.7 02 ]) <fY';;L - S:-7 d-- :3
City license Registration #
State Certified license#
~7q~
Ftr.
Pre SlB
lintel
FRM.
Insul. Cl
Wl
MI/"""~ C/e(". ~ tJ.F
ELECTRICAL
MECHANICAL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SlB
Tub Set
Water
/1- 3 - C.:?> I~L ~ Sewer
Final
Breakers
Ducts Insl.
Compressor
Final /
i/
/
,/
;'
Drivewa /
F P /-J.I-03 !,'5S ~;[~I /C;/-
REINSPECTION FEES: When extra inspection trips are neces'!>ary 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.
\ \
*_ \'\ 1y J\
UlmElR I S
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUI~DING DEPARTMmNT 5335 8th STREET ZEPHYRHILLS, fL 33940
PhonaI813-7BO-~020 Fa~le13-780-0021
lJA'fm RJll<1JIlIVSlo ~...__.._ _~~=H _____
PI,ANS R!IIVImC J'S1J11-----!!___ _..
I1A""_____ :;'1 >"h AIf\J~ A16~^:1.---. PHON" CONT^',F.'3-Z f:;:t.-:-.3.o.1'l
AD[JR!DS s38:1. Y!l-.._-J.-.--d(j~-__LE;1_.'-Y. ~lllJ /L---.. __ _____ _
,JOB ST'l'El
LElrJAL ])ElSCRTPTION:LOT(S)
BljUC'K
SlIBlJIVISJON
--_._.__._-~_._ ,. .___4.____..__.
PARC!BJI, If} If
---------~
.~---~.__._---_._.._~-~_.__._----~--~------------_._-----.._--_._---------..._.~._._.__.._--.__._-----~._-
(OBTAIN FROM PROPElR'l''l 'l'AX NfJ'I'ICEl)
WJRK PRO!?SllllJ I [JNBlH CONSTRUCTION
o AD!JI'I'ION
DAL'rEJRATION
1:..1 R!DPIHR
[J INSTAL!,
[)SIGN
[J MOVE
o DElMar/ISII
PROl>USEIl USE:: [JSC3l, F1\MU,Y DWEl,IjI11G
[h1tJI/I'I. FAlvIU,Y
0# OF mUTS
IJ MOBII.El !Ior11ll
[) corlrvII1lRc.! fA t,
o INDUSTRIAL
[] SWH1MIWJ POOL
[] OTlIBlR
D RE1STAURANT & HElAI,TH DH:PARTIII1lNT APPROVAL
IJEJSCHIP'!'WN OF HORK __~ ~cXv'<'S"/L /r;!/~__(lo~~!"..l7u_5:!.(.q~/.__.___.
BUH,fHNB 91ZEl ~ .._.__.___ SQUARE FOOTAGE .:::/;-L212.9_~4. leX) HElWfI'f ..:____.____._
RESWENTIAT, I A'I"f1\CH (;3) PI"O'J' PI"Al18 & (2) SElTS OF BUII.lJIN<J PLANS & (1.) SElT E1NElRn't FORMS,
CO~1MBlR(~I1\Ij: A'I"l'AC!H (3) SETS OF BUILIJING PLANS & (1) SET ENElR(lY FORMS.
PROPElRTY SURVEY REQUIRED FOR ALL NEW COl-lSTRUCTION.
~ERMITS REQUESTED
[] Bll II.U I Nc3
$-----
('~~/:!7;C!-
Ai'1P ,9ERVICEJ
rlf' FUJRIDA POWER
[]
W.R,E.n.
VALUATION OF TOTAL COHSTRUC'l'ION
OJ ElLElCTRWAI,
[J P WI18 I NG
[J J.1BJUHANICAlj
,
$.-.--.-----...-- VAl,UATION OF tilECIlANCIAr, UIS'I'AI,IJA'I'ION
[] (JA8
rJ ROOFWG
[J SPElnIAI/I'Y
[) O'}'HElR
'J'Y-PEl OF' CON8'1'RUC'I'ION: 0 BLOCK
[J FRA1ilEl
[] STEEl!'
[] OTHElR
FINISHElIJ Fr,OOR BlljEVATIONS
------------
IS PR(XTE)CT IN FLoon zemEl ARElA [J YEla
o NU
BUIr"Dl!lR
******************************************************************
CotilPANY___.._____.__.._____..___..._._ "_..__ _ _.___._____._..__
STATE CElR'!' OR REGIST # '_'_"__'_ ..____.____... ___.__
CITY PROCESSING IL_._______.._.___.____ ..___.__...___._
Ell r.lHATtJREl
--_._-~._.--------_._---------_._-_._~---_._---
Blr,m(1TRla~. A.N ~~.~. ~LL COf1PANY/'L1L/wI't.. ~caQ__&~~.. __..cJ.... F...._9:!..~..._.. _F._. _~._._
. 0:% ' STATE CERT OR RElGIS'l' II cf..C.QC2~.~0...~?__._ _.
8"'IIA'I'IIR '... ~ - ..- ~-_ ___. el'ry PROeES8 IN,' #.0..7 _2 ._r._.. ._..._._..
********************k*********************************************
PIjUMB!IIR
_._~--_...~.~..~---......_-~ ---_.
(~OM PAN Y -.------ _'.___"_ ..___________._.__...__...__... ______.____.._ _..... ..__
STATE CERT OR REGIST # __.__.____._..__....__..___...
CITY PROCESSING #
SWNA'l'tlREl
******************************************************************
MBlC!HANICAJ, COMPANY __...____.._._.._..___._~..._____._._._____..__,_
STATE C~ER'f OR REGrST # _____.__...._________.____._
8 TGNA'l'tJREJ (!l1'Y PROCESS ING #
----.---..-.--..----.--- -.- .....-...--.-------..- _.-
"""---.-----.---.-....___....4__+___...,___.__~ _..._________________.__..._..._____
***************************.**********~**************************
o'rUBlR
(~m'IPANY
STATE CElRT OR REGIST #
CITY PROCESSING #
.._-_.....>.-------.--._~--_._"-----------
SWHA'I'UREl
. -~.". -----.--.---.....- --- ,-- -.-
----.----.-- --.._--_._-~._---~- --
*****************************************************************
-~----:...-.__.__._.~--._--.--~-,.~_.,~ . ----~-_._,
CONDITIONS OF PEBNIT AE'E'IDAVIT
. A. . NO'l'ICE OF DEED RESTRIC'rIONS
'rhe undersigned understands thqt Lh:LI' pl<irmit may be subject to "deed restd.ctions" which
mety be more restl'ictive than City r':9ulod:ions. 'I'lle 1ll1der:ligned assumes responsibility for
compliance with any applicable dee:dr,::st:rictiuns.
B. UNLICENSED CON'l'RAC'l'ORS AND CON'l'RAC'l'OR RESPON~iIBII,ITIES
If the owner lias hired a contractor or contractors to undertake work, they may be required
to b~ licensed in accordance with state and local regulations. If the contractor is not
1 i oellsed as requJred by lavJ, both the OVlller and contractor may be cj ted for a udOldellleanoJ:
violation under state laH. If the owner or intended contrclCtor are ullcertain as to vJhat
li censing requirements may apply for the intl:nded wor:k, they are advised to contaot the
City of ZephYJ::hill s Building Depal:tment, 813-788-6611.
Flu:thermore, it 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 whicll they
will bl: !.esponsible. If you, as the owner signs ~s the contractor/ YQl,\ are indicat:.ing that
you, .Lather than the contractor, are responsible for the work. If the contractor I'dshes
you to sign as oontractor that may be an indication that he is not properly licensed and is
llOt entitled to permitting privi.leges in the City of Zephyrhi.lls.
C. 'I'RANSI?Ok'l'A'rION IMI?ACT FEES AND U'l'UI'l'Y CONNECTION FEES
D. CONS'fRUc'rUION I,IEN LAW (CHAPTER 713, FLORIDA STA/fU'l'ES, AS AMENDED)
1 certify that I, the appli.cant, have been provi.ded with a copy of "Flori.da'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
Ilave obtained a copy of the above described document and promise in good faith to deliver
it to the "ownerN prior to conunencement.
E. CON'fkAC'rOR' a/OWNER'S AFFIDAVI'r
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 constnlCtion, zoning, and land
development.
Application is hereby made to obtain a permit to do work and installation as indicated. I
certify that no Hork or installation has cownenced 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
EnvirOllmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Bensttive
Lands, Water/Wastewater Treatment
*Soutllwest FlorJda Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Wateroourses
....Army Corps of Engineers-Seawalls, Docks, Navigable WatenJays
*lJepar:tment of Health & Rehabilitative Services, Environmental Health \Jnit-Wells,
Wastewater Treatment, Septic Tanks
*\1.8. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone ~A" or "A,etc.N, it is
llndeJ:.stood that a drainage plan addressing a "compensating volume" 'will be sublni tt:ed whioh
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, aIte!.-, or' set aside any provisions of the technic.:al codes,
nor sllall issuance of a permit prevent the Building Official from thereafter requiring a
correction of errors in plans, construction, or violations of any oode. Every permit
issued shall become invalid unless the work authorized by such permit is oOllunenced within
si.x months of issuance, or if \iork authorized by the permi.t is suspended or abandol1ed for a
period of si.x months after the tillle 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
ill wd ting to the Building Official. An approved inspection must be logged during each ai x
month period, or the project will be considered abandoned.
WARNING TO OWNElRI YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUW' IN YOUR
PAYING TWICE E'OR IMPROVEMENTS TO YOUR PROPERTY, IF YOU INTEND TO OB'rAIN E'INANqINq, ~qN~UL'!'
WI'l'H YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NO'l'ICE OF COMMENCEMEN'r. JOBS UNDER
$2, SOD IN VALUEl DO NO'l' NEED '1'0 RECORD AND POS'}' A "NOnCE OF COMMENCE:NEN'f".
SIGNA'l'UREI OWNER OR AGENT
SIGNA'l'URE: CONTRACTOR
STA'rE OF nORIDA
COUNTY OF
The foregoing instrument W~S aoknowledged
Before me this -----slay of----, 19
by
(name of person acknowledged)
r::1ho .is personally known to me, or
S'I'A'rE OF FLORIDA
COUNTY OF --.
The foregoing instrument was acknowledged
Before me this __._____ day of ______, 19_
by ~__
(name of person acknowl~dged)
Dwho is personally known to me, or
o who has produoed
( type:
and wbo[] did [] did not
of identification)
take an oath.
Dwho has produced
(type of identifioation)
and Hho Ddid [}.iid not t.ake an oath
Signatul;:'e of person taking acknowledgement
Signature of person taking acknowledgment
-----~-------------_._--
\.l~~~~;--t~;p-~~l, printed or stamped
-
Name Lyped, printed a!. stamped