HomeMy WebLinkAbout03-1742
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BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N!
(813) 780-0020 _
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1742
hO-
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Date
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Sewer Conn
Water Conn:
Water Meter:
Zoning:
DescriPtion of Work
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
FINAL
C.O.
,-113
NO OCCUPANCY BEFORE C.O.
Inspector
DATE
!r(fi
City license Registration #
State Certified license#
~~/~
BUllDI
41
Permit Fee
CSig~at-Ufe)
Company
Address
Telephone#
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t...A ~-/f.;;z;fP
Valuation or ~
Contract Price
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ElECTRICAL 19'1
9:~;t2
PlUMBIN
(/tlL a/(.9-!!Lu7;
MECHANICAL /Ib-
Breakers
Ducts Insl.
Compressor
Finalt, ./'
SLB
Tub Set
Water
Sewer
Final t./
Tp.Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final,/'
Ftr.
Pre SlB
lintel
FRM.
Insul. Cl
Wl
Driveway
P 3,'00
h /- ";:L ;2 -03
~~,Iq-
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 ~h trip for each trade: /7
L-- J./~W . X--'
a. Wrong Address f/}. c:1 t35fPA
b. Condemned work resulting from faulty construction. U?~
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 ZEPliYRHIIJLS PERMl'r APPIJ!CATION
BUILDING DmPARTM~NT 5335 8th STREET ZEPHYRHILLS, FL 33~40
PhoneIB13-780-~020 FaxIB13-7BO-0021
llA'rB RmnnVl!lD -1...~,/q .-=f2,2~
PI,ANS RBlVIBlW Jl'BlB_'-_____ 'IL..____
UNtlEJR I 8 lTA~lEl t-,....~J 11 0 AI "L ~
.--____._.~.,.______._"__._.. ______..LI_____... ___..___,_ ~._.
PHONRJ CON'l'lV!'I'
w___ ____ ~..n_.______..~ h_..__~.
,TOB B ITEl AD[)REl8Suty::z../~_f____.___.___________.___ ____.__.
LHlGAL DBJ8CRIP'I'I0l1: IJOT(S)
BLOCK
SUBIllVISJOll
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~'_"lJ:.2":.._.__.._.... .__'_~'___. '.. .,.__.~_~...___
PARr!Ell, I/l 11
(OBTAIN FROM PROPElR'ry '{,AX 1'10'1' WBI)
._---.._~-----_.__._----'--------_._-_..._-_.._._---~-~.._~---_._......_.~ _.__.._....__--._.._----~---
WORK PROWSEI) I LJNBll'l C'ONS'I'RUCTION
[] ADDI'rrON
o A L'I'Hi RA'I' ION
[1 REJPAIR
1.:.1 !N8TAT,I,
[]strm
[J MOVE
o DEMOl,ISII
PRO!?OSFJIl USE: I L.lsr:)], FAfvlIIJV DNELllllm
[] COM~1EJR(! JAI.
o INDUS'l'RIAT,
[]# UF mUTS
[J SI'HtlJMING POOL
HT4c)'BIlJEl ItotlJl1l
[] OTHBlR
[h1UW'I" FAMJI,Y
CJ REi8'I'AlJRANT & HElAW.'H DEPARTt1ENT JI.PPROVAI..J
)JElSCRIP'!'ION OF 110RK ._ M .A...____~___._____~_._____.
~---_. ._._------_._-........-.~....------~ ---......----~
BUIr.nIN(3 SIZE SQUARE FOOTAGE
/I EI H3H'I'
RES IDElHTIATJ I
COf\1MBJRl!IAL, :
A'I"rACH (2) PLo'r PIJAllS & (2) SElTS OF BUUIHNG PI,ANS & (1) SElT ENElRnV FORMS,
A'I'tAC!H (.3) sEl'I'S OF ButLIJING PLANS & (1) SElT ENElIH~Y FORtiJ8.
PROPH1RTY SURVEY REQUIRED FOR ALL NEW CONSTRUC'I'ION,
iE~TS REQUESTED
C1 8lJILIJINf1
L_.______,__._. VALUATION OF TOTAL CONSTRuc'rrmr
L1 BJl,8JC'I'RlCAI,
_ ___________.____~ AtiJ P ~ Hi R V I eEl
[J FIDRIDA POWER
[1 vl.R.E.C.
[] PLtJtlJB ING
U IIJEiUHlI.NH.!AI,
$._....
--- VALUATION OF tiJECHJ\.NCIAL HIS'I'AI,IJATTON
[] GAS
[] ROOFING
LJ SPEC!1AL'l'Y
[] OTHER
frvpm UF Cot18'I'RUC'rWN: [J BLOCK
[] FRAlIJEl
[] S'I'EElL
[] OTHER
FIlUSHHlIJ FT,OOR IlJIJEJVATIONS
IS PRO,TEC'I' IN FLOOD ZONEl ARElA[] YEla
o NO
BtJIU)BlR
81GNATtIREl _.._~~~________.__.____
CotIJPANY_._Ll. _____.______.__ _.
STJI.'I'E C!'JR1' OR RElGIS'1' # -------___m.m___. ____
CITY PROCElSSING L.m___._______________._ ,',_"_,..___..
"**"**'*"'**"**"'*'*******'******'******'*'*""**'*"*"'*'*
BlUlC'rRIC!AN
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CO!'1 P AN Y_ ,A~~__ __ ____~ .~___ ___.____.
STATEl CERT OR RElnTS'!' #
CI'I'Y PROCESSING #
0-_.-__- ___.._~.~__. __.'_____.._ _. + _. __.,._.,.._.__~______
SWNA'I'\JRIil..__._~.~~
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(~(jfY1PANY-'-"~-___.._____._..__.__,______m______
STATE CElRT OR REGIST # ________.___.._____._____.
CITY PROCESSING #
PI,UMBER
.._--._-~..._~-.----~--_.-._._._._~------_.._-
MBlCHANICAJ.
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COI'1J P ANY_......L1. '::':::=:::u.___.__.____ '___.u___ __ __..___,.___._
8TA'rE CE1R'r OR REG I 8'1' #
CITY PROCESSING #
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CCJ!.1PANY
STl\TE CElRT- OR RElC1I8T -r-------.-------------.
CITY PROCESSING # --..-.---.--,-----------------
--..__~_____..o...__~___._____'____._.______~
SWNl\'l'IJREJ
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CONDITIONS OF PERNH' AFFIDAVIT
~: NOTICE OF DEED RESTRICTIONS
The undersigned understands th~t Lhi~ permit may be subject to "deed restriotionsff wllich
may be more restrictive than City regulations. The undersigned assumes responsibilit; for
compliance with any applicable deed restriction~.
B. UNLICENSED CON'I'RAC'I'ORS AND CON'rAAcTOR RESPONSIBII.I'I'IES
If the Ovlner has hired a contractor or contractors to undertake work, they may be requin,d
to bl:: licensed in accordance wit.h :>tate and local regulations. If the contracl:or is not
licensed as required lJy lavJ, both the OHner and contractor may be cited for a 1ll1sdemeanor
violation under state law. If the owner or- intended contractor are uncertain as to vlhat
licensing requirement:> may apply for the intended work, they are advised to contact the
City of Zephydlill s Building Department, 613-'786-6611.
l!~urtherlllorc=, if the owner has hired a contractor or oontractors, he is advised to have the
contractor(s) sign portions of the "Contractor Sectionsff of this application for which they
will be responsible. If you, as the owner s.igos CIS the contractor, yo\.! are indiaatlng that
you, rather than the contractor, are responsible for the work. If the contractor wishes
you to sign as contractor that may be an indication that he is not properly licensed and is
llot entitled to permitting privil~ges in the City of Zephyrhills.
C. 'I'RANSPOR'l'ATION IMPACT FEES AND U'l'UI'l'Y CONNECTION ImES
D. CONS'l'RUC'I'lJION LIEN LM~ (CHAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
1 certify that I, the applicant, have been provided with a copy of "Florida's Constrllction
lien Law - Homeowner's Protection Guldeff prepared by the Florida Departmellt of Agrioulture
and consumer Affairs. If the applicant is someone other that the "owner", I cerify that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the "owner" prlor to COlTunencement.
E. CONTRAC'l'OR' S/OWNER' S AFFIDAVl'l'
I certify that all the information in this application is accurate and that all vlOrk will
be done in compliance with all applicable laws regulating construction, zoning, and land
development.
Application is hereby made to obtain a permit to do work and installation as lndicated. I
certify that no Hork or installatlon has commenced prior to i:>suance 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 jurisdiction. I also
certify that I understand that the regulations of other governmental agencies loay apply to
the intended work, and that it is my responsibility to ldentity what actions I must take to
be in compliance. Such agencies include but are not limited to: *Department of
EnvirolllT!ental RegUlation-Cypress Bayheads, Wetland Areas and Environmentally Bens.J.tive
Lands, Water/Waste\Vater 'freatlllent
*Soutllwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
"'Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of Health & Rehabi.litative Services, Environmental. Uealth 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 ~Au or "A,etc.ff, it is
understood that a drainage plan addressing a "compensating volume"'wi.Ll be submitted \r/hich
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
authoril:y to vi.olate, cancel, alte!., or set aside any provisions of the teohniGal codes,
nor shall issuance of a permit prevent the Building Official from thereafter requiring a
correction of errors in plans, construction, or violations of any code. Every permit
issued shall beaome invalid unles:> the work authorized by such permit is COllulIenced \r/Jthin
six months of issuance, or if work authorized by the permi.t i.s suspended or abandoqed tor a
period of sil{ months after the time the work is conunenced. One 90 day extensi.oll of time
may be allowed for the permit with fee charge of $15,00. The extellsion shall be tequested
jn writing to the Building Official. An approved inspection must be logged duri.ng each l:lix
month period, or the pr'oject Hill be considered abandoned.
WARNING TO OWNER: YOUR FAILURE '1'0 RECORD A NOTICE OF COMMENCEMENT MAY RESUUl' IN YOUR
PAYING TWICE FOR IMPROVEMEN'l'S TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN l!~INAN(1INq, ~9N~UL'!'
WITH YOllR LENDER OR AN A'l"fORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. JOBS UNDER
$ ~, 500 IN VALUE: no NO'!' NEED TO RECORD AND POST A "NOrl'ICE OF COMMENCEMEN'I'".
S T GHA'l'URE : OWN ER OR AGEN'I'
SIGNA'I'URE: CONTRAC'fOR
S'fA'fE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this ____ day of
by.
acknowledged
, 19_
STATE OF FLORIDA
COUNTY OF
The foregoing instrument w~s aaknowledged
Before me this .------J,iay of----, 19 __~_
by
(name of person acknowledged) .
Qho is personally known to me, or
(name of person acknowledged)
Dwho is personally known to me, or
[J who has produced
(type
and who[] did []did not
o who has produced__.__. ___
(type of identification)
and Hho Ddid DUd not t.ake an oath
of identification)
take an oath.
Signature of person taking acknowledgement
Si.gnature of person taking acknowledgment
------------------------
j.i~.I~;;-tYp~.Z:Cpri.nted or stamped
Hame typed, pri.nted or stamped
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PASCO COUNTY, FLORIDA
..-..........;.--.----..........--
Permit No. --.-llft!- ___
Date Permlttecl-...L::..IL::.122L_
Builder Nal11e/O~',!~Nall1e~.t...aul ill ~'W> Control # __.~___
County F'areel No, 36!-~-r::.:,~~L-:6f2La~t1~>??}O- tL.L!!l-- SubDiv: ______________
Adclress/I..ocatlon__.:!i 7j,,1.3___.n~ _~~______________________.__.
Classlflcatlon/Type of use____~n._ZZ.I~ -~)(e.~--.-__.__.____.___.__.____.___
TRANSPORTATION IMPACT FEE
Rate: _____________ Sq Ft Unit: __.____-'--_
E)cernpt [] Yes [25.r'No How Determined ____.___.___.______________________
Irnpact ~~;~no~JI1t -~.~....6_.1~cL_____ Zone No. _______ TAZ: ____.________
SCH6cJtTM~cfF~E --.----- --...-..-----.
Account (056) Slngle..Family Detached I-louse AmoLlnt $ ____'______._..__________
(051) Mobile Home _________________________
. (058) Other Residential _._.____
. \.i)23J",Collectlon Fee
(,,-='::'~~~).~__23~~.~-JJ No How Determined __________________
liARKS AND RECREATION FEE ----
Land Account Land Credit Land Total
----.-.------.---------------- ---..- ---------------
ReClealioll Account Recreation Credit Recreation Total
. ~.---------- ----..----.---... -----
lot I~~
TOTAL AMOUNT ...~_____..__.____.____.____
Exetnpt [] Yes [J No
TiSRARYF"EE- ,-
land Account
I bw Determined
---..-----.-.---.-.---_~_u__________.__....__.
..----.----...--.- ....... -.------__ w
----..---.,,--.. -_._---------~
l.and Credit Land Total
---.----------.-
Facility Ar;coLJl1t ___.__.___.____.___ Facility Credit ___________ Facility Total_________.______
-.---.......-- -....-.-.---.------..
Exempt [] Yes [] No
How Determined Total Amount
---..-..-- ---.------
RESOURCEFEE-- .cN-:t;;r-----. ERU
TOTAL AMOUNT ...., {) .. 7
...---.-----.-.- . -.--------.-
__B___M_____.________
---....,..._'~.._.-...,''''''._--'-~...,...-_.._,...--..-__.-.._-,-.,,_...._----------.....-
-~;.....;.
Prepared By Checked By
----- -... --.---____4. .----.---------.-------.---- -----------.---------.--.---R._____.;.;J
NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION
PERFOHMEU UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN PAID AND
RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY
Acl<nowledgernellt below does not Imply acceptance of concurrence, but simply receipt of El copy oflhlsfpttl1i
Ihe blllldlng pennlt owner on nollce of this assessment and Ihe conditions of paynlent fof Slit11e.'"
(Jel)
DATE _n______ _ -- ~ - A typ)f.J e/ RECEIVED BY
RECEIPT NO, f2.()1~ 7_ 'DATE d!'-I~J BY
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