HomeMy WebLinkAbout03-1743
100
BUilDING
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N2
(813) 780-0020
JlD cJ~-
PLUMBING MECHANICAL
1743
,/0
ELECTRICAL
Date /- It:, -0 "'3.
Sewer Conn / ~ 'If?
Water Conn: ~)
Water Meter: /~O
1~?lO
-:{~I?I. /~O
tJ. fJ,JIft1.) '17S-
T.I.F.'s:
Property Owner:
Job Address:
Parcell.D. ,
~~11/i?~~~
Zoning:
Description of Work
FINAL
C.O.
1-
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Valuation or
Contract Price
~s)
Permit Fee
Signature
Company
Address
Telephone#
DATE
Lt{ tI 11-00
City license Registration #
State Certified license#
ElECTRICAl/8?
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final ..../" /-/7 -") If.:rc
SLB
Tub Set
Water
Sewer
Final l. /1-1 7 -03 /IO't>
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final t!1-;) 1-0 ~
Ftr.
Pre SlB
lintel
FRM.
Insul. Cl
Wl
R/J-J
Driveway
FP !-:l~-{)3 3:~ UrwJ~ U
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the fO, 1I0wing reasofls, a
charge of twenty-five and 00/100 Dollars ($25.00) shall be made for each trip f'/t:Ch tr~ ~6t1".#
a. Wrong Address c-;)t ~tf) LJA ~ t
b. Condemned work resulting from faulty construction. a:.
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.
I
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CITY OF ZEPHYRHILLS PERMIT APPLICATION
aUII,nnw DEPARTMENT 5335 8th S'rRElBJ'f ZllJPHYRHII,I,S, FL 33540
PhoneI813-780-~020 Fa~1813-7eO-0021
nA'rBl RBCBlIVEO ~.___. _ __~.
PI,ANS RBlVIBlW lI'BID.u___.___l_'. ____
OI'1t1EJR I 8 llM1El --0"'~J2.I!..~_!'::c't:~.__,_____. __________.____ .___ . _____ _ PHONEl CON'!' lV~'~_______ ___ ______ __.__.
,108 S ITEl ADIJRBl88__':-_c.C.I.J_~~_ ___m_ _______________________ _________ __.__________.______
Ull<1AL I.lElSCRIP'I'IOll: .LOT(S)
B I,(X! K
SUBfJIVISlOH
.fL.~.t1,v~.'_It~ I "t,,~_:_
PARCEll, ID It
HORK PROPSBlIJ I UNEllN r.'ONS'l'RUC'rWN
--~---------'-~--_._---'-_._----------------~--------_. _.__._--.-_...._--~---------"_.__._-_.__._-..-------.........-.....-
(OBTAIN FROM PROPEJR'ry '{,AX NO'l'WHl)
[J ADD f'l' ION
[J AUI'EllRA'l' ION
[J REPAIR
LJ IN8TA!,!,
[)eIGll
[J MOVE
o DElt10I,ISII
PROPUSEJIl USE: I [Jsr]I, F1\IvlIIjY DWElLI,Ilm
[Jt1tJIil'I - FAl'1Il.Y
[J# OF {/HITS
OSNH1MING POOL
--
B1ii08 II.EJ liOf1BJ
[] Cm1MElR(!JAT,
rJ INDUS'l'RIAL
lJO'I'!IBlR
IlEl8CRIP'l'ION OF I'/ORK
o REi8TAURANT & HElA1,'l'II fJElPAR'H1ElN'I' APPROVAL
...)I/1I_~.._____.___. __......__.._____ ...._...____ ______._...
.~._._---_..._----~.._---,._~---. _._~-_..--"
BUILDING SIZE
--.------.---.-.. ._---~~----
SQUARE FOOTAGE
--._----~-~--~
HE1IGH'!' ..._.'.__.______....
RBl8IDBlN'I'IM, I
CO~1MBlRC!IAr, :
A'I"I'ACH (2) pun PLAllS & (2) SETS OF sunDING PLANS & (I) eEl'I' ElNElRrJY FORMS,
A'I"I;ACH (3) SE'fS OF BU!LfJING PLANS & (1) SE'I' ENERClY FORfIlS.
PROPB1R'I'Y SURVEY RElQUIRElD FOR ALL NEW CONSTRUCTION.
~ERMI,!S REQUESTED
[) 8lJIltIJINf~
$-_._-~----__._, VAl,UATION OF 'I'O'l'AL COHS'I'RUC'I'ION
IJ ElLElC'I'R 1 CAI ,
----..--__ AtllP SERVICEI
o FIDRIDA POWER
[J W.R.El,n.
[] PlttJt1BING
LJ 1.1ElUH1\N H.!AI,
,
$-----.-------- VAI,UATION OF MECIIANCIAI, H/STAI,I,ATTON
[) c~A8
r.J ROOFING
[J SPEC!tAI/l'Y
o OTHER
'l'YPHJ OF COH8'I'RtH!'I'WN: [J BLOCK
[J FRT\J1El
[] STElElI I
[J OTHER
F'IlHSHEllJ FltOOR ElI,EVATIONS
18 PRO,JECT IN FLOOr) ZONEJ AREiA 0 ':lIllS
o NO
Bt1ILnBlR
81Gl'1ATUREl _.W~~ _________________
******************************************************************
mr,mC'fRICIAU COf1PAN Y _.L!.~_~___ __________.._______.______"_ ._____
SJ "''''lURE. ...... .~~. 2[~__~__ ~;~~. P~~~~8~~N~.~T 8~1.:=:~=_:===__.:_=:
~. * * * " * * * * * " * " * * * * * * * * " ~ " * * * * * * * " * * " * " * * * * * * " * * * * * * * * * * * * * * * * * * " * " *
(~OMPANY-""O~_________._h.._____,_.________
STATE CER'l,' OR REGIST # ______.__...__.._________.__,.
CITY PROCESSIN~ H
_._._--_.~------- ~--,-- _.._~_._--_._._---- .._-.._._~--.._--------
PJ,UMBBlR
SIcmA'l'IJRE ,._--,-_f:<!...~~
MmCHANICAr.
SWNA'l'UREl wc!....-~~
-_.=r_~~_.....___..____
""***"************************************************************
CCJI"1PANY_~~_~____._____._______________ '___
STATE CERT OR REGrST #
CITY PROCESSING #
--~.__. --..--.. --"--'"-""- ---.----.----
****************************"******************************"*****
------....-------.-.--..--- -.--..------
OTlImR
-----------------.--
C~OI.1PANY _ _______ _ ____..____ ____..._. _. ___
S1'1\'j'El C'ElRT - OR - REc1 1ST # --
CITY PROCESSING # ------------- -...~__.,_"_.'____n_'.______.__
..-----_._._...~---------_._--~_._--_._---_.._---------
SWIIA'I'I1REl
*****************************************************************
-~_..._--_.---.. _..__._.-._---~-------.- "--- . .." .. -.--... -- --.
CONDl'l'IONS OF PERNI'!' AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
'1'he underaigned understands thijt this permit may be subj ect to "deed restd.ctions" Hhich
may be more restrictive than City regulations. The undersigned assumes responsibility fo~
compliance with any applicable deed restriction~.
B. UIH,lCENSED CON'l'RAC'l'ORS AND CON'l'RAC'l'OR RESPONSIBIT.I'l'IES
If the o~..mer has hired a contractor or contractors to undertake work, they may be required
to be licensed in accordance with state and local regulations. If the contractor is not
lic611sed as required by la~l, both the o~mer and contractor may be cJted for a lIIi.adell\eallOr
violation under state law. If tlH::: oWller or intended contractor are uncertain as to Hhat
licensing requirements may apply for the intended work, they are advised to contact tlae
Ci ty of Zephyrhill s Building DepaJ::tment, B 13-7 88-6611.
Ifurtherlllore, 1 f the OHner bas hired a contractor or contractors, he is advlsed to have the
contractor (8) sign portions of the "Contractor Sections" of this appli.cation for Hhich they
will be responsible, If you, as the ovmer signs CIS the contractor, YQlI are indicating that
you, rather than the contractor, are responsible for the wor'k. 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'I'ATION lMPAC'I' !fEES AND U'!'ILI'l'Y CONNECTION fEES
Do CONS'I'RUC'I'UION I,IEN LAv~ (CHAP'I'ER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided Hith a copy of "Florida's Construction
lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affair's 0 If the appllcant 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
j t to the "owner" prior to COlTUllencement.
E. CON'I'RAC'I'OR' S/OWNER' S AFFIDAVI'I'
I certify that all the information in this application is accurate and that all Hark will
be done in compliance with all appJ.1cable laws regulatlng construction, zoning, and land
development.
Application is hereby made to obtai.n a permi.t to do work and installation as indicated. I
certify that no ~wrk or installation has conunenced 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 j\lrisdiction. J also
certify that I understand that the regulations of other governmental agenc1es may apply to
the intended work, and that it is my responsibility to identify what actions T mllst take to
be in compliance. Such agencies include but are not limited tOI *Department of
EnvirOlm!ental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Bens4.tive
Lands, Water/Waste~"ater Treatment
*SouthHest E'lorida Water Management District-Wells, Cypress Bayheads, Wet1and Areas,
Altering Watercourses
"'Army Corps of Engilleers-Seawalls, Docks, Navigable Waterways
*Department of Health & Rehabllitative Services, Environmental. Health lJn1t-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 ~A" or "A, etc.", it is
understood that a drainage plan addressing a "compensating volume" 'will be submitted \'Ih1ch
is prepared by a professional engineer registered in tlle state of Florida prior to pennit
i.:isuance,
A permit issued shall be construed to be a license to proceed with the work and not as
authority to violate, cancel, alter, or set aside any provisions of the technical codes,
nor sllall issuance of a permit prevent the Building Official from thereafter requiring a
correction of errors in plans, construction, or vio~atians of any code. Every permit
issued shall become invalid unless the work authorized by such permit is OOllUlIenced within
six months of isauance, or if work authorized by the perm1t is suspended or abandol}ed for a
period of six 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 tequeated
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 'I'O OWNER: YOUR FAILURE '1'0 RECORD A NOTICE OF COMMENCEMENT MAY RESUL'I' IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPER'ry. IF YOU INTEND TO oB'rAIN E'INAtH";ING, ~qN~UL'!'
WlTH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMIvtENCEMEN'r, JOBS UNDER
$2,500 IN VALU&: no NOT NEED '1'0 RECORD AND POS'l1 A "NOTICE OF COMMENCEMEN'llll.
S T GNA'l'l1RE : OWN ER OR AGENT
SIGNA'I'URE: CONTRACTOR
s'rA'rE Of Ii'LORIDA
COUNTY OE' --..
The foregoing instrument Has acknowledged
Before me this ____ day of ______" 19_
by.
(name of person acknOWledged)
DHho 1s personally known to me, or
o who has produced
(type
and whorl did []did not
of identification)
take an oath.
STA'rE OF I!'LORIDA
COUNTY OF
Thefor'egoing instrument WqS ackrlOHledged
Before me this __----S-iay of---, 19 ,_~_
by
(name of person acknoHledged)
[1ho is personally known to me, or
o who has produced__._ ____.____
(type of identifioation)
and Hho Odid []Jid not take all oath
Signatur.e of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
-
l'lame typed, pri.nted or stamped
. '" ,._.,,""'h'f~~- -,' ~ -,___
PASCO COUNTY, FLORIDA
-.... -
Permit No. --..LZfl _
. Date Permitted + - ,- 0 ":3
Builder Nerne/Owner Name J~~ Control # ___~
County Parcel No. c3._1..~:;5~L:~.LJ..QiD-Q;22()O- iT /Jh?. SubDlv: ________.___
Addless/l.ocatlon cl--2'--L1._.d~~__. _____
Classification/Type of Use -,-.l'~l1J~L_~_____ _________
TRANSPORTATION IMPACT FEE Rate:_ Sq Ft Unit: _________
Exempt [I Yes S"NO How Determined ______________________________
Impact Fee Am,ounJ..J-L f~9./-)_____ Zone No. TAZ: _.._________
"U4f.. 1-- t:,.-o ~ :zgi.?
scrrootlM~CfFEE (' -- ---- ______
Account (066) Slngle~Famlly Detached House Amount $ --'-.----._____.h._.____
(057) Mobile Home _____________._
(058) Other Residential __________..______
-~3) Collection Fee
C:::A;:::'R~~:N FE:OW Determined -------------
Land Account L.and Credit Land Total
--.----.---.---. ---.--
Recreation Account Hecreatlon Credit
-----------...---
._...._--~- -~-_.__.-
R.ecreatlon Total
lone
..'--...--------.--.-.-.
TOTAL AMOUNT _L______._____~_
F-xernpt [] Yes [J No How Determined
llSRAAYFEe'~-'--'- .
balid Account Land Credit
---.---------------.-----.-----.
-.....--
--
-----------..
Land Total
-.-----....-.-...--..- --------.--
Faelllty Account __________ Facility Credit ______ Facility Total ,_
-.---...---.----
Exempt [] Yes 0 No How Determined
ResouRCE FEE M"_'_~____ --,-- -
lOTAL AMOUNT
---~-.~- -~----
Total Amount
---~......-..
ERU
-----.------
~.....,--..,--;.,....;,.......-...........,-----_.._,-----._----_.
.----------
PrSl1ared By ___H___________________________ Checl<sd By __._____.____._______
NO CER'T1~ICATE OF OCGUPANCY WILL BE ISSUED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN PAID AND
RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY
Aokhowledyement beloW does 110t Imply acoeptance of concurrence, but simply receipt of a copy of thla form, pfacln(j
tlie bulldlnrJ permit OWher on notice of ttlls assessment and the conditions of payment for same.
bATE~~~~~~---i.--A/jJ/~1fl .~__ -RECEIVE~,B'y ------
RECEIPT No. f.tXi 1.;;5 ;fOAtE '2-/~~y ~-.J...C..R__
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