HomeMy WebLinkAbout03-1744
BUILDING PERMIT
Permit N~
If 0
CITY OF ZEPHYRHILLS
(813) 780-0020
J/D
1744
(pO
~s-
Date /-~-03
Sewer Conn /,;27R
Water Conn: i&~,S"b
Water Meter:/ Y!O
T.I.F.'s: I Q
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cd Jjj;O'::F:~-P\);i;;;rr
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BUilDING
MECHANICAL
Zoning:
~~..
FINAL -t?3
DATE
C.O. -~3
DATE
Inspector (:)
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.
City license Registration /I
State Certified License#
1/1
~~~~>J--~~
Company
Address
Tele hone# '7 7;J ~ fu
Valuation or
Contract Price
ELECTRICAL /17
'-
MECHANICAL ?"~
Breakers
Ducts Insl.
Compressor
Final ./ 1-/7-t73/~
/7":r (}
SLB
Tub Set
Water
Sewer
Final e,/ /-/7-t?3
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final //-/7-'3 #.:Jb
-
Ftr.
Pre SlB
lintel
FRM.
Insul. Cl
Wl
Driveway
r? 1-;2;2-0 3 '.?~ G>-V ~FU-;r~
REINSPECTION FEES: When extra inspection trips are necessary due to a~ one of the followinQ reasons, a
charge of twenty-five and 00/100 Dollars ($25.00) shall be made for each trip for each tr~s1a;L 'If! - .f)
.-----J ':i;;::l7-U ,,>Ji.~
a. Wrong Address <-.......-. ,~.../~-Ic!G) tL6~
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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4034 The Fenway .
Mulberry, FJ. 33&60 Oil! , ViS" c..v A/,
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OI'lNEJR 'S IlM1E: ~.__k /'-~c.P..._.._L{Q~f-~~'~__._ ,. ________...._____.__ __________ PHONE CON/l'A(!'~'_.__ <<________ _____
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,JOB S I'l'El ADDRESS?.,:,!_!'. ~-'l---____ __ ______________.___ _ . ________.. ____._____ ._.______
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUIUJING DBlI?ARTMlllN'r 5335 8 th S'rRElEl'r ZI!JPH'lRHIIII,S, P'L 33540
I?honeI813-780-~020 P'axI813-7BO-0021
IJA'fl!J RBOJllIVlllo _.____. ..__~. _.____
I?J,ANS RBlVIBlW rJllIII
--'--'--'.---' --
LEl(]AL IJE]SCRIP'1'IOI1: 1"O'1'(S)
BLOCK
SUBJJIVISIOll
~..__._-_._._.__._---
-'-'-"-~-,~- _.'~ '.- - ~ -___.- a, ____. ._~___ +__"._._
PARC!ElIJ In II
_...~.----_._~-~,--_._----- ---------<-----..-.---- _._--~_.__.._-_._-..... .-----.--...--... ..----~._-.-~--_._--_._--
(OBTAIN FROM PROPERTY '{,AX NO'l'J('El)
WORK PROPSElll I UNHlN C'ONs'rRUCTION
[J ADDITION
[JAL.'I'ERATIOH
[] REPAIR
U INSTAl,I,
[JSIGIl
[] ~10VEl
[] DEWJU 811
PROI:JU8EI1 USE: I L1SGII, FAMrLY DWELI,I11t~
n~1lJl,'1'I' FAtvlIltY
0# UF ON 1'1'8
~El 1l0f11lJ
(] OTHER
[J CClt1HBlRC! fA I,
rJ INDUS'l'RIAr,
[J SW1f1MIN(] POUL
IrnSCRIPTIUN OF WORK
CJ R~IS'I'AURANT & HE:AUl'1I DEJPARTf.1EN'r APPROVAL
.~..:...fL.____--:-------__ _ _______ ._________. ______.__._.
----_._-_..~--------_...- -.--..----- _. ..__.._~
8!JIr.rHNt~ S 1 ZEl
----------- ._--_.__._---~
SQUARE FOOTAGE
--.- --------~----.--
118WH'r
RHl8IDENTIMJ I
CO~1MElR(!IAT~ :
A'I'T1\CH (2) PLo'r PIJAllS & (2) SElTS OF BlIIJ,DING PLANS & (1) SEl'1' ElNElRrn FORMS,
]\'I'TACH (3) SE'I'S OF BUIJ.fJ!NG PLANS & (1) SElT ElNEJFH~Y FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
FEBHIIS REQUESTED
L1 BlIn.DIN(~
L1 EIJIllC'I'RICAI,
[] P I.tJf1B I NG
U HE<.!H1\NIC!ArJ
$
VALUATION OF TOTAL COHS'I'RtJc'rION
- ---~-_._---.._.._---
1\ti1P ,9ERVICEl
D
FU1RIDA POWER
[1
W,R.E,C.
,
$----.--------- VAIJUATION OF ~1a:C'HANCIAI, UISTAI,I,ATTON
(] (ms
U ROOFING
[J SI?EOIAW'Y
Cl OTHER
'1'YPHI OF' COl~8'I'RUC!'rrcJl-l: [] BLOCK
(] FRM1EJ
(J STEEJ~
[J OTHER
F'rN I8HElJJ FI,OOR B1IJEVATIONS
IS PROLTElc'!' IN FLoo!J ZONE AREAD YBlS
(] No
BUILnBlR
~._--_._-_..._-
81 {]!-1ATI1REl 0J-.' , -
_...~- - ~.._- . ------------.-----
******************************************************************
ml,JIlC'rRICIAH
S J (mATtJRE] _'_m
cot1PANY _.J::t_<=::-.~___ ______________.__. ___.,
~_ ~~__.___ ____________ ~'~~'~E P~~~~S~~N~E~IS'l' #------.-----_____u_._
PI.UMBI!IR
,.."..,.,....,..,....,...... H H. :,::::::. ~.~~':~...:------
STATE CEJR'l' OR REGIST # ____~____ _~________..
CITY PROCES8IN(] #
._--_...__.._~-..__..__..,---- -_.~.--- '--~' -. _. --...-.. .._--_._.._~
SIGNA'rlJRE ._.--~--~.L(~
SWl'lA'I'!/RE ~~ ">- ~~#L7,______._.__
******************************************************************
cell'!] PAN V......!:f. ~~___.__.._____________ ___ _ '_,,___..
STA'I'E1 CHlRT OR RElGIS'r # _______._____..._. __"n_________
CITY PROCESSING #
_.._...-.~_.._---_._-~.._--.._..---,..~---_.,---
MBlC!HAUr CAr,
-- --------------------.--..-----.
*.************************************~**************************
OTHER
-......---------------
cor,1PANY
STATE CERT OR REGIST #
CITY PROCESSING #
~-_._-._--_.._._-_.-.-_..- .--.. .~.. ._-...
SW1IA'l'tJRE
_._----_._-~----_._-------.-_._-
----_. ---~.,_.._-_.._.~._- .---'-- _._-
*****************************************************************
- -~_._-'-. ..-..---.-.-----.---- .-....-. ,--- -~._---~--,_.
CONDITIONS OF PERMIT AFl:!"IDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands th,t Lhis parmit may be subject to "deed restriotionsu Wllicll
may be more restrictive than City regulations. 'l'he under:sj yned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNI,ICENSED CON'I'RAC'l'ORS AND COH'l'RAC'rOR RESPONSIBIl,I'l'IES
If tile owner has hired a contractor or contractors to undertake work, they may be required
to be Ii cellsed in accordance wit.h state and local reglllations. If the contractor 1.s not
l1.cellsed as requ1.red by la~~, both the o~mer and contractor may be ci ted for a nd.ademeanor
violation under state law. If the owner or intended contractor are uncertain as to ",hi;lt
licensing requirement::l may apply for the intended work, they are advised to contact the
City of Zephyrhills Building Department, 813-788-6611.
Furthe.t:lllore, if the owner has hi.red a contractor or contractors, he is advised to have the
contractor (10) si gn portions of the "Contractor Sections" of this appli.cation for Hhich they
vlil1 be l.esponsible, I f you, as the O\^lner signs as the contractor, you. are indicat:.i ng that
you, rather than the contractor, al'e 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
not C1litit.led to permitting privileges in the City of Zephyrhills.
C. 'I'RANSPOR'l'A'rION IMPAC'l' FEES AND UTILITY CONNECTION ~'EES
D. CONS'l'RUCTUION LIEN LMJ (CHAP'l'ER 713, FlJORIDA STATUTES, AS AMENDED)
1 certify that I, the applicant, have been provided with a copy of "Florida's Constrllction
lien Law - Homeowner's Protection Guideu prepared by the Florida Department of Agriculture
and Consumer Affair's, If the appl.i.cant is someone other that the "owner", I cerify that I
have obti;llned a copy of the above described document and promise in good faith to deliver
it to the "owner" pri,or to commencement,
E. CON'I'RAe'roR' S/OWNER' S AFFIDAVI'r
I certify that all the information in this application is accurate and tllat all work will
be done in compliance with all applicable .laws regulating construction, zoning, and land
devf?lopment.
Application is hereby made to obta.i.n a permit to do work and installation as indicated. I
certify that no Hork or installaU.on has commenced pri.or to issuance of a permit and that
all work w.i.ll be performed to meet standards of all laws regulating construction, City
codes, zoning regulations, and land development regulation!:> .in the jurisdiction. I also
certify that I understand that the regulations of other governmental agenc.i.es may apply to
the intended work, and that it is my responsibility to identify what actions I IlIllSt ti;lke to
be in compliallce. Such agencies include but are not limited to: *Department of
Envi1:onrnental Regulation-Cypress bayheads, Wetland Areas and Environment.ally Sells,itive
Lands, Water/Wastewater Treatment
*Soutllwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Alter.i.ng Watercourses
"Army CO.lpS of Engineers-Seawal.ls, Docks, Navigable Waterways
*Vepartment of Health lie Rehab1.1itative Services, Envi.ronmentaJ. Uealth Unit-WeLls,
Wastewater Treatment, Septic Tanks
*U,8. Environmental Protection Agency-Asbestos abatement
I also certify that, i.f fill material is to be used in Flood Zone "AU or "A,etc.fi, it is
understood that a drai.nage plan addressi.ng a "compensating volume" 'wil.l be l:iubmitted Hhich
is prepared by a professi onal engineer registered in the. State of Flodda pdo!' to perini t
issuance,
A peunit issued shall be construed to be a license to proceed with the work and not as
authority to vi.olate, cancel, alter, or set aside any provisions of the technical codes,
nor shall issuance of i;l permit prevent the Building Official from thereafter requiring a
correction of errors ill plans, construction, or violations of any code. Every permit
issu~d shall beoome invalid unless the WOJ:K authori:,?;ed by such permit ia oOllunenced Hithin
six months of issuance, or if work authorized by the permi.t is suspended or abanqoqed tOl' a
period of si.x months after the time the work is commenced. One 90 day extension of tillle
may be allowed for the permit with fee charge of $15.00. The extension shall be ~equested
:1 tl writing to the Build:1.ng Official. An approved inapection must be logged during each ai x
1II0ntb period, or the project Hill be considered abandoned.
WARNING '1'0 OWNER: 'tOUR li'AILURE '1'0 RECORD A NonCE OF COMMENCEMENT MAY RESUL'1' IN YOUR
PAYING TWICE E'OR IMI?ROVEMEN'l'S TO YOUR PROPERTY. IF YOU IN'l'END TO oB'rAIN b'INANGING,~ON~UI:I'
WITH YOUR LENDER OR AN A'l"I'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. ',JOBS UNDER
$2,500 IN VALUE DO NO'I' NEED 'I'O RECORD AND POS'l' A "No'nCE OF COMMENCEMENT".
SIGNA'l'lJRE: OWNER OR AGENT
SIGNA'I'URE: CONTRACTOR
S'I'A'l'E or FLORIDA
COUNTY OF
The foregoing instrument was
Before lI\e this __ day of
by
acknowledged
_, 19_
STA'l'E OF ~"LORIDA
COUNTY OF
The forego.ing instrument WaS aOknQ~lledged
Before me this _----Slay of------, 19
by
(name of person acknowledged)
aho is personally kno~m to me, or
(name of person acknowledged)
Owho ia peraonally known to me, or
Owho has produced
(type
and who[] did [Jdid not
of identification)
take an oath.
D who has produced____ ___________
(type of identification)
and ~Jho Ddid DUd not t.ake all oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
- --_._----_._.-.--~.- ._".~--~
Hame typed, printed or stamped
Nallle typed, printed or stamped
PASCO COUNTY, FLORIDA
-..---
Permll No, __Lrtf:
Date Permitted .- _::~O.3
Bulltle, Nelna/OWlle' Name ~$'I.M~ ( 7' 4wntro, #
County Parcel No, 4-.~.~~~L:12Djf2=.PGJ~)(.)-'Z-jQ'j SubDiv: ________~_.___
Addtess!1 ocatlon -cJl_7:...~.;;2--C~lB:1tLJ2u.. /~
ClaSSlfleatlonlType of Use ~J~(=~~~_____
/
Rate: __________ Sq Ft Unit:
T'RANSPORTATION IMPACT FEE
"
eX~ffipt [] Yes 'Q( No How Determined _________._____._______________
:~~8~I:e~ A~_o(~l1tMf{_e,~ Zone ~ __~=-~~ ~A~:==
SCHOOL IMPACT -1EE
Acocunt (066) Slngle~Famlly Detached House
(057) Mobile Home
,..'. . ., '. (058) Other Residential
'-Z>--'''.'~;I)~ Collection Fee
, (tG. ":~~.lljll>l,,~' I? N~ How Determined
~KS AND RECREATION FEE
Land Account Land Credit
Amount
$
------------------
----- ----.-..-------
Land Total
-------~,-_.-
Recreation Account
Recreation Credit Recreation Total
---...-----. -.....---
LOrle
TOTAL AMOUNT' ..1__._________._..____
. ,!i"F;;~xernpt [] Yes [J No How Determined
LiB~AAY FEE~--~---'--
band Account Land Credit
--_._----_._._._--_.~."_._--,-.---_.,_._----.
--"I..,~..___--------~--
----.--.-----.---.--.---
Land Total
-_.~.. .----..------..-------
ra<.:lIlty Account _.__._._____ Facility Credit ___________ Facility Total '___.___._._
_._._'-----~-,. _.~.._,.._._--~
Exempt [] Yes [] No
How Determined
..--..--- ----
Total Amount
~g~~~~~~~ --!Jr 91!~"
ERU
--.......-.....,......-,..----.---J..,--.._..____....w___~_.________---............
Prepared By .___, ____.__.__'--____.._____ Checked By ________.______ ____
NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEl:N PAID AND
RECEIPTEIl FOR BY A CENTRAL PERMITTING OFFiCe OF PASCO COUNTY
A61mowladgarHent below does not Imply acceptance of concurrence, but31mply receipt of a copy of this forml ~Iaorhg.
' the bulldli,g perl11ll owner on notice of this assessment and the conditions of payment for Bame.
"~~::'~~N6i~1~~d/!:' ;fill/V?sY RECEIV~B~/,
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