HomeMy WebLinkAbout03-1754
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BUILDING PERMIT
Permit N2
CITY OF ZEPHYRHILLS
(813) 780-0020
1754
Date 1- 1- 03
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcell.D. "
Zoning:
Description of Work
lois
50Ll\
M . St> -aM e,,--y
~~ 'ST.
Water Meter:
T.I.F.'s:
Energy Code:
SLAb
Radon Gas:
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
FINAL
C.O.
-13 -03
DATE
NO OCCUPANCY BEFORE C.O.
Inspector
DATE
/lUo
City License Registration ,
State Certified License'
Permit Fee -3.5.' /tiJ
){iignature .K~ ~Jr~
Company
Address
j;elephone# ?/~ ~ '7 F.z ~ '7 ~ 1 P
Valuation or
Contract Price
;).50 . ?YO
=Ow f\L'Y
Tp. Servo
tF-f;~ Rough In
~ Meter Can
Const. Pol
Pool
Pre-
Fi I
PLUMBING
MECHANICAL
BUILDING
Ftr.
Pre SLB ./1- f1-()'~
Lintel
FRM.
Insul. CL
WL
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Com pres r
Final
Driveway
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 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.
OI'lHEJR I 8 "llA~1E___._~~;:i.h_.L!L_~~!Y c. _~~___ ______
,JOB S1'I'S" ADDRE88..9!:2Y (-h---_~__~!__~_tf~______ _ ______
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUII,DItW IHllPAR'rMElN'I' 5335 8th S'fRElBl'r ZEJPHYRHII,I,B, FL 33540
PhonaI813-780-~020 FaxI813-780-0021
ph_" --- IJA'fm RRCBltvllln
HANS RBlVIBlW rlllll
PHONE: CUNrl'Ar~'I' ~t 3 ? f:? ~ - 7 "2 7<;--
LElC3AL I.lBJSI!RIPTIoll: LOT(8) ---~:-~-':L:_~~f_ BLOCK ___;?~]___ SUBfJIVIS]()t! ______.____..__~.___
((~I~~~r10[") 1/- .:{, 4. - ::z I - 6 '''0 - .;;:. 0'/ 0.- <> 0 <:; cJ (OBTAIN FROM PRnpER'rv '{'Al{ NOTICB1)
.. -- .----- h...----.---.- ._~c_______ -:.J:LE....____.___..____ _.____..__.___._._... .._____._,...... _..__......_._ __ __._.__...
HORR I?ROl?8EllJ I U NBJl'l l'oNs'rRUC"I' ION [] ADD I'rrml [J AI/I'ElRA'I'IOH [) REJPA IR IJ IN8TA!JI,
" -- -- ------_. - --.. --..- -. _.- ------ -- ------..--
LJ S WIl
[] ~10VE
o DElMUl/ISlI
PROJ:lOSF1Jl USE: I [)(am, FAtHLY DWElLI1Ilm
[h1lJI/l'I.. Fl\l'1II.Y
[J# OF mull'S
LJ 1108 II.El HO/1El
t::J DTHIllR
r:J CC.JMMIII RC' JA I I
[] INDUS'l'RlAL
OSWU1MING POOL
IJEl8eRT P'l'IUN OF NORK
CJ RI118'1'AURANT & B8lAl/l'B D8lPART;1Il1NT APPROVAIJ
--~--5.b~__.____._.___._________.______.___._.__
BUIUHN<~ 8IZE
---.----.-.--- ..--..--------
SQUAREl FOOTAGE
RES I DIllNTIl\JJ I
C'O~1MElR(!IAL, :
---------,----
HEJTC3B'1'
._u___,,_~,._ __ _~...._. __
A'J'TACB (2) PUJ'1' PIJAllS & (2) SElTS OF BUIl ,DING PI,ANS & (1.) 8E1T ElNElRr~y FORI18,
A'J'TAC!H (3) sEi'l'S OF BUIJ,lJlNG PLANS 6< (1) SET ENElR(}Y FORrIlS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
)Q BIlII/DING
IJ EJIJIlIC'J'RlCAl,
I>ERkUTS REQUESTED
. o-c
L_ :<:5""~--=-_____, VALUATION OF '1'0'1'A1J COl-1S'I'RlJC'J'ION'
--.--------,_,.___-'- MIIP ~8lRVICEl
[J FLORIDA POWER
[] W . R , El , (1 ,
[] PLtHlIBING
U 11ElUHANIC!Ar,
$._- --.,
VALUATION UF MECHANCIAI, UIS'J'AI,I,ATTON
[] (mS
LJ ROOFING
[J SI?El(!IAl/l'Y
[) OTHER
TYPE] UF' C'OH8'I'RtJC!TIDN I [] 8LOc;K
[J FRAHE
[] S'I'EEJ J
[J OTHER
FlHLSBElI) FLOOR I!lIJElVATIONS
-------.-------.---.
IS PRO,TElC'f' IN FLOof) ZOl.IEl AREA n YEJa
o NU
B t1 UJD RlR cor1 P AJ:.r;~_ -----t!2~!~_..h_. ___... . ___.____ _ ...._.
V Ynnl.. STATE CFJRT OR RElC3IS'I' # .___._____._.___. -___no ________
81 'lNATUR~~..___ ___ eny PROCORBINa IL_.. ...._._....... ......_ .__'_.
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ml,BlC/fRICIAN
8 J l3I1ATIIREJ __.....
-._---~_. ..-- ------ .._~-- .-------.-. .,,- .__..__.---~~ --~'-'-'--'~---'---------
COf1PANY__.___ __ ______ ______ ___________ ..___
STATE CERT OR REGIST #
CITY PROCEBSINr} #
1<. * * * * * * * * * * * * * * * * * * * .* * I< * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
----,.._._-~._. ...._- -.--.-..-.. -.-. ----_.__..-------~
PI/UMBER
._._~----.._.~._._.~---..._-_.- -.--------..__._._--_.~._-_._-~--
COf',l PAN Y ---_____._____________.______..__.__._..__________..
STATE CEJRT OR REGIST # _________._.__...____...
CLTY PROCE8SINC3 #
S WNA'l'lJR ffi
MEGHANI CAr I
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.---.---...--. _._~--------_._----_.._---
----_._----_._-_._.__..._.~--._----...~--..._~.._~---
CO(o.1P ANY-__ _n____._.______ ....____.. ._______._._. ___ ._.__._..._...._.
STATE CH:RT OR REGIS'r # ____..____._____.______________.._.
CITY PROCESSING #
SWNA'l'UREl
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------..-------..-..---..-- ----'-._----~
o'rnER
S WI IA'l'URE:
_..w___________._..___~_
cor.1PANY
S'1'A'I'E CERT OR RE~r----_.--.h--_----.---_.
CI'ry PROCESSING # --.-------..-,~__....___._____._____
-------~-------_.__._-----
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-.~_.--_.~ _~O .._.._ _"_0___.________._ 0 _~ ____.___._ "_._____<
CONDITIONS OF PERl'lIT AFE'IDAVIT
-A, NOTICE OF DEED RESTRICTIONS
The undersigned understands thqt lhil:l p\:Jrmit may be subject to "deed restr:ictionl':l" ilhich
may be more restrictive than City r"lI;!ulations. 'rhe undersigned assumes respOnSilJility for
oon~liance with any applicable deed restrictions.
B. UNLICENSED CON'l'RAC'l'ORS AND CON'l'HACTOR RESPONSIBILI'l'IES
If the Oimer has hired a coutractor or contractors to undertake Hark, they may be requin,d
to be ljcensed 1n accordance with state and local regHlatiolls. If the contractor is not
licensed as requ1red by law, both the Oimer and contractor may be cj ted for a ndsderneanor
violation under state laH. If the owner or intended contractor are ullcel:tain as to vlhat
Ucensillg requirements may apply for the intended work, they are adv1sed to contact the
City of Zephyrhil1s Building Department, 813-788-6611.
Furtherlllor-e, j f the ovmer has hired a contractor or contractors, he is adv1sed to have the
oontractor (s) sign portions of the "Contractor Sections" of this application for \dlich they
Hill be .responsible, If you, as the olrmer signs as the contractor, YOl! are: indioaUng that
you, .rather than the contractor, are responsible for the wo.r-k, If the contractor wishes
you to s19n as oontractor that may be an 1ndication that he is not properly 11cenaed and 1s
!lot entitled to permitting privileges in the City of Zephyrhi.lls.
C. 'l'RANSPOR'l'A'rION IMPACT fEES AND UTILITY CONNECTION IfEES
lJ, CONS'l'RUC'rUION LIEN LA~1 (CHAP'l'ER '713, FLORIDA STATUTES, AS AMENDED)
J oerti.fy tllat I, the applicant, have been provided with a copy of "Florida's Construction
lien Law - Homeowner's Protection Guide" prepared by the Flor1da Department of Agriculture
and Consumer Affairs, If the appl.i_cant is someone other that the "owner", I cerify that I
!lave obbd.!led a oopy of the above described document and promise in good fai th to deliver
it to the "owner" pri.or to cormnencement.
E. CONTRAC'l'OR' a/OWNER'S AFFIDAVI'l'
I certify that all the information in this applicaU_on is accurate and that all \lOrk will
be done in compliance with all appl1cable laws regul ati.ng constructioll, zonillY, and land
development,
Appliuation is hereby made to obtain a permi.t to do work and installation as indicated. I
certi fy that no Hork or installaU_on has cormnenced pd.or to issuance of a permit and that
all work will be performed to meet standards of all laws regulating oOllstruotion, City
codes, zoning regulations, and land development regulat.ions .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 IlIlHit take to
be in compliance, Such agencies include but are not limited tOI *Department of
Environmental Regulation-Cypress 8ayheads, Wetland Areas and Environmentally Sens.j.tive
Lands, Water/WasteHater Treatment
*Soutllwest ~lorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
-I<ArlllY Corps of Engineers-Seawalls, Docks, Navigable Watenlays
*lJepartment of Health & RE:!habilitative Services, Environmental Health 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 ~A" or "A,etc,", it is
understood that a drainage plan addressing a "compensating volume" 'Hill be suomi tted v/h1ch
is prepared by a professional engineer registerE:!d in the. State of Florida prJor to permit
j ssuance.
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
cor~ection of errors in plans, construction, or violations of any code. Every permit
issued shall become invalid unless the work authorized by such permit is cOllulIenced wlthin
six months of issuance, or if Hark authorized by the pernd.t is suspended o.r- abandor~ed for a
period of aix months after the time the work is conunenced. One gO day extension of time
may be allowed for the permit with fee charge of $15,00, The extension shall be tequested
In wrlting to the Building Official. An approved inspection must be Jogged during each'sjx
month period, or the project will be considered abandoned.
WARNING TO OWNERI YOUR FAILURE TO RECORD A NOTICE m' COMMENCEMENT t.1AY RESUL'l' IN YOUR
PAYING 'l'\'iICE I)'OR U1?ROVl!iJVIEN'l'S '1'0 YOUR PROPER'ry. IF YOU INTEND TO oB'rAIN !PINANqINq,CqNljUI/I'
WITH YOUR LENDER OR AN A'I"rORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'!'. ,JOBS UNDER
$2,50D IN VALUE DO NO'I' NEED ,!'O RECORD AND POS'l' A "NO'nCE OF COMMENCEMEN'!''',
////:-
./
I
SIGNA'l'URE: OWNER OR AGENT
SIGNA'!'URE: CONTRAC'l'OR
S'l'A'l'El OF FLORI DA
COUN'!'Y OE' _._-
The foregoing instrument was acknowledged
Befor-e me this ____ day of _____, 19__
by ~__
(name of person acknowl,dged)
Dwho is personally known to me, or
STA'!'E OF FLORIDA
COUNTY OF _________
The foregoing instrument was acknowledged
Before me this _---sjay of--------, 19
by
(name of person acknowledged)
o.ho is personally known to me, or
Dwho has produced
(type
and who[] did 0 did not
o who has produced__.___ __________
(type of identifioati.on)
and vlho Ddid [}Ud not take an oath
of identification)
take an oath.
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Harne typed, printed or stamped
Name typed, printed 01.' stamped