HomeMy WebLinkAbout03-1758
BUILDING PERMIT
CITY OF ZEPHYRHIW Permit N~
(813) 780-0020
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
VflVI~j
~~ f? I ;;>. I
1('1 S ~
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Property Owner:
Job Address;
Parcell.D. ,
Zoning;
Descriotion of Work
tIt'(.
j:;ergy Code;,
C OIV\J 1 ~J
J Radon Gas;
W ; V\, (fdle)<; d- ~
JJrt
.
51A4'1 E'Ml-n-.
1758
Date
j- 1":1 - CJ :s
Sewer Conn
Water Conn:
Water Meter;
T.I.F.'s:
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.
FINAL
Inspector
DATE
DATE
1/:5t:>
Valuation or
Contract Price
! O1}O ' P-O
,"
-dS' rro
ct~ ~-f,tJ~
Permit Fee
)<'Signature
Company
Address
\J8'ephone# S> J> - 7? 2.... - ? / ~ s
City License Registration #
State Certified License#
-owvu.-y
BUILDING
SLB
Tub Set
Water
Sewer
Final
PLUMBING
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Driveway
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final
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.
O\'lNElR I S HM1El____2A.tLJ.'_11___ R~_s.~j(~___________
,JOB 8 ITEl ADlJ~Bl8S .-;13._7 ~l.-----il.kLj_~-l"_0:::___________
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUll,Dum DEI?ARTMBlN'r 5335 8th S'rREBI'f ZEI?H'iRHII,I,S, P'L 33540
PhonaI813-780-~020 Fa~1813-7eO-0021
D1\,'rm RBC1Il1IVJJ!O
~'H_____ -'~____k__:''''4____
PI,ANS RHlVIIlIW rEIIl__h___ L'
PHONEl C:ON'l'Ar!'r._&'L,i=Zg~ -: z.~r s-
JJElrJJ\L !)BJ8l!RIP'I'lONI LOT(S)
n_ _______._.___ ._._.__._.,.._~_______.__
BIDC!K
PARCEl, ILl #
-~-'-'-,-~
SUBIJIVI8JON
--.---.---.------
--------.... ...._._.,..._-_..__._~-~-
~WRK PROPSEllJ I [JNIllN CONSTRUCTION
-- ._-----_._-_.-._-_._-~-~--- .__._----_.._-~
------------.---..---------- _.__....~--._- -....---...-... --'---.. ~~ - ---_.._--~..--
(OBTAU1 FROM PIWPERTY 'I'1\)( N01'H'IlI)
rJ ADDI'rIClN
o AL'I'ERATION
[J RI!IPAtR
LJ INSTAl,I,
[JSHm
[) MOVE
o DEMor,ISII
l?RO/,l(lSEJI1 tlSE: I [.lSGl, FAMILY DWEL,I,IlIG
rJt1t1I.'l' I . FANIL,y
[J# OF ONI'I'S
fJ S~1!r.1tHNG POOL
(] MOBII.El llot.1!ll
(J OTIU!lR
[J CCJt1MIlJRC JAI,
[) INDUSTRIAT,
CJ R~8'rAI1RANT & HEJAI,TlI DEPARTf\1EN'I' APPROVAL,
IJE.CUPTION OF NORK 1. ":)lq ~T- -1dL ~~t<- ".:!:.__Q EJ ~....._.._____ _..~_. .....
BlJILfHNC3 SHm -~tt_){J.~ SQUARI!I FOOTAGE __________ HEJIGH'r .,____~________
RESIDENTIAT"
(~O~1MIllR(!IAI, I
A'r"I'ACH (:2) PLOT PIJAI1S .& (2) SETS OF BUrr ,/)INr~ PI,ANa & (1) SIlIT ENElRriV FORMS,
A'I'T1\C!H (3) SETS OF BU!LDING PLANS & (1) SElT ENElIWY FORMS,
PROPElRTY SURVEY REQUIRED FOR ALL NEW C!ONS'I'RUC'I'ION.
FERMITS RBOUESTED
[] BIJIJ,IJIN(~
.' Co' cJ
$__._-<; ~~-:::...._--~ VAL,tJATION OF 'I'OTAIJ COl\1S'fRlJCTION
[J EJLIlJC'I'RlC.!AL
[] PI,tJt1a ING
U HEIUHANICA1,
----.-------__ MIIP ~ElR"ICE
fJ FLORIDA POWER
rJ W,R,E),n,
$__.___'
- VALUATION OF tIlElCHANC!IAI. UISTAI,l,ATTON
[J (~A8
LJ ROOFING
[J SI?EC!lAUry
[] OTHElR
1'YPEJ OF (JO/18'1'RUCTION I [) BLOCK
[J FRAMEJ
[] STEElL
f] OTHER
FINISHEr) FLUOR I!lIJElVl:TIONS
---------------
IS PRO,JEC'f' IN FLOOD ZCJt.TEJ AREA tJ YHls
o No
BtfILnl!lR.
BlONATtlRm ..j)~_~..._....___~
ml,lIlCTRICIAN
**************************"*****'***'****************************
(XH1P AN Y__._____________________ .___..___.__ _ __________ '__
STATE CEJRT OR RErJIST # _______________.________;. ______
CI'rY PROCESSING IL_________.________________ ._._.._._____
SllmATIJRE! ___.._.
'-'__. h__ ....___ ~________.__.__. "__"__.'___. ......___.____.____
COf'1PANY _'___ ________ _ _ ____ _ _______
STATE: e'ERT OR RElCJTS'I' It
CITY PROCESSING It
.~--~.-_..------_._.._- ---..--
.---.. ---. -- ~--- ._-~+-------_.._----_.__.-_._.
Pf,UMBmR
* , * * * * * * * * * * fr. * * , , * fr' * * "* "* * , * , , * * * * , , * * "* * , * * * * * * * * * * , * * * , * * , * * * , * * ", * *
--..---. -_..~----_....__.._-- --..-. --. - ..-.~ '--" -_._--".~--
"- --_.._--.-.__._._--_..~. --------
._~-_.__._---
COl'I P 1\N Y ----____________-,-______.___..____.__. _.. ____ _______ -..__
STATE CEJRT OR REJGI8T # ___________.____.____.._
CITY PROCESSING #
SIcJNA'I'I1REJ
MmClHANI CAl,
",*******",*'*******************************************************
----.--- -"-'--_~_.'4___._.___.._.___.___._.___
-_._--_.._---~_._--_._--_......__.._-
Cel/Ii P ANY ----------________. ___________ __ _h._._
STATE CERT OR REGIST #
CITY PRUCESSING #
------- ....-.-.-- -..~.- ----.--.-------.------.-.. --.
8 WNA1'IJREl
OTUmrl.
*******************************************************"'**"***
----._---_._-~----_...~-----
.....--.---------..-------.---..----.--.-------
-.._----_._~_._--._-
COt,'IPANY
81'1\ l' E cEiRT-orCRiillST-r------.--- -------_ ___"_. _
CI'rv PROCESSING # -.________.____________
s [(mATURE
*************'**********************************'******'****'***'
-----------....... ._.._.__.--------.,_.-.-~<,-_.~,--_._._-_.-
CONDI1I'rONS OH' PER~IrI' AE'FI"[)AVIT
A. NOTICE OF DEED RESTRICTIONS
The I.\.ndertil.gned understande th~t Lh:Li3 p!3rmit illay b.;: subject eo "deed restdction6" which
maY be more LesLl:ictive than City r-e9ulations. 'i'll,;: luJd,;:.L"si'Jned assumes responsibility for
c.:omplii:Ulce \d th any applicable d€:t:drestrictiolls.
B. UNLICENSEr~'CON'l'RAC'l'ORS AND CON'l'RAC'l'OR RESl?OFlSIBILI'l'U:S
If the O\>luer has hired a contractor or contractors to undertake work, they nlay be required
to ptl licensed in accordance wi.th .:;tate cUld local regul,:iU.ons, If the contracto1: is IlOt:
licen6ed as requlred i..ly law, both the ovmer and contraotor way i..le clted for a miademeanor
violation under state law, If th", owner' 01: int",nded cOrltracto1: a1:e uncertain as. to vlhat
licensing requirements may apply for the intended work, they are advised to oontact the
city of Zephyrhills Building Department, 813-766-6611,
Flu:thermol:e, 1 f the owner has hir-",eJ a contractor or contractors, he i.s advised to herve the
contractor(s) sign portions of the "Contractor SectionsU of this application for which they
vlil1 be tesponsible, If you, as the owner signs as the contractor, YQ\,! are indic:ating that
you, rather than the contr-actor, are responsible for the work. If the contractor- wishes
~'ou to slyn as contractor that mC\y be an indi.cC\tion that he 1s not pt-operly licensed and is
llot entitled to permitting pri.vi.l~ges in the City of Zephyrhi.lls,
c. 'l'AANSPOR'l'A'rroN IMPAC'l' IfEES AND U'fILI'I'Y CONNECTION FEES
lJ, CONS'i1RllCTUION I,IEN LAW (CHAPTER 713, FlJORIDA STATUTES, AS AMENDED)
1 certify tllat I, the applicant, have been provided with a copy of "florida's Construction
lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs, If the applicant is someone other that: the "owneru, I cerify that I
llave obtained a copy of the above described ~ocument and promise in good faith to deliver
it to the "ownerU prior to conmencement.
ill. CON'rRAC'i'OR' S/OWNER' S Al!'fIDAVI'P
r certify that all tile information in this application is aocurate and that all work will
be done in compliance with all applicable laws regul ating constnlction, zoning, and land
developmellt,
Application is hereby made to obtai.n a permit to do work and installation as indioated. I
ce~tify that no Hark or installation has commenced 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 regulat.ions in the jurisdiction. I also
certify that! understand that the reS:1ulations of other governmental agencies lOay apply to
the intended wor'k, and that it is my responsibility to identify what aations I IllllSt take to
be in compliance, Such agencies include but are not limited to; *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Bens~tive
IJeHlcts, Water/Wastewater 'freatment
*Soutllwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*A1:my Corps of Engineers-Seawalls, Docks, Navigable Waterways
*lJepartment of Health & Rehabilitative Services, Environmental Health Unit-Wel.ls,
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.", it is
understood that a drai.nage plan addressing a "compensating volume" 'will be submitted v/hich
is prepared by a professional engineer registered in tlle 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, alter, or set aside any provisions of the technical codes,
nor ahall issuance of a permit prevent the Building Of~icial from thereafter requiring a
correction of errors in plans, con~truotion! or vio~~tions of any oode. Every p"mit
is,iu~d ahall beoome invalid unless the Hark authori:z.ed by suoh permit ia oOllunl\lnced Hithin
six months of issuance, or if work authorized by the penult is suspended or abandol!ild f9t" a
period of SLK 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 extenaion shall be reques~ed
ill writing to the Building Offioial. An approved inspection must be logged during each a!x
month period, or the project Vlill be considered abandoned.
WARNING '1'0 OWNER: YOUR Ii'AlLURE '1'0 RECORD A NO'i'ICE OF COMMENCEMENT MAY RESUL'l' IN YOUR
PAYING 'l'WICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IN'fEND TO OB'!'AIN li'INANqINq, {::9N~UU!'
Wr'l'H YOUR LEHDER OR AN A'i"PORNEY BEIi'ORE RECORDING YOUR NOTICE OF COMMENcEMEN'r. JOBS UNDER
$~, 500 iN VALUE!: DO NO'i' NEED 'l'Q RECORD AND POS'l' A "NOnCE OF COMMENCEMEN'i"',
SIGNA'l'URE: OWNI1lR OR AGENT
SIGNA'i'URE: CONTRACTOR
of identification)
take an oath.
STA'!'E OF FLORIDA
COUNTY OF
The foregoing instrument w~s acknowledged
Before me this _~ay of---, 19
by
(name of person aoknowledged)
o.ho is personally known to me, or
o who has produced . ______
(type of identification)
and V/ho lldid [}Ud not t.ake an oath
B'!'A'i'm Oli' H'LORlDA
COUNTY OF
'l'he fO.l.-egoing instrument was acknowledged
Before Ine this ___ day of ____, 19_
by ___..__
(name of person acknowl,dged)
OHho is personally known to me, or
o who has produoed
(type
alld whoD did Ddid not
Signature of person taking acknowledgement
Signature of person taking acknowledgment
ll-a-I~;;;-ty'p~-:-prTnt';;d o~-~tamped
Name typed, printed or' stamped