HomeMy WebLinkAbout03-1759
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N2
(813) 780-0020
1759
Date
1- {3 -03
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcell.D. #
Zoning:
DescriDtion of Work
:=fCN+?\J1 /,V E h.J\A~~
c:; lj L( '3 I tt rt. ST.
Water Meter:
T.I.F.'s:
Energy Code:
-f ~L
Radon Gas:
'S.a-v V.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
FINAL
C.O.
DATE
NO OCCUPANCY BEFORE C.O.
DATE
Inspector
Valuation or
Contract Price
-
--
. :~.~
Permit Feej ;:777j , ~
)Signaturgy. P-o 7-?.k.~-
com~
Address
yelephone# '//~ ., ~3 Y'1ft,;
-
City license Registration #
State Certified license#
ELECTRICAL PLUMBING
Ftr. Tp, Servo SLB Breakers
Pre SLB Rough In Tub Set Ducts Insl.
lintel Meter Can Water Compre
FRM. Const. Pole Sewer Final
Insul. C Pool Final
W Pre-Meter
Final "/3, /1-- (J;} I2.Ll.f ttfJ6
Driveway
if? :3 - ~/-O3 ~- q ;d).. I P
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'"'S" S HAM",_ hHl~_.::L_---nLj,tf. C~~_ _, _ ~__
,TOB SITE: ADlJRBlSS..._s..ff/H'5________I_r.~---__..__
CITY OF ZEPHYRHIIJLS l?ERMI'!' APPIJICATION
BUII,I>ING DEI?ARTMENT 5335 sth S'fREE'f . ZllJPH'iRHU,I,S, FL 33540
PhoneIB13-780-~020 ra~telJ-780-0021
lJA'fllJ RBC8lIVIllo
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PI,ANS RlllVIBlW Jl'JJ1I1
.
PHONEl CON'l'Ar~'r~.. 32ffJc?7!.<?:3
l,BHJAL JH!lSCRIP'l'IoN: LOT(S}
BU)CK
SUBIllVISlotl
---~-~-+----...... ---~-"'-~....-. .~~ ._-~.-
P1\R(!I!lI, I [l #
WORK PROI?8E1lJ I {JNEW r'f)NSTRUCTION
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(OBTAIN FROM PROPERTY TAX NOTICE)
[]srGll
[] ADDITION ~/1'ElRATlnN [J RElPAIR LJ INSTAT,I,
[] MOVE 0 bE~101,rSII
[h1lJL'1'I .. FMIJIl.Y [J# OF UNIT8 lJ MOBnEl HOflJBl
[J INDUSTRIAL rJ SNIMMING POUL [] OTHBlR
PRO\,108EJI1 USE I [laGL F1\tlllIJY DWELr,U1r~
rJ CCJt1MHlRt! 1:A I,
IlElSCRIPTION OF WORK
D R~8TAtJRAN'I' & HElAI,TH DElPJ\R'l't.1HlN'r
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PROVA.L
BUrLflIN<3 ElIZa ~1-1E..Q.__________
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IIE1IGH'I' _/~_
RE8IDlllNTIM'I
COMMBlR(nAI'1
A'I''f1\CH (;&) PLOT P1JA118 & (;&) 8ElTS OF BUIJ,DING PLANS & (1.) 8El'r E1NE:Rn'i FORMS,
A'I"I;AC!H (J) s!1i'rs OF BUILDING PIJANS & (1) SI!lT ENHlRe~Y FORMS,
PROPHIRTY SURVEY REQUIRED FOR ALL NEVI CONS'I'RTJCTION.
PERMITS REQUESTED
LJ BlJII.IJINe~
$
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VALUATION OF '1'01'1'11, COH8TRtJCTION
L1 ElUllCTRWAl,
----.-_____.___ M1P ~ElRVICEl
rJ FlDRIDA PONElR
[J W.R,E,<!,
[] PI.tItlJB ING
lJ IIIEICHI\NIC!ATJ
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--- VAI,UATION OF ttlEClIANC!AI, U1STAr,l,ATTON
[lems
rJ ROOFINeJ
LJ SPE(!IAUry
[J OTHER
'j'1{PE OP' CON8'I'RtJC!TIOH: [J BLOCK
[] FRAME!
[] S'l'ElElL
[J OTHER
F IN I SHE/l F!.O()R mlJEVl-TION8
IS PR(XTEC'I' IN FLoon ZONEl ARElA [J YElS
o NO
Bttunm~
---..-.--.-....~__~w_.____'______.~__~_~_.___.___._
COt1 PAN Y___.._______.._______________.. .._.. __. .__ . _ ___._______ '_
STJ\'I'E: CI!IRT OR RElGts'!' # ____.__..____._______.._____,.__....___
CI'1'Y PROCESSING fL__ _____ __._______..__._ ___._.__._ .....
81GNATUREl
~*~***********************~****************'**********'**'*"**'**
8"1 GW\TIJREJ ...
C<Jlo1PANY ___r/w ~'--_____~._____...__..__.._.___ __..__
8TA'l'E CERT OR REGrST #
CITY PROCESSING #
.----. - _. ._-..~.. .~._---.-- --'--- --- ----.. - "...-
BlUldTRICIAN
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---_.__._._.._---.-.__.._~, --- - -..-....-. '- -------_.,._~---"-------
Py,tJHBBlR
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COM PAtTy ----_______-,--______._.__.__...____.._____..
STATE CElRT OR REGIST # ____..________....
CITY PROCESSING #
S WNATI1R E
HBlCHANI CAI I
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--_._~--_._-_..~._-_._-,....__..----_.-
(!()~1P ANY ______._____.___, .______._______ ...._._.._.._._
STATE CElRT OR REGIST #
CITY PRUCESSING #
"-~----_..__._-----.~. ~.__._---_..-
SIGNATURE]
*********'****'*******************'***~*****************'********
------,._-_.__._--_.,._.~--_.-
OTHBllt
---------_._-----_._~-----.-
Cor-,1PANY
STATE: C'ElRT OR REOtST #
CITY PROCElSSING #
----.~_....-._--,._._-_...,._... '~--...
.-.----..---------.:..------.;...-...-.-....,--...-------.---
S Il3lIA'I'tJREl
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CONDITIONS OF PERl'1I'f AFFIDAVIT
"A. NO'I'lCE OF DEED RES'l'RIC'rIONS
Tne undersigned understands thqt thil:1 penni t may be subject to "deed restriotions" -wllich-
may be more r6st1:ic:tive than City re9ulations. The undeu:liyned assumes responsibility for
con~liance with any applicable deed restrictions.
B. UNLICENSEP !CON'l'RACTORS AND CON'l'HAC'l'OR RESPONSIBII,I'l'U:S
I f the owner has hired a contractc,r or contractors to undertake work, they Illay be required
to pi: licensed in accordance ~dth state and local regulatJ.ons. If the contractor is not
licensed as required l.Jy law, both the vI-mer and contractor may be cited for a misdemeanor
violation under state laH. If the O\mer or intended contractor are uncer-tain as to vJhat
li censing requirements may apply for the intended wOl:k, they are advised to CQntaot the
City of Zephyrhills Building Department, 813-788-6611,
Fur'therlllo~-e, if the Oymer has hired C:t contractor or contractors, he 15 advised to have the
contractor(s) sign portions of the "Contractor Sections" of this application for Hhioh they
will be responsible, If you, as the owner: signs as the contractor, YQl! are indicating that
you, lather than the contractor, are responsible for the work. If the contractor: wishes
you to sign as contractor that mClY be an indication that he 1s not pr:operly licensed and is
not entitled to permitting privileges 1n the City of Zephyrhi,lls.
c. 'l'RANSPOk'1'ATION IMPAC'1' If'EES AND U'l'ILI'I'Y CONNECTION FEES
l), CONS'1'RUC'1'UlON l,IEN LAW (CHAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
j certify tllat I, the app11cant, 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 "owner", I cerify that I
have obtained a copy of the above described aocument and promise in good faith to deliver
j t to the "owner" pri.or to COlTUllencement.
E. CON'1'RAC'l'OR' S/OWNER' S AFFIl1AVI'l'
I certify that all the information in this application is accurate and tllat all work will
be done in compliance with all applicable laws regll1ating construction, zoning, and land
dev4;llopment,
Application is hereby made to obtaln a permit to do wOi-k and installation as indicated. I
ce~tify that no Hork or installation has commenced prior to issuance of a permit and that
ail work will be performed to meet standards of all laws regulating aOllstruction, City
codes, zoning regulations, and land development regulat10ns in the jurisdiction, I also
certify that I understand that the regulations of other governmental agencies may apply to
the intended wor'k, olfld that it is my responsibility to identify what aations I must ti:lke to
lJe in compliance, Such agencies include but are not limited tal *Department of
EnvironllleHital Reguli:ltion-Cypress bayheads, Wetland Ai'eas and Environmentally Sensj.tive
Lands, Water/Waste~'later Treatment
*Southwest florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
AArmy Corps of Engineers-Seawalls, Docks, Navigable Waterways
*lJepartment of Health 6i Rehabilitative Services, Env1ronmental 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.N, it is
understood that a dra1nage plan addressing a "compensating volume" 'wiLL be su!Jmitted Vlhi.uh
is prepared by a professional engineer registered in tile State of Florida prior to penuit
issuance.
A permit issued shall be construed to be a license to proceed with the work and not as
authori ty to violate, cancel, al ter', or set aside any provisions of the tectlllical codes,
nor shall 1ssuance of a permit prevent the Building Official from thereafter requiring a
cpr~ectiQn of errors in plans, gon~truction! or vio~ations of any code. Every pe,mit
ist.t~ed sh~ll become invalid unl~ss the HarK authorized by such permit is cOllunenced within
six months of issuance, or if work authorized by the perm1t 1s suspended or abandoned f~r a
period of SiK months after the time the work is commenced. One 90 day extension of time
may be alloHed for the permit with fee charge of $15,00. Tile extension shall be ~equeated
in writing to the Build!.ng Official. An approved 1nspection must be logged during each'siK
mOnth period, or the project Hill be considered abandoned.
WARNING '1'0 OWNElR: YOUR E'AILURE '1'0 RECORD A NO'l'ICE OF COMMENCEMENT MAY RESUL'I' IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPER'ry. IF YOU IN'I'END TO OB'rAIN Ji'INANqINq,~qN~UljI'
WITH YOUR LENDER OR AN A'l"I'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'r. JOBS UNDER
$2,500 IN VALUEl DO NO'l' NEED '1'0 RECORD AND POS'l' A "NO'l'ICE OF COMMENCEMEN'I"',
SIGNA'l'URE: OWNER OR AGENT
SIGNA'l'URE: CONTRAC'l'OR
STA'L'E Olf FLORIDA
COUN'I'Y Olf
The foregoing instrument was ackncwledged
Before Ine this __ day of , 19_
by _____..__.
(name of person acknowl~dged)
Dwho is personally known to me, or
o who bas produced_.
(type of identification)
and who[] did []did not take an oath.
STA'I'E OF FLORIDA
COUN'l'Y OF _______
The foregoing instrument w~s acknoHledged
Before me this ----5iay of-------, 19 __~__
by
(name of person acknoHledged)
Gho is personally known to me, or
o who has produced_____________
(type of identification)
and Hha Ddid DUd not t.ake all oath
Signature of person taking acknowledgement
Signature of person takiug acknowledgment
Nallle typed, printed or stamped
-
Name typed, printed or stamped