HomeMy WebLinkAbout03-1771
BUILDING PERMIT
Permit N~
CITY Of ZEPHYRHILLS
(813) 780-0020
1771
Date l- /5~ tJ 3
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcel 1.0. ,
Zoning:
OescriDtion of Work
~5 h,.sTtr
'1 '1 ;;. I 8" 'f-'-... ST.
Water Meter:
T.I.F.'s:
Ene,gy Cod.'~
f?.e -- K
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL ~ -/ ~t' 5
DATE
Complete Plans. Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Valuation or
Contract Price
It (}-Of)
. t!F\'
Inspector
Permit Fee ,5~. &0
).s;gn.tu,~-U/ ~:z.~
Compan __
Address
~Iephone# ,7~.2". CJ ~ f' 1
City license Registration #
State Certified license#
OvJ~
Ftr.
Pre SLB
lintel
FRM.
'nsul. CL
WL
Tp. Serv.
Rough In
Meter Can
Const. Pol
Pool
Pre-M
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Ins
Compr
Fina
BUILDING
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.
-;r-- ~c .~
Ol1l1SR' 8 !lA". vi d-/?/e'.,s R h:;; eel- PHoll. '''IN'1'A'''r,~ZZ!~~f,f'7
-'~,-- --~----t:i?':---z,' -- --'- -----"T --7 .'
,TOB 8 I'n ADlJRB88 -4!'i.2(:t=_~g;j; _: zeg~!:/&'If:; ~u;j'2 .5:f.=?
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8th STREET ZEPHYRHILLS, rL 33540
Photler813-780_Q020 FaXI813-780-0021
lJA'rB1 RJJI(tBlIVlllo
~.~ -,..~~.....-"~+ ..--.--
PI,ANS R!llVIJ!JW Jl'1lI111___ ___ "L
lJBlrJ1\L J)EJSUR T P'I'Iotl: LOT (S)
PARCEll, ILl #
-~._._-++-- -..---------
BfJ(JCK
~-.~_.--._.~.-
SlIBlJIVISJOU
_._..--..~-_.... -.---. ..-.--.,,-..- +-~---
WORK PRnPREfJ r [J HEN f'ONS'rRtJCTION
--_.~------_._--_.__._---------------------- ._----~----_._----------_._..- .---..-.----.---..--
[J ADIJf'rION
(OBTAIN FROM PROPEJR'l'Y '{'A)( NOl'H~El)
DSHm
U AL'f'ERATION
U RllJPAIR
[J INSTAT,!,
[J MOVE:
[] DEHO!,ISH
PROJ,lOSEIJ {JSE: I [J8CH, FAMn,y DWEJL!,I1m
f]f1lJL1' r - FAMIl,Y
[J# OF lINI'I'S
LJ MOB Ir,El liOf1Rl
UOTHER
fJ Cor1MllJRt! I.A f /
[J HTDUSTRIAf,
fJ Svllt1MING poorJ
IlEJ8CRIPTION OF NORK
o RS8'rAURANT & HEAlmr DB:PAR'n1EN'I' APPIWV1\I,
".~ rtJif____'______~ ___'___ __"___'_"
BUIr.nING E1IZEl
-....-----
SQUARE FOOTAGE
.._-----------~~-----
----.-.- ~'._-- --.
RElSIIlBlNTIAI'1
COMMI!lIWI AT,I
A'r'rAC!H (:3) PLOT P!JAI!S .& (:3) SElTS OF BUI! ,IJIN(] PLANS & (1.) sEI'r ENIl1Rny FORMS,
A'f'1;ACH (3) SETS OF BUILDING PLANS & (I) SET ENERClY FORMS.
PROPIllRTY SURVEY REQUIRED FOR ALl, NEW CONSTRUCTION.
0-.-... __________ __~
HEl!OH'!'
--..--"-..--.- -,~ ---.-.--
CJ BIITJ,IJIN(~
I>l!lRMITS RmQUE~TBlD
&:=V ~
$-./2o.~______ VALUATION OF TOTAl, CONS'fRlJCTION
CJ ElLElC'I'RICAl,
l.J Pl,uf1BING
---------------.;.. At1P ,9ERVICE
o FLORIDA POWER
o W.R,Bl,C,
o /1B:CHTUHC!AI,
[J GAS
fJ ROOFHm
,
$-- --------------- VAI,UATION OF t1HJC'HANC IAI, 1I-18'1'AI,I,1\TI0N
fJ SPEr.!tAUrv [] OTHER
']'YPEJ DF' CONSTRUCTION: [J BLOCK
[J FRAME
[J S'l'ElEL
[J OTHER
F INISHEllJ FI/OOR BlI,EVATIOHS
--..-----._~--
18 PROlTEC'I' IN FLOc)fJ ZOHE AREJA. 0 YElS
o No
BIllt".. "OMPANV,,'-_____ U -U'__u _,_ "._ -.. _" _ _ _ "
~ ~ p,?, ~- STJ\TEl CE1RT OR RElrJIST # ____,_ ______ ___. _ . ___ _ _ ____ ___.
81 GH ^ TIIR. -. ~ 0:#=--,'__------.:.~_____,,___ CITY PROC.8 8 ING "-__, . .,_ , u__._ .,,_~. __. ",.,,__ '._
""""""""'*"'*"'*"A*'****'****,,*,**,*,,*,,*"*"*"""
ml,IlCTRICIAN
.... ---'-- -_._-._----._---------~,-_. --..---------
COHPAN Y _______________ _____________________ _____
STATE e'ERT OR REGIST #
CITY PROCESSING #
._-_.~. -- ------..---.-.--------..--._. _"k._
8] GI1l\'l'IJRE ____
PJ,t1MSBlR
"'*"'*A"A"""*"""""""",****""",,*,******,*,,*,*.*,
---'---~"'----'.__'h_'_._____~,__,_"., _____.___..___.____._
._~_.-..~-...._...--.~~-_.-......_~- ----
- -----.---------
COI>l PAN Y --------------------.,-______._____.....___ _u__ _._ ________
STATE (!ER'I' OR REGIST # _____________________________.
CITY PROCES8ING #
8WN.A'l'l1Rlll
*********"*'*'**'*****'***'**'****'~**"****'*'*'***'*"'***'**"
MOCBANICA!, (!OMPANV__"___,,,,_,.. .. __,._.. "'._ ,,_
S1'A'rEl ('ElRT OR REGrST # --~--___h_'__ ____________________
STGNA1'{JREJ CITY PROCES8ING #
--.-- "'''--~ '-~~-..._--_._.._.- .---- --..-----.---
OTHER
*"'***'*"'****'**'*""""""'*"*""*""*'**"*""*'*'*'*
------------.--_u,______ ______..________ ___._____ _________
B I m'1J\'I 'tJR III
--~-'--~_.-'-_.._-----~_._-----_._......------_._-----------,--
~k______.__
cOr'!PANY
S'rA11B] ciRT- OR -RE~.#---------.~._._-----... ~--_.._____,~..._... '~_'__~
CI'ry PROCE88ING # _____________________________.
'***'**'****'*****'****'*****'**'*'***'*******'***'**************
----~-"-. ..,--'---._._-----.-.._~--'--.,- - -'_.~--.
CONDI'rIONS OF PEPJ'1I'!_' /".:::::.DAV:.';.
A. NO'!'ICE OF DEED RES'l'RICTIONS
, The underaigned understands thijt t_hls p~rmit .:OOlY b,ij iiubjectt:o "deed restrictions" which -
may be more l.eatriative than City r,aglllations. '1'11,= undarsi;rned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNLICENSEP'CON'l'RAC'l'ORS AND CCJol'l'RAC'l'OR RESPONSIBILI'l'IH;S
If the O\-lnel: has hired a contractor or contl:actors to undertake \Vork, they Il\ay be required
to be licensed in accordance with state and local regulations. If the contractor is llot
licensed as required by lav~, both the owner and contractor may be oited for a lIdl:ldemeanor
violation under state law. If the owner or intended contractor are uncertain as to vdlat
licensing requirements may apply for the intended wOlk, they are advised to contapt the
City of Zephyrhills Building DepaLtment, 813-788-6611.
Furthennore, if the owner has hil:ed a contractor or contractors, he is advised to haviiI the
GOntlactor(s) sign portions of the "Contractor tlecti.ons" of this application for \~hiah they
Hill be l:esponsible. If you, as the owner signs as the contractor, YQ\,! are indicating that
you, l-ather than the contractor, al'e responsible for the HOl:'k. If the contractor wishes
you to siyn at;:! eontractor that may be an indication that he is not properly licensed and is
not entitled to permitting privileges in the City of Zephyr-hills.
c. 'l'RANSl'OR'l'A'1'ION IMJ?AC'l' FEES AND U'l'ILI'I'Y CONNECTION fEES
D. CONS'l'R\lC'l'UION 1,IEN LAW (CllAP'l'ER '713, FLORIDA S'I'A'1'UrnS, AS AMENDED)
1 certify that I, the applicant, have been provided with a copy of "florida's ConstJ.:uctlon
lien Law .- Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs. If the appU_cant 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
it to the "owner" prior to commencement.
E. CON'1'RAC'I'OR' a/OWNER'S AFFIDAVI'l'
I certify that all the information in this application is aocurate alld that all work will
be dOlle in compliance with all applicable laws regulating construction, zoning, and land
development.
Applioation is hereby made to obtain a permit to do work and installation as indicated. I
certify that no Hork or installation has commenced prior to issuance of a permit and that
ail work vlil1 be performed to meet standards of all laws regulati.ng construction, City
codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that thl? regulations of other governmental agencies may apply to
the intended work, and that it is my J:esponsibility to identify what actions I must 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
Lands, Water/Wastewater Treatment
*Soutllwest florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
~Anny Corps of Engineers-seawalls, Docks, Navigable Watenlays
*lleplutment of Health & RehabilitCltive Services, Environmental Health \1nit-Wells,
Wastewater Treatment, Septic Tanks
"u.s. Environmental tlrotection 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"'wi.ll be submitted which
is prepared by a professional engineer registered in the state of Il'lorida 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 shall issuance of a permit prevent the Building Of~icial from thereafter requiring a
correction of errors in plans, construction, or vio~ations of any code. Every petmit
is,sUed shall beoome invalid unless the work authorized by r:mch permit is oOllullenced within
six. months of issuance, or if work authorized by the permit is suspended or abandoqed for a
period of si.x. months after the time the work is commenced. One 90 day ex.tension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be teq"es~ed
in writing to the Buildi-ng Official. An approved inspection must be logged during each ai-x
month period, or the project will be considered abandoned.
WAfUUNG '1'0 OWNER: YOUR Il'AIWRE 'fO RECORD A NO'l'ICE OF COMMENCEMENT MAY RESUL'l' IN YOUR
I?A'tING 'l'WICE FOR IMPROVEMEN'l'S TO YOUR PROPER'rY. IF YOU INTEND TO 06'1'AIN FINA1H~INq,~qN~Ul/1'
Wl'l'H YOUR LH:NDER OR AN A'l"l'ORNEY BEfORE RECORDING YOUR NOTICE OF COMMENCEMEN'l'. JO!3S UNDER
$~, 50D HI VALUE DO NO'l' NEED TO RECORD AND POST A "No'nCE OF COMMH:NCEMEN'l'''.
--.--.----.--.
SlGNA'l'URE: OWNER OR AGENT
SIGNA'l'URE: CONTRAC'l'()R
STN1'E OF FLORIDA
COUNTY OF -------
The foregoing instrument w~s aolwovlledged
Before me this _--------1iay of---, 19
by
(name of person acknowledged)
[1ho is personally known to me, or
S'!'A'l'E OF FLORIDA
COUNTY OF-
'l'he foregoing InstJ::\llllent was acknowledged
Before me this ____ day of ., 19...-
by._-.--
(name of person ackno~ledged)
Owho is personally known to me, or
o who has produoed
(type
and who[] did Odid not
of identification)
take an oath.
o who has produced --------
(type of identification
and v~ho Odid [}Jid not t,ake an oath
---.----------.-
Signature of person taking acknowledgement
Signature of person taking elOknowledgment
.--.----...--.-.. -. --,_...__...--------~. ----.--
Hame typed, printed or stamped
~-- .,.--.--"---' -_._---_._-----------------------_._-_._--_._'_..~-_..-...
Hallie typed, printed or' stamped