HomeMy WebLinkAbout03-1789
BUILDING PERMIT
Permit N~
CITY OF ZEPHYRHILLS
(813) 780-0020
1789
h()~~
Date 1-:<'3'- () 3
.
BUilDING
~Al PlU~
----
P",perty Owne, I;j i:1 N- ~ MI tuf'
Job Address: -J.-<yt _._ __ ~ to.) t ~ &
Parcell.D. #
M~ICAl
Sewer Conn
Water Conn:
Water Meter:
Zoning:
Descriotion of Work
3~()ys ~~
/~ j-O
JN~
Energy co~
(Y~
Aadon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
DATE
Complete Plans. Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Permit Fee -:i; ~ ~
)Signature _ ~ ~_
Company
Address
~Iephone# er-?(7 Ll uO
Valuation or
Contract Price
City license Registration #
State Certified license#
Ii /l~/{~
Ftr.
Pre SlB
lintel
FRM.
Insul. Cl
Wl
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SlB
Tub Set
Water
Sewer
Fin
Breakers
Ducts Insl.
Compre
Fin
BUilDING
ELECTRICAL
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'lNElR' 8 HAl-1El_____~_tJ.__tLJ-:l--T-A1J.I1 f'~ ___ __ _ _ _ _ __ _____h__._ PHONE CON'l'IWI'
.1OB SITE ADDRESS --L;r.-~J;-----h-_I4Jf_'7--u.a.l-L_u.!_~;g__ /?11/,t:________._
l,EGAL DB18(!RTP'I'Ioll: 1.OT(S) ---___~Z:_____ BLOC'K__n__...__ SU8TJlVI8TOt! .k't.J2-r--I:'::.-q~~~I.t-:::d
PARCEL, I II # -----~-L ~=k~~~-2:~_-..a/~-.tL__.=?!p ~~Q_~~~~~:15~~~[!.~~~'~_~_1~~~ ._~~~~~T~~~~___
HtJRK PRCH?SBJJJI [JHBJN C'ONS'I'RUCTIOH [I AflDfTIOl'1 OAL'I'ElRATION [1 RElPAIR k-1-+NSTAIJI,
CITY OF ZEPHYRHlr~LS PEJRMl'r APPIJICATION
BUII,DING IHIJI?ARTMElN'r 5335 sth S'rRElBJ'r ZElI?HYRHIr,I,S, P'L 33540
PhonElIS13-780-0,020 FaxI813-780-0021 . 'j,-.1,1.-/J. "2
DA'rB1 RDlCIilIVllIn fI J
PJ,ANS RIDVIHlW rBlsr .~".- -~"~ ----
[18 I ml
[J MOVE
o DElt-10I,ISII
PROIMSEIJ USE I []St';!I, FAt-al,Y DWEI,l,Ilm
[h1Ui.'I'r - FAHII,Y
[1# OF UNITS
LJSNU1MING POUL
LJ MOB Tl.EJ !iofm
fJ cm1HERr.!IAl,
[I INDUSTRIAJ,
(~YI'HElR
C~/p-r
CJ REI8'l'AlJRJ\NT & HEALTH DEPJ\R'l'f.1EN'I' APPROVAJ.,
I lE8CR I P'I'toN OF NOR K --_~~/(') r._L_~._______________ '___________.________________ --..._-'-n._... _'_'___
BUtr,nINt] SIZEl 1. J2.l..~_____..______ SQUARE FOOTAGE: _oj p.f!._~_ HEllGH'I' -'_?_~__________
RE8Il1111NTIATJ r
cm'MBlR(!IA III
A'I"r1\CH (2) PJ,o'r Pl-lAllS & (2) SElTS OF BUu,nnm PJ,AN8 & (1) SElT E1NElRGY FORMS,
A'r'l;ACH (J) SETS OF EUll,DUJG Pl-lANS & (1) SElT ENElRCW FORMS,
PROPElRTY SURVEY REQUIRED FOR ALL HEN CONS'I'RUCTION.
FERMITS REQUESTED
~iJrI,IJING
L_J2--.1. s_____ VALUATION OF TOTATJ COHS'fRt1CTION
Cl ElIJBJC'I'RICAI,
-.----.--------
AtIfP ~ERVICEJ
fJ
FLORIDA POWER
[]
W.R,El.{!,
[] P I.tJf1B I NG
o IIfHICHANlt!AJ,
,
$----..----'-------- VALUATION OF HIlJe'HA.NCIAJ, UI8TALI,ATTON
[] (~A8
LJ ROUFING
[J SPEJC1tAUry
[] O'I'HEJR
'l'YPEJ OP' C!ON8'I'RUl!TIOFI r [j BLOCK
[J FRAME!
[J STElEll-l
[I OTHElR
F'INISHElJJ Fl,OOR ElI,EVl'TIONS
---------.-.--
I8 PRO,TEC''f' IN FLOOD ZONEl AREA [] YElS
o NO
BtJunrllR q 17 0)-1 Cl
"IGNAT1J.. _.c=-~ _~~ ___
******************************************************************
COf1P I\Ny-----4....lc::--L_L~_..pA-L </JJ;:l- ___ ._,
STATE: CFJRT OR REGIS'I' # ----s::.[-La~kV'r~_
CI'rY PROCESSING fl-_-I1_5.~_.____. _n .'. ___._._ .__ _H'
mr,BlO'I'RICIAN
S] mrA'l'lJRE _____
. .._......_....._ n.', __ __~'.___~,_,_"
.~_.._~,. _0__.._.-..- _____ __._.____
cnr'1PANY _______ ____ _______ _h___ ________
STATE C'ERT OR RElt1T8'I' #
CITY PROCESSING #
.---.- ._-. .-----.-.-..-.....-..--.--..-....
******************************************************************
.__.._---,----~ -'-...--. ----. --......-.. --.
PJJUMBI!IR
._.-~~O_.'_""-"_'___"'_"___m ________
(~OM P ANY - ----_____ _________,---_ __._______..____ ____._. ___.____.______.__
STATE CERT OR REGIST # ________________________
CITY PROCESSING #
8 WNATI1R EJ
MTllr!HANICAl. COMPANY__________________.________._______ "___u____
STATEl ('ElRT OR REGreT # ____________________________
SIGNATUREl CITY PROCESSING #
******************************************************************
-~.~-_._,------~---_._-_.- .__..._.._----.~---~.~
---~._-----.---------~--_.._.__.,...O__.._._____ -----..-~____._O____~,._______,_
*****************************************************************
OTlIBlR
----'----------~-_.._--------------
(~OrIIPANY
STATE CERT OR REmST #-------.....-----.------..----- ---
crry PROCElSSING # ------------- -.________________
----_.._+-_.-----_-..~---_.~--_.~.--_.__._-~---------
S WNA'I'lIREl
*****************************************************************
-'~-----.-."-..- ._--_.---~-~---......_.,_.-'-- ... - -'."-..--'" .----
CONDI'1.'IOl'JS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understande thqt Chi:. p~al\it may be sub:ject to "deed restd.otions" w,hJch
may be mure restrictive than City r.:gulations. 'I'he und,=rsigned assumes responsibility for
oompliance with any applicable deed restriction~.
B. UNLICENSEP 'CONTRAC'!'ORS AND CON1'HACTClR RE:SP~)NSIBILI'l'IES
If the o\~ner has hired a contractor: or contractors to undertake work, they Illay be required
to btl lIcensed in accordance wit.h state and local regulations. If the contractor is not
1 I oens..d as required !Jy law, botb the m)ner and oontract:or may be cited for a mi.sdemeanor
violation under ::;tate lal/. If the O\'iner or intended contractor are uncerlain as to "lhat
Ii ct::!nsillg requirementl:l may apply for the intE'.lnded WaLk, they are advised to contaot the
City of Zcphyrhills Building De:partmcnt, 81.3-788-6611.
Furthermo!:e, 1 f the owner bas hil:ed a contractor or contractors, he ls advised to have the
contractor(s} slgn portions of the "Contractor Sections" of this application for "dlich they
will be: j.esponsible. If you, as the owner signs CIS the contractor, YQl,! are indicating that
you, Lather than the contractor, at'e responsible for the work. I f the contractoj.' wishes
you to siyn as contractor that may be an indlcation that he is not properly licellsed and ls
not entitled to permitting priv1leges in the City of Zephyrhllls.
C. 'I'RANSPOR'I'ATION lMPAC'l' FEES AND U'I'UI'I'Y CONNECTION h'EES
D. CONS'rRlJC'fUION LIEN LAvJ (CHAP'l'ER '713, FLORIDA STA'rU'l'ES, AS AMENDED)
1 certify that 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 "owner", I oerify that I
have obbdned a copy of the above described document and promise in good faith to deliver
it to the "owner" prior to commencement.
E. CONTRAC'l'OR' S/OWNER' S AFlfIDAVI'l'
I oertify that all tile information in this application is accurate and that all work will
be done in oompliance with all applicable laws regulating construction, zoning, and land
development.
Application is hereby made to obtain a penuit to do \-<ark and installation as i ndiaated. I
certify that no work or installation has con~enced prior to issuance of a permit and that
all work will be performed to meet standards of all laws regulating construotion, City
code::;, zoning regulations, and land development regulations in the jllrisdictlon. I also
certify that I unde1:stand that the regulations of other governmental agencies may apply to
the intended work, and that it is my .tesponsibility to identify what actions I IIIlHlt: take to
be in compliance, Such agencies inolude but are not limited tOI *Department of
EnviroluQental Regulation-Cypress Bayheads, Wetland Areas and Bnvironmentally Sens~tive
Lands, Water/Wal:ltewater Treatment
'" Southwest E'lodda Water Management District-Wells, Cypress Bayheads, Wetl and Areas,
Altering Watercourses
"Anny Corps of Engineerl:l-Seawalls, Docks, Navigable WaterHays
*Department of Health & Rehabilitative Services, Environmental Health UnIt-Wella,
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
ullderetood that a drainage plan addressing a "compensating volume" 'wiLL be SUbllli tted VJhich
is prepared by a professional engineer registered in the; state of Jj'lorida prJor to penllit
issuance.
A permit issued shall be construed to be a license to proceed with the work and not as
authority to vlolate, cancel, aIte!., or set aside any provisions of the techllical codes,
nor sllall issuallce of a permit prevent the Building Ofticial from thereafter requiring a
correction of errors in plans, ~onstruction, or violations of any oode. Every permit
iSl'Ju(;d shall beoome invalid unless the work authorized by such permit is cOllullenced Hithin
six months of issuance, or if work authorized by the permi. t 105 suspended or abandorled f9r a
period of si.x months after the time the work is conunenced. One 90 day extenei.on of tillle
may ~e allowed for the permit with fee charge of $15.00. The extension shall be requea~ed
ill wrItlng to the Building Official. An approved inspection must be logged during each six
llIonth period, or the pr:oject Hill be considered abandoned.
WARNING '1'0 OWNER; YOUR FAILURE '1'0 RElCORD A NO'fICE OF COMMENCEMENT MAY RESUW' IN YOUR
PAYING TWICE FOR IMPROVEMEH'l'S TO YOUR PROPERTY. IF YOU INTEND TO OB'rAIN }:1INANqINq, ~{tN~UL'r
WITH YOUR LENDER OR AN A'l"rORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. JOBS UNDER
$~, 500 IN VAW&l DO NO'I' NEED TO RECORD AND POS'!' A "NOTICE OF COMMENCEMEN'l'''.
_~~4--_u ~d-P-~ ~~;;~70?06
SIGNA.~~~~~R AGENT SIGNA/i'URE: CONTRACTOR '
S'I'ATID OF FLORIDA
COUNTY OF
'1'he foregoing instrument was
Before me this ___ day of
by~
acknowledged
,19_
STA'l'E OF FLORIDA
COUN'l'Y OF
The foregoing instrument vla,S acknoVlledged
Before me this ------S-iay of--, HI.......:-
by
(name of person acknowledged)
[1ho .is pet'sonally known to me, or
(name of person acknowledged)
Dwho is personally known to me, or
o who has produced
(type
and who[J did [Jdid not
of identi.fication)
take an oath.
o Hho has produced___. ~_____
(type of i.dentificati.on)
and IJho Ddid DHd not t.ake all oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, pri.nted or stamped
Hame typed, printed or. stamped
17L1- ~'UN t'~~
Ul <)6 t;J~ uIlrJJ
SQ.FT.
PRICE
Main
Other Area
Under Roof
Valuation:
Building: "O~ ~
Electric: AlIff It
Plumbing: AI~ i6
0~
Mechanical: Ilrr
Radon: 1(, <~ ()
School Impact "A \/
Fees: (t/7 If'
Connection
Fees:
;JIlt
Trans. Impact . (I
Fees: 1J(,Pr-
Site Plan
,ve exan dimensions of driveways, sidewalks,awnings, screen rooms, porches, decks & etc...
Give desire d 10 cation of all land im provements; wells, septic tanks, power po les, culverts & etc...
.. Give exact dimensions of Home
. Jndicate direction from door to-face & location ofhitc'hes to Home
i;J
. Indicate street TO lot/homesite
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, m ylour signature(s] below indicate that'this is the desired site plan for the installation of our new
Ime and all the improvements that h~vy been included within the purchase of our new Home.
Ime Buyerlsl ~Ul/IArlo.. A'G' Date /1- 7/- 0 :;t.. .
lme Buyer(sl Date',
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4034 Th~ f.nw/;\y
Mulberry. f!crk:(o. :i3tl60
TIlI~phoI'l4l/Fo.)( (963) 646-5517
Mobil. (863) 297-7073