HomeMy WebLinkAbout03-1793
BUILDING
Property Owner:
Job Address:
Parcell.D. "
Zoning:
Description of Work
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N2
1793
(813) 780-0020
/ -';;2J'-03
Date _l l
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
~~CT
~C::; l,~ S- 1I'f'l... sT.
Water Meter:
T.I.F.'s:
Energy Code:
f ~4JO
Radon Gas:
S~U. -fr> ~&,4~ 5
FINAL
C.O.
NO OCCUPANCY BEFORE C.O.
DATE
Complete Plans. Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Valuation or
Contract Price
DATE
Inspector
City License Registration II
State Certified Licensell
~
Permit Fee
....-.icSignature
Company
Address
0elephonell 1f1:3 ~ 1- '1:5~2-
Ftr.
Pre SLB
Lintel
FRM.
Insul.
Driveway
C) 9.5 a
Cnv";on..~-Y ~Jn S7L
ELECTRICAL
Breakers
Ducts Insl.
Compress
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final / {- J ,- 0 ..~
SLB
Tub Set
Water
Sewer
Final
l~ L '1
F,o /-3/- tJ3 11-")-5' ~. U
REINSPECTlON 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.
.. I.. ...
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N~
,~ .--
...." ....; &.
\
,
1793
(813) 780-0020
Date
'-I ( ,
).
-
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
~ '_~_""4'__J
Property Owner:
Job Address:
Parcel I. D. /I
Zoning:
DescriDtion of Work
J ,I .-t
"~~, --r'" .-, .
< ''',~: (.
; J
l) L~ \
.tl-
Water Meter:
T,I.F.'s:
Energy Code:
.,j1~" iL",~(ly
,
--,I'
Radon Gas:
uu, I . I?, ;:;..; () c.J /J "'7/i'-:::' ,
,v'-', v. v, " ""7 '
NO OCCUPANCY BEFORE C.O.
FINAL
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
c.o.
DATE
Inspector
City License Registration #
State Certified License#
'~...:) (/~) ..-'
p.; , / ,-ryo
Permit Fee ;2! ,,) . 'I
, . (" .'/ ;? ( -
- S,gnature I,d.v'", /'~, I ,.y---
Company .;1'-
Address
../
'/telephone# r:'./ '_
Valuation or
Contract Price
. ~:) '2_-
/, .>ff~' /,
( i.l/. YV .;htIt~j1...~rr:rk". c.~.).,..J':'.) ,}/
-- - ~ - - ~...;';;.:..
Ftr.
Pre SLB
Lintel
BUILDI~G
/
/
/
/
,/
ELECTRICAL
PLUMBING
I
MECHANICAl..
/
/
/
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final 1/ ! - }, (- () 2; /\ L '1
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
I
FRM. /
I
Insul. GL
WL
Driveway
I
/.
_ )- 5' . --,1!(A/,',f;...t
'. I'
/..-/,
REINSPECTlON 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.
CITY OF ZEPHYRHILLS PERMIT APPLICATION
Bun,UlNG DEIi'ARTMEN'r 5335 sth S'fREBl'r ZI!IIi'HYRHILLS, rt. 33540, ,
PhonElI813~780-0)()20 'axI813-780..00:n .. __ .. '7
nATa RIJ(1IIVllIb -J~::;?/t.:jtL~_
PJJANS RIVIBlW Jl'JlIIll_'-'-'__~_'L'______
,
ONNBJR' 8 HAfI1E :s- rl t ~, /-/~;.,- PHONE CON'l'Ar~'!' J~_l"=c?,,,!:l ~
-------.,.__..._-_._-------_..~_.__._---_.__._-_._.._._----
lTOB SITE ADDRESS ---~-.Z~.;)::----Ij-~-!~--__.x.l.Jsn'?__L r-:-___.______~.._______. .h_____.__._____,____-.._.__
U3JtlAL IJBlSCRIPTIONI LO'r(S)
-~-.._---_.-.-_._--
BfJOC!K
SlIBfJIVIS lOt!
PAROEll, In #
_.._.~----_._._------- :-
WORK PROPSl!ltJ I lJNI!lN C'ONS'l'RlJCTION
_._-_._-'"._--_.._------~---~--~----_._--------_._-_..__.-----.---------------
(OBTAIN F'ROM PROPERTY 'I'Al{ NO'I'H~EJ)
[laWN
PROtJOSElll lISElI ;f1sr]IJ FANILY DWELIJIHG
[J Cm1MElRc' lAI,
[J ADDITION ~ ALTERATION [J RBlPAIR IJ rNBTAYJI,
o MOVE 0 DEMOLISH
r-Jt1tJt,'1'I .. FAMIl,Y 0# UF UNITS IJ MosnBl II ot1 III
o lNDUS1'RIAT, [J SWIMMING POOL [J OTHER
o RB:STAUR1\NT & HI1lAI,nt DEPARTt1ENT APPROVAL
".aCRr P'I'IoN OF WORK ,~7& u <f'. ~ r: a.. 4, t:D 2.0010 ~ ,5:'-.,___.,."..,___.,._" ''''__"_,,,
aurWIN" sr.. _,,__ aQUARE Foono. ..1,24' ~~ ,~, HalON" c,_,_____
R.!llBWBlNTIArll AT'l'1\CH (2) PI,OT PI.ANS & (2) SElTS OF BUIIJDum PLANS & (1) 8ElT ElNI!lROY FORMa,
(20MMEIWIArJ I A'l'1iA(~H (J) SETS OF BUiLDING PLANS & (1) SET ENElRcN FORMS,
PROPHlRTY SURVEY REQUIRElD FOR ALL NEW CONSTRUCTIoN.
i.ERMITS REQUESTED
Cl BllILlJING
I~BlCTRlCAIJ
c:! '- r)<?
$__.___~t:)/). -"---..
2-_c:2L:) _---"-' At1P SElRVWEI
VALUATION OF TOTAL CONS'rRlJCTION
[J PI,tJt1BINr3
o '"EUfH\NWATJ
Et~-'FI,oRrnA POWER
o WoR.E,C!,
[] W\8
U ROOFING
,
$---..------- VALUATION OF t1ElCHANCIATJ INs'rAI,IJATTON
[J SPElrJrAUry
[) OTHER
'l'YPEl 01:1' CON8TRUC'l'ION I [J Bl,()(~K
o FRAME:
[) STEEL
[J OTHER
FINIBHElJ FI,OOR I1II,ElVATIONS
18 PRO,TECT IN FLOOD ZOHEI AREA [] YHlS
o [~O
,.
BttILOBlR
. .. ..
_.._--_.~......._.--.:.-_-~-----~-------------_._._-
COt1 l? ANY ___._______.__..______________..__.__.___._.____.____
STA'I'Bl CElRT OR REeHST # --_.__u________.___.._'-. ____
CITY PROCESS ING IL__.._.__.________________.________
SIGNATURE
~~******'~*******'*******~*****~*~****"*"************'********
./ /
BlI,RlClTRICIAN .,/. ..././~ 7 /.. ....../ . ...... Cm1PANY&.'L.~:...,1./!!~"I-k-:...S/~.. .!.-;L5.L~~~.___.--.-..-..-
!. ')/ j/ / / STA'I'El e'ERT OR REGIST # C<::'-':;")d~ 7 z...
a "!HATHR" .pik:::L/:,L,-L.f<~-==::::~~'::.. _-':C~~__ (, r Ty P RoC" a 8 I Nt! # ::i 9?f;:?' ~ ", u_,< < " _ u,
It" _____________.__.____...._.._.__.__..__..__
* * * * * * * I< * * * * * * * * * I< * * * *. * * * * * * * * * * * * I< I< * * * * , * * * * * * * , * , * , * * * * * * * * * ~ ~ * ,
prJtIMB IIR
.__.._---........~............_---.,~ -.
._--_._~--
C !Ol>l PANY---________~----_____..____.____________.._
STATE CERT OR REGIST # ____________.________._..
CITY PROCESSING #I
S lrJHA'l'l1RE
MBlCHANICAT.
****'*'*************"*'***"'**'**********'*'**"***'************
----_._-.~._--~--------_._-~_._------..~
~'----....-..._--_._.......~-_._-_._..__.,--
cotvJPANY _________.___._..______~_.__.. ._____.. ____
STATE ~ERT OR REGIeT #I
Cl'I'Y PROCESSING #
._----~.~.._.._--_..._._--_._---_."_._--.
S WNA'l'lJRBl
OTIIBlR
******'**************'*'**"'**"'~*'************'**"***********
---------------.--.--..----.----.-
---..:..-~-~--......c__________
CO,",1PANY
S'I'A'I'El CERTCiR REOIST #I
CITY PROCESSING #
S [rmATURE:
._--._---~-------, .......-.-
------..-------.---------
********~*******'*******************'*"'*'*'***'*'****.***~*****
---~.~..._.._-_._--~_._-~--..:..-.>_._._---~---_.
COI'lDI'rIONS OF PEFMIT AFJHDAVI'I
A. NO~ICE or DEED RESTRICTIONS
T.he: undersigned understands thqt this pt:;cmi t may be stlbJectco "deed restrictions" w
may be more restrictive than City n'9ulations. 'l'he und,arsigned assumes respolHlibili\-y _
compliance with any applicable deed .restJ:iction1:i.
B. UNI,lCENSED C;ONTRAC'l'ORS AND CON'l'.RACTOH HESPONSIBII,I'l'IES
If the owner lias hired a contractor or contractors to undertake work, they may be required
to bl:: licensed in accordance with f:ltate and local regulations. If the contractor is not
licensed as required by law, both the owner and contractor may be cited for a misdemeanor
violation under state law. If the owner or intended contractor are uncertain as to wllat
licensing requirements may apply for the intended work, they are advised to cantapt the
city of Zephyrhills Building Department, 813-788-6611 0
Furtherloore, it the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor SectionsH of this application for which they
will be responsible. If you, as ~Ie owner signs as the contractor, YQ4 are indicating that
you, rather than the contractor, are responsible for the work. If the contractor wislles
you to sign as contractor that may be an indication that he is not properly lioensed and is
tlot entitled to permitting privil~ges in the city of Zephyrhills.
c. 'l'RANSI?OR'l'ATION IMPAC'l' !fElES AND UTILITY CONNECTION !fEES
D. CONS'l'RUC'rUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
r certify that I, the applicant, have been provided with a copy of "Florida's Construction
11en Law - Homeowner's Protection GuideH prepared by the Florida Department of Agriculture
and Consumer Affairs. If the appliclilnt is sOlueone other that the "ownerH, 1 oerify that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the "ownerH prior to commencement.
E. CONTRACTOR' S/OWNElR' S AFFIDAVIT
I certify that all the information in this application is accurate and that all work will
be done in oompliance with all appli.cable laws regulating construction, zoning, and land
development.
Applioation is hereby made to obtain a permit to do work and installation as indicated. I
ce+tify that no Hork or installation has commenced prior to issuance of a permit and that
all work will be performed to meet standards of all laws regulating construotion, City
codes, zoning regulations, and land development regulations in the jurisdiction. J also
certify that I understand that th~ regulations of otller governmental agencies may apply to
the intended wor.k, and that it is my responsibility to identify what aotions I muat take to
be in compliance. Such agencies include but are not limited to I *Department ()f
Environmental RegulatiQn-Cypress Bayheads, Wetland Areas and Elnvironmentally Sens~tive
Lands, Water/Wastewater Treatment
*Soutllwest florida Water Management District-Wells, Cypress Bayheadsl Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Vepartment of Health & Rehabilitative Services, Environmental Health Unit-WeBs,
Wastewater Treatment, Septic Tanks
*U.S. Environmental Proteotion Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone qAH or "A,etc.H, it is
underatood that a drainage plan addressing a "compensating volume"'wiLl- be submitted whioh
1s prepared by a professional engineer registered in tlle State of Ilorida prior to pean!t
jssuance.
A permit issued ahall be construed to be a license to proceed with the work and not as
authority to violate, cancel, alter, or set aside any provisiona of the technical codea,
nor shall issuance of a permit prevent the Building Official from thereafter requiring a
cQl:j::ection of erron in plans, pon~t:t:uction1 or violi.':\t:ions of any oode. Every p~u;mit
ia~uc;ld shall beoome invalid unless the WOX:K authorized by such permit is oOllulIElnced within
six montlls of issuance, or if work authorized by the permit is suspended or abandoqed f~r a
period of six months after the time the work is commenced. One 90 day extension of time
~ay be allowed for the permit with fee charge of $15.00. The extension shall be ~equea~ed
in writing to the Building Official. An approved inspection must be logged during each alK
month period, or the project will be considered abandoned. .
WAm~ING TO OWNERI YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING 'rWICE }j'OR IMPROVEMEN'l'S TO YOUR PROPERTY. IF ":(OU INTEND TO OB'rAIN Ii'INANqIl~q, .c'4N~\.JL'r
WITH YOUR LENDER OR AN A'rTORNElY BEFORE RECORDING YOUR NOTICE O!f COMMENCEMEN'l'. Joas UNDER
q2,500 IN VALUE DO Norr NElEm '1'0 RECORD AND POST A "NOrnCE OF COMMENCEMENT".
SIGNA'I'UREI OWNER OR AGENT
SIGNA'l'URE I CONTRACTOR
acknowledged
,19_
STA'I'E OF FLORIDA
COUNTY OF
The foregoing instrument w~s
Before me this -----Pay of
by
S'l'A'rHl OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by
acknowledged
, 1~~_
(name of person acknowl~dged)
Owho is personally known to me, or
o who has produced
(type
and who[] did Odid not
(name of person acknowledged)
Gha is personally known to me, or
of identification)
take an oath.
Owho has produced
(type of identifiGation)
and Hho Odid [}Ud not t.ake an oilth
Signature of person taking aoknowledgment
Signature of person taking acknowledgement
Name typed, pdnted or stamped
Name typed, printed or stamped