HomeMy WebLinkAbout03-1801
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N!
1801
(813) 780-0020
Date
1,028"- tJ 3
BUilDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn f ;2 ? t
w.~, Conn '?!:
Water Meter: /~
T.I.F.'s: /, If. I tJtJ
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...-r'" em ''7 -
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::::~.:~' i1~~~ '(},I-(t
ParceII.D.' 3/-::25 .. ;l(, IJOIO .,.. 0 :lR-tPo - 0 'SOCJ
Zoning: Energy Code: Radon Gas:
H. It.
SJ 1- ~f
DescriDtion of Work
FINAL - C?3
_ DATE
C.O. ...~ ~ tv -- 0 '3
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
City license Registration #
State Certified license#
L-i~
Inspector
....~mit~ee ~ 8"/"" ~
C ----siQnatur~ I../<:~~
Company
Address
Telephone#
rf IIJV
Valuation or
Contract Price
--
nuti -f,( (1.e.2t!
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BUilDING
ELECTRICAL
PLUMBING
MECHANICAL
Ftr.
Pre SlB
lintel
FRM.
Insul. Cl
Wl
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final ./ "& -t- -c ~
SlB
Tub Set
Water
Sewer
Final L/ ;2 -&, -p 3
Breakers
Ducts Insl.
Compressor .
Final t/,2 -4- - () 3 j(t'l.
RL11-1-JJ() .r 1-/r.J()
,flYI t$ If r lJ
Driveway
fi~ 02-7- (j/ 3 (~~ ~
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 ~. 12M.'
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.
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,TOB S I'l'E ADlJRBl8S_~.G'_'C1 ~::--J7/t! J---~-19J:!..e._'-___"_______________.____.__q___
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DIllI?AR'I'MBlNT 5335 8th S'fRBlBl'f ZIllPHYRHII,LS, FL 33540
PhoneI81]-780-~020 Fa~1813-780-0021
DATE RIllOlilIVlllD -L:--2g::~3_ h
PI,AUS RlIlVIBlW I'IBI_'-_"___~"t!_____.
, .
PHONE CON'l'J\r~'I'
-"--~_.-..-~._._- -'-~-.'-'-' .----..---
!JElGAL D81SC!RIPTION: LOT(S)
B U)(! K
SUBIllV I S JON
--..--.---------
PARC1ErJ HI #
--.......-.------.. --....-..-.--.--
o ADDI'rImr
[J ALTERATION
------~---_.--._----_.-- ._-......_~-----_...-
(OBTAIN FROM PROPER'ry 'I'Al< NO'1'WE)
HrJRK PRnPBED I (]NIlJN c'ONSTRt1C!'I'ION
--_._-------'--~._----------'---
[J RElPIHR
[J INSTAl,},
[lsnm
o MOVE
[] DBlMOI,ISII
I?ROl-'081lJIl USE I LlSCHJ F1\MIIJY DWELrJIl%1
[h1tJUI'I.. FAI-UI,y
fJ# OF UN!'I'S
B MOB I f,El !tolilBl
U C0/1MI1IRC1JAT,
[J INDU81'RIAIJ
[JSWIMMING pour.)
/] OTHER
IlBlSCRIPTION OF WORK
CJ R~8TAURJUIT & HEAIlTlr DEPARTt.1ENT APPROVAL
M. (I"
s-d
~----~._------- ------'-.------------.-----..--- -------- .-.----
SQUARE FOOTAGE ______~ HEIGH'r ...____..________
8t1U,fJIN(~ SIZE
--.----.---
RESIDENTIAl'1
(~OMMER(nAr, :
A'I"rJ\Cm (:2) I?I,OT PIJIUlS & (2) SETS OF BUIJ,DING PI,ANS & (1) SEl'r ENERGY FORMS,
A'I"I;1\T'H (.3) SE'rs OF BUIIJDING PLANS & (1) BE'r BlNElFWY FORMS,
PRCl!?B1RTY SURVEY RElQUIRElD FOR ALL NEW CONSTRUCTION.
FERMITS REQUESTED
tJ 811IJ,IJIN<~
$ -------
VALUATION OF TOTAL CONSTRUCTION
L1 ElLBlC'I'RWAr,
_._---...-'"'""----~
At-1P SERVICE!
[]
FI,ORInA POWER
[)
W.R,E,C),
[] Pl,tJtilBING
o IIJEUHANIl!ATJ
$--.---.-
- VALUATION OF tlJECHANCIAI, INS'I'ALIJATTON
[] (JAS
f.] ROOFING
fJ SPECJtAUry
[I O'I'HElR
'l'YPHl OF CONS'I'RUUTION I [J Bl,()CK
o FRAMEJ
[J S'I'ElElIJ
[J OTHER
FIN ISHEI) FLUOR EIJElVATIONS
_.-----~-
IS PROLTBlC'I' IN noon ZONEl AREA 0 YHlS
o NO
BUILOlllR um1PANY
...t/..A-/? STATE CElRT OR REGIS'l' # ____.______._______._~.'_'--___
· t GHATIJRO .h/ ~_________ C,I'fY PROCO..ING 1L_..fj..&'-__~._...___.._._._
******************************************************************
liIf,JlOTRICIAU
SJGlrA'l'IJRE -----.-w--~~n---_-_-__--
cor1PANY A<:.... <--
_..-L...~____..__.___.,____~_ _._____._.__...._________. __'__
STATE e'ERT OR REGIST <<
CITY PROCESSING #/-0/7---------------------
------I---ff.--____. _.__._.__._ ..._....____..____"---_
* * * * * * * * * * * * *. * * * * * * * * * * * * * * * * * * * * * >I- * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
(!Of>l PANY ---.L!~!..d---._____________.___________
~ STATE CERl' OR REGIST # _ ____~_~____._______..
· I<lHA'1'1JRO -._Jd..~..=L!::.~ ._-=.._ r!I'l'Y PROCO.. ING # --.y1?_____._~___ .___
PJ,t1MBBlR
******************************************************************
MBlCHA1U CAr, cotv! P ANY ~t:;- ~ ___ . ____._________ ____. u________
STATE ~ERT OR REGIST #
.WNAT".. ~ W ~~___ CI1'Y PRO"O..ING #_J5=':'~-=='~~..=~~==
**************************************~**************************
OTIIBllt
..._----------,"----
----------..
(~m.1PANY
STATE] C'BlRT OR Ri~#-------------------
CI'rY PROCESSING # --________.____________.
S WNA'l'tJREl
*****************************************************************
------.__-+-o..-..__..___.____~._______.____....__ .____.
CONDITIONS OF PERMIT AFFIDAVIT
A. -NO'rICE OF DEED RES'l'RIC'UONS
The undersigned understands th4t this p~rmit may be subject ~o "deed restriotionsH which
ma~ be more ;Le/iltl'iati va than City regulations. 'l'h.= und'=rsigned assumes responsibili ty_ for
oomplianoe with any applicable deeclrestrictions.
B. UNLICENSED (~ONTRAC'l'ORS AND CON1'RACTOR RESPONSIBII,I'l'IES
If the owner has hired a contractor or contractors to undertake work, they may be required
to Ptl IJc:enaed in accordance with state and local regltlations. If the contractor is not
licensed as required by law, both the ol-mer and contractor may be cited for a miademeanor
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 contact the
City of Zephyrhills Building Department, 813-788-6611.
Furthermol'e, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor SectionsN of this application for whicll they
v/111 be responsible. If you, as the owner signs as the contractor, YQI,\ are i.ndicating that
you, lather than the contractor, are responsible for the work. If the contractor l"lishes
you to sign as contractor that may be an indication that he is not properly licensed and is
not entitled to permitting privileges in the City of Zephyrhi.lls.
C. 'l'RANSI?OR'l'ATION IMPACT !fEES AND UTILITY CONNECTION !fEES
D. CONS'l'RlJC'l'UION LIEN LAv~ (CHAl?'I'ER 713, FLORIDA STATUTES, AS AMENDED)
T certify that I, the applioant, have been provided with a copy of "!flori.da's Construction
lien Law - Homeowner's l?rotection GuideN prepared by the E'lorida Depar'tment of Agriculture
and Consumer Affairs. If the appli.clilnt is someone other thlilt the "ownerN, I aerify that I
have obtained a copy of the above described document and promise in good fai.th to deliver
i.t to the "owner" prior to commencement.
E. CON'rRAC'rOR' a/OWNER'S AFFIDAVI'r
I certify that all the information in this application is accurate and that all work will
be done in compliance with all appli.cable laws regulating constnlCtion, zoning, and land
devl\fllopment.
Applioation is hereby made to obtai.n 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 regulati.ng construotion, City
codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other governmental agencies may apply to
the intended work, and that it is my responsibility to identify what aotions I must take to
be in compliance. Such agencies include but are not limited tal *Department of
~nvironmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sens~tive
Lands, Water/Wastewater Treatment
*Southwest florida Water Management District-Wells,Cypress Bayheadsi Wetland Areas,
Altering Watercourses
'Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Depu:tment 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.H, it is
undel:stood that a dralnage plan addressing a "coh.;'snsating volume"'will. be aubrnitted whioh
is prepared by a professional engineer registered in the State of rlorida 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 technioal codea,
nor allall i.ssuance of a permit prevent the Buildi.ng Official from thereafter requiring a
cor~ection of errors in plans, oon~truction! or violations of any oode. Every p~rmit
issued shall beoome invalid unless the work authorh:ed by .such permit is oOllullenced within
six months of issuance, or if \'lOrk authori.zed by the permlt 1s suspended or abandoqed f~.r a
period of six months after the time the work is commenced. One 90 day extension of t1111e
may be allowed for the permit with fee charge of $15.00. The extension shall be requea~ed
in writing to the Building Official. An approved inspection muat be logged during each six
month periOd, or the project will be considered abandoned. .
WARNING TO OWNIilRI YOUR FAILURE '1'0 RECORD A NO'nCE Of COMMENCEMENT MAY REaUL'!' IN YOUR
PAYING 'I'WICE !fOR IMl?ROVEMEN'l'S TO YOUR l?ROPERTY. IF 'iOU INTEND TO OB'rAIN FU-lANGINq,{::9N~UL'I'
WI'l'H YOUR LENDER OR AN A'I"rORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'l'. JOBS UNDER
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOnCE OF COMMENCEMEN'l"'.
SIGNA'l'URE: OWNER OR AGENT
SIGNA'IIURE: CONTRACTOR
ackno~'iledged
, 1!L-
STA'l'E OF !fLORIDA
COUNTY OF
The foregolng instrument w~s
Before me this ---Fay of
by
STA'rE Q!f FLORIDA
COUNTY OF
The foregoing instrument was
Before llIe this __ day of
by
aoknowledged
I IS ~
(name of person acknowledged)
Dwho is personally known to me, or
(name of person acknowledged)
C1ho is per.sonally known to me, or
o who haj:l produced
(type
and who[] did Odid not
of identification)
take an oath.
Signature of person taking acknowledgement
Signature of person taking aoknowledgment
H-~-l~t-~;p-ed~ printed ~-~tamped
~----,_._,._.-........_~,---_._-
Name typed, printed or stamped
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PASCO COUNTY, FLORIDA
---- ~. --,.........0..-.....
..... --------
---
. .
Pennlt No. f 80 I
Date Perrnllted-~, c 3
Builder Name/Owner Name -0-Jlu.-V1~ )~-fJR I Z0N Control #
County PBrcel No, 3~~..;l.s:_;!._~_/)o I 0 - D;l,"'. J. TI S () SubD Iv: G'.'<"'l:!. .,JL_pt", .... i o...s
AlidressfLncallon _32(eL'i-~1PY'-',,---/ll/ e '___ _._~
Classlflcallunllype of Use -LI1~ /)( 1~~M_e. _ ._____
TRANSPORTATION IMPACT FEE
Rate: _________ Sq Ft Unit:
Exempt [] Yes ~ No How Determined _____
. ~..o
Impact Fee Amount $ Il./ 0 O. Zone No. TAZ:
-----f'U::..g::~"___ --:-,==:
SCHOOL IMPACT FEE
Account (066) Single-Family Detached House
(057) Mobile Home
(058) Other Residential
J-11~3) Collection Fee
Exelllpt ~Yes 0 No Haw DBtermlned ____________
----.-----
-------------.---.---
Amount
$
----.---.-----....,....-~_..'n..__.~__
_._-_._._---_._----_.._...~-_....-
PA"Rl<a AND RECREATION FEE
Land Account Land Credit Land Total
----------.-----. -----
Recreation Account
-----..--------.--.-----
-----------...-
Recreation Credit
Zune
----------. ----
Recreation Total
._--_.._--~.-._-_.
TOTAL AMOUNT ..1_______~__
Exempt [) Yes [J Nu
How Determined
ITBRAAYFEE-"---------
Lalld Account Land Credit
'.~-----_._~----------_._-
.-..------
---------------
Land Total
.-- --'-.-.--..--. - ---------~.
Facility Account ___________ Facility Credit ________ Facility Total ._________
_._~----_..-._---._---
Exempt [] Yes [] No
How Determined Total Amount
--._~- -----
mffi.J1lCE FEE" --- ERU
TOTAL AMoUNT ~1(f?0- --lfL . . . -&.~~'0
-.-----------,,--_d--0-~~~ :.R(-t_ -2.:5f
Prepared By ____. _ _ _______.________________ CheGI{e~~=___________ .
NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN PAID AND
RECEIPTeD FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY
Aclmowledgemel1t below does not Imply acceptance of concurrence, but simply receipt of a copy of this forlll. placing
the building permit owner on notice of this assessment and the conditions of payment for same.
DA TE-----------------------
RECEIPT NO. DATE BY
RECEIVED ay-----------
------ -.-------.-
.-.-_.-._------~