HomeMy WebLinkAbout03-1802
1802
BUILDING
(813) 780-0020
fV ~5
ELECTRICAL PLUMBING
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Date
I/D
MECHANICAL
Sewer Conn I" tl/}'{ -
Water Conn: '~3"O
Wet" Mete" /g ~j) -
T_I.F.'s: ___ __
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Zoning:
DescriDtion of Work
. Energy ~~ Radon Gas:
~ ~JL-6-:rv
NO OCCUPANCY BEFORE C.O.
FINAL
C.O. d- /
-P3
DATE 3
-~ t7
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
DATE
Ll(cfl(~
City License Registration #
State Certified License#
/f>1
c-~.~~it~- t~~
",--Signature -~t../I
Company
Address
Telephone#
Valuation or
Contract Price
~7771:&J
'- - BUILDI G
a~u .-
ELECTRICAL /~ /f
I~~..;/..!
PLUM G
{2,-e -
MECHANICAL ~
Breakers
Ducts Insl.
Compressor
Final ~
SLB
Tub Set
Water
Sewer /
Final ,/'
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final /../tfl." 1'-1-0 3
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
RIA.(
Driveway
AD c2- / L( -0.3 !f:3 S /lfi; 1/
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 "'D -<J. 12P~,,::zs I",~jJ
b. Condemned work resulting from faulty construction. ^-e
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
BUILDING DIllI?AR'1'MElN'f 5335 8th S'rRElEl'f ZElPHYRHILIJS, FL 33El40.
PhoneI813-780-0,020 Fa~1813-780"002l. .. . .~.
nA'rEl RBO!llIVl!lD J.::,:L.~J:::j) ~
PI,ANS RlIlVIElW 1'~'-_'-___.tL_______
UNNElR 'S HA/l1El____(r'A ~~!_ f{o{l.j ~u:.."!.______________________________ PHONE C()N'l'A(~'~_____________"__________
,108 S I'l'El ADDRI!ISs_!-:-:T.1F_Lu_ _______ ________________~_____________ _______________ _____
IJBlClAL !)81SURTP'rWl1, LOT(S)
BfJOCK
SUBTJIVI8JON
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PARC1ElI, Hl #
..-._----_._--_.._--~'----------~--_..__._-_._-----~----~----.-..... +._---+-~---~--~.-.....
(OBTAIN F'ROM PROPElP.TY 'I'AK NO'l'Wm)
WORl< PROPSElIJ t LJNBlN r.'ONS'rRlJCTION
[) s rem
o ADD IT ION [J Af/I'ElRA T ION [) RBlPAIR LJ TN8TATJI,
[J MOVE 0 DElliJOI.ISH
[] ~1tJt,'l'I - FAt"! I f,Y [1# OF UlnTS ~,FJ HnliJJll
[J INDUS1'RIAfJ [J SW IMMING POUL lJOTHHlR
PROPOSEIl tJSElI [JSC_H, FAMIIJY DWELrJIl1t~
[] CCHiJMI!lRC.! rAT,
11El8CRIP'I'ION OF NORK
o RIllSTAURANT & HElAIJTII DElPAR'l'r1I!lN'I' APPROVAL
-eLJL______________
~-_. .._-~_......_-_.~_.- ._---------,~.-.. _.-..__.~--- ..........- ._-
BlJH,nINc, SIZEl
.--.....-.--.------
SQUAREl FOO'I'AlJEl
HElIGH'r
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RBlBIDElNTIAIJ I
COJ'.1MElRC!I J\TJ I
A'r'rACH (2) Pl,OT PLAllS & (2) SElTS OF BtJII,lHNG PT,ANS & (1) SElT ElNI!IROY FORMS,
A'riliAC~H (3) SE'l'S OF BUtI,IJING PLANS & (l.) SElT ElNER<3Y FORMS.
PROPElRTY SURVEY RElQUIRElD FOR ALL NEW CONSTRUCTION.
FERMITS REQUESTED
(] BlI ILIJI NC~
$------_____---' VALUATION OF TOTAl, CONSTRUCTION
L1 ElLBlC'I'R WAr.
-----___---'--- AttlP ~ElRVH~El
o FIDRIDA POWElR
o W.R.E.n,
rJ PI.tJMBING
o ItlBJUHANIl!Ar,
,
$---.------ VALUATION OF ~t1BJCHANCI1H, urSTAI,l,ATTON
[] (jAS
f] ROOFING
[] SJ?ElC1IAI/I'Y
[1 OTHER
'l"lPEl OF CON8'I'RtJC'l'ION: [J BLOCK
[J FRAME!
[] STEEL
[) OTHER
F IN I SHEll FI.OOR I1lTJEVJI,T IONS
~
IS PRO,TElCT IN FLOOD ZONEI AREA 0 Y'!!lS 0 No
padul1qs J"O P;qI1T.:xd 'pedl\::J- elU1:1N
pedunqs .:xo p;;qupn 'pe~_li=l ;;1U~~J~
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CONDI'rIONS OF PERl>1l'I' AFFIDAVIT
A.~ NO'flCE OF DEED RES'l'RIC'l'IONS
~The undersigned understands th~t thia permit may be subject to "deed restriotionsU which
may be more l.e.;lt:dotive than City regulations. The undersigned assumes responsibility for
oomplianoe with any applicable deed rel:ltrictions.
B. UNI.JICENSED \:;ON'I'RAC'I'ORS AND CONTRACTOR RESPONSIBII,I'l'IES
If the owner has Ilired a contractor or contractors to undertake work, they may be required
to b~ licensed in accordance with state and local regulations. If the contractor is not
lioensed as required by law, both the Oymer and contraotor 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 oQntapt the
City of Zephyrhilh Building Department, 813-768-6611.
Furtherulol:e, if the owner has hired a contractor or contractors, he is advised to have the
oontractor(s) sign portions of the "Contractor SectionsU of this application for which they
will be responsible. If you, as the owner signs as the contracto~1 YQ4 are indicating that
you, i-ather than the contractor, are responsible for the work. I f the contractor wishes
you to sign as cOlltractor that may be an indication that he is not properly licensed and is
not entitled to permitting privil~ges in the City of Zephyrhills.
c. 'I'RANSI?OR'rATION IMPACT f~ES AND UTILITY CONNECTION fEES
D. CONS'fRUC'rUION LIEN LAW (CHAPTER '713, FLORIDA STATUTES, AS AMENDED)
J certify that I, the applicant, have been provided with a copy of "Florida's Construction
lien Law - Homeowner's Protection Guideu prepared by the Florida Department of Agriculture
and consumer Affairs. If the applicant is someone other that: the "owner", I cerify that I
have obtai.ned a copy of the above described document and promise in good faith to deliver
it to the "owner" prior to conunencement.
E. CON'I'RACTOR' S/OWNER' S AFFIDAVI'r
I certify that all the information in this application i.s accurate and that all work will
be done in oompliance with all applicable laws regulating construotiQn, zoning, and land
devl?lopment.
Application is hereby made tQ obtain a permit to dQ work and installation as indioatlild. I
ce-r;tify that no ywrk or installation has cOlTUj1enced 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 the regulations of other governmental agenoies Inay apply to
the intended wor'k, and that it is my responsibility to identify what actions I must take to
Le in compliance. Such agencies include but are not limited to: *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sens~tive
Lands, Water/Wastewater 'rreatment
*Southwest Florida Water Management District-Wells, Cypress Bayheadsl Wetland Areas,
Altering Wateroourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Depar-tment of Health I< Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U. S. Environmel1tal I?roteetlon 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"'wLU be submitted which
is prepared by a professional engineer registered in the State of Florida pdor to permit
issuance.
A permit issued shall be construed tQ be a license to proceed with the work and not as
authority to violate, cancel, alter, or set aside any provisions of the technioal codes,
nor shall issuance of a permit prevent the Building Of{icial from thereafter requiring a
correction of errors in plans, con~truotioq! Qr vio~ations of any code. Every p~rmit
is~ued ahall beoome invalid unless the work. authorized by such permit is oOlllrnencedwithin
SiK months of issuance, or if work authorized by the permit is suspended or abandoqed for a
period of sLx months after the time the work is conunenced. One 90 day extension Qf time
may be allowed for the permit with fee charge of $15.00. The extension shall be ~eque~~ed
i n ~yri ting to the Buildlng Official. An approved inspection must be logged during each fiix
month periQd, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NO'rICE OF COMMENCEMENT MAY RESUI/!' IN YOUR
I?AYING 'rWICIE FOR IMI?ROVEMEN'l'S TO YOUR PROI?ERTY. IF YOU INTEND TO OB'rAIN It'INANqU'iq, ~'JN\\UL'l'
WITH YOUR LENDER OR ~i ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
$2,500 IN VALUE DO NOT NJ!;ED TO RECORD AND POS'l' A "No'nCE OF COMMENCEMEN'l"'.
SIGNA'l'URIE; CONTRACTOR
SIGNA'l'URE: OWNER OR AGENT
S'J'A'J'E OF IfLORIDA
COUNTY OF
STA'l'E OF FLORIDA
COUNTY OF
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PASCO COUNTY, FLORIDA
--____6
---......,-
Permit No. ---L2t2.&.
Date Permitted .L::.a2..%.-D --~
Builder Nama/Ownar Name ~042L (/~pt< ._ Control # ___:-;___ ,
Coullty Parcel No. .:11'.<:2~/__-:J2e!i2 - O';::>,!'OL2 - ,Lz:tn. SubDlv: ~~""-_ QV~l';,<,
Ad(lrass/locallond1~ ..!;tJ~ L {",.. "- ____-'-
, CIBsslflGatlonlType or Usa ~~C7/-... ____~.___~
TRANSPORTATION IMPACT FEE Rate: _____._. Sq Ft Unit: ____.__
Exempt [] Ves (Rf No How DatermlnBd __._______.__.._._______.__.____
Impact Fee Amount _.$___ !!./ %0-___ Zone No. TAZ: _.______
'--i'~'- () .3
-----.- ..._~ -' -L _.,...-. ... III __ _. _.._..~._
SCHOOL IMPACT FEE
Account (056) Slngle.-Famlly Detached House
(057) Mobile Home
(068) Other Residential
\?1~3) Collection Fee
Exempt ~es (J No How Determined
Amollnt
$
--.--------..-----
PARi<SANDRECREATION FEE--
Land Account Land Credit
-._---------....__.~-
--.----.---.---
Land Total
Recreation Account
-----_.~.-
._~_._-_.~-
Recreation Credit
----.-.
Recreation Total
Zone
._--.,_._~.._-._----
TOTAL AMOUNT .-L___
Exelnpt [I Yes [J No
liSRAAY F~E------.-
l!and Account
How Determined
---_._-_._---------_._.__...__._._--~-~_.__._--_.
-....----
..----
.. ---.-.---------.-- -'-_._-----~-.
Land Credit
_..~._-_._._-_._.-
L.and Total
Facility Account _____________ Facility Credit __
_._~-_._.._-..._-~----_.------
Facility Total _____
Exempt [J Yes 0 No
How Determined
._-~- -------
Total Amount
~t~~~I~~I~~~ -~ -:; &7;> -. ERL,==__~___
-------------------.:21 ,~.-/3~-()"3 ..,., ;~9q-3.
;,~P:::~---.--'-~ "d(.v(~ , _ _ f
----.--._----------~ -------..---------
NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN PAID AND
REGEIPTeU FOR BY A CENTRAL PERMITTING OFFicE OF PASCO COUNTY
Acknowledgemellt below does not Imply acceptance of concurrence, but simply receipt of a copy of this form, placing
tile building permit owner on notice of this assessment and the conditions of payment for same.
DATE----.-----------
RECEIPT NO. DATE
RECEIVED BY
---.-- ---..-----
BY
_._-----_.__.--~_._----