HomeMy WebLinkAbout03-1808
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N~
1808
(813) 780-0020
Date
1~029-tfJ3
MECHANICAL
Sewer Conn
Water Conn:
BUILDING ELECTRICAL PLUMBING
P<aperty Owne" b Dh ). a""'(F
Job Address: ..5'~ n (; I 7 +-f..\ S ( .
Parcel I. D. II
Water Meter:
T_I.F.'s:
Zoning:
DescriDtion of Work
__ Ener~y C~~
~"'\ <::.T""
I\Q,v)
Radon Gas: .
S o~JJ..,.I{ I ( nQ
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
-D3
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Valuation or
Contract Price
City license Registration #
State Certified license#
c2c;vV
DATE
Inspector
Ikr~
~I ~
Permit Fee .
,lCSignature .J.I. ~ /~ 4
Company
Address
).&relephone# 1 Cf/ -11 (Po
J
Ftr.
Pre SlB
lintel
Tp. Servo
Rough In
Meter Can
Const. P
Pool
Pre-
Fin
4ft /f;~f'/v/~~.
PLUMBING
SlB
Tub Set
W~M ~
Sewer ,/ .:1-ij-03 ~
Final i/ .r (,)
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.
-,
OWNBR' B "'''> __ 6~ __ .La J2:j-~;:---. .__ . _________ __. _____
lJOB SITE! ADDREl88 _ ~ 1z 0 re__ __ -L~_-t:. ___?>!_...:..________ ____ ______
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DIllI?AR'I'MElNT 5335 8th STREET ZIllPHYRHILLS, rL 33S4~
PhoneI813-780-~020 Fa~1813-780~0021 ....
DATI RBOlllIVlllD ~__":_i~ .c.':",,,,_, _._____
PI,AUS RlIlVIllIW I'Jjf.-'-'-'L~"tJ_______.
PHONE! C()N'l'A(~'!'_'J_~;J_=!Zjl_L
LElCJAL D81SCRIPTION: LOT(S)
--.------...--------..-- ------..-....--,.--
~-.._~._.- --.'-..----
BrJOC!K
PAROElIJ In #
-----.--.-.-
SUBIllV IS loti
------------ ..----....--...-
M.~._____.________.___
------------_..---_._.._--~.__..._------_._---".._....,. ..--..... -----.---.----. .......
(OBTAIN FROM PROPElR1'Y 'I'1\l{ NO'I'rc~m)
HURK PROPSBllJ I [JNIllN C!ONS'rRUCTION
[J ADDITION
(J AI/I'ElRA'1' I ON
[J REPAIR
I3-1NSTAIJII
C] 8 IaN
[J MOVE
o DEWJI,rSH
I?R<WOSFJ!l USE I [JSCilI, FAMIIJY nWElLIlING
[J~1tJ!,'l' r.. FAl-1n,y
[J # CJ F tJN l'I'S
fJswnilMING POUL
lJ MOB!I,El 1ID/11ll
[J OTHER
[j C0/1MElRC! IA I,
[J INDUS1'RIATJ
11BlSCRIPTION OF WORK
CJ RBJ8TAURANT & HIilAI,Tlr DEJPAR'll1ENT APPROVAL
__/17:5-/-4 !L--'l-~---se{d2~ /1 O::L___-----'-.___
BUILTHN(J SIZE!
.----.---
SQUAREl Foo'rAGE
.----.___._4___.."........._."....__._.. .....____
RB:BIllENTIJ\I,t
(~OMMElR(!IAr, :
A'l"l'J\(m (2) PI,O'r PIlAUS & (2) SETS OF BUIT,DIN() PLANS & (1) BEl'l' ElNE1RrJY FORMS,
A'l"rA(~H (3) SETS OF BUtLDING PLANS & (1) SElT E1NER(~Y FORMS.
PROPERTY SURVEY RElQUIRED rOR ALL NEW CONSTRUCTI(H~.
HEJIC1HT
..;--_r_.._____
[1 BlIILIJINC~
FERMITS REQUESTED
$ --.---
VALUATION OF TOTAlJ CONS'rRlJCTION'
L1 ELBlCTRleAr,
[] Pl.t1tilBINr:3
o 11EC!HAN I<.!ATJ
-'---_....._---~
AMP SElRVICEJ
o
FUJRIDA POWElR
D
W.R,E.n.
$____-.'
-- VALUATION OF ~1EJCHANCIAI, INSTAIIIJATTON
f] (JAS
f.] ROOFING
[J Sl?ECHAUry
o OTHER
'l'YPBJ OF CON8'I'RtJU'r!DN I [] BLOC!K
o FRAME
[J STEElIJ
[) OTHER
F IN I SHElll FLOOR l!lllEJVMIOHS
18 PRO,JEc'r IN FLOOD ZONEl AREJA [1 YES
o No
~
Bt1nfJIllR
mJ,JIlOTRICIAN
******************************************************************
COr1 PAN Y ___._._ ___________..___ ______.._.. .____..._____ ..___ ___________ __
STATE CElRT OR REl(3IST # __on. ________________-'-._______
CITY I?ROCElSS nm L.._________________.___ ____________
81GNATUREl
. -
-~_._'-'-."""--~-_.._-----_..-.--_._._--
S] GllA'I'IJREJ ___.
..-----.-. ~-_._-------'-_.._.__.._-,.__._----~-
CCJr-1PANY _.__.________ ______________________ '__..._..
STATE CElRT OR REnTS'!' It
CITY PROCESSING #
.---- "--'. ~-..._-....- .-.--- -.--.- --..---- _.. ...-
PI,t1MSBlR
SWNA'l'tJRBl .._~~'^-
*******'************************************'***************'*****
---------..__.___. b.,"__. _.. _..._._ ~., ._ ___. __.. _'_.-....__._
----.---- -.---.------------.-----------
(!O"II?ANY -.tiS.51LCLU~ PL~i~tLJ_--k_C_~_______".
STATEl CElRT OR REJ(3IST # _~ 9-t:Ii.~__._____h_"___...
CIl'Y PROCElSSING #
MllICHANICAl.
****'*"'***"*'***'*******'**********"***'********'*************
COlvJPANY ______________._____._______________.____
STATEl CBlRT OR RElGrST #
Cll'Y PROCElSSIN(3 #
--..----..----.-.-.---..---.--------.--
S WNATtJIUil
......._--~-_._-_._---_._---_..__._-
O'I'lImR
'A****'******,***,******,****,***,,**,**,************************
-_.~-_._-----_.__.~..,------
~~--....~
-----
C!m.1PANY
STAl'E CmRT OR REGIST #
CITY PROCESSING #
S IrmA'i'tlRE
-----.----.--.
------.---.------ _._~.. '....... ,---
******'****************************'*****'*******'*********~*****
_._-----_.._--_....-...._~--- -- ~
---~-----'--._-_.._-_.--------.._.-._. '---.. ---.- _._-
CONDI'rIONS OF PERMI'f AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands th~t this p~rmit may be subject to "deed restriationsH which
may be mbre :restd cti va than City regulations. '1'he undersigned assumes responsibility for
complianoe with any applicable deed restrictions.
B. UNIJICElNSElD. \:;ON'l'RAC'l'ORS AND CONTRACTOR RESPONSIBILI'I'IES
I f the m-wer has hired a contractor or contractors to undertake work, they may be required
to be lJcensed in aacordance with state and local regulations. If the contraator is Ilot
licensed as required by law, both the ovmer and contractor IlIay be cited for a misdemeanor
violation under state law. If the owner or intended contractor are uncertain as to V~lat
licensing requirements lUay apply for the intended wo.t:k, they are advised to contact the
city of Zephyrhills Building Department, 813-788-6611.
Furthe.l:Inol:e, if the owner has hired a contractor or oontractors, he is adviaed to hClVlil the
contractor(s) sign portions of the "Contractor SeotionsH of this application for which they
will be responsible. If you, as the owner signs as the contractor, YQ4 are indicating that
you, l-ather than the contractor, are responsible for the work. If the contraotor wishes
you to sign as COlltractor that may be an indication that he is not properly licenaed and is
not entitled to permitting privileges in the City of Zephyrhi.lls.
C. 'l'RANSPOR'l'A'rION IMPACT FE;ES AND UTILITY CONNECTION FEES
D. CONS'l'RllCTUION LIEN LAW (CHAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
I oertify that 1, the applioant, have been provided with a copy of "Florida's Construction
lien Law - Homeowner's Protection Guide" prepared by the Florida Depa:r.tment of Agriculture
and Consumer Affairs. If the applicant is someone other that the "ownerH, I carity that I
have obtained a oopy of the above described document and promise in good faith to deliver
it to the "ownerH prior to conunencement.
E. CONTRAC'l'OR' a/OWNER' 8 AFlfIDAVI'r
I certify that all the information in this application is accurate and that all work will
be done in compliance with all appU.cable laws regulating construction, zoning, and land
development.
Application is hereby made to obtain a permit to do work and installation as indicated. I
ceftify that no Hark or installation has commenced prior to issuance of a permit and that
all work vlill be performed to meet standards of all laws regulatlng construotion, City
codes, zoning regulations, and lalld development regulations in the jurisdiction. I also
certify that I understand that th@ regulations of other governmental agencies may apply to
the intended wo:rk, and that it is my responsibility to identify what actions I must: take to
be in compliance. Such agencies include but are not limited tOI *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sens~tive
Lands, Water/Wastewater Treatment
*Bouthwest Florida Water Management District-Wells, Cypress Bayheads) Wetland Areas,
Altering Watercourses
*Anny Corps of Engineers-SeawallS, Docks, Navigable Waterways
*Department of Health &. Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U. S. Enviromnelltal I?rotection Agency-Asbestos abatement
I also certify that, if fill material is to be used in flood Zone ~AH or ~A,etc.H, it is
understood that a drainage plan addressing a "compensating volume"'will be submitted whioh
is prepared by a professional engine~r registered in the State of Florida prior to pennit
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 tllereafter requiring a
cor~ection of errors in plans, construotion, or violations of any oode. Every p.,mit
is~ued shall beoome invalid urlless the work authorized by such permit is cOllunenced within
six montlls of issuance, or if work authorized by the permit is suspended or abandoij~d f~r a
period of eLK months after the time the work is conunenced. One 90 day extension of time
may be allowed for the permit with fee charge of $15,00. The extension shall be requ@a~ed
ill \'1riting to the Building Official. An approved inspection must be logged during each SiK
month period, or the project will be considered abandoned.
WARNING TO OWNI!lRI YOUR B'AILlJRE TO RECORD A NO'rICE Of COMMENCEMENT MAY RESlJW' IN YOUR
PAYING TWICE FOR IMI?ROVEMEN'l'S TO YOUR I?ROPER'fY. IE' YOU INTEND TO OB'l'AIN FINANqINq. _~qNiuL'r
WI'l'H YOUR LENDER OR AN A'l"rORNEY BEFORE RECORDING YOUR NonCE OF COMMENCEMEWl'. ,JOBS UNDER
$2,50D IN VALUE no NO'l' NEED TO RECORD AND POST A "NOrrICE Of COMMENCEMENT".
S1GNA'l'UREI OWNER OR AGENT
SIGNA'I'URE: CONTRACTOR
acknowledged
,19_
STA'l'E OF FLORIDA
COUNTY OF
The foregoing instrument w~s
Before me this ~ay of
by
s'rATfJ OF H'LORIDA
COUNTY OF
'J'he foregoing instrument was
Before me this _ day of
by
aoknowledged
, 1 9 ......:._
(name of person aokno"l~dged)
Dwho is personally known to me, or
o Hho haa produced
(type
and whot] did Ddid not
of identification)
take an oath.
(name of person acknowledged)
Qho is pf;lrsonally kno~m to me, or
Owho has produced
(type of identifigation)
and Vlho Ddid DUd not t.ake an oath
Signature of person taking acknowledgement
Signature of person taking acknow~edgll\ent
--~._------._,------------.
Name t:yped, printed or. stamped
Hame typed, printed or stamped