HomeMy WebLinkAbout03-1810
BUILDING PERMIT
Permit N~
CITY OF ZEPHYRHILLS
(813) 780-0020
1810
Date
1'~O-CJ3
60
BUilDING
Vo
ELECTRICAL
-a
PlU~G
3~
MECHANICAL
Sewer Conn
Water Conn:
Property Owner: ~ ~
Job Address: j.AJ + y.? L(
Parcel I. D. #
11tt~
/ll'i~sr-~ &.
,
Water Meter:
T.I.F.'s:
Zoning:
DescriDtion of Work
Anergy Code:
~ ~d,J'
.
Radon Gas:
~~f
FINAL
,(j.J
DATE
NO OCCUPANCY BEFORE C.O.
Complete Plans. Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
DATE
J(L d IIfa
Permit Fee /7.5". 6-'\)
;><:5ignature tJ- '-'J--lY ~ >>
Company
Address
).1elephone#
Valuation or
Contract Price
City license Registration # Vrr-
State Certified license#
~/1/.PV J'{ dtls-
~~ (.::(ec.
/5u If -e-1<' h ..e,/ds
Au-
BUilDING
ELECTRICAL
PLUMBING
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final /;; -5-- C' .3
SlB
Tub Set
Water
Sewer
Final ./' d -.5--03 ,RlY
, rJ !/eJ c>
1: L ~ "I-I/fo
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final /' t9 -:5- 0 3
Ftr.
Pre SlB
lintel
FRM.
Insul. Cl
Wl
1(lLf
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.
CITY OF
ZEPHYRHILLS
IINOTICE"
OF ADD.ITION OR CORRECTION
BUILDING
DEPARTMENT
DO NOT REMOVE
I ADDRESS ,1, 'rTE. PERMIT .",
L,* IL~err-t(o! fo,'~e 2{s/OJ (?lID
THIS JOB HAS NOT BEEN COMPLETED. T~e following additiqns or corrections shall be made before the job
will be accepted.
,
-* A \\ f. riJ f e.r4y . ''''''c'r keF 5 <: t", U b<< e.~ fose ./ q J + ;."<1 e
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be
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It is unlawful for any Carpenter, Contractor, Builder, or other persons, to
cover or cause to be covered, any part of the wor1< with flooring, lath, earth
or other material, until the proper inspector has had ample time to approve
the installation.
AFTER CORRECTIONS ARE MADE CALL
780-0020 FOR RE-INSPECTION
INSPECTOR ~ /- ~
OFFICE HOURS 7;30 AM - 5 PM MON.-FRI.
IJBlfJAL IJ81SURlP'rIOl1t LOT(S)
UI'lNEJR I S l1A~1E_____fu-l-~__._A1.'C.~kS________________.______ _________ PHONEl CON'l'Ar~'!'_______. _____________
,JOB 8 ITE ADDRESS h --?_::-~__.L= '1-----------------_______________________________________ ___
SUBD IV I S lOt! ~~~~c)~j!J:~_/;__~__
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUI LDING IlIllI?AR'I'MElN'f 5335 8 th S'fRlIllll'f ZIllI?HYRHII,I,S, FL 33 S 4 0
PhoneI813-780-~020 Fa~IB13-780~0021
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PI.AUS RlllVIBlW I'BBl_ ~.---_~_'l!
..
B LO(.; K
--.._-._----~.._-~-
PARClElIJ HI It
HURK PRO!?SED I [JNBlN C'ONs'rRUCTION
----------------------_._~._--~----~------------------------------- -.------.------------
(OBTAIN FROM PROPElR'l'Y 'I'1\){ NOTWEl)
[j S Ian
o ADDITION f]AI/l'ERATION [) RElPAIR [J TN8TAr,11
[J MOVE 0 DEMO!'!SH
[hlU 1,'1' I _. F Af1 II, Y [J# (IF UN 1'1'S IJ MOB u,m Ii 011 III
[J INDUS'1'RIAIJ [JSWIMMUIG POUL /] OTHER
I?RO!:'DSEIl USE) I [JSGIIJ FAMILY DWEL!JHm
f] Cm1~1H1R(t IAI,
IlEJ8CRIPTION OF WORK
o R~STA!JR1\NT be HElAllTlr DElPAR'n1ENT APPROVAL
--_.&J~__h<>J .A.L___.
0____._-- .____________..___....__.._ ..~.___~
B{JILnrN(~ 9!ZEl
..--....-.---------
SQUARE FOOTAGE
H8J 1GB'I'
''':~----.------
IU1l8IIIElNTIAT'l
(~OMMElR(!IJ\fJ :
A'I''rACH (2) PI,OT prJANS & (2) SBlTS OF BtJII,IHNG Pr,AHS & (1) SEl'r ElNERm.' FORMS,
A'I"liA(!!I (.3) SEl'I'S OF BU!IJDING PLANS & (1) SET ElNEJ1WY FORMS.
PROPIlJR'I'Y SURVEY REQUIRElD FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
CJ BtlIr,IJINf~
$~-----~_.---~ VALUATION OF TO'I'AL CONS'I'RlJCTION
Ll ELBlCTRHJAI,
-----.---------'-' M1P SERVICEl
[) FLORIDA POWER
[J W,R.E.n.
LJ pl,milBINf3
lJ 1111lUHA.NWATJ
$----_.'----
- VALUA'I'ION OF MElCHANCIAI, INSTAIJIJATTON
[J (~A8
L1 ROOFING
f] SI?ElUIAurv
[) O'I'HElR
'l'Y.PEl UP' CONS'I'RtJl!'l'WN I [J BLOCK
o FRANFJ
!J STEEL
[] OTIlER
FINISHE!J FLOOR EIJEJVl'TIONS
--------
IS PRO,TElc'r IN FLOor) ZONE! ARElA [) Y!llS
[) No
B t1 I LO BlR COri!P A N Y_._________.________._ ___
-~M STATE CElRT OR RE!CJIST # ___. --_____.u___________.______
B.tGHATUR> -._~~_._~___~ CITY PRoemBBINO L.. __.____.._____..____.._.___.
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C0f'1PANY -- ~---~':~!.=--------<c------ .______
STATE CERT OR RElCHS'I' #
CITY PROCESSING #
.---- '--._--'--~._._--,._---_._---_._-..-.- -_..~. .-
PIJT1MSBJR
SI:t~NA'l'IJREl ._-.-.....v..~~~_________
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C!OMPA1'IY-____L1~___--__--..__._____________
STATE CER'l' OR RElGIST # ______~_._______.
CITY PROCESSINCJ #
.----------...---. .-.-.----. -. - -----~.._-..-.__o..___
MBlCHANICAT,
~*************'***********************'********************"*'***
---'-_.-._-'--------_._--~- --_.-.._._---~--~-_..-
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:-~-----~~-_.._---._-
cotvJPANY -..h~=:::-
STATEl ~rnRT OR REGrST #
~ll'Y PROCESSING #
--,._--~----_..._-_..__. -.-_._- --...---.. --..--
S IGNA'I'tJREl
'--._--..._-~-_._----------_..-
OTIIBJR
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-----.--.-..--..-----
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S WNA'l'tJREl
--_._--~
(!O~1PANY
S'I'A'I'EI C!F.RT OR. R"EGiST"r-------------'---..-"--
CI'rY PROCElSSING # -___._____________
***********************'*********'***********************'*~*****
-------_._......_-------_.._-----'---_._,~--,._---,
CONDI'l'IONS OF PERl'1I'l' AFFIDAVIT
A. NOTICE Of DEED RESTRICTIONS
The ~nderaigned understands th~t thim p.rmit may be
mCiY be more restrictive than City regulations. 'I'he
compliance with any applicable deed restrictions.
B. UNLICENSED. bONTRAC'l'ORS AND CON'l'RACTOR RESPONSIBII,I'l'IES
If the owner lIas hired a contractor OE contractors to undertake work, they may be required
to b~ licensed in accordance with state and local regulations. If the contractor is Ilot
licensed as required by law, both the ovmer and contractor may be cited for a miademeanor
violation under state law. If the owner or intended contractor are uncertain as to wllat
li censing requirements may apply for the intE:lnded work, they are advised to Clontapt the
City of Zephyrhills Building Department, 613-766-6611.
furthenool:e, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor SectionsU of this applioation for whicl. they
vlil1 be Lesponsible. If you, as the owner signs as the contractor, YQI,! are indicating that
you, rather than the contractor, are responsible for the wOj;-k. I f the contractOj;' \vishes
you to sign as COlltractor that may be an indication that he is not properly licensed and is
not entitled to permitting privileges in the City of ZephyrhUla.
c. 'l'RANI:lPOR'l'ATION IMPAC'l' Ii'EES AND UTILITY CONNECTION )fEES
D. CONI:l'l'RUC'l'UION LIEN LAW (CHAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
1 oertify 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 "ownerU, I oarity that I
have obt:ailled a copy of the above described Qocument and promise in good faith to deliver
it to the "owneru prior to commencement.
E. CON'l'RAC'l'OR' S/OWNER' S AfFIDAVI'l'
I certify that all the information in this application is accurate and that all work will
be done in complianoe with all applicable laws regulating constnlCtion, zoning, and land
devfillopment.
Applioation is hereby made to obtain a permit to do work and installation as indicated. I
ceq:ti fy that no viOrk or installation has commenced prior to issuance of a permit and that
all work will be performed to meet standards of all laws regulating construction, City
codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that! understand that the regulations of other governmental agencies loay apply to
the intended work, and that it is my responsibility to identify what aations I must take to
be in compliance. Such agencies inolude but are not limited tal *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally l:lensJ_tive
Lands, Water/Wastewater Treatment
*Southwest Florida Water Management District-Wells, Cypress Bayheads) Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Fload Zone ~Au or "A,etc,U, it is
underetood that a dralnage plan addressing a "compensating volumeu'will be submitted which
is prepared by a professional engineer registered in the State of florida 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 technical codes,
nor shall issuance of a permit prevent the Building Official from thereafter requiring a
cor~ection of errors in plans, oon~truotiOQ1 or vio~ations of any code. Every permit
iSriued 13hall beoome invalid unless the Hork authorh;ed by such permit is oOllUTumcedwlthin
SlK months ot issuance, or if \vork authorized by the permlt is suspended or abandolled f~r a
period of six 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 tequea~ed
ill \iri ting to the Building Official. An approved inspection must be logged dud l11J each six
month period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING 'l'WICE FOR IMPROVEMEN'l'S TO YOUR PROPERTY. If YOU IN'l'END TO OB'rAIN FINANqINq, .CqN,UL'I'
Wl'rH YOUR LENDER OR AN A'l'TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'l'. JOBS UNDER
92,500 IN VALUE no NOfl' NEED TO RECORD AND POS'l' A \\NOfnCE OF COMMENCEMEN'I'".
-
subject ~o "deed restriotlonsu which
undersigned assumes responsibility for
SIGHA'l'UREI OWNER OR AGENT
S I GNA'l'URE I CONTRACTOR
STA'l'E Of FLORIDA
COUNTY Of
The foregoing instrument w~s
Before me this -------Pay of
by
S'l'A'I'El OF fLORIDA
COUNTY OF
The foregoing instrument was acknowledged
Before me this __ day of , 19_
by__
(name of person acknowl~dged)
Dwho is personally known to me, or
D who has produced
(type
and who[] did 0 did not
aoknowledged
, l~ _:.._
of identification)
take an oath.
(name of person aoknowledged)
Gho is personally known to me, or
Owho has produced
(type of ldentifioation)
and Hho Ddid DUd not t.ake an oath
Signature of person taking acknowledgement
Signature of person taking aoknowledgment
Name typed, printed or stamped
Name typed, printed or stamped