HomeMy WebLinkAbout03-1811
BUILDING PERMIT
Permit N2
CITY OF ZEPHYRHILLS
(813) 780-0020
1811
Date
1-:3& ,- 0 :3
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner: VA\J ; &
Job Address: "3 ??-~ ~ (
Parcell.D. #
1?a,.~ k~
-1/lA I C ~ C!..; R. .
Water Meter:
T.I.F.'s:
Zoning:
Descriotion of Work
Energy Code:
o.d~1'etV- ~ nt~~/.J
,
Radon Gas:
J- /-L;;~ /~ ~t1~J--
FINAL
C.O.
'-c_s
DATE
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.
Inspector
DATE
~ - d-- lidO
City license Registration #
State Certified license#
P'F ~
ermlt ee
)<Signature .2);
Company
Address
Yelephone#
JC~
Valuation or
Contract Price
<;? /j----l S 2- - 7/'fS
t!JtvJV/y
BUILDING
ELECTRICAL
PLUMBING
Ftr.
Pre SLB
lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Canst. Pole
Pool
Pre-Meter
Final! ~-~-CJ 5
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Com pre
Final
Driveway
~L r cI-
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) shaH 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
BUlunNG DIllI?AR'I'MElN'f 5335 8th S'fREIll'f ZIllPHYRHII,LS, ll'L 33540 ...
PhoneI813-780-n020 Fa~1813-780-0021
DATBI RBl<HIlIVlllD _____~c.~ .:.~-'-'"
PI,AUS RlIlVIBlW I'BlBl_'-_~~"__'~:d_____'
OWNBR' B !lAMB_'V ~",-,~-JL~"c2-i::'~__________,___ P"ON" CON'J"C'~2!1':?c,::Z!!''[_c
,TOB B 1'1'9 '''''R'9B_ ____315 ?-2/_____J! 'fJe<!c!:'____ _"-_'!~~.._ _-2o/"f.;:r..;( ,,/Is: ___ __ _
IJEJCJAL 1J818t~RTP'rlON: LO'r(S) ____________ BUK'K ________ SUBfJIVISroN f/JI'37--~_._C;e:<!?~_'5:...
PJ\ROIllI, In #
WJRK PRnpSEllJ I [JNBlN r'ONS'fRt1CTION
o J\DIJ!'rWN
o AUfElRATION
------.---------.-~-----.-----.--.-. .--.-.._ "4...__________..__
(OBTAIN F'ROM PRnPElR'l'Y 'I'1\){ NO'l'H~m)
.-------.-.--.--
[) 8 mu
[] RElPA I R
U TUBTJU,I,
o MOVE
[] DElMOI,ISl/
I?ROI:'tlSEJI1 USBll (Olsen, F1\MIIJY nWEIJIJING
fl r1Ut/rr . F Ar1I I I Y
[)# (IF UN!'I'S
[JSWINMING POUI,
[] MOB!I,Bl llorilllJ
[J OTHER
f] Cm1MElRC! IAI,
[J INDUSTRIAT,
o R&:8TAURANT & IlElAlmr DBlPARTlilElN'f APPROVAL
"EBeRIP'I'WN OF WORK ---c{c/d.~_-j2/~s i- L-l-Fi,L__<;??-"-'i_~ -Jf------
BIJH,DIN(1 SIZE!
---------
SQUAREl FoO'rAGEl
RElBIDBlNTIAJ'I
(JOMMElR(!IArJ:
1\'I'TJ\r!H (2) PI,o'r PTJAI1S & (2) SElTS OF BtJ!JJnnm PLANS & (1) 8ElT ElNII1ROY FORMa.
A'r'1'Atm (.3) sElni OF Butr.rnNG PLANS & (1) SElT ElNBlR(N FORMS,
PROPElRTY SURVElY REQUIRED FOR ALL NEW CONSTRUCTION,
HElJGH'r ______~__
FERMITS REQQESTED
[) Bll rr,IJINC~
$
VALUATION OF TOTAL CONS'rRlJC'rION
!J BJLBlCTRlCA/,
!] PI,tJMBING
-.-------------
MtfP SEJRVICE
o
Fr,cJRIOA POWER
o
W.R.H1.C,
o ItfBlUHANrc!1\.TJ
$---_.'
~ VALUATION OF ItfECHANCIAL, HISTAr,IJATTON
(] GAS
f.] ROOFING
[J SPEC1tAl,'fY
[) OTHER
'1"tPEl OF C!ONB'I'RtJc'rWliIl [J BLOCK
D FRl\MEl
!J S'1'ElIllTJ
[) OTHER
FINISHEllJ FLOOR ElTJE1VATIONS
IS PRO,TE)CT IN FLoon Zen-TEl ARBlA 0 YES
D l~()
~
SUII,OBlR
Bly,mOTU 0 IAN
BlllNA'J'ilRE 4:])~_V:<~____
******************************************************************
COlil PAN Y --- -"----_______. ______________ _m______._ _____.________ ._
STATE CERT OR REGIS'!' # ____________________'-- _~____
C I'l'Y PROCESS 1NG #l_.____________..______________.________._
SIGNATUREJ
. . -
_.._-_.._'~._-----'-.._.._---~----------_._-~-
COI'1PANY (1wh o A/"
-,.--C,l...~---~.~____ ____ _._________.. '__.
STATEl CElRT OR RElGrs'!' #I
CITY PROCElSSING #
---~'--"---' ---..---
._-._-,..~------,~ -..-..---.---- '~-"--. _. ...-
PIJt1MSBlR
******************************************************************
._-------~--_._------_. -'---"-'.' - - ~-------. -'-"~---
_..._.._-~~._-~.~...-.._--- -~----
.----.-----
(~OM P ANY --_____.__________-,-____________.._.._______".__ ._.___________.__
STATE CElR'l' OR REGIST # _____~_.______..._
CITY PROCESSING #
S WNA'l't7RE
******************************************************************
MIIlC1HANICAf, cotvJPJ\NY ______________._______________.______._
STA'rEl ('I1lRT OR REll3I8'r # -----.------------~----_"_u_.
ST<1N1\1'tJ~El CITY PROCESSING #
-~._-+..~--------------.----____u..._
O'I'HBlR
**************************************~**************************
------~--_._-_..__._-- ----------
""'----"""----~-~----
---._-_._---------~
C!()~1 P ANY
STA'I'El C!};JR~RElOIST
CITY PROCElSSING #
r------------.----------.------ --
S WIl1\T1JRE
-----------,---------~.-...~--- -,
***********************************************************~*****
--....._--~-~-,._-_._---~--------.,-_.._-_._---
CONDITIONS OF PERMIT AFFIDAVIT
A. NO~ICE OF DEED RESTRIC~IONS
Th", undE:.."t"signed understands thqt t.his p,,"rmit may be SUb)e:ctco "deed restriotions"'wllic'"
may be more restrictive than City regulations, The undersigned assumes responsibility for
compliance with any applicable deed restrictionl.;,
8. UNI.ICENSED. 'CON'l'RAC'l'ORS AND CON'l'RACTOR RESPONSIBII,I'l'IES
If tile owner has hired a contractor or contractors to undertake work, they may be required
to be Ii ceBsed in accordance ~.ith f:ltate and local regulations. If the contractor is Ilot
Ii cellsed as required by la\l;, both the o\lmer and oontractor may be oited far a misdemeanor
violation under state law. If the owner or intended contractor are uncertain as to \I~lat
li cansing requirements may apply for the intended work, they are~ advised to contaot the
City of Zephyrhills Building Department, 813-768-6611.
Furtherlllol:e, if the owner has hired a contractor or contractors, he is adviaed to have the
contraotor(a) sign portions of the "Contractor SectionsU of this application for which they
\I/il1 bE: responsible. If you, as the owner signs as the contractor, YQ4 are indicating that
you, rather than the contractor, are responsible for the work. If the contl:actor wishes
you to sign aa contractor that may be an indication tllat he is not properly licensed and is
not entitled to permitting privil~ges in the city of Zephyrhills.
c. 'I'RANSPOR'l'ATION IMPAC'l' fEES AND UTILITY CONNECTION b~EES
D. CONS'l'R\JC'l'UlON I,IEN LA~~ (CHAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
I certify tllat I, the applicant, have been provided with a copy of "florida's Construction
lien Law - Homeowner's Protection Guideu prepared by the florida Depal:tment of Agriculture
and Consumer Affairs. If the applicant is SOJlleone other that the "owneru, I cel:ify that I
llave obtained a copy of the above described document and promise in good faith to deliv&r
it to the "owneru prior to conunencement,
E. cOWrRAC'l'OR' 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 applicable laws regulating constt-nction, zoning, and land
development.
Application is hereby made to obtain a permit to do work and installation as indicated. I
ceJ:tify that no \lwrk or installation has conunenced 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. I also
certify that I understand that thi;l 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 tOI *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sens~tive
Lands, Water/Wastewater Treatment
*Soutllwest Florida Water Management Distriot-Wells, Cypress 8ayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*lJepartment of Health & Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater 'l'reaj:ment, Septic 'ranks
*U,8. Environmental Proteotion Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone ~Au or "A,eta,N, it is
underetood that a drai.nage plan addressing a "compensating volumeN'will be submitted which
is prepared by a professional engineer registered in tile State of ilorida prior to peonit
iaauance.
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
correction of errors in plans, oon~truotion! or vio~ations of any oode. Every p.~mit
iSl:iu"d shall become invalid unless the wo.r:k authorized by such permit is cOlllmenoljid within
si.x monthe of issuance, or if work authorized by the permi.t is suspended or abandoijed f9r a
period of aLa 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 ~equea~ed
in writing to the Build1ng Official. An approved inapeation must blji logged during each aJx
month period, or the project wi.ll be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NO'rICE Ov~ COMMENCEMENT MAY RESUL'I' IN YOUR
PAYING 'rWICE FOR IMPROVEMENTS TO YOUR PROPER'ry. I F YOU INTEND TO 08'l'AIN FINANqINq,cqN~UL'r
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE Of COMMENCEMEwr. JOBS UNDER
92,500 IN VALUE DO NOT NEED TO RECORD AND POS'l' A "NOTICE OF COMMENCEMEH'I"'.
SIGNA'l'URE; OWNER OR AGENT
SIGNA'I'URE I CONTRACTOR
acknoHledged
, 1~
STA'rE OF FLORIDA
COUWry OF
The foregoing instrument w~s
Before me this ------i-iay of
by
s'rA'rEJ Of IfLORIDA
COUNTY OF
'l'he foregoing instrument was
Before me this __ day of
by
aokno~l1edged
, 1 ~ ......:..._
o who has produced
(type
and who[] did []did not
of identification)
take an oath.
(name of person acknowledged)
C1ho is personally known to me, or
Dwho has produced
(type of identifioation)
and Hho Odid Q.iid not t.ake an oath
(name of person aoknowl,dged)
Owho is personally known to me, or
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, IHinted or stamped
Nallle typed, pri.nted or stamped