HomeMy WebLinkAbout03-1812
BUILDING
BUILDING PERMIT
Permit N2
1812
CITY OF ZEPHYRHILLS
(813) 780-0020
/-30-tJ3
Date
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
P,"perty Owne" 0('0...1\ ~
Job Address: 57~( ~_. /:J..J--
Parcel I. D. "
Zoning:
DescriDtion of Work
~ ' Water Meter:
~t . (
T.I.F.'s:
!o U;'S 18. ..:1...- f...l.:. )
Energy Code: Radon Gas:
r ~~ ~ S.a--v-V.
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
2 ~ 3- 0 3
DATE
Complete Plans. Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Valuation or
Contract Price
DATE
Inspector
eLl.t
-----
Permit Fee ~. PO
>Signature
Company
Address
"kTelephone#
City License Registration #
State Certified License#
c:2g 5-5-
Ftr.
Pre SLB
Lintel
FRM.
Ibt-.Jey!vovs-€ {:-/ec.
Breakers
Ducts Insl.
Com pre or
Fina
ELECTRICAL
PLUMBING
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final 1/ 2 -3~o3 RLf
SLB
Tub Set
Water
Sewer
Final
rj7 ~-j-~ 3 q.'35 cd W
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.
ONNEJR I S l1M1El ..JO,/J to. ~W
-------------.-.-'f:-U~_____________ ...__________.________
l108 S I'rE ADnRBl8S_~?_ttl_s..~/,m()/!~___!?f._______________
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DIllI?AR'I'MEl~r 5335 8th STREBlT ZIllI?HYRHILLS, FL 33540
PhoneI813-780-~020 Fa~1813-780~0021
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PI,ANS REVIBlW rEBl_,",_"_"__ t:___.
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PHONEl CON'1'Ar!'!'..Zlfl_-:-f.i:>_.2.7" _______
LBlGAL D81SCRIPTION, LOT(S)
.----.--.--- .~--------_._------- -----.--
BLOCK
SUBDIVISION
--..__.~~_._----
PARnEll, In It (OBTAIN F'ROM PROPElIVry 'I'AX NOTWIll)
WJR' PROP8..'~[JN.N '~;J~-;;';"C;:;;)~-~O ~;);J rr Im;-o ^;";.R~~ IO;..- ~;;'-;---.IJ u;;;1'~r:r-:-.-
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[J S re3N
o MOVE:
[] DEW)1,ISII
PROPUSFJIl USE I nSGIJ FAMIlJY DWElLr~Ul(~
[J~1UUI'I - FAMIl,Y
0# OF UN I'l'8
[] SW!tiJMING POUL
I~B II,Bl lIorilBl
[J OTHBlR
f] C0/1MElRc! TAl,
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CJ R~8Ti\lJRANT & HElA1,TH DElPAR'n1ElNT APPROVAL
))EJSCRIP'l'ION OF I'WRK (flR'?-M_t!lM-e!__.-5C7t!v.!..~~;p-,vrL
_._.~----_.. .._--------_._.~- -----_.~._--~_._.-.._- -.--~ ....-- --
BlJILfJINtJ 81 ZEl
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SQUARE F'OO'rA<JE
RE8IDElNTI1\l'1
C~OMMElRCIAr~ I
HEl1l1ft'r ___________
A'r'rJ\CH (:3) PIDT PI"1\llS & (:3) SElTS OF BUU,IJINI] pr ,ANe & (1) SEl'f ElNElRny FORMS,
A'r1;ALm (.3) SETS OF ButLDING PLANS & (1) SET E1NElfWY FORMS,
PROPERTY SURVElY RElQUIRElD FOR ALL NEW CONSTRUCTION,
iE~ITS REQUESTED
[J BIII r IIJINr~
P.fELBlCTR 1 CAll
$
.joo
-------
VALUATION OF 'rOTAI~ COl\fS'rRlJCTION
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o FI,rJRIDA POWElR
o W,R,E,n,
[] pwrilBING
o lilBlUHI\NWA1,
,
$----"-
- VAI,UATION OF MElCHANCIAr, INSTAlJIJATTON
[J r3A8
f] ROOFING
[J SPElC!tAI!l'Y
[) OTHER
'l'YPEl OP' CONS'I'R{J(!'rWN I [J BLOCK
[J FRA1i1FJ
[J S'I'EIllL
[J OTHElR
FINISHElIJ Fr.oOR ElI~EVl>:TIONS
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IS PRlXTECT IN FLOOD ZONEI ARElA 0 YES
o Nu
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Blr'BlCfTRICIAN~J J
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S j GlT1\'I'lJRE __ ___ '__ ___.~___~_________________
******************************************************************
C!orilPANY ----.---_____u_.__________..___ _____________.__.____.___._
8TA'I'E CElRT OR RElt3IB'I' # ___.______ _______________, ________
C lTY PROCIll88!NG iL___________________________ _______________
SlGNATtJREl
- -
_.~'_._-'---._---".........._------_...------_._-----
Cm1PANY~~!_tv,$~_M~L~.5:._~_~~____ _______
STATE CElRT OR REGTST #
._~-,.__. --.--... ~ .------ ---.--------..----- --
CITY PROC!ESSINlJ #__2J>~_________.__ ______._~___
PI,T1MBBlR
* ** * ** ** * ** ** A** '" "'***** * ** * * * '" * *** ** * ** * *********"***** ** ** **** ***
---~__v_._.__..._____.___
._---_._~_._--
C! 0 1>1 PANY --___________-:--______________~_______
STATE CElRT OR REGrST # --------~----___h.
CITY I?ROCElSSING #
S Ic3HA'l'tJR EJ
MEdHANI CAT., (!OIVlPANY ____________.____________ __________
STATEl (!I1lRT OR RElGIS'r # ___________________________
STGN1\'I'tJt:l.El CITY PROCESSING #
~*****************************************************************
---_..._._~----,---+----_._._-----_.-
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OTHER
..--.._--~_...,----'-----._---.._---------
(!{)~1 P ANY
STA1'BJ cERT-oRREOIST #1
CITY PROCESSING #
SI<m1\TtJREl
. ---_.__.__.-._.,--_..--'~.._-
__.4__.____.___.....__.____ ___ ~
***********************************************************~*****
--"._----_.._......._._.----_._._-----,-~.,--_._---
CONDITIONS OF PERMIT AFFIDAVIT
. A... HO'rICE OF DEED RESTRIC'L'IONS
The undersigned understands th~t Lhls p~rmit may be subject to "deed restrictionsU which
may be more restriotive than City r'=9ulations. TII'= llnd'=_rsigned assumes responsibility for
compliance with any applicable deed ('est:riction~.
B. UNI,lCENSElD 'CONTRAC'l'ORS AND CON'l'Ri\CTOR RES PONS LBII,I'l'IES
If the oHner has hired a contractor or contracto.ts to undertake work, they may be required
to j:)e licensed in accordance with state and local regl1latJon6. If the contractor is not
1 Jcensed as required by law, both the o,mer and contractor may be oi ted for a misdemeanor
violation under state law. If the owner or intended contractor are uncertain as to .~lat
licensing requirements may apply for the intended work, they are advised to contapt the
City of Zephyrhilh Building Depar;tment, 813-768-6611.
Furtheuno.t-e, if the owner has hired a contractor or contractors, he is advised to hilve the
contractor (a) aign portions of the "Contractor Sections" of this appli.cation for Hhich they
will be responsible. If you, as the owner signs as the contractor, YQ4 are indicating that
you, .tather than the contractor, are responsible for the work. If the contl::actor \dshes
you to sign as contractor that may be an indication tllat he is not properly licensed and is
riot entitled to permitting privil~ges in the City of Zephyr;hills.
c. 'I'RANSI:'OR'rA'rION IMPAC'1' Ii'flflS AND UTILITY CONNECTION li'EflS
D. CONSTRUC'rUIOl~ LIEN LAW (CliAP'l'ER 713, FLORIDA STATUTflS, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "florida's Construction
lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that: the "owner", I cerify that I
llilve obtained a copy of the above described document and promise in good faith to deliver
lt to the "owner" prior to commencement.
E. CONTRAC'l'OR' S/OWNflR' S AflfIDAVIT
I cer;tify that all the information in this application is accurate and that all work will
be done in compliance with all applicable laws regulating construction, zoning, and land
devl?lopment.
Application is hereby made to obtaln a pennit to do work and installation as indioated. I
ce~tify that no work 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. r 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 actiona I must take to
be in compliance. Such agencies include but are not limited tal *Department of
Environmental Regulatipn-Cypreas Bayheads, Wetland Areas and Environmentally Bens~tive
Lands, Water/Wastewater Treatment
*Southwest !l"loridc. Water Management Diatrict-Wells, :Cypreas Bayheads, Wet1and Areas,
Alterlng Watercourses
"Army Corps of Engineers-Seawalls, Docks, Navigable Watenlays
*Vepartn~nt of Health & Rehabilitative Services, Environmental Healtll 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 flood Zone ~A" or "A,etc.H, it is
understood that a drainage plan addressing a "compensating volume"'wi.ll. be submitted which
is prepared by a professional engineer registered in the State of Florida prior to permit
ll:lsuance.
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 ther;eafter requiring a
cor~ection of errors in plans, con~~ruotioq~ or vio~ations of any oode. Every p.rmit
is~u~d shall beoome invalid unleas the work authorized by such permit is oonunenoedwlthin
six months of issuance, or if work authorized by the permi.t is suspended or abandol1ed f9r a
period of aLa months after the time the work is commenced. One 9D day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be requ@s~ed
in writing to the Building Official. An approved inspection muat be logged during each /:iiK
llIonth period, or the project will be considered abandoned.
WARlUNG TO OWNERI YOUR FAILURfl '1'0 RflCORD A No'rrCE Or' COMMENCElMENT MAY RESUL'r IN YOUR
PAYING TWICE Ii'OR IMPROVEMENTS TO YOUR PROPflRTY. IF '.(OU IN'I'END TO oS'rAIN f'INANqINq, _{X)NljUI/I'
WH. 'H YOUR LflNDER OR AN A'1''l'ORNflY BfllfORE RECORDING Y~/.CE Of COMMflNCflMflNT. ,JOBS UNDER
~2, 500 IN YAW. no NOT NEEO TO RECORD ""0 P081' A "GO' COMMEN' mNT" ,
..~--~------_.
SIGNA'l'UREI OWNER OR AGENT SIGNA'l'UREI CONTRACTOR
acknowledged
, 1~
STA'l'El OF FLORIDA
COUN'l'Y OF
The foregoing instrument w~s aoknowledged
Before me this ----------f.iay of---, 19.....:._
by
(name of person acknowledged)
Qho ia personally kno\'m to me, or
S'!'A'rJil OF IfLORIDA
COUNTY OF
'1'he foregoing instrument was
Before me this __ day of
by
(name of person aokno"l~dged)
Dwho is personally known to me, or
o who has produced
(type
and who[] did Ddid not
of identification)
take an oath.
Dwho has produced _
(type of identiflgation)
and liJho Ddid DUd not t.ake an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, pr;inted or stamped
Name typed, printed or stamped