HomeMy WebLinkAbout03-1830
BUILDING
Property Owner:
Job Address:
Parcel I. D. II
BUILDING PERMIT
Permit N~
1830
CITY OF ZEPHYRHILLS
(813) 780-0020
;-/fJ - 03
Date
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
,
~
IIFl1
l.{~ 1~
m AI va- t1hh
11~ :sT
Water Meter:
T.I.F.'s:
Zoning:
Descriotion of Work
Energy Code:
Se c..J e-v I; o'\.t
Radon Gas:
R~t...c ~w..nA:t.
- ;2..5-&
DATE
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
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
/< if( r /-/fo
)(Signature
Company
Address
\,J'elephone# (t3 1 .5) 797 - ~t fJ 1
{)tJ~
City License Registration #
State Certified License#
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Driveway
PLUMBING
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Mete
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
. Compress r
/0../ 2-2S--t?.3~Final
~
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.
OI'lNElR' S 17Af\1EJ_______~Zim__J&\. c..l!th~5!__JCl_~ ~________________ PHONEJ (X)N'l'Ar!'!'__~.!J591-.i?_68r
,JOB S I'l'El ADlJR1ll88.__'i.B.30..__19- -t_~___~_:ir~-et-:_________________._________.______._ _d_.__.
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUII,fJING DBJl?ARTMBlN'r 5335 ath 8'rRElBl'f ZElPHYRHILI,S, P'L 33540
PhoneI813-780-Q020 FaxIS13-780-0021
DA'flll RIlIO~IVJlJn ___ __:.. ~""'._
PJ,ANS RSlVIIl/W rJllIli._~_.___~:___..
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IJBJClAL DBJSt!RTP'rION: LO'r(S)
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PARr.!ElI, III /I
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SUB[)lVI81ON
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HURK I?ROPSEltJI fJNBlN r'ON8'I'RUC'TION
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(OBTAIN FROM PROPElR'l'Y 'I'Al{ NO'I'H'El)
[] ADDITIClN
[] ALTERATION
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[)SH1/1
[J RElPAIR
LJ INSTAr,!,
[] MOVE:
o DElt10I,ISI!
PRO/:'OSElIl USEJ I [Jsm, FAMILY DWELLU1G
[h1[JI,1'I - FAt1I1.Y
0# OF UNITS
lJ MOB nEl ItoME
[JC(Jt/lfvlIlJR(!IAI,
o INDUSTRIAr,
C]SNIMMING POUL
IJ OTHIllR
IJESCRIP'l'ION OF t10RK
o RelS'I'AlJRANT & HElAI,TII DBJPARTt1ElN'r APPROVAL
.--.i'_~~~~_QL~ e ~ -e r -1\~\Q. ~___ .________._____________.___
BtJIr,DING SIZE:
-------..---. -----.---
SQUARE FOD'rAGEl
REl8IDIllH'l'IAT'1
(~Of\1MElR(!IAr, :
A'I'TACB (2) Pl,o'I' PLAl1S & (2) SElTS OF BUII,IJING PLANS & (l) 8E1T E1NElRGY FORMS,
A'I"!;ACH (3) SE'rs OF BUiLDING PLANS & (I) SElT ENElfWY FORt18,
PROPERTY SURVEY RElQUIREJD FOR ALL NEW CONSTRUCTION,
--.- ._._------~-
I/El !GB'r
--.-----.. ..---------
LJ BllJI,IJINn
~ERMITS REQUESTED
L1 ElI,I!JCTRWAl,
$--------------' VAl,UATION OF TOTAl, CONs'rRuc'rION
---.-------_ At1P aElRVICEl
o FLORIDA POWER
[J W,R,EJ,C,
(] PI.lJt1B 11'113
o HBJUBANI(~AIJ
,
$-----------
VAI,UATION OF MECHANCIAI, U1S'!'AI"IJATTON
[J (JAB
r.J ROUFING
[J 8PBlr.!!AUI'Y
[) OTHER
'l'Y'PEl OP' CON8TRUCTION I [J ELOCK
[] FRAME
[J STEEL
[] OTHER
FIN rSHElf) FT.r)OR EI,EVlITIONS
--------~---
18 PRO,TElCT IN FLoon ZONEl AREA 0 YElS
o No
BUUn81R
EI,B1Cl'rRICIAU
***** '" ***** * ** *** *** "''''* "'*** * * **** * ** * ***'" ** '" *** ***** *** *** *** **** *
Cor1 PAN Y ___.________________._____.__ ___., __. .__,_.. __._____.____.._ ~_
STATE CElRT OR REGIS'I' # _._______.__..__.._._____,.._____._
CITY PROCIllSSING #______.____.__,_._.____.____ _________.__._._
SIGNATURE!
. .
___u____~~'~___.__..._________________. ____
S J <3l1A'1'[JREJ ____. hh__
'.... -~._~._~ _.~---------,-. --'_..~-----_.,-------._---
COHPANY._._____.__._________________ ___ _____. '_ __.___..
STATE CERT OR REGIST /I
CITY PROCESSING /I
._-_.~. ~.-. .-..-...-.. ._.._._h_____._..__.. "_'_"__. _. "...._
PI,tIMBBlR
* * * * * * * * * * * * * * * * * * * * '" '" * * * * * * * * * * * * * * * * * * * * * , , * * , * * * * * * * * *. * * * * * * * * *
-..--- ..-._---~-~ -....-.----. - '.-.,_.. '-. .- -'-'-"'--'._~'"----_.
8I<JNA'l'17RBJ
COM PAN Y --___.____________________________.. _.. ..._ ___.________...
12 .~ A"'~ STATE CERT OR RElens'r # ______._._._.._~___._______..
W-" --{H'ry PROCEJSSING #
. .-.---- ..k....._ __________ ___..__..._____________________________.___
MlIlCmANI CAr.
'***********************************************************'*****
COf'1 P ANY_____________.___._.____....__. _ ""__ ...____._..
STATE ~ERT OR REGIST #
CITY PROCESSING #
~--- ----.----..-- -~--"- -._---~_._._--_._-
S TGNA'I'IIREl
-----------_._------...._----~---
o'rUER
**************************************~**************************
---_.__.~-------_._-_._~_..._. ~-----,-
SWllA'l'lJRE
------_._.._--_._---------,-~----
'************'*******************'*******************************
(~01"IPANY
S'J'A'I'E CERT OR -Rm~#-----------------...-._.,
cI'ry PROCESSING # ____.._.____________________
-~---------_...._-_._,._----
--------~---. ....- ._-'--._-._------~~-~-- .~..~ -_._-~---~.
CONDI'l'IONS OF PEPMIT AFFIDAVIT
A. NO~ICE OF DEED RESTRICTIONS
The undersigned understands thijt this pDrmit may be subject to "deed restrictionsU whicll
may be inore restri ati ve than City regulol\:ions. The undersigned assumes responsibili ty for
compliance with any applicable deed restrictions,
B. UNLICENSEDdON'l'RAC'l'ORS AND CONTRACTOR RESPONSIBILITIES
If tile owner lias hired a cOlltractor or contractors to undertake work, they may be required
to be licensed in accordance wi.th :otate and local regulations. If the oontractor is not
licensed as required by law, both the ovmer and contractor may be cited for a mi.sdemeanor
violation under state laH. If the owner or intended contractor are uncerlain as to Vlhat
licensing requirements may apply for the intended work, they are advised to contaot the
City of Zephyrhills Building Department, 813-768-6611.
Furthenno:re, i.f the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor SectionsH of this application for which they
will b~ responsible. If you, as the owner signs as the contractor, YQ~ are indicating that
you, rather than the contractor, are responsible for the work. If the contractor wislles
you to sign a~ contractor 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'RANSPOR'l'ATION IMPACT FEES AND UTILITY CONNECTION !fEES
D. cONS'rRlJC'I'UION LIEN LAW (CHAP'I'ER 713, FLORIDA S'l'ATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Constr\lction
lien Law - Homeowner's Protection Guideu prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "ownerH, I cet'ify that I
llave obtained a copy of the above described document and promise in good faith to deliver
it to the "owner" prior to commencement.
E. CON'I'RAC'l'OR' S/OWNER' S AFFIDAVI'I'
I certify that all the information in this application is accurate and tllat all work will
be done in compliance with all appli.cable laws regulating construction, zoning, and land
development.
Applioation is hereby made to obtain a permi.t to do work and installation as indiaated. r
certify that no Hork or installation has commenced prior to issuance of a permit and that
all work Hill be performed to meet standards of all laws regulating construction, City
codes, zoning regulations, and land development regulations in the j\lrisdiction. I also
certify that I understand that the regulations of other governmental agencies loay apply to
the intended work, and that it is my responsibility to i.dentify what actions I mllst take to
be in compliance. Such agencies include but are not limited to: *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Bensttive
Lands, Water/Wastewater Treatment
*Southwest Florida Water Management District-Wells, Cypress Baytleads,-Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waten/ays
*Uepartn~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 ~Au or "A,ete.N, it is
understood that a drai.nage plan addressing a "compensating volume" 'will be submi tted "'lhiah
it> prepal.-ed by a professional engineer registered in the state of Florida pdor to pennl t
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 i.ssuance of a permit prevent the Building Official from thereafter requi.ring a
correction of errors in plans, oonstruction, or viol~tions of any oode. Every permit
issued shall become invalid unless the work- authori;l;ed by such permit is oOllunenaed within
six months of issuance, or if work authorized by tile permit is suspended or abandoQ~d far a
period of si.x months after the time the work is commenced. One 90 day extension of time
may be alloHed for the permit with fee charge of $15.00. The extension shall be requested
ill writing to the Buildlng Official. An approved lnspeetion must be logged during each a!H
month period, or the Pl.-oject Hill be considered abandoned.
WARNING 'I'O OWNER: YOUR FAII~URE 'fa RECORD A NO'fICE OF COMMENCEMENT MAY RESUL'l' IN YOUR
PAYING TWICE E'OR IMPROVEMENTS TO YOUR PROPER'fY. IF YOU INTEND TO OB'l'AIN 11'1 NAIH:;INq , _(.:qN~ULT
WITH YOUR LENDER OR AN A'rTORNEY BEIfORE RECORDING YOUR NOTICE OF COMl-tENCEMEN'r. ,mas UNDER
$2,500 TN VALUE DO NO'l' NEED '1'0 RECORD AND POS'l' A "NOTICE OF COMMENCEMENT".
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
STA'I'E OF FLORIDA
COUNTY OF
'rhe foregoing instrument w~s acknoHledged
Before me this _----Sjay of----, 19
by
(name of person acknowledged)
C1ho is personally known to me, or
S'rA'l'E or E'LORI DA
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
Dwho has produced
(type
and who[] did []di.d not
of identification)
take an oath.
o who has produced___
(type of identifioation)
and ~/ho Ddid DUd not t.ake all oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
J:i~I~~-t-YP-;,i~-'-p r in t ed-~;--s tamp ed
Name typed, printed or stamped