HomeMy WebLinkAbout03-1834
BUILDING PERMIT
Permit N~
CITY OF ZEPHYRHILLS
(813) 780-0020
1834
Date .2-/:1- 03
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcell.D. ,
Zoning: Energy Code:
Descriotion of Work __cJr ,- V f' c.-J f
(!~eJ..~
~ r-z '5 '-{
COK
I 7 'f-I-,. SoT
Water Meter:
T.I.F.'s:
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL "2.2/-0.J
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
DATE
(fJb J R L If
~,c-. 9-0
Permit Fee . J
)(Signature . C ~
Company
Address
)f6lephone# 18- g.- 7:.1 'J. S-
Valuation or
Contract Price
I &00 ~ {'TV
,
City License Registration #
State Certified License#
tJi/JN-y
BUILDING
ELECTRICAL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Met
Final
(/ ~ - ;2 (- 0 3 LI7S0
SLB
Tub Set
Water
Sewer
Final
-'
Breakers
Ducts Insl.
compr
Final
/
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Driveway
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) 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 PERMIT APPLICATION
BUII,IJIN(~ DIlJI?ARTMElN'l' 5335 8th 8'l'RElBl'l' ZIlJI?HYRHILI,S, P'L 33/;40
PhoneI813-780_0,020 Fa)(1813-780..0021. 2. -/;<-..03
!JA'l'lll RIll<1!l1IVIID
, -'--. ., -- __....c,;.. ___ .__
pr,ANS RIIIVIBlW i'lllR__'__n__. _____.
O""'ER' S lJA>10___d~__,.l:f4J X_ _______'_''_____'_ PHONO <!ON'I'M"".____ -.-L.CCC_____
,10. S no AU!JRms s, -4']5..iJ... .-,-1.7.'f'4_ ,';;T.,_ ___ ___ "_, ____, __ '_'. _ __. '__ _ _ ',_" __, ,
LEl(]AL DH]StJRIP'l'IONI I"O'r(S)
P1\RC!EJll HI It
_.-.._--.._--_.--.~~-
BLOC'K
----.------
SUBllIVISlON
_..__.__._.._,~.- .,. ._---..~--
....------.----".--.--------------.-...-----.---------.-----...... -...--.-..--,--...----..--
[] ADDITION
(OBTAIN FROM PROPER'ry 'l'Al{ NO'l'H!IlJ)
HCJRK PROl?SEllJr UNElN CONS'I'RUC'TION
[] s rem
[] ALTERATION
[] RElPAIR
I.J JN8TI\f,r,
[] MOVE
o DEfl/Or.rSII
PRO!:lUSEJII USEI I [JSGL FAMILY DWELT,ING
[]f1tJW I - FAHILY
0# OF ON 1'1'8
U MOBII,E) 1l0f1El
[J CClt1f\1BlRCIAr,
[J INDUS'l'RIArl
o SWIMMUIG POOL
/] OTHER
CJ RBlSTAURANT & II ElA IlTll DEPARn1EN'r APPROVAL
1l0.CRIP'rro", OF WORK __~ a_~,~ 3l~ dni;e~""+-.,______,.______,__.~___.___.
BUIT,DINC3 SIZE:
---.----..-----
SQUARE: FOO'rAGE:
HEllGH'r
~'-'----._'----
RE8IDElNTIAI'1
C0f\1MBlRC!IAI. :
A'I"rACH (2) PIIO'I' PI"AI18 & (2) SElTS OF BUIIlIHNc1 PLANS & (1) 8ElT E1NEJRrJY FORMS.
ArVACH (3) S~'rS OF BUtLDING PLANS & (1) SET ENERGY FORMS,
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUC'rION.
~II'IJING
FERMITS REQUESTED
L_~_ ~~~_.__, VAl,tJATION OF 'rOTAL COHS'rRlJC'rION
1.1 E1LBlCTRWAI,
-'-------..-_ ArIfP SElRVICE
[] FLrJRIDA PONER
[] N.R.E.n.
(] PWfl/BING
U HBICHANIC!AIJ
$----....'
- VALUATION OF MECHANCIAI, UISTAI,l,ATTON
[] (JAS
rJ ROUFHW
rJ SPElCIAUfY
[J OTHER
TYPE: UP' CON8'I'RtJCTIOH: [] BLOCK
[J FRAII/E
[] S'I'EElI,
[j OTHER
FIN ISHElIl FLOOR Blf,EV1,TIONS
-----_._--~---
IS PReXTECT IN FIDCm ZONE AREA [] YElS
o Nu
BUI !,f)I!lR
SIGNATURE X,-ce~~__,_______
ilIl,JIlCTRICIAU
"'**""***'*'*'*"""'*"*"**'**""**'*"""**"'"*,*"",,
0J ~__._ _____.__.......___.. __.__.__.. __ ____.._____.._. ._
STA'rEl CFJRT OR REl8IB'I' # .___ --------.-----..--.--___H ___._._
CITY PROCESS LNG fL.___..____. ._H.h.___..._. ____.._._.....____
PWM.IR "OMPANY. --, -___.~__,_,_,__,__,_.___ '-'m,
STA'rE CERT OR REGIST # ______________..__.__,____..._
SIC3NA'l'l1RI1J CI'I'Y PROCESSIN8 #
'*"'" * * *" *' '*' ****'* Ir**" * *' 'Ir' ** "" *' '" "*'**" ,.I, * * ***'****
COf1PANY _h___. ._.. __ ___ _____.___.._ ___
STATE CERT OR REGIST It
CITY PROCESSING #
'-~-_.... ~ --.--- ..... ._. _._n.._____
., """--'-'-- .... "-
S J Gl1A'l'lJRE _''''
.-0__. ".._ _'_~__~ _.._____._~,___.._.___~.__ '_'_...~_________
-.---..--------.-----.....--...- - ._---..~_.._--------~
MBlC!HAllI CAl,
- .~.._--_...._.~_._-,._-------_..._-_._-._-- -..--.-...-.------.-----.-...-----.-.--.--
*'*'**'***'***************************'*********"'***"'*****'***
o'rUBlR
*"*****'*'*'*.I********Ir******.I*******~,***,**,**,,****'*'*'*'***
CO/v(PANY _________._._.______._.____..._._.____..__..,
STATE ~@RT OR REGIST #
CITY PROCESSING #
._~_._--_.~-_._--_.,- -.-----.-------.--
8 H.H1 A'I' lJ R El
-'------'__.o.-.-_____...~____.~...________
---~_._~~_.._~_._----_..- -------
SWl1A'l'UR E
~.-....._-~--..._""--.....----_.,._------_.._-----_.-
---------_..._-_._~
C!O/..IPAHY
g'rA1'EJ e'ERT OR REGIST fr----------------.---..----.--
CI'rY PROCESSING # _....______.___.____.__,_
**'**'*'***********'******************'******'****'****t***,,*,**
------.-----'"-. ~ .-..-------- -._._~-_. - ~------ '.. ---. ----" ----.
CONDITIONS OF PEFJ:vlIT AFFIDAV~'T
1\.... NO'rICE OF DEED RESTRIC'rIONS
'1'11e unde'L.~ignad understands thijt this p~rmit ffiC:(y b'ij subject: to "deed restrictions" which
may be more restrictive than City regulations, Tile undersigned assumes responsibility fdr
oomplii:HlCe wi th any applicable deed restricti()n~.
B. U1H.I CENSED c'ON'l'RAC'l'ORS AND CON'l'RACTOR RES PON S I Bl LI'I'I ES
If the owner' has hired a contractor or contractor:s to undertake work, they ulay be required
to be licensed in accordance with state and local regulations. If the contractor is not
licensed as required by la~J, both the mmer and contractor may be cited for a misdemeanor
violation under state laH. If the owner or intended contractor are uncertain as to ~Jhat
1.i censing requi rements may apply for the intended WOlk, they are advised to contact the
city of Zephyrhills Building Department, 813-788-6611.
Furtherlllore, if the owner has hin:.d a contractor or contractors, he is advised to have the
cOlltractor(a) sign portions of the "Contractor Sections" of this application for which they
will be respon6ible. If you, as the owner signs as the contractor, yo\.! are indicating that
you, Lather- than the contractor, al-e responsible for the ..wrk. I f the contractor wishes
you to sign ae contractor that may be an indication that he 16 not properly licensed and is
llot entitled to permitting privil~ges in the City of Zephyrhills.
C. 'l'RANSPOk'!'ATION IMPAC'!' FEES AND U'l'ILI'l'Y CONNECTION FEES
D. cONS'rRUC'rUION I,IEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
1 certify that I, the applicant, have been provided with a copy of "Florida's Constrllction
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
have obtained a copy of the above described document and pr-omise in good faith to deliver
it to the "owner" prior to conunencement.
E. CON'rRAC'I'oR' S/OWNER' S AFFIDAVI'I'
I certify that all the information in this application is accurate and that all Hork will
be done in compliance with all applicable laws regulating construction, zoning, and land
development.
Applioation is hereby made to obtain a permit to do work and installation as indioated. 1
certify that no ~wrk or installation has conunenced 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 j\lrisdict1on. 1 also
certify that I understand that th. regulations of other governmental agencies may apply to
the intended work, and that it is my responsibility to identi.fy what actions I must take to
be in compliance. Such agenci.es include but are not. limited to: *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensttive
Lands, Water/Wastewater 'rreatment
*Soutllwe~t Florida Water Management District-Well6, Cypress Bayheads,-Wetland Areas,
Altering Watercourses
"'Army corps of Engineers-SeawallS, Docks, Navigable Waterways
*lJepartment of Health Eo Rehabilitative Services, Environmental Health Unit-Wells,
Wa6tewater Treatment, septic Tanks
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill materi.al is to be used in Flood Zone ~A" or "A, eta.", it is
understood that a drainage plan addressing a "compensating volume" 'will be submitted which
is prepared by a professional engineer registered in th. State of Florida prior to permit
issuance.
A permit i6sued shall be construed to be a license to proceed with the work and not as
authority to violate, cancel, alter, or set aside any provi.sions of the teohnical codes,
nor shall issuance of a permit prevent the Building Official from thereafter requiring a
correctlon of errors in plans, pODstruction, or violations of any code. Every permit
issued ahall become invalid unless the work authori~ed by such permit is oOllullenced within
six months of issuance, or if work authorized by the penult is suspended or abando11ed for 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 requested
in \"/ri ting to the 13uildi.ng Official. An approved inspection must be logged during each six
month period, or the pr'oject ~Jill be considered abandoned.
WARNING 'fO OWNER: YOUR FAIIJURE '1'0 RECORD A NO'l'ICE OF COMMENCEMENT M1\Y RESUL'l' IN YOUR
PAYING 'l'WTCE E'OR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OB'rAIN E'INANGINq, r;;qHf!UI/l'
WaH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'f. ',JOBS UNDER
$2,500 IN VALUf!l DO NOrr NEED 'l'O RECORD AND POS'!' A "NOTICE OF COMMENCEMEN'I'''.
S 1 GNA'l'URE : OWN ER OR AGENT
SIGNA'l'URE: CONTRACTOR
acknowledged
19_
STA'rE OF FLORIDA
COUNTY OF
'l'he foregoing in6trument Wtl,S aoknoHl edged
Before me this --5iay of.:----, 19
by
(name of person aoknowledged)
C1ho is personally kno~m to me, or
s'rA'rE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by
(name of person acknowl.dgedl
Owho is personally known to me, or
o who has produoed
(type
and whot] did [] di.d not
of identificatlonl
take an oath.
Owho has produced
(type of identification)
and ~Jho Ddid [}Ud not take all oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
--_._-----"_.._~--~------------~--'----_._~-
Name typed, pd_lIted or stamped
Name typed, pri.nted or stamped