HomeMy WebLinkAbout03-1836
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N!
1836
P,aperty Owne" ~ <J-:;t.
Job Address: ~ I
(813) 780-0020
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EL~ ((!L~~BIN~ ~ewer Conn
~ Water Conn:
~"or Lf ~/i:" ~ , W.te, Mete"
__ ~_ T.I.F.'s:
Date
c:2-/tl-03
~..~_...
Parcel I. D. II
Zoning:
/
Descriotion of Work
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
DATE
Complete Plans. Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Valuation or
Contract Price
Permit Fee
~
/pI,eD,
-m'7'/7l . I~
Company
Address
W:2Y15-
City License Registration # _____
State Certified Licen~
'7 f';. - ;Z 9.5-- 9"
BUIL~'-'-
-----
~
--
PLUMBING
ME~
~
Breakers
Ducts Insl.
Compressor
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
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.
{J5S~./2-
57'51 l\f -Il sf
L
CtJiZ,..;2 ;; -I :2 -0 3 lif
~r~~ Ih~D~
SQ. FT.
PRICE
Main
Other Area
Under Roof
Valuation:
Building: fA l J to-
Electric: j'J
~01,orv
Plumbing: bl tC "-
Mechanical:
Radon: rJ IT
School Impact A ~ ~
Fees: }U / t
Connection I~
Fees: ~f I
Trans. Impact 1/ J iff
Fees: fJ
OWNER
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CI"l"T OF Z;XPHY1UI.IJ.l.S BUIL.DING DEPARTMENT
,~
V (' ~C -e...
JOB LOCATION
PARCEL I. D . . #
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2 rAy Y It ,"l-l ;.
.3 3:::;-"T~
SUOW ALL KX.IS"fIJIG &: PROPOSKD STRUCTURES GIVING DIHKNS:IORS &: SETBACKS_
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UTILITy\r;ILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
(NOTE EXAMPLES 1 & 2)
1. SETBACKS FOR Rl, R2
60'
10'
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STREET
ZON,I NG ORKSHALLCO IPLYwtrHAM.-'rBACKS FOR R3 ZONING
u.~ W ES -RIDA!:it !ll1)ING 60 I
AlLlNGCOD ',. ND
?REV , AL~' ':; . CC Ai'
CO E..NAl ORD 'CES 10'
OF
10'
FRONT PROPRR"l"Y l..IHE
10'
EXISTING
101
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20'SGL FAM
30'DUPLEX
FRONT PROPER'l"Y LINK
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OWNB' 'S lIA"B_..~_ (!Zil0!-. /J!-,--e~1 '" '5'-.. _ __ __ _.._ _'_ P HONB "ON'l'Al!T j1;[: Z!i; c:.-?.f s?
,108 8 I'l'El ADDRBl8Su__.:2~~ 3.1_ _..l..-~--~-~t:----<?~~_jf:!2!.,'IJ.J___~2~~_~___ _ "_"__
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUIUJING DBJI?ARTMEN'l' 5335 ath S'rREEl'r ZHlPHYRHILI,S, P'L 33540
Phone, .13 -7'0 -0,020 .... '"3 . 7'0. oon /.... J
lJA'rBl RBC1li1rVlllO .3...1- Iff l...{),;)>--
PLANS RIllV IIlJW II'JllIli_~._.., "L____.
IJElGAL DESCRIPTIUN: LOT (S)
---..----.---------
BU)('K
PARClEJI, ID It
---------.-.--
SUBDIVISION
---..------.- _. -". --....---- ~-- '---.--
WURK PROPSElfJ f UNElW l'ONS'rRUCTI0N
-"-__w_.._____________..
--"'------..~--..-.------.------.-----....-....-- --_._._....4____.__.__.___
(OBTAIN P'ROM PROPERTY 'I'Al{ NO'I'ICEI)
o ADlJI'rH1N
~ 1\I/I'ElRA'1'ION
[] DErvlOI,ISII
[] RBlPAIR
[J IN8TAT,I,
[]snJn
o MOVE
PROt,>OSEJIJ USE) I IX{S!]I, FAMILY DWELT,INr..l
f] CO~1(11IllRC' JA I,
['h1UUI'I. FAMILY
0# OF l1Nl'1'S
U MOBII,Bl BOt1E
[J INDUS'l'RIAT,
C]SNHIMUIG POUL
IJOTf/ER
o RE1STAURANT & HElAIJ'l'!1 DBlPAR'rt.1ElNT APPROVAL "
. IkI eft 1'I.lJ'
"B S C. I P'!' roN OF NO. K jf 'f m 6 4~L/ Q,,-- "d "Y. ~ Db'" <1. +..__ EQ .:'-__~..::.._ ,'>..~')t;+-7i!' ~ "LS t<o<J~
BUILTJINll SIZE
-----
SQUARE Foo'rAGE
RBlS IDENT IAL I
CO/l1MBlRCIArI:
A'I"I'J\CH (2) PI,OT PI~A!lS & (2) SElTS OF BtJII,DING PLANS & (1) SElT E1NHlRr~y FORMS,
A'r'l'ACH (3) sl1i'rs OF BUILDING PLANS & (l) SE'I' ENElR(H' FORMS,
PROPERTY SURVEY REQUIRED FOR ALL NEv./ CONS'I'RUCTION.
---- .---------......-
/I B1 HUI'r ________ ___ ______,____
FERMITS REQUESTED
[] BIIII.IJINc~
L1 ELElCTRlCAr.
't.'i! Pl,{J~IBING
$
VALUATION OF TOTAL CONS'rRlJC'rIOl1
-.---------
M1P BEJRVICEl
o
FLORIDA POWER
[J
WoR,I!J.n.
U HBJCHANIC!AIJ
f] (JAB
fJ ROOFING
$,---..------~- VALUATION OF ~IIEJCHANCIAI, U1S'rAI,I,ATION
[] SI?EC!tAUl'Y
[) O'I'HER
TYPEJ OF l~OU8'1'RUC!'l'IDN: !P.'q BLOCK
[] FRAJ.1Bl
[] STEET,
[) OTIIElR
FIN ISHEllJ FI,UOR ElTJElVliTIONS
-----.--
IS PRO,lEleT IN FLOOD zemEl AREA. 0 YBlS
o No
SUII,nmR
_...,-_._-,._.~----.;.--------_...:...._~~---------~-
co~" PAN Y -------_____________ ----___h_____.. ________ ___________ '_
STA'I'EJ CFJRT OR REG I 8'1' # -----'------...---------'_h-C. ____..___
CITY PROCESSING #
BIGNA.TlJREJ
B1I,JllClTRICUN
*****h******************hh****************************************
. ----.-.- .---..----- .______4___.~__.
.'----_.._~_..---- --"-
S] GHATIJREJ "'_
-.. ..--......- -----.---...------------...--.----..------------
cm1PANY -.__'h.____________.____________ ______
STATEJ e'ERT OR RECHaT #
CITY PROCESSING #
"--- -----.----.. .------------.-..---. "..-
PI,UMBER
***************************************h*h***************hh*******
.----.--~_..-_.._-_.._----- .----.--..---.0........-._-
f
COMPANY-~~_~_________________..________
\ /J. . p/)/ ~ ~ STATE :~ERT OR REGrST # '_~._____.
'fI'WNA'l'''.B __~t?Z~2P?7, LL~ ___ CI'!'Y PPOeBSSING U ____.______._~_.._.._
***~**********************************'***************'*""'*'*
MBlC!HANICAl, CO/V(PANY__,_____,__ ________________________..____
STATE (IElRT OR REiGI8'r # ______...__.________,..,..______
STGNA'l'tlREJ CITY PROCESSING #
--------------_......_-,----- -------------.---------.---------
hhh***h'***********,**************************************hhh****
OTHBlR
----_......._~---_._--------------
.------
COr'!PANY
8TA liE CElRT OR -RiTIm-sT#----------h---- -------._
clrry PROCESS 1NG # -_._-.~-.___ ____._____...________.._
S WNA'l'UREJ
*************************************'*********************~*****
----------..-..---...-.----..---""---..----.-.-......- --
CONDI'l'IONS OF PERMI'." AF';'.':;)AV~'T
A. NO~ICE OF DEED RESTRICTIONS
The undersigned understands th,t ~hla p~rmit may b~ s~oject: ~o "deed restrictions" which
mi::lj' be more r'estrictive than City r'=9ul,d:ions, '1'h.;; lInd';;l.'si';}ned assumes respollslbility for
compliance with any applicable deE::d rest:riction~,
B. UNLICENSED c'ON'l'RAC'l'ORS AND CON'l'HAC'l'OH RES PONS IBII.I'I'IES
If tile owner has hired a contractor or contractors to undertake work, they may be required
to be licensed in accordance with state and local reglllations. If the contractor is not
licensed as required by law, both the owner and contractor may be cited for a misdemeanor
violation under state la\J. If the owner or intended contractor are uncertain as to ~lhat
li censing requirements may apply for the intended work, they are advised to contact the
city of Zephyrhills Building Department, 813-788-6611.
Furthenno:re, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor Sections" of this application for which they
will be responsible. If you, as the owner signs CIS the contractor, you. are indicating that
you, rather than the contractor, are responsible for the work. If the contractor \^lishes
you to sign as contractor that mflY be an indication that he is not properly licensed and is
not entitled to permitting privileges in the City of Zephyrhills.
C. 'l'RANSPOR'l'ATION IMPAC'l' FEES AND U'l'I LI'l'Y CONNECTION j!'EES
D. CONS'rRUC'rUION IJIEN LA~~ (CHAP'l'ER '713, FIJORIDA STATUTES, AS AMENDED)
T certify that I, the applicant, have been provided with a copy of "Florida's Constructlon
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
Ilave obtained a copy of the above described document and promise in good faith to deliver
it to the "owner" prior to conunencement.
E. CONTRAC'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 compliance with all applicable laws regulatlng construction, zoning, and land
development.
Application is hereby made to obtain a permit to do work and installation as indioated. I
certi fy that no ~mrk or installation has corrunenced 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 th@ regulations of other governmental agenci.es !nay apply to
the intended work, and that it is my responsibility to identify what actions I IIllU:lt take to
be in compliance. Such agencies include but are not limited to: *Department of
Environll!ental Regulati.on-Cypress Bayheads, Wetland Areas and Environmentally Bensi.tive
Lauds, Water/Waste\>1ater 'rreatment
*Soutllwest ~lorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*AnllY Corps of Engineers-Seawalls, Docks, Navigable WatenJays
*llepar'tment of Health Ii. Rehabiliti:ltive Services, Environmental Health Unit-Wells,
Wastewater ~reatment, Septic Tanks
"U.S. Environmeutal Protection Agency-Asbestos abatement
1 also certify that, if fill material is to be used in Flood Zone "A" or "A, etc.", it is
understood that a drai.nage plan addressing a "compensating volume" 'will be submitted \<Ihich
is prepared by a professional engineer registered in tlle state of Florida prior to permit
i..suance,
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 teohnical codes,
nor Sllflll issuance of a permit prevent the Building Official from thereafter requi.ring a
correction of errors in plans, construction, or violations of any code. Every permit
is~u~d shall beoome invalid unless th~ work authorized by such permit is oOllulIenced Hlthln
six months of issuance, or if work authorized by the permit 16 suspended or abandoqed for a
period of six months after the time the work is conunenced. One 90 day extension of tillle
may be allowed for the permit with fee charge of $15.00. The extension shall be requested
in writing to the Buildlng Official. An approved inspection must be logged during each'ajx
month period, or the project will be considered abandoned.
WARNING TO OWNER; YOUR FAILURE '1'0 RECORD A NOTICE OF COMMENCEMENT MAY RESUL'l' IN YOUR
PAYING TWICE FOR IMPROVEMEN'l'S TO YOUR PROPERTY. IF YOU INTEND TO OB'I'AIN FINAlH1INq, ~9N~UIll'
WITH YOUR LENDER OR AN A'l'TORNEY BElfORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. ,JOBS UNDER
$2,500 IN VALUE: DO NO'r NEED 'I'O RECORD AND POST A "NO'l'ICE OF COMMENCEMEN'l'''.
SIGNA'l'URE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
acknowledged
, 19_
STA'rE OF FLORIDA
COUNTY OF
The foregoing instrument WaS aoknowledged
Before me this --slay of-----, 19 -.:.--
by
(name of person aoknowledged)
Qho is per:sonally known to me, or
S'l'A'fE OF FLORI DA
COUNTY OF
The foregoing instrument was
Bt:lfore me this ___ day of
by.
(name of person acknowledged)
Dwho is personally known to me, or
Owho has produced
(type
and who[] did []did not
of identification)
take an oath.
o who has produced___
(type of identification)
and ~Jho Ddid DUd not t.ake all oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
--------_.__.._-.,.,~...-......---,.~._--~
.---- - -----.-- .._._-~-------~-----
Name typed, printed or stamped