HomeMy WebLinkAbout03-1840
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N~
(813) 780-0020 l(f)' 6"> Date c2 -13 -0 ~
1840
BUILDING
,9;0
'3;- .
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcel 1.0. ,
.~~S
wl(J~
II /~:tt~~~
1~' <sT.
Water Meter:
T.I.F.'s:
Zoning:
OescriDtion of Work
~. '. ,Energy Code: ~
C ~Q
~ ~n Ga~
~ ~. ~rjz
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
FINAL
C.O.
;;2-19 -&3
DATE
NO OCCUPANCY BEFORE C.O.
DATE
City License Registration #
State Certified License#
Inspector
Permit Fee 5' . ~
X-Signature frr.
Company . 5""' cJ /"V' ~ '-I S
Address / () ~ ~" l () S. "3>0 ( /J 11 f")P ('';i y F (
);relephone# 3 C; J..-- c;- ft:' 9"'J-b ') 2. V
()
Valuation or
Contract Price
d.., ~go ~ ~
,
~~5 !t ;)D "
BUILDING
c:;j f)I-\ (f\. ( IS 'it dOC;
ELECTRICAL
~i/tn{ 's #d-{)~
PLUMBING
MECHANICAL
Breakers
Ducts Insl.
Compressor .. .
Final ./ ..:7-/7'-tf'3 ,#:To
SLB
Tub Set
Water
Sewer
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final 7~-17""v3
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
j/Jc.:J
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.
CITY OF ZEPHYRHILLS PERMIT APPLICATION
aUI1,CING DBPARTMENT 5335 8th STREET ZEPHYRHIL1,S, F1, 33540 .
Phonet813-7BO-~020 FaXt813-780-0021
CA'rm RBCJ!lIVEO
_'_"'_"~.o..-..<-t.o-:;. ..'___..__
PI,ANS REVIEW Jl'11ll_'-_~c_"_'l:_.__._
UNNEJR I 8 llM1E_._::r-..d:l!~1_~___JLe__XMdk"d..!_,________ PHONE (~ON'l'AC!'~_~_~?_=c/~::~_~____
,JOB S ITEl 1\DDREl88__6_LQ.lP.______fs__:f!z.____?_7_________ ___________.____,________._ ________
I,ElCJ1\L DBlSCRIP'rIOI1: LOT(S)
BLO(~K
SUBIlIVISION
PARCEll, In It
(OBTAIN PROM PROPElR'ry 'PAX NOTWEl)
._._-_._-~,-----_.:...--..._-------------_._-----_.~-~--,~.----~-----._~_._-_._....~..__._._---*-
HURK PROl?SEltJ I [JNBlN ('ONS'l'RUCTION
[] cmll(vIBlR(~ J1\ I,
[J ADD I'l' ION [J ALTElRA 1'1 ON [1 REPAIR U INSTATJJ,
o MOVE: 0 rm r'lOl , I 811
[)rmLTI. F1\[v1Il.Y 0# OF lJtUTS lJ MOBIIrEl llot1E
o INDUS1'RIAT, []SNUIMINCJ POUT" (] OTHER
[) S JGl1
PROPUSEIl USE:1 [ISGl, FAMILY DWEJLT,I1K~
BUIJ,TlIN(] SIZE
~='AlJRANT & HEAlml DElPARTt'lElN'I' APPROVAL,
~_____~m~~=----f~-.~-----.- ~..~-..
SQU1\REl FOOTACJE HIDJCJHT
llEJ8CRIP'l'ION OF HORK
RES IDBlNTI1\JJ I
(~OMMElRC;IAL'1
A'I''I'ACH (2) PI,OT PT"Al1S & (2) SElTS OF BUII,lHNt1 PLANS & (1) 8ElT ElNE1Rrn~ FORlv!8,
A'r"rAl!!! (3) sEi'l'S OF BUII,DING PLANS & (l) SElT E:NElROY FORMS,
PROPERTY SURVEY REQUIRED FOR ALL NEW CONS'I'RUCTION.
PERMITS REQUESTED
-_.----
[] BIJII.lJItm
L______.__-' VAl,UATJON OF TOTAL CONS'l'RtJCTION
'f::t-ELElCTRl C1\r,
____,______ At'll' SERVICE
o FI,oRIDA POWER
[] W . R . El . (! .
[] PWt<1BING
tB J.1BICH1\NICAJ,
$__,J..~_' ~__ VAJ"U1\TION OF tI\ECHANCIAI, UJSTAIJI,A'I'TON
[]G1\8
LJ ROUFING
[J SI?Er.!IAl/l'Y
[I OTHER
TYPE OP' CON S '1' RtJC !'l' JON : [J BLOCK
o FRAME
[] STEETJ
[) OTHER
FIN I8HEll FIAJOR ElIJElVJ',TI0N8
18 I?RO,JElC'f' IN FLOOD ZONE AREA. 0 YES
o NO
BUIT~nBlR
Cot'l PAN Y___.__________.__________ ___. __..___ _ _______.______. .__
STATE] CElR'I' OR REGIS'!' # '____.__________._.__________._____.__
CITY PROCESS 1NG #..__, ._d__________'_________.,__~__..__..___._
81GW\TtJREJ
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::'::::~::^Ng~~~_tJ~_~__._ ~~~!::~~~~s~~~~~~~~f~~~~~~~~-~~
'****'*.**,***",*",..*..*.**,*,,*.,,*.***,****,,******'*"***'"
P,,"MSO' (1'd ~~~~~N~~-;;t;-,;;;~:~; ~~.Q:ij~:jjr:lf "br=
S ""'"'1'11" -"-~._-~~-__"__m ~___ ___ eI'TV p.oe.ss INO # ~~.__"_"__..__..._~.
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OTHER
CO!:lP1\NY
S'I'A1'E CffiRT OR - REGr8T #-------.~_._-~----_. ..._____.u..__._,.~...__
CITY PROCElSSUJCJ # -'-"---,--.----,------------
SW1JA'l'tJRE:
******"*'*'***'*'***"**'****'***'********'**""'*******'*****'
CONDI'l'IONS OE' PERM!'l' AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
~~e undersigned understands thijt thi~ permit may be subject to "deed restrictions" which
mi::lY be more restrictive than City Legulations. The undersigned assumes responsibility for
complii::lnce with any applicable deed restrictions.
B. U1nrCENSED c'ON'I'RAC'l'ORS AND CON'l'HACTOR RESPONSIBII,ITIES
If the owner has hired a contractor or contractors to undertake work, they may be required
to be lioensed in accordance with ~tate and local regulations. If the contractor is Ilot
licensed as required by law, both the owner and contractor may be cjted for a mjsdemeallor
violation under state laH. If the owner or intended contractor are uncertain as to ~~li::lt
li censing requi rement::l Inay apply fen the intended work, they are advised to contact the
City of Zephyrhills Building Department, 813-788-6611.
Furthermol'e, if the o~mer has hired a contractor or contractors, he is advised to IHlve 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, YQ4 are indicating that
you, rather than the contractor, are responsible for the work. If the contractor wisl16S
you to sign as contractor that may be an indication that he is not properly licensed and is
not entitled to permitting privileges in the City of Zephyrhills.
C. 'I'RANSPOR'l'ATION IMPAC'l' H'EES AND UTILI'!'Y CONNECTION FEES
D. CONS'l'RUC'rUION LIEN LAW (CHAP'l'ER '713, FLORIDA s'rATUTES, 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
Ilave obtained a copy of the above described document and promise in good faith to deliv~r
it to the "owner" prior to commencement.
E. CON'rRAc'roR' a/OWNER'S AFFIDAVI'I'
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 construction, zoning, and land
development.
Applioation is hereby made to obtain a permit to do work and installation as indioated. I
certify that no Hork or installation has cOllUnenced prior to issuance of a penni t 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 jllrisdiction. I also
certify that I understand that the regulations of other governmental agencies way apply to
the intended work, and that it is my responsibility to identify what actious I must 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 Ii'lorida Water Management District-Wells, Cypress Bayheads" Wetl and Areas,
Altering Watercourses
"Army Corps of Engineers-.Sea~Jalls, Docks, Navigable WatenJays
*LJepartlllent of Health 0. Rehabilitative Services, Environmental Health 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.", it is
understood that a drainage plan addressing a "compensating vol.ume"'will be submitted which
is prepared by a professional engineer registered in the State of Florida prior to pennit
i l:lsuance.
A permit issued shall be construed to be a license to proceed Hith 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, construction, or violations of any code. Every permit
iSliued shall become invalid unless the work authorized by such permit is oOllunenced within
slx months of issuance, or if work authorized by tIle permit is suspended or abandoqed for a
pel:iod of sLx months after the time the work is conunenoed. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be reques~ed
in \'1r1 ting to the Building Official. An approved inspection must be logged during each ai x
month period, or the project vdll be considered abandoned.
WARNING TO OWNER: YOUR FAILURE 'l'0 RECORD A NOTICE OF COMMENCEMENT MAY RESUL'l' IN YOUR
PAYING TWICE H'OR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OB'rAIN FINANqINq,~qN~UL'l'
WI'l'H YOUR LENDER OR AN A'l'TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNfJER
$2,500 IN VALUE DO NO'l' NEED '1'0 RECORD AND POS'l' A "NonCE OF COMMENCEMEN'llll.
S I GNA'l'URE: OWNER OR AGEN'l'
S I GNA'l'URE: CONTRACTOR
BTATB OF FLORIDA
COUNTY OF
'l'he foregoing instrument was
Before me this _ day of
by.
acknowledged
, 19_
STA'l'E OF nORIDA
COUNTY OF
The foregoing instrument Was
Before me this ----Jjay of-
by
aoknowledged
, 19~_
(name of person acknOWledged)
Dwho is personally knoHn to me, or
(name of person acknowledged)
Gho is personally known to me, or
o who has produced
(type
and who[] did 0 did not
of identification)
take an oath.
001110 has produced
(type of identification)
and Vlho Ddid DUd not t.ake an oath
Signature of person taking acknowledgement
Signature of person taking aoknowledgment
N~~~-ty'p;d~-pri;lt;d~r stamped
Name typed, printed or stamped