HomeMy WebLinkAbout03-1852
BUILDING PERMIT
. NO
Permit -
CITY OF ZEPHYRHILLS
(813) 780-0020
1852
Date 07 - /Y' - Cl.3
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Property Owner:
Job Address:
Parcell.D. #
1j!f I(; lit )J ,
,,? '17 78(,lrrh~/(nt dr.
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
Descriotion of Work
Enerlj,V Code: , d- 1<. \J ~doR Gas:
(X411J.eWj _ r~
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
J t(~,f)
,
~ (!1-"V
p~rmitFee~~~
)-SIgnature,
Company
Address
ytelephone~ 7 ;y-c;c;oo
City License Registration #
State Certified License#
-rrSt'h
BUILDING
ELECTRICAL
PLUMBING
Ftr.
Pre SLB .12-2)(- ()"1 If:JD
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Me r
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compr.
Fi
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
aUIljDUH; DEI?ARTMElN'f 5335 8 th S'fRElBl'r ZElI?H'iRUII.IjS, In 33540
PhoneI813-7BO-~020 FaxI813-780-0021
lJA'fBl RIll<1l!lIVllIn ~___.o ~~'"' _.. _.
PI,ANS RllIVImW rSIIi
''''tiER'" llA"B___itL=~?I!'A_ ____ ____ __ _ ________ _____ PHONE r!ON'j'wr78.s;-5~QO__
~:~:A: ':::":::}::::1I'~(~~lig:2l~~~:'~~__--~~~lJ::~ rSJ'~r-E~~~111J_}!i_
P1\Rf.!ElI, In II
NORK PRnPBEllJ I LJNElN CONSTRUCTION
-~--~------_.~~~---_._--_...._----------_.._-_._---_.._-------~'----'---'- ----'~._..-.~------_.._-_..-.
(OBTAIN FROM PROPER'l'Y '1'A1< NOTWEl)
o ATlDI'rION
o 1\ I/rElRA'I'l ON
[J RElPAIR
[J INSTAl,I,
[}snm
f.J MOVE
[) DEMOI.ISI/
PRO!:'()SEn USE: [JSGI, FAMILY DWELIJI1TG
[h.1lJUl'I. FAI"in,y
[J# OF ONITS
[J SWIMMING POOL
IJ MOBII,El 1I0t1Ill
[] OTHER
r:.J Cm,IMElR(! fA I,
[J INDl1S1'RTAT,
CJ RE18TAURAHT & HElAImI DEPAR1'~1EN'r APPROVAL
"ESCR I P',' JON OF WORK ---_iJ1:-1 '{/CcA/~-- _R- ~ ~___ _ __ ______ ____ _ _ ___ __ ______
8lJIl,fJING SIZEl SQUARE FOOTAGE 118IGB'r
.~-----_.,---_..- -.-----"--
RillS IDElN'I'IAT, t
(~OMMHlR(!IAT, :
A'I"r1\CH (2) PIlOT PI..Al1S & (2) BElTS OF BtJIJ,DING PLANS & (l.) SEl'r E1NElRrJ't P'ORt.18,
A'I"IiAr!H (3) SE'l'S OF BUILDING PLANS & (1) 8E'l' ElNElRrJY FORMS,
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRu~rION,
[] 8lJII,UINC3
FE~TS REQUES~ED
$__)'-,l;IflO' ~_~ VALUATION OF T01'A!, COI'8 'rRUCT I 011
IJ ElLBlCTRICAI,
--.-----_.___ AMP ~ERVICEJ
o FIDRIDA POWER
[J W.R.El,n.
[] Pl,lJt1STNG
U HB1CHI\N I (~AT..
$..---..-------- VALUATION UF t1ECHANCIAI, U1STA.I,l,ATTON
[J e~AS
LJ ROOF' INn
[J .9 PElr! rAW'Y
[) OTHER
TYPE OF' CONSTRUC!T ION: [J BLOCK
[J FRAHE
[] STEEll,
[J OTHER
F I1HSHE/J FI,()()R ElIJEVATIONS
-.----.-------
I S PRO,! Ee'I' IN FLOCJl) ZONE AREA 0 YIllS
o No
Burr,nSlR
"('mATUR8 ------tJ~ ~-----_
*****~**********************~*************************************
Cot1P ANy-_...-_L'f..~ () ^,,--Lo.1f/Jc-!~. u__.___ ....
STATEl CFJRT OR RElGIST # ....u.__o,'Y.l.____ _____...
CITY PROCESSI/:1(3 1t--_/537.____. ,__. . --_u...__o_ _.,
IIIUlo'rRICIAH
SJI3!T1\TIJREJ __u_
.. ~.._~----_._~--_._,---,.. __.____w_._..~..__._._.__________
COl1PANY -____h________ _ _._____ __..__________.
STATE e'ERT OR REGrST H
CITY PROCE88JNl3 #
'-----'''--' .-- ....~._-- ._.._-_.,----~--_. -_. -.--.----.-,.-
*k**~*************************************************************
-.--.-----~_._. _~_'u__. __. _._._~. _ ___.___.. _______~
PI,TJMBl!IR
.._.._._--~--.'.._-_._..._-_... -~-_._-
C ~()lvJ PAN Y -....-__._____._.___ ____.,.__________ ___ .... __._ _..____.______....
STATE CERT OR REGIS1' # _________.___.___._________..
CITY PROCESSING #
Sllml\TIJREl
MBlr!HANICAT,
******************************************************************
----.---.---..- -. '-~--~------_._...~_._-_.---- ._--
...o.....-.___________________.~._______._...,..,______,.______.
COlvfPANY __________._. __.__ ...____._______._...._ _ .._'__"'_..
STATE cmRT OR REGIST #
CITY PROC'ElSSING #
-..--..---...-....-..... -..-.-.--.-- ---.--.,...- .'.-
STGNATIJRBJ
*******************************************************~*********
..- ---.--- -.------------- _._--_.__.~._-_. .- .,.-
OTUllIR
---------.-..------
eXJf.1PANY
S'1'A1'El CEJRT- oR-R:EfiiST'tr---"-'----- .......----____n_...._
CI'rY PROCEl88ING # ------..-----.---__.___._u._________.
~._-_._._...._--_._--"------------------------
s It~11A'ruRE
*****************************************************************
-~~---~--~-- "--'-_._-'~~---"_____~_H__ .._ _. . ,_.._._._,~ ___. .__
CONlJI'l'IONS OF PERlI1IT AFFIDAVIT
A. NO'I'ICE OF DEED RES'l'RIC'rroNS
The undersigned understands th~t this p~rmit may be subject to "deed restrictions" Wllich
m~y be more restrictive than city regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNLICENSED CONTRAC'l'ORS AND CONTRACTOR RESPONSIBILI'l'IES
If the o\~ner- has hired a contractor or contractors to undertake work, they may be required
to bE; Ii censed in accordance I~lth ::>tate and loca] regulations. It the contractor is nut:
Ii aensed as required by lal~, both the olmer and contractor may be cited for a misdemeanor
violation under state law. If thE; owner or intended contractor are uncertain as to Vlh~t
Ii censing requirement::l may apply for the intended work, they ~re advised to contaot the
city of Zephyrhills Building Department, 813-788-6611.
Furthtu::1I10r"e, 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 t.hey
will be responsible. It you, as the owner signs as the contractor, YQU are indicating that
you, rather than the contractor, are responsible for the work. If the contractor wishes
you to siyn ae contractor that may be an indication that he 1s not pr-operly Ii censed alld i.6
llot entitled to penn1tting privJ.leges in the City of Zephyrhills.
(;. 'l'AANI:JPOR'1'A'rIDN IMPACT FEES AND U'I'ILI'1'Y CONNECTION FEES
D. CONS'1'RUC'1'UION LIEN LAv~ (CHAP'1'ER 713, FLORIDA S'1'ATUTES, AS AMENDED)
1 cert1fy that I, Lhe appli.cant, have been provided with a copy of "FlorJ.da's ConstructJ.on
li~n Law - Homeowner's Protection Guide" prepared by the Florida Departmellt of Agriculture
and Consumer Affairs. If the applicant is someone other that the "owner", 1 cerify that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the "owner" prior to COllUllencement.
111. CONTRAC'l'0R' S/OWNER' S AFFIDAVI'l'
I certify that all the information in this appli.cation i6 accurate and that all work will
be done in compliance with all appli.cable laws regulating construction, zonillg, and land
development.
Application ls hereby made to obtaln a permit to do work and installatioll as indicated. I
certi fy that no Hark or lnstallation has conunenced prior to issuance of a perrnt t ~nd that
all work Vlill be performed to meet standards of ~ll laws regulating construction, City
codes, zoning regulations, and land development regulat10ns ln the jllrisdlctlon. J also
certify that I understand that the regulations of other governmental agencies Inay apply to
the 1ntellded wOlk, and that it is my responsibility to identify what actions I must take to
be in compliallce. Such agencies 1nclude but are not limited to: *Department of
Envirolunental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensttive
Lauds, Water/Wastewater 'Preatment
*Southwest Inoritia Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
* Army Corps of Engineers--Seawa lIs, Docks, Navigable WaterVlays
*\Jepar:tment of Health & Rehabilitative Services, Environmental Healt:h Unlt:-Wells,
Wastewater Treatment, Septic Tanks
*U. S. Envir"onmental I?rotection Agency-Asbestos abatement
1 also certify that, if fill material 1s to be used in Flood Zone qA" or "A,etc.", it is
understood that a drainage plan address1ng a "compensat1ng volume" 'will be submitted Hh1ch
is prepared by a professional engineer registered in tile state of Florida prior to permit
issuance.
A permit issued shall be construed to be a llcense to proceed with the work and not as
autllority to vlolate, cancel, alter, or set aside any prov1s10ns of the techllical codes,
nor shall issuance of a permit prevent the Building Official from thereafter requiring a
correction of errors ill plans, construction, or violations of any code. Every permit
iSfjued shall become inval1d unless the work authorized by such permit is cOllunenced within
si.x months of issuance, or if work authorized by the perm1.t 1.6 suspended or abandol1ed for a
period of silt 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 extens10n shall be ~equested
ill writing to the Buildi.ng Official. An approved inspection must be logged during each I:d x
month period, or the project Viill be considered abandoned.
WARNING '1'0 OWNER: YOUR FAILURE 'PO RECORD A NOTICE OF COMMENCEMEN'l' MAY RESUW' IN YOUR
PAYING TWICE FOR IMI?ROVEMEN'I'S 'I'D YOUR PROPERTY. IF YOU IN'PEND '1'0 OB'PAIN FINANqINq,~qN~UIiI'
WlTH YOUR LENDER OR AN A'I"rORNEY BEFORE RECORDING YOUR NonCE OF COMMENCEMEN'I'. ,JOBS UNDER
$2,500 IN VALUE: DO NO'1' NEED 'I'D RECORD AND POS'1' A "NOTICE OF COMMENCEMEN'l'''.
S I GNA'rURE: OWNlilR OR AGENT
S I GNA'l'URE: CONTRAC'l'OR
S'I'A'l'E Of FLORIDA
COUNTY OF ------
The foregoing instrument was acknowledged
Betore me this _.___ day of 19_
by __.____
(name of person acknowl,dged)
Dwho is personally known to me, or
STArrE OF nORIDA
COUNTY OF "-~---_._----
The foregoing instrument WCl,S acknowledged
Before me this _....JJay of , 19~_
by _____
(name of person acknowledged)
D-iho :is personally knovln to 1l1i:l, or
o who has produoed
(type
and who[] did [Jdid not
of identification)
t.ake an oath.
o who has produced____
(type of identification)
and who Ddid DUd not take an oath
Signature of person taking acknowledgement
Signature ot person taking acknowledgment
l-hune typed, printed or s l:amped
-
Name typed, printed or stamped