HomeMy WebLinkAbout03-1853
BUILDING PERMIT
Permit N~
CITY Of ZEPHYRHILLS
(813) 780-0020
1853
Date oJ - /q - 0 3
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner: '75({,).b~4 ~
9 -...,.... ',1
Job Address: 54(.1(1 .I JZ~ C( ,0....1 L N
Parcell.D. #
Water Meter:
T.I.F.'s:
Zoning: Energy Code:
Descriotion of Work --dv ( \J f (.-0 tt..,
< ~don Gas:
I- ':RV ,-pc~
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
Permit Fee Ii' ~ : ~
,><.Signature ~
Company
Address
;><relephone# 7~ - S- ~-D 0
Valuation or
Contract Price
,;)( Lf DO . (YL1
City License Registration #
State Certified License#
"'--1 1-1 s.."",
r
BUILDING
ELECTRICAL
//
/
F
PLUMBING _
/
I
MECHANICAL
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pol
Pool
Pre-M
Fin
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
compres/
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.
UlmER 'S 11M1EJ a / u fl AU q ~
-.-._-~--..--.... ..----- -.- .---------. '.--.- -- F2 --.------...--.----~----
,TOB e ITEl 1\DlJRm88~.Y...4'_Lj__. -./!~If1Q________0L.____...______ ----_n_...
!JBI(]AL DIlJ8CRIPTIOtll LOT (8) !t!.-(;;J.SQ_ BLOCK _________....._ SUBTJIV IS JON
CITY OF ZEPHYRHILLS PERMIT APPLICATION
Burr.rJIN<1 IlEl?AR'I'MBJN'l' 5335 8th S'l'RElBl'l' ZIllPHYRHII,IJS, FL 33540
PhonaI813-780-Q020 FaxI813-780-0021
VA'flll RIlWBlIVllJn __.____ _ ~,~ ____
InANS RllIVIBlW IJ'JllIll
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PHONE <~ON'l'1\C!'!Zt~=~>Qf!_u___
[) Af)DT'l'WN
- --'---_._---------,._-.-._._._.._--~.-. ---._----_.._~~.~ -------..--- .'- - .'-... ---------- ----.--.".-.
(OBTAIN FROM PROPER'l'Y 'I'A)( NO'l'TC!El)
}iji@!4 11t-
P1\RUEI, ID It
WORK PROl?8ElJ I L.JNEN I-'ONS'I'RUCTION
..........._.~~---~_._._-_._---~-------_._-_.._-
o 1\I/rEJRA'rIOH
LJ REJPAIR
[J INSTALl,
[) 8 Iml
o ~10VEl
o DEI,10I,ISII
PROPOSElIl {J8E) I [JSGI, FAMILY nWElLr,U1G
r]~.1U!/l'I - FAMIl,y
[) # OF tiN ITS
[]SWIHMING POOL
IJ M081I,rn HotlJIll
f] CotIIMIlJRC' fA r,
rJ INDUS'l'RIAI.
[] OTHER
)lBJSCRIP'I'lCJN OF 110RK
o RE1STAURANT & HEALTH DElPARTtlJElNT APPROVAL
__jJo I/CC{)JLY-L~jJf)J-)_____________.____... _._
SQUARE FOOTAGE __.______ HEllOH'!' ._._.____________.___
BUH,DIN<l 81ZEl
----.---.-----.-.--.----
RESIDEN'I'IAlJ I
<~Of\1MI!lIWIAlII
A'I"l'1\CH (;1) PI,O'I' PllAI!S & (2) SElTS OF BUIl ,Dnm PLANS & (1) SElT E1NElROY FORMS,
AT'I;ACH (3) SElTS OF BU!I,fJING PLANS & (1) SET ElNER<N FOR~18.
PROPElRTY SURVEY REQUIRED FOR ALL NElW CONS'I'RUCTION,
C1 8lJILIJINO
[J ELElC'I'RI CAI,
(] Pl,WIJBING
lJ HEI(~HAN I<..!IUJ
~ERMITS REQUESTED
$---~ I(&l!..~~___.;, VALUATION OF TOTAL CONSTRlJC'!'ION
------------_ AMP SERVICE]
o FI,oRIDA POWER
o W,R.El,(l,
[] (~A8
LJ ROOFH1G
I
$----..-----'------- VAIJUATION OF ~-1B:CHA.NCIAr, HISTJ\l,IJATTON
[J SPE(!IAUl'Y
[J OTHER
'I'Y'PEl OF' <~ON8TR(J(!T ION I [J BLOCK
[] FRMIJEl
[] STEE:L
[J OTHER
FIN ISHEIl FLOOR ElIJEVATIONS
-----.---------
IS PROIJEC'I' IN FLoor> zemEl AREA n Yms
o NO
llIUlc'rRICUU
** *** * ***** * ** * * * ********** * ************ ** -I< *** -I< ******** * * * *** * *** *
/! "
COIIJPANY -'_. -LV-SJ2""-_.Cf2!!-&~~~. ___..____.___
S'I'A'I'H: CElR1' OR REGIST # .--.n-_n__7,________. _'n_ __'_
CI'l'Y PROCB188ING tt--j5.~_Z'__n_ ___. . '__.___
BI1ILDI'llR
81rJNATtJREl -.,.---.f!~_~_---.._.__
.... ----~--_._~_._._--'--_.._._------~.~,-_._---,---_._-
Cot1 PAN Y _ _.___..______.__ __ _ _._____ .__..__ __~...____ __ ___."
STATE CERT OR REGrST It
CITY PROCES8Ili/(~ 11
_..__._-...~. _. ..'.n_' -----...--_Uh.,_
S] <m1\TURE __..__
PI,UMBER
*********~********************************************************
-"~-'_'_'_ h__._____. ______.___._______._
.._-_..._-_._,...._~-..._--.._--- _._'--_._'------.._._--~.._-_.-----
< !(JM PAtTy -..---.- .------.--~--.7--- __._____..__..._..___ .._._____ ._.
STATE CERT OR REGIeT # -----__.._n._.__._._.___.___...
CITY PROCESSING #
SIr1HJ\TllREl
MIIlOHAHICAl, COfvlPANY___________.____._.__m._____._....__.. _'_uoo__
STATE CI11R'f OR RElGI8'r # _____..___.__ -------..n________.u__
SlGNA'I'tlREl CITY PROCESSING #
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~-_._---_._---_..._._-----~- ---.----.-....--.-..----...-.---.----
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o'rllER
..----.--. .._--'---_.---->"---------_._--------~--_.--
--------~--------,----_._._----
(~m.1PANY
S'1'1\1'E) CElRT OR-RIDGI8TW-------- ......--------..---.._.._
C pry PROCElS8ING # ___...._ ________._____.____.___.__ ___.
8 WIIA'l'lJREJ
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._--~_..~-_...- _._-_.._~---_._----...._-..~ - ~'.._--._---~.__..
CONDI'l'IONS OF PERMIT AFFIDAVIT
A. NO'1'ICE OF DEED RES'l'RIC'rroNS
The undersigned understands thqt this pennit may be subject to "deed restrictions" which
mdY be more restrictive than City regulations. 'J'lle und'=J:signed assumes responsibility for
complicwce with any applicable deed restrictions.
B. UNIJICENSED CON'l'RAC'l'ORS AND CON'l'R<\CTOR RESPONSIBILI'l'IES
If the D\-Iner- has Idred a contracto!: or contractCJl:s to under-take Hork, they illay be required
to be 1i censed in accordance ~d.th state and local regulations. If the contractor is not:
1i censed as required lJy la\...., both the owner and contractor Illay be c1 ted far a mLedemeanar
vi olati on under state la\J. I f the owner or- intended contractor are uncer'lain as to vihat
lioensil19 requirements may apply for the intended work, tlley are advised to contact the
Ci ty of Zephyrhills Building Department, 813-788-6611.
Furthermou::, if the owner has hired a contractor or contractors, he is advised to have the
ooutractol:(s) sign portions of the "Contractor Sections" of this application for which they
will be responsible. If you, as the owner signs as the contractor, you are indicating that
you, rather than the contractor, ar.-e responsible for the vwrk. I f the contractor wishes
you to sign as contractor that may be an indication tllat he is not properly lioensed and is
llot elltitled to permitting privlleges in the City of Zephyrhills.
C. 'l'RANSPOR'l'A'I'ION IMPAC'l' IfEES AND UTILITY CONNECTION FEES
D. c.:ONS'I'RUC'rUION LIEN LAW (CliAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
r certify that I, the applioant, have been provided with a copy of "Florlda's Constrllction
lien Law - Homeowner's Protection Gulde" 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 promise in good faith to deli.ver
it to the "owner" pri.or to commencement.
E. CON'rRAC'l'OR' S/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, zonill<1, and land
development.
Applioation is hereby made to obtain a permit to do work and installation as indioated. I
ce-l=tify that no Hork or installation has commenced prior to issuance of a permit and that
all work will be performed to meet standards of all laHs regulating construction, City
codes, zoning regulations, and land development regulations in the jllrisdictjon. I also
certify that I understand that the regulations of other governmental agencies IDay apply to
the intended work, and that it is my responsibility to identify what aotioue I must take to
be in compliallce. such agencies include but are not limited tal "Department of
EnvirolUDental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensltive
Lands, Water/Wastewater 'freatment
"Southwest Il'lorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable WaterHays
"LJepartment of Health & Rehabilitative Services, Environmental Health UnJt-Wells,
Wastewater Treatment, Septic Tanks
*u.S. Environmental I?rotection Agency-Asbestos abatement
I also certify that, if fill material is to be used In Flood Zone ~A" or "A, etc.", it is
undeJ::stood that a drai.nage plan addressing a "compensating volume" 'will be submitted v/hich
is prepared by a professional engineer registered in tile state of florida prior to permit
issuance.
A penDit issued shall be construed to be a license to proceed with the Hork and not as
authority to violate, cancel, alter, or set aside any provisions of tbe technical codes,
nor allall issuance of a permit prevent the Building Official from thereafter requiring a
oorrection of errors in plans, con~truationr or viOlations of any code. Every permit
iSrJued shall beoome invalid unless the wOJ:k authot'ized by such permit ia oOllulIenoed Hithin
sil( months of issuance, or' if \-mrk authorized by the permlt is suspended or abandol1ed for a
period of S11t months after the tilDe the work is commenced. One 90 day eKtenslon of time
may be allowed for the permit with fee charge of $15.00. The extension shall be ~equested
in Hriting to the Buildlng Official. An approved inspectlon must be logged during each alK
month periOd, or the project Hill be considered abandoned.
WARNING '1'0 OWNERI YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMEN'l' MAY RESUL'l' IN YOUR
PAYING TWICE E'OR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IN'rEND TO OB'I'AIN E'INANqINC~, \.X?N@UL'f
WITH YOUR L~IWER DR AN A'l"!'oRNEY BEFORE RECORDING YOUR NO'l'!CE OF COMMENCEMEN'I'. JOBS UNDER
$2,500 IN VALUE: DO NO'l' NEED '1'0 RECORD AND POS'l' A "NOTICE OF COMMENCEMEN'llll.
..~.._.,---~~-"...~--_._--~--
SIGNA'l'URE: OWNER OR AGENT
SIGNNfURE: CONTRACTOR
STA'l'E OF FLORIDA
COUNTY OF
'1'he foregoing instrument was acknowledged
Before me this ..............-1ay of----, 19 _:..-
by
STATE OF FLORIDA
COUNTY OF
'l'he foregoing instrument Has acknoHledged
Before me this __ day of _______, 19_
by
(name of person acknawl,dged)
OHho is personally knoHn to me, or
o who has produoed
(type
and who[] did []did not
of identification)
take an oath.
(name of person acknoHledged)
Gho is personally knovin to me, or
o v~ho has produced _____
(type of identifioation)
and VJho rJdid [}Ud not t.ake all oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
-~_._----_..._-~.._.-_...---._-_._-~------._-.------_._-----
Name typed, lJrinted or stamped
Name typed, printed or stamped