HomeMy WebLinkAbout03-1863
BUILDING
Property Owner:
Job Address:
Parcell.D. #
BUILDING PERMIT
Permit N2
1863
CITY OF ZEPHYRHILLS
(813) 780-0020
~- :zC( - Cl _~
Date
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
PI/lie..
~5.~(P
~
11~ ~1~(~
Water Meter:
T.I.F.'s:
LA.,Jr
Zoning:
DescriDtion of Work
h;ZY,Code:
~O ?
Radon Gas:
p~ ~~i
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FINAL
NO OCCUPANCY BEFORE C.O.
Complete Plans. Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Valuation or
Contract Price
DATE
'L I- l/fb
Inspector
P~rmit Fee, ~ g5"' ev
~Ignature ~;
Company
Address
)?elePhone# ~ \ '1 I~ ~ -z... ~ 4LL
City license Registration #
State Certified license#
-
Ftr.
Pre SLB
lintel
FRM.
Insul. CL
WL
Driveway
()IAJ A.4.~
MECHANICAL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Me r
Final
SLB
Tub Set
Water
Sewer
Fina
Breakers
Ducts Insl.
Compressor
Final/.,,/ :2 -:<. S- C' 3 1ft 'f ./#7"
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 ZEPHYRHIIJIJS FERMI'!' APPIJICATION
BUrUJING IlBJI?ARTMHlN'l' 5335 8th S'rRElBl'r ZFJI?HYRHILIJS, FL 33/540
PhoneIB13-780-Q020 FaxI813-780-0021
IJA'rJlI RJIlC1B1IVIlID
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I?IJANS :RIllVImW rIll. ."
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UI'lNElR I 8 IIM1B.____-Df...<<..K..___CU~.~ .... _________________________ ~O~~~1'}\r~'~___2/~.9iJ...l---
,TOB BIT' hDUROBB .1.s--.1'--~~-ut'llt"='c~J..J~ _ m__ __ ___ ___________ ________ _ _______
IJElG1\L DBJSCRIP'l'IOl1l LO'l'(S) BU)(.:'K SUBDIVISION __________.___~_________.__
PARnEJIJ III 1~__;X::Jf::, - 21.:'Q.~;'_Q_=--Oi;:) C)~-::::. D ~ qiJ
HURK PROPSElJ f UNBlN l.'ONS'I'RlJCTION
[1 AflIH'I'ION
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(OBTAIN FROM PROPElR'I'Y 'I'AM NO'l'WIJl)
o AUf'ERATION
[] RIllPAIR
U INSTAlJ!'
[JSHm
o MOVE
o DEfIJOI,ISIl
PROPOBEIl USEil CISGl, FAMILY DWELI,It!G
[Jf1UW'I - FAMIl,Y
0# OF UlU'l'B
[J SN n1M nlG POOL
U M08 n.m liOf1El
LJ OTHER
U Cm1~1BlRC 1A I,
[J INDtJS'l'RIAIJ
)JE]SCRIPTION OF NORK
o RE1S'I'AURANT & HBAlmJ DElPARTf1ElNT APPROVAL
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8UIIrflING SIZEl
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SQUAREl FOOTAGE
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lIB) TGH'f
RE8IDl!INTIArJ I
(~O~1MBlR(! I AI, I
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A'I"rACH (;)) PI,OT PI"A118 & (;)) SElTS OF BlJIl,lJING PLANS & (1.) SEI'I' ElNI!IRl1Y FnRf\1S.
A'l'TACH (3) SETS OF aUILfJING PLANS & (1.) SElT ENEfWY FORtIJS,
PROPERTY SURVEY REQUIRED FOR ALL NEW (,ONS'I'RUCTION,
RERMITS REQUESTED
[] 8\1II.IJINf~
$
VAl.UATTO'N OF TOTAL CONS'rRUC'I'ION
L1 ElLI!JC'I'RWAI.
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ArIJP ~ElRV I eEl
o
FI,oRIDA POWER
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VI.R.Bl,n,
[] P IrtJfIJ8 I NO
~ l'lE1UHA.NIC.:'AIJ
[] (1A8
LJ ROOFING
$--tJ--tJ.il----- VAIJUATION OF to1ElCHANCIAI, UISTAl,lJATTON
[J SPEC!IAI/!'Y [I OTHER
'l'YP!JJ OF' CON8'l'RU(!'l'ION: [] BI,()C'K
[) FRAJIJEJ
[] STElEL
[] OTHER
F !lUSHEr) FI,UOR llJIJElVl.TIONS
-----------
IS PRO,TEur IN FLOOf) ZCJl.TE AREA 0 YEls
o NO
BUIJ"DI!lR
******************************************************************
CotIJ PAN Y ~---"----~---'---_"___n__... ___. __..__________.___
S'I'ATE CFJRT OR RElGIST # .--..------.----...--____.c.__..___
CITY PROCElSSING IL_______~_________________.____.___.__._
8WI-IATlJREJ
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mlJBlOTRI C!All
S:I l3IH\'l'lJREl __.__
. ----....- -----~.__.._--~--_.- .~._._.-.._-_..__...__..._--._.-
cor1PANY ____.________ _._______________.._,__ _____
STATE CERT OR REGIST #
(!ITY PROCESSING #
'-- .-_ .__._H_....___._____._._____.__. _...._._
******************************************************************
----.-----.---..--.-.--.--.-. - -..-----.. ---------
Pl,UMBER
.._-.__._-....--......~~_._~..._-- ----
COM P AN Y -----_ ...___._________._____~___...,.....____._._______
STATE CERT OR REGIST # _______.__.__..__._.._____.
CITY PROCESSING #
SIcmA'l'17RBJ
S TCJNA'l'UREl
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· CITY PROCESSING #
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MEnHANICAI,
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OTHIllR
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(XJf.1PANY
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STATE CERT OR REGrST #
CITY PROCESSING #
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CO~\~!~)lrJ.lIONS OF PER~Irr AFB'IDAVIT
A. NOTICE OF DEED RESTRICTIONS
'rhe ~under<!3igned understands th~t t.h:L:;1 pennit m~y IH= :;,lb:}ect to "deed restd.ctions" wldeh
may be more restrictive than City r.:qulations. The und,n'signed assumes respollsibil'ity for
compliiHlce with any applicable dee:d .cestrictions.
B. UNl~ICENSEDc'ON'l'AAC'l'ORS AND CON'l'HAC'I'OR RESPO''1SII3IJ,I'l'II!:S
If the owner has hired a contractor or contracl:()rs to undertake work, they may be required
to lJtl lictlnsed in accordance with state and 108al regulations. If the contractor is not
licensed as required by law, both the ovmer and contractor may be cited for a misdemeanor
violation under state law. If th~ owner or intended contractor are uncertain as to V~lat
licensing requirements may apply for the intended work, tIley are advised to contact the
City of Zephyrhills Building Department, 813-788-6611.
Furthennor-e, if the owner has hired a contractor or contractors, he is advised to have the
oontractor(s) sign portions of the "Contractor Sections" of this applioation for which they
will be responsible. If you, as the owner signs as tile contractor, YQij are indicating that
you, rather than the contractor, are responsible for the work. If the contractor wislles
you to sign ae contractor that may be an indication that he 1s not properly licensed alld is
llot entitled to permitting privil~ges in the City of Zephyrhills.
c. 'rRANSpOR'l'ATION IMPAC'!, fEES AND UTILITY CONNECTION FEES
D. CONS'l'RlJC'l'UION LIEN LAW (CHAP'l'ER '713, FLORIDA S'l'ATUTES, AS AMENDED)
I certify that I, tile applicant, have been provided with a copy of "Florida's Construction
lien L~w - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "owller", I cerify that I
have obtained a copy of the above described document and promise in good faitll to deliver
it to the "owner" prior to COlTUllenCement.
E. CON'l'RAC'l'OR' S/OWNER' S AFFIDAVI'l'
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, zonillg, and land
development.
Applioation is hereby made to obtain a perml.t to do work and installation as indicated. I
c.q:ti fy that no work 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 1 understand that the regulations of other governmental agencies Inay apply to
the intended work, and that it is my responsibility to identify what aotions I must take to
be in compliance. Such agencies include but are not. limited to: *Department of
Environmental Regulati.on-Cypress Bayheads, Wetland Areas and Environment.ally Sensltive
Lands, Water/Wast.eHaLer Treatment
*Southwest Wlarida Water Management District-Wells, Cypress Bayheads,-Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waten/ays
*Uepartn~nt af Health , Rehabilitative Services, Environmental Healtll Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.8. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone qA" or "A, etc.", it is
understood that a dralnage plan addressing a "compensating volume" 'will be submitted which
is prepared by a professional engineer regist.ered in the St.ate of florida prior to permit
j ssuance.
A permit issued shall be construed to be a license to proceed with the work and not as
autllority to violate, cancel, alter, or set aside any provisions of the technical codes,
nor shall lssuance of a permit prevent the Building Ofricial from thereafter requiring a
correction of errors in plans, oon~truotion, or violations of any oode. Every permit
issued shall beoome invalid unless the wo.rk authorh:ed by such permit is oOllunenced within
six months of issuance, or if work authorized by the permit is suspended or abandoQed for a
period of six months after the time the work is commenced. One 90 day extension of tillle
may be allowed for the permit with fee'charge of $15.00. The extension shall be ~eque6~ed
in writing to the Building Official. An approved inspection must be Jogged durinCJ eacb six
Inonth period, or the project will be considered aban~oned.
WARNING TO OWNER I YOUR FAILURE '1'0 RECORD A NO'l'ICE OF COMMENCEMENT MAY RESUL'l' IN YOUR
PAYING TWICE E'OR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OB'l'AIN FINANC:;INq.~')N@UI1L'
WI'l'H YOUR LENDER OR AN A'l'TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'r. JOBS UNflER
,2,500 IN ~ Nmo NEEIl '1'0 RECORD AND PO"" A "N""'~OMMEN("'MENT" , _____
SIGHA'l'lJRE: OWNER OR AGENT SIGNA'l'URE: CONTRAC'l'OR
Signatur
edgement
STA'l'E OF FLORIDA
COUNTY OF
The foregoing instrument w~ ~oknovJle.9g~t.Js
Before me this ~D Ilay O~~-, 4<4~_
by
(name of person acknowledged)
7*ho is personally known to me, or
o who has produced
(type of identification)
and whi. tt]QAB8ER OUd not t.ake all oath
.~~.St~~~.~:.I= _
SiglOb\Tlhf~tQMt16*1 taking acknowledgment
._.__.__ :::J ~ Co ~ ~ .~ ~ .- ______________.______
~~SL Q
f(~~ t)
and
II">
,.
Hame typed, printed or stampbd