HomeMy WebLinkAbout03-1869
BUILDING PERMIT
Permit N~
CITY OF ZEPHYRHILLS
(813) 780-0020
1869
Date
c2~;;lSr-()3
BUilDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Property Owner:
Job Address:
Parcel 1.0. /I
tJM.5 eh~
.':::::;4 ( 'J- 7 'sT.
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
Descriotion of Work
Energy Code:
~~ [t'h
Radon Gas:
~-~
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
City license Registration #
State Certified license#
I/;~
Permit Fee
~ignature
Company
Address
"J'lephone#
w
-,,' C
.
-
Valuation or
Contract Price
oJ, Lf tuJ
(
I 9-r..')
.%7~:Jr
WCI/;' ~ err:;
. {J
BUilDING
Ftr.
Pre SlB
lintel
FRM.
Insul. Cl
Wl
Tp. Servo
Rough In
Meter Can
Const, Pole
Pool
Pre-Meter
Final
MECHANICAL
SlB
Tub Set
Water
Sew
Fin
Breaker
Duct nsl.
Co pressor
nal
Driveway
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.
UI'lNEJR' 8 IlJH1EJ lAJ M 5 CIlItIZJJc/2...
-------- -.------ --....------. --~--~-_._--".- . - -----.-- --.--.- ----_. - ---------
,TOB S I'l'E1 ADDRESS . --..['X!~..__ --2-----?._r:______ ___________ ------__u ______
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUIl,DING IJEI?ARTMElN'r 5335 8th S'rRElElT ZElPHYRHII,I,S, Fl, 3354.0
Ph0l1ElI813-780-0,020 FaxI813-780-0021 ..00./...2...
tJA'flll RBOlllIVSJD -.2!. '2.c.<2f",f: _/.__
PJ,ANS Rlllvrmw Jl'JllJlj ..
-" - --- -.-. -- .~_..~-.-- ..
PHONE (X)N'l'l\(~T
LEl<3l\L J)EJ8(!R 1 PT lOtI: LOT (8)
---.---.---- ...--.------
BLOCK
PAR(!EJl, ID It
.n___._.___~._. _.__
StlBIJIVISJntl
-'~_.~. .--. -'-".. - ,.-
WURK PROPSElIJ I L)NBlW C'ONS'l'RlJCTION
---.--------.---..--.----------.-------.-------..----.--. -...--------... -.-----....-. .---..- ..-------.--.--..
(OBTAH1 J;i'ROM PROPER'l'Y '['AX NOTICE)
[J ADm'nON
OALTERAirrON
[J RElPAIR
[J IN8TAI,I,
[J S WlT
(J MOVE
o DElt1ot,ISII
PROP08Elll USEli [JSG!, FJ\tHLY nWELLU1G
[lt1tJL'1'I.. FAlvIII,y
[]# UF I1HITS
[J SW!MMING POUL
U MOBII,El 1I0l1El
f] CDl']MHlRC' I A t I
[J INDUS'l'RIAT,
[J OTHER
IlBJ8CRIP'!'ION OF l^10RK
CJ RE18TAURANT & HElAl/l'H DElPAR'l'l1ElN'l' hPPROVAJ-l
--LtMfL/?__ O~~ 71J__J~ 12o~_..!Jt?fk/~..____~_____________
SQUAREl FOOTAGE: flEl r<m'I'
'''--._-..~ ......-- -,~
BlJn,DINc~ SIZEl
.--------..----. -.-------
RElBIDElN'rI}U, r
CO~1MEIWIAI, r
0-.-- .__.__~ __--.__
A'J"l'l\CH (2) Pr,O'!' PI"AI1B & (2) SETB OF BtJI/,IHWJ PLANS & (1) BEl'I' ElNElRflY F'OR~'IS.
A'l"liAC!H (3) sHiTS OF BUILDING PLANS & (1) SET ENEROY FORlIIS.
PROPERTY StJRVElY RElQUIRElD FOR ALL NEW CONS'I'RUCTION.
... ------~. .~. .-.-._. -------------
[] 8IlII,IJIN<~
If. I>~RHITS REQUESTED
$1/- / () tJ <t--"
-_:.L__~_.__. _.
/
VALUATION OF TOTAL CONSTRUCTION
(J EJLElCTRICAI.
(] PI,HtIlBINC3
o HBI(JHANWAI,
-.....-.-.....---..----
MIIP SEJRVICEI
[]
FUJRIDA POl^1ER
[]
W.R.El.n.
[] GAS
LJ ROOFING
$-- --.--.--------- VAI,UATION OF lllElCIIANCIAI, UISTAI,IJl\'I'TOH
[J SPE)(!IAUry
[) OTHER
'l'YPEJ OF' CONSTRUC!TION I LJ BLOCK
[J FRAt..JEl
(] STElB1L
[J OTHElR
F llHSHElJ Fl.UOR ElI,ElVAT IONS
---------------
IS PRO,TElC'l' IN FLO(J[) ZONEl AREA[J YRla
o No
BUIr,tJIllR
B11,lllCl'rRIdIAH
*****~************************************************************
COllIP AN Y_u__. ---____u____~____ u_______..... __u_uu . _. ____.. u___ ._.. u__
STATE CFJRT OR REJ<:3IS'l' # __'_ -_.u_.._u____.______.
CITY PROCESSIN<:3 #..__.____.__ -..___u________ _.______.__...
8lGNATlJRHl
-'....-....-..--.--.---.-.--.-------------.--.--------
----- ------ "-"---.-..., ..._-----~--..-.-.- -....,-_._.._----~--
CO!1PANY -.___h__________ --------.--__u___________
STATE e'ERT OR REGIS'!' #
CITY PROc.'EJ88INlj #
.----. ,---- --_._,.~_._..__._--------- '-"'-."-'."--'-,----
SJ 13IIA'l'IJREJ '_'u._
PJ,UMBBJR
********************************************************~*********
-..--.----..----.-- ---"---. _.. -._--- - -----.----. ---------
w._'_~..______~,..___._......_ __.
.---.-----
( !OM PAN Y -. ----______..__.__._________________...._____. _'__.. ___ ___..__
STATE CElRT OR RElGlST # --------...__u.___._.._____.
CITY PROCElSSlN<:3 #
S IlmATl1R El
******************************************************************
.--.-----.--------.--------.----.-.--------
"/ ~ '~-" '~ ...
O'l'I1B1. R '.~ lC,'L-'4T 7-~1t;: M'e>,h',</?-' ~~~;~"~.t~R":.I8T0~j1i2'7.T---
8 "'"AT".. -cff-~_~_______ CITY PROCESSING #Jj"==--=~-LL:~::-===_:
*************"''''******'''***''''''*'''*****''''''****'''**''''''******'''*'''*"''''*'''*****'''
*.* * * '" * * '" * * * * * * '" * '" * '" * '" * * * '" * * * * * '" '" * * * '" '" *.* * '" '" * * * * '" '" '" * * * * * * * * * '" * '" * * * '"
CONDIl1.'IONS OF :?EP>J~.Ir;.1 AFE'~~:JAV~r;.
A, NOTICE OF DEED RESTRICTIONS
The undersigned understands thqt thL~ p~rmit :;nay b'3 subject eo "deed restrictions" which
may be more restrictive than City regulations. ']':!1'= und=rsi;1ned aSSllmes responsibility for
compliance with any applicable deed n;:strictiorw.
B. UNLICENSED CON'l'RAC'l'ORS AND CCN'l'Rl\CTOR RESPONSIBILI'l'IES
If the owner lias hired a contractor or contractors to undertake work, they may be required
to hI:; Ii censed in accordance with state and loca:L regulatiolls, If the contractor is nut
licensed as required ~y law, both the owner and contractor may be cited for a misdemeanor
violation under' state law. If the owner or intended contractor are Ullcer'lain as lo vlhi:lt
licensing requirement.i:l may apply for the intended work, they are advised to contact the
c1 ty of Zephyrhill s Building Department, 813-788'-6611.
Furtheunor'e, if the owner has hil'od a contractor: or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor Sections" of this application tor whicll they
will be l:esponsible. If you, as the ovmer signs as the contractor, YQL! are indicating that
you, rather than the contractor, are responsible for t.he vwrk, If the contractor Hishes
you to sign as contractor that may be an jndication that he 1s not properly ljcensed and is
\lot enUtled to permitting privileges in the City of Zephyrhills,
C. 'l'RANI:H'Ok'l'ATION IMPAC'l' FEES AND U'l'ILI'I'Y CONNECTION FEES
D. CONS'l'RUC'l'UION LIEN LAv~ (CllAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided vdth a copy of "florida's Construction
lien LaH - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs, If the applicant is someone other that: the "owner", I oerify that I
have obti:iined a copy of the above described document and promise in good faith to delivar
it to the "owner" pri.or to couunencement.
El, CONTRAC'l'OR' S/OWNER' S AFE'IDAVI'l'
I certify that all the information in this application is accurate and tllat all Hark will
be done in compliance with all applicable laws regulating construction, zoning, and land
development.
Applioation is hereby made to obtain a permjt to do work and installation as indicated. I
certi fy that no Hork or installation has conunenced prior to issuance of a penni t and that
Clll work vii 11 be performed to meet standards of all laws regulat1.ng construction, City
codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other governmental agencies mi:lY apply to
till:: intended work, and that it is my responsibility to ident1fy what aations I ll\l1st Lake to
be in compliance, Such agencies include but are not limited to: *Department of
Envirollmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Bensttive
Lands, Water/Wastewater 'rreatlllent
*Southwest ~lorida Water Manag~nent District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
~Army Corps of Engineers-Seawalls, Docks, Navigable WaterHays
'kiJeptu.tment of Health & RehalJilitative Services, Envi.r'omnental lIealth Unit-Wells,
Wastewater 'I'reatment, Septic 'ranks
*U.8. Environmental Frotection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone ~A" or "A, eta,", it is
understood that a drai.nage plan addressing a "compensating volume" 'will he submitted which
i6 prepared by a professional engineer registered in tile State of florida prior to pennit
jssuance.
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 tile technioal codes,
nor shall issuance of a permit prevent the Building Official from thereafter requi.ri.ng a
correction of errors in plans, construction, or violations of any code, Every permit
issued shall become invalid unless the work authorized by such permit is cOllullenced ~dthin
si.x months of issuance, or if work authorized by the permi.t is suspended or abandol!ed for a
periud of si~\ months after the time the Hod, is commenced, One 90 day extension of time
may be allowed for the permit with fee charge of $15,00. The extension shall be ~equested
in Hriting to the Building Official, An approved inspection ,must be logged during each sjx
month period, or the project will be considered abandoned,
WARNING '1'0 OWNER: YOUR FAILURE TO RECORD A NO'l'ICE Ob' COMMENCEMENT MAY RESUl/l' IN YOUR
PAYING 'l'WICE E'OR IMPROVEMEN'!'S TO YOUR PROPERTY. IF YOU INTEND TO OB'l'AIN nNANGING, ~oN~UIJI'
Wl'i'H YOUR l.ENDER OR AN A'l"I'ORNEY BEE'ORE RECORDING YOUR NOTICE OF COMMENCEMENT, ',JOBS UJ~I>ER
,>,50n IN__~~~ NE;;~;CORD AND POS" A "4i ZNC:;;~___
SlGNA'l'lJRE: OWNER OR AGENT SIGNATURE: CONTRAC'l'OR
STA'I'E OE' FLORIDA
COUNTY OF
The foregoing instrument Has acknoHledged
Before me this _-----5jay of-------, 19
by .
(name of person aoknowledged)
O/ho is pet:sonally knOl'w to me, or:
S'1'A'l'El OE' FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
Before llIe this ___ day of 19_
by ___..____
(name of person ackno~ledged)
Dwho is personally known to me, or
o who has produced
(type
and who[] did [Jdid not
of identification)
take an oath.
o Hho has produced__._.___________
(type of identifioation)
and Viho Ddid [].Ud not t.ake an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
_. .--.-....---.-..- .. ~ .-_. .~~~----------------_._----
Harne typed, pdnted or stamped
Hame typed, printed or stamped