HomeMy WebLinkAbout03-1906
BUILDING PERMIT
Permit N~
CITY OF ZEPHYRHILLS
(813) 780-0020
1906
Date
J. 7- 0 3
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcell.D. #
Zoning:
DescriPtion of Work
OL~/(l
3 9 ~S--5
'-
( cf0~t.&
5Y4 /) l/f' ~
W-P-€~
Water Meter:
T_I.F.'s:
1(l'E:er~
Radon Gas:
Permit Fee
Vignature C) Ql1 Q W.1LP 0--2-
. Company
Address
~lePhone# ~ l~ - 7/5-6 IS'!
FINAL ;;-/9,-(73
DATE
C.O.
DATE
s. )?~'f r !-/SO
Inspector
I:' .5' t1U
NO OCCUPANCY BEFORE C.O.
Complete Plans. Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinance
Valuation or
Contract Price
Lf O-Q , p-O
City License Registration #
State Certified License#
Ot,-JN/V
Tp. Servo
Rough In
Meter Ca
Const. P Ie
Pool
Pre-
Fina
SLB
Tub Set
Wate
Se er
Fi al
HANICAL
BUILDING
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
(
Break s
Du s Insl.
== ~mpressor
1 ;n.1
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
BUILDING nBPART~ENT 5335 8th STREET ZEPHYRHILLS, FL 33540
PhoneI813-780-Q020 Fa~le13-780-0021
!lA'n RIll(1JllIVI!lD ~_ _.__~~ _..___
PI,ANS R!IlVIBIW 11mB __.
OI1NElR 's llAl'1El ~_.__Qltl~.__ t_ oCWqr-c::f1.~_~l~___.______._ PHONE] C()N'l'1\(~'r..._.__ _. ....
\lOB SITE ADlJRBl88_._._3_S-3S.~___-:-.~.._a~_~____.___.____.. ____. __h____._____..____.__
lJBl(]1\L DESCRIPTION: LOT(8)
BlJOC!K
SUBIJIVIS]ON
PARC'El, ID #
(OBTAIN FROM PROPERTY 'l'AK NOTICE)
_._--------~--_._._-~---~._.~-------.__._-_._-----~--_._--"--+.,"_. ---~-.--_.._~-_..~,~~---+-----_.__.- ."-.-...-.."- -~..._+._---_. -,'-
WURK PRO!?SEltJ I [JNB:~'I r~oNSTRUC'TION
[J 8 mil
[] AIlDI'l'ICiN o ALTERAT ION .~tllPIHR [) IN8TJl.TJI,
o MOVE 0 DEIIJOI,I811
[h1lJI.'l'I'. FAI"lIl,Y []# OF UNITS IJ MOBIl,El HmlJEl
[J INDUSTRIAL [] SWH1MING POOTJ U OTIIHlR
PROJ:lUSElIl USE! I)>q"8GI, F1\MIIJY DWELr,IHG
[) CUt1MHlR(! 1A I,
C:J REI8'fAURAN'r & HElAlmJ DElPAR'l'tIJElNT APPROVAL
IJEJ8CRIP'l'ION OF NORK .-_2'-Lt~ ~_~__~.&__.__.____ ___~____._._~_.______._____.
BUILDINI] ElIZE ___LS~_.LL__.___.____
SQUARE FOOTAGE ___1S:c.2_Q....__
HBlIGHT .,_IQ_-b~I_
RElBIt1ElNTIAIJ I
Cm1MBJR(!IAL, :
ATTACH (2) PI,OT PIJAl18 & (2) SETS OF BUII,IJIN(] PLANS & (1) sEI'r EJNt!lRrJi' FORMS,
A'l"I;AC!H (3) sl1i'rs OF BUiLDING PLANS & (1) SET ENER<lY FORMS,
PltDPERl'Y SURVEY REQUIRElD FOR AI,L NEW CONS'I'RUCTION.
FERMITS REOUES1ED
1<(81l I LIJINr~
$ __4.~_90 '--OC?__.-' VAl,UATION OF TOTAL CONS'rRtJCTION
1.1 ELBlC'I'RlCAl,
________.___ MtlP ~E1RVICEl
o FI,rJRIDA POWElR
[] W,R,EJ,n.
[] PI.tJttlBINC3
o HB1UHAN WAI,
$---....------------. VA1,UATION OF t1EClIANCIAI, UI8'1'1\I,I,A'1'TON
[] <JAS
Ji!(ROUFING
LJ SPElntAUI'Y
[) OTHER
TYPE UF 1~0I~8'I'RUCTION: p( Bl,OCK
FINLSHEiJ norm ElI,ElVATIONS
o FRAttlE)
[J 8TEEIJ
[) OTHER
IS PROcTElC'I' IN FLOOr> ZONEl/{REA 0 YEla
o flU
BUILDBlR
81rJHAl'UREl
('Oftl PAN y---..-DJ..A..2~..Le....r=.__h__ __... __'_
STATE CElR'1' OR REGIST # ___~'_~___.'_._~._
CITY PROC!HlSSING #
'*'**'*********"**"'*"*"*t********"**""",,*,,*"'*""""
IIf,B1ClTRId!Ml'
8 J mm'l'lJREJ .._.'.
....._-_...--- ..._..__.~--- -.----.-.-.... '._-'-'-~~*. --_._.....~---------
cm1 PAN Y _'_________.__ __._ _____. __.__________... ,__.__._._ _'_ _____.
STATE CERT OR REGIST U
CITY PROCE18snm #
"-...----...-- -..--------- .._~_.- -.----. - _._--_.-._--.__.._---~-
'**""*""""'*'**"*'*""*'*"*'*""**"'**'*'*''**'*'***"*
PI,UMBBlR
r ~or1 PAN Y -'----..- -----..----.--___.__.__. ..... __..__ ._. __ _.._____ ____...
STATE CERT OR REGIST # _____~.__.____._____.
CITY PROCESSING #
SWNATlIRE:
-_...____.'.__.4___~._.__.___._._ __.._.______ _._
MBlC!HANI CAl,
*""'*'*""**"'*****'****'*******~****'*******'***'""*'******
------~--_._------..~-----_._~.._.....__.._~--
COI"lPANY ___.__~_._.__._......_____ _ .____ _________.
STA'rEl (~ElRT OR RElGIST #
CITY PROCESSING #
S IGHA1'UREl
_.__..._.._-----_...._~----_..__.. _.~_.~---.
'*'*"*********'*******""'*"*"'*"'*"""****'**'""'*"'"
(J'rlilllR
~--_._---_....---_._------
Cotl!PANY
ST1\TE CElRT OR - REG 1ST -#-------.----~_._---_....._.-.._-
CITY PROCESSING # ----.----.-..----~-.._--_.-.
~._._.._-_._._---_._--~....~---._-------_._----_._-
SWN1\'l'UREl
""'**"'*""'****"*'*'*"'*'*"*'**'**'*"**""'*'*'*'~'****
CONDI'rIONS OF PERMIT AFIHDAVIT
A~ NO'UCE OF DEED RES'l'RIC'rIONS
'l'he undersigned understands thqt this permit may be subject to "deed eestrJcUons" which
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNLICENSED (~ON'I'RAC'l'ORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they may be required
to be IJcensed in accordance with state and local regulations. If Lhe contracLor is Ilot
lioensed as required by law, both the ovmer and contractor may be c1ted for a misdemeanor
violation under state laVi. If the owner- or intended contractor are ullcertain as to v,hat
licensil19 requirements may apply for the intended work, they are advised to contact the
City of Zephyrhills Building Department, 613-766-6611.
Ifurthennol:e, if the owner has hired a contractor or oontractors, he Js advJsed to have the
cootractor(s) sign portions of the "Contractor Sections" of this application for whiell they
will be r:esponsible. If you, as the owner signs as the contractor, yo!,! are indicating that
you, rather than the oontractor, are responsible for the work. If the contractor wisllas
you to sign as contr.actor that mCiY be an indication that he is not properly licensed Cind is
not entitled to permitting prJvileges in the City of Zephyrhi.lls.
c. 'I'RANSPOR'l'A'nON IMPACT fEES AND UTILITY CONNECTION FEES
D. CONS'fRUC'l'lJION LIEN LAW (CHAP'l'ER '713, FWRIDA STATUTES, AS AMENDED)
r certify that I, the applicant, have been provided with a copy of "Florida's Constrllotion
lien Law - Homeowner's ProtectJon Guide" prepared by the Florida Department of Agrioulture
and consumer Affairs. If the applicant is someone other that the "owner", I cerify that I
have obtained a copy of the above desoribed dooument and promise in good faith to deliver
Jt to the "owner" prior to commencement.
E. CON'I'RAC'I'OR' a/OWNER'S AFIi'IDAVI'l'
I certify that all the information in this application is accurate and that all work will
be done in oompliance with all appUcable laws regulating constnlction, zoning, and land
development.
Application is hereby made to obtain a permit to do work and installation as indioated. 1
certify that no ~JOrk or installation has commenced 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 jurisdiotJon. I also
certify that I understand that the regulations of other governmental agencies may apply to
the intended work, and that it is my responsibility to idenUfy what aations I must take to
be in compliance. Such agencies include but are not limited to: *Department of
Envirollmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment
*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
J<Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of Health & RehabU.itative Services, Environmental Health \Jnit:-Wells,
Wastewater 'l'reatment, Septic 'l'anks
*U.S. 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
under:stood that a drainage plan addressing a "compensating volume" 'wiLL be submitted whi.ah
is prepared by a professional engineer registered in the State of Wlorida prior to permit
issuance.
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 issuance of a permit prevent the Building Official from thereafter requiring a
correction of errors in plans, cDn~truction, or violations of any code. Every permit
iSfJUed shall beoome invalid unless the \vork authorized by such permit is COllunenced within
six months of issuance, or if work authorized by the permit is suspended or ahandolled for a
pln-iod of S111 months after the time the work is conunenced. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be requested
in wri ti.ng to the Building Official. An approved inspection must be logged dllring each aix
month period, or the project will be considered abandoned.
WARNING 'fO OWNER: YOUR FAILURE 'fQ RECORD A NOTICE OF COMMENCEMENT MAY RESUL'l' IN YOIJR
PAYING 'l'WICE FOR IMPROVEMENTS TO YOUR PROPER'l'Y. IE' YOU IN'fEND TO OB'rAIN li'INANqINq, CqN~Ul/r
W1'l'H YOUR LENDER OR AN A'l"l'ORNEY BEFORE RECORDING YOUR NO'l'ICE OF COMMENCEMENT. JOBS UNDER
$2,500 IN VALUE DO NO'!' NEED 'I'O RECORD AND POS'l' A "NO'l'ICE OF CQMMENCEMEN'r".
._--_._--~_._._-~----_.~---~--------
SIGNA'I'URE: OWNER OR AGEN'l'
S I GNA'I'URE: CONTRAC'l'OR
s'rATE OF FLORI DA
COUNTY OF-
The foregoing instrllment was acknowledged
Before me this __ day of ______, 19-----0..
by ___________
(name of person acknowledged)
Owho is personally known to me, or
o who has produoed__
(type of identification)
and whoD did Odid not take an oath.
STATE OF FLORIDA
COUN'l'Y OF
The foregoing instrument w~s aoknowledged
Before me this _---Jjay of.-----, 19 __:__
by ____
(name of person acknowledged)
[1ho is personally known to me, or
D who has produced___ ______
(type of identifioation)
and who Odid [)Jid not take all oath
Signature of person taking acknowledgement
Signature of person takiug acknowledgment
.._--~.__.--_._-_...__.
"i:l-~m';---ty-p-~~i~---p~j~n tad 0 ~-~ t amp ~d ----------
-.._--------_._-----_.._,.------.._._~,---._,.._-,,_.........-~-_.-
Name typed, printed or. stamped