HomeMy WebLinkAbout03-1908
BUILDING PERMIT
Permit N~
CITY OF ZEPHYRHILLS
(813) 780-0020
1908
Date
3 - 7- {t7 5
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Property Owner:
Job Address:
Parcell.D. #
V " l2- K~
5&<-/0
Water Conn:
J.,c; V -e--v T u '€-.
1<6~ sT.
Water Meter;
T_I.F.'s:
Zoning:
Description of Work
Energy Code:
~ :Jlt~~
Radon Gas:
~-)~(/ ( C '€.
TO
/so~.
NO OCCUPANCY BEFORE C.O.
FINAL
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be pertormed in accordance with City Codes and Ordinances.
c.o.
DATE
Inspector
~~;~~::,:e ~ (~ ~L
Company
Address
Xt'elephone# ~l 3- 7RP, - 28<6 L{
f.:>.'i.~ .4.J dI ;::-I-e c .
Valuation or
Contract Price
.---...
City License Registration #
State Certified License#
Ftr.
Pre SLB
Lintel
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SlB
Tub Set
Water
Sewer
Final
Breakers
Ducts Ins!.
Com pres r
Final
BUILDING
ELECTRICAL
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 ($25.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUIWING I>EI?ARTMBlN'f 5335 8th 8'rRBlBl'f ZBlPHYRHII,I,S, FL 33540
PhoneI813-780-~020 'a~le13-780-0021
I>A'rBJ RIIClIIV!lJo __._._ ___. __u___
PIJANS RI!lVIBlW Jl'1IIJ1_________. c_____..
lWlI1EJR I S 11M1E_.__\~L!~_'6_~.__L~Y_~--\:_~'~_.~___.___.n_.~.. ___ _________ PHONTiJ C(JN'1'M~'!'_RJ~nS_O.t. t5:.3..$"
.TOB 8 ITEl AD1JRElSS _5-l'L4tL.-.J~-\n~--S'\"'!"~~_____2e{lh~l"..h~1ls+-EL._~-3.S~ Q_~_____ _._
LEGAL DBlSCRIPTIUN: U)T(S) B[,()(~K BUBIllVI8l0N ___.____._._._._.__
----.._----_._._._-_..~-
PARCEll, m #
WURK PROP8ElfJ I LJNEJt'l CONSTRUCTION
-- --------_._~_......_-~._------_._-,--_._--------_._----~_.-._--~_._-_.._--,~_.~._------_._~.~_.- -"--._~... ..- ----_.._---~..--
(OBTAIN FROM PROPBlRTY '1'AX NOTWEl)
[J ADDITION
o AUrERATION
[J RHlPAIR
[J INSTAf,I,
[18Iml
[J MOVE
o DElr-1or,IslI
PRt)l>uSEJIl UBE: I t\!l'Sf:jIJ FJ\fvlIJ.Y DWELI,Ilm
[Jr'1UL'l'I.. FAr-1rr,y
[J# OF lIHITS
fJ SWH1MING POOL
U MOBII.El Hot1EJ
[J Cot1MElR(~ IA I,
o INDUSTRIAL
LJ OTHER
C:J RmSTAURANT & HElAUI'H [)ElPARTt.1ENT APPROVAL
IlESCRIP'l'ION OF NORK t_\ec.:h;(A\S ~'r v i c.~-__~~o..clE'__________.________.____.________________._._____._.__.
BlJIr.rnNG SIZE: --____________ SQUAP.E: FOOTAGE __ _ ~~O___ HElIGHT .___.__.______.____
REJ8IDENTIMJ I
CO~1MHlR(!IALJ :
A'r'fACH (2) PLOT PI.jAl1S & (2) SElTS OF BtJII,lJIN<J PLANS & (l) SET FJNIllRrJY FORMS,
A'I"l;A(~H (3) SE'fa OF BUILDING PLANS & (1) 8ElT ENBlR(N FORtIlS,
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
~ERMITS REQUES.TED
(J B 1I II, IJI NC~
L____._____.__. ---' VAl,UATTON OF TOTAL CON8TRlJC!'rroN
---11- ~----'- AtIlP ,9E1RVICEl ~ nORmA POWER [J W. R. E. n,
/5 () 'fJr-e'-~
tV( BlI1ElCTRWAI.
f] PI.tJtIlBING
U IIIBICH1\.NIC!AJl
$.---..----------- VAI1UATION OF tIlECHA.NCIAI, UISTALI,A'I'TON
f] GA8
f.J ROUFING
[J SPEntAUl'Y
[I OTHER
TYPE UP' c;Ol~8'I'Rt1l~TION: [J BLOCK
o FRAlIIE:
[J STEEJJ
[J OTHER
FINI8HEl/J F'J,OOR ElI,EVATION8
--------~~-----
18 PRO,fElC'I' IN FLOOf) ZONE ARElA [J YIllS 0 Nu
BtJIUJlllR
--.-. ~,. -- -.~-.-.-.---..--.-~-------- .""""'---------.~_~_w_. _._____
('Ot1 PAN Y_..__. _______..._______.______ .__._ ___.__ ..
STATEl CFJRT OR REGIS'!' # ___._____.___..._
CITY PROCESSING #
81 m'JATlJREJ
***** '***** *** ****** **** **** I< * ********* * I< ** * *** ***** ** * * * * * ** * ****
-,~..-. '- ._._.__~..._,_u _4__...,...~______._~____,
B1r.J1IClTRldIAN j COr1PANY_~ro...s.~clt__ .E_ie.c..h--.i.c f--~n_(., __h.
~ /\ ~ A - - d STATE: CERT OR RECaST II .E-c_poo 11 "2.)_ __ _ .
SWHA'1'lJREJ___ - -.--~ _~ CITY PROCE8S1N(~ II
.----------- -~-_._-._- -~------._--
******************************************************************
PI,UMBBlR
..- .-...---....-.-..- --_._-~.~_.-. ----_.
( !OM PAN Y ---.-.-.- --_. _....__._..______________~.. .._____. ...____ ._________..__
STATE CE:RT OR REGIST 1/ _______..__.___._._______.
CITY PROCESSING #
8WHATlJRE
HIllCHANICAJ.
*'****************************************************************
-_.__._._~---_._-----._.~---.._-----_._~
--.----.-..--______4__.__._..... 4_.___._-....__.....___.._.____
COlvJp ANY ___________.__...__..__.____..________._.._
STATE (!ElRT OR RElCH s'r #
C1TY PROCESSING #
~--- .--,.__._.._---_..-.__._.-._~._----_.-.._--_.
S T<lNA'I'lJREl
***************************..*********~**************************
-- -----.-------.----.-----. '.-------
OTUBJR
SWI1ATlJREJ
------.....-----------------
f~OMPANY
S1'/\'!'E C~RT OR--REGrST ij---~-----..~...... .---- -~..~.-..,-~-- .~.~-
err\' PROCESSING # ----.--.---___._______.__.._..___
.._~--_.-._._---~_.~...__...~---------------_._----_.-
***********************************************************~*****
--.- ------...- ._--_._--~-.- .~.~_._._~ -.---. ~-,--_.- -.
CONDI'l'IONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands th~t this permit may be subject to "deed restriotionsU which
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UlnICENSED C:ON'I'RAC'l'ORS AND CON'l'RACTOR RESPONSIBILI'I'IES
I f the Ol-lner has hired a contractor or oontractors to undertake work, they may be requi red
to be U censed in accordance with state and local regulations. If the contractor is not
licellsed as requiJ:ed by law, both the ovmer and contJ:actox: may be cited for a mLsdemeanor
violation under state la\L If the owner or intended contractor are ullcer'Lain as to vlllat
Ucensing requirements may apply for the intended work, they are advised to contact the
city of Zephyrhills Building Department, 813-788-6611.
Ifurthennor-e, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor Sect10naH of this application for which they
vlil1 be responsible. If you/ as the owner signs as the contractor, you are indicating that
YOll, rather than the contractor, are responsible for the work. If t.he contractor wishes
yuu to sign a/:l contractor that may be an indication that he is not properly licensed and is
not elltitled to permitting privil~ges in the City of Zephyrhills.
c. 'l'RANSPOR'l'ATION IMPAC'!' lfEES AND U'rUI'I'Y CONNECTION IfEES
D. cONS'rR\JC'l'UION LIEN LAvJ (CllAP'l'ER 713/ FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Flori_da's Constructi.on
lien Law - Homeowner's Protection Guideu prepared by the Florida Department of Agriculture
and Consumer Affairs. If the appli.cant is someone other that the "ownerH, I cerify that I
ll&ve obtained a copy of the above described document and promise in good faith to deliver
it to the "owner" prior to conunencement.
E. CONTRAC'l'OR' S/OWNER' S AFFIDAVI'!'
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, zoning, and land
development.
Applioation is hereby made to obtain a permit to do work and installation as indicated. I
certify that no vwrk or installaU.on has conunenced prior to issuance of a permit and that
all work will be performed to meet standards of all. laws regulating construction, City
codes, zoning regulations, and land development regulations in the jurisdiction. J also
certify that.1 understand that the regulations of other governmental agencies may apply to
the intended work, and that it is my responsibility to identify what actions I must take to
be in compliance. Such agenci.es include but are not limited tOI *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
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Departlllent of Health & Rehabilitative Services, Environmental Health 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 "A" or "A, etc.", it is
under-stood that a drainage plan addressing a "compensating volume" 'wiLL be submi tted v/hich
is prepared by a professional engineer registered in the State of Florida prior to pennlt
issuance,
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 the techllical codes,
nor shall issuance of a permi.t prevent the Building Official from thereafter requi.ring a
correction of errors in plans, construction, or violations of any code. Every permit
il3fiued shall become invalid unless the work authorized by such permit is cOllulIenced wlthin
slx months of issuance, or if work authorized by the permi.t is suspended or abandoqed for a
period of sLit months after the time the work is commenced. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extellsion shall be ~equested
ill writing to the Building Official. An approved i.nspection must be logged during each six
month period, or the project will be considered abandoned.
WAfUHNG '1'0 OWNERI YOUR FAILURE '1'0 RECORD A NOTICE OF COMMENCEMEN'I' MAY RESUL'l' IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IN'rEND TO oB'rAIN FINANqmq, ~()Nl?UI/l'
WITH YOUR LENDER OR AN A'l'TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. ,JOBS UNDER
$2/50D IN VALUE: no NOT NEED '1'0 RECORD AND POS'l1 A "NOTICE OF COMMENCI:!-:MEN'llll.
S I GHA'l'URE : OWN ER OR AGENT
S I GNA'J1URE : CON'I'RAC'I'OR
acknowledged
/ 1 9--:..
STATE OF FLORIDA
COUNTY OF _______
The foregoing instrument w~s acknowledged
Before me this ---siay of.----, 19 __~_
by
(name of person acknowledged)
Qho is personally known to met or
s'rATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this ___ day of
by
(name of person acknowledged)
Dwho is personally known to me, or
o who has produced
(type
aud whot] did [J did not
o ~~bo has produced___._______
(type of identification)
and Hho Ddid DUd not t.ake au oath
of identification)
take an oath.
Signature of person taking acknowledgement
Signature of person taking acknowl edgmtmt
Harne typed, printed or stamped
Name typed, printed or stampt:H.i