HomeMy WebLinkAbout03-1925
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N~
1925
(813) 780-002~)
~ 0 I/D IIi) /___.-p- '-. "
~ (~' (~/~
Pmperty Owne" \..: HA ....,,/ o,;~Px'"
Job Address: ~ 0 T 1:210 ,~7lt 38 7J... t91./A?~ IZrc
Parcell.D. , ..3 4 - ,t,j,--.2 /-1.)0'0- 4i O/.) - /;;160
Date_ ~""17 -/23
Sewer Conn &,t)r?'-
Water Conn: 5"2 /'7j-/t;:)
Water Meter: /9 {) ri9Dtf/k
r.I.F.'s: / J.1 ~D
,7-
1!"xE:111 fJ r ,6' r ~
Zoning:
DescriDtion of Work
~. 9I~ R.don~ ~ '#-
~ d 0 1l0-{
FINAL3..-:Z '"' - {J 35
DATE
C.O. 3 - <' , - 0 3
DATE
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
City license Registration #
State Certified license#
11
Permit Fee 7 ~ '::;-0
Signature t,..J. ~p~
Company
Address
Telephone#
Inspector
If (, Gj J Iff'O
Valuation or
Contract Price
Of< 11 IL
-
MECHANICAL 5
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final ,/ -~.. ..;t.x - c"3
S~ B~a~~
Tub Set Ducts Insl.
Water Compressor
Sewer Final ~ --3 r :;;La' - '(.; 3 RLi-{ d-
Final f..,/ 3--~ x -C'3 RLI-f J- )J:TD
\4S0
Ftr.
Pre SLB
lintel
FRM.
Insul. CL
WL
RL ~ .t {-tio
Driveway
ftJ ]'31- t73
9..'L(5 PtJ~~
~
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 DEPARTMENT 5335 8 th S'rREIll'I' ZBJPHYRHII.IJS, P'L 33 I; 4 0
Phone 1813 -780 -0,020 fax 1813 -780.. OO~~trBl RII<1BlIVllIn ~~:j__~/1::...@.
PI,ANS RHlVIBIW Jl'J!lJ!l______ ... __.__
ONNEJR'S ITM1E1___ ~~)-_~.Ji QI'f ~.;..~~__.___~_____.______.__._____ PHONE Cr)N'l'}V~'~._____.u_
,JOB S I'l'El ADlJRBlS8_~':-'.L.._...J.~_-'>_.__~<?..1.~"'!..u__l~IY'_f!:..._____ .,________ .'___'_'_ __n___ h___._
LElrJ1\L DBl8CRIP'l'WN: LO'l'(S)
BLOCK
SUB[JIVISION
PARCSl, III #
\'IORK PROPSElJ I [J NEW CONSTRUCTION
_.~---~---_.-._----~-.._--_._--_._---._---------_..._._._._----~.- _.__._--_.._~-----_._._... -----..--...---.,--..---..-..
(OBTAIN FROM PROPElRTY TAX NfITTCEl)
[Je1mT
CJ AnIJI'I'WN [J ALTERATION [J REPAIR LJ INSTAI,I,
o ~10VE [J DElMOI,ISlI
[hmW'I. FAt-tln.y [}# OF IJNI'I'S r~,E !lonE!
[J INDUSTRIAL [J SN IMMIWJ POur~ IJ OTHER
PROPOSED !JSE) I C1sm, FAMILY D\'1El,LIIKA
[] Cm1~1IllR(' JA I I
]lBlSCRIP'l'lON OF NORK
o RElSTAURANT & HElAlml DElPARTt1E1NT APPROVAT-l
....k1.::d __.~.._.._.____.._.__________._.__.. ..______._...._
.-."-----'-~------_.-..,......_........_.__._.. h_____~
BUUfHN(! SIZE
---------.---...-.-----.---
SQUARE FOOTAGE
IIEl WHT
RES IDElH'rIAJ. I
(~O~1MIlIRCIAI, :
A'I"I'J\CH (;,]) 1'1,0'1' PIJAIlS & (2) SElTS OF BtJIf,nUTtJ PLANA & (1) SElT ENElRny FOR~1S,
A'I"liAC!H (03) SETS OF BU!J,IJING PLANS & (1) SET ENE1R(~Y FORf18,
PROPERTY SURVEY REQtJIREJD FOR ALL NEW CONS'I'RUC'TION,
~ERMITS REQUESTED
[] 8IJILlnNr~
$
VALUATION OF TOTAL CONSTRlJC'l'ION
101 ELElCTRWAl,
AMP ~ElRVICEJ
o
FI,oRIDA PO\'1EJR
[J
\'1.R,E,C,
[] PI,tH1BINC3
U HBJ(JHANWAI.
,
$-------------- VAI,UATION OF tIJEC'HAHCIAI, IllSTAI,IJA'I'TOH
[lrms
[1 ROOFING
[J SPEJC!IAU!'Y
[J OTHElR
'I'YI?E OP' COH8'I'RtJC~tI'HJN I [j BLOCK
[J FRAJIJE
[) STEEr.
[J OTIIER
FINISHEllJ FI.oOR IlJI,EVATIONS
IS PRO,fElC'I' IN FI,OO[) ZONE J.\REAO YES
01'10
BtJILoma
81l1NATUREl _j_/:!_~----_-----------
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lJ~'.Ij'\ \{.
cOrIJPANY.fi-~_--.----......----h- ______.____.__. ._.
STATE CElRT OR REGIST # .......~--..---H____.'___H____
CITY PROCESSING #
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B1I.BlCTRIC!AH COf1PANY ----J:1.~--"'!?:=...________________._.___ ____.._._. ___'___
STATE CElRT OR REnTST #
81 <lllAl'I1REI - - -~ ~: _u__ L? ~__u~ _____ CITY PRoe.ss 1 WI #____~--~:_.:::=:-__==_=~~_:
***********************************************"'**"'******1********
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.....-~..~?1~_~____._____
COfvlP1\NY----~____--.-_-_____.-_.---....-_-___.-_-
STATE r~ElRT OR REGI8T # _______._.__._~_.._...___....
CITY PROCESSING #
PIJUMBBR
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MEC!HANICAJ, COlvIPANY_.L1._~~___._._ ..__.._____.____...._._ ...._.__n_.
8TA'rEl r'E1RT OR REGrST #
SlCmA'l'tJRf] ___ CJ_~______~ CITY PROCElSSINC3 #.._..__~=~~_=~~~:.~~-~~~:.-=-~~._~~~_--=..=
***'***"'*******"''''****'''****'''*'''*''''*'''*''''''''''''''' * "'*"'''' *"''''''''''*''''''''' , '''''''''''*'''''*'
o'rllER
--.-----------.--------
r~or,1PANY
811ATEJ CHlRT OR-REGIST .#-.----~-.---".-------. --~.-.-----..--~..--
CI'fY PROCESSING # ---..-..----.----------.-.-----....
-.-.--..---'--__4____,.____,_____.____~___________
SWllA'l'IJRE
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-.-.---.---. .._'---_.~---_..-.,._._._....._------- -----..
COIWl'rIONS OF PERl'1I'I' AFE'IDAVIT
A. NOTICE OF DEED RESTRICTIONS
Yhe undersigned understands th~t this permit may be subject to "deed restrictionsU Wllich
may b~ more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNLICENSED 'CON'I'RAC'I'ORS AND CON'l'RAC'l'OR RESPONSIBILI'I'IES
I f the o\-./ner has hired a contractor or contractors to undertake Hark, they IlIay be ragui red
to bl: 11 censed 1n accordanoe \-li.th state and 10ea.1 regulations. If lhe cOl1traol:or is not
licensed as requi:t:ed !Jy law, both the owner and contraoto:t:' may be cited for a miademeanor
violation under state lalL If the owner or intended contractor one uncertain as to what
li censing regui rements may apply for the intended wOl:k, they are advised to contact the
City of Zephyrhills Building Department, 813-788-6611.
Flutherlnol:e, if the owner has hired a contractor or contraotors, he 1s advised to have the
contractor(e) sign portions of the "Contractor SectionsU of this application for whiell they
Hill be l.eeponsible. If you, as the owner signs as the oontractor, you are indicating that
you, rather than the oontraotor, are responsible for the work. If the contractor l'Iishes
you to siyn as contractor that may be an ind1cation that he is not properly llcensed and is
not enUtled to permitting privileges in the City of ZephyrhUIs.
C. 'I'RANSPOR'l'A'fION IMPACT FEES AND U'l'ILITY CONNECTION IfEES
D. CONS'I'RIIC'l'UION LIEN LAW (CliAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
1 certify that I, Lhe applioant, have been provided wilh a copy of "Florida's Construction
lien Law - Homeowner's Protection GuideU prepared by the Florida Departmellt of Agriculture
and Consumer Affairs. If the applicant is someone other that the "ownerU, I cerify that I
Ilava obtained a copy of the above described document and promise in good faith to deliver
it to the "owneru prior to corrunencement.
E. CON'I'RAC'l'OR' S/OWNER' S AFFIDAVI'l'
I certify that all the information in this application is accurate and that all work will
be done in oompliance with all appli.cable laws regulating construotion, zoning, and land
development.
Application is hereby made to obta1n a permit to do work and installation as indicated. 1
certify that no Hork or installation has oorrunenced prior to issuance of a per'lfIlt and that
all work will be performed to meet standards of all laws regulating oonstruotion, City
eodes, zoning regulations, and land development regulat10ns in the jurisdiotion. I also
certify that I understand that the regulations of other governmental agencies Inay apply to
the intended wOl'k, and that it is my responsibility to identify what actions T must lake to
be in compliance. Suoh agencies include but are not limited to: *Department of
EnvirOlllljental Regulation-Cypress Bayheads, Wetland Areas and E:nviromnentally Sensj.l1ve
Lands, Water/Wastewater Treatment
*Southwest ~"lorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
"Army Corps of Engineers--Seawa1.1.s, Dooks, Navigable WaterHays
*llepartment of Health & Rehabil1tative Servioes, Environmental Health Hnlt-Wells,
Wastewater Treatment, Septio Tanks
*H.8. Environmental Protection Agency-Asbestos abatement
1 also certify that, if fill mater1al is to be used in Flood Zone "AU or "A,etc.u, it is
understood that a drainage plan addressing a "compensating volumen'will be submitted which
is prepared by a professional engineer registered in the; State of li'lodda pdor to pennit
issuanoe.
A permit issued shall be construed to be a license to prooeed with the work and not as
autllOri ly to v1olate, canoel, alter, or set as1de any provi.sions of the tealmical codes,
nor shall issuance of a permit prevent the Building Offioial from thereafter requir1ng a
correction of errors in plans, con~truction, or violations of any oode. Every permit
is!iu~d shall become inval1d unless the work authorized by auch permit is cOl\ulIenced Hithin
s1.x months of issuance, or if \-./Ork authorized by the perm1.t 1.s suspended or abandoqed for a
period of s1.:x months after the time the work ls conunenced. One 90 day extension of tillle
may be allowed for the permit with fee charge of $15.00. The extension shall be requested
in writing to the Building Official. An approved inspection must be logged during each six
lIIonth period, or the project Hill be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NO'rICE OF COMMIllNCEMENT MAY RESUW' IN YOUR
PAYING 'I'WICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN li'INAN(1n"q,~qN@UI/r
WITH YOUR LENDER OR AN A'l"I'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. JOBS UNDER
$2,500 IN VALUE DO NOrl' NEED '1'0 RECORD AND POS'l' A "NOTICE OF COMMENCEMEN'llll.
SIGHA'1'URE; OWNER OR AGENT
SIGNA'I'URE: CONTRACTOR
S'I'A'l'E OE' FLORIDA
COUN'ry OE'
The foregoing instrument was acknowledged
Before me this __.____ day of _._____________. 1~
by _____
(name of person acknowlo;dged)
Dwho is personally known to me, or
STA'I'E OF nORIDA
COUN'l'Y OF
'fhe foregoing instrument Wi3,S aokrlOwl edged
Before me this .----J.iay of---, ] 9._...:._
by __
(name of person aoknowledged)
C1ho is personally known to me, or
o who has produoed
(type
and who[] did [J did not
of identifioation)
take an oath.
Signature of person taking acknowledgement
Signature of person taking acknowledgn~nt
'_'~'4'_"____.'__,__,___________.______________
I'lame typed, pri.nted or stamped
Name typed, printed or stalnpt:Hj
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PASCO COUNTY, FLORIDA
_..._..wc...--..___-.-...._.______'''''~_.,_........______..."'''..........._"...__,
Permit No, I cr..;t. '5-~
-----~,...._-~._._-----_..-
Date Permitted 3::::l..J..=O~3._
BUilder Name/Owner Name ll'f'a lA. Q .ft:u 1,", ; o.,g Control # ___.~.._.__
)
COlJllly Parcel No. .:'i/:/:;;? ,5:::..;;/ l:..QQlQ:fJ Pl."", - / ~ 8ubDlv: Qm.H.il ttQI':L~ 0 "s
Ae Id les s/l.Dca lion _._3_'1 L~ ;2-fi.__bJLC t;,.-~~t1J.!..._e..._____.___________________._______.___
Classiflcatlon/.f"ype of Use _-..k1~1Q-~_~.J~~._H QJ~._~.__.________________.___________.__.____
TRANSPORTATION IMPACT FEE
EXell1pt [] Yes [~'o
Rate: __._.___________ Sq Ft Unit: ______________
How Determined
--~.._-_._---~---_._--_._-_._----_._--_...-
Impact Fee Amount -.l..___________.____
Zone No,
TAZ:
SCiTOOL-IMPACT FEE -----.. .
Account (056) Single-Family Detached House
(05"1) Mobile Home
(058) Other Residential
1) 2~) Collection Fee
Exempt r jYfes [] No How Determined
---------
-------..........,
Arnount $
--.-.- -----..--..--..---..- ...-..-----.....-...
._-_.__.__..._-_.~---_.."---_.._.
---~---~-------_..._-------
-........---_--..v _ _---..."....____-..--
PA~I<S AND RECREATION FEE
Land Account Land Credit
._-----'-~_._~._-_.__._--------~-_._--
.~--......---..__.
.. -----
Land Tolal
Recreation Account Hecreatign Credit Recreation Total
Zone
TOTAL AMOUNT_l__._. ._._._.____.__...____
Exelnpt [1.y~"'FJ No
/~
1]BRARVFEE~--_.n--
L:and Account
How Determined
. .
-.~-_._...-.~-~_.--------.--~.----....-..-..--.----.-..,.-~..._. .._____u_.
.. ~--_._-....
------------.-....-
-..--..-..-.-....-. ----.-.... -.---..,..- '--'
l.and Credit
Facility ACcOlmt -.--.-________.___...-~a.GllitfC~~dlt _._______ Facility Total ._____._.._.__.____..
.-';~~
---
---..-
------.---[a !leIIOIal
~ _'__h'_ ...__.._..__..__ ...__...."_
Exempt [J Yes Q"Ne;' How Determined _______ Tutal Amount ..____________
RESoaR~1.---. c2<l'f'" -..---~----.,-_w.__._~~_=_~___
TOTAL AMOUNT' 8 1,z.
-----.---.---.---.-------
--,...-...~---'''......--..--,......,----........----- . .................v_._.________...... -.._____......__,--.
Prepared By _________.__.________.._._..________ Checked By ___._._______.______________
NO CERTJr=IGATE OF OCCUPANCY WIl.L BE ISSUED OR FINAL INSPECTION
PERFOr~ME[) UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN PAID ANn
REGEIPTEr> FOR BY A CENTRAL PERMITTING OFFice OF PASCO COUNTY
Acknowledgement below does not Imply acceptance of concurrence, but simply receipt of a copy of this form, placing
the bUilding permit owner on notice of this assessment and the conditions of payment for same.
-DATE-~---.-G/^__:__~-- ", l _I,) nEG t\fED BY .--.-------.--
RECEIPTNlJzlfliO _ DATr3i:J.~~ BY 'ifJ:P~__