HomeMy WebLinkAbout03-1926
BUILDING PERMIT
, NO
Permit -
&0
BUilDING
ft)
ELECTRICAL
CITY OF ZEPHYRHILLS
(813) 780-0020
/I{) ~S--
PLUMBING
MECHANICAL
Pmperty Owne, V:IA~./ ~P-1~~l-,
Job Add.... . J.OT h -~7 (,5!1' ~p~ 1&
Parcell.D.1/ 3(- :l~-J.J"'OO'/')-I;;~6DO-/)/~D
Zoning: Energy ~de: ~7'J7 ~ Gas:
Description of Work ~ ~/L- ~
1926
Date _ ,.3 - /1--0?:>
Sewe, Conn -'t D -{ - - ~
Water Conn: O. sv (tt;; -:r/l-t./
Water Meter: ./ q D ; /{?j)~t.-
T.I.F,'s: .I If fD
-- p-....c r-.
reo: XE(11 I <d I ~
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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.
Valuation or
Contract Price
City license Registration #
State Certified license#
~Jfl
BUll 5'
1~
;q;;~
' ElECTRI A. I '1
FINAL ~/-
C.O.
-03
DATE
_ 03
DATE
(./:To
~tzf~~
PlUMBIN
a /II-
MECHANICAL ~
Ftr.
Pre SlB
lintel
FRM.
Insul. Cl
Wl
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final / <;-7 -0 i
\.../
/"1 '?
-v:J
SlB
Tub Set
Water
Sewer
Final _ .--/V- 7
Driveway
F? 1--;)3~03 3 :/0 ,J~
Breakers
Ducts Insl.
Compressor
Final r;./~ r7-0 :s
e-r
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 IlEPARTMBlN'r 5335 8th S'rREIll'r ZEPHYRHII,I.S, P'L 33540
PhoneIB13-780-0,020 FaxI813-780..0021 4-..-/1'--0 ~
IlA'rBJ RIll(!l1!VED _..-!_._ ... _~.. _ __d
PJ,l\NS RIllVIBlW Jl'J!l1l
()\'IllER' 8 11AI'18 ----f..n3..~~_J!__Lf~ ';"-<-:'~__n._.__ _ __.____.___ _______________ PHONE CClN'l'l\r ~'I'
,JOB S I'l'EJ ADlJRBl88 . --?:~T-J.J-____~7_~__!::i..__!3:!~_--r;~~____ . ___________._..___________
LElllAL DIll8URIPTIDNILOT(S)
BIJOCK
SUBDIVISION
pARr!~I, ID I~
--------_._."._--"------~-~._---._-,-._-~-----_._~._---.~~.._..__._--~
(OBTAIN FROM PROPERTY 'l'AX NO'l'ICEl)
H(JRK PRnPSEIJ r UN!lll'l C'ONS'I'Rt1C'I'ION
, - _.~----- ._--- -------.-- _. ,'"-- --..... -..- --. .--..----. -. ....
[J ADIH'I'WN
o AUI'ERA'l'ION
[OJ R!!IPAIR
LJ J N8TALI,
[lsrml
C]MOVE
o DEJI"1OI,ISI1
pROP013F:Jl USEl: LJSGI, FAtlILY DWEll,I,U1G
r-h1UUI't. FArnr,y
[]# OF UlUTS
[J S\'1lf.'IMING POOL
1:-J-rvl58 J[, El I tor11ll
[J CDr1MElRC! r A I I
[] INDUSTRI AI,
[] OTHER
IlIlJSCRIP'l'ION OF NORK
C:J RS18TAURANT & HElAl,TH [)ElPARTr1IllNT APPROVAL
---~fl___._..______..._._..__.________.___. __________..._..._.
---.-------....--.--..--. .-.--.---- --.... -----.
8lJILfJING 91ZEl
.~+---_._--- -. ------"-.--
SQUARE FOOTAGEl
HElIGHT
RES IDENTIAT, I
(~m1MElR(!IAL, :
A'I"I'ACH (2) 1'1,0'1' PI"AHS & (2) SElTS OF BUnnING PI,AN8 & (1) SHI'l' ENElRny FORMS,
A'I"l;ACH (3) SETS OF BUILDING PLANS & (1) Sill'!' ENERny F'ORr18,
PROPERTY SURVEY REQUIRED FOR ALL NEJ\'l CONSTRUCTION,
~ERMITS REQUESTED
L1 BlIII.DING
$
-~- ~~--~--'-'- ~--
VALUATION OF TOTAL CONS'fR!JC'l'IoN
[J ElL,ElCTRlCAI,
------______ M1p ~EJRVICE
o FIDRIDA POWER
[J \'1,R,El,(1,
[] P r.tJr1B I NC3
LJ J.1BlCHANWAL
$.----.------ VAIJUATION OF MBlCHANCIAfr INS'I'AIJI,A'I'Tl1N
[] GAS
LJ ROOFING
[J SPElntAUl'Y
[] OTHER
'\,YPEJ OF' COH8TRtJt!'l'ION : [J BLOCK
o FRAHEl
[J STEEl,
[J OTHER
FIN ISHElll P'I.oOR EJIJEVATIONS
IS PRO,TECT IN FLOO[J zemEl AREA[J VEla
o Nu
BUIU)Blll
B 1 fJNATI1REl _.~_~~~_______,,___.~____
COt1PANY _ _____________.__.._..___. .___________._
STATE CFJRT OR RElGIS'!' # ._.____._. ._______.__.__. ____.__
CITY PROCES S HTG #___ _ .__...__.___.______.. _ _.____...___
""""""""""""""""""""""""""""'t""""
mf.BlC'rRICIAN COl1PANY _.-..ff<::-~______ _____.____________ ._____._._ '_"___
S ] {lllATURE ........_<-J '==~ _._ ._._ ~';~~B P~~~~B~~N~s~~:~#:::.:.~ :.: ::.:~_____:
""""""""""""""""""""'*""""""""""""
P f.UMB BIll (!OM PAN Y _.::P~___________.____._....______.___._.__._____..._
8 IGH1\'l'lTR E --.41.9kc~~ ___________.._____ ~'~~~E P~~~~S~~N~El~I_:~.~_=-==-=~=~~:.::.::.=~==.~=:~
"""""'*'*"""""'*"""*"""""'*'*""'"""'*"""
MBlCHAIUCAJ, CCJlvrPANy_4':::~ ____n._ h__u_.________...__.._..___....
STATE ('EJRT OR RElGIS'r # _____.__._.___________~_._.___.
STr1NA'l'tJREl W CITY PROCElSSIN13 #
'*""**"**""**"'*'**'***"**"**'~"""*""*'"""""'"
----.------------.-----.. - '~-,--_._~
OTHBlR COMPANY
--------.--------- S'rl\1'El CElRT- OR - REGIS'1' -r------.--..--------------
8I(~1,11\'l'tJRE _______~_~___~.___.________ CI'rV PROCESSING # __________ __~____.____________
"""""""""""""""""""""""""""'*"'~"'"
-~.-._-._--_. ..- .--------.___~_..._.__h.. ___ ___. ._.__'_______._~. ..__.
CONDI'l'IONS OF PERMI'!' AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The unde~signed unde~stands thijt this p~rmit may be subject to "deed restriotionsU whiell
may be mOI:e restri eli ve than City regulations. The undersigned assumes responsibility for
compli~nce with any applicable deed restrictions.
B. UNI4ICENSED (~ONTRACTORS AND CON'l'RACTOR RESPONSIBII.I'I'IES
If the owner has hi~ed a contractor or contractors to undertake Hark, they lllay be required
to be licellsed in accordance with state and local regulations. If Lhe contractor is not
Ii censed as requi red by law, both the ovmer and contractor may be cited for a misdemeanor
violation under state la\!. If the owner- or intended contractor are uncertain as to vlhat
licensing rr::quirementl:l lIlay apply for the intended work, they are advised to contact the
City of Zephyrhills Building Department, 813-766-6611.
lfurtherlliol:e, if the Ovmer has hired a contractor or contractors, he 1.05 advised to have the
contractor (s) sign portions of the "Contractor Sections" of this app1i.cation for whi eh they
.1111 be responsible. If you, as the owner signs as the contractor, you are indicating that
you, lather than the contractor, are responsible for the work. If the contr'actor' Idshes
you to sign as uontractor that may be an indication that he 1s not pI:operly licensed and is
nol enl:itled to permitting pdvi.leges in the City of Zephyr-hUls.
c;. 'l'RANSPOR'l'ATION IMPACT IfEES AND UTILITY CONNECTION lfEES
D. CONS'!'RlJC'rUION LIEN LM~ (CllAP'I'ER 713, FLORIDA STATUTES, AS AMENDED)
r certify that I, the applicant, have been provided with a copy of "Flori.da's Construction
lien Law .- Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that: the "o.mer", 1 cerify that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the "ownerU prior to coumencement.
E. CON'rRAc'roR' S/OWNER' S AFFIDAVI'l'
I certify that all the information in this application is accurate and tllat all work will
be done in compliance with all applicable laws regulating constl'uction, zoning, and land
development.
Applioation is hereby made to obtain a permit to do work and installation as indicated. I
cEq:tify that no vwrk or installati.on has commenced 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. I also
certify that I understand that the regulations of other governmental agendes may apply to
the intended work, and that it is my responsibility to identify what act.i.ons I mllst take to
be in compliauce. Such agencies include but are not limited to: "'Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensj.tive
Lands, Water/WasteHater rrreatlllent
"'Southwest Florida Water Manag~nent District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
"Army Corps of Engineers-Seawa l.ls, Docks, Navigable Watenlays
"'Department of Health Ii Rehabilitative Services, Envir'onmental Health Unit-Wells,
Wal:llewater Treatment, Sept1.c Tanks
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone ~Au or "A,etc.u, it is
understood that a drainage plan addressing a "compensating volume" 'will be submitted i'lhic:h
is prepared by a professional engineer registered in the State of florida prior to permit
issuance.
A permit: issued shall be constn~ed to be a license to proceed Hith the work and riot as
authority to violate, cancel, alter, or set aside any provisions of the technical codes,
nor shall issuance of a pennit prevent the Building Official from thereafter requiring a
correction of errors in plans, construction, or violations of any oode. Every permit
issued shall become invalid unleas the work authorized by such permit is cOllunenced Hlthin
six months of issuance, or if work authorized by the permlt is suspended or abandoqed for a
period of slIt months after the time the work 1s 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 Build.i.ng Official. An approved inspection must be logged during each' six
month period, or the project v-l111 be considered abandoned.
WARNING '1'0 OWNER: YOUR FAILURE 'I'D RECORD A NOTICE DE' COMMENCEMEN'J' MAY REBUI/I' IN YDUR
PAYING TWICE li'OR IMPROVEMENTS 'l'O YOUR PROPERTY. IF YOU IN'I'END TO OB'I'AIN b'INANC:;INC1, ~qNIi\UI:I'
WITH YOUR LENDER OR AN A'!"rORNEY BEFORE RECORDING YOUR NO'l'ICE OF COMMENCEMEN'!'. .JOBS UNfJER
$2,500 IN VALUE DO NO'l' NEED '1'0 RECORD AND POS'l' A "NO'l'ICE OF COMMENCENEN'11fl.
SIGHA'l'URE: OWNER OR AGENT
SIGNA'!'URE: CONTRACTOR
S'l'A'l'E OF FLORI DA
COUN'rY OF
'l'he foregoing instrument Has ackno~,lledged
Bt:lfore me this ___ day of _____, 19--"-
by__
(name of person acknOWledged)
Owho is peraonally known to me, or
STA'l'E OF IfLORIDA
COUNTY OF ___
The foregoing instrument w~s aoknowledged
Before me this .__........rlay of.----, 19
by _'__
(name of person acknowledged)
Qho is personally known to me, or
o who haa produced
(type
and whoO did 0 did not
of identification)
take an oath.
o who has produced_.__.____________
(type of identification)
and v~ho Ddid DUd not tala: all Oi:lth
Signature of person taking acknmdedgement
Signature of person taking acknowl edgllll:nt
Name typed, printed or stamped
_.~--'----_._-----~-----.-._~-.._-_.._~._._.__.~-~..-
Name typed, printed or stampt:ld
FROM
8-23-1995 9:21PM
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r;;ECE II..)[]) i"3 Y
PASCO COUNTY, FLORIDA
-----------_....~--
-~--.........._~-.._----------.~-._-
Permit No. -----.i.2id..k__
Date Permitted . 3-1 ?:_~~J___
Builder Natne/Owner Natne ~ ,Q, /.h'-=~lli.L Control # _,_ '~','_ __,__,,,
COullty Parcel No. ..._~I'f.-_ ;).~~:~.L___OQ1_Q: D~h? '~~~)SllbDlv: 6_~~~.~_~.&__.Y_~_'('_!{ ~):......S
Address/l..ocation --..-3..-Zk'!::l~Y_=-_._Il~.!..&.....k;' -~--Il!,Le- _______.____________
Classification/Type of Use _-_I!IQf3, L~~9. \-Vl 'E:::... __________~_____________.__.____
TRANSPORTATION IMPACT FEE Rate: __h____._______ Sq Ft Unit: ___._________
Exempt [] Yes [Hfic; How Determined ______._____.___._.____._____________
Impact Fee Amount .J__
Zone No. TAZ:
--.---------- ---"-----'------.
SCHOOL IMPACT FEE
Account (056) Slngle,-Famlly Detached House
(057) Mobile Home
(058) .. Other Residential
JJ S3-( Collection Fee
Exempt l~Yes [] No How Determined
------
Amount $
---...~_._.___.4.._._....._"........,__.___._
--__H.__....__..___.__...__._______..
-----._-------~-----------_..
PA'RRS~ANf)RECREATR5N FEE
Lalld Account Land Credit
------...
~...,--
--'--'--"---'-'---
Land Total
---------..--.---...-.--
Recreation Account Hecreetl6n Credit Recreation Total
--~_..._._---_.-.- -------.- ------
Zone
TOTAL AMOUNT ._~__.._.___..__..___...__.____
Exempt [] Y~/ [71 No
IisRARYFEe------ . ~-
Land Account
How Determined
..----..----..----....-
--------.
-------...
..._-- ._"-'-'_._--"-~-- ---"-'--.
Land Credit
-.---.-.-----.-
Land Total
....----.---.....--.-.-..--.--.
Facility Account Facility Credit Facility Total
-.-.~...--~--_._._--.L __~_____._ .__~..._....___.__
--
./
Exetnpt [] Yes QN'o How Determined _____.__ Total Amount ___._._________
RES~~C tPf-:----ERu-' --
TOTAL AMOUNT < ~ 1.----- ..-----.-----_...._______._____...
---------.-.---------.-..
-_......._~._..,.,---~._'_._--_._----"._--_.,-_..__.~--------,--.-------
Prepared By _.______.____________________ Checl<ed By _____._____________.________
NO CERTIFICATE OF OGGUPANCY WILL BE ISSUED OR FINAL INSPECTION
f'ERFORMEU UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN PAID AND
REGEIPTI:rJ FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY
Ar.I<nowledgernent below does 110t Imply acceptance of concurrence, but simply receipt of a copy of this forlll, placing
the building permit owner on notice of tills assessment and the conditions of payment for same.
, DA TE----7;;79;:-T( --- II '\ )(') L--..> R
RECEIPT NO. ,,_ W___ DATE '~l/!il1?BY
~..._._.__._-_._-