HomeMy WebLinkAbout03-1934
BUILDING PERMIT
, NO
Permit -
CITY OF ZEPHYRHILLS
(813) 780-0020
1934
Date
3 .-/~-tJ3
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcel 1.0. "
Zoning:
DescriDtion of Work
~-~~<);;t;~
<)(.
Water Meter:
T.I.F,'s:
Energy Code:
1;l)C.50
I
Radon Gas:
('Lvi \if L..'(('
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
0--- it) 3'
DATE
Complete Plans. Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
o d-Rly
City license Registration #
State Certified license#
Permit Fee -t9.. t1J;f)
)<-Signature pj;;: ~ ~re.~
Company
Address
)<Telephone# ~ 7' $"- 7'77 r
Valuation or
Contract Price
1 (333 ' trV
;2So~
1:'h5Ctl!o &m.~ ~(' .
BUilDING
Tp. Servo
Rough In
Meter Can
Canst. Pole
Pool
Pre-Meter
Final
,/ 3 -,;). 0 - 03 RL ~ J- H To
PLUMBING
MECHANICAL
SlB
Tub Set
Water
Sewer
Final
/
/
/
I
I
/
I
,/
Breakers
Ducts Insl
Compr sor
Fina
/
/
,-
(/
Ftr.
Pre SLB
lintel
FRM.
Insul. CL
WL
/
I
I
/
(
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
BUUDING I>BlJilARTMElN'f 5335 8th S'rRElIll'f ZIllPHYRHILI.S, P'L 331;40
PhoneI813-780-~020 'axI813-780-0021 \
tJA'rBJ RB<HllIVllJn '6 J ~~ Lc:r3.___
pr,ANS RHlVIIlJW Jl'EII____ _4. _, _._
IH'lNEJR'S NAME ~ - ~ ~ ~ PHONE: (10N'l'I\(~'!'__~_<t:5'::-71!' .~_.
,JOB S I'J'B ADlJ~~SS3~~~~_~~r..-~~__~-"'~-~,-_:L~,,~11isO"'k'~') ~1u
LBl(J1\L IJESCRTPTIO!T: LOT(S) _._.Q-.j____ BUX!K _______....._ SUBIllVISJON ___..______..___..,_.____._._
PARCEll, In 1#__Q24-;;> _~~_'?:J~900~ -= 00 ~~~ ~dCf~__.~_~~TA~~~.._~~ROM .!~~~E~~.~_.'l~~~_.~~:~~.(!Ill_~._
\'lURK PROP8BlIJ I [JNBl\'l l'ONS'I'RlJCTION rJ ADDITION OALTElRA'rION [J REIJPAIR IJ INSTAl,!.
[JsrGn
o ~10VEJ
[] DElMOI, I 811
PROI,lOSEJIl USEJI lJSr;lIJ FAMIIJY nWElLLIlKI
[h1tJW'I. FM1Il,Y
0# UF IIlH'l'S
[J S\'l Ir1MU1G POOL
I] MOBII,El llor1Bl
[] Cm1MEJRC TAl,
[J INDU8'l'RIAIJ
[] OTHHlR
IlESCRIPTION OF NORK
C=:J REl8'l'AURAN'I' & II ElAl.TII DElPAR'I't,1ElN'I' APPROVAL,
-~~S9_____~ l..u""1t--~~----__~__
SQUARE FOOTAGEl ~O 0 HEl JaH'!' .
---.. -------------
8un.rHN<] SIZEl
'-~------ ---.---------
RIllBIDElNTIAJ'I
COHMBlR(!IAI. :
h'_~..__._ ______..____
A'I"l'ACH (2) PLOT PI,AHS & (2) SElTS OF BUII,lJINl3 PLANS & (1.) SElT ElNElRrn F()R~18,
A'I"l;A(~H (3) sEi'rs OF BlJ!LIJ1NG PLANS & (1) SElT ElNHlRny FORr18,
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION,
C] BllII,IJINc3
RmRMITS REQUESTED
L_l~ ~ 3. ~9__._" VALUATION OP' TOTAL CONS'rRuc:'rroN
[1 ElLElCTRIC'AI,
----.----_.__ At1P ~ERVICEl
o FU.lRIDA POWER
[J \'l , R . El , (~ ,
[J PI,m1BING
o HHIUH1\NIC!AIJ
$-- .-q---------- VALUATION OF HEJCHANC!IAI. U1STAI,LA'I'TON
[J (311.8
[OJ ROOFING
[J SPElCJtAi/l'Y
[) O'I'HE:R
TYPE] OP' C'OH8'1'RtJC!TION: [J BLOl!K
[] FRA!1EJ
lJ STEIDL
[] OTHER
FIN LSliEfJ FLUOR ElIJElVATIONS
----------
IS PRO,TElC'l' IN FLOOD zemEl ARElA[l YEla 0 No
BtJILlJBlR
**************************************'*'*********'********'*"'**
COf1 P 1\ NY...... "___ ....._______._..__ __.. .__.... '___._. _.. __... ___ ._. .__
STATE CE!RT OR REGIS'!' # .......____..._..___ ....___._ __~q___
CITY PROCElSSING It______..___...._.__ _... ..__..__.__.._. _'_
8.1 {mA'l'tJREJ
_.,.,--~,.__._......_--_.._"~---~---_.--~----_.._------ ----
B1J.Bld'rRICIAN
-- ._--_._-~-_. ~_.._._.__...- -.-.------.,- ~ .-.---.--..----------.-
COl1PANY ______ .__ __ _'______.. ____
STATE: c'ER'!' OR RE:CH S'1' #
CITY PROCESSING 1#
------ ---..... "-""'--'-'- ~'--_.-.- -... -._. .___._. '0_- ._
8] mm'l'IJREJ '_'h._
-.--.-- --,,'. -.-.-.". ----~-.__.._--.-.- -_.~"----_.. -,....-
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.----------.-- ---. .-- ._-- -_.- -.--. - _.- ---_._.. - ---..---
PJ,UMBBlR
---._......._-_....,.~--..._.._----_.- -.---.........-
C!OM P ANY ---.--.-.-------.---____u.__.___....__.__.___....._________.
STATE CER'I' OR REGIST # _______.____...____..
CITY PROCESSING #
S I<3HA'l'IIR Bl
MECHANICAL
*""""*******'*'*""**'**"*"'*""*'**"*'*****'""*,"**"
._-._-,-._.__..._--~- ---..---.-----_._-..~
.-'--._----_._--------_._---~-~-,- ....----.---...----
C()rvlPANY___._______~__..._... .____n.._.______...._._.
STATE ('EFT OR RElCHST #--'-'-____._.__n__ ____...___._.._.__
(!l'1'Y PROCESS INC3 #
SIGNA'I'IIREl
o'rUIllR ~--(l~~~sc--.._____ (;OI'1PAN~~~_.Lk_~':'?..&__L~.::...
S'I'1\'I'H1 C'EJRT OR REGrST # p1Xtl.:_J2C>.9..77_?_..___.._
S t'"IA'l'1JR'~... _~r~ -' -<- -______ C ITY PROC'S-o/.~'h 'I:- -.iF_____ _~S_E~____ _____ _ ______
"*'**'**"'***""*"**'**""'***"""'**""'*"'**'*""""
-- -------_.~----_._-_...__._-_.__._.- -- .._._~_.._----
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COHDI'l'IONS OF' PERNI'!' AF'E'IDAVIT
A. ~OTICE OF DEED RESTRICTIONS
'1'he undersigned understands thqt lhia p~rmit may be subject to "deed restrictions" which
may be more restrictive than City regulations. The undersigned assumes responsibility for
con~liance with any applicable deed restrictions.
B. UNLICENSED 'CON'I'RAC'l'ORS AND CONTRACTOR RESPONSIBILltI'IES
If the owner has hired a cOlltractor or contractors to undertake work, they may be required
to be licensed 1n accordance with state and local regulations. If the contractor is not
1 i Gensed as required by IavJ, both the ovmer and contractor may be oi ted for a IIIj sdellleanor
violation under state law. If the owner or intended contractor are uncertain as to what
licensing requirements may apply for the intended work, they are advised to contact the
City of Zephyr'hills Building Department, 813-788-6611.
Ii'\uthennol:e, 1 f the ovmer has hired a contractor or contractors, he is advised to have the
cantractor(s) sign portions of the "Contractor SectionsU of this application for whicll they
will be responsible. If you, as the owner signs as the contractor, YQ\.! are i.ndicating that
you, lather than the contractor, are responsible for the wor'k. I f the contractor' wishes
you to sign as contractor that mOlY be an indication that he 1.05 not properly licensed and is
110t entitled to permitting privil~ges in the City of Zephyrhills.
C. fl'RANSl'ORfl'ATION IMPAct!' F'EES AND U'l'ILI'l'Y CONNECTION F'EES
D. CONS'l'RUC'rUION LIEN LAW (CHAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Constr\lcti.on
lien Law - Homeowner's Protection Guide" prepared by the Florida Depar.tment of Agriculture
and Conswner Affairs. If the applicant is someone other that the "owneru, I carify that I
have obtained a copy of the above descri.bed document and promise in good fai th to deliver
it to the "owner" prior to commencement.
g. CON'I'AAC'I'oR' S/OWNER' S AFFIDAVI'!'
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 construction, zoning, and land
development.
Application is hereby made to obtain a permit to do work and installation as indicated. 1
certify that no work 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 j\lrisdictlon. I also
certify that I understand that the regulations of other governmental agencies may apply to
the intended work, and that it is my rilsponsibility to identify what actions I must Lake to
be in compliance. Such agencies include but are not limited to: *Department of
Envirollmental Regulation-Cypress Bayheads, Wetland Areas and Environmentaily Bensttive
Lands, Water/Wastewater Treatment
*Southwest Iflorida Water Management District-Wells, Cypress Bayheads, Wet.1and Areas,
Altering WatercOUrses
*Anny Corps of Engineers-Seawalls, Docks, Navigable Waterways
*UepartmenL of Health & Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater 'l'reatment, Septic Tanks
*11.8. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone ~Au or "A,etc.N, it is
understood that a drainage plan addressing a "compensating volume" 'will be submitted ~dlicll
is prepared by a professlonal engineer registered in thEl State of Florida pdor to permit
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 tectlllical codes,
nor shall issual1ce of a permit prevent the Building Official from thereafter requiring a
correction of errors in plans, aon~truction, or violations of any oode. Every permit
issued shall become invalid unless the work authorized by such permi t is cOl\unenced Hithln
six months of issuance, or if \vork authorized by the permi.t is suspended or ahandolled for a
period of si.. months after the time the work 1s cormnenced. One 90 day extension of tlllle
may be allowed for the permit with fee charge of $15.00. The extension shall be ~equested
In writi.ng to the BuildJng Official. An approved inspection must be logged during each' six
month periOd, or the project Hill be considered abandoned.
WARIHNG '1'0 OWNIllRI YOUR FAIWRE TO RECORD A NOrnCE OF COMMENCEMENT MAY RESUL'l' IN YOUR
PAYING 'l'WICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO oBtrAIN FINAl'H1INq, \,::qN~UI/I'
WITH YOUR LENDER OR AN A'I'TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. JOBS UNDER
~E DO N:~ RECORD AND POST A "N01'ICE OF COMMENCEMENT",
---~-~ -- e?~ ~~
SIGNA'I'lJRE: OWNER OR AGENT SIGNA'j'URE: CONTRACTOR
afI'A'!'E OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
Before me this ___ day of ______, 19---,-
by___
(name of person acknowl~dged)
Dwho is personally known to me, or
STA'I'E OF E'LORIDA
COlJN'l'Y OF
The foregoing instrument w~s aoknowledged
Before me thLs .---liay of----, 19....:._
by ___"___
(name of person acknowledged)
Dvho is personally knol'll1 to me, or
o \vho has produced__ ___
(type of identificatJon)
and who[]did [Jdid not take an oath.
o who has produced________________
(type of identification)
and Hho Ddid DUd not take all oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
I'lame typed, prillted or stamped
Name l:yped, printed or stamped
~ CITY OF _ZKPIIYRHI~ BUIl.DING DEPARTHENT
ILQQ~ -a::-,-/ 0~
5867 D1&1;/L ~ S-6.
,
. .;;:;. .L_ 0. (p - ~(- 6oot::J - D t!J 100 - 00 Z 6
PARCEL LD. # +- _
OWNER
JOB LOCATION
snOH ALl. EXISTIIIG & PROPOSED
DIHENSIONS & SETBACKS.
STRUCTURES GIVING
LtO
I~
J
It
I --I
~
~
'-
<<\)
UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
(NOTE EXAMPLES 1 & 2) STREE'r
1. SETBACKS FOR Rl, H2 ZONING
60'
10'
P E
R X
0 I
10' p S 10'
0 T
S I
E N
D G
20'
FRONT PROPERTY LINE
~
"1...L-
i
FRONT PROPE TY LINE
2. SETBACKS FOR R3 ZONING
60'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30' DUPLEX
1 0' 1 0'
FRONT PROPERTY LINE
ROSCILLO CONCRETE & JfASONRY INC
OFFICE PHONE - (800) 797-7450
CELL PHONE - (813) 695-9998
BILL TO: PROPOSAL DAlE
~-~ ~ . -slJ~/6Z.
JOB LOCATION f- 'll-t s ~ ~ - ~ L ~
'4') -
\VI11J p ~ -t ~._ 0 PK',.
ITEM
QTY.
PRICE EA.
EXT. PRICE
'3 /\j Ai ~ J rt -z "i LiI ~ .v
ia...v 56 I j~, ....'-" '"3~~ 9 ,00
Ie-
...-;r ~_D /J' ~. ~
u
i
11 -: 1, .4 rf\J A%. ")
~ I It Ii- cf-()~W pt f,- T),c- ;"'/-A -.
~
I
I
I
!
TOTAL COST
~
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