HomeMy WebLinkAbout03-1939
BUILDING PERMIT
Permit N~
CITY OF ZEPHYRHILLS
(813) 780-0020
Cf r el.l
BUI~DIN: ElE~CAl PLU~G
Property Owner: _YrL\'" k S."""ef~' k,t
Job Address: -\ "I ~1. ry (I ~ \>r. (Le.}.
Parcell.D, ,
MEC~CAl
I~S
6. P.)
1939
Date .~" 4 /03
Sewer Conn
Water Conn:
Water Meter:
r.I.F.'s:
Zoning:
Descriotion of Work
Radon Gas:
Energy Code:
S Ie,!:,
['ife,1/t S I ~ /1 11ft/v t/ ~-tf
-1';~.5C' bill &r
NO OCCUPANCY BEFORE C.O.
if - 2 ,- 0 ~
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
FINAL
C.O.
Inspector
DATE
? L 'J / (~:To
)400, ~
<t~. ~.
() f:I)-
Valuation or
Contract Price
Permit Fee
Signature
Company
Address
Telephone#
City license Registration #
State Certified license#
73fJ_S-50t/
~
( y S u .'",
BUILDING
Ftr.
Pre SLB /' LI-2.- f) '3
.
lintel
FRM.
Insul. CL
WL
Tp. Servo
(It ~ Rough In
/-IJ" 0 Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Driveway
/y_z-C')
....
ra t.(,
J- ?/0~
Breakers
Ducts Insl.
Compressor
Final
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
BlJII,DING nIllPARTMBlN'r 5335 8th S'rRBlm'r ZHlPHYRHII,I,S, P'L 33540 ..
PhoneIB13-780-~020 FaxI813-780-0021
DA'rBJ RB(~81IVIiID _~. .._ _ __~_ ...___
Pr,ANS RIllVIBIW Jl'J!lBl_ ;---__~L'_____.
"NNSR 's nAMS __ --_&1)"; t _ SJ!i._~!JI~________ _ ______.. _ _ _____ PHONS CON'I" "',.)\1'.5: :5:<>:0 d ___
:~:.:r:::s::II):':::'1 '~~~8:~tf-:d:~,,:.~~.__==--sll:[:~r:")tl--i~t-;1111J1E;1
PAR('I!lI, III It
\'lCJRK PROPSEJlJ f UNIlJN t'ONS'l'Rt1CTION
..-- -----~~~----_..._----..__.._.- ---------:...-_.__._-_._----_._---_...._-_._.._--._-~~,. ------------------------- --- ----.-.-----..-----.. _..
(OBTAIN FROM PFWPI!lR'fY 'l'AX NO'l'H!El)
[J smIl
o ADDITION [J AL'l'EJRA'r I ON LJ RElPA IR U IN8TALI,
[.J WJVE: [J DElMOI/ISII
[J~.1tJUl'I - FAlvJU,Y []# UF lINI'I'S IJ fvJo B rr, El Itof11lJ
[J INDUSTRIAIJ rJ S\'lU1MING POOL U OTH!!lR
pRO[.'USEJIl USE: I LJSGI, FAMILY fMEJl,T,H1G
fJCmtIMIllRCIAI,
IlEJ8CRIP'l'!ON OF l"lORK
D R~18'I'AURANT & HEALTH [)ElPAR'!'~1EN'1' APPROVAI.J
-- ----KILllfl(L___~_____._ ._____ ________
BUILDING SIZE
-_.__L____~_______
SQUARE FOOTAGE
---. .-------
IlEJTGHT
RElBIDElNTIAJ, f
COJl1MBlRCIAfJ f
..-"-<...--..-----------
A'!"!'1\CB (:I) pl,O'!' pI.jAI1S & (:I) SElTS OF BUll ,DING PLANS & (1) 8E1T E1NElRr3Y FORMS,
ATtAr!!! (3) SETS OF BUlr.rnNG PLANS & (1) SET ENHlRGY FORtIlS,
PROPElRTY SURVEY RHlQtJIRED FOR AIJL NEN CONSTRUCTION,
CJ BllII,IJIN(3
L1 l3lI.jElCTRl CAli
[] PI,mIlBING
0 1113:uHANr(~AIJ
~ERMITS REQUESTED
$---)~g----.---__ VALUATION OP' TOTAL CONSTRtJC'I'ION
-.---.------.__ Ar1P SERVICE!
o FI,rJRIDA PO\'lER
[J W.R.E!,(1,
[] GAS
$- --.----~-- VAT.JUATION OF rllE)CHAHCIAr, H1STAI,l,1\'I'ION
r.J ROOFING
[.I SPE(!!AUry
[] O'I'HER
TYPE OF C!ON8'I'RtJ(~TION I [] BLOCK
[J FRM1EJ
[] STEEL
[J OTHER
FINISHEllJ FLOOR IlIIJEVATIONS
-..._-._---~_.-
IS PRO,JEC'I' IN nocm ZONE! ARElA [J YElS
o Nu
BUIU)SlR
******************************************************************
cor1 PAN Y_.__ _. ______...__ .____ _...____ __ ..__.. _ __.___ _ ..__.______......_
STATE CEJRT OR REGIST # __'. ____._______.._______
CITY PROCESSING IL________.__._.....______.. .___._...__ '_
8 WI'TATlJR El
-,. -...._--'---_..-._------~...__..~---_.__.-- .--------~._---_. --.-.-----
B1UldTRICIAH
8 J r3llATlJREJ _'_
. ...---.-.....- ..,~,,---, ---- '.---.-,--.- '...-------- -- _._._._-_...~-----~-----
Cot1 l' AN Y _._______._ ___ ,__ ______
STATE: CEJRT OR REGIS'l' II
CITY PROCESSING #
------. - -_.--.~ ._...___.__w._.__..._._.. __.__..__ ~
__4__.,__"._ ._._~. ___o__~____._ __0._.__.__, _....._
t**********************************.*********************'********
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Pi.UMBBlR
...~----'_..._~-~._-----. -----.---.-
(!OM PAN Y -. ---.-..--___.____.________._._____......__.__.._. __......_...______..
STATE CER'!' OR REGrST 1/ _________....._____.__..._____.
CITY PROCESSING #
8 WH1\.'1'1 JR BJ
MBlCHAIU CAr I
.'**'*************************************************************
----.-.-..-.-.--.----..______o.~___~__..___
-_______o____._____._____.__~....__.._.__
cotVfPANY _______________._ '.__.._________.____.__..____
BTA'rEl ('ElR'r OR RElGIST #
(!ITY PROCElSSING #
-----.." _..~--.~_.._---- .--..--------..- ----..-
8 WNA'I'lIREl
*****************************************************************
----'--.__4___..~_..___._.__ _'_Y_.__.
OTHBlR
-_._._---~-.._-_._..._---'
r~OI,1PANY
8TA TEl CElRT - OR - REGI8T-r------.--------..-------..---
(Try PROCESSING # ------..-..- _________________.._.
S [(nl1\'l'l IRE
---.---~--..----......_....___o_..____~,_
***********************************************************~*****
~._----~--~_.- ~._.._-_.-~._-----.._--~-_---.-.,~ -'-'--.--- .. _..
CONDI'l'IONS OF PERNl'r AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
~'l'he vnde.L:signed understands th13t thie permit may be subject to "deed restrictiollS" wid eh
may be more restrictive than City regulations. The undersigned assumes responsibility for
oomplianoe with any applicable deed restrictions.
B. UNLICENSED 'CON'I'RAC'l'ORS AND CONTRACTOR RESPONSIBILI'I'IES
If the o\'ll1er has hired a contractor or contractors to undertake work, they may be required
to bt: Ii ct:nsed in accordance ~~ith state and local regulations. If the contractor is nol
Ii Gensed as required by la~~, both the o~mer and contractor: may be oj ted for a ntlfidellleanor:
violation under state la\l. If the owner or intended contractor are uncerlain as lo ~Ihat
J.j censin\} requi rement.:> may apply for the intE:!nded work, they an:l advised to contact the
City of Zephydlills Building Department, 813-788-6611.
Furtherlllon~, if the ovlller has hired a contractor or contractors, he 1s adv1sed to have the
contractor(s) sign portions of the "Contractor SectionsU of this application for which they
\'Iill be responsible. If you, as the o\'lner signs as the contractor, you are indipating that
you, Lather than the contractor, are responsible for the work. If the contractor wishes
you to sign as contractor that may be an indication that he is not properly licensed alld is
llot ellU tIed to penni tUng privileges in the City of Zephyd1i.lls.
C. 'I'RANSPOkTA'fION IMPACT FEES AND l)'I'ILI'I'Y CONNECTION fEES
D. CONS'I'RUc'rUION LIEN LAv~ (CHAPTER '713, FLORIDA S'rATUTES, AS AMENDED)
j certify that I, the applicant, have been provided Hith a copy of "Florida's Constructlon
lien Law - Homeowner's Proteotion Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "owneru, 1 oerify that I
have obtained Ii copy of the above described document and promise in good faith to deliver
it to the "o\'lner" prior to conunencement.
Ill, CON'I'RAC'l'OR' S/OWNER' S AFFIDAVI'r
I certify that all the information in this application is accurate and tllat all work will
be done in compliance \'lith all applicable laws regulating construction, zoning, and land
development. '
Application is hereby made to obtain a per-nd t to do work and installation as :1 ndicated. 1
cert! fy that no vlOrk or installati.on has conunenced prior to issuance of a penni t and that:
all work will be performed to meet standards of all la\'ls regulating construction, City
codes, zoning regulations, and land development regulat.Jons .in the ju:dsdict:1on. I also
certify that I understand that the regulations of other governmental agencies may apply to
the intended \'Iork, and that it is my responsibility to identify what actions I mlll:it take to
be in compliance. Such agencies include but are not limited to: *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Bensttive
Lands, Water/Waste\'later Treatment
*Southwest Inorida Water l'1anagement District-Wells, Cypress Bayheads, Wet.] and Areas,
Altering Watercourses
"Army Corps of Engineers-Seawa lls, Docks, Navigable Waten~ays
*Department of Health & Rehabilitative Services,' EnvJronlllental Health IIn:1.t-WeLls,
Wastewater 'l'reatment, Septic 'l'anks
*II.S. 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" '\'Iil1 be submitted Vlh.ich
is prepared by a professional engineer registered in tIle State of Florida prior 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 technic:al codes,
nor shall issuance of a permit prevent the Building Official from thereafter requiring a
correction of errors ill plans, con~truction, or violations of any code. Every permit
is,5Ued shall become invalid unless the 'dork authorized by such permit is cOllullenc:ed Hithin
six months of issuance, or if \'iork authorized by the permi.t i.s suspended or- abandoqed tor a
period of six months after the time the Hark 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
:1 n wri ting to the Building Official. An approved inspection must be logged during each f;j x
month period, or the project Hill be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUW' IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPER'ry. IF YOU INTEND 'I'O OB'l'AIN FINAW;rNG, ~{ms.UIJl'
WITH YOUR LENDER OR AN A'l'TORNEY BElfORE RECORDING YOUR NOTICE OF COMMENCEMEN'r. ',JOBS UNfJER
$2,50D IN VALUE DO NOT NEED '1'0 RECORD AND POS'l1 A "NOnCE OF COMMENCl!~MEN'I"(.
SIGHA'l'URE: OWNlilR OR AGENT
S I GNA'I'URE: CONTRAC'l'OR
a'rA'rE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
Before me this _.____ day of ____., 19--,-
by ___.__
(name of person acknowl,dged)
Owho is personally knoHn to me, or
STA'l'E OF nORIDA
COUNTY OF
The foregoing instrument H~S aoknowledged
Before me this .____JJay of---, 19 __.:..._
by
(name of person acknowledged)
[1ho is personally knol'm to me, or
o who has produced
(type
and who[] did [)did not
of identification)
take an oath.
o who has produced______~_.___
(type of identifioation)
and Hho Odid DUd not take an oiilth
Signature of person taking acknoHledgement
Signature of person taking acknowledgment
I'lame typed, {JrJnted or stamped
Name typed, printed or stamped