HomeMy WebLinkAbout03-1940
BUILDING PERMIT
Permit N!
CITY OF ZEPHYRHILLS
(813) 780-0020
1940
Date J f19/0]
-- 0'.'
lf~' -
BUILDING
Property Owner:
Job Address: '1 S \
Parcell.D. ,
Zoning: Energy Code:
DescriDtion of Work.--SJ" b
PL~G
MECHA~CAL
Sewer Conn
Water Conn:
La-\- ?c;,
Water Meter:
T.I.F.'s:
Radon Gas:
FINAL
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.
c.o.
DATE
Inspector
Permit Fee
Signature
Company
Address
Telephone#
~fJ--
Valuation or
Contract Price
)lfo o. (~
City License Registration #
State Certified License#
7 ~ )~-[)()
T~l<; (,'.,,\
BUILDING
EL CTRICAL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
/ -;: - :2/- ~ 3 IfJO
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) shaH 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 ZEPHYRHIIJLS PERMrr APPIJICATION
BUII.nING nEI?ARTMBlN'f 5335 8 th S'rRBlm'I' ZBJI?HYRHII,I.S, P'1. 331;40
PhoneIB13-780-~020 FaxI813-780-0021
DA'rBJ RJlC1l!lIVllIn _.___._.. _~~. ._____
PI,ANS RIllVIlIJW Jl'llltll_'-_____.l:..____..
(M"". 'S """"~~..._..' jt.rt!(-1J12.uJ If: ~_~_.~__ .._ _~~._.~ PHO"" ''(IN'J'Ar''LL~-S-~(:.J_.,
::~:":':J):B::~):':::I1' . :r~: II j~::/~~~~~~.=~ _' ~UB~;V I~]O" .. i:~Lc.~!~ A~;(
PARC!ElI, In #
HURl< PROPSHlIJ I LJNElVl CONSTRUCTION
~. ~---------------~-.__._-------_.- --.---- ------~-- -------- ---- -.-~-- ------------..-- ---- .----- ._--- -
(UBTAIN FROM PRnpER'I'V 'l'A.X NO'I'WEl)
rJ ADDI'I'IOlT
[J ALTERATION
[J RElPAIR
LJ INSTALl,
[J 8 I em
[J MOVE
[J DElMOI,ISII
PROP08Flll USEI I LlsCH, FAMILY DWEll,T,IUG
[h.1tJL'l'I' FAl"iU,Y
[J# OF IJHI'l'S
[J SNn1MING POOL
U MOBII.El 1l0f1Bl
[] OTHHlR
U Cot1~1HJRC JA I,
[J INDU8'l'RIAr,
IJElSCRIP'l'lON OF I'lORK
[:J REJ8'fAURANT & HElAIlTlI DElPAR'l't1ElN'I' APPROVAL,
-------~-\.L_J?_OO._.__~_________.._ h. ._..________.__._.
8UH,fJING SIZE:
----..--------.-----.----
SQUARE F'OOTAGEl
H81WHT
REl8IllElNTIlU.1
CO~1MHlRf.!IAIJ :
A'I"l'1\CH (:2) PLOT PI~AlTS & (2) SEl'I'S OF BUIlrlJING PI,ANS & (1) 8El'!' ElNElRrn~ FORMS,
AT'liACH (3) SE'rs OF BlJiI.Il1NG PLAN8 & (1) SET ENElRcn FORr18,
PROPERTY SURVEY RElQUIRElD FOR ALL NEW CONSTRUCTION,
~ERMITS REQUESTED
CJ BllTLIJINn
$
2 i dc:)
VALlJATION OF TOTAL CONSTRlJC'l'IOH
-... ~~--~._-----"---
[J EJI.ElCTRlCAlI
-.---.--_~_._._____ Ar1P SERVICEl
D FLORIDA POWER
[J ~L R , E . C ,
[] PI.lJttJ8INC3
[J J,1BIUH1\N f(~AI J
[] GAS
LJ ROOFING
$________________ VAIJU1\TION OF tIlEC'HANUI1\I, I1ISTALIJA'I'TON
LJ SPElnIAUl'Y [) O'I'HElR
'l'YPE: UF' CON8'1'RtH!TION: [J BLOCK
[J FRAJIIEJ
[] STEElL
[J OTHER
FINISHElTJ Fr.oOR HlIJIWATIONS
IS PRO,fEC''I' IN FLOCH> ZOBEl AREAn YElS
rJ NU
BUILnBlR
---'_._-,.._."-_._~--_.__..._-~----_._._----~_._---_. -.-----
C'orllp1\NY __________ ____._____________.____.. _.____~___.___
STATE CERT OR RElGIST # ._._.______.___.___,____.___
CITY PROCESSING L_.________.___.________ __"__'_'_"_ _'_
81 GlrIA'I'UREl
* * -I; * * '" * * * '" * * '" * ." * * * * * * * ", * * * * * * .~ * ." * * * * * * * * * * * * * * * * * * .~ * ." * * * * * * I< * * * * * *
Illr.DldTRIC:rAN
S] mlA'l'llRFJ ____
h _._ '>.n_ _.. ____.____.._ ._,___.. .._______.__ ____._ _ _,. _....._'__._____._
COI1pANY__..__. no.._ _..____ _____ ___.._____
STATE CER'!' OR REGIS'!' #
CITY PROCE8SHm #
._--_.,--._-_.__._....._--_..._---~..._.._-_..__. -- --
*.,,*'**.*k***********~*"'********'***'***~************'*************
.-.----. ---_.-.._-----._..._.__.~-_.. - ._- - ..--...-..... -_._~.._--
I?JJtJMBER
(~OM PAN Y ---.-------__._________________.____.....__.__...__.._ _ _.._.___._
STATEl CEJR'l' OR RFJGIST # _________..___.____........_.____..
CITY PROCElSSING #
8WNA'1'lIREJ
MIllC!HANICAT.
*'*********************I*~********************.,,***********1*****"
.----..-- --'- -..-------- -----..- .. -..--..-..--.-..-.----. -.-...
----_._------------.-._~--_._----_......_-_.._---
COMPANY ______._________.__ _. ..__. __.._.. ..__.._..._
STATE ('EFT OR REGtST #
CITY pROCElSSING #
S I GHA'I'1 IREJ
************"**"'*'*'***1********************************'*I~****
-_ -_.___m_..._______._..__ .. _.__~ .._._._. ______._~
OTIIER
-------------~-----------_.__._-----~_._..
(;0l,1PANY
S'T'A1'E} CE1RT- OR-'REGrST -ij-- ________..._n..__~___ '-'---..-~--~,,----. .--..---
CITY PROCElSSING # --..-..----- -..--__.___.__n___..._
._.__._~--....__._.__._.,._.__."._._--_._---~----
8 WN1\'l'UREl
*************************'*'***********************"'******'~*****
--..-----..-.- --'~--'----~.'-'_._~-""-" -.-----....---
COHDI'l'IONS OF PERNI'I' AFlfIDAVIT
A. NOTICE OF DEED RESTRICTIONS
~he u~dersigned understands th~t this permit may be subject to "deed restrictions" which
may be more restrictive than City regulations. '1'l1e undet'signed assumes responsibility for
oompliance with any applicable deed restrictions.
B. UNI,lCE:NSED 'CON'I'RAC'l'ORS AND CONTRACTOR RESPONSIBILI'l'U:S
If the O\.,mer has hired a cOlltractor or contractors to undertake work, they may be required
to be licensed in accordallce with state and local regulations. If the contractor is not
licensed as required by lavl, both the ovmer and contractor may be cj ted for a miOidemeanor
violation under state laH. If the owner or intended contractor are uncertain as to V1hat
licensing requirements may apply for the intended work, they are advised to contact the
City of Zephydlills Building Department, 813-'788-6611.
Furthennore, 1 f the ovmer has llin:d a contractor or contractors, he is advised to have the
contract.or(s) sign portions of the "Contractor Sections" of this application for Hhich t.hey
vliJ.1 be responsible. If you, as the owner signs as the contractor, you are i.ndioating that
you, rather than the contractor, are responsible for the work. If t.he contractor Nishes
you to sign as contractor that may be an indication that he ls not pr-operly li censed alld is
not entitled to permitting privileges in the City of Zephyrhllls.
C. 'I'RANSPOR'l'A'rION IMPACT FEES AND UTUI'l'Y CONNECTION FEES
D. CONS'l'R\JC'rUION LIEN LAv~ (CHAprl'ER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction
lien LaN - HomeoNner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "owner", I cerify that I
have obtained a copy of the above described document and promise in good t'aith to deliver
j t to the "owner" pri.or to corrunencement.
E. CONTRAC'I'OR' S/OWNER' S AFff'IDAVI'l'
I certify that all tht:l information in this application is accurate and that 1;111 Hork 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 vlOrk or installation has commenced prior to issuance of a permlt: and that
all work wlll 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 agencies may apply to
the intended work, and that it is my responsibility to idenU.fy what actions I must take Lo
be in compliance. Such agencies include but are not limited to: *Department of
Environll!ental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Bensj.tive
Lands, Water/Wastewater Treatment
*Southwel:>t lflodda Water Management District-Wells, Cypress Bayheads, Wet.1and Areas,
AJ tering vJatercourses
.Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department: of Health 0. 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 "AU or "A,eta.", it is
undeJ:stood that a drainage plan addressing a "compensating volume" 'wiLL be submitted Hhich
is prepared by a professional engineer.registered in tile State of Florida prior to permit
issuance.
A pennit 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 tile technical codes,
nor shall issuance of a permit prevent the Building Official from thereafter requiring a
correction of errors in plans, con~truction, or violAtions of any code. Every permit
iSliued shall become invalid unless the work authorized by such permit is oOllunenced wlthin
six months of iS5uance, or if \vork authorized by the permit is suspended or abandor~ed for a
period of si~ months after the time the work is commenced. One 90 day e~tension of time
may be allowed for the permit with fee charge of $15.00. The e~tellsion shall be reques~ed
In writing to the Building Official. An approved inspection must be logged during each ,.ix
month period, or .the project Vlill be considered abandoned.
WAfUHNG TO OWNElR: YOUR FAIWRE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUL'I' IN YOUR
PAYING TWICE FOR IHPROVEME:N'l'S TO YOUR PROPER'!'Y. IF YOU IWl'END 'I'O OBTAIN J!'INANqn-l'i, PqN~UI:I'
WITH YOUR LENDER OR AN A'l"!'ORNEY BEFORE RECORDING YOUR NO'l'ICE OF COMMENCEMEWl'. .JOBS UNIJ!!:R
92,500 IN VAWE DO NOT NEED '1'0 RECORD AND paS'll A "NonCE OF COMMENCEMEN'l'It.
SIGNA'l'URE: OWNER OR AGENT
SIGNA'I'URE: CONTRACTOR
S'fA'l'E OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
Before llIe this __'_ day of , 19~
by ______
(name of person acknowledged)
Dwho is personally known to me, or
STA'rE OF FLORIDA
COUNTY OF
The foregoing instrument Was acknowledged
Before me this .___l:.iay of---, 19 __:__
by ___
(name of person aoknowledgedl
Dvho .is personally knol-ln to me, or
o who has produced
(type
and who[J did Ddid not
D Vlha has produced___ '_'___
(type of identification)
and Vlho Qdid [l.Ud not t.ake an oath
of identification)
take an oath.
SignatuJ:'e of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
_.---._._--------------_..._,_._--_._-_.,,----_._~ ~-'---'-
Name t:yped, printed or ~talflpt".l