HomeMy WebLinkAbout03-1951
BUILDING PERMIT
Permit N2
CITY OF ZEPHYRHILLS
(813) 780-0020
1951
~D
BUILDING
Un
ELECTR~CAL
L(O
PLUMBING
3>
MECHANICAL
Date .3 -P2S-~ 3
J.fe-f)'~
.:Lo-o' (1-'0
Sewer Conn
Water Conn:
Job Address:
Property Owner: :r JFe,y'"L-( F~~~
,33-084 h~v~ J.-N'
Parcell.D. # I L( - 211 - 2/ - O/po - 00('00 - &5"50
Water Meter:
T.I.F.'s:
51:(- (S
fro . ~.,
91ft>.. i2~
(, 1~'7. g-o
Zoning:
DescriPtion of Work
Energy Code:
1'-\. l-\. <) ~ A.f
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
I' -('13
DATE
- f) 3
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
V"0o
Permit Fee ...e- ~ .......-
)<s;gn.tu'~2 ~ < -,
Company _
Address
).1elephone# f?1],- Sf/a ~~~
FL.,;.I11;:tE. J?J:JIJf/"rT $~ic 5~f/l~o( rStoIlf>/'f F/~. hi/c,. "7.2#hy,;r 47/...",-t'e- 5ItrUd-Sv/pf.
if.- 3oy'3. 7/ 3~rf'~ #.3c>2 .,
BUILDING ELECTRICAL PLUMBING MECHANICAL
Valuation or
Contract Price
)~6Jo' 6YO
3CJ~V
City License Registration #
State Certified License#
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Canst. Pole
Pool
Pre-Meter
Final 1""""--- Y - li- () .~
SLB
Tub Set
Water
Sewer
Final L.--'/
Breakers
Ducts Insl.
Compressor
Final L-/
L{ - (7 - 0 .3
(/- {7 ~ 0 .3
Driveway
(f j--2- 03
3: I~ /J1t"5>/<<v11- ;:::~
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.
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PERFORMANCE BUSINESS PRODUCTS. INC. 813-719-8008 FAX 813-719-7919
~ ",~ -- I 'J.. <i
CITY OF ZEPHYRHllLS
ZEPHYRHIliS, FLORIDA
WATER ACCT. NO.
DATEj -2 "--0 ~
OWNER/
RENTER
F( &WL
J11\lL~~~ :t\a;vvr*
MAILING 7 c:. 13f) k ?1 0 q
KA+4farL ft. 3384q
, I
SERVICE ADDRESS -=? ~ c 31 Je .m-IL'1 /v-
/.-01- ~- 5"
SHUT OFF SERVICE 0
TURN ON SERVICE ~
INSTALL METER ~
READ METER 0
CHECK METER 0
OTHER 0
[J/'WATER
o SEWER
o GARBAGE
GJ/ IN CITY
o OUT CITY
I
_ No. OF UNITS
- DEPOSIT AMOUNT
3 /l, -II- -ff:-
It.( LJ~r ~r
_ AMOUNT LAST Bill
_ DAlE
_ MISC. CHARGE
WORK COMPLETED BY
& DATE COMPLETED
ORDER lAKEN BY
\
\.
\
!
-;2~t!J3
/
Retam white form in office at aU times. ~
Send pink & yellow forms to Water Service Dept.
Water Service Dept. to sign yellow form & return to office.
CITY OF ZEPHYRHILLS PERMIT APPLICATION
aUIl,DING nEI?ARTMEN'f 5335 8 th S'rREm'f ZEPHYRHII,I,S, P'L 33540
PhoneI813-780-~020 P'axle13-780~0021
fJA'rE RBn8lIVEn _______~_ _______
PI,ANS RllIVIBIW rEBI_______ _"____
n"NER' 8 IlA"O -~Lk~b,ify~___________ PHONID CON'J'A(!'!,___., "_"',", ___
.rOB SITE AD[}RElSS____1?S-C2.3j_._~q~~':../j?s_____G_,.~ '<::.________________________________ ___
LHllJAL DBlSCRTPTIOlll LOT(S} S~-.S~ BIJDC!K 0 SUBlJIVI810tT h!.1Z'ju~~-~..._4!!..:::_:.J..__
---.-...-..-------
PARCEllJ In It / L/ -c:::?&~o?l- tJ /~O --<90000- 0 ~S--o (OBTAIN FROM PROPElR'l'Y 'PAl< NO'l'WEl)
---+-----.-----'--.-----..------------.,--..-----------.-----.------..--'.,-----,---..-----..-
HURl(: PROl?81lHlI [JNElN l'ONS'l'RUCTION [] ADDI'rIClN []AUrERATION [] REJPAIR [9-lwrrAfJI,
[JSWll
[] MOVEl
[] DElf'lOI,ISII
PROi:'OSEJIl USEI: [JSGl, FAMILY DWElLI,INGl
[]f1tJI/I'I - FAMILY
0# OF UNITS
rJSNHlMING POOL
[~,El llot1El
[] OTIIElR
[JCCJt1MIllRt!JAf,
[] INDUS1'RIAL
o REl8TAURANT & HI1lAI,T}t DI1lPARTf111lNT APPROVAL
IlESCRIPTION OF l'IURK __ ~~ J c./~-LJ!c'V -d..{!.?! 3--fl~;;;.r.~CJc)~_m.._Lft..__
BUH,fHN(! SIZE ~ 3. ~.k__.ij _.$!"_ SQUARE FOOTAGE _,_ 94! ~__ HEJWH'I' --L-S=-~___
RE8IDBlNTllUJ I
(lOMMElR(!IAI, I
A'I"r1\CH (;2) PI,OT PI.AlTS & (2) SElTS OF BlJILIHN(l PI,1\NS & (1) BElT E1NHlRGY FORf.1S.
A'l''l'ACH (3) SETS OF BUtIJDING PI.ANS & (1) SBJT ElNI1lR(lY FORMS.
PROPElRTY SURVEY RElQUIRElD FOR ALL NEW CONSTRUCTION.
~;JINc3
[~CTRICArl
~f1BING
~HANIC!AIJ
PERMI'rS REQUESTED
$___L~c/ ~c.__ VALUATION OF TOTAL CONSTRlJC'l'ION
_c22o Q- NiJP sElRVICEI 0 Fl,QRIDA POWElR [J W, R . El . (! .
$--__00
~CJ
D:--
r---
[J ems
VALUATION OF fiJElCHANCIAI, UlSTAr,l,ATTON
[] ROUFINn
LJ SPI1lC!IAUry
Ll OTHER
'1'Y-PEl OP' (~()N8'I'RU(!TION I [J BLOCK
o FRl\!iJEl
[l S'l'BJElIJ
[~R
FINISHElD FI~OR ElLElVATIONS
---------
IS PRO,TI1lCT IN FLoon ZONEI AREA 0 YIllS 0 No
BUILnSlR- / /----:/-v7 t:/f../,LC-,:S
._-_.~~~~-
----"---_._----
COf1PANyA~ ---.-_Z2?~,uE...2?f;2~;::e.~___ _
STATE! CElRT OR REGIS'!' # ..---7"'gf1!?-t:J.~.r...!:.=~_____
CITY PROCElSSINlJ tL--.-.----3_(!')~Lf._______._.____._"._____
* * ** * * * * * * * * * * * * * * * * * ** * * *,..... .............. '~)'2';:,~' .g'tJ.%1f-, S (y
~~-, .II 7'''I1!' ~ ~~' <= ~ _ " GP/2 /
BlI,BlCTRICIAN < v ~ ~/3es.(j'btR"9~ot1PANY.....z __f!..!~_:.~__~_-==__=~___~_..:'_=-=-_______
<~' v~ ~ 8TA'I'ID ""RT OR ROOIST ~-,::,'Q,~-.""
9 "'1I1i'1'IIRID --"" -~ -----, ~",,--, __C _,,_ ______ (!I'I'Y PROCID88 I WI #_____-= "'_ __'" ": "'.""'~.;>,? 3~
* h * ~ * * * * h * * h * * * * ,I; * * * * ~' * * * * * * * * * * * * " * * * * * * * * * * * * * * * * * * * * * *, * * * * * * * * *
~ .---, ~ .....--. ~
PIJUMBBlR ?'r -rn C:X.h~/..5 ('()MPANY~L~--~L~__.k~..s-~ ___
..-.,-..-....--.--~"'" ..- ---------Z STATE CERT OR RElJIST # _-:?--d..OOJ!Q._~_E.______..
~,gr(3NA'l'URBl " ,,- CITY PROCESSING #
" ,," ". ::~. :::~. . . :::~::-:-::::=: . . .. . .. . . . .. . ~. .. .. =:~ :: :~~:---_._----
MBlCHAlfICA ~:rL L,)' ~,~ T t!OMPANY---.d2~-:?; ~S...PR~_________~_._______
~ STA'rEl (!ElRT OR RElGIST # L~-ci..r2~L_._
STGU,,-,-' - -- ~ CI'1'Y PROCElSSING #
.....---.-...-..-.---
---_._---_..~~.--~._-
OTnER -~-----eBl4 NY
------------ -----------.. --'---,'. ----'.--..----- ,--- --
S'T'l\'1'EJ --ElR..-E...EKHST #
SI(~lIA'l'UREl ___________.______ CITY PROCESSING .1f---..._-----:----- ____..______________.
.--------.--. ._.._~~::::-~-----. ---._..-- - .-.-'-_.._--_._~
* * * It * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * It * * * * * * * * * * * * " * ~ * * *'*-*"~.._,..,.
**************************************~**************************
_._.~._---------.__.~...__._,_._-.
I.;U1Wl'!'10NS OF PERlI1Irf AE'E'IllAVIT
A. NO'rICE OF DEED RES'l'RIC'rIONS
.'rhe u.ndersigned understands thqt thie pl'lrmi t may be subj ect to "deed restrictions" which
may be more restrictive than City regulations. The undersigned aseumes responsibility for
oonv1iance with any applicable deed restrictions.
B. UNLICENSED CON'I'RAC'I'ORS AND CONTRACTOR RESPONSIBILI'I'IES
If the o\"mer has hired a contractor or contractors to undertake work, they may be requix:ed
to bl:l licellsed in accordance with state and local regulations. If the contractor is nol
licensed as requiLed by law, both the ovmer and contractor may be cited tor a mlsdemeallor
violation under state laH. If the owner or intended contractor are uncertain as to vlhat
licensing requirement.s may apply for the intended work, they are advised to contact the
Ci ty of Zephyrhills Building Department, 813-788-6611.
Furthenllor-e, j t the ovlller has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor Sections" of this application for which they
will b~ responsible. If you, as the owner signs as the contractor, YQ4 are indicating that
you, rather than the contractor, are responsible for the work. If the contractor \.lishes
you to sign as contractor that may be an indication that he is not properly licensed and is
!lol elltitled to permitting privileges in the City of Zephyrhi.lls.
C;. 'PRANI:lPOR'!'ATION IMPACT FEES AND UTILI'l'Y CONNECTION ~~EES
D. CONS'PRUCTUION I,IEN LAW (CHAP'l'ER 713, FLORIDA S'l'ATUTES, AS AMENDED)
I certify that I, Lhe applicant, have been provided with a copy of "Florida'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 "owner", I cerify that I
have obtai.ned a copy of the above described document and prond.se in good faith to deliver
it to tbe "owner" prior to commencement.
E, CONTRAC'l'OR' S/OWNER' S AFFIDAVI'l'
I certify that all the information in this appJ.ication is accurate and tllat all work will
be done in compliance with all applicable laws regulating constr-uction, zoning, and land
development.
Application is hereby made to obtai.n a permit to do work and i.nstallation as indicated. I
ce~tify 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 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 identify what actions I /IIust take to
be in compliance. Such agencies include but are not li.mited to: *Department of
Envirollmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensttive
Lands, Wat:er/WasteHater Treatment
*Soutllwest Florida Water Management District-Wells, Cypress Bayheads. Wetland Areas,
Altering Watercourses
'Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of Health & Rehabilitative Services, Envir:onmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone qA" or "A, etc.", it i.s
under'stood that a dralnage plan addressing a "compensating volume" 'will be suumi tted Ylhich
is prepared by a professional engineer registered in the State of florida pri.or to permit
issuance.
A permit issued shall be construed to be a license to proceed with the work and not as
autllority to violate, cancel, alter, or set aside any provisions of the teohnical codes,
nor shall issuance of a permit prevent the Buildi.ng Official from thereafter- requlri.ng a
correction of errors in plans, construction, or violations of any oode. Every permi.t
issued shall become invalid unless the work authorized by such permit is cOllunenced within
six montlls of issuance, or if work authorized by the permit is suspended or abandor~ed for a
period of six months after the time the work is comnenced. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be ~equested
in writing to the Building Official. An approved inspection must be logged during eacb I:lix
month period, or the pr:oject Hill be considered abandoned.
WARNING TO OW1UlR: YOUR FAILURE '1'0 RECORD A NOTICE OF COMMENCEMENT MAY RESUL'l' IN YOUR
PAYING TWICE FOR IMPROVEMEN'l'S TO YOUR PROPER'l'Y. IF YOU INTEND TO OBTAIN b'INANqINq,~qNt.;lUL'l'
WI'fH YOUR LENDER OR AN A'fTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. JOBS UNDER
$2,50D IN VALUE DO NOT NEED '1'0 RECORD ~D POST A "NOTICE OF COMMENCEMEN'I'".
SIGHA'l'URE: OWNER OR AGEN'l'
S I GNA'I'URE : CONTRACTOR
acknowledged
,19_
STA'rE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
Before me this -------Jjay of---, 19
by
(name of person acknowledged)
Qho is personally known to me, or
S'fA'rE OF FLORI DA
COUNTY OF-
Th@ foregning instrument was
Before me this __ day of
by
(name of person acknowledged)
Owho is personally known to me, or
o who has produced
(type
and who[] di.d Ddid not
of identification)
take an oath.
Owho has produced
(type of identificati.onl
and who Odid DUd not t,ake all oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or. stamped
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