HomeMy WebLinkAbout03-1957
BUILDING PERMIT
Permit N~
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2~
9S
CITY OF ZEPHYRHILLS
(813) 780-0020
~~
1957
Date
~2. - tl fJ-'03
Property Owner:
Job Address:
Parcell.D. /I
ELECTRICAL PLUMBING
GJt;rJ;l/-wJ
~erconn
Water Conn:
BUILDING
&
Water Meter:
T.I.F.'s:
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
DATE
Inspector
Valuation or
Contract Price
I? ?JOO-
City License Registration #
State Certified License#
BUILDING
ELECTRICAL
4 pc
Tp. Serv. , - :;2 {7-?'f f-- Y SLB
Rough In Tub Set
Meter Can Water
Canst. Pole Sewer
Pool Final
Pre-Meter
Final
reakers
Ducts Insl.
Compressor
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Driveway
C(C-(. tt-J7-if3 PLy
fM~' rf ?lhJ. It~ i~~ -1(-27-03 6,6
REINSP~TION 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.
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CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUIIlDING DBlI?ARTMElN'f 5335 8th S'fRBlBlT ZBlPHYRHII.IlS, P'L 33B40
Phone 1813 -780 -0,020 Fax 1813 -780 e. 0021 if', /,._, ,]
lJA'rB1 RBC1Jl!IVllIn f.1"l AJV _______
PJ,ANS R!IIVIBIW rill _________ :.",____.
UW"ER' a "A>lE --Jlt,'Cl'+_-G ('(. t,J.__.._.__ __~__._~__~.._~__._ PHOWE ('OW'j'A"'LSI~L _' ('11_.._
,TOB SITE ADnREl88_-,'fL~l'-h-J.c!~rL________j:_~_l't~J.l-4__a).jJS_'i_~______________.___._.. _ ____
IJElGl\L ))8JSClRIPTIDl1: LOT(S)
BIJOC!K
8UBIJIVISJOt!
-~-----"._-----
--"-.-- -.-., - - '.-.-.....---...-..-....- ._--~_.-
PARC!8JI, ID It (OBTAIN F'ROM PROPEJR'l'Y 'l'AR NOTWIll)
HI JRR PR{JP8El~:~NElN~~~~-'~RtJ~;IO;-.[J A~~~l~--- [] A~'~';RA;IO~~_._n-l Rffi~~~~------l~~-~';;;~~:~----
[J S ION
o MOVE
o DHlMOLISII
PR()l.lOSEll USE I [J SGll , FAMILY DWELI,Ilm
[h1tJ1/l'I - FAMIl.Y
0# ClF' maTS
[JSWU1MING POUL
[J MOB ILEl ItoMEl
l] OTH!!lR
f] C{JttlME:RC' IA I,
[J INDUSTRIAlJ
CJ RS8TAURANT & HE:AlmJ DHlPAR'I't1EbTT APPROVAL
ll.aCRIP'l'ION OF NORK J~.t1~f-..l",,~lL...,j:L~i:"':l-_:L i""'4<-t:&-~-f-tl<<:t.x~tJ;j.1t
StJIr,fJIN{3 SIZEl
-----.__~4____
SQUARE FOOTAGE
-..---------
H8JIGH'r
RBiS IDBlNTIAJJ I
CO~1MIlJR(nAJJ :
A'l'T1\CH (2) PLOT
A'I"l;ACH (3) SElTS
PROPElRTY SURVEY
--.-..---..-.------
~ BlJII,JJINtJ
[~ BlLIlJC'I'RlCAT,
~ PWt-1BING
I?TJAllS. & (:2) SElTS OF BtJIf,num PI,ANS & (1) 8!!lT E1NEl;;C;GY ()R~18,
OF BunDING PLANS & (1) SElT ENEJR(~Y FORMS.
RElQUIRElD FOR AIJL NEW CONSTRUCTION. . t?r1
. Lf/1 ~' ...//.-
gERMITS REQUESTED ~/---
$ ---~---1~.~!..._ _. VALUATION OF TOTAL CON8'l'RlJC'rION
--------_,___ Ato1P ~E1RVICEl
o FUJRIDA POWER
[1 W,R,B.n.
o HBICHANIC!ATJ
$---_..
VAIJUATION OF t1ElCHANCIAT, UIS'l'AIJI,ATTON
[] G1\S
[] ROOFING
[J 8PECIAUI'Y
[] OTHER
']'Y-PEl OP' CONS'I'RU(~TION: [J BLOCK
o FRMo1EJ
!l STElEllJ
[J OTHER
FINISHEllJ FI,OOR !1lIJElVATIONS
---------
IS PRrXTECT IN FLOOD zemEl AREA [J YBlS
o ~()
BUIWBlR /J
al0NATURE --..r~~,._4~__..__________
******************************************************************
C'Ot1 P AN Y -- --Qfd:J2-~_____ ____ '__h __H__ _, ____._____._
STATE CEJRT OR REGIS'I' # ____'_______.________..._________
CITY PROCESSING #
---..... - '~._~------_._-..._....-._------ .~._.-._---.__.--... -~-'. ---
Blr,B1ClTRICIAW I /J Cm1PANY_0-~__________..__________.____
S] H I 1R I r JA1/ ..IJ ~ STATE CERT OR REGIST It_____________________.__
.( 1 A' 'I EJ __h__. u.________.__________________________ CITY PROCESSIN() #
........................................ .~, .....................
PW....R ~ <!OMPl\N~kL2:1.e.4L__~_.-.----_-.. -_un__
a "'''A'N'R E ___~_j. .JJ~ __ __.___ ~~~~. P~~~~S~~N~E~ 1ST ~-==--==~=:::=-:::==:::
-..--.-----~-~--._-.-- --..----. ----_ __w~._._..~___.
MBlCHANICAr.
******************************************************************
----...._-~._-----..__.._--
cutvlPANY ___________ .._._________ ____ "_"___'_,_,
STATE CERT OR REGIST #
CITY PROCESSING #
----..--------...-.-.--.----- ..------.
S TGNA'l'tJREl
**************************************~**************************
-- ----.------.---.---.---- -- ._~ -~--_.__.-.
OTUBJR
(;()(vlPANY
srrA11El CERT- OR -RE~-r_----------.------..---_.- - --"-~---
C I'ry PROCESS LNG # --------_ __________________
-----....----------.--------
SI(HIA'l'IJRE
***********************************************************~*****
.------ .-..--'-...-----.---------. ----.,--- ..._---
L;UJW!'!'!ONS OF PERllI'f AFB'IDAVI'I'
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands thqt this permit may be subject to "deed restrictions" which
may be more re~trictive than City regulations. TIle undersigned assumes responsibility for.
compliance with any applicable deed restriction<i.
B. UNLICENSED CON'I'RAC'l'ORS AND CONTRACTOR RESPONSIBII,I'l'IES
I f the O\-lner has hired a contractor or contractors to undertake Hork, they nlay be required
to b.. Ij censed in accordance \dth state and local regulations. If the contractor is not
Ii censed as requi.red by law, both the ovmer 'and contractor may be c1 ted for a milidemeanor
violation under state laH. If the owner or intended oontractor are uncertain as to vlhat
licensing requirements may apply for tile intended work, they are advised to contapt the
city of Zephyrhills Building Department, 813-788-6611.
fflutherIIlOl-'e, j f the ovlller has hired a contractor or contractors, he is advised to have the
contractor (s) sign portions of the "Contractor Seotions" of this appUcation tor which they
vli11 be l-esponsible. If you, as the owner s.igns as the contractor, you are indicating that
you, rather than the contractor, are responsible for the wo:r:k. If the contractor Hishes
you to sign a~ contractor that may be an indication that he is not properly licensed and is
not entitled to permitting privil~ges in the City of Zephyrhills.
c. 'rRANSPOR'l'ATION IMPAC'r !fEES AND U'rILITY CONNECTION FEES
D. cONS'rRlJC'rUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
J certify that I, the 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 cerity that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the "owner" prior to commencement:
E. CONTRA.C'l'OR' S/OWNER' S AFFIDAVIT
I certify that all the information in this application is accurate and tllat all Hark will
be done in complianoe with all appUcable laws regulating construotion, zoning, and land
development.
Applioation is hereby made to obtain a permit to do Hark and installation as indicated. I
certify that no Hork or installation has commenced prior to issuance of a permit and that
all work vlill be performed to meet standards ot all laws regulat1.ng construction, City
codes, zoning regulations, and land development regulations in the jllrisdiction. I also
certify that I understand that the regulations of other governmental agenoies may apply to
the intended work, and that it is my responsibility to identify what actions I must take to
be in compliance. Such agencies include but are not limited to: *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environment.ally Sensj.tive
Lands, Water/WasteHater Treatment
*SouthHest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
'Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
'u.S. Environmental Frotection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone ~A" or "A,etc.H, it is
understood that a drainage plan addressing a "compensating volume" 'will be submitted which
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 Hith the work and not as
autllority to violate, cancel, alter, or set aside any provisions of the technical codes,
nor shall issuanoe of a permit prevent the Building Official from thereafter requiring a
correction of errors in plans, oonstruction, or violations of any code. Every permit
issued shall become invalid unless the work authorized by such permit is cOllunenced within
six montl1s of issuance, or if work authorized by the permlt i~ suspended or abandoqed for a
period of sll, months after the time the Hork is commenced. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be requested
in writing to the Buildi.ng Official. An approved inspection must be logged during eacb six
month period, or the pr'oj eet Hill be considered abandoned.
WARNING TO OWNER: YOUR FAIWRE 'l'0 RECORD A NOTICE OF COMMENCEMEN'l' MAY RESUL'l' IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IwrEND TO oe'rAIN InNANqHlq,~9NlJUL'I'
WI'l'H YOUR LENDER OR AN A'r'rORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'r. JOBS UNDER
$2,50D IN VALUE DO NOT NEED 'I'D RECORD AND POS'l' A "NOnCE OF COMMENCEMENT".
SlGNA'l'URE: OWNER OR AGENT
SIGNA'l'URE: CONTRACTOR
Dwho has produced
(type
and whoD did [] did not
STATE OF FLORIDA
COUNTY OF
The foregoing instrument H~S aoknowledged
Before me this -----Pay of--, 19
by
(name of person aoknowledged)
[1ho is personally known to me, or
o who has produoed .
(type of identifioation)
and vJho Ddid DUd not take an oath
STATE OF FLORIDA
COUN'I'Y Oli'-
'J'he forego1.ng instrument was
Before me this __ day of
by
acknowledged
1?_
(name of person acknowledged)
Dwho is personally known to me, or
of identification)
take an oath.
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped