HomeMy WebLinkAbout03-1958
BUILDING PERMIT
Permit N~
CITY OF ZEPHYRHILLS
(813) 780-0020
1958
Date
J-01?--tl'3
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
P",perty Ow.., C~ ~ oc# T.J\<.~
Job Address: 10 L 4 0 h cJ Q 6\ V ,
Parcell.D. #
Water Meter:
T.I.F.'s:
Zoning: Energy Code:
DescriPtion of Work~~ S(. err'
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
c.o.
DATE
Inspector
City License Registration #
State Certified License#
~~,ev
Permit Fee ,..>."
)<--5' ~
Company
Address
,kTelephone#
Valuation or
Contract Price
'/500
,
~'
SlU'\ ~~~ f\ \ IJ V\^.tJ .
BUILDING
ELECTRICAL
R. L i .r IJ~erv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Met
Final
PLUMBING
Breakers
Ducts Insl.
Compre
Final
Ftr. ,/4- 7- 03
Pre SLB
Lintel
FRM.
Insul. CL
WL
SLB
Tub Set
Water
Sewer
Final
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
BUII,DING IHllPARTMElN'f 5335 8th S'fRElBl'f ZBlPH'lRHU.I,S, FL 33!l40
PhoneI813-780-Q020 FaxI813-780-0021
!JA'n RIIl(~!l!VIlJD
PJ,~NS RBlVIBIW P'lIlIll
(eM, 3-2S-tJ3
. 'tf
-.
UvmEJR f S IIM1E_____Q...qS:::~'-~_2~,t<:J~~~\.h_~ ~______ ___ PHONE (~()N'l'Af!'!'_5.<j_J -: t"l ~__..
,TOB S TTE ADIJREl88._~~~ ._.__~.~~_.~~___.____._._._.. ___'__.__
IJeJGAL DESCRIPTION: LOT(8)
B!J()CK
8UBllIVI8lrHI
-~-.._--.----.._----
PARC'81, III #
HURK PROPSElIJ I I)4NBlN r'ONS'I'RlJC'rION
-_.~-_._----~_._._._._-_._-. _.._-_.._-------_..-._-_._-~---~_._--._._._..---- --~-._-- _.._---_.__.-..~ ._----.._~'.. ".- -.._._...--~_.__..._--.-.-
(lJBTAIH F'ROfvl PROPERTY 'PAX NO'!'WI1l)
[J ADDI'l'Wl'T
[J AL'I'ERATION
IJ RElPAIR
LJ J NSTAI,I,
[)SHm
[] ~10VEJ
[J DEf-101,ISII
PRO!,l()i3EJIl USE: I [Jsr;!!, FAfv1IIJY DWEJ.,I,IlTG
[-h11J!il'T .'. FAfUl,Y
[J# OF lIIUTS
[]SWIHMING POUL
lJ MOB lIrE! llot11lJ
IJ OTHER
)t} Cot1~1ElR(! I A I,
o INDUSTRIAT,
CJ RESTAURANT & IlEALTIl DE:PARn1ElNT APPROVAT..
IJIllSCRIP'l'ION OF 1^10RK ___.J ~~.~_~_~__.~\. Gs:_....:J_____..__..__._.. ______..._._.__________.______..__.
B!Ju'DHm SIZE:
._---~_._--_. -, -..---.------
SQUARE FOOTAGE
---- ---.-- ---.--
HEl I (3HT
RESIDENTIAl,1
(~Of1MElRCIAI'1
.- ....----- -,,- ............ ---....--'----
ATTACH (2) PLOT PTJAl18 & (2) SETS OF BlJII,DINlJ PLANS & (1) SEI'!, ElNElRGY FORMS,
A'L"liJI.C!H (3) 8El'I'S OF BUILDING PLANS & (1) SElT ENER(N FORt-18.
PROPElRTY SURVEY RElQUIPJ;]j) FOR ALL NEVI CONSTRUCTION.
[] 811II,IJING
L1 ElLElCTRHJAI,
[] Pl,tH1BING
LJ '.1E:CHl\N I CAT,
FERM1TS REQUESTED
$__~S_~c>_~._~ VA1,UATION OF TO'l'AL CONS'I'RlJC'rION
----..-----_._____ MtlP t9ElRVICEJ
o FI~RInA POWER
[J W , R . E . (1 .
,
$.---...----'------ VAI,UATION OF ttlEC'HANCIAI, UIS'1'AI,I,A'1'TON
[J (JAS
[OJ ROOFING
LJ SPElotAUl'Y
~ OTHER
TYPEl OF' conSTRUe'I'ION I [J BLOCK
[J FRAJ1E1
[] STEEl!,
~ OTHER
FIN r SHEllJ FI,OOR Ell,EVATIONS
-------.-..--.---
IS PRO,TElC'I' IN FTDO[) ZONEI AREA 0 YElS
[J NO
Bt1U..omR
**'**'**."****'****'**'**'*"**"',.,'*""'*"""'*"~"~'ll"~'"~
COf1P AN Y-.~B--.."3_L9-U::._~__..~ _._....___._ Pu
STATE CFJRT OR RElGlS'!' # .._~_~~_ ._.___..,. _'_"'_
CITY PROCESSING #..___ .-_'__.'U". ___... .._......_.
----~
_.....~ ~"'"";;;;,.-
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SHmA'I'tJREl ~'~4'.- ~,.P' ,"-~
_.. --2 ~~-:.-~~-------_.._._----_._._._--
B1I,BlCTRIdIAN
8] (mA'I'IJREJ ___..
'-'-'--.-..- ..._._~-----_..._-_._._--
~~'___h."'____,_",_",_____
COl1PAHY '_..'_'___._ _.____ '..-'---"-'-_-.'_m___.,
STATE e'ERT OR RE(nS'I' II
CITY PROCEJ88IN(~ #
.--._-----. ----._~... '_'._,-.-,---~--,...
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PI,UMBBlR
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( 'nrtl PAll Y ___'_00_ ..__..._________ .___..____'....__.._..___..._____."..
STATE CERT OR REnTST # ___.________..__.__.__._.___.
CITY PROCE8SING #
S WHJ\TtJR E:
MBlCHANICAI.
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----..-- .."-... .-.--..--.-..-- ~~- .._--._~~-~_.---_..- ._-
......._-----'_._._._--~--_...._---_._--_...,,~.._-,+----
COlv!PANY ___________._ _.. .._..'._____.____. ....__
STATE ('E1HT OR REJGIS'r #
CITY PROCESSING #
-'----, _..~-- --.,,-- ----, - ----.~._---- - -,-
Sll.~NA'l'UREl
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-----...-----------.---.---.--- . '--"---.-,-.
OTlHlIR
-----____4~___._,______________~.____
(~OfllPAHY
STATE crnRT- OR - REGIST -#---------. .-..-.----.--.---~._--._"..-~...~. --~
CITY PROCESSING # -.------.--.__._.____________
..--.- _._..__._--~...._-_..._----------------------
SWITA'I'URE
'*"*'**'***""'**'**""*"'******'**k'*""'*"",***'*'~*'*'*
-.---.--...-- --- "- .-..-.-..-------------.--- ----.. ,. --'---.---.. -,- ---
CONDI'l'IONS OF PERM!'!' AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
, 'l'he undeJ.:signed understands th~t this permit may be subject to "deed restrictions" which
may be more restrictive than City regulations. The undersigned assumes responsibility fo~
complicmce with any applicable deed restrictions.
B. UNLICENSED (~ON'l'RAC'l'ORS AND CON'l'RACTOR RESPONSIBILI'l'IES
If the owner has hired a contractor or contractors to undertake work, they may be required
to be licensed in accordallce with state and local regulations. If the contractor is not
licellsed as required by law, both the owner and contractor Illay be cited for a misdemeanor
violation under ::;tate laH. If the owner or intended contractor are uncertain as to Hhat
licensing requirements may apply for the intended work, they are advised to contact the
City of Zephyrhills BuUding Dflpartment, 813-788-6611.
Furthenl1or-e, if the ovmer has hired a contractor or contractors, he is advised to hAve the
contrActor(s) sign portions of the "Contractor Sections" of this application for whicll they
will be responsible. If you, as the owner signs as the contractor, you are indicating that
you, rathel' than the contractor, are responsible for the work. I f the contractor Hishes
you to sign a/:1 contractor that may be an indication that he i.s not properly licensed and is
not ellLitled to permitting privileges in the City of Zephyrhi.lls.
C. 'I'RANSl-'OR'1'ATION IMPACT FEES AND UTILI'I'Y CONNECTION FEES
D. CONS'I'RIIC'1'UION LIEN LAvJ (CHAP'I1ER '713, FLORIDA S'l'ATUTES, AS AMENDED)
J certify tllat 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 appl.icant is someone other that the "owner", I cerify thcat I
have obtained a copy of the above described document and promi.se in good faith to deliver
it to the "oHner" prior to conunencement.
E, CON'!'AAC'1'OR' SIOWNER' S AFFIDAVI'l'
I certify that all the information in this application is accurate arid that all Hork will
be done in compliance with all applicable .laws regul ating construction, zoning, and land
development.
Applioation is hereby made to obtain a permit to do work and installation as indicated. I
certify that no vwrk or installation has commenced pri.or to issuance of a permit and that
all work v/ill be performed to meet standards of all laws regulati.ng oonstruction, City
codes, zoning regulations, and land development regulations in the jurisdiction. I also
oertify that I ullderstand that the regulations of other governmental agencies may apply to
the intended work, and that it is my responsibility to identi.ty what aotions T must take Lo
be in eompliallce. Such agencies include but are not limited tOI *Department ot
Environn\ental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensltive
Lands, Water/WasteHater Treatment
*Soutllwest ilorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterway::;
*Department of Health Ii Rehabilitative Services, Environmental Health UnJt-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 ~A" or "A,ete.N, it is
unde.t:stood that a drai.nage plan addressing a "compensating volume" 'Hill be submitted v/hic:h
is prepared by a professional engineer registered in the 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 technical codes,
nor shall issuance of a permit prevent the Building Official from thereatter requiring a
correction of errors in plans, construction, or violations of any oode. Every permit
iSliu~d shall beaome invalid unless th~ Hark authorized by such permit is aOllunenced within
six months of issuance, or if work authorized by the permit is suspended or abandoqed for a
period of sbt months after the time the work is commenced. One 90 day extension of time
may be allowed for the permit Hith fee charge of $15.00. The extension shall be requested
il\ writing to the Buildlng Offici.al. An approved inepection muet be logged during each silt
1II0nt1l period, or the project will be considered abandoned.
WAfUHNG '1'0 OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMEN'll MAY RESULT IN YOUR
PAYING TWICE FOR H1PROVEMEN'l'S TO YOUR PROPERTY. IF YOU IN'I'END TO oa'1'AIN FINANC;ING, .(::QN~UI/I'
WITH YOUR LENDER OR AN A'l"!'ORNEY BEFORE RECORDING YOUR NO'llICE OF COMMENCEMEN'1'. 'JOBS UNDER
$2,50D IN VALUE DO l'lO'r.~~~lJ:p'_.:.:.~O .~~~~RD AND POS'!' A "NOnCE OF COMMENCEMEN'l'''.
81 ..-~//-._=:=:;~~ 8~~-=~3:>-;--~
S'l'A'rEl OF FLORI DAjJfi 11,('J
COUN'I'Y OF - ,.,..::?
'l'he foreaoing .instrument was acknoHledged
Bdore ~ this -:;S- day of /?J/'I/2..t!.# , ~..2C1tl3
by . qL ~~€/,q
~(name of pereon aaknowl~dged)
~ho is personally known to me, or
STA'I'E OF FLORIDA L?
COUNTY OF rA..st!..c.
ThE3 for'ego.ing instrument w~s acknoHledged.
Befor, e me~lis o?~y of.-,&l/9..~fl4- , oW 2~3
by , ',,!Jv L... 'A'!/e,.c:; / /i-
{name of person acknowledged)
~is per:sonally kno\'Jn to me, or
Owho has produced
(type of identification)
an~ Ddid not take an oath.
c-r'" ~crfd ~
"Signatur'e of person taking acknowledgement
o who has produced________~_______
(type of identification)
a,ndt.Odid ~Z~ an oath
~ ~~ t -----
S gnature of person taking acknowledglllt:nt
Hame typed
1>I'l~~ed ~ccmo
~~"::1 MY COMMISSION t CC 949169
~\ . ~ EXPIRES: June 26, 2004
'1~R";":l . Bonded Thru Notary Public Undorwrltors
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SHlRDEN K. DEL cono
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Bonded Thlu NoIary NIle Undonn1laII
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TOP = 108.0'
INV.= 104.68
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INV. = 102.60
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fYPE "[" GRATE INLET
TOP = 107.00
~. INV.= 104.43
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Ernest S. SiIco~ P.E. 1#8161
Silcox Eagiaee-:i-g. IDe.
Civil Engineering
5409 N. Nebraska Ave.
Tampa. FL 33604
(813) 238-9755
SILCOX ENGINEERING, INC.
Post Office Box 8574
TAMPA, FLORIDA 33674-8574
(813) 238.9755
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Ernest S. Silco~ P.E.1#8161
Silcox Engineering, Ine.
Civil Enginccring
5409 N. Nebraska Ave.
Tampa. FL 33604
(813) 238-9755
EX PO~()e.E.: 0
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