HomeMy WebLinkAbout03-1963
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N~
1963
(813) 780-0020
Date
3 -.;2, ~,.;() 3
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Zoning:
Descriotion of Work
Water Meter:
Property Owner:
Job Address:
Parcel I. D. "
UJ::;;Y Code:
VMcR..~J
Radon Gas:
j~~
NO OCCUPANCY BEFORE C.O.
FINAL
~-22-03
DA];en
-5 -J, ? ~ {// ,
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
c.o.
DATE
Inspector !ISo d R ( Cj
City License Registration #
State Certified License#
l( 8"; " .
Permit Fee ;:;~().o
,"signature LJ~
Company
Address
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~Iephone# 7
Valuation or
Contract Price
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BUILDING
{/l A-~/J a
&~jJdo
ELECTRICAL
PLUMBING
~~-fi(7
MECHANICAL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final ./"
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
SLB
Tub Set
Water
Sewer
Final 1/
Breakers
Ducts Insl.
Compressor
Final i /'
Driveway
f 17 Ii /z 2-/<,' 3
t; -; t( 0 D I C\/V\t\
/c{L
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.
b.
c.
d.
e.
f.
g.
Wrong Address
Condemned work resulting from faulty construction.
Repairs or corrections not made when inspection called.
Work not ready for inspection when called.
Permit not posted on job site.
Plans not at job site.
Work not accessible.
!J<J,
jZ4-{? .
~~~~I
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
BunDING IHIlI?ARTMEN'l' 5335 sth S'fRIllIll'r ZIllPH'lRHILI,S, FL 33540
PhoneIS13-780-Q020 FaxI813-780-0021
lJA'rB1 RBC1111IV!lJD
-----........... --"_._----.:.~.
PI,ANS RIllVII!lW JI'!llf(______. ~UH~__.____.
UWNElR I S HM1E_J).L.l__LJ..~ _ ___ _________________.____________ PHONE CON'l'Ar~'L________.__._.._____
,JOB BITE ADDRE:88../.:._:!.7 Lf_O____~_________________.___ --~----n____._____n__._._______ _____
LEJrJAL DBlSC!RTPTIOI1= LOT(8) BlJOC'K SUBIJIVI8JOtl kfcci.~2!~"___.9Af:-!__
PARC!E1IJ ILl It
-_._-----_._._--~._-_..----
~----_._---_.__._-_._._----------._._-,_._._,P..._"'--------_.~_
(OBTAIN FROM PROPElR'rV 'I'AM NOTICEJ)
HURK PROPSEllJ I LJNIllW CONSTRUCTION
[lswu
[] ADDI'I'ION [J ALTElRATION [] RElPAIR LJ INSTAl,t,
o MOVE CJ DElMOI,ISII
[h1lJI/I'I - FAMII,Y [J# OF l1N I'I'B 1C! MOB II.El 1I0t1El
[J INDUS1'RIAL rJ SWU1MING POOL LJOTHHlR
PROI?USEJll USE: I [JSGI, FAMILY DWElLI,I1K-l
[]CCJt1MIllRC!IAI,
llBJ8CRIP'rION OF NORK
o RElSTAURANT & HEA1JT1t IJElPARTt1E:N'I' APPROVAL
-Ii #1.______..
---~-.-~_.--- --.-_____.__...w._ _______~~__ __'_"_'__'_ ._.. _ ..____.
BUn,fHN(~ SIZE
.---.------
SQUARE: FOO'I'A(JEJ
_._-~._-
HE! WH'r
RESIDENTIAl"
(~O~1MI!lRCI1\IJ I
A'I'Tl\CH (2) PLOT PLAn8 & (2) SETS OF BUI! ,DUI(] PI,ANS & (1) BElT ElNEJROY FDR~1S.
A'I"rA(~H (3) SETS OF BUtUJING PLANS & (1) SEl'I' ENERGY FORMS.
PROPElRTY SURVEY RElQUIRED FOR A1,L NEW CONS'l'RUCTION.
~ERMITS REQUESTED
[1 BlIILIJING
$
VALUATION OF TOTAL CONS'I'RUC'I'WN
L1 BlLElCTRlCAI.
-.---.-----.---
AMP ,9ERVICE!
o
FlnRIDA POWER
[J
W.R.E,C.
[] P!,tJt1B IN!]
U HElUHANIl!AIJ
$____,.
VALUATION OF MBlCHANUIAI, U1S'!'Al/I,ATTON
[J (1A8
[] ROOFING
LJ SPElCIAUI'Y
lJ OTHER
'l'YPEl OF' CON8'I'RtJC!TION I 0 BLOCK
[J FRN-1El
lJ STElElJ
[J OTHER
FINISHElIl FI/OOR BlIJElVATIONS
-------
18 PRO,TElCT IN FLOOD ZCJNEl AREA. 0 YES
o NO
BUlr,DBlR CCJr1PANY __________.....__..________._______
~t/'] ~ STATE! CElRT OR RE!GI8'I' #..______._______________,._______
8lGNATUREl __t..M'_~~~________ CITY PROCElSSING #___..________________..___._~__.._
"""""""""""""""""**""""""'*"*'""""'*"
BJl,1II0TRIdIAN
B 1 llHA'I'UR' ___uJ'~~__ ____ _ ______
CCJt1PANY --~.l3_tJ._~_/. .,4-/~___ ______..___________ _____
STATE CERT OR REl8T8T #
CITY PROCEJSSIN(~ #
--- --. ._..__._-~.._---,._-~------.., --_. _.'--
PI,lm... ....,.",.".,..........."..,.... :,:::::::'~~'~'-"~:'-~-_-____
-7~ STATE CElRT OR RElGIST # ___________._______._____..
8WNA'l'lIREl .--"--'..t.:!..--~~r\JI/---..----- CI'I'Y PROCElSSIN8 #_..__.._________..___________________._
MBlCHANICAIJ -II""""", *", *.".".", * *k'." * *"" *' *" -II ;!;)~;;~~~~Z~ * =_~~._~.:.:..::~_*____.__._____..____ ___..
STATE C8RT OR REGIST #
(!ITY PROCESS INn #
_._-_._'"--_~ __ H.._.__. ___.._.__. _._~__.____. __________
S IGNA't'tJREI
~~_.._~----
----___.+__.4_ .___~_...__._.____~_~_,. .________
***"****'**'*'**'****'*"****'******'*'***'*******'**'*'***'*"*
~ .-----.-.---~--_.____h_.___.. _ .__...._.______.
OTIIBJR
BIenlA'l'URE
--------------
(~Or,'lPANY
S'rJ\'l'E CElRT - OR -RimsT -r------------------------.-----
crry PROCEl88ING # -----------_____________
-------------------------
*************"*****"""""***'*"*'***'**'*******'**'**~'****
._------------._'----.--~---_..,--_.....__..._,-_._-_._,
l;U!Wl'i'lONS OF PERMI'f AFFIDAVIT
A. NO'fICE OF DEED RES'lIRIC'fIONS
The undersigned understands thqt this permit may be subject to "deed restrlctions" widell
may b~ more restrictive than City regulations. The undersigned assumes responslbility for
compliance with any applicable deed restrictions.
B. UNLICENSED CONTRAC'l'ORS AND CON'l'RACTOR RESPONSIBILI'l'IES
If tile owner has hlred a contractor or contractors to undertake work, they may be required
to b~ licensed in accordance with state and local regulations. If the contractor is llot
licensed as required by law, both the owner and contractor may be cited for a misdemeanor
violation under state laH. If the owner or intended contractor are uncertain as to vlhat
licensing requirements may apply for the intended work, they are advised to contact the
City of Zephyrhilla Building Department, 813-788-6611.
Furt.hennor-e, j t the ovmer has hired a contractor or contractors, he is advised to have the
oontractor(s) sign portions of the "Contractor Sections" of this application tor whicll they
will be Lesponsible. If you, as the owner signs as the contractor, you are i.ndicating that
you, rather than the contractor, are responsible for the work. If the contractor wishes
you to sign as contractor that mOlY be an indication that he ls not properly llceused and is
not entitled to permitting privil~ge$ in the City of Zephyrhills.
C. 'I'RANSPOR'l'ATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONS'fRUC'fUlON LIEN LAW (CllAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
I 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 cerify that I
11ave obtained a copy of the above described document and promise in good faith to deliver
it to the "oHner" pri.or to conunencement.
E. CONTHAC'I'OR' a/OWNER'S AFFIDAVI'r
I certify that all the information in this application is accurate and that all work 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 installatiol1 as indicated, I
cc:q:tify that no vlOrk or installation has conunenced prior to issuance of a permit and that
all work V1ill be performed to meet standards of all laws regulating construation, 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 aations I IIIUSt take to
be in compliance. Such agencies include but are not limited tOI 'Department Df
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensttive
Lands, Water/Wastewater Treatment
*SouthweClt Ii'lodd.. Water Management District-Wells, Cypress Bayheads, Wet.1and Areas,
Altering WateruDurses
*Anny Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.S. Environmental I?rotection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone qA" or "A, etc.", it is
understood that a drainage plan addressing a "compensating volume" 'will be submitted which
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 tbe technical codes,
nor shall lssuance of a permit prevent the Buildlng Official from thereafter requiring a
correction of errors in plans, con~truction, or violations of any oode. Every permit
is/iUed shall beaome invalid unless th~ work autho:r:1zed by such permit is oOIlunencljd within
six months of is/mance, or if work authorized by the permit: is suspended or abandoflCld for a
period of s1x months after the time the work is oonunenced. One 90 day extension of tillle
may be allowed for the permit with fee charge of $15.00. The extension shall be requested
in writing to the Build1ng Offioial. An approved inspection must be logged during each six
month period, or the project will be considered abandoned.
WARNING 'ro OWNERI YOUR FAILURE '1'0 RECORD A NOTICE OF COMMENCEMEN'l' MAY RESUW' IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROI?ERTY. IE' YOU INTEND TO OBTAIN lnNANGINq,~9NijUL'r
WI'l'H YOUR LENDER OR AN A'fTORNEY BEFORE RECORDING YOUR NOTICE OF COMlvtENcEMEN'r. JOaS UNDER
$2,500 IN VALUE DO NO'l' NEED 'l'0 RECORD AND POS'l1 A "NOTICE OF COMMENCEMENT".
SIGNATURE: OWNER OR AGENT
SIGNATURE; CONTRACTOR
STA'l'E OF E'LORIDA
COUNTY OF
The forego1ng instIument was acknowl~dged
Betore me this ~_ day of ___, 19_
by.
(name of person acknowledged)
Dwho 1s personally known to me, or
Owho has produced
(type
and wbo[] did Odid not
of identification)
take an oath.
STATE OF FLORIDA
COUN'rY OF .________
The foregoing instrument w~s acknowledged
Before me thls _-----liay of--, 19
by
(name of person acknowledged)
C1ho is personally known to me, or
o who bas produced
(type of identifioation)
and 1'1110 Ddid .DUd not t.ake an oath
Signature of person taking acknowledgement
Signature of person tak1ng acknowledgment
Hame typed, printed or stamped
Name typed, printed or stamped