HomeMy WebLinkAbout03-1970
BUILDING PERMIT
Permit N~
1970
CITY OF ZEPHYRHILLS
(813) 780-0020
BUILDING
ELECTRICAL
PLUMBING
Property Owner:
Job Address:
Parcel I. D. "
-=r; e
3 <6Y I V
(Vlc... C (~I'V\
5-1"'. Ave,
C5?J
Date
~-I- () 3
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
Descriotion of Work
Radon Gas:
R~e~gy ~
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
~ 'Fll''''-O
~ermlt ee =-
.-!\signature. A~ ./-
Company
Address
\FGlephone#
Valuation or
Contract Price
~ [111'"
~<i)
City License Registration #
State Certified License#
(~r~ ~\5t.
DATE
Inspector
BUILDING
ELECTRICAL /'
/
/
I
I
I
I
I
I
SLB
Tub Set
Water
Sewer
Final ;
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
/
,
!
i
,
Driveway
PLUMBING
/
/
/
/
MECHANICAL
/
Breakers
Ducts Insl.
Compressa
Final
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. J
Work not ready for inspection when called. I _
Permit not posted on job site. -./)0\.-(
Plans not at job site. I
Work not accessible.
c: ~ecf ~
~ 336Y
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
BUILDING IlIIII?A'RTMBlN'r 5335 8th S'rUlBl'r ZBlI?HYRHIlJI,S I rL 33540
PhoheI813-780-~020 'axI813-780-0021
DAtUl RIIIC!lIIVEO ........____.__~"~ ..____
PI,ANS RHlVtBlW Jl'1II111_,__ _..__ ::
'MilER'S IlAM"___J Q~_ _ /L~fu,lL1_ u_6'--y.__---___ __ __ PHON" "O"'J'A"Tg-U-{,~9~ Lfie!
.JOB SITEl ADDRESS .3.-~-l.jjk----.5'~_00X~____7- ~~[ftdll~J!i..,} ~_.['j_Q_____ ,_._ ___. ____
"
IJBlGAL f)ElSCRIPTION: LOT(S)
BIDCK
SUBIJIVI810N
--'_.__.~._.-..._---.... '_._"-'-'-.'-~, "----._--
PARCElll III #
WURK PROPSEl[J I [JNElW r'ONS'I'RtJCTION
.-----.._-_.---~-_.._-_...__.._---'"-._~------_.---_.__.--~- ~._-~_.. - ...--.--------..----....-... -.._- ...-,..~-----_._---_..-..
(OBTAHl F'ROM PROPElR'l'Y 1'AX NOTICEl)
[J ADDITION
[JAUI'ERA.'I'ION
\tRElPAIR
~STl\r'l'
[Jsrml
[J MOVE)
o DElI'1orJI SU
PROJ:108E)1l USEJ I C1Sf]I, FAMIIJV nWELIJIHr~
\J.6.J~1~1BJR(~ rA I,
[lt1UUl'I.. FAMIl,Y
[] # OF' mUTS
[J SWIMMING POOL
(] MOBII.El IfOf1B
(] HTDllS'l'RIAL
(J OTIH!lR
CJ RElS'I'AlJRANT & HEArmI DEJPARn1EJN'r APPROVAJ.,
IlBJ8CRIP'l'WN OF NORK .-C~-.-r~'\__ rv>J:..{)_Ct1-etJ/---.C..e_-:LQ_G~_______._._____._____._u_______.
SUILDIN!) SIZE! .kh..l~______ SQUAREJ FOOTAGE :?..O ~O ___ HElJGHT ..:)_Q_~____.___
RESIDENTIAl'I
(m~1MSJRC!IAIJ :
A'J"I'1\CH (2) PI,OT PIJAllS & (2) SEJ1'S OF BtJII,lJINlJ PI,ANS & (1.) eElT ElNElRr~y FnR~18.
A'I"I;1\.(;H (3) SEl'I'S OF BUtLDlNG PIJANS & (1.) 8ElT EJNEJR(~Y FORMS,
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
[] BllTr.IJIN(~
02 ( Y?9 ,r" I>ERMITS REQUESTED
$".~ _.-.; VALUATION OF 'rOTA1, COl~S'fRtJc'rroN
L1 EIl,BJC'I'RHJAJ.
- ------_____ M1P 8 EJ R V I eEl
o FI,oRIOA POWER
[J W , R . E . (l .
[] PWt1BING
LJ f.1EJUHA.N IC!AIJ
$-.-------'-----.-- VALUATION OF ~..,a:CHANCIAI, U1STA!,I,ATTON'
(] <~Ae
(01'ii:XJ F'I N<3
[I SPEJC!tAUry
~HER
1'YPEl OF (~ON8'I'RU(~TION I [] BLOCK
[J FRl\MEl
[] STEE!.
[] OTHER
FIIH8HElIJ FI.oOR ElIJEVATIONS
IS PRO,TElCT IN FLoon ZONEl ARElA n YElS [] l'lO
:~:::::.. ~~------
COHI?ANLLQA::C______
STATE CElRT OR RElGIST
CI'rY PROCESSING t._._ __.._____._..___.
tr~qb_~.__~ r _L
# CC--'-_Q 6.0:b~tU_..._
****************************************************'****'**'*'*******
!lIUICI'rRICIAN
Sll31lA.'l'IJREJ ___..
. - -'-.-. '-'-- -.--_.-----.. '--'--_._~ ---..-.-.--.-.----.-
cot1PANY _.__._______________ -----___.____u_~__
STATE CERT OR RE~T8T #
CITY PROCESSING #
. __4___.. _. __.~_._.~ _____<.... ___.... ..~. __'__ ~_ _. .__.._.
* '* * * '* * * * * * '* * Id * * * * * * * '* * * * * * * * * * * * '* fd * '* " * * '* * , , * * * '* * '* '* '* '* '* '* '* * * * * * '* * '*
~_._--_...----~-~- ---'---~ ~ .-..- --~-_._- . ~-_.._-~"'
PJ,UMBER
...... ._'--_._....._-.~- -~._-'--...- -~.------
('OM P ANY --------.__.._.________________...._....___ _....___... ______ _ _____
STATE CEJRT OR RE<HST # ___.______..____.._..___._...
CITY PROCESSING #
SIGNA'l'tJRE
MEC!HANI CA1,
***'********************'******************'*******'*****************
-----.--.- ""..-.- ----..------ -.-- ...-...-.-______._._L_
-----------~------....__.----......,.-----,.--~---
CO!11PANY _______________..____________...._.____.
STATE CERT OR REGIST #
CI'I'Y PROCESSING #
--~-_.._-.---.-_.____.__ _.__R__~.___._._~__._
S WNA'rtHH!1
***********************'**********"*'*************"**"'**'*'***'
--_____~__'4__________ __._._ "__'~'__'___
OTIIBlR
--------_._._--~-
C!0I.1PANY
STJ\TE CElRT OR REl~IST ij-----.-------....-----..---
CITY PROCElSSING # --..--------~....---______
-~--_._._...._---~._..._--~_._.;.-----_._-_._----_._-
s r<H1J\'l'tJRE
*""**""'*"'*""*'*"'**"'*'*""'**'******'*"*"*"***'*'
-.----.---...-.--.-.-------.-.-.---..-..-.----.--......-
CONDI1rIONS Off' PERMI'l' AFFIDAVIT
A. NOTICE OF DEED RESTRICTIoNS
The undersigned understands thijt this p~rmit may be subject to "deed restrictionsU wllieh
m~y be mure restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNLICENSED 'CON'I'RAC'I'ORS AND CON'l'RAC'l'OR RESPONSIBIl,r'I'IES
If the cHner has hired a contractor or contractors to undertake Hark, they nlay be required
to be Ucense;d in accordance with state and local reglllations. If the contractor is llot
licensed as requi.red by law, both the ol-mer and contraci;or IlIay be cited for a 1Il1ademeallor
violation under state lavl. If the owner or intended contractor are uncertain as to vlh~t
licensing requirements may apply for the intended work, tlley are advised to oantapt the
city of Zephyrhills Building DElpartment, 813-788-6611.
Furthermol::e, if the owner 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
vlill b<; responsible. If you, as the owner signs as the contractor, yo\.! are indicating that
you, rather than the contractor, al-e responsible for the work. If the contractor wishes
you to sign a~ contractor that may be an indication tllat he is not properly licensed and is
not entitled to permitting privileges in the City of Zephyrbi.lls.
C. 'I'RANSPOk'l'A'l'ION IMPAC'l' FEES AND U'l'ILI'l'Y CONNEGTION FEES
1). CONS'l'RlIC'l'UION LIEN LAW (CliAP'l'ER 713, FLORIDA S'l'ATUTES, AS AMENDED)
1 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 Affair-s. If the appl.i.cant is someone other that the "owner", I cerify that I
have obtdned a copy of the above described document and promise in good fai.th to deliver
1. t to t.he "owner" pri.or to COllunencement.
E. CON'I'RAC'l'OR' S/m-INER' S AFFIDAVI'l'
I certify ttlat all the information in this application is accurate and that all work will
be done in compliance with all appli.cable laws regulating constr-uction, zoni.llg, and land
development.
Application is Ilereby made to obtain a permit to do work and installation as indioated. 1
ecq:tify that no Hark or installation has cOllunenced prior to i.ssuance of a permit and that
all work will be performed to meet standards of all laws regulating construation, City
codes, zoning regulations, and land development regulations in the jllrisdiction. I also
certify that I under'stand that the regulations of other governmental agencies may apply to
the intended Walk, and that it is my responsibility to identify what actiona I IlIllst take Lo
be in compliance. Such agencies include but are not limited tal *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally SenstLive
r,anda, Water/Wastewater 'rreatment
*Southwest ti'lodda Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
'Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*lJepartment of Health & Rehabilitative Services, Environmental 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 ~A" or "A, etc.", it is
understood that a drai.nage plan addressing a "compensating volume" 'wiLL be sllbmitted which
is prepared by a professional engineer registered in ttle State 6f Florida prior to peonit
isauance:.
A permit issued shall be construed to be a license to proceed with the work and not as
auttlority to violate, cancel, alter, or set aside any provisions of tbe techlliual codes,
nor shall issuance of a permit prevent the Building Official from thereafter requiring a
correction of errors in plans, oon~truction! or viol&tions of any oode. Every petmit
iS~iUed lihall become invalid unlees the Hork Cl.uthorized by such permit is oOlluneoced within
six months of issuance, or if work authorized by the permi.t is suspended or abandolled f~u- a
pel"iad of el.. months after the time the work is cOllUnenced. One 90 day e..tension of time
may be allowed for the permit with fee charge of $15,00. The extension shall be reques~ed
ill writing to the Building Official. An approved inspection must be logged during each Ifllx
month period, or the project Hill be considered abandoned.
WARNING '1'0 OWNElRI YOUR E'AIWRE 'I'D RECORD A NonCE DE' COMMENCEMENT MAY RESUL'l' IN YOUR
PAYING TWICE FOR IMPROVEMEWl'S TO YOUR PROPER'l'Y. IE' YOU IN'l'END TO oB'rAIN .I!'INANGINq,~qN~UI/l'
WlTH YOUR LENDER OR AN A'l"l'ORNEY BEFORE RECORDING YOUR NOTICE: OF COMMENCEMEN'l'. . JOBS UNfJ\tR
$2,500 IN VALUEl DO NO'l' NEED '1'0 RECORD AND POS'l' A "NO'l'ICE OF COMMENCEME:N'l'".
SIGNA'I'URE: OWNER OR AGENT
S I GNA'l'URE I CONTRACTOR
S'fA'l'f] OF FLORI DA
COUN'l'Y OF
The foregoi.ng instrument was acknowledged
Before Ine this ___ day of ___, 19_
by..___
(name of person ackuuydedged)
Owho is personally known to me, or
STA'l'E OF FLORIDA
COUNTY OF
The foregoing instrument Was aoknowledged
Before me this .--pay of----, 1~ __:__
by
(name of person aoknowledged)
C1ho 15 personally known to me, or
o who has produced
(type
and who[]did Ddid not
of identification)
take an oath.
o Hho has produced
(type of ident:Ufo-iUon)
and Hho Ddid DUd not t.ake an oath
Signatul'e of person taking acknowledgement
Signature of person taking acknowledgm~nt
I'lame typed, j?rinted or stamped
Name typed, printed 01 stall1p~d