HomeMy WebLinkAbout03-1971
BUILDING PERMIT
Permit N~
CITY OF ZEPHYRHILLS
(813) 780-0020
1971
Date L{- ( - 0 '3
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcel I. D. "
Zoning: Energy Code:
Descriotion of Work --..d Y' ; w wr.vt.er-
t1~~
Wo
Water Meter:
T.I.F.'s:
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
("- -03
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
7='[ I
Permit Fee 10
//1'
~ignature /:/L r <-:M./~
Company
Address
''>2felephone# t- C; S -'7 C;C; r
.7"0
Valuation or
Contract Price \ l ~ ~ -~ . e-o
City License Registration # c2 50 ;r
State Certified License#
'Ro5~ lit! f:lJ~Ke
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
PLUMBING
MECHANICAL
BUILDING
Driveway
Ilcf! (}:s ~LJ-SO
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
I
/
/
Breakers
Ducts Insl. /
compre~
Final
/
//
/
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 IH1JI?ARTMBlN'r 5335 8th S'rRElEl'f ZBJPHYRHII.I,S, P'L 33540
PhoneI813-780-0,020 raXI81.3-780'-0021 3..... "")~-o----::Z
IJA'rm RBellllVlllD 0" 0 7
-~_. ...:.-.,~_._~.. ----.--
PI,ANS RHlVII!JW II'Jll!li
CJ\'lNEJR I S I1M1El
CJ ^ "" _ /J'
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.....---...,.---- '---_...._-_.__._---_._--~._--_..~-,--_._--.__.~_.-._-_..._~--_._--
PHONE C!ON'l'1\(!'!'a_{?__~5?_-._!]!.~_
'.'
-_.,----_._-~. ...
,TOB SITE 1\DDRE881~t5__R_~_f3_d ~~~-~-I!lff-------.---------------
IJEl(]1\L DB18CRIPTIOll: LOT(S) ---'?__c..._____ BUX'K ______.___ SUBIJlVISJOtl
....--- ."-- -~"_.-. - -. '-.--.......--
PARC1E1IJ ILl If ;;2...t -;;> <a - ';;l \ - D ()- 00 I Oa _ 6o~ 0 (OBTAIN FROM PRnpElR'l'Y 'J'1\}{ NO'l'H'!J))
---~ ------------ q") -- -----------.------------------------------ - ----.... ---.-----------.--..
~~ORK PROPSBlfJ I [JNHlN CONSTRUCTION [J AOIJI'l'WN [J AUI'ERATION [) RElPAIR LJ J N8TA!,I,
_..._---~- _. - -..~-~...'~._- ~.. -.-----
ClaIml
o MOVE
[J DEMOLISH
PROPOSED USE: I [Jam, FAMILY DWElLI,IllG
[lt1UW'I.. FAMU,y
[1# OF tJlHTS
[J SNH1MING POUL
[J MOBII,m BOMEl
f] Cm.1MElR(~ IAI,
[] INDUS'l'RIAL
(]OTHHlR
CJ R~8TAURANT & IlEJAI,Tir DHlPARTt1ENT APPROVAL
IJEJ8CRIP'l'ION OF NORK -.-.J a ~SL:L--.-~~~_.___.______._______
BtJILflING s:r.ZEl .__..__._______ SQUARE FOOTAGE ---~_O_h__
. ._---~_._._--_.-'- ---.-----..-. "-" ~.._-_.
IlEJIGH'f
RBJ8IIJElNTIAr'l
COJl1MBlR(~IArJ :
A'!'TACH (2) PI,OT PI"AllS & (2) SETS OF BtJII,DINc3 PI,ANS & (1) SEI'!, E1NElROY FDR~1S,
A'l'tACH (:3) SElTS OF BUrUJING PLANS & (1) SEl'1' BlNEJRGY FORMS.
PROPElRTY SURVElY RElQUIRElD FOR ALL HEN CONS1'RUCTION.
'-~'----"---"- ~------._~--
C1 BIIII,)JIW~
~ERMITS REQUESTED
$ __'..} :?~ 00.__.
VALUATION OF' TOTAL CONSTRtJC'I'ION
L1 ElLElCTRlCAI,
--.---_____ At1P SElRVICEl
[] FIDRIDA POWER
[J W.R,El,e.
[] P I.tJt1B I NG
U I1BJUHANH!AT,
$-----
VATJUATION OF t1ECHANCIAI, IITSTAI,I,ATHJN
[] (~AS
LJ ROUFING
[0] SPElCIAI.'l'Y
[I O'I'HElR
']'YPHl OF CONS 'I'RtJC'rI ON : [J BLOCK
D FRAME
[J S'l'BlEIJ
[J OTHElR
FINISHEllJ FI,DOR ElIJElVATIONS
------------
18 PRO,TEeT IN FLOOD ZONEl AREA 0 YIllS
Dim
BUIWIlR
"'**"""""""""'**""'*"*"""""*'*"""**"""""
COt1PANY _________________________.._._..__.__. _ .___._______._
STATE CElRT OR REGIS'!' # ._...._______.____..__ _____.._
C I'l'Y PROCESSING #___ --------.--..-----___..n_n____. _"'_'_
SIGNATURE
-_._-------'------_.._----------~--_._-_._~-
BlI,!II0TRIdIAN
S T l3l1ATUREl ______
.__..._~ ---'4-____-----.--------..----.--- ______________
Cot1 P ANY ______.._____ __ ______ ._.______
STATE CElRT OR RElCHST #
CITY PRO(,E8SIN(~ #
._-._~--- ---.---. ~--.- -.-. .-'_.,- .--_______ - --0, .
'*""""*'**'*"*""'***'*"""'*'*'***""*"""""""""
-.---___._4______.______._.. __ . __'""-._"__....._~_______.
PIJtJMBBJR
.----___._.~v______~ _W___.
(~OM P ANY ----____._________________..___________________
STATE CERT OR REGIST # ______~________..__..__....
CITY PROCESSING #
S WN Arm R I1J
MBlCHANICAJ,
""'*'*"""""""""**""*""*""'**'*'*"'*'*"'*""***
"-.-.--.--- ..---.------------..-.---.--- -_.-
-----~-----_...._---
(!OMPANY_________________.________.___________..__
STATEl CElRT OR RElGIS'r # ~___________________.._
CITY PROCEl88ING #
S IGNATlJREI
OTUBlR __C:q, t:~ ~_(?t?h / ~/'JCr!dA__..__
SIc3NA'l'lJRE: ~ ~.,~._.
..-
*'**'*'**"*'****"**'**,.************'**"***'*******"*'1'*,,**
--_..o____.____.____,.__~__.__,_~
COI.1PANY ~fcrd.<<" C~~ ~."
------~--------..----.____"L._____.._. __
STA1'El CBJRT OR REGrST # n~~ 00"'1777
CITY PROCElSSING # 2. _ r~.u~:-~6--------.------
-Z -U!!:f-L_ _ ----.----__..2f_~ ._____.___.
**********'**********************1*"1******************'**~'****
L;lJIW1'1'lONS DE' PERl'1I'f AFlrIIlAVI'f
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands th~t this p~rmit may be subject to "deed restrictions" which
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNI,ICENSED CONTRAC'l'ORS AND CON'l'RACTOR RESPONSIBII,I'l'IES
I f the o\"mer has hired a contractor or contractors to undertake work, they Hlay be required
to be licensed in accordance with state and local reglllations. If the contractor is not
lioensed as required by law, both the o\"mer and contractor may be cited for a mil:ldemeanor
violation under 6tate laH. If the owner or intended cuntractor are uncertain as to Vlhat
licensing requirements may apply for the intended work, they are advi.sed to contact the
City of Zephyrhi.lls Building Department, 813-788-6611.
Furtherlnol: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
Hill be r'esponsi.ble. If you, as the owner signs as the contractor, YOl! are indicating that
you, loathe!: than the contractor, are responsible for the work. I f the contractor wishes
you to sign as contractor that may be an indication that he is not properly licensed alld is
not entitled to permitting privil~ges in the City of Zephyrhi.lls.
c. 'I'RANSPOR'l'ATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONS'I'RlIC'I'UION LIEN LAvJ (CHAP'I'ER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the appli.cant, have been provided with a copy of "Florida's Construction
1i.en Law - Homeowner's Protection Guide" prepared by the Flori.da Department of Agriculture
and Consumer Affairs. It the applicant is someone other that the "owner", I cerity that I
have obti:iined a copy of the above described document and promise in good faith to deliver
it to the \\owner" prior to conunencement.
E. CONTRAC'l'OR' S/OWNER' S AFFIDAVI'l'
I certify that all the informati.on in this application is accurate and tllat all work will
be done in compliance with all appli.cable laws regulating construction, zoning, and land
development.
Application is hereby made to obtain a permit to do work and installation as indicated. I
certi fy that no \"wrk or installation has commenced prior to issuance of a penni t 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 jllrisdiction. I also
certify that I understand that the regulations of other governmental agenci.es lnay apply to
the intended work, and that it is my responsibility to identify what actions I must take to
be in compliance. Such agencies i.nclude but are not limited to: *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environment.ally Bens~tive
Lands, Water/Wasteh'ater Treatment
.Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*AC1UY Corps of Engineers-Seawalls, Docks, Navigable Waterways
*LJepartment of Health & Rehabi.l.itative Services, Environmental Health \Jnit-WeLls,
Wastewater Treatment, Septic Tanks
*lI.S. Environmental Protection AgencY-A~bestos abatement
I also certify that, if fill material is to be used in flood Zone ~A" or "A,etc.", it is
understood that a drainage plan addressing a "compensating volume" 'will be suumi tted vlhich
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 sllall issuance of a permit prevent the Building Of~icial from thereafter requiring a
correction of errors in plans, construction, or violations of any oode. Every pe1:mlt
issued ahall become invalid unless the work authorized by such permit is cOlJuuenced within
six months of issuance, or if work authorized by the permit is suspended or abandoqed for a
period of Sill months after the time the work i6 commenced. One gO day extension of tillle
may be allowed for tbe permit with fee charge of $15.00. The extensi.on shall be requested
in writing to the Building Official. An approved inspection must be logged during eacb'six
month period, or the project Hill be considered abandoned.
WARNING TO OWNER; YOUR FAILURE '1'0 RECORD A NO'I'ICE OF COMMENCEMEN'I' MAY RESUL'I' IN YOUR
PAYING 'l'WICE fOR IMPROVEMENTS TO YOUR PROPER'fY. If' YOU INTEND TO OB'I'AIN li'INANC;IN~, ~qNftlUL'I'
WI'l'H YOUR LENDER OR AN A'f'rORNEY BEfORE RECORDING YOUR NOTICE OF COMMENCEMEN'!'. JOBS UNDER
$~2,'/~.U " no NOT NEEl> "0 RECORD AND POS" A "NonCE OF COMMENCEMENT".
y~~~
SIGNA'l'l1RE: OWNER OR AGEN'l' SIGNA'I'URE: CONTRACTOR
of identi.ficationl
take an oath.
STATE OF FLORIDA
COUNTY OF
The foregoing instrument w~s acknowledged
Before me this ------siay of----, 19
by
(name of person aoknowledged)
[1ho is personally known to me, or
o VlilO has produced
(type of ident.ifioation)
and VJho Ddid DUd not take an oath
S'fA'rE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
Before me this __ day of ___., 19_
by.
(name of person acknowledged)
Dwho is personally known to me, or
o who has produced
(type
and who[] did Ddid not
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or st.amped
Hame typed, printed or stamp.,;c.l
CITY OF ZEPHYRHILLS BUILDING DEPARTHENT
~~)~
JOB LOCATION '/0-7 ,;L (Q 3~/'1 ay~ ~"'-'? L<..J~
;;) 4- -..2 G.- :;:2 / - tBDt!;)o - 00/0<)- 0 c:>9'o
PARCEL I.D.' #
OWNER
SIIOW ALL EXISTU'G .& PROPOSED STRUCTURES GIVING DIHKNSIONS .& SETBACKS.
40
IJ.. !g
(
~
UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
(NO'l'E EXAMPLES 1 & 2 ) STREE'r
1. SETBACKS FOR R1, R2 ZONING
60'
10'
P E
R X
0 I
10' P S 10'
0 T
S I
E N
D G
20'
FRONT PROPERTY LINE
.
.J
~I
J
.V ,
~\)
~ Vl
C\
\
"-
'22 (
~
3D
FRONT ROPERTY LINE
2. SETBACKS FOR R3 ZONING
60'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30 ' DUPLEX
1 0' 1 0 I
FRONT PROPERTY LINK
ROSCILLO CONCRETE & MASONRY INC.
OFFICE PHONE (800)797-7450
CELL PHONE (813)695-9998
BILL TO:
PROPOSAL DATE
JOB LOCATION
~;?" .s .? ~ E( t7-(:,
P~P/~~~
~-~ S;~
ITEM QTY. PRICE EA. EXT. PRICE
d- \.;vc So \ ~ ~ l.... '0", (7-,
n A I: J.-L./ ..JiC} ~
U
... 46 ,ou ..LG--
(J1/LA. A I "1
V .....
fl. J J.. oJ rJ,;';t .........
\..J - ~
ll? ~/LA' 1l> (-r (/(/-' /-
" .
- ,
-
~ ~ ~~~, 1//
Total Cost