HomeMy WebLinkAbout03-1973
BUILDING PERMIT
Permit N~
CITY OF ZEPHYRHILLS
(813) 780-0020
1973
Date 1-(-0 3
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcel I. O. "
tRl.<:....
5"::< (Cj
#/ 1/:-- ~ eft I'l&-
3 rc-l- :Sl'
Water Meter:
T.I.F.'s:
Zoning:
Oescriotion of Work
Energy Code:
-- L(
I--~e 0 . (J}
Radon Gas:
6'1
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
-t) 3
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
DATE
RL'1 d- I+TO
City License Registration #
State Certified License#
Xs::~::.:e~~
Company
Address
~Iephone# '::t-/~'1f"J1- ~ :;f'i-k>J...6 vJ
Valuation or
Contract Price
() vJ YV.-if
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Po
Pool
Pre-M
Final
SLB
Tub Set
Water
Sewer
Final
MECHANICAL
BUILDING
Breakers
Ducts Ins!.
Compress r
Final
Driveway
REINSPECTlON 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
BUUDING IlBlI?ARTMBlN'r 5336 8th S'rRIllBl'f ZBJI?HYRHII.LS, rL 33540
Phonela13-780-Q020 ra~le13-7eo-0021
lJA'rB1 RBlOIIIIVIlJO ~~_.~.". _~_. _____
I?I.ANS RIlIVIBlW B'1ll1li________. __.______..
O"".R '~ "AM~ -_S(\~gjf: ~ ~~l-- _______~_;:-< PH~N. "O"<I'A~3-:f!~~~~. i,
.TOB BT IE AtH RBJ8S -----bJ-9--------------t!..Y2f____~--!:J-!-:b~J-----K------ ___ _____ ___..._
lJI3lGAL DBlS(!RTP'I'IOIl: LOT(S)
B fJ()(~ K
SUBDIVISION
~~-.,-_._--_..-_.._-_._-_.-
_._--~---_.... - --_..._~--,.._----
P1\RC!ElII III #
WURK PROPBEllJ I [JNElW l'ONSTRl1CTION
----~---------~._._--...-------.._---.-----------------.-.---.-..-.-..-...--------.------..........-~.- .----~.....~.~-----...____.. ROO
(OBTAIH FROM PROPElR'ry '{,AX NOTWEl)
o ADD rrI my
o A I/I'IllRAir ION
(] RElPAIR
IJ IN8TAr.!,
[JSIGN
[J MOVE:
o DEMOI,ISI!
PROJ,108FJJl tlSE: I Clam, FAMILY DWEl..I,Hlr.:l
r-lt1lJl/I'I - F AMI LY
[J # OF lIlUTS
[J SW IMM UIG POU T..
[J Mo 8 II. El II Of.m
[J OTHBlR
[.I cm1MBlRl! 1A T,
[) INDUS'I'RIAT,
11EJ8CRlprrHJN
CJ RE18TAURANT & HElAI,TH DEPARTt-1EN'!' APPROVAL
OF 110RK (,. r/J 2'1 t( X 6" +-~
--~\..&.._--_._--_.._--_._--_._._--_.._-----_.__..._-_.__.-----....---- .-.-'--
BUU,DIN<l SIZE
~-------_._-_.._.__..__._--
SQUARE FOOTAGE
..........._--~------
lIElJGHT
RESIDIllNTIAl'I
(~m1MBlR(!IAr'1
A'I"!'1\CH (2) PI,OT PI"Alla & (2) SEl'I'S OF BUU,IJINlJ PLANS & (I.) 8E1T E1NElRr~y FORf'1S,
A'r1iJ\CH (3) SElrrS OF BUILDING PLANS & (1) SE'!' E:NIllIWY FORMS,
PROPERTY SURVEY REQUIRED FOR ALL NEW CONS'I'RUCTION.
._~.~.._-,--------
FERMITS REQUESTED
[1 BlITLIJINrJ
L_______.____--' VALUATION OF '1'OTAL COHS'fRlJC'rION
Ll ElLIllC'rRlUAI,
--..-------___~ AtlfP SERVICE!
o FI,ORInA POWER
D W.R,El,n,
[] PlotJt1B ING
LJ IIfBIUH1\N H!AIJ
$--------'------- VALUATION OF ME:CHANCIAI, U1STALIJATTON
[] GA8
COJ ROOFING
LJ ElPEO T. AU!'Y
[) O'I'HER
'J'Y-PIll OP' CON8'l'RU(!'rWN I [J BLOCK
[J FRAME)
lJ STIllElJ
[J OTIIER
FIN18HBlfl F'UJOR I!JTJEVATION8
----.._--~._-
18 PROlTEC'r IN FLOOr> ZONE! AREAO Y'!llS 0 NU
**
CDt1P ANY ---.-_h~~______...__.______.... _._____._. '_
STATE CElRT OR RErJIST # _________.._-._______.__;_. ~~___
CI'rY PROCESSING IL___._____.__...__.____________.__ ...___..________
tlIJ.IIlCiI'UdIAN
S"1 mmTI1REJ __'_
-._-- 'w, ---.-.. -___ ___._._.__ '._ -__~_A ____ __..__..__________
CCJt1PANY _____.___________ _____ ._______.___._____._._ ___
STATE CERT OR RErJTST ff
CITY PROCESSING #
. ---.-.--. -_.'-"'~" --.'...-...------- -.- ...----._~._-. .~. -,'.-.
** ** ** * * "** ~ ***** * ***** * * * -Ie" * "*" * * "* **"" ** **"** ** *** ****** **** ****
~----.,-_.._,.._- -.- --_._..- .-"--.-. _.~_._...__.~._._._-~_.
Pr.UMBBlR .
..- '-...-_...._.~"~4~_._..___._, _._ ~
C!OM PAN Y --..-_____.__._____________.____...... ._____ _. _________________.._
S'I'ATE C~ElR'l' OR REGIST # -------------___-C......___.._____._.
CITY PROCE8SING #
S lGNA'l'IJR El
MBlCHAIU CAT I CO~1 P ANY _____________. _ . __________ __ -_h'_h_.._ __.
8TA'rEl ('ElR'r OR REGIS'r # _____________ ._____.__.______.._
SWN1I.1'I1REl C l1'Y PROCESS ING #
'********************************************************"********
-.--..-- ,..- ----..-----.-..- .--..-.-------.----. ~..-
-.---------------.-----.----------.- --.--...-.--------..------------ .- -- .---
**********************************"***"*****************""*******
OTUlllll.
S WNA'l'tJREl
------_._~------
COl1PANY
S T A 1'E r~ EmTCiR-RiDGiST-ff----------------.-.- .-..--
eI'I'Y PROCESSING # ----------.________________
_._-_..._._-<----~~_..__._-------------
****************************************************"************
-.-.--.-."""- ~_..- -~~-----~----_..- ...--- .----. ~--.-.- +- ...-.
CONDI'rIONS OF PERl'1I'r AFFIDAVI'r
A, NOTICE OF DEED RESTRICTIONS
The undersigned understands thqt thili permit may be subject to "deed restrictions" widell
m~y be mure restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNI,ICENSED 'CON'l'RAC'l'ORS AND CON'l'RACTOR RESPONSIBUI'1'IES
If the o\">ll1er has hired a contractor or contractors to undertake work, they may be required
to be licensed in Clccordance with state and local regulations. If the contractor ia nut
licensed as requJ.l:ed by law, both the ovmer and cont.l:aotoJ: may be cited for a misdemeanor
violation under state la"L If the owner or .intended contractor are uncertain as to vlhi:lt
licensing requirements may apply for the intended work, they are advised to contact the
City of Zephyrhills Building Department, 813-788-6611.
Furthermore, 1 t tile owner has hi.t:ed a contractor or contractors, he is advised to havla the
contractor-Is) sign portions of the "Contractor Sections" of this application for which they
will be responsible. If you, as the owner signs as the contractor, YQY are indioating that
you, .tather than the oontractor, are responsible for the work. If the contractol: wishes
you to sign as corltractor that may be an indication that he is not properly lioensed and is
llot ellt1t.led to permitting privileges in the City of Zephyr-bills.
c. TRANSPOR'l'ATION I MPAC'I' FEES AND UTILI'I'Y CONNECTION FEES
D. CONS'l'RUC'rlJION LIEN LAW (CHAP'l'ER "7l3, 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 appli.cant is someone other that the "owner", I ce.r:'ify that I
llave obtained a copy of the above described document and promise in good faith to deliver
it to the "owner" prior to conunencement.
E. CON'rRAC'l'OR' S/OWNER' S AFE'IDAVJ'l'
I certify that all the information in this applicatJon is accurate and that all work will
be done in oompliance with all applicable laws regul ating constnlction, zoning, and land
development.
Application is hereby made to obtain a permit to do work and installation as indioated. 1
cer;ti fy that no ".ork or installation has commenced prior to is/:luance of a permit and that
all work vJill be performed to meet standards of all laws regulating construction, Ci t:y
codes, zoning regulations, and land development regulations .in the jlll.:ifldictlon. I also
certify that I unde.t-stand that the regulations of other governmental agencies lOay apply to
the intended work, and that it is my responsibility to identity what actione I IlIIH:lt take Lo
be in compliance. Such agencies include but are not limited tal *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sens}tive
Lands, Water/Wastewater 'freatment
*Soutllwest rlo~ida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
~ArlllY Corps of Engineers-Seawalls, Docks, Navigable Waten>lays
*Uepartn~nt of Health & Rehabilitative Services, Environmental Healtll Unit-Wells,
Wastewater Treatment, Septic Tanks
"U.S. Environmental l?rotection Agency-Asbestos abatement
1 also certify that, if fill material Js to be used in Flood Zone "A" or "A, etc.", it is
understood that a drainage plan addressing a "compensating volume"'wi.ll be submitted Hh1ch
is prepared by a professional engineer registered in tile State of Florida prior to permit
il:lsuance.
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 Of~icial from thereaftel: requirirlg a
cor~ect!on of errors ill plans, construcition, or violations of any code. Every permit
is!iued shall become invalid unless the v>IDrk authorized by such permit is oOllunenced v>lithin
SiK montlls of issllance, or if ""lork authorized by the permit is suspended or abandoqed for a
period of aJ:lt months after the time the work is conunenced. One 90 day extension of time
may be allowed tor the permit with fee charge of $15.00. The extension shall be reque~ted
in writing to the Building Official. An approved inspection must be logged during each' six
month period, or the pl:oject Hill be considered abandoned.
WARNING 'fO OWNER: YOUR FAILURE 'fO RECORD A NO'rIcE OF COMMENCEMENT MAY RESUL'l' IN YOUR
PA'tlNG TWICE FOR IMI?ROVEMEN'l'S TO YOUR PROPER'ry. IF YOU IN'l'END TO OB'l'AIN l!'INANqHHj, .~9N~UL'I'
Wl'l'H YOUR LENDER OR AN }\'l"fORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. .JOBS UNDER
$2,500 IN VALUE DO NOT NEED '1'0 RECORD AND POS'l' A "NOnCE OF COMMENCEMEN'l'''.
SI.GNATURE; OWNER OR AGEN'l'
SIGNA'l'URE: CONTRACTOR
acknowledged
,19_
STATE OF FLORIDA
COUWry OF
The foregoing instrument W~S acknowledged
Before me thJI:1 .---pay of--.------, 19
by __
(name of person acknowledged)
[l,ho is personally known to me, or
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by.
(name of person acknowl~dged)
Dwho ~s personally known to me, or
o \'>lho has produoed
(type
and who!] did []did not
o V>iho has produced____.
(type of identification)
and vJho Ddid Q.Ud not t.ake au oiilth
of identification)
take an oath.
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name t~yped, printed or stamped