HomeMy WebLinkAbout03-1974
BUILDING PERMIT
Permit N~
CITY OF ZEPHYRHILLS
(813) 780-0020
J 5, ffO
BUILDING
'3 <S ' e--V
ELECTRICAL
PLUMBING
MECHANICAL
Property Owner:
Job Address:
Parcel J.D. "
d'~
-j ~ 3<"
c,~
L-:>\ V &.
1974
Date
'-1- ( - 03
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
Descriotion of Work
Energy Code:
'"J:l\l $\ ~
Radon Gas:
Sic~
w~
NO OCCUPANCY BEFORE C.O.
FINAL S - 9 - 0 3
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 f? L '( r I( ,ro
Permit F~ 7V
~gnature~;)
Company (J
Address
'tTelePhone#( 2-3 ('1) 5 ~ ( - b '-I- a b
Valuation or
Contract Price
City License Registration #
State Certified License#
~~~~
rMttJ(./) (0~~,~
BUILDING c:; 'fe c '
h~Jf~ ((,J\t::t~'-
5(1' (.
ELECTRICAL
PLUMBING
Ftr. Tp. Servo SLB
Pre SLB Rough In Tub Set
Lintel Meter Can Water
FRM. Const. Pole Sewer
Insul. CL Pool Final
WL Pre-Meter ,
Final 1/ ~. 7- 0 3 4i:J /<( 7
Driveway r I/JO
MECHANICAL
Breakers
Ducts Insl.
Compres r
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.
lNAL-L ~,~<~
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
r (!yJkQ 5- ,Zr..-o ~
(
DATE RECEIVED 3 - ~ ~ - () t.3
PLANS REVIEW FEE
OWNER'S NAME
Bt't.l NIL.C-iL. ~ L-' "-lOA , ~ f'lC
PHONE
JOB ADDRESS 7 (p t-/ 3
G.-" L<- J3, <- l) 0
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID #
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: [JNEW CONSTRUCTION
~IGN
[J ADDITION
[JALTERATION
[J REPAIR'
[J INSTALL
[J MOVE
[J DEMOLISH
PROPOSED USE: [JSGL FAMILY DWELLING
[J COMMERCIAL
~STAURANT
iN~T^L-L-
[JMULTI-FAMILY
[J INDUSTRIAL
[J# OF UNITS
[J SWIMMING POOL
[J MOBILE HOME
[J OTHER
& HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK
v--J A. L-<....
s ( ~ ~ t="'OIL-
\
C+fCLI So
BUILDING SIZE
'i.;l(><.(oo
SQUARE FOOTAGE S S 2- 0
HEIGHT
RESIDENTIAL:
COMMERCIAL:
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
~BUILDING
r:fELECTRI CAL
$
\~I \) OIL.. c.-l ( T\'l
ru (c; r, ~G- AMP SERVICE
f--'\<- ~e-e..1" ,,-. c... - tl y
[J FLORIDA POWER
O'/H ~
[J
W.R.E.C.
VALUATION OF TOTAL CONSTRUCTION
[J PLUMBING
[J MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
[J GAS
[J ROOFING
[J SPECIALTY
[J OTHER
TYPE OF CONSTRUCTION: [J BLOCK
[J FRAME
[J STEEL
[J OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREA[J YES
[J NO
T.MA &LS c,/lrV ~I' I C S f'CC./4 ( 7/tC-:j
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
~
E S - 00003 b /
BUILDER
-r- ^. A ~ ~p H { c... 5 /',eC It?r tile"",
COMPANY ~ ' ""'" J
STATE CERT OR REGIST # (:..$ - 6 Q 0 0.3 b I
I~ PROCESSING #
*****************************************
SIGNATURE
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
PLUMBER
* * * * * * * * * * *.* * * ** * * * *** ** *** * * * ** ** * * * * ** * * ***** ** * **** ** ** * ** * ** * *
SIGNATURE
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
MECHANICAL
*****************************************************************
OTHER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
CONl)J'!'lONS or' J:>1:mMl'!' Af'r'lDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit 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. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they may be required
to be licensed in accordance with state and local regulations. If the contractor is not
licensed as required by law, both the owner and contractor may be cited for a misdemeanor
violation under state law. If the owner or intended contractor are uncertain as to what
licensing requirements may apply for the intended work, they are advised to contact the
City of Zephyrhills Building Department, 813-788-6611.
Furthermore, 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
will be responsible. If you, as the owner signs as the contractor, you are indicating that
you, rather than the contractor, are responsible for the work. If the contractor wishes
you to sign as contractor that may be an indication that he is not properly licensed and is
not entitled to permitting privileges in the City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTUION LIEN LAW (CHAPTER 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
have obtained a copy of the above described document and promise in good faith to deliver
it to the ~owner" prior to commencement.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
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 installation as indicated. I
certify that no work or installation has commenced prior to issuance of a permit 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 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 actions I must take to
be in compliance. Such agencies include but are not limited to: *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment
*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department 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 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 the technical codes,
nor shall issuance of a permit prevent the Building Official from thereafter requiring a
correction of errors in plans, construction, or violations of any code. Every permit
issued shall become invalid unless the work authorized by such permit is commenced within
six months of issuance, or if work authorized by the permit is suspended or abandoned for a
period of six months after the time the work is commenced. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be requested
in writing to the Building Official. An approved inspection must be logged during each six
month period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
$2,500 IN VALU DO NOT NEED TO RECORD AND POST A ~NOTICE OF COMMENCEMENT".
, S~TO~
STATE OF FLORIDA f'\^ .\ ^ "
COUNTY OF ,,,.o...n~~
;:~o;:r:~O~~Isi~S~:~to;i\^~;~~Wl~~~O~
by L~r...~ () i ~
(name of perso acknowledged)
~o is personally known to me, or
STATE FLO~A ~
COUNTY OF Cl..V\,Q:
The foreqoinq inst.rument was ac:know.1 edCJed
Before m~ this ~ day of (\A.o..V' c...h , ~o 3
by Lo-~(." D (") i ~
~ (name of perso acknowledged)
~ho is personally known to me, or
and
Dwho has produced
(type of identification)
and whoD did ){1~id not take an oath.
('~~ f\J..., 'K~~
Signature of person taking ackno ledgement
Name
.~
SWu III t~ Iml $t1m:cr.UJ'~ Ix:f(ll,'l~ rr\': t,y _ C. ~ "'-~ I"'v c.- G-.<-IL.C-c"~
whQ is J~i!!!!i-'~::J.()'~ nil: Ct pro,luc:ed_____._}U ~_
as i<i,~ntHi&i1tlot:l, llIld wh,~ r:lid_.._tllk:<:: .lIl (18.11, Iflis _I '1~Clny of ~.\; 1 a.. it (',L
.;?tl~?_-:t Q n
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COlllmi!:sion N<).n~pi;.-ation:~._J_Qh:~.u~ ____
AU~ INFOI ~\l~ ~ nON MUST BE TVPED OR PlUNTED LEGlOL Y 'W COMPLY "'rIll R.6:CORDING R!:QI}Tt{.J;r,/'ENTS.
~r-05-03
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From-Brinker Int! .Stratelic Sourceina
972 770 1736
T-193 P.001/001 F-826
Th1::; 1ns~ml"..ll'~ Pr~ppred By:
111111111111 1111I11111111I111111111I1111I1111111111111111111'
2003057224
Na-ne:;.__jJ!.1.~J~ t::-LCA..t 0,,-\ .~C-
Addrcss:.__._~~ L- D~~
Rec: 6.00
IT: 0.00
Dpty Clerk
Permit NQ. :____._.____.
Rcpt.: 668181
DS: 0.00
04/01/03
Tax. Folio No. 80t.! 1()O;J}3 ~ 8
NOTICE OF COMMENCEMENT ~z, S _ 2.5 _ 2.. J _ l) I { 0 --.
ODO DO - 60"'-0
STAn:~OF FL-cMO/\
COUNTY OF__f.. f'r5 ~==
THE UND8RSIGNED her<~b;l gives nofice that improvement will be. mad" to certain real property, and in accordance with Chapter 713, Florida
Slll~:l~~;. the following illfo~mHion is provided in this Notice ofConunerlcement.
I.
JED PITTMAN PASCO COUNTY CLERK
04/01/03 02: 0!lm 1 of 1
OR BK 529 I PG 359
2.,
Descriptiotl OfproptT[l: (legal dc:>crip'j,;m Qt'propc~, aJ1d SU\:eladdrc3$ ifa"~lable.)
7fe>'1-:!> ~ Ll- 6.L.UO
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Gen~r'J.1 description;) f ;mproveJl\Cnt;
IN':> Till '-1-1\ T I G,,,J C re S I ~ :>
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Owm:r informatr.on ~ ~ 2... 0 L B 3' F fL.c...(; ~III. '-I
8 Name and address: h.... 7 2-....J
b. lnt.crnst in property: YV" l-Lt"\:5. 'T 1<- 5 -,- b
c.. N~me al'ld a<1dres3 if fhe: llimp1c: titleholder (i~othcr man owner):
Sc H ~ H 0 ~ E:- . '" Cc.-t.'-'I (....1 ,C!l ..r,..J c...
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l t g ~ ~ J4 t:-7 "- 0 P !\I'\...,(...t.J1\ Y
P -r- I t._,,:..., ell- s. F L 3 39 (-"t..
4.
(~ntI~tot Name and a.<1c1r~ss;~lt~..:,
b. Arnc'lJtlt ofooEld S_____f)<,."i
e. fa~: QUI'lll>er (op\j.mal. if:scrvic: by m is IICCcptIJllc):
SlIrely:
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c.
d.
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fm; ltuml.>r:r(opr.i<>Il~I. ifsavje-: by fax is acceptable):
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P~I'SOOS withil!. the !Jl.'\lu of Flcrld<l dcsigrultJ:.$lhe following perslJI1(S) to receive a copy of the LiCllQf'S Notice as provided ~S.J: ;.{' :-,
in section In, l3{IW~}7.. F1:l1'idaStatr.le-J: """"A" _ .
ft. Name <md. ~. fMre~: LL. ~..L. ........ ~
b. I?h[lo" N'::ml)(',r. u.. ,,-" ~: :\"1
o. ~~ Ilumta: (opti'}lal, ifservi.C1l by Ca..tis ;;K;Ccplablc): C .:_ .: :.' , :_..
In ~dditi.Qn to bimself. OWn.et designaws Ih~: rolJ~wing ~crson(s) t;l (1;lXM: a oopy Gfdtc Lienor's Nolicc as pmvidrd in ~caoa ~j;j3(l:)~).(:~r d:1'-.
St!l.lre$.: : ... .....
a. Natn..: atcd wktrE:s:t C) . _
b. l?h(lne N::rnb;r.
e. FUuumbur (optional, ifselVi~ by lu i~ acceptable);
EJ;pir:ation date of 1I.0:.I~l ,>f C}nunenecmt'.nt (!he expiration dab: is 1 yellr from tbc date of recording unless adiCl1
Signature: ofOwncr:
Owner's Name:
Owner's Address; G g L.w
.D Prt-L ,~
("..... g -3' F~_t-J." Y
rl\... 75~ct-e
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FOR l/It" bOLT/5CREU (STEEL) AI .. 0.049 IH
FOR 3/1611 !OLT/SCRUI (STEEL) AI .. 0.0216 IN
TIJUS SQUARE fOOT or SlOI PER 80LT/SCRE~
FOR J/O": SQ. rr. SIGH .. ^R rfiOVIDED
As REQUIRED/SQ. rr.
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FOR 1l0LL~ roue. BLOO: USE TOCGLE 80LTS'
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