HomeMy WebLinkAbout03-1975
BUILDING PERMIT
Permit N~
CITY Of ZEPHYRHILLS
(813) 780-0020
1975
Date .t;-:2 - 0 3
BUILDING ELECTRICAL PLUMBING
Pmperty Owne, LIJa~ r ~
Job Address: Y7 S I /7 'f-I., ST.
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Parcel 1.0, ,
Zoning:
Descriotion of Work
~ergv Code:
;e-~
Radon Gas:
NO OCCUPANCY BEFORE C,O,
FINAL
oj
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C,Q,
All work shall be performed in accordance with City Codes and Ordinances,
Inspector
Valuation or
Contract Price
;<:-(50 '
po
Permit Fee
->Signature
Company
Address
~Iephone#
35 ~
(~~ e7~
City License Registration # .-
State Certified License#
vw~
BUILDING
Ftr,
Pre SLB
Lintel
FRM,
Insul. CL
WL
Tp, Serv,
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
PLUMBING
MECHANICAL
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Ins.
Compr. ssor
Fin
//
/
/
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 ($25.00) shall be made for each trip for each trade:
a, Wrong Address
b, Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called,
d, Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g, Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same,
CITY OF ZEPHYRHIIJLS PERMrr APPldCATION
BUnOING IHllI?ARTMIllN'f 5335 8 th s'rRBlBl'f ZBJPHYRHII.IJS, iL 3 3!5 4 0
PhOn$IB13-780-~020 FaHI813-780-0021
lJA'fBl RBC:&!IVlllD
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I?I,ANS RlllV!BJW I'JlII11______ ___ ~.
()I'IHEJR' S HM1EJ__.ti4cU5'.. -~4c- __ . _ __________________ _______ PHONE: C:()N'1'Ar~'!'_?L3 - ]/~=5/..f2.7
,T08 8 rTEl ADlJREl8S .. -1(2=iL ___ __ 12i/'__S1_ _____ ___ ____ ___ _ __ ___ ___________ _ _ _ _._ _ _ __ _
LElOAL DESt!RTP'rI0111 LO'r(S)
B UK' K
SUBIlIVISlOt!
--.-.-.-..-.--------
-~---_.- ~-- -~..... ---_.~---_._-'. ,.- -----
PARf'E1II In If:
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--------- ----.-..-----~-.~-. .._____n__ ____ .___... _._...... _.._____.... ~_ __.__. .____.. _..
(OBTAIN FROM PROI?E1R'l'Y 'I'AX NOTH~El)
WURK PROI?SElTJ I LJNIll~l (IONSTROC'TION
[J ADDf'rION
[J AL'I'ERATION
r~ElPA tR
LJ 1 N8TAfJl,
[lawn
PROJ:lOSE)1l USE: I [~C,lIJ FAMIIJY DI'IELrJIl-lG
[J MOVE
o DElWJI,ISl!
fJ Cot1MIllR(~ rAI,
rh1tJL'I'I - FA1",n,v
o INDlJS1'RIAIJ
[J# OF lJNI'I'S
lJ MOBH,E HDr1BJ
[J OTIH!lR
rJ SI'IH1MING POUL
o RgS'I'AURANT & HEAIJTlI DBlI?ARTt1EN'f APPROVAL
J lEl8CRT P'l'ION OF 110RK ._1L_L...Q~ -1'.__________ .---------------------------_..______h__________________
BlJU,DINl3 SIZE
..------..--- -. --~-----_.-
SQUAREl FOOTAGE
_..>~ --_._+---_._-
II E!J T GU'f _'______.__________
RllJ8IDIllNTIAfJ I
(~O~1MBlR(!IAf, :
A'I''I'ACH (;2) PI,OT PI,Al1S & (2) SElTS OF BtJII,IHNG PI,ANS & (1.) SElT ElNElRWI FORMS,
A'r't~cH (3) SE'fS OF BUtLDING PLANS & (1) 8ElT ENIllRny FORtI8.
PROPBlRTY SURVEY RElQUIRElD FOR ALL NEW CONS'I'RUCTION.
FERMITS REQUESTED
[] 81IJLIJIW~
$___ffi.._O~lJ ____--' VALUATION OF TOTAIJ CONS'fRuc'rION
[J ElLllICTRlCAI,
--------____ Ar1P SElRVICEJ
0- FflJRIDA POWER
[J W. R . El . (! .
[] PW118TNG
o I-IHlUIIANWAIJ
.
$-.-..
---- VALUATION OF tIlECHANCIAI, INS'I'ALIJATTON
[] (~A8
[]ROOFING
[OJ 8PElCltAUry
[) OTHER
1'YPl3l up' t1oN8'r'RtJ(~TION : [J BLOCK
[J FRM-IEl
[] STEElIJ
[] OTHER
FIN ISHElII FI,oOR EIJElVATION8
--- -------------
r S PRrXTEJCT IN FLoon ZONE! ARElA 0 YElS rJ NU
BUILI1I!lR
SltJHATtlREl C~_./ ~__._____
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e'Or1P ANY___________...._____ __________.__ _________. _ ____,____ __'_
STATE! e'BlRT OR RElGI8T # ___________. ._________....0_.______.__
C'rry PROCElSSUTG fl-_____._____u_______._ u_____.__ .____
BIt ,IiIC'rR I C I All
SWtlATIJREJ _____
".,". ---.~--- --,~-_. -----_._~.._. ...,-_.-._-~._-_..,---,._-_._----.-
COr1PANY__ ___ --------____u_____ ___________.__
STATE CERT OR RElGTST #
CITY PROCE188ING #
.-.--....-...--. -_. --.-.. ._..~--.--+._----_._---~,----- _. --
* * , , * * ~ * ~ , * * * * * , , , * 'I * * , * , * * , , , , * , , , , , , _* , , , , , , * , * , , * , , , , * , , , , , , , * *
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PJ.,tIMBBJR
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(~(Jr1 PAN Y - --- - ----________~______~_________ _____. _.__~_.._____________
STATE CElR'l' OR REGIST If: ________._~.__________.
CITY PROe'ElS8ING #
8WNA'l'tJREl
MBlCHANICAf.
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..---.--....-..----..--.-.--.- .---..-----..--.-......-
~------_.__...._._---
COI\1PANY __u___________________________.__._____._.
STATal CElRT OR REGIST #
CITY PROCESSING #
----_.....__.__._---._._"--~._._--_._-
S I(jNA'l'tJ~El
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--__.4__.___+.__.__._~..__ .._____
OTHBJR
----------------.-.
(~OHPANY
STA11E f;ERT OR - REOIST-.r----------P.-....----~ -.--.......-... -"'.--- --...
CITY PROCESSING # ---.-------------______________
.._.__.'"-_._----------~.__....__..._-_.._--.__..- -~---_._-
S WHA'l'UREJ
*'*"*"""**'**"*"'*"*""*"""""*"'*""'""***'*""
--.-.-.-----. .-_.._._---..-.-----_._~_._-..._.~ +-...-....-- -. -----_..
CONDI'rIONS OF PERM!'l' AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands thqt this permit may be subject to "deed restrictions" which
m~y be more restrictive than City regulations. The undersigned assumes responsibility for
complianoe with any applicable deed restrictions,
B. UNLICENSED 'CON'I'AAC'I'ORS AND CON'l'AACTOR RESPONSIBII.I'rJES
I f the OIwer has hired a contractor or contractors to undertake work, they Illay be required
to be licensed 1n ~ccordance with state and local reglllations, If the contractor is not
licensed as required by law, both the owner and contractor may be cited for a misdemeanQr
violation under state law, If the owner or intended contractor are uncerLain as to Wll~t
licensing requirementl:l may apply for the intended work, they are advised to contact the
city of Zephyrhills BllUding Department, 813-768-6611.
Furthe.r:more, if the owner has hi.t:ed a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor Sections" of this application for which tlley
will be .t.esponsible. If you, as the owner signs as the contractor, yo\..! are i.ndioating that
you, rather than the contractor, are responsible for the work. If the contractor wishes
you to sign a~ contractor that may be an indication that he is not properly licensed alld is
riot entitled to permitting privil~ges in the City of Zephyrhills,
C. 'l'RANSl?OR'l'A'rION IMPAC'r FEES AND U'l'ILI'I'Y CONNECTION fEES
D. cONS'rRUc'rUION LIEN LAW (CHAP'I'ER 713, FLORIDA STATUTES, AS AMENDED)
1 cert.ify 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 carify that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the "owner" prior to cOIlUllencement.
E. CONTRAC'l'OR' S/OWNER' S AFff'IDAVI'l'
I certify that all Lhe information in this application is accurate and that all work will
be done in compliance with all applicable laws regulating construction, zoning, and land
devellopment.
Application is hereby made to obtain a permi t to do work and installation as indioatlild. 1
ce~tify that no ~wrk or installation has commenced prior to issuance of a permit and that
all work ~Jill be performed to meet standards of all laws regulati.ng construotion, City
cQdes, zoning regulations, and land development regulations in the jurisdiction, J also
certify that I under'stand that the regulations of other governmental agenoies may apply to
the intended work, C:lnd that it is my responsibility to identify what aotions I must take to
be in compliance, Such agencies include but are not limited to; *Department of
Environmental Regulatiqn-Cypress Bayheads, Wetland Areas and Environmentally Sens1tive
Lauds, Water/Wastewater Treatment
*Southwest fi'lodda Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*ArlllY Corps of Engineers-Seawalls, Docks, Navigable WatenJays
*lJepartlllent of Health & Rehabilitative Services, Environmental Health Unit-Wella,
Wastewater Treatment, Septic Tanks
*U.8, Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone ~A" or "A, eta,", it is
unde~stood that a drainage plan addressing a "compensating volume" 'will be submitted whicll
is prepared by a professional engineer registered in tile state of Florida prior to penniL
iasuanoe.
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 techniual codes,
nor shall issuance of a permit prevent the Building Of~icial from thereafter requiring a
correction of errors in plans, cDn~truction! or vio~qtions of any code. Every p~~mit
iuued shall beoome invalid unless the work authorized by suoh permit is oOllunenclad within
six months of issuance, or if work authorized by the perm1t is suspended or abandoqed f~r a
period of sLx months after the time the work is cOIlUllenced, One 90 day extension of time
may be allowed fo~ the permit with fee charge of $15.00, The extension shall be teques~ed
ill writing to the Buildi.ng Offioial. An approved inspection must be Jogged during each I:jjx
month periOd, or the project Viill be considered abandoned,
WARNING '1'0 OWNElR; YOUR FAUURE '1'0 RECORD A No'rrCE OE' COMMENCEMENT MAY RESUW' IN YOUR
PAYING 'l'WICE FOR IMPROVEMENTS TO YOUR PROPER'ry, IF YOU IN'rEND TO OB'l'AIN li'INANqnlq, '~9NijUL'l'
WlTH YOUR LENDER OR AN A'j"l'ORNEY BEFORE RECORDING YOUR NonCE OF COMMENCEMEN'l'. JOBS UNDER
$2,500 IN VALUE DO NO'l' NEED '1'0 RECORD AND POST A "NonCE OF COMMENCEMEN'l''',
SlGHA'I'URE; OWNER OR AGENT
SIGNA'l'URE): CONTRACTOR
STA'I'ID OF H'LORIDA
COUNTY OF
The foregoing instrument was acknowledged
Before ll\e this __ day of ___, 19_
by __ _____
(name of person aoknoWledged)
Dwho is personally known to me, or
G who has produced
(type
and who[] did 0 did not
STA'I'E OF FLORIDA
COUWry OF
The foregoing instrument \i~f:l ao}mo~dedged
Before me this .--------Slay of----, 19 ~~_
by
(name of person acknowledged)
C1ho is personally known to me, or
o Viho has produced___. "__
(type of identifioation)
and ~Jho Ddid Olid not t.ake an oath
of identification)
take an oath,
Signature of person taking acknowledgement
Signature of person taking acknowledgment
I'lame typed, printed or stamped
Name typed, printed or stamped