HomeMy WebLinkAbout03-1978
BUILDING PERMIT
Permit N2
CITY OF ZEPHYRHILLS
(813) 780-0020
1978
Date
1/-3'- (}J
BUilDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner: (i)~ [AX
(j /' 5 t./ 7 -t4 c-r;
Job Address: 7 I I / J I .
Parcel I. 0, ,
Water Meter:
T.I.F.'s:
Zoning:
DescriDtion of Work
Ent;rgy ~ode:
St-..-b.
Radon Gas:
NO OCCUPANCY BEFORE C.O,
FINAL
C,Q,
DATE
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances,
DATE
Inspector
City license Registration I
State Certified license I
Permit Fee 7'0
.>>ignature ~ f: \.J:Jj
Company
Address
;>lelephonel
Valuation or
Contract Price
/J .~
C?<, &-DO
(
v w J'Vl-r
PLUMBING
MECHANICAL
BUilDING
Ftr, / t;- .J';.' 0311-5'0 Tp, Serv,
Pre SlB L/ ~ ..2 5-0"; l-rSD Rough In
lintel Meter Can
FRM, Const, Po
Insul. CL Pool
Wl Pre-M
Final
SlB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl,
Compress
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
BUnnING IHllPARTMIllN'f 5335 8th S'fRl!llll'f ZllJPHYRHn.r..S, ri. 33540
PhoneI813-780-Q020 raxI913-780-0021
I>A'fllJ RIllCBltVlDD
~......_.._.;._,-..... ;.~;.. ,_._---
InANS RllIVtBJW II'J!If(_______ _____.
:::::E::,:."::::;~~ ("0fih ~~~! ~Si~ ~-~7frrA/uiJ=: ~~
PHONEl ['ON'l'IWI' 7f?6 - 9.~;2 5'
LBlGJUJ })ElS(!RIP'rIOtl: LO'r (8)
BLOCK
SUBIJIV I SlOt[
~-'~-._-,.._-_.__._----
-_._..~--...._-.-.. .------..""".-'-' -.--.--
PARC!Elli In #
WURt< PROPBEllJ r [JNElW C'ONSTRUCTION
-.----.-..--.-'-----~.---.-------....--~-----------.----.--~-.,.......-----~W_---__..__........____...__40.~__~,,__..__._........
(oBTAIN F'ROM PROPER'rv 'I'AK NO'l'H~El)
[)SWll
[J ADDITION [J AL't'ERA'I' ION [J RElPAtR IJ JN8Tl\T,t,
[) MOVE 0 DElf"'OI,ISlI
[1t1tJUl'I - FAIUI,Y [1# OF mUTS (] MOBnEl Hor1El
[J INDUSTRIAT, [] SWIMMING POUL [] OTHElR
PRO!:lOSFJI> 08El: LJaGI, FAMII,V DWELIJIHr~
f:.J CDt1MElRC!IAI,
11EJSCRIP'l'ION OF WORK
[-=:J RESTAURANT & HElAlml D@PAR'1'~.1ElN'f APPROVAL
---------54V12_._
.~~--._-_. '-----..-.._.~~....... ._--_.~---,._-_.----_.__._,-.-. .._-_._~
BUlr,rnN<~ ElIZEl
.~--_..__..__.-. -~-----,---
SQUAREl FOOTAGE
--- ---- -----.---
HElIGHT __.____.__~_____._
REBII1BlNTIATJ I
c~OMMBlRCIAr'l
A'I"t'nCH (2) PI,oT PI"A1l8 & (2) 8E'I'S OF BUUIJINlJ PLANS & (1) sEI'r ElNEJRny FORlvlS.
A'r'liAC!H (3) SE't'S OF BU!LDING PLANS & (1) am'I' ENElfWY FORr-1a.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONS'I'RUCTION.
[] 811rr,IJINC~
IJ ELI!JC'I'RlC!AT,
RERMITS REQUESTED
, --) lVO
t.d~.?7' ____-' VALUATION OF 'roTA!, CONS'fRlJCTION
-.-------.-___ 1\t.1P ~E1RVICE
D. FLORIDA POWER
[J W . R . E . (1 .
[J pwr1SING
LJ I-1E:UHl\lHC!AIJ
[J (~AS
LJ ROOFING
I
L_ ------'-----------___ VALUATION OF t-1EC'HANc~rArt U18TAI,lJATTON
[0) 8P@C!!AL'l'V
[) OTHER
TYPEJ UF CONS'I'RUC!'rION I [] BLOCK
[] FRAM8J
[] STEElIJ
[J CJTIIElR
FINI8HHlfl F'I.<JOR ElI,EVATIONS
---.------------
IS PRO,JElC'r IN FIJOCl!l ZONE! AREA 0 Yl!lS 0 NO
BUrtnBlR
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Wf\...l~
COt1 PAN Y..___________ ___ _______ _____ __. __.___. ____..___...__
STA'I'E CEJR'l' OR REGIST # .____.___ .____________________
C I'rY PROCElSS I NG 1l___. _ ----------__n____ ___,__. _____h__
BlUIC'!' RI C!A N
. -0 _. _. ___.,.~__. "4 ______._ .._,._.._.__~_~ ."__. __., __"_'__~.__. ___
cm1PANY ___.___________ ---.---_h__________ ___'__
STATE CERT OR REGIST #
CITY PROCE8snm #
. -~------. --,-~.-.. -____._u_______...._, ~_.' _._~. ..,._
S] mmTIJREl __M
***"******"**'*****'*****'*'*'*"***'**'**'*'***"****'*'**'**'*
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(~OM P ANY -----______._______._____________._...__..._____.____________
STATE CElRT OR RElGIST # -----~-~_'o......._____....
CITY PROCE8SING #
SWNA'l'lJ!UJ
MBlC!HANICAJ,
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.--....-. .._.._----,-~-.- .-._.-..~-- --~.._----,-~-
---------~-----_.~---_._"_._._....._-_.._-------
COlv] P ANY _________________. .__.___________________.___ __. ___ ..__.__
STATE ~ERT OR REGIST #
Cl'I'Y PROCESSING #
---_.. ---._-~-'+- --_.-._+ -...~+-~~~__ -'____~n_.
SWl'lATI1REl
*"'*"""'*"""""'*""'*"*'***'*"'*"'***"'*"*"""*'
----~-_.._._--_.__._------~. --~------
OTHllJR
-----------------
COflJPANY
STA1'El CElRT OR -RiG r ST -#---~------..---------_.----.-----
CITY PRClCElSSING # ---.------ -____.._____________~
~--....- --------.:..----.----------.------------------
S WllATtJREl
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COlHll'rIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands thqt lhis permit may be subject to "deed restrictions" \^lllich
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B, UNIJICENSED 'CON'l'RAC'l'ORS AND CONTMCTOR RESI?ONSIBnr'l'IES
If the rmner has hired a contractor or contractors to undertake work, they 1I1ay be required
to I:H:l U ct:llsed in accordance Hith state and local regulations. If the contractor is not
licell13ed as required lJy law, both the o~mer and contractor may be cited for a misdemeanor
violati on under state laH. I f the owner or intended contractor are ullcertain as to ~Ihat
licensing requirement.s may apply for lhe intended work, they are advised to contact the
City of Zephyrhilh Building Department, 813-788-6611.
Furtheunol::e, it the owner has hired a contractor or contractors, he is advised to have the
contractor (s) sign portions of the "Contractor Sections" of this appli.cation for which they
will b~ responsible, If you, as the owner signs as the contractor, yay are indicating tlla.t
you, rather than the oontractor, are responsible for the work, If the contractor wislles
you to sign as contractor that me,y be an indication that he is not properly lioensed and is
Ilot entitled to permitting privil~ges in the City of Zephyrhills,
c. 'I'MNSl'CJk'l'A'rroN IMPAC'l' If'EES AND U'l'ILI'I'Y CONNECTION Ii'EES
lJ, CONsrrRllc'rUlON LIEN LAv~ (CIiAP'I'ER 'Jl3, FLORIDA S'I'A'l'UTES, AS AMENDED)
1 certify that I, the appli.cant, have been provided \^lith a copy of "Florida's Construction
lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affa.irs, If the appli.cant is someone other that the "owner", I cerify that I
have obti:l1ned a copy of the above deacribed document and promi.se in good faith to deliver
it to the "owner" prior to commencement.
E. COH'rAAC'l'OR' SimmER' S AFFIDAVl'l'
I certify that all thb information in this application is accurate and that all work will
IJe done in compliance with all applicable laws regulating constl:ucti.on, zoning, and land
development.
Appliuation is hereIJy made to obtain a permit to do work and installation as indicated. I
ce~tify that no work or installation has comnenced 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 jllrisdiction, I also
certify that I undel:stand that the regulations of other governmental agencies may apply to
the intended work, and that it is my responsibility to identify what aCltions I must take to
be in compliance, Such agencies include but are not limited to I *Department D.f
Envirollmental Regulation-Cypress Bayheads, Wetland Areas and Bnvironmentally Sensitive
Lands, Water/Wastewater Treatment
'Southwest IJ'lodda Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
'Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of Health & Rehabilitative Services, Envi.ronmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
-Au,S, 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
understood that a drainage plan addressing a "compensating volume" 'will be submitted which
is prepared by a professional engineer registered in tl.. 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
authod ty to violate, cancel, alter, or set aside any provisions of the teclmioal codes,
nor shall issuance of a permit prevent the Building Of{icial from tllereafter requiring ~
correction of errors in plans, oonstruction, or violations of any code, Every permit
is~u~d shall beaome invalid unless the Hork authodzed by such permit i6 oOllunenced within
alx months of issuance, or if ~vork authorized by the permlt 1s suapended or abandoqed for a
period of slx months after the tilne 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 reques~ed
ill writing to the Building Official. An approved inspeotion muat be logged during each aix
month period, or the pr'oj ect Hill be considered abandoned,
WARlHNG TO OWNER: YOUR FAILUREJ TO RECORD A NOTICE OF COMMENCEMEN'l' MAY RESUL'l' IN YOUR
PAYING 'l'W1CE FOR IMPROVEMEN'l'S TO YOUR PROPERTY, IF YOU INTEND TO OB'rAIN E'INANGIl'lq,~9N~UL'!'
WITH YOUR LENDER OR AN A'I"!'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT, JOBS UNIJER
92,500 IN VALUE DO NOT NEED '1'0 RECORD AND POST A "NOnCE OF COMMENCEMEN'l'''.
S H-iNA'l'lJRE : OWN ER OR AGEN'l'
SIGNA'I'URE: CONTRAC'l'OR
a clmowl edged
, 19_
STA'I'E OF FLORIDA
COUN'ry OF --------_
'l'he foregoing instrument w~s acknowledged
Before me this ----Slay of----, 19 _..:_..
by
(name of person acknowledged)
Qho is personally known to me, or
STATE OF FLORIDA
COUNTY OF ---
The foregoing instrument was
Bt:fore Ine this __ day of
by
(name of person acknowledged)
Owho is personally known to me, or
o who has produced
(type
and who[] did Ddid not
o Hha has produced____
(type of identification)
and Hha Ddid DUd not t,ake all oath
of identification)
take an oath.
Signatur'e of person taking acknowledgerrient
Signature of person takiug aoknowledgment
Name typed, printed or stamped
Name typed, printed or stamped