HomeMy WebLinkAbout03-1987
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N2 1987
(813) 780-0020 Date 1- /V - 03
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner: 'V-A \J I'd
Job Address: (" 0 d.-S
Parcell.D, #
~aj~
iO~ Sl
Water Meter:
T.I.F.'s:
Zoning:
DescriPtion of Work
Energy Code:
d<iS" e0
Radon Gas:
~ I ~t ('--f~~s......
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,Q,
Inspector
DATE
I-/UO d- l'{ V
Valuation or
Contract Price
~
Permit Fee
)(Signature ..
, Company
Address
\telephone#
City License Registration #
State Certified License#
(;'
{;J)PW4
Ftr.
Pre SLB
Lintel
FRM,
Insul. CL
WL
Tp, Servo
Rough In
Meter Can
Const, Pole
Pool
Pre-Meter
Final
PLUMBING
Breakers
Ducts Insl
Com pre sor
Final
AL
BUILDING
SLB
Tub Set
Water
Sewer
Final
Driveway
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 PERMrr APPIJ!CATION
BUUDING DBlIi'ARTMlllN'r 5335 8th S'rRllll!l'r ZlllPHYRHII,I.S, FI. 33540
Phon.1813-780-~020 ra~1813-780-0021
DATI RJlOI!IIVlIlD
PI.ANS R!lV!I!IW I'BlBI
.
mINER' S IIA~1ElJ)~-,.LL.D___--f\~Or~_________ ._________ PHONEJ CON'l'A(~'!'_..RLL)J5;lliW
,JOB 81'1'8 ADDRElS8 -~O.ash--\(L~s1-.0-.d--~ilillli-_fL_~:3_5~__._______ .____
BWC'K vi
LEl(]AL ))81SURTPTIOlll LOT(S}
SUBlJIVISlotl
---.._----------.~._..._- .-".---.-
PARC!ElI. I n it
-~"--'"-_....._-_.._~
(OBTAIN FROM PROPElR'l'Y 'I'A1< NO'1'ICEl)
_._-~'--_._--------....--_.-.._~~---------_.,--..
WORK PR()PSElfJ I [JNEW C'oNs'rRUCTION
Usrml
o AnDI'rION OALTERAil'ION [J REPAIR o INSTAT,I,
[J MOVE 0 DEl~101,ISII
[It.1tJ1,I'I.. FM1II.Y []# OF mlJ.'l'S (] MOB TIim ItntiE
rJ INDUSTRIAL [J SWn1MING POOL (] OTHElR
PROJ:108Ell USE: I CISC;II, FAMILY DWELl/11m
[] CW1MElRC! 1A[,
Burr,rnNG SIZE
o REl8TAURANT & HEAl,TIt DEPAR'rr.1ENT APPROVAL
?~. --..tlp-.fQ~ ce.
~____.._______ SQUARE FOOTAGE _~~
.--. .,----,---_.~_.._- ----.---.----.-- --."---_.-.- .-, -;.--~
IlESCRIPTION OF l'10RK
BEl I GfI'r .c~-\:~qt__.._._
RESIDENTIAl, I
(~OI'-1Ml!lR(!IArJ I
A'I"r1\CH (2) PI,o'r PI"AI1S & (2) SETS OF BUII,lJINC3 PLANS & (1) 8El'1' ENElRny FOR~18.
A'l"I;A.C!H (3) 8EiT8 OF BUILDING PI"ANS & (1) 8ElT ENER(~Y FORMS.
PROPERTY SURVElY REQUIRED FOR ALL NEW CONS'1'RUUTION.
~BlBmTS RJJlQUBlSTBlD
t1 BtIlI/DING
$ --..---..
._.~-..;.
VALUATION OF TOTAIJ CON8TRtJc'rrml
L1 ELElC'I'RWAI.
[J PI.tJ~1BING
o I1BJ(!H1\.N WA1,
-_____.____ M"P ~ElRVICEl
o FLORIDA POWElR
[J W.R.m.n.
$.- -.-.
----- VALUATION OF ~"!l:CHANCIAlj Ul8TAl,I,ATTON
[] C~A8
[J ROOFING
[J SPElC!tAurv
[] OTHER
TYPE OF COH8'I'RUC!'rrrJN I [] BLOCK
o FRAME
[] STElElIJ
[] OTHER
FIN 18HElll FI,OOR ElI,ElVATIONS
IS PROlfElC'I' IN I:<"LOO[) ZONEI AREA 0 YES
o NU
BUIlJOBlR
cor"p AN Y ____.._Q~_______..___....______.. ____._____... .__
STATE CE!RT OR RE(]IST # ....--------..-.--.-.--____c...._____
CITY PROCESSING L_.__..._____________....._..________
******************************************************************
B1UIOTRICUH
S] mlA'1'IJRE! __..
"'~___"__'_ u....__.__..._..__.__...", '~.._~_.___._.___________._
cm1P ANY ______________ ______ ___.____.____._
STATE e'ERT OR REGTST #
CITY PROCESSING #
. ---....----.--... -~ ._----- ~.~----_._... -."--
******************************************************************
---~-_..._-.~.-.- .--.--. -- --...-.--- , -.---..,----..-----
PI,UMBBlR
(!OM P ANY --------.---____--,--_______.____,__.__...___________
STATE CERT OR REGIST # -------~---'-_._h____..
CITY PROCESSING #
SlGNl\'l'lJRlll
-_._.._---~----------._~---~~....-..-
MBKlHANI CAl,
******************************************************************
----------~---_.__....---~----
COlvlPANY ----------.______.____._________ _..__.. __'_h
STATEl CElRT OR RElCH 8'r #
CITY PROCE8SIIW #
-.----.--...--.--..--...-...--.-.-----.--....--.---- .-.
SICJNA'l'UREI
-_...._._~_....._._-_.__._._- -. .-------.
*****************'*************************'*********************
OTHER
-----....---------
COHPANY
-----~.-._...~----- ----_.._----~.. .__...-
STATE! CERT OR REGIST #
CITY PROCESSING #
----~ .-----. --~-~- ._---~..__._- ----,
SWNA'l'tJREl
-----_.~---
***********************************************************~*****
CONnI'l'IONS OF PERNl'I' AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The und:rsigned understands thqt this pfarmit may be subjeot to "deed restriotions" which
may be more restrictive than City regulations, The undersigned assumes responsibility for
compliance with any applicable deed reetrictions,
B, UNLICENSED (~ON'l'RAC'l'ORS AND CONTRACTOR RESPONSIBILI'rIES
If the owner lias hired a contractor or contractors to undertake work, they may be required
to be licensed in accordance with state and local regulations, It the contractor is Ilot
licensed as required by law, both the owner and contractor may be clted for a miedemeanor
violati on under state lav/' I f the owner or intended contractor are uncertain as to vlhat
li censing requirements way apply for the intended work, they are advised to oontact the
city of Zephyrhi.lls Building Department, 813-788-6611.
Furthermore, it the owner has hired a contractor or oontractors, he is advised to have the
contractor(s) sign portions of the "Contractor Sections" of this application for whiell they
will be responsible. If you, as the owner signs iilS the contractor, YQl! are indici\ting that
YOll, rather than the contractor, are responsible for the work, If the contractor wishes
you to sign as contractor that may be an lndication that he is not properly lioeneed alld is
Ilot entitled to permitting privil~ges in the City of Zephyrhills.
C, '1'RANSPOR'l'A'rIOH I MPAC'l' IfEES AND UTILITY CONNECTION lfEES
lJ, CONS'l'RIIC'l'UION LIEN LAW (CHAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Constrllctlon
lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs. If the appllcant is someone other that the "owner", I cerify that I
have obta.i.ned a copy of the above described document and promise in good faith to deliver
it to the "owner" prior to COlrunencement,
El. CONTRAC'l'OR' a/OWNER'S AFlfIDAVI'l'
I certlfy that all the information in this application is accurate and that all vlOrk will
be done in compliance with all appUcable laws regulaUng construction, zoning, and land
devl?lopment,
Application is hereby made to obtain a permit to do work and installation as indioated. 1
certi fy that no vlOrk or installati.on has conunenced prior to issuance of a permit and that
all work will be performed to meet standards of all laws regulating c6nstruction, City
codes, zoning regulations, and land development regulations in the jtlrisdiction. r also
certify that I understand that thl? regulations of other governmental agencies may apply to
the intended work, and that it h 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 Environment.ally Sensj.tive
Lands, Water/Wastewater Treatment
*Soutllwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses .
"'Army Corps of Engineers-Seawalls, Docks, Navigable WaterVlays
*lJepartlllent of Health & Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater: 'l'reatment, Septic 'l'anks
*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 drai.nage plan addressing a "compensating volume"'wi.ll be submitted which
is prepared by a professional engineer registered in the State of florida prior to permit
iS13uance.
A permit issued shall be construed to be a license to proceed with the work and not as
au~hority to violate, cancel, alter, or set aside any provisions of the techllical codes,
nor shall issuance of a permit prevent the Building Official from thereafter requiring a
correction of errors in plans, con~truction, or violations of any oode. Every pe~mit
iSliued shall become invalid unless the work authorized by such permit is cOllunenced Hlth.i.n
slx months of issuance, or if \vork authorized by the permit is suspended or abandoqed for a
period of si1t months after the time the work is commenced, One 90 day extension of tlme
may be allowed for the permit with fee charge of $15.00, The extension shall be !eques~ed
in writing to the Buildi.ng Official. An approved inspection must be logged during each six
month period, or the pr'oj ect Vlill be considered abandoned.
WARNING TO OWNElR: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUL'l' IN YOUR
PAYING '1'WICE FOR IMPROVEMEN'I'S TO YOUR PROPERTY, IF YOU IN'fEND TO OB'l'AIN IfINANCjINq, -'X~NiUL'l'
WITH YOUR LENDER OR AN A'l'TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'{', .JOB8 u11nER
$2,500 IN VALUE DO NO'l' NEED TO RECORD AND POS'l1 A "NO'l'ICE OF COMMENCEMEN'11lf.
8 I GHA'l'URE: OWNER OR AGEN'l'
SIGNA'l'URE: CONTRACTOR
STA'rE OF FLORI DA
COUNTY OF
The foregoing instrument was
Before me this __ day of
by.
acknowledged
, 19_
8TA'I'E OF FLORIDA
COUNTY OF
The foregoing instrument W~S
Before me tide ~ay of
by
aokllovlledged
, 19 ~__
(name of person acknowl~dged)
Owho is personally known to me, or
(name of person acknowledged)
[1ho is personally knoVln to me, or
o \<Iho has produced
(t ype.
and whoD did Ddid not
of identification)
take an oath,
o who has prodlwed____ " _
(type of identifioation)
and Hho Ddid DUd not t.ake an oath
Signature of person taking acknowledgement
Signature of person taking aoknowledgment
Name typed, prlnted or stamped
-
Name typed, printed or' stamped