HomeMy WebLinkAbout03-2001
BUILDING
Property Owner:
Job Address:
Parcel 1.0. ,
Zoning:
OescriDtion of Work
BUILDING PERMIT
Permit N~
2001
CITY OF ZEPHYRHILLS
(813) 780-0020
1./- /7-t'_5
Date
ELECTRICAL
MECHANICAL
PLUMBING
Sewer Conn
Water Conn:
~tlN 111~ COv
C;.fr~ I if ( 57
Water Meter:
T.I.F.'s:
Energy Code:
C'~ (J./Rb; f) tzt".
Radon Gas:
FINAL
NO OCCUPANCY BEFORE C.O.
DATE
c.o.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
City License Registration #
State Certified License#
Valuation or
Contract Price
DATE
;},30fl
(
\~
Permit Fee
'(Signature
Company
Address
)iTelephone#
"8(5) 973" / 7/0
Ftr,
Pre SLB
Lintel
Driveway
Vo!pA;1/j, /1//2 5'15.
,
MECHANICAL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Me r
Final
SLB
Tub Set
Water
Sewer
Fin .
Breakers
Ducts Insl.
Compressor
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.
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING nEPARTMENT 5335 ath STREET ZEPHYRHILLS, FL 33B40
Phonala13-780-~020 'axI813-780-0021
HA'rm RIllCIIIIVBlD.__ ~"_.______
PI,ANS R11lVIBlW IJ'B1Ji_______ _L____..
OWN". '8 IIA"" _.~J<: ",,-_~M C <::'_~.~_ .~_ ~--~___U~___~__ PHON" CON'J'AC'~._.'T~_02_-:;.fQ.~
,TOB SITE AI1iJREl88 -s-g~..O---,-L~_n__~L_____,_____ _ _____________.___________
IJElGALJ DESCRIPTION: LO'r(8) BfJ()('K SUBllIVI8l0t! ____.______._
---.----------.---- -.-------...- D
PARCELl III #.--ll--2~..~..J____~__?..J_'9 C> 1'D ~D__~(_~)~TA.~~__~.ROM ~~~:-=:~~'_~_ '1~~_~_,~~~~~~(~Ill_~__.
~WRK PROPSElJ I [JNBlN CONSTRUCTION [J AODI'rIOtl DAI/rElRA'rrON [I REJP1HR )6 INSTAl,!,
[JSI<1N
[] MOVE
rJ DEJr.10I.ISI1
PROPOSED USE:: ~rJL Fl\f/IILY DWElLl,INa
C1 CDt1MBlRC 1A II
[Jr.1tJIiI'I - FAfv1II.Y
0# OF UNITS
[] SwtMMING POOTJ
[J fv!C)8!I,El Hot1Bl
[] OTHER
o INDUSTRIAL
IJEJSCRIPTION OF l'fORK
o RBlSTAURAN'l' & ItE:Alml DE:PARTr1ElN'r APPROVAL
---A-#_J~~.
d ~2__...L9-J €~__.,S:~~__i___/ l!.t_~
FOOTAGE L..::Lt:) t!?_.{F
HEIGHT
BUILDIN(! SIZE
-----------....-.--.-
SQUARE
RBlBIDl:llNTIATJ I
(~or1MER(lIJHJ :
A'r'r1\CH (:2) PI,OT PI/AilS & (:2) SElTS OF BtJII,lJn1C~ PLANS & (1) SElT ENERGY F'ORI>18,
A'I"l;Ac~H (3) sHi'rs OF BU!LDlNG PLANS & (1) SElT ElNElR(~Y FORMS,
PROPERTY SURVEY REQUIRElD FOR AIJL NEW CONS'l'RUCTION,
_....._._--..~...........--_.-
FERMITS REQUESTED
t1 8tlII,IJIN(~
$
VALUATION OF TOTAL CONS'rRuc'rION
L1 EI1BlCTRWAI.
- --------___ At1P ~ E: R V ICEI
o FI,oRIDA POWER
[] W, R , El . (1 ,
[] PIJtJt-1BING
r
,fJ'I1BJCHl\.NICAr,
[] (~A8 LOJ ROOFING
.~ 3DO.O-U
$- --. / - VALUATION OF r1ECHANCIAr, HlSTAI,IJATTON
[] SPElmAUI'Y [] OTHER
'l'YPEJ OP' (!ON8'1'RUC!TION: [J BLOCK
[] FRM1El
[] STEElIJ
[] OTIIElR
FIN LSHEllJ FI.<)OR ElI1ElVATIONS
-----~~~
IS PR(XTECT IN Fr,oon ZONEI ARElA 0 YElS 0 NO
BUIJJnmR
******************************************************************
cor1 PAN Y____._._,______,_, ______ '_.____.. _...., ______.. ______.__ .____._. ____
STATE CElRT OR RElGlS'!' # ._________'.___________,__________
CITY PROCESSING #_______,___._____________ .._________.
81 mIATUREl
. .
-"---~- .__._~----~---~~---------_._-~-------
mIJlIlCTRICIAH
S 1 mm'l'lJRE _"'___ __,_
,. ---.-------.----.--.-.-.--.-- --_......,._-~.-----
COI1PANY_.____.______________._.___.___ ________ _,__
STA'l'El CE:RT OR RE]<HST #
CITY PROCESSING #
._._~--.__.~---~~.." --._._---~-_._- -. -..--... .~- '----
****'*'*""****'*****************'***********'*****'***'***'*'*'*
----.---.-..-- .------.-...--- . _~_4_.__....._.___
PI,UMBBlR
...- ._.....-.__.......--..~~ .--...---.- -._---
(~Of\l PAN Y -.-----_..._._.__'__________......__...___,__. ___._______
STATE: CElR'l' OR REGIST # _______~_._._______..
CITY PROCESSING #
8WNA'l'IJREl
................................................~;.z:~..~~..~ ,"~ 7:
MBlC!HANICAI.~" ,2 ~~ (.~OI'1PANY .pn-!f-!-'~/1 .__... -.-_-#L:R!1..r,__',__'__ ~_I!J:
STA'U CElRT OR REGr8T # C~~_M_LL/ ~___
SWNA1'tJREl. _' CI'I'Y PROCESSING #
. . '" *-::-: * * * * *-~-~~~, * ,~.~ * ,.* * ~-:~~:-:-,' * * * *., *' * * *' * *' * *.. * *' *' * * * '* , ,:-~~.__._---_. ---.-----
OTIIB. .---".--__.__~___~____ '"""PA", i)cj'!;;<. A.4-'__.---'U_./7?'
S1'1\'I'Bl C'ElRT OR EGIST # /, iL /' () '---'7" ilL
SI(RIA'1'URE: ---___ _______________ CITY PROCEJ88ING # ~~/.Lk.._ -':::"-__L__ ___
---'-"~--'------._----~--...-._----~----
"*'*""*'*"*******"'*******'***"**'*'****""""****'~*****
-- ------. - - .---~~.--_____._.h_ _._~.__ .___~..___~____~__
CONDI'rIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands th,t this p~rmit may be subject to "deed restriotionsU ~hicll
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNLICENSED C;ON'l'RAC'l'ORS AND CON'l'RACTOR RESPONSIBILr'l'IES
If the owner has hired a contraotor or contractors to undertake Hork, they may be required
t.o lle Ij censed in accordanoe ~d.th state and local regulations. If t.he contracl:or is not
licensed as requi.red by la~II, both the ovmer and contractor may be clted for a mlsdemeano.r
violation under state len-II. If the owner or intended contractor are uncertain as to vlhat
licensing requirements may apply for the intended work, they are advised to contaot the
City of Zephyrhills Building Department, 813-766-6611.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
oontractor(s) sign portions of the "Contractor SectionsU of this application for whicll they
vJill be responsible. If you, as the owner signs as the oontractor, YQlI are indicating that
you, rather than the oontractor, are responsible for the work. If the contractor \o/ishes
YOq to siyn as contractor that may be an indication that he is not properly licensed and is
not entitled to permitting privUeges in the City of ZephyrhUls.
C, 'l'RANSI:'OR'l'A'rION IMPACT nES AND U'l'ILl'l'Y CONNECTION Ini:ES
D. CONS'l'RUCTUION I,IEN LAW (CHAP'I'ER 713, FLORIDA S'l'ATUTES, AS AMENDED)
I certify that I, the applioant, have been provided with a copy of "Florida's Constrllction
lien Law - Homeowner's Protection GuideU prepared by the Florida Department of Agriculture
emd Consumer Affairs. If the appli.c~nt is someone other that the "owneru, I cerify that 1
have obtained a copy of the above described document and promise in good faith to deliver
it to the "owneru prlor to cOllUT\encement.
E. CON'I'RAC'I'OR' a/OWNER'S AFFIDAVI'I'
I certify that all the information in this application is accurate and tllat all work will
be done in oompliance with all applicable laws regulating construction, zoning, and land
development.
Application is hereby made to obtain apermj t to do work and installation as indioated. I
certlfy that no Hark or installation has oommenoed prior to issuanoe of a permit and that
all work will be performed to meet standards of all laws regulating construotion, City
code~, zoning regulations, and land development regulations in the jurisdiction. I also
oertify that I understand that the regulations of other governmental agencies may apply to
the intended work, and that it is my responsibility to ldentify what actions I must take to
be in complianoe. Such agencies include but are not 11mited to: *Department of
Environmelltal Regulation-Cypress Bayheads, Wetland Areas and Environmentally Senstt1ve
Lands, Water/Wastewater Treatment
*Soutllwest rlorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of Health lie Rehabilitative Service~, Environmental Health Unit-WeLls,
Wastewater Treatment, Septio Tanks
'U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone ~Au or "A,etc.u, it is
understood that a drainage plan addressing a "compensating volumeu 'will be submitted v~lich
is prepared by a professional engineer registered in the State of Florida prior to permit
issuance.
A permlt issued shall be oonstrued to be a license to proceed with the work and not as
aqthorit:y 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 thereafter requiring a
correction of errors in plans, con~truation, or violations of any code. Every pe~mit
iSllued shall become invalid unless th@ work authorized by such permit is aOllullenced within
six months of issuance, or if work authorized by the permit is suspended or abandoqed far a
period of 13111 months after the time the work is cOllUT\enced. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be tequested
j n writing to the Buildlng Official. An approved inspeotion must be logged duri.ng each' 6i x
month period, or the project will be considered abandoned.
WARHlNG '}'O OWNER: YOUR FAILURE TO RECORD A NOTICE OJ!~ COMMENCEMENT MAY RESUW' IN YOUR
PAYING TWICE j!'OR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND '1'0 DB'rAIN j!'INANGING, c'm~UI}r
Wl'1'H YOUR LENDER OR AN A'I"rORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'l'. 'JOBS UNDER
$2,500 IN VAWE DO NO'!' NEED TO RECORD AND POS'!' A "NOTICE OF COMMENCEMEN'llll.
SIGNATURE: OWNER OR AGENT
SIGNA'i'URE: CONTRACTOR
acknowledged
,19_
STA'I'E OF FLORIDA
COUNTY OF
The foregoing instrument WqS aoknoHledged
Before me this .------5iay of----, 19
by
(name of person acknowledged)
C1ho is personally knovm to me, or
OHho has produced
(type of identifioation)
and Hho Ddid DUd not t.ake an oath
S'T'A'rE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before llIe this _._.._ day of
by
(name of person acknowl,dged)
Owho is personally known to me, or
Dwho has produoed
(type
and who[] did []did not
of identlfication)
take an oath.
Signature of person taking aoknowledgement
Signatqre of person taking acknowledgment
-~----'--~----'.-.-~--~--~---"-_.__._-
Hame typed, printed or stamped
Harne typed, prlnted or' stamped