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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
(J~
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Sq. Feet:
Cost:
Amount Paid:
052 Issue : 5/07
GENERAL BUILDING PERMIT
ELECTRIC SERVICE/NEW
NOT APPLICABLE
Est. Value:
600.00 Total Fees:
35.00 Date Paid:
A ress: 4807 1 ST
ZEPHYRHILlS, FL
Township: Range:
Lot(s): Block: Section:
Book: Page:
Subdivision: CITY OF ZEPHYRHILlS
Parcel Number: 14-26-21-0010-02800-0010
~]flli8f,~it~ti;~_~;~1~~llf~iI~~;f .:). '
LE .
PRE-SLAB CONSTRUCTION POLE 2ND ROUGH PLUMB I DUCTS INSULATED
LINTEL PRE-METER WATER FINAL MECHANICAL
FRAME MISC SEWER MISC
INSULATION WALL MISC MISC. MISC.
INSULATION CEILING MISC. MISC. MISC.
DRIVEWAY I MISC. : MISC. FIRE DEPT. FINAL
REINSPECTION FEES: When extra inspection hips are necessary due to anyone of the following reasons, a
charge of Thirty-Five Dollars ($35.00) shall be made for each bip 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
nWarning 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. n
"
NO OCCUPANCY BEFORE C.O.
~.
SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOnCE REQUIRED
PROTECT CARD FROM WEATHER
UI'lNER I 8
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUII~DIl-m IHllI?ARTMElN'r 5335 8th S'rRlIllll'r ZlIlI?H'iRHII,I,S, FL 33B40
PhoneI813-780-n020 FaxI813-780-0021 ..
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,TOB S!TEI
lJEl<1AL DElS(!RIPTIOlll LOT(S) BrJOCK SUBDIVISJON _______..___.___.___
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HURK PROPBEllJ I UNElN CONSTRUCTION 0 AfJDI'rION [J A L'I'E1 RAT ION B'1fElPAIR IJ INSTAT,!,
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o MOVE:
I] DE:fvrOr.rSII
PROI,lUSEIl USEI, L1SGJL FAMILY DWElLI,INGI
[h.1tJI,'I'I., FAr'lII,Y
[)# OF UNITS
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IlllJSCRIPTION OF NORK
D Rfj)8TAURA1,rr & IIE:AI,TII DBl~J\RTtiElNT APPROVAL
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SQUARE: FOOT AGEl
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HElHm'f _____.____.._
RESIDENTIAlJ I
(~O~1MBlRCI./\J'1
A'I"rACH (2) PLOT PTJAl1S & (2) SElTS OF BUIT ,IHNG PLANS & (1) 8E1T ElNElRny FORMS,
AT'11A.CH (3) sHi'rs OF BUtLDING PLANS & (1) SEl'!' ElNElRny FORMS,
PROPERTY SURVEY RElQUIRED FOR ALl, NElW CONSTRUCTION.
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FERMITS REQUESTED
$___cPoc) c;!JL. ._..----' VALUATION OF TOTAL CONS'fRIJC'fION
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U HEICIH\.NIC!ATJ
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----- VAl,UATION OF ~1ECHANCIAr, HISTAI,IJATTON
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[)ROOFINC3
[J SJ?E:CIAUry
[) OTHER
'l'YPEI OF CONSTRUCTION I 0 BLOCK
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FIN rSHElT) FI,OOR E1fJElVATIONS
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I8 PROIIBlC'I' IN FLOOD ZONEl ARElA n YElS 0 Nt)
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Cot1PANY ___...________.___.. _______..__ .______... _..__.__.______. ___
STATE CFJRT OR RElGIST # ___.-'__.__.__...________,q____.___
CITY PROCESSING #
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B1rJlIlOTRICIA~ ~t&:J= ~. COt1PANY_( "-,::_c:t<;r;;~:..t:; k.:c... -__m___
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STATE: CEJRT OR RElGIST # _____________________.
CITY PROCESSING #
SWNA'l'tJRE
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MBlC!HANlcAr, ClOMP ANY ___..____.___._______..._____.._.._____..._
STATE1 r'E1RT OR REGIS'r # _____.__.___.._______..___________
SIGNATlJRffi CITY PROCESSING #
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(~m.1PANY
srrJ\1'E CERT OR-REoIST -tr----.----..".----- ----".-..,.--..,~..-...
CITY PROCESSING # .----..-------.--h____~______..h
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CONDITIONS OF PERMIT AFFIDAVIT
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 VALUE DO NOT NEED TO RECORD AND POST A ~NOTICE OF COMMENCEMENT".
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
acknowledged
19_
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____day of
by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____ day of
by
acknowledged
19
(name of person acknowledged)
Dwho is personally known to me, or
(name of person acknowledged)
[1ho is personally known to me, or
of identification)
take an oath.
Dwho has produced
(type of identification)
and who Ddid [}:iid not take an oath
o who has produced
(type
and whoD did 0 did not
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped