HomeMy WebLinkAbout04-2816
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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
2816
,Permit umber:
Permit Type:
Class of Work:
Proposed Use:
Squa(e Feet:
Es~. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Wor Desc:
2816
MECHANICAL
AlC CHANGEOUT
NOT APPLICABLE
Address: 5220 10TH ST
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 11-26-21-0010-18100-0110
1,650.00
3/11/2004
40.00
40.00
3/11/2004
CHANGE OUT AIR-HANDLER
Name: CHURCH OF THE LIVING WORD
Address: 5220 10TH STREET
ZEPHYRHILLS, FL. 33542
~__ Phone:___
----- ---- ------__ -L____ . ~_______________ ___
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge Of Thirty-Five Dollars ($35.00) shall be made for each trip for each trade:
i (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
"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
__~E!!.~r~ recordin9 y~ur notice of commencement. "___ _ _____ _____
Complete Plans, Specifications and Fee Must Accompany Application.
--- u_u__ __ __~II w~r~.?hall be_performed in-.CIccordC!'lce with City Codesand OrE.!na':!.ces________ _____
NO OCCUPANCY BEFORE C.O.
/~~ ~
v'. CONTRACTOR tt~t:E I:PECTION _ 8 HOUR NOTIC~RE~:X~~~i OFFI
PROTECT CARD FROM WEATHER
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Dade City 35;Z'.~2:-4977
Zephymills 3.13- 779.95l5
Brandon 813-.054-2::':.3
3rooks'Iiile 352 .~88.82S0
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SERVICE ORDER
INVOICE
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CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX:813-780-0021
DATE RECE IVED
3 -II - 0 ~
PHONE CONTACT FOR PERMITTING
, f > 1 (/
OWNER'S NAME c...huv- ch 0 .-/.ht IAJ/ll1j \IV IT d. . _ PHONE
JOB ADDRESS 5 d. ~O (O-ih Sf '2e:rh~r h iI/sl F i-..
LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION
,gg - 4-5 ~b
t3354-0
PARCEL ID # 11-. dk, - di- 0010.- i g/OD'- DO D
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: ONEW CONSTRUCTION
Os I GN
o ADDIT ION
o MOVE
o ALTERATION
o REPAIR
o INSTALL
o DEMOLISH
PROPOSED USE: OSGL FAMILY DWELLING
o COMMERCIAL
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
BUILDING SIZE
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
C.h&ztlje wt aM-- -IuMUr.
SQUARE FOOTAGE
HEIGHT
DESCRIPTION OF WORK
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMM~RCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
o BUILDING
o ELECTRICAL
$
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
o
FLORIDA POWER
------..........
~,/'"- ,
o W.R.Ef'Y.;
~ql&
1; -.
INSTALLATION ~
o PLUMBING
~ECHANICAL
$
/050.0'0
VALUATION OF MECHANCIAL
o GAS I 0 ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES 0 NO
[ I
. __.__J______________
~O~~"Q~I!;zl;$.~m~~
...---.--___.__J
BUILDER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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ELECT~ICIJ\N
I
SIGNA~URE
COMPANY
STATE CERT OR REGIST #
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PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
SIGNATURE
MECH1\NlCAL
************* **************************************************
~
STATE CERT OR REGIST #
OTHER I COMPANY
SIGNATURE STATE CERT OR REGIST #
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictions" W11ich
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 contracior 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, 813-780-0020.
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 indica~ion 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 addressi.ng a "compensating volume" will be submitted which
is prepared by a professional engineer registered in the State of Florida pricJr 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 v.dthin
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 eacll 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, CONSUI,T
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".
acknowledged
, 20_
. :J&WtUL ~~
SIGNATURE: CONTRACTOQ-'_u
STATE OF FLORIDA
COUNTY Of
The foregoing instrument was acknowledged
Before me this _day of , 20
by
(name of person acknowledged)
[1ho is personally known to me, or
j{1l111L
SIGNATURE: OWNER OR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by
(name of person acknowledged)
Owho is personally known to me, or
of identification)
take an oath.
Owho has produced
(type of identification)
and who Odid [):iid not take an oath
Owho has produced
(type
and whoO did 0 did not
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped