HomeMy WebLinkAbout04-3141
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
3141
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost: 3,600.00
Date Issued: 6/08/2004
Total Fees: 50.00
Amount Paid: 50.00
Date Paid: 6/08/2004
-. Work Desc:m FLAT CONCRETE SLAB ONLY 16' X 64'
3141
SLAB PERM IT
SLAB
RV PARK
Address: 3337 MALACHITE DR
ZEPHYRHILLS, FL,
Township: Range: Book:
Lot(s):43 Block: Section:
Subdivision: EMERALD POINTE
Parcel Number: 24-26-21-0020-00000-0430
Name: O'CONNOR, TIM
Address: 3337 MALACHITE DR
ZEPHYRHILLS, FL. 33542
Phone:
i I
REINSPEcTION FEES: when-extra inspectiori- 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:
(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 p~ymen~f inspection fees shallbe 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
before recording your notice of commenc::ement."
- ---------------Complete Plans, Specifications and Fee Must Accompany Application. -- ---- - - -- -
--- '- __._____~Lvvork.?hall be performecUn a~cordance with City Codes and Ordinanc~~____ ___
NO OCCUPANCY BEFORE C.O.
-..-~.._._---.._---_'___.'_~__.m.___._____..___.._._. '___._.____..____..__~~____.________.___._ _____..____,,___,.___ ___..______
~
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CONTRACTOR SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH st, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECEIVED
t7.tt-o tj
PHONE CONTACT FOR PERMITTING
OWNER'S NAM0\M 0' G)J ~()\Z
JOB ADDRESS 333 7 MfA llA c.. ~\ -t e..- '1>~,
LEGAL DESCRIPTION: LOT (S) -# 4-_~ BLOCK
PARCEL In # 1'1- - ~, - 7. [- 00 ;l 0 - cooo a. 0 q.....3o
PHONE 813 - 'i II J.. - C; 319
Z e ~ ~ '1 \c ~ f \ L~ F. 3 3~- 4-0
lei "
SUBDIVISION ;; m e~r4-1 fb / VlT
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: ONEW CONSTRUCTION
Os I GN
PROPOSED USE: OSGL FAMILY DWELLING
o COMMERCIAL
o ADDITION
o MOVE
OALTERATION
o DEMOLISH
o REPAIR
o INSTALL
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
DESCRIPTION OF WORK
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
CO U C-\R--e-\ L 'rltJ. Ie, X <;. 4-
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMMERCIAL: 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.
')( BUILDING
o ELECTRICAL
PERMITS REQUESTED
$ 3C.oc:>.oo
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
o
FLORIDA POWER
'\
.", I
o W.R.E.C. I i
" /1 /
INSTALLATION~
o PLUMBING
o MECHANICAL
$
o GAS
o ROOFING
o SPECIALTY
VALUATION OF MECHANCIAL
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
BUILDER
SIG~ATUR~~ () \ e~
C()~TRAqro~<,SECTI()N
COMPANY~:-( lA-vr 0 IWv1.l(ftc>,c ~ Ov vt. prt
STATE CERT OR REGIST #
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ELECTRICIAN
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
MECHANICAL
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COMPANY
SIGNATURE
STATE CERT OR REGIST #
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OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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, 813-780-0020,
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign po~tions 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 conunencement.
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 conunenced 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 mLlst 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 conunenced 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 conunenced. 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".
~~~ O~
SIGNATURE: OR AGENT
STATE OF FLORID~1 .
COUNTY OF _ t2~5C!-{J
The .~egoing in~tr~ment was
B fo ", is YI y of
by ~~
(name of person ackno edged)
owho is personally known to me, or
SIGNATURE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _day of
by
acknowledged
, 20_
(name of person acknowledged)
C1ho is personally known to me, or
~O/has produced rl- f) J.- D-2S~-po1~4.f.1f'?' 00 who has produced ""
_--.--- (type of ~entlflcatlont. (type of ldentlflcatlon)
and/~hoo did did not talfo/'an oath, / and who odid D:lid not take an oath
c- '~/'
Signature of person taking acknowledgment
Name
Name typed, printed or stamped
Lo-i- tt: 1-3
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