HomeMy WebLinkAbout05-4176
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
4176
Permit Number: 4176
Permit Type: ADDITION/ALTERATION
Class of Work: ADD/AL T COMMERCIAL
Proposed Use: COMMERCIAL
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
2-
5/ti/2005
52.50
52.50
5/05/2005 Phone:
FOUNDATION SLAB ONLY FOR ADDITION
Address: 5734 GALL BL
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Name: BEST WESTERN
Address: 5734 GALL BLVD
ZEPHYRHILLS, FL 33542
DUCTS INSTALLED PRE-SLAB CONSTRUCTION POLE 2ND ROUGH PLUMB
DUCTS INSULATED LINTEL PRE-METER WATER
SHEATHING FRAME MISC SEWER
MISC INSULATION WALL MISC MISC,
MISC, INSULATION CEILING MISC, MISC,
MISC. DRIVEWAY MISC. MISC.
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Thirty-Five Dollars ($35.00) shall be made for each trip for each trade:
(a) Wrong address (b) Condemned work resulting from faulty construction (c) Repairs or corrections not made when
inspection called (d) Work not ready for inspection when called
(e) Permit not posted on job site (f) Plans not at job site (g) Work not accessible
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your property. If you intend to obtain financing, consult with your lender or an attorney
before recording your notice of commencement."
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances
NO OCCUPANCY BEFORE C.O.
'~~l -, ~.
. CONTRACTOR SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS ~J!i.t<MJ. ".1" ,'U.....'-'.n.... ....'-'...
BUILDING DEPARTMENT 5335 STH st, Zephyrhills, FL 33542
813-780-0020 FAX:S13-7S0-0021
DATE RECEIVED
-~ ----
.:) -;/-oS
PHONE CONTACT FOR PERMITTING S()Z -23 d /S9$
o
OWNER'S NAME S( 1//;'-" / IlL
JOB ADDRESS 67 ..] ~ C-i- A Ll
PHONECW? 7!?z .s-:'-:;-:z ?
'Bu/j) Z~?H!Jrf-/JLLS' ..fL.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID # 11-:Uf/- f...r-no f U- o{)"buu --- 0 1-5 c)
(OBTAIN FROM PROPERTY.TAX NOTICE)
OSIGN
lir-'ADDITION
o MOVE
~LTERATION
o DEMOLISH
o REPAIR
o INSTALL
WORK PROPSED: 0 NEW CONSTRUCTION
PROPOSED USE: OSGL FAMILY DWELLING
~OMMERCIAL
OMULTI - FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOM]
o OTHER
c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK A~ I) I Tt () tV. Cn ~ T o/' I~'--JJ'
BUILDING SIZE
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS"
COMMERCIAL: ATTACH (3) SETS OF BUILDING, PLANS & (1) SET ENERGY JORMS"
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. ~
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. 5 z I 5"'0/
') )L~l
PERMITS REQUESTED 13&"
SQUARE FOOTAGE ~ I:y (/7
, AI"
HEIGHT 1<;' .3
I
aJ BUILDING
qi ELECTRICAL
ij}/PLUMBING
$ VALUATION OF TOTAL CONSTRUCTION
'S'}.\STI N~ AMP SERVICE ci Progress Energy 0
IGYMECHANICAL
o GAS ~OOFING
cO
$b/O{)
o SPECIALTY
?~
VALUATION OF MECHANCIAL
TYPE OF CONSTRUCTION: aYBLOCK
o OTHER
ltr FRAME
~STEEL
o OTHER
I
FINISHED FLOOR ELEVATIONS ~"'~hti 10~
IS PROJECT IN FLOOD ZONE AREAO YES I8t NO
BUILDER ~
S I GNA'rJlRK/"'~1
, . .
COMPANY ~}..:r71(c;rrJ (i.:.L,--.,;7) jY\'-:;:{'A. it.- t)/I'r<
STATE CERT OR REGIST # c: se C)0 /6 5 J
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COMPANyAll-:- ~ l\J - ONe lL~c;; IC-
STATE CERT OR REGIST # f:'K!-('01C:;3 5d
ELECTRICIAN
SIGNATURE
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SIGNATURE
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COMPANY.j}-\\I'OO'~or'f\ I C.'::; ilJC
STATE CERT OR REGIST # CAe )5865'{
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COMPANY LLQ teA, 11. u-v""\o I N(~
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STATE CERT OR REGIST # ere I ~j2G J ~c;
SIGNATURE
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OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
A. NOTIGE OF DEED RESTRICTIONS
Th~ 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 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.
Appliqation 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 issuahce 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.8. Environmental Protectiori Agency-Asbestos abatement
I also certity 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,c~des,
nor shall issuance of a permit prevent the Building Official from thereafter requ1r~ng a
correction of errors in plans, construction, or violations of any code. Every perm1t
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 a?andoned.for~a
period of six months after the titne,the work is commenced. One 90 d~y extensJ.on of tJ.me
may be allowed for the permit with fee charge of $15.00. The extensJ.on shall b? requeste~
in writing to 'the Building Official. An approved inspection must be logged dur1ng each S1X
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
, 20_
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
, 20_
(name of person acknowledged)
Owho is personally known to me, 'or
(name of person acknowledged)
[1ho is personally known to me, or
Owho has produced
(type of identification)
and whoO did Odid not take an oath.
Owho has produced
(type of identification)
and who Odid [}:iid not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped