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1 I
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
4969
4969
Permit Type: ADDlTION/AL TE TION
Class of Work: 434-ADD/AL T RES DENTIAL
Proposed Use: SINGLE FAMILY R SIDENTIAL
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
Address: 39342 9TH AVE
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot{s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
41,520.00
9/29/2005
498.80
498.80
9/29/2005
FAMILY ROOM AN
RUTH ILL
39342 9TH AVE
ZEPHYRHILLS, FL. 33542
Phone:
REESE ELEC.
DAVE COMER PLUMBING SVCS INC
SONNY'S DISCOUNT APPLIANCE, INC,
r: ~Jdo /0 ~
&/f;
TE 1
DUCTS INSTALLED CONSTRUCTION POLE 2ND ROUGH PLUMB
DUCTS INSULATED PRE-METER WATER
SHEATHING MISC SEWER
MISC MISC MISC.
MISC. MISC. MISC.
MISC. DRIVEWAY MISC. MISC.
REINSPECTlON FEES: When extra in paction 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 i spection when called
(e) Permit not posted on job site (f) Plan not at job site (g) Work not accessible
The payment of inspection fees shall be m de before any further permits will be issued to the person owning same
"Warning to owner: Your failure to r cord a notice of commencement may result in your paying twice for
improvements to your property. If y u. intend to obtain financing, consult with your lender or an attorney
before recording your notice of comm hcement."
Complete Plan f Specifications and Fee Must Accompany Application.
All work shall be rformed in accordance with City Codes and Ordinances
o OCCUPANCY BEFORE C.O.
~.
PERMIT OFFI
SPECTION - 8 HOUR NOTICE REQUIRED
OTECT CARD FROM WEATHER
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< " Lt) cr7"
NTRACTOR SIGNATURE
CALL FOR I
P
I 1
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECE IVED
9~~/or
OWNER'S NAME
PHONE CONTACT FOR PERMITTING 7 B'2.. 0) BG8
(LA2.2-Y )
PHONE 782 -'2?(O~
WORK PROPSED: 0 NEW
JOB ADDRESS
2e
SUBDIVISION ~Ut-.Jcs.e:T' ESTA TE'S ~
BLOCK
PARCEL ID # 112.-
- 00000 -0 0
~ADDITION
DALTERATION
o REPAIR
o INSTALL
DSIGN
PROPOSED USE: ~GL FAMILY
o MOVE
o DEMOLISH
o COMMERCIAL
DMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
DESCRIPTION OF WORK
c:J R STAURANT & HEALTH DEPARTMENT APPROVAL
~am;1 r(OOM A dJ;tion
SQUARE FOOTAGE
SiC:,
7 ~ u.. "
HEIGHT ..
BUILDING SIZE
'21.f )C 24 =
RESIDENTIAL: ATTACH (2)
COMMERCIAL: ATTACH (3) SETS
IF SIGN PERMIT ONLY (2) SET
PROPERTY SURVEY
PLANS & (2) SETS OF BUILDING PLANS
OF BUILDING PLANS & (1) SET ENERGY
OF ENGINEERED PLANS REQUIRE~
REQUIRED FOR ALL NEW CONSTRueN
& (1) SET ENERGY FORMS.
FORMS.
PERMITS
~BUILDING $
Ii'ELECTRICAL AMP SERVICE W.R.E.C.
ri PLUMBING
riMECHANICAL $ ';"00 VALUATION OF MECHANCIAL INSTALLATION Jf L{q~ q
o GAS o ROOFING o SPECIALT 0 OTHER
TYPE OF CONSTRUCTION: ~BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES [3"'No
SIGNATURE
COMPANY Wood C 0 t"\ ~rlJ c-r I '0"
Roo+'u'",~
STATE CERT OR REGIST # '372
BUILDER
****************
SIGNATURE
5o,q 0 COMPANY R~e.,~ E: I ec. +Y"' c.a. J
STATE CERT OR REGIST # EC I ~oo, '353
ELECTRICIAN
PLUMBER
* * * * * * * * * * * ** * * * *,..;l-d * * * * * * * * * * * .tff * * * * * * * * * * * * * * * * * * * * * *
1 ~ I .) JIll [)e.. W(J1 eI'L
COMPANY ~~~~ c:.~ ~ZCf~
SIGNATURE
STATE CERT OR REGIST #
MECHANICAL
* ************************************************
tftj,~ 0 COMPANY SO l"lny's
SIGNATURE
STATE CERT OR REGIST #
ltk 60 I fit , (
**************** ************************************************
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 Zephyrhil1s.
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.
Appli~ation 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, br 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: CONTRACTOR
SIGNATURE: OWNER OR AGENT
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
Before me this _ day of , 20_
by
(name of person acknowledged)
Dwho is personally known to me, or
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
Dwho has produced
(type
and wrioD did D did not
of identification)
take an oath.
Dwho has produced
(type of identification)
and who Ddid DUd not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped