HomeMy WebLinkAbout05-4973
I II
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
4973
Permit Number: 4973
Permit Type: SLAB PERMIT
Class of Work: SLAB
Proposed Use: SINGLE FAMILY RE
Square Feet:
Est. Value:
Improv. Cost: 1,800.00
Date Issued: 9/30/2005
Total Fees: 40.00
Amount Paid: 40.00
Date Paid: 9/30/2005
Work Desc: 24 X 24 SLAB
Address: 5240 19TH ST
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot{s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Name: LEE NORRIS
Address: 5240 19TH ST
ZEPHYRHILLS, FL. 33542
Phone:
REINSPECTlON FEES: When extra in ion 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 e before any further permits will be issued to the person owning same
"Warning to owner: Your failure to r ord a notice of commencement may result in your paying twice for
improvements to your property. If y ... intend to obtain financing, consult with your lender or an attorney
before recording your notice of com elncement."
Complete Plan , Specifications and Fee Must Accompany Application.
All work shall be rformed in accordance with City Codes and Ordinances
o OCCUPANCY BEFORE C.O.
~~
PERM~
SPECTION - 8 HOUR NOTICE REQUIRED
bTECT CARD FROM WEATHER
III
I,
DISCLOSURE STATEMENT FOR OWNER
CITY ot ZEPHYRBILLS BUILDING DEPARTHENT
~
have read and fully understand and
agree to the provisions of t is instrument.
The undersigned states and a firms that he or she is desirous of constructing,
renovating, adding to or rer ofing his or her own domicile" that he or she
actually occupies, or will 0 qupy by said domicile, and same is not for
rent, lease or sale. That h or she shall comply with the following conditions:
1. That the owner and he or .he alone shall act as the builder for all phases of
construction.
2. That the owner will comp ~ with all provisions of the City of Zephyrhills
ordinances and codes per inent to the building.
3. That in the event variou phases of construction are subcontracted, he will
engage only properly lic sed subcontractors and will personally supervise
such work.
4. That in the event the B 'lding Inspector shall require corrections to be made,
the owner will assume f 1 responsibility to insure they are made, and upon
completion will call for a reinspection before proceeding with the building.
5. That the owner shall ass e full responsibility for the construction and will
not expect supervision f his work from the City of Zephyrhills Building
Department.
6. That prior to additional fees, including reinspection
fees, must be 11. A written request from this office shall
constitute an officia~ otice to pay additional fees.
7. That the owner shall co 1y with all City, State and Federal laws in regard to
social security, workm '8 compensation, lien laws, etc., where applicable.
8. That the owner shall co ly with all the safety codes issued by the Florida
Industrial Commission.
9. State law requires cons ruction to be done by licensed contractors. You have
applied for a permit un eo:" an exemption to that law. The exemption allows
you, as the owner of yo property, to act as your own contractor with certain
restrictions even thoug you do not have a license. You must provide direct
onsite supervision of t e construction yourself. You may build or impr~ve a
one-family or two-famil residence or a farm outbuilding. You may also build
or improve a commercial building, provided your costs do not exceed $25,000.
The building ~or residen e must be for your own use or occupancy. It may not
be built or substantial y improved for sale or lease. If you sell or lease a
building you have built dr substantially improved yourself within 1 year after
the construction is co 1ete, the law will presume that you built or
substantially improved ~ for sale or lease, which is a violation of this
exemption. You may not ~ire an unlicensed person to act as your contractor or
to supervise people wor ~ng on your building. It is your responsibility to
make sure that people loyed by you have licenses required by state law and
by county or municipal ~censing ordinances. You may not delegate the
responsibility for supe ising work to a licensed contractor who is not
licensed to perform the work being done. Any person working on your building
who is not licensed mus work under your direct supervision and must be
employed by you, which ~ans that you must deduct F.I.C.A. and withholding tax
and provide workers' co ensation for that employee, all as prescribed by law.
Your construction must ~mply with all applicable laws, ordinances, building
codes, and zoning regul tions.
OWNER'S SIGNATURE
ADDRESS
PHONE
DATE
9'- JtJ,-OS-;
/
WITNESS
PERMIT #
II'
,
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECE IVED
PHONE CONTACT FOR PERMITTING
JOB ADDRESS
'-
Ze-
PHONE
OWNER'S NAME
LEGAL DESCRIPTION: LOT(S)
::-~
WORK PROPSED: ~EW
o SIGN
BLOCK
SUBDIVISION
BUILDING SIZE
~
o ADDITION
o ALTERATION
o REPAIR
o INSTALL
o MOVE
o DEMOLISH"
PROPOSED USE: OSGL FAMILY
o COMMERCIAL
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
~ OTHER
D
& HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK
SQUARE FOOTAGE
{aOD
HEIGHT
#
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 REQUIRED.
REQUIRED FOR ALL NEW CONSTRUCTION.
& (1) SET ENERGY FORMS.
FORMS.
PERMITS REQUESTED
~UILDING
o ELECTRICAL
$
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
o Progress Energy 0
W.R.E.C.
o PLUMBING
o MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALT
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
COMPANY) ~ ert~
SIGNATURE
STATE CERT OR REGIST #
****************
*************************************************
ELECTRICIAN
COMPANY
SIGNATURE
STATE CERT OR REGIST #
****************~*************************************************
PLUMBER COMPANY
SIGNATURE STATE CERT OR REGIST #
**************** *************************************************
MECHANICAL COMPANY
SIGNATURE STATE CERT OR REGIST #
*****************************************************************
OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictionsU 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 SectionsU 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 Guideu prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "ownerU, I cerify that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the "ownerU 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 "AU or "A,etc.u, it is
understood that a drainage plan addressing a "compensating volumeU 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 d~ e~~ime
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 COMMENCEMENTu.
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by
acknowledged
,2U-
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _day of
by
acknowledged
, 20
(name of person acknowledged)
Dwho is personally known to me, or
(name of person acknowledged)
C1ho is personally known to me, or
Dwho has produced
(type
and whoD did 0 did not
of identification)
take an oath.
Dwho has produced
(type of identification)
and who Ddid Diid not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
I II
CITY OF ZEPIIYRHILLS BUILDING DEPARTHENT
OWNER
JOB LOCATION
PARCEL IoD.'ff
SIIOW ALL EXISTUIG & PROPO SED STRUCTURES GIVING DIMENSIONS & SETBACKS.
--
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I
'VJ~
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1
~o
I
I~ ()UL-
UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
~RONT
PROPER'ry LINE
--
(NOTE EXAMPLES 1 & 2 ) STIEET
1- SETBACKS FOR Rl, R2 ZON NG
60'
-.--
10'
P E-
R X
0 I
10' P S 10
0 T 1 0'
S I
E N
D G
20'
--
FRONT PROPERTY LIft:!:
2. SETBACKS FOR R3 ZONING
60'
10'
10'
EXISTING
10'
1 0'
PROPOSED
20'SGL FAM
30 ' DUPLEX
FRONT PROPERTY LINE