HomeMy WebLinkAbout91-1565
ST ATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
PermitN~
1565/3
,b --..S~ -7/
3--5--: cro
Type of Permit :2b - cTD
~~;;"G ~~C;~~V PLUMBING MECHANICAL
Property Owners Name: ~/~ A,f '/cr1 ;~
Job Address: .3 7r~P- L/A~.A..D ~
Sub.Div. V~ h /t-.?"
Zoning CI: / 'I .- d-b - cJ..../ - 0 - d-. - 0
Des~;~o~:!~~:tj ;:::
BUILDING DEPARTMENT
1-813- 788-6611
Date
Legal Description:
Lot
Blk.
:/;~7~k~"'"
/t4J7J'Y'YL-
Energy Code Readout:
'~27-"11 ~
Complete Plans, Specifications and Fee Must Accompany Appr ation
Estimated Cost: ,,3. $f -J. 7, 0-0
--
Fee: 0'J~
:~'~~
ADDRESS
TELEPHONE #
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances_
Jll
OCCUPATIONAL LICENSE # (}1./ /2~4n ~,
"' J::'A'~A~ _~2ft/~ /J1c /(~/!
~~IN~) P~~
Ftr. SLB
Pre SLB Tub Set
Lintel VVater
FRM. 4P-ll-'/ (i.Ja Sewer
Insul.CL Final
WL
JJ; ~Y1 1n<-1-,
crucTRICA~~:119
Tp.Serv.
Rough In ~-t'I- C; (
Meter Can
Const. Pole
Pool
Pre-Meter
Final
M~ICAL
.............
~ Breakers
Ducts Insl.
Compressor
Final
Driveway
Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of l ,- r 06)
dollars shall be made for each _."/r--.L d.e- (/s: aD)
(a) Wrong Address
(b) Condemned work resulting from faulty construction
(c) Repairs or corrections not made when inspection called for
(d) Work not ready for inspection when called.
The payment of reinspection fees shall be made before any further permits will be issued to the person owning same.
APPLICANT
~)NO~
APPLICATION FOR PERMIT
CITY OF ZEPHYIDfILLS
BUILDING DEPARTMENT
0'> Q f:-'S,~ C ~..:::,
~~~~ ~~~~,.y- L~
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PHONE .., 'dL lo~ \J_
'M \..\( )
ADDRESS
OWNER
JOB LOCATION
60 f(>r.€-; 194>6 W \D(,UI ",(J LOT SIZE
x
AREA SQ.FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I. D. j~
JL! -db- J-I- tJ
~- 0
WORK
PROPOSED:____New Construction ~Addition ~lteration'
'BJ. \ \....-~ \rSO-oO b~
_Sign/Temp. ____Sign
~epair
____Install
_Move
____Demolish
PROPOSED USE: ____Single Family
_M/F
____4~ of Uni ts
__M/H
_Commercial
____Indust.
_Swim. Pool
Other
_Restaurant & Health Department Approval
BUILDING SIZE:
L-.
Square Feet,
Height
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.'"
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
**COpy OF CONTRACT REQUIRED.
PERMITS REOUESTED
v--/
____BUILDING
$ c-.l. If ;J.. 7, tID
Valuation of Total Construction
~ELECTRICAL
AMP Service
Florida Power Corp.
_W.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBING GAS ROOFING SPECIALTY
,1
TYPE OF CONSTRUCTION: _Block _Frame ____Steel ~~~~er
FIN ISHED FLOOR ELEVATIONS: __FT.
******************************************
CONTRACTOR SECTION
Company 1_. ~ ff\ C _ '( L\J...
State Cert. or Regist. #
City License Registration # -4-7
******************************************
C~~\
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/~.".-/~:::---
Signatur-e"L /
..- r -
Company ---fY)~ bl ~,1p. "\
.- "yYJ -;-- State Cert. or Regist. 4~ G:.. 1'9
{I /11,,"7/f())'I.- 17 City License Registration 4~ -
***********~*****************************
ELECTRICIAN
Si"n.~ure ja?Y'.!'(
Company
State Cert. or Regist. #
City License Registration # -
******************************************
PLUMHER
Signature
Company
State Cert. or Regist. #
City License Registration #
******************************************
MECHANICAL
Signature
Company
State Cert. or Regist. #
City License Registration #
OTHER
Signature
*******************2**********************
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this plrlit lay bt subject to "dted rtstrictions" which lay be lore rtstrictive than City
regulations. The undersign.d alsUI.S r.sponsibility for cOlplianc. with any applicable d..d r.striction,.
8. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSI8ILITIE~
If the owner has hired a contrittor or contract'f' to undertake work, tbey liY be required to be licensed in accordance M)th.
state and local regulations. If the contractor is not licensed as required by law, both the owner Ind contractor lay be '
cited for a lisdeleanor violation under state law, If the owner or intended contractor are uncertain as to what licensing
requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building D2partlent, (813)
'788-6611.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorls) sign portions of the
"Contractor Sections" of this application for which they will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for th~ work. If the contractor wishes you to sign
as contractor that lay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D.
CONSTRUCTION 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 - HOleowner's ProtectiDn
Guide" prepared by the Florida Departltnt of Agriculture and Consuaer Affairs. If the applicant is soaeone other than the
"owner", I certify that I have obtained a copy of the above described doculent and prolise in good faith to deliver it to the
"owner" prior to cOllencelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work will be done in cot,liance with all
applicable laws regulating construction, zoning, and land developaent.
Application is hereby aade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has r.oalenced prior to issuance of a perlit and that all Nork will be perforled to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other governtental agencies lay apply to the intended work, and that it is
IY responsibility to identify lIhat attiC/ns I lUst take to be in cC/lpliante. Suth agencies include bllt ~le not liaited to:
I Departlent of Environaental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally SenSItive lands,
Water/Wastewater Treatlent
t Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
I Any Cc,rps C/f EnQineers - Seawalls, Docks, Navigable Waterways
I Departlent of Health L Rehabilitative Services. Environtental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
t US Environaental Protection AQency - Asbestos abatetent
I al50 certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understoDd tliat a drainage plan
addressing a 'colpensatlng volute' will be subaitted which is prepared by a professional engineer registeied in the State of
Florida prior to pertit issuance.
A perlit issued shall be construed to be a license tc/ proceed with the work and not as authority to viol~te, cancel alter, or .
set aside any provisions of the technIcal codes, nor shall issuance of a perait prevent the Building Ufficial fro. thereafter
requiring a correction (,f errors in plans, construction, or violations of any tode. Every perait iSSlIl!d :;halI bec(.le invalid
unless the work authorized by such perait is cOllenced within six tonths of issuance, Dr if wC/rk au tho I Ized by the perlit is
suspended or abandoned for a period of six tonths after the tite the work is toa.enced. One 90 day e~t€nsion of tile, aay be
allowed for the perait with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection lust be logged during eath six to nth period, Dr the projl!ct will be considered dbaildoned.
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 A1TORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
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SIGNATU~:~/ ~_'_' ,_~:.2~~~--
// R AGEI'llT
DA TE__':-~-=~S\_S:\___________
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MY COMM I SS I ON EXP I RES . Notary PubliC. State 0,1 florlO<
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"'SIGNAT, r ~4 JLL:l-":_
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CTOR
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NOTA~r AS TOIi' J~
CONTRACTOH___ --~~--~Q--~O!---
. otarv Public. State of FIOri a
E Feb 20. 1995
i'ly COM!-lI 5S I ON EXP I RE~~~~~~_~~__'________
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(2) IF ATTACHED, HOW IS IT TO BE FASTSNED TO STRUCTURi?
()) DESCRI&E POST SPACING" ,ASTINING (IF TO CONCRiTS, IN WHAT MANNER?)
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PROPOSAL SUBMITTED TO
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37528 Hwy. 54 West
ZEPHVRHiL~S FLORiO'\ 335c;]
(813) 788-7308
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JOB NAME
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CITY, STATE AND ZIP CODE
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ARCHITECT
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.. We hereby submit specifications and estimates for:
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1II!Il' JropO!ll' hereby to furnish' material and
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with above specifications. for the sum of:
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Auth9rized" . -_-:~..-.,..:~\;~\-~
Si~atu.re. -, ~. '--- ,
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'.. Note: This proposal may be
withdrawn by us if not accepted within
All material is guaranteed to be as specified. All work to be completed in a workmanlike
manner according to standard practices. Any alteration or deviation from above specifica.
tions involving extra costs will be executed only upon written orders, and will become an
extra charge over and above the estimate. All agreements contingent upon strikes, accidents
or delays beyond our control. Owner to carry fire, tornado and other necessary insurance.
Our workers are fully covered by Workmen's Compensation Insurance.
('0 ''"'
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days.
Atttpluutt nf 'rnpnsul- The above prices, specifications
and conditions are satislactory and are hereby accepted. You are authorized
to do the work as specifietl, Payment will be made as outlined above.
Signature
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Date of Acceptance:
Signature
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PRODUCT 118-3 ~elnc-. Groton. Mass_ 01471. To Order PHONE TOLL FREE 1 + 800.225.6380