HomeMy WebLinkAbout91-1617
STATE OF FLORIDA
City of Zephyrhills
Type of Permit
~~
ELE~L
PASCO COUNTY
BUILDING DEPARTMENT
, 1-813-788-6611
PLUM~ MECH~
PermitN~ 1617 {3
Date -7 - J.- 1/
tJ'O
"::> 0 ~
Property Owners Name: --Raz:. 6-1,\.11\ L-I".) SlV'1 ~ D~ ~
Job Address: 33 V1 a. 11-1 ~j)JtA L U;-,..J T,;-tL It V.
Legal Description:
Sub.Div.
Lot
Blk.
Zoning CI:
Description of Work ~~. L.oo'f
A ~o .,flt..
rtl/~ riD~~9
Energy Code Readout:
~ 1-liJ.Yl ~
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost: 2 J qq 7. e (j
OCCUPATIONAL LICENSE #
VD
'2 '"', .:J (J
Fee: VV
SIGNATURE cf~
COMPANY MJi....lk12 (CNOS,.) iN <-
ADDRESS /71<3 Hu I '1' 3DI tJ.~""bF (17'-/ /I FL
TELEPHONE # 304-JSltl7. taD4-i 3~S2.~
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
MII.-- !5AJ'L
BUILDING
Ftr.
Pre SLB
Lintel
FRM.
Insul.CL
WL
SLB
Tub Set
Water
Sewer
Final
Tp.Serv.
Rough In
Meter Can
Const. P e
Pool
Pre-M
Final
ICAL
Breake
Ducts nsl.
Com ressor
Fin
Driveway
Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons. a charge of I If T Jl9)
dollars shall be made for each ~.Ir-~ de.. /Ai'"; t:JV )
(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.
. ....~1iI~,-
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'rllltlluul
Page No.
of ..,
.. Pages .
State Certlfl~d
'9uildin;; Contrjdcr
#CBC023221
State Registered
Roofing Contrifctor
#RC0055215
"'1 ItB l\H CO N~ I ; ~ U cr: ~ ~.:, !".JC.
1719 North iilgl1W::SY 301
DADE Ci TY, FLORIDA 33'525
(904) 567.6047
(a,};)) 562.2393
U.S. Intee
CerWif'd 1'1',L}'!u
#5204
PROPOSAL SUBMITTED TO
Reginald L. SimnoH'", H.D.
STREET
Members Of P"sc:;
Builders Assoc t~
Dade City Chan,[}.;r
of Commerce
38193 Medical Center Avenue
CITY, STATE AND ZIP CODE
zeph rhi 11s, FL 33540
ARCHITECT
PHONE
dl:V7D3-7G77
JOB NAME
lI.".,; liU i-, !. Si:T'0nS, M.D.
JOB LOCATION
DATE
06/27/91
38193 Medical Center Avenue
DATE OF PLANS
JOB PHONE
We hereby submit specifications and estimates for:
Zc~hyrhi11s, FL
RE-ROOF - Medical Office
1. 'Renvve all loose roof gravel and mechanically fastc:!n ~2" recovery hoard insulation over
~-'t.heeXistIiigtar and gravel roof ~lith zinc-coated ~ec.:],~ f;;,,~r,.~\JS \Ii th 3" sb:cl platos.
2:'~'-'.-Provrdeaiid iiistcilInew U.S. Intec Brat $1:>':.4 roofirq m2;nbran<~ \lhich is (1 tordl-aLvlic1,
. fully-adhered modified bitlunen roof system thi1t~ is lv::?~it-({elded at the SGa!;1S to form cne
---sheet. 0:8. Intcc Brai SP-1 hC1s ;) "1 2 y:.~ur 12Zlk-pl:o')f uarranty on L'iIX)r and m3b.:.~dals
,. from U.S. Intec Ivhen ins tall e-J by a ~rtifir:?j in:3tallec. 'l'his \iarrantf is a "full
-+,;;.-.---- --. ....--
" value II \-larranty, is not pro-rated, ha:; 0;10 dollClr lLnit" on r,)pair or re91ac<:'Il12nc for
_____~he entire len.:]th of t.he \larranty, dnJ is tran:>fc'rdbl,~. -
3. Prior to
----iIfurglass
roof and
plates.
installation of the Brai 8P-4 roofinJ, m:~ dill mc.-'Clunici'llly fasten a 28 lb.
base sheet over the IE:!\{ inSUlation dnd throu;;h t11e :~xi[otitYf tar an::: jravel
insulation into the metal decl( wit.h zinc-cuat.c)\1 rJec!~ c,Cn!;lS .lith 3" s\:;ec~l
4;'---A11 ri1ef:.alarid Concrete surfacc:,s 1fi 11 r,,~ :)rimc~.] ~lith an asphalt h,lse primer prior t<)
installution of Brai SP-4 roofitKJ mer:tbraih?
5. Install a 4" perlit~ cant strip alan] all para",h;?t ,lalls and ~ all rcX)f curbs arld
-'--penetrations.
t)~"""Remove throo-(3).. Courses of asphalt shinglos on the;> front para[JCtwall a.nd flash the
wall llith netl Brat SP-4 roofing ril:::!rnJJr:.]n'c~. Inst.all 118,/ ispinlt s~1in:::fJ,es ovc.r tl1i.; [;.09 of
the 13rai SP-4 membrane.
Ifr 'rupUBr hereby to furnish material and labor - complete in accordance with above specifications. for the sum of:
See page two.
Payment to be made as tollows:
Due upon completion..
dollars ($
) .
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.
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Authorized , . L--- 6-<' "}
Signature ..x_ -.\--- -. / . V \ /r- ,
I'
Note: This proposal may be 30
withdrawn by us if not accepted within
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days.
Atttptuntt of Jlroposul- The above prices, specifications
and conditions are satisfactory and are hereby accepted. You are authorIZed Signature
to do the work as specified. Payment will be made as outlined above.
Date of Acceptance: Signature
40)(2.8
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11, 1111 B. 1\ n (' 0" \",..:':.. ", "." _. . I
..1 ~ ~h ,,\, 1J..:d L l,H... J~,JI,
IllY North Hlg!lway j()l
DADE CITY, FLOf.?i[),,\ j3S?5
(904) 567-6047
(800) :%2-2393
'~ll.,~
:;lJ.;. ;'
State Registered
Roofing Contractor
#RC0055215
Members Of Pasr:o
BUIlders Assoc, .&
Dade City Chdmb~r
of Commerce
PROPOSAL SUBMITTED TO
Reginald L. Simmons, M.D.
STREET
PHONE
HI3/788-7G77
JOB NAME
H8:jinald L. Sinrloils, H.D.
JOB LOCATION
DATE
06/27/91
38193 Medical Center Avenue
CITY, STATE AND ZIP CODE
Zephyrhills, FL 33540
ARCHITECT
38] 93 (1e<:Ucal Center Avenue
DATE OF PLANS
JOB PHONE
ZGphyrhi l1s, FL
We hereby submit specifications and estimates for:
-1..':,.All.,bloclc.parapetwalls will beurappecl with Brai SP...4 rOOfing menlbrane up the inside
Of the walls and over the t.op anel c10\Jn 2" on the outside of the ~vall; fasten th~ Gdqe
';;;'..:'-_.Qfthe 8J::'aLSP::4 f;,1emb.t::'ane \dth 4ft aluminum tenninatioD bar secured uithnusonry anchors
and sealed with [X>lyurethane C<:lull<.
8. The entire roof will be coatGd '#ith a !J.T.. rated Class "A" aluminuril 8illulsion roof
___COCltlng (G+unc1yAI..."1B).
9.~ U~S! Intec Brat SP....4 is a U. L. Class ",2\" fir2-rated roof m8J'1lbram!.
J.0..J\11 wet. 01::'. Qqllt1CJod t::'oaf docl.;: or insulation ;viu J~ repaired as neclded on a cost-plus_u
, basis.
It. MilBar Construction, Inc. to provick! G~~neral Liability and ~vorJ\:2r's CompGnsation
I!lE?urance ( $1 ,000, 000 linli t) .
l~! MilBar Construction, Inc. to provida all mat,~dal, labor, and r:~-roofinJ pamit as
sJ.X-'Cified arove.
JIb 'ropose hereby to furnish material and labor - complete in accordance with above specifications. for the sum of:
Iwo thousand nine hundred ninety-seven and 34/100-----------______ ') 997 'H
Payment to be made as follows: dollars ($., - _' '_
) .
1)tlA 1lpnt1 r"i)n1pl...1: ion.
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,
Authorized
Signature
.f
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'-'- ----/
~
Note: This proposal may be
withdrawn by us if not accepted within
30
days,
Atttptuntt nf Jlrnpnsul- The above prices. specifications
~nd conditions are satisfactory and are hereby accepted. You are authorized Signature
"'to do the work as specified. Payment will be made as outlined above.
Date of Acceptance: Signature
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CONDITIONS OF PERMIT AFFIDAVIT
1(:\:-: NOTICE: OF DE:E:D RE:STRICTIONS:,.
The undersigned understinds that this perlit lay be subject to "deed restrictions' ~hich may b~ nore restrictive than City
regulations. The undersigned assuleS responsibili~r.for. cOllpHance with any applicabl~ deed rest,rictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIE~S
If the owner has hired a contractor or contractors to undertake work, they m~y b~ r~quired to be licensed in accordance with
state and local regulations. If the contractor is not licensed as required by law, both the ouner and contractor ~ay be
cited for a lisdeaeanor violation under state lall. , If the owner or intended contractor are uncertain as to what licensing
require.ents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departeent, (813)
788-6611.
Furtherlore, if the owner has hired a contractor Dr contractors, he is advised to have the contractor!s) 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 the Hork. 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 per&itting privileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FE:ES
D.
CONSTRUCTION LIEN LAW
(CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided lIith a copy of "Florida's C[Instruction Lien Law - Homeowner's Protection
Guide' prepared by the Florida Department of Agriculture and Consumer Affairs, If the applicant is soeeone other than the
'owner', I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the
'ollner' prior to COlmencement.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
J certify that all the information in this applicatiDn is accurate and that a1l work Mill be done in co~pliance with all
applicable laws regulating constructiDn, zoning, and land development.
Application is hereby .ade tD obtain a perlit to do 1I0rk and installation as indicafe~: L certify that no work or
installation has co&~enced prior to issuance of a perlit and that all Hork Hill be performed to meet standards of all laws
regulating construction, City codes, zoning regulations, and land development regulations in lhe jurisdiction. 1 also
certify that J understand that the regulations of other governmental agencies ~ay apply to the intended Mork, and that it is
IY responsibility to identify what actions J must take to be in cc.mpliance. Such agencies include bill ~ie Iie,t li,lited to:
I Departsent of Envi,oneental ReQulation - Cypress Bayheads, Hetland Areas and Environmentally Sensi live lands,
Water/Waste~ater Treatment
I Southwest Florida Water ManaQement District - Wells, Cypress Bayheads, Hetland Areas, Altering HatercOUfses
I Army CorDs of Enoineers - Seawalls, Docks, Navigable Waterways
I Departlent of Health ~ Rehabilitative Services, Environ~ental Health Unit - W~IIs, HasteNater Treat~en~. Septic Tanks
I US Environoental Protection AQency - Asbestos abatement
J also certify that, if fill material is to be used in Flc,od Zone "A' Dr 'A,etc.', it is undt.rstc.[.d tl.,t a drainage plan
addressing a 'colpensating volu~e" will be submitted which is prepared by a professional engineer regist~ied in the State of
Florida prior to perilit issu~nce.
A pertit issued shall be construed to be a license to 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 permit prevent the Building Official frol thereafter
requiring a correction of err[,rs in plans, te.nstructi[,n, or violati[,ns of any c[.de. Every perlllit isslled "hall bece..e invalid
unless the work authorized by such permit is COllftenced within six months of issuance, Dr if HOlk authorJied by the perlit is
suspended or aband[.ned for a perie.d of six lonths after the time the \lork is ce.r..mcnced. One 9(; day e~tt;.;;ioll of tile, lay be
allolled for the per~it with fee charge of ~15.00. The extension shall be requested in "riting to the Building Official. An
approved inspectic.n r..ust be l(,ggedduring each six month period, [<f the project Hi II be c[,nsidered i:ibaiidc.r,i?d.
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 II NOT I CE OF COMMENCEME:NT".
SIGNATURE__~~-~~-----~ SIGNATURE_~C~~~----
OWNER OR AGENT CONTRACTOR
DATE_______OJ~~l)5J------------------------
NOTARY AS TO A/. .(L _ '/J/;=/_-JJ-
OWNER OR AGENT__~~~~~------
MY COMMISSION EXPIRES____t1-fd~Z-----.----
DATE_______~:7~1U~~~-------------------
~~~~~~C~~R~~~-----
MY COMMISSION EXPIRES__~~}~----
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APPLICATION FOR PERMIT
CITY OFZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT
MilBar Construction, Inc.
OWNER
1719 Hwy 301 North, Dade City, FL 33525
Reginald Simmons, M.D.
PHONE 904/567-6047
ADDRESS
JOB LOCATION 38193 Medical Center Avenue, Z-hills LOT SIZE_____X
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I. D. f~
WORK PROPOSED:____New Construction ----Addition ____Alteration ____Repair ____Install
____Sign/Temp.
_Sign
_~love
____Demolish
PROPOSED USE: _Single Family
_M/F
_# of Units
.____~1/ H
____Commercial
_Indust.
_Swim. Pool
Other
_Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Fee t,
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 FORl'lS.**
**COPY OF CONTRACT REQUIRED.
PERMTTS REQUESTED
~UILDING
$ Z~':J7. 34-
,
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
_____H.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
____PLUMBHfG
....
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ____Block
____Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
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CONTRACTOR SECTION
Company
State Cert. or Regist. #
City License Registration ~fr
******************************************
BUILDER
Signature
ELECTRTr.TAN
Company
State Cert. or Regist. iF
City License Registration #
******************************************
Si!!nature
Signature
Company
State Cert. or.Regist. 0
City License Registration iF
******************************************
PLUMBER
Signature
Company
State Cert. or Regist. 0
City License Registration 0
******************************************
MECHANICAL
Signature
~
..-. ~~y~
Company MilBar Construction, Inc.
State Cert. or Regis t. i; RC 0055215
City License Registration if 37
OTHER
APPLICATION APPROVED BY *'L:J~~~***.**'~.*.*****'*'* PEllilIT OFFICER.