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Home My WebLink About91-1674 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 PermitN~ 1674 - 'rn Type of Permit 71NG 0RICAL Property Owners Name: _.~ Job Address: ",-5 ~ t) ? ~~ING ~tvvl 1/7''!j~ Date2-d0-tj / Legal Description: Sub,Div, Lot Blk. Zoning CI: Description of Work trlc/ ~;/-- / Energy Code Readout: c~?~ Complete Plans, Specifications and Fee Must Accompany Application Fee: ~5e.P 9- ~S ()~fr. SIGNATUR4~'^ ~1 ~ COMPANY ADDRESS TELEPHONE # -iI Estimated Cost: ;;:>d '-II], I .:) All work shal! be performed in accordance with the above and all City Codes and Ordinances, fi;,4(Jn/M( J: 11/, OCCUPATIONAL LICENSE # 9/ ~~-:-) Breakers Ducts Insl. Compressor Final BlJ~U E~L ---- Tp.Serv, Rough In Meter Can Const. Pole Pool Pre-Meter Final Ftr. Pre SLB Lintel FRM. Insul.CL WL Driveway Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of 'I.. [I] i ~) dollars shall be made for each IMfJ.T'rd-k (j ,5: tJ7J) (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, APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT /,. l. P;J ./ f} R..~ ::::55 ~~:O ~ D~!:~ JOB LOCATION '2 l.(/J ~ r hi '{ & LEGAL DESCRIPTION: LOT (S) 7, ~ " ,IJ 'B ()Pk.. I fI1/ p~ O{; '1-1- PHONE f//J '- 7 Y2. -/ )t/o KCtll"r LOT SIZE_X BLOCK ~c> SUBDIVISION AREA SQ.FT, PARCEL I.D.4F -A-Repair _Install WORK PROPOSED:_New Construction _Addition _Alteration _Sign/Temp. PROPOSED USE: ~Single Family _Sign _Move _Demolish _M/F ..-L-# of Units __M/H _Commercial _Indust. _Swim, Pool Other _Restaurant & Health Department Approval BUILDING SIZE: -X-, 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 _BUILDING $ Valuation of Total Construction _ELECTRICAL AMP Service Florida Power Corp. _W.R.E.C. _MECHANICAL $ Valuation of Mechanical Installation _PLUMBING .' GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block _Frame ____Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration # ****************************************** BUILDER Signature SiQIlature Company State Cert. or Regist. # City License Registration # ****************************************** ELECTRTCIAN Company State Cert. or Regist. # City License Registration # ****************************************** PLUMBER Signature Company State Cert. or Regist, # City License Registration # ****************************************** MECHANICAL Signature OTHER ~ / Company 1ft / (i'<o. <J Tf(. L S. t.J L 7117 /) H /J _ State Cert. or Regist, 4F C AC. 0 3.,r'l cjL. 5 ignature - ".Jn1 g-7\...iv v ~ Ci ty License Regis tra Cion iI "~~L:~""""""':~"*""""* APPLICATION APPROVED BY ~~' PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject to "deed restrictions' which lay be lore restrictive than City regulations. The undersigned assules responsibility for cOlpliance with any appllcable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES , If the owner has hired a contractor or contractors to undertake work, they lay 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 lay be cited for a lisde.eanor 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 Departlent, 1813} 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 the 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 - Ho.eowner's Protection Guide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the "owner", I certify that I have obtained a copy of the above described doculent and promise in good faith to deliver it to the .owner. prior to cOllence.ent. 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 co.pliance with all applicable laws regulating construction, zoning, and land develop.ent. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation has co..enced prior to issuance of a perlit and that all work 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 governlental agencies lay apply to the intended work, and that it is IY responsibility to identify what actions I lust take to be in compliance. Such agencies include bllt ale not li.ited to: f I Departleflt of EnvirDnlenlSl ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive lands, Water/Wastewater Treat.ent * Southwest Florida Water ManaQelent District - Wells, Cypres~ Bayheads, Wetland Areas, Altering Watercourses I Ar.y Corps of EnQineers - Seawalls, Docks, Navigable Waterways I Depart.ent of Health ~ Rehabilitative Services. Environ.ental Health Unit - Wells, Wastewater Treateent. Septic Tanks I US Environ.ental Protection AQency - Asbestos abateeent I .1 ~ I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.', it is understood that a drainage plan addressing a 'colpensating volute" Hill be sub.itted which is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A perlit 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 fro. thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued ~haJl becole invalid unless the work authorized by such perlit is co..enced within six months of issuance, or if work authoflzed by the per.it is suspended or abandoned for a period of six lonths after the tile the work is co.menced. One 90 day e~t~nsiOIl of tile, aay 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 lust be logged during ~ach six month period, or the project will be consider~d abaiidoned. 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 _A_N_D_ ;_P_OO_~~____A__I_IN_O_TICE OF COMMENCEMENT". SIGNATURE ~~ SIGNATUR~~:~~_____ AGENT CO~TJACT DATE____________:7~ _~ _ MY COMMISSION-:::::::~~~~~~;~~~~~ MY COMMI EXPIRES SERVICE INVOICE _jIIr \.NI,nOl ::>>ys1eITIS Southwest Inc. SP No. 50~97 FORT LAUDERDALE 500 s.w, 21st TERR. B 103 FORT LAUDERDALE. FL 33312 DADE: 621-8412 BROWARD: 791-560S BOCA RATON: 368-1799 WEST PALM BEACH 1387 N, KILUAN LAKE PARK. FL 33403 PALM BCH.: 845-1407 MARTIN: 283-9459 ST, LUCIE: 461-0278 WORK TO BE DONE ./\ /\.1\ 1/\ 01/1'1 /1. SOURCE C~T OrY. ~".--~ - ~ Ll--/ (: , I r~M ......, ~./___ -/' . / Lr I" ~ _.i /-- / "'-- - . . /'.~ -- ~ ~ ,~":-// r~. ....-- -' ~-~.c"' ~~ L _.-~ v-c.... r~ - _ - LZ. ~V'/ j ~ - -/J//2 --/~.'---J -~./_- -- ..: --~.... _/ ~ Z-~. ~~L. I A,,~. . , CORPORATE OFFICE 62BO ARC WAY. FORT MYERS. FL 33912 FL WATS: 1 (BOO) 432-5562 FORT MYERS 6280 ARC WAY FT. MYERS, FL 33912 CHARLOTTE: 639-6858 LEE: 275-8720 COLLIER: 597-1890 PRICE ~ .- ~- L ~ L-~7 .~ TAMPA ST, PETERSBURG 10820 - B 75th ST, N, LARGO. FL 34647 CLEARWATER: 541-7600 TAMPA: 225-1379 PASCO 845-1212 LAKELAND 687 -0395 CUS~.- STATE CERTIFIED CACO 35496 .. DATE 7.- /6 ~ J~r7n S~E~..., 7 / / ,., 7J,~ P7N;p:;2. -J urn -- BILL TO NAME STREET CITY PHONE STATE ZIP _ .A /! _() .- .A6'-~ ~~-r- __ ,,/. ~ ~v / ~'r- T~/~ a-/.- - r~' I~/'~' rR a 7~ , - ..-- MAKE V MODEL SERIAL NUMBER iL:.. / JJ co/ g lJ.LJ.. h1J <'" J7<"69h1. '" / -~" DO . DESCRIPTION OF WOR/1 ERFORMED .-./Z ~--~ /"\/ /' J~~ ~ /I f(__~- ---'/ , V/.n.I< 'AT;" 11/.... / / j/... ? r ..7 IF YOU ARE SATISFIED WITH THE SERVICE YOU RECEIVED TODAY TELL A FRIEND, IF NOT PLEASE TELL US, ~;g- I~ ..;' .A~ - - .... .- ~ /7 _./...-..... ....L _ ~ - A .. /..;-_ ~ _~ -~~ /J _ ~~7ff jp~ -~-7 __, -T../ /. -.....1..' - ~..- l ~ , I /) A ",,/. J ^ ~ .4 ',- /1 .~ rllfI7 ~ ' TRAVEL TIME: TO FROM TIME ARRIVED TIME ARRIVED L4-;;;tJ I fj 6,}.. TIME DEPARTED TIME DEPARTED SERVICE PARTS SERVICE LABOR CUSTOMER DISCOUNT TOTAL CHARGE DEPOSIT BALANCE DUE $ ~ _.i__'-~ .,/ /"7_ ./- /'./ /./ .7 r PLEASE PAY FROM THIS INVOICE RV /I' TERMS: NET DUE ON COMPLETION . en :~~l::~a:. subl8Ct to a Finance Charge of ,-, /2% per month, Annual Percentage Rate of 18% which .s -c It is agreed and understood by the panie. that all equipment and pans ,Which ar. sold pursuant hereto shall. NOT z: become f1JC1ur.. or pan of the real .stale where they ar. pieced. Sa.d pans and equipment shall at all time. 0 remain persona' property and the title thereto shall remain in the seUer until payment in full is received. Buyer. hereby agrees that all pans and equipment may be reposs.esled In the event of non-payment. Se. revers. Side for warranty and instructions. I ha"e authonty to ord.r~h. work UHiO: above. I agr.., 10 pay all costs and reasonable anarney's fee. ., this (J1 lnVOICClJ;lS aced In the hand. n attorne for collection. c:=> - -......) ~ ~lT f :/' ~ $ ~1 '/1. I ~ fiXAN~T::'(/ Y IY /J/J/V ~ $ ~SfO . :::y~ IZ CARD , NO, EXP. DATE EJ