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Home My WebLink About91-1738 STATE OF FLORIDA City of Zephyrhills Type of Permit ~ PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 -!2...r Permit N~ 1738 Date ? - ~ 9 - 9 / ~AL ~ MECHANICAL Property Owners Name: Job Address: S 3l~ ii a1k--- 3~~ Legal Description: Sub.Div. Lot Blk. Zoning CI: Description of Work ~- t:!k~;~ ~ .IdJ~flo-9/ Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Application Estimated Cost: #;?~~ CJ OCCUPATIONAL LICENSE # #- L iI. GJO Fee" ~S-- SIG~ATUR~~ COMPANY~_____ _________~ ADDRESS TELEPHONE # All work shal! be performed in accordance with the above and all City Codes and Ordinances. BlJILD~G , PLUMB~ ,/ ELEC~AL " ~~4~ MECHANICAL ~ Ftr. Pre SLB Lintel FRM. Insul.CL WL SLB Tub Set Water Sewer Final Tp.Serv. Rough In Meter Can Const. Pole Pool Pre-Meter Final Breakers Ducts Insl. Compressor Final Driveway Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of .1 .1) (/6-' d?J ) .. 'rupuliul Page No. of Pages .." .,,(' , . ~ , " sc~npt's D!SCO!JNT APPLIANCES, !NC. 3399 South HIghway 301 DADE CITY, FLORiDA 33525 (904) 567-6224 "\ PHONE DATE S?~"'?Or 0/ /,:1"'-' /, STREET m..,. ,/' ... /' . - ' JOB NAME CITY. JOB LOCATION ARCHITE DATE OF PLANS JOB PHONE We hereby submit speclflcatl?ns and estlf1;.?Jes for. / ' ;i ./~;,./ .~A~~.-~.bV~"- /,1C~R 3 () - ,1kVa.~/ / 1/ / ,Jif (; J ~ - ~~~y --; I / ""' // ,.t ,Ji.. /'.J. ,;) 3;;1f. O? 0 - c.-J7 "c.:JAtA---c>t...-" u{d..,/j) <l~~,r ./ ,/ :-- li.r! 1.1. M /1 A.ft. . '-4.. :' .,:~/ 1~::tPJ' :/~ / / /' // /. / ,. ;.) /:.- ,/ /-- 07 /1/: ~ \..{p) '0. ~~-&/ !I.J~:-9/ ~/ ..----c7';2- r jti7,25. / //. .' .'-l , -liZ::/,A, :!:d '/~1 /L;~ /L..' .fCU- l./' ." ...- /7) mr 'roponr hereby to furnish material and labor - complete in accordance with above specifications, for the sum of: Payment to be made as follows: 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. Authorized. /~- /~. 1~.' . , . Signature ( / , ., ----- , 1/ . . Note: This proposal may be V V withdrawn by us if not accepted within days. Attrptuutr nf Jlrnpnsul- The above prices, specifications . ( and conditions are satisfactory and are hereby accepted. You are authorized Signature to do the work as specified. paym. ent will be made. as outlined abOVje. v--- ') I.f' - elf' s Date of Acceptance:') - c7" . ignature I.... I , \ ..r~ ./ PRODUCT 118.] (iVCiiS)"IOC" Grolon, Mass. 0]47], To Order PHONE TOlL FREE 1+800-225.6380 ( . APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT I JOB LOCAT LEGAL.- DE6~;TION: LOT (S ) LoT SIZE X AREA SQ. FT. APPLICANT ADDRESS OWNER BLOCK SUBDIVISION . ~~'JljP.-C~ r~ WORK PROPOSED:____New Construction ----Addition ----Alteration ____Repair ____Install~ PARCEL I.D.f~ ____Sign/Temp. ____Sign _Move' ____Demolish PROPOSED USE: ____Single Family ~/F ____# of Units ----H/H ____Commercial ____Indust. ____Swim. Pool Other ____Restaurant & Health Department Approval BUILDING SIZE: x Square Fee t , Height RESIDENTIAL: ATTACH (2) PLoT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FoRMS.** COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** **COPY OF CoNTRACT REQ~ED. '. PERMITS REQUESTED ____BUILDING $ Valuation of Total Construction ____ELECTRICAL b"ECHANICAL AMP Service Florida Power Corp. $ 17b 1''':" 8' 7 Valuation of Mechanical Installation , W.R.E.C. ____PLUMBUfG GAS RoOFING SPECIALTY TYPE OF CoNSTRUCTION: ____Block ____Frame ____Steel other FINISHED FLOoR ELEVATIONS: FT. ****************************************** CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration # ****************************************** B1JILDER Signature ET.F.CTRTC1AN Company State Cert. or Regist. # City License Registration # ****************************************** Sirmature Company State Cert. or Regist. # City License Registration # ****************************************** PL1JMBER Signature Signature '1.. ~ Compan~ -. - ~ State Cert. Regist. f~ - - ~ City License Registration II . * *** ********************************** J3j";J.j MECHAN1CAL ... Company State Cert. or Regist. # City License Registration # Signature APPLICATION APPROVED BY PERMIT OFFICER. .. ..r CONDITIONS OF .PERMIT.AFFIDAVIT, A. NOTICE OF DEED RESTRICTIONS :';', ' Th~ und~r5ign~d und~rstinds that this p~r.it .ay bl subject to -deed restrictions' whicR' .ay be .ore r~s~rictive than City regulations. Th~ und~tsigned USIl.!! reil'ons1bill\Y.'7f.~~ co.pllanc, with any applicab}e_~~~~,. restrictions. . - . . .; -, ' B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they .ay be required to be licensed in accordanc~ with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor .ay be cited for a .isde.eanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requir!.~~ay apply for the intended work, they are advised to contact the City of Zephyrhills Building Depart.ent, IBI3) 7BIf -bb 1 1. Further.ore, if the owner has hired a contractor Dr contractors, he is advised to have the contractor Is) sign portions of th~ 'Contractor S~ctions' of this application for which they will be responsible. If you, as the own~r sign as th~ contractor, you are indicating that you, rather than th~ contrattor, are responsibl, for th~ work. If th~ contractor wishes you to sign as contractor that .ay b~ an indication that he is not properly lic~nsed and is not entitled to per.itting privil~ges 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, th~ applicant, have be~n provided with a copy of 'Florida's Construction Lien Law - Ho.eowner's Protection Guide- pr~pared by th~ Florida Depart.ent of Agricultllre and Consu.er Affairs. If the applicant is so.eone oth~r than the 'owner', I c~rtify that I hav~ obtained a copy of the above described docu.ent and pro.ise in gobd faith to deliver it to th~ 'owner' prior to co..ence.ent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT . I certify that all the infor.ation 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 .ade to obtain a per.it to do work and installation as indicated. I certify that no work or installation has co..enced prior to issuance of a per.it and that all work will be perfor.ed to .eet standards of all laws regulating construction, City cod~s, zoning regulations, and land develop.ent regulations in the jurisdiction. 1 also certify that I understand that the regulations of other govern.ental agencies .ay apply to the intended work, and that it is IY responsibility to identify what actions 1 .ust take to be in co.pliance. Such ageftelU include b1lt Llle not liiited to: I Depart.ent of Environ.ental ReQulation - Cypress Dayheads, Wetland Areas and Environ.entally Sensitive lands, Water/Wastewater Treat.ent I Southwest Florida Water KanaQe.ent District - Wells, Cypress Dayheads, Wetland Areas, Altering Watercourses I Ar.v Corps of EnQineers - Seawalls, Docks, Navigable Waterways f Depart.ent of Health L Rehabilitative Services. Environ.ental Health Unit - W~lls, Wastewater Tr~at.ent. Septic Tanks I US Environ.ental Protection AQency - Asb~stos abate.ent I also certify that, if fill .aterial is to be used in Flood Zone -A' or 'A,etc.', it is understood that a drainage plan addressing a .co.pensating volu.e' will be sublitted which is prepared by a professional engineer register~d in the State of Florida prior to perlit iss~ance. A per.it 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 per.it prevent the Building Official fro. thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issuud ;hall beco.e invalid unless the work authoril~d by such per.it is co..enced within six lonths of is~uance, or if work authorized by the per.it is susp~nded or abandoned for a period of six .onths after the ti.e the work is cO.lenced, One 90 day extensioll of ti.e, lay be allowed for the permit "ith fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection lust, be logged during each six .onth period, or the project will be considered i!balldoned. 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 ~OST A "NOTICE OF COMME~N EMENT". . SIGNATURE____ _ _L-.J litL~-- SIGNATURE___ ________,~1_~~~--- OWNER OR AG l:) CONTR TOR DATE______~~r~~j_______________________ DATE___________1ij_~~q!______~------ NOTARY AS TO ~~ _ ~ ( OWNER OR AGEN~ - - Net., to Staff of rr 'd MY COMMISSION EXPIREl[f~~~~r.~~~--- ......." Th,,. rro, 'eln I ' 93 . . n'"'anee IIlCo NOTARY AS T~~~ CONTRACTOR . - ----- -ft-fi-rn-~ Co .na eo ona. MY COMMISSION EXPIR~ ommission Expires Nov. 30,19931 -~""""'"rfv","rtm\lml\'rl!i~ , .