HomeMy WebLinkAbout91-1740
STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
Permit N~
1740//
Type of Permit
D- ..")
Date :1 -5 0 - r /
- ,
~AL PL~ ~~
~::P:;:r~:~ers;;e~ '1 ~~~!J;\ A fs L:~
BUILOING----
Legal Description:
Sub.Div.
Lot
Blk.
Zoning CI: .
Description of Work -A-/ (
(~ClJ rf e ~ ~~
Energy Code Readout: ~ q )
rrT~ ~ 1D~ '
Complele Plans, Speciflcallons and Fee Must Accompany Applicalion P
Estimated Cost: 37 c;-z;. v-----C
.'
OCCUPATIONAL LICENSE #/[,.J.1/:-- ~'Yri~.
Fee: ,_?~--' d'Li
SIGNATUREB ~u.. ~~c.S;L
COMPANY
ADDRESS
TELEPHONE #
1
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
ELE~L
Tp.Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
?yr: ~/jA
( MECHANICAL / '
-----~.__. .--
.~-
Ftr.
Pre SLB
Lintel
FRM.
Insul.CL
WL
Breakers
Ducts Insl.
Compressor
Final
Driveway
Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of I )
dollars shall be made for each JIIip."7Ya- d. e. ( /<6--: cJ7J )
(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 shalI be made before any further permits wilI be issued to the person owning same.
APPLICATION FOR PERI-lIT
CITY OF ZEPIIYRHILLS
BUILDING DEPARTHENT
ADDRESS
OWNER Cd L; b'
JOB LOCATIONSI '30 rI GALe . 8t.-tJ \).#
(~LPIIONE3m ~:S9b~39rf"'
APPLICANT
~.
LOT SIZE_X
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S) BLOCK
SUBDIVISION
PARCEL 1. D. ~~
WORK PROPOSED:____New Construction ~Addition _Alteration ~Repair ____Install
____Sign/Temp.
_Sign
_Hove
____Demolish
PROPOSED USE: ____Single Family
~M/F
____~~ of lTni ts
, ._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 nUILDING PLANS & (1) SET ENERGY FORMS.**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORHS. **
**COPY OF CONTRACT REQUIRED.
PERMITS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
~MECHANICAL
AMP Service Florida Power Corp.
$ ~ 7 00 Valuation of Mechanical Installation
\-l.R.E.C.
...
. . .
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ____Block
_Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
Signature
CONTRACTOR SECTION
Company
State Cert. or Regist. #
City License Registration #
******************************************
BUILDER
SiC'Ynature
Company
State Cert. or Regist. n
City License Registration n
******************************************
ELECTRTCTAN
Signature
Company
State Cert. or Regist. 0
City License Registration n
******************************************
. PUJMRER
MECHANICAl c/ Company
(')[\ (,\/-C ') * State Cert. or Regist. ii
Signature K:M..u. ~ ~CL. . City License Registration i!
*..... .......................****.******.
If');:;),
OTHER
Signature
Company
State Cert. or Regist. n
City License Registration n
APPLICATION APPROVED BY
******************************************
11 ,::.l:./h...f'.--01 A1 ' Q/)AJ'I/f)
\j
PERl'lIT OFFICER.
CONDITIONS,Op,PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Th~ .und~rsign~d und~rstands that this per.lt .ay be sub3ect to "deed restrlctl~ns' which ~ay be ~ore restr.ictive than City
regulations. The undersigned aSSullles responsibiHt{~.~or,co.p1iance with any applicable deed restrictions.
'.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor Dr contractors to undertake wor~, .they lay be required to be licensed in accordance with
state and local r~gulatlon5. 11 the contractor Is not licensed as required by law, both the o"ner and contractor nay be
cited for a lisdeaeanor violation under state laH.. If the owner or Intended contractor are uncertain as to what licensing
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713a-6611.
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'Contractor Sections' 01 this application for Hhlch they will be responsible. If Y~U, as the Dwner sign as the contractor,
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City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D.
CONSTRUCTION LIEN LAW
(CHAPTER 713? FLORIDA STATUTES, AS AMENDED)
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'owner' prior tD COI~encement.
: ~, ': ':~~. ... ' ; :
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
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applicable laws regulating construction, zDning, and land developcen~.
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Water IWastewater 1reahent
. Southwest Florida Water. ManaQelent District - Wells; Cypress Bayheads, Hetland ~reas, Altering HatercvUfses
I ArlY C~rps ~f EnQineers - SeaHalls, Docks, Navigable Waterways
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I US EnvironDen~al Protection AQenct - Asbestos abatement
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FIDrida priDr to permit issuance.
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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. JOOS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNAT.U~~..~-----
I)~-- - m.fNER OR ~NT
DATEJ:f:Zurc-b..Lf-fL-----.-------
NOTARY AS TO - ~
OWNER OR AGENT .~~~---
, ",_",.,. ;";'~.:,'~:".,~, S':/\;[ ,~-::7 ;~~L_O::~!i-O;r\
MY COMMISSION EXP1R~S~~~~~~~~~~~i~~~~--
."'.,,.' '_,n~J I dH~ Nt:lyARY PUBL.IC _UNOER"'VRITERS~'
DATE_~-~~~J'~-----------
~g~~~~C~~R~~-~--
MY COMMISSION EXPIRES__________________
, ",,_, ...... ::"~ yv~: .~
".,11-.,':; ,0;-'; J~_-<l::;:~::S: ii'J\i. 2'7. 199!a
l t-l 1-< \J N.~fi\ay PUO:_IC LN8Eh:VVRITERS..I
i'
€A S~"-
)iJ.....D .21'" ~;;'7"
\;ft....l ,....
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[\10
CARBON
REQUIRED
II""!\ M r'p'.'!l ~ ~ "" ~.
,'" --\.- '!fI;- ,.- ...: --r...."...
CARBON LESS
FORM 3850
TI'JII':tTE
PROPOSAL
. ,
No. i':; I ...~
Accurar,(;l Air
1o~G4 Rol1inu oahs Dr.
Hudson, pl. 34bb7
Date
l)-,--- i..11
Sheet No.
Proposal Submitted To:
1-bOO-741-7071
Work To Be Performed At:
Nam8
Street
City
State
Phone
Golden corral
':e,t..brj hills, Fl.
Street
City
Date of Plans
Architect
State
We hereby propose to furnish the materials and perform the labor necessary for the completion of
change out existing Bard Ston 3vbas~ units as follows:
,
S each with 2 new sU,tJpliestoipenetrate roof' (penetration done by other)
1 new sUJ!iJly ran exvosed in Kitchen to hell'> cool recessed area in dinin
room. price $14,~~O.OO 1/~ oh ec~uipment delivered to Job site 1/~ on
net 1;., daJ's.
J each with same conditi,ons as above.
1 each with same.conditions.
-
pric~ $9,1'7'>.00
price $3,700.00 Net 1S day~
l
3 units we will clean remaing ..and try to rej,Jair leaK for
J .'
1 unit we will clean remaining and tr.y to reL-'air leaK. for
I,
I I
, ,
New unit have a 1year parts and labor, ~xtended 4 years on ~ompressor.
..
All material is guaranteed to be as specified, and the ~bove work to be performed in accordance with the drawings and
:,pecifications submitted for above work and completed in a substantial workmanlike manner for the sum of
Dollars [$ J.
Should we
unit.
cbanging
$240.00.
cnanging
$400 . OU. ,
change 5 units we will clean and try to rej,Jair leaK in 6th
with payments to be made as follows:
.-+~
..,~
-I-
Any alteration or deviation from above specifications involving extra
costs. will be executed only upon written orders, and will become an
llxtra charge over and ebove the estimate. All agreements contingent
lIpon strikes, accidents or delays beyond our control. Owner to carry
fire, tornado and other necessary insuranca upon abova work. Work,-
men's Compensation and Public Liability Insurance on above work to be
taken out by
/%..
Respectfully sUbmit~ ..
~----~
. -- =--:=-~~
Per
Note- This proposal may be withdrawn by us if not accepted
within . days.
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified.
Payment will be made as outlined above.
Signature
Date
t} ( (>~
. (.c?v V
7.6:.~e' c'_.______.
Signature