HomeMy WebLinkAbout91-1768
STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
PermitN'~
17686
BUILDING DEPARTMENT
1-813-788.6611
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prOperIYOWner:,Na~e:!(T~ /~',u-4T l' }(,.ill ',';r
Job Address: ,) p- / / ~ J1 /';G)~ I ~"
Legal Description: Sub.Div.
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Zoning CI: ,-J -d b - eJ-/ -- 00/ C)
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Description of Work /1)_0 /1" /;l/{:(.~,.~ <.2...
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Energy Code Readout:
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost: ,..:-1 rsu. L77)
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All work shaH be performed in accordance
with the above and all City Codes
and Ordinances,
OCCUPATIONAL LICENSE # II r
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BUILDING '~
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SLB
Tub Set
Water
Sewer
Final
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Pre SLB
Lintel
FRM, '1~f) ..1/
Insul.CL
WL
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Driveway
Fee: 7~ -, ou::
SIGNATURE ~~ .~_ 0, ,.t3~L
COMPANY
ADDRESS
TELEPHONE #
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Tp.Serv.
Rough In 9-/2- -q I
Meter Can
Const. Pole
Pool
Pre-Meter
Final
ICAL
Breakers
Ducts Insl.
Compressor
Final
Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of ten (SIO.OO)
dollars shall be made for each trip.
(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.
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Richard Back Contracting, Inc.
5215 Bernadette Drive
Zephyrhills, FL 33541
(813) 782-7277
Proposal
Page No.
DATE
PROPOSAL SUBMlnED TO
PHONE
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STREET
JOB NAME
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CITY. STATE AND ZIP CODE
JOB LOCATION
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ARCHITECT
We hereby propose 10 lurnish malerials and labor necessary lor the completion 01:
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WE PROPOSE hereby to furnish material and labor - com;:>lete in accordance with above specifications, for the sum of:
I - " .
, .:! " dollars ($ ....e , )
Payment to be m~e ,as fOll,qwsr
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All material Is guaranteed to be as specified, All work to be completed in a sub-
stantial workmanlike manner according to specifications submitted, per standard Authorized
practices. Any alteration or deviation from above specifications involving extra Signature ., .,..
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 Note: This proposal may be
delays beyond our control. Owner to carry fire. tornado and other necessary in-
surance. Our workers are fully covered by Workmen's Compensation Insurance. withdrawn by us if not accepted within days,
ACCEPTANCE OF PROPOSAL The -,' ,
above prices, specifications and condi- ..' / ~, .' " ..
tions are satisfactory and are hereby accepted. You are authorized to do the work /'",/.r/../ , , / , . ,
as specified. Payment will be made as outline above, Signaturlt/ .-",' '" ,,<!' .' , , "i "1, -. -."
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Dat. of Ac"punc.: Signature
APPL'ICAT'ION FOR PERl'lIT
CITY OF ZEPIIYronLLS
BUILDING DEPARTHENT
APPLICANT f2u+,4-f4:) f3~ -a.~~/lJ&- J ~C ,
ADDRESS 3~~7 n..,tt./Oh r2~' '13wD
OWNER Nrlo /l1A1<t:::.6T ~ uA~ }/t;i.:X)frJGS --;So V. ,
.381'"3 " CtAflt:~ ~J.j). SpAeE
JOB LOCATION/i1Ate~T ~U.qIGE. S/Jl>(J(J/1JG LOT SIZE .z~ ~ AREA SQ.FT. 1/70
s.~
LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION t"'!/7 ~F ZGPHlj 12.. JflLL 5
PHONE
7 9i.-1 :1..77
PARCEL 1. D. ~~
WORK PROPOSED:____New Construction ~Addition ~Alteration ~Repair ____Install
:z -:1-& - :l. J - ~e>IO '- (J 39()C .. bO-:LO
____Sign/Temp,
_Sign
_Hove
____Demolish
PROPOSED USE: ~Single Family
Lcommercial
~M/F
____~~ of Units
.._M/H
_Indust,
____Swim., Pool
Other
_Restaurant & Health Department Approval
BUILDING SIZE: 2. 0 X fJJ 0 ,
1170
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 FORl'1S."*
**COPY OF CONTRACT REQUIRED.
~BUILDING
~ELECTRICAL
:PERMTTS REOUESTED
.3~5(), f/7) valuation of Total Construction
$
AMP Service Florida Power Corp.
_H.R.E.C.
_MECHANICAL
-LPLUMBING
$
Valuation of Mechanical Installation
GAS
/BloCk
ROOFING
_Frame ~Steel
SPECIALTY
TYPE OF CONSTRUCTION:
Other
FINISHED FLOOR ELEVATIONS: FT.
.A? ,.cONTRACTOR SE~ON
P\lTT.DF.R-~~ c..ZJ,j~ Company u<fUZP ~ Co_""COAJ6- 1Me.
, State Cert. or Regist. if C-7!:x:r -.' ~:z,"211-f
5 igna ture ~ - ~- Ci ty License ReG' ~ t,.a t ion II / ~ 9
******************************************
******************************************
Signature
t5..l5/"nu c-
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6G
Company
State Cert. or Hegist. D
City License Registration a
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ELECTRTCIAN re~
Si"nature [f..,2 ,;2-
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Company
State Cert. or Regist. ;!
City License Registration D
******************************************
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Signature
Company
State Cert. or Regist. a
City License Registration 0
******************************************
MECHANICAL
Signature
Company
State Cert. or Regist. 0
City License Registration if
OTHER
APPLICATION APPROVED BY
9J;;,' **,** ******,~****** * *, ** * ** 1e-!: i:-:: i: 1, 1: * i: 1: 1e * 1, 1:
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PERl'lIT OFFICER.
CONDITIONS;O~,PERMIT AFFIDAVIT
NOTICE OF DEED RESTRICTIONS
A.
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The,undersigned understands that this per_it .ay bl sublect to 'deed restricti~ns' which ~ay be ~ore restr~ctive than City
regulations. Thl/ undersigned aSSUIU!S responsibi~it1Y~or:,cD.p1iance lIith any applicable deed restrictions.
, '
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a t~ntract~r Dr c~ntrattorl to undertake work, 'they lay be required to be licensed in accordance with
statl/ and local regulations. 'I,f the, c~ntrilctor is not llcennd as require'd by l.w, both tho t'l1nOr and contractor IlaY be
citrd for ~ lisdeleanor violation under state laH., If the tJwMr or intended contractc.r are unc~rtaj~ as to what licensing
requirell!nts laY apply fc,r the intended work, they are advised 'tC cont\ic.t th,e Ci ty c,f Zophyrhi 115 ~ui Iding Departlent 18131
nB-bbll. ' ,', ' '
Furtherlore, if the owner has hired a contractor or contractors, he is advisod to havo tho contr.ctor(sl sign portions of the
'Contractor Sections' of this application for which the, Hill be respDns[ble~ If you, as the owner sign as the contractor,
you are indicating that y~u, rather than the contractor, are rrsponsible 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 per&itting 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 Protection
Guide' prepared by the Florida Depart_ent of Agriculture and Consuler Affairs. If the applicant is S02ec.ne other than the
'~wner', I crftify that I have (,btained a, ccipy of the above described dClculIJent iJnd prorr,is~ in gClod fai th to del iver it to the
"ollner" prior to COI!encement.
: 1, .~ ,:~;,. ': 1 ; :
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inf~rllJation in this applicati~n is accurate and that all work will be done in coapliance with all
applicable laws regulating construction, zoning, and land development.
Application is hereby lade to obtain a perlit to'do work and install~tion as indicated. I certify that no work or
installation has cotlenced prior to issuance of a per.it and that all work will be performed tCI ~eet standards of all laws
regulating construction, City codes, zoning regulati~ns, and land development regulations in the jurisdiction. 1 also
certify that I understand that the regulations of other governmental agencies ~iJY apply'to the intended work, and that it is
my responsibility to identify what actions I lust take to be in compliance. Such agencies ir,clude bill ~l elicIt lillited to:
...
I Departle~t of Envir~nmental ReQulation - Cypress Bayheads, Wetland Areas and EnviTConmentally Sensitiiie lands,
Hater/Wastewater Treatment
f Southwest Florida Hater ManaQl!lent District - Wells; Cypress Bayheads, Hetland Areas, Altering Hatercourses
I ArlY Corps ~f EnQineers - Seawalls, Docks, Navigable Haterways
f Depart.ent of Health ~ Rehabilitative Services. Environmental Health Unit - Hells, IJastewater Treat~en~. Septic Tanks
I US Environaental Protection AQency - Asbestos abatement
1 also certify that, if fill lIaterial is to be used in F1e.od Zc,ne "A" or 'A,etc.', it is understc,c,d \!.~l a drainage plan
addTessing a 'colptnsating volute' will be sub.itted which is prepared by a professional engine~r regist~ied in the State ~f
Florida prior to pertit issuance.
A perlit issued shall be construed to be a license to proceed with the work and not as authority to viColate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit pr~vent the Building Officiol frol thereafter
requiring a cc,rrection e,f errors in plans; constructic.n, or violations of any cod~. Every per~it iSSUed :hall becc'le invalid
unless the lIork authorized by such permit is cOJllenced within six llIonths c,f iss'uanci?, tor if liC<r~; autllc,\ J;:ed by the perlit is
suspended or abandoned for a period of six _onths after the ti'e the H~rk is commenced. One 90 day e:le~5iD\\ of tile, say be
allowed for the permit with fee charge of $15.00. The extension shall be requested in writfng tB the Building Official. An
approved inspectic,n l!Iust be Ic,gged during each six lIonth period, or the project Iii 11 be cc,nsider!?d db';lIdc,ned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENC~MENT 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 "NOTICE OF COMMENCEMENT".
SJGNATUHE_~_~-~--
CONTRACTOR
SIGNATUR~~--#-------
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DA TE ____,_______:JJ-I.-'!..I'.L--;.-------,-------
NOTARY AS TO ./.,/J L, / /J
OWNER OR AGENT_~~~-~-~~~~-
DATE____~~f~~_1_~____________________
NOTARY AS TO /'/1 '-7/ d
CONTRACTOR__~~-.t:-.-~
MY COMM I SS ION EXP I RES Notary Public, State of Florida
-mve~~m~~~'~l~
MY COMM I SS ION EXP I RES_~q!!!.ry..PJJ.buc...Stafa.O~~&r1da
,'v Comm:,s'on Expires Oct. 13. 1992
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M J I< E P R J L L I M A iN ,R.EA L T Y
38//3 M'AR KETSQUARE' DR.
MARKfT SQUAR,E SHO;PPI.NG CENTER
ZEPHYR /-IlL L,S, ,FL. 33540
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