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Home My WebLink About91-1813 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 Permit N'~ 1813/1 Type of Permit Date 5">-30- '71 ---I::WIL61t~C PL~ ~A~V Properly Owners Name: ~ d~ ~:;I~ Job Address: ~ - / ;z;( Legal DescriPtrb~~ ' Sub.Div. Lot ~~. Blk. Zoning CI: Description of Work -A;/ c (7kr ".J Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Application Estimated Cost: ~;l f.s-- o-v Fee: SIGNATURE COMPANY ADDRESS TELEPHONE # All work shall be performed in accordance with the above and all City Codes and Ordinances, OCCUPATIONAL LICENSE # ~ ---~. . ~ ---..... ~AL ~, @~~r 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 ten ($10.00) 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. APPLICATION FOR PERMIT CITY OFZEPHYRHILLS BUILDING DEPARTMENT APPLICANT J; /IN#' ~.ek4/ / 7~ ' ~ /~ sT ;?-#,L/ ~~~// T* ~ /~ S-/ z- ,~L ;?e///y/C' ~-ee PHONE ~?,-.3~d.R JOB LOCATION 1//;2.. ,J; ,HWAI /1/2- LOT SIZE_X AREA SQ. FT. ADDRESS OWNER LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D. t~ //--02~-,~/- 00/0 '- CJ6000 .,-tJ/3/ /3 WORK PROPOSED:____New Construction ____Addition ----Alteration ~Repair ____Install ____Sign/Temp. _Sign _Hove ____Demolish PROPOSED USE: ____Single Family _M/F _t~ of lTni ts .____1-1/ II _Commercial ~Indust, _Swim: .1'001 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.** COMl-IERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORl-IS. ** **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED _BUILDING $ Valuation of Total Construction _ELECTRICAL -K-MECHANICAL AMP Service /Olg',b" 03 Florida Power Corp. _W.R.E.C. $ Valuation of Mechanical Installation _PLUMBIN'G GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Frame _Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** Signature CONTRACTOR SECTION Company State Cert. or Regist. 0 City License Registration ~fr ****************************************** BUILDER ELECTRTCTAN~- ~,~~Q.\ Q.I....~ .., ' Company L -' \A.\\...\.....!; El....0c..-...... ~ State Cert. or Regist. il <:=0 :2,.l(.,'?' Signature ' .' "",' City License Registration;) LO - ,,**************************************** Signature Company State Cert. or Regist. # City License Registration j~ ****************************************** PLUMBER MECHANICAL .:Ji//AI r /(/l/lf/e-.V ,', Company ;?e~//Y~ ~/ee ~ ~ / State Cert. or Regist. " .M&otG.t?6Z,O Signature /' ' City License Registration ;'~ ?? , . ... *~****' *......**...**...,.,J,J,J..,.J.....cJ.J.J..CJ.J..,.J- .... ... .. ........ n n.' .' .. .. .. .. .. .- .. .... .. .. .. .. PTHER Signature Company State Cert. or Regist. 0 City License Registration r APPLICATION APPROVED BY ~;;~.::~..~~~.;;:~**.~****<**:.*** PERl-lIT OFFICER. CONDIT.IONS OF PERMIT AFFIDAVIT A.', NOTICE OF DEED RESTRICTIONS:, , The undersign~d understinds that this perlit lay be subject to "d~ed restrictiDns' which ~ay b~ &ore restrictive than City regulations. The undersigned nsules responslbi1i~.Y.for co.pliance with any applicabl~ deed restrictions. ;\', 8. UNLICENSED CONTRACTORS AND tON TRACTOR RESPONSIBILITIES If the OHner has hired a contractor or contractors to undertake work, they may b~ requireq to be licensed in accordance lIith stAh and local regulatiDns. If the contractor 11 not licens~d as re,quired by lall, be,th the oltner and- contractc,r ~ay be cited for a misdeaeanor violation under state 1all. , If the owner or intended contracior are uncertain as to what licensing requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departeent, (BI3) 7BB-6611. Furtheraore, if the owner has hired a contractor or contractors, he is advised to have the contractorls) sign portions Df the 'Contractor Sections. of this application for which they will be responsible. If you, as the ollner sign as the contractor, you are indicating that youj'rather than the contractor, are responsible for the work. If the contractor lIishes you to sign as contractor that aay 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 providedllith a copy of .Florida's Construction Lien Law - HomeoHner's Protection Guide. prepared by the Florida Departaent of Agriculture and Consumer Affairs. If the applicant is SOIEone other than the .ollner., I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the .0Hner' prior to cOimencement. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the information in this application is accurate and that all wort "ill be done in co~pliance with all applicable lalls regulating construction, zoning, and land development. Application is hereby lade to obtain a per.it to do lIork and installation as indicated. I certify that no work or installation has com!enced prior to issuance of a permit and that all wort will be performEd to roeet standards of all lalls regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other governmental agenciei may apply to the intended \tork, and that it is my responsibility tc. identify what actions I lust take to be in ce.mpliance. Stich agencies include bllt ~ie IiC,t li.lited to: I Department of Envitonoental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensi tive lands, Water/Wastellater Treatment I Southwest Florida Hater ManaQe!ent District - Wells, Cypress Bayheads, Hetland ~reas, Altering Hatercourses I Army Coros of Enoineers - Seawalls, Docks, Navigable Haterways I Department e,f Health ~ Rehabilitative Services, Environ~lental Health Unit - (Jells, Ilasteliater Treahten~. Septic Tanks I US Environoental Protection ~Qency - Asbestos abatement I alse. certify that, if fill material is to be used in Flood Ze,ne .~. or "A,etc.', it is underste,e,d tl.,t a drainage plan addressing a 'colpensating volu~e' will be subMitted which is prepared by a professional engineer registered in the State of Florida prior to permit iss~ance. \ A per.it issued shall be construed to be a license to proceed with the work and nDt as authDrity to yiol~te, cancel alter, or set aside any provisions e.f the technical codes, nor shall issuance of a permit prevent the Building Official frol thereafter requiring a correction e.f errcors in plans, construction, [,r violations of any cc.de. Every permit isslIl!d :;hall bece..e invalid unless the work authori2ed by such perlit is com~enced within six months of issuance, or if work authDrlied by the per.it is suspended or abandoned for a period of six lonths after the time the Hork is co~mrinced. One 90 day e=tE~sjoll of tile, aay be allowed for the per~it with fee charge of $15.00. The extension shall be requested in Mriting to the Building Official. An approved inspectie,n l!Iust be le,ggedduring each six Mnth period, or the pre,jr:ct \'lill be cc,nsidl?red dbaiidoned. 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 NO~ICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND pOST A II NOT I CE OF COMMENZ' " . . " ~A SI;;NATURE-------aE~ii"A~~~--- SIGNATURE -- CONTR?c'~~--- nATE______________________J?~~i---------- DATE_____________~~~.(------------ ~~~~~y O~S A~~NT _/l~-~4-------- ~g~~~;C~~R:~J?~-~-------" MY COMMISSION EXPIRES NotarYPUUii\; ----~mmfiH~T~------- '; i;ommission Expires Dec. 20, 1991 MY COM~1ISSIO~j EXPIRES NotarvP'" - - r.:C:1-.....!JI...u:.---------- SWill o. flarida at Larae .iy Commission Expires Dec.20.199J ... ~ " ... ~>----------- ,-~ Lie # RAB05084 CONTRACT ZEPHYR ~IRE P.O. Box 1243 · Zephyrhills, FL 33539 (813) 788-6284 Contract Su~mitted To} ;:) " / , I Phone (office) I Phone (home) I Date " II'. /hll.l// L/ /'J /? ' II( /0/ .;;;,t; 7- ~:? i- t, l 9- 19-?' ~,,;? / Street ( I,.l/.l- -- Job Name 0 -.'j, I ,Ai-; ';/ 'r:s:.~" ,,/.,/ /",7 ,...:;.' ~ ,,' // ,- /1 /4 './ City, State and Zip Code 1. I Job Coeat'iori' "- / .,-/j- / /7 l-;'" ,1:" ' -7" '" ,. " i r-; l~Vu .,/,: .z C..-/--',jl....';:t-// 1/'.".5 f/- I _ t" ~ ,We h~r:~by Submit to fu.!~iSh mateJiaJ and la~or - come!ete in ~ccorda.nc~ with specifications I~~IO~. f~r tt1~$um of: ! ," 1'h ,'" 'i) ;I,c::. /l A,./(JR "2) Z,{A ...../' /t" I "'2 x;:; ,,- .. /1.,... ,/ L)/,.,' :5,./ N" / ti, ,'I' ~ r'.: /,r." t..r ." / Y dollars ($ - I ,..,..1 ). Including Tax. Payment to be made as follows: 7 , , 40% upon acceptance of contract, 60% upon completion /,~) Cl ;/; // . /, ,/ / I t ( " /</;':-'/," .1'" /.~ ,-t- " All material is guaranteed to be as specified, All work to be completed in a workmanlike manner accord. Authorized ,~>;;::t:/ '?"_.~ ""., ,-../. J /' ,/. ing to standard practices, Any alteration or deViation from specifications below Involving extra costs will Signature , . " Z',. I/' .. t.)-?/ be executed only upon written orders, and will become an extra charge over and above the estimate, All Note: This contract may be agreements ~ontingent upon strikes, accidents or delays beyond our control. 1-;"') withdrawn by us if not accepted within i~1.., days, We hereby submit: ,{I #~ ,: ",' '? /~';...v .//~>;,~/kC /,' . /~. ,..t-''c?'/X' {,A//.1/C.. ",/' /f'&,v ~' .'/ ,i-t. "Ii" Equipment Model No. Tonnage S.E.E.R. C.O.P. H.S.P.F. , ; T" ';,'.'7;:) "/";/ / t,'.J [) 23).';[ " // So ~.J #. "'" ". " f. ; "--- 1..1 ..,,' 1.../ l{"/./ t.:' ,;? ;..; L.1 '" .l...i'L,) ,":>'J y' ,- /, 7-:;t' /' ..-' i.. J''';''''-/ ~-' ,'...J.b C'/\-' Y<'./ r; f / 'l' /6 Duct Work Metal Y..... 5 GA. Duct Board #475 Yc" ..s #800 ~ (-' - _.~' I . ." I No. of Supply Diffuser "r" )< / ~:' ; ~"v' c"' No. of Return Grilles /- ~'1:::7"'/MC Electrical Incl. Yr>s Not Incl. Sub Contractor Insulation R. Value A./~ Sq. Ft. Sub Contractor /1/ (.) / ~ Pre-Hung Door Attic Ladder ,/lIci Walkway I .... . L ' /J !. . .-" /..;1 /J II " /;.:- ./) '/~- ~ /~'..ve /':;'A/(: ( t. A/ 'fJi:~ r 7' f" .,~//';;""7 '7,) /(/ ,,.c. A'--;"t/ ",r "L' .4/ {.-'?,4,/L./--A./!.~ /117',<> ,l'/,t/'p (.9.0'.4~ / . Warranty: No. of Year(s) on Parts and Labor t:.!# e No. of Years on Outdoor Coil .J::, I/e No. of Years on Indoor Coil ;::; ve No. of Years on Compressor /7 r/e Comments: "" Acceptance of Contract - The above prices. specifi- ' ;; ,/.....-:; ., I , ,I' i, cations and conditions are satisfactory and are hereby Signature /,') ,,1~/ft/ .' . .'-r,'J 'T, I l " ,( .-<./ l.- i l (/ "'j,' - '-- .. accepted. You are authorized to do the work as specified. Payment will be made as outlined above, Date of Acceptance: Signature