HomeMy WebLinkAbout91-1839
STATE OF FLORIDA
City of Zephyrhills
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Type of Permit dD
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PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
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(MECHANICAL)
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PermitX~ 1839/Jt
Date ;fJ- 1-7/
Property Owners Name: ~ J4';t;;: C('ZfIhi_
Job Address: .. ./ .:2. - e... '
Legal Description:
Sub.Div.
Lot
Blk.
Zoning CI: JI/- d. I- . ~ ~ - f()J C'- ~ o~ t-) 0- ~ /5D ,
", , ti 1.'7 c-' ) --fA .'
Description of Work c---...:;> - ' y . ~..J-.t1 _ ("
Energy Code Readout:
.~
Complete Plans, Specifications and Fee Must Accompany Application
BlJJ.l...DfNG
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Lintel
FRM.
Insul.CL
WL
Feef ~!52- ct;;;1
SIGNATURE ,'11, ,Lv-
COMPANY
ADDRESS
TELEPHONE #
Estimated Cost: -j ~ t ~3 3' .!J..
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances,
OCCUPATIONAL LICENSE #
"...,....-
ELECTRICAL
S
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.
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PAITIE ELECTRIC & REFRIGERATION
r 011'- eo 39111 PATTIE RD.
AA-' ZEPHYRHILLS, FL 33540
06ldw C(Jla..fJ (813) 782-3319
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5,
002571
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PROPOSAL SUBMITTED TO
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STREET
SF- ?t:1 c:<..
JOB LOCATION
CITY, STATE AND ZIP CODE
;:;:;2!-ff
ARCHITECT
DATE OF PLANS
\ JOB PHONE
We hereby submit specilicalians and estimates lor:
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II pa,meol1'LM. made~::" 14 ~ ~f'''- -.q~~n (,1..__\ '-'~___
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I All material is guaranteed to be as specified. All work to be completed in a workmanlike f It ~
manner according to standard pl"actices. Any alteration or deviation from above spec ilications AuthorIZed '- --~, -. ,'/L:l' ,- ; .. A l../'""
! involving extra costs will be executed only upon written orders. and will become an extra Signature --L_ ' ~"-"
~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,. .insura, nee, Our Note: 11".0 plOposal may be <::: i)
~workers are fully covered by Workmen's Compensation Insurance, __ _ Withdrawn by us " PCI acceptea w,n"" .---"-
hcepbmceof'rnpo8aI - The above prices, specifieatl:n-~and ISIGNATUF1E
I.. conditions are satisfactory and are hereby accepted. You are authorized to do th. e I
' work as specified, Payment will be made as outlined above,
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JIlr 'rl1pl1Sr hereby to furnish material and labor-complete in accordance with above specifications, forthe sum of:
d ZL,.s':slL
._________ ollars ($ _ _
FORM 65103. RAPIDFORMS,INC,. THOROFARE. NJ 08086-9499
~?~ '
APPLICATION FOR PEIDlIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTHENT
~ .
'~PPLICANT ~~ Ej~Q ,
C:t5DRESS -S<1\\'\. '~~ R(\'~ 2~")h~\7i'\~:\l~
OWNER ---=-je~"'\\l ~ f\. VV\:\toN
.
JOB LOCATION~~\()l ~'^- ~l
.~A
PHONE ~r:s-'\~'2... ~::. \ 9'
"
LOT SIZE_X
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 1. D. i~ fl.! .-'"'LfO-"Z. \.-00 \ (~-- 00.$ oc- 0 \$ D
WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install
____Sign/Temp.
PROPOSED USE: ~Single Family
_Sign
____~love
____Demolish
____Commercial
_Indust.
____Swim. Pool
, .____H / H
AhD ~ Other
,-:,--M/F
____i~ of Uni ts
____Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL:
COM1'lERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORHS.**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOR~lS. **
**COPY OF CONTRACT REQUIRED.
~ERMITS REOUESTED
_BUILDING
$
Valuation of Total Construction
J:::::::.ELECTRICAL
~ECHANICAL
AMP Service
Florida Power Corp.
_W.R.E.C.
$ z''iW ~
Valuation of Mechanical Installation
~
.. ... .
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ____Block
____Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
Signature
CONTRACTOR SECTION
Company
State Cert. or Rcgist. #
City License Registration 0
******************************************
BUTl.DER
:T::::~~ companY~~~~
State Cert. or Regist. i~ E.,K/"ol'>SI2.'1
~O" . t1~1~ .. City License Registration ;,1 ~"S'l
******************************************
Signature
Company
State Cert. or Regist. 0
City License Registration 0
******************************************
,PLUMBER
~. ~tIiE .~C?
MF.CHAM#' Company .r -f-: iJ<.U',
~ ~ ds: State cer't, or Regist, i' Rl'I.Cc2.'\'~
Signatu e '1 ' L""'" City License Registration 'I D5,,!;
. ~. ********************************~*********
.oTHER
Signature
Company
State Cert. or Regist. 0
City License Regist~~tion 0
APPLICATION APPROVED BY
PERl'lIT OFFICER.
CONDITIONS;OF,PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Tht,undtrsigned understands that this perl\t .ay be subject to "deed restrictions' which Nay b~ ~~re restr,ictive than City
regulations. The undersigned assumes respon5\b\1\ty~for,colp1\anCI! with any appl icable deed restridions.
.. '..... ' ' .
B. UNL I CENSE::D CONTRACTORS AND'CO'NTRACTOR RESPONS I E I LIT I ES
If the owner has hired a c~ntractor ~r 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 OHner and contractor ftay be
cited for a lisdeaeanor violation under state law;! If the ~wner ~r intended contractor are uncertain as to what licensing
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781l-bbll. : ,;
Furtherlore, if the owner has hired a contractor or cDntractors, he is advised tfl have the ce,ntradortsl sign portions of the
'Contractor Sections' of this application for which they will be responsible. If you, as the ~wner sign as the contractor,
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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)
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.owner' prior to cOI~ence~ent.
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E. CONTRACTOR'S/OWNER'S AFFIDAVIT
1 ,..'ify ,.., .11 ". i.f....,l.. I. ,'1. .ppll,.'I" I. .".,... ..d ,..' .11 ,.,k .ill b. d... i. ,..pll..,. .11' III
applicable laws regulating construction, zoning, and land developDent.
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Water/Wastewater Treatment
I South~est Florida Hater Manaqe~Ent District - Wells; Cypress Bayheads, Hetland Areas, Altering Hatercourses
f Aray Corps ,of EnQineers - Seallalls, Dods, Navigable Waterways
f De artlent of Health ~ Rehabilitative Services Environmental Health Unit - H~lls, Wastellater Treat~e~~. Septic
f ~S Environ~ental Protecti~n AQency - Asbestos abatement
Tanks
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Florida prior 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. JOBS UNDER $2,500 IN VALUE
00 NOT NEED TO RECORD AND POST A "NOTICE OF CoMMENC\N/lf". (i ,
A-~----- SIGNATUR~l~--=---------
OWNER OR AGENT CONTRACTOR
DA TE__________.LIL.::2-~-L---------,-------
DATE 1 (')-- (-Q I
___~------J------------------------
NOTARY AS TO ,. ,'...
OWNER OR AGENT__~~~~~--~-
MY COMMISSION EXPIRES___AC~-~~~~~-------
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MY COMMISSION EXPIRES___Ji_=:~~~~---