HomeMy WebLinkAbout91-1902
ST ATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
Permit N~
19(2)1
Type of Permit
~EL~
Date / / - / - 7/
PLU~
Property Owners Name: d: dv"'L JJt ~
Job Address: ,-J>? 0 :t <f - ~s~ tl"J-f?
Legal Description:
Sub.Div.
Lot
Blk.
Zoning CI: /0( - '4" d.J - () (1] 0 - 0 acfO C! -
Description of Work- < Ie [1L.~(' ~
() 0 v 0
~
Energy Code Readout:
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost:
-1..3 (J '7, (){)
./
OCCUPATIONAL LICENSE # ?/
Fee: "LO, ~ _
SIGNATURE ~~~.(~
COMPANY
ADDRESS
TELEPHONE #
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
'-----
BUILmN~
~G
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EL~CAL
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~,L:Al.k
- ME'CHANICA~ <
Ftr.
Pre SLB
lintel
FRM.
Insul.CL
WL
SLB
Tub Set
Water
Sewer
Final
Tp.Serv.
Rough In
Meter Can
Canst. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Ins!.
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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APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
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APPLICANT J J T~~tn ,';-' "/nO '-r=r-
:3 C) 0i7lfJJlr~('5'~' '.4~Vcr-
OWNER '~'{j'~7c':- :;,:~d'l /
JOB LOCATION ,;~j _i? 'j l>j"Vi" ., ;,0'~ '~
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ADDRESS
PHONE
"7'gf~'7% 3~cr-
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'LOT SIZE
X"
.:" AREA I SQ, FT . : i!
'," ~, , " J.'j~', . ~ '; .
2/ J./-JI'rs U~+-S
LEGAL DESCRIPTION: LOT(S)
PARCEL 'I.'D~~I,' iH'l~r..:2!l!;;::"'2l';... d6 ~O' :- DO 3.0!) -' Do\.{o"';',
'. .. J. . ~ M . .
;"Lt~"i ~t'j{'" i ....t,'..<t~ ' . i; '~.I : . i;" _ 1" .t " ;
WORK PROP~SEP!:, <.:-~~~~c~n~)~r~~tiC?n i ,~~4i:tion
: 'f ,:,;,::
'~S~gn/Temp,' ____Sign
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~~'~~r', 111 - ":"i~fJt~:'~J .','
PROPOSED USE: --i.,SingleFami!y""'''"''.:..:.:.Jf/F'
BLOCK
SUBDIVISION
---Alteratio~ '2Repair!, .;1 ; Install'
',i1'. ';:lJi'r.!;"i..I"(~:/~:}\Xvt~~I.';: "
---2.)Iove ,,1., .,)l,l'Demolish
.
I , ,:.'(; _ "..", ' ~
, '.....--4PibfLUnits
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..l:JI/H
..:~}li:f;;j.iV1..\ ~j(.1 ,"'lrf io' .~'n, i,~"n '.,. ";1"",
'_Commercial ,"~Indust. ____Swim. :Pool
:1';:;'l;"~~~e~'~~~~,n~;~fHeai~~pep~~,tment~.~p~roval,; ',' 'Id '..
i''''4tt1lf ,~'~l l'j.- L"f:P'~'::l'
BUILDING SIZE: X
Other
'.' . . ~
-.t; I
" "." ~;
~. t
'Square Feet, ~;
^ol' .
Height
I ',1.; ,
RESIDENTIAL:
COMMERCIAL
ATTACH (2) PLOT PLANS & (2) SETS OF .BUILDING PLANS & (1) SET ENERGY FORMS.**
ATTACH (3) SETS OF BUILDING PLANS &'(1) SET ENERGY FORMS.**' ~
,~,~COPY ,Or ,CQNTRACT ,REQUIRED,
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PERMITS ReOUESTeD
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! 'tf'.
"'~j'; ,
_BUILDING ,,~,' '~""~' $ ..
_ELECTRICAL..: ,~! ,j ,"
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~ECHANICAL
t! ! ;',
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Valuation of Total Construction
I;: "
"'~. ~; ~ '
;1 fo'
.' ! ~, jl . 1
AMP'Service ' , Florida powertCorp, ,
$" :'~:"~:";~'~~~alUatiO~ ~f'Mechanical 'Insta~latio~
,
,W.R.E.C.
J
~PLUMBING 'tll I '! '~. ~... ~ GAS iI,;
ROOFING'
',.i'."" 'SPECIALTY,<
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TYPE OF CONSTRUCTION: --:,..Block
~ .: '. . ", : .,"
FINISHED'FLOOR ELEVATIONSt " FT,.'
'i
i,' Other
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******************************************
CONTRACTOR SECTION
Company
State Cert. or Regist. ~
City License Registration fl
,.******************************************
BUILDER
Signature
: ~'
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iF
F.T.F.CTRTCTAN
Company
State Cert. or Regist, fl
City License Registration ~
******************************************
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Silmature
:. I.,
Company
State Cert. or Regist, ~
City License Registration fl
. ' ******************************************
; ~': i . ',\.: ~ r.
PLUMBER
Signature
"
Signature
Company .J} II? C o,,;--r-KoL
.
State Cert. or Regist. ~
City License Registration
**************************************
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Company
Statt~ Cert. or Regist. it
City License Registration fl
OTHER
Signature
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APPLICATION
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APPROVED B~ iii '., . .:tj:':'.~ ~ p.a Ah. "r ,
PERMIT OF1"ICER.
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CONDITIONS.OF PERMIT AFFIDAVIT
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A. NOTICE OF DEED RESTRICTIONS
Thl undlTligned undlrltlndl thlt thil plTlit lay b, lubjtct to 'd"d Teltrictions' which .ay be lort TII~Tictivl than City
ngul~U!~!.:,;'.!!~! .~~~;!~~i.~n,~~,~~,-~~~,r~~~o,~,1-bl~ttl/OT COIpUlncl wUh Iny IppllClblt dltd r.~tridlons.
. ." , '
B. UNLICENSED CONTRACTOR~ AND CONTRACTOR RESPONSIBILITIES
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,.
If the ownlT bas hirtd a contrlctor Dr contractorl to undertake work, thty lay be rtquir,d to bl licensed in accordlnt' with
ltate Ind IOi:ll'ttgulaUonl,"'U"th" cOlltractor 11 not Hnnlld .. nqulnd by lall, both th, owner Ind contndor IIY b.:
cittd fOT I lild'ltlnOT Y~.lltion underltlt, lal. If the owntr or intendtd contractor art uncertain IS to what licensing
requirel,nts'llY apply for'th.'intlnded'loTk, they are adviled to contact the City of Ztphyrhills Building D'plrtlent, (813)
788-66U, '
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FurtherloT', if th. Diner hll hired I contrlctor Dr contrlctorl, hi il advised to have th, contractorCs) lign portionl of th,'
'ContrattoTStctionl"of"thi"'lppllutlon'forllhich they will bl responsible. If you," the owner lign al th, contractor, 'f,,'
you ,ar..,indictUng thltY!U,t,TlthlT tha~ th. con~ractor, Ire n~ponlible for the work. I f the contractor wish" you to lign, '.
'as contractor~\h.t lay b"lnlildi,caUonthlt he il not proptrly llcenl,d Ind is not ,ntitled to peTlitting priYilegel in th.,l;..
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CUy of:"Zephy~bi115. ,i~'~,li '< ,
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C.
TRANp~ORTATION IMPA9~ F~~S A~D Ui'ILIT~ CONNECTION FEES
CONSf~U~!,~9~.,~~EN L~W .d,~f.J'lAPTER 7~3"FLORIDA STAT,UTE~, AS
,,"- ~ :.
D.
AMENDED)
I certify that ,I, the applicant, have bien provid.d with a copy of -Florida's Construction Lien Law. HOleowner's Protection
Guide' prepared by.the Florida Departlent of Agriculture and ConsUler ,Affairs. If the applicant is sOltone other than th,
lowner', I certi!r 1hat I hav~ o~t,ained,a,~~p,!o', the above described doculent and prolise in good faith to deliver it to the
lowner' prior: to coIIIRCllent. ' . " ,', ' ' '
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E. CONTRACTOR'S/OWNER'SAFFIDAVIT
I certify that III the inforlation in thil applicltion is accurlt, and that all work will be dont in cOlpliance with all
Ipplicable, lall regulating, construction, zoning, and Ilnd,~,veloplent.
." I" "
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Applitation is hereby .ad, t~obtlin I p.r.it toldo lork and lnltllla~ion al indicated, I certify thlt no work or
inltlllltion hll cOII,nc.d prior to illulntl of . plr.it Ind th.t .11 work lill bl perforled to leet stlndards of III laws
regulating con~truction, City cod'l, zoning ,'Igul.tionl, and land dev,loplent r.lgulations in the jurisdiction, 1,1110
certify that funderlhnd that the regulaUonl of other governltnhl Igencies lay apply to the intended Mork, and that U is
IY responsibility to identify ""It; Ictionl 1.lult hke to be in cOlpliance. Such agencies include bllt all! Ilot lilited tOI
. DeDartlent of Envirenltn.n Reaulatloft.;Cyprfls Bayhlldl, lIetland Areas and Environltnhlly SensitivI lilnds,
, " ". " lIater/Wntewater Treiltlent'
. Southwest Floridl lIater "ilnaaelent DistTic\ . 11.111" Cypress Bayheadl, lIetland Areils, Altering lIatercourse5
. ArlV CorDI of Enaineers - Selwllls, Dockl, Navlglble IIlterwlYI
. DeDartlent of Health l Rehlbilitltive Servlc'l. Environlental Health Unit - lIelll, lIastewater Treatlent, Septic Tanks
. US EnviroRlentll Protection Aa.ntv - Alb.~tol ,abatelent . '
0; , ; '" .' ;1,;:~..j' ," .. .
I also certify that, if fill Iilterill il to be used in Flood Zone ~A~or "A,etc,', it is undefstood that a dfainage plan
i1ddre5linga ,'colpensating volulI~ wi11,be lubliUed whichllprepilred by a professional engineer registered in the Shte, of
Floridl prior: to penU issuance.;', !; · ' '
j' ~,d; l i
A perlit illued shall be construed to be . licenle to proceld with the work and not'll authofity to violate, cancel aiter, Dr
Sl!t aside Iny provisionl of the technicIl cod.s, nor shill iSluance of a ptrlit prevent the Building Official frol thereafter
requiring I correction of 'rrorl in pllnl,cDutrutUon, or. violations of Iny code. Every ptflit issul!d shall beeolt invalid
unless the;..rk'luthorized by,such perllt:1lPCOllenced .lthin six lonths of issuanct, or if work authorized by th, perlit is
suspended Ot,Jlblndonedfor IptriDd6f;lhJI..tlal .ner 'hI! \lit ,the work is u..~nttd. On. 90 day extension of UIt, lay be
IlloMed forth, perlit lith fee chlrg.'.r.1S~OO.The .xtension Ihall be requllted'in wrUing to the Building Official, An
approved inspec'ion,lUlt be logged during elch lix lonth ptriod, Dr the project'Mi11 be considered Ibandoned.
. .': .' '~ -1','; .
WARNING ,TO OWNERs, YOUR FAIL.URE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT <IN ,YOUR pAYING 'TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU
INTEND TO OBTA1N.FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE. RECORD I YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT~NE;EDL R CORD,~AND,POST A "NOTICE OF, COMt1EN~EMENT".
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, . . ,""V" '. _ '.-.~SIGNATUR
---~-~- -------- --~ - ---
, ,OWNE~ OR AGENT,
DATE_~_~7.c2--~~JZ~~fZ----~--------,_.
NOTARY ~S;TO "A',. .':': .~
OWNER ~.,~~~,,~---------
MY COMMISSION EX;IRES___~~_~~~---------
R
DATE_____________~~_~___:_~!_________
NOTARY AS TO /il ;~
CONTRACTOR ~
MY COMMISS~:~-~::~~::~~~~~~~;?~~~~
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80CA RATON: 368-1799
WEST PALM BEACH
1387 N. KILUAN
LAKE PARK, FL 33403
PALM BCH,: 845-1407
MARTIN' 283-9459
_ConIroI-~-.s-n
I n I/~ Sol!!!!!!!t Inc.
[, p. 6280 ARC WAY, FORT MYERs. FL 33912
FL WATS: 1 (800)432-5662
FORT MYERS
6280 ARC WAY
FT, MYERS, FL 33912
',' CHARLOTTE: 639-6B58
LEE' 275 B720
SPNo.544'81
SERVICE INVOICE
FORT LAUDERDALE
500 S.W. 21st TERR, 8 103
FORT LAUDERDALE, FL 33312
DADE: 621-8412
BROWARD' 791-5805
$T, LUCIE: 461.027B
COLUER: 597-1890
TAMPA
ST. PETERSBURG
"' 10820 . 8 75th ST, N.
LARGO, Fl 34847
ClEARWATER' 541.7600
PASCO
845-1212
.~ T~MPA: 225-1379
LAKE LAND
687-0395
DATE-P;;tf!?/
/
TRAVEL TIME:
,~ .. : "'. :2 ,STATE CERTlfIED~ CACp 35496
WORK TO BE DONE........ ,...- .:>- CUST~E' ~ / ~- - -:... /.-..A 7-./
I 1 , \ c \. ",.' _ T'\ ,-' ~: ~ '..f / ,/ /77- : p ~.... /' r/./J /
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sou~~:":TY - ~! ;':'. - . ..P",~E :~
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~ b ~~~ /!-:-~- CIlY. ..;- D." STATE
.l/~'47fj:,:)::;:~.. =_
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J /"' - -57 A-7 L.,~ '. MAKE ~ ~ MODEL SERIAL NUMBER
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1/ (2? ...-h/ .t)~ /"'V ..... J LJ...J.... r ~C7 ','Z.' rr./ "V'_ -;.,; ~./? X/. J
. / ~ 7:J1n J ~ :,:~- ~ ...-DAT~_ DESCRIPTION OF WORK PERFORMED
I ~. CI, f1//j /. ~ ~ ~7. ~~// .inch /~~-::..
/ ""1'/m.~ Y).c:rf ~ LU' I - 77?'JAJ~, ~ L ......::.- .... H - _ v ~ / J -r- .;
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IF YOU ARE SATISFIED WITH THE SERVICE YOU RECEIVED "1 / A "7 A -JII-' -'
TODAY TELL A FRIEND, IF NOT PLEASE TELl US. :, ! /). ~ A ~ h./~ .A /?~ ~ ,-z.J1.A.. J _ -
A~ .- ....d~ K~' 4__"7r-
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yt'..9M THIS INVOICE
TERMS: NET ON COMPLETION, 'en
=:- ..:. :,biltCt to . Financtl Charge of 1-1 /~ .... month. Annual Percentage Rate of 1'" whtch i. -C
It .. ...... and ~ by the IMlrtift thet .11 lIquipment and I*U which are. IOId purwuant hereto shall NOT Z
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p -/ n ::r~=-O"":'~n:::='" - _.......n. m.ybe _,n "'" _of non_'M. S.. r_ _ ~
'" 'A' ... IhI ,,,..- ___H_~_# "72---'--'-' dill..
~ .'~ ",1M.. on "'.._lor f" _ ' ~
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$VJ'j ~ - T 1 NATURE.! /~ _--.....-. f' .J' 00
W"V-~~./OO'l _ _ ~~/ '.- . ..
ZIP
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TIME
ARRIVED
TIME
ARRIVED
TIME
DEPARTED
TIME
DEPARTED
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SERVICE PARTS .;
SERVICE LABOR
CUSTOMER DISCOUNT
TOTAL CHARGE