HomeMy WebLinkAbout91-1903
STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
Type of Permit 5,J'~ o-D
~. El~ Pl~ ~
Proper'y Owners Name: ~::: ~b
Job Address: ~/ y 7_~_+ _
Legal Description: Sub.Div. Lot
Permit N~
1903/t1
Date /I-/~' 7/
Zoning CI:
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Description of Work C
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Energy Code Readout:
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost: ..J/ (J /~ ou
OCCUPATIONAL LICENSE # 9/
Fee: 3s: C7V -I-' ~ l ~;."
SIGNATURE ~~, __~
COMPANY
ADDRESS
TELEPHONE #
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances,
BUILDING
PLUMBING
SLB
Tub Set
Water
Sewer
Final
ELECTRICAL
AJk
Ftr.
Pre SLB
Lintel
FRM.
Insul.CL
WL
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 t_.. "16.00) /.5-: crJ
dollars shall be made for each trip.
(a) Wrong Address
(b) Condemned work resulting from faulty construction
(c) Rt:pairs 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
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ADDRESS
PHONE
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OWNER;~.dri f' ,;: :""' ,
JOB LOCATION ' r, i r." ~..;;~~Y'f:- w r.~' ' , '
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LOT SIZE X' AREA SQ,FT.
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LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION 2/lt\\ s c.c\o '^'1 Co fIi\:~~l '
PARCEL .I.D~~I,'lnI1!?'t~'h",~;te~' r;(' ()!1/(J Q~60 ()(J 00
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WORK PROP~SE~\ .1. N"~fl<=~n~!~~~tion "..;.-A?cli:tion . ---.J\lt~r~~i~r,
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PROPOSED USE: --..;..Sinsle Family'''' ..4;.:..::.:......Jf/F .'! , '_41'ofi'UnitS
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'_Co.ercial , " '--'::"":'Indust. _Swl114 :Pool
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.---.Jepair: ,,'.'1'<:. Install'
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~Move',,~ ~ ; t~Hf~!'tiell~lish
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Other
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,...f, ~es tau~..n~ ' ~ i~eal~ ipepar.tII~ntt, ~pt)rovall:
BUILDING SIZ~':'l 01 j~ .,1' x' .'1 '1:'11";t,~:" ,'"t.,,:. Square' Feet,'~'~'
Height
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RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF ,BUILDING PLANS & (1) SET ENERGY FORMS.**
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & !(l> SET ENERGY FORMS;** ~ ,
, ;,,' "tr*COpy . O~ ,CQNTRACT REQUIRED,
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PERMITS RROUESTED '
_BUILDING, :: ,:' ,-" $ ,
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, Valuation of Total ,Construction
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, " Florida Power' 'Corp.
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_ELECTRICAL".~ '
~ECHANICA~ ' $
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. AMP, Servi~e .
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W.R.E.C;
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Valuation of Mechanical Installation
_PLUMBING <'.,.;.,'..', ,I.",; ." ~ , .
". ..,; :~ GAS ",,"~i:r ;.'
ROOFtNG "
, . ,?, ,I> ' SPECIALTY.,
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TYPE OF CONSTRU~ION: ' _Block '~Frame';
FINISHED/FLOOR ELEVATIONS:' "PT.
Other
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Signature
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CONTRACTOR SECTION
Company
State Cert. or Regist, #
City License Registration #
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BUILDER
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ET.F.CTRTCT AN
Company
State Cert. or Regist. #
City License Registration #
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Silmature
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PLUMBER
Signature
Company
State Cert. or Regist, #
City License Registration #
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Company 1?1'-11 tl-Rf;J 'j A-6.e.~ - A life. otii
State Cert. or Regist. '41 c.,.. e.c .3.(V9(
City License Registration #
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Signature
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OTHER
Signature
Company
State Cert. or Regist. #
City License Registration #
APPLICATION APPROVED BY
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PERMIT OFFICER.
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CONDITIONS,OF PERMIT AFFIDAVIT
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A. NOTICE OF DEED RESTRICTIONS
Th. undlrlign~ und.rltrndl th.t thil p.rlit ..y bl lub;.ct to 'd.ld r..trictions' which lay be lorl rll~rictiv, th.n City
reguhUon~,~: ;~! ~e~!~~.i.~~~~,~~'~II' r~~!Dn~.ibi~Ul..,fDr CDlpllann wUh .ny appncabl. dlld rl~tricUons.
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B. UNLICENSED CONTRACT9RS AND CONTRACTOR RESPONSIBILITIES
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If the owRtr ba. hind. CDntr.dor or contra don to undlrhh work, they lay bl r.quind to bl Hunl.d in .ccord.nn wUh
l\att .nd lotal;ttgul.tionl,"~lfth. CDntrador il not llcenlfd .. required by llW, both th. owner Ind contractor I'y b. ,:
cited for . lildlle~nor.,Y4~lltion under.tat. law, If th. owner or intended contractor ar. uncertain IS to whit licensing
requirelents IIY .pply for th,"int.ndedwork, they Ire adviled to contact the City of Zephyrhills Building Deplrtl.nt, (813)
788-6611..
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Furth.rlor.. if the owner hll hired I contractor or contrlctorl, hi il advised to have the contrlctorls) sign portions of th.'
'Contractor S,dionl" of' thillppllcation for which they IIUl b. responsible. If you, .. the owner sign II the CDntractor, '..'
youan,Jndit,U~9 thatVD.u.tnthtr thl' th.con~rador, In n~ponlible for the 1I0rk. If the contrador wishes you to lign,
'IS contractorithlt IIY bt an lildi,taUon th.t h, .. not prop.rly llunled Ind is not entitled to penUting prlvilegtlin th.t
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CUy of".z.ep~rrh.!l1s. , .
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TRANSPORTATION IMPAC~ FE~S A~D UTILITY CONNECTION FEES
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D. CON~:r~U~!I9N, ..~~EN L~t" 41,(S~APTER 713, ,FLORIDA STATUTES, AS AMENDED)
I certify that ,I, the appliclnt, h.ve been provided lIith a copy of 'Floridl's Construction Lien LaM - HOleowner's Protection
Guide' preplred by-the Floridl Departlent of Agriculture Ind Consuler ,Affairs. If the applicant is sOleone other thin the
.ollner', I nrtify .that I have obtained I ,copy, of the Ibove described doculfnt and prolist in good hUh to deliver it to the
'ollner' prior)o~co'"nn.ent,' ,',' ,.',' '" ' " , ' "
....
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
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1 certify thlt 111 the inforlation in this applic.tion is accurlte and that all work lIill be done in cOlpliance with all
applicable hilS regullting construction, loning, Ind Ilnd,d~velop.ent.
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Application is hereby 'Ide to, obtain I ptrlU to, do lIork InO Inlh11.\ion II indicated, I certify thlt no 1I0rk or
lnstlllltion hal cOI.enced prior t. lIIUIAC. of I plrllt and &hlt .11 1I0rk lIill bl perforled to leet st.ndards of 111 lalll
regullting con_truetion. City cod.., zoning,r.gulltlonl, and llnd dev,loplent (egulltions in the jurisdiction. J Ilso
certify that I understlnd that the regulltions Df other gDvernlental Igencies lay apply to the intended 1I0rk, and that It is
IY responsibility to identify IIh..t Ictio.ns tlult take to be in co.plilnce, Such agencies include bllt all! 1I0t lilUed tOI
. Dl!Dartl!nt of Envir.nlen~ Reaulatioo,;, Cypr'ls Blyheads, Wetland Arels Ind Environlentally Sensitive lands,
, ' Water/Waltelllter Treatlent"
I Southwest Florida Wlter "Inlaelent Diltrict - Uells" Cypress Blyhllds, Wetllnd Arels, Altering Watercourses
. Arlv CorDS of Enaineers - Selwllls, Dockl, Nlvig.ble Wlterways
I Departlent of Hellth l Reh.bilitative Services. Environlental Hellth Unit - Wells, Wastelllter freat.ent, Septic Tlnks
. US Environlental Protection Aaency - Asbeltos abltelent ' '
I Ilso certify thlt' if fill laterill is to be used in Flood 'Zone ~A' Dr "A,etc,', it is understood that a drainlge plan
addressing a~CD.penIlUngvolulI~;1I111Ibe subliUed which is ,prepared by a professional engineer registered in the State of
Florida prior; t, plrlH hlDlnn" ':', ,': l;i! ',',' ' .
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A perlit issued shill be construld to be I licenle to proceed lIith the work and not as authority to violate, cancel alter, or
set aside Iny provilions of the technital cod.l. nor sh.ll i_sulnce of a perlit prevent the Building Official frol thereafter
requiring I correction of error. in plan..~Rltruction, orviol.tions of Iny code. Every perlit issued shall becole invllid
unless th.'lIDrk authorized by such perlUHlrco.enced within six lonths of issuance, or if work luthor i zed by th. perlU is
suspended ot;lblndonedJoT I plrlOdofr.iI;.."thllner theUlethe 1I0rk il"c~!I!nced. One 90 day C!xtensioll of tilf, lay be
allowed for th, perlit lIith fie charge:of!.15~OO. The txteRslon shill be reque.ted'in writing to the Building Officill, An
approved inspection.lult b,e logged during Ilch six lonth period, or the project' IIi 11 be considered abandoned.
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WARNING .TO OWNERs YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESUL T.,.IN~ YOUR PAYING 'TWICE FOR IMPPOVEMENTS TO YOUR PROPERTY. IF YOU
INTEND ,TO OBTAIN.FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE,RECQRDING YOUR NOTICe: OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT~ NEED ~,:r0: RECORD "AND, ;POST A II NOT I CE OF COMMENCEMENT II .
SIGNATUR~~~~---- SIGNATURE~~
DATE_~_~~:~~~~.i~_~~~~_2___--~--------- DATE___________L_~~~---f
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MY CO~MISSION EXPIRES_____~~~~~_~___
SER'iICE IIUYOICE
Me. Marlon L. Howell~!
. 5147 Jennifer Lane
:z.phyrhlll.. FL33541-3301
FORT LAUDERDALE
500 S.W, 21st TERR. B 103
FORT LAUDERDALE. FL 33312
DADE: 621-8412
BROWARD: 791-5605
BOCA RATON: 368-1799
-i1Ii' Control Systems
Southwest Inc.
SP No. 54320
t ? 33J-..
CORPORATE OFFICE
6280 ARC WAY. FORT MYERS. FL 33912
FL WATS: 1 (8001432-5562
FORT MYERS
6280 ARC WAY
FT. MYERS. FL 33912
CHARLOTTE: 639-6858
LEE: 275-8720
COWER: 597-1890
WEST PALM BEACH
1387 N. KILLJAN
LAKE PARK. FL 33403
PALM BCH~ 845-1407
MARTIN: 283-9459
ST. LUCIE: 461-0278 ,_) :', ""
W7'/' ~VltT.,p-c~'~
TAMPA
ST. PETERSBURG
10820 - B 75th ST, N,
LARGO. FL 34647
ClEARWATER: 541-7600
.' T~PA: 225-1379
WORK TO BE DONE
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PASCO
845-1212
LAKELAND
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I- SERIAL NUMBER
DESCRIPTION OF WORK PERFORMED
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IF YOU ARE SATISFIED WITH THE SERVICE YOU RI:CEIVED
TODAY TELL A FRIEND, IF NOT PLEASE TELL US::'.;; ~
TRAVEL TIME:
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FROM
TO
TIME ~
ARRIVED
TIME C
ARRIVED A "
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TIME ;:
DEPARTED
TIME ,
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SERVICE PARTS
SERVICE LABOR
CUSTOMER DISCOUNT
TOTAL CHARGE
DEPOSIT
BALANCE DUE
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'jPLEASE PAY FROM THIS INVOICE
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TERMS: ~ET DUE ON COMPLETION en
~~~ ..:.~ to. Finlll'lCe Charge of 1.1/~ pet month. Annual Percentq8 Rate of 18% which ;. -a
tt ie ...... .nd__~ by the parties that all equipment and .-ns which .... IOtd pursuent hereto aheM NOT Z
-, lbrtu.... , ~......... wher. tlMy .. pieced. SIIid Pl'rts and equipment shan at: .. times 0
remain and title thereto sha" . .t until payment in full is received. Buyer
henlbt'~~ all pam and uiltmem may be in 1~ of noft.peyment. S.. ........ side. ,
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IE<;:HNICIAN slGNATUR U..'" \.. --= / FIJI '"
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CUSTOMER'S SIGNATURE .-c ........ -
=-= CARD EXP, ffij
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