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Home My WebLink About91-1915 STATE OF FLORIDA City of Zephyrhills ....---' . ./ ,p.!:; PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 PermitN~ 19is.4 Date 11-6'- 9 J , I Type of Permit ".,.' C~ E~C PL~(r-- MECIIAr~I(jAL Property Owners Name: \.., ~fA.u~ CJ~. ~t} . c: . CZ::f./,/'''' Job Address: ,-3 1 c-q?lS- - ~ . Cl ~ . Legal Description: Sub.Div. Zoning CI: Description of Work Lot Blk. Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Application Estimated Cost: ,1 If 0 (). All work shal! be performed in accordance with the above and all City Codes and Ordinances, Ftr. Pre SLB Lintel FRM. Insul.CL WL PLUMB!NG, SLB Tub Set Water Sewer Final Driveway /;1 /]d-' ~ t Fee: 'P ,~ I.'" SIGN~ TURE ! (; I<<; '" (t~ . COMPANY ADDRESS TELEPHONE # ,-,....-.......~.. MEC Tp.Serv. Rough In Meter Can Const. Pole Pool Pre-Meter Final Breakers Ducts Insl. Compressor Final 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 PERI-lIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT -~P)'t, U nl H:=::c:n !2 U 4' CEJn ~ 1'1/- I ne 'II/'Ll C J ---, \ - i ).,\ 'J ), II rf ADDRESS J..L.J (Ll ".Jt:?Uc.tfC' _ ,}t J) T"CLK'::;0l E' / " { ow~m~-T/u.j~~ ?~\ n L~ t. n \ n e... , ,;OR LOCATION < ~~cr~ 4 ~- ({)'i-t-, (11~ F / PHONE Ctc 4 - -; (70 - "'~-r''2 ~ - LOT SIZE<IDIJx x7 AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D. # WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install _Sign/Temp. _Sign _Move _Demolish PROPOSED USE: _Single Family _M/F _j~ of Units _N/H _Commercial _lndust. _Swim. Pool Other _Restaurant & Health Department Approval BUILDING SIZE: x Square Feet, Height 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 OF CONTRACT REQUIRED. PERMITS REQUESTED _..L-BUILDING $ / Lice cO . I Valuation of Total Construction _ELECTRICAL AMP Service Florida Power Corp. _\-l.R.E.C. _MECHANICAL $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Frame _Steel Q.Ef'(\en+ Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** Signature CONTRACTOR SECTION Cowpany State Cert. or Regist. ff City License Registration # ****************************************** BUILDER F.T.ECTRTCIAN Company State Cert. or Regist. # City License Registration ff ****************************************** Signature PLUMBER Signature Company State Cert. or Regist. # City License Registration # ****************************************** MECHANICAL Signature Company State Cert. or Regist. # City License Registration # ****************************************** Signature company-p;..i H If\iy:,efl)'L_{ tf 0f.[Qe\\1 'nc- ' State Cert. or Regist. IF__SZ 3>( City License Registration # * * * * ~*_*,.~.!;; **)*'*.~ ,? *..~,* * * * **,* f*~} :.,.-k*~~~* * * * *** * (", "'. . ;l~;<.o:: ' /<.):f[ , --t ~-u;Ji' APPLICATION APPROVED BY PERI-IlT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject to "deed restricti~ns' which lay be lore restrictive than City regulations. The undersigned assules responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertak~ 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 owner and contractor lay be cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what lice~sing requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Depafllent, 181j) 78B-bbl1. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractorlsl sign p~rtions of the 'Contractor Sections' of this application for which they will be responsible. If you, as the owner sign as the contractor, you are indicating that you, rather than the contractor, are resp~nsible for the w~rk. If the c~ntractor wishes you to sign as contract~r that lay be an indication that he is not pr~perly licensed and is not entitled to perlitting 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 Departlent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the 'owner', I certify that I have obtained a copy of the above described doculent and prolise in good faith to deliver it to the 'owner" prior to cO.lencelent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inf~r~ation in this application is accurate and that all work will be done in c~.pliance with all applicable laws regulating c~nstructi~n, z~ning, and land developlent. Application is hereby lade to obtain a perlit to do work and installation a5 indicated. I certify that no work or installation has COllenced prior to issuance of a perlit and that all work wili be perforled to teet standards of all laws regulating construction, City c~des, zoning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other governlental agencies lay apply to the intended work, and that it is .y responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include bill ale ~ot lilited to: I Departlent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive lands, Water/Wastewater Treatlent I S~uthwest Florida Water "ananelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways t Departlent of Health ~ Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks t US Environlental Protection AQency - Asbestos abatetent I also certify that, if fill laterial is to be used in Flood Zone 'A" or 'A,etc.', it is understood that a drainage plan addressing a 'colpensating volule" will be sublitted which is prepared by a professional engineer reqisteied'in the State of Florida prior to perlit issuance. A perlit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a pertit prevent the Building Official frot thereafter requirin~ a correction of errors in plans, constructi~n, or violations of any code. Every per.it issu~d ~hall becole invalid unless the work authorized by such perlit is COllenced within six lonths of issuance, or if work authorIzed by the pertit is suspended or abandoned for a period of six lonths after the tite the work is cOlmenced. One 90 day e~tEnsio\i of tile, aay be allowed for the permit with fee [harge of $15.00, The extension shall be requested in writing to the Building Official. An approved inspectiun lust be logged during each six lonth period, or the pr~ject Hill bp tonsidered nbdi,donp.d. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERlY. IF YOU INTEND TO OBTAiN FINANCING, CONSULT WITH YOUR LENDER OR AN A1TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". " 1'1 - DATE I v' ., - :' I -------------~------------------------- 5IGNATURE:ts- ,__ _..Jj.ul--13Ji2{Jl2~cf ONTRACTOR u ~ DATE____1I-"J.:-"'odl:.::tL ----- ---,----------- ~ 'J (!., f1" (l 5IGNATURE..:}_~~j.:..t~~5'f~~~-~~~~-tlA~- NOTARY AS TO:~ -L* NOTARY A5:~ :X'-- OWNER OR AGENT _~__ iliU:S'",d'--T-i,;.hlL~ CONTRACTOR_ - - - '-C~_ -- -_.: _:ydt".. MY COMMISSION EXP I E5 _=~t;i!~,~I.!:.;..~t~tf!.Jli.ELotld.a-af-large MY COMM I 55 ION XP I RE~~~.!Y_r:.u~!..s..5!..alQ..oiJ.lnJ:U!... at La rge Y mmlsslon Expires SEPT, 4, 1993 My CommiSSion Expires SEPT. 4, 1993 ,Bonded Thru Western Surety Co. ,Bonded Thru Western Surety Co. STANDARD FORM OF AGREEMENT BETWEEN CONTRACTOR AND OWNER . THIS AGREEMENT made the 7/I;A'TI- f-:J;/~',:;'T- ~ of ~''i Nineteen Hundred and /VIIVEf/'{/v(;~- .. by and between req €...Ae hereinafter called the Contractor, and -/ ;f.'-E.{~ 1!/1t..){fl / Nfl ' Owner, Witnesseth, that the Contractor and the Owner for the considerations named agree as follows: i" the year hereinafter called the ARTICLE 1. SCOPE OF THE WORK and perlorm all of the work shown on the Drawings and described in the Specifications , j', acting as and in these , and shall do everything required by this agreement, the general conditions of the Contract, the ARTICLE 2. TIME OF COMPLETION ') The work to be performed under this Contract shall be commenced AS ~n Cl.<; t-ebl/)'\I+ j<, substantially completed WITH-IN CN6""~.F k. ~ \e.(~..le'0e~ ~nd shall be ARTICLE 3. THE CONTRAcr SUM The Owner shall funds as follows. 'ons provided therein, in current Authorized Change Orders will be submitted by the Contractor for all work not specifically included in this Contract ARTICLE 4. PROGRESS PAYME.NTS (Insert here any provision made for the amount retained after the work reaches a certain stage of completion.) ARTICLE 5. ACCEPTANCE AND FINAL PAYMENT Final payment shall be due --r}+H day, ~ substantial completion of the work provided the work be then fully completed and the Contract fully perlormed. ARTICLE 6. THE CONTRACT DOCUMENTS The General Conditions of the Contrac~, the Specifications and the Drawings, together with this Agreement, form the Contract, and they are as fully a part of the Contract as if hereto attached or herein repeated. The following is an itemization of other essential pertinent information: " )/j~, ,,?? 1 :i /"1/.-. /) )..,~'-/I,~,,,..../ Owner -../1-/..2... /"1) )/ SEMINOL.E FORM 41 ~ >'.~ 13{/5' ," ( ,:"fJ l~iL'~- :J )(8 'I !-~d-F~ Uti ~ 710dt. "],(, II ~o ~ // 1/'(;/)< k,' CoIl CJ'efe" D.e./l.1elJt7' 4' t!lq~7hcr .3LA~ T 1{),1 /, / I '-I X :5(,,-, (l7 ()!3/ if ~c/ S?,1 - i.J(/-j . (- /-i(.t.~ J )(8 -, lcclf-/~. L/'t ~? 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