HomeMy WebLinkAbout91-1932
ST"TE OF FLORIDA
City of Zephyrhills
BUILDING DEPARTMENT
.r' 1-813-788-6611
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PASCO COUNTY
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Property Owners Nam~: ~~~~
Job Address: h 03 J ~ L '
PermitN~
193211
Date .II -/0----9/
Legal Description:
Lot
Zoning CI:
Description of Work
Energy Code Readout:
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost: ..s 'H 7:J. o-v
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
COMPANY
ADDRESS
TELEPHONE #
OCCUPATIONAL LICENSE # rt I
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Ftr. SLB
,~~
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E~AL
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Tp.Serv.
Rough In
Meter Can
Canst. Pole
Pool
Pre-Meter
Final
Pre SLB
Lintel
FRM.
Insul.CL
WL
Tub Set
Water
Sewer
Final
Driveway
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.
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APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
. BUILDING DEPARTMENT .
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APPLICANT
ADDRESS 1612 SEABOAiRr.kis'ID!' W !'}FbRTMYE~S' '
L;UK!\ bM.iTH
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OWNER
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PHONE ,S7.'3-";.'58 0 0'
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. bU~i M.IN~KVA .~~.
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JOB-LOCATION . ." ., .. ~. , .,,'
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LEGAL DESCRIPTION: LOT(S)
BLOCK
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PARCEL ,I.D..L ., ,
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WORK PROPqSEI);:", ':Ne~f.tc~n'~,~~~d~n :'~?di:tion
'f i;Sign/Temp. _Sign
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PROPOSED USE: ---...;,.Single Family." ~""T'~/F
-Alteration ~epair' ;.'i.!. :Install'
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---':Mo';e h. iHil: t>em~lish
..
. '_4~ ,,'of Units
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:",::-kt~liif1,~., -e:-'(~ ""l.tfi"r~t. f~l.tf'" .1
. _Commercial _Indust. _Swim.
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t)i. ~es taurant . & Health ',Department Approval
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Pool
Other
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BUILDING SIZE: X : .' .,
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Square Fee t,
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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 &'(1) SET ENERGY FORMS.**' ~
" ,~,.!~:~c,pP~ r OF. .;CQNT~C.~ REQ~~D.., " , , :
PERMITS ReQUESTED
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_BUILDING i, ,;'.. $
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_ELECTRICA~. ; r ',,' ~.l8 '7 ~Os~n:i~e ,. Florida Power . Corp.
----MECHANICAL $ Valuation of Mechanical Installation
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Valuation. of TotaliConstruc:tion
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W.R.E.C.
_~LUMBING 'H; I.~ #
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GAS 'f.:
ROOFING .
"
SPECIALTY.
TYPE OF CONSTRUCnON:" . ~Block' L.:-.-Frame. "';"""'Steel ;,
. !
Other
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FINISHED FLOOR ELEVATIONS (
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******************************************
Signature
CONTRACTOR SECTION
Company
State Cert. or Regist. #
City License Registration #
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EY.F.eTRY CY AN
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Company
State Cert. or Regist. #
City License Registration #
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Simature
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Company
State Cert. or Regist. #
City License Registration #
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'I RttllARO' yiAiiE''R J~'~:H AIR CON'rROL SYSTEM sW't,
MECHANICAL ' ,',.... Company CACeJS496.
State Cert. or Regist. #
City License Registration #
******************************************
PLUMBER
Signature
Signature
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Company
State Cert, or Regist. #
City License Registration #
Signature
APPLICATION APPROVED BY
PERMIT OFFICER.
...
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CONDITIONS OF PERMIT AFFIDAVIT
1
A. NOTICE OF DEED RESTRICTIONS
Thl undlrligntd.undlr.trndl t~.t thil p.rlit I.y bl lubject \0 Idl.d restrictions' which lay be lorl rls~rictivl than City
nguI~~iD~~,~L;!.~!~e~.!r~~.~ft,~~,~~'~1I r~~!o~~,lbi~)~tl/or COlplilnu NUh Iny Ippnubll dud r'~tricUonl.
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B. UNLICENSED CONTRACTORS AND CONTRAC~1~S~9~SIBILITIES
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If thl own,rhalhired a contractor or contractorl to undlrtlkl Mork, they lay be requirld to bl lic,nstd in accordancl with
state and IDUl'rtgulaUDns;';'lf'thl co"tractor h not lic,nltd .. required by hW, both th, ONner Ind contractor .ay bl ;:
cited for I lildllelnor v\~lation under stlt. law. If the ONner or intended contractor Ir' uncertlin as tD what licensing
requirelents'lay Ipply for~thl'int.nded MDrk, they are advised to contact the City of Zephyrhiill Building Dtplrtlent, (813)
788-6611..' "
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Furth,rlort, if the ONne~ has hired a cDntractor Dr cDntractDrs, he il advised to hay, the contractorls) sign portions of the'
'Contractor s,ctionl"o(thil applicaUonfor which they wlll bl responsible. If you, IS the owner sign as the nntrador, ' .
you .arl, indi~~ti~g thlt y~u,~nthlr tha~ the CDn~ractor, Irt re~ponsible for the work. If thl contractor wishes you to lign. .
. as CDntractori\hat lay b.an hditaUonthat h, il not prop,rly licenled and is not entitled to p,raitting prlvilegtl in th....
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C.
TRANprORTATIO~ IMP~~~F~~SA~D UTILITV CONNECTION FEES.
CON'~~~S!.~,2~,.~I.EN L~W 'l,~~$?)"fAPTER 713, !FLORIDA sTin,UTES, AS
, ;. :~
AMENDED)
D.
I certify thlt .1, .the applicant, haye b,en proyided wit~a copy of 'Florida's Construction Lien Law - HOleoNner's Protection
Suide' prepared by.theFlorida Depart.entDf Agriculture and ConlulerAffain. .. If the applicant is SOleone other than the
'owner., I ClrU!y .that I have. o~!~~~.~d}'.i~~'YI Df: the .bDve described dotutent and prolise in good faith to de1.iver it to t~e
.owner. prior;to:co.~enc~lent. . " ' . .
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E. CONTRACTOR'S/OWNER'S.AFFIDAVIT.
I certify that all the inforlation in this applitltion is accurate and that all work will be done in cOlplilnce with all
applicable. h~s, reguhU~ construction, zoning, \and la~ld,veloplent,.
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. Application il hereby lade tD,.obtlin a perlU to./,dD wor_,.lndinst.IUa\,ion al indicated. I certify that no work or
inltlllltion hll cOlllncld prior to illulnce of I plrllt Ind thlt all Nork NlIl b. perforled to leet Itandards of III llws .,.
regulaUng.. tPn~~ru~\ion,' &i ty cod.s"zDning ,r.guIIUonl" and land deyeloplent ~~guhUon5 in the Jurisdittion. I ,1110
certify that lundenhnd that the regulaUilltl of other governtental Igeneies lay apply to the lntended NDrk, and that it is
IY respDnlibility tD'ide~tify '.lIhd,i 'tUo.nll.~'~ take to be in tOlpliance. Such agencies include bill are 1I0t lil.ited tot
I Deoartlentof Enyir.nltn~' ReaulatiDR.;Cypre.11 Bayhlldl, Wetland ~reas and Environlentally Sensitive Lands,
..' " , ,. . .. Ifater/lflltewater Treattent .
I Southwest FIDrida Nater "anlaelent District - Ullls,. Cyp~ell Bayheads, Wetland Areas, Altering Watercourses
I ArlY CorDI of Enoineerl - SlaNIIII, Dockl, Navigable WlterwlYs
I Departlent of Bealth 1 Rehabilitative Services. EnYironaental Health Unit - Wells, Wastewater Trr.atlent, Septic Tanks
I US EnvirDntentl~ Protection.AaencY ~ Asbll~DI ~batelent
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I also certify that, if fi 11 laterill is to be used in Flood Zone ~A' or 'A,tlc.', it is understood Ulit a drainage plan
addrellinga .coapensaling volUl.~~wUI"bl subliUed Nhichhprepared by a professional engineer registered in tbe state of
Florida prior: tD perait issuance.."'. i. (" I! ,. . '
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A perlit issued shall be construed to b. . licenle to proceld Nith the Nork and. not al Iuthority to violate, clncel alter, or
set aside Iny provision of the tecbnicII cod.., nor shall lalulnce of a penH prevent the Building Official frol thereafter
requiringacor.redion .of erron in plalS,otlftltrucUon,Dr viDlations of any c~de.Everyperlit issulld shaH beco.. Invalid
unless th.:wo,.k luthDrized by such perlUHtruMenced NUh,n six IDnths of issuance, Dr if Nork author ized by thl penit is
suspendld Drr:ablndoned .for ap.rlod 'of '.Ihl..ntltllfter the Ule the Nork is.co,!l,!nud. Ont 90 day extension of Ule, lay be
allONed for 'lb, plrlit witb fie charge-of~.l':OOi. 'The ext.nlion shall be requelted in Nriting to the Building Officill. An
approved inspection lU~tbllogged during IIcb six lonth period, or the project' "ill be considered abandoned.
. '.' "..,;' :.'.: :
WARNING :TO OWNER I .. YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAV
RESULT,IN;VOURipAYING'TWICE FOR IMPROVEMENTS TO VOURPROPERTV. 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
DO NOT ~~,ED' ~O l RE,CORD, ~D ,rO,ST A "NOT,ICE OF ~,CErNT;
SIGNATURE~~~----- SlGNATUREJ____J________ ~-----
. '. OWNER OR. AGENT. CO JRAC R
DATE_~~~~~~~~~----~-;-~--------
NOTARY AS TO. ?
OWNER OR.AGENT_
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NorA~~ ;'~ "!~;:fr;< r.;:~,Tr "~F .~f
MY COMMIS'o,,,.,.i\'~~~ES:--~__- _..._":1~-------- MY
..
NOTARY PU3UC, ",.f:: O? FLC,,;i)A.
EXplJReStllSSiON _:rf'iL<:9: .J~H': 2?iS9?..
BONDED not ~MJ.6,~~'tiR9...
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FORT LAUDERDALE
500 S.W. 21st TERR. B 103
FORT LAUDERDALE. FL 33312
DADE: 621-8412
BROWARD: 791-5605
BOCA RATON: 368-1799
WEST PALM BEACH
1387 N. KILLIAN
LAKE PARK. FL 33403
PALM BCH.: 845-1407
MARTIN: 283-9459
ST. LUCIE: 461-0278
_coen.ul5ysIemS
Southwest Inc.
~""TE OFFICE
6280 ARC, . 33912
CL WATS: 1 (800) 432-556
FORT MYERS ~
6280 ARC WAY
,"-~YE~ ~~~3g;;~.
LO : -
LEE: 275-8720
COLLIER: 597.1890
SP No. 54.912
SERVICE INVOICE
J?IP 71
TAMPA
ST. PETER!"'"A~
~0820. B 75!.l1 ST. N. )
.~ LARGO. FL"34~__
CLEARWAII:H: I>4f-7600
TAMPA: 225-1379
PASCO
845-1212
LAKELAND
687 -0395
STATE CERTIFIED CACO 35496
DATE
I~~/
,
WORK TO BE DONE
SOURCE
COST QTY.
ITEM
PRICE
~~ER ~ ~L1- ~ :.r~
S;:~~I A-'.VlfJru/'L' <7. 7DJfZ - O\{~9
I C L' . / /. STATE P
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Bill TO:
. NAME ,:. ;~. . __ . fA /1 /1
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--- 'rrt~ /' /JIJA A. r ?i, P ,': V ,DATE .... DESCRIPTION OF WORK PERFORMED
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IF YOU AR...E...~.A TIS. WITH. THE SI;RVI _ X. OU R. E. .C. EIYED ~_". ;.;t' /! ( f 'r ,
TODAY TEL. I D~F_b10T~,EA-SE ELlUSJ~':>~ - y) Ar~ Alt.,.
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~OM;:~ ~ ~.- '.~PLEASE PAYi'R6u.~Y-OICE
61r:.~RTED . r.:"., .~ TERMS: NET DUE O~.........~~ (J)
,.... , ' Thia lnvoice is aubject to . FI ., / nuel Parcentage Rate of ,... which as ....
TIME:".. f"i~ ~ -t~ albNedbylew." ~ ...
DEPADTrn ltioeo-.nd. by ---~.nd......whic:lt....-pu..uont__NOTZ
I ~ ~ ..-..1"'"1 ;.;, ~,... .. become fixtur.. or JMIn ~ ~~ Ie where they .re piKed. Said peru and equipment .hall at aU times 0
SERVI'fyr-AFr!~....~,> IY~ "'" ==th.t"':':~":':-:":=;"::=:=~n-::r=:;=::"~Liss:"'::.e:.
SERVI~~ -")'" .. ~~;;;:;';~~"~~~_'O""Yell""".nd""""'''''_''_H_ CJ1
CUSTOMER~~oUNT .. ~q7 ~/) m_-1 u;:;z:.n_,/ J1,.~ b4 ~. ~
TOTAL CHARGE Sl191i Vtl TE~CIAN)iJ~NATURE __ ;p _ _ 7/ ~
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S CUSTOMER'S SIGNATURE
S ""7"'/.11 CI:= CARD EXP. m
5 , ~ YV . NO. DATE
.,
CITY
STATE
ZIP
1 ifl' '"
. . ,MAKE A c I'~~ ~ " SERIAL NUMBER
I1J b 'l Z ':4 I ~"7'? r '? I T
TO
TIME
ARRIVED
TIME
ARRIVED
DEPOSIT
BALANCE DUE