HomeMy WebLinkAbout91-1938
STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
Permit N~
1938/3
Date-L' / -/1 - 9 /
BUILDING ; EL~ ~ MEC~
Property Owners Nameii~ Jlz ~ L
Job Address: c3<fY() _ ~__ --'-- ~
Legal Description:
Sub.Div.
Lot
Blk.
Zoning CI: J / -,;J.fo -;;LI ~ 0 OJ 0 - . 0 ()~O 0 - 0 ~ h D
'z .... ~ r- (!d~
Description of Work _ ~ . A"./( ~ < ~~rl./lt-<l. l-
)Jr7U) -7' P/;;J~~.
'z..k
~
Energy Code Readout:
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost: ~.. )I 7' ~ c-tJ
OCCUPATIONAL LICENSE #.s-~3_ r1ft
~:#~~~
Ftr. SLB
Pre SLB Tub Set
Lintel Water
FRM. Sewer
Insul.CL Final
WL
Fee: I/O. tT[)
SIGN-ATURE~ ~ t~
COMPANY
ADDRESS
TELEPHONE #
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
"-
~TRICAL
~
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 (SIO.OO)
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 PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT f?O~~f S SrC;f\ ~pO--+ IV\C
/0 I Deot IF (A-ue fS!'OoIc!::'v,I/<:: I FL
,
JohV\..::,oV\. er.;e' ,1\s,'L'i ~-\--e
JOB LOCATION ::3 '30 ~'G 1U01't'r-... Aue
PHONE
90Y'-719-/9.:J_~
ADDRESS
OWNER
LOT SIZE_X
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I.D.ifF
'/~C)b -;;)I-OQIO-ODg'OO- OdbO
_Sign/Temp.
_Addition
ASign
_Alteration
_Repair
_Install
WORK PROPOSED:_New Construction
_Move
_Demolish
PROPOSED USE: _Single Family
~commer~ial
_M/F
_ifF of Units
._M/H
_Indust.
_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 FOR~S.**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.*~'
**COPY OF CONTRACT REQUIRED.
PERMITS REOUESTED
_BUILDING
$
L/!j7o~
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
_\-I.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
Signature
IU..:I /:
CONTRACTOR SECTION () . '-l -,.....,
Company ~O r:l' r S S ~ I'\. [)~ r .J.. II C
/J State Cert. or Regist. # R)t.." 06;:>0"3'5
,I:C-e-~ City License Registration IF 5''6 ~
~******************************************
BUILDER
Signature
Company
State Cert. or Regist. #
City License Registration IF
******************************************
ELECTRICIAN
Company
State Cert. or Regist. #
City License Registration #
******************************************
PLUMBER
Signature
Company
State Cert. or Regist. #
City License Registration ~
******************************************
MECHANICAL
Signature
Company
State Cert. or Regist. #
City License Registration #
OTHER
Signature
APPLICATION APPROVED BY
**~*****.*~~************************
~ vA A'Jvr"J
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictions" which may be aore 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 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 owner and contractor lay be
cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Department, (813)
788-bbl1.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor Is) sign portions 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 responsible for the work. If the contractor wishes you to sign
as contractor that aay be an indication that he is not properly licensed and is not entitled to permitting 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 - Ho.eowner's Protection
Guide" prepared by the Florida Departlent of Agriculture and Consumer Affairs. If the applicant is sOleone other than the
"owner", I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the
"owner" prior to cOI.encelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work will be done in coapliance with all
applicable laws regulating construction, zoning, and land development.
Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or
installation has co..enced prior to issuance of a perlit and that all work will be performed to meet standards of all laws
regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other governmental agencies lay apply to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include bllt ~le not liaited to:
* Departaent of EnvifCInlllental Rellulation - Cypress Bayheads, Wetland Areas and Envirc<nlllentally Sensi ti Vi? l.::inds,
Water/Wastewater Treat.ent
. Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
* ArlY Corps of Enllineers - Seawalls, Docks, Navigable Waterways
t Departlent of Health ~ Rehabilitative Services, Environmental Health Unit - Wells, Wastewater Treat~ent, Septic Tanks
* US Environ.ental Protection Allency - Asbestos abatement
I also certify that, if fill aaterial is to be used in Flood Zone "A" or "A,etc.', it is understood tb~t a dlainage plan
addressing a 'colpensating volume' will be sublitted which is prepared by a professional engineer reqistE.ed in the State of
Florida prior to perlit issuance.
A permit issued shall be construed to be a license to proceed with the work and not as authority to yiol~te, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Uffici~] from thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every permit issued shall becole invalid
unless the work. authorized by such permit is cOlmenced within six months of issuance, or if wOlk authDI lzed by the permit is
suspended or abandoned for a period of six lonths after the ti.e the work is commenced. One 90 day e:IE~SlOII of tile, may be
allowed for the per.it with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection must be logged during each six month period, or the project will be considered dbjl~oned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU
INTE~D TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN A1TORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
OWNER OR AGENT
SIGNATURE__~~-_~~/~~~~-------
KoB(;,RT "". t<'ct1~NTRAC~~--
FL DtZ R 2~2 --rt;;L". - tol -4-4lo - 0 ( E- - 9~)
DATE______~~~\~~i___________________
NOTARY AS TO . r. d~'
CONTRACTOR rJ,A..
--- -- -- "'NOT1\RY "'PUBtrr;;""SnIT' 'Or-n:a R I DA
My commission expires Jan. 28, 1995
MY COMM I SS ION EXP IlRiaktlwL.I?atwsmul3.echt..Agency
SIGNATURE
----------------------------------
DATE
---------------------------------------
NOTARY AS TO
OWNER OR AGENT_____________________________
MY COMMISSION EXPIRES
----------------------
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Rgal
100 DANIEL AVENVL:
QFlOOK5VILLE, FL 34601
-
'Contraot.
, .
"A Sign Of Qutd/fy"..
(904) 799..1923
Olle ,/0 /d<ljC/1
, ,
. \ .
GENtLEMeN; RQQor~ SIgn Deput, Inc.. propO$es to fllilnulaClUte and/or deliver, snd/or install the iteme descrlbO<lln thl$ prOP!)ul, &lll>JeCI
to tho terms end oondlllons Bet forth on both the front and back 0' this. prOPOSAl. PrIces ehllrged for services fandered Mdlor Items
manufactured ..re quoted In the liChedule bQlow. Terms and con"iti~ns on back L\r. pt.\rl of thl~ oonlrMt. .
L- rrO~()U'SUbn\lttQ~"O ._..... - I [ W~;k.l()B~p~lrl..llI1lld^'
Nlmo . ._1..~hn~Qn EYe ~.~18.tl t.ll t e " t:llreel _.' ~ame
8lflil'" __ 3e03~. NQr.t.h.Av.c.._.__. CIt)' _'. _ _.. _._
. .
.Clty ~t'p.byr].t..U.s_ !:;tote...JU . _ 33-5-40. DlI.too1 Pia II:! "..._
YolephoneNllmt>(!r 1-'800.. ~Jl.2.:"..3.1A5. .-K..a.t.rina Faxl 813- 7 e 2.. 3979
We will fl.lrnlllh 611 ~he required meterlll.le. whloh WI) (lUbrenlee will be a6 $pecltled, flod Wi will perform fI!! th$ Ilbor requited for thll
oomplotlon of:
J
.. --.'.,--.
St81~
ManuCnctUl"f\I and Illstall One set of 12" and 811 channel Lotters mOUntClt
on raceway
Copy: Johnson fiye Ins ti t\~t (iI'
Letter style as por logo
$2078.00
Mnnufucturc Qad Install O)1(l logo .. 2211 X 30"
AMOUNT
na('eway~
Returns:
Dluo to match building - Size 511 x 6"
~13 Bronz.e
"Trim C"p
J1flCOS
Chrullle
$2076.00
Blue
S~b Total
bopoalt
1039.00
balanc.Oue
NOTICE
(1) PanTonc Colo,.. .t& 100.00 pQr colQr Q)(tfa. (2) Cuslomer i~ ro!pOnslble for finel eleotrlc., (;onrlectlOn to 51g0 '1'lCl tor location of 5lgn,
Ol'le dr,wlng per cOrltract will be furnl6hecl. (3) ContrAct to be paid In fvll on In81allation. [;&ch eodillQl'Ill1 trip tor oollectlon will be charged
an addlll0l\81 ~O.OO mll'l., (4) Chango$ In the f1bove epecificatloni: may be malje only upon wdtt~n egteerncnl. 1M el(t(8 ohargee will be
made. All 19re&ments 8re conllnpont OpOI'\ &trlkee, accidents or delays bl)yond our control. You ell) to carry 1110. tornado .I\d other
necenary I"'lhlrll.nce upon .bolls worn. Our workertl lire fully covered by Workmen'6 CompenUllon and Pvbl:ic LIability fmwrance, 'thl&
proposal mey b& withdrawn by us at any time befos:e,",oentance. (5) P8li(rnttr1t'jO be made (iB follows:
)U, .uown SilO HQ a C\ue 11 Hln
Acceplanett Ditill /oh 4'/9./
Th. .b.,. "'''', ....11'..11.". .,," ..".",.", ". ,,".... P.t.., , I, Will be ....e" ~'Ih .bovo, ~ [: , ,
RC9r>"l"lflllt\l '.I,tu1)illlHf f:;;""..,,,.:-~, 0#/' v ~ ,'A . ~~~
,-
.
"'Pi . ',',;~,l
S. ~\f!F8 ~t~'
.. liP _ " H ~, Ine.
, .
100 DANIEl- AVENIJE
aROOKSVILt.~, f'1.,$4G01
.
(904) 799.1 ~23
Contract
"A Sign 01 'Quality"
, ,
Oale -l.O..:..2~ 1
~ENTLEMEN; RQ9lHS 5lgn DepQt, 10C. fHOPO$&S \0 manufacture BOO/Qf dClllv$(, liInd/or In~tf.lI 'he It.rYI~ ~UQdt>ocll... ....1& proJ>c>ul, oullJetil
~~ Ihe terms end condtllons eel forlh on l)Ot1\ the lront BOO btlol\ of thIs propoul. Prl\Xl~ ~h.r~$" f"($6NI~4 fvr'l<l~r$d Mdlor Ueme
O\~nufacturocl'(. quoted In tho &Qht'tiv1e palow.lerrn:s 'HII.! wml I 110m; on bael~ lire p~rl 0' \hl. 6onlteet.
I.
1 I
PI"poee.16tit)mlt\t~ 10
Work T Q O. PllrtOI1T1Q(I ^'
..~
N.frIt _ ~ohnson'p'Yo In~tituto Str8.1
8trOot . 38Q.~~ North Ay.e. r Oily
Qlty .__MZepl:!Yr.h11l.4-.JMat-.-- ~3~40 OaleofPlene ------..--.--.--.. _____.. .__
.t'l(lp~Ol'I.Numbo' ..1.:..8JHl-2Jt2..::.3.7.45 }[,drtna Pax '813.782-3979
Wt WIll' 'urnllhf.11 ttle roqulrell fTlcuerli\1$. which we guarantee will be .$ &paolllad, eM we will perrorm .11 the le.tlQr requIred '(.of the '.
oomploUQn 0': . .
Same
GIll.
Manufacture and Install
ontacew~y
Copy: "John~on Bye
ono sot or 12". <,:.lu~.nJlc:l ltllt..ers rno\lllted
W01"ks .t
- Letter style as per logo
$1670.00
..tanufacture and Im;tal1 one logo - 16t1 x 24"
Unceway:Bluc ~t:om~tch builcllll& - Sl~~ S" A (,It
Returns: '1$ .Bronzc
Tt'h\. Co.ll..Ch1'omo
Fac~f; .. Dlue
AMOUNT
--------~~~-~-----_._---~..._._-<<._~_._--------.--~
Manufacture and Instnl1 one Neon Sigll n\ountc:u OlI
2 t 8'* oX 8 t G1' X 611 sheet metal cabinet
$~420.00
Copy:
'*r.~pr~li&fl ~u to logo
Color: Pink
Cabinet: nluo to match bu11dtng
Sub Tot"
$750.00
Oe~o~1t
1210.00
8ahmce Due
NOTICE
<') PMn'tcme Oolun; i1ra100.00 p9( color exl..a. (2) Cu~lorlier 1& feapo'l61ole 'v, 'i....1 ..1"'''1.;"",1 o,;V"I1t:t,;l;vn tu :>1"" illl.d 'vr locatjon or &Iijn.
One drawlov per contracl will be furnllJ.hcd. (3) Contract to In: paid 111 '1,111 on lm.ti:llli:lllon. Elich ilddltlunel tllp for collection will be cnargGd
.n addlllonal 00.00 min., (4~ Cheo"olll In the 4:\UUVC tlJlt:dfll;aliun:s mil)' l1Q rnlldt.1 anI)' uJlun wrlUl:1n Ilgrtltlfll(,nl. anCl exlra Charges will be
lIl"de. All .vreementa ere Gonllngont upon :ltrilu.ltl, vvuldulIla VI uulu)''' lIu)'vlIIJ VUI l:vnhvl. Yuu IJlG to \'1I1t~ file. tornA(J6 ",'Iol vlh",
r\oO(t&6ary In.ur.nos upOn above wOlk, 01,11 wUllo.t!ltf blEl 'ully evn:led Ii)' Workmen's C('>lfIpoflllall<m "lid r>vltlfc Llabllll)' Insur.floe. 1 till
PTOpofH~1 may be wUhdulwnlly Utl ttl t(Ilr time t>cforc llc.vcplanco. <~) Paymcnt$ to bc made D$ follow,!;:
,
AQQ;"p~."e. Dille
'''a .-. P'"c.., ....clII..".... .... ~"."'o.,,.~ .~p'o'. Paymoo', wt" .. m.do.. /'j ..0:.. - '.. 0 .
AO&(18<1t!ullyeul1mHltd _ ..'. elg(\l-hJr~~~:~~""'"
The- "'9~v, prlcfI&, ep&GlIicetionc ar'ld contfltlC>f\1l are aceO~I1. Peym901& Will oC' ",.............. -~.,7-;; --:7':-~.-~. ~/p.&~~..Ch
.. _S\gnll.lUrll,( ~ ~~. -
n.tll'>AoHullv 8vbmllted. - . . · - .'
~ JOHnson
...." EYE INSTITUTE
David A. Johnson, M.D.
Medical Director
Board Certified Eye Physician and Surgeon
Judith A. Johnson
Administrative Director
November 19, 1991
Mr. Bob Rogers
Roger's Sign Depot
100 Daniel Ave.
Brooksville, FL 34601
Dear Mr. Rogers:
This letter will advise you that you have our permission to install one set of
channel letters which read "Johnson EyeWorks Express" on the wall of our building.
Sineerel y, . -' /}
~~~~
~:;:. B. Bracewell
Marketing d.
5vJOcYl ~ ~ SubsC!/u'hud ~11'U! I"YU ~ /7~ ~
o/J NO~n-J~ ;41). /99/.
Wi tnessed by:_~_U~B.l:;}..g.~______________________
My
commission
~ KARLA L. MER
, Stale of Florida
. My Comm. E.lO. June 19. 1994
eXpIre s: ____________~_____-_==________________
1-800-282-3745 (Nat'l W A TS)
38038 North A venue, Zephyrhills, FL 33540
(813) 788-7656
(813) 782-3979 FAX