HomeMy WebLinkAbout91-1943
STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
Permit N~
194 3 ~1
Type of Permit
Date 11-:20 -7/
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Property Owners Na~e: {!.:-::7;<.. "1!:lJf-_
Job Address: b () .::Ls:- .
BUlt-otNG-.__...._~_
~_~G
Legal Description:
Sub.Div.
Lot
Blk.
Zoning CI:
Description of Work 4/ {-
C~~f .4 -P -
(/
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Energy Code Readout:
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Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost: 7;, <S - .s--O. oz.)
Fee:
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
OCCUPATIONAL LICENSE # 9 /
/
COMPANY
ADDRESS
TELEPHONE #
Ftr.
Pre SLB
Lintel
FRM.
Insul.CL
WL
------
ELEcmJ.Q.AL
---.........
@(,:~~,
C---. MECHANICAL)
'---- -------
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BUILotNG--- -
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 '
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APPLICANT
ADDRESS (00 '2 r c:, ~Jf- '!11ti!;(yJ '~ .
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OWNER "(~~ ,..' ."','" ,
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JOB LOCATION .
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:LOT SIZE
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.,<, AREA 'SQ. FT ~,:" ; !i
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LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
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PARCEL ,I.D.41' .:. .... < ''',
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":"~'f,t~;;" ';'; !<t::"~~ I ';' '~t j".~ 1,'1 .~'
WORK PROP~SEI> 1~~J4~~C~n~,~~~ti~n ,'~?d,ition
, IF.
~Si,gn/Temp., ____Sign
PROPOSED USE: ~Sin~1~tF~~i;'~ll:'J!~~~t(" HIF" 1;'1: i_4~'bf Units
~ ~i
-Altf7ration ~epair' ..i. 'Install;
... I, ,t t;t.J J:' " ;}l :{::; ~ 1~~: ~ i; , :'.
~Hove ",I (,: .'. IHfnem61{sh
..
.-.::...:.JII H
;:~1}~tt;.~l.ii1,-~ ::e'(~"'~ Ir1 (" r~:t, j.~~.t"t;
. _Commercial.... '_Indust.
~Swim. Pool
Other
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( l'l'~:j~e,stau~,n~: &, Heal~ :.pe~ar,tmen~ Approva\
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BUILDING SIZE: . X '. " " _Square Fee t,
H~ight
. ~ '.;
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF ,BUILDING PLANS & (1) SET ENERGY FORMS.**
ATTACH (3) SETS OF BUILDING PLANS & '(1) SET ENERGY FORHS.**' ~
t~~COPY ,OF,CQNTRACT REQUIRED.
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_BUILDING.,..,...$ ..
1".';' ,.',., '. ,I
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_ELECTRICAL... '. .
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~ECHANICAL $
_PLUMBING'toir I" "
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PERMITSRROUEST~D
Valuation. of Total Construction
,
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,,': ,I AMP Service' , I Florida. 'Power 'Corp.' "
'Lf'5-'f&-'t'::cla, i '~~alUatiO~ ~f Mechanical Installa~~on .
. ,... ~ GAS' f(.' ROOFING . SPECIALTY.
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W.R.E.C.
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,
FINISHED'. FLOOR ELEVATIONS:..
TYPE OF CONSTIUiCTION: ~Block ____Frame....:......;S teel'
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FT..
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******************************************
CONTRACTO~ SECTION
Company
State Cert. or Regist. #
City License Registration #
"******************************************
BUILDER
Signature
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EY.EeTRIel AN Company
State Cert. or Regist. #
Siqnature City License Registration #
******************************************
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PLUMBER
Company
State Cert. or Regist. #
City License Registration #
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Signature
Signature
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Company Air Control Systems S()uthwe~t Inc.
State Cert. or Regist. 4t CACO 35496
City License Registration # 91 CA C035496
****************************
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OTHER
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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
A. NOTICE OF DEED RESTRICTIONS
The underllg~d underltlndl th.t thil p.rlit I.y bl lub11Ct to Idled restriction.' which lay be lore rel~rictive than City
reguh~iD~~~:;!~~ ~~~,r~.I.~~~~:~~'~'I'~~~on~,lbl~l,tl/or cOlplilnn with .ny .ppficable deld n~tricUonl.
. . ," ,. ,
B. . UNLIC~~SED CONTRACTO~~ AND CONTRACTOR RESPONSIBILITIES
. .~ ..It....'!'t'~~'I,'''~.'''..':~f~.,\~Ii~...\..~I....'' ',"'-;"""~'" ,.' ,:-' '
If th. owner ~al hirld a contrlctor or contractorl to undertake work, they lay be required to bl-liclnsld in accordlncl with
Itlte and lotlil'regulathnl;" 'If th. Cofttrlctor il not linnlld .. required by law, both the ownlr Ind contndor lay be '
cited for I ~IJd'le~nor l~,)ation under Itat. la~. If the owner or intended contractor are uncertain as to what licensing
requirelents IIY Ipply for the'lnt.ndedMork, thlY are adviled to contact the City of Zephyrhilll Building Depart.ent, 1813)
788-6611..
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Furtherlorl, if the owner hal hired a contractor or contractors, he il advised to havl the contrlctorll) sign portions of thl;
IContractor Sectionl" of'thi&lpplh:IUDnfo, which they will be responsible. If you, II the ollner lign II the CDntrader, ' .
YOII,ar',lndictU~g 'h~ty~u'l nth.r tha, 'h., con,ractor, Irt re~pon"ble for the work. If the contractor wishes you to lign
'as contrlctor!that IIY b~an'1rdl~aUon thlthe h not proplrly licenled and is not enUUed to per.UUng prhileg.s in thl,ll ..~
CUy ofi,lep~Y~~HI'. q~!~, i ..
.
C.
TR~~~~ORTATION IMP~~~F~'S A~D UTILITY CONNECTION FEES,
CON~r,~U~.!,~.2~; .,~. ~ EN L~W ,. 'r'~ ~l'APTER 7 ~ :3, ,FLOR I DA ST A T,UTES , AS
'f' "
AMENDED)
D.
I certify thlt .1, the applicant, hav, be,n providld Mith I copy of -Florida's Construction Lien Lall - HOI.owner'l Protection
Buid,' prepared by-th' Florida Departlent of Agriculture and ConsulerAffairs. . If the applicant is sOleone other than the
-owner', I tldifV .that I have Db\aineda~~p,,01. th. above described doculent and prolise in good faith \0 delivtr it to 'he
10llner- priorjtD~co~lentllent.' ..".,,0' > ). . . .... .... . . . "
..'. j'" ';'~':'i~ill~..[,'...:).;'t'\'j . ......'!
E. CONTRACTOR.S/OWNER'S,AFFIDAVIT.
,',~
"
I certify that all the inforlation in thil application is accurate and that all work will be done in cOlplilnc. with III
applicable..1alls,ngulating, construction, loning, ,Iod Ilnd,d~veloplent,.
; , /"; ; ~ ,: ' . .\;' 111-- '. "
Application iI hereby lad. tDJ .obt.i~ I Plr.U t~.do ItOr_and.Jnlt~lla~ion II indicated. I certify that no MOrk or
lnlt.11atioR hll cOlllnc,d ptior to illuane. of . plrllt and 'hat all lIork will bl perforled to leet stlndardl of all 11MI
reguhtingtDn~'rUt~~!ln,'City cod.,,!IDning ngul.Uonl, and hnd develDp"nt (Igulations in the jurisdiction. l.1lsD
certify that I.understand'that thl regulatiDRI of other governlental agenties .ay apply to the intended lIork, and that It is
IV respD,nsibll1ty to ide,~ify,ttb.t" .cUo,nl ,~~IUI,t take to be in co.plhnce. S\lch agencies include bllt all! Ilot lil.~ted tOI
. DeDar\ll!flt Df EnvirenllnWl ReoulaUoD; Cyprlll Bayhlldl, WeUand Areas and Environaentall Y Sensi ti ve lands,
, I . , . ": ~,".. '. . water/Wastewater Treatltn\"' '
t SDuthwest Florida Water Kanaoe.ent Diltrict - Willi,. Cypr'ls Bayhe~ds, Wetland Areas, Altering WatercDurses
I Arlv CorDS of Enoinelr. - SeaMalls, Dockl, Maviglble WaterMaYI
I DeDartlent of Htalth l Rehabilitative Servicel. Environlentll Health Unit - Uells, WalteMlter Treatlent, Septic Tanks
. US Environaefttal Protection' AOlnn - ~sIIlItol abateaent . .'
I also certify that, if fill .aterhl il to be ulld in Flood Zone ~A' Dr "A,etc.", it is understood that a drainage phn
addressing a .rcolpenlating voIUJe~wUl,be IUbli~t.d Nhich iI prepared by a profe5lional engineer r.g~sterl!d in the Statl of
Florida prior: to plrlitlsluanc:e~'h, . ;},i !,,' . ,
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F' ,
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A per.it ilsued shall be construed to'bl a'lice.leto proceed with the work andenot'as luthority to violate, cancel alter, or
set aside Iny provilions of th. technical cod'I,.nor shill illu.nce of a perlit prevent thl Building Officill frol thertafter
requiring I 'corr,ecUonof erronJn plalll,,;ttM'rudion,or,viDlltions of anv c~de.Everv per.H ilSued shall becole invalld, .
unlesl the'IID,k'authoriztd'by'such per.l'~l"t''''nced within I~I lonths Df ~Isuance, or if Mork authorized by the perlit is
IUlpended orr'ablndonedJof. a 'p.rlodDf;:ihtl...tlal after, th, U.,the work is C:O~.l!nCld. Onl 90 day extension of tilt, lay be
allolled for'thl plrllt,ltUhftt' thlr't'~fl"l'~OO. 'Tht Iltenl10n shall be requested in llriting to the Building Offichl. An
approved inlp~ction,~tt.i ~;~ '1!1ged during lath sill lonth period, Dr the project' IIi 11 be considered abandDned.
. t ,. ." i'. \.~ ~ ; "' ~.
WARNING ,TO OWNER I VOURFAILURE TO RECORD A NOTICE OF COMMENCEMENT MAV
RESULTflN1YOURtPAYING'TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU
INTEND:TOOBTA1N:FINANCING, CONSULT WITH YOUR DER;OR A ATTORNEY
~~F~~~l :~~~~~~N:E~g~~ ..~~I~~B.. ~F A C?~~i~~~M~~T COM~ ~EI~i $2. 500 r VALUE
SIGNAnm~~.'-..'."'....'..' ~'. ~;..._..".!..'.;"".~.~..' .-... _I.'. ~:::!.'..'~". _..' _.~ 1.: --.<~j,.-.::..::~~ SIGNATURE_~ \ ----- ----- -----r~ -- -
. ,,;iL\;,~AGENT. I, -+ ,ClINTRACTO
DATE kr~- 1.~""" eve " DATE ~'-r\i'-. ,\-".? lei ,'\")
--J,.~-------- _~____~__l__._________...__ _L_...........l.-.:....-"..}..."'........----'-.......----"-. ...., ----.-
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NOTARY AS TO ~~~~=~C~~RT_~_~.....' "-(;t........... 1__"_.,_._<_.__.._,'1.__. (::~
OWNER ~~~~ENT~___~___~___________________ ~-- ~ - ~ =----
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_I. N TARY P1.JBL1C..Stat" ol.F\!lrida a\ Large
MY COMMISSION EXPIRES______________________ MY COMMISSI4"" E,X~_~E ~..;=:;~~~~ Ins, Co
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UNl: cas. '15'60 .@Q ~g<1' lof
cow J9aO, s&- _
ON COMl'L.Z-r=ON ;) 5 2S 0 \ DO
CUS':'OMEa N~ K \..tS5~CL CD~'f E-L.,L
ADDRESS (;;,'OdS } 81:.lt ::r
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MOD~ tJ
PACX.
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INS'!'. DAn; {~ ~ 1 A.M" G.~::2
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ZIP CODE _t3~t.f 0
SAUS mvoIa ;I 5 P ~ 7
CIn OR. COUNT! !A.'a:S PAID '1'0 'fA 5C 0
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PRONE NmmER_
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OLD EOUI!'MEN'!'
MODE!. I}
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HEAT IN NEW UNIT
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Ala SIZE
DtSCONEC! NEEDED
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DOC'! WO.RK ~Dt:!~\=:ONS
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~'!S 75/ft'! /
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__FROM COMMEN"rS
5L~~S / 7I~~,DEL~Y
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FOR