HomeMy WebLinkAbout91-1990
STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
Type of Permit J- (). o-V .;J~-: CT7>
B~ C~TRr~ p~ ~HANIC3)
~~:P:~;r~s:~er~N;; ; Q"- ~?::. ~~X ~ ~
Permit N~
199011
Date /~ .../~ - '1 /
Legal Description:
Sub.Div.
Zoning CI:
Description of Work A- / c
Lot
Blk.
~~.-k;J-" - ~
.(
t-3- .
1-'
I
Energy Code Readout:
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost:
~~ 7::l.ti{)
Fee:
All work shall be performed in accordance
with the above and all City Codes
and Ordinances.
OCCUPA T10NAL LICENSE #~
SIGN).TURE
COMPANY
ADDRESS
TELEPHONE #
UILDING
Ftr.
Pre SLB
Lintel
FRM.
Insul.CL
WL
SLB
Tub Set
Water
Sewer
Final
Tp.Serv.
Rough In
Meter Can
Canst. 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.
Thc payment of reinspection fees shall be made before any further permits will be issued to the person owning same,
APPLICATION FOR PERMIT
CITY OFZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT .;?e/JI/y-e ~L'~
.
ADDRESS 3ff8''1/ j) SL' SI/E " 7-///115 "!:/4
OWNER F/A,ue /S 2/c- t;..(l/'155 e
JOB .LOCATION 3,~770 J/t//e'4A/"~
PHONE
7 tf:f" -&/ R',/
LOT SIZE_X
AREA SQ. FT.
tECAL 'DESCRIPTION: LOT(S) BLOCK SUBDIVISION
, PARCEL 'I:D.4~ .~ f/z-7F''U-,. '.A-K /b~LJI-h~;J{///l/6Whew
,
Jn~.:' \ ',\.'.~x
'WORK PR~POS~D :---":NewCo~sti\ic:tfofi' ~Addition
~, ':> ~
-Alteration
..k..Re'pair
_Install
~Sign/Tentp.
_Sign
_Hov~
_Demolish
J'L.:,''?::,t't''";
;p'RopolE:D USE: -=--:-Sing1e Family
_MfF
----,-U of Units
__M/H
~Cbmmercia1
...:.:....-Indust.
--,....Swim. Pool
Other
"
~'.;'" ~';<' ._,~1:"
"~Res taurant::' & 'Health'1'>epattment
;; ; r~;;; i~~,~ !;,;: t'~?~T'_~~i_:r:!..: i
'BUILDINC;$IZE :.
Approval
,\~-;-el(;,~,t;':~NT~ri~ !~',.;
r"ii:ES OCimNriAL':,
~:\CbMME~dAL :
x.
, )
Square Fee t,
Height
AtT:~{n{ (~'2:Y:pI.a~~ J!tA~$.& (2) SETS OF BUILDING PLANS & (1) St::T ENERGY F,ORMS. **
AfT~CI:l ,(3)!S'~~~,:.et Bt!tLX>ING PLANS & (1) SET ENERGY FORtIS. **
**COPY)OF CONTRACT REQUIRED, ,
PF.RMITS REQUESTF.D
: ~(. ];:.~ .. .
_BUltIHNG
$
-:. Valuation of Total Cons truction
..,. ,',
_ELECTRICAL
-LMECHANICAL
AMP Service
Florida Po\-'er Corp.
W,R.E.C.
$
/ IP 7;Z O..f!
Valuation of Mechanical Installation
_PUJMBUfG
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block
_Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT,
******************************************
Signature
CONTRACTOR SECTION
Company
State Cert. or Rcgist. Y
City License Registration ~
******************************************
BUILDER
ELECTRICT AN \:L '-~(.. E~ .-, () Company -z...-\,-\ \l,..L-S t=' ~S:>C'I ~~u.
~ ...,('J State Cert. or Regis t. iF C)O() ?--l(.,'C
Si!matur~r... . ~/ City License Registration 1/ I ()
******************************************
PLUMBER
Signature
Company
State Cert. or Regist. ~
City License Registration 0
********************~**************~******
Signature
Company ~/4/ n.tV/V~
State Cert. or Regist. I,! ,-ht~/?'~~cfr'"
City License Registratio~ 0 . ~
OTHER
Signature
Company
State Cert. or Regist. 0
City License Registration 0
APPLICATION APPROVED BY
PERl-lIT OFFICER.
_ ....'-::-., - ;'-'-~---r'
I,
CONDIT.IONS OF PERMIT AFFIDAVIT
+
A": NOT I CE OF DEED RESTR I CT IONS:. ,
The undersign~d understands that this perlit lay be subject to 'd~ed restricti~ns' ~,hich ~ay bn 5~re res~rictive than City
regulations, The undersigned assules respon5ibili~~,f~~ co~pliance Mith any applicable oe~d restrictions.
,... ':.." " '. ' I
8. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor Dr contractors to undertake Mor~, they may b~ required to be licensed in accordance with
statl! and local Tl!llulatio-ns, If thl contractor is not licensed as r~quir!!d by law, beoth th!! oltnH and contract~r ~ay bl!
cited for a aisde.eanor violation under state law. , If the OMn!!r or intended contractor are uncertain as t~ what licensing
r.q"""'" "y .pply I" tho ",.,d.d ,.,k, 'h.y .,. .d",.d " ""." 'h. C"y ,I 1.phy,h'll, ','Id'" D.,."..", 18131
788-6611.
Furtherlore, if the owner has hired It contractor Dr contractors, he is advis~d to have the contractortsl sign portions of the
'Contractor Sections' of this application for which they will be responsible. If you, as the owner sign as the contractor,
Y" .,. ',d".'I" 'h.' y", ,.th., Ih., tho ,.,Ir.".r, .r. r."",ibl. I" 'h. ,ork, II 'h. ",',',',' ",h., y" " ,I"
as contractor that lay be an indication that he is not properly licensed and is not entitled to per&itting 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 ,.,"Iy 'h.' I, 'h. ."Ii,.", h.,. b.., ,r.,ld.d ,Itb . ,.,y .1 'FI,r'd.', C""",'i" L',n L., - H""""" "".,'1.'
',Id.' pr.p.r.d by 'h. FI,,'d. n".r'.." .1 A,rl"lt,r. .,d C.",.., Aff.ir" If 'h. .p,li,." i' "..". ,'h" 'h., 'h'
"".,', I ,.rt'ly 'h., I b.,. .bl.I,.d . ,.py .Itb. .b.,. d..,rib.d d.,.,." ..d "",.. i, ".d I.,'h I. ,.11,., i' " 'h'
'OMn~r' prior to cOlienc~ment.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I e.rtily 'h.1 .11 'b. i,I.,.."., in tbi. .,pl\,.I'" i. .,e.r'" .nd 'h.' .11 ",. ,ill b. d'" " ".,Ii.,e. ,i'h .11
applicable laws regulating construction, zoning, and land development.
Ap,I',."., " h.r.by ,.d. I. ,bl.i, . ,.r.it I. d. ,.rk .,d i"I.II."" ., i,die.'.d, I e,,"ly ,.., ,. "rk "
i.,t.ll.t'" h., "...".d pri.r ,. i....n,' ,I . ,.r.'1 .,d 'b.1 .11 ,." ,ii' be ",I",.d " "., ".,d.,d, ,I .1\ I."
,.,.I.'i', """,,'i,', c"y "d." ",',' r.,.I.'i.", .nd I.,d d.,.I."." ,.g.I."". i, 'h, i"i,d','i", I .1"
e.,"ly 'h.' I .,d.r.\..d 'h.' Ih. r.,.I."". .1 .tb., ,.,.r,..".1 .,."i,. "y ."Iy " 'h. in",d,d "", .,d 'h., i' i,
'y ",pon,'hi I ity ,. "onii fy ,b.1 ,," '"' I ".1 lak. I. b. " mp Ii..", Soch .gco"" i "d ,d. ." I ;;. ,,' I li .it.d ,,,
. n.,.rl.", ,I '"'r.,..,,.1 A.,.I.'i., - Cy,r.,' B.yb..d., H.'I.,d Ar'" .,d """""..11y 5,.,il'" L,nd.,
Water/Wastewater lreatment
I Southwest Florida Water ManaQe~ent District - Wells, Cypress Bayheads, Wetland Arcas, Altering Haterc~urses
I Armv Coros of Enoineers - Sea~alls, Docks, Navigable Waterways
. n. .".." .f H...,. l R,b.bili'..". .."i,.. '"ir.,.",.1 H..I'h U," - "11., H...,..", ....,..." '.pli, ,..k,
I US Environoental Protection AQenct - Asbestos abatement
\ .\.. ","Iy 'b.t, if lill """.1 " "b. ".d i' Flood lon. 'A' 0' 'A,."'" iI i. ..d""",d \I.,' · dra'na,' pi"
.ddr.,"" . ',..p"""" ,.1.,.' ,ill b. .,b.i'l.d ,bi,h ,. ".,.,.d by . p"f,..i,..1 ..gi.", ,.,i.I.,.d i. ,.. .,.,. ,f
Florida prior to permit iS5u,ancc.
A,.,." "...d ,h.ll b. """..d ,. b. . li,.n" I. ,r.,..d ,ilh 'h. ..,! .,d ,,' ., .,'h""y " ,i,I.,.. ,.".\ .1'", .,
..\ ..id. .,y p",i.,." 'I 'h. ,.,b,i,.1 ,.d." '" .h.11 "".". ,I . p.,.il ,."..1 'h. ',ildin, 0Ifi".1 f'" 'h.r..f'"
ro,.i"" . "n" "on .f ",H' " p 1m, ""Ir""on, 0' ,i .1.ii,,, of any "d', '",y ,mil i "',,' ,".11 b"'" i ".1"
"I." 'b. ,.rk ..'h"i,.d by ..,b p.r.i' ,. ".,.".d .'Ibi, ". .,,'h. ,f i.""". " if ",' .,'h",..d by'" ,.,.i' i.
"""d.d " ..and,'''' fH . ,ori,d ,I ." ..,'b. .Ilor Ih. "an the ''',' i. ,,,,,,Old, ,,,,e, d'j ",,,,.,,,, ,I Ii.., "y b,
.11".d I.' ,,,. p."" ."h f.. ,b.rg. .f ~'S,", lb. ..1."", .h.11 ,. ,..,..',d " ,'i'i.g " 'h. I,il'i', 'lfi,i.I, "
."rmd i"p""on ,,,, b. I.".dd"i', ",b .,. ..,'b ,Hi,d, 0' th, proi.d ,i 11 b. ",,,,,or,' "",dH"d,
WARNING TO OWNER, YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY, IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A 11 NOT I CE OF COMMEN.CEM~NT,;". .. ~
/ /j~y
SIGNATURE_---U~-Ji2.-~----- SIGNATURE__~j;{~c2-;-#~M,.t:<<-
OWNER OR AGENT ' . CONTRACTOR. ~
DATE ~ - 1;2. - 1j
_____~--_u-----------------------------
NOTARY AS TO // M /) ~
OWNER OR AGENT_~~----~~~-----
State of Florida at Large
MY COMMISSION EXPIRES~~~W~~~~~~~L----
;;~;~~~i~~~~~~~~~~~~~~
Notzry Public
MY COMMISSION EXPIRES. State of FIoridaat Lar"'"
-~1com~iXplles-oe~i991
~ . .
.~.,
..
Lie # RAB05084
CONTRACT
ZEPHYR AIRE
P,O, Box 1243 · Zephyrhills, FL 33539
38841 D S.R, 54 E, · Zephyrhills, FL 33540
(813) 788-6284
Contract Submitted To: Phone (office) I Phone (home) Oate
",
..l':/.,) /I' /V -," 1.5 ' ' //,',,~. / .<:' (~ ' " ,1 >- 9/
.< /..~. .
Street Job Name
.3 r, '/ ,..;~, " /,' /
/' I" /- '/' ~;/ /I_
City, State and Zip Code Job Locatlon
..,;~:-~~:- /j/.../><>,< /: .1,"// .:":. /:>' ;..; --:; t;i/
..- I,
We hereby Submit to furnish mat~rial and labor - corryJ'lete in accor~ance with specifications below, ~or.t~e sum of:
/ .' / /.. . '/. ,/ /i /I"'.,cJ ? \. , 0/ '. /.. ". / '
(./,'t- ',(."<:///I..) "'/.,/'/f,'//,t",{ ..I-.vr-A,'. ",(.1/,-. dollars ($ ,6// ),lncludingTax.
Payment to be made as follows: /
40% upon acceptance of contract, 60% upon completion 100% upon completion y;...;-
Authorized -'
All material is guaranteed to be as specified. All work to be completed in a workmanlike manner accord- .' -_...~
Ing to standard practices. Any alteration or deviation from specifications below involving extra costs will Signature ; " ",-:",.-,- - /t~~.. 1..'./
be executed only upon written orders. and will become an extra charge over and above the estimate. All Note: This contract may be
agreements contingent upon strikes, accidents or delays beyond our control. withdrawn by us if not accepted within r3u days.
We hereby submit: ~ - 1:- ,-- .:/: I .' i/
l..-l/' ".'
/..-/.7 << .".'./ ,", / < /1/ ~"'..~~ //If' /~4c/' y,< ,/ /<./
Equipment Model No. B.T.U. K.W, RATING , S,E.E.R. C.O.P. H.S,P,F.
//.('1/,// j/.- r .? .'.11"/1"/' ' ,
I ,,/ .(.' /, ! (.(
, I 9.~
..~I/;1 \,/ -/>'r'A/ /. ,/, /'/,// / />-A/ X;c t..
,,-) '-' '. -, 'T '.. . .'<:"~>~--/~~~h~/ :t/;/ T
..L:/;,y ...~. /,..... ~...:) (. .!)
Duct Work: Flexible }~6 Metal #)' /;"./,(..-f;,->".r: Duct Board #475 #800
No, of Supply Diffuser f7 " 'i/X't No, of Return Grilles (~ it./(~~ / l y ;)'(. Electrical Incl. Yes
,)/)(
I I! ,I... "
Hot Water Recovery Unit .A/{: Line Cover . c~ Drain Pan Air)
L;;' :; ;/11) /';/c: /
Equipment Removal Pre-Hung Door Attic Ladder Walkway Aio
,
Concrete Pad ~.<r 4':1 Humidistat A/I) . Refrigerant Line ././ v
Warranty: No, of Year(s) on Parts and Labor ( /tie
No. of Years on Evaporator /;v,,~.:.
-
No, of Years on Condenser )- 11.'/ e_
No. of Years on Compressor h:/ c.
Comments: (',/;:/ ~'T l~// /~/
/ //
Acceptance of Contract - The above prices, specifi- ..
cations and conditions are satisfactory and are hereby Signature j' " ; ......(~ ..... ~-~_.' . I .ALk
accepted. You are authorized to do the work as specified.
Payment will be made as outlined above. ;
Date of Acceptance: Signature .- , ~-/ ."7 I i.(
, . "