HomeMy WebLinkAbout92-2048
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
No
, .
2048)1 j
I
Date /- !y- 9;z.
B~
'---
ELECTRI~L
'-
PL U MBtNQ..
~sewerconn
Water Conn:
Pmpeny Owne, Z~:Jt 7u
Job Address: ~ / I
Water Meter:
T.I.F.'s:
Parcell.D. #
Zoning: Energy Code:
Description of Work<...-:J:;.~ ~ LA ,
Radon Gas:
~p7;~
NO OCCUPANCY BEFORE C.O.
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
c,
../
Inspector
DATE
Valuation or
Contract Price
.3./ -.50- trV
/
Permit Fee ,.#'""': ~
Signature w~fl\O(/llAr~
Company . (
Address
Telephone#
City License Registration #..s- 9 3
State Certified License# c:J 0/ R-s- / b d ~ 0/ 7 7
.~~?~
~~A~
Breakers
Ducts Insl.
Compressor
Final
; tJ:dlJrIJ.-tl#'ft v,v
2- - 3-'fZ- M-
BOiL.Q.ING
~
EL~ICAL
"'
PL~'NG
............
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Driveway
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
APPLICATION FOR PE~IIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT Lla2.hJ ~6-lk rote ?riuru-'flp ~
ADDRESS 600(0 ANOfAz..~()~1<o 'TAMPA, FL. 3~0 ~Lf
I
OWNER K~5(4~>e JIVC.
JOB LOCATION ~~~ ~~8 \(~tvtfrn(~ 6t.-D~.
PHONE (. 613) f?g~ -77</-1
LOT SIZE_X
AREA SQ,FT.
LEGAL DESCRIPTION: LOT(S)
PARCEL 1. D, ~F '- -q - d.. 6 - a /
BLOCK
SUBDIVISION
WORK PROPOSED:____New Construction ____Addition
XAlteration
____Repair
_Install
____Sign/Temp.
_Sign
_Hove
_Demolish
PROPOSED USE: _Single Family
Xcommercial
_H/F
_~F of Uni ts
__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 FORMS,**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
**COPY OF CONTRACT REQUIRED.
PERMITS REOUESTED
____BUILDING
$
Valuation of Total Construction
_ELECTRICAL
LMECHANICAL
AMP Service
Florida Power Corp.
_\~.R,E.C.
$ '3.100.00
I
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
~ )(171'1 NC'}---.O ther
TYPE OF CONSTRUCTION: ____Block
_Frame _Steel
FINISHED FLOOR ELEVATIONS: FT,
******************************************
CONTRACTOR SECTION
Company
State Cert. or Regist. #
City License Registration #
******************************************
BUILDER
Signature
Si~ature
Company
State Cert. or Regist. #
City License Registration #
******************************************
ELECTRICIAN
Company
State Cert, or Regist. #
City License Registration #
******************************************
PLlJMRER
Signature
Signature
Company (! 'fZl !JN~lL h ~ l2. ?QDTI~-C-rlO J
(JJ ~/I- \ S~ate ?ert. or R~gist. ,1.' ~~ " 00 7
~ liWAi:G C1ty L1cense Reg1strat1on ~F
** **************************************
MECHANICAL
Company
State Cert. or Regist. #
City License Registration #
OTHER
Signature
APPLICATION APPFOVED BY
~**********~!************************
~ _ ..v\AJ"Vt ,....-
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit 'lay be subject to .deed restrictions" which lay be lore restrictive 'han 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 Dr 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 Departlent, IBI3)
78B-6611.
Further.ore, 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 lay be an indication that he is not properly 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 Departaent 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 docu.ent and prolise in good faith to deliver it to the
.owner. prior to cOllencelent.
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 co.pliance with all
applicable laws regulating construction, zoning, and land develop.ent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has cOllenced prior to issuance of a perlit and that all work will be perforled to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other governlental agencies .ay apply to the intended work, and that it is
IY responsibility to identify what actions I .ust take to be in co.pliance. Such agencies include but are not lilited to:
. Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive lands,
Water/Wastewater Treatlent
. Southwest Florida Water "anaQe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
. ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
. Depart.ent of Health & Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
. US Environ.ental Protection AQency - Asbestos abatelent
I also certify that, if fill .aterial is to be used in Flood lone "A. or .A,etc.", it is understood that a drainage plan
addressing a .co.pensating volu.e. will be sub.itted which is prepared by a professional engineer registered in the State of
Florida prior to per.it 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 shaJI issuance of a perlit prevent the Building Official frol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becole invalid
unless the work authorized by such per.it is cOI.enced within six lonths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six lonths after the ti.e the work is cOllenced. One 90 day extension of tile, lay be
allowed for the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection lust be logged during each six .onth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO"KENC~ENT KAY RESULT IN YOUR PAYING TWICE FOR IKPROVEKENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COKKENCE"ENT. JOBS UNDER $2,500 IN VAlUE DO NOT NEED TO RECORD AND POST A -NOTICE OF COnnENCE"ENT".
SIGNATURE: OWNER OR AGENT
/)(111(1 (A)~J~o./'I(L-JJy 1---13~9~
SIGNATURE: ~;~ACTOR J CJ
was acknowledged
, 19 _ by
STATE OF FLORIDA VA beD
COUNTY OF r I '
The foregoing instr~ent w~7 acknowledged
before me this /3r H JAI}J19 92 by
009[(; lAJ L-OI/\/Rt,J
who is personally known to me or who has ( \
produced FL D/~ ~ L~OO - /7q-&/ --44.2 -0 E9t;.-J
as identification and who did/did not
take an c.ath.
STATE OF flORIDA
COUNTY OF
The foregoing instrument
before me this
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
IName Typed, Printed or Stamped)
NOTARY PUBLI C
(Name Typed. Jnted or Stamped)
NOTARY PUBLICi: ARY ~uBLrc, ~TATE OF FLORIDA
y commIssion eXPires Jan. 28, 1995
Sonded thru Patterson. Becht Agency
(Signature)
(Signature)
UIUi\lI~~L..L.. I-in..:.
-,
PROTECTION
SYSTEMS
COMPANY, INC.
8006 Anderson Road
Tampa, FL 33634
PROPOS'AL
L
~
AND CONTRACT
Avenue
. ~.r.; ., I
...tf'.....,....
CUST. P.O. NO.
SALESM"'N
Guy H. Smith
INVOICE TO ,
"'Hermes
"~':".". ~ .
! .......
8
Inc.
'~'.f
..: ..J "10 ~', )'" - ~
;,....;.,-.......,l
"
.. .r
. '. -
,..,'}"~_ \"..'V ..4
, ;.
Furnish and install
Heads as'
flFP-l
& Associates. . S stem will be installed and
Grinnell under this ro osal will test in
tested as er N.F.P.A.
high pressure onI the new work involved, and any high pressure test
re uired on the old work will be taken care of as an extra to the
contract rice and on the sole res onsibilit of the Bu er.
All work to be done in normal work
Permit and taxes are included.
hours Monda thru Frida .
TERMS OF THIS AGREEMENT ARE:
o TIME AND MATERIAL
o PRICE NOT TO EXCEED S
Fixed Price:
$3,150.00
IMPORT ANT NOTICE TO CUSTOMER:
A.) THE TERMS OF PAYMENT FOR INVOICES RENDERED AGAINST THIS ORDER SH"'LL BE NET 10 DAYS FROM D"'TE OF INVOICE. INVOICES ......Y BE RENDERED ON ...
"PROGRESS" BASIS, "'ND THE CUSTOMER "'GREES TO PAY SUCH PROGRESS BILLINGS IN FULl. IN "'CCORD"'NCE WITH THE TERMS OF PAYMENT.
B.) THE PRICE FOR WORK TO BE PERFORMED UNDER THIS AGREEMENT SH"'LL BE B"'SED UPON THE PREVAILING GRINNELL FIRE PROTECTION SYSTEMS COMPANY, '..e.
PRICES FOR MATERIAl. LABOR,. AND RElATED ITEMS, IN EFFEC:r AT THE TIME SUPPLIED UNDER THIS AGREEMENT. FURTHER,IN THE EVENT THAT THIS AGREEMENT IS
EXECUTED ON'" "PRICE NOT TO EXCEED" BASIS, THE' PRICE TO THE CUSTOMER SHALL BE THE LESSER OF 1.) THE LIMIT PRICE QUOTED, OR 2.) THE "'CTU"'L CUMULAnve
BILLING BASED ON THE AFOREMENTIONED PREVAILING PRICES.
C.) THIS PROPOSAL NOT VALID IF NOT EXECUTED WITHIN THIRTY (30) DAYS OFTHE DATE OF THE ':'ROPOS"'L
0.1 SEE REVERSE SIDE OF THIS ORDER FOR OTHER GENERAL TERMS AND CONDITIONS.
Guy H. Smith
Contract Representative
ACCEPTED BY:
AUTHORIZED CUSTOMER'S SIGNATURE
DATE
TITLE OF PERSON SIGNING
AREA FINANCE CENTER COpy
AMERICAN
INSTITUTE
o F
ARC HIT E C T' S
.
AlA Document Al 07
Abbreviated Form of Agreement
Between Owner and Contractor
For CONSTRUCTION PROJECTS OF LIMITED SCOPE where
the Basis of Payment is a STIPULATED SUM
1987 EDITION
THIS DOCUMENT HAS IMPORTANT LEGAL CONSEQUENCES,. CONSULTATION WITH
AN A TTORNEY IS ENCOURAGED WITH RESPECT TO ITS COMPLETION OR MODIFICA TION.
This document includes abbreviated General Condltions and should not be used with other general conditions.
It h~ been approved and endorsed by The Associated General Contractors of America.
AGREEMENT
made as of the Twelfth
Nineteen Hundred and Ninety One
BETWEEN the Owner: Sun Medical Corporation
(Name and address) 6719 Ga 11 Blvd.
Zephyhills, Florida 33541
clay of
December
in the year of
and the Contractor:
(Name and address)
Hermes, Inc.
8329B w. Hi11sborough Avenue
Tampa, Florida 33615
The Project is:
(Name and location)
Rescare, Inc. Office
Sun Medical Office Building
6719 Gall Blvd.
Zephyrhills, Florida
\
The Architect is:
(Name and ae/dress)
Long & Associates
3902 Henderson Blvd., Suite 203
Tampa, Florida 33629
The Owner and Contractor agree as set forth below.
Copyright 1936. 1951. 1958, 1961. 1963. 1966, 1974, 1978, @1987 by The American Institute of Architects. 1735 New York
Avenue. N.W" Washington, D.C. 20006. Reproduction of the material herein or substantial quotation of ils provisions without
wrinen permission of the AlA violates the copyright laws of the United States and will be subject to leg:d prosecution,
AlA DOCUMENT A107. ABBREVIATED OWNER.CONTRACTOR AGREEMENT. NINTH EDITION' AlA'" . @ 19H7
THE AMERICAN INSTITUTE OF ARCHITECTS. 1735 NEW YORK AVENUE, N,W" WASHINGTON, D.C. 20006
A107.1987 1
~"-,--~""~,..""",,,,,,,,,,,,,,-,,,.,,,,,",---,,,,,,,,"-"'-"'" .... ...--.:...~--. -
.....~~..'111iilil
~
--------~ -
ARTICLE 1
THE WORK OF THIS CONTRACT
1.1 The Contl':lctor shall execute the entire Work described In the Contract Documents, except to the extent specific:llly indicated
in the Contract Documents to be the responsibility of others, or :IS follows:
""
ARTiClE 2
DATE OF COMMENCEMENT AND SUBSTANTIAL COMPLETION
2,1 The date of commencement is the date from which the Contract Time of Paragraph 2.2 is measured, and shall be the date of this
Agreement, as first written above, unless a different date is stated below or provision is made for the date to be fixed in a notice to pro-
ceed issued by the Owner.
(blSl.'I't the ckJle of commencemerrt. if il diffen from the dale of Ibis Agreemenl or, if applicable. slale Iballhe dale u'iII he fiJ..ed i" a "otice to proceed.)
2.2 The Contractor shall achieve Substantial Completion of the entire Work not later than February 28, 1992
(lmert tbe calendar dale or "umber of calendar days after the dale of commencement. Also imert any requirements for earlier Substantial Completion of certain por.
tions of tlJe Work. if "01 slaled elseu'bere in Ibe Conlracl Documents.)
(If the contractor achieves substantial Completi~n during the period ten (10) days
prior to February 28, 1992, he will be paid $100.00 per day for each day he has
completed the work early.)
. subject to adjustments of this Contract Time as provided in the Contract Documents.
(l"serl prO/'isions. if ''''y. [or liquidated ckJmaRes relal/ng 10 failure 10 complete on time.)
.j""
Final Completion: March 1, 1992. The contractor will be assessed a penalty for each
b d March 1, 1992, which is $100.00 per day. Maximum penalty
day completion falls eyon
will be $1,000.00
ARTICLE 3
CONTRACT SUM
3,1 The Owner shall pay the Contl':lctor in current funds for the Contractor's performance of the Contl':lct the Contl':lct Sum of
Forty Two Tliousand Dollars
(5 42,000.00 ), subject to additions and deductions as provided in the Contl':lct
Documents.
AlA DOCUMENT A107' ABBREVIATED OWNER.CONTRACTOR AGREEMENT. NINTH EDITION. AlAs. @19tli
. THE AMERICAN INSTITUTE OF ARCHITECTS. 1735 NEW YORK AVENUE, N.W.. WASHINGTON, D.C. 20006
A107.1987 2
_"~. ~~""..-....-.....--..,,-lc"""" .._.......~......,~"'..".._.~.~._..._,-~.<:>., --,_..".
.J.
ARTICLE 21
OTHER CONDITIONS OR PROVISIONS
This Agreement entered into as of the day and year first written above.
CZIlJ~L~
, ~
(Signatllre)
Sun Medical
Richard G. Hermes, G.B.I., President
(Printed name (lml title)
11 A107-1987
AlA DOCUMENT A 107' AnrlREVIA TED OWNER.CONTRACTOR AGREE~IE:'-IT' :-i1:-iTH EDITION . .~IA' . @ I ')H7
THE AMERICAN INSTITUTE OF ARCHITECTS, 17.~S NEW YORK AYE:'WE. :'-I.W., \X'ASIlI;';GTO:--:. D.C. lIMHI(,
10/87
..
',"" ,-...,"'..>..'.._;-.......--.....,~------,.~~~ ..,~.....,'._.._.....,.".,-~,.. "