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Home My WebLink About92-2120 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit No . . --- ~_J- 0 2120/!1 ;2 -/0 -7/~- Date -,.. ~ Property Owner: Job Address: Parcel LD. # ~TCAL P~G '- tf;;~1~X~~ ~<2.HANIC~ Sewer Conn Water Conn: Water Meter: T,I.F.'s: Zoning: Description of Work ;(tJ '"1(T- FINAL 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.o. _ DATE Inspector B u.JJ,..BtNG ~ E L E c..J.RtCAL"- - Permit Fee Signature 1/"'- ~;1 ~ C~ Company Address Telephone# r~~~Y _;l!~~_ -:- -~. P~G f,~_...... MECHANICAL) -- - Valuation or Contract Price ~.9/){)' D2- , City License Registration # 110 /) ~-f State Certified License# ,1 ./J <..7 L) 1'7~7 ( --- 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 Breakers Ducts Insl. Compressor 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. , ,I Sl:R t I , I' ". II :, I' 'I , 'Iii I." " '1\ ili , ill 'i' ill i IJ STJ11m wOAt<JO H;:;! ., Iti1 I ;; Ii ; ',. S09fflCE, Ii., t!;jt 1: I:, lUll ,ii' ii, j ~ l ':1 l.l.i.fl . :H I ; ,", , lit , . ,.; 1'1'" ; :1'1' J , . i' IE)!. i " 'I!;! f 1~I'TP. '. ;T1WI't?4 <-pin :~ 1" . T~V~1 T!ME! ARRIV riME; fi~~IV dlS- 171, I)/. ij p,' 1 ~ tlJ, 'I:! ~ bi" jj:cH H' lif ," !~ i: I r '." I "r'~ SUI} :'~"n.t,. .~. ., -,,, 1"; r~oling"ii' 11 Il'i I,: 1::: -1: ; C~ '\ IP Ii ~H I ,; III ! > 'P 1.,1 1~7b ..1 Ii' j ,~. , ," lij:' f83~7509 Zeph.. ~;le~. ~..el/JA.)(.?ES ':Jfhl/~_,zI/J.c.D $ El:l ~l,; I ~,"'L.I, j L2 Vr.<"'I.',n 1::- J)? E!P-~~ .. ":::>J"- -, - Ii J.,jj;,?,!V :.'".fi ..._r,TI'-C....;;;.<../!:;:;: .../-1-' /.,.1. z; .,,;;)- ~\ / . rt YJr-jU i,: STATE ZIP '1 ~ ~~, ~ yEh'ILLS 1 r'L4 , :a.gS'I1 'i ' i h, .! 1j ,If j' I CUSTOMER, f' ,l-Jj9I' ~r7M'e- .... I ' r I frl, i '1 PHONE ~ ~-'! 1tif ;, . S;A~E 1 '-I "j~ j' , .' ' , TIME & tMTERIAL 0 . i REPLACE 0 .. , l' 0 C.O.D. tEW UNIT 0 OONTRACT 0 C.B 0 j i W~9HN!~f';n{r~e.ey C!/fry-/-/de--/w" ',1', lit .liMA : -, ~(MODEL SERIAL NUMBER l~i 1 : ~j HI -,- ! :i I fi f q. i /1"): ':,.' I I .Ib,~ ',,: Ed,'" f.. :, rl. 't'!ll~ ~)o~lge~A.1~ ~-10 v~ oU/ I'! ;~~A-)f€ t/NI"/J=O..e Ep;::;/(!E/J(!. ,1/ :',;/,'1:11 ~ff#Uq.drL/~; -c C( j 3 i i [. 'il. ,. j '.1', I,', ii, [}t. ' , l:r:; j,t'}:j llir~,' t " , L,ji J U I': T I! '!R ~l' I , ~d! 'h " ). i !! " l' I ilT 1 dp: i I ! I i I ; i ; I I I J . ,I dAT'E dJ- /" -7';;" pEl !i i :~i' :11 t II' 11 : j. :. Ii: ..',.' . . ; ,,~ ~;.' ,," illl 1, CACO 49271 it ~ :' RTIFIEDJj~~ifL~'f ," . ,-~'......., "1," ~.f,; , .~: " E 1 t I .t 11845 }lte i?~' :13t ~ I \ ~~ !' Ie : " . .~ ~' .. ii ~ , ITEM ., \' 9 iT QTY ~ j 1Jf6- 7V AI ~ ' IA/ B-1 ;:~/:t'~)L_ ? ~ ;;?'77217/6-tIT L~tJ1 tV /771' / t j::: /.1/ i/e;t9/ ~77J2/ P..5' ~. ';;;u?;2L.V : K e-TU ;i.jJ __ ,; t T5- ,~'-J} ( '. ~ t!O N C ;s.L./f ;9~ ):i:t()/- 0';:::>. t : DESCRIPTION OF WORK PERFORMED ~ I" ZIP ;~ r !; : ] .\ ~ : 1 1 i. t ,~~ ~ ~ / '\ 1/ t i' ~ I ~ } t: I i." '-17J ;rffL ' l ~ ~t L. / --,-,.'I.. ; ~ k / /tV - lAiJ?' /2,./ l'1Iu . · ~ jh/ \- "'f./ ., li' >. ... Il ;W f 1 .~;v ,;' /.' .........:' t' . I~ r, \0~ t. i, A / /)/1 J/ , ...'., 'I r /1' // ( // . t .~ ': : :, i' i' I l' Ii ,': ,. Ii! \;, t, i, I'~ fV , 'jl i u ; i " "4!,' 'l~tL J W ~. ii;i I~EASE PAY FROM THIS, INVOICE ] tt;RM ihJ' : " tl! ~ ,~: " ,. I, .' .- v " .::}tt' . SATISFIED WITH THE SERV1~EfyO JL A FRIEND, IF NOT PLEASE;JELl i' j,'! ~ I - , TO FROM I r !': I'. TIME DEPARTEDJ, t TIME .,' l' ~ DEPARTED" t. I Due ON COMPLETION '~t to; a finance Char;7> of 1'':"~ pet' rOOnP't' Annual ~(:~~ R;tre of 18. 'o\~lf:t':" t'~~ H ' .. , '~ I. ~tQod by. the oa'll8~ tha.I ,dll eQUtpmef'tl anO parts whICh atc's06d DUrso..'lr.~"I"""~to ~"'.;tu'NOT 1 ~'~rlt~l t:: =f!:~a'~~I~~":ee ~:~eent~a~t~~u~=~'~;'~~~;:: ;~~~ ",'.,'- ~T may be reooss@ssed.n the eo.oent of no:\.p.'vtne'",-Sep.,~ 9::Ir W "'A,,.~nt>; .I~ , f<i' , .) ..... , ~ : ;j:' .t j a~~":;:~~;~~7~~_a~7,.'.',',..a"'M"", ..,.. ..~~"~s., "6 , h l',:/4"j 7V .C/~~ I l.:-,~'C~1f I ~,:I~rURE , / ! '" ~qTslOM S SIGNATURE lit ~~l ,,6~D 1 rif , H ..~,. ~H .' fi". ., - .: I :: I, ';' !~ L . , , i H SERVICE PARTS' SERVICE LABOR CUSTOMER DISCOUNT i' ~' TOTAL CHARGE 1 DEPOSIT., Ii BALANCE DUE . i ~ ';, .'........."'F ....1 T EXP DATE ',; _-I ,; t , . APPLICATION FOR PE~~IT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT 5u;tJ ~~" ""'/i> / ffiq T/~.J ~ aC)~7 ~ T A - /0 cJ.t/SMf'~ /.4 PHONE ~77 ...2'-;> C' , 7,S3-?..s-O? . OWNER aUq~.s S?: ../ ~AN"""'~ S"' S-r:'c;>A.1 /q",./ ADDRESS ~31 JOB LOCATION ~7'Ty' ~~.../c.4 ~R. Z~/~v''?,..A ~,4. LOT SIZE_X .:? .Y5"9/ LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION AEEA SQ,FT. PARCEL I. D. 4F WORK PROPOSED:____New Construction _Addition ____Alteration ____Repair ~Install ____Sign/Temp. ____Sign _Move _Demolish PROPOSED USE: ____Single Family _M/F ____fF of Units _M/H .~~2#J'h/ Other . _Commercial _Indust. _Swim. Pool _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 ~MECHANICAL AMP Service Florida Power Corp. _\~.R.E.C. $ :2, '?OO ,.. Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Frame _Steel ,Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** Signature CONTRACTOR SECTION Company State Cert. or Regist. if City License Registration # ****************************************** BUILDER ET FCTRI C1 AN Company State Cert, or Regist. # City License Registration # ****************************************** Signature Signature ~ ' I;~ ~~ Company ..J D't!!~"O}J. /9~9r-/. ~ ~';;,; 'J .~r..zc.,c.. State Cert. or Reg1st, iF - ~ ~ City License Registration J ****************************************** PLUMBER MECHANICAl Company 5~A"1'';'"p &d/:Uq ~ eC'{;'i ~7 ...7/w:. ,. State Cert. or Regist. 1,' ../ c~co _671 Signature ~ a ~_.J'-+'t- City License Registration :~ , ****************************************** OTHER *** Signature if APPLICATION APPROVED BY PERMIT OFFICER, CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perait aay be subject to "deed restrictions" which aay be lore restrictive than City regulations. The undersigned assuaes responsibility for coapliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they may 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 aay be cited for a aisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requireaents aay apply for the intended wor~, they are advised to contact the City of Zephyrhills Building Departlent, (B13) 788-6611. Furtheraore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s} 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 wor~. 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 Departlent 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 doculent 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 cOlpliance with all applicable laws regulating construction, zoning, and land developlent. 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 may 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 but are not lilited to: f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treataent f Southwest Florida Water "anaQeaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways f Departaent of Health & Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks f US Environ.ental Protection AQency - Asbestos abatelent I also certify that, if fill laterial is to bf used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addressing a "colpensating volule" will be sublitted which is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A per.it 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 shall 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 perlit is cOllenced within six tonths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six tonths after the tile 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 lonth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO""ENCE"ENT HAY RESULT IN YOUR PAY INS TWICE FOR IHPROVE"ENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCINS, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDINS YOUR NOTICE OF COH"ENCE"ENT. JOBS UNDER $2,500 IN VALUE DO UOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE: OWNER OR AGENT ~C?,~ SIGNATURE: CONTRACTOR was acknowledged , 19_ by STATE OF FLORI~ COUNTY OF 1./JJ' C. 0 The foregc,ing i nstrum.g:~was acknc,wledged before me this /0 - J-4~ 19~ by i? tC/.//J!2 iJ p. ChRPPljJO who is persDnally known tD me or whe: has prDduced Fn L-H Cl/~0- '7Y 1 -Sl.> -30b as identification and who did/did not tak an oat . , ..., 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. (Signature) . /,J or Stamped) (Name Typed, Printed or Stamped) NOT ARY PUBLI C NOTARY PUBLIC, STI\TE OF FLORIDA My commission expires Jan. 28, 1995 Bonded thru Patterson - Becht Agency