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Home My WebLink About92-2125 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit N~ 2125/~ Date ~ -Is -7.:1. BU~ ~L PL~ Pmperty Owne' ~~~-1- Job Address: l ? _ ~__ -- Parcel I. D. # Zoning: Energy ~Odj: Radon Gas: Description of Work -.A-/ C C:,/../AA1--! P - ~ ~AN~sewe' Conn Water Conn: Water Meter: T_I.F.'s: NO OCCUPANCY BEFORE C.O. FINAL Z c DATE Complete Plans. Specifications and Fee Must Accompany Application. C.O, All work shall be performed in accordance with City Codes and Ordinances. DATE Inspector Permit Fee ~--;. t:I'f) Signature ~ c? ~_ .. Company Address Telephone# Valuation or Contract Price q:l- tJ-zJ. crv City License Registration # J / I) State Certified License# BUILDING ~ PlDMaING -... SLB Tub Set Water Sewer Final Tp. Serv, Rough In Meter Can Const, Pole Pool Pre-Meter Final Ftr. Pre SLB Lintel FRM, Insul. CL WL 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 PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT S~~~~/'O~ A?~#q ~ao~;vy ~~.z..CC' / ./ ADDRESS .13/ .t7o':Jhs S~ ;?-/CJ (/~hfr?,eJ r;:, Jf/D /7 PHONE 7C13-7509 OWNER .4A/AJQbe/ A'"€~..lI JOB LOCATION3?/'-f:? 6ve .z~i'..t~a J.J5/t) LOT SIZE_X AREA SQ.FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.~F WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install ____Sign/Temp. ____Sign _Move ____Demolish ____Commercial ____Indust. ____Swim, Pool __M/H .4k..7d~fi~ Other , PROPOSED USE: _Single Family _M/F _IF of Uni ts ____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 AMP Service Florida Power Corp. _H.R.E.C, ~Mg-CHANICAL $ 3200 Valuation of Mechanical Installation ____PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block _Frame _Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** CONTRACTOR SEGTION Company State Cert. or Regist. # City License Registration # ****************************************** BUILDER Signature S hma ture Company State Cert. or Regist, # City License Registration # ****************************************** ELECTRTCTAN Company State Cert. or Regist. # City License Registration # ****************************************** PLUMBER Signature Signature Company _S-r~ ~crr;~ ~C'e>C,4~ ~r ~. ~ State Cert. or Regist. IF CAC'O J '/ C?' ~"""-- City License Registration iF ****************************************** MECHANICAL Company State Cert. or Regist. # City License Registration # OTHER Signature APPLICATION APPROVED BY ~~********~************************* 1 ~A'>~ 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 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 Dr 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, 18131 788-6611. Furtherlore, if the owner has hired a contractor Dr contractors, he is advised to have the contractorlsl 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 FEE~ 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 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 but are not li.ited to: f Departlent of EnvironlentaI Requlation - Cypress Bayheads, Wetland Areas and EnvironlentaIly Sensitive Lands, Water/Wastewater Treatlent f Southwest Florida Water "anaqelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArlY Corps of Enqineers - Seawalls, Docks, Navigable Waterways f Departlent of Health ~ Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treat.ent, Septic Tanks f US Environlental Protection Aqency - Asbestos abatelent I also certify that, if fill laterial is to be used in Flood Zone 'A' or "A,etc.', it is understood that a drainage plan addressing a 'colpensating volule' will be subaitted which is prepared by a profeSSIonal engineer registered in the State of Florida prior to perlit issuance. A perlit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, Dr 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 cOlaenced within six lonths of issuance, or if work authorized by the perlit is suspended Dr abandoned for a period of six aonths after the tile the work is cOIDenced. 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 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 CO""ENCE"ENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A 'NOTICE OF COMMENCEMENT". SIGNATURE: OWNER OR AGENT ~a~ SIGNATURE: CONTRACTOR STATE OF FLORIDA COUNTY OF The foregoing instrument befc,re me this was acknowledged , 19 _ by STATE OF FLORI~~ COUNTY OF UC 0 _ . The foregc~ng instrument was ac1rowledged befc,,-e me this /3-r;L.E.fJ.-, 19~ by If ( CI--f.4!LIJ C!.#FrP ~ nLJ who is personally known to me or who has prc.duced F/)L '# C! / Ss-- 7'1/ -S-~-'?'\QJc:> as identification and who did/did not t~Da%:, _ ~ .~ r) ~b '< ~ fJ J- (~ ure) . B e~77J- B:._ L €-.w ( J (Name Typed, Printed or Stamped) NOTARY PUBLIC who is persc,nall y known to me or whc. has produced as identification and who did/did not take an oath. (Signature) (Name Typed~ Printed or Stamped) NOTARY PUBLIC ,Uf /lilY PUBLIC, STArE OF FIJJF/; , [viy C'JiT:;Tlrss;o:'l 10XpJ2S J,:"1n.:2 , 1 :J,~j5 Bonded thru Patterson - B",Ctlt Ag",ncy ;'I."'."~""t;'"!"~"''''''' ..,.~. . """-'~'.''''''''''''''''''',..,~,.''' ,.- SERVICE INVOICE Superior Heating & Cooling Management, Inc. 231 Douglas Street Building A Suite 10 Oldsmar, Florida 34677 (813) 854-3449 783-7509 Zeph. I cr:J0;:EJ. nL.o I / ~e Ilf /C ~fl,J)U~. 1M ,J-'-I ~I ~ P J STATE :l :1.(" c?'o lcU5TOMERNO. GACO 49271 STATE CERTIFIED WORK TO BE DONE SOURCE COST OTY .- o '- ------ I I PRICE I fJ/t.. I IF YOU ARE SATISFIED WITH THE SERVICE YOU RECEIVED TODAY TELL A FRIEND. IF NOT PLEASE TELL US. TRAVEL TIME TIME ARRIVED TIME ARRIVED <0 J \5 f) ITEM ---- {' - 7 -- , :l T/::J.... -::::ro n c; l'r C 01l-Jt.n~t. I{ - "/(:> I f2 /-In Yl,..) I ( rl I-S-f~r ('on., 0/<' r -r^~ - J Je , 1 ~<~l CD 11878 (pSI -$f/~ DATE:;J.-/ ;). - '12. ~~~ f.;q/S? c.uz I' 0 t t./L - NU BILL TO NAME STREET I PHONE STATE ZlP CITY o cnmw=r 1M: l 0 REPlACE 0 . . . . 0 coo- NEW l.NT I~ C()NTR.tCT 0 ca 0 TECHNICIAN - \ I'""N / I cA It d V MAKE MODELl' SE~ NUMBER 5'4/1 -;tAl I DATE DESCRIPTION OF WORK PERFORMED <_I~ YI11 TO FROM TIME DEPARTED TIME DEPARTED SERVICE PARTS SERVICE lABOR CUSTOMER DISCOUNT "TC>1M. CHARGE DEPOSIT BALANCE DUE 'ThIs ~ rS SJIDtect to.a F!I"I.Y'IC~ Cl"\,)r,)" '::J ,.~:., ()ei' ~ "~I ~eot"t'aqe- R"'e "",e ....,or':~ IS ,,~..>(J t7V .... I~.. - i1~ bot ~ oa,rN!S :t\al ..II ~ ..1"l'.J Darts wnC"l arc SoCIICl 0Uf<;u."'. "_t:>r-. v-a11 NOT ~ lI"tOJn;::Jf' o:wT oC the- real estale ~ Tney are plaCe<] Sa<l parts ar<l t!QI.ItOI'1"Iel "l"'.l;. .:! ."111 "".".s rema, '.. j pIOOl! af"(I rhe t.ne TheretO Shall r~ If'\ the Setlef IJntl! oaymenI' ..., tu$l 'S rece~ BY'...... ''It'''''!.:'' ,'lQft"i"S .....~: ' p; "" ~ ,n .... ..... '" non-o.'Y"'""' 0;........... ...".. 'n< ~>o..n,. ,.", ~i~'~~~:-X-;~--'-"" s R) nl> ~ T SlfiNA~URE' /./ 'u. 7 //9 J_ _/~ pr,~ L7 /" / qr ./.J' tl~~ S COS10MERS SIGNATU'TlE I ~ CARD EXP _ NO DATE S PLEASE PAY FROM THIS INVOICE TERMS: NET DUE ON, ~OMPLEl1ON -!