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Home My WebLink About92-2127 '--- BUILDIN\..:J BUIL~~r:i2HY~L~RM!! N~ 2127/~ (813) 788-6611 Date ;} -/</~ f'::L, ~L 'PlJ.LMBING GECHANlc0ewe, Conn ~~ _________ Water Conn: Pmperty Owne" %- . ~AA-AH'A- Wate' Mete,. Job Address: '-l ~_ ~ TI.F.'s: Parcell.D. # Zoning: ~.' ~necrgy co~~ A~ '" Description of Work ~ ~(;_~ Radon Gas: ~ NO OCCUPANCY BEFORE C,Q. FINAL 2- DATE Complete Plans, Specifications and Fee Must Accompany Application. C,Q. All work shall be performed in accordance with City Codes and Ordinances. Inspector Permit Fee 3' ~< c.--o Signature .;e:~ c?'. C;:~t~_..<- Company Address Telephone# Valuation or Contract Price ~ ) 0 0 - t:/7_, City License Registration # / / 0 State Certified License# B~G Ik=E ELEC L ........... P~G --... Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer 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 vL)e~rOtC &9 rt'.uQ fL C"CJt?1~~ ~r ...z#c , J / ADDRESS ,;23/ .IZ'Y~\' Sr-;#'A-/tJoff~-<, ~ ,7Y"i5/}' PHONE OWNER C~/~S 0(CQver ?)J_~ -75-09 JOB LOCATION ~7f~ pr-tjy ~AA'1v~~ /"4 LEGAL- DESCRIPTION: LOT(S)" ~ 3S-VO LOT SIZE x AREA SQ. FT. BLOCK SUBDIVISION PARCEL I.D.~~ WORK PROPOSED:____New Construction ----Addition ----Alteration ____Repair ____Install ____Sign/Temp. ____Sign _Move _Demolish ____Commercial ____Indust. _Swim. ,Pool .-M/H .f!&" C1~.vQ e Other (j'ur- t/ PROPOSED USE: _Single Family ~/F ____# of Units ____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. _W.R.E.C. -A-MECHANICAL ____PLUMBING $ .~ 700 Valuation of Mechanical Installation GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block ____Frame ____Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration # ****************************************** BUILDER Signature Signature Company State Cert, or Regist. # Ci ty License Regis Crac.iOl{,f ****************************************** ET.F.CTRTCT AN -.-';~"-..>:~~- "~:ii'oI;'_~~-=-~~_~ Signature Company State Cert, or Regist. # City License Registration ~ ****************************************** PLlI11J3 ER MECHANICAL Company ~",,..~/::'.t4 &.,y;~ F~ot1~ ~r~e~ -' I~ /1 State Cert, or Regist. ~r ("'ArC') {/t?;J 7/ Signature ~a ~ City License Registration If . ******************************************' OTHER Company State Cert. or Regist, # City License Registration # Signature APPLICATION APPROVED BY ~*********~************************** 1 . ,t2~;- .. PERMIT OFFICER. '~1\r .,-- 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 res~rictive than City regulations. The undersigned .ssules 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 Iiw, 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, (813) 788-6611. Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorts) 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 th~n 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 LaM - HOleowner's Protection Suide. prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOle~ne 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 cOI.encelent. 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 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 performed 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 .y responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include bllt ';1 e lIot lilited to: I Departl~t of Environlen}tl ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive l~nds, Water/Wastewater Treatlent I Southwest Florida Water KanaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Waterc~urses I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways I Departlent of Health ~ Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treataent. Septic Tanks t US Environ.ental Protection AQency - Asbestos abatelent I also certify that, if fill laterial is to be used in Flood Zone .A. Dr "A,etc,., it is understood th3t a drainage plan addressing a .co.pensating volule~ will be sublitted which is prepared by a professional engineer feqi5t~ied 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, or set aside any provisions of the technical codes, nor shall issuance of a per.it prevent the Building Official frol thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issll~d ~hall becole invalid unless the work auth~'rized by such perlit is !:(\I!!!eilced Kithin six lonths (,f issuance, elr if 1'101 k auth{lIlZed by the perlit is suspended or abandoned for a period of six lonths after the tile the work is coemenced. Doe 90 day e~tto5ioll of tile, lay be allowed for the per.it 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 dbdl,doned. 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 $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". ~IGNATU ~-.1I~JJ$_LL~- 1-- -OWNo/OR AGENT DATE_______________________________________ SIGNATURE__~~-~~--- CONTRACTOR f/{,- DR.. C It;t; 74-1 L;b -30h ( E 'I a> DATE__~t[-l1S-j:,[~~---------------- NOTARY AS TO OWNER OR AGENT NOTARY AS TO D - S -,-,,. CONTRACTOR_____~q_~~__f{J_~lJ_______ ----------------------------- MY COMMISSION EXPIRES______________________ MY COMMISSION EXPIRES ------------------ NOTARY PUBLIC, STATE OF FLORIDA My commission expires Jan. 28, 1995 Bonded thru Patterson - Becht Agency SERVICE INVOICE Superior Heating & Cooling Management, Inc. 231 Douglas Street Building A Suite 10 GAGa 49271 Oldsmar, Florida 34677 STATE CERTIFIED (813) 854-3449 783-7509 Zeph. CD 11 88 1 DATEJ - I J - 9' J.... , t . I ,'JORK TO BE DONE ...--r-- CUST~~I 5 h /?AI/C 0;: ~ ( , - { STo/~ S;L '1 :f~ r- oo " rn"bS~3 ~~,:::'_4 '" J..., / I .} PJ'TE 33S-~V SOURCE COST QTY ITEM PRICE c:x:lHT'R.IlCT NO I CUSTOMER NO. BILL TO NAME STREET I PHONE - STATE ZIP CITY 7 o c::c>>rmACT T1t.E & w;TERlAL 0 REPLACE 0 IVI I . . . I o C.O,D_ lIEWlHTD CONTRACT 0 c,aO , /1 ( ~ 9J TECHNICIAN J -/J k! ~':>,{tt. v Ice ~ (,A/\) ; IS I r;-. ~ MAKE I MOOR SERIAL NUtv'BER - J J f~ C101tAS / (:(/ C> C/(j ;) -I,on DATE DES~PTION OF WORK PERFORMED C::;lr file . Ikl/..(~ _<;.~ 1/ '/- }-o c-{ h. d U;J It <;' ,/ S'+ ~ -.. ' (1" -- /) /, 1-. r(!I"1 r /'001 (" I'J () II '" 4 ~ (" L r:: / a (' 7- _ 1.0';'" J , (n/ { -( J /') ;y, / n /{'~ j ~ ~ tls /tJ;rJ,.J }Jew Ti ';;/rr -7Zu-s: I r d AU-./!J, .v / Jkr rc '" -~J, "(1 A.J ( ,/ I' '.UI:f If AI/ -I AI< ~ OOM I~-r T :>b ~ " 1.v'1 tt.... I 5-11/1- ;:0 ~ /lex t ( ......r - - M ~A~e-- !)UL /?r // ,J. no/? ~700 ~ 1'1), CL..a. ~ ':::':: ~, R ~714'1--. -,...., 'lI"' //J,,\ ./ (I / ( ~ 04') /1/ M JI IF YOU ARE SATISFIED WITH THE SERVICE YOU RECEIVED ',- c. - TODAY TELL A FRIEND, IF NOT PLEASE TELL US, TRAVEL TIME: TO FROM PLEASE PAY FROM THIS INVOICE TIME TIME TERMS: NET DUE ON COMPLETION ARRIVED DEPARTED TIME TIME Thas 1l"I\oOCe IS suo,ect to a F"lr'\3f1Cl!' Char;)"> 01 ,._,,~ Del' IT'I()n'M 4,.,,,,u;t1 Perct'"t~ R"fe of Ie ",,"'...-:1": 1"3 1''<'....1'0 Dv law ARRIVED DEPARTED ~ 0 r:l~ n IS ~ .1nd ul"lOef'Sl00d try me oarheS :'"'Ial ..II eQulO""ef'f ..ne cans whICh arc SOld ;1Jr~"'r' .........rc 'S"<lU MJT SERVICE PARTS become h:rlures or o.:trt 01 .... r1!4I1 estate ~ fhey are OlaC~ SalO carts and ~t <j1"\1;1 .:1 .111 ltl'l"lPS remall" QP.I"SOf\al ptOCle'rt'f and rhe MIe ~ sJ'latl re-m.a.r"l '" the seolef untIl nayment ," lull '5 rec.~ Ek,"~f ",-"fOb" agr~s ~t ali parts al"'lCI ~ may Ole' "'!'OOssesseo .,., I"'t" e-vE"'lt 0' "'O:"'-o.'YlTl@'nl ~ r~ "..,... 1:"\. oN~tr""h .t"l1 SERVICE LASOR onstrlCtK:ll"S '- .-" . - - -~~. -" "..- ..-.,,, ""'-.' '-"- CUSTOMER DISCOUNT ...,.,. 's ""K"'" ~: ,n",..., "" '" /7 ~. ?l TOTAL CHARGE $ ~70" -~ ~'''GNA;'-V' ,;.b'/>A" ~ \,. ,<f;) G'V~[) DEPOSIT $ / DC() ,.- ZMER S SIGNATURE -., ~ CARD EXP -I BALANCE DUE $ 1700 NO DATE j