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Home My WebLink About92-2172 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit N<! 2172/1 Date J - ;2 - 7' ~ B~G ELWRICAL PL~ GECHA~ Sewer Conn Water Conn: P,"pertyOwn., {1/;/"'~K~ 4.t~ Job Address:....5 ..3 .:J..- 0 - Water Meter: T,I.F.'s: Parcell.D, # Zoning: Description of Work Energy COde~ A;lC ex d~ 1 Radon Gas: ~-J- NO OCCUPANCY BEFORE C.O. FINAL :2.- 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 Pe,m;t Fee 'tfd/J . tTV Signature - avt-~ i~~ ~ Company Address Telephone# Valuation or Contract Price ~ 9 7-5: t7? / City License Registration # I / 0 State Certified License# Breaker Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Tp. Servo 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. ..~. ~ "'.--:'" SERVICE INVOICE Superior Heating & Cooling Management, Inc. 231 Douglas Street, Building A Suite 10 Oldsmar. Florida 34677 (813) 854-3449 Zephyrhi1ls 783-7509 Lakeland 688-1823 CD 12021 STATE CERTIFIED CAC049271 DATE '3,;; 7..1.. WORK TO BE DONE --- ClfflM2, / Lv I n k (' h Y' J1.. / ...-. (- - / STREE1, ;) 0 'S .t- 7 I?~- 7J- 9 \( ,'(j? ~,~?LI/(.._ r rATE ] sS \}'() SOURCE COST OTY ITEM PRICE NO. I CUSTOMER NO. BILL TO NAME STREET I PHUNI: - CITY STATE ZIP ('0 nelr.: ~r -< o camw;r' TIME & wcrERIAl. 0 REPLACE 0 /"1: ;? l.- r.'\.,.\ j (, ". Oc.~ NEW \.NT Q CONTRACT 0 c,B.D . Cv c: W /1 ( I C - /( ''\ TECHNICIAN: ) e -f+ 1('" 11~ J I / 1V10 )'; ~ ,I;. J . C;-r-A -r MAKE MODEL S~AL NUMBER A / / 'R. t? 1Ii-Lt'ri .; ID lew Ii (J4 T DATE DESCRIPTION OF WORK PERFORMED ,- ) \1,Ir fJ j/;,-,\ Cl \;-<:' W.<J R P'A of\./ ( .I r ) 99<. ~ ..... I 154D ' _ '~<.. IF YOU ARE SATISFIED WITH THE SERVICE YOU RECEIVED .. ~--,-9~ TODAY TELL A FRIEND, IF NOT PLEASE TELL US. -- TRAVEL TIME: TO FROM PLEASE PAY FROM THIS INVOICE TIME TIME TERMS: NET DUE ON COr.4PLETlON ARRIVED DEPARTED TIME / TIME Thfe N'1\IOICe I~ subred to a Finance Char~ 01 "-:-"'0 per monltl Annu;tl Pefceonta<)e Rate of 18' ....klf':~ IS l'IC'Wf'd tly law ARRIVED DEPARTED ../ tt IS aoreed .lnd understood bv the oarheS thai an eQUipment ana parts wh<<:h arc ~ DufSU:V'" r~ft>to ~"'aU NOT '7 1i\ Q~ SERVICE PARTS become li.tUfWS 01 ~rt of the real ...1It wnere the'y are o&aceCI Satd oarts and eQulOI'l'len! ~t'.,:l .:1 .'18 Ilm.-S remaIn pera.otW prooetty and t~ tt1tlt Ihltreto Shall rem..on In the .-lief unlll oayrnent '" luIt 'S fece.....o au-.--, ......'pb.. AOfHS that atl Plrts and eQUIlClment may be repasses.eo 'n the event 01 no..,.paymenl Sef' ,~ IJIdr II'), \lWaorAnt-y ,.nd SERVICE LABOR tnSfrochons I hOW! aut""''''' 10 ~ the ..". a. cu..ned abow I "",,,.10 Dav aN cost. ~asc.nao'" .1I0'~)' '..... ,I 'h" CUSTOMER DISCOUNT r .... ,:::~~~'r"J""..~,c~IO>) ()(J lA f / \~)t1~ TOTAL CHARGE ;:. '2 t'j 'IS ", )FCl:f~IA"'SjGtf~. / DEPOSIT $ _ '-:0:; .,I' It,.' /C 2,-J--t--J1f? / J ~/ M10MER S SIGNATURE '\ / / - J BALANCE DUE $ :!IE: CARD EXP --I NO DATE . -' >. -- APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT ADDRESS PHONE OWNER JOB LOCATION LEGAL- DESCRIPTION: LOTcS5 LOT SIZE x AREA SQ. FT. BLOCK SUBDIVISION PARCEL 1. D .1F WORK PROPOSED:____New Construction ----Addition ____Alteration ____Repair ____Install ____Sign/Temp. ____Sign _Move ____Demolish PROPOSED USE: ____Single Family _M/F _# of Units .-M/H .. ____commercial ____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. PERM1TS REOUESTED ____BUILDING $ ValUation of Total Construction ____ELECTRICAL AMP Service Florida Power Corp. _W.R.E.C. ____MECHANICAL $ Valuation of Mechanical Installation ____PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block ____Frame ____Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration iF ****************************************** BUILDER Signature Signature Company State Cert. or Regist. # City License Registration # ****************************************** ET.ECTRTCT AN Company State Cert. or Regist. # City License Registration J (7 - ****************************************** ~/'1..-e._~ Company State Cert. or Regist. # City License Registration ;F ******************************************' PT.t~ER Signature MECHANICAL //0 Signature Company State Cert. or Regist. # City License Registration # OTHER Signature APPLICATION APPROVED BY *~**************j********************** CL/h ""~ -,/'J" ~~ PERMIT OFFICER. """""I"" ....-"- CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject to 'deed restricti~ns" which .ay be lore restrictive than City regulations. The undersigned assules responsibility for cOlpliance with any applicable deed restriction~. 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, (813) 799-6611. Furtherlore, if the owner has hired a contractor or 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 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 - Ho.eowner's Protection Guide' prepared by the Florida Depart.ent of Agriculture and Consuler Affairs. If the applicant is s~.e~ne other than the 'owner', I certify that I have obtained a copy of the above described d~culent 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 cDlpliance 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 c~lienced prior to issuance of a perlit and that all work will be perf~rled to leet standards of all laws regulating construction, City codes, zoning regulations, and land developlent regulati~ns in the jurisdiction. I also certify that I understand that the regulations of other governlental agencies lay apply t~ the intended work, and that it is IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include bllt ~Ie not lilited to: I Depart.ent of Environlenl:t ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive l~nds, Water/Wastewater Treatlent f Southwest Florida Water KanaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses I Ar.y Corps of EnQineers - Seawalls, Docks, Navigable Waterways I Departlent of Health ~ Rehabilitative Services, Environ.ental Health Unit - Wells, Wastewater Treatlen~. Septic Tanks I US Environ.ental Protection AQency - Asbestos abatelent I also certify that, if fill latE'Tial is to be used in Flood Zone "A' or 'A,etc.', it is understcl~d that a drainage plan addressing a 'colpensating volule: will be sublitted which is prepared by a pr~fessi~nal engineer registried 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 n~t as authority to vi~late, 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, Dr violations of any c~de. Every pertit isslled ;hall becole invalid unless the work authorind by such penit is tOllenced within six lonths of issuance, ~r if ~j(lrk auth{'llZed by the perl it is suspended or abandoned for a period of six lonths after the tile the work is c~..enced. Doe 90 day e~t€"SiOIi 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, ~r 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 FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT R AND POST A "NOTICE OF COMM~CEMENT". SIGNATUR~:~_:~~-~ TD '- -,+ B ~2NG~~C~~~ Sr- ~l?-O DATE___~~-~~~~~------------------- DATE_________________________ MY COMMISSION EXPIRES______________________ NOTARY AS y~.... t' ---/ -P, CONTRACTO~~~'~ MY COMM I SS I ON EA8f~~-te,-S-l'Aff~FL_rnrn:rA My commission expires Jan. 28, 1995 Bonded thru Patterson. Becht Agency NOTARY AS TO OWNER OR AGENT_____________________________