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Home My WebLink About92-2193 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit N~ 21931f Date t? - / (J - 7':;1_ ruLUINlJ tL~CT~ p~ ~HANIC~ S'W" Coon Water Conn: Pmp,,,, Owne, ~ fe2i! -- Job Address: ~ ---==-/ _ ~ Parcel 1.0, # Water Meter: T,I.F.'s: Zoning: Energy COd~ Radon Gas: Description of Work ----A- / C. ~;t:?- ~ NO OCCUPANCY BEFORE C.O. FINAL C.O. DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances, Inspector 5> Permit Fee Signature Company Address Telephone# .3& - tro ~d~ -- ....- Valuation or Contract Price~Q-O ' t/CJ City License Registration # /1 0 State Certified License# Ftr. Pre SLB Lintel FRM. Insul. CL WL ~'~ - ,.,~..#\ ..... MECHA~icAL _ Breakers Ducts Insl. Compressor Final ~AL ------- SLB Tub Set Water Sewer Final P~G ~ "'BtJILQIW~ Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter 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 ($15.00) shall be made for each trip for each trade: a. Wrong Address b. Condemned work resulting from faulty construction. c. Repairs or corrections not made when inspection called. d. Work not ready for inspection when called. e. Permit not posted on job site. f. Plans not at job site. g. Work not accessible. The payment of inspection fees shall be made before any further permits will be issued to the person owning same. APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT S~LJeR/OR &cpr,..";uq ~ ~Q04~q ~;7 ~c.,. ,,/ ...., v../ , ADDRESS ;ifr ~9'/fU" S~ #4-~ o/~'A'9'A.". /"4 J'n-- 77 PHONE v ~ OWNER AZQ Sc-C)# JOB LOCATION 60/3 /7~ APPLICANT 783- 7.s-07 ?Y/r,r;.~~ 37.51tJ LOT SIZE_X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.# WORK PROPOSED:____New Construction ----Addition ____Alteration ____Repair ~Install ____Sign/Temp. ____Sign ____Move ____Demolish PROPOSED USE: ____Single Family ____M/F ____4F of Units ,_M/H ____Swim. p$ C"'?'.vqe OpT ..;;?h Other %',,)' -y~'T 5js7e"'1 _Commercial _Indust. ____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 -XME'CHANICAL AMP Service Florida Power Corp. _W.R.E.C. $ ::1. ~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. # City License Registration 4F ****************************************** BUILDER ELECTRICIAN Company State Cert. or Regist. # City License Registration # ****************************************** Si!mature PLUMBER Signature Company State Cert. or Regist. # City License Registration # ****************************************** MECHANICAL Signature ~ d Company ~~e,e,e,.e &'I';r;~9' ,L-&L'"f~ ~/ ~c, State Cert. or Regist. ~F cACO 1'7.:/7/ ~ City License Registration IF n***************************************** OTHER Signature Company State Cert. or Regist. 4F City License Registration # APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this per.it .ay be subject to "deed restrictions" which lay be lore restrictive than City regulations. The undersigned assu.es responsibility for cOlpliance with any i1pplicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they aay 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 .isde.eanor violation under state law. If the owner or intended contractor are uncertain as to what licensing require.ents .ay apply for the intended work, they are advised to contact the City of Zephyrhills Building Depart.ent, (8131 788-b611. Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor(sl 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 .ay be an indication that he is not properly licensed and is not entitled to per.itting 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 Consu.er Affairs. If the applicant is so.eone other than the "owner", I certify that I have obtained a copy of the above described docu.ent and pro.ise in good faith to deliver it to the "owner" prior to co..ence.ent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the infor.ation 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 .ade to obtain a per.it to do work and installation as indicated. I certify that no work or installation has co..enced prior to issuance of a per.it and that all work will be perforled to .eet 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 govern.ental agencies lay apply to the intended work, and that it is .y responsibility to identify what actions I .ust take to be in co.pliance. Such agencies include but are not li.ited to: f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally 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. Environ.ental Health Unit - Wells, Wastewater Treatlent, Septic Tanks f uS Environlental Protection AQency - Asbestos abate.ent 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 volu.e" will be sublitted which is prepared by a professional engineer registered in the State of Florida prior to per.it 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 per.it 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 cOllenced within six tonths of issuance, or if Mork authorized by the pertit is suspended or abandoned for a period of six .onths after the ti.e the work is cOltenced. One 90 day extension 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 .ust be IDgged during each six .onth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCEHENT HAY RESULT IN YOUR PAYING TWICE FOR IHPROVEHENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COH"ENCE"ENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE: OWNER OR AGENT STATE OF FLORIDA COUNTY OF The foregoing instrument before me this was acknowledged , 19 _ by who is personally known to me or who has produced as identification and who did/did not take an oath. (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC ~c7: ~ SIGNATURE: CONTRACTOR STATE OF FLORIDJr-) COUNTY OF ...L/" A <J./' A . The foregoing instrument was aC~~Wledged befcll-e me this /6 ~ , 19 .;L by .<:?~/7A~ /)/~~ ()J~~ who IS personally known to me or who has produced Fj)L #-(1 / S-J'~ 7'//- S-c. -30~_ as identificatic1n and who ~did not t~k?2 ;;t;~ -zf~~.; (s~~re) L' ) Rr f-rA- B. €W/~ (Name Typed, Printed or Stamped) NOTARY PUBLIC NOTARY PUBLIC, STATE OF FLORIDA My commission expires Jan. 28,1995 Bonded thru Patterson - Becht Agency SERVI~E IrV01CE . ,( '. i e;E/stR/8 Superior Heating & Cooling Management, Ine. 231 Douglas Street. Building A Suite 10 0ldsmar. Florida 34677 (813) 854-3449 Zephyrh111s 783-7509 Lakeland 688-1823 CD 12095 STATE CERTIFIED CAC049271 DATE ]- '1-9 ~ IIIIORK TO BE DONE ~ C:~OMER R-Z/f '?co// tt.<:' ( , --- ( STREE'h D I '< J 7 tL. I gj/(f-;.J -/ ;)2:] - ~ <Z. 12 "- --; /l.. FI STATE ~)~y~ SOURCE COST CTY ITEM PRICE NO I CUSTOMER NO, /J BILL TO NAME /7LZJ{) A/tJ,J , STREET I PHUN~ - ZIP /4tJ /)" /0 ("~/ CITY STATE , f/ o c:clNmN;T l-...e & WUERW.. D REPlACE D , .' . o c.o,Q. NEWlNT-O. C()NllW;T D c.aD - (1/-(14Y\ TECHNICIAN: ~ .eH -- I~A1.. of \J -... rL"k MAKE MODEL "TRIAL NUMBER - , JtCr ~ DATE DESCRIPTION OF WORK PERFORMED -"' I/~I-'" - -/D 76J~/' Lt~>.L) hY'/L d5 \:.. I \ + (. r"'J D f) U...J h ~.J . 51e- /AJ / 77r r'JJ j:)(? (Iv n ( (\ /f?~~ (~() ,.~ On I~ ~ t:.c? -'"\,J ".. ~~L /)~eS ttktJ "'- f2 ( C () ;-..., - ;t ~r.# ~s-nr- /y~'~ (', h. /) Y"L 0 c... lOc,Zrl ~6 ~vl'f,,,b)JF'A- ~ f:of?- /' '7":l-f. Dl p .( ~ef ,6 A. b ( '6 . '(~ "I l, /' /' /1 Al / f(r n:80 rt. j ~ AtVI I" It: < -r /7$: , ~-~.e RJlftC- J;:::: , -.... ......,ty;) 5.,< ~L ~ IF you ARE SATISFIED WITH THE SERVICE YOU RECEIVED TODAY TELL A FRIEND, IF NOT PLEASE TELL US. TRAVEL TIME: TO FROM PLEASE PAY FROM THIS INVOICE TIME TIME TERMS: NET DUE ON COUPlEl1ON ARRIVED DEPARTED TIME TIME n. ~ ~ s.Qed to ~ F".nance ~ ~ 1'~' oer ~ Annual ~ Rate ~ 18'. wt1d: IS ,,~ by .... ARRIVED DEPARTEO II: IS ~ and Uf'Il3er.StOOd br the t*'1Ies that a. ~ ..., DW1S wncn ~ SOld cursu.'1r.~ ~ YtaIt NOT SERVICE PARTS beCOme fnrtures 01 0Mt 01 .......... where they ~ Diaced Sad E*1S and ~ s/",lJl ;;:1 ;aR tlln'PS ~If'l oerSONII DfooerTY rd !he ... thIttetIO It\8fI ~ ." the _tel untJ' ~ Il'\ fuI IS ~ Buypt ~ ~s TV ....1 .all parts .., eQJClfNnt ".., be reoossessea 'n fI'Ieo ~ 01 l"I():'1-oayment 5e@ ~ o;ldr 10' *,WI';lnt)' .,no SERVICE LABOR ...UC1OOnll ,_ __ ~ """'"""..~ '", _.. costs and~""""'" .nomr,., '....' .... CUSTOMER DISCOUNT ....,.,...- J riI..""._.......~it. A ~ L.. TOTAL CHARGE $ ,q L~ TECH~ SlGNATURE,a /':i. ...MA #"' \I/~~ , Jl - :.r- DEPOSIT S C4'l510~R'S SIGNATURV ,- :Ie ~RD EXP --I BALANCE DUE S DATE