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Home My WebLink About92-2280 BUILDING PERMIT Permit 2280)11 ~-/7-7;L CITY OF ZEPHYRHILLS (813) 788-6611 N<! ;20. at) B~ GLECT~ ~~ ,----:uZ~ Property Owner: ~ Job Address: 3 . 3' 7.-A Ah -. (L~ 30' ov PL~.~HAN~ewer Conn Water Conn: Date Water Meter: T.I.F.'s: Parcell.D. # Zoning: NO OCCUPANCY BEFORE C,Q, Complete Plans. Specifications and Fee Must Accompany Application, C,Q, All work shall be performed in accordance with City Codes and Ordinances, DATE Inspector City license Registration # State Certified license# liP , Permit Fee '~~ ' cTD 1!!.- ~~ Signature ~--- a-r::~ ,~.. ~ Company Address Telephone# Valuation or Contract Price ,;2. f- 9 -s"": o-u ./ t?~A J~ ~HANI~ Breakers Ducts Insl. Compressor Final B~ Cl~~ \J'.AJ ~CTRI~~6 PLU~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 ADDRESS PHONE OWNER JOB LOCATION LOT SIZE_X AREA SQ,FT, LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D, 4F 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,u 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, I _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 # ****************************************** Company U./l & State Cert, or Regist, # City License Registration # ..,;J.5.6 ****************************************** BUILDER Signature ELECTRICTAN SiQnature Company State Cert, or Regist, # City License Registration # ****************************************** 'J Company (J../J~1 tJ~ State Cert. or Regist. IF City License Registration # ****************************************** PLUMBER Signature .", MECHANICAL Signature // X- Company State Cert, or Regist. # City License Registration # OTHER Signature APPLICATION APPROVED BY ~~*******~*****w******************** ~A~ t?AA'h~ PERMIT OFFICER, CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Th~ und~rsign~d und~rstands that this p~rlit 'Iay b~ subj~ct to "d~~d r~strictions" which aay b~ .or~ restrictive than City r~gulations, Th~ und~rsigned assuI~s r~sponsibility for cOlpliance with any applicabl~ de~d r~strictions, B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If th~ ONner has hired a contractor or contractors to undertake work, they lay be r~quired to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by laN, both the owner and contractor lay be cited for a lisdeleanor violation under state IaN. 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, IB131 7BB-6611. Furtherlore, if the ONner 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 FEE~ D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, have been provided Nith a copy of sFlorida'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 promise in good faith to deliver it to the "oNner" prior to cOlaenceaent, E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the infortation 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 perait to do Nork and installation as indicated, I certify that no work or installation has cOllenced prior to issuance of a perlit and that all Nork Nill be perforted to teet 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 aust take to be in cOlpliance, Such agencies include but are not litited to: f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands, Water/Wastewater Treatlent f Southwest Florida Water "anaqelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArlY Corps of EnQineers - SeaNalls, Docks, Navigable Waterways f Departlent of Health L Rehabilitative Services, Environaental Health Unit - Wells, Wastewater Treattent, Septic Tanks f US Environaental 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 "coapensating volule" will be subaitted which is prepared by a professional engineer registered in the State of Florida prior to perait issuance. A perlit issued shall be construed to be a license to proceed Nith the work and not as authority to violate, cancel alter, Dr set aside any provisions of the technical codes, nor shall issuance of a perait prevent the Building Official froa thereafter requiring a correction of errors in plans, construction, or violations of any code.. Every pertit issued shall becole invalid unless the work authorized by such perlit is coaaenced within six tonths of issuance, or if work authorized by the perait is suspended or abandoned for a period of six aonths after the tile the work is co..enced, One 90 day extension of tite, lay be allowed for the perait 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 aonth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COK"ENCEKENT KAY RESULT IN YOUR PAYING TWICE FOR I"PROVE"ENTS TO YOUR PROPERTY. IF YOU INTEND'TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COftftENCEKENT. JO'S OHOER '2,500 IH YAlUE 00 HOT HEED TO 'ECORO 'HO POST' 'HOIICE OF COH"HCE"EHT'.~' SIGllATORE: lllIHER OR _T ~c:r(~ ~ ~ was acknowledged , 19_ by STATE OF FLORIDA ___ COUNTY OF f~f+S (0 , The foregoing instrument was acknowledged befDre me this )1(H APJ?(L19Q2 by 12013E:;:72T A is, L E W 1-&' who is personally knDwn to me Dr who has produced FL DR.. p45 f.p 72..7 3 ~ 3,;;2.8. 593 as identification and who did/did not ~ake 7:2'.L _./~ _. ~/~~J...J ignature) 120 sEBr A 13 I L GJ..J I ~ (Name Typed, Printed or Stamped) NOTARY PUBLIC STATE OF FLORIDA COUNTY OF The~foregDing ins~rument before me this who is personally known to me Dr who has produced as identification and who did/did not take an oath. (Signature) (Name Typed, Printed Dr Stamped) NOTARY PUBLIC NOTARY PU~L1C, STATE OF FLORIDA My commiSSion expires Jan 28 199" Bonded thru Patterson - Be~ht Agenc: A irdex Inc 2901 . 44th Ave, No, St. Petersburg, FI. 33714 Air Conditioning Heating & Electrical 521-2602 .527-2123 24 Hour Service Available TO: JOB NAME: ADDRESS: CITY ZIP: LABOR ~CAJm~ :~08112 PHONE: HOURS RATE AMOUNT CHECK LIST I TERMS: DUE UPON COMPLETION lauANI ITEM OR PART NUMBER ICODEI PRICE COMPRESSOR ~ ~ <:".; 1:: ~~ o VOLTS ~ o AMPS I 0 RATED 01 21 ~ 121 o ELECTRICAL CONNE~S o CONTACTOR POINTS o FAN A, f RATED CONDENSER COIL o CLEAN WATER gpm_ o FIN CONDITION o AMBIENT OF o ENT AIR OF o LVG, AIR OF o OIL LEVEL REFRIGERANT o LEAK OO,K, FAN AND MOTOR o AMPS / RATED o PULLEY/BELT o LUBRICATION ELECTRIC HEAT STRIPS o INSPECT CONNECTIONS o AMPS RATED EVAPORATOR COIL o CLEAN o AIR IN OF o AIR OUT OF CONDENSATE AREA o INSPECT PAN o INSPECT DRAIN AIR RLTER o I acknowledge that service has been performed in a manner satisfactory to me. In the event payment is not made as agreed, Purchaser agrees to pay all costs of collection including a reasonable amount as attorney's fees. Interest at the rate of 1'12% per month will be added to all delinquent balances, DATE I certify that I have performed services indicated and installed parts listed. #~~ TECHNICIAN' SIGNATURE o OUR TRAINED PERSONNEL SUGGEST THE FOLLOWING IMPROVEMENTS: o o Customer request preventative maintenance inspections be performed per year, until cancelled by eijher party in writing at least 60 days prior to each anniversary date. PREVENTATIVE MAINT. $ + REPAIRS (PER INSPECTION) o FUll. MAINTENANCE PRICE FOR NEXT 12 MO. $ x SIGNATURE IIIlLlNft ~n~v r2. (" " St-tr] ~ (Z; PARTS WARRANTY All parts as recorded are warranted as per manufactur- er's specifications. LABOR GUARANTEE The labor charge as recorded here relative to the equipment serviced as noted, is guar- anteed for a period of 30 days. "No charge" warranty work will be provided only during normal working hours. o JOB INCOMPLETE o JOB COMPLETE o REFER TO: TICKET # CK# o CONTRACT o BilLING o WARRANTY o C.O.D. o CREDIT CARD o START UP o OTHER PARTS LABOR TRIP CHARGE INSPECTION FM CONTRACT QUOTE TAX AMOUNT PAID: BALANCE DUE: OK'D BY: O PLEASE PAY WITHIN 5 DAYS TO AVOID A BILUNG CHARGE