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Home My WebLink About92-2313 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit N~ 2313-Jh j Date 2.J-Zq- 9 L BU~ EL~L PL~ $ z.,S-~ MECHANICAL Sewer Conn Water Conn: Property Owner: ~~o.J\-v ~d Job Address: ~q 0..4-('\ q"Tji ~. Parcell.D. # Zoning: Energy Code: Description of Work ~ c.... ~ A'HA'*:- Water Meter: T.I.F.'s: Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL 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 City License Registration # II G State Certified License# Permit Fee /:l ~ 5 S;gna~ ~ <7- ~.~' Company ~tvu..AYt ~-~- 1-- 1) Address Telephone# Valuation or Contract Price tJ J 5'l)'C) ~ -..J ~"\V\\~ f- I'iI1ECHANICAL~ Breakers Ducts Insl. Compressor Final BUI~NG ELECTlicAL , PLU~ING , Ftr. Pre SLB Lintel FRM. Insul. CL WL Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer 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. . SERVIGE INVOICE Supel<>ior Hea'dng & Cooling Management, Inc. 231 Dougla.s Stre~t. Building A Suite 10 Oldsmar. FiOrida 34677 (813) 854-3449 Zephyrhills 783-7509 STATE CERTIFIED CAC049271 Lakeland 688-1823 CD 12518 DATE H-c)J1-q~ WORK TO BE DONE C.USTOMER.s T -e () J, (> ".1 f( ~' tl ,. II 11- STREE13 q ~ LJ () qiJ.AIJe 7~;1./"'/h() ciTV Ze PH . ~l~~ .-. ZIP, , .-1./ ......, I PRICE c:oN'Y'NICT NO. I CUSTOMER NO, . , SOURCE COST QTY. ITEM I ~ 'l:::t TON ~s/c~ J!i::o ,00 Bill TO NAME ;-.0 1'>1 0. ~-n:/ R.. STREET PHONE -.' (()^",(Jp f\}:.,t)R - CITY STATE ZIP o CONTRACT ' 11ME & WlT'ERW. D REPlACE D J ,-S,AT N ,~ 1,.0 . QC.O,D. NEWlNTD (;()N'TJW;T D c.aD J \../ R. DtnA " 1/ 1(. TECHNICIAN: . I I MAKE MODEL SERIAL NUMBER DATE DESCRIPTION OF WORK PERFORMED I.A PI) A) f)f..J~ I JA I f::. ~ I.J II. v/ rlJifr.s /de UNIt 2AJ , Rf'I7/ .f~ AcA 5 h J:Jp-e I IJ:~...) S l'cI ~ '{jNr'7 . , ::J, rJ ,s i I~ At:-f?/lprJ/ S liA-P~ f:"'of( I. ,',.s A,G-e~ {( a:Ct"J~"tJt~ ' I II I R e{)//J( -er'i\.~ f:'n r< .' " lItJ,7 , n ; JpA}///h,",')--'-/ ~ u f. Pt)~c.....pc... I I , I , , , 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 COMPlETlON ARRIVED DEPARTED TIME TIME ~ II'WOICe I~ !Ubtect 10 . Fln.1nce Char~ of I'~' Def .month A.nnuRl Petc~aoe Rate of '8'. wh.-;h " .\'\row(.>d ~ low ARRIVED DEPARTED " II aorHd and understood by the DlIfhel ~l all eQUlDn'IItnl and o,arlS whCh at!! SOld j:M'SlJ.'V'l! ~f'1O ''''aJl NOT SERVICE PARTS become hxlUres or DArl of the ~I .Ita. whete lhe., are DtaCecI Satd Darts and eauonen1 S",JII z.l ... h"....S ,~In ~ prooerly ~ !hi htte 1hef'efo shall remMlf'l In lhI _let' un1tl 08Ymen1 If' full IS rec~ BuV"" 'l(>rf'bv ~fft'S L~/) ~ "'-I ..., part. ancl eauoment may be ~...s.eo 'n the event Of nc""-O.Jymen1 ~ Pt!'Ylef'W 'IIOr' too' ..,arranty ,tI'WJ SERVICE LABOR W'l8trucbonS ,"- ~Z""'''''' as -'''''''~.. 10...,.. eO....nd ~""'"'''''' "10<....,., '...... "'. CUSTOMER DISCOUNT WftIOCe IS ed..1 and. d an i1nC'f"tly fof eOfle(;f / /1 .A A I ,< ,-/ /1/1 A_A l'i11 00 TOTAL CHARGE S l'ECHNIC~1It SIGNATURE' ~ / ~ w.,..,# , . ~ '".~ '.- . DEPOSIT S M10MERS SIGNATURE" / . EXP., II Z CARD .. - .BALANCE DUE S NO. DATE '. ~j j APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT S~/J-e/<"/"aJ'(? &9T;''''J ~ ~cxJ)~~ ~T;/-ZNc.. ADDRESS ';;.5/ ~...~h..5' ...>r.,&/6 ,4-/0 O~~~<'~. J~"77 PHONE 783 - 7..5""0 P" OWNER Sr:~..vIeN' ,e'~~ JOB LOCATION ,79;:2/'/0 ?T~ve ~..,I7~~ 3~~/LOT SIZE_X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D. # WORK PROPOSED:_New Construction ----Addition _Alteration ~Repair _Install _Sign/Temp. _Sign _Move _Demolish PROPOSED USE: _Single Family _M/F _4~ of Uni ts ,_M/H _Swim. Pool ~ adye C!'u~ Other _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 :.r ---6.MECHANICAL AMP Service Florida Power Corp. _W.R.E.C. $ 9}CO ~ GAS Valuation of Mechanical Installation _PLUMBING ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Frame _Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** Signature CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration iF ****************************************** BUILDER ELECTRICIAN Company State Cert. or Regist. iF City License Registration iF ****************************************** Sis;mature PLUMBER Signature Company State Cert. or Regist. # City License Registration iF *********************t******************** MECHANICAL . Company ("~eR,Io-t' ~rh~~C"oo",(~ ~T-....2'Pc. ~ '/ /1 " State Cert. or Regist. iF CAco t,r?;Z 7/ Signature ~4 ~ City License Registration iF ***************************************** OTHER Signature Company State Cert. or Regist. iF City License Registration iF APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this per.it.ay be subject t~ "deed restricti~ns" which lay be lore restrictive than City regulations. The undersigned assu.es responsibility for cOlpliance with any applicable deed restricti~ns. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake w~rk, they lay be required to be iicensed 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 ONner or intended contractor are uncertain as to what licensing require.ents .ay apply for the intended work, they are advised to contact the City ~f Zephyrhills Building Depart.ent, (B131 7BB-6611. Further.ore, if the owner has hired a contractor or contractors, he is advised t~ 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 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 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 Nith 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 leet standards of all laws regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction. I also certify that I understand that the regulations of other govern.ental agencies .ay 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 lilited to: f Depart.ent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands, WaterlWastewater Treat.ent f Southwest Florida Water "anaqe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f Ar.v Corps of EnQineers - Seawalls, Docks, Navigable Waterways f Depart.ent of Health L Rehabilitative Services. Environ.ental Health Unit - Wells, Wastewater Treatlent, Septic Tanks f US Environ.ental Protection AQencv - Asbestos abate.ent I also certify that, if fill .aterial is to be used in Flood Zone "A" Dr "A,etc.", it is understood that a drainage plan addressing a "colpensating volu.e" will be sub.itted 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 aper.it prevent the Building Official fro I thereafter requiring a correction of errors in plans, construction, Dr violations of any code. Every perlit issued shall becole invalid unless the work authorized by such per.it is co..enced within six .onths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six .onths after the ti.e the work is co.tenced. 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 logged during each six .onth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COKKENCEKENT KAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERry.. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF CO"KENCE"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 was acknowledged , 19_ by STATE OF FLORIDA COUNTY OF t'ASC.o . The foregoing instrument befc11-e me th is 4 - 1.. q STATE OF FLORIDA COUNTY OF The foregoing instrument befclre me this was acknowledged , 19 q 1... by who is personally known to me or who has produced as identification and who did/did not take an oath. R \ C \-\ p.., R D P\. . e.. \-\ J\ t' l'V\ flI t-J who is personally known to me or who has produced DR\\lER'S L\ c..E. J'.JS E a~entifica~n and who did/did not t~~t;'~.! \) ~ . '-.....----"" (Slgnature) DE. 6B I t= Po.. RO\.0E. ',--L (Name Typed, Printed or Stamped) NOT ARY PUBLI C :tt: u 102, / ~ . \.iT ARY PUBLIC, STATE OF FLO My commission expires Oct, 2. 1 ~onded thru fatters(l"J - B.9cht Alt., (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC ,OTARY PUBLIC, ST^T~ Of rt Of" kv commlssiun expir.-'$ Ur;! ,'. ' 'c; l't_ "h1k1C tnlc~ r,_'~,14,-~;...: , r'''''''i''