HomeMy WebLinkAbout92-2362
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N~
236213
/z'O. crt)
~~0 ELECTRICAL ~ MEC~ Sew", Conn
Pmperty Owne' ~!~ 1;1.J;~ f-:c..~~ ~:: ::':'J
Job Address: .....~_ ~_(__ __'CP. T.I.F. s:
ParcelLD. # /1- :J-6- ~ 1- tJ of/) ... b5?O 0 - od-s-D
Date 0-- BJ-<J' d-
Zoning: Energy Code;
Description of work\fl.A;~ --d./;i:u ~~ j
Radon Gas:
'-
4-A-JA1
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
FINAL
C.O.
DATE
NO OCCUPANCY BEFORE C.O.
DATE
Inspector
Permit Fee ~ (J ~ ~
Sig~ature ctl ~-1, ~!..e-41
Company
Address
Telephone#
Valuation or /
Contract Price ~ tf- / E;> . o-c
City License Registration # .3 7 7
State Certified License# '-.:;r tJ tJO 00 G- 3.
Breakers
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.
PH ,_..~ - ~ ~
, ..... 'tV~. 'i" . ,., ," "~ ..' !'-,\ '
.JI.. {),-,,'>. ~,nJ~L
FROM:
A~E.S., ING...
Post Office Box 1716
~h~s,~ 33539
PAGE NO,
DATE
1
OF
1
PAGES
1.1-1-~2
JOB NAME
PROPOSAL SUBMITTED TO:
TOWNE Sr;ut,FH=:
ADDRESS
vr' .
7'eDhyrhil1s, FL
CITY ISTATE/ZIP
[PHONE
~"'~.. .'",.\:r.. _..,: ~<_..,
J.
We hereby submit ~pecifications and estimates for:
One (1) OfF TO pylon sign with Tenent Panels. 18' OAH.
Support seeel/8" squere tubing painted dark bronze,
Ret'mners end Fillers/mill Finish aluminum.
10 Faces re~ding: TOWNE SQUARE to be pan with ~mbossed letters/dk.blue
background to match building Fascis; white letters. Suggp.sted letter
ttyle For 10 faces, OPTIMA SEMISBOLo.
Tenant panels/Flat 1/8" ";hlte sorysteel. Copy tel be vinyl letters
per owner's drawings. I" side w/leesing phone #.
$4 , 81 S . 64 :'
i '",
,....
, ~'
/W":r Ji!!' ~ y"~ :
Fn",..
We hereby propose to furnish labor and materials. complete in accordance with the above specifications, for the sum of
, ,
t:hn, Ic:::~nrl F'; Oht: h"nrl"'F'!rl c::: i ~'t:","F'!rl---Edoll~19t$ 4. Po 1 Fi ~Il ) with payment to be madclas follows,
de~osit ($2,408.32) and remaining balance upon comDl~tion. j
.'
50%
-
All material is guaranteed to be as specified, All work to be completed in a workmanlike manner according to standard practices. Any alteration
or deviation from above specifications involving extra costs wiII be executed only upon writteri orders, and wiII become an extra charge over
and above the estimate. All agreements contingent upon strikes, accidents, or delays beyond our control. This proposal subject to acceptance
c;
within days and is void thereafter at the option of the undersigned.
klthorized Signature ;'-::;<~~'c:,-t:-"C:-;
_..). )" /7 /
./ / p/ y
... , ~~--'-
ACCEPTANCE OF PROPOSAL
The ab9ve prices, specifications and conditions are hereby accepted. You are authorized to dOJh,e work as specified. Payments will be made
as outlined above. / /-- ,.--.,-\ 1
.._~~--j - /. /'
, /'7E/ (. -/ \... ."'/~ 1 .-.4.-' //,)1' .{
ACCEPTED:
Signature
Date .-:/ ,~. ;;...<'
,c E-Z CONTRACTORS FORMS FORM NO. EZ 120
Sign:lture
APPLICATION FOR PHRHIT
CI'IY OF ZEJ.IIffRIIILLS
BUII.DTIiG DEPARIlIfHMT
OWNER'S IWtE !AJtlLES:LP( }afRPf'M8J\ ccep PHOR~~.b9~D90/
OWNER'S ADDRESS ..?-~'?O ~~7/h..c R...CJ ?;;;/i;. ~t'?~ /~~A73:~ .c7 7~6..:y::>
JOB ADDRESS ~5'/~ - _"'J:~-'7<'o 61//" g/t/d? ~/-?f-r./t'I'I'<:; r J::? 3;!1J5-3'
LEGAL DESCRIPTION: L.OT(S)
RI..OCK
SUJBDIVISIOlNl
PARCEL IoD.f---1I~-2..lo-~\ - 00 tt) -01::)700-- 0;.<;0
WRK PROPOSED:_lSlev Construction _Addition _Alteration _Rep.~ir _Install
~Sign _!!love _Deaoli.sh
PROPOSED USE: Single Faaily
_KIF
_' of Units
MIH
IQ1 o().,,~ -
a fR~~-A~8i~Gr--
b(~tU
_~rcial
_Indust.
_Swi.-. Pool
_Restaurant &: Health Depart:aent Approval
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL:
COftKERCIAL :
AtTACH (2) PL.OI' PLMS &: (2) SEI'S OF BUII.DIMG PLAlNlS &: (1) SEI' E'BERGY FORMS. **
ATTACH (3) SEI'S OF BUIl.DIlNlG PLAlNlS &: (1) SET ENERGY FORKS. **
**COPY OF CONTRACT RIlX!m:RIJD.
PERKITS REQUESTED
X-BUILDING
~ELECTRICAL
_MECHANICAL
$Lfg(&.~c.f
Valuation of Tot:al Construction
MIP Service
Florida Power Corp.
W.R.E.C.
$
Valuation of Kechanical Installation
_PLUMBING GAS ROOFING
SPECIALTY
TYPE OF CONSTRUCTIOlNl: _Block _Fraae _Steel
Other
FTIiISHED FLOOR ELEVATIOIiIS:
FI' .
IS PROJECT IN F'LOOD ZONE AREA?
YES NO
******************************************
CORI'RACTOR SECTION
BUILDER
Signature
mMPANY
State Cert. or Regist. ,
City License Registration ,
******************************************
ELECTRI~
,
SiPrlat:ure
CO!IPMfY
State Cert:. or Regist:. ,
City License Registration I
******************************************
P!-."!fBER
~A..~
State Cert. or Regist. ,
City License Registration t
******************************************
Signature
flEmAl[[CAL
mMPMiY
State Cert. or Regist. 4#
City License Registration I
******************************************
Signat:ure
-~;t_~
O11IERl
Signature
mMPMIY
State Cert. or Regist:. I
City License Registration ,
...........a...~.....**......**..********
APPLICATION APPROVED BY
7! a-.uo 1 ~ ,:>/1 "4/'- r
PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this peraitaay be subject to Oared restrictions' which lay be lore restrictive than City
regulations. The undersigned assuaes responsibility for cOlpliance ~ith any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor o~ ~oniractors t~ undertake ~~rkl ihey lay be required to be licensed in accordance with
state and local regulations. If the contractor is nlii licensed :!3 r~quired by lal"" both the owner and contractor lay be
cited for a aisdcteanor violation under stat~ la~. If the o~np.r "r intended contractor are uncertain as to what licensing
requirelents lay apply for the intendeo work, t~?V dIE advis2d ,J contJct the City of 2~phyrhills Building Departlent, (8131
788-6611.
Furthereore, if the owner has hired a contractor ~r cnntractorsl he is advised to have the contractor(s) sign portions of the
'Contractor Sections" of this application for which they Mill bE responsible. If you, as the owner sign as the contractor,
you are indicating that you, rather than the contractor, are respnnsible for the work. If the contractor Mishes 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 UTlLITY CONNECTION FEE2.
D" CONS_TRUG"T T9H....!."JF::N1,.A~J ' CH0.PTER 718, FLOFU DA STATUTES ~ AS AI'1ENDED)
I certify that I, the applicant, have been provided IIHh a copy (f/ "dorida's Construction Lien Law - HOlec'lIner's ProiediDii
Guide" prepared by the Florida Departaent 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
"owner" prior to cOleencelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVI~
I certify that all the inforlation in this application is accurate and that all work will be done in co.pliance with all
applicable laws regulating construction, zoning, and land dl!vel;):.~~nt
Application is hereby lade to obtain a ~l!r8~t ~~ ~o work and j;;f~~ll~t.\on as indicated. I certify that no work or
installation has cOllenced pri~r to issu?nc~ of " per.it and t,!?t a:l ~or~ will be oerformed to leet standards of all laws
regulating construction, City codes, zon:;19 (€:gu!ations, and :.~ 1 d"'!f:lopilent regulations in the jurisdiction. I also
certify that I understand that the regulations Gf nth2f g~ve,n~fntal ilQencies lay apply to the intended work, and that it is
IY responsibility to identify what actions I eust take to be i~. cQ~~liance. Such agencies include but are not lilited to:
. Departlent of Environaental ReQulation - Cypress Bayheads, Wr~lanri ~reas and Environlentally Sensitive Lands,
Water/Wastewater Treatment
t Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t ArlY Corps of EnQineers - Seawalls, DOCKS, Navigable Waterways
f Departlent of Health ~ Rehabilitative Services, Environlental Hea'th Unit - Wells, Wast~"ater Treatlent, Septic Tanks
t US Environlental Protection AQency - Asbestos abatelent
I al:;i) ;:Eitif, th;:.t, if fil: >;:}'_;,-:,,,' i~ I'" ,.~"~;,, j::1~1'" 7,1' "f-,' ',r 'A,eic,', it is undl'rstood that a drainage plan
addressing a "colpensating volule" will be subeitted which is prepare~ by a professional engineer registered in the State of
Florida prior to pereit issuance.
A pereit issued shall be construed to be a license to proceE~ ~ith the work and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a perait 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 pertit is cOllenced within six lonths of issuance, Dr if work authorized by the permit is
suspended or abandoned for a period of six lonth~ after the tihl! ~he work is COlienced One 90 day extension 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 eac!! six lonth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTILf OF COKKENCEt:ENT KAY RESULT IN YOUk PAYING TWICE FOR IMPROVEMENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LtNOER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
CO""ENCEKENT. UNDER $2,500 IN VALUE DO NOT NEED TO RECORD ANb POST A "NOTICE OF COMMENCEMENT".
d~?/d~/
SIGNATURE: CONTRACTOR
s
I
STATE OF FLORIDA
l.u~nll ur ,~~~~_
Tne foregoing instrument was acknowledged
befe,}-e me this M~ ~ I ,19q~ by
(]~Y'lie /IJ. ::Pea-I
who is personally known to me Dr who has
produced Fl "])rit/v Lic..;JI.J) c,(t'D. IIV.'I7- '/1'1
as identification and who ~iq/did not
take an, s.ath. L
If). /cA'T.J-,~ L!J.~
(Signature)
J). ~a.'l-AeritVeMdr fj fIJ
(Name Typed, Printed Dr stamped)
~9TARY PUBLI C
STATE OF FlORID~
CliUrHY OF / /~/~~
The foregoing instrument
before me this ~~ /~r
/
was acknowledged
, 19,'.ol by
who .
who has
'It, t
NOTARY PUBLIC. STATE OF FLORIDA.
MY COMMISSION EXPIRES: August 26, 1995.
BONDED THRU NOTARY llUBLlC UNDERWRITERS.
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
z~ &~,~
L7 If 'hi
~..~.
APPLICANT
ADDRESS
PHONE
OWNER
JOB LOCATION
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
____~F of Uni ts .
__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.
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
BUILDER Company
State Cert. or Regist. #
Signature. City License Registration #
~.........:...........**..........*....*..,
ELECTRICIAN ~ E~~...L-r" - Company
~ ~ State Cert. or Regist. #
Sil2:nature / ~ City License Registration #
~ ******************************************
~fL
Company
State Cert. or Regist. #
City License Registration #
*********************~********************
PLUMBER
Signature
f,
Company
State Cert. or Regist. #
City License Registration #
******************************************
MECHANICAL
Signature
Company
State Cert. or Regist. #
City License Registration #
OTHER
Signature
******************************************
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit ..ay be subject to "deed restrictions' which lay be lore restrictive than City
regulations. The undersigned assules responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RE ONSIBILITIES
If the ONner has hired a contractor or contractors to undertake work, they ay be required to be licensed in accordance with
state and local regulations. If the contr.ctor is not licensed as requir by law, both the owner and contractor lay be
cited for a lisdeleanor violation under state IaN. If the ONner Dr intended contractor are uncertain as to what licensing
requirelents lay apply for the intended Nork, they are advised to contact the City of Zephyrhills Building Departlent, (813}
788-6611.
Furtherlore, if the ONner has hired a contractor or contractors, he is advised to have the contractor(s} sign portions of the
"Contractor Sections" of this application for Nhich they Nill 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 LaN - HOleowner's Protection
Guide" prepared by the Florida Departlent of Agriculture and Consuaer Affairs. If the applicant is sOleone other than the
'oNner', I certify that I have obtained a copy of the above described doculent and protise in good faith to deliver it to the
"oNner' prior to cOlaencelent.
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 developlent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work Dr
installation has cOllenced prior to issuance of a perlit and that all work will be perforled 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
IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and EnvironlentaIly 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 Departtent of Health ~ Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
f US Environlental 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 that a drainage plan
addressing a 'colpensating volule" Nill be sublitted which is prepared by a professional engineer registered 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 perlit 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 perlit is cOllenced within six lonths of issuance, Dr if work authorized by the perlit is
suspended Dr abandoned for a period of six lonths after the tile the work is cOllenced. One 90 day extension 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 .ust be logged during each six lonth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO"KENCEKENT "AY RESULT IN YOUR PAYING TWICE FOR IKPROVE"ENTS TO YOUR
PROPERTY. IF YOU INTEND'TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER DR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
CDft"ENCEKENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF CO""ENCE"ENT'.
SIGNATURE: CONTRACTOR
SIGNATURE: OWNER OR AGENT
was acknowledged
, 19_ by
STATE OF FLORIDA
COUNTY OF
. The foregc.ing instrument
before me this
STATE OF FLORIDA
COUNTY OF
Th~,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.
who is personally known to me or who has
produced
as identification and who did/did not
take an (lath.
(Signature)
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLI C
(Name Typed, Printed or Stamped)
NOTARY PUBLI C
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SHEET NO. I
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SILCOX ENGINEERING, INC.
5409 Nebraska Avenue
TAMPA, FLORIDA 33604
Phone (813) 238.9755 CHECKED BY
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ELEVATION: O/F 10 PYLON SIGN W/TENANT PANELS
TOWNE 5QUAAE
GALL BLVD. ZEPHYRHILLS, FLORIDA
A.B.S., INC.
Post Office Box. 1716
Zephyrhills, Fl 33539
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