HomeMy WebLinkAbout92-2489
BUILDING PERMIT
Perrnit
2489~i
7 - /.$ -9~
j.5 DY
~LD~ ~AL
~opertv Owne'~ 1/~ dd!:;r~
Job Address: <:>... . ~ 1 . )
CITY OF ZEPHYRHILLS
(813) 788-6611
N~
Date
PL~ M~~werConn
Water Conn:
Water Meter:
T.I.F.'s:
Parcell.D. #
Zoning:
Description of Work
1/l.e.~CL6
NO OCCUPANCY BEFORE C.O.
FINAL q...
C.O.
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Valuation or
Contract Price
3, !f3,h'~
Permit Fee
Signature v---DPrNiEL. $, >c e
Company -5Jltr1ofll-O /fiJ~ SCIlV/('r:' Q;,4jJ
Address 19(""1 LAf:E- ~- L~ / ~
Telephone# ~,-. ~~l{~OI. )Q/
EL
PLUM
ME
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
I=inal
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.
'O~\J
STRNDARD H"jMf f.ERU I CE CORPORATION'" MANUFRCTURER OF MOO I LE I~~ME ROOF -OUERS .
-
t 9:54 Lake Av.nu. SE Largo Florida 34641
CaTITonFree 1+800-624-01:50
c..i~. Fvst! tq~~~:Z ~ ~ h~L l)/1k /', F_
Addr"4PSS I ~E>7' L _ .. / ~-Cf ~
LQg..J DQscrjptjon
,
ownship Rant/.' Subdiv, Blocle
II Job No. I t
:J Lot No. I /0 J
.
I 33SY-'ci
C;ty
"'-
~~ivclte Lot I ;// L-LA6 e G )tJ c_
Homt'Phone jCff, ) 76:8 - /'3S7...-
Contract Oat. I <t5" /l.c../ 9 ~jrCll' Typl'
We Submit Ttle Follo",in Specificatir IS And Esti mate
1) Furnish & Instilll Aluma-Steel rJof-Over with 2inch thick CelloFoam insulation on Moblle Home
Coacn ~pproXi mete si~e:' Le"~!n c::2'5Z] ft. X Width I~y ~ ft.
2) Over hang Roof-Over On Ca'~ort side ~ inches.
3) Over hang Roof-Over on '~obi1e Home Rai n Gutter side I #/,.,.-1 inches.
4) Over hanll Roof-Over ~1tl Mobile Home sides I 'tf-~ I inches. if no existing Rain Gutters.
5) Over hang Roof-Ov~:' on Mobile Home front and rear I f-G: I inches. if no obstructing fescie.
.
6) Replrce existt r:~ ,:>':haust fan ext!'!rior roof vents and se\oler gas roof vents ",ith ne\ol al umi num s~ n vents.
7) furnish end 1"btall 5 inch Fascia around Mo
B} Ci rcle type of heatt IlQ system: Gas
9) Special i /l1ltl"uct;ons or other 'Work:
S/f't--f.-. $~J ~ c r-;b
,
Electric I
,
I
S-+715F7fe.7{)..e;r f1;Jj/J-vCE-- Iff r i2IJ ();rt-~
L.
.
ST AND ARC HOME SERVICE CORPORATION HEREBV AGREES TO FURNISH MATERIAL AND LABOR COMPLETE IN
ACCORDA~I"E ~H THE '*'B()VE FOR ~ 5l.2
$ ~ ~:?h "Pius Sal.s Tax $ (If R.ntal ~ $ ~I Pric.
PAV.MENT Q,eE MADE ,*,S FOLLOW~
'-='C hd~C~~UTHORIZEDSIGNATURE: ~ ~
NO ICE T J OW'NER. DO NOT SIGN THIS HOME I MPROYEMENT CONTRACT I N BLANK. YOU ARE
ENTITLEli TO A COPY OF THE CONTRACT AT THE 11 ME YOU SIGN. KEEP IT TO PROTECT YOUR
LEGAL RI.,iHTS. THERE ARE ADDITIUNAL TERMS ON THE REVERSE SIDE OF THIS CONTRACT"
CUSTOMER ACCEPTANCE. THE ABOVE PRICES AND CONDITIONS ARE SATISFACTORY AND ARE HEREBY ACCEPTED.
ST AND ARC HOME SERV ICE CORPORATION IS AUTHORIZED TO 00 THE WORI< AS SPEC IF. lED. P AYMENJ '1'!1- ~ADh
OUTLINED ~ @/h1~ - CJO/rr',p'"'-'it .
SIGNATUR : I;:: tf SIGNATU E: //a?z. -c..le DATE: ,;)d- 9~
I
STRTE CERTlFlEO,SPECIRTY STR CTURES CONTRRCTOR - SCC 045072 - COPYRIGHT 1992
DATE: 07/06/92 PASCO COUNTY PROPERTY APPRAISER
o N - L I N E PAR C E L P R I N T 0 U T
PARCEL-ID: 02 26 21 001C 00000 0100 TYPE:
SC TP RG SUB BLOCK LOT
STATUS: A
DLA: 01
PARENT:
NOTES: H & W QUALIFIED 87 HX
DATE-SPLIT: 000000 CL
ADDR CHG PER IIC 7-10-89
NAME: WAMBOLD FLOYD E & MILDRED E
.I ADDr~
38738 VULCAN eIR
Z E PH Y r~ HI l..I... S
VALUE & TAX INFO: E X E M P T I 0 N I N F 0:
LAND AG: NUM CD H W D V T PCT Hx.-o~mI[)E REC
....Mr~I<T t 76~~9 001 1 0 0 0 0 59(
SLDG: 26186
XFOE: : 1255
APpr~ :
EXMT:
~l~'j070
~?5000
--------------------
----------.----.-----
TXBL.: 10070
ACRES:
AF~EA : 30ZH
LOTS:
CHG:
YEAR MON Bom< PAGE
198:1. :I. j.56 (:)759
:1.986 11 1552 1948
S ALE S~
SALES-AMT INST XFER QUAL ST
7!500 WD
LEG A L DES C RIP T I 0
VILLAGE GROVE i1 PB 20 PG 67 LOT 10
OR 1552 PC; 1948
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APPL:A.i.i:ATIOB FOR PERKIT
CIty OF ZEnlIKlII fILl,S
B1lJII.DDiG DEP.ARI'KEffl""
OIlIIER'S IWIE poy?:> E. W/rm/3tJLL) -6:}) ?J\f- 93J.;t
OWNER'S ADDRESS 3cF7;?6-" (/{jAC;17zJ C/4-CL~ --CU ~~ljl AI/Is r-e 33~C/O
JOB ADDRESS !; /}-7v7L
LEGAL DESCRIPTION: UJI'(S)
PARCEL LD.' t>).. :;c..
JD
.
-:)/
BLOCK_LsUBDIVISIOlli VI LL46€ G~OtJc.-
CYO/t2 C>C>OOO 0100
WRK PROPOSED:_llev Construction --...Addition _Alteration _Repair X-Install
S.
- 19D.
_Move
_Deaolish
PROPOSED USE:
Single Faaily
_"IF
_, of Units
-,K"K/H
_~rcial
_Indust.
_Swa. Pool
Ot:her
_Restaurant &: Health Depart:aent Approval
BUILDING SIZE: :;; i X S;(
Square Feet,
Height
. RESIDENTIAL:
COttKERCIAL :
ATTACH (2) PLOl' PLMiS &: (2) SEI'S OF BUILDING PLANS &: (1) SEt' ENERGY FORKS.**
ATTACH (3) SEI'S OF B1llIJ)DiG PI.MS &: (1) SEt' mmRGY FORKS. ~~
~*COPY OF COl!iTRACT REQtDIRED.
PERl!lITS REQUESTED
_BUILDING
:$
Ji3f- 9.Q
Valuation of Tot:a1 Construction
_ELECTRICAL
AIfP Service
Florida Power Corp.
W.R.E.C.
_MECHANICAL
s
Va1uation of Hechanical Installation
_PLUMBING
GAS
KOOFDlG
SPECIALTY
AI#-
Ot:her
TYPE OF CONSTRUCTION:
_Block
_FraIIe ___Steel
FINISHED FLOOR ELEVATIONS:
FI' .
IS P.RO.JE('T IN FLOOD zmm AREA?
YES NO
***~**********~*******~***~**~****~~~~****
BUILDER
CIBII'nlACIOR SECTION
i\ n c/hYL CO!tPANY5/It1-JD~':::> )Bh.E.5'E;2iJLCE C'6/L ~
~ State Cert:. or Regist:. , .5CC_ CJ C/C;D7L-.
City License Registration ,
*******~***********************~**********
Signature
ELECTRICIAIf
CO!tPARY
State Cert:. or Regist:. ,
City License Registrac~on f
_*_***_****>L .":**_**********************
SiPTlature
PLUtlBER
Signature
CO!tPBY
State Cert. or Regist. ,
City License Registration I
*************.j,**_*ii:**.It**.....*****~**..."'.. ...:..."''''
KEmARICAL
Signature
CO!IPANY
State CP-rt. or Regist. ,
City License Registration I
******************************************
OTHER
Signature
CO!tPOY
State Cert:. or Regist:.I
City License Registration ,
*********************~***...****************
APPLICATION APPROVED BY
PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlitlay 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 RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they lay be required to be licensed in accordance with
, ~.. ':t ' " II;
state and local regulations. If the contractor is notticensed as required by law, both the owner and contractor lay be
cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to Khat licensing
requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (B131
788-6611.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor(sJ 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 with a copy of .Florida'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
.owner. prior to cOltenCelent.
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, 20ning, 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 cOltenced 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 Iilited to:
I Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treatlent '
I Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
I Departlent of Health L Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
I US Environlental Protection AQency - Asbestos abat~lent
I also certify that, if fill .aterial is to be used in Flood Zone .A. or "A,etc.., itis understood that a drainage plan
addressing a .colpensating volute. will be sublitted which is prepared by a profession~l 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 per.it is cOI.enced within six lonths of issuance, or if work authorized by the permit is
susp~nded or abandoned for a period of six lonths after the tile the work is cOI.enced. 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 each six lonth period, or the project Mill be considered abandoned.
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 TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A 'NOTICE OF COMMENCEMENT..
//
,/
SIGNATURE: CONTRACTOR
SIGNATURE: OWNER OR AGENT
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
befcll-e me th i s _.__._.__~, 19_ by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
before me th is __-----" ._"..' 19 by
who is personally known to me or who has
pl-oduced
as identification and who did/did not
take an oath.
who is personally known to me Dr who has
pl-oduced
as identification and who did/did not
take an oath.
(Signature)
(SignatLn-e)
(Name Typed, Printed Dr Stamped)
NOTARY PUBLIC
(Name Typed, Printed Dr Stamped)
NOTARY PUBLIC
APPLICATI05 FOR PERKIT
CITY OF ZlWHI'KHllnT.S
BUILDllIG DRPAR'DIE5T
OWNER' S RAKE
moB
OWNER' S ADDRESS
JOB ADDRESS
LEGAL DESCRIPJ'IOl!i: I..OT(S)
BI.OCK
SUBDIVISION
PARCEL I. D.'
WORK PROPOSED:_lIfev C'oost:ruct:ion ----l'ddit:ion _Alt:erat:ion _Repair _Install
_Sign
_Move
_>>eaolish
PROPOSED USE:
Single Faaily
_"IF
_, of Doit:s
_K/H
_~rcial
_Indust:.
_Swt.. Pool.
Ot:her
_Rest:aurant: & Realt:h ~t: Approval
BUILDING SIZE:
x
Square Feet:,
Height:
. RESIDENTIAL:
COItKERCIAL :
ATTACH (2) PI.Or PIAKS & (2) SEI'S OF BUILDING PI...!\.5S &(1) SET ENERGY FORKS. u
ATTACH (3) SEI'S OF BUIIJ)DlG PIAKS & (1) SET ENERGY FORKS. **
**COPT OF COIfI'RACT RIlQm:RIlD.
PERKITS REQUESTED
_BUILDING
$
Valuat:ion of Tot:a1 Coost:ruct:ion
_ELECTRICAL
AKP Service
Florida Power Corp.
W.R.E.C.
_KECH.AlfiCAL
s
Valuat:ion of Hecbanical Inst:allat:ion
_PLUKBING
GAS
KOOFDlG
SPECIALTY
TYPE OF CONSTRUCTION: _Block
_Pralle _St:eel
Ot:her
FInSBED FLOOR ELEVATI05S:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
****************..**.*****...*************
COIlTRACIOR SECI'ION
BUILDER COIIPANY
St:at:e Cert:. or Regist:. ,
Signat:ure Cit:y License Regist:rat:ion ,
************.*****..**********************
ELECTRICIAH COIIPA!IiY
St:at:e Cert. or Regist:. ,
Si~ture City License Registration t
***********.**.........*........*..******************.*
PIJ:ItBER COIIPARY
St:ate Cert:. or Regist:. I
Signature City License Registrat:ion t
****...*...........t***.........tw..,...."''''...*........**....*******
flECBAlUCAL COIPA!IiY
St:at:e Cert:. or Regist:. t
Signature City License Registration t
***.**....*......*.*...**..*.....*........
OT'IIF.R COIIPAlilY
St:at:e Cert:. or Regist:. ,
Signature City LiceJlJLSe Registration ,
...........***....*..~...............*.....*....**...*********
APPLICATION APPROVED BY PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this peraitaay be subje~t to "deed restrictions" which lay be lore restrictive than Clty
regulations. The undersigned assules responsibility for ~olpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a ~ontractClr or fP~tractors to u~dertake 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 ~ontractor 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)
788-6611.
Furtherlore, if the owner has hired a contractor Dr contractors, he is advised to have ,the contractor!s) 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 with a copy of "Florida's Construction Lien Law - HOleowner's Protection
Guide" prepared by the Florida Departlent of Agriculture and Consuaer 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 cOllencelent.
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 cOlpliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a perait to do work and installation as indicated. I certify that no work or
installation has cOllenced prior to issuance of a perait and that all work will be perfor.ed 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 govern.ental 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 Depart.ent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treat.ent
f Southwest Florida Water "anaQeaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
f Depart.ent of Health ~ Rehabilitative Services. Environ.ental 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" or "A,etc.", it' is, understood that a drainage plan
addressing a "colpensating volule" will be subaitted which is prepared by a professional engineer registered in the state of
Florida prior to perlit issuance.
A perait 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 permit issued shall becole invalid
unless the work authorized by such permit is coa.enced within six lonths of issuance, or if NorK authorized by the per.it is
suspended or abandoned for a period of six months 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 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 CO""ENCE"ENT "AV RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
CO""ENCE"ENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF CO ENCEHENT".
~
SIGNATURE: CONTRACTOR
~~2hilJ c: Lu~ A~p
SIGNATURE: OWNER OR AGENT
-
SlATE :li: flORIDA0A
COUNTY OF m~O
The Ic.regoing instr,u~nt was acknowledged
before me this .~~~__~ 19~~Y
jJ1/LZ>/ZL/J &.. i#47#' gaLL>
who is personally known to m~ or who has
produced
a~"~.d ti~ficatic..n and whc, .did/di.!LD9J:.
t~&/? ~~L.
(Signature)
STATE OF FLORIDA r}:;seo
COUNTY OF / .
The foregoing instrument
before me this ~~
was acknowledged
19 92 by
/lL
/I/lLL
who is personally known to me Dr who has
produced /2~/2IDA .Dh L ,
a~,~..~~fication a'.fld w.~o di.d./d~.,.t
t~~~~/~h;~e
(SignatLr.-e)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
CHARLES R.IALDERSlONE
Notary Pubic, State 01 Rodda
My comm. expires Oct. 7, 1995
No. CC150285
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
CHARLES R.IAI.DIRITOIE
Notary Pubic. StIlI of Florida
My eomm. exp/rll Oct. 7.1.
'I" CC1-50285