HomeMy WebLinkAbout92-2499
BUILDING PERMIT
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CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
24994,
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Daw
p~. ~~'erConn
Water Conn:
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Parcell.D. # .:36- s? .~- ,.:21- ()DL5/l- - tJ DOOO - II tJD
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Water Meter:
T.I.F.'s:
Zoning:
Description of Work
FINAL
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Ftr. {'\---30 .4 L.-
Pre SLB
Lintel j- ~.-q z...
FRM.
Insul. CL
WL
City License Registration # ~9
State Certified License# 07< (! /) 1/S77fL
!!!S?R:.7J
__ ELEORtCAl..
---
~~LL
~,6.
Inspector
~f}fi
Permit Fee. · --
S;gnaMe _~__---- hg~
Company __
Address
Telephone#
~ II<;
Valuation or . -? I / /J I -
Contract Price ~ I 0 oG
~....
PLU
....-
MECl:l ^ ~JIE:AL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Ins!.
Compressor
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 ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e, Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
APPLI~ni]R Ftm. -"-S'FNIT
GI'IY OF ZIlPIIYRlUUS
BmIJ)DiG DEPAR'IHElNlT
OWNER I S RAttE
Ro(\ e,{tY'L-
~ (S" ,S-.3 3 C ~VY1 d €-,J
5~e~
4v~"
mon ,$~'~
Z-L~Al (' hI lls-( Fl. j3'5:tj 0
OWNER I S ADDRESS
JOB ADDRESS
LEGAL DESCRIPl'IOl!i: LOI'(S)
B.I..OCK
SlIlBDIVISIOR
~~CELi~~'~:.--~ .3 S- -- r1 S- - ;2 I 0 OS-A - 600 (1 0- I I (', 0
WORK PROPO~ED: l/.ew COOStructi.....n ~tion ___Alteration _Repair _Install
_Sign
_!!love
_Deaolish
_~rcial
_Indust.
_Swill. Pool
_K/H
fA) -+ L L- Other
PROPOSED USE: S:ingl.e Faaily
_KIF
_, of Units
BUILDIHG SIZE:
_Restaurant & Hea1th lIepar~t: Approval
X 101 L, ~ . Fr. (,.jCt If Square Feet.
Height
. RESIDENTIAL:
COHKERCIAL :
A'lTACB (2) PLOT PLMiS & (2) SEI'S OF BUILDING PI.AliS & (1) SET EliERGY FORKS. **
ATTACH (3) SETS OF BUIUrDiG l'I.J'lMS &: (1) SET ENERGY FORMS. **
**copy OF COIITRACT KEQ1lJIRED.
~TS REOUESTED
~UILDIHG
$ ,~ l ~ ~ . 0 0
Valuation of Total Construction
_ELECTRICAL
Atw Servi.;~
Florida Power Corp.
W.R.E.C.
_KEGllAJlICAL
$
Valuation 01: l!Iecbanical Installation
j<Ai;:,~,
_PLUKBIHG
GAS
V:loclt
KOOFTLIiG
SPECIALTY
TYPE OF COHSTRUCTION:
_~ _Steel
Other
FINISHED FLOOR ELEVATIOl!iS:
FI' .
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
cmJrI'RACIOR ~f.CTION
RmTllER COIfPAn ,epttYK:.m~~()I\,I~ C:h~T. ~/)( I
~ ~. {j fV\ 12 ". A-_ State Ce:iC't. or Regist." C () S; 77 L
Signature . A ~ / f l . -L.J~ City Lic~e Registration ,
\ *********,,1,-.1<******-"***-"*-"**-"******-"********
ELECTRICIAN CO!IPANY
State Cert. or Regist. j
Si2n3ture City License Registration t
************;:**...*...**********...***-.,**-.,**-.,***
PLOKBER CO!IPMY
State Cert. or Regist. ,
Signature C~ty License Registration f
*****"'*****~**"'*~k***************-"********
KEaIANICAL COIIPANY
State Cert:. or Regist. 1=
Signature City Lic~~e Registration I
******************************************
OTHF.R CO!IPANY
State CerL or Regist. ,
Signature City Licease Regbtration I
.........****-.,***********************
APPLICATION APPROVED BY PERKIT OFFICER.
,~7
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlitlay be subject to "deed restrictions" which lay be ~ore 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 may be required 'to be licensed in accordance with
state and local regulations. If the'c6nt1actor is not 'licensed a~ 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 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 or contractors, he is advised to have thecontractorls) 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 - HOleowner's Protection
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 document and promise in good faith to deliver it to the
"owner" prior to cOllencelent.
E. CONTRACTOR'S/DWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work wi.ll be done in compliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby, made to obtain a perlit to do work and installation as indicated. I certify that no worK or
installation has cOlaenced prior to issuance of a perait and tha~ 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 governmental agencies aay apply to the intended worK, and that it is
IY responsibility to identify what actions I aust take to be in cOjpl~ance. Such agencies include but are not limited to:
f Departlent of Environaental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treatment
f Southwest Florida Water KaRaQement District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f Aray Corps of EnQineers - Seawalls, Docks, Navigable Waterways
f Departlent of Health ~ Rehabilitative Services, Environlental Health Unit - Wells, Wast~water Treatlent, Septic Tanks
f US Environlental Protection AQency - Asbestos abateaent
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 submitted which is prepared by a prof~ssional ~ngineer registered in the State of
Florida prior to perlit issuance.
A permit 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, or if work authoriz~d by the pertit is
susp~nded or abandoned for a period of six months after the tile the work is cOli~nc~d. On~ 90 day extension of tile, lay b~
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 b~ logged during each six lonth period, or the project will be consider~d abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCEKENT KAY RESULT IN YOUR PAYING TWICE FOR IHPROVEMENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY, BEFORE RECORDING YOUR NOTICE OF
COKKENCEKENT. JOBS UNDER $2,500 IN YALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
Jf~ /Jr. ~~.
SIGNATURE: OWNER OR AGENT
~~-1 rh. 6~
6NATURE: CONTRACTOR
STATE OF FLORIDo/)f'::I. n"
COUNTY OF .t. u S~- U
The foregoin? instr~~r~ ~~,~~knowledged
before me thIS \ --L...Lb;VM'}_~y
\-)~L rr\.~~ --JucL.rf) 01" BI~StD/\
who is per~onatly knqwn,tp me Dr who has w~qjLi~ per:on~~lx known ,to Je Dr ~ho has
produced ~\ h \ A ).{ J\ ~SUV\.,ill-. .~ \o.\.\l rll3- J'fl b"Huced , A'J .....' II l\-Cl_ll '1 t~ J\ D1.-: r \.
as identificat~on and who did/did not as identification and who did/did not
take an oath" ~o --..L-..~ take an c.atJ-y." ) ,j f;) r~;rr-
~W \ (_ \,jl..<.~' (;7.' t<y--J..A-<-"'}"
(Signature) 0 (SignatLr.-e) -~ rUllllilllll/.i
tu~ ~~~Q\f(;..':...~/S ,
(Name Typed, Pr i nted Dr St(~mpe ) (Name Typed, F'l- i nted Dr a, 'e~ y.... ~ \
NOT ARY PUBLI C NOT ARY PUBLI C IS l My Comm. Expires'" is
NOTARY PUBLIC, STATE OF nORmA. ~ June 2, 1996 i ~
MY COMMIS~lON EXPIRES: Dec. 12, 1994. \ ... No. CC 205012': ~
BONDED TIlRU NOTARY PUBLIC UNDERWRITERS. . '{J!
~~'..!.'UBL\C__..~~ ~
~ Af'h.:. -.u.' ~v ~
~, (:-- OF F\-O ,,\t~
7/"l/lJlml!,i\\\\\~
STATE OF FLORIDAv?A
COUNTY OF r <5 ( ()
The foregoing instrume~t
bef~"tj-e me th i s {-')<=., 't-h
was acknowledged
C .-
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Proposal
Proposal No. \
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Sheet No.
38841 I Hwy. 54 E.
Zephyrmlls, FL 3424,8.....
(~13) 782-565T!'~'" i.
Performed
Street
_ity
Date of Plans
Architect
t'
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All material is guaranteed to be as specified, and
and speciAcations submitted for above work and
the abave wark to' be performed in accordance with the drawings
completed in a substantial workmanlike manner for the sum of
f. Dollars ($ .~, \o"l.' 0':> ).
h JoW'k a w.\ t;.~ ~,~ tor ~\~~\ n ~
OI...v\t'\Q'('- S
:!th ~yments t~te made as follows:
J-~ ""' L\ I CI . ~Y' r~r\e\.'~
o~
Any .alteration or deviation from above specifications involving extra costs, will be executed only upon written orders, and will
become an extra charge over and above the estimate. All agreements con.tingent upon strikes, accidents or delays beyond our
control. Owner to carry fire, tornado and other necessary insurance upon above work. Workmen's Compensation and Public
Liability Insurance on above work to be taken out by '2-ML.
Per 2-tp\..'1'1'
S\ow~
. ,",
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C~f'~ i' W
(~v\..~\-.
Respectfully submitted
Note - This proposal may be withdrawn by us if not accepted within 90 days
..
ACCEPTANCE OF PROPOSAL
The above prices, specifications andcondition.s,at~ sa!isfactory and are hereby accepted. You areauthori,led1o dothewqrki!3~',
specified. Payment will be mode os outlined above. .,' , " ',," '. . ','!i','::
A,,"PI'd~ 0 &qA1/
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~ Signature ..,
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Wntgale Printing. Inc. 1886
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