HomeMy WebLinkAbout92-2519
BUILDING PERMIT
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CITY OF ZEPHYRHILLS
(813) 788-6611
Perm it
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Property Owner:
Job Address:
Parcell.D. #
Zoning:
2
NO OCCUPANCY BEFORE C. .
Complete Plans, Specifications and Fee Must Accompany Application, C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
City License Registration #
State Certified License#
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Inspector
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Company
Address
Telephone#
Valuation or ~ 4' ,/ ? / /9- if) 6)
Contract Price 7" 111.:J 7;
ELE
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 ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
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40% Pre-Consumer Content. 10% Post-Consumer Content
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Page No,
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SONNY'S DiSCOUNT APPLIANCES, INC.
3399 South Highway 301
DADE CiTY, FLORiDA 33525
(904) 567-6224
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DATE
--7- ;5 -
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JOB LOCATION
CITY, STATE
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A
ITECT
PLANS
JOB PHONE
We hereby submit specifi,pations and estimatE!s;.f.eT':
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Dr 'ropo!lr hereby to furnish material and labor - complete in accordance with above specifications. for the sum of:
.
Payment to be made as follows:
dOllars.($/! 'it/9. (YU ),
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 specifica.
tions involving extra costs will be executed only upon written orders, and will become an
extra charge over and above the estimate. All agreements contingent upon strikes, accidents
or delays beyond our control. Owner to carry fire, tornado and other necessary insurance,
Our workers are fully covered by Workmen's Compensation Insurance.
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Authorized /" --<,' ~ ( . '~." ~- - ,1".
Signature ~~ V-_. -~C:
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Note: This proposal may be
withdrawn by us if not accepted within days,
!\tttptuntt of 'ropo.aul- The above prices, specifications
and conditions are satisfactory and are hereby accepted, You are authorized
to do the work as specified, Payment will be made as outlined above,
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Date of Acceptance: ,/ -'2 7/ ...~
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Signature
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PI1iJDUCI1183
APPLICATIOlil FOR PIOOtIT
CITi' OF ZIl;ntI'KH II.J,~
BUIIJ)IlIG DIl'PARI1!IRln"
OWRER'S lWtE /~ ~1;tf.d~d~~!iE
_'S ADD~:?q'i~!- {#-::~- ~-D
JOB ADDRESS 3 x- ~ ~.. r-L - - . I
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LEGAL DFSCRIPJ'IOI!I: LOI'(S)
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SlJBDIVISIOIJ
PARCEL I. D. #
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_Alteration _Repair ~~t:all
~~'L-~/71.?'/-fH.il7
_Deaolish (<J 0 ;&~~ A- Ie- /)
WORK PROPOSED:_liIew Construction ~tion
PROPOSED USE:
Single Faaily
.,_K/F
_' o:f Units
_K/H
_~rcia1
_Indust.
_Swia. Pool
Ot:her
_Restaurant &: Hea11:h ~t Approval
BUILDDlG SIZE:
x
Square Feet.
Height
, RESIDENTIAL:
cottIIERCIAL :
A1.'TAGII (2) PL01' PUUiS &: (2) SEI'S OF BUILDDiG PLAIIS &: (1) SEr EBERGY FORKS. **
ATI'Aca (3) SEI'S OF BUILDDJG PLUS &: (1) SET EllERGY FORKS.**
......COPY' OF CONTRACT RIlQUIRED.
PERKITS REOUESTED
--BUILDING
~ELECTRICAI.
L'KEalAliICAL
$'
Valuation o:f Tot:a1 Construction
~ AMP Service Florida Power
$. 1/, 3'19,0 0 Va1naticn !-:f Her.harical
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Corp .
W.R.E.C.
Installation
_PLUKBDlG GAS ROOFDiG
SPECIALTY
TYPE OF CONSTRUCTIOIJ: _Block _Fnme __Steel
Ot:her
FllIISHIID FLOOR ELEVATImiS:
FI' .
IS PROJECT Di FLOOD ZONE AREA?
YES NO
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QJlIO'RACIOR SECl'ION
BUTT JlER
CDlPMiY
St:ate Cert:. or Regist:. I
City License Regist:ration ,
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Signature
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;ij 'I COlIPANY
I !II St:ate Cert. or Regis .,
:1'" 1 r I' 'IJ City License Regist ion I.
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PUllBER
CO!IPAIIY
St:ate Cert:. or Regist:. I
City License Registration 1
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Sigoat:ure
KECBARICAI. tJ'Ji (l =~rt:.
Signat:ureA AlJ ~~.L'J:E}' City License Regist ation
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0T1Iml
CO!IPAIIY
St:ate Cert. or Regist:. ,f/:
City License Registration .,
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Signature
APPLICATION APP.ROVIl:D.~~. ."
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CONDITIONS OF PER~IT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this per.it.ay be subier:t b "deed restrictitlns" Ilhichuy be .ore restrictive than City
regulations. The undersigned assu.es responsibility for co.pliar~e lIith any applicahle deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the ollner has hired a contractor or contractors to unde~take ~ork, tney ~ay be required to be licensed in accordance lIith
state and local regulations. If.tttl! l!oJttractbr is not licenseci as Tl::quired by lalt, both the ollner and contractor aay be
cited for a .isde.eanor violation under stot~ law. If the ownEr 'i 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, (8131
788-6611.
Further.ore, if the ollner has hired a contractor or contractors, he is advised to have the contractorls) sign portions of the
'Contractor Sections' of this application for Mhich they Mill be responsible. If YO'u, as the ollner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the work. If the contractor lIishes 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.eollner's Protection
Guide' prepared by the Florida Depart.ent.of Agriculture and Consu.er Affairs. If the applicant is so.eone other than the
'oMner', 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 cOltencelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infor.ation in this application is accurate and that all 1I0rk lIill be done in compliance with all
applicable laMS regulating construction, zoning, and land develop.ent.
Application is hereby aade to obtain a perait to do Mork and installation as indicat~d. I certify that no work or
installation has coa.enced prior to issuance of a perait and that all Mork Mill be perforaed to leet standards of all lalls
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 governlental agencies aay apply to the intended lIork, and that it is
IY responsibility to identify what actions I lust take to be in co.pliance. Such agencies include but are not lilited to:
I Department of Environmental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treatlent
f SouthMest Florida Water KanaQelent District - Wells, Cypress Bayh;,ads, Wetland Areas, Altering Watercourses
I ArlY Corps of EnQineers - SeaMalls, Docks, Nr.vigable Waterways '
I ~artlent of Health & Rehabilitative S~rvi~~~~viron~entaJL_Health Unit - Wells, Wastellater Treatlent, Septic Tanks
I US Environaental Protection AQency - Asbe5~lJs aD,Iti:~lIIen~
I also certify that, if fill laterial is to be used in Flcod Zone 'A' or 'A,etc.', it is understood that a drainage plan
addressing a 'colpensating volule. Mill be subaitted which is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A permit issued shall be construed to be a license to proceed with the lIork 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 Mork authorized by such permit is commenced within six lonths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six aonths after the ti.e the Mork is co..enced. One 90 day extension of time, lay be
alloMed for the perlit with fee charge of $15.00. The extension shall be requested in IIriting to the Building Official. An
approved inspection lust be logged during each six lonth period, or the project lIill be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO"KENCEKENT 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
COftKENCEKENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND T A "NOTICE OF COMMENCEMENT".
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S16 URE: OWNER OR AGENT
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STATE OF FlORID~
COUNTY OF f/ ~C-D
The foregoing instrument
before me this 7-::/3
was ackn;:.wledged
, 19 9.:u by
STATE CF FLORIDA tjJ
COUNTY OF ~~
The foregoing instrument was acknowledged
befc'l-e me th i s '7 ~ c:<.3 ~ 19 9':L by
/f)~ I/~
who is personally known t~me or, who, has
produced Ci)~ ~~
as identification and who di did not
take~ ~J~
(Signa ure I. S-
f--.c UJ d N tV
(Name Type , Printed or Stamped)
NOTARY PUBLIC
who is pe n to me or who has
pl-oduced
as identification and who did/did not
take al)/9ath. Y, i?
~S7'- ~, y1 U/2l~
(Sign51ture) '. S
. liMY A-, WdVV,J
(Name Typed~ Printed or Stamped)
NOTARY PUBLIC
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