HomeMy WebLinkAbout92-2781
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
Nf! 2781,5:
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Date
E~AL
p~- M~:werconn
Water Conn:
Zoning:
Description of Work
Property Owner:
Job Address:
Parcel 1.0, #
Water Meter:
NO OCCUPANCY BEFORE C.O.
FINAL / /-/6 -5':.5
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Valuation or / ,/1U' 1-!!-.
Contract Price ~ .:>L.+.- &.
City License Registration # 61 ~ ~ ~ 41 .
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c: BUll~ E~-'
Inspector
. ~~ Od>'
PermIt Fee . I
SignaMe . - - ~ ~
Company
Address
Telephone#
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
PLUM~ .
--
MECH~--
----
Breakers
Ducts Insl.
Compressor
Final
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.
FILE. COpy
FENCING ESTIMATE AND PROPOSAL
SEARS, ROEBUCK AND CO.
No.1
7 { "1;;, 5 Jl
CUSTOMER'S NAME
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Q.
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STATE
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HOME PHONE
7ff 6f,15
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J .', , , lSAlESCHECK/~~~.,-~(v1flER
(.'>Jt- I~ I/;>;'_;~. <,. ) / (_>
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S E ASSOCIATE NAME UNIT NUMBER
ZIP CODE UNIT PHONE
/- ~'i/' ";? '5>~'(/i:
DIV.
10
DATE OF ESTIMATE
1/ 2/ k
UNIT ~DRESS ,,;~ r /J
IV:J'L""'l ~ l).vcY
O~ /'ht,,')'cl7.:,/
F,..,. Jt;:,
CITY
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Y'" (Ii '." v
WORK PHONE
ADDRESS
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STATE
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INSTAllATIO~.'1'\. flORESS IF DIFFERENT..
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p ft,V~c.P L~.....
THE FOllOWING POINTS HAVE
BEEN COVERED WITH CUSTOMER'
ASSOCIATE IN!
(SEE REVERSE SIDE OF THIS ESTIM E
AND PROPOSAL FOR VISUAL DESCR _
TION) FENCE TO;
A) FOllOW SLOPE OF GROUND 0
B) FOllOW CONTOUR OF GROUND 0
C) BE lEVEL WITH HIGHEST GRADE 0
D) BE lEVEL WITH lOWEST GRADE 0
E) BE lEVEL AND SPLIT THE GRADE 0
LINES CLEAR OF OBSTRUCTIONS 0
LINES STAKED WITH/BY CUSTOMER 0
GATE LOCATION/SWING DIRECTION 0
PERMIT RESPONSIBILITY 0
CONTACT UTILITY COMPANY 0
OIRECTIONS OR AOOITIONAL INSTRUCTIONS
STATE
ZIP CODE
" f>"/:.;
ZIP CODE
SPECIAL INSTRUCTIONS
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FENCING
DIAGRAM
I KEY: I
FENCE r
LINE
TO BE
ERECTED
TlE.ONS
(GET PERMISSION)
TERMINAL POST
EXISTING FENCE
.
o
XXXXX
BUilDINGS: :
WALK GATE L.---if.a..-."
DOUBLE GATE a'b
GATES
ITEM # /TYPE QUAN. WIDTH HGT.
I . f /
':;, f:l'
J 10 6'
SPECIAL WORK TO BE i
PERFORMED BY CUSTOM~R
~~~~f.12~~::~~I~S
" ?~.~R ~~<'> k . I ) i'?'7 I.f '"
t{f ) '0 C~V y;;t;.r .' d ) '"
{;A:DlIV.y . ["'..
/;df~ t~
TOTAL L.O.F.
LENGTH
FENCE
HEIGHT
/70
6'
-J . . . f. 1'-'''-
i /1: 5 -r f' , r
( .l-'
. Ad L:---
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...
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l
WOOD
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1 .'. --"~'. (; "
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~ 11 . /",,1
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l/
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t
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ITEM # /DIAMETER
TOP RAIL
LINE POSTS
TERMINALS
?
pr
t-~- \ < ~"
G. ',?? 11'"
INSTALLATION ESTIMATED
TO BEGIN WEEK OF
..I.. 1I!L.a_ 4" - . ~ /'; t/ O~ ,~".?'" ,:.,......
\,JSTALLATION CLERK: Enter b61O~ File and Installer's Copies:
I understand that this is only an estimated date and I will be
contacted prior to this date to schedule the actual installation date.
Contractor's Charge
For Delivery
Contractor's Charge
Work Specified Above
OTE TO CONTRACTOR: SENO BILL FOR THIS WORK TO:
EARS, ROEBUCK AND CO.
(Permit No.)
(Contractor)
(Address)
(Address)
(City)
(State)
(Zip Code)
(City)
(State)
(Zip Code) *
PRINTED ON RECYCLED PAPER
541-010 Rev. 8/91
- 1(\ (-
Fv? customer nampd on the reverse sick v. :' yOLl tn pre. NFl t '1,,:~ti\\;ation ::f the specified addi'ess, of matwt'1I~'
specll:ed on the reverse side and/or ell >,(:'-18d 3ketch Of sr,ecltCJt'cT sneet. By tne acceptance at this crde:/OLi
agree to protect and Indemnify said cListonr:~r :llld Sears. Hoerluck ,':1l1d Co.. from all claims or demands on accow't ot
IrlJury to persons or property oCCUrring dUring or as a resuit of said Installation You are responsibie for payment oj all
contributions and taxes due under and for all requirements of Federal and State Social Security and Income Tax 1:1WS
with respect to any payrolls incurred in performance of the work herein specified. These provisions do not in any way
amend or modify any other agreement that you may have with Sears, Roebuck and Co. On completion of the job, you
agree to obtain the customer's signature on the Letter of Satisfaction below, and execute the Waiver of Lien, submitting
both to Sears, Roebuck and Co" along with your invoice.
WAIVER OF LIEN
(TO BE SIGNED BY CONTRACTOR)
To Whom It May Concern:
I, the undersigned Contractor, having been employed by the customer whose name appears on- the
reverse side, do hereby certify that the work referr~d to on the re,!~rse side has been completed to
the custoiD.fi~~.9_tj~i?c:;!ioQ I hereby acknowledge receipt ot PAYMENT IN FULL, and hereby waive and
reililqulsh ail liens and ;-:11 rights and claims of liens which L the Lindersigned, now have or rnay hereafter
have for labor 01 mate!:?' icirnlslircC I the underslqllecl certify that all the \fork. ('ud matenais
iurnlshed, if any IJV arl'! mh"I' O:lI't" " C,' tie' lID'):: the clrder c.! tne
h~~c
~u nv
or rnaterial suppl\c( c~airY':lnCi Ih2. ~';qnt. tC) tllc JU.2,!1 a lien
:i,':] which may
. mechanic
lor Furthci, i the' ,t<1(Jr-:rr...1i!F<1 ::";rf:F Ir, C~i: !:'P the 0:''''1'\1 ,d(iiiSe ,v
he tiled 3CF\lnst tnt? on:lr1:c"8t, 1":+'11': Ce'18,:3F' ,)\, a::\
1\/url~
IilS
'1 t. i i urthcr
agree lo pay anv and all ooS1S, exoellses anO ;jttOri 1tlV '(-,CS incurred OJ tile custO:!I(~i Ii" nOSE ,;eJY"
appears on the reverse Side and/or Sears, KoebucK 31leJ Co, tram and against .allcosts and expenses
arising from or by reason at such lien or the release or dlsc.liarge at such liens.
Signed and delivered this
,.,....
day of
19
Signature of Contractor
CERTIFICATION OF COMPLETION
(TO BE SIGNED BY CUSTOMER)
TO: SEARS, ROEBUCK AND CO.
The installation of
ordered by me has been completed satisfactorily
NOTICE TO CUSTOMER: DO NOT SIGN THIS STATEMENT UNTIL THE INSTALLATION IS SATISFACTORILY COMPLETED.
Customer's Signature
Date
.
~'."
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