HomeMy WebLinkAbout92-2870
BUILDING PERMIT
Permit
2870;7(
Date /4. - ;:J. ~ -9 ~
CITY OF ZEPHYRHILLS
(813) 788-6611
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Sewer Conn
Property Owner:
Job Address:
Parcell.D, #
}~tt41;~i~~r f)o5iJ
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
Description of Work
NO OCCUPANCY BEFORE C.O.
FINAL
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
:~;~~:;::!-mf =:U~
Company
Address
Telephone#
Valuation or dI '/ / _ 0 D
Contract Price 'iP ~ f 7 ~ f -
City License Registration # / c:2 CJ
State Certified License# e.. * u /Sfl.::l6-
E LE CT R !.CA-I::--'
c-----
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
r~. ~E..R6~)_
~(Jp..1K~ULJ~p .
PLUM~/ ,MECHANICA~
~
BUIL~'
~
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
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.
APPLICATIOII FOR PERKIT
CITY OF ZEPIIYRBILLS
Bm::tDIlIIC ,DEPAR'IKEIn'
OWNER I S MAKE
L u..C I i..L ~ UJi siJ I E Lv 5' k i
J] U "11211- trt ':0 II .
lfE1..iRft-/Yt ''bI2...
mmm
7P,,2, -- tJ S- ~ S
OWNER'S ADDRESS J.... 3:2. 8
JOB ADDRESS
r.f;(R
LEGAL DESCRIPTIOlIf: wr(S) RT,OCK SUBDIVISIOII ZCIJIf X€.. /ffJ6tfl:S-
PARCEL LD.I )2 ~ 2./" -~l- DDJ' D -1!Jt9~()O -171),,'-0
WORK PROPOSED:_5ev Construction ~tion _Alteration .--Repair _Install
_Sign
_!!love
_Deao1ish
PROPOSED USE: .--single Faaily
_"IF
_, of Units
_K/H
_~rcia1
_Indust.
_Swia. Poo1
Ot:her
_Rest:.aurant &: Bea1t:h Depa.r1:IIent Approva1
BtnLDING SIZE:
x
Square Feet,
Height
RESIDEIfTIAL:
cottItERCIAL :
ATTACH (2) PLOI' PI...AliS_ &: (2) SEI'S OF BUILDING PI...MS &: (I) SET ENERGY FORMS. **
ATI'ACII (3) SEI'S OF BUILDDiG PLUlS &: (I) SET ENERGY FORMS.**
**COPY OF COlITRAct RIlQm:RIlD.
PERKITS REQUESTED
_BUILDING
$~
Va1uation of Tot:a1 Construction
$
AfIP Service
I 'i7S~ aL-
F10rida Power COrp.
W.R.E.C.
_ELECTRICAL
~fmawuCAL
Va1uation of Kechanica1 Inst:allation
_PLUKBTIfG
GAS
BOOFDiG
SPECIALTY
..
TYPE OF CONSTRUCTION: _B1ock _F'raIIe _Stee1
Ot:her
FlliISHED FLOOR ELEVATIONS:
FT.
IS PROJEct Di FLOOD ZOBE AREA?
YES NO
******************************************
COJIi1I'RACIOR SECTION
81TH llER
Signature
COIfPANY
State Cert:. or Regist. I
City License Registration I
******************************************
ELECTRICIAH
COIfPdY
State Cert. or Regist. I
City License Registration f
******************************************
SiPf1~ture
PLUKBER
COIfPARY
State Cert:. or Regist:. I
City License Registration f
******************************************
Signature
Signature
(\ 11 LA / ="~~~r tt::"~t4{t /1#~f
t:J 11/1../1# ,-h~ City License Registration f I ~ '1
*******..*********************************
KECIIAlfICAL
0'I'1IfJr
Signature
COIfPARY
State Cert. or Regist. I
City License Registration f
*********** ************* ***
APPLICATION APPROVE'D BY
PERKIT OFFICER.
.-'.........-'
,;
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit 'lay 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
state and local regulations. If the contractor is not licensed 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 .hat licensing
requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, 18131
788-6611.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorlsl 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 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 prolise 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, 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 governaental 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 liaited to:
f Departlent of Environaental ReQulation - Cypress Bayheads, Wetland Areas and Environaentally 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 Watenays O'
f Departaent of Health ~ Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
f US Environaental Protection AQency - Asbestos abatetent
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 .coapensating voluae' will 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 froa 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 coatenced within six aonths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six .onths after the tile the work is co.tenced. One 90 day extension of tile, lay be
allowed .for the perlit Hith fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection tust be logged during each six lonth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COK"ENCEKENT "AY 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""ENCEKENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A .NOTICE OF COKKENCE"ENT..
SIGNATURE: CONTRACTOR
SIGNATURE: OWNER OR AGENT
was acknowledged
19_ by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument
before me this
STATE OF;FLORIDA
COUNTY OF
The foregoing instrument
before me this
was acknowledged
, 19_ by
who is persc'nall y known to me or who has
produced
as identification and who did/did nc.t
take an oath.
who is personally known to me Dr who has
produced
as identification and who did/did not
take an oath.
(Signature)
<Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
DateLCl/c9 /,/yd Customer # ,]>737
HEATING AND COOLING Name;J)AS. (UC/L-C6 /0 StPjGJ,J}/C.J:-
CORP. AddressS3;? 8 It~;'T/t.l'J11,1 ;!}t....
State Certified Air Conditioning Contractors #CACO-) 5825 2 &/lfty,& /L Ls;. r~ L- , 3..3SY D
Main Office: 2034 Weaver Park Drive' Clearwater, Florida 34625 Phone2X- 2 -as?.&-' Mech, ,~(j &c%72--
Pinellas (813) 443-4099 · Pasco 845-4422
Hillsborough 854-3298 ~ (~]
SERVICING ALL MAKES AND MODELS - AIR CONDITIONING, HEA T1NG & APPLIANCES ~ ~
r. '
\
FLORIDA ENER'GY
[Z]
AIR CONDITIONING/HEATING SYSTEM
New
Air Conditioner
o Gas (LP / Not,)
o Thermostat (AC -
DUCTWORK:
t New Return Air Ducts and/or Grilles
Hook Up Existing Supply-and/o(fIeturnS"~
New Supply~ and/or Grilies
New Supply Air-Roof Ducts and/or Grilles
o Replace Existing Grilles W / AC Type
o Cut Through Concrete
(0
7
REMOVAL:
~
o
o
Remove Existing Ducts or Equipment
Remove Wall Unit and Patch
Remove Register and Patch
Remove Space Heater and Patch
LEGAL DESCRIPTION:
Lot /2- Block U. Sub 21 Plat Book 003 0
Page en YOO::ity ODJ'oCounty /47-.5(0
PLEASE NOTE:
This proposal does not Include any type of painting or re-
decorating, or maintenance of filters or drain lines.
This agreement contains the entire contract and the parties
hereby agree that no statement, remark, agreement or
understanding oral or written, not contained herein, will be
recognized or enforced,
WIRING:
DO New Low Voltage Control and 220V Power Wiring
o New Electrical Service Required:
0150 AMP 0125 AMP
o Hook up to Existing Electrical
o Add Electrical Disconnect Box
Special
AIR PURIFICATION:
o Duct Sanitization
o Electronic Air Cleaner
o Space Guard
o Electrostatic Filter
o Filter Size(s)
o Supply Grilles
Heat Recovery Unit
Attic Insulation - Inches
Insulate Existing Ducts
Water Heater Blanket
SERVICE: ,,;,"1
~ ~t'~~~;~~~p~~~s~;~;,~~~~e Year Warranty an tJ
o Preventative Maintenance Agreement '...,'
o Number of Years i:'1
j,. ;:
, ~
l i
i 1
;- ~ ,~
i "
I.';
!t!
;;
r'j
}:' .~
i ;
Return Grilles
Sq. Ft,
RETAIL INSTALLMENT CONTRACT
NOTICE TO THE BUYER: (a,) Do not sign this before you read It or if it contains any blank spaces. (b.) You are entitled to an
exact copy of the paper you sign. (c,) You have the right to pay In advance the full amount due and under certain condi-
tions to obtain a partial refund of the time price differential.
Any holder of this consumer credit contract Is subject to all claims and defenses which the debtor could assert against
the seller of goods or services obtaIned pursuant hereto or with the proceeds hereof recovery hereunder by the debtor shall
not exceed amounts paid by the debtor hereunder. In case suit shall be brought for the collection of any sum due herein, or
the same has to be collected upon demand of an attorney, or we have to enforce or defend any provisIon herein, customer
shall pay reasonable attorney's fees and after completion at 1-1/2% Interest per month.
/y/[-L~
Unpaid Cash Balance upon Completion, , , , , . . . . ,$ /; /...J
-0-
Time Price Differential: , , , , , , , , , . . , . . . , , , . , . , . , , , $
Time Balance: . , . . , . . . , . , , , , , . . , . , . , . . . , . . . , . , ,$ -- CJ
which time balance agrees to poy In consecutive monthly Installments of
$ each. beginning on "Buyer" means each of the Buyers, If
more than one, ]01 tlyon severally,
DATE /d' .,,{
Signature:
'//. -,r-t.">"
Cash Price: . , , . , , , . . , , . , , . . $ /7 7....>, ----
Cosh Down Payments: , . , . . . $ --r;/-
FEC Rep:~ j?c/'C/L..- /:-/2tf;o
Date: /~ - a/ --9~
ACCEPTANCE OF PROPOSAL - 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 outllne~bove,
Date of Acceptance: /.:1- 51/- .f~~ C\)
Ail returned checks will be charged $20.00
,.,'; ~.., \,' ,:Y"^'~'.~".'''''-.
Signature: "'.:.,- "
Compony Acceptonce Slgno,"~~ ~.
'I.
Signature:
" " "~
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FE 104 !Rev. 9/90)
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