HomeMy WebLinkAbout92-2874
BUILDING PERMIT
Permit
2874~
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CITY OF ZEPHYRHILLS
(813) 788-6611
N~
Date
Property Owner:
Job Address:
Parcell.D, #
~' ~-
~~~, f1b:ji~(Er,
M~-Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
Zoning:
Description of Work
FINAL
NO OCCUPANCY BEFORE C.O,
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
Valuation or t. ~ tj..f?c. - tfD
Contract Price ) ~ · -
City License Registration # J,;,9 -3 rt3---11
State Certified License#
L PLUMB AL
Ftr. ~.8 Tp. Servo SLB Breakers
Pre SLB 1~~_c1~ Rough In Tub Set Ducts Insl.
Lintel Meter Can Water Compressor
FRM. Canst. Pole Sewer Final
Insul. CL Pool Final
WL Pre-Meter
;--CO.-Cj!:> A.e. 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 ($15.001 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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APPLICATION FOR PEIDlIT
CITY OF ZEPHYRHILL5
BUILDING DEPARTMENT
APPLICANT
\DDRE5S
Marie LaBarge
4R?? r.ot.t.rlgP St..
7.-Hil', R
PHONE
OWNER
Above
JOB LOCATION
Above
LOT SIZE_X
AREA 5Q.FT,
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I.D,iF i1/ -2t,-21- 0000 - (."J CJ...200- L9600
WORK PROPOSED:____New Construction ..2LAddition ____Alteration ____Repair ____Install
____sign/Temp, _Sign _~love ____Demolish
PROPOSED USE: --,-Single Family _M/F _iF of Units ' .____~11 II
____Commercial _Indust, ____Swim, . Pool Other
_Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL:
COM1'1ERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FO~~S,**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOR~lS. ;,*
**COPY OF CONTRACT REQUIRED.
~LDING
~RMTTS REQUESTED
$
-.7C/ r/ ~.
~ t-~ -Y valuation of Total Construction
____ELECTRICAL
AMP Service
Florida Power Corp.
_H,R,E,C,
____MECHANICAL
$
Valuation of Mechanical Installation
"
____PLUMBING GAS
ROOFING SPECIALTY
_Frame ~ &/lJrJ,b7G: ~rAUltf/ZI/UlIl4
TYPE OF CONSTRUCTION: ~Block
FINISHED FLOOR ELEVATIONS: FT.
*********~********************************
Signature
CONTRACTOR SECTION
Company Kpn wi' Py r.onRt -M,'li nr p- TnI'
State Cert, or ReGist, iF_
City License Registration ff ~q_#1R1-#41
***********************************
Signature
Company
ti J C State Cert, or Regis t. ii
e" ~ City License ReGistration iF
/ ' ************************,~**** ,~*,';;; ,'; -I, ;"~ ,'; ,'; '.~;; *
~ __ Company
~ \ A f'J J~ State Cert. or Regist. if
I\. J U City License Registration iF
, ** ** ** * **************** * -{,* ** -{,* * ,',;;;,~, ,',~; * 1,;, ,', ,',
,JD~
Si!?nature
PLUMBER
Signature
Company
State Cert, or Regist, 0
City License Registration #
******************************************
MECHANICAL
Signature
Company .
State Cert. or Regist. 0
City License Registration 1
OTHER
******************************************
PERl-lIT OFFICER.
APPLICATION APPROVED BY
CONDITIONS, OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Thr undrrsigned undrrstands that this perlit aay be subject to "deed restricti~ns" which ~ay be o~r~ restr.ictive than City
regulations. The undersigned assules responsibility~for, cOlpliance with any applicable deed restrictions,
,,' . ,
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITI~S
If the owner has hired a c~ntract~ror contractors to undertake work, 'they lay be required t~ be licensed in accordance with
state and local regulati~ns. If the contractor is not licensed as required by law, both the owner and contractor ~ay be
cited for a misdemeanor violation under state laH. If the owner or intended contractor are uncertain as to what licensing
require.ents Day apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (8131
788-bbll.
Furtheraore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
'Contractor Sections' of this application for which they Hill be responsible. If you, as the ~wner 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 aay be an indication that he is not properly licensed ~nd is not entitled to permitting 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~eowner's Protection
Guide' prepared by the Florida Departlent of Agriculture and Consumer Affairs. If the applicant is s~te6ne other than the
"owner", 1 certify that 1 have e.btained a, cripy of the above described de,cullient and prt,rrli:e in good faith to deliver it to the
.owner' prior to cOI~encement.
" 1 '. ~: 7 "
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
1 certify that all the information in this application is accurate and that all 110rk will be done in co~pliance with all
applicable laws regulating construction, zoning, and land development,
Application is hereby made to obtain a perait t~'dD work and installction as indicated. 1 certify that no wor~ or
installation has cOI=enced prior to issuance of a per.it and that all work will be performed to meet standards of all laws
regulating construction, City codes, zoning regulations, an~ land development regulations in the jurisdiction. I also
certify that I understand that the regulatiDns of other governmental agencies may apply'to the intended work, and that it is
/tY responsibility te. identify Hhat actions I must take to be in compliance. Suc!. agencies include bllt ~le Ii(,t linited to:
...
I Departle~t of Envir~nmenial ReQul:tion - Cypress Bayheads, Hetland Areas and Environmentally Sensi live L3nds,
Water/Wastewater Treatment
I SouthKest Florida Water ManaQelent District - Hells; Cypress Bayheads, Hetland nreas, Altering Hatercourses
I ArlY Cotps ~f EnQineers - Seawalls, Docks, Navigable Waterways
f Depart.ent of Health L Rehabilitative Services, Environroental Health Unit - Wells, Wastewater Treal~en~. Septic Tanks
f US Environaental Protection AQency - Asbestos abatement
I also certify that, if fill aatl:rial is to be used in HClod Ze,ne NAN elr 'n,etc,', it is ur,derst(,e,d t1,~t a drainage plan
addressing a 'colpensating vDlume" will be sub.itted which is prepared by a professional engineer regi5t~red 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 yiol~te, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official fro~ thereafter
requiring a ce,rrection e,f errors in plans; ce.nstructie.n, e.r violations of any c(,de, Every per~it iSSIIl,j "hall bec(,le invalid
unless the lj(or~ authorized by such permit is ceoJllIIenced within six months Df issuance, (,r if lIe,d: aut!.[" ],ed by the perlit is
suspended or abandoned for a period of six lonths after the t;~e the work is commenced. One 90 day e:tensioll of tile, aay be
alloHed for the per~it with fee charge of $15.00. The extension shall be reque~ted in writing to the Building Official. An
approved inspectie,n /!lust be le,gged during each six Illonth period, e,r the proj['ct 11ill be c[,nsidered dbdl,d[,r,fd.
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 Al'TORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A II NOT I CE OF COMMENCEr1EN r" ,'/" )
SIGNATURE ~.. ~ _ i.ffM,..~-- SIGNATURE_2L2,~
1-1-~~~ J ~
DATE__~_~_L~ DATE_______________________
~
NOTARY AS TO
OWNER OR AGENT
"
MY COMMISSION
NOTARY AS TO
CONTRACTOR
MY COMMISS
...;):t1
~ iJIil
, ., .
MELVIN JAMES MARSHALL
Notary Public. State of Florida
My comm. Expires Sept. 3, 1996
No, CC '&67tIJ .
l ~: '. MelVIN JAMES MARSHALL
{ , ~I\ Notcry Public, State of F\OrIda
, . My comm, ElCplrw Sept. 3, 1996
_ CC 226760
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KEN WILEY CONSTRUCTION-MAINTENANCE INC.
1214 Bobolink Crystal Springs Fl.
782-0546
PROPOSAL SUBMITTED TO:~ 1:tJ. LA-BAA.Cta DATE: PEe ,ct/i-z
ADDRESS re~ f/;.~~~ trr ~ l,.)rLYl3 PkJltl<.. ;
CITY: ~ R1>/Jy/t#It-t.c;. I=L.. PHONE: 78 JOB# I 98
We hereby submit specifica~ions and estimates for:
I DL\~~_W4r I~ K 9
Co 0 ~c. a.J;~,/rr;; CA I? PCJR. r- K... u.1It-, 1'y rt.{)()~ 12 X 'fD
J A- L u. ^-'L l A1 fA. IVL C.A.-A po /l ?- 2 I X II' I. liT t"TlEI<. KrAcl.4 ~r c
l u...11'- I r V J(aDM 7' X / 2.. (2tJMf>'-~1E- / DlJi)JC wrT# wltVOOed
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F I L '-- A-s R.~ ~UI R.Eo
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We hereby propose to furnish labor and materials-comp~e~e in accordance
with the above specifications/for the sum of,$ 3,$:{S.oO /xx Dollars
~. ~
gs.'pos';[ !:!~oo <U! ~IO Bv CH-f:f'f ~k 'r(n. ?onl
ALANe... C!... OM l...ET/~AJ . 15 ~
I'
All material guaranteed to be as specified. All work to be completed 1n
a workmanlike ~ahner according, to, standard practices. 'Any alteration
from the specifications involving extra costs,will. b'ecome an extr?
charge over and above the estimate. All agreements contingent upon
strikes/accidents or delays beyond our control. Final payment due the
day of substantial completion,payed to the installer or authorized rep-
resentative. We shall then issue a Wavier of Lien. Amounts past due
are subject to 1~% per month interest/should collection be required,
owner shall pay reasonable attorney fees. Venue of any suit concerning
this proposal shall be in Pasco Coonty, Florida. All accepted proposals
over $1/000.00 may require a Notice of Commencement in accordance with
Section 713.13 of the Florida Statues. The contractor carries all In-
surance required by Federal/State/County and City Statues/all other lia-
bilities shall b. e the responsiJoility of the owner." This proposal sub-
ject to acceptance within ~ days and is vo'id thereafter at the
option of the undersigned.-
~~~.
ACCEPTANCE OF PROPOSAL
The above prices/specifications and conditions are hereby accepted.
You are authorized to do the work as specified. Payment will be
made as outlined above. ~/.2
ACCEPTED, SrGNATUR~~ ~~f<-
DATE: [) r:;;. r_ Y,;'7'<. SIGNATURE
PROPERTY DESCRIPTION:
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