HomeMy WebLinkAbout93-3001
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit N ~
3001/1
Date ;;2 -7-;1'?
~
Pmp'rty OW"" i!,~ ~
JobAdd""S,f-6t ~ ~ ~~~
Parcell.D, # ~
Zoning: Energy ~ Radon Gas' L
Description of Work -4/ L r'.. .AA-I rr t2 ~- Z2:, r "'^ elL ."j
'~L
P~
G;HAN~ S'W" Cooo
Water Conn:
Water Meter:
T,I.F.'s:
~~'-A~ .-'
DATE
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
Permit Fee J 0.. ~)
Signature .~d C:-;A'-"~
Company
Address
Telephone#
Valuation or
Contract Price
.2. ~ 0-0. cro
,
City License Registration # / J 0
State Certified License#
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
~ ~'h~=~
P""'MBING _ M~HANICAL _
Breakers
Ducts Insl.
Compressor
Final
BUILD~
--
~L
.
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
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.
APPLICATIOIN1 POl'< PERKIT
GI'lYOFZEPIIYRHILI..S
BUILDING DEPAR'I1PIEXr
OWNER'S MAKE EJ/9 ~.4/eR maNE 7e.;z- e557
OWNER'S ADDRESS 38,,1~h -POA./Wr!JCJ/ /%~e 2'j1"6y';{if4-. ~ 3J.SY/
;' J
JOB ADDRESS Jl!;J~6 ..z;.O/VWOOc/ /'hee 2'YA~Y,0~} /4, 3'..J'0-Y/
LEGAL DESCRIPTION: I.01'(S) ~SUBDIVISION /7"e/rrWt!'JO/
PARCEL 1. D. #
WURK PROPOSED:_lN1ew Construction _AdditiOfi _Alteration _Repair ~Install
_Sign
_I!fove
__ne.o~ish
PROPOSED USE:
Single Faaily
_KIF
_, of Units
_K/H
_~rcial.
_Indust.
_Swia. Pool
Other
_Restaurant &: Hea1.t.:h Deparu.en1: Approval.
BUILDIXG SIZE:
x
Square Feet.
Height
RESIDENTIAL :
GOHKERCIAL :
A'l'TACH (2) PLOT PI.ANS &: (2) SEIS OF BUILDIIiG PLANS & (1) SET ENERGY FORKS. u
A'l'TAaI (3) SETS OF BmLDDG PI.ANS & (1) SEI' mmRGY FORKS. **
**COPT OF C01!iTRACT REQUIlUlD.
PERI!IlTS REOlJESTRD
_BUILDING
$
Val.uation of Total. Construction
_ELECTRICAL
AKP Service
Florida Power COrp.
W.R.E.G.
--L.JtEawuCAL
$
~coo
Val.uation of Mechanical. Installation
_PLmfBllIG GAS ROOFBiG
SPECIALTY
TYPE OF CONSTRUCTION: _Block _F'raIIe _Steel
Other
FINISHED FLOOR ELEVATIOIN1S:
FT.
IS PROJECT IN FLOOD ZONE AREA?
******************************************
YES NO
COIlI'RACIOR SECTION
BUILDER
CUllPAHY
State Cert. or Regist. 4t
Ci~ License Registration 4t
******************************************
Signature
ELECTRICIAN
';(J!fpMU
State Cert. or Regist. ,
Ci~ License Registration I
******************************************
Sil!fl.3ture
PLDtBER
COlIPA1!iY
State Cert. or Regist. ,
City License Registration I
********..************~*******************
Signature
MECHANICAL
CUllPMY S,:~eR/o,,;, /4n~ .,fuc7'" C"'coP'~ 4~ f~
~c::;"" ~ State Cert. or Regist. I CACCJ ~?;Z7/
, City License Registration I
** **************************************
Signature
OTHER
CUllPAJfi
State Cert. or Regist. ,
Ci~ License Registration I
******************************************
Signature
APPLICATION API'IlOVED BY 11 ~ Sxt.P/UJ\/li
PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perait 'aay be subject to "deed restrictions" which aay 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 cont!actor or contractors to undertake work, they lay be required to be licensed in accordance with
state and local regulations.' If the contractor is noj 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 what licensing
requireaents aay apply ,for the intended NOrl:, they lire a~'Jised to contact the City of 2ephyrhills Building Departaent, (813)
7BB-b611.
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 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 FEE~,
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 doculent and promise in good faith to deliver it to the
"owner" prior to cOllencelent.
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'alJ
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a perait to do work and installation as indicated. I certify that flO work or
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 governlental 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 lilited to:
I Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive Lands,
Water/Wastewater Treatlent
t Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of EnQineers - Seallalls, Docks, Navigable Waten.ays '
t Departlent of Health L Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treataent, Septic Tanks
f US Environlental Protection AQency - Asbestos abatelent
I also certify thatj if fill !aterial is ~~ ~~ ~~<.j in fl~,rl Z3n~ "A" ~r "A,etc.", it is under5to~d th~t a drainage plan
addressing a "colpensating voluae" will be sublitted lIhich is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A per.it 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 per.it is cOllenced within six tonths of issuance, or if work authorized by the pertit is
suspended or abandoned for a period of six lonths after the tile the work is cO.Denced. One 90 day extension of tile, lay be
allowed for the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. ~n
approved inspection lust be logged during each six tonth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT KAY RESULT IN YOUR PAYIN6 TWICE FOR IMPROVEMENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDIN6 YOUR NOTICE OF
COKKENCE"ENT. JOBS UNDER $2,5 0 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
~/!
~a~
SI6NATURE: CONTRACTOR
SIGNATURE: OWNER OR A6ENT
STATE OF FLORIDA
COUNTY OF ~fi.sCo
The foregoing instrument
before me this FeB 8TH
-
was aCj<nc,wledgen
, 19 ~ b/
STATE OF FLORIDA
COUNTY OF /' AS' C 0
The foregoing instrument
before me this ~~ i~
-
was acknowledged
, 19 9.3 bv
, -'
(Signatur
Inn
(Name Typed, Printed or
NOTARY PUBLIC
~/C#/fRL7 ~f CW'/!F/14A/
who is personally known to me or who has
produced r/O~/O/9 /}fl t/ff.Rs L/cE/V'Sfi"'
as identification and did/did not
. i/
(Signatur )
/Y1 fl j? Y ELI Z 1i.8 t7H /II L..L
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
E 1//1 /? I7CJL /J~;f'
who is personally known to me or who has
produced nO~/t?A ,L?...('/VFR> L/CErVS"E
as identification~and w did/did not
t~.~ 0 h
..~~~::t.;:;;lro MARY ELIZABETH HILL
t*{ "JJ;" :*1 MY COMMISSION' CC 232529
~;6j! EXPIRES: Sept8mber 30. 1996
';/f..<if..r,.lto Bonded ThIU NolBly PublIc lJnderNlilera
MARY EUZABETH Hill
MY COMMISSION' CC ~
EXPIRES: September 30,1996
Bonded ThIU NolaJy PlIb/lc llndIt'MIIIn
t ;. ...,.-." '"T-""~-~~~:C.,,~,'n-1r0~'~::': l;;;'<~'-r1~.~~~~~';'~~~!..~~ ~"""'.~f~'~<;..~~."!.'",~:~.;<....~...".p:r~:"~,;''''''''.~ '-'''''
SERVICE INVOICE Superior Heating & Cooling
Management, Inc.
231 Douglas Street, Building A Suite 10
Oldsmar, Horida 34677
(813) 854-3449
Zephyrhills 783-7509
STATE CERTIFIED CAC049271 Lakeland 688-1823
1r-r'~'r...
CD ,'t ,.
WORK TOB~~ / ~ c::: // CU~R &.?'L
".....,., -"~ /. . '''' ~ '''''j~
~a/ ~L~~~/V , ST~JiR~.L/,.<' 7:: J /:,; J ~ ~,,<S <'7
~ 'CI~~/~ ~TATE '? '< <;4 JIP
~ r". '~
CONTR.t.CT !lie: 1 CUSTOMER NO, ,
SOURCE COST OTY ITEM PRICE
~ ~ 0'!'~~ /~~ , '..--;)~", ~/ BILL TO //
':?/IO~ NAME -, --""
~ /~ 7,<,/ /-/0 .tP STREE~ ~ ./ ~ ",./ ~ 1 PHO~
- ;;',' '/~~_>uI_ .A ,/t::::1.c;
v , V ~~ CiTy..... STATE ~ ZIP
... I
r:; ~ // A/"'/~J /& /~ _/ I' o CC>>fmACT TIME & MATERIAl 0 REPlACE 0
("j" "/L /'A.... ~~-~ V / ~ . . . . OC.O,D, NEW UNIT 0 CONmACT 0 c.B.D
...
j:" J i-/ 1/. ." A/.. ,~z. ,. I ~kf TECHNICI~ .../~ ./ ~~
A/ , /2~""~1 /~ .;y~/ I' rvfOD~L SERIAL NUMBER
d/
I ~ c-- l/7? /././ /"') ,. ,I '/
V::?~ ~-Z~ ~// DATE DESCRIPTION OF WORK PERFORMED
if' //' 07& / ~A "J ...0.#
V /'
0 V /T7J /~, /,-:;"LA'
-..-" ) ~ .~.
,......,../~t:' ~ - ~ ;;v-L2, _: / ~_ ;,~~_ "
...c / _/ c::7._-?'/ ///,~ - - /~
7
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/. KLfQ::) I,.--t> , I
IF YOU ARE SATISFIED WITH THE SERVICE YOU RECEIVED
TODAY TELL A FRIEND, IF NOT PLEASE TELL US,
TRAVEL TIME TO FROM PLEASE PAY FROM THIS INVOICE
TIME TIME TERMS: NET DUE ON COMPLETION
ARRIVED DEPARTED
TIME TIME This Ir'lWlCe IS SUb,ect 10 a Fin,1nce Charq" 01 "':'.0 per month Annual Percentaqe R.'lle at '8 .....hj{:r.~ 1<; "'C'\o':f'd by
law
~~o DEPARTED
/"} /,h^ II IS agreed and understood by the parties that all equipment and Darts whICh arc sold pur<;LI.ln~ t''''E'IO "hall NOT
SERVICE PARTS C'~ become fixtures or oar! of the real estate where they are placed Said oarts and eqUIpment Sl"\lil c:t .111 limps remalf'
personal prooerty and the title thereto shall remain In the seHer urlll payment In lull IS recelVe-o BU',''''r 'lL'rpt)V agreps
~ ::::::.::.~ .. - _ " _"._" " ... ,. oo,~ '" ., """'"
SERVICE LABOR
tt~ I have~ ""''' as out~g'ee 10 cayall cosls ,,,,,, '" ""0'''' OIloonn, , Inps,' IhE
CUSTOMER DISCOUNT ,n"'ce'sOlacedI _ nd~"0'n oocol 2, ")
.. ,,:-<.'''' ./'''/''-
~c, / ,,,,,,,, _ / _, ,/
TOTAL CHARGE $ ~6'a? ~ 'rIAI<.L<\IGN A I I"
.~b' /y f-~ .~, 7 \ ~ ~g;{
'.' , ' v.. '/" . / y-v, 'Y
DEPOSIT $ ~SroMERS SIGNAT~
~ .... CARD EXP --I
BALANCE DUE $ ... NO DATE
\
c;J t ~ '<
DATE ~~c..l ~