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Home My WebLink About93-3089 BUILDING PERMIT 5~ 3 ~--~ BlJl.L01~ CITY OF ZEPHYRHILLS (813) 788-6611 Permit N'? _3089B ~-/~-9~ Date E~'- p~ M_~sewer Conn Water Conn: Zoning: Water Meter: Property Owner: Job Address: Parcell.D, # T,I,F.'s: '0 NO OCCUPANCY BEFORE C.O. FINAl2~II-q3 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 teE R -?? eiil- Contract Price ' . t,O I , City License Registration # '6'a ~DF/ib- State Certif.ied Ligense# Lit!.... {!"u4 9.Eh 7 ~~;'-J;-r~}~ BUILDING ELEC Address Telephone# Ftr. Pre SLB Lintel FRM. Insul. CL WL ~-' Breakers Ducts Ins!. Compressor Final Tp. Ser . 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 ($15.00) shall be made for each trip for each trade: a. Wrong Address b. Condemned work resulting from faulty construction. c. Repairs or corrections not made when inspection called. d. Work not ready for inspection when called. e. Permit not posted on job site. f. Plans not at job site. g. Work not accessible. The payment of inspection fees shall be made before any further permits will be issued to the person owning same. State License I CCCA35614 Member Better Business Bureau of West Florida Owner's Letter of Authorization I hereby authorize the below named individual to act as my agent to obtain all necessary permits for residential roofing work for: Owner: MA-iG.A~ WtJCo'1N~ at tlris location: ':; 2ZD s hOt.~ ~ I- { t-1 This person is also empowered to obtain, complete, and sign all forms, applica- tions, registrations, and documentation, with this limited power of attorney, on behalf of me that may be required to accomplish the issuance of any per- mits that may be required in any jurisdiction throughout the State of Florida. Authorized Person: f(. OO~ r+ fo tf-e ~ Authorized Person's Signature: ~ef~ * X7)}~~'1J ('~ Owner ~ ~ (fUf1s.{J '[) bL-- ,to... SW:::>PN ,"..NO SUBSCRl~l'~. {J Z p'"-:'=;->-' 1.':.= THiS!f-OAYOF/liW.l19k .J{arJUJ I. ~ , ~~. 7l~ {$I:?J~ . {;.(f_ /<<( ~O/ /19.1 INVINCIBLE CENTER. 10931 75TH ST. . LARGO, Fl 34647 . 813/545-1800 · 800 / 937-6635 (!:Olltruct ~~~7n . ~, i ROOFS OF ! c[[fPOHP l HYPALON"' SYNTHETIC RUBBER [INVINCIBLE] ~~ ROOFS OF c[[f PO [!) HYPALON"' I SYNTHETIC RUBBER_JI ,z/~ Pi'ONE l1J J) ~i5 -77 JI MHP NAME STREET 6' L.y.- ?J ~""4-1 APPROX, JOB COMPLETION DATE ,;;....7~. We hereby submit the following specifications and estimates 7. PROVIDE D LUXE;JlUPONT HYPALQN ROOF SY.ST ...-.:JOR THE F . AREA L \ ~/' r J-.Ci J-+J11?7 r' Q t ~ FURNISH & INSTALL OOU~~ F~ INSULATION AS CIRCLED: NONE 3/4" <?~1JxE 1-:~~ FURNISH & INSTALL NEW SPUN ALUMINUM VENTS: J SMALL - J LARGE- FURNISH ALL REQUIRED PERMITS CLEAN UP AND REMOVE ALL JOB-RELATED DEBRIS FROM JOBSITE MAIL OUT LIFETIME, NO-LEAK, NON-PRO-RATED, TRANSFERABLE WARRANTY FULLY COVERING ALL LABOR AND ALL MATERIAL ADDITIONAL 1NF~R}1ATIOJ\J:...o '. '-. I h )l.:L!:+ v-r..J-b--;KJV6 /).. C Q'p....r /) ~... I '7 - f") 1. 2. 3. 4. 5. 6. k},~ '1t./~~~ J::} , [INVINCIBLE] \- State License # CCCA35614 Member Better Business Bureau of West Florida INVINCIBLE CENTER e 10931 75TH ST, e LARGO. FL 34647 e 813/545-1800 e 800 / 937-6635 1. CASH PRICE ~ $ 2. LESS DOWN PAYMEN771J."/E?~ $ PAID BY ~."J 3. UNPAID BALANCE OF CASH PRICE $ 4, TOTAL BALANCE OF CASH PRICE DUE IS PAYABLE BY BUYER(S) IN:? ~ --L INSTALLMENT(S) OF $ l~:fi ON COMPLETION OF ALL WORK "BUYER'S RIGHT TO CANCEL" (Reverse side) o Thi. trenllKtion i. to be ..cured by the (checkedl item on the premi... to be improved, [ ) Mortg898 [ ] "'lIillnment of lend cont"ct ,[ ) Mechenic. lien [ ] Promillory note [ J Oth.r (describe) 7 g,,4 pj) [ J Thi. trenllKtion i. un..cured, Buy.d.l ecknowledge. tl\et this contrect _ compl.tely filled in prior to .x.cution end ecknowl.dge. r.ceipt of en execut.d copy of th i. ce.h contrect, I, (we) herewith expressly agree to pay not as a penalty but as liquidated damages, 10% of the principal amount of this contract to Invincible Roofing Systems in the event of a breach of this agreement by I (we) for any reason whatever, nish material and labor - complete in accordance with above specifi ations, for the sum of: _ I I J I "'~ ,f' "2 .4 $ ~ 1"!oI . . DoltarslS i/ o~i , ~ ("~~ ~;:~~irZ:d ;4;. .y: -:J .~ NOTICE TO OWNER Do not sign this home improvement contract in blank, All mat.rial ia guarant..d to be.a apeclfl.d. All work to be compl.t.d In a workm.nllk. m.n- n.r.ccordlngtoat.nd.rdpr.ctlc...Any.lt.r.tionordevletlonfrom ebov. speclflc.tlons or before you read it. You are entitled to a copy of involving .xtra coata will be .xecut.d only upon writt.n ord.rs and will becom..n .xtrs the contract at the time you sign. Keep it to protect ch.rg. ov.r .nd .bov.th. .atim.t., AII.gr..m.nts contlng.nt upon strik... .ccld.nts or you r legal rights. d.l.ya beyond our control, Owner to cerry fir., torn.do .nd oth.r n.c....ry Insur.nc., Our work.rs .r. fully cov.r.d by Workm.n's Compensation Inaur.nc., FL UC /llCC CA35614 s,gnatureAIJ;Il~-G 17. ~{ Oete of Acceptance Signature APPLICATIOIiI FOR PERtlIT CI'IY OF ZEPIIYlUnU..s BUILDDJG DEPARIHE'.!iIT OWNER'S NAIlE fY1(j( a.qff}::{OVt17. " OWNER' S ADDRESS~ 7 0 ;;ta~ JOB ADDRESS fJ.0 0 r/ e ' PlIoNE (g g - 995 / ~SL LN LEGAL DESCRIPl'ION: LOT(S) BL.OCKrJ1l~O SUBDIVISIOIfi .s ~ ad V L 0 - ~-E, -2-/- 0 () (0 - 01 3()O-Cl 0 <::> c I f&1: PARCEL LD.I KORK PROPOSED:_!!ifew Construction _Addition _Alteration _Repair _~Install _Sign _l!Iove _De.olish PROPOSED USE: S ingIe Faail:y _KIF _, of Units _R/H _eo..ercial _Indust. _Swia. Pool Other _Rest:aurant &: llealth Deparblenl: Approval BUILDING SIZE: x Square Feet. Height RESIDENTIAL: COHKERCIAL : ATTACII (2) PLOT P.I.ABS &: (2) SEIS OF BUILDING PL..I\I!iS &: (1) SET ENERGY FORM.<;. H ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOm-IS. U **COPY OF COI!ITRAC"J." REQm::RED. PERKITS REOlW..5TED _BUILDING $ ,~ ~€f'~ ( Valuation of Tot:al Construction _ELECTRICAL AKP Service Florida Power Cbrp. W.R.E.C. _MECHANICAL s Valuation of Mechanical Installation _PLUMBING GAS ROOFlliG SPECIALTY TYPE OF CONSTRUCTION: _Block _FraBe _Steel Other FINISHED FLOOR ELEVATIOHS: FI' . IS P.ROJECT IN FLOOD ZONE AREA? ),"'ES NO ***********************************~~~**** COMRACTOR SECTION' COHP.MIIY State Cert. or Regist. , City License Registration # ****************************************** 8UILDER Signature Sismatllre COlIPANY State Cert. or Regist. # City License Registration f ****************************************** ET.ECTRICIAN CU!lPAHY State Cert. or Regist. , City :L.icense Registration i ***********************************~~*~~~* PLmfBER Signa ture COlIPANY State Cert. or Regist. , City License Registration t ****************************************** HE.CHAHICAL Signature L7 00 r- 1',u0 01'1IER (\ 1 Signatur-V 1 j~l (\- / . .I. Q'}:tIPMfi .~/,/ State Cert. or Regist. , ~~~ City License Registration I~*************~*~***~~~=*~~************** f ~~~p~~;-lj)r APPLICATION APPROVED BY PER.~T OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit ~ay 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 contracto~ Dr contractors to undertake work, they'may be required to be licensed in accordance with state and local regulations. . If' th'i!' confractor is not"licensed as required by law, both the owner and contractor lay be cited for a lisdeleanor violation under state IaN. If the owner or intended contractor are uncertain as to what licensing reQuirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (BI3) 7BB-6611. Furtherlore, 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 "ill 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 LaN - HOleoNner's Protection Guide" prepared by the Florida Departlent of Agriculture andConsuler Affairs. If the applicant is sOleone other than the "owner", 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 cOI.encelent. 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 perfor.ed 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 govern.ental 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 hut are not lilited to: f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive :Lands, Water/Wastewater Treat.ent f Southwest Florida Water HanaQe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways ' f Departlent of Health ~ Rehabilitative Services. Environ.ental Health Unit - Wells, Wastewater Treatlent, Septic Tanks f US Environ.ental Protection AQency - Asbestos abatelent I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addreSSing a "colpensating volule" will be subaitted which is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A perait issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, Dr set aside any provisions of the technical codes, nor shall issuance of a pertit prevent the Building Official frol thereafter requiring a correction of errors in plans, construction, Dr violations of any code. Every per.it issued shall becole invalid unless the work authorized by such perlit is cOI.enced within six Donths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six lonths after the tile the work is comaenced. One 90 day extension of tile, lay be allowed for the perait with fee charge of $15.00. The extension shall be requested in writing to ,the Building Official. An approved inspection must be logged during each six to nth period, or the project will be considered abandoned. WARNING TO OWNER: YtlUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT HAY 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 COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENC MENT". SIGNATURE: OWNER OR AGENT STATE OF fLORIDA COUNTY OF The foregoing instrument before me this (Name Typed, Printed or Stamped) NOTARY PUBLIC STATE OF FLORIDA ~ . /' /J COUNTY OF r (/');r.f u.. el/:) The foregoing instrument was acknowledged befcol-e me this t!J3-0'7, 19.2..3- by tt:.:O '--::> ~m(/~f'C __ ~Iho is el- scina 11 y knoYIl1 to me or \"Iho has ~ produced as identification and who did/did not ta~~e :;r1~~K f ~-th~/( \Sll;lna,~..un?) 'J:) ~ ;:::::'r Jt/lk'EAJ /1< ~~LL-L (!'!ameTYC/ld, Pdnted co)- Stamped) NOTARY PUBLIC J / /' ,_/. ..~ c;; a..t{;JC /! ~(z<d ~1;7/9~ was acknowledged , 19_ by who is personally known to me or who has produced as identification and who did/did not take an oath. (Signature)