HomeMy WebLinkAbout93-3274
BUILDING PERMIT
;$ O. oi)
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Parcell.D. # J 1-;26.- ;;l/ -0 d I 6 . CJ<:J-7 (J 0 - 0 / ? 0
Radon Gas: J: 1.::2.
CITY OF ZEPHYRHILLS
(813) 788.6611
Permit N ~
_ 3274/3
Datl3 ....5--~6 -7?
MECHA~...
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning: -:z. Energy Code:
Description of Work_ lA.P'-""A-f ~
NO OCCUPANCY BEFORE C.O.
FINAL
s
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Permit Fee
Signature
Company
Address
Telephone#
~+
3;/2.
Valuation or
Contract Price .2...,~ 3 7. ttFD
City License Registration # f r-
State Certified License#
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
AL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
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.
APPLICATIOR FOR PERIIIT
CITYOFZEFB1'ImILLS
BUIl.DllIG DEPAImIEIn'
(bAt. Sf\(V1 0
owrmR' S ADDRESS 9 6 C) f, OJ t f-t ST.
JOB ADDRESS---..S60f, C(tt+ 51:
LEGAL DESCRIPTIOJI: lDI'(S) 17 T 1<3 BlOCX tb7 SOBDIVISIOII-.J <3')0
PARCEL I..D.'~ I ,... ~b -~ J -00 10 - (9~ ')00 --- (9l?O
MJRK PRO~ED:_lIew Construction ~ition _Alteration _Ilepair _Install
OWNER · S RAIlE
GtVE tJ
PllDIIE
')g~- ry~~3
per.
3)~
S.
- 19D.
_!!love
_Deaolish
PROPOSED USE: Single F_ily
_ec-ercia1
_K/F _, of Units _K/8
_Iudost. _Stria. Pool .cce..li.'lJ m. Other
_Restaurant &- Hea1t:h. ~t Approva1
BUILDING SIZE: ~.1J:L. 3 ,2-
~e Feet.
\),\
~ . / Height
RESIDERTIAL:
cottKERCIAL :
ATrAaI (2) PLOI' PlANS &- (2) SEIS OF BUTI.DDiG PIAIIS &- (1) SEI' EtiERGY FORKS. **
ATrACK (3) SEIS OF BUTI.DDlG PLOIS &- (1) SEI' DIERGY FORKS.........
........COpy OF COlITRAct RIlQUIRIlD.
PERKITS KEOUESTED
~UILDING
$ 23"t;.50
Va1uation of Tota1 Construction
_ELECTRICAL
AKP Service
Florida Power Corp.
W.R.E.C.
----1fEaIAIfICAL
$
Va1uation of Kecbani.ca1 Installation
_PUJKBIliG GAS ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Pralle _Steel
I\( U IVlI fJOMJ1:her
FIllISHED FLOOR ELEVATIORS:
FI' .
IS P'KO.JECI' IIi FLOOD ZOIIE AREA?
YES NO
........................................................................................................................................................................
COIII'I'RACIOR SECl'IOM
BIJTI.DF.R
allPANY
State Cert. or Regist. I
City License Registration ,
........................................................................................................................................................................
Signature
ELEcrRICIAIi
allPARY
State Cert. or Regist. ,
City License Registration ,
........................................................................................................................................................................
SilmAture
PLUIIBER
allPAlIY
State Cert. or Regist. I
City License Registration ,
........................................................................................................................................................................
Signature
KEaIAlIICAL
OTIIF.R
allPANY
State Cert. or Regist. ,
City License Registration ,
........................................................................................................................................
Signature
Signature
allPAllY~ (nAP T
State Cert. or Regist. I
City License Registration ,
.........................................................................................................................................................
APPLICATION APPROVED BY
PERKIT 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 co.pliance 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 what licensing
requirelents lay apply for the intended wort, 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 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 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 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 co.pliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby .ade to obtain a perlit to do wort and installation as indicated. I certify that no work or
installation has cOI.enced 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 wort, and that it is
IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not li.ited to:
f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally 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 Waterways
t Departlent of Health L Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
f US Environlental 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 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 frol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every per.it issued shall becole invalid
unless the work authorized by such perlit is cOllenced within six lonths of issuance, Dr if work authorized by the perlit is
suspended Dr abandoned for a period of six lonths after the tile the work is cOllenced. 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. An
approved inspection lust be logged during each six lonth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO""ENCEKENT KAY RESULT IN YOUR PAYING TWICE FOR IKPROVE"ENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
CO"KENCEKENT. JOBS UNDER $2,500 IN VAlUE DO NOT NEED TO RECORD AND POST A "NOTICE OF CO""ENCEKENT..
.SIGNATURE: CONTRACTOR
SIGNATURE: OIlNER DR AGENT
was acknowledged
, 19_ by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument
before me this
STATE OF FLORIDA
COUNTY OF
The foregoing instrument
before me this
was acknowledged
, 19_ by
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
(Signature)
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLI C
(Name Typed, Printed or Stamped)
NOTARY PUBLI C
ii
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m@'i~
Aluminum. Concrete
6017 Gall Blvd.
Zephyrhills, FL 33541
(813) 782-7497 1-800-343-3014
P1788' \16 ~3 DAT[~ - ~q.--q3
JcrK:[ ~ 4-0~05
Page No.
of
Pages
JOB lOCATION
'.
ATTENTION:
JOB PHONE
We hereby submit soeClhcaltons and estimates for:
li"~~ SC~r0
CO~Rt1G
~V(y\\.VUM
,A~~fV1lNUN\ .02<0 f~}J fo:>~ 'UJf1tt
f:>f2) G-U\1E ~ / ~rv SR:)U\SI '~f\SC lA-
~.
(~{\2 )
VJ l1H
T\;JO
[XO~.s
q.1t
S:C<Zf-LA)
,I cog. c( t\A AJCi7~H I 9
(co fYl ("c:.o( 1" y
with~ve specifications. for the sum
~($~37. 50
of:
) .
All m.,....1 is lu.,.nIHd 10 ... as .peciRed. All _k to ... comllleted In . _km.nllk.
m.n..., ac:cordin, 10 st.nd.rd p,.ctic.s. An, .Iler.tion or dev..lioft ,_ ._ .pecific..
tions In_in, ...,. CCKtS win... ..ec:uled onl, upon writt... ord.rs. .nd will become .n
...,. eh.... _ .nd .bov. the e.tim.t.. An ."........t. conlin,ent upon .trik.s. .ecidents
0' de..rs beyond our control. Own.. to c.,,, 'i,e. to,n.do .nd oIhe, nee...." insu,.nc..
Our _rs ... fUll, cove,ed by Wort"n.n', Compensation 'nsur.nc..
Authorized
Silnature
Note: ThiS proposal may be
withdrawn by us if not accepted within
days.
Arrrptalttr Df 'rnpnsal- 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 outlined above.
Date of Acceptance:
Silnature