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Home My WebLink About93-3445 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permi,t N ~ _34458 J>'--c:2~-9 ? Date ,3' b. cTD ~~ p,op,nyOwoe, ilj"r l3y:fJ rk.../ Job Address: <3_3 _ /; '-. -s-(zz:' dAre- Parcell.D. # Jf - d- 6 -:JI - /) oj 0 - / b.5(J o. CJ 01 0 ., bl. (9 ~ c:rV ~~TRI~ PLUMBING MECHANICAL Sewer Conn Water Conn: Water Meter: T.I.F.'s: Zoning: Description of Work Energy Code: Radon Gas: \, ~_';J./') /I1?~P!L:/A- q Complete Plans. Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. FINAL C.O. DATE NO OCCUPANCY BEFORE C.O. DATE Telephone# '7~ do. c-~J:: (/",A/ r- ~~~~ a~A< zd BUILDING ELECTRICAL .;<Y 0 PLUMBING b-5- Inspector Valuation or Contract Price :2. 3 t?'-S-. crv " ~ City License Registration # State Certified License# - c, ~7 [) MECHANICAL Ftr. Pre SLB Lintel FRM. '1- ~")~"W?1 &.....U Insul. CL WL Breakers Ducts Insl. Compressor Final Tp. Serv. Rough In ~. ~f)-q ~ Aftl... 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 ($15.001 shall be made for each trip for each trade: a. Wrong Address b. Condemned work resulting from faulty construction. c. Repairs or corrections not made when inspection called. d. Work not ready for inspection when called. e. Permit not posted on job site. f. Plans not at job site. g. Work not accessible. The payment of inspection fees shall be made before any further permits will be issued to the person owning same. APPLICATIOII FUR PERtI1T CITYOFZEPIID8llLLS BUII.DlliG DEPAKJIul;IfI OWER'S IWtE r. 'ft so ~ !? ~ j;) f, ~ f (! i L/ /f c /c;. PIIOlIE /' cP J. .- S-J-7 7' OVRER'S ADDRESS.$ ~ ~ d () -:;:--r4. J7J e ;Z -& ,. 4,/~ Ia . . /~, F/. , / / JOB ADDRESS S i>t~ t~ e- LEGAL DESCRIPl'IOlI: I.OI'(S) / - I ~ PARCEL LD.' II - j ~ - j. / - d CJ Ie? - /1:5-&& - (l) c:; / 0 . / WRK PROPOSED:_lIev Construction ~tion _Alteration _:Repair _Install B~SUBDIVISIOII ,... _Sign ~ve _ne.o1ish PROPOSED USE: single Fam1y _"'F _' of Units _K/H +~rCia1 _Indust. _Swia. P001 Ot:her ~t:aorant &: Bea1th Depar~t Approva1 BUILDING SIZE: x ~e Feet, Height RESIDENTIAL: mttIIKR.CIAL : A1TAaI (2) PI.OI' PLAIIS &: (2) SEIS OF BUllDING P.IAIIS . (1) SEI' EllERGY FORKS. ** A1TAaI (3) SEI'S OF BUII.DDIG PUlIS . (1) SEI' .EIIKRGY JlOItIfi... ..mn OF ~ct 1UIQUIIIIlD. PIl'RIITTS RKOIIIlCiTED _BUILDING $~.:$ ~.s-~ va1uation of Tota1 Construction _ELECTRICAL NIP Service F10rida PoIIer Corp. W.R.E.C. _ttKmAllICAL $. va1uation of Kechanica1 Inst:allation _PLUKBING GAS ROOFDIG SPECIALTY TYPE OF CONSTRUCl'IOII: _B1ock ~ _Stee1 Other FIIiISBED FLOOR. ELEVATIOIiS: n. IS PROJEct III FLOOD ZOIIK AREA? ._ YES NO .......................................... I'mlDF.R ~ Signature / aJIII'KACIOR. SKCl'IOII <<DIPAJlYJd h ~J ,-. s: 0--> I - ~ k C3 II A/ .0~ ~ ~ State Cert. or Regist. f Rf2 ~~ 7~~/ - ..< City License Registration . 6 .s .......................................... :::12 H'~ OOIIPMY;f:el, A/(? l ;(11;JOlfL( f[kL7/tIC;'LC"g/t./T; t p IL _", State Cert. or Regist. . FI( cVO /.;1. 9/0 S.::IIt: . / 'L-{i-A-C/ . I ~Xd/-f' City License Registration . .2 ~/() .......................................... PI..IIKRER OOIIPAIIY State Cert. or Regist. . Signature City License Registration . .......................................... KEaIAliICAL OOIIPAIIY State Cert. or Regist. . Signature City License Registration . .......................................... 01"IIRR <<DIPAIIY State Cert. or Regist. . Signature City License Registration . .......................................... APPLICATION APPROVED BY PEJDnT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit aay be subject to "deed restrictions" which lay be lore restrictive than City regulations. The undersigned aSsutes 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 work, they are advised to contact the City of 2ephyrhills Building Departlent, IB13J 799-6611 . Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorlsJ 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 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 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 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 but are not li.ited to: , Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands, Water/Wastewater Treat.ent , Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArlV Corps of EnQineers - Seawalls, DOCks, Navigable Waterways , Departlent of Health & Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks , US Environ.ental Protection Aoencv - 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 Mork 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 perlit is co.tenced within six lonths 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 cOllenced. One 90 day extension of tile, lay be allowed for the perlit with fee charge of 115.00. 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""ENCE"ENT "AY RESULT IN YOUR PAYING TWICE FOR I"PROVE"ENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF CDltItENCE"ENT. JOBS UNDER 12,500 IN VAlUE DO NOT NEED TO RECORD AND POST A "NOTICE OF CO"tIENCE"ENT". SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR STATE OF FLORIDA COUNTY OF The foregoing instrument befc.re me this was acknowledged , 19 _ by STATE OF FLORIDA COUNTY OF The foregoing instrument befc.re me th i s 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 PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLI C 'FROM JOHN L. SMITH CONST 31326 Rutledge Dr. Zephyrhills, FL 33541 Proposal Proposal No. Sheet No. Date IF - J..:i -,9J Name Street City State Telephone Number Proposal Submitted To Work To Be Performed At Street City Date of Plans Architect State All material is guaranteed to be and specifications submitted for as specified, and the above work to be performed in accordance with the drawings above work and completed in a substantial workmanlike manner for the sum of Dollars ($ ~~~ S-d tLI. with payments to be made as follows: wit & ,..r C'd J,"J;2 po ~ '/e I Any alteration or deviation from above specifications involving extra costs, will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insur?nce upon above work. Workmen's Compensation and Public Liability Insurance on above work to be taken out by 6 u ( / tY (J /L ~.e Respectfully submitted . "- Per /' -/~ -- 4 Note _ This proposal may be withdrawn by us if not accepted within days 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 outlined above. Accepted Signature _~7 ~~ Date Signature LITHO IN U. S. A. TOPS FORM 3450 C V