HomeMy WebLinkAbout93-3479
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N~ 347911
9-/c- 93
Date
BUILDING
ELECTRICAL
PLUMBING
~AN~ Sewer Conn
Water Conn:
Pmperty Own., d;; (i P
Job Address: 3
Parcell.D. #
~
Water Meter:
T,I.F.'s:
Zoning: Energy Code:
Description of work-A/ C CZAr 1#
Radon Gas:
~
NO OCCUPANCY BEFORE C.O.
FINAl~(j - 2- /,....
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
Contract Price
Permit Fee
--.5.'-0 .- c-v
&/L G~~
;; 9' 3Yr CD
./
City License Registration # :L.
State Certified License#
Signature
Company
Address
Telephone#
BUILDING
ELECTRICAL
PLUMBING
Ftr,
Pre SLB
Lintel
FRM,
Insul. CL
WL
Tp, Serv,
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.
APPLICAnOli .fOR PERKIT
CIlY OF ZEnlIKH I T.Le;
BUIlDDIG DEPARIIIERT
a e(} v G j; J1/E UJ( () /}/'l
7 oyD 7 bY~t/J 5' 16ft'
JOB ADDRESS 3 81f31 ~ 'fA Ifvp' Z e jJ/t If If /1,'1/5 ;:-:- d /
o"'J':"''J-Co-d-,1 -0010 -/6700-()O/O
LEGAL DESCRIPl'IOII: 1OI'(S) ...L ~SOBDIVISIOII
OWNER' S RAIlE
PIIDIIE
-7f(/ (J... s- ~- 5 2..-
.
OWNER' S ADDRESS
,0 V I
PARCEL I""D.t
'-
IiORK PROPOSEI):_llev Cons1:ruc1:ion _Addi1:ion _Al1:era1:ion _Repair ~Inst:a11
_Sign
_Move
_De80lish
PROPOSED USE:
Single Fam.1y
.+-eo..ercia1
_fl/F
_' of Unit:s
---1f./H
_Indus1:.
_S~. Pool
Ot:her
_Restauran1: &: Hea1t:h ))eparmen1: Approva1
BUILDING SIZE:
x
~e Fee1:.
Height
RESIDENTIAL:
cotIIIERCIAL :
A'lTAaI (2) PUJI' PIAIIS &: (2) SETS OF BUlLDIJIG PI..US &: (1) SET ElIERGY FORtIS.......
ATI'AaI (3) SETS OF BUlLDIlIG PIAIIS &: (1) SEI' EIIERGY 1lORIIS.......
......oopy OF ooll'I'KAct KIlQOIRIlD.
PIl1DI11S RmUESTED
----....BUILDING
$
Va1ua1:ion of Tot:a1 Cons1:ruc1:ion
_ELEcnuGAL
AIIP Service
Florida Power Corp.
V.R.E.C.
J....JmawrrGAL
$ 6y J'f ~ 51--
Valua1:ion of flechanica1 Inst:alla1:ion
_PLUltBING GAS ROOFDiG
SPECIALTY
TYPE OF OONSTRUCl'IOII: _Block _~ _S1:eel
Ot:her
FINISHED FLOOR ELEVATIORS:
Fr.
IS PROJECI' IN FLOOD ZOIlE AREA?
YES NO
......................................................................................................................
aJJIDIACIUIl SECl'ION
RmTJ)ER
CDlPANY
St:a1:e Cer1:. or Regis1:. #
Cit:.y License RegiSI:.ra1:ion #
........................................................................................................
Sigoat:ure
RI.JI:CTRTCIAN
aJ!IPMiY
Sta1:e Cer1:. or Regis1:. #
Cit:.y License Regisl:.ra1:ion #
..............................................................................................................
Si-t:ure
PIJRRKR.
aJIIPAIIY
St:a1:e Cer1:. or Regis1:. #
City License Regisl:.ra1:ion #
........................................................................................................................
Sigoat:ure
IlECllAllIGAL
~
I
CDlPAIIY 5" b N/f/it (5 4~, (5 C cJ,J7V T71f1Ij'If~;
//1 .It St:a1:e Cert. or RegiS1:. #
rJ~ylf5 City License Regisl:.ra1:ion # ~v
......................................................................................................................
Sigoat:ure
OTIIKR CDlPAIIY
St:a1:e Cer1:. or Regis1:. #
SigJJat:ure City License Regisl:.ra1:ion #
........................................................................................................................
APPLICAnOll APfROVIl'D BY PERIIIT O.FFl:CER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlitlay 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 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 Zephyrhills Building Departlent, (813)
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 cOlleDcelent.
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 cOlleDced 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 governtental 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 litited to:
f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and EnviroDlentally 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
f Departlent of Health & 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 volulev 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 fro. thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beco.e invalid
unless the work authorized by such perlit is cOllenced 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 Mork is cOltenced. 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 tonth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO"~NCE"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
CDMIENOEKENT. JOBS UNDER $2,500 II VALUE DO NOT MEED TD RECORD NlD PD5~~COIOEHCEREIT"
=- ~~~ I tn---~'
~~WNER OR AGENT " SIGNATURE: CONT ACTOR
f 1J;f?IJ<;O~ g
STATE OF F~A
COUNTY OF ~ ~e::.
The foregolng instrument was acknowledged
befc,re me this ~"'(~ ~ ' 1~ by
'='~"~~,, ,,~~
who is personall own to me or who has
produced ~~l:S~ ~\J ~,
as identification and who did/did not
:: an Da~
~) \~;::
(Name Typed, Printed or Stamped)
NOTARY PUBLI C
~.....~~....... ~,,~
~c~ ~ .J~"',
~ "~<I)~I:\S<.. ')
STATE OF FLORID~ r-- ' _
COUNTY OF /7 ~ C 0
The foregoing instrument was acknowledged
before me this ~f~ 5)r~h, 19 ~-? by
who is perSO~llY known to me or who has
produced /IItJw LJ y mE
as identification and who did/did not
take ~1f~ ~
(Signa ure) /
~A-Lt..Y YOII'N~
(Name Typed, Printed Dr Stamped)
NOTARY PUBLIC (! 0 h1 /II, ;: yf'"
..ser>l, t 171'7
00;
\!'.t,\),. 40% Pre.Cons'Jmer Content. 10% Post.Consumer Content
'ropo!lul
Page No.
of
IiElglii
/'
30NNY'S DISCOUNT APPLIANCES, INC.
3399 South HJghway 301
DADE CiTY, FLORIDA 33525
(904) 567-6224
PROPOSAL SUll~ TO 117 i)yV PHONE I DATE l' IJ-3
f '-1--6;. ' 6 5i~ . ~. /3/ ( '-~
\.. ,--/.-"-- ~~'\./
STREET V~; ( {,:E; /J "-' JOB NAME ! I
's ~ (
V
CITY, .:,TATE AND ZIP ,.,cODE ! "';> ,- f JOB LOCATION
// !-/ rv .
"",7 /" ,;1 t" r_"'1 ,{ I ( I ,.
/"" > /.1/
ARCHITECT I DATE OF PLANS I JOB PHONE
We hereby submit specifications and estimates for:
r
-..:- ''r~ r\ ,f'/ (; (i tJ J
t4 /1/ -I' I
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b 'J ~?~
Ifr 'rnpnnr hereby to furnish material and labor - complete In accordance with above spE!cifications, for the sum of:
Payment to be made as foil ows: dollars ($ ),
" L:;'
. ".. " ,?
All material is guaranteed to be as specified. All work to be completed in a workmanlike '/'-:';1 l../ ,'" /
manner according to standard practices. Any alteration or deviation from above specifica- Authorized ,,/ ~:;-'L~..#tc/~
tions inVOlVing extra costs will be executed only upon written orders, and will become an Signature
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 insurance. Note: This proposal may be
Our workers are fully covered by Workmen's Compensation Insurance. withdrawn by us if not accepted within days,
\-. ~
, 'rnpnsul- The above prices, specifications ~
Attrpluutr nf
and conditions are satisfactory ,!nd are hereby accepted. You are authorized Signature
to do the work as specified, Payment will be made as outlined above,
Date of Acceptance: Signature
" ./
PRODUCT 118-3 INEBs/elnc.. Groton, Mass. 01471. To Order PHONE TOLL FREE 1 +800-225-6380