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Home My WebLink About93-3495 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit N~ _ 3495;11 q- /~ -lj-:3 ~. 120 C:;;CTR~ ~G :~~:~:,~,:~e' srf;i 3 qth~s~ G01. Parcel J.D. # /5".....,.2.4 - :; 1- 0 /7 AO':< ~ Vo - oO/1-D I .......- ~D ~HAN~ Date Sewer Conn Water Conn: Water Meter: T.I.F.'s: FINAL -~3- 93 DATE NO OCCUPANCY BEFORE C.O. Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. C.O. DATE City License Registration # ::r-~- '7'11~e/2, State C:p.rtifio:>~ liceAse# 4- _5'""-9 ~~ ~ r Inspector Qd: ~ - ,,') Permit Fee ~' .~ Signature A~ro ...:1PflJY\A1 Company Address Telephone# --q~~.?a \9 Valuation o~ ~ ~ ~Rt E- Contract Price ' Breakers Ducts Insl. Compressor Final Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Ftr. Pre SLB Lintel FRM. Insul. CL WL Driveway REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of Fifteen and 00/100 Dollars ($15.00) shall be made for each trip for each trade: a. Wrong Address b. Condemned work resulting from faulty construction. c. Repairs or corrections not made when inspection called. d. Work not ready for inspection when called. e. Permit not posted on job site. f. Plans not at job site. g. Work not accessible. The payment of inspection fees shall be made before any further permits will be issued to the person owning same. ~-:~ ....... Jropllsm Page No. of Pages ====-= -=== -=c--= ==-=.-= ...11111 ~. ~ \ \} ,,:$ t; :"'1 ~~ I I ... '.. PROPljlSAL SUBMITTED TO ~_<f:~} \. . " \ , ,. ~--" ~ ;,. PHONE ". r::":' I ( C JOB NAME ] DA~E:~_ ..'. ! , ,-) ,\ (1 A'RCHITECT JOB LOCATION SI~.I=~.:r. ,_ -:. \ O. .CITY, STATE AND ZIP CODE \ '~',. it ,i '" A 11." \', JOB PHONE DATE OF PLANS 1.1 We hereby submit specifications and estimates for: i.~! (, _/ ,M::; i ( L~l~,""L, \" ~~ ," (-. J 1/,' ".......!--- r4' i~~)0 . ,-I- .I,. \... .~\,~~ ''-1 ;"-'ICe' .t\_. ; ~ ., -~ ,~_., :~_.t. ! JY'i-t1W:.kJ~) ,/ 1,1,. iY '/ \ \ ';" CO, \ \ "-' \ ?-...!' ..,~ - 'j " - ( /-) {.../ Lei . , I I '. /" I ; I ;j , ~.:;.'.' .'....._-' /\"0...--<> / V .i't=:l q ..' J::t\- :""'l', +--J( (l I --.\,-",--/\.. -..l>,. 1?,'-'1~::,::,;~,-,C'CI' ,/' ,.44zQ(~-r'- _.X.(~)J, (0 , ., 1"..4'1 ../ ,,----,-,,~- ~ \ / ...... ,''''......1 )\ c:-'<-;>- ~) \ y\- ..... "-'-~ -~ (J., >io-Ctfft i-li'r lV '\ +,.', 'I.._/'''-<.....) <~ i'~__L~:_~~/ ._-tjid k)>--- ....,.1.._. .:- " , t>,"'; \ . )__'1...)) ~t~. Z_~:) l. VJ.. i,_L \- . ',.". f'" "..1' A Ci r Y / . J lOr l1ropoar hereby to furnish material and labor-complete in accordance with above specifications, forthe sum of: ,') fl , , l.." .j ; i. \ '-.dollars ($ ), Payment to be made as follows: All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. 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 insurance. Our workers are fully covered by Workmen's Compensation Insurance, Authorized Signature I ,," !\_k L::<r:-'C, ....., '>- ....( M~j Note: This proposal may be withdrawn by us if not accepted within hteptann of JropoeaI - 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: SIGNATURE SIGNATURE '+~j__.. 'z-... j 1289 FORM 65103, RAPIDFORMS, INC., THORO FARE, NJ 08086,9499 APPLICATIOIII fOR PERllIT CITY OF ZIlJ"HIICHH.I_~ BUII.DIIIIG DItPAImIEIO' 'b"{e OWRER I S ADDRIfSS "?-'ll -a :3 H--\ 'l ~--::f:'^- DQ ~ JOB ADDRESS 3 "\-7N?:> 8- \ \ C'.s-'..::,O.. ~ Q " =L \ <::2. r,~~ r--;) -=+- \0..,-) \ FROB '1 ~"'~ ~ q~3'?::' l OWRER I S RAIlE LEGAL DESClUPI'IOW: wr(S) ~SOBDIVlSIOlI PARCEL I.D.' \ ~ - ~ln - d- \ - 0\\ hO'cX?{')(j - cx=A:~C') IiOKK PROPOSED:_IJev Construction --Addition _Alteration _:Repair LInstall S. - 19D. _lIove _De.olish PROPOSED USE: Si.ng1e FamJ.y _fl/F _, of Units _fl/H _~rcial _Indust. _Swia. Pool Other --.Jlestaurant &: Bea1th J)epa.rment Approval BUILDING SIZE: x C\nn ~e Feet. Height RESIDENTIAL: cotIIIERCIAL : AtTACH (2) PLOI' PLAJIS &: (2) SEI'S OF BUII.DDIG PIAIIS &: (1) SKI ElIERGY FOlDIS......... ATtACH (3) SEI'S OF B1JII.I)DIG PLUS &: (1) SKI ENERGY 1'OIUtS......... """"OOP!' OF mNTRAct 1UIQlBIIUID. PERIIlTS RmllR.~Tm _BUILDING $ Valuation of Tota1 Construction -LELECIRICAL 1JmawnCAL AIIP Service Florida Power Corp. W.R.E.C. $. d/ya. 1 ~ Valuation of flechanica1 Inst:allation _PLUff.BING GAS ROOFDiG SPECIALTY TYPE OF OOIlSTRUCl'IOR: _Block _~ _Steel Other FIRISHED FLOOR ELEVATIOIIS: FI' . IS PROJEct IR FLOOD ZOO AREA! YES 110 ........................................................................................................................................................................ aJDI1'RACIOR SECl'ION RmlDER Signature CDlPAIIY State Cert. or Regist. , City License Registration , ................................................................................................................................................................... :==h~. WllPAIIY MitH', CJ~c:J-e Ie -' ~ State Cert. or llegist.. Fe ~a iOiln'i\ .() City License Registration , ,- ........................................................................................................................................................................ . Pl.DIAD Signature WllPAlIY State Cert. or Regist. t City License Registration , ........................................................................................................................................................................ IlECBARICAL CDlPAIIY~th € ~I ed-e ~ C_ 011 A ~ ~ 10\..-- State Cert. or Regist. , C'~JY'("'r::, 554,1.0 Signature 'LnU >--... -il~U' YL-{i City License Registration , ~ .."') .' ........................................................................................................................................................................ OTIIIIR c:DfIPAlIY State Cert. or Regist. , Signature City License Registration I ..................................................................................................................................................................... APPLICAnOIl APPROVED BY PERIIIT OFFICER. .... " . CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Th~ und~rsign~d und~rstands that this p~rlit 'Iay b~ subj~ct to "d~~d r~strictions" which lay b~ lor~ r~strictiv~ than City r~gulations. Th~ und~rsigned assuaes r~sponsibility for cOlplianc~ with any applicabl~ d~~d r~strictions. . B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If th~ own~r 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 lisdeaeanor violation under state IaN. If the owner or intended contractor are uncertain as to "hat 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 Prot~ction Suide" 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 cOlaenced 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: , Departlent of EnviroRlental Requlation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive lands, Water/Wastewater Treatlent , Southwest Florida Water "anaqelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses , ArlY Corps of Enqineers - Seawalls, Docks, Navigable Waterways , Departlent of Health & Rehabilitative Services. Environlental Health Unit - NeIls, Wastewater Treatlent, Septic Tanks , US Environlental Protection Aqency - Asbestos abatelent I also certify that, if fill laterial is to be used in Flood Zone "A" Dr "A,etc.., it is understood that a drainage plan addressing a "colpensating voluae" 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 cOlaenced 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 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""ENCE"ENT ~Y RESULT IN YOUR PAYING TWICE FOR I"PROYE"ENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COItItENCE"ENT. JOBS UNDER $2,500 IN VAlUE DO NOT HEED TO RECORD AND POST A .NOTICE OF COtltlENCE"ENT". lOp }41f1A )p()r)'L(; SI6HATURE: CONTRACTOR \Ai SI6NATURE: OWNER OR ABENT STATE OF FlORIDAr:") COUNTY OF \r ~ The foregoing instrument was acknowledged before me this .s'~ /s, 19 9'3 by ~o //. ~y who is personally know 'to me or who has produced D /'U:J~ dJ.J' ~ as identification and who did~ take an oatt?~ ~/A/ (SiC2ature) ~ au / (2/1 e. ;/0 J I i?~ (Name Typed, Printed or S amped) NOTARY PUBLIC STATE OF FlORIDA,~ COUNTY OF ~ ..J/ ua-e-.o The foregoing instrument(was acknowledged before me this _~...1' /<;- , 19..z?..:L by t1iho is p~so*kno~~or whc. has produced as identification and who did/e!d noi:> take an oarPu~~ //~~ (Signature) r:? 0 a / -e" e /1(;7 / /-e: r/ (Name Typed, Printed or StamPed) NOTARY PUBLI C