HomeMy WebLinkAbout93-3571
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788.6611 PO
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Property Owner: ~ ~
Job Address: ?;J..3:2 - r:(}4~ C~
Parcell.D. # ...is'" -~ --.;2../ - 0 [),--~' CJ ~ n ~I!) /)0 ~
() 7/0
Zoning: Energy Code:
Description of Work ~..A J?~ ~~
- /
Radon Gas:
? L.r. .A 4 A-?-7J-:n--t-..+-
Permit N ~
_35718
Date ,/ 0 -/~-- X.3
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
~ ~ ?~-e-.
11-29-93
DATE
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector W. A. BURGESS
Valuation or
Contract Price
!;;L 0-0 . crv
77
Pe,m;t Fee ;t::': ~
Signature . j~f/ ~2t..
Company
Address
Telephone#
City License Registration #
State Certified License#
X:J;-E
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PLUMBING /~
BUILDING
ELECTRICAL
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
l[l2b-C/Jd3
Tp. Servo . SLB JCJ-~-q~ ~
Rough In 1/-/2--76 ~ Tub Set . --1. '3
Meter Can Water
Const. Pole Sewer ;/-13 -tj'), eo
Pool Final
Pre-Meter
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.
APPLICATIOIl fUR PERKIT
CI'IY OF z.tl;ntIJCHTU..!i
BUIIJ)I.IIG DEPAKnImII'
OWNER · S RAIlE
ho~ ~~~,
-r;)..?J /--" aM~~
5 0('(\ ~
PIIOIIE ,?;3> - dS 35
OWliER' S ADDRESS
~~'t\7
JOB ADDRESS
LEGAL DESCRIPl'IOII: IDI(S) JlI.O(2( SUBDIYISIOIi
PARCEL I<<D. t ~- ;LS - ';).-\ - aa5<:::> ~ ~CJ ...., all C)
-
IiOKK PROPOSED:_1Iev Construction ~tion _Alteration ~ir _Install
S. _tIove _De.o1ish
- 19D.
PROPOSED USE: Single Fam]y --1I/F _, of Unit:.s _II/H
_ec-ercia1 _Indust. _Swu. P001 Ot:her
--.Jlest:aurant .. Hea1t:h DeparI:.erlt Approval
BUILDIRG SIZE:
x
~e Feet.
Height
RESIDENTIAL:
COItKERCIAL :
A'lTAaI (2) PIDI' PLUS .. (2) SEI'S OF BUIlDDfG PLUS .. (1) SEI' ERERGY FORtIS. **
ATI'AaI (3) SEI'S OF IlUIIJ)I.IIG .PI..DS .. (1) SET EIIERGY FORKS. **
**ooPl' OF OOKrRACI' KIlQUIRED.
PERIf115 REQUESTED
-X-BUILDIRG
-X-ELECl'RICAL
$~ ~C{) :?Q
Valuation of Tot:a1 Construction
AIIP Service
Florida .PoIIer Corp.
V.R.E.C.
_IIECIIARICAL
$.
Valuation of lIecbanica1 Inst:allatioo.
X-PLUltBIBG GAS ROOFDIG
TYPE OF OORSTRUCl'IOR: _Block _Fra.e _Stee1
SPECIALTY
Ot:her
FIIIISBED FLOOR ELEVATIOIiS:
Fr.
IS PROJEct IIi FLOOD ZONE AREA?
YES RO
*******************-*******************-**
aJIIITRACIOR SECl'IOR
7 ? 1i,,f/$Ofl
___------..---.-.------________ WllPAIIIY~~ 5 '\D'\~, ~W\.
--::::::=-- ~ .' ~ State Cert. or Regist. t
Signature ......-- ,~ ~ Cit::y License Regist:.ratioo. t i 1. ,
~~. ~~..~.........................
:_::: CIAR A.- --.-.--=-=- ~ .,.. WllPAIIY ffi Q~ ~ r F-..~.J.A.-
. State Cert. or Regist. t
S' . City License Regist:.ratioo. t
*-**********-**-******-*******************
~~ WllPAIIIY C~~t!~~ (jJ~Io)~ .
State Cert:.. or Regist. t
Signature' , ~ City License Regist:.ration t /;;:2. :)"
***********-******************************
RIJTTJ)F.R
PIJIIIRF.R
IIEaIAlIIICAL WllPAIIY
State Cert. or Regist. t
Signature City License Regist:.ratioo. t
******************************************
0T1IF.R ~ WIIP~~IJ-<./~.vJ
./'TL Il /J St:ate Cert. or Regist. t
Signature V V~ City License Regist:.ratioo. t
*******e*****-*-****-*********************
APPLICATIOR APPROVED BY
PERIIIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit lay 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 Dr 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 Dr 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 Dr contractors, he is advised to have the contractorls) 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
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 .ade to obtain a per.it to do work and installation as indicated. I certify that no work Dr
installation has cO'lenced prior to issuance of a perlit and that all work will be perforled to .eet 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 Environlental Requlation - Cypress Bayheads, Wetland Areas and EnvironlentaIly Sensitive Lands,
Water/Wastewater Treatlent
, Southwest Florida Water "anaqe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of Enqineers - Seawalls, Docks, Navigable Waterways
, 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" Dr "A,etc.", it is understood that a drainage plan
addressing a "colpensating volule" Mill 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 Mith 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 perlit issued shall becole invalid
unless the work authorized by such perlit is cOllenced within six lonths of issuance, Dr if Mork 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 Nill be considered abandoned.
YARNINS TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO"KENCE"ENT KAY RESULT IN YOUR PAYINS TWICE FOR I"PROVE"ENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FIIANCINS, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDINS YOUR NOTICE OF
CIJ/t"ENCEKENT. JOBS UNDER $2,500 IN VAlUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMENCUENT".
SISNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing inst ument was ac~qwledged
befc.re me this 10 1..3 , 19-Z2... by
......~.,/
who i s ~known to me or whc, has
produced
as identification and who
take an oath. _ ~ L..v.
. /I. ,'-(
. (Signature)
STATE OF FLORIDA
COUNTY OF
The foregoing instl~nt was ~knOWledged
before me this (b ~~ ~_19 ~ by
/~~)
who is personalfy known to me or who has
produced
as identif~icati ... ~nd who did/did not
take an oat ~ ~
.c.../'~ (&-rlr:/~->
<Signature) /- /,,/r #'1%...A..
.t<.l (r?, ~ i:..~::.t?.SJ
<
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
? 1% C-i)
Notary ~ub\ic P~sco ~~. ;i. \995
My CommisSion E~?lreS Y
CA
1(6 1'i7( Q~.~~
(Name Typed, Printed or Stamped)
NOT ARY PUBU C b1' P Co FL
Notary Pu IC asco .
My Commission E~?ires May 13. 1995
~
SlTl~ PLAN
(RPSIDFJ1TL\.L US~ fiNLY)
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\11 drawings shall be druvlI to Henle for nIl purcel:; ur luLH live Iol:11:!; ur il:.'j!l.
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~I~OW ALL .EXISTlNC AND pr;OPUSED STHUCTUJU~S GIVl!ll; DJ.M.Fl~:ilOW; AU;) ~J':lJ-.:\,i::,
:~y BOl)I~S O! \.lATER AND HOAD'.~AYS (WCLUDIllG ';M1E:,) /-'1),]/\(:1::,]' ';\':;i,' : j ,
[IlE SIZE, YUJ{, !>ND N!\:\E OF l'\'JIHLF' ~UCll I\S )',1 .. "'J' .'.0 L' ',.
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All "EASEl-tEN'rs" , "
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SUN ST,~;TE l\lUMINlJMi
3/528 SR 54 West
ZEr~ dRHiLLS. FL 3354 i
(813) 788.7308
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PR~AL SUBMITTED TO
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STREET
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CITY, STATE AND ZIP CODE
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ARCHITECT
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JOB LOCATION
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DATE OF PLANS
JOB PHONE
We hereby submit specifications and estimates for:
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Dr 'roponr hereby to furnish material and labor
complete in accordance with above specifications. for the sum of:
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Paym:nt 112 be made as follows:
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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 specifica-
tions 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
Signatu re
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Note: This proposal may be
by us if not accepted within
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withdrawn
days.
A{ttptuntt nf 'rnpnliul- 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.
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Signature ~ {' '0 I "', '-(
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Date of Acceptance:
Sig'nature
PRODUCT 1183 INl:BSj~lnc.. Groton, Mass_ 01471. To Order PHONE TOll FREE 1 +800.225-6380
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