HomeMy WebLinkAbout93-3591
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
PermRt N C!
_3591,&
Date /0 -rJ..7- Y5
~IL~
Pmp'~VOw"" IJ~ ~
Job Address: ( l<f-/ t) V ']v...-t.
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.LF.'s:
Parcell.D, #
Zoning: Energy Code:
Description of wo~; J? ~ ~
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAlrT. \
C.O. JJ::..J
'l/
Inspector
DATE
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances.
DATE
City License Registration #
State Certified License#
7,7
Permit Fee
Signature
Company
Address
Telephone#
bZO/f? ,~t9-0 - u--u.l:.... ,,)
~O-- (~ r~
Valuation or
Contract Price / 0 ,J C) - i7"V
ELECTRICAL
PLUMBING
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
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.
APPL,ICATION FOR PERKlT
CITY OF Z.I!:IJIIYRHILtS
BlJIIIDHiG DIl'.PA\RlftElIiT
OWNER · S NAttE
h~ \_C\,~10D
3<6/OV tJlA/rlLS
(,() /.AjTfU. S If tI- f
.PHONE
OWNER'S ADDRIl'SS
UL.
.JOB ADDRESS
LEGAL DESCRIPTION: tofU;;)
BLOCK
SUJBD IVIS ION
PARCEL I. D. t
.-Jddition _Alteration ~~ir
_Install
WORK PROPOSHD:_lNfev Construction
_Sign
_l!Iove
_DeIIOlish
PROPOSED USE: \.~ingle Faaily
_H/F
_, of Units
_K/8
_~rcial
_Indust.
_Swa. Pool
01:her
-----.Ilest:aurant & Health Depar~t Approval
BUILDING SIZE:
x
Square Feet.
Height
RESIDENTIAL:
COIIfttERCIAL :
ATTACH (2) PLOI' PLAliS & (2) SEI'S OF BUILDHfG PLUS & (1) SEI' ENERGY FORKS...
ATTACH (3) SEI'S OF BUILDDIG PLMS 5: (1) SKI' ERERGY FORKS...
"OOPY OF OOIITRACT RE'QlIJIRIlD.
~UlLDING
. flU
$ !ttb()
PERKlTS REQUESTED
Valuation of Total Construction
_ELECTRICAL
AKP Service
Florida Power Gorp.
W.R.E.C.
--1IEt."HANICAL
$
Valuation of Mechanical Installation
_PLlJKBING GAS ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _FGmIe _Steel
Other
FUIlSHED FLOOR Kt.EVATlONS:
FI' .
IS PROJECT IN FLOOD ZONE AREA?
YES NO
................................................
aJIIlTKAcroR SECTION
BUILDER
CU!lPANY
State Cert. or Regist. ,
City License Registration ,
..........................................................
5 dI{Snt-r€
4C(JHr't/()~ ~c
7,7
Signature
ELECTRICIAN
CU!lPADlY
State Cer1:. or Regis1:. ,
City License Registration t
........................................................................
Silmature
PUJKBER
Signature
COIIPART
State Cer1:. or Regis1:. ,
City License Registration t
......................................................
KEmARICAL
Signature
CU!lPARY
State Cer1:. or Regist. t
City License Registration t
..................................................................
OTRKR
Signature
CUKPMfl'
State Cert. or Regis1:. ,
City License Registration ,
..........................................................
APPLICATION APPROVED BY
PERKlT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A . N.Qll~E OF _pEt;:D_.f:ESJR I CT lONE:;
The undersigned understands that this pertit ~ay'!b~-~ubject tD 'deed restrictiDns' IIhich tay be tore restrictive than City
regulations. The undersigned assules responsibility for co~pliance lIith any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the ollner has hired a contradCfr or contract~-;'-~'''i;-~~d;;t~ke 1I0rk:th;y.~-;y-b-;~~quired 'to be iicensed in accordance lIith
state and local regulations. If the contractor is not licensed as required by lall, both the ollner and contractor lay be
cited for a .isdeleanor violation under state IaN. If the ollner or intended contractor are uncertain as to IIhat licensing
require,ents lay apply for the intended lIor~, they are advised to contact the City of Zephyrhills Building Departlent, IBI31
7BB-bbll.
Furtherlore, if the ollner has hired a contractor or contractors, he is advised to have the contractorls) sign portions of the
"Contractor Sections' of this application for IIhich they lIill be responsible. If you, as the ollner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the work. If the contractor IIi shes you to sign
as contractor that .ay be an indication that he is not properly licensed and is not entitled to per.itting privileges in the
City of Zephyrhills.
C. TRANSPORTAl' I ON ! NPACT FEE~_ ?)NQ..JlI1J:::J TY...~.QN~FCTJ ON.. FEE!?.
D . ~ONSTRUCT I ON l"._I E!Ll"..BH (CH{)PTER '7 j 3 ~ FUJr.: I Dn STATUTES, (IS ()t'lHmED)
I certify that 1, the applicant, have been provided with a CDPY of "Florida's Construction lien lall - HOleollner's Protection
Guide" prepared by the Florida Depart.ent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the
"ollner", I certify that I have obtained a copy of the above described doculent and prD.ise in good faith to deliver it tD the
"ollner" prior to co.tencelent.
E. CONl:Rr'CTOR I S/OHNER I S ~EE.!J2l:lYl.::r.:.
I certify that all the inforlation in this application is accurate and that all lIork lIill be done in cOlpliance lIith all
applicable lalls regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a perlit to do 1I0rk and installation as indicated. I certify that no work or
installation has cOllenced prior to issuance of a per.it and that all lIork lIill be perfor.ed to leet standards of all laws
regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction. I also
certify that I understand that the regulations of other govern.ental agencies .ay apply to the intended 1I0rk, and that it is
IY responsibility to identify "hat actions I lust take to be in co.pliance. Such agencies include but are not litited to:
, Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive lands,
WaterfWastellater Treat.ent
, Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
, ArlV Corps of EnQineers - Seallalls, Docks, Navigable Waterllays
f Departtent of Health l Rehabilitative Services. Environlental Health Unit - Wells, Wastellater Treatlent, Septic Tanks
, US Environ.ental Protection Aqencv - Asbestos abateleot
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 volute" "ill be subtitted IIhich 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 pertit prevent the Building Official frol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becote invalid
unless the work authorized by such perlit is cOltenced lIithin six tonths of issuance, or if 1I0rk authorized by the perlit is
suspended or abandoned for a period of six lonths after the tite the work is co.tenced. One 90 day extension of tile, lay be
allowed for the perlit lIith 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 MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCE"
SlGN(~ -,
j?~
STATE OF FLORIDA
COUNTY OF
The fon?going inst2Lent
before me this If) 7
I
was acknoltlledged
, 19.ti. by
who is personally known to me or who has
produced
as identification and who did/did not
take an oat~/ ~~
(SignatLll-e)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
Notary Public Pasco Co. FL
My Commission Expires May 13. 1995
STATE OF FLORIDA
COUNTY OF
The foregDing instrument was acknowledged
befc.re me this /01>7 , 19 <73 by
I
//15 CQ_
who is persDnally known to me or who has
pl-oduced
as identification and who did/did not
take an oat~/~ ~
(Signature)
(Name Typed, Printed or Stamped)
t:,l.QT ARY PUBLI C
Notary Public P~sco Co. FL
My Commission Explres May 13. \995
S IT 1~ 1'l.AN
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::iUO'W ALL EXISTING AND PH'JPUSED STJIUCTUHES G I'll I,,; j)JJiFll~}l()~;~j Alii) ~l'::!.....,::,
:.J\Y BOL>IES OF 'WATER AND HOAlY,{A'f~ (n:CLUDIllG :;/d'\E~;) AD.iJ\CI::. j' ':\ '.,i.' ..
TILE $IZE, i'EfJ{, ".!'ID NI..:I!:: OF :'\'J;)lLE; ~UCIi J\~ L' ;; uU'. j,'~U" ~'L;,.,i\,'
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37528 SR 54 West
ZLPH 'fRHIL!.3. FL 33j41
{813) 788,7308
!NC
PROPOSAL .?~BMIT.:rED TO
PHONE
JOB PHONE
STREET
JOB NAME
CITY, STATE AND ZIP CODE
,JOB LOCATION
\
ARCHITECT
DATE OF PLANS
We hereby submit specifications and estimates for:
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Dr Jropol11' hereby to furnish material and labor
complete in accordance with above specifications. for the sum of:
", .\....:.',~_. -":,,~ ",,,:,," -...,
Payment to be made as follows:
~~, ~::.~~:.~ ~~
dollars ($
. ;~
:2~\ ,~).~"~:,:::.~::;..~",_
).
... .'.~--.... ~'.,. "',.
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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 . - - ' ~-r;..'~
Signatur~;" ~.--" -':';'~;';I..~~.4-'''''-- .
/ .-:..-~-
, -- _.- NO'fe:'Thls proposal may be
withdrawn by us if not accepted within
days,
AtttptuUtt nf 'rnpnsul- 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.
Signature
l . ___".
. II
;i/1-.>1./!.<1"..~<..~.i
L ,;
I
l/;t.....-..
/ I.
.. .!....J /\J......,...,
Date of Acceptance:
Signature
PRODUCT 118-3 jNElisl.}nc., Groton, Mass- OWL ToOrde.- PHONE TOll FREE 1 +800-225.6380