HomeMy WebLinkAbout94-3790
BUILDING PERMIT
Permit N ~
CITY OF ZEPHYRHILLS
(813) 788-6611 ,.dif f.rr-D
Date
~'tJ .0-0
PLUMBING ~ANICA~ewer Conn
-- Water Conn:
3790)1
/-,;lCJ-9'/
BUILDING
,219. ~
~~~
P<ap,rty Own", ~ -a
Job Address: "/ . ~I>
Water Meter:
T.I.F.'s:
Parcell.D, #
Zoning: Energy Code:
Description of Work 4 ,.~ tj t2 A rj{7.R\
_~n G"
4 .
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
DATE
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances,
DATE
Inspector
Permit Fee
Signature
Company
Address
Telephone#
Valuation or
Contract Price
/~,3tJZ). (J-O
,
City License Registration # )'/ /
State Certified License#
~}ki
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Breakers
Ducts Insl. 01/24/94 BOB
Compressor
Final
Tp. Servo
Rough In
Meter Can
Canst, 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.
The Contrador shaH cany insurance as fisted below and fumish to WAL.MART . cettificatton of InIurance betonI
construction is started. The C8t1ification must indicate that the insurance will not be canceled while the work
specified herein is in progress wilhout thirty (30) days prior written notice to WAL..MART.. WAL."M6BI M.USI 1>>.
namAd . E add~ namAd .ir1su18d Go AU.. poI~ies gf Insuranca.
rteE
PmduetR CftmpIet9d Op8!;lt~~ General
Liabili\y Insuranc& PQljgx
(with Vandalism" Malicious
Mischief Endotsemem)
LIMITS OF IN~URANCE
Contract AMount
(tot total including all
'. ~1taCt.)
Statutory Amount
$ 1,000,000
W0rkm9n'~ ('..nmnAn.qatinn
Waiv., and Subrogation where pennitted by law
~"$ Liability
C'h'1traclots General "'i~~)(
Bodily Injury (Inck.ading Death)
Property Damage
Per Occurrence
$ 2,000,000
S 2,000,000
Subcontractor'A AAnAr.:d I iahilh
80diIy Injury (IncWllg Death)
Property Damage
Per Occurrence
$ 2,000.000
$ 2,000.000
CQrnI'8CtOr'S Automobile liability
Bodily Injury (Incfuding Death)
,
Property Damage
Per Occurrence
$ 2,000,000
$ 2,000,000
Contractor shall payoff and discharge timely any and all debts and obfigations Incurred pursuant to petfOnnIng
the work .. out above, inctuding but not limited to obligations owed to suppliers of mater1af anet subcontractors.
Contractor specifically agrees to defend, indetmify and hold WAL-MART harmless from and against Irfi and ,.
loss, ctaim or liabaity arising in any way out of or as a result of the performance of this Contract, Including but not ,
IimMed to mechanics or material man's liens.
Colonial M.~h8n1~81 In~.
Firm
by
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. ............ ............. ........ .......... ... ...................... ..... .... ..... .. .... ..... .............. ........... ....... ... ...... ... .... .... ... . ... .... ..... .........
ACCEPTANCE OF PROPOSAL
The above plans. specifications. condiions, and klmp sum amount are satisfactory and are hereby accepted as
of the date first written above.
Robert J. Mulphey
Vice President
Construction S8Mces
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II
III
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RECEIPT FOR FULl. SET OF BID FORMS AND Sf.'ECS
I hereby oertify I have rtJCeived a fuU set of Bid Forma. Speoa and a con'tfHte Scope of Wortc.
_ ~t/: ~
COntractor
De~efQber 27.1993
Date
9~
T n or Regional Manager
. .
Revised 0311&93
Page 18
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O~ S~~~~~NO~ - '~N3 ~~~W-I~M WO~~ 90:~l v66l-6l-~r
III
19, ClealH,lp and housekeeping are vety inl)Olt8nt, This ptOjeCt will be k8l:lt dean and otderty at au times. The
.
..
WAL~RTCONTRACTP~OPOSAL
DATE: December 27. 1993
SUbmitted to: John Mann ing
Judith A. Sooth
HVAC Contract Administrator
Phone: 501-273-8524
Submitted by: S C 0 etA. S w 1 she r
COlQnial Me~hanical Inc.
.
804 Pinell.. St..
Clearwater, Fl 34616
<< ,"'.
(814) 443-5"541 .
WOft< to be performed at: Waf-Mart Store. 706. In Ze p her hill s. 'F'l.
Contractor hereby proposed to fumish the materiaJs and perform the labor necessary for the wotk outJlned and I'
specified in the Scope ot WOf'k and Specifications attached her.to and made a pan hereof.
The work set out Will commence on or before .J II. n 11 A r y 7 r ] Q <<;) 4
and above shaH be compfeted and operabte not Iatet than . r ~ n 1I.llt r y , 2 ~ 1 <<;) <<;) 4 . provicted that,
at the option of WAL-MAAT, reasonable adjustments as to the time schedule may be made for strikes, accident.,
and other delays beyond Contractor's cancro!. , Conttactot ahaU coordinate its WOIk SChedule with WAL.MARrS
Store Manager. The aboVe work is to be pel10rmed tor the kJmp sum amount of $ 1 2 , ~ 0 0 00 .
with payment to be made as follows: 50 percent of Contract Price within 30 days of receipt of Invoice. The
remainder of the contract price when all deficiencies are corrected and projec:t accepted. 00 NOT FORWARD
INVOICE FOR FINAL PAYMENT WITHOUT SIGNEe RELEASE FOR FINAL PAYMENT DOCUMENT,
CERTIFICATE OF INSURANCE AND FINAL PAYMENT RELEASE OF LIEN.
Any alteration or deviation from the above Scope of Wotk and Specifications shan be made only upon written
Change Orders as approved by WAL-MART, and will therefore become an add or deduct amount to tne sum set
out herein.
If Contractor fails to perfOrm satisfactorily to comptete the Contract within the Contract time allotted, Wat-Mart
shall have the right to terminate this contract and finish the work. and the Contractor ahall reimburse Wat-Mart fOr
any and all costs incurred as a result of the Contraao(s failure to perform.
contractor warrants that all material is to be as specified, and all work is guaranteed, to be performed in a
woIkmanlike manner acceptable to WAL-MART, which shall be the sole judge of quality 0' materials and WOt'k. In
the event the materials or WOIk proves to be unacceptab'e prior to the time payment I, due, upon r~ of
written notice from WAL-MART, Contractor shall have .1Q days to correct the defeat at its own expense, with
payment then due upon completion of the correction(s). It Contractor fails to CO"ect satisfactorily within the time
speci(I8Cf, WAL-MART Shalt have the right to correct the defects and deduct the COI1. thereof from the amount
owed to Contractor and to c:oaea from Contractor any COst of correction of the defects in excess of the amount
owed the Contractor. In the event that defects In the materials or work are dlacovered by WAL-MART after
paying Contractor the above sum and within a65. days of the date of final completion and acceptance of the wOlk,
then, upon ree. of written notice from WAL.MART. Contractor shaJI have.1Q days to correct the defects at its
own 8XpenM. If Contractor 'ails to correct satisfactorily, within the time specified, WAL-MART shaH have the
right to cure the defects, and Contractor shall reimburse WAL-MART for any and aU cost. Incurred therein.
Revised 03116193
Page 02
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APPLICATIOII fOR PERllIT
CItY OF ZlwuIKHII.I_4;
BUII.DIlIG DEPAKllml1I
OWNER · S RAIlE
t~ I- /j/~r I cl-r;-p
/J:~A-!e./? v" J~ .4r k J
~~// /?k/
PIDIE ~t7I-.J?3 - q-~c;J L/
OWNER I S ADDRESS
JOB ADDRESS
7 tj ;2 5-
LEGAL DESCIUPl'IOB: LOI'(S)
~StmDIVISIOB
PARCEL LD.'
J '-I - :2 5-- :;? / - 3- 2.
IiORK PROPOSED:___ev Construction ~tion ~A1teration ---RePair _Inst:a11
S.
_ J.8Il
_Ifove
~1ish
PROPOSED USE: Single F.-il.y
Xec-ercial
_fl/F _, of Units
--1118
_Iodust. _Swa. P001
Other
RpStaurant 5: Hea1th Deparment Approval.
BUILDING SIZE:
x
~ Feet,
Height
RESIDENTL\L:
aJfINItRCIAL :
AtTAaI (2) PIDI' PLAIIS 5: (2) SEI'S OF BUII.DIlIG PLAIIS 5: (1) SEI' ElIERGY FOIUIS...
A1TAaI (3) SKIS OP IRJILDIlIG PLAIIS 5: (1) SEI' ElIERGY FOIUIS...
..OOPl' OF OOIn'RACI RIIQUIJUtD.
PIIJIJIITS BEOIIR.4;nm
-----..BUlLDIRC
$.
Va1uaUon of Total Construction
IU.RCl'RICAL
AIIP Service
Florida Puller Corp.
W.R.E.C.
~ICAL
$.
Valuation of If.ecbanica1 Iost:allation
-PLUIf.BIIIG GAS ROOPIIIG
SPECIALTY
TYPE OF OORSTRUC'l'I.OII: -----..Bloclt ---Yr&8Je _Steel
Other
FIBISBED FLOOR ELEVATIOIIS:
fT.
IS PROJECI' IN FUJOD mIlE AREA!
YES IiO
..........................................
mnJIACIOR SECI'ION
BUII.DRR
<<DIPAIIY
Sl:ate Cert. or Reg.i.st. ,
City License Registration I
..........................................
Signature
IU.RCTRTCIAR
aJIIPAIIY
State Cert. or Regist. ,
City License Registration ,
..........................................
Si"'Ature
PUIMRRR
alllPAIIY
State Cert. or Regist. ,
City License Registration ,
..........................................
Signature
IIEaIOICAL d allPAIIY WWN 1fH.. I'hlfc-~/cAt..- J / N C-
~ -+- State Cert. or Regist. I CA-c-A-,-r/7' 7
Signature ~ ~ City License Registration I /'1/
.......................................... '
OTRRR a.lPAlIY
State Cert. or Regist. ,
Signature City License Registration ,
..........................................
APPLICAnOR - n <-I/dA04~'-;~O/j"Jw-- PmIIT Ol'I'ICBR.
CUNP' I J (JI.lH fir F'FFI-" r r,rr IIHW 1 T
;) . NP IJ.~_~__P.f..._lJg~!Lm:}?'LP~tr; I.IJJ.LI H
lh~ "ndprsignpd undprst~nds th~t this p~r.it I~y bp ~ubj~et to "d~~d r~strictions" Hhieh May b~ .ore rpstrictivp than City
rl'guhtions. Ihe undersigned aSSUMes responsibility f{lf eOI!l"liam:~ Hith any applicablp deed restridions.
Fl . LII~!:::.L~gtt~E-!LJ,::_Qt~.IB!~GLQB!:).. (.)IW.. __ (;(jIJJrIOL,:TlJI3_ RE E:iF:QN !?I!U!"" IIJ.E;;$
If thp o"ner has hirpd a eontr~ctor or contractors to undprt~~p Hork, thl" l!Iay b~ requirpd to bp licpnspd in ~ccordancp Hith
statp and local regulations. If the contractor is not lic~nspd ~s rpquirpd by I~", both tne ownpr and contractor lay bp
citpd for a .isde,panor viol~tion undpr statp IaN. If thp ONnpr or intpndpd contractor are uncprtain as to "hat licpnsing
rpquire.ents lay apply for the intendpd work, thpy ~rp advised to contact thp City of Zephyrhills Building Depart,ent, 18131
7IlB-bbll.
Further~orp, if thp owner has hirpd a contractor or contractors, he is advispd to have the contractor Is) sign portions of th~
"Contractor Spctions" of this application for Hhich thpy Hill bp responsibl~. If you, as the ownpr sign as the contractor,
you arp indicating that you, rathpr than the contractor, arp responsible for the work. If the contr~ctor Mishes you to sign
as contractor that lay be an indication that hp is n~t properly licpnspd and is not entitled to perlitting privilpges in thp
City of Zpphyrhills.
t: . .LB(}N!:?.f' 08 -r A - r ..U}LLUJF ()t:;.LEJ;.l;.ILD1.::H>-,JJ...U.kl.LY_ LQNN.I;J,-;THJ.!:J....E~J~;.$.,
D.. l:;.m"'STRUt;;TL!JN_kLQL1JlH (CII(\F'TER '1.t:=~ ~ FLI.lF< IIH) SnHUTES, ns (WIEHDED)
I cprtify that I, the ~pplicant, h~vp bepn provided with a copy of "Florida's Construction Lien LaH - HOMpoHner's Protection
Suidp' prepared by thp Florida Dppart.pnt of Agriculturp and [on;".~r Affairs. If thp applicant is so.pone other than thp
"OH"P'", I [~rtify that I havp obtained a cop, of the abovp dp~[,ibed do[n~pnl and pro~i~p in good f~ith to dplivpr it to thp
.o"npr" prior to co..pncplpnt.
F . L;Qr.-!TRflCTQR ' SLP~'Jb!.~B.~_!?_._(}fEI."P.O\lJ.I.
I cprtif, that all the inforMation in this application is accuratp and that all work Hill be done in co'pliance with all
applicablp laws regulating construction, loning, and land dpvelopMpnt.
Application is hereby lade to obtain a per.it to do Hork and installation as indic~ted. I certify that no work or
installation has cO'lenced prior to issuancp of ~ per.it ~n~ that all Hork Hill be perforlpd to Ipet standards of all laHs
regulating construction, City codps, zoning rpgulations, and land develop.pnt regulations in thp jurisdiction. I alsD
[prtify that I undprstand that the regulations of oth~r govprn.ental agpncies lay apply to thp intpndpd Hork, and th~t it is
MY responsibility to identify Nhat actions I lust takp to be in cOlpliancp. Stich agpncips include but are not lilitpd to:
· Depart.pnt of Environ.ental ReQulation - Cypress Bayhpads, Ketland Areas and EnvironMpntally Spnsitive Lands,
Water/Wastewater Ireat.ent
, SouthHest Florida Water nanaQelent District - Wells, Cypress Bayheads, Ketland Arpas, Altering Katercourses
, ~r.y Corps of EnQinpers - Sea"alls, Docks, Navigable Natprways
· Departlent of Health L Rehabilitative Services, Environlenlal IIealth U~lt - Wells, WasteHater Trpatlpnt, Septic Tanks
, ~S Environ.ental Protection Aqpncy - Asbpstos abatp.pnt
I also cprtify that, if fill laterial is to be used in Flo~d Zone "n" or "A,etc.", it is understood that a drainage plan
addressing a "coMppnsating volulp. Mill bp sub,ittpd Hhich is rrepared by a profpssional engineer registpred in thp Statp of
Florida prior to perlit issuancp.
A perlit issupd shall be construpd to be a license to procped with thp Hork and not as authority to violatp, cancel altpr, or
set aside any provisions of the tpchnical codes, nor shall issuancp of a perlit prevpnt the Building Official frol therpaftpr
rpquiring a correctien of errors in plans, construction, or violations of any code. Every perlit issued shall bpcoIp invalid
nnless the Hork authorized by such ppr.it is co"pncpd Hithin six lonths of issuancp, or if Mork authorized by the pprlit is
susppndpd or abandoned for a period of six .onlhs aftpr thp tile the Hork is cOI,pnced. Onp 90 day extension of tile, lay be
allo"pd for the perlit with fee charge of $15.00. The extension shall be requested in writing to thp Building Official. An
approvpd insppction .ust bp loggpd during each six .onth ppriod, or the project "ill be considered abandoned.
WARN INS TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEnENT nAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
PRUPERTY. IF YOU INTEND TO OBIAIN FINANCING, CONSULT WITII YOUR LENDER OR AN ATTORNEY eEFORE RECORDING YOUR NOTICE OF
conMENCEnENT. Joes UNDER .2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT",
'JG"'"", ....R OR 'G'N' ,~~~
STATE or FLORIDA
CO,," TV OF
'lie for ego i I1g ills t1-ument
befof-e me this
1'185 acknDI'lledqed
, 19_ by'
I'1~1[o is person.:llly ~:nD~m to me or ,.,ho h.:ls
Ploduced
as identific.:Itioll .:IlId who did/did not
take i'ln o.:lth.
(Signa!;uf-e)
(Name Typed, Printed Dr .St.:lmped)
t:lQJ ArtY PUBL) C
STATE OF FLORIDA -) I
COUNTY OF /-; /)..e / let 5
The frwf?QDim.j instrument I'I,:\S acknol'lledged
befol-e m~ this /- 7 ' 19~ by'
~
..a/ltV -I-~ rfa.rO
Io'/ho is pel-son.::!ll y !
pl-oduced ~,'/"--.---'
as identifi ation
Ge .:In o.:lth. (! ...-----~ . !
(~ -6L-< -l::L-~ U "-..../' / / "<1..:.:..../.A .r ~'---' /
(Signature) ........ . /r-,
I'Yl 4 /'f -5 /---/ /) a.. /[: }-L- / r'::;~<': cr-
(Name Typed, Printed Dr Stamped)
llg]fif M~~~K~~H
: My Comml..lon Explr..
\ ; April 28. 1996
'SClF~.. Comm. No. CC 197176
..........
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