HomeMy WebLinkAbout94-3873
BUILDING PERMIT'
Permit N ~
'1st?-
C-~~'I-~;;~
_ 3873~
:l-~3-94
CITY OF ZEPHYRHILLS
(813) 788-6611
C::~:2;
(]aJL~ a~~AJ1-L)
:49~4~- focy-Lt a~-.
1.?--.:2 " - .2 /- 00 ~v - V D $-t'fJ
Date
~sewerconn
Water Conn:
Property Owner:
Job Address:
Parcell.D. #
Water Meter:
T.I.F.'s:
-T\'~ DIDD
Zoning:
FINAL
C.O.
DATE
Description of Work
, 'Y-.
/nag uAR... efh?7i: t2t~ ~
NO OCCUPANCY BEFORE C.O. ~~ ~L .
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances.
/1~j)O' Qf: .fl..5' ~
~, J..f &:S PO 5D' ~
Valuation or ~ Z~ q - 00
Contract Price . '5 I ,71JT
cf,. tJ m l5/v,,;j;:>
City License Registration # ~ D M0i26
te Certifi License# e. P ~I') 0 'IS '7-7
DATE
Inspector
~~o~
Permit Fee' -
S;gnaMe _ : - -, - !.-- ~
BUILDING
PLUMBING
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool &:,,0.)1) 2rZ-4..q~ flcll
Pre-Meter
Final
SLB 02/24/94 BILL
Tub Set
Water
Sewer
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
STEEL 02/24/94 BILL
Driveway
Breakers
Ducts Ins!.
Compressor
Final
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.
Plllellas
(813)942-2209
942-2200
~'k~~~J
"Luxury ~ou Can Afford. ..
HiIIsborough
(813) 855-1773
To All Building Departments
All Departments
I Wes Welden, give authorization to all persons listed below
to process and obtain penni ts, also to obtain any occupational
licenses needed to perfonn work here in Florida, for Dynasty
Pcx>ls, Inc.
Ka.c.kQ.. ~':>SO J G,~ Pc ~
'!he fOr~ng instrument was acknowledged before me this .....~~
day of, '7lAl, 1 9 'I if by Wes 11./ [L/.llVJ , who is personally , 0
known to me.
.
~~
CD' ~ JEAAlLYN ANN JONES
~i :- MY roMMISSlON , CC2937lIlI EXPIRES
. June 26. 1997
. IlIIUIlllRl1llllY fAIN lIISlNNCI.lIC.
P.O. Box 214 Taq)on Springs, 1'1 34688
, ~ t-J \L. -'1<")LI'
/3
~,..; 'I l3 LA.{'J (.c)
'Rte:5 (De NT) r/l.€"Pe(l..(LfZO ALUM. )tJL.
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-- F EB-22-' '941 UI::: 1 J.. : '-11,:'
l ~I: ,_ [ ",' Uf' "T?rl,FH; '_,_c.
] E:L ILl:;::: L:::,
"3~!l:?3
t:I(J44 >:U.2
CONDITIONS OF PERMIT AFFIDAVIT
A~ NQTICE OF DEED RBS~RICTIONS
. , Ibe under.igned un4er.tands tbat tble peratt .ay be sUbject to 'deed restrictions" wbicb '~f be lOre t81trictive tban City
regulation.. Ib, under8Jgned 188U1e8 reiponeibillty for cOIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the OlDer bls blred-, contractor or contractors to undertake work, they IIY be required to be licenled In accordance with
.tate and local regulation.. If tbe contractor is not license/! liS requind by law, both the owner and contractor la, be
cited for a 111d8l8anor violation under state law. If the owner or intended contractor are uncertaIn 81 to what licen.inq
requlr8lentl lIy Ipply for the intended work, they are advised to contact the City of Zepbyrbilll Building Departlent, (813)
788-6611.
PurthlIlOr., if the owner bas bired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
'Contractor SecUon.' of this appHcaUon for wbieb they will be responsible. (f you, as the owner sign 18 the contractor,
you are Indicating that you. rather than the contractor, are responsible for the work. If the contractor wishes you to slgn
as COQtrlctor that I'y be an indication that be 18 not properly licensed and Is not entitled to per.itting privileges in tbe
City of Zepbyrhille.
C. TRANSPORTATION I MPAC'l' FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify tb.t I, ~. applicant, ba.. heiR provided with a copy of IFlorid~'s Construction Lien Law. HOIeownar'. Protection
Guide' prepared by the llodda Departaent of Agriculture and ConsUller Affain. If tha applicant is IOleone ot!ler tban the
'owner-, I certify that 1 have obtained a copy of the above described docUlent and prOlise in good faith to deliver it to the
lowner' prior to COIIIDcllent.
E.. CONTRACTOR' SIOWNER 'S AFFIDAVIT
I certi'f that III the infoflltlon in thi, application i. accurate and that all work wIll be done in COIpllanc8 wIth all
applicable 11.1 regulating construction, loning, and land deveJoplent.
Application i. hereby IIde to obtain a per_it to do work and installation as indicated. I certIfy that no JOrk Or
install,tlon b., COIIeDced prior to Issuance of a per.it and that all work viII be perforJed to leet standard. of all law8
re9Ulating con.truction, City codea, lonlng regulations, and land develop.ent regulations in the jurisdiction. I also
certif1 that I un4lt.tand that the regulations of other g0gel'nlental agencies .ay apply to the intended vork, and tbat it is
.y rllp0ft8lbl1it, to identify what actions I lust take to be in co.pliance, Sucb agenciee inelude but are not li.ited to:
t Dep!rtJent of InvironJental Reoul.tion - Cypress Baybeads, Wetland Areas and Bnvironlentally Sensitive Land.,
Water/Wastewater Treatlent
t 8ou~lest Florl4. Vater Hanag8l~t District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t Art' COrDI of laGin..rl . Seawall., Docks, Navigable Weterways
t Departllat of HlIltb , Rehabilitative Services, InvJrOftlental Health Unit - Wells, WaBtewater freatlent, Septic fartks
· US Indrcuentl1 Protection AllenCY - Albestos abatuent
1 alao certifr tblt, if fill laterial J8 to be used in Flood Zooe lAW or "A,etc.l, it Is understood tbat I drainage plan
addre'ling a 'CDIpInI.tin9 volute. will be aubtItted wbich is prepared by 8 professioDal engineer registered 1n the State of
Florida prior to perlft lssulI\ce,
A petlit Issued 8hall be construed to be a license to proceed with the work and not as authority to viollte, cancel alter, or
let alide an, provi.ion8 of the technical codes, not .hall issuance of I perlit pre.ant the Building Offlcill fral thereafter
requiring . correction of Irforl in plans, con8truction, or violations of any cods. Bver, perJit i81Ue4 ,ball beCOll in'llid
un!eSl the IOrt luthorhed b, IUcb P8l'11it 11 COll8need wit.bin ailllOnths of il8uMes, or if lork autbor1le4 br tbe per.it is
'uspen4e4 or abInc10ned for a plrlod of Iii IOnths after the tile the work Js couenced. one 90 day uten.ion of t_, lay be
allowed for tbt perlit with fee charge of $15.00. fbe extension 8ball be requested in writing to the Building Official. An
approved inlpectioo 1U8t be logged during each six IOntb period, or the project .ill be considered abandoned.
WWING TO lMD: YOUR IAILURI fO RlCORD A HO'lICE or COHMBlfCiMlNf MAY RESULf IN YOUR PAYING f1IlCB POR IMPROVEMBIl1'S fO YOUR
PROPIRn. IF YOU IIfUD to 08!lIH PJfWfCING, COJlSULf WITH YOUR LJJlDIR OR AN ArfOJU1IY BBYORI RBCORllllfG YOUI IO'I'ICI OF
COHMBIfCIMBMt. JOBS UNDER f2,500 IN VAWI DO Nor NEED '1'0 RECORD AHD posr A "NOnCR OF COHMBNCIXENY".
---/~
SIGMAfURI: maR O'A~1 ~--- SIGHArUMB;
srA'E OF FLORIDA
coumo,~.
The foregoing 1DBtrum~ was acknowledged
before ID8 this _d;::} "::- , 19..:1::L by
~\arvAr~ D\
... --r]Y'\'1 D fYll.o
who 18 pereonally known to me or who has
produced '<.t--Sb I ;\)vJ~ ^'-L
ae identif1c and wb did/~ot
take an oath. oJ-P d '~_
(Sign8tur.~~. L, ~JSO
(Name Typed, Printed or Stamped)
NOTARY PVBLl!;
~.,.y 'UI,ofo RACHEL L RUSSO
":0 My Commis.ion CC303185
:. " Expir.. Jul. 28, 1997
. . B,nded by HAl
"'.., ~..
-"'lOffl.'I>'tl 800-422-1555
srUB OF FLORl~ \ \
coom OF . 5.
The foregoing instrument wal acjnowledged
beforA me this .d.a"..1 , 19.5L by
~ -eJ::,v---uA"1 'To{"\.'-1 BIAA ~
who 18 personally known to me or who haa
produced p-Rr .JO^.a-t \:::a J..v\"'''''''''''''''-t-
as idelltifDl and who id/, ot
take an 0" .
. .....-.,
(Signature)
~A~-e.\ L3~sS'C:)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
I ---._
~
"~'ofo RACHEL L RUSSO
.~ . My Commission CC303185
. Ii' Expir.. Jul. 28, 1997
. .
'" ,. B>nded by HAl
?''lOFf\.fII''~ 800-422-1555
,'REfER~G/)
ALUMINUM
INSTAllATION
INC.
LICENSE #SCC051711 11726 N. 14th ST. . TAMPA, FLORIDA 33612 . (813) 977-2698
~Vi 11r~ PU-o({
ADDRESS 4 OL{ I 0, (J. .) ~ !l.l. 1'Avyo4r"\ \ F.
INSTAllATlON ADDRESS ~ ~ (., ~ A v-e_
PROPERTY OWNER M _ PHONE
SOLD TO
PHONE
DATE
2./ I U
I
19 ') tj
CITY
CITY
TERMS
PROPERTY OWNER ADDRESS
FLAT:
HIP:
GABLE:
CITY
SQ.FT. i i ,
SQ,FT. : i ,
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APPROX. CONSTRUCTION DATE
ROOF: (S
x
17'
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hC" \
IV
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WALLS:
MANSARD:
DIVING DOME:
BLOCK
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CARRY BEAM:
LOAD BEARING POST:
ALUMINUM ROOF:
SCREEN DOORS:
CHAIR RAIL:
KICKPLATE:
FLORIDA GLASS: X
SUPER GUTTER:
FRAME COLOR:
DOGGIE DOOR:
PERMIT:
LOT
SUBDIVISION
COMMENTS:
UN. FT.
X =
SQ,FT.
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\ \ Vi'
VJ flV+'
I\(J r-. 1 ·
f ..---r '+rr Y-
: I ') 1\ 0-'" 'n ',m
.'0 (' Q" r )~v
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f...mU
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SQ. FT.
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,
ANY CHANGES AFTER FINAL MEASUREMENTS WILL BE CHARGED ACCORDINGLY
MATERIAL AND WORKMANSHIP GUARANTEED FOR 1 YEAR
"t.. '""m,
j , ,I
ALL C.O.D. JOBS - 50% DEPOSIT REQUIRED
A survey sheet or a plot plan and complete legal discription is required on all pool and patio enclosures.
Purchaser agrees to supply electrical power at jobsite.
'Section 501.025, Florida Statutes, (Consumer Protection) provides thal....the buyer has the righllo cancel a home solicitation sale until midnight of the third business day after the day on which the buyer
signs an agreement....
l!We have read the foregoing proposed contract and accept the same on the terms and conditions printed on
~:~m~"/A2e_
1~~~
CONTRA PRICE -J
o D .::;;:;--
DEPOSIT
Preferred Aluminum Installation Inc.. By
Date
'0{Ll s ~
BAl. DUE
THIS PRICE IS BASED ON DIMENSIONS
SHOWN IN THE ABOVE SKETCH,
SUBJECT TO TERMS AND CONDITIONS ON REVERSE SIDE
TERMS AND CONDITIONS OF SALE
1. QUOIIItIonL PREFERRED ALUMINUM INSTAllATION INC. offers '0 sell, fabricate, deliver and install the goods described herein upon
the prices, terms and conditions of 'his quotation. PREFERRED ALUMINUM INSTAllATION INC. and '0 the extent it utilizessub-contrac'ors will
be hereinafter referred to as "Seller". This quotation and the offer contained herein expires thirty (30) days after the quo'e date. None of our sales
represen'atives have authori'y '0 modify, rescind or revise any of these terms or any of the terms appearing on the face of this quotation. Seller
reserves the right to correct stenographic and clerical errors contained in the quotation and Buyer agrees tha' seller may do so without penalty.
2: ~ 01 Quotdon. This quotation constilUles Seller's offer 10 Buyer and shall becOme a binding ~n'ra~ upon, 'he lerms:andconditions
88l tanh herein upGn acceptance by Buyer either by Buyer's wri,tterl acknowItIdgment of the ~nce of 'his quotation or by BUyer's sobmiliaion of
a pU,rch~ order ~r lhe ~s ~Uoled. Any ,arms an~ conditions (Inc!\(d~~ce ~.~ ~~, ~ Byyer i~ a~pllng Seller's offef which
are Inconsistent Wllh or In addition 10 \he ,arms herein set forth, shall be;voict SlId of no 8ffec:t unleu and 10 the eident expresilly acceplitd by Sellet's.
authorized representative in writing, This quotation does not constitute an ilcceptance by Seller of'll/lYniqUest fc)r quote or.....y purchqa order, Reference
In 'his quotation 10 any such request for 9UOle or purchase ~ shaU in no way CQIlSlIlUW .. modiflcationdf 1l/lY' of th~ 'ermsal1il' conditions of 'his
quotation. The foregoing provisions of lhis paragraph are intended to have lhe force and effect of limiting acceplance of 'his quotation 10 its 'erms as
provided in Florlcla StatutM section 872.2.207(2)(a). ' {...' i
3. PIt-. Prices are based on quantities processed, plans, spec:lflcations and measurements, In ,he _nt tha' the quantities ordered are less
than those quoted or lhe plans or specificetions changed or ,he measurements changed, Seller reMrWS the privilege to inc_ prices 10 cover. addi-
lionaI coeta. Work on orders which are proc:esaed f7IIer ,period of time ilxceeding sixtY (60) days of orders which are unusually large may. in 'he discretion
of Seller be invoiced either mocrthly or at some other ~orter interval as the work pIOgresses. Since the prices quoted herein have ~n delermined
In relation 10 the present cost of materials. Seller reseMIS the Ttght 10 cherge the customer for any Increase In said cost of materials. H~r, Seller
shall not charge Buyer for any increases in the cost' of material- expertenced during 'he initial 'hirty (30) day term of 'his quotation unleli8 those cost
inc:rMMS are, in SeIler's experience, linusual or ~ed. \
4. Terms 01 ~t: Unleu otheiwise specifled,'all i9I:is require a 50% ~ and' payment of'remainlng balaDceupon completion of the
InSlIIIlaIion. " i
" ' i
5. DelIwry. Dates qUOled are estlmalecf and not guaranteed aild are ~bjectto"'ler's ~iort load. availabilily of materials and sllt'Vices at
the date of our quotation, Seller does not assume responsibility for d~.~ng <<Jut of or ~g to any delays which are beyond its direct con'rol
including and wlthou' limitation, cau_ due 10 fire, floods, power shol1ag8s,.:1abbr trouble. .m8l;hanical '. breakdowns, acts of God, delay of carritlfS or
lrUcks, 'otal or partial failure for any reason 01 usual sources of supply or 'rartspo!1ation, requl~nts apts, regulations or requeSlII of any governrnen'
or subdivision 'hereof or any 8imUar C8UlI8 beyond Seller', control. Delivery .. are F.Q1l at the;b Site, unleu olh_lse stated on the face of this
quotation, Seller reMrWS ,he right to mak8 delivery in inSlllllrnents. unIes8 ~,~ stlpul~ herein in writing. All such installmenl!l shall
be separately invoiced and paid for when due withou' regard 10 subseqQent deliveries. '~/ln such delivery of any installments shall not relieve Buyer
of its obligation 10 accept remaining deliveries. Any complete order on whictl shipment is 1IeI~ more then 'hirty (30) days beyond specified shipping
date for Buyer's convenience, Is subject 10 addltlona1 cherges for storage. tlan4llng and In~ce u~ delivery hu been made.
6. __ Pr1ce8 are subjecllO any saJes or manufacturer's l8l! impoeed~,.i.d,rat, state,m~ or Olher, governmental auth_ority upon the
sales and.lor manufacture of the materials quoted, and the amount 01 Such lax shall t:ie-in addition to!h8 Purchase price herein Slated and shall be paid
by the Buyer. . .
7. Canc:ellat~. When a quotation has been accepted by 'he Eklyer, 'hili o,[der is nol,subject '0 cancellation except wi'h Seller's consen' and
upon 'erms 'hat will indemnify Seller against all Io88es or dama~es. In 'he ~ that Buyer l:ancels an order following acceptance of this qUOlation,
whether manufaeluring by Seller has commenced or not, Buyer agr:e" 10 pay ~Itr for any expenditures incurred for raw materlaI8, labor, handling,
overhead. molds, jigs, fixtures. dyes, speciallools or special materialhnd,.:su, ~llesIorder+t by Buyer or provided by Seller as necessary for producing
Buyer's order, as well as all 0Iher reasonable COSl8 and expensa inea.irtild. in connec:tiofl with ,he order.
a ~ In the went that any specified quantity is received by ..;e~ljyer in ~ qUanlity lesslhad lhe-quanlily of malerial supplied by Buyer.
claims for shortage, which exceed one and onHtaJf percent (11}.,%) 01 a speclflcq~ntity1>rdered and supplied must be made within 'en (10) days after
receipt of ,he goods, or no credit will be given by Seller for said shortages. No claim for JhOrtages will be made for shortages which are one and onHalf
percent (11}.,%) or less of ,he material supplied by Buyer, it being specifically understood by \he Buyer 'hat there will be during 'he manufaeluring process,
a certain amount of waate or foes of material.
9. ~ and 1\'acIem8rllL As required products and Items shall be processed by Seller to specifications fUrnished by the Buyer. In the lIVent
Buyer provides such specifications, ,he Buyer warran's 'het ,he items produced by Seller will not be an infringement of any valid pa'en' or trademark;
and 'he Buyer further agr-. at his own expense, 10 defend any and all aellons and suits which may be brough' against Seller charging infringemen',
and 10 pay ai' attorneys fees, costs and expenses of every nature incurred in such defense and to fully sa'isfy any al'ld all judgmenls or decrees for profils,
damages or costs lherein and Olh_ise agrees '0 indemnify and hold Seller harmleu in case of any_infringement.
10. Wananty. Seller warrants all products of its manulaelure lD be free from defects In workmanship and ma'erial at 'he time and poin' and delivery,
and Seller will, at its option, replace, repair or render a creel" '0 Buyer for any item furnished by Seller and proved to be defeclive or nonconforming
10 Buyer's specifications within a period of lwelve (12) mon'hs from its installation. SELLER SPECIFICALLY DISCLAIMS ANY AND ALL IMPUED WAR-
RANTIES OF MERCHANTABIUTY OR FITNESS FOR A PARTICULAR PURPOSE. THE WARRANTIES PROVIDED HEREIN SHALL BE THE SOLE AND
EXCWSlVE WARRANTIES BETWEEN THE PARTIES. SELLER SPECIFICALLY DISCLAIMS ANY CONSEQUENTIAL DAMAGES INCWDING INJURY
10 PERSONS OR PROPERTY WHICH OCCUR AS A CONSEQUENCE OF A DEFECT IN A SELLER MANUFACTURED PRODUCT OR AS A CONSE-
QUENCE OF DELAY IN DELIVERY OF A PRODUCT.
11. ClaIma. Buyer', clalms for nonconformity with speclflcations or shortages must be made in writing within ten (10) days after receipt of goods.
Seller will not honor claims for defectlve goods on lhose items further processed by the Buyer and resulting in change of dimensions or charaeleristics
from item8 as ordered. Only claims which the Buyer Identlf1e8 In writing as defective or nonconforming will be <:onsidered. Seller reMrWS the righ' 10
il1llp8Ct the goods prior 10 maldng a settlemem and Seller's lIabilily shall be limited as 88l forth in paragraph 10 above.
la.Jfa~I..lr. ...1IpecIIIo...o1loM. UnleRGlIllInMe apedfled by the Buyer. all shlpmentll will be packaged in bulk and pnll8Clted agalnstnormal
handling and transler. If special ~. requlIlIted. it will be charged .'III\.ma. Unless olherwlse indicated ori the f1lCe oIthls quolIItion, all materials
shaP be processed in accordance with .5alJer's specifications.. Wheo Buyer purchasas PUlllUant to his own spectftcations Seller will nol be responsible
for the design ind fittIng.of parts, toleranees, finishes and other rWclulremenls specified by the Buyer,
13. DeIIIuIt. No dlilllult shaH exist If the performance 01 Sellilll"s obligations Is prevented or delayed by acts of God or government, labor disputes,
failure or delay of traneportIItion or by 'I8f1CI[n or subcOr1tI'aCtOr, fit' any olher similar cause or causes beyond Seller's reasonable control. In lhe _nt
Seller retains an attorney 10 enforce 'he 'erms and condllions of 'his quotation, or 10 collect sums owed it under this quotation, whether said sums are
owed for nonpayment of tfte goods dalivefed, or for cancellation of any order or other cause of Buyer giving rise '0 damages. Buyer agres' 10 pay Seller's
~ atlOmeys fees and costs, including coats and attorneys fees' Incurred, on the trial and appellate Iwell!. Sums which are due but which are
not Paid lri'ieco'rdance with the terms and conditions of 'his quotation will accrue imerut a'the maximum rate aI~~ by the laws of 'he State of FlorIda.
14. CoMIrucIIon. This quotation and the pertormanCle of the partielI hereunder shall be construed In ~ with and ~ by the I8wa
of ,he State 01 FlorIda. ' . .',
, '
, I
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER'S NAMEC{\yOLp ~S_,_____,__~__"__~, __PHONE: l~~.:.:~g@8
OWJlSH'S ADD1lBB8~ - lo"-t'lClue.~~"--~h.rhj~ (\
:::~(8~~;~i~al~
PAReSt I.D.,~Jla~Ql:.caYQ...:.Qo.AaQ - ()OloQ
WORK PROPOSBD: ~e. Construction ____Addition ____Alteration ____Repair ____Install
_Sign
_.__ Move
_DemoliSh
l..l\OPOSED US!:
Single Family
M/F
--
_Co_ereial
Indust.
____, of Units ____"/8
~m. Poold.tm.c'L Other
~\~~
-
____Reataurant & Health Department Approval
BUILDING SIZE: ~x~, Square Feet,
Height
RBSIDENTIAL: AttACH (2) PLOT PLANS, (2) SETS OF BOILDING PLANS & (1) SET ENERGY FOkMS.**
COMMERCIAL: ATTACH (3) SgTS OF BUILDING P4AHS & (1) SET ENERGY FORMS..*
**ooPY OF CONTRACT REQUIRED.
PERMITS REQUESTEQ
BU1LDING
-
. \a)4~S.oo
.Valuation of Total Construction
_ELECTRICAL
_MECHAN1CAL
_PLUMBING
AMP Service
______Florida Power Corp.
_W.R.I.C.
.
, _Valuation of Mechanical Installation
"GAS
ROOFING
SPECIALTY
_Other
TYPE OF CONSTRUCTION: _Block _Frame _Steel
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
*********'********************************
YES NO
CONTRACTOR SECTION
BUILD~R ~~~du'" COMPANY\'-., .nr~ ~.~ ~~
\~I"'\ . State c~tR~ijt7-~___~)1
Signature ILA~~ City License Registration #
......**.****.****************************
Cl>>!P~~ c:kU:, If" tv~~ i0~
. State Cart. or Regist. . 7C~m Os:
City License Registration * .. ____
_".'u **i'ii'iiiu u**********. ****...,,****
PLUMBSR COMPANY\'-,. \ n~ \~ \ o.c..
'~\ '" r-.... - - State ce~ Regist. # C-pc.g:)~5h1
Signature,~ l.~.....o~ City License Registration #
*****..**"t*******....******.,************
JO:CBAHICAL
COMPANY
State Cut. or Regist. ,___
City License Registration #
i***********~i*****************.*******.*
Signature
OTHER
Ugnatute
COMPANY
State Cert. or Regist. #
__ City License Registration #
***..********..**************....******..*
.. -....--.o-.-...--~
"PLICATION APPROVED BY
PERMIT OFFICER.
If::'" "., . '~l 11 j',- 1 J' . ,.)1, 1[1;' j I', li;- d,.,:-'H I H H ~L,:,
--- .. _t)-.:::.::.-- :"q_l_ . _' _ . "_- _ _
i EL 111.1: Ie:: L 3::::::::: 32'3=:
l:tiJ.J4 Fr.l2
CONDITIONS OF PERMIT AFFIDAVIT
..\. l!QTICE OF DSED RESTRICTIONS
!be un .reigned under.tandi tbat tbla petitt lay be SUbject to 'deed restrictions" wbicb '111 be tore restrictive tban City
regulations. Ib, under.igned a81U1es responsibility for cOIpl.lanee wltb any applicable deed restriction..
D. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner h.. bired-o contractor or contractors to undertake work, they IIY be required to be licensed in accordance with
.tate and local regullUonl. If tbe contractor is not licenaee! liS required by lew, both the OlDer and contractor lay be
cited for I .iI48l8anor ,iolation under state law. If the owner or intended contractor lre uncertain 8S to wbat licen8inq
requlr8lentl lay apply for the intended worl, they are advised to contact the City of Zepbyrbilll Building Departlent, (813)
788-6611.
Furtb8llOr., it the owner bas hired a contractor or contractors, he 18 advised to have the contractor(s) .ign portions of the
'Contractor Sections' of tbil application for whicb ther will be responsible. It you, as the orner lign as the contractor,
you are indicating that you, rather than the contractor, ate responsible for the wort. If the contractor wishes you to sign
as cootractor tbat .ay be an Indication that he is not properly licensed and is not entitled to per.itting privileges in tbe
City of Zepbyrhills.
c. TRANSPORTATION IMPACT FEES AND UTILITY CO~NECTIO~ FEES
D. CONSTRUCTION LIgN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, tbe applicant, bave be!n provided with a copy of .Florida's Construction Lien Law _ HDI8OMD8r'. Protection
Guide' prepared by th. 'lorida DepartJent of Agriculture and ConsUler Affairs. If the applicant i8 lo.eone other tban the
-owner-, I certif, that 1 have obtaine~ a copy of the above described docUlent and prOl!se in good faith to deliver it to the
-owner' prior to COIIIDcllent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certif, that 111 the Infoflltion In tbil Ipplication il accurate and that all work wIll be done in COIpliancl with all
eppllcable llWI regulating conttructlon, loning, and land developlent,
Application 11 hereby IIde to obtain a peuit to do work and installation liS indicated. I certify that no work or
in8tall'tlon ba8 COIIeDced prior to issuance of a per.it and that all work will be perfOrled to leet 8tandard. of alJ law8
r@gulating conltruction, City code., lonlng regulations, and land deyelop.ent regulations in the jurisdiction. I al10
certif, tbat J und.rltand that the regulations of otber go,erntentBI agencies .ey appl, to the intended worl, and tbat it is
'Y relponlibUit, to idlfttify what actions I lust take to be in co.pliance. Sucb agencie. include but ere not U.ited to:
t Departlent of Invironlental Requl.tion - Cypress Barheads, Wetland Areas and EnvironJentally 8ensitiys Land.,
Water/Wastewater IreatJent
· SOUtblest Florid. Water Hanagel~t District - Mells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t All' COrDI of Blain..rl . Sea.alll, Docks, NaYigable weterways
t DapartllDt of Sealtb , Behabtlitltl,. Services, lnyjrDnlental Health Unit - Wells, Wastewater freatlent, Septic fanks
t US In,iroDllfttal Protection Avancy - IlbestoB abatllent
I also certif, that, it fill laterial 18 to be used in Flood Zone "AW or "A,ete.", it is understood tbat I drainage plan
addres.ing I 'CQIPIDIltJng volute" will be lublitted which is prepared by a professioDal engineer registered In the State of
Florida prior to peraft issuance.
\ I :',^ "~1.0rt-,>
~(MfIR OR AGlIfT
A petitt il8Ued eball be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
let alide an, prowl.ioal of the technical codes, nor shall i8suance of a pettit prevent the Building Official frOl therellfter
requiring. correction of Irrors in plana, construction, or violations of any code. B,er, perJit i81Ued Iball becOI8 in,alid
unleSl the IfOr) authorhed br 8uch pel'Jlit fa couenced witbin dl IICntbs of bauance, or if work authoriled by tile pertit f.
8uspended Dr lbandcmed for I plrlod of III IOntha after the UIe the work 18 cQUenced. one 90 day uten8ion of U., lay be
allowed for tbe perllt with tee charge of $15.00. rbe tlten8ion sball be requested In writing to the Building Official. An
appro,ed InlpectiOD IUlt be loggea during eacb six IOntb period, or the project will be considered abandoned.
WARNING YO 0ItDI: YOfJrl FAlLURE 10 RBCORD A NOTICE OF COMHBMCiH!H! MAY RESULt IN YOUR PAYING !IIlCS FOR IHPROVEMEIl1'8 10 YOUR
PROPIRn. IP YOU IlIbD to OBTIIJI FINANCING, COJlSULf WITH YOUR LBJlDIR OR AN ArrOMEY B&FQRB RBCORIlIHG YOUJIlIOTICfl OF
COHKENCIMRMt. JOBS UlDIl f2, 500 IN VALUE DO HOI NBED fO RECORD AND POST A wNOTICK OF COMKBNCEHENT".
- \.~,(y,.la~
-----.-- SiG rURI: C !KAeTOR
SIA'I OF FLORIDA " I' I
coom OF if /I \
The foregoing 1nstrUm~t was 8~knowledged
before 118 this ;23/12i:. , 19..!:1j by .-te6 >
(/Jp S ~Je Ld~J\ _'_
who i8 Per.onany known to me or who has
produced
.e identif1~n and who did/did not
take an oat~,~cvt; 4.1 ~ ___
(Signature)
(Hame Typed, Printed or Stamped)
NOTARY PU8L~
~"~,, , ~*, .,,',' ",::', ',"',., , , ., ", !IflI.185
."1...., , ~",,,.
; . - - - ; ~- .
. ~.
. ..... ,.1115
~~ O~/LORIOA .~( I J S' ,
The foregoing instrument1waa actnowledge~~t'
beforQ me this ~ ,~a ~ _, 19--9:;- by r ..0.
who is p.rf.6..~:i;M!;;:fj ~ ~hO haa
produced
as identific~_t. and \tho ~did/d1~ot
take an OQtbi' I
{ ~ a'
(Signature)
(Name Typed, Printed or-Stamped)
NOTARY puaLIC
. ji"'l..,,,." !, R,AC, HEL L RU,SSO
.~ " .Ml'Commie.~CC~1..
: '1C : Expjres Jul. 2et ~. ~ '.
'" lOt &mded by HH
~It Of f\.Q".aOO"'22'1~
-----------.-----------
----,-_..-~.-~.-
Florida
Power
CORPORAflON
N1\ME~_.___.
. ADDRESS . 30\ rLI....\ '--\__,tu~___fudE
CITY L .- \-hi:.-l<i
~ The pool proposed for construction at the above address DOES NOT
conflict with any underground or overhead facilities of Florida
power corporation, provided that the pool is installed in the
location shown On the attached site plan provided to us by the
pool contractor. ... (!v ,~eR.""'tt) ~A-i Vf'\It'1'D N.... c., c.., ~t..!i~~-rs
,I\-" '"to btst~ ~ ""'l2,~ &- ~...., ~ii."", @'
The pool proposed for construction at the above address DOES
conflict with:
OVERHEAD
UNDERGROUND
facilities of Florida Power Corporation.
Arrangements have been made with us for relocation of the
facilities so as to clear the pool area shown on the attached
~i:.$-.p~n .
~~~ION
Cost for relocation of electric facilities will be paid by:
OWNER
POOL CON'rRACTOR___~___
./'
PRIOR to relocation of facilities and construction of pool.
~J~'.~"~"".-'I qk~'.~\.'...,.A..'.,r !:'.~ p .--F:;...'~4v~'H,:" l -:~ ~l{'\R'D,6. '1,12-:1.-8
MEMBER
U--6~
t::::i.
..,,. rlO',.,
~::; r~ ::~~)~
t~i(\ \~~*
\'::J) POOLS INC. ~X~
Main- Office:
Pinellas 942-2209
HiIIsborough 855-1773
STANDARD RESIDENTIAL
SWIMMING POOL CONTRAC r
PERIMETER
"LI/\ I/rv 'rou em Aflord ..
40419 US 19 N.
Tarpon Springs
Florida 34689
PURCHASER
MAILING ADDRESS
Exce.. lill
2, Filler System
I\.
3 Pump & molor
12
e:s-
YL:;..--+--"
5 Surlace skImmer ~
6 Pump concrete to d,\9' ~
Inlels /' G:Y ____
....... '. ~ . 't/
9. Dig lime allowance r: 7 /(::>~ -.J
Add,'oona, ProvoSH'lnS ~
4. Start up chemicala
13, DN:k
NOTE. C:')flIraclor wd not war ranI r:nol d~ck
Over an _xt<;llna slab
r~~.r
.4 Deck drainage -----.kCM I
'5, Ladd"r/Grabra'ls '~.
16. Steps/Handrail ~_
17 D,vlng Ba o\.4ftnd r _ V
20 E"'ctrical hookup
21 . Dead Iino with rocl<
22
23
24 Automatic deaner
25 Bench __
26 Swimoul _
~~.-
IL...
--/-~
~
~
TERMS
Unless specially agreed IInd set forth herein, Purchaser hereunder agrees to make pfOg"''' payment. based on the lolaf price set ronh in this conlract. 10 :he
Con'rac1or, as follows: '. (/r~
CONTRACT PRICE ~ r ~ 'J - s
Down payment
When rough !I~II 15; in pt8ce
Whpn plumbln9 IS complelf"d
'JIIIlen pool " ready for Inlerror 'lnlSh $200.00
NOTICE TO PURCHASER
DO NOT SIGN THIS CONTRACT BEFORE YOU READ IT OR IF PERTINENT INFORMATION IS MISSING FROM BLANK SPACES
This is a home aolicitation sa.... "you do notwanlthe good. or services conlracted for. you may cancel this agreement by maIling a notice to Ihe seller, Thi. nOllco mus:
Indicate thai you do not ",ani the goods and services and must be postmarked by midnight the third day alter you signed the agreement
ThIS con/raCI shall be deemed an olfel 10 rhe COnlIJC/OI and shall be null and vOid unless accepted by a duly aulhomed olflcer 01 "'e Cor"'ae!ry "",Ih,n fril,,!,!" aa,s ollht' dJln .l",~
year noted above the Purchaser's .ignafures The .alesman has no au/honly 10 blOd Ihe Conllaclor All agleemenls and unders/and,ngs are contamea ,n 'hlS con/racl "nc Ie,"
Purchaser warrant. Iha/ Ihere ale no agleemen/s 0' unders/a,ndings o/hel fhan ale seT /olfh ;n rhlS document Accep/ance of Ihe ler""s 01 IhlS contl;;cl /)y Com:aoor '5/0 t)f'
communicated to the PUlchaser by 'fansm1fftng ~ cop , thIS onrrac 'Olhem showmg acceptance by the selle' S b~ 'hI? executlQn of a, dUly +J~h '..er1Z2~' 0' / p cor,1fractOf {)( P'.
commenClOg con.l1uc/lon / ,.,/ (7 (.' a-- /l ~, r tlA~
DATE ~/ PURCHASER U/~' ~
--: 3-,.~q..~
PURCHASER(S), BY SIGNING ABOVE. ACKNOWLEDGES AND AGREES TO ALL THE TERMS ANO CONDIT IONS ON ALL PAGES or THIS AGREEMENT EVEN
THOUGH SPACE LIMITATIONS REQUIRE THAT SOME ARE PRINTED IN SMAll ER TYPE
PURCHASER
SUBMITTED BY
ACCEPTED BY
OWNER
II purch.....r. lire hu.band and wila, BOTH
Florida
Power
COAPORAflON
N l\ME t (~" "- 't,:
-~..__.....,.._--_._.""_..._~-"...,.__...__.-- ..----.-
ADDRESS C3Ct ~L'--\ \ i (;t!,;'\, lO::
. .- ..::.=\._- ----,___u___...!.11:..!;;________u__,_..____
CITY 2 ,,- \hLL. <:.
.. &--...Jo...___._._.L-_____..._._.....,__.~.___...-_
~ The pool proposed for construction at the above address DOES NOT
conflict with any underground or overhead facilities of Florida
Power corporation, provided that the pool is installed in the
location shown On the attached site plan provided to us by the
pool contract.or. - ll;O:3;-TtS\AAe.R_ '"'tn VYIA-1~"T1It1'"J N,e.,~" ~~-(.{ui~6'(E1v-rS
l~ "1-0 bt -s"1Vrt-<.~ t~~\-V\. ~u {2J"-~ &- L-~L """'~ ~f7....r1. r...L!: ~f_G.
Ci~~
The pool proposed for construction at the above address DOES
conflict with:
OVERHEAD
UNDERGROUND
facilities of Florida Power Corporation.
Arrangements have been made with us for relocation of Ule
facilities so as to clear the pool area shown on the attached
~. u--p~n.
~-_/~---,_.._--"
- - ORfD~~.R ~~~~BON --.--,-
Cost for relocation of electric facilities will be paid by:
OWNER
POOL CON'l'RACTOR
....---.--'-'-- .....~......--'_.
/'
'pRIO~ to relocation of facilities and construction of pool.
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