HomeMy WebLinkAbout94-3948
BUILDING PERMIT
Permit N ~
CITY OF ZEPHYRHILLS
(813) 788-6611
39486
f-~--9Y
Date
c;:OI:?)
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
P<aperty owne'. r!/./L~~r
Job Address: 03 ~
Water Conn:
Water Meter:
T.I.I=.'s:
Parcell.D. #
Zoning: JY Code:
Description of wor'; -R J-7V- ~ ~
Radon Gas:
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
SignattHe ~
Company
Address
62.!> " Ol
t~
Valuation or
Contract Price (, 7 OU - c/7)
City License Registration # ? b
State Certified License#
Telep~one#
5l\-7 . oS: ~ "')..---
~ AY ~ ...-:L-
ELECTRICAL
PLUMBING
MECHANICAL
Breakers
Ducts Insl.
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.
APPLICATION FOR PERKIT
CIlY OF ZIl:nII'KH II.'-~
BUII.DIIIG DEPARIIIEIIT
_'S_~~~ ~\~-'~f~
_'S AD~5~ ~. CifY'~ -;, 7~tTh-l('\\\\\ ~L~ C-
JOB ADDlIESS5-:YO 9-ryn.~i)\~Y1~-=+-, 2e~'r\\ \'l~ \~\...??J'CAJ
LEGAL DESCRIPTI": IDI'(S) BI.OCX SOBDIVISIOII S~1.1 (2,E.S'\ ft'\'ctf
PARCEL LD.#
liOn PROPOSED:_IIev Coost:ruction .-JUIdition _Alteration ~ir J!a Install
S.
- J.gIl
_lIove
_De.o1ish
PROPOSED USE:
Single F_i1y
_"'F
_, 0:[ Unit:s
_"/B
_~rcia1
_Indust.
_Swm. P001
01:her
Resbmrant &: Hea11:h Departaent Approval.
BUILDING SIZE:
x
~e Feet.
Height
RESIDENTIAL:
COItItERCIAL :
AtTACH (2) PIDI' PlAIIS &: (2) SEIS OF BUIIJ)IIIG PlAIIS &: (1) SEI' ElIERGY PORtIS."''''
ATI'ACII (3) SEI'S OF BUIIJ)IIIG PLUIS &: (1) SEI' ElIERGY JIOIUIS."''''
"''''COPY OF CONTRAct RllQUIlUlD.
PERIIlTS RmllR.~TRD
_BUILDING
$. \~D().aO
Va1uation 0:[ Tota1 Construction
F.J.ItCI'RICAL
AIIP Sexvice
F10rida PoIIer Corp.
W.R.E.C.
--.JtECIL\lUCAL
$.
Va1uation 0:[ ff.echanica1 Inst:allation
_PL1Jff.BING GAS ROOFDIG
SPECIALTY
TYPE OF OONST.R1JC'I'IOR: _B1oc1t _~ _Stee1
Ot:her
FI8ISHED FLOOR ELEVATIOIIS:
Fr.
IS PROJECT IIi FLOOD ZONE AREA!
/
YES NO
............................................................................................................................
~CIOR SECl'IOIi
RllTIJ)1tR
Sigoat:ure
aJ!IPARY
State CerL or Regist. ,
Cit:y License Regist:ration ,
..........................................................................................................................
F.J .F-Cl'RICL\II
aJ!IPAIIY
State CerL or Regist. #
Cit:y License Regist:ration ,
............................................................................................................................
SiPnAt:ure
PI.DIR1tR
aJ!IPAlIY
Stat:e Cert:. or Regist. #
Cit:y License Registration f
........................................................................................................................
Sigoat:ure
ff.IlDIAIIICAL
0T1IItR
Roo~\ t\. G-
CDlPAIIY
State Cert. or Regist. ,
Cit:y License Regist:ration #
........................................................................................................................
B, \l ~~\J
fDlPAlIY l J)C\.,urr-.8L 0\~~ S.{\\lERS." \1" C
~' D J State CerL or Regist. # C.~f\3~blL(
Cit:y License Regist:ration # cc... ~ 3S,,"ll{
................................................................................................................
Signature
Signature
1)
'" Bb
APPLICATION APPROVED BY
PERIIIT OFFICER.
CONDITIONS OF PERMIT ArFIDAVIT
A . N.QI,!J,:J~_OF ___DEEDJ~SJR U;;T I Ot:Ji:l.
The undersigned understands that this per.it .ay be subject to "deed restrictions" which .ay be .ore restrictive than City
regulations. The undersigned assu.es responsibility for co~pliance with any applicable deed restrictions.
B. UNL I CENSED CONTRACTORS ~t!.r.L_G_QtnBfl~TQR J.::;:"'~p_E9NS.I.~_1 LIT !ES
If the owner has hired a contractor or contractors to under take work, the.r fIlay be required .to-b;-i-icensed in accordance wi th
state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor .ay be
cited for a .isde.eanor violation under state la". If the owner or intended contractor are uncertain as to "hat licensing
require.ents .ay apply for the intended work, they are advised to contact the City of lephyrhills Building Depart.ent, 10131
700-MIl.
FurtherMore, if the owner has hired a contractor or contractors, he is advised to have the contractor!sl 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 .ay be an indication that he is not properly licensed and is not entitled to per.itting privileges in the
City of lephyrhills.
(' IBANSPORTATION H1PACT FEES {-)ND UTI1-ITYJ~_QNNECTl.QN FEE.9..
D. CONSTRUCTION L".IEtL!-AW. (CHAPTER 713, FLORID() STATUTES~ ()S m'1ENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien La" - Ho.eowner's Protection
Guide" prepared by the Florida Depart.ent of Agriculture and Consu.er Affairs. If the applicant is so.eone other than the
"o"ner" , I certify that I have obtained a copy of the above described docu~ent and prOMise in good faith to deliver it to the
"owner" prior to co..ence.ent.
E. CONTRnCTOR'S/pHNER'S AFFIDflVII
I certify that all the inforlation in this application is accurate and that all work "ill be done in co'pliance with all
applicable laws regulating construction, loning, and land develop.ent.
Application is hereby lade to obtain a per.it to do work and installation as indicated. I certify that no work or
installation has co..enced prior to issuance of a perlit and that all work "ill be perfor.ed to .eet 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 governlental agencies lay apply to the intended work, and that it is
.y responsibility to identify what actions I lust take to be in co.pliance. Such agencies include but are not li.ited to:
. Depart,ent of Environ,ental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive Lands,
Water/Wastewater Treat.ent
. Southwest Florida Water "anaQe,e"t District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f Ar.v Corps of EnQineers - Seawalls, Docks, Navigable Waterways
. Depart.ent of Health ~ Rehabilitative Services, Environ.ental Health Unit - Wells, Wastewater Treat.ent, Septic Tanks
* US Environ.ental Protection Aqency - Asbestos abatetent
I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc,., it is understood that a drainage plan
addressing a "colpensating volute" Mill be subtitted which is prepared by a professional engineer registered in the State of
Florida prior to per.it issuance.
A pertit 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 per.it prevent the Building Official fro. thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every per.it issued shall beco.e invalid
unless the work authorized by such per.it is co..enced within six .onths of issuance, Dr if Mork authorized by the pertit is
suspended or abandoned for a period of six tonths after the ti.e the work is co..enced. 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 sir. tonth period, Dr the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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 COMMENCEMENT".
1\ ~ ~l
SIGNATURE: OWNER OR AGENT ~
1'> \ fA.,( ~
SIGNATURE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF ~ \f'-eJ,\,t.,j
The foregoing instrument was acknowledged
before me this' l.{-th l\faJ,4 19~ by
R... e.. ~ ~o V060--
who is personally known to me or who has
produced lL Oft.... (.tec~
as identification and who di Idid .iiDf'
.~ake an oath. V V
(Signature) ,~ /).
f'C. ~V I ^ K.f/&.~~ _
. .~T'.Iih:"1t or tamped}
DT ARq;";P~~~.g~:l!~L
(1V'""''''!}V "91 ;73t..:C f.:,'Y'ATE ':.:)P FL?RIDA
~,,)l.-v- - .. NO_ CCl97050
\ Y::S9:;0::l?1~9"J ~:.AP~J-51996J
STATE OF fLORIDAr\
COUNTY OF r\ ^e1 t... I'
The foregoing instrument1was acknowledged
befc,re me this ftm.,I'1K , 19.ft- by
(C..,c ~o VOC-tL
who is personally known to me or who has
pl-oduced h._OJ\. l..i t:!. ~
as identification and who di {did not )
take an oath. ~ ~~ -
(Signature) I .J ..J__
f<:);; l> .^ ~S1O:..
(Name Typed, Printed or Stamped)
t.~ ,~/i'"}.-r:'r';-S\C---l
KE.i/;N .r.I~.L;}.',.;'
NCfrn<y FU;',UC :;-;1".1E C-F FLORIDA
C~.:::;/;<' ;S:~.iCl'.:I\jO. CCJ97050
L'f.v"'..'."P'Y")~" "T) 'P" ~"1996
;.;/..1,,;,.,':;;:;.L:"'~l'i .~~:::;.~~ ~" (.:..1\,.'_" I"~ . ;:"h L.u..
(!: Uti trac t
CiJ ~'<1.
~-0-~eJ1
PROPOSAL. SUBMITTED TO
11fA /'11;2 S
Consumer Energy Savers, Inc.
GOOD IDEAS FOR THE WA Y WE LIVE TODA Y
10930 Endeavour Way - Unit C · Pinellas Park, FL 34647. State License #CCCA35614
({) 813-547-0522 Toll-Free 800-422-2012 (()
1. PHONE
IAN l3,ltov T g-/3.- 7 f L - 0 ~ f q--
/l11J;Z 6' L
/7
',) ,2
DATE
3(31/9'1
STREET
JOB NAME
530 L.-
6''-'-
33S-tf
JOB LOCATION
JOB TO BEGIN (APPROXI
JOB COMPLETED (APPROX)
FURNISH AND INSTALL FIRESTONE UL TRAPL Y 78+ SINGLE PLY ROOF SYSTEM
FOR FOLLOWING AREAS:
~ain Mobile Home Roof 0 Carport 0 Florida Room
sysrlM" DESIRED:
o Shed
CIRCLE
System #1: Membrane only, termination bar.
System #2: Install wood to perimeter edge of old roof surface, connect 3/4" insulation board to
old roof(s) surface, install Firestone Ultraply 78+ over the insulation surface and
secure with termination bar around perimeter of home.
~~stall treated wood to perimeter edge of old roof surface. Connect 1-1/4"
aluminum faced insulation board to old roof(s) surface. Install Firestone Ultraply
78+ over the insulation surface and secure with termination bar around perimeter
of home. Replace all vents (except furnace vent).
Additional Work:
TERMS AND CONDITIONS OF PROPOSAL
CONSUMER ENERGY SAVERS, INC. hereinafter referred to as seller, or your, or you; and purchaser(s}, hereinafter referred to as
purchaser(s), or I/We, Me/Us, My/Our, agree to the following terms and conditions, to-wit:
Seller to perform all work in a good workmanlike manner and will at all times maintain proper workers compensation insurance and shall comply with federal and slate contractor's
license regulations,
II This proposal is subject to acceptance by the seller at its office and becomes a binding agreement. It may be terminated at the option of the seller if said proposal cannot be financed
if purchaser(s) elects to purchase on a time sale price. Seller has 10 days from the date of this proposal to accept or reject the same.
III INle agree to pay for any other work done and not specified in this proposal in the event such work is done at customer's request after work has commenced.
IV If purchase order is being financed by a lending institution or by you, INle agree to execute all necessary documents immediately upon request and presentation.
V INle agree that any changes, alterations or extras from the plans or specifications which may be required by any public body or inspector, shall
constitute an extra and shall be paid for by the customer to the seller, based upon the seller's actual cost plus 20"!o.
VI ItHe agree that in the event of a breach by me/us of this purchase order after acceptance by you and before the installation is started, I/We will pay to you on demand Ten percent
(10"!o) of the cash price as stipulated damage for such breach.
VII If it is necessary for you to take legal action to enforce, protect or defend any of your rights under this proposal, IIWe agree to pay such sum as the court deems reasonable for
attorney's fees and court costs. Venue for all litigation will be in Pinellas County, Florida.
VIII No claim will be made by me/us except as provided in this order.
IX ItHe give CONSUMER ENERGY SAVERS, INC. permission to use pictures and/or references to our home in their newspaper and other forms of advertising.
X ItHe give CONSUMER ENERGY SAVERS, INC. permission to check our credit history.
XI ItHe agree to pay CONSUMER ENERGY SAVERS, INC. 18"!o APR interest on all moneys past due per this agreemenl
XII In the event any provision of this proposal should be found to be illegal or unenforceable, it shall not affect the legality or enforceability of any other provision.
XIII lifetime transferrable warranty will be mailed to buyer when seller has received payment in full.
The undersigned acknowledges receipt of a true copy of this proposal, acknowledges that he/she has read and knows the contents hereof, and understands. 1 hat no other
agreement(s), or representallon(s) by the salesman, verbal or otherwise, is binding upon the parties hereto, and that the same contains the entire agreement
Make all checks payable to: CONSUMER ENERGY SAVERS, INC.
CASH PRICE AND PAYMENT SCHEDULE (Reference to " phase of construction means all work, materials and equipment necessary to
complete that phase). Buyer agrees to pay Seller the Cash Price at Seller's office in accordance with the following payment schedule:
1.
2.
3.
4.
Price $ ~"7 0 0 '-.0 C>
Tax $
Down Payment $
Balance $ I. 7 0 0 I OV C 0 1::>
ON COMPLETION OF A'LL WORK. /11 rlS 7 6 f~
"BUYER', RIGHT TO CANCEL" C H If fL.';' t:
(RIV.,.. Side) +1 !S"3 l/ 7 .-s 0 If' - t./72 3 --!:- Y 1/
I have the authority to order the above work and do so order as outlined
herein. It is agreed thaI the seller will retain title to any equipment or
material furnished until final & complete payment is made. An express
mechanic lien is hereby acknowledged for security of this debt and the
total amount will be paid within terms shown.
Authorized
Signatur.
6- Xf'
06/7f-
NOTICE TO OWNER
An malerial is . anteed to be es spec~ied. All work 10 be completed in a workmanlike
manner aceOf'" Ing to standani prac1~s. Any alteration or deviahon from above
spec~icalions involving extra COllts win be executed only """n wrRten orders and will
become an extra charge over and above the estimate. All agreements oontingent upon
slrikes, ~dent5 or delays beyond our conlrol. Owner to carry fire, tornado, an~ olher
necessary N'lsUrance. Our worker. are fully covered by Workers Compensation Insurance
Do not sign this home improvement contract in blank,
or before you read it. You are entitled to a copy of
the contract at the time you sign. Keep it to protect
your legal rights.
Acceptance of ([ ontract -The above proees. ~pee"'eatlOn.
,nd condition, .r. ."idaetory and .re hereby accepted You are authorozed
to do the work a' specified. Plyment will be made a~ outlined above.
Deu of Acc.ptance:
./J ~ -y. 15 ~
Signature 11(l/1/7 )0 ,-U1'../ d /~/rIJ, > hLL.-?-7 c:;--J'
Signature
--~
Consumer Energy Savers, Inc.
GOOD IDEAS FOR THE WA Y WE LIVE TODA Y
10930 Endeavour Way, Suite C Largo, FL 34647 State License NCCCA:350J4
Contractor's Letter of Authorization
I hereby authorize the below named individual to act as my agent to obtain all neces-
sary permits for residential roofing work for:
. Owner: MARGARET v AN BRUNT
at this location: 5302 BRUNSWICK ST. ZEPHYRHILLS, FL. 33541
LOCATED IN SHADY REST MHP
This.personisalso empowered to obtain, complete, and sign all forms, applications,
registrations, and documentation, with this limited power of attorney, on behalf of me
that may be required to accomplish the issuance of any permits that may be required in
any jurisdiction throughout the State of Florida.
Authorized Person:
R;rh:=orn v08~1
Authorized Person's Signature: t>
JM
""-..
F~~-
-
Bill Croteau
State License #CCCA35614
~b(-
___,,,_,,.. .-....-. ..... "7.::.:....--..""'1
6C~"'(H' i,L-"r.;,.'. .'. .",1 !
.~~ t~ i~l;'~>;'~~"";.:~K~~;:~':\~.~ . -. . _ ~
NOTAR. y !.)lJH!.x:.s.;:,.>..T.~oc;.'..'.h..Oi.Ui)i'..l
COMI'i\l3SK,N NC!. C097i;ci() I
MY C(;M~Ai5~,10N EXF, AP;~~'2.U
.. ,~-;""--=-"-
Notary
Kevin Kruse
Sworn and Subscribed Before me this
4-+L Day of A-"A'ul
19~
(() 813-547-0522 Toll-Free 800-422-2012 (f)