HomeMy WebLinkAbout94-3971
BUILDING PERMIT
{, (/ - tro .;20 - dV
C-;U~DINV C ~LECTRIC~0
Pcoperty owne'~~~
Job Address: 7 . -~
P,coell.D.' ~--.;A5-- -. .tt52Z::- 0&60<> . OOyo
PLUMBING
r::uJ. c7z)
CMECH.~
Permit N~ 3971/J
Date ~- / r- 9,Y
CITY OF ZEPHYRHILLS
(813) 788-6611
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning: :zrgy Code:
Description of Work !1-t4 ~ ~;L. ~~
.;;.n G.",.
.. _-bJH~J
aA.I!..A
FINAL
C.O.
DATE
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance wit City Codes and Ordinances.
DATE
Valuation or
Contract Price
S' trz;Iz/ - t7-cJ
.....
Inspector
City License Registration #
State Certified License#
jLiJ 7
I
;~;~~~
Company
Address
Tel~phone# 9v~ -.E&'T - '2..1:} 3_~
PLUMBING
~7
Ftr.
Pre SLB
Lintel
FRM. 1-~~.q-( ~u....
Insul. CL
WL
Tp. Servo
Rough In '1-ltlj,qc..I ~
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl. L/- 2 "Cr9'1 B6A
Compressor
Final
Driveway
t{ -- 2 ~ --'i'1 'BiLl--
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 PERMIT
CITY OF ZEPHYRHIU..S
BUILDING DEPAR1IIENT
OWNER'S BAKE ROj)N~i E M.D I....AlJRA .s.. .8'C-€ PHONE 782 -- 80Cl.5
OWNER'S ADDRESS 72.05 APPI..Cr197"E .Dl?IJE-. Zep~RifJu..S.. ,:2,33.510
~ (
JOB ADDRFSS
SJ&/,.-,E.
LEGAL DESGRIPI'lON: toTeS) /...cr 1
BLOCK
SUBDIVISION AL.P~A v,L.l..JI'J're. E'sIIF/gs ~IISt:I.
PARCEL 1. D.'
3,5~,:<s-QI ~ OOS()-OOO()()- oCd-D
WORK PROPOSED:_New Const.ruct.ion _Addition ---L.Alt.eeat.ion _Repair _Install
_Sign
_Hove
_DeIIOlish
PROPOSED USE: 'f. Single FUlll}'
_tf/F
_, of Units
~tf/H
_ec-ercial
_Indust..
_Swu.. Pool
Other
_Restaurant &: Health DepartJIent Approval
BUILDING SIZE: 2. 8 X.:5 () .
/ ''fa 0
I
Square Feet.
8"
Be ight
RESIDENTIAL :
cotIPIERCIAL :
ATTACH (2) PLOT PLMiIS &: (2) SETS OF BUlLDlliG PLANS &: (1) SET ENERGY FORtfS.
ATrACH (3) SE"I'S OF BUILDING PLANS &: (1) SET ENERGY FORtfS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERKITS REQUESTED
...LBUlLDING
~ELECTRICAL
~ttECBArflCAL
$
'7:<?t ~
Valuation of Total Construction
AIIP Service
Florida Power Corp.
W.R.E.C.
$
Valuation of tfechanical Installation
_PLlI'IBIRG
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTIOH: _Block _FeUle _Steel
Other
FINISHED FLOOR ELEVATIONS:
Fr.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
. CORTRACI'OR SECTION
S-~rf--;2 933
B~~ ~ COKPARY S-r. ~6C"H L?oN~ntJ(;.'IJO~..:L.rJ<..- ,
Stat.e Cert.. or Regist.. I C B 0 'i'5 2 3 t
Signolture ti City License Registration t -'/0 'T
******************************************
HI=CIAII_ (0 ~ 6/" =~rr.:: k&i:f./j N7,J, C
SiPD:#IIture ;';'!'>;;/"/d 1(/ ~V<-/ City License Registration I. 50
****.***..**.*.***************************
PLUKBER
GOKPAH
State Gert. or Regist.. ,
City License Regist.rat.ion I
******************************************
Signature
Signat.ure
,
cottPARY TA t-1~ S. AI L- tt~7 f vtJ 6
State Gert.. or Regist.. I (t- fl-iLtJ
Cit.y License Registrat.ion I b~
******************************************
OTRF.R
COMPANY
Stat.e Gert.. or Regist.. I
Cit.y License Regist.ration I
******************************************
Signat.ure
APPLICATION APPIllIVED BY '11 aAt1' V _"ff ~
PERllIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
!be undersigned understands that this peIlit lilY be subject to 'deed restrictions" ,bieb lily be lOre Iestrictive than City
regulations. !be undersigned asSUle& responsibility for COIpliance lith any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the OIfIIer bas bired a contractor or contractors to undertake IOrk, they laY be required to be licensed in accordance with
state and local regulations. If the contractor is not licensed as required by la" both the 0IIIIer and contractor lilY be
cited for a lisdel8anor violation under state law. If the owner or intended contractor are uncertain as to Ifbat licensing
reguirl!leDts lilY apply for the intended IOrk, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
788-6611.
FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
"Contractor Sections' of this application for whieb they ,ill be responsible. If you, as the OIfIIer sign as the contractor,
you are indicating that you, lather than the contractor, are responsible for the IIOrt. If the contractor ,isbes you to sign
as contractor that laY be an indication that be is not properly licensed and is not entitled to penitting pri,ileges in the
City of zepbyrbills.
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 lith a copy of 'Florida's Construction Lien Law - HaIeoImer's Protection
Guide" prepared by the Florida DepartJent of Agriculture and COnsUler Affairs. If the applicant is 8OI8ODe other than the
"owner", I certify that I have obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
"OIfIIer" prior to co.enCl!IeDt.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infoIlation in this application is accurate and that all wort ,ill be done in COIpliance ,ith all
applicable lalB regulating construction, zoning, and land develOpleDt.
Application is hereby lade to obtain a pelllit to do IIOrk and installation as indicated. I certify that no IOIk or
installation bas <<DIeDcecl prior to issuance of a perlit and that allllOlk ,ill be perforled to .et standards of all laws
regulating construction, City codes, loning regulations, and land developlleDt regulations in the jurisdiction. I also
certify that I understand that the regulations of other goveruental agencies lilY apply to the intended lOll, and that it is
If responsibility to identify what actions I lUSt take to be in COIpliance. Such agencies include but are not luited to:
t DepartJent of EnvirODleDtal Regulation - Cypress Baybeads, Wetland Areas and BnviroDleDtally Sensitive Lands,
Water /lfast8later !reatJent
t Soutb,est Florida Water Hanagl!leDt District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t Al1Iy Corps of Engineers - Seawalls, Docks, lavigable Waterways
t DepartJent of Health i Rehabilitative Services, BnvirODleDtal Health Unit - Wells, Wastewater !reatJent, Septic !anks
t US BnvirODlental Protection Agency - Asbestos abat8leDt
I also certify that, if fill laterial is to be used in Flood Zone "A' or "A,etc.l, it is understood that a drainage plan
addressing a '~ating volUle" ,ill be sublitted ,bich is prepared by a professional engineer registered in the State of
Florida prior to pelllit issuance.
A peIlit issued shall be construed to be a license to proceed lith the IOrk and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a peIlit prevent the Building Official fIOI thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every peIlit issued shall beCClle invalid
unless the IOrk authoriled by such pelllit is COIIllDced within sillOnths of issuance, or if IIOrk authorized by the peIlit is
suspended or abandoned for a period of six IODths after the tile the work is couencecl. One 90 day extension of tile, lilY be
allowed for the peIlit lith fee ebarge of $15.00. !be extension shall be requested in writing to the. Building Official. An
approved inspection lUSt be logged during each sillODth period, or the project ,ill be considered abandoned.
WARlUG !O (JIIR: YOUR FAILURE !O RECORD A IO!ICE OF aJIIIICEIIDl' BY RESUL! II YOUR PAYIHG !lICE FOR IIIPROVIIID1'S !O YOUR
PROPmY. IF YOU III'IDD !O OB'lAII FIIAICIIG, COISOL! WID YOUR LBIIDIR OR AI AftORDY BEFORE RECORDIIG YOUR IfO!ICI OF
momlCEHM. JOBS OlDER $2,500 II VALUE DO IO! mD !O RECORD AID POS! A 'IO!ICE OF crJIMBICBIIII!".
.r~~~'<-~L<O
SI !URI: (JJIR AGm
~~Lv---
S'l'A!E OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before me this , 19____ by
S!A'fE OF FLORIj)I-~
ComrrY OF . C-o
The foregoing inJtrument was acknowledged
before me this ~ I L/ , 19 qL{ _ by
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
who is personally kn.\\'t.WI\~ 0:. f. ..IlA k_
od 8d ,~,' R "r A '~'"
1'1. u"'" ,';-' J.. ....' '
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
llI- .".....
_t_~
CARBON LESS
FORM 3850
D'....
NO ."
CARBON
REQUIRED
"". PROPOSAL";~'
TRIPLICATE
..~-,..--~~~..
PROPOSAL
Propou. Submitted To:
Name oet!.~y,~ ~PlJlP ,Bu~
Street- ...!.?~S..;;.Bi?~r.-.~~l:C.-_.. ...,
City_~.&PtlY~.H-J~._._.__..~.... .o_____....
Stata _...F:.'---.. .H........._.____.._.......
Phone ........... .,....___.._.... ,..-.____-"-__...__...
Work To Be Performed At:
Street. .. .s.Af!'...l:...-_......._____._______. ... .... ......_._....._....__..
City . .____________._...___..__. .._.__.____.... State ._.._._....__:.....c.~
Date of Plans A_____-'___ <... "'.__.____^_____ .. .~_~~..__m_..'"_..~~___
Architect ..__.___........._.
We heraby propose to furnish the materials and perform the labor necessary for the completion of
_ffl:J~L.. ...~.It.Utf~ ;c,~S'l:'- '1rl:: '1:)( I~ ;-/J ~~~/So 0 . . ...,. -.-'.-- :~.::'$ ~.:I2=:~'
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..............._... ~L~ tJ&W .z...__..<2~.~/A,~ry'.,.J. $..T'(f",-. ..""~~_. ....._.__. . ___..__.._..__...___~
_-==.m-~~~..~~~~-=.~.;. ,~~:;}~?~~~.~~;~..-..~..-.:w;~.s-w. .4...-..~.:.~t-.~..... ...--. ::'" .'
~_.__._____.__._._I).""- ~ &-..-.-.--------~ _ _ . ~~e. ~- -:- ,-J.)--~
~1?Qu~;----2.A.~~~:"J5.i:'~~.;:t-.-.7Q.~,,:.~i!=.:~~..Pii..:~:~:;;./;;;;'--~~A -~-~---=~~-- :.p-l~~
=-~.-"~~=~="~=_~"....;;!::::;A"1Ed~~=:=.... .m~~;=~===. ..~~~Jt~~_
=--=~~~.".=~.~.==-:__~...---..~...__{~~~~. .. _$~-';'~ -~ ~~/(7oJ?u~hoCk~-..A~.~ I.t) -i~) --~=~=...~5i-:-S'L-~o~.
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----...--.-.......-...-. -. --H:J~~'7' I--"-"--~i.i ~ ... ,-- -.... . ----.-...-.---...........-.. J e~
-.--.--..-..------........-..----.---l.!J.r--.~W}LC{. ..- ..---..------.~........_')..Z.~..fL.~
All material is guaranteed to be as specified. and the abova work to be performed in acCordance with the drawings and
specificationa submitted for above work and completed in e substantial workmanlike manner for the sum of
'~% Dollars ($ tfO',4 ~ ).
with payments to be made es follows: . I. .o. oJ ..s.(~NI-l'- o.F (;9,l71~ . --.-------..I):<Qb.:!,,-
:.~__.__=~...~=.....--....._:.--.--...~-. ........-lg ~ ~7:::r ?'t;;/!/A.-/ I2Q,.~(.. .. .... '--"...-..-.. "'=.~".~__':
. ~"rJ rJ
_....__... ..............:_ . ............._. .._..~.Q__o. . ""p~ COr')PwTC
Ally altwetion or deviation from alxMl epecificatlOll8 involvil1ll extra
CCI8tI, will be exacutad only upon written ordere. and will become In
extra charge lMIr and aIxMI the eetlmate. All agreements contil1llant
upon strikes, accidenta or daIayll beyond our control. Owner to carry
. fire. tornado and other -.y Insurance upon alxMl work. Work.
man', CompalW8tion and Public .Llabillty II1IlII'lInC8 on alxMl worlc to be
tak.-I out by
Res_fuIlY.Ubm~ ... '~rN~=.-":-=~
Per
Note- This proposal may be withdrawn by U8 if. not aCcepted
within_ _______ days.'
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