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Home My WebLink About94-4021 BUILDING PERMIT Permit N~ CiTY OF ZEPHYRHILLS (813) 788-6611 402111 Date -5-- / eJ-:l Y BUILDING ELECTRICAL PLUMBING ~A~ Sewer Conn Water Conn: Pmp."V own",_~ J Job Address: 0 Z _ -~---M. Parcel 1.0. # Water Meter: T,I.F.'s: Zoning: Description of Work X Energy Code: ~ M'LJ< y../ A-Ie -"ad~ 77 ,~p~cd~ FINAL_-L C/11 \ DATE C.O. 1\~ . ) I DATE NO OCCUPANCY BEFORE C.O. Complete Plans. Specifications and Fee Must Accompany Application, All work shall be performed in accordar~e with City Codes and Ordinances. Inspector Permit Fee Signature Company Address Telephone# :fJ~ Valuation or Contract Price tf;; y;L(}. 0-0 / City License Registration # -P State Certified License# "7 ~ Z - (p 'l ,('6 ?-J ( BUILDING ELECTRICAL PLUMBING ir'~ a~ MECHANICAL ~tib YCJ~ E Breakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Tp, Serv, 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. APPLICATION FOR PERftIT CITY OF ZEPIIYRBILLS BUILDING DEPARTItEBT OWNER · S RAIlE Ct") (d ~rJ (!o/G~~L a ~ /I SIr/d. (JAil lJ/vd, PHONE 766J}Sso OWNER' S ,ADDRESS $ I ,i () JOB ADDRESS 5.- I 3D 'z- H FL Z.//, FL. LEGAL DESCRIPTION: LOT(S) B~SUBDIVISION PARCEL LD.' WORK PROPOSED:_New Construction _Addition _Alteration ~epair _Install _Sign _Rove _Deaolish ~f/\ f.\N~e-- CJG.l"r' Ifl~ PROPOSED USE: Single FMlily -"IF _, of Units _RIB _~ercial _Indust. _SII18. Pool Other _Restaurant & Bealth DepartJIent Approval ~re Feet, Beight BUILDING SIZE: x RESIDENTIAL: cotUtERCIAL : ATI'ACII (2) PLOT PLUlS & (2) SETS OF BUILDING PLARS & (1) SET ENERGY FORKS. ATI'ACII (3) SEtS OF BUILDING PLANS & (1) SET ENERGY FORKS. PImPERTY SURVEY REQUIllRD FOR ALL ImW WNSTRUCTION. PERKITS REQUESTED _BUILDING $ Valuation of Total Construction _ELEcnuCAL AIIP Service Florida Power Corp. W.R.E.C. _~...JmCBAliICAL $ Valual:ion of tlecbanical Installation _PLOHBIBG GAS ROOFIliG SPECIALTY TYPE OF WNS'lKUCtION: _Block _FrMle _Steel Other FIIUSBED FLOOR ELEVATIONS: FI' . IS PRO.JECl" IN FLOOD ZONE AREA? YES NO ****************************************** WNl'RACfOR SECl'ION BUILDER Signature cotIPAIIY State Cert. or Regist. , City License Registration , ****************************************** F.T.F,cnuCIAII COItPAIfY State Cert. or Regist. , City License Registration , ****************************************** SiPTI~ture PLUKBER Signature COtIPARY State Cert. or Regist. , City License Registration , ****************************************** Signature r;o 1~ COItPARY 2* ~ State Cert. or Re ist.' R 80 se> 8 if City License Registration , BCd ****************************************** IlECllARICAL OTRF.R COItPARY State Cert. or Regist. , City License Registration , *.~****************************.********** ' Signature APPLICATIOR APPRoVED BY '1d~q :>lJ 1~"vrr-- - , nmnT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS I'he undersigned understands that this peait lap be subject to 'deed restrictions' which lap be lOre restrictive than Citp regulations. !he undersigned asSUle& responsibilitp for CfIIpliance with any applicable deed restrictiODS. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has bired a contractor or contractors to undertake work, thep lap be required to be licensed in accordance with state and local regulaticms. If the contractor is not licensed as required by law, both the owner and contractor IIBY be cited for a .isd_anor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirl!lents IIBp applp for the intended work, thep are advised to contact the Citp of Zepbyrbills Building DepartJent, (813) 788-6611. Furthel'lOre, 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 wbich thep 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 wort. If the contractor wisbes you to sign as contractor that IIBY be an indication that be is not properly licensed and is not entitled to perJitting privileges in the Citp of Zepbprbills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certifp that I, the applicant, have been provided with a copy of 'Florida's COnstruction Lien Law - lkJIeowner's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsUIeI Affairs. If the applicant is 8OIII!ODe other than the "owner., I certify that I have obtained a copy of the above described docUIIent and pIalise in good faith to deliver it to the "owner" pdor to co.eDCeIeIlt. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforaation in this application is accurate and that all work will be done in cOlPliance with all applicable laws regulating construction, loning, and land develo.-ent. Application is hereby lade to obtain a Perlit to do work and installation as indicated. I certify that no wort or installation bas (DIeDced prior to iSsuance of a perJit and that all work will be perfOlll!d to _t standards of all laws regulating construction, City codes, loning regulations, and land developl8Jlt regulations in the jurisdiction. I also certify that I understand that the regulations of other gDV8IDIeIltal agencies lay apply to the intended work, and that it is If responsibility to identify wbat actions I lUSt tate to be in COIpliance. Such agencies include but are not lilited to: t Departlent of BnvirODleDtal Regulation - Cppress Bapbeads, Vetland Areas and InviIOlllentally Sensitive Lands, Vater /Wastewater I'reat:lent t Southwest Florida Water Hanagl!l8llt District - VeIls, Cppress Baylteads, Wetland Areas, Altering Vatercourses t lIlY Corps of Bngineers - Seawalls, Docks, lavigable Vatenays t DepartJent of Health i Rehabilitative Services, InviIODl8Dtal Health Unit - VeIls, Wastewater I'reat:lent, Septic !ants t US InviIODlental Protection Agency - Asbestos abat8lent 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 "C0Jpen8ating vol_" will be sublitted wbich is prepared by a professional engineer registered in the State of Florida prior to peIlit issuance. A peI'lit issued shall be construed to be a license to proceed with the wort and not as authority to violate, cancel alter, or set aside anp provisions of the technical codes, nor shall issuance of a peIlit prevent the Building Official fIOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall becCII8 invalid unless the wort authorized by such peIlit is ~ced within sillODtbs of issuance, or if work authoriJed by the perlit is suspended or abandoned for a period of sillODtbs after the tile the wort is ~ced. One 90 day 8Itension of tile, lIBy be allowed for the perJit with fee charge of $15.00. I'be 8Itension shall be requested in writing to the Building Official. An approved inspection lUSt be logged during each sillODth period, or the project will be considered abandoned. WARRIIG TO OVIIR: YOUR FAILURE TO RECORD A IOI'ICH OF C<lElCIIIBMI HAY RESULI' II YOUR PAYIIG !IIICH FOR DIPROVIIIIITS 1'0 YOUR PROPIRIY. IF YOU II'rBJID 1'0 OMAII FIIIAICIIG, COISULI' VID YOUR LBMDIR OR U InoRIIY BI10RE RICORDIIG YOUR DICH OF motDCBIIBMl'. JOBS UNDER $2,500 II VALUE DO 101' NEED to RECORD AMD POSI' A -IOI'ICI OF aJIIIDCBIIBMl'''. 04t,#~~... tJl ~ / SIGIIA'lURI: (IftIBR GIll SIGIIA'fURI: COI!IIAC!OR / / STATI OF FLORIDh coum OF E~c.o The foregoing instI'WIent was acknowledged before me this Ih; I D , 19 Cf c.f by --s- ~.~ t?tlu lM~ +t'\J u... who is personally knOwn to me or who has produced ~ as id fication and who did/did not take oath. i cf/- /Jt1. c~ ( ~~ure) C r ( ~ ~ ,0..,0 A yYl \......e l It. 'V\ (Rame Typed, Printed or Stamped) ROTARY PUBLIC STAI'E OF FLORIDA ? COUI'lY OF A ~ c 0 The foregoing instrument was aCknowledged before lie this (JfJ}7 I () , 19.,fL by '}../,., /-J,HJ E., TfdVJt~S who is personally know.n to me or who has produced FL.' r s: L,~ 0f c-c..- as ident' ication and who did/did not take o~th. c#' #I( ~ (S' r ) ...... .:.;.-~, OFfiCIAL SEAL (_ \ SUS."N A. McCOllUM : My Commission fl(;)lres : Apr1/16.1997 ~Qt~.. Comm. No. CC 268679 ........ .~.~' OFFICIAL SEAL I \ SUSAN A. McCOLLUM 1 ~ My Commission Expires t J April 16. 1991 .....~ ~.' Comm. No. CC 268679 .....~~ ....,. ZEPHYR AIRE N~ 2358 P.O. Box 1243 Zephyrhills, FL 33539 Lie #RAB05084 (813) 788-6284 Make Model N...... (;0 \ d-r:: AJ d IUlA-I S~tA. t,l ;:s Lvcl Date AMOUNl "-5130 S" 9 -q'lf OTY. MATERIALS UNIT WORK PERFORMED City Pmmlsed CONDENSING UNIT CONO'SATE DRAINS Ztf .pI. . Leveled Cleaned Main Drain Phone C~ Before 0 A.M. Repaired 76S - 35'.30 0 P.M. Cleaned Coli Main Drain Technk:lIIn &..D Autharized By Checked Cleaned I1AJe. "B. Charae PIn Drain Repaired Repaired Leak In Coli Pan Drain Wotk to be Performed ~ itA. I jl\l/7- Repaired , IVt' ~ 01..1.1 Leal< In Copper FURN, or FAN COIL v Oiled Motor Replaced Ben DESCRIPTION OF WORK PERFORMED Checked Adjusted Belt Motor (l ~,~f'I' (0 our A-/C' ~ ~~~~ed ~,.~~ced ~ t U:Claced =ted I ~~LlISted Cleaned Blower ~__C TI),D Replaced :e~~:: UI\J ;& ConIactor . I ~,!;,Start Oiled Motor ~,Start Oiled Bearings dlor . ~~ Roo Cleaned cltor Heal Exch, ~~~~:ctor Replaced Heal Exch, ~~~~ed Cleaned or "ilL Pilot Replaced Fuse Replaced TherlllOCOUllle Replaced ~ed Vs EVAPORATOR COIL =:ced Va ~Ia~~ Cleaned Burners ~llSted DUCT Em, Valve 1l!..e:1aced Repslred Tube Cleared Replaced CID Tube ~alred TIERMOSTAT Co j"j eak I :edCOM, Replaced Cleantd CoI Adjusted HRS. LABOR RATE AMOUNT Leveled Coil AMP!RAOE ELECT. Hm. Replaced Link PRESSURI! ReplacedKlIx Law Malertllls & Ubor May be TOTAL LABOR Repaired Wire High ContInued 011 Other SIde TOTAL MARTE RIALS Replaced Coni, Recommendations LIMITED WARRANTY. All materials, I'lLTI!RS [J Cleaned [J Replaced partS and equipment are warranted by the manu- facturers' or suppliers' written warranty only. All TOTAL SUMMARY labor performed by the above named company makes no other warranties, express or Implied TOTAL I have 8Uthorily to order the work autIIned Ibove wtw:h hlIa been aatItlfactorlly COIttI'IeIIld. Seller and ils agents or technicians are not authorized to MATERIALS rtIll11ns IItle to eqUptnIlnImatlltlllle fwnlIIhed InIIIInIII peyment Is mede. If ~t Is not mede make any such warranties on behalf of above TOTAL _ 8g88d, Seller CII/l remove MId equIprtwntI~ at Seller'a 8XJlllM8, Any damage...... named company, LABOR Ing from said removal shaI not be ... ..........ty of Seller, o REGULAR o WARRANTY TRAVEL o SERVICE CONTRACT CHARGE o INSTALLATION CONTRACT TAX Cus_ SllJIature Date THANK YOU TOTAL ~ '-/~CJI8o Serial N1nber SerIal Number