HomeMy WebLinkAbout94-4170
BUILDING PERMIT
No
Permit '.
CITY OF ZEPHYRHILLS
(813) 788-6611
4170 8
Date 7- /7- ;1 '"/
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~BUIL~ ELECTRICAL PLUMBING
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Parcell.D, #
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
Description of Work
~gy Code:
AA~
Radon Gas:
,/
Cj/
NO OCCUPANCY BEFORE C.O.
:;--/13'
FINAL
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordar~e with City Codes and Ordinances,
DATE
Inspector
Permit Fee ,;2.,.5--' o--i,")
Signatu re flt.J/fL.<. Ii, (L,t;~
Company
Address
Telephone#
Valuation or
Contract Price ~ ~ 0 O. CJ-D
City License Registration # 51 '/
State Certified License#
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BUILDING
ELECTRICAL
Ftr. ~"d$=~TP.serv.
Pre SLB Rough In
Lintel Meter Can
FRM. Canst. Pole
Insul. CL Pool
WL Pre-Meter
t2 0 Final
Driveway 1/2.:<) -'P4U61;-
PLUMBING
MECHANICAL
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
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.
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OwDer,'Wlbuliseth/that the Conlra~r and the Owner for the conslderatloDllWDed qree .. follOws:
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ARTI:~ 1.\ . SCOPE OF THE ~OIUC .
TheCo~lractorahRn furnish aU materials ~d' perfonn all of the wOrk mown on the Drawings and described in the , SpeclJicatlODS
entitled <:]'" ., . ~'. -e. \I. .
prepllre~I'by .... . ~ . . acting as and ~ese\
Contract Documents entitled the teet, and man do everything requ1recl by this agreement, the general conditions of the Contract, the
Specl8catioDl:~ the.Drawinls, ,.. ,
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ARTICLE i.':,,';TIME'OF COMPLETION "
The..~rk;'~!~' ~fonned under this Contrabt sJ~ll be commence..f IlS ~ #; r'8e/l1/r i"5 ~KLJHA
substanUaDycompleted /L)/77,IIN t)NH" ~K
~. !
. c".' the. year
. ,
"erefDafter eatW the
...
.nd .hall be
ARTICLE 3. THE CONTBACI' SUM
The Owner shall
funds as follows'
Authorizec:l ~nge, Order. wiD be submitted by the Contractor for.n work not speciJically included in this Contract.
ARTICLE 4. ':Pl\OCBESS PAYMENTS
. .
(Insert here any provisioD made for the &mount reta.ined after the work reaches a certain stage of completioD.)
ARTICLE 5. ACCEPTANCE AND FINAL PAD-lENT
Final payment shall be du.. -nil!" da~.i: substantial completion of the work provided the work be then fully completed
and the ~tract fuD)rlperformed.
ARTICLE 8. . rim CONTBACI' DOCUMENTs
The General Conditions of the Clntracijt the Specifications and the Drawings, together with this Agreement, form the Contract, and they
are as fuUy a part of the Contract as hereto attached or herein repeated The following Is an itemization of other essential pertinent
information:
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Notary Public. State of FIorJdl
MyColnm. expi.... June 22. : 1988",
Comm. No. CC 388272
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APPLICATION FOR PERHIT
CITY OF ZEPBYRHlLLS
BUILDING DEPARTKENT
Ifrc
OWNER'S lWtE Cl4ifl~l.EC; 4; ffruN fI Fo>r tIL
mONE
OWNER · S ADDRESS
JOB ADDRESS Ceo '% (fir PEIHlL- 5r.
Dflt.S/Q:. fI/ O~l/-E #O#/c. Pf+t2J:.
LEGAL DESCRIPTION: WT(S)
BLOCK
SUBDIVISION
PARCEL I. D.'
~ddition _Alt.erat.ion _Repair _Inst.all
WORK PROPOSED:_New Const.ruct.ion
_Sign
_Hove
_DeJIOlish
PROPOSED USE:
Single Faally
_H/F
_, of Unit.s
_K/H
_eo..ercial
_Indust.
_Swi.. Pool
~~~)
_Rest.aurant. & Health Departllent. Approval
BUILDING SIZE:
x
Square Feet.,
Height.
RESIDENTIAL:
COfIKERClAL :
ATTACH (2) PWTPLMS , (2) SETS OF BUJILDIRG PLANS & (1) SET ENERGY FORMS.
ATTACH (3) SE.TS OF BUILDING PI.ANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQIURED FOR ALL JmW CONSTRUCTION.
PERMITS REODESTED
_BUILDING
$
Valuat.ion of Tot:al Const.ruct.ion
_ELECTRICAL
.MIP Service
Florida Power Corp.
W.R.E.C.
_fIEGHAIIJICAL
$
Valuation of Mechanical Installat.ion
_PLlJPIBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUcnOli: _Block _Fraae _St.eel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
******************************************
YES NO
BUILDER
CORTRACTOR SECTION
COKPMJiW nl~f'"\04. -4-(\01)\ l""n+ ll\~'
~ l JJ J Stat.e Cert.. or Regis~. f ,/:'/
. ~ ;r:.vof L.Y - City License Registrat.ion' rr
******************************************
Signat.ure
ELECTRICIAN COMPANY
St:at.e Cert. or Regist. ,
SiPn~ture City License Registrat.ion ,
******************************************
PLUKBER COKPAM
State Cert. or Regist. ,
Signature Cit.y License Registrat.ion I
******************************************
KECllMfICAL COKPMfY
State Cert. or Regist. ,
Signature Cit.y License Registrat.ion t
******************************************
OTHF.R . COKPAIiY
Stat.e Cert. or Regist. f
Signat.ure City License Regist.ration f
*********************..*.*....*....*..*.*.
APPLICATION APPROVED BY PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
!be undersigned understands that this peIlit lily be subject to Ideed restrictions I wbich lilY be lOre restrictive than City
regulations" rbe undersigned asBUleB responsibility for allpliance with any applicable deed restrictions"
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the OIfIler bas bired a contractor or contractors to undertake IIOrk, they lily be required to be licensed in accordance with
state and local regulations. If the contractor is not licensed as required by law, both the 0IfIler and contractor lily be
cited for a lisdeJeanor violation under state law" If the mmer or intended contractor are uncertain as to what licensing
requiretents lilY apply for the intended IOrt, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
788-6611.
FurtheIlOre, if the OIfIler bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
IContractor Sectionsl of this application for wbich they will be responsible. If you, as the OIfIler sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the work" If the contractor wisbes you to sign
as contractor that lilY be an indication that be is not properly licensed and is not entitled to perlitting privileges 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 with a copy of IFlorida's Construction Lien Law - lIoIeoImer's Protection
Guidell prepared by the Florida Departlent of Agriculture and ConsUll!l' Affairs" If the applicant is 8OIeOIle other than the
Immer", I certify that I have obtained a copy of the above described dOC1JleDt and prOtise in good faith to deliver it to the
"mmerl prior to co.enCetent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infoIlation in this application is accurate and that all wort will be done in cDIPliance with all
applicable laws regulating construction, loning, and land developlellt"
Application is bereby lade to obtain a peIlit to do work and installation as indicated" I certify that no !fOrk or
installation bas (DIeDced prior to issuance of a perlit and that allllOrk will be perfoIJed to leet standards of all laws
regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction" I also
certify that I understand that the regulations of other goverDll!lltal agencies lilY apply to the intended work, and that it is
Ii responsibility to identify wbat actions I lUSt take to be in cotpliance" Such agencies include but are not lilited to:
t Departlent of EnvirOJllelltal Regulation - Cypress Baybeads, Wetland Areas and EnvirollleDtally Sensitive Lands,
Water /Wastewater rreatlent
t Southwest Florida Water Hanagetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
t Arty Corps of Engineers - Seawalls, Docks, Navigable Waterways
t Departlent of Health i Rehabilitative Services, Environtental Health Unit - Wells, Wastewater rreatlent, Septic '1anks
t OS EnviIODleDtal Protection Agency - Asbestos abatetent
I also certify that, if fill laterial is to be used in Flood Zone IIAI or IA,etc"l, it is understood that a drainage plan
addressing a lCOIpeDSating volute I will be sublitted wbich is prepared by a professional engineer registered in the State of
Florida prior to petlit issuance"
A perlit issued sball be construed to be a license to proceed with the wort 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 frot thereafter
requiring a correction of errors in plans, construction, or violations of any code" Ivery perlit issued shall beCOle invalid
unless the IIOrk authoriled by such peIlit is ~ced within SlxlOllthS of issuance, or if work authoriled by the peIlit is
suspended or abandoned for a period of SlxlOlltbs after the tile the IOrk is c08el1ced" One 90 day t!ltension of tile, lily be
allowed for the perlit with fee charge of $15.00. '1he t!ltension sball be requested in writing to the Building Official. An
approved inspection lUSt be logged during each sil IOllth period, or the project will be considered abandoned"
WARMING '10 omR: YOUR FAILURE '10 RECORD A NO'IICE OF COIIMBNCBIIBtf'I MAY RESOL'I IN YOUR PAYING fiICE FOR IMPIIOVIIIIIl'IS '10 YOUR
PROPER'IY" IF YOU lllUIID '10 OB'IIDI FIIlAllCIJlG, CONSUL'I WIrH YOOR LIIIDIR OR AN AnomY BIFORB RECORDING YOUR IIO'IICE OF
COIIMENCBMIJI'I. JOBS ONDER $2,500 IN VALUE 00 110'I NEED '10 RECORD AND POS'I A INO'IICE OF aJOIBJfCEIIEJftl"
~.;;~,
SIGIA'IORI: OOBR OR AGBJI'I
~~ O~F FLORIDA P 1t5c 0
The foregoing instrument was a~~owledged
before me this ..:ru...~ t t; , 19~ by
who i
produce
as identification and who did/did not
tak~hl1.. ~~
3V~E) /L.....E51?[.L
( ame Typed, Printed or Stamped)
NOTARY PUBLIC
BRUCE A. ASBEL
Notary Public, Slate of FIortda
~ CoInm. expires June 22. 1988
Comm. No. CC 388272
~ ~I.~
SIGJIA : COIl'lllAC'lO~
S'IA'IE OF FLORlDAPA
CommOF _ SCO
The foregoing instrument was aCkn~ledged
before me this j'ttL l.( l S- , 19 'f by
fUr;
who is ersonally to me or who has
produced
as identification and who did/did not
~ta~e oa.tJJ"4. ~
(51 ture) /J
C€. !:J:.. ..;.~-
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
BRUCE A. ASBEL
Notary Public, SIIte of Florida
My COInm. expi.... June 22. 1_
Comm. No. CC 388272