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HomeMy WebLinkAbout94-4172 BUIL~t~9HY~L~RM!! m 4172~ (813) 788-6611 Date /'-d.-/-j"! ~LDI~~ ELECTRICAL PLUMBING MECHANICAL Sewer Conn ~~ Property Owner: Job Add,.... ~/!' ::: ,. /<~9 J)./I. Parcell.D. # Water Conn: Water Meter: T.I.F.'s: Zoning: Energy Code: Description of Wor; ~ /')~ Radon Gas: ./ ./ ,~ l~ ./ ;)-/~ FINAL DATE NO OCCUPANCY BEFORE C.O. Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordar~e with City Codes and Ordinances. DATE City License Registration # State Certified License# 3D Inspector- Permit Fee ~~ ~ ~ Signature r.-- ~.L-< C~ Company Address Telephone# Valuation or Contract Price----dj ;).. Y s:- lrz} j)gJL_ ELECTRICAL PLUMBING MECHANICAL Tp, Servo Rough In Meter Can Canst. Pole Pool Pre-Meter Final Ftr. Pre SLB Lintel FRM. Insul. CL WL SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compressor Final 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 CITY OF ZEPHYRBILLS BUILDING DEPARTMENT OWNER'S NAKE /)-1 /L1 Fv/' :://j I :.s. IC f./ f L r--- / /~ , PHONE ? / .") -(;~;y /- /.) .~~/ OWNER'S ADDRESS DO x 5'1.)2-. , ~. f/J j~ /1:f'c C,AJVtJ ".c c-- . .3 3iV 7 JOB ADDRESS '3. '-II'; (?"./~1.1t;:<C,-/fV' t/ I 'v,?jjf~E- .[).7 /1 II c- ~ /7ft:"f. /1-<; (lei L/ S -.5 LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I. D. t (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED :_New Construction _Addition _Alteration _Repair _Install _Sign _Move _Deaolish PROPOSED USE: _Single Faaily _KIF cJ ____K/H -L-' of Units _eo..ercial _Indust. _Swim. Pool _Other _Restaurant & Health Departaent Approval DESCRIPTION OF WORK: /;/'c l~~C)/C::ijV/6=.. 9] ~ BUILDING SIZE: x Square Feet, Height RESIDENTIAL: COMMERCIAL : ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED _BUILDING $ ~ Z L( X t'f' AKP Service Valuation of Total Construction _ELECTRICAL Florida Power Corp. W.R.E.C. _MECllARICAL $ _PLUMBING GAS Valuation of Mechanical Installation ,"~ ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** CONTRACTOR SECTION BUILDER COMPANY State Cert. or Regist" t City License Registration t *******************************.....*.***. Signature ELECTRICIAN COMPANY State Cert. or Regist. t City License Registration t *******.*********.*..*..***.***.*********. Si2118.ture PLUMBER COMPANY State Cert. or Regist. t City License Registration t ****************************************** Signature MECHANICAL OTHF.R ) r_l/ ,/ I , /l-:& '- COMPANY State Cert. or Regist. # City License Registration t ***************************************.** _ COMPANY Ci i'< I i_ l; (;/ , State Cert. or Regist. , l/<-~__ City License Registration f *******.***.*..*..**..*.***.*.*****.***..* Signature Signature APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this petlit lay be subject to 'deed restrictions" which JaY be lOre restrictive than City regulations. !he undersigned assUles responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they lay be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor JaY be cited for a lisdeieanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing requireJents JaY apply for the intended work, they are advised to contact tbe City of Zephyrbills Building Departlent, (813) 788-6611. FurtherlOre, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) 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 tbe work. If the contractor wisbes you to sign as contractor that lay be an indication that he is not properly licensed and is not entitled to petlitting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, bave been provided with a copy of 'Florida's Construction Lien Law - HOJeOWDer's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsOler Affairs. If the applicant is sOleone otber than the "owner", I certify that I have obtained a copy of the above described docUlent and prolise in good faith to deliver it to the "owner" prior to cOllellceJent. E. CONTRACTOR'SjOWNER'S AFFIDAVIT I certify that all tbe inforJation in this application is accurate and that all work will be done in cOlpliance witb all applicable laws regulating construction, loning, and land developleDt. Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation bas cOllenced prior to issuance of a petlit and that all work will be perfofled to leet standards of all laws regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also certify tbat I understand that the regulations of other governJeDtal agenCies laY apply to the intended work, and that it is IY responsibility to identify wbat actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to: * DepartJent of EnviroDJeDtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater Treatlent * Southwest Florida Water HanageJent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses * Atly Corps of Engineers - Seawalls, Docks, lavigable Waterways * Departlent of Health' Rehabilitative Services, EnvirODJeDtal Health Unit - Wells, Wastewater !reatlent, Septic ranks * US EnvirODlental Protection Agency - Asbestos abateJent 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 volUle" 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 tbe work and not as authority to violate, cancel alter, or set aside any provisions of tbe technical codes, nor sball issuance of a petlit prevent the Building Official frOl tbereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beCOll! invalid unless tbe work authorized by sucb petlit is cOlll!nced within six IOnths of issuance, or if work authorized by the petlit is suspended or abandoned for a period of six IOntha after the tile the work is cOlleDced" One 90 day extension of tile, aay be allowed for the petlit with fee cbarge of $15.00. The extension sball be requested in writing to the Building Official. An approved inspection lust be logged during each six IOntb period, or the project will be considered abandoned. WARlfING TO OWIER: YOUR FAILURE TO RECORD A IOTICE OF COMHBlfCBJIBIlI HAY RBSUL! Ilf YOUR PAYIIG !WICE FOR IHPROVBMnTS TO YOUR PROPERTY. IF YOU IIfEIID !O OBTAIN FIMAHCING, CONSULT WUH YOUR LBlfDBR OR AN AnoRm BEFORE RBCORDIMG YOUR MOTICE OF COMHBNCEHRN!. JOBS UHDER $2,500 II VALUE 00 lOT IEED TO RECORD AND POST A I'NOTICE OF COMHBNCEHBIlI". ..) ;/ ), f~/. ,'/ A';" ~ " ,/' // ' '---"'. . -i. <' . .1// .-.. i Jf'/l ;- \ "..'./ L "'--~ _._ c_/\ 'l...-.t- _ ~,1,..- ~ "\. SIGMATURE: OWNER OR AGHili SIGMATURE: CON!RACTOR iJj3A . STATE OF FLORIDA COUlllY OF P /1 S c- 0 The foregoing instrument was acknowledged before me this 7,J. 'J-I ' 199~ by . STA!E OF FLORIDA COUlllY OF I/J ~ c 0 The foregoing instrument was aCknowledged before me this 7- J- I , 19 9</ by 7<..- c- k {7 AO.' h who is personally known to me or who has produced fJ.pf? SO n.4IJ~ /(....,t?Wt'I. To m-l!.,/ as identification and who did/did not t~~/th~ ~ . . ( ignature) ~ (Name Typed, Printed or Stamped) NOTARY PUBLIC BONNiE J. KINNEY My Comm Exp. 6/10/97 NOTARY . ~ PUBLIC ~ Bonded By Service Ins ~~ 0';; No. CC293758 OF f\; l\PersondlyKnown 1l0lher1.D. ~, l/ (~ I . <-1'- -rA-U, h who is personally known to me or who has produced bIZ5OI.l)}/li ..(',DU)) 70 /lJf!-I as identification d w 0 did/did not t.ke~ I.K- (Sign. ure) ~ (Name Typed, Printed or Stamped) NOTA PUB IE J. KINNEY My Comm Exp, ?/10/97 '" NOTAi<Y <( Bonded By Service Ins y PUBLIC !2 CC293758 ;,o~ 0<1: No, OF f\; ^Per~Of'IiI,y Known \1 0\heI1. D. 'J\ G~VIN ROOFING 1,1 lie. # RC 0046241 Labor Guaranteed One Year .~I (904) 567.5034 ------- :"":;'.Q 15)';--r~~~c0'~-_-=_ JOB NAME I ---- 6..f!4Uce~ --.f}-1Li~_ _ ____~~_.j, JOB LoeA r ION' I . { -IJ, 7;r fi~--- .!:-I;---i----- .-- Ii PLANS ___ J~~~rlO:__.__ .-- ~--------- ---- I II I Ii I i I I II II 'I I' II !I Ii II Ii II II I I i I /' . - - -.... - -- - --- . --..- . ----._- ---.--..j -.---.'-----------.-.---.---.---..-..-..-.----.....-----l' IB, 'ropo", ""'by to fom'," m,t"", oed "bo, -. ,.on:Plete in accordance with abovE SPEClflc.'atlons, for the sum Of:. I' i:f{,(.,o {.:;~ ~A'e;;'{.; ~ r,uiJ ;<I. vi t?-L2 + /#Rp-&.lLr_~_ doll", ($ --!ij.L&._) i tlz..-<1~~?LC~ j,L_:M~ - -- --------- - -------11 :;;::';~::~,:;',~":;::,;~ ";,:,;,i::';~ .:; :,~:: :; ::;::,7::;;:~'".::,::~;;:~:::'-- AO~:'::- -?/:;F/, - - -..- . - i) ~ /fl- . . -- -- .]1 tions involving extra costs will be executed only upon written orders. and will become an Slgnat'~re -.---f~-..-L..-~.___.t!~~.__. ----- _. I extra charge over and above the esti,mate. An ag.reements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire. . torn~do and other rl€CeSsary lrI$urance Note Th!s pro~)o~a; may be /./" kJ jl ::::~: "~~:::~:'.":':: :::::"::,"" ''"'''''',:"'~''"':." ", -"::' "0', ""eo,,~ ;:_:~::__=~-::~::_~"=:~ and conditions are satisfactory and are hereby accepted, You are autnorrzed Signature -~~- .- - - ~- --- - -. -- -11 ::.:0 o:h:::::,~'''''" ?me .,," b, m ",,""","'" 'hO'~_ .= s"""o,,_==_~_ ~::.: === ._==~::.) ;~':~/~'~~:~r{":";.ft~'t';:~:~'7'7.'.:.~1;~.~~~,..:",~~.",~..;;:'::.;.-;;~:",;, l'rnpOllal u. PROPOSAL SUBMITTED TO M rR~/CKJ>r::S- -!:f _ )2S-2. CITY, STAT AND ZIP CODE L A/it':'; .?r1~P /c:- ARC:: _ / ~E OF ~Ve bereby submit specifications and eSlimates ~cr' -;e/J /? ~COJc~ .5' ~//I/? c. ~5 ., J- r1.// // 100/ ! V w/ /'# ,;2u /~, .;-. -e.::. /- .--...,,' .7- --. c ? , ,.. ,0 ~(.:-,( C c A 55 NCt-v tJ /liiL7 J 7;fJ? { r.::.4 C v" e TA/?jX/ 7C 6;/~ ;};t> / "v ;C~;;Jt: c ;j eN /'5 S c:- e:>vf5 / /J /J A ~,( ,t ~.L.J ,. KE~}/;c~ (/V", //,/ /~(..;J C'. .7./-f c: JJ/f?;7 1/,( II 727 /5' <:E" t- / fi./. ,,~ /}cc.- /' .. /") tf- CE:iL/ 11 A!/ fLeA- J jl .~o~ t:t7/7 /G// tI 'l LI1 0//1 t</~cLJ 8()/l,t>p f}tJ)/b fb "06 k>e /9r co..) ;: ------=--~-- - --------