HomeMy WebLinkAbout94-4321
BUILDING PERMIT
Permit N.~
CiTY OF ZEPHYRHILLS
(813) 788-6611
_ 432113
~ -;2-3 -}''f
~o.~ C>2o.c5v ~
CBUIL~INV CELECTRIC9 ~
::~::~,~,:~e~7i f~ 33.~rt: ~
Parcell.D. # '- ? -'c9l:, -;;J../ - LJi.5CJ - LJ-~ CJCJ D
Date
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning: Energy Code: ~ Gas:
Description of workcf)ftl~~ /~ -i'A~- ~A1.e4/l
VA1~~~
NO OCCUPANCY BEFORE C.O.
FINAL
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordar'2'e with City Codes and Ordinances.
Inspector
Permit Fe~~
Signa'ture '--_\ ~ r<\ JJL~
\
Company t
Address
Telephone# ~ fr ~ - /0 ??7
/~~~
c20
PLUMBING ' MECHANICAL
Valuation or
Contract Price ~ tJ?J-o - tJ-C>
~ Jr ,,,^
City License Registration # ~
State Certified License#
~~d~~<~
~A1'",~ // ..t~
,
ELECTRICAL OZtJC::,
Ftr.
Pre SLB
Lintel
~
FRM. '
InSUI.~~ ' ~ J,/
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool ~~ I()-~-q<f tjt-h
Pre-Meter
Final
SLB 9:z..\o ~ ct 4 . -B Jr
Tub Set \
Water
Sewer
Final /)..-i~4.'f i61"\..
Breakers
Ducts Insl.
Compressor
Final
Driveway
~ ~..t..lD-q4S~
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.001 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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H;metown Pools. Inc.
3700& Price Dr.
Zephyrhills. FL 33541
813-782-7077
;TANOARO RESIOENTIAL
IMMING POOL CONTRACT
iFI, TAMFA SAY CHA?'icr;
This contract made as ot I"e date ot wnnen accegtance by the member builder listed aDove
hereinatter termed -Contractor'" and I". party named below, heretnatter termed -Purcnaser:'"
P\JRCHASErl
ROBERT HElM JR.
Ph. HOM~
MAILING AOORESS
6253
HUNTINGTON
DR.
Ph. BUS
ZEPHYRHILLS
ZIP
ContraCfOr a~ 10 COftstrvCf a SWlmmino pool.ncs acoun_nces 1~e1D.~ "",einafter cwovlded by '''e olaros. soecdicallOns and terms 01 t"e contr:ICf at:
INSTALLATION AOOR'ESS 03 26 21 0150 00000 0134
LEGAL DESC.
r.nS'T'OM
90
MAX WIDTH
I" DI:r:TH. 3
1 I:)
ft. to
fff MAX LENGTH'
6
30
Ilf WATEl=4 AREA 450
It. illS?! TYpe: A
sIt
POOL SHAP~
.
P:MIMETE~
It. to
1 1. Und_aler Iic;nll""
t 2. MaIn drai" 1
t 3.. Dee" ~XXXXXX~6rY~XXXXXXXX
, <4. Oedl ~inaoe XXXXXXXX y
~
! 5. l.aClder/GtaDrad~ vvvvvvvvvv
1-12v-100 w
21. Timer 4-1
22- Tes. kit 4-1
23. VactJI./m neat! 1 Vact. hose 1
24. Brusn 1 t..eat net 1
25. AdiusIaole gale
2~. Sla~cnemlcal"
I.' :XC1tSS 11I1 own e r
:. Fill.r Svst.'" de - 6 5
to Pumo I molor 1 ho
I. Method of cnlonnalior1'. r 1
i. Surlace skimmer
i. !ackwasn disocS8' Y Q Q
, 6. SleoslHandraol
t 1. OiVl"9 6d.. <1 s:a"tl
Pit.onolintet" !":rn 4() r"lTr
7:-e:.::.~ j..~XXXXX
Til. 6 X 6 Color. .
InlenOl' ti",,, mar c i t p
10. ::..0.
27. Heater yyyy~--yyyx
;;:;;. ':'..:~::;.:::; :le~"~~ S t UJ;!_
19. ~n'ilever/coCl"9ltile .... i 19
20. Electnc::li hoolcW (-. n n t G~
29. t..o..e seatxXXXX
:30. Swinoout 1
Bench 3 ft
2dlllonaJ Provision"
TERMS
,tess Soe<:1alty agreed and set Ion" herein. Purenaser hereunder ao~ 10 rnaAe Ol'ogresa aaymenlS based on .he lotal once sel lorr" in lItis contract. to I".
,ntrac:tor. as lollows:
CONTRACT PRICE ~ 7 R () () () () S
10.. Cown peymen'
so... ....",." rouo" snell is in glace
35' ....",." C1lumbing IS como'-I-'
5' Wh.", 0001 is comOI.,ed. r.acy for intenor fln.sn
ConSlr\JCflon orC)Qress may De arrested tletwe.n otllinq and recelOI 01 cay."enl lor eaeft chase ot c:onst",Cllon.
NOTICE TO PURCHASER
00 NOT SIGN n-4IS CONTRACT BEFORE you READ IT OR IF PERTlNEHT INFORMATION IS MISSING FROM BLANK SPACES.
'S IS a nome solicltalion sale. If YOU dO nol wanl Ihe oooos ors.,."ces contrac:ted for. YeN may cancel IhlS aor.emenl tly maIling a nouc.to lne seller. ThIS nouee must
21C:a1. lhal you 00 nOI want Ihe OOodS and seNlces and muSI be ooslmantlld l:7y mldmont l"e Ihlrd day atler you SIQned Ifte agr.emenl.
.,'. t:D"".~t $".11 b. ".,,'"~ M" (l1'I~,. to '''t! Can".r::a, .."" ~".II b. Itull."d ",~d UIt/~7$ ..t:e.IJ'~d bY'. du/" ..ulft"'t'PfI o";~.rot ,,.~ C.,,..,.r:to, .....,,.,,, I,".." (I."'S 0' ,It~ 0.'.
~fI."f!." rt"trffl ..eow. ,,,. Pu't:".~.r 's Sl9".,urrs. T71. $.,.sm..n ".$"0."11"0"'" 10 O'''f3 ,,,~ CQ,.,,..cra, All ~qrr.,"."'s ""f3 .."."r'tr~"G'n9$ ~,~ CD"'.'''f!d,n ,,,,, CD"".a ,,"f3
.~ FAu'tf':6$~r "."."'$ ,ft., ,It..,. ~'.,..o .9,rr,"'"p",S Dr U"t1ft'J'."~'~f/S o,,,~, ~-t~".rp I~t 10"""" ""s ~tle:J'".'" A~rftt1'."t:~ -3' ,"., ,I'f"t, 0' !''''''S Ctl~".t:t OV ::a"".C:""$ '0
~ r:olft""un,,:.,rfl to tn. Pur-ef't.~., 0" "."s,",n"'9 . COD'r' 01 ""$ ~a"''''~: to ~-~'" $"0"""""9 "cr~~'.nCI 0.: It~s bv ~"" .Cu'r DI.~, dul".utnOftr~fI ""'C" 01 ,,,.
'''''.1:1", ", 0" Cl1,",".nc",,; c""strucrro".
PURCHASE
PURCHASER
Date OWNER
II ourenase~ are husoand and ....l!. botn mUSI slQn. II owner .s dltt.,enllrom ouren.set'. owner muat SIOn.
J~~l-4ASERISl. BY SIGNING ABOVE. .l.CXNOWL::OGi:S ~NO AGREES ro A.Ll. THE TEFlMS .ANO CONDITIONS ON .toLl. PAGES OF THIS ~C;RE=MENT C'VEN
'Ct,;GH SPACE ....IMtTATtONS REOUIRE Tlo1AT SOME .loRE ;:!:lINT;u :N SMAL,-:i=l rv"'~
/
AT~
U8MITT:O 8Y
::CEPTEO BY
-
.. ' . .
--=---=c ::;'=:~~'-
,
LIMITEtl WARRANTY
The ~..~Q "'''''~'1 r.::a ~ ,= 0..... t~...en"'''''''''''' ...............0 to ""'-"'" MCt-..c'lO"""" '''. ~ - 0ftIt p-' .".
CDM__QII'.OO,"'_.,",,_ __,--.."..------ _.___'-'l=-'o_PV"CMASE.~
.oG :w.......-, .... __ ,,. '.... _- ..... ._. 01 011_ .ftCII_ eo.-- at ,... _--= ....JAC"ASE~ ,........0 - - ..-,. 10
c:::)W-~&:-OA accorG"""';.~ ,,,_ QCI-..c- ...., _or_ 0f'04PI"I s....lIOIG1!'W. .......~ ~..e Of "~D..o 8CC-.or.................. "'-'-""'"
"'_ CO-....~ =-~ "'."'rtI.C'lu...... ..~.... e"': C:O....Ts::v.c:-:;a ......,..., ..."..nu 01 o~..."'_.~ aGVI~ ~ 01"'.... (#I .....,...,~
_....___ .--CI ......-e...., 0' -:Ni.c.~-~. ,. '-'CP "..,.. 101\8" ~ ':""'.""'" ~ ..,.... .~c ~__.......~:J1 ...c fI'la"'Utect-.........,........ OPC'II 01......
CluMC:-- QGIIIIftOus fft..t...I:on..... I)- ~..-.:, W'WI e. ..or-..: 01 ....~.: Cll\JI1CMA$C:r!t ..~
~. ~... Slfl.ICt.,:. ,.........~ '2..... . ..- flO, ..... .........., 1M! " AI\._ CIIP"~ .....Ct:t"ty OU'""-..o tfta. ,.....
Th.. .....".., _.. _ _" ono_. OUIC".a_ .... tJI _S 0__ .,,-.
........ .,,=.'ED WARA....!"V "'RIS...a 8'" oPEA..no.. or !TAn I....w IS I.IU:TlD r.: ~"'E OURATIOOo ~ notE o..e ~ wARRANTIES MEJ'EIN
cc,,~","E:D
... ..oa'.'. ...,.",,_' _...an""...; ,,,. __ _",-.0: ..._ IftIa c:on"Cl _.. !lie _.., to Ifte '"""=-' .ftCII., - !lie ..00 a.~ · - ", - - -.
DEFIN!TIONS
n.. _ "1'\1:1,,'. ,..... o:.consfCI.',", '" 'OERFO",M SA T1Sl'ACTOIllII.'" Of'" 'STRU~AALL. Y SOUHC. oa ,_.... ..-",-......-..-..-,.--..-
....car...o" at , "!- 'e 3 ~ r g.r da.. .
POOl. S"'EI.L "" "'?:JL ST",uCTVIlIE . .... canc:''''. __ -.:I'l .___ .... ._ '....,o.o"o..os ,...- 1- - .- DAn '" .- -
~ .0...0"'.'" ....IC!" =-"01'_ .... lunC"'" '00 .....ocr> It ... .,..'0...., s.... De CoOf'lSICI.-.d to ."EAF':'",'" SATlSFACTCA'\. T.
.OeClC "'NO PATIO wc;al(. snail" 0_10 ",_" ..conc:_..lll. .""~....".. - "'_.."-C'I--I...---..'--....--....----
.c: '
"".,1:1'..... "'.IG'."'. _ US"" as '''. -rTC 'HTl:...oa FINISH '!\aU l)e.....0'IVnI ",_._.... ."0_..0 .....-_n _.-.a,. - __.na _II"~_
..." 0..... -"QO'..;.....-.I'l)e ',,," 0' "'.0......,... _.". ",__,. .moun' 01 ott-"'n.-'CO...-,...... ~ ___."__!lIe_ toaurt__.___.
uaon ,ft. ."'0"'" Of c.0W')f "" ... aoo'eoa'. -.aecs
LIMITATIONS
_ ....."'" ....nos '0 _ Den '0 ,... -'. __.... Of _nen_a _ I..lu,. 01 0iMec:t .. ~ D\r ...., ", - -"'CI _....100.01 _c
&I)..... _ d .._.... car.. _ 01 ............, __ftCII. ,morooet _110ft: --: - 01 God: - - - --
"'_%Ift!; 01 _,.. .." "nc:,re"...'" "" _Oft!; _ Ii".... __ hlnvre. or _ _......t.
. SuO..!.UlOOft; __, 01' ~. 01 __ "'"! _"'IIT ..._ _ .__ _D1S D\r - CQIItInctar - ftIIOM - 'M -- or ... Of --
1'1110&" 01' ......... 01 ,,,, DOot 00 eav_' DT u..."""",,.., Den_ -.c:ft .....Ila in ~ 10 01 ,....... Of - -~
w... ,...... ._._ __ or __ wfttCft '"'0" _ 11\. _ or _or.
Cracw.nQ. c:........rw;. gee""9. _,........ .ro:>sOOft. DIm...;. diScOI_ _ ...ninO at _ - tlnI8I'I ~ D\r ... 01 -- --.. 1ft - ~ Of "- --
Suo............ t:I ......... ........n =-- D\r .__ _... _ -=- 01 ...,..... ~ ..,...- - or -"" - .... ...- --
_-no '" ...... tJI _ as . ,...... 01 tfte gr....... Of .- __ or _ out._ lorc.a .._It .". .-.
Ora-no 01.... oaot tor '_If or _,__ __ _ .,_", _- ~rc _tw.
",,-, ....rva. 10 _ftClI' .0"'_" lrom 11'___ Iin_ or i9fttnt"O.
CONDITIONS
n.. -' .",,_._fIt &n8llDeu..cl ill. _.._ ,__m.n... __....,'n = __tn'M.~_OIIIItIy'Meonrr-_IM_-'~
EXCLUSIONS
_ 01 eav--" _..a_.."........,- v...."' If'Offt n_lo,,'" -"_110'" t1_.- _---. -- eIC.._.....", ----....
-,..,..,.
._~~
91'- c:1'I":Iu"9 ,n '''' oecoos _ coelloa __"'..."..... di....... ....,."0. onn_ or 0""" -- .....- -- c:NC:I&inO ...__--0....--
__"'.' PaoI ~I_' _ _""..- D\r lfte N....".. Soa."" POOl ...........
NfV .Iat.... "'_.-.. .'--"'0. rnortteoo 01-..0-- to 1......_11.....",- JlIIlIOI_II..,.... --.. ____..,..-..L8ftaII.......--NDlSU--
_..... Of _ _SIte ~ ".. c-trw:c0l. .
____1_1"-
o-roo. __'_. _..._. ......"0. ~_...... _..no. -''''0 .. '-'''9 ", _ _ - _dO - AF'TEI" 'f1olE POOL IS ~ WITH """TEA - -""
_._ 1>>0..... _ _ De ~.. OiMacI_ _"_0 01___ _ - PDft"'- c:onar-.
Ct.AIM PROCEDURE
__ _...."...._............'" ..........., t1..._Contncl." an.. ~nortf\c:a.__ ~.... Purc:__ _. ",-. ~__.._eo.-or. -"/'..............-
lie _ WI '"'"''''0 .... _ 00 _.., '0 .... c-..-, .".,..,._ _ 01 __ - ., ".. '- 01 '"- 1 '" .,..---=t.
BY-
PURCHASER
SIGNATURE OF CONTRACTOR
OR CONTRACTOR'S AGENT
PURCHASER
to ~s3 H\v-r'\-\-\ r)C -'-Of) ~.
07/28/94 ' 15: 18 ~ tt813 963 2616
~6be.T-i \\f'=' "'"
PREMIERE ENG.INC
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III 002
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-=- BOUN,oARY .sUI'rVIZ"V -=-
LEGAL DESCRiPTION: Lot ,g4, SILVfR OAKS PHASE ONE, .. per map O~ ~lat thereoF recorded in
Plat Book 2S, pase 46. of the Public Records of P~sco County, Flo~id4.
SURVE'( NOTES:
, No underground inst411.~ions or improvements haye been located, .~~a~t as noted.
2 I~o in$truments of ~.cord reflecting ....m.nts, rights-of-way and/or cwner.."1ip werl:
'/\.lrnhh,<J this surveyor, flXCapt as ,hown.
3 Unl.,s o'therwise shown :1'I'''.on, no jurisdictional wetland .,.eas 0" othe... phy,;>:.1
l,opograph ; c f..atv...s t-.av.. ba.n 1 cc.t.d.
4, [)imension3 8hown are per Plat a,.d Fi.ld v.,.ifi.d, unl... oth.~wi.. .hown.
5. Bas.d On Flood In8u,...noo Rate Ma.,s communH.y Pan.l No. 120230 0005 OJ dated O.c.mb.... 17,
'1991, the pl"ope,.ty shown h"".on appe.rs to Ii, with1", Zone "X".
6. lS..~ i nOI b...d On t.h. we,t I'" i ght -of .way 111'1e 0' Hunt lngton 0...; ve, wh ~ el'1 b....5
S.lO'26'42"E. '..
CER'rU'!I!:D TO;
Robert Heim; Executive Title of Florl~a, Inc.;
Ea~eecn Home Mortgage, Ine.; & SunState Title Agency, In:.
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PREPAREO FOIII:
ER OAKS REALT'i
.....-
~....... "".,II_RlNG, INCl.
~ CIVIL ENGINEERING
~ LANO SURVEYING
('131"'-739'1
7,Ztii.~
OAT(
N'6.t:55 ~" ~~
QIIDt!R NO, DWN C:K'~
THIS SUAV\!Y HOT V..UO UIfl.I..I_INUD WITH .aN EM.osaBl 5U11VlYOA'S SEAL.
POOL ENCLOSURE ^fFID^VIT
It is lJndP.rstood. and agreed thllt the OWNER will comply with the following regulntJ.olls
concnrnin~ pool enclosure:
l. That immediately upon completion of pool construction. tho OWNER shall:
n. Construct around tho pool a four (4) foot high fcnco with self.
closing, self.latching gates with no opcnings largo enou~h to admit
n [our (4) inch sphere;
b. Construct a screen enclosure -around the pool which is permitted by
the Pasco County Central Permitting Division; or
c. In the case of a portable above.ground spa, provide an impenetrable
spa Cover securely fastened over the stfucture when not in use,
2. Thnt one of the enclosures described above will be completed prior to final
inspection of the pool.
3. That the OWNER will require his/her pool contractor and screen enclosure
contractor (if applicable) to call for a finnl inspection immediately Col.
lowing the structure's completion.
I.. If the following conditions arc found on the property, it shall comprise
presumptive evidence that the OWNER is in violation of Section 315 of the
Standard Swimming poor Code and Section 530.4-0 of the Pasco Coullty Land
Development Regulations:
a. Hore than seven (7) days have passed since all work was completed on
the pool structure, except for a final inspection. and:
( 1) ^ fence or poo 1 enclosure as doscr ibed above is not in
place; or
(2) Work to build a fence or pool enclosure as described above
IaMi not commenct1d and is proceeding in good faith; or
b. TIle pool is being used for swimming or bathing- purposes without a
fencH or screen enclosure as describlld abovtL
5.
Thllt II violation of Section 315 of the Standard Swimming Pool Coc.ln or Sec-
tion 530.1.-0' o[ .the Pasco County Land Dovnlopmr!nt Rogulations sh(11l result
in tho issuanc(! of a "Notice of Viollltion" to the OWNeR b}o the Pasco County
Building Official and may result in II fine not to exceed $500.00 [or (!(\ch
day the violation exists.
6.
If the signnture of the OWNER'S ^GENT flppenrs bolow, the ^GENT promises in
good (flith to make the OWNER 8Wl1n~ of the above-described requirr!rnents Illld
pennltics before commencing construction.
'!i",..\\".\"t..., ':.-.;.
SWORN ^ND s~~~r.ne~;ftE.[ORE HE TIllS
s 0/ ....~ ~
RTJ1 .J@v OF *~
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~-? ...... ..;.... ':!,.v.:::::-
, 19.2.'/
C), ,-~
OWNr:J~ DR ^CENT'S
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I'LE^SE TYPE on
YY\.~/1_
S I CNA\UTU:
~,'l~ \.
PTUNt-'N^ME ^IIOV!::
roo 1 : c I~
Notar.y Pub'.ic, State of Florida
DIANNA L. TRZNADEL
My C-'m.IE~. Nov. 11. 1995
Comm. No. CC 159184
7/92
FPC ZEPH HILLS OPS eTR TEL:813-
#E.!~) ~Iorida
M .: Power
~ c............
" :~
S~p 08'94 10:26 No.002 p.Ol
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NAME ~r J./{5/M
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~'POOL PROPOSED FOR CO~'STRUcnON AT iHE ABOVE ADoms DOES NOT
CONFLICf VlITIi ANY UNDERGROUND OR O\IERHEAD FAOUTIES OF FLORIDA
PO\VER CORPORA nON, PROVIDED 11iA T mE POOL [5 lNST ALl .cO fN THE
LOCATION SHOWN ON 111E A TIACHED SITE PLAN PROVIDED TO US BY THE POOL
CQaRACTOR.
.
",,-::-.'..... :'
mE POOL PROPOSED FOR CONS1RUCI10N AT1HE ABOVE ADORES DOES CONFLICf
Wl1H: O~ UNDERGROUND
FACUIlES OF FlORIDA POWER CORPORTAnON.
. p'
ARRANGEMENTS HAVE BEEN MADE WITH US FOR RELOCA nON OFTHEF ACUJTIES
so AS TO CLEAR. lHE POOL AREA SHO\VN ON lHE ATIACHEO SITE PLAN.
"":'''_~#L ~~'-.5-~;~.-'"
~ 00"
CCET FOR. ~J:'J lY'" -AnON OF ELEC'I1UC FACILITIES WIlL BE PAID BY:
OWNEll
I'OCL <XRrRAcroIt
PRIOR 10 Jl]:l (X:.A1I0N Of FACILl1lES AND CONSTRUCIlON OF POOL
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CITY OF ZEPHYRHILLS REGISTRATION CERTIFICATE
5335 EIGHTH STREET
ZEPHYRHILLS, FLORIDA ~1~j~l40
i
Business, Profession or Occupation
ALUMINUM SPECIALTY CONTRACTOR ADMINISTRATIVE FEE $ 20.00
#85
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For the period commencing October 1, 19 ~ . and expiring September 30, 19 ~
,
HAWLEY, REX
REX HAWLEY ALUMINUM
32818 PEACH TREE LANE
ZEPHYRHILLS, FL 33544
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VALID WHEN SIGNED AND RECEIPTED BELOW
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APPLICATION FOR PERMIT
CITY OF ZEPBYRHILLS
BUILDING DEPARTMENT
l .
(l !pU p- ,c;U
,~.~~\ q ~J / (
OWNER'S NAME ~obp\+ We\ I"r) 0\.
OWNER'S ADDRESS (/J~,-"')3
JOB ADDRESS Ze;:;hqrh j / /::>,
LEGAL DESCRIPTION: LOT(S) Ji 3J.j
PARCEL I.D.' ()l~ - ~(k' - ~ J
PHONE
?8~ - 379l~
~ II r--. -\-- \ Y'\. G -\-n 1""\ q-)r-
d2 (j
. 'L . { =1',,=3/'5 L/ J
SUBDIVISION (~i' t )e'_\
0000
()Qks
BLOCK
/)L~O
WORK PROPOSED: _New Construction _Addition _Alteration _Repair - Install
_Sign Move _Demolish
PROPOSED USE: Single Family _M/F _, of Units _M/H
_Co_ercial Indust. Swim. Pool Other
- ----
_Restaurant &: Health Department Approval
BUILDING SIZE:
x_,
Square Feet,
Height
RESIDENTIAL: ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS.**
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. **
**COPY OF CONTRACT REQUIRED.
PERMITS REQUESTED
~
$ ~ c;6C6 Valuation of Total Construction
BUILDING
ELECTRICAL
AMP Service
Florida Power Corp.
_W.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBING GAS ROOFING
TYPE OF CONSTRUCTION: Block _Frame _Steel
SPECIALTY
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
******************************************
YES NO
ELECTRICIAN
BUILDER
Signature "
CONTRACTOR SEC'l'IO~ ~ D " _ ~
COMPANYJJ '''''-A. ,~ \\ ~ ~ <-
State Ce t. or Regist. I C Pc..' ~ ~ 'S" <''-4 )--.
City License Registration, 020
******************************************
COMPANY ~A--/A~/?~
State Cert. or Regist.' 00 lob;' 7
City License Registration I ;; 9
******************************************
PLUMBER
COMPANY
State Cert. or Regist. ,
City License Registration I
******************************************
Signature
MECHANICAL
COMPANY
State Cert. or Regist. ,
City License Registration #
******************************************
Signature
MBER ~
Signat /<? /
APPLICATION APPROVED BY
COMPANY ~)1;;. #U~fi-'~
State Ce'rt. or Regist. ., RX: ~~
City License Registration,
******************************************
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
!be undersigned understands that this penit JaY be subject to 'deed restrictions' Ibieb JaY be lOre restrictive than City
regulations. !he undersigned assUlleS responsibility for co.p1iance lith any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the OlDer bas bired a contractor or contractors to undertake work, they lilY be required to be licensed in accordance lith
state and local regulatiOJl8. If the contractor is not licensed as required by law, both the owner and contractor lily be
cited for a lisdeleaJlor violation under state lal. If the owner or intended contractor are uncertain as to "bat licensing
requireleDts lilY apply for the intended work, they are advised to contact the City of Zepbyrhills Building DepartJent, (813)
788-6611.
FurtherlOre, if the OlDer has bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
IContractor Sections' of this application for Ibieb they lill be responsible. If, you, as the OlDer sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the wort. If the contractor "ishes you to sign
as contractor that lilY be an indication that he is not properly licensed and is not entitled to penitting privileges in the
City of Zepbyrhills.
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 - BcIIeowner's Protection
Guidel prepared by the Florida Departlent of Agriculture and COnsUler Affairs. If the applicant is 8OIeOIle other than the
1000erl, I certify that I have obtained a copy of the above described docuent and prOlise in good faith to deliver it to the
lownerl prior to COIIeDCl!lellt.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the info[l8tion in this application is accurate and that all IOrt lill be done in cOlpliance lith all
applicable laws regulating construction, zoning, and land developleDt.
Application is hereby Jade to obtain a perlit to do lork and installation as incJicated. I certify that no IOrk or
installation bas COIIeDced prior to issuance of a penit and that all work lill be perfol'led to Met st:aDdards 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 goverDlleDtal agencies lilY apply to the intended work, and that it is
If responsibility to identify what actions I lUst take to be in COIpliance. Sueb agencies include but are not lillited to:
* Depart:lent of EnvirollleDtal Regulation - Cypress Baybeacls, Wetland Areas and EnvirollleDtally Sensitive Lands,
Water/Vastewater !reatlent
* Southwest Florida Water ManagelBDt District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
* Ally Corps of Engineers - Seawalls, Docks, lavigable Watenays
* Departlent of Health & Rehabilitative Smices, EnvirODleDtal Health Unit - !fells, Wastewater !reatlent, Septic ranks
* US Envirouental Protection Agency - Asbestos abateleDt
I also certify that, if fill laterial is to be used in Flood Zone 'A' or IA,etc.', it is understood that a drainage plan
addressing a 'COIpeJ1Sating VOlUle' "ill be sublitted Ihieb is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A perlit 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 penit prevent the Building Official frol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every penit issued shall bea.e invalid
unless the wort authorized by sueb perlit is COIIeDced lithin sillOnths of issuance, or if work authoriled by the perlit is
suspended or abandoned for a period of sil IODths after the tile the IOrk is COIIeDced. One 90 day Bltension of tile, lilY be
allowed for the perlit with fee ebarge of $15.00. The Bltension shall be requested in lriting to the Building Official. An
approved inspection lUSt be logged during eaeb sil IOJlth period, or the project lill be considered abandoned.
WARMIHG !O OIlIER: YOUR FAILURE !O RECOlID A IO'I'ICH OF CCJIMDCIIID'f MAY RESUL! IH YOUR PAYIHG 'fIIICH FOR DIPROVIIlIIIS TO YOOR
PROPmY. IF YOU IJImD TO OB'fIIJl FIIIAICIIG, COISUL! WI'fH' YOUR LEIDER OR D AftORDY BBFORE RICORDIKG YOOR KOrICH OF
COMMEJICEMEI'f. JOBS ORDER $2,500 II VALUE 00 10'1' IBID TO RECORD AJID POS! A 'IO'I'ICE OF ClItMDCEMEKTI.
,
S!A OF F~DA
coum OF ~S00
The foregoing in~ent was acknowledged
before me this .~ , 19~ by
~';~~'T4 \-\e\~ ~r.
who is pers~llY known to me 0 who has
produced:t "'"
as identification and who di did not
t~ oath. ~
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(S).gnature) -
CX-)h,~-\-\P \- rY\~)-
(Name Typed, Printed or Stamp
NOTARY PUBLIC
S!A!E OF FL~
coum OF \---Q '2:.C_ 0
The foregoing inJJtrument was ackJ;lowledged
before me this ~~trj-~~ , 19~ by
-=--rohn L. rtli \ b
who is personally known to m~ or who has
produced ~(q
as identification and who did/did not
;~'~~'~
,~{)--n. ().// Qf
(Name Typed, Printed or St~ed)
NOTARY PUBLIC C ct:tro>J,'3l:::...;)..~
t~~~~t;2i~f~::'1
Notary Public, State of Florida
My Commi$Sicn Expires Feb. 22, 1995
BOnded Thru Troy Fain. Insurance ,;,w;.
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SOUTHERN BUILDING CODE CONGRESS
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fll' WET INSTITUTE
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1. POOL~ c; lJ...5 / r:::.... __I'. NO. .tL10
2. SIZE -I ~ X ~ 0 'lIr OII'THS 3 TO (..0
2. 'TILI ~ '}..l,4 flU'
4. DECKING'- COlO" -
L IWHDDECK --. LDtQllf, ._'-,- HEIGHT
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1. 'u.n.. n'PI-O (::- ~1t1. FT. L. 5' .
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\0. LIGHT SWlTOt AT:
11. DIVtHG ----
12. IKJUME"
11 INLET FmlHGS - (( <<::r.::::
14. MAIN DWN (j AI '€.
'I. THEftN'Y.ETS -
lL IUOt -- A -.zI
17. 'LOATJHG SWUP. ,<:;,,/r7k TYPE ----
11. 04lO'UNATOft (1_1- -?,t,)U TYPI
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22. EHa.OStO"A --
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21. UHDUWATEA Viti:
21. nblT NO.
21. C.AHD't 1.0. NO.
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