HomeMy WebLinkAbout94-4343
BUILDING PERMIT
Permit N'~
CiTY OF ZEPHYRHILLS
(813) 788-6611
_ 434313
7-df--~'t'
Date
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Pcoperty Owne~ ~ ~T(
Job Address:0') tJ. , ,.if-
Parcell.D. # 3 -fJ6 -;;;/-0 13 - OoOCJCJ
Water Conn:
Water MJl!er:
T,I.F.'s:
- /)'77-
,
Zoning: ~ !i..nergy Code:
Description of Work ~~
4J.y
Radon Gas:
FINAL
1f)-~tJ'
,
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.
JPe Y.3o:l..IJ Inspector
DATE
City License Registration #
State Certified License#
'/'1
Permit Fee ~-: ~
Signature~ J1 fi'd/iPk
Company
Address
Telephone#
Valuation or
Contract Price
d.~. cri)
.J
ELECTRICAL
PLUMBING
MECHANICAL
::: s?~-5~ft~
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
J1J ... Cf I 2,t \.-
Driveway 'V --;:.. {'1 /l
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 Z.EPIIYKHIUS
BUILDING DEPARI'fIENT
qftLu/;L 9?irlf
gy
OWNER · S lWtE E f) (;J I/- JZ. D :r A- L \I I S
PHONE
OWNER' S . ADD:RESS
mBADDUSS 3770~ ~~Oa
LEGAL DESCRIPI'lON: LOT(S) ,Of #-
PARCEL LD.' '3 - Uo..- 7-1 -- 0 I~O - OOJ.DD '- 07 q, 0
BLOCK
SUBDIVISION ..
... t
WORK PROPOSED:_Nev Construction _Addition _Alteration _Repair ~ Install
_Sign
_Hove
_D~lish
PROPOSED USE:
Single Fa.ily
_H/F
_' of Units
_H/H
_ec-ercia1
_Indust.
_Swia. Pool
Other
_Restaurant. & Bea1th Departllent Approval
BUILDING SIZE: S~/Z. X Sf Tt.
~e Feet.
Height
RESlDEN1'I.AL :
COtVIERClAL :
ATI'ACH (2) PLOT PLAIlS & (2) SETS OF BUILDING PLANS & (1) SET ERERGY FORKS.
AtTACH (3) SILTS OF BUILDING PLANS & (1) SET ENERGY FORIIS. .
PROPERTY SURVEY REQUllUID FOR AU. JOl.W OONSTRUC'l'ION. (O(L(/t,IZT~ SU5.>
r: t1- {JR.l Vii lUft Y
LJT{c(r"l. /Z~
Valuation of Total Construction
PERHITS B.mUESTED
_BUILDING
$
?(X)O .00
_ELECTRICAL
AIIP Service
Florida Power Corp.
W.R.E.G.
_MECHANICAL
$
Valuation of Hechanical Installation
_PLtJHBUIG
GAS
ROOFIIIG
SPECIALTY
TYPE OF OONSTRUC'l'IOIi: _B1oclt _Fra.e _Steel (bN::!/2R:!C.-
Other
FINISHED FLOOR ELEVATIONS:
FI' .
IS PROJECI' IN FLOOD ZONE AREA?
YES NO
******************************************
BUILDER
Signature ~ 't1dok
CONTRACI'OR SECITON
cotIPAllYP\-\ ff\~r\\U ct-Q.em{":'(\-\- \~.
State Cert. or Regist. , \
City License Registration , ~
******************************************
F.T.F.CTRICIAli
COHPANY
State Cert. or Regist. ,
City License Registration ,
******************************************
Siml#lture
PLtJHBER
COtIPAIY
State Cert. or Regist. ,
City License Registration ,
******************************************
Signature
MECHANICAL
COtIPANY
State Cert. or Regist. ,
City License Registration ,
******************************************
Signature
arRF.R ,
COHPANY
State Cert. or Regist. ,
City License Registration ,
******************************************
Signature
APPLICATION APPROVED BY
riR&tTOFf'IcEk .
CONDITIONS OF PERMIT AFFIDAVIT
A. 'NOTICE OF DEED RESTRICTIONS
'l'be undersigned understands that this penit JaY be subject to .deed restrictions" wbieb Jay be lOre restrictive than City
regulations. !be undersigned assUle& responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas hired a contractor or contractors to undertake work, they JaY be required to be licensed in accordance with
state and local regulations. If the contractor is not licensed as required by law, both the 0IfDeI and contractor JaY be
cited for a lisdl!leanor violation under state lall. If the owner or intended contractor are uncertain as to what licensing
requirl!lellts JaY apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
788-6611.
FurtherlOre, if the owner has 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 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 work. If the contractor wishes you to sign
as contractor that JaY be an indication that be is not properly licensed and is not entitled to perlitting 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, have been provided with a copy of .Florida's Construction Lien Law - JbIeowner's Protection
Guide" prepared by the Florida DepartJent of Agriculture and COnsUIeI Affairs. If the applicant is SOIeOJ1e other than the
-owner", I certify that I have obtained a copy of the above described docuIent and prcmse in good faith to deliver it to the
"owner" prior to C~Cl!l8Jlt.
E. CONTRACTOR'SjOWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work will be done in cDlpliance with all
applicable laws regulating construction, loning, and land developlent.
Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no wort or
installation has CDIeJlced prior to issuance of a perlit and that all IIOrt will be perfofled to leet standards of all laws
regulating construction, City codes, loning regulations, and land develoPl8Dt regulations in the jurisdiction. I also
certify that I understand that the regulations of other goveruenW agencies JaY apply to the intended wort, and that it is
If responsibility to identify what actions I lUSt tate to be in COIpliance. Sueb agencies include bot are not lilited to:
t Departlent of InvirOlllelltal Regulation - Cypress Baybeads, Wetland Areas and Invirolllelltally Sensitive Lands,
Water/lfastewater 'l'reatlent
t Southwest Florida Water Manag8leDt District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t ArlY Corps of Ingineers - Seawalls, Docks, Xavigable Waterways
t Departlent of Health & Rebabilitative Services, InvirODleDtal Health Unit - Ifells, Wastewater 'l'reatlent, Septic 'l'ws
t US InvirODlelltal Protection Agency - Asbestos abat8leDt
I also certify that, if fill Jaterial is to be used in Flood ZOne -A. or NA,etc.., it is understood that a drainage plan
addressing a .cOlpeDSating valOIS. will be sublitted wbieb is prepared by a professional engineer registered in the State of
Florida prior to perlit 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 perlit prevent the Building Official fIOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall beCGle invalid
unless the work authorized by sueb perlit is COBeJlced within sillOnths of issuance, or if wort authoriled by the perlit is
suspended or abandoned for a period of sillODths after the tile the wort is co.enced. One 90 day 81tension of tile, JaY be
allowed for the perlit with fee charge of $15.00. 'l'be 81tension shall be requested in writing to the Building Official. An
approved inspection lUSt be logged during eaeb sil IODth period, or the project will be considered abandoned.
IIAIUlING '1'0 0IfKER: YOUR FAILURI '1'0 RlCORD A 1000ICE OF WIIlDCIIlIIft' MAY RlSULt IN YOUR PAYING rvICE FOR DIPROVIIID'I'S '1'0 YOUR
PROPIR'I'Y. IF YOU III'I'IID '1'0 OB'l'IIX FlIlAlCIIG, COJISUL'I' WI'I'H YOUR LIJIDIR OR D AftORIIY BEFORI RlCORDIXG YOUR XO'I'ICI OF
aJOIIXCEMEI'I'. JOBS DIDO $2,500 IX VALUE 00 XO'I' IUD '1'0 RlCORD DO POS'I' A "IO'I'ICI OF C<>>OlIIfCIMIK'IN.
~/~
SIGlAruRB: (MIIR GII'I'
~l~l~
SI : COIft'RAC'l'OR
~~ O~F FLORIDA PfJ-5co
The foregoing ins~ent was a~~owledged
before me this - :;.e; , 19 ~ by
SOu.J;4ro ~VIS
who is per~lly known to me or who has
produced J..1), _
as identification and who diq~id not)
ta~~oa~ ~ aM)
(S~~1t) IJ, ItSf!EL
(N Typed, Printed or Stamped)
NOTARY PUBLI~RUCE A. A8BEL
Notary Public. SUIte of Florida
My COMm, expirM June 22. 1998
Comm, No. CC 388272
S'I'A'I'I OF FLORIDA P fjS
COUI'I'Y OF ro
The foregoing in~rument was aCkn~ledged
before me this - 2 cJ , 19 q by
.
REG ef E..
who is ersonall kn to me or who has
produced'.. ~
as identification and who did'l id not)
ta~at}.1. ~
~j;JJCEeJ /J, It SI1SL
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
BRUCE A. ASBEL
Note'" Public. SUIte of Ftorid1t
My COInm. expi.... June 22...1.
Comm. No. ec 388272
. ',(l'i;'.l~~ I'"
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Bii_~J~~cfJR~~~~_R~' .
~i~', ~1::.;\f'j: "'1'" :-" ,.',"..t. , . . '., ,'~'.'~..~,' l-,~'~i .~.,.'",,:~...t'.' "j'
mISAdmbhoo.:~de"the ,"::':" ''VJ ,'.,...:dno('.:'~F'dftMKbW_
Nhlete;t(~~!~ :~~}/iJJ€T'f, ~u (L' _' "r andbO~ft'CiLd7 .~.
hereinafter ~ed the ContractDr, and ,Gi)Wftt,O...J A-/tVI ~ ' ' ' .'
Owner,' Wib!e..e~/tbat the ContractDr and the Owner for the conaideraUoDl named alfeO .. foUOws:
:: -:': :~~t:<;.:i',~~~ I?":: ":, ~ . ,-' .'. '~ , ," ,.' I .
ARTI,~ I.: SCOPE OF THE ~ORlC .'.
.. :.., . '. ' .. ,
The Contractor.baU f~lah aU of the materials and, perfonn all of the work mown on the Drawing. and described in the,SpeclficatJotlS
..Ullod< .~~.. ~8) If!!; ~lf:.~1 UflU!y ~"""'.J.MPO :tr<xf . '.
p.epe.red by _~ _ 'AI, _ t3_(f._ _ ~. . . acting u and fuilies~
Contract DocumeDta entitled the chitect, and .han do everything required by this agIeement., the general conditions of the Contract, the
SllCci6cationa:aad tho, Drawing...' " .
.f,'.. J ~ :~, ':' '~,' I.'; , .
ARTICLE sYTJME 'OF COMPLETION
The ~~r~.t:;\b:' ~~ed under this ContraCt .I~n be commenced /l5 ~ /K /'d1eI17/r' i*5 1~1f{)h"A
substllDtiallycomplcted Ltj/TNIN ~N6" ~X
..\
~' . '.
, I". the yetlJ'
'.1 ....
hereinafter CaUed the
...
.qd .hall be
ARTICLE 3. THE CONTRAcr SUM
The Owner shall
fWlds as follows:
r for the perfonnance of the Contract, subject to additions and deductions provided therein. In cune.lt
-JWO tJ tJ v~ _
(Slale here the lump IUJD amoUDt, UDit prices. or both, at desired)
Au~ ~Dtle. Order. will be IUbmitted by the Con~ctor for all work not speciJicaUy Included in this Contract.
AllTIa.E ... 'PROGRESS PAYMENTS
,\
(IDlelt bent any provision made for the amoUD! retaiDed aller the work reaches a certain stage or completion,)
ARTICLE S. ACCEPTANCE AND FINAL PAn-lENT
, DP
Final payment shan be du.. -nl1F <:laY"ttIIr substantial completion of the work provided the worle be then fully completed
and the Conu.ct luDyl performed.
ARTIa.E 6. THE CONTRACI' DOCUMENTS
The General Conditions of the Contract the Speci6cations and the Drawings. together with this Agreement, fonn the Contnlct, and they
&Ie as fuDy a part of tbe Contract as if hereto attached or herein repeated. The following is an Itemi7.ation of other essential pertine..t
information:
,/Jwu !/r ~
aRUCE A. ASall
NMary Public, S\lta of FlOrida
My CcNnm. expir.. June 22. 19G8
Comm. No. CC 38il12
~ ;J.()M
aRuct: A. ASSEl
NOIary Public. State of Florida
My Cotnm. expire, June 22. 1 998
Comm. No, CC 31il72
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