HomeMy WebLinkAbout94-4516
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit N~
4516lS
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CBUIL~~
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G:E~:
Date 1;2 - 6 -.7 Y
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Pmp,rtyOw"" y~ // -f~
Job Address: J J----S.-y t; - - t:2..t.~
Parcell.D. # //-:J6- C:V-cJCJ/O - /6900 - OCJSO
Water Meter:
T.I.F.'s:
Zoning: Energy Code: Radon Gas:
Description of Work A/~ A"/ /1 .."L, ~ A1 4- A T# JPlcz-<! L4-LO
NO OCCUPANCY BEFORE C,O,
FINAL
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
C,O.
Permit Fee
Signature
Company
Address
Telephone#
Valuation or
Contract Price J c-""ZJ. c/-i)
~J>W
City License Registration # r2 9'0
State Certified License#
~-;;:;f bJ,,~~- r ~ .7!I
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Ftr.
Pre SLB
Lintel
FRM.
InsuJ. CL
WL
Tp, Servo
Rough In
Meter Can
Const, Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts InsJ.
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 ZEPHYRHILLS
BUILDING DEPARTMENT
7-11 *!(,5-_~-S
:-\ X- _r;- 'i ~ '--~- -\-l s::-f-
~<.: A- (V'- t
I (--d (P - d. , .- CD (7:;) I (0 CJ (:) CJ 0 0 ~u
LEGAL DESCRIPTION: LOT(S) / BLOCK SUBDIVISION
rJ-
PHONE
~ 1:.)- {Of ~
OWNER'S NAKE
OWNER'S ADDRESS
JOB ADDRESS
PARCEL I. D.'
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction ~itiOn --...Alteration ---Repair _Install
~gn ---"ove _Deaolish
PROPOSED USE: Z Faally ---"IF _' of Units -1I/H
ec-ercial _Indust. _Swia. Pool _Other
---Restaurant & Health Depar~ent Approval
DESCRIPTION OF WORK: W ~ l' (f> f 7 f"^'- S " S~) + 1\ 'T f'v'-
BUILDING SIZE: -SlL-x G .~ Square Feet, I ~ 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
~CTRICAL
$ -3 cTZ)
/J(1
'---0
Valuation of Total Construction
AtIP Service
Florida Power Corp.
W.R.E.C.
----"ECllAlllCAL
$
Valuation of Mechanical Installation
_PLUKBING GAS ROOFING
SPECIALTY
TYPE OF CONSTRUcnON: _Block _Fr_e _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
CONTRACTOR SECTION
BUILDER
COMPANY
State Cert. or Resist. .
City License Registration .
***********........***********************
~~ ~~ ~~I~,f
. .. State Cert. or egist.' l?C 000
City License Registration .
**** *********************************
Signature
:=~;11 JJA
,
/Cf'l~
PLUKBER
COMPANY
State Cert. or Resist. .
City License Registration t
******************************************
Signature
IlECHANICAL
COMPANY
State Cert. or Resist. .
City License Registration .
*****************.****.*******************
Signature
OTRRR
COMPANY
State Cert. or Regist. .
City License Registration .
****~**********************************
Signature
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit aay be subject to 'deed restrictions' Ibieb laY be lOre restrictive than City
regulations. !be undersigned assBles responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas bired a contractor or contractors to undertake work, they aay be required to be licensed in accordance lith
state and local requlations. If the contractor is not licensed as required by law, both the owner and contractor .y be
cited for a lisdeleanor violation under state lal. If the owner or intended contractor are uncertain as to Ibat licensing
reguiretents lay apply for the intended work, they are advised to contact tbe City of Zepbyrbills Building Departlent, (813)
788-6611.
FurtherlOre, if the OlDer bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
IContractor Sections' of this application for wbicb they lill be responsible. If you, as the owner sign as the contractor,
you are indicating that you, rather tban the contractor, are responsible for the work. If the contractor wisbes you to sign
as contractor that .y 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, bave been provided with a copy of 'Florida's COnstruction Lien Law - ROJeOIIIler's Protection
Guide" prepared by the Florida DepartJent of Agriculture and ConsUJeI Affairs. If the applicant is SOJeODe other than the
lowner", I certify that I bave obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
"01fl1er" prior to COIIII8DCetellt.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work will be done in cQIPliance lith all
applicable lals requlating 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 cOlleDced prior to issuance of a perlit and that all wort will be perfoIJed to leet standards of all laws
regulating construction, City codes, loning regulations, and land developl!Rt requlations in the jurisdiction. I also
certify that I understand that the regulations of other govelDleDtal agencies laY apply to the intended IOrt, and that it is
IY responsibility to identify wbat actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
t DepartJent of EnviroDJeDtal Regulation - Cypress Baybeads, Wetland Areas and BnviroDJeDtally Sensitive Lands,
Water/Wastewater Treatlent
t Southwest Florida Water HanageJeDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
t ArlY Corps of Engineers - Seawalls, Docks, lavigable Waterways
t DepartJent of Health , Rebabilitative Services, EnvirODlental Health Unit - Wells, Wastewater Treatlent, Septic !ants
t US EnvirODJeDtal Protection Agency - Asbestos abatelent
I also certify that, if fill aaterial is to be used in Flood Zone IAI or IA,etc.l, it is understood that a drainage plan
addressing a 'cOJpenSating volDle" will be sublitted wbich 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 frUl,thereafter
requiring a correction of errors in plans, construction, or violations of any code. Bvery perlit issued shall becoIe iovalid
unless the work authorized by such perlit is COll8Dced within sillOoths of issuance, or if work autborilecI by the penit is
suspended or abandoned for a period of sillOntbs after the tile the work is co.encecI. One 90 day l!Itension of tile, ., be
allowed for the perlit with fee charge of $15.00. Tbe extension shall be requested in Iriting to the Building Official. An
approved inspection lUSt be logged during eaeb silaonth period, or the project lill be considered abandoned.
WARIING TO OWIER: YOUR FAILURE TO RECORD A IOT[CE OF COIlHDCKHBIft' MAY RlSULt' [I YOUR PAYIIG D[CE FOR IHPROiBIIDTS TO YOUR
PROPERTY. IF YOU Ilft'BIID TO OBTAIH FIHAIICIHG, COIISULT WITH YOUR LBJIDIR OR All AnoRIEY BEFORI RICORDIH' DICE OF
COHHENCEHBIft'. JOBS UIDBR $2,500 II VALUB DO lOT NBBD TO RlCORD AJID POST A "IOT[CB OF "
M 1-1 j I . ,/ tI
S[GjATURB: <*IBR OR AGBIft' SI AT B: COIft'RACTOR
STATB OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
before me this , 19____ by
STATE OF FLOR[DA
COUlft'Y OF
The foregoing instrument was acknowledged
before me this , 19_____ by
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
who is personally known to me or who has
produced
as identification and who did/did not
take an o~th.
(Signature)
(Name Typed, Printed or Stamped)
NOTARY.PUBLIC
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
AUG 10 '94 11: 34AI1 Zn1MERMAN SIGI'l CO
. " .P, 2/6
~
ZIMMIRMAN SIGN .COMPANY
IS EAST INDUSTRIAL OR.
P,O. BOX 4397
LONGVIEW, TX 75606
903.757-8084 FAX 903.236-4913
SUBCONTRACT
AGREEMENT
'-
(:\\~
SUBCONTRACTOR:
SPIRIT ELECTRIC OF CENTRAL FLORIDA. INC.
.Mark NOQpert
3804 aohn Young Parkway. n A
ORLANDO, FL 32804 .,
Contract /I 4862
Project /I EDS
LOCATION:
100 7ME1even ~to~~~ in thA T~mp~ area
See Att'achm~nt "A" fnro !o:tor~ 1; d; J
including ~tpr~ nlJmh~r!o: ~ add~esses
You arc to perform work as follows:
xx Survey XX Permit xx Install
Service )( v Photos Required
0...
SCOPE OF WORK:
SURVEYS:
PERMITS: (si.gn)
ELECTRICAL PERMITS ONLY AS REQUIRED:
INSTALLS: Interior
Exterior
ELECTRICAL BEYOND II:
Cohduit per running foot
includes other materials that might be
Each.
Each
Each
Each
Each
Hourly
per fOQt
necessary
$40~.OO
$80...00
$ao~.oo
$50~,OO
$80~.OO
$45~OO
$,1.25.
, SEE ATTACHMENTS "'AII l1ocation list) & liB" (other conditions)
CONDITIONS OF THIS CONTRACT:
A, No extra, wUl be allowed without prior authorization' by Zimmennan Sian Company,
Installation Manaser.
B, A copy of your tnaurance Certificate naming Zimmerman Sign Company as certificate
holder mUlt be on file at Zimmerman Sign Company,
C. Completion Porm must be attached to involoe when work completed, slaned by the customer
and "ubcontractor, with (2) two let. of photos of the cgmpleted Job. Forward to the
attention of Installation Manager, .
0, Mall copy of permit to Zimmerman Sian Company, Lonaview, Texas.
g, It I. under.tood and .sreed that any and all original desi,ans submitted by Zimmerman
Sign Company, i. the lolc property of Zimmerman Sign Company, and may not be reproduced
In any manner whole or pan, without the eltpre.. consent of Zimmerman Sign Company,
F. All material II guarantocd to be at specified by Zimmerman Sign Company Design Number
, All work to be completed in a workmanlike manner, Any alteration or deviations
from specifications wlll be executed by a written order by Zimmennan Sign Company,
S~IRIT ~I ~tTRIC?MARk NnpPFRT
Subcontractor
By:
ZIMMERMAN SION COMPANY
B)': ~ ~~i~ISSY T1BBITS
~..~;
Title:
Date:
~'. 0..'
Title: NATTObl4L" CO-ORDINl1TQ~
Date: A'lgllst 10. 19PQ
....;....-:..~.,
Slsl;lt and return acceptance cop'v.
';-lJ
. ~~~~ ~L
.;..."..., . "'-'''AU~-11l4. '94 "'134: [[PM -iiMMERMAN SIGN CO p, 4/4 ."~
~llRMAN SIGN COMPANY "CONVENIENCE STORE" SURVEY FORM ~~
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Representative:
Date: g- / cy C;
f
Store Address: r<& ~ L( 4, ~ -I- ~
Sf k S'4
7/eleven Store #:
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A: ;:)-:-=s
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~ity
Cross Street Name:
,.,.,
~te: DimensionaDy locate below any wall items (i.e., phones, water &. ice machines), etc,.) on tne drawing
.mow. Also ""'"" ~ MAIN S'tRl':ET TRAFFIc in relation to the &ont or the Store. Ji..
u th~ front interior of'tb. .tore, describe the ceJling receptaole locations: #~J ()
~ote the existing total 711i.L2VBN sign sqJare footage: (Count ODe side of any :1 si ed sign" circle # or Faces)
:tore Front: "y r'8' ':)fu Sid. WaUs('s): .
Jarkini lot: Pole 1/ 2 :l2ZJ ( .., - \ \ nument 1 / 2 7 x I
DMp CelUng~;J'NO Walk-In-Box - Le*,~~lght
lddiliOllal Commenta: A ~
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Building Face WO~~Plaster
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ATM Siin location most visible to the Customer's view (traffic)circle Left I Right:
cation - below the Correct window panel with a (CR):
:1diJ:a~ the reco'mme
,dicate the cash registe
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7hen a Plot Plan hu l!.21 been provided: Dr",.. a Simple Plot Plan on bAck or ,he Survey Fonn! Indicate the
li1ding location. Property LineJ. and secondary frontages i.e. parking lot or street - Show Dimensions. Show
~inB sisnage on either Plot Plan.
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SILCOX ENGINEERING, INC,
Post Office Box 8574
TAMPA, FLORIDA 33674-8574
(813) 238-9755
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LIMITED POWER OF ATTORNEY
DATE
I hereby name and appoint Mark Noppert of Spirit EI~ctric to be
the lawful attorney to act for and apply to
for an ATM sign
permit fo~ work to be performed at a location
'.'"
described as (see Attached_List).
section
Township
Range
Lot
""
Block
Township
(Address of Site)
The Southland Corporation, 1300 Lee Road, Orlando, Fl 32810
(Owner/Agont of Property and Address)
and to sign my name and do all things necessary to this
appointment.
Sandra Shaver
(Type or Print Name of Property Owner/Agent)
cz:(~ .~
(S1gnature of roperty Owner/Agent)
= = = = = = = = = = = = = = = = = = = =.= = = = = = = = = = = = =
Acknowledged:
Sworn to and subscribed before me this /~ day of
~ A.D. 19 U.
I personally know Sandra s~ver.
(Seal) .~~d-da;tc1L-?~)~~~
tary PubI1~, State 0 Flor1da
~~,
*Jf/*
~"f\.'"
CHARLOTTe H WASMUND
Uy Con..........~
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166 ,5 ~
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Lots 8, 9 & 10, Block 169 of the map or plat of
Zephyrhi I Is, in Sect. I I, Township 26 South, Range 2/
East, Pasco County, Florida.
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