HomeMy WebLinkAbout94-4555
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit ~
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Property Owner: 'I" ~
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Parcell.D. # / / -.:.1 b 'd.-/- A) J- L~ If -.)0 -::l/~ ~:J-
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Date /eJ -/5--7'1
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Water Mejer:
T.I.F.'s:
Zoning:
Description of Work
/) Energy Code: .' Radon G:&--<."k _
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NO OCCUPANCY BEFORE C.O.
FINAL 2-)-q~
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Permit Fee
Signature
Company
Address
Telephone#
Inspector
Valuation or
Contract Price >: ~ I 0--{)
City License Registration # ,y,3 y
State Certified License#
BUILDING
~;..t~ CY!u~
ELECTRICAL ;l6 '/'
PLUMBING
MECHANICAL
/J1 r ij -L~ /J-L..-'}'Uc,...u y' Cr) .
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Tp. Serv.
Rough In id -d:J-'1q..fnf,..
Meter Can
Const. Pole
Pool
Pre-Meter
Final '2-7-'1'5' ~'yu
SLB
Tub Set
Water
Sewer
Final
Ftr.
Pre SLB
Lintel
FRM. p;.~.lf....,.f3t ~
Insul. CL
WL r t>../
Y\~\A;
Driveway "V '1 0,0/
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 ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
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APPLICATIOR FOR PERMIT
CITY OF ZEPBYRHILLS
BUILDIRG DEPARTHERT
OWNER'S RAME h, JJePd t. a~.I9N (.
OWRER'S ADDRESS 6Jf~1 04-~-<- 13:>.
.Q7t2/ C;.-9~L S, &P~'/~4I'LL-G,.,c-L--'
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LEGAL DESCRIPTIOR: LOT(S) BLOCK SUBDIVISIOR
PARCEL 1.D.# /1- ;;If:, - ;L/ V?:l- /'1-::2tJ -d/'-.;)~ /:J /70BTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:__ew Construction ----^ddition ./ Alteration ____epair _Install
IY) ,D . PHONE
Zept<lu.#{l-~~
71' J? - rs- c:2 </
JOB ADDRESS
_Sign
-.JIove
->>eaGlish
pmPOSED~E: _S~eF_ily
~erCial
---l4/F _# of Units _K/H
_Indust. _Swia. Pool _Other
____estaurant &: Health Departaent Approval
DESCRIPTIOR OF WORK: ]?.eY~'.4~ a-rf-rr~1"J < > ..$tVo/l &C!.-T
,
BUILDIRG SIZE:
x
Square Feet,
Height
RESIDEBTIAL: A'n'ACH (2) PLOT PLANS &: (2) SETS OF BUILDIRG PLANS &: (1) SET ENERGY FORMS.
COMMERCIAL: A'n'ACH (3) SETS OF BUILDIRG PLANS &: (1) SET ERERGY FORKS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
~UILDIRG
~ ELECTRICAL
PERMITS REOUESTED
. "0
$ f 500 - Valuation of Total Construction
#~'1-c:Nti1iJ'~/6r /(91175,.,.4J>. ~ ,(kep,
Service Florida Power Corp.
W.R.E.C.
---llECIIAlIICAL
$
Valuation of tlechanical Installation
_PLUKBIRG GAS ROOFING
TYPE OF CORSTRUCTIOR: _Block _Fraae _Steel
SPECIALTY '
Other
FlIJISBED FLOOR ELEVAnORS:
Fl.
IS PROJECT IR FLOOD ZONE AREA?
YES NO
..........................................
I
CONTRACTOR SECTION
w~ . cm:AIIr $'(]v,~"..JHO' -MDC,..7;;C.
.. State Cert. or Regist. # C oc:...3 '5
Signature~~" City License Registration #
~ ..........................................
BUTI.DRR
r
RT.RCTRICIAII
/{":'
SilmAture' ~ tr-;}o--.,
v
~ COHPARY A ->,1. ~ 'j ~ r. A ~ ~ t7 ~<;r;;, ; f;^ 11 L~ ,-;)
-\ ""'0 J, / State Cert. or Regist. # k /~ ~~D'72 I.. ~
'i!. t 'Av f ~.i....-', City License Registration # _
..........................................
PLUMBER
COtIPARY
State Cert. or Regist. #
City License Registration #
..........................................
Signature
tlECBANICAL
COMPANY
State Cert. or Regist. #
City License Registration #
..........................................
Signature
. m1IBB
COMPARY
State Cert. or Regist. #
City License Registration ,
..........................................
Signature
APPLICAnON APPROVED BY
PERMIT OFFICER.
" .
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
'!'be undersigned understands that this penit lay be subject to 'deed restrictions" wbich IIY be lOre restrictive than City
regulations. 'I'be undersigned assUJe& responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas bired a contractor or contractors to undertue 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 IIY be
cited for a lisdeIeaDor violation under state law. If the OlDer or intended contractor are uncertain as to "bat licensing
requirl!lellts Jay apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
788-6611.
FurtherlOre, if the owner bas bired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the
RContractor Sections I of this application for wbich 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 wisbes you to sign
as contractor that laY be an indication that be 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 with a copy of IFlorida's Construction Lien Law - HOIeOIIDer's Protection
Guide' prepared by the Florida Departlent of Agriculture and CODSuer Affairs. If the applicant is SOleODe other than the
'mmerR, I certify that I have obtained a copy of the above described docUleDt and prOllise in good faith to deliver it to the
I/owner" prior to COlleDC8l8Dt.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infonation in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, loning, and land developleDt.
Application is bereby lade to obtain a penit to do work and installation as indicated. I certify that no work or
installation bas cc.lenced prior to issuance of a penit and that all wort will be perfoIlec1 to leet standards of all laws
regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other governnntal agencies JaY apply to the intended work, and that it is
.y responsibility to identify wbat actions I lUst take to be in cOlpliance. Such agencies include but are not lilited to:
I Departlent of Envirolllel1tal Regulation - Cypress Baybeads, Wetland Areas and EnvirollleDtally Sensitive Lands,
Water/Wastewater 'I'reatlent
I Southwest Florida Water Hanagl!lellt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
I ArlY Corps of Engineers - Seawalls, Docks, lIavigable Watenays
I Departlent of Health & Rehabilitative Services, EnvirOllleDtal Health Unit - Wells, Wastewater Ireatlent, Septic 'fanks
I US Invirouental Protection Agency - Asbestos abateJent
I also certify that, if fill IIterial is to be used in Flood Zone "AI or HA,etc.', it is understood that a drainage plan
addressing a lCOIIpensating volUJeI will be sublitted wbich is prepared by a professional engineer registered in the State of
Florida prior to peIlit issuance. .
A penit issued shall 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 sball issuance of a peIlit prevent the Building Official frOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every penit issued shall bealle invalid
unless the work authoriled by such penit is COIIeDced within six IOnths of issuance, or if work authoriJed by the penit is
suspended or abandoned for a period of six IODths after the tile the work is COIIeDced. One 90 day utension of tile, IIY be
allowed for the penit with fee charge of $15.00. '!'be utension sball be requested in writing to tbe Building Official. An
approved inspection lUSt be logged during each sil IODtb period, or the project will be considered abandoned.
WARMING 'f0 OIlIER: YOUR FAILURE 'f0 RECORD A 10UCE OF <XIIMDCIIIBIIf MAY RESOL'f II YOUR PAYIIG DICE FOR IHPROVIIIDIS 'f0 YOUR
PROPERlY. IF YOU II'fEIfD 'fO OB'fIIH tIWCIIG, COISuL'f WI'I'H toUR DER OR 11 A'f'fORIIY BlFORE RECORDIIG YOUR JIO'IICB OF
COMHEIlCEHEIf'I'. JOBS OlDER $2,500 III VALUE DO 110'1' mD '1'0 RECORD lID POS'I' A 'IIO'1'ICB OF C CEHEIf'I".
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SIGIfA'fURE: OWIIER Q
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COIf'l'RAC'l'OR
S'I'A'I'E OF FLORIDA A
coom OF '/lC/)
The foregoing inst ent was acknowledged
before me th. s . , 19.ff' Py
)
who is personally known to me or who has
produced
as identification and who did/did not
~~th. ~ k
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( gnature) -
iZ~r;'np ;VI, AY'6:vver
. Name Typed, Printed or Stamped)
NOTARY PUBLIC
",UfI,
~~'\ir.~f~ KATHERINE M. BREWER
~*(~~)i MY COMMISSION * CC317615 EXPIRES
~A.~" September 28, 1997
"Il.tif.X:o.'c." IlONOED lMIU TFIDV FAIN INSURANCE,II<<:.
S'I'A'I'E OF FLO~
COUIf'I'Y OF ?O
The foregoing inst~ent was a~~ledged
before me thi~~ ~) , 19 by
Ua'7l1L I)i/ ~ ~LIAuW~ -l
who is pe~nallY knoWn to me ~r who has
produced ~ # !JZ,?:/i"';;)- p~S -~?-86-cJ
as identification and who did/did not
~oath.'?n ~
' W?LR I VII? ./ / Jf?/t --'
( ignature)
~~.rv J1.p f}1. A'('pyye r
Name Typed, Printed or Stamped)
NOTARY PUBLIC
.."",'~I:'"",- lCA1'HERINE M. BREWER
1~l:'I~\ ~ COMMISSION' CC317815 EXPIRES
~{t~ September 26, 11197
~x.....tI SONDEDTHRll'lllOYFAlIlIHSURANCI.II<<:.
',Rr,,~
281 P03 NOU 07 '94 1~:30
McGUINNESS & co. INC.
Mid-Town Clinic
2
';0/3/94
I thank you for the opportunity to quote on this project.
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Sincerely,
~u..:x:.~~~~~.~~",^"
Edward, p'.. M:cGuinness .
President. CG CO~3951
Certified General Contractor
Sinoe , 982
Acoepted by: ~ 1l1A. ~
For: ;t{-.. c:: ~ --t-o v.) IlL ~ \ ':' v'\.. ~ c...
Date: / /- 7 - 9 &.{- ..
. ~
Midtowll ~ P.A.
'821 0aU Blvd.
Zqia)ItUJJt. FL 33$41
. (113) 71~"52.4
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281 P132
NOU 137 '94 15:29
MCGUINNESS & CO. INC.
DESIGN/BUILD GENERAL CONTRACTORS
Mid.Town Clinic
5821 Gall Blvd.
Zephyrh~ls, Florida 3'3541
Attn Mr.; Howard Cloke
, l'
, f
October 3, 1 994 :
Re: Mid- lown Clinic
Zephyrhills, Florida
Dear Mr.! Cloke,
T~is will ~.e.r.ve t6" confirm. our verbal pr.i~a' quo~e '6t .EiQht Thousand
Five Hundred Dollars ($'8S',d.O".'(,O) f'or work described below~.. '
" 1) Pro~ide."a req'uire.d Pasco 'Co~nty Constructio'n Permh
2) tarpen,~ry Work:. ,
a} Drywall "Partitions - Approx.'40 L.F'. of partition to be
constructed to the underside of existing ceilings
b} Instan Three (3) doors to match existing
c) Close in the existing pass-thru window
d} Provide 4" vinyl Cove Base to match existing on new
walls only
e) Remove and modify the front reception window
3) El,ectriqal Work:
: '! a) three :(3) switches
b) S,ix, (S) Receptacles
c) Three (3) 2'X4' lay-in florescent lights (standard)
d) Four (4) Telephone boxes - open box only. wire:and
jacks by others
4) Paintin~: New drywall work shall receive one prime coat and
one finish coat of Glidden II Spred-Ultra" flat latex paint
5) No Fire, Sprinkler Work is included. If retluired, it will be
priced :,se.parately
6) No FIQor 'Covering or Wall Cov.eriligs are: included. Please be
.' ~ : I .' ,
' ~warethat ~hi~, project has been bid per :your specifications.
7) All work shali be performed during normal straight-time '
working hours.
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281 P04
NOU 07 '94 .15:30
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SEC. /I. TW~ '2~ S.. RNG. 2/ E,
PASCO CouNry, FL.aR/OA
C/ry, tt)~ ZEPNYR..H/LLS
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LEGAL OUe'l PHON 'I
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Let, 19. 20, 21 Iftd 22, Block 12, CITY OF. IEPHYRHfLlS. ~
u par plU of the TOliN or IEPHtRH/LLS, thereof ro- . i
Corded in Pllt BeQk 1, Page 54, PUblfc Retards of Pasco
County, F1ar16., It i
ANDJ
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That part of Lots '3.4,5 and 6", B10"k 12, CITY OF'i.'
~i.PHYRHIllS as pe,. plat of the :rQWN OF ZEPHYRHILlS' ,
thereOf recorded tn Plat Book '1 Page 54. PHb11c
Record$ of Pasco County, F10r1di, lying West of
V.s. Hfghwal Nort* 301.
A~D t
Tht East 40.00 feet of Lots 16, 17 and 18, BTock
CITY OF ZEPHYRHILlS, as per plat of the TOWN OF
IEPHYRHILlS as recorded in Pl.t Book " Page 54,
PUb11( ReCOrds of Pasco County, Florida. '
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ZEPHYRHILLS FIRE DEPT
---Cl
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Zephyrhills Florida 33540 (813) 782-8184
FIRE CODE INSPECTION
Business Name 1/ /" /) 7;'//.,/1..-- /' /~dr ' C-'
I
Address ~.,..;, ,. 2 / (-;; /I //
Classification /-;>"-"7/,,</ e;::;;
Business Phone
-...., <) >:- -' ...) _.~)._~) cI
/ ,/ ,/- / .'
Owner/Manager l7.~'/f' /IA;::1' (", '/' /~e , .
/'/j/":-"//" t;.A!. _. .e)(-~'A'{//('",-c'
Emergency Contact Phone 7<? ':;>- /':;-2 '-I
Occupancy Load
Alarm Monitoring Co.
Phone #
TYPE OF INSPECTION CONDUCTED
o QUARTERLY
ORE-INSPECTION
~ APPROVED
~' FINAL 0 ANNUAL
o OTHER
o NOT APPROVED
OBI-ANNUAL
o COMMERCIAL CHECK
Listed below are items which must be complied with before this occupancy can be approved by the Fire
Department.
o CODE VIOLATIONS
This inspection report specifies code violation(s) which if not corrected could cause a fire, contribute to the
spread of fire, or prevent safe egress during a fire. Your immediate attention to the correction of these
violations shall be required, as failure to do so is a violation of the city of Zephyrhills Fire Prevention Code.
..... "
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Inspect. Date
Re-Inspect. Date
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l/ .,. Inspect. Time / ",<,-",/) Fire Dept. ID.#
Inspectors Name..r? / /c.' <, /r-c;, ,-,
I},...", r ,-., ,f C Ot,\(Jc Title
:: ---;,-/
Owner/Manager Signature
This building has been checked by the Zephyrhills Fire Dept. under the codes & regulations of the NFPA minimum
standards, the State Fire Marshall's Uniform Fire Safety rules and other local fire safety codes.
White Copy .. File Yellow Copy .. Bid. Dept. Pink Copy _ Business