HomeMy WebLinkAbout94-4564
BUILDING PERMIT
Permit N~
CITY OF ZEPHYRHILLS
(813) 788-6611
4564 t
Date j ~ -.20-9 Y
Zf; Ol)
,;l (J) .. o-i)
ELECTRICAL
~/J- Oi)
PLUMBING
MECHANICAL
Sewer Conn
BUILDING
Water Conn:
~
Property Owner:
Job Address: Ii ----:;;f-:j~-" j)A-
Parcel 1.0. # .2-~6 - ;;L/ - I;;L- ()
Water Meter:
T.I.F.'s:
Zoning: Energy Code: ~ ~adon Gas:
Description of Work\..JA-"l :J~"'" /. ~ M #~ t?~~L
/ / -
NO OCCUPANCY BEFORE C.O.
FINAL ~!- 7 - )-:-)
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordarce with City Codes and Ordinances.
DATE
Inspector
~u
:~;~~::,:eC\ ~~
Company
Address
Telephone#
Valuation or
Contract Price J J.. J ~" cTL>
City License Registration #
)i~ Licens~
, ,WJ
./
BUILDING
t~o. -4~~
ELECTRICAL ..2.(} 6
_J?~i?r-~
c}..O
PLUMBING
MECHANICAL
FtL 12-lfffi g.U
Pre SLB .... -tfl/ Bl~L-
Lintel
FRM.
Insul. CL
WL
~ ~ 2~ 7- 'i~ DILL
Driveway
Tp. Servo.
Rough In
Meter Can
Const. Pole
Pool ~ 1~'2fCjq t&b
Pre-Meter
Final '2.... )- 0~ S~
SLB l1-:O -Gf~ ~\~
Tub Set
Water
Sewer
Final 2--?~q'J r.jl~
Breakers
Ducts Insl.
Compressor
Final
~ '.)/~:l-q4 ~
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 001100 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.
POOL ENCLOSURE AFFIDAVIT
j)-,
It is understood and agreed that the OWNER will comply with the following regulations
concerning pool enclosure:
1. That immediately upon completion of pool construction~ the OWNER shall:
a. Construct around the pool a four (4) foot high fence with self-
closing, self-latching gates with no openings large enough to admit
a four (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 structure when not in use.
2. That 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 final inspection immediately fol-
lowing the structure's completion.
4. If the following conditions are found on the property. it shall comprise
presumptive evidence that the OWNER is in violation of Section 315 of the
Standard Swimming Pool Code and Section 530.4-0 of the Pasco County Land
Development Regulations:
a. More than seven (7) days have passed since all work was completed on
the pool structure, except for a final inspection, and:
(1) A fence or pool enclosure as described above is not in
place; or
(2) Work to build a fence or pool enclosure as described above
has not commenced and is proceeding in good faith; or
b. The pool is being used for swimming or bathing' purpOSE!S without a
fence or screen enclosure as described above.
5. That a violation of Section 315 of the Standard Swimming Pool Code or Sec-
tion 530.4-0 of the Pasco County Land Development Regulations shall result
in the issuance of a "Notice of Violation" to the OWNER by the Pasco County
Building Official and may result in a fine not to exceed ~i500.00 for each
day the violation exists.
6. If the signature of the OWNER'S AGENT appears below, the AGENT promises in
good faith to make the OWNER aware of the above-described requirements and
penalties before commencing construction.
SWORN AND SUBSCRIBED BEFORE HE TIllS
A ~ . DAY OF [H'M ",be i . 19 "1'1
WA () I j pG..r6t'r1~ !!.I)()lt)/j --) />'lei
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/l,j/7() A-(')77 ~/')OJUAj./L
NotARY PUBLIC :5f1~cY) /. &"bf~
N"ttlry r"J!Jllc, !fa~:'! ~ ~orldlf
Pool: cef.~.,. r "--,-,:,,,"7- F..'. "? "Ion"
'j,'~' ----_',,~aJ;:.,_"L ,-.-,J.. ,JI;__~ '~7~
SIGNATURE
\
r;--{ ~ VY-\. LlL \
PLEASE TYPE OR PRINT NAME ABOVE
Cor::,,:_,j Thrl.l Troy h.n -Insurance ~
7/92
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P.O. BOX 596 - ZEPHYRHILLS. FLORIDA 34283-0596. (813) 782-9080
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APPLICATION FOR PERKIT
CITY OF ZEPHYRBILLS
BUILDING DEPARntENT
OWNER'S NAHE
CAROL M. BROWN
PHONE
OWNER'S ADDRESS 15760 RIVER RUN DR. SPRING LAKE , MI. 49496
JOB ADDRESS
6642 NORTH LAKE DR.
ZEPHYRHILLS
LEGAL DESCIUP'I'ION: LOT(S)
PARCEL I.D.,-2 ..;26 -:LJ - /.::l -C) -
BLOCK
SUBDIVISION SILVER OAKS
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSBD:~ew Construction ---..Addition ----..Alteration ---...Repair ,_Install
_Sign
---'love
-1)eaolish
PROPOSED USE: _SiDgle FaldJ.y
---.J'J./F _' of Units ---.J'J./B
_ec-ercial
_Indust. ..1L.Swia. Pool _Other
-----Restaurant & Bea1.th Departaent Approval
DESCRIPTION OF WORK:
CONCRETE POOL
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL: ArrACK (2) PLOT PLARS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COHKERCIAL: ArrACK (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORHS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERKITS REOUESTED
~UILDING
$. 10,000.00
Valuation of Total Construction
RT.~cnuCAL
AIIP Service
Florida Power Corp.
W.R.E.C.
---1tEaIAIIlCAL
$. 2000.00
Valuation of Kechanical Installation
----..PLUMBIliG
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ___lock _Fraae _Steel
Other
FIlIISHED FJ.OOR ELEVAnOBS:
FT.
IS PROJECT IIi FLOOD ZOBE AREA!
YES NO
..........................................
CONTRACTOR SECTIOB
BlITIllRR
Si_tore -J ~
cotIPABY HOMETOWN POOLS
1"\/1 i ,,^ State Cert. or Regist. 'CPC07"'i"'i47
~ City License Registration' 20
..........................................
COMPANY COMM. SER.
State Cert. or Regist. .
City License Registration .
...................................***.*..
t)b 1:2./<-/1
r::lJl '" '
PLUMBER
Sipa_e ~~
IlECBARICAL /1
COMPANY HOMETOWN PIDOLS INC.
\ State Cert. or Regist. . C.f1<:..<J~~ Y ~
~ City License Registration .
....................*...........*..*.**.**
Siguature
COMPANY HAWLEY ALUM.
State Cert. or Regist.' fiYtJ~::_~tH'/
City License Registration' S~
.................*....*...**.......*..**..
OTRRR
COMPANY
State Cert. or Regist. .
City License Registration .
...............*..*.....*.................
Siguature
APPLXCAUOH APPIIlIVBD BY J1,. -;>UA 0, lJJ {h'-~
PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
!be undersignec1 understands that tbis petlit lilY be subject to Ideed restrictions I Ibieb lilY be lOre restrictive tban City
regulations. !he undersignec1 assUIeB responsibility for capliance litb any applicable deec1 restrictiOll8.
B. UNLICENSEP CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If tbe OlDer bas birec1 a contractor or contractors to undertake wort, tbey lilY be required to be licensed in accordance litb
state and local regulatiOll8. If tbe contractor is not licensed as required by lal, botb the OlDer and contractor lilY be
citec1 for a lisdl!leanor violation under state lal. If tbe owner or intendec1 contractor are uncertain as to lhat licensing
requireJenu lilY apply for tbe intended IOrt, they are advised to contact tbe City of Zepbyrbills Building Departlent, (813)
788-6611.
FurtberlOre, if tbe OlDer has birec1 a contractor or contractors, be is advisec1 to bave the contractor(s) sign portiOll8 of the
IContractor Secti0ll81 of this application for Ibieb tbey lill be responsible. If JOU, as tbe owner sign as tbe contractor,
you are indicating that you, ratber than tbe contractor, are responsible for the IOrt. If tbe contractor liabes you to sign
as contractor tbat lilY be an indication tbat be is not properly licensed and is not entitled to perlit.ting privileges in tbe
City of Zepbyrhi11s. --
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, tbe applicant, bave been providec1litb a copy of IFlorida's COnstruction Lien Law - &.olDer's Protection
Guidel preparec1 by tbe Florida Departlent of Agriculture and ConsUler Affairs. If tbe applicant is 8OI8OIl1l otber than tbe
lownerl, I certify tbat I bave obtained a copy of the above described docUlent and pl'Cllise in good faitb to deliver it to tbe
Rownerl prior to cOll8Jlcelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infoIJation in tbis application is accurate and tbat all work lill be done in cOlpliance litb all
applicable lals regulating construction, loning, and land developlent.
Application is bereby lade to obtain a perlit to do IOrk and installation as indicatec1. I certify that no IOrk or
installation bas ~cec1 prior to issuance of a penit and that all IOrk lill be perfoll8l1 to leet staDc1ards of all laws
regulating construction, City cocles, loning regulations, and land develoPleDt regulations in tbe juriSdiction. I also
certify that I understand tbat tbe regulations of otber goverDII8Iltal agenCies lilY apply to the intended wort, and that it is
If responsibility to identify ,hat actions I lust tate to be in COIpliance. Sueb agencies include but are not lilitec1 to:
t Depart:lent of Envirolll8Dtal Regulation - Cypress &aybeada, Wetland Areas and Envirolll8Dtally Sensitive Lauds,
Water/Wastewater !reatlent
t Soutbwest Florida Water Managel8Dt District - Wells, Cypress Baybeads, Wetland Areas, Altering watercourses
t ArQ Corps of Engineers - Sealalls, Docks, lavigable Waterways
t Departlent of Healtb i Rebabilitative Senices, InvirODlBDtal Healtb Unit - Wells, Wastelater !reatlent, septic !ants
t US EnvirODlBDtal Protection Agency - Asbestos abatl!lll!Jlt
I also certify that, if fill Iilterial is to be used in Flood Zone IAI or IA,etc.l, it is understood that a drainage plan
addressing a ICOJpenBating voluel lill be sublitted lbieb is preparec1 by a professional engineer registered in tbe State of
Florida prior to peIlit issuance.
A perlit issuec1 shall be construec1 to be a license to proceec1litb the IOrt and not as authority to violate, cancel alter, or
set aside any provisions of tbe technical codes, nor shall issuance of a perlit prevent the Building Official fl'Cll thereafter
requiring a correction of errors in plans, construction, or violations of any coele. Ivery perlit issued shall beCOll! invalid
unless tbe IOrt authorized by sueb peIlit is ~ced litbin sillODtbs of issuance, or if IOrk authoriled by tile peIlit is
suspended or abandoned for a period of sillODtbs after the tile the IOrk is co.encec1. One 90 day atensiell of tile, lilY be
allowed for tbe penit litb fee charge of $15.00. !be atension &ball be requested in writing to the Building Official. An
approved inspection lUSt be logged during eaeb sil IOI1tb period, or the project lill be considered abandoned.
WARRING !O OVXD: YOOR FAILURE !O RlCORD A IO!ICK OF C<IIIIDCIIIIMl' MAY RESUL! II YOUR PAYlIG DICK FOR IIIPROVIIIIIIS !O YOUR
PROPIR'lY. IF YOU IIDIID !O OB!IDJ FIIUCIIG, COISUL! WI!B YOOR LDDIR OR II AnoRDY BIFORI RICORDIHG YOUR HOlICK OF
COMMIICIIDr. JOBS URDU $2,500 II VALUE DO IO! IIDD !O RECORD AHD POS! A 'IO!ICK OF COMMIICllDrI.
~JVVI ~~
c~ '~_I
SIGIIA'lURI: 0IfIIR OR AGm Cb.-Fe I /lr[;L~ I,
SlAtE OF FLOWJA
COmy OF ~Ct :'5 (-D
The foregoing instrument was acknpwledged
before lie this / ;2 /; .s.- , 19 ~ by
, I
La flJ i fj ('[xu I)
who is personally kJ)own to lie or who has
produced r: L /) / ~
as identification and who did/did not
tak~7 ~ oath. I. /,'7 /
li/]q.-u')7/v7<:ja11.~,.\.
(S!9nature) .'
,~Y1ay-c"J) /.-- ' l~b'E' r-
(NUt!. Typed, Printed or Stamped)
NOTARY PUBLIC Notol'Y fiji/ii" Stlltc fA Florida
M; C~mmb$ion Elt!l;m Feb. 22, 199$
Itonded Thl"\J Troy Fain -lnsuran,eJllc..
i-
c.
- j
"l_
Hometown Pools, Inc.
37008 Price Dr.
Zephyrhills, FL 33541
813-782-7077
.. "0....
..... ._00t.
~."f'VI.
rANOARO RESIOENTlAL
MMING POOL CONTRACT
Fl. TAMPA cAY CHAr:TCM
This contract mad. as 01 Il'Ie date 01 wnnen acceOlance by Ihe member OUllder listed aoo".
nereinafter tenne<l -C.:lMlractor" and tl'le party named below. nerelnatter lermed -?urcnaser.'"
F'URCHASEfI
CA~OL M. BROWN
Ph. HOMF
MAILING ADDRESS 15760 RIVFR RUN DR SPRINt; foI\K::(. MY. "19456
Ph. BUS
ZIP
CGfttraC!O' aQreea 10 consrrvct a swomrnino PGO' and aooun_nc:es I"'ereto a~ ...,eenafter prov.ded by Ine cllattS. sDecdicallons and terms OlIn. contf3C! at:
INSTALLATlON ADDRESS 6642 NORTH {,ARE OR
LEGAL OESC.
POOL SHAP~
PE"IMEiE~
R'3
cU'5nm
MAX WIDTH
IIf O~~' "
14
Iff MAX LENGTH 2 2
t/f WATER AREA 264
It. NS~' TYP= A
slf
It. to
:5
It. to
OWa1er
:xc:ess fill
. Filt.r Syste", EfC de') 5
PumD'" molor IHP uta rite
MetnOCl at c"'onnalio"" C 1-1 CO
1
t 1. Underwal.r liqnllnq
1012,,-100.
1
SQ, ft. ar.a.....214
~:)d~
no
21. Timer
22. T eSI kil
1
4-1
~11!S
41) pvc
t 2. Ma.n drain
t:l. oee"A?Yl. '
,.. Oec:x ~ina9.
~
1 So Ladder/GraD,.""
16. SleoslHanc:trall
t 1. Oi"'n9 sa. & stan'"
2:1. Vacuuln hea'" 1
Vae hose 1
.24, Brusn
1
Leaf net
SaCx..sn disooSllI
Pitllng & int.,;!'C:1
2
no
1":0
25.
2~.
21.
AdiuSlaOle pole 1
Sla~1:nemll:al" ye II
Heater XXX1OC:'ti~..,.X~,.A.~~XXXX
,'~tt:b
Surface skimmer
7:"e:..~~ j..:.
15.
:..0.
no
tile,
GFl_
~~.
.:....::,:::.::: :!e3."~:"
Int.nor ti".5I'
Color:
narclte
..
, 9. ~ntil.yer/coorno;ltile
20. Electncai "'ookUO -::0:.'. t
29. Loy. sea! XXXXXXX:,II'.a.ncn XXXXXX
:l0. S.,",ouI y a.
TiI~x6
lcllllonal Provision"
screen ill ith super gutter remote 1 i.:!ht BW! td. aery! ic deck
iERMS
lleSS sOttC:lal1y agreed and set fort'" h.r.in. Purcnaser h.r.und.r a9~ 10 make progress oaymenls Oased on t.... IOlal pnce s.1 fortn in Inis conlract. to I".
'nt~aDr. as follows: ~
CO~ACT ~RICE $ $
10.. Cown OIIym.nf
~ When rouo" sn.n is in plee.
35' When QlumCino IS c;:gmplet-.f
5' Wh.", pool is comOI.ted. rllaoy for inl.nor flnl5ft
ConslNetron orogress may oe arresl.d berwe..n otllinq and r.ea.ot 01 oa.,.~.nl for eae" onase ot c;:gns'",Cllon.
NOTICE TO PURCHASER
00 NOT SIGN n-4IS CONTRACT BEFORE YOU RE..A.O IT OR IF PERTINENT INFORMATION IS MISSING FROM eUNK SPACES.
.s I.S a nom. solicltalion sale. II yOU dO not want I...e 9000s ors.,.,.c:es c;:gntr:aeteafOf. you maycattcelln.s agr.emenlCy mailing a nOIlC.IO Ine sen_. nus noue. must
l>Cal. In.l you 00 not .ant tn. goodS and se...."e.s and must b. ClOstmanceO l)y rrlldnrgnt l.... In.rQ cay after you SIgned I"e agreem.nt..
". t:D''''.~t zn.11 b. fI."I'rtf!'f3 ." a"'~"tI r"~ Can".c:tl' ."t:1 s".1I br "ull."d .o,d ..,,'/'!'~$ .CClltlt.d 0.,. du/"" .Ulllor,rrfl ot'f;rrrof ,It. CD,.".r:ro, .....,ru" I,""." D."S 01 ,,,~ D"'~
'fI .,~.,. n,,'~fI ~eov. tit. "'\ur:1't.~.,"r SltJ".,U'ftS. n.. s.'.sm." ".$ no ."11"0""""0 O.,.fZ ,II~ C"I't,,.era, All .t}'.~,"~"rs ."d fJnl3.'~t."tI'''r;$ .,. eo'tr.,"~d ,ft ,"'S CD"".n .,.~
p Ptu'r:~6~~r --."."U lit.' ,It..,. 6'."0 .9"~rn',,"p""J 0' L1"Gt!rsr."f1'~'1S Otl'~, ~"6".~ ,~t to,.,.",,. 1ft,S t:DC~'".'" Af:t:~"'."e~ ~I ,ft. rp,""'S l1f ~"hS Ctlt":".t:t O'Y' CD"".C''''''s I"
. cO,"",un'c.'rtl to ,n. Pun:".s., tJy 'f_ns,",n'''9 . CaD" 01 ,,,'s :t1"''''t:t to :"~m Sfto""'''9 .C~ltllt."C. 0.. In. J.".n OW' :tf. ~.ftCU"O" 0/., duiY4utnOft'f1t/ "",c~' of ,,,.
':;:'.., 0' 0" 1:0'"'"."""''1 1:0",,"'''''0''. PURCHASE~ 0~~ ~
I~ ~
U8MITrEO BY \, . ",' , PURCHASEM
:C::?TEO BY '-.\ L\ \ ,{t// Date OWNE~
" ~rc"asen a;" ~usoand and ...oIe. bcKn must slQft, II own.r '5 o'th!fenl from ourenasar. own., muat SIC;!n.
J~"'''SERfSl. BY SIGNING 4BOVE. .:.Cl<NOWLEOGcS -'NO 4G~E=S ro ALl. THE TERMS .AND CONDITIONS ON ALl. P4GES OF THIS -'QREEMENT EVEN
'eWGH S?4CE :'lMITATlONS REOUIRE Tl-lAT SOME .:.l:IE ~QINT~D:N SMAL:':R TYP~
/
- -
=-=c =-=::~=='-
L./MITED WARRANTY '
The e,oa.tTQ&~OCl "'~~'I r:a ~ t= o......"""'...en 1It.......-...,., .................... to""'~ .,,-..c1Of"filIo '01...... "" ~ ,.-- 11ft.
CDft__"".or'___.n.._ ._~__"O"______ _.____.-r._'o-PVl"CHA5E.~
..., :W~...' .... __ ,,. ..... __ .... ,_. 1:1# .._ ."" _ eo.-- Of ,..............:: ....JAC"..SE~ ,....... ,. - - ae..-'. '0
co..-~..::-O'" __"...~.~ ,... _-.co..... -..... """"' ....._t~. -'!"r ~_0I..~",_.c.c:__ ---"---
,.... =_~ ,,..,, ""."ttI'ClU.P' .....,...... e"': CO""T~~A ......"'-, ..".nu 01 a.......-...,eft 8OVt"'-- ~ 01"'._ f1I......,.ac"'I~
_....... ....ct "''''''C''''o 0' ....~ac~.... .,. "-'C,.. "PftS .....,.. ':-"8.-,..0" .,..... .~c~"",""""~:II ....c: ".....,.ect.-............... o.tCD or t......
c:auMC :""r ODw'lOus ""'It."I",... O. -....o..-et.... M' ,.....c 01 ......c..G .: pvQC"A.Si:rS ..oe"'M
~. ~... .,....:!..:. ......... -=--... . .... 110. .... ........... t... II aAa" DlP"~ ......Ct:tl".y ou~, tftal ,....
nu, .......:"ty c.cotI"ft ..o.c: W'fteft O"OIf'W' aun::-...... ".01 ..... a..:roec ar~
....... ,w=_IEO W..AA....!Y "'AI!'ooG BY OPE",...no.. 0' STo\~ 1....... IS L'''':TEO r.: 'l'HE OURATlOOo 0' 'n4e o..e ~ ...AAAHT'ES ..~EIH
CO"':' .....(0
!
)
(
A ..oar... "'S."'"...... .."aft""....; U,...,... ......:JI'"'.c: wftOef tftea CO"trllCl .... De Df'OWCI..s 10 ffte Pur-..naM. 8ftG II ....: be ~"~J ...... 01 .... CDfIIf"ICI ~.
OEFIN!TIONS
no. _ "ru::tu.e s..." !loOcons"'.'ecs 1= .Oe~FO"''''' s.r. T1Sl'ACTOAIL r Of De .STRU~AALI. Y SOUNC. eo ,_.." ._1:1#_-..--.... ''--''-
...,ac:o,a'lo" Of 1 '!I- 'c ), ~ r eM'" aa.' .
POOL S"ELI. ... "?:JL STIlIUC'T\JRE . _ conc"t'e _ WftICI\ ......_ _ ._ ,""O"'f'O Do~ 1",- - - nar aelt 1:1# - -
ooor ...."'0....1'1 _fC'" :le..onns 1_ lun=",n '0' -ocn ., ... oeS'llnecl s.... De COft........ to .PE"F':'IlIM $ATlSFACTOf"L T'
.OeCK AHO PATIO Wv:aOC' Sft.II De 0_10.....1' _. cone_..liI_."" _.....,............. ...con._I___'__......._..,-_IOt.__I&.._~--
..c
.....Cl'''~ ....~....,.. _US..... '"'' -IT'! I~""OQ ~NISH S.... Do. _""'..'" _eCtOft'_ .n"_""__-ft __,.__"-_",,_UDo..-......
_00..... AOO'ltQ.... .-al' De "un o"neQu.....,.. WIt" a 0<_"'''''..'''''''''' Of oft....". -,a_..ftCI .-__-.. ,- -... - to -- "'--,.....-
uaon tit. ."'CNi'" ot CD"" '" .,. aogr4!'Qll.'. ...<<1
LIMITATIONS
No _....nov ......."S 10 .,.,. oalt to 'N _. ""'10"''''' Of _n__.. _ ,._. '" ".,ea .. ...- Dl/ ...., 1:1# - ~ _.411'"-_ '" _a:
AD_. IaC'O '" ,.__ ......, _ 1:1# ___......, ___. J~ _.1Oft: --: _1:1# God: - - - _.
~'''Z''''; 1:1# _I., "'" uncl":U"'" In ot"'"DlftQ _.. Ii".... _as. taturo. or _ __t.
SuOslll"'"," __, '" _""".1:1# __ ~ _.Ily ___ ..... __..., __ "" - Contnctor -.eft '"'9f'Il - tN -- or ... 1:1# .. III
"_If 01 ..",_ 1:1# ,,,. crool or ~nl ".,. u""",,-"zacl lI8n_ __ .._lIS in ___ to .. ~ t1J .. --"
W.,. '<ClIft ..._, .....-c.. 01 __ _1Cft _I'll -0- 1ft. _ 01 _or.
CI.=-'''O. C........ro;. e>aal'"I!. _..,-'. ......IIOft. _ro;o _,,;..,.,.. _ ...nW'lQ Of "'" __ -...- Dl/ ... 1:1# -- --.. In - CMaIW"'; 1:1# ". -
SU"'.....n.... t:I ..",.... _"'I' ~ Dl/ ........_ _I. '""" __ 1:1# ...,..... ~ IIIOUn:IIII. - .. -'" .. IICIGI .. - -.
_...."01:1# ..... Of _ as . ,-..11 1:1# _ or_ft 1:1# .... __ 01 - cut._ ,- Do_" - .-.
0.._ 1:1#.... _.... '_If or _._.- __ _ .,_na _- ~nc_.
""-. auf9'I. 10 ...c.nca. _u'_' ,....'" ,...._Oft lift.. t:J1f iQfttnIftO.
CONDITIONS
'""._.ncl__""'II\a&I.._...._.I_.~m."...__.,acl."~WllI"..'~_OOIII""...c:.orw.------...--.
EXCLUSIONS
_l:I#aQV-"'---u...".........-. :1_n""""_,o"...-,,..llOlfttr_._gru--_.-_ate.._"",,toDo.....""'''';' _IC"
_'ow,.,..
9t'_COWc>uftQ.n ''''08C><S''''' 0-....--"'.......... "iu.... -""0. ....._.. 0",.,_--- _c:nc:tUnO"___ _~_____._f_I..-
__"'_, _ !t_' .. _"....- Dl/.... H."""":so.."" 0001 In........
1wfV.,...... "'llCIDIC>tWltOftS. .._a_. "",n,- ..__--tat.....-ft-d- DOai_Il..'..--,----.,--.,..,,-Do-~..-
_to,ral 0< _ _e or ".. c-lI'OCSOO. .
o.couno, __. _....... ....."0. ~....,....., _no. __.. -f'O d _ __ - -- -- AFT'ER n4E POOl. IS ~ WITH WATER - -
_._ r.o"", _1_ _ ~.. ".,acs_ _"__0 "'_ - - OUt - - c:.crmr-.
CLAIM PROCEDURE
__ _....,"..CCJIftC>Ul.n.. snouIG _....._ ".."'.C4nnwctt:J1f lilt.. -'nlSll\l::a'..... .,.,t_ Pu__. .- ___t1JIIW~", -_.......,.....
Do _ '" oofl'_ .no __ or _... 10 ,_ c-r,_. D"ftClI_ _1:1# _ - ., - va 1:1# ~ , IS .... oanoroc:&.
DATE'
BY'
PURCHASER
SIGNATURE OF CONTRACTOR
OR CONTFlACTOR.S AGENT
PURCHASER
..~...
.~......
:.~.\
-
" ' "
/!cIfrJ€77IW~ ICJdL; S
Elorida
Power
COIPOI.TlOI
~ .
,
~~~~J~~~~.
.
~ POOL PROPOSED FOR CONS1RUcnON AT 11IE ABOVE ADDRESS OOES NOT
CCNF~rCT \VI~,r J.:.~"'.' ill~'"S::::RCR8L;~;c OR OVERHEAD FACILITIES OF FLORIDA
POWER CORPORATION, PROVIDED TI-lAT TIIE POOL IS INSTALLED TN THE
LOCATION SHO\VN ON THE A IT ACHED SITE PLAN PROVIDED TO US BY THE POOL
CONTRACfOR.
1HE POOL PROPOSED FOR CONS1RUcnON AT 1HE ABOVE ADDRES OOES CONFLICf
WIlli: OVERHEAD UNDERGROUND
FACIllTIES OF FLORIDA POWER CORPORTATION,
. .
ARRANGE!v1ENTS HAVE BEEN MADE WIlli US FOR RELOCATION OF THE FACILITIES
SO AS TO CLEAR THE POOL AREA. SHO\VN ON TI-IE A IT ACHED SI1E PLAN.
-.,' .
,\'<;'::::~{",",',.,"---""- ._....~._... .-....-.- _....-'-_.-~~._---._---;-- -
."~;"~~~n~~9Y '.
I ~. l 'r....' I ~ ~ j t_;o . . ,.., J. '. ',.' " . ....
COST FOR RELOCATION OF ELECrRIC FACUlTIES Wll.L BE PAID BY:
OWNER
POOL CONlRACTOR
PRIOR TO RELOCATION OF FACUlTIES AND CONSTRUcnON OF POOL
t,
. ,
.~ .
"
ZEPHYRHILLS OISTRICT OFFICE: 31231 Sm AYe. . Z,phyrhllll, florld.US40 · (.13) 1.2.15"
A FIor/fill Progress Compllny