HomeMy WebLinkAbout94-4582
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N.~
45828
Date /;1.. -;2.9- 9 y
@
P,"perty Ownec tb-~Jf~
Job Address: 6
ELECTRICAL
PLUMBING
MECHANICAL
Sewel' Conn
Water Conn:
Water Meter:
T.I.F.'s:
Parcell.D. #
Zoning:
Description of Work
Energy Code:
tZA~~
Radon Gas:
/
NO OCCUPANCY BEFORE C.O.
II )} 7
o ./
FINAL
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
"'-
Permit Fee ...s II - i7ZJ
Signature 7 /l a-..,~LI. ~J2
Company
Address
Telephone# 0'1 - J.. 'l.r -:J... r y L
Valuation or
Contract Price
/; ..5 '0-0 - &-0
./
City License Registration # ,-;2 '7/
State Certified License#
UA j~ I2~J
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final
Tp. Servo
Rough In
Meter Can
Canst. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
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.
APPLlCAnON FOR PDKIT
CITY OF ZEPIIYRBILLS
BUILDING DEPARTMENT
OWNER'S NAHE I /J.r r~
r
RC/ -f--I-Ol"
PHONE /,yO~ Il.o c)
OWNER'S ADDRESS
JOB ADDRESS c,,,y ~ f'
JJo-t/ IlMrl
LEGAL DESCRIPTION: LOT(S)
B~SUBDIVISION
PARCEL I. D.' (OBTAH. FROM PROPERTY TAX NOTICE)
WORK PROPOSED:---..New Construction ---.Addition ---^lteration ~pair V'Install
--Jign
--Ifove
-1)eaolish
PROPOSED USE: -5iog1e Feaily
Veo-ercial
--1t/F _' of Units --1t/H
_Indust. _Swia. Pool _Other
--Restaurant lr Health Departaent Approval
DESCRIPTIOR OF WORlt: 1lJ.sfd' L..
c.cI'.....)
Atunh.S'
Td
p"..,,., ~ 0 f
il. rh./..;W ...
-
BUILDING SIZE:
x
Square Feet,
Height
RESIDEIITIAL :
COKHERCIAL :
ATTACH (2) PLOT PLARS i (2) SETS OF BU1LDIHG PLANS i (1) SEr EBERGY FOBHS.
ArlACB (3) SETS OF BUILDING PLANS lr (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CORSTRUCTIOH.
PERMITS REQUESTED
~UlLDING
$ ~S(jO, 0'0
Valuation of Total Construction
RI.RCTllICAL
AIIP Service
Florida Power Corp.
W.R.E.C.
-1IECllAlllCAL
~UHBING
$
Valuation of Hechao.ica1 Installation
GAS
ROOFIRG
SPECIALTY .
TYPE OF CORSTRUCT:lOIi: _Block _Fraae _Steel
Other
PIllISBED FLOOR ELEVAnORS:
Fl.
IS PROJECT IN FLOOD ZORE AREA'
YES NO
..........................................
COIiTRACTOR SECTION
..
BUn.DRR
, COtIPANY A,..,jj Afvh/.; e
...
d ~ State Cert. or Regist. .
City License Registration .
~.........................................
..:I:1t:-
...7 7 J
Signature ~ RJ.1/
RT.RCTRICIAIiI COMPANY
State Cert. or Regist. .
SianAture City License Registration .
..........................................
PLUMBER COMPANY
State Cert. or Regist. .
Signature City License Registration .
..........................................
IlECllAHIGAJ. COMPANY
State Cert. or Regist. .
Signature City License Registration .
..........................................
OTRRR COMPANY
State Cert. or Regist. ,
Signature City License Registration ,
..........................................
APPLICATION APPROVED BY PDKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
!be undersigned understands that this pemit lily be subject to 'deed restrictions' .bieb lily be lOre restrictive than City
regulations. !be undersigned assU1e8 responsibility for COIpliance .ith any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas bired a contractor or contractors to undertake work, they lay be required to be licensed in accordance .ith
state and local regulations. If the contractor is not licensed as required by law, both tlIe owner and contractor lilY be
cited for a lisdueanor violation under state la.. If the owner or intended contractor are uncertain as to "bat licensing
requirl!lents lily apply for the intended work, they are advised to contact the City of ZepbyrhiUs Building Departlent, (813)
788-6611.
FurtheIlOre, if the owner bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
'Contractor Sections' of this application for wbieb they .ill be responsible. If you, as the owner 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 be is not properly licensed and is not entitled to perlitting privileges in the
City of Zepbyrbills.
C. TRANSPORTATION IMPACT FEES AND UTILI'l'Y CONNECTION FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, bave been provided .ith a copy of 'Florida's COnstruction Lien Law - lIoIeolmer's Protection
Guide' prepared by the Florida DepartJent of Agriculture and ConsUEI' Affairs. If the applicant is SOl8Oll8 other than the
'owner', I certify that I have obtained a copy of the above described docuIent and prolise in gool1 faith to deliver it to the
'owner' prior to COll8llceaent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infOIlation in this application is accurate and that all work will be doBein COIpliance with all
applicable laws regulating construction, loning, and land developaent.
Application is hereby Jade to obtain a perlit to do .ork and insWlation as indicated. I certify that no vork or
installation bas CDlencecl prior to issuance of a pemit and that all vork will be perfOlll!d to Jeet standards of all laws
regulating construction, City codes, loning regulations, and land developaent regulations in the jurisdiction. I also
certify that I understand that the regulations of other goveIDJelltal agencies lily apply to the intended vork, and that it is
Ii responsibility to identify uat actions I lust take to be in cOJpliance. Sueb agencies include but are not lilltec1 to:
t Departlent of BnvirolllellW Regulation - Cypress Bayheads, Vetland Areas and BnvirolllellWly Sensitive Lands,
Vater/Vastewater !reatlent
I Southwest Florida Vater "anaglllent District - VeIls, Cypress Baybeac1s, Vetland Areas, Altering Watercourses
I Arty Corps of Engineers - Seawalls, Docks, lavigable Vatenays
I DepartJent of Health' Rehabilitative Services, BnvirODlBDtal Health Unit - Vells, Wastewater !reatlent, Septic lanks
I US InvirOJlllental Protection Agency - Asbestos abatl!lellt
I also certify that, if fill IIterial is to be used in Flood Zone 'A' or 'A,etc.', it is understood that a drainage plan
addressing a 'COIpensating voluae' will be sublitted "bieb is prepared by a professional engineer registered ill the State of
Florida prior to perlit issuance. .
A perlit issued sball be construed to be a license to proceed with the vork and not as authority to violate, c:anc:el alter, or
set aside any provisions of the technical codes, nor sball issuance of a perlit prevent the Building Official frol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall beeme invalid
unless the vork authoriled by sueb perlit is co.enced within sillOntbs of issuance, or if vork authoriled by the perait is
suspended or abandoned for a period of sillODtbs after the tile the vork is ~cecl. One 90 day 81tension of tile, lilY be
allowed for the pemit with fee ebarge of $15.00. tbe 81tension sball be requested in writing to the Building Official. An
approved inspection lUSt be logged during eaeb ail IODth period, or the project will be considered abancJoned.
WARMIIIG to OVIIIR: YOUR FAILURE 10 RlCORD I 1I0lICI OF aJIIIDCIIlBIf lilY RlSULr III YOUR PIYlIG "'ICI FOR DIPROVIIIIIIS 10 YOUR
PBOPmY. IF YOU IJIDIID 10 -OB'IIII -Fll1A1CIIG, COISULI'VIIB YOOR LBIIDIR OR U AnORllY BIFORI RICORDIIG YOUR 1I00ICI OF
_" ',',/:-Jl1JS _, ~'2. 0 U ,_ ~.1IJr IIEIII !O BIClIIIIIIIIl POlIr I '1IJrlCl OF _'. .
;:;1 tW~ ~ A'~ r;t..Q
SIGJII_~ OR AGm ,.. SIGllIURI: C / ,-
StArB OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before IDe this , 19_ by.
SfllB OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before me this , 19_ by
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
who is personally known to me or who has
produced '
as identification and who did/did not
take an oiJth.
(Signature)
(Rame Typed, Printed or Sta.,ped)
ROTARY PUBLIC
(Signature)
(Rame Typed, Printed or Stamped)
NOTARY PUBLIC
~ Jrnpn.aul
~RD.~
AWNING & UPHOLSTERY, INC.
503 FIFTH STREET, S.W. . WINTER HAVEN, FLORIDA 33880
Phone: (813) 293-2442
FAX: (813) 299-6655
PROPOSAL SUBMITTED TO:
PHONE: ;78(J- /70~
. ~,:flf' G.--z....-
JOB NAME:
NAME.
STREET.
STREET:
CITY:
STATE:
DATE Of PLANS.
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flOU ./.:t..v
bJlu.r;4v (rfC.i.,,)
S ul if) yJ L ,l}:x Ii
71M u:,j
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We hereby propose to furnish labor and materials -/mPlete in accordance with the obave speciflcatians, far the sum af,
,~ dollon 1$ t:: 97', Z-<J ) with payment to be mode os follows.
71d~
/'l
~ -
~/~b
All malerial is guaranteed to be os specified. All work to be completed in 0 workmanlike manner according to standard practices. Any
alteration or deviation from above specifications involving extra costs, will be e.ecuted only upon written orders, and will became an e.tra charge
over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner 10 carry fire, tornada and
~h.< ..,.,~<, ;......... 0.. ..<.." ... 1.11, ....... II, W........ C..p....,;.. '~ (j ~ _~,
Authorized Signature ~ ~.L..-.
NOTE. This proposal may be withdrawn by us if not accepted within
day..
Attrptul1tr of Jroposul
The above prices, specifications and conditions are satisfactory and are here
work as specified. P e made as outlined above.
Signature
re authorized to do the
Attrptrb:
~
Date
Signature
'7
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The Awning Design and Standards Manual
Page 140
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