HomeMy WebLinkAbout95-4925
BUILDING PERMIT
Permit N~
CITY OF ZEPHYRHILLS
(813) 788-6611
4925.B
S-/67 .-9~-
Date
~~.
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Pmp'''V Own" :Jt-' f1:.'!..~~
Job Address: &_---~--- ~
Parcell.D. /I
Water Meter:
T.I.F.'s:
Zoning: Energy Code:
Description of wor;-R ~ -~
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL .:.J'-- / j - S-
DATE
Complete Plans. Specifications and Fee Must Accompany Application. C.O. -'
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Permit Fee
Signature
Company
Address
Telephone#
~?~
Valuation or
Contract Price <.. '? 0 ,~--O . trV
-'"
City License Registration # /0 I
State Certified License#
r/3 ..$"36 2.271
(~~-1HO~
BUILDING
?-Ch O(JJ--
ELECTRICAL
PLUMBING
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
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.
APPLICATIOR FOR PERKIT
GIlT OF Zll:PHIJlHIT.LC;
BUllDIIiG DEPAImIEIIT'
OWNER'S RAKE GEORGE FAGNER
OWNER'S ADDRESS 6138 LINNET STo ZEPHYRHILLS, FL. 33540
PlK)RE 783-3267
JOB ADDRESS
6138 LINNET ST. ZEPHYRHILLS. FLo 33540
LEGAL DESCRIPl'ImI: WI'(S)
~OBDIYISIOll OAKSIDE MHP
PARCEL I.D.'
WRK PROPOSED :_Rev C'oostruction ----Addition _Alteration .x....Jepair _Install
_Sign ~ve ~lish
PROPOSED USE: Single Faaily _H/F _, of Units ~/H
_ec-ercial _Indust. _Sw~. Pool Other
-----,estaurant & Hea1t:h DeparbEnt Approva1
BUILDING SIZE: 12 X 48, 766 ~e Feet, Height
10 ~ 19
RESIDENTIAL: AITAaI ,,2) PLOI' PLAlIS & (2) SEIS OF BUILDIlIG PLAlIS & (1) SET ERERGY FORMSo**
COttItERCIAL: AITAaI (3) SETS OF BUII.DIIIG PIAIIS & (1) SET EliERGY FOJUIS. **
**con OF COllTRACI IUIQUIRED.
PII'RIIITTS REQUESTED
_BUILDING
$
3050000
Va1uatioo of Tota1 Construction
_ELECTRICAL
AIIP Service
Florida Power Corp.
._WoRoEoC.
---1tEGlWiICAL
$
Va1uat:ion of Hechanica1 Installation
~UHBIRG
GAS
y
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _~ _Steel SINGLE PLY RUBBMh~MBRANE
FIIIISHED FLOOR ELEVATIONS:
fT.
IS PBOJECI IN FLOOD ZONE AREA? X
YES NO
.*****.*.*.....*....*****.*..*********..**
COJI'I'KACIOR SECJ'IOR
DAVE MCNETT
MY rnNC;;:TTMR'R Rl\IR'RGY S A. "li:R~ INC
tate Cert. or Regist. '<:<:<:057199 .
ELECTRIGIAR
SiPnAture
COIIPARY
State Cert. or Regist. ,
City License Registration ,
.....*.*...*.....*.......***.*.*....*...**
Signature
COIIPAIIY
State Cert. or Regist. .
City License Registration f
.*.**.**.*........***...****.***.**.....*.
PLOtIBER
KEmAlIICAL
Signature
COIIPAIIY
State Cert. or Regist. ,
City License Registration f
***..*****....*.*..*.*.***.*******.*...***
0T1IF.R
Signature
aJ!IPAlIY
State Cert. or Regist. ,
City License Registratioo f __
..*~.*.***...*.*..********.*.*.*..*.*.***.
APPLrCAnO" APl'IlOYI1D BY 11~4fuq J1f ~Li
PElm:D' OFFICERo
CONDITIONS OF PERMIT AFFIDAVIT
A. t.~UTICE OF PEEILrif_STRI_CTIONE":i.
The undersigned understands that this per.it May be subject to "deed restrictions" which lay be .ore restrictive than City
regulations. The undersigned assu.es responsibility for cOlpliance with any applicable deed restrictions.
tl . I,,~~JL I CENSED CONTR{~CTORS AI'-JD CONTR{~CTOF\ RESPONS I B I LIT I EE,
If the owner has hired a contractor or c~nt';;do~-~-t~-~~d~;t-~i;';~~i;they--;;;'-'b;;~q;i-r-;d't~-b-;-i'iCl!nsed in accttrdance with
state and local regulations. If the contractor is not licensed as required by laN, both the ONner and contractor lay be
cited for a .isde.eanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
require.ents .ay apply for the intended lIork, they are advised to contact the City of Zephyrhills Building Depart.ent, lBl31
7BB-6611. .
Furtherlore, if the ollner has hired a contractor or contractors, he is advised to have the contractorls) sign portittns of the
.Cttntractor Sections" of this application for which they will be responsible. If you, as the owner sign as the contractor,
yttU are indicating that you, rather than the contractor, are responsible for the work, If the contractor wishes you to sign
as contractor that .ay be an indication that he is not properly licensed and is not entitled to perlitting privileges in t.he
City of Zephyrhills.
l' IF:ANf?PORTAT I ON I t'lP{-,\CT FEEtLl)N.p__lJ.LLUl.Y...J,:~.gNLiECTLQI'(YEE9-.
D. CONSTRUCT I ON L I EN '=-.1l.H (CHAPTER 71 3~. FLOR I Dn STATUTES ~ AS AI'1ENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - HOleowner's Protection
Guide" prepared by the Florida Departtent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the
'oNner", I certify that I have obtained a copy of the above described docll_ent and prOMise in good faith to deliver it t(l the
'oNner" prior to co..ence.ent.
E. CONTRACTOR 'S/m'JNEFi~~.J)fE.LD{lY-.!.I.
I certify that all the infortation in this application is accurate and that all work will be done in COMpliance Nith all
applicable laws regulating constructi(ln, zoning, and land develop.ent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has cOI.enced prior to issuance of a perlit and that all work Hill be perforled to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developaent regulations in the jurisdiction. I also
certify that I understand that the regulations of other govern.ental agencies .ay apply to the intended Hork, and that it is
ay responsibility to identify what actions I lust take to be in co'pIiance. Such agencies include but are not li_ited to:
I Depart.ent of Environlental ReQulation - Cypress Bayheads, Hetland Areas and Environ.entaIly Sensitive Lands,
Water/Wastewater Treat~ent
I Southwest Florida Water ManaQe.ent District - Wells, Cypress Bayheads, Hetland Areas, Altering Waterc(lurses
f ArlY Corps of EnQineers - Seallalls, Docks, Navigable WaterHays
I Depart.ent of Health l Rehabilitative Services, Environ.ental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
I US Environ.ental Protection AQency - Asbestos abateMent
I also certify that, if fill .aterial is to be used in Flood Zone .A" or 'A,etc.", it is understood that a drainage plan
addressing a "co.pensating volute" will besublitted Hhich is prepared by a professional engineer registered in the State (If
Florida prior to perlit issuance.
A per.it issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, (lr
set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frOM thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every per.it issued shall beco.e invalid
unless the "ork authorized by such perait is co.tenced Hithin six .onths of issuance, or if Hork authorized by the perlit is
suspended or abandoned for a period of six .onths after the tile the work is co..enced. One 90 day extension of ti,e, lay be
allowed for the per.it with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection lust be logged during each six tonth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
(Ldtif0~ ~~
SIGNATURE: OWNER AGE T SIGNATURE: CONTRACIOR
STATE OF - IDA .
COUNTY OF ne1
The foregoing instr t I'/as ~Wledged
befof'e me this . ~ 19. by
r3 (jJj)L<" ~ P f/?r:: U'''' l
1"1110 is ~c;"'n;a 1 y ImE;wn to me or l~ho has
pr'oduced
as. identification i~~
ke a
me or who has
~>-------
INam Typed~ Prin
NOl ARY PUBLI C
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Corporate Office
12350 S. Belcher Rd. #2-B
Largo, FL 34643-9925
(813) 536-2274
PROPOSAL SUBMITTED TO
Consumer Energy Savers, Inc.
GOOD IDEAS FOR THE WAY WE LIVE TODA Y
FLORIDA STATE CERTIFIED ROOFING LICENSE #CCC057196
<i:..R.
Vero Beach Branch
1121 7th Avenue
Vero Beach, Florida 32960
(407) 569-2788
DATE
5-~ .-C1 s-
TOLL FREE 1-800-422-2012
:;{61
STREET
(01 ()~T 5.
CITY, STATE and ZIP CODE
Z - \-\i
ARCHITECT
'7-6
~~SLlo
DATE OF PLANS
JOB PHONE
1\
We hereby submit the following specifications and estimate"
JOB TO BEGIN (APPROXI
JOB COMPLETED tAPPROXI
FURNISH AND INSTALL FIRESTONE UL TRAPL Y 78+ SINGLE PLY ROOF SYSTEM
FOR FOLLOWING AREAS:
)(Maln Mobile Horne Roof 0 Carport )(Florlda Room 0 Shed
CIRCLE SYSTEM DESIRED:
System #1: Membrane only, termination bar.
System #2: Install wood to perimeter edge of old roof surface, connect 3/4" insulation board to
old roof(s) surface, install Firestone Ultraply 78+ over the insulation surface and
secure with termination bar around perimeter of home.
~~ ~ Install treated wood to perimeter edge of old roof surface. Connect Hi."
aluminum faced insulation board to old roof(s) surface. Install Firestone Ultraply
78+ over the insulation surface and secure with termination bar around perimeter
of home. Replace all vents (except furnace vent),
Additional Work:
~OOlS .1:nC-
TERMS AND CONDITIONS OF PROPOSAL
CONSUMER ENERGY SAVERS, INC.hereinafter referred to as seller, or your, or you; and purchaser(s), hereinafter referred to as
purchaser(s), or I/We, Me/Us, My/Our, agree to the following terms and conditions, to-wit:
Seller to perform all work in a good workmanlike manner and will at all times maintain proper workers compensation insurance and shall comply with federal and slate contractor's
license regulations.
II This proposal is subject to acceptance by the seller at its office and becomes a binding agreement. It may be terminated at the option of the seller if said proposal cannot be financed
il purchaser(s) elects to purchase on a time sale price. Seller has 10 days from the dale of this proposal to accept or reject the same.
III IN/e agree to pay for any other work done and not specified in this proposal in the event such work is done at customer's request after work has commenced.
IV If purchase order is being financed by a lending institution or by you, IN/e agree to execute all necessary documents immediately upon request and presentation.
V IN/e agree that any changes, alteralions or extras from the plans or specifications which may be required by any public body or Inspector, shall
constitule an extra and shall be paid for by the customer to the seller, based upon the seller's actual cost plus 20"10.
VI IN/e agree that in the event of a breach by me/us of this purchase order after acceptance by you and before the installation is started, llWe will pay to you on demand Ten percent
(10%) of the cash price as stipulated damage lor such breach.
VII If il is necessary lor you to take legal action to enforce, protect or defend any of your rights under this proposal, I/We agree to pay such sum as the court deems reasonable for
attorney's lees and court costs. Venue for allliligation will be in Pinellas County, Florida.
VIII No claim will be made by melus except as provided in this order.
IX IN/e give CONSUMER ENERGY SAVERS, INC. permission to use pictures and/or references to our home in their newspaper and other forms of advertising.
X IN/e give CONSUMER ENERGY SAVERS, INC. permission to check our credit history.
XI IN/e agree to pay CONSUMER ENERGY SAVERS, INC. 18"10 APR interest on all moneys past due per this agreement
XII In the event any provision of this proposal should be found to be illegal or unenforceable, it shall not affect the legality or enforceability of any other provision.
XIII Lifetime transferrable warranty will be mailed to buyer when seller has received payment in full.
The undersigned acknowledges receipt of a true copy of this proposal, acknowledges Ihat he/she has read and knows the contents hereof, and understands that no other
agreement(s), or representallon(s) by the salesman, verbal or otherwise, is binding upon the parties hereto, and that the same contains Ihe entire agreement.
Make all checks payable 10: CONSUMER ENERGY SAVERS, INC.
CASH PRICE AND PAYMENT SCHEDULE (Reference to " phase of construction means all work, materials and equipment necessary to
complete that phase). Buyer agrees to pay Seller the Cash Price at Seller's office in accordance with the following payment schedule:
1. Price $ _~O SO
2. Tax $ \
3. Down Payment $
4. Balance $ -y) SO
ON COMPLETION OF ALL WORK.
"BUYER's RIGHT TO CANCEL"
(Reverse Side)
I have the authority 10 order the above work and do so order as outlined
herein. II is agreed thaI the seller will relain lille to any equipment or
material furnished until final & complete payment is made. An express
mechanic lien is hereby acknowledged for securily of this debt and lne
tolal amounl will be paid within terms shown.
.".."... 0 ~ ~ ~ ~ '
Slgneture 0 ~
All malerial is guaranleed to be as ."edied. All w~rk 10 be rrpleled j.
man,ner according to standard praetic~s. Any atteration or dnviahon In...
specifications invONtng extra costs wiH be executod only 1Ip-:>n written 0
~me an,eX'tra charge CNer and above the eslimate, All agreements 00.
stnkes, ac~dent' 01 delays beyond our contlol. Ownel to cariy tire, lornad
necessary Insulance, Our work.... ale lully covered by Workers Compens
NOTICE TO OWNER
Do not sign this home improvement contract in blank,
or before you read it. You are entitled to a copy of
the contract at the time you sign. Keep it to protect
your legal rights.
Acceptance of ([ontract-TheaboveP"ces.speclf,catlons
Ind condltionl ere latisfactory and ere hereby accepted You are authorized
to do the work aSlpecified. Payment will be made as outlined above
Dete of Acceptence:
SIgnature ~_~~
. I
S,gnature
r. P a.~~
.. y
)
Consumer Energy Savers, Inc_
GOOD IDEAS FOR THE WAY WE LIVE TODAY
12350 S. Belcher Rd. #2-B, Largo, FL 34643 State License #CCC057 196
Contractor's Letter or Authorization
I hereby authorize the below named individual to act as my agent to obtain all necessary
permits for residential rooting for:
Owner: GEORGE F AGNER
at this location: 6138 LINNET ST. ZEPHYRHILLS, FL. 33540
LOCATED IN OAKS IDE MHP
This person is also empowered to obtain, complete, and sign all forms, applications,
registrations, and documentations, with this limited power of attorney, on behalf of me
that may be required to accomplish the issuance of any permits that may be required in
any jurisdiction throughout the State of Florida.
Authorized Person: p vM/I"?'1 f r;.e~t:'N-:
/ :/ .fJ .
Authorized Person's Signature: i~~~../ (?-11./'1./).-...........
(. - ~c!
Owner:
BERLY G ULD
Ii
SWORN A D SUBSCRIBEp ~EFORE ME THIS
<"' (~./'6 ! 1
. DAY Od:~~_199
1
I
~~
Dave McNett
State License #CCC057196
({) 813-536-2274 Toll Free 800-422-2012 ({)
Consumer Energy savers, Inc.
GOOD IDEAS FOR THE WAY WE LIVE TODAY
State License # CCC057196
Owners Letter of Authorization
I hereby authorize the below named individual to act as my agent to obtain all necessary
permits for residential roormg for:
()~er: GEORGE FAGNER
atttuslocation: 6138 LINNET ST. ZEPHYRHILLS, FL. 33540
LOCATED IN OAKS IDE MHP
Ttus person is also empowered to obtain, complete, and sign all forms, applications, regis-
trations, and documentations, with this limited power of attorney, on behalf of me that
may be required to accomplish the issuance of any permits that may be required in any
jurisdiction throughout the State of Florida.
Authorized Person's Signature:
Authorized Person:
r'----:, >>"
NOTARY
S~ORNj AND SU'gRI~, i
. ~I DAY OF
1995.
,
Consumer Energy Savers, Inc. .12350 S. Belcher Rd. · #2-B · Largo, FL 34643 · 81JeS36.2274 800-422-2012