HomeMy WebLinkAbout95-4963
BUILDING PERMIT
Permit N!
CITY OF ZEPHYRHILLS
(813) 788-6611
- 4963)5
S -;9-96-
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1.0
~.
Date
BUILDING
~G' ME~eAT:
p,"pertyown.~ ~ ~~.
Job Address: - n . a- ( . ,
Parcell.D. #
J-o
ELECTRICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
Description of Work
En.,gy Code'. ~ R.don G.~
">.. {A-11iJ;/~ 0- ...#~
NO OCCUPANCY BEFORE C.O.
FINAL s: 3- ~- q f'
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
c.o. _,
DATE
Inspector t
P"m;' F'~ "
Signature ~ L'
Company
Address
Telephone#
-
Valuation or
Contract Price
~ f(<~'-
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City License Registration # ~C;l
State Certified License#
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Ftr. /Tp. Servo SLB
Pre SLB YRough In 5~f1~" Rub Tub Set
Lintel Meter Can Water
FRM.6:'--!1-4} ~(LL Const. Pole Sewer
Insul. CL Pool Final
WL Pre-Meter
Final
MEr.~
~
Breakers
Ducts Insl.
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.
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APPLICAnOR FOR PERKIT
CITY OF ZEPIMUIILLS
BUILDING DEPAR'l'HERT
OWRER t S IIAHE
OWIIER. t S ADDBESS (y' 1'..t ...{--
II P. ?l 1-14 C J I~ Gu / f iJ 1-1 J --f' ,INC PHONE 7~ tJ - /..:~ ?.:S
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6 7 d. f- r f! 01. -c ~. -tic c:' b p. _ Z t' ~ .( '/ ~ ~ . . ./4- F ~ -..r ~ J "9'0
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JOB ADDRESS
LEGAL DESCRIP'l'IOR: LOT(S) B~SUBDIVISIOR
PARCEL I. D. 1 d - d 6 - J 1 ~ {!J tJ cl CJ - (!) t!J / ~ CJ - C! t!J IS 0 (OBTAIR FROM PROPERTY TAX NOTICE)
WORK PROPOSED:~ew Construction ~ition ~teration --..Jl.epair _Install
_Sign -.JIove ->>eaolish
PROPOSED USE: _S~e F_i~ ----3t/F _' of Units ----3t/H
~rcia1 _Iodust. _Swia. Pool _Other
__estaurant Ii: Health Departaent Approval
DESCRIP'l'IOR OF WORK:
THIf:~I-~~
/2 e t '1-"1 0 dt-'
/,',...., r.;:.
"
BUILDING SIZE:
x
Square Feet,
Height
RESIDBIlTIAL: ATtACH (2) PLOT PLUS Ii: (2) SETS OF BUILDING PLARS Ii: (1) SET EHERGY FORKS.
COMKERCIAL: ATTACH (3) SETS OF BUILDING PLARS Ii: (1) SET EHERGY FORKS.
PROPERTY SURVEY REQUIRED FOR ALL HEW CORSTRUCTION.
PERKITS REQUESTED
~UILDING
$
~ cP S-. & D
Valuation of Total Construction
RT.RcrJUCAL
AIIP Service
Florida Power Corp.
W.R.E.C.
-"ECBAIIICAL
-PLOIBIXG
$
Valuation of llecbanica1 Installation
GAS
ROOFIRG
SPECIALTY
TYPE 9F COItS'l'R.UCrIOR: ----..Block _Fraae _Steel
Other
PIIIISIIBD PJ.OOB. ELEVAnoRS:
FT.
IS PRO.JEcr IX FLOOD ZOO AREA?
YES NO
***...*............*....**..*.............
CONTRACTOR SECTION
COIIPAIIY To it ~I .. L, S:',-,- . . j- /1- {! d ", S ~.
. ~te Cert. or Regist. 1 /2' L~ .. f 7_';'.L /
-~ity License Registration 1 6.s-
.........................**...............
:=~, " . COIIPAIIY ~~,t? {~'"",::o 4C L FL h?^K,c/Lr' ",<JT,
/ ~~ ~ State Cert. or Regist. 1
? ~...." City License Registration 1 ~ ~y .
...**......*........*.....................
RIff' .DO
~
Signature
PLtJIIBER. COKPAIIY
State Cert. or Regist. 1
Signature City License Registration 1
*.*...*.*.*...............................
KECllARICAL COIIPAIIY
State Cert. or Regist. 1
Sigoature City License Registration .
*..*.....*.*...*....*..**...*.*...........
OTRRR COHPAIIY
State Cert. or Regist. 1
Signature City License Registration .
.....................*....................
APPLICAnOB APPROVED BY PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
!be undersigned understands that this penit lily be subject to "deed restrictions" whieb lily be lOre restrictive than City
regulations. !he undersigned il8SUIe& responsibility for ~liance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the OImer bas hired a contractor or contractors to undertake work, they lilY 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 lilY be
cited for a .isdeleanor violation under state lal. If the owner or intended contractor are uncertain as to what licensing
reguireIeDts lily apply for the intended work, they are advised to COQ.tact the City of Zepbyrhills Building Departlent, (813)
788-6611.
Furthenore, if the ower has hired a contractor or contractors, be is adviBed to have the contractor(s) sign portions of the
"Contractor Sections" of this application for which they lIill be responsible. If you, as the ower sign as the contractor,
you are indicating that fOu, rather than the contractor, are responsible for the work. If the contractor wishes you to sign
as contractor that lily be ail indication that he is not properly licensed and iB not entitled to perlitting privileges in the
City of ZephyrhillB.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEM LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's construction Lien Law - lIoIeoImer's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsUIeI AffairB. If the applicant is 8OIl!OD8 other than the
"OImer", I certify that I have obtained a copy of the above described docUIent and pIOlise in good faith to deliver it to the
"owner" prior to COIIeDceIl!Ilt.
E. CONTRACTOR'SjOWNER'S AFFIDAVIT
I certify that all the infoIliltion in thiB application is accurate and that all work will be done in ~liance with all
applicable laws regulating construction, loning, and land develoPEDt.
Application iB hereby Iilde to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has CDlenCed prior to iSBuance of a penit and that all work will be perfoIJed to leet standarcls of all laws
regulating conBtruction, City codes, loning regulations, and land develoPEDt regulations in the jurisdiction. I also
certify that I understand that the regulations of other goverDlleDtal agencies lilY apply to the intended work, and that it is
Ii responsibility to identify what actions I lUSt take to be in ~liance. Sueb agencies include but are not lilited to:
t Departlent of Bnvil'Olllelltal Regulation - CypresB Baybeads, Wetland Areas and BnviroDleDtally Sensitive Lands,
lIater/Wastewater !reat:lent .
t Southwest Florida lIater Managl!lleDt District - lIe1l8, Cypress Bayheads, lIetland Areas, Altering lIatercourses
t AIIY Corps of Engineers - Seawalls, Docks, Havigable lIaterways
t DepartleDt of Health' Rehabilitative Services, BnviIODleDtal Health Unit - lIe11s, lIastewater !reatlent, Septic !anks
t US BnviIODleDtal Protection Agency - Asbestos ahateleDt
I also certify that, if filllilterial is to be used in Flood Zone "A" or "A,ete.", it is understood that a drainage plan -
addressing a "C0Jp8D8ating volute" will be sublitted wbich is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A ~it issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel aiter, or
set aside any provisions of the technical codes, nor Bhall iSBuance of a perlit prevent the Building Official fIOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall beCf118 invalid
unlesB the work authorized by sueb perlit iB ~ced within BillOnths of iBsuance, or if work authoriled by the perlit iB
Buspended or abandoned for a period of sillODtbs after the tile the work iB ~ced. One 90 day stension of tile, lilY be
allowed for the pmit with fee charge of $15.00. fbe stension shall be requested in writing to the Builc1ing Official. An
approved inspection lUSt be -logged during eaeb Bil IOIlth period, or the project will be considered abandoned.
IIARHIHG !O OIIHER: YOUR FAILURI !O RlCORD A IfOfICE OF COIIIBICIIIIHf MAY RISUL! II YOUR PAYIIG !IIICE FOR DIPROVIIIII!S !O YOUR
PROPEm. IF YOU III'IBHD !O OB!lIK FIMAKCIIG, COKSOL! IIID YOUR LBIIDIR OR 1K AnomY BIFORB RICOBDIKG YOUR DICE OF
aIOIEICIMBII!. JOBS ORDER '2,500 IK VALUI DO lOt DID fO RECORD lID POSt A 'HOtICE OF aJIIIIICBIIIK!'.
Ii'-.e ~ ~y ~ -/ ~;g_J
.7 SIGllfURI: (IOlIR OR AGIII'l ,7' SIGIIA'IURI: COKDACrOR
8!I'O OF FLORIDA 0
coom OF [frf:Jj)
Tbe foregoing instrument was acknpwledged
before me this t{Ai 1(/ n... , 19~ by
~ ~./5 f\-lt+t,
wbo is persona~ly !m~ to ~ or who has
produced .Bn(U()~ ~\Jt>11s.. LA c.EIJ'S€.
as identificat}9D and who did/did not
~ake/~~(M~'~
~~k<J~m --
(Name Typed, Printed or St~ed)
NOTARY PUBLIC
S!A!E OF F~
coum OF tl-S"n
Tbe foregoing instrument was acknowledged
before me thiS~, 19-55. by
J{;)~,S~'\
wbo is personal!y ~wn to me. orwbo has
produced -:tl n'flA OA IUle11J k \C.fnsF.:
as identif1cation and bo did/did not
tak~%4~ ',/'
V~ J (, ,r-;~~
Si~at~ _
~D .~t'\S6n
(Name-Typed, Printed or Stamped)
NOTARY PUBLIC
A ROBERT L. JOHN.sON
._. Nota;y P:,jolic. S!;;~F cf Fi'>:'irJa
. ." ,MY Comm. 8~fJ!,ri)( i:.CI,i ';~.J ~
No. (;C4:)>;;';~ ~
~ Bond9d Thru (f;[fina! ~\-lr',.:,....'lI ~r"ll:[" I
1-(8CO) 123-0121" .. ,
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R03mn L- JOHNSON
Notur~' r\;t~:C. St;;t.1 of Flr;Ttda
M'j C,)mm. Hxpir&s ~.~;:.y 08.' 999
No CC~::'I'Si2
Bonded ThjJ (f':~irdlt: ~r::,~,,'1! ~t'r,.irt
1jg.OQ) 723.0121
Proposal
Date May 15,1995
John L. Smith Construction
37326 Rutledge Drive
Zephyrhills, Fl. 33541
(813) 782-0470
RB 37321
Proposal Submitted To
Work To Be Performed At
Name Dr. Daniel W. McGrane
Street 6725 Cedar Ridge Dr.
State Zephyrhills ,Fl. 33540
Telephone # 788-7662
Street 6725 Cedar Ridge Dr.
City Zephyrhills State Fl. 33540
Date of Plans
Architect
We hereby propose to furnish all materials and labor for the completion of
Build approximately a 10' wall with one 3' Luan hollow core door and cut a 3' wide opening between units
3 and 4. Install 1 light switch, move lights as needed and install 2 wall plugs.
All material is guaranteed to be as specified, and the above work to be completed in accordance with the
drawings and specs submitted for above work. All work and materials to meet local industry standards and
existing codes in effect at date of this proposal. The above work to be performed for the sum of
FOUR HUNDRED EIGHTY FIVE and 00/100 Dollars ($ 485.00 )
with payments to be made as follows:
WHEN COMPLETE.
Any alterations or deviations from the above specifications involving extra costs, will be executed only upon
written orders, and will become an extra charge over and above the estimate. All agreements contingent upon
strikes, accidents or delays beyond our control. Owner to carry fire, wind and all other necessary insurance
required upon above work. Workers Compensation and Public Liability Insurance to be taken out by builder.
Respectfully submitted ~ ~ ~~
Per John L. Smith Co~truction
This proposal may be withdrawn by us if not accepted within 5 days
Acceptance of Proposal
We, the undersigned have read this proposal and do agree to the terms and conditions as listed above and to any
attachments, if included. We authorize you to do the work as specified. Payment will be made as outlined in
this proposal.
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ZEPHYRHILLS FIRE DEPT
Zephyrhills Florida 33540 (813) 782-8184
FIRE CODE INSPECTION
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Classification (// /
Business Name
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Address ~.,C '.'..-..)
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OwnerlManager' , ;' ..
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Business Phone
Emergency Contact Phone
Occupancy Load
Alarm Monitoring Co.
Phone #
TYPE OF INSPECTION CONDUCTED
o QUARTERLY 0. FINAL 0 ANNUAL
/
ORE-INSPECTION 0 OTHER
\ ;"
o APPROVED JQ NOT APPROVED
("
o COMMERCIAL CHECK
OBI-ANNUAL
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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Inspectors Na~~\" "-;~?
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Owner/Manager Signature
Title
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