HomeMy WebLinkAbout95-4989
BUILDING PERMIT
Permit N.?
CITY OF ZEPHYRHILLS
(813) 788-6611
49898
Date -S - SO ~ 7'<..<:'-
~ ELECTRICAL PLUMBING MECHANICAL
Pmp,ny Ow,", ;fyf~ 1Jf~
Job Address:<... ?~ ~ _ ~_
Parcel I.D. # 3 -::J6 .;)../ - 0 /..g 0 ,.. t!J f) CJ <J lJ - (J~ --7 cJ
Sewer Conn
Water Conn:
Water Meter:
Tl.F,'s:
Valuation or
Contract Price
:2 '/~CJ. crv
"
FINAl__
C.O.
DATE
Zoning:
Description of Work
NO OCCUPANCY BEFORE C.O.
Complete Plans. Specifications and Fee Must Accomp'
All work shall be performed in accordance with Cit
City License Registration #
State Certified License#
Y$I
,
r~~nd Ordinances.
~ r Inspector
Pe,m;' Fee ~ - ~
;gnatu;. It _ t -,b~
Company __
Address
Telephone#
DATE
13 -+ kJ Ilt ~~_
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
FRM.
Insul. CL
WL
Driveway J"~'-1o) 61U--
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.001 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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APPLICAnON FOR PERIIIT
CITY OF ZEPBYRIIILLS
BUILDING DBPARTHERT
OWNER'S IWm .5/1/e~v J}/;4l2JlJlFI?..<VJ"v ~R .
OWNER'S ADDDSS 37(~cj5f a/l /)0 7Mt!&
JOB ADDRESS 5A/7J e-
PHONE
'-
LEGAL DESCRIPTIOII: LOT(S)
B~SUBDIVISION cqf?/-I,V/C '.~b;i6-
PAaCEL LD.' 3-d/, c::;') -/')/3{/ -bDon /'") - o59/J
(OBTAIII FROM PROPERTY TAX NOTICE)
WORK PROPOSED:~ew Construction ---..Mdition ---J\lteration
Repair _Install
_Sign
--.-JIove
~lish
PROPOSED WE: _S~e F_i~
----.Jt/F _' of Units ----.Jt/H
_ec:-ercial
_Indust. _Swia. Pool _Other
Restaurant & Health Departaent Approval
DBSClUPTIOB OF W01l1I./JhjflJRUP ,,6:J.ff:;.fb 11. '0 RI!.L(!f/) "1/ I' ~aet ,I .~N ,i'LVR! ""-.5/))6J/4/ 16
BUILDING SIZE: X Square Feet, Height
RlmIDEI1TIAL:
COMMERCIAL :
ATTAaI (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET DERGY FORMS.
ATTAaI (3) SETS OF BUILDING PLANS & (1) SET DERGY FORKS.
PROPERTY SURVEY REQUIRED FOR ALL NEW COIISTRUCTION.
~LDING
PERMITS REQUESTED
$ 02~ .CJO
Valuation of Total Construction
RT.RcnuCAL
AMP Service
Florida Power Corp.
W.R.E.C.
-"ECIWIlCAL
$
Valuation of llechanica1 Installation
.-PLtIIBIIIG GAS ROOPIRG
TYPE QF COIiSTRUC'l'ION: _Bloclt _Fraae _Steel
SPECIALTY
Other
FDIISIIED FLOOJl ELEVAfiOIlS:
PT.
IS PROJECT IN FLOOD ZOO AREA?
YES NO
..........................................
BIJTT.DRR
COIITRACTOR SECTION
.d a>>IPAllY7flll ~Mo/~()1'Wr lAiC--
~ . State Cert. or Regist. . .
tMY/ tt?d1.P./ City License Registration' ~L/
.............*............................
Signature
RT.RCTRTCIAR
COKPANY
State Cert. or Regist. .
City License Registration .
.................................*..*.....
Sianature
PLUMBER
COMPABY
State Cert. or Regist. .
City License Registration .
..........................................
Signature
KECIIAlIICAL
COHPABY
State Cert. or Regist. .
City License Registration f
..........................................
Signature
OTRRR
COMPANY
State Cert. or Regist. .
City License Registration t
..........................................
Signature
APPLICAnON APPROVED BY
PERIIIT OFFICER.
_ _,~,..."" v '.'~~~.:p:'.,( ~~"V: .~
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
'fbe undersigned understands that this penit IlaY be subject to 'deed restrictions' Ibich IlaY be lOre restrictive than City
regulations. !be undersigned ass_ respcmsibility for COIpliance lith any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the OlDer lias IIired a contractor or contractors ' to undertake IOrk, tIIey lilY be required to be licensed in accorclance litll
state and local regulations. If the contractor is not licensed as reguired by law, both the 0IIIlef and contractor IlaY be
cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to "bat licensing
reguireaents IlaY apply for tile intended work, they are advised to COBtact the City of Zepbyrbills Building Departlent, (813)
788-6611.
FurtheIlOre, if the owner bas lIired a contractor or contractors, be is advised to bave the contractor(s) sign portions of tile
-Contractor Sections' of this application for Ibicll they lill be responsible. If you, as the OlDer sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the work. If the contractor lIiabes you to sign
as contractor that IlaY be an Indication that be is not properly licensed and is not entitled to penitting privileges in the
City of Zepllyrbills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN' LAW (CBAPTER 713, FLORIDA STATUTES, AS .AMENDED)
I certify that I, tile applicant, bave been provided lith a copy of 'Florida's construction Lien Lal - lReoImer's Protection
Guide- prepared by tile Florida Departlent of Agriculture and Consuaer Affairs. If tile applicant is soaeone other than the
-OIDer-, I certify that I bave obtained a copy of the above described dOCllleDt and praUse In good faith to deliver it to the
-OlDer' prior to co.enceaent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the Infonation in this application is accurate and that alllOrk lill -be done In COIpliance lith all
applicable laws regulating construction, zoning, and land develo(lK!llt.
Application is bereby Be to obtain a penit to do work and installation as Indicated. I certify that no IOrk or
installation bas CDlenced prior to issuance of a penit and that alllOrk .ill be perfoned to .et standards of all laws
regulating construction, City codes, zoning regulations, and land developaent regulations in the jurisdiction. I also
certify tIIat I understand that the regulations of other gOYeI1IIIeIltal agencies IlaY apply to the Intenc1ed work, and that it is
If responsibility to identify wbat actions I lUSt take to be in coapliance. Such agencies include but are not lwted to:
t Departlent of BnvirOlllelltal Regulation - Cypress Baybeads, Wetland Areas and BnvironRlltally Sensitive Lands,
Vater/Vastewater 'lreatlent
I Southwest Florida Vater Manageaent District - Veils, Cypress Baybeads, Wetland Areas, Altering Watercourses
I ArIy Corps of BnqineeIS - Seawalls, Docks, Ravigable Waterways
t Departaent of Health i Rehabilitative Services, BnvirOlllental Health Unit - Wells, Vastelater 'lreatlent, Septic lants
I US BnviIOJlll!lltal Protection Agency - Asbestos abateaent
I also certify that, if fillllaterial is to be used in Flood Zone -A' or -A,etc. -, it is understood that a drainage plan
addressing a 'COQ8IlSating volute- lill be sublitted Ibicll is prepared by a professional engineer registered in the State of
Florida prior to penit issuance.
A peJ;lit issued shall be construed to be a license to proceed .ith the IOrk and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a penit prevent the Building Official fICII thereafter
requiring a correction of errors in plans, construction, or violations of any code. Ivery perait i88ued aball becaIe invalid
unless the IOrk authorized by such penit is co.enced .ithin sillODths of issuance, or if work authoriled by the penit is
suspended or abandoned for a period of sillODtbs after the tile the work is co.enced. One 90 day atension of tile, IlaY be
allOlled for the penit .ith fee cIIarge of $15.00. file atenslon sball be requested in writing to the Building Official. An
approved inspection lUSt be logged during each sillODth period, or the project lill be considered abandoned.
WARMUG 10 CMIR: YOUR PIILURI '10 RlCORD I ROIlCE OF CIJIIIBICIIIBII MAY RISOLf II YOOI PIYIIG niCE FOR IIIPROVBIIIIIS 'fO YOUR
PROPERlY. IP YOU IJIIIID 'fO OBtAIII' FlllAlCCllG, COISOLI WIIB YOUR LIIIDIR OR All IftORIIY BIPORI BICOBDIIG YOUR JIOIICI OF
OIIMEICBMm. JOBS utmlR $2,500 II VALUE DO IOIICIID 'fO RECORD AID POSI A 'IOIICE OP CCIIIIICCIIIIIC'f'.
SIGIA'lURI: COIIRIC'fOR
SIGIA'lURI: (MIIR OR AGm
SUfi OF FLORIDA
coum OP
The foregoing instrument was acknowledged
before me this , 19____ by
S'lIU OF FLORIDI
coum OF
The foregoing instrument was acknowledged
before me this , 19_ by
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
who is personally known to me or who has
produced
as identification and who did/did not
take an o."th.
(Signature)
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stuped)
NOTARY PUBLIC
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S'T AI\IJARD' FORlYl OF AGREEMENT
BET\tVEEI\I C()l'~TRACTOR AND OWNER
THIS AGREEMENT mode the..-=/42.?0L/:i::../2{Kll-t..___ ----_day c{ flJ/Jl
Nineteen Hundred anLlY!&er"l'_E/()&_ _. __" __by unl brt\\'('('n_($~"Be..El!3k
hereinafter called the Contractor, a ld..:;S/iLIZiE~. --fl'll1f:..LlheL.5().N.._~. _____ .
Owner, Witnesseth, that the Contnctor a!ld the -bwl1Cr f(.r ~e cOllsiderathns named agree as follows:
--in the year
..---.- - --- _.._~----~-'-,
hereinafter called the
AHTICLE 1, SCOPE OF THE WOIIK
The Connctor shall furnish all 0' the mate~ls ,lIld perfoml all ot the work shown on the Drawings and described in the Specifications
entitled (Jw~ ~&L aU .. _/)I!I-'.I~ft'I; {I/il!!/l~gr .;.:5Md.tJL.&Mm_ts/bEi-UflLks
prepared by73.+f.I m~[)N/CJ,/-+2!em.ELCt-. live-- -- __ ____ __ __ ____________. actmg as and in these
Contract Documents entitled the ~rdlltect, and Sh,lll d,) .".Cl} thlll': "''ll11'rel by thIS ,\greelllent, the general conditions of the Contract, the
Specifications and the Drawings.
ARTICLE 2, TIME OF COMPLETION
The work to be perfonned under tlu Contract shall be cummen('ed.iL:.;--~~_L:tL_t~:P.llZlL_..L':l._/!EelC"'()F~
b t 'II I d 1,')/-rU/^/ CJA/~ tl.:>CC'L/
su s antia y comp ete ~"-:L1JLLLL_~.'>.->..L____~________
Rnd IhaIl be
ARTICLE 3. THE CONTRAGf S:UM
The Owner shaIl p~.,the co~'!)tor for the pe... rfolmancf' .of the. c..o.ntract. subject to additions a~ deduc~ )lrovided therein, in current
funds as follows: ("Df~~ /'ZcJO -~t!!/.Y..t~E0.~1t],.u./61?~/\ /7F,L~ V/Oo
(State here the lump rum amount. unit prices. or hoth, al de.ired)
Authorized Change Orders will be submitted by the Contractor for all work not specifieaIly included in this Contract.
ARTICLE 4. PROGRESS PAYMENTS
(Insert here an}' provuloll made for the amount relained after the work rea rho, a certain .talle of completion.)
ARTICLE 5. ACCEPTANCE AND FINAL PAYMENT
--ru r:- elF
Final payment shall be due---.LLLC:'_____davltl..... substantial completion of the work provided the work be then fully completed
and the Contract fully perfonned. .
ARTICLE 6. THE CONTRACT DOCUMENTS
The General Conditions of the Contract; the Sp..cifkalions and the Drawings, together with this Agreement, form t11e Contract\ and they
~fo:af~~~: a part uf the Contract as 1l ht'reto att;ll'h,.d "r herrin repeated, The following is an Itemization of other essentia pertinent
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:: : My Comm. Explr,.: ::
= : arch S, 1996 : ==
: CC1853q7 1 :
. ::::