HomeMy WebLinkAbout95-5156
BUILDING PERMit 0-
CITY OF ZEPHYRHILLS permit:N\. -~515V IJ
(813) 788-6611 Date ?-J. ~ ?s.-
e
Property Owner: ~ .)/ ~C) , .
Job Address:<..5.i: i.s-~ ~-!}~- -s----;F-- 6 0
Parcell.D. # cJ -.:2.-6 -02/ - l) t> .() () - {) / / / _
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
C-I LY1A-< ~-:}
o//::J..-lJ/I3_C9/1 V
Water Meter:
T,I.F.'s:
Zoning:
Description of Work
Energy Code;
~~~
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
'(1 )
DATE
Complete Plans. Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
Valuation or
Contract Price
~3 J?3. -:- nJ
/ -
/y~
Permit Fee if t.9 - t7D
Signature~.AA..._ ~ y~
Company
Address
Telephone#
City License Registration # / y ~
State Certified License#
L~r;r ~/&L-
Ftr.
Pre SLB
Lintel
BUILDING
~~A.f-95 (JIL..'-
ELECTRICAL
PLUMBING
-
MECHANICAL
..
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Ins!.
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.
APPLICATION FOR PERMIT
CITY OF ZEPHYRBILLS
BUILDING DEPARTMENT
OWNER'S NAME r;ENce~L /-lame [J6;)...Uf~OpnCNr PHONE <KId -S~ /- ~Sgl
OWNER'S ADDRESS ~/;;( :s'~'7 []:. -S Tf2C-eT lA4:fEc'tv';:-l- ~
JQB ADDRESS 315 '15'1. '3 g "'1,5 ~ I :3 Y 4S~. 3 g <..{60 Co rr CJNwoo:i Pt..,qc&
, , ,
LEGAL DESCRIPTION: LOT(S) IIi} II~,. IJ.~JI'I BI.OCIL--SUBDIVISIONj)~ i f'T'-Uocci \II H f\cJG"
PARCEL LD.' d-J)1o -~) -cx::rtY>-OIIl.On:t..O /1.3,0111.{ (OBTAIN FROM PROPERTY TAX NOTICE)
, , r
WORK PROPOSED:.)L..New Construction _Addition -...Alteration _Repair _Install
_Sign
-.JIove
_Deaolish
PROPOSED USE: _Single Faaily
-.JI/F _, of Units _M/H
_ec-ercial
_Indust. _Swia. Pool _Other
------Restaurant &: Health Departaent Approval
DESCRlPTIOR OF WORK: ;;;'0 ><6D FREE 5/rlHd/Al9 CAlZ-pC/2.- r
I I
BUILDING SIZE: (:){) X tOO. Square Feet, ~~/OHeight
RESIDERTIAL: ArrACK (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS.
COMMERCIAL: ArrACK (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTED
_BUlLDIRG
$
Valuation of Total Construction
_ELEC'1'RICAL
AIIP Service
Florida Power Corp.
W.R.E.C.
-"ECllARlCAL
$
Valuation of Mechanical Installation
_PLUMBIRG
GAS
ROOFING
)('X SPECIALTY
TYPE OF CORSTRUCTIOR: _Block _Fralle _Steel
Other
FI1IISBED FLOOR ELEVAnORS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
CONTRACTOR SECTION
-~_.-.
BIJTI.DER
COMPANY
State Cert. or Regist. ,
City License Registration .
******************************************
Signature
RI.RCTRICIAII
COMPANY
State Cert. or Regist. t
City License Registration ,
******************************************
SionJlture
PLUMBER
COMPANY
State Cert. or Regist. ,
City License Registration ,
******************************************
Signature
IlECHARIGAL
COMPANY
State Cert. or Regist. t
City License Registration ,
******************************************
Signature
Signature
COMPANY EdwAe.d L, J...A RA DE M.I}, C~K LLon 6 ~~Co,.
~ ~d~ ,.. ;J State Cert. or Regist. t ~.Xt 4.31'
j! . ~ City License Registration' Iv7..~M.
*****~** ******************************** 'c'
OTIIRR
APPLICATION APPROVED BY
'.. .'.'., '.
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Tbe undersigned understands that this perlit laY be subject to Ideed restrictions" wbich laY be lOre restrictive than City
regulations. !be undersigned assUles responsibility for COIpliance with 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 with
state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor laY be
cited for a lisdeJleaJ\or violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requirl!leDts laY apply for the intended work, tbey are advised to contact the City of Zepbyrbills Building Departlent, (813)
. 788-6611.
FurtheIlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
"Contractor Sections 1 of this application for wbich they will 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 wisbes you to sign
as contractor that lay 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 UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of IFlorida's Construction Lien Law - HOIeOIfDer's Protection
Guidel prepared by the Florida Departlent of Agriculture and ConsUJeI Affairs. If the applicant is sOleOIle other than the
lowner", I certify that I bave obtained a copy of the above described docUJent and pro.ise in good faith to deliver it to the
Downerl prior to COlleDCeJIeDt.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infoIlation in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, loning, and land developlleDt.
Application is hereby lade to obtain a perlit to do wort and installation as indicated. I certify that no work or
installation has cOlleDced prior to issuance of a perlit and that all wort will be perf oIled to leet standards of all laws
regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
certify that I understand that the regulations of other goveIDleDtal agencies laY apply to the intended work, and that it is
If responsibility to identify what actions I lUst take to be in COIpliance. Such agencies include but are not 11lited to:
* Depart:lent of EnvirOllleDtal Regulation - Cypress Baybeads, Wetland Areas and Envirollll!J\tally Sensitive Lands,
Water /Wastewater 'freat:lent
t Southwest Florida Water HanageJIeDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
t Departlent of Health & Rebabilitative Services, EnvirOllleDtal Health Unit - Wells, Wastewater 'freatlent, Septic Yanks
t US InvirODlental Protection Agency - Asbestos abatelent
I also certify that, if fill laterial is to be used in Flood Zone "AI or "A,etc.l, it is understood that a drainage plan
addressing a ICDlpeD8ating volUJeI will be sublitted wbich is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A peIlit issued sball be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall 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 beCOle invalid
unless the work authoriled by such perlit is ~ced within sillOntbs of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of sil IOntha after the tile the work is C08eDcecl. One 90 day l!Itension of tile, laY be
allowed for the perlit with fee charge of $15.00. 'fbe l!Itension sball be requested in writing to tbe Building Official. An
approved inspection nst be logged during each sillOnth period, or the project will be considered abandoned.
WARMING 'l'O omR: YOUR FAILURE 1'0 RECORD A IO!ICE OF CCIIMERCEIlm HAY RESULI' IN YOUR PAYING fiICE FOR IHPROVBMmS 1'0 YOUR
PROPER'lY. IF 'YOU III!BID 'f0 OBllIH FIHAIICING, COIISUL! WIn YOOK LIIIDIR OR lI1 AnoRHIY BEFORE RECORDIIG YOUR IO!ICE OF
COHMEICBHm. JOBS OlDER $2,500 IN VALUE DO NO! REED '1'0 RlCORD AID POS'f A INO!ICE OF COHMIIfCBHlll'D.
\
~ofJu/~~
SIGlA!URE: COIll'RACl'OR ~
~ca./~O('y~
SIGlA'IURIl: OOBR OR !Gift
SI'An: OF FLORIDA
coum OF Hernando
The foregoing instrument was acknowledged
before me this July 27 , 19~ by
Edward L. Larisey
who is personally known to me IJjC~
~M
ask~t~;~ca,tion an, d, who did"'/,did not
e~<~.~a 0, t4'1tfC7)
(S1gnature) l
Patricia F. Felger
(Name Typed, Printed or St~ed)
NOTARY PUBLIC ~ f I'JJ '! B I
NOTARY PUBLIC, STATE OF FLORIDA..
MY coMMISSION EXPIRES: Dee. 26, 199'. "
, IONDED T81tU NOTAIlY PUBLIC UNDDWJU'l'E~
S'l'A!E OF FLORIDA
COUll'Y OF Hernando
The foregoing instrument was acknowledged
before me this July 27 , 19~ by
Edward L. Larisey
who is personally known to me ~x.hQdura:
I~Hf*
as 'd tification and who did/did not
a oath.., I) 11! /J -: ~
L(). tL,' .J" <,~
( gnature) ~
Patricia F. Felqer
(Name Typed, Printed or ~tamped)
NOTARY PUBLIC (!,,{!/ J /) / </8/
l'<..H,..a i'li..LiC, Sl'A'l'h OF ""LOKIDA.
MY COMMISSION EXPIRES: Dee. 16, 199'.
laNDED TllRU NOTARY PUBLIC llNDUWBlTERS.
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BECK GRAPHICS INC" CLEARWATER FL 813,443.3803
DATE t -\Ci-CiS
CUSTOMER NAMaQ.,V--<--(U'i ( f-h=;N
L ~~~ \
JOB LOCATION c -r- 10 '1 - \ 0
TAKE OFF DONE BY C"13-i-VE-
COX LUMBER CO.
ALUMINUM DIVISION
P.O, BOX 10450
BRooKSVILLE, FL 34601,0450
" ' (904) 7~-7732
DATE WANTED ~Ot 0..,
. \
QQ-c~I.o ~i~:i( 5t7-~S9(
LOT
LEGAL
BLK
JOB#
PERMIT #
STREET CCTI"t; fl.l,....XC.O
COUNTY Pf\~ (:,
~LQ--
COX INVOICE #
COLOR OF SOFFIT:
SIZE OF OVERHANG:
DRIP EDGE TO BE INSTALLED BY COX:
ROOF LINE: HIP GABLE
SIDING IN GABLES:
COLOR OF SIDING:
TYPE OF SIDING:
SCREEN ROOM:
W.O, #
10002
FASCIA:
FASCIA SIZE:
YES
TYPE RETURN:
YES
BRAND NAME:
DBL5:
DOOR:
SIDING:
FOOTAGE:
NO
LEVEL
UPRAKE
NO
VINYL
WHITE
DBL4:
BRONZE
OUT/LAP
HIl
H/R
COX LUMBER CO. AGREES TO PROVIDE AND INSTALL THE FOLLOWING:
\ i/-,J ~ T7A-\ \ ;.j-D X (/)O 'F{\..v~"S IAf'-I D (t-.JC eA-a ~J(';ft( l'0.~'~l~\ .
c~ W--l'L i l""sZ'u^'" c... i"\ r"A -:. ec\ .) IS TO t:ra 1''\~.'l {..e d I r-J ( G,0C l'\.Qk_
I 1 '., J. 1',\ b\Cf; c L TO e 1> 1+ {- C '" ;;: ~ r-J is h. en <; ~./ Q. F1~- P'.....L~ ~ P.e e ("\ l t
DIRECTIONS:":-=>:,}... e - "3C \ '5 - -r/ C-
.
P-..J.I)O -2.0 ('\(-{'--'"IArrr) ,-7,0 c...-; (I~
'<.i-.J' L/ -fIe; <; 011 (-eA---;' I
I
MISC, 'f (')-75'0- -' [_
PRICE SUBJECT TO CONFIRMATION AND FIELD MEASUREMENT
BEFORE INSTALLATION IS STARTED
COX LUMBER CO, RESERVES THE RIGHT TO CORRECT ANY ERRORS IN EXTENSION AND ADDITION ON THIS BID.
TOTlI:" NET SUM OF $ U " </~ _:-'"7 SI PLUS TAX: , q / Q TOTAL: U ::2, (:"/ - ""\'0
SIGNED \ <J \. PURCHASER S-.o I I ,---I ,~ :J ~CI-
Tit!e to above described property shall not pass by delivery, but shall remain vested in and be the property of Cox Lumber Co. until piJrchase price has been fully
- -- "=:~: 2::>"-' ,..:~;e:~ te lien laws, 10% handling charges on returned merchandise. ALL INVOICES ARE DUE: AND PAYA8LE BY THE 10th OF THE
' ,- :-':"~_,)WIN-:; Pt';?,8HASE Payment not received by the 15th of the month following purchase will be considered delinquent and a ~ i.'2% interest charge