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Home My WebLink About95-5173 BUILDING PERMIT- '-5173111 CITY OF ZEPHYRHILLS Permit W! , - -" (813) 788-6611 ,0"- Date)7 - 7- 7~ BU~ Q /)p~ ~~ :;::~:::. Pmperty Owne" -ff&~ "t. -i/.J:l4:".' . l YD%,~~ Wote, Mete, Job Address: ~__ :0 ~ - _ __ T,I.F.'s: Parcel I. D. # Zoning: Description of Work '!..n::Jl. Code: U Radon Gas: ( "~-L- -U /flL/ ;q (1_ Q),~L~ NO OCCUPANCY BEFORE C.O. FINAL C.O. 8~J~-9S DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. DATE Valuation o~ 4 ~ ?? 2 --, ~ i:.> Contract Price . - ~ Permit Fee Signature Company Address Telephone# City License Registration # 10 6 State Certified License# a/j (! n t29g~ E!lu/JiJt.tJ4"! ~'~A11?' ELECTRICArffIIBi BU~ ~ CA1t~~~{hk-: PL~ MECHANICAL ~ - Tp.Serv. Rough In Meter Can Const. Pole Pool Pre-Meter Final Ftr. Pre SLB Lintel FRM. Insul. CL WL SLB Tub Set Water Sewer Final 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 ($15.001 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. cd~e..J<C APPLICATION FOR PERKIT CITY OF ZEPHYRBILLS BUILDING DEPARTKENT _'S _llf~V ~~ PROBE OWHER t S ADDRESS 9 - ~<.f tf c(' S~ - ft~ Yf2f1ztLC; BLOCK />6 SUBDIVISION C/T7 l> I- Zo/,t(fK.~;/J JQB ADDRESS 7f?e - Ig-C;~ / z/i JI- IZ- , LEGAL DESCRl.PTI.ON: LOT(S) g PARCEL 1. D.' (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:~ew Construction _Addition ---..Alteration ~epair _Install _Sign ----1fove _Deaolish PROPOSED USE: f..-Sin8le FalIily ---1f./F _' of Units _M/H _ec-ercial _Indust. _Swia. Pool _Other .-J,estaurant & Health Departaent Approval DESCRIPTIOR OF WORK:-13 J~ tlfItTRJYY)P CfffftdtF-()W BUILDING SIZE: x Square Feet. Height RESIDENTIAL: AT'lACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. COMMERCIAL: AT'lACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED _BUILDING $ Valuation of Total Construction _ELECTRICAL AIIP Service Florida Power Corp. W.R.E.C. ~CllAllICAL $ Valuation of Mechanical Installation _PLUMBDlG GAS ROOFING SPECIALTY TYPE OF CORSTRUcnOR: _Block _Fraae _Steel Other FDJISBID FLOOR ELEVAnORS: Fl. IS PROJEct IN FLOOD ZORE AREA 'I YES NO .......................................... CONTRACTOR SECTION COHPARY State Cert. or Regist. . City License Registration . ...********.**...*********** BUTIJ)ER Signature COHPARY g State Cert. or Regist. ity License Registration . * ***..*****.*..*****.*******************. COHPARY State Cert. or Regist. . City License Registration . *...*.*****.....*..****.**** OOIJPAIf'Iljl) I/JIf'./JP mr,/U f!1 ~ _State Cert. or Regist. . M AP" City License Registration' J (9 ~ ****************************************** PLUMBER Signature IlECllANICALfi Signatur(~ COHPARY State Cert. or Regist. . City License Registration t ****************************************** OTRRR Signature APPLICATIOR APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS 'l'be undersigned understands that this pemit JaY be subject to "deed restrictions" wbieb 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 ower 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 lisd_anor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing requirelents JaY apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813) . 788-6611. Furtheraore, if the ower bas hired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the "Contractor Sections. of this application for whieb 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 work. If the contractor wisbes you to sign as contractor that JaY be an indication that be is not properly licensed and is not entitled to pemitting 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, bave been provided with a copy of .Florida's Construction Lien Law - HOIl!OIOler's Protection Guide" prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs. If the applicant is scmeone other than the .owner., I certify that I bave obtained a copy of the above described dOCUJent and prOlise in good faith to deliver it to the "owner" prior to COIIenceaent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the infoIlition in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, loning, and land developllent. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation has COIIenced prior to issuance of a perlit and that all work will be perforJed to leet standards of all laws regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other governJelltal agenCies JaY apply to the intended work, and that it is .y responsibility to identify what actions I lUst take to be in colpliance. Sueb agencies include but are not lilited to: * Depart.lent of BnvirODlental Requlation - Cypress Baybeads, Wetland Areas and Bnvironaentally Sensitive Lands, Water/Wastewater 'l'reatlent t Southwest Florida Water Manageaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t Arty Corps of Engineers - Seawalls, Docks, Navigable Watenays t DepartJent of Health , Rehabilitative Services, Bnvironaental Health Unit - Wells, Wastewater 'reatlent, Septic 'anks t US Bnvironaental Protection Agency - Asbestos abateaent I also certify that, if fill Jaterial is to be used in Flood Zone "A. or "A,etc.", it is understood that a drainage plan addressing a .coapensating volute. will be subtitted wbieb is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A perlit issued shall 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 sball issuance of a perlit prevent the Building Official fl'Ol thereafter requiring a correction of errors in plans, construction, or violations of any code. Bvery perlit issued shall beCDle invalid unless the work authorized by sueb perlit is COIIenced within six IOnths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of sil IOnths after the tile the work is cOBenced. One 90 day extension of tile, laY be allowed for the perlit with fee cbarge of $15.00. 'be extension shall he requested in writing to the Building Official. An approved inspection lUSt be logged during eaeb sillODth period, or the project will be considered abandoned. WARRING '0 MER: YOUR FAILURE '0 RECORD A NorICE OF ClIIMBHCBIIm MAY RESUL' IN YOUR PAYING BICE FOR IMPROVBMBM!S '0 YOUR PROPBR'fY. IF YOU IJIJ'DD '0 OmAIN FIXAMCIMG, COJlSUL' WI!H YOUR LBJIDBR OR AM AnoRIBY BBFORE RECORDIMG YOUR CB OF COMHBRCBMBlft'. JOBS OlDER $2,500 1M VALUE DO lor IfIBD 'f0 RECORD AND POS' A. ICB OF COMHBR n" ('hQA~JA~_ ~~}.)~~A' SIGJlAfURI: amR OR AGBJI'l S'fAfB OF FLORIDA P CDUm OF ' A:s =-> The foregoing instrument was acknowledged before me this 4.-- ~ '7 , 19 ') J--- by C,. e-A.X2. I /<" -I (.;v " .-I o is personally known 0 m or who has pro uced as identification and whQ did/did not take an oath., / ;-~ fc~ (Signature)____ 'J /', ,./ J 61Z.~e D ~k-"" ,. ~ (Name Typed, Printed or Stamped) NOTARY.I"'~.. OFFICIAL SEAL ! ~ \ TERENCE O. SMITH , : My Commission Expires \. ! Feb. 28. 1996 .1lA.- :f>.... .;.:1'tOFf~dI'... Comm. No. CC 183155 ........" S'fA'fB OF FLORIDA ~, CDUm OF fd:S c-) The foregoing instrument was acknowledged before me this .~ /' , 19 ~ by CM~ ,,4 ~:4/z~ ~lS persona Iy known tn~e or who has pr uced as identification and who did/did not take an oath. ~ l I ~--'-- c.~ (Signature)_ , t' ,. / e;rLe-~<-e c-~ ~? '&r r 0/4 (Name TYP~F..,rinted or Stamped) NOTARY P.. ~.. OFFICIAL SEAL .~. : ~ TERENCE O. SMITH . . : : My Commission Expires \"'" . ,.... Feb. 28. 1996 ..;~~oF~Fl&-~..' Comm. No, CC 183155 -..... ..' ~ RECYCLED PAPER <6& Contents: 40% Pre,Consumer . 10% Post,Consumer ij 'roposul Page No, of Pages State Certified ENVIRONMENTAL CONTRACTORS 10221 Highway 301 DADE CITY, FL 33525 Phone 567-5515 Electrical EC 0000491 Plumbing CF C037171 Air Conditioning CA C029382 loli P7: --- JOB LOCA liON JOB PHONE We hereby submit specifications and estimates for: ..ey../{,v.t2.f3= 'Ht:.I-12?L4~ . i~#il~~;~~~: .Q~'H"" .. ~:i~~ti~;S~~i~~sli;; ,H.....fiH'J't2..'H:/.~H'-.4!.l=lfa~1L!'..., , .......lHHHI!~r!(!fi~p.f/~:~C...,' ..rrt1.....""."CIkR;tf. ..........~?~~r1t:??LPJ;TI~.HH...,., *~I?;;i~~~;:;~;1:!t~I?~=~(....~...::: ktfH 1/5 ~Hk~r.f...~H~~L.'2,~(.~~?:. Z'[?J.II/". ....Ii~P:t.r..l!..C!~~:....1 ..............:.~..~.~~.../ft~~=~1ti~& .e~(~(~~,."..,' .....,I~>L'.f.!~.......lHP:,~eHH~.!2.,. .~.H....'...H....'..H'....." . ::> ere.. ....""".....".........,..,ITs:.....,....=."... IIf 'rOpOSf hereby to furnish material and labor - complete in accordance with above specifications, for the sum of: dollars ($ ), All material Is guaranteed to be as specified, All work to be compleled in a workmanlike manner according to standard practices, Any alteration or davlation from above specifications Involving extra costs will be executed only upon written orders, and will become an extra charge over and above the estlmata, All agreements contingent upon strikes, accidents or dalays beyond our control. Owner to carry fire, tomado and other necessary insurance. Our workers are fully covered by Workman's Compensation Insurance, Authorized Signature Note: This proposal may be withdrawn by us if not accepted Within Date of Acceptance: SignaIUre~~V' ~ .signatur~~ It ^A ~ ~ ~ Acceptance of 'roposal- The above prices, specifications and conditions are satisfactory and are hereby accepted, You are authorized to do the work as specified. Payment will be made as outlined above,