HomeMy WebLinkAbout95-5231
BUILDING PERMIT~~
lLTO
D.
CITY OF ZEPHYRHILLS Permit
(813) 788-6611
r~5231 /'1
BUILDING
Qb. OV
-~
CELECTRIC~
PLUMBING
--.
--.? ~ . trD
---::::::::-
~ANI~ Sewer Conn
Water Conn:
Date
7- 6 -7S-
fk 1:'
Property Owner:"\ /'L.on
JabAdd'.." 6/Y, ,- /3,~ 7
Parcell.D. # c2 - (9.- b -jJJ - "Oko - 0 0.,;,1 0 0 - t"?/ /0
Water Meter:
T.I.F.'s:
Zoning: Energy Code:
Description of Work i..-/1.LA-J A- /G
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
'7
Valuation or
Contract Price
d/---5h. cro
/
City License Registration #
State Certified License#
BUILDING
~ KDd~ ~I
ELECTRICAL
PLUMBING
~..<.t #C
MECHANICAL
-
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Servo
Rough In
Meter Can
Canst. Pole
Pool
Pre-Meter
Final
Ftr,
Pre SLB
Lintel
FRM.
Insul. CL
WL
Driveway
6jP~,- Cj-7-e;S fiB
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.00) shall be made for each trip for each trade:
a, Wrong Address
b. Condemned work resulting from faulty construction.
c, Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
To- c (s ~lc- -+ ~
ADDRESS \:Ltc 0 \ A 6 \?eLf DI/~U/~ JJOd~ C;~vf{)3-)~HONE 10'1-
OWNER F LJC h w', \ \ I'Ct rr-.5
JOB LOCATION Go J Lf l..{ l/fA.
APPLICANT
S-.;l! - 0 Y..:l- 0
s+
LOT SIZE
x
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
II BLOCK :<... SUBDIVISION Ty,$c;>-n /'1 t3 '-I 1'6 Itt/~
PARCEL I.D.~F ('/-2 - 2~l\;Zf~6080'0026.0 -C?J/V
WORK PROPOSED:____New Construction _Addition _Alteration _Repair _Install
_Sign/Temp.
_Sign
____Move
_Demolish
PROPOSED USE: _Single Family
_M/F
_~F of Uni ts
__M / H
_Commercial
_Indust.
_Swim. Pool
Other
_Restaurant & Health Department Approval
BqILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
**COPY OF CONTRACT REQUIRED.
PERMITS REOUESTED
_BUILDING
$
Valuation of Total Construction
IC _ELECTRICAL
AMP Service
Florida Power Corp.
_W.R.E.C.
~~;.
r_MECHANICAL
_PLUMBING
$
Valuation of Mechanical Installation
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
Signature
CONTRACTOR SECTION
Company
State Cert. or Regist. #
City License Registration #
******************************************
BUILDER
:::::::~:~ Company R,,~,,-< s Ei0.-;c
. / __ S~ate ~ert. or R~gis t. , ~F E R 06 I ;;L';)' ~ '1
C1ty L1cense Reg1strat1on # ~ 3, I
******************************************
PLUMBER
Signature
Company
State Cert. or Regist. #
City License Registration #
*********************~********************
Signature
Company 3Af*'5 Ale C>t H!J
State Cert. or Regist. # ~d-cg lj/,,2,;20
City License Registration # 9
******************************************
APPLICATION APPROVED BY
1tU
***** * ** ****** *** **** * * ~**** ** *** * * * ** **~~:.~
-...,....,.".,....
Company
State Cert. 9r Regist. #
City Lfc~p~e Registrati~n_
OTHER
Signature
MIT OFFICER.
~ ~ ".. ,
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit lay be subject to 'deed restrictions' which lay be .ore restrictive than City
regulations. The undersigned assules responsibility fOT co.pliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake Nork, they may be required to be licensed in accordance with
state and local regulations. If the contractor is not licensed as required by law, both the ONner and contractor .ay be
cited for a lisdeleanor violation under state IaN. If the ONner or intended contractor are uncertain as to what licensing
requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, 18131
788-6611.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorlsl sign portions of the
'Contractor Sections' of this application for which 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 wishes you to sign
as contractor that lay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
City of Zephyrhills.
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 'Florida's Construction Lien Law - HOleowner's Protection
Guide' prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the
'owner', I certify that I have obtained a copy of the above described doculent and prolise in good faith to deliver it to the
'owner' prior to cOllencelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has cOllenced prior to issuance of a perlit and that all work will be perforled to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other governlental agencies lay apply to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treat.ent
f Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
f Departlent of Health & Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
f US Environ.ental Protection AQency - Asbestos abatetent
I also certify that, if fill laterial is to be used in Flood Zone 'A' or 'A,etc,', it is understood that a drainage plan
addressing a 'colpensating voluae' will be sublitted Which 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, Dr
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. Every perlit issued shall becole invalid
unless the work authorized by such perlit is cOllenced within six lonths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six tonths after the tile the work is comlenced. One 90 day extension of ti.e, lay be
allowed for the perlit 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 lonth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COKKENCE"ENT "AY RESULT IN YOUR PAYING TWICE FOR IHPROVE"ENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMKENCE"ENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A 'NOTICE OF COMMENCEMENT'.
x
~ r)nt-.. ~. l~t~~
-
SIGNATURE: OWNER OR AGENT
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
before me this S.f.( ...s<qf-, 19~by
~y U /'-1. hJ;///Q).H1S
who is personally known to me or who has
produced l:7n\Jt:.f.5 ..J.. -; (.
as identification and who .../did not
take an oath.
PfJ5Co
STATE OF FLORIDA
COUNTY OF
. The foregoing instrument
befctl-e me this 5-6-
p;rg C 6
"as ackno"lledged
19 q~ by
(Name Typed, Prin
NOTARY PUBLIC
JOhn I. 1G3-~
who is~rsonally
produce
as identification and who did/did not
takKl1~' d. QAd6
(Si}<~ture) R ~i-t
I I +a. L. ~ d
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
'i'
JAMES H. ROGERS
State of Florida
My Comm. Exp, .I1Ile 28. 11117
COMM ICe 298157
RITA l. REDDITT
NOTARY PUBLIC, STATE.OF FLORIDA
My Ci,;lilf!iISsion Expires May 29, 1999
Commission No. CC 467880
FJ JACK'S
\(1JAIR CONDITIONING & HEATING
l':'~: 't'n / (.J ;/1; '.,))1'1 ~ . . .
TO: LOCATION OF JOB 6/'/ (I / ( ./. /,
2 t::tfA ynh....~/I".,
WORK ORDER
Cert. # CAC041220
1260 I Abbey Drive . Dade City, FL 33525
24 Hours . (904) 521-0420
DATE
8- ;-3 1- ? .~-
23S'ra
7d'I- 3'-06
We propose to furnish all labor and equipment (license and permit when necessary) for complete installation, to be tested and ready to operate
at location above.
We have carefully analyzed your equipment to be of sufficient capacity to produce design conditions according to Florida Energy Code High of
91 Q outdoors temperature and 78Q indoor temperature. Building must be kept reasonably tight, windows and doors kept closed except for
normal passage of persons and properly insulated (minimum of 6 inches thick).
Eqipment includes:
1. Air Handler with:
2. Condenser Unit #
3. Thermostat MO.#
4. Suoolv-Grille & R A
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15. 11
16.
17.
18.
19.
20.
21.
22.
23. Option: Insulation- II A
24. Up-Grade Service Yes~ No 0 Size- Amps- /A/i rE' V It )1:$. 8 2.0 ~
25. Existing Ceiling-Damage [] Yes [] No <11/~
...<;1:
F'l
B KW:MO# FACf/lF 621t'
~S"L /-!1/ <.. ./)L ~~4 S.E.E.R. /6 C.O.P./HSPF
~ - :.-j-r:;) -; ~ ~7'<::':.1. At- / ,'; ~? ~ c2...p /
,.).~ "J!(.~ - ~ 4-Fl
!1 .,
...)~
Total BTU's
1!.p>-n~ v'...::::... /~.41 / / -4...:.
.-L~ ~1: /) 4/~Y" ~'J/6:-e /~ v- ;'?A l".-:;;:;::,I; .~ r-e~ ~ n..- :' ;;;~ I
) -t.dl I.J/ J \J. ? .a,) IL ,'f,./:J!. ~ /. ,-,4 ~ ~ ;.s7f~ J.ot.~<-". _ i M
~ ~~~' 0 v~ 'd ~ ~ ~ ~ ~
'~-:~3~/(:~ 'f;'-~,:>l ~?,;';;;-;;~'~~:.; -5 ~~ '-,. .
IU.,) y r.,JWZ~6
I.. 10 /0
,
~~~: ~!~~S5
or-
Q ,v'-r.n. -rY;-:,: c "'f'
:z.. ";f 3' ~
~
eLO
r 3 5-t. C!.!!:
Duct work will be designed, Fabricated and installed in accordance with American Society of Heating & Air Conditioning Engineers Standards of
Supply and return registers and grills will be properly sized and of aluminum.
LIMITED WARRANTY AND SERVICE:
All equipment, materials and controls furnished by us has a 1 year warranty from the date of inslallation against defects in workmanship and material. In addition we extend to you
the manufacturers 5 yr. protection plan on Ihe compressor. Our one year service responsibility does not include breakdowns of Air Conditioner due to blown fuses, tripped breakers,
dirty fillers or plugged drain lines. Warranty service will be performed during normal working hours of 8:00 a.m. to 5:00 p.m. Any request for service after 5:00 p.m. or on weekends
or holidays will be billed to customers at current billing rates of lime and one-hall.
For this service the purchaser agrees to pay the seller the sum of 3 1St. Dollars, including ta
ayable as follows:
00-
'" - . Price quoted nol valid after 30 days.
Thi order contains the entire eement affecting this purchase. No other agreement, understanding or warranty has been made a part of this contract unless written herein.
"If this instrument is referred to an attorney for collection or enforcement, the maker agrees to pay a reasonable attorney's fee, plus court cosls. If Ihe maker is delinquent for a
period of thirty (30) days. A delinquent fee of 1 1/2% per month will be charged. Tille to the inslalled merchandise remains vested in the seller until all money due, as Ihe result of
the sale has been paid to the seller. Your acceptance below will be our authority to proceed with the installation. Thank you for your business."
. ~
PURCHASE~"'.),y' ; h.\
J-.31-9~.-
III ( II~I/ (.1 ':',r i' /
ACCEPTED DATE