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BUILDING PERMIT~.
CITY OF ZEPHYRHILLS Permit l\T!
(813) 788-6611
. .
-;~53~~ )1
BUILDING
rJ-D . d-V
~TRICAL~
PLUMBING
gS'c-chJ
GCHANI~ Sewe, Co,"
Water Conn:
Date
/0 -.3/-9--S
::::,~.:~'jt~- ~.:..er
Parcel I. D, #
Zoning: Z Energy Code: Radon Gas:
Description of Work. A~ <eL. ~?.A.--~ -.I-- ~C.
Water Meter:
T.I.F.'s:
d ~ ~,J2-.
NO OCCUPANCY BEFORE C.O.
FINAL I
Complete Plans, Specifications and Fee Must Accompany Application, C.O.
All work shall be performed in accordance with City Codes and Ordinances,
Permit Fee
Signatur
Company
Address
Telephone#
DATE
i::t~
Valuation or
Contract Price '- ~ ;( B1J - cr-t)
City License Registration # / t) ?
State Certified License#
BUILDING
~K7~~d-67
ELECTRICAL
~-L~~
PLUMBING
MECHANICAL
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final /1- zr ~ 5 -&b
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final 1-2 - '-fr~ 5' ~,h
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 ZEPHYRHILLS
BUILDING DEPARTMENT
APPLlCANTTYli2,S .~'tI 0/ZI'UU<-
ADDRESS ~ j (J /8' 'S--r:-
O~ER ~C;~~
JOB LOCATION <;;: I9-rn E-
PHONE '7S"?('- G~ be;
LOT SIZE_X
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
PARCEL I.D.~t //- d.(P-;( 1- (90/0
,
BLOCK
SUBDIVISION
IJ;;lO V'
o~l70 7J
WORK PROPOSED:____New Construction ----Addition ----Alteration ____Repair ____Install
_Sign/Temp.
_Sign
_Move
~emolish
PROPOSED USE: __Single Family
_M/F
_~t of Units
.-M/H
____Commercial
_Indust.
_Swim. Pool
Other
----Restaurant & Health Department Approval
BUILDING 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
~ECTRICAL
~CHANICAL
Valuation of Total Construction
~orida Power Corp.
_W.R.E.C.
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: __Block __Frame __Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
CONTRACTOR SECTION
BUILDER Company
State Cert. or Regist. #
Signature City License Registration #
:::::::::AN ~I ~~................:::::::.. ..............
State Cert. or Regist. #
. City License Reg1strat1on #
******************************************
~
, .
PLUMBER
Company
State Cert. or Regist. #
City License Registration #
******************************************
Signature
Signatur
Company
State Cert. or Regist. #
City License Registration
******************************************
~
OTHER
Company
State Cert. or Regist. #
City License Registration #
Signature
******************************************
APPLICATION APPROVED BY
PERMIT OFFICER.
...
, .
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands ~~at this perlit lay be subject to "deed ,restrictions" which .ay be lore restrictive than City
regulations. The undersigned assules responsibility for cOlplianc' with any applicable deed restrictions.
~''Il'''! '~\!I:"'"f" ,w- ,.
, it. r 'III;h" j ...
";
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
.' .i
If the owner has hired a contractor or contractors to undertake Mork, they lay be required to be licensed in accordance Mith
state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor lay be
cit~d for a lisdeleanor violation under state laM. If the OMner or intended contractor are uncertain as to Mhat licensing
requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
788-6611.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorls) 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)
[ 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 soteone other than the
"owner", I certify that I have obtained a copy of the above described doculent and promise 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 cOltenced prior to issuance of a perlit and that all work will be perforled to .eet 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 cotpliance. Such agencies include bill ~l p. Bol litited to:
f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive lands,
Water/Wastewater Treattent
f Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of EnQineers - SeaMalls, Docks, Navigable Waterways
f Departlent of Health L Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent. Septic Tanks
f US Environlental 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 d,'ainage plan
addressing a "colpensating volute" will be subtitted which is prepared by a professional engineer feqistei~d in the State of
Florida prior to perlit issuance.
A pertit issued shall be construed to be a license to proceed Mith the work and not as authority to viol~te, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frot thereafter
requiring a cDrrection of errors in plans, cDnstruction, or violatiDns of any code. Every peuit iS5111!d ~hal1 becole invalid
unless the work authorized by such perlit is COltenced within six lonths of issuance, or if \'I(IIk authollZed by the penit is
suspended or abandoned for a period of six tonths after the tile the work is cot.enced. One 90 day e~tEnsioll of tile, lay be
allowed for the permit with fee charge of .15.00. The extension shall be, requested in writing to the Building Of~icial. An
approved inspection lust be logged during each'six lonth period, or the project will be considered dbdlldoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN A1TORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A .. NOT I CE OF COMt'iENCEMENT II .
SIGNATURE__________________________________
OWNER OR AGENT
SIGNATURE______________________________
CONTRACTOR
DATE_______________________________________
DATE___________________________________
NOTARY AS TO
OWNER OR AGENT_____________________________
NOTARY AS TO
CONTRACTOR_____________________________
MY COMMISSION EXPIRES
MY COMMISSION EXPIRES__________________
----------------------
..
40% Pre.Consumer Content . 10% Post.Consumer Content
~~rnpn!lal
Page No.
of
Pages'
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y
State Certified
ENVIRONMENTAL CONTRACTORS
3843 Hwy. 301 So. Dade City, Florida 33525
Phone 567-5515
Electrical EC 0000491 Plumbing CF C037171
Air Conditioning CA C029382
S,*--r:~tA-
C~J'3) (,.,&1 B09'Cf
PROPOSAL SUBMITTED TO
i''l'y'p '['IJrnp,-
PHONE
STREET
7f~P-r:~(~{)
JOB NAME
CITY, STATE AND ZIP CODE
:'nnh rtdll!c;
rxistinn (' C
JOB LOCATION
ARCHITECT
DATE OF PLANS
" q f) F~ t. I; .... t-
JOB PHONE
We hereby submit specifications and estimates for:
J~:('-'Ilq ,fl!
;: .', h'll i!l'l L if,nhi 1 r:> 11',tI,0 i';")c/.;;'lr;.-:, IHI j t: r.kx]p] ~,!l'l\HC30Jl.t:
'~(\(iI)I, r"II!'~~ n.()Lh'~!:"'lf- c:tril1 rrp: lJ.OO
j:qrr~F : :~h'/d?J(l a~OO ~
--~-_._-_.._-_-...._-,_._--~--- (^';-~ ----~-------_.'------
',l.r, ~nn fWlr.
)r_, t> ('(j "...'t.t!. f~
hi nh (' rfi c ipn~"'l l\;)ck:Jr:c IlTli t.
(;. r. n; r:"':1t;~tT j l1 FFP
t'~) J(T : ~'J1)7n. (In
;"ndd PHC)f130.1\KP
11 . ''i0 enp: 3.1R
f/'~~'T/lLT,I\TTnn 'In Tt'cr,fl[ir; '1'IW F'()f.f.r'\i:Tr'r,
I)r'r'h("'f:.(.'\""~- "~I '-lJrr"rH' ~/r' ,<:W:-~f-''''JI; j"e)ll':jnq n:('c'lj fic~t:i.()1l r-f. pxistinq duct "lor~ as necps-
';;,r'/ II:oinn fr,jl h;:lcbv! Hhnrf11t'si3 r'Pre" hn;'l[(] .lnd/nr [nil-f."lcf:'c1 flr>;dhle insul.=Jterl duct AS
.11'(-1 i, ',t ii,,, ,10ii'TJ:)S. 1111 dllct ~'n''''rr" hutt -jnints t:o he clnt-h tap",--j ;:mr~ douhle st,pled. "11
-inin~'.', t" hn .'~0r"'i(>c1 ',vith r;''1ssnp P]1l C0j[Jl{'rci,jl or",]p "lcrylic foil tAPp. FXistino cOP!Y"r
]'r'[d'!OI?nt": )irv'~~, f-11"'rjLn.(;t:,-~t: I.;ir"', ,'tv' nJpctric-ll cnnnectinns 30r1 h:;\ulware will be
pc''''''] l;;hc'u' pnc;sihln ()r rr:>~'JacrJd Iflh"'Tl w,<:,pss'1ry. 1\ new thermostat wilJ be provided.
-~----....' ---_._._~- -, .--.---..- '....------- - --.- ---- -- ----.---
['ric"" (111"l-r'," i.nclll'in~; '1(l(1jT)(J 011P [lrk:iti.r')I'Fll [;uroly nutlel-s.
"'I'("VI'F: PriC!'~s ~:tJo!:r>,: 0('OV" I/1(],lJlJr' .111 f'lf'(:t:riC'~l hid of (; 77~;
i'Tic.':-' c-;t-:,,!:p(. jqc.lt1rle:~~~K)f cllr~'in(J - r'p.ta] rillct COV?[ _
n('~!.,....(.t:()r - i"O;'1 Tti0rll:n~~t-'--lt-. - i'-lAct- (ic81 I;iri nq to cnd""
*,*r .:,'!:.T'P .1Ir~'** f-~ r:
1;'1 oct-. r ic surqe
JIIIr 'roponr hereby to furnish material and labor - complete in accordance with above specifications, for the sum of:
Payment to be made as follows:
dollars ($
SFF 71,P0Vf
) .
~)(\'r ,.,t- ('nnt-r;:v':-; ::i.nnlnrl - l)()'* '11-. CO[!p]Qt;Or)
All material is guaranteed to be as specified. All work to be completed in a workmanlike
manner according to standard practices. Any alteration or deviation from above specifica-
tions 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, tornado and other necessary insurance.
Our workers are fully covered by Workmen's Compensation Insurance.
Authorize
Signatur
/}
~~.
Note: This oposal may be
withdrawn by us if not accepted within
lie;
days,
Date of Acceptance:
Signature
Atttptantt nf 'rnpnsal- The above prices, specifications 4t.~ '1 ~./
and conditions are satisfactory and are hereby accepted. You are authorized Signatu~ . ...... {
to do the work as specified. Payment will be made as outlined above,
I'fill/MII.I 118 j !~,(~1Ulnc,Gfotcn,M_OI471. foOfderPtiONE TOClrRH 1+800.22S.631O
L2/01/199S 02:45
'30<1%7745'3
E':::E I tJC ,/ Etj\/ I PI] CCJIHI]
F'AI3E' 02. .
? 5"3 L.(3
/~
ARKAY ENGINEERING, INc.
struotural encine~r8
December 1, 1995
ESJt, Ine.
10211 Highway 301
Dade City, ~L 33525
Attention: Chuck Ehman
Re: Structural Ass8ssment of Root System for Ale loads
(Arkay Engineerin9, Inc. Job 11080)
Dear Chuck:
PR~ your request, 1 evaluated the 8truotural inte9ritr of the roof
framinQ system, on the attached sketoh, to daterm ne if it is
c~pabla of aupportin9 a 320 pound ~aof top mounted Ale unit.
It i8 Illy professional opinion, that the 2*. X 6 It roof framin(j
eystem oan adequately Support the 320 pound Ale unit (a. located
on tho sk.etch).
If you have any questions or require any further a..j.~4nae with
this matter, plea.e give me a call.
g, Ino.
Attachment
921 Shadow Drive - Suite '10 - Lakeland, Florida 33809
Phone: 813-8~3-2711 Fax: 813-8~3-8593
12/01/1995 02:45 9045577459
CERTIFIED FOUNDATIONS TEL:813-859-3889
E':E It'jC,iEtl\lIPCI CCJt.HCI
F'A(:iE fJ:::: -.
Dee 01,95 11:23 No.002 P.03
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