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Home My WebLink About95-5350 BUILDING PERMIT..- CITY OF ZEPHYRHILLS Permit N! (813) 788.6611 ~~'535~t1 Date 11-/ - 9-S- BUILDING ELECTRICAL PLUMBING GECHAN~) Sewer Conn Water Conn: Pmperty Owne" J?~!<<AIJ ~~ Job Address: -..S ...3...5.--0 Parcell.D. # 1/ -J-b -;V~ CJ C) /~. /3~'oo- Water Meter: T.I.F.'s: 0/ f' D Zoning: Energy Code: Description of Work ~....LA......J -0/ L 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 Inspector City License Registration # State Certified License# btJ p.'m~~. frO e Signat~~~ Company ? Address Telephone# Valuation or , Contract Price 02 7 tJ~--' crv " ')'f e --f: =-r r 'I (;,-84-1 Aje -i )lJ~/ BUILDING ELECTRICAL PLUMBING MECHANICAL Ftr. Pre SLB Lintel FRM. Insul. CL WL Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final 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 ($15.00) shall be made for each trip for each trade: a. Wrong Address b. Condemned work resulting from faulty construction. C. Repairs or corrections not made when inspection called. d. Work not ready for inspection when called. e. Permit not posted on job site. f. Plans not at job site. g. Work not accessible. The payment of inspection fees shall be made before any further permits will be issued to the person owning same. APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER'S NAME IJ~~ OWNER'S ADDRESS 5"3 S- 0 JOB ADDRESS S =:3 SO /)~'~9fd.5. ~ r-h )( f...-1 5'( PHONE f ( 3 - 7ft J1-1Do 9. Z-J/i:ds Z-IIit& R :JySvo H ~ 3S-~ LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1.D.' l J-2~-2.J. c)oIO-/SS-OO-OtCfO (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition _Alteration ~epair -5-Install _Sign _Move _Deaolish PROPOSED USE: ~Single Faaily _M/F _' of Units _M/H _eo..ercial _Indust. _Swta. Pool ___Other _Restaurant &: Health Departaent Approval DESCRIPTION OF WORK: f"v$ r /t<A I4(cl(f(eJ S7$~. 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. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED ~UILDING $ Valuation of Total Construction _ELECTRICAL AKP Service Florida Power Corp. W.R.E.C. --1IECHANICAL $ ;l.. 7oS"~ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fr8lle _Steel Other FIRISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** CONTRACTOR SECTION COMPANY State Cert. or Regist. . City License Registration . ****************************************** RIJTI.DER Signature Signature COMPANY State Cert. or Regist. t City License Registration t ****************************************** RT .RCTRlCIAN Signature COMPANY State Cert. or Regist. . City License Registration t ********************************** PLUMBER COMPANY &/~ ~.(#~~ State Cert. or Reg1st. t . 0 z..~" 7 City License Registration' ~Q. Cl4r..Dy..",-,,~ ***************************************** . OTRRR COMPANY State Cert. or Regist. # Signature City License Registration , .******************************.********** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Tbe undersigned understands tbat this peIlit lay be subject to Rdeed restrictions" which laY be lOre restrictive than City regulations. the undersigned assUles responsibility for COIpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If tbe owner bas hired a contractor or contractors to undertake wort, tbey 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 lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing requireJents lay apply for the intended work, they are advised to contact the City of Zepbyrhills Building Departlent, (813) 788-6611. FurtberlOre, if the owner bas hired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the "Contractor Sections I of tbis application for which they will be responsible. If you, as the owner sign as the contractor, you are indicating that you, rather tban the contractor, are responSible for the work. If the contractor wishes 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 Zephyrbills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, tbe applicant, bave been provided with a copy of IFlorida's Construction Lien Law - HOIeOWDer's Protection Guide" prepared by the Florida DepartJent of Agriculture and ConsUIeI Affairs. If the applicant is sOleone other than the "owner", I certify tbat I have obtained a copy of tbe above described docUleDt and prolise in good faith to deliver it to the "owner" prior to couencelent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all tbe inforaation in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land develoPlQDt. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify tbat no work or installation bas COlleDced prior to issuance of a peIlit and tbat all wort will be perf OIled to leet standards of all laws regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also certify that I understand that the regulations of other goveIDIeDtal agencies aay apply to the intended work, and that it is IY responsibility to identify what actions I lUst take to be in colpliance. Sucb agencies include but are not lilited to: * DepartJent of EnvirODleDtal Regulation - Cypress Bayheads, Wetland Areas and EnviroDleDtally Sensitive Lands, Water/Wastewater Treatlent * Soutbwest Florida Water Hanaguent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses * ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways * Departlent of Health & Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatlent, Septic tanks * US EnviroDlental Protection Agency - Asbestos abatuent I also certify that, if fill laterial is to be used in Flood Zone "AN or "A,etc.l, it is understood that a drainage plan addressing a Rc~pensating volUle" will be sublitted wbich is prepared by a professional engineer registered in tbe State of Florida prior to peIlit issuance. A perlit 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 tbe technical codes, nor shall issuance of a per.it prevent tbe Building Official frOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued sball becOle invalid unless the work authorized by such peIlit is couenced within six IOnths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six IOntbs after the tile the work is couenced. One 90 day extension of tiae, aay be allowed for the peIlit with fee charge of $15.00. Tbe extension sball be requested in writing to the Building Official. An approveD inspection lUst be logged during each six IOnth period, or the pro' 1 I be nsidered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NO'I'ICE OF COHHDCEHElft' HAY T IN YOUR P NG fNICE FOR IHPROVEIIEIft'S TO YOUR PROPERTY. IF YOU Ilft'EHD TO OBTAIN FINANCING, CONSULT WITH YOUR LIND OR AN AnO EFODB DB RDIXG YOUR XO'I'ICE OF COHHENCEHBXT. JOBS UHDER $2,500 IX VALUE DO NO'I' NEED TO RECORD AND ST A IN OF COHHEN lft'1. l" ~J~~> SIGNATURE: OWNER OR AGE STATE OF FLORIDA r-1 COUN'fY OF ~[,'k... rasCQ The foregoing instrument was aCknowledged before me this IVou. / , 19~ by ",.~'i{..~:'fit- SANDRA L. CARVALHO ~. rA\:~ MY COMMISSION * CC461982 EXPIRES ~'~~~i May 30, 1999 7;r,,<if.:r..<t'" BONDED THRU TROY FAIN INSURANCE,INC. t-. (Name Typed, Printed or NOTARY PUBLIC ,........" SAN-a L '..M'lI. u" ~~ii\'f.t'~ LIIV\ . VI'V1YnwN.. f*t'A'7;:1 W<< COMMISSION * CC461982 EXPIRES "",.~.",~ May 30, 1999 ~1.'Ji;;;-;.,,~ 8DNIlED 11lRU TROY FAIN INSURANCE INC. I"tll\~' , ~()LI:'S 41~ ~()~I)ITI()~I~f7 4N1) t11:4TI~f7 37338 Kossik Road Zephyrhills, FL 33541 (813) 783-3723 PROPOSAL No. Date If..' - AI.f- - rt S-. 51. Carl. #CAC042667 Sheet No. Work To Be Performed At: Name Street City State Phone 'lit .~- 3 ~i!) 8-;-'" ~sr. "2 [- p f/ y K. I-ll\..l~ F-I €I J j. 7 ,l~:) . i OL' '1 J'tf/flG-. Street City Date of Plans Architect .5 (-&rL 1~,Yu lJd/.t/Jp!Tt I tJr/ (- 7' l.-~ rt. f1ttLls 4L-fl ,.t- 1d7 C;,h-s /If- f /le.4-Jd LC.,11.1c.r/ o.v C!4- ,wfJ.l6-$'..J(l ,~ /11 M-z..-~~) 11 JJ i It ,,1-,,1 ( q '1 ~71-/l. /11. (; k..'\. .0....( 7 ~(1 All material is guaranteed to be as specified. and the above work to be performed in accordance with the drawings and specific-ations submitted for above work and completed in a substantial workmanlike manner for the sum of /L.t..h' !A.fU!;/Jl.f.../" 5~:'-U'h,,-/'/r.w...../~~/~~ cj. ~;) uollars ($ ;L 7oS'~ J. with payments to be made as follows: . 'I. II !J oS' ':-> Ov d-';J..o t" ~ r'Y .s( ~1 /oJ C' f Cd ,....f-t.,1<-IJ { . 11 ~""-~/(--- riu' V- I ~u~ 3/llf Any alteratIon or deviation from above specifications involVing extra costs. will be executed only upon written orders. and will become an extra charge over end above the estimete. All agreements contingent upon strikes. accidents or deleys beyond our control. Owner to cerry fire, tornado end other necessary insurence upon ebove work. Work- men's CompensatIon end Public liability Insurence on ebove work to be taken out by Respectfully submitted posal may be withdrawn by us if not accepted within '5" ~ys, ACCEPTANCE OF PROPOSAL 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. Date I 0 .- z-- 4- - q S- dUJQ -, Signature - .A "1Jl~ A~.J Signature