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HomeMy WebLinkAbout95-5372 ;2(J. u-v ~CJ. lTiJ ~~~0 P,aperty Owne' J/1;~ 01jiZj;{:L ~ Job Address: 38-C1:l5 ____ BUILDING PERMIT-- CITY OF ZEPHYRHILLS Permit N!- (813) 788-6611 j~537~ 13 Date 1/ -9-9S- PLUMBING MECHANICAL Sewer Conn Water Conn: Water Meter: T.LF.'s: Parcell.D. # Zoning: Description of Work Energy Code: '/ Radon Gas: .t~~ ~~ ~r City License Registration # State Certified License# Y~3 Permit Fee Signature Company Address Telephone# Inspector NO OCCUPANCY BEFORE C.O. Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. Valuation or Contract Price --- CJ. cIG> ~- r?~(;~ {l~ /'/?~ BUILDING ELECTRICAL PLUMBING - MECHANICAL Ftr. Pre SLB Lintel FRM. U~1-Q 'S (), L. L Insul. CL /' WL ~ hN~ /l-t.!-tjJ . [LJ.. Driveway Tp. Servo SLB Rough In II -.:21...t::l~ S2:> 6 Tub Set Meter Can Water Const. Pole Sewer Pool Final Pre-Meter Final /2-~t/~'7 &J? Breakers Ducts Insl. Compressor Final 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 PERKIT CITY OF ZEPHYRBILLS BUILDING DEPARTMENT OWNER'S NAKE fJtl-s.c..o fkdi,::~.J Arts Ce.~kr-Il-t~cr~"i{:i PHONE 7 Y31 t66 OWNER'S ADDRESS JIb/I{ ~I'~ Ce....~tJ.v.c.. J "2~jtL.c.rAltls J R- , "38'tJ3S m~/W ~~a.VC-r Z4~A;J'sJI1~ 11s"~(j . LEGAL DESCRIPTION: LOT(S) ~ ~ '/ BLOCK SUBDIVISION I'~~(:C Wv:J;CA.I rr~'#=N JOB ADDRESS c:t rfs PARCEL 1. D. f (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED: _New Construction _Addition ~teration _Repair _Install _Sign _Move _Deaolish PROPOSED USE: _Single Faaily _M/F _' of Units _M/H Leo..ercial _Indust. _Swia. Pool _Other _Restaurant & Health Departaent Approval DESCRIPTION OF WORK: ..r~l-a-r d'< /JiAI/J -C","r tJr nt d,~1 0 ~~- BUILDING SIZE: fa" 'I -x...l/f2:, 1.l{fl~ - Square Feet. Height (JII'-C- ~.fDnr - RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED LBUILDING ~ELEC'l'RICAL $ 737~..EE- _ ~ Valuation of Total Construction I 2. 5 AMP Service Florida Power Corp. W.R.E.C. _MECHAliICAL $ Valuation of Mechanical Installation _PLUHBING GAS ROOFING TYPE OF CONSTRUCTION: _Block LFraae _Steel SPECIALTY Other FDllSHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? BUILDER YES NO *************************** Signature CONTRACTOR SECTION COMPANY fJre.c,-sc.... Ccv..~/r~/ ---, J:~ State Cert. or Regist. f c.h- - CA-~~ ~~,j City . ense Registration f 1~"3 ********************** CO ANY Cl-l r" ~ Cuv...rfJrt:.;-.- ate Cert. or Regist.' E :;;;,.., 21 City License Registration' J l.f?r ************************* Si COMPANY State Cert. or Regist. . City License Registration . ****************************************** MECHANICAL COMPANY State Cert. or Regist. , City License Registration f ****************************************** Signature OTRRR COMPANY State Cert. or Regist. f Signature City License Registration f APPLICATION APPROVED BY 1ft;f}iit;:;;;;;;;~.~.......... PERKlT OmeBa. CONDITI~NS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit aay be subject to Rdeed restrictions" which aay be lOre restrictive than City regulations. The undersigned assuaes responsibility for coapliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS .AND CONTRACTO~ RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake wort, they aay 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 aay be cited for a aisdeieanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requireaents ~y apply for the intended work, they are advised to contact the City of Zephyrhills Building Departaent, (813) 788-6611. Furtheraore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) 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 aay be an indication that he is not properly licensed and is not entitled to peraitting 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 RFlorida's Construction Lien Law - HOIeOIfIler's Protection Guide" prepared by the Florida DepartJent of Agriculture and Consuaer Affairs. If the applicant is SORODe other than the Bowner", I certify that I have obtained a copy of the above described dOCUllent and prOllise in good faith to deliver it to the "owner" prior to CODenceaent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforaation in this application is accurate and that all work will be done in coapliance with all applicable laws regulating construction, zoning, and land developaent. Application is hereby aade 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 aeet standards of all laws regulating construction, City codes, zoning regulations, and land developaent regulations in the jurisdiction. I also certify that I understand that the regulations of other governaental agencies aay apply to the intended work, and that it is ay responsibility to identify what actions I aust take to be in coapliance. Such agencies include but are not liaited to: t DepartJent of EnviroDleDtal Regulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands, Water/Wastewater TreatleDt t Southwest Florida Water Manageaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways t Departlent of Health & Rehabilitative Services, Environaental Health Unit - Wells, Wastewater Treatlent, Septic Tanks t US Environaental Protection Agency - Asbestos abateaent I also certify that, if fIll aaterial is to be used in Flood Zone RAR or "A,etc.", it is understood that a drainage plan addressing a "c~pensating voluae" will be subaitted which is prepared by a professional engineer registered in the State of Florida prior to perait issuance. A perait 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 shall issuance of a perlit prevent the Building Official frOll thereafter requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall beCOle invalid unless the work authorized by such perlit is cD8lenced within sil aonths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of sillOnths after the tiae the wort is ~ced. One 90 day extension of tiae, aay 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 at be logged during each six _nth period, or the project will be considered abandoned. WARMING TO omR: YOUR FAILURE TO RECORD A NOTICE OF CQlMDCEJIBHf MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEllllfS TO YOUR PROPERTY. IF YOU INTEND Tf) OBTAIN FIIIAMCING,COISULT WItH YOUR LBJIDBR OR AN ArrORHBY BEFORE RECORDING YOUR DICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE 00 NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEIIIIf". SIGNATURE: OWNER OR AGBNT SIGNATURE: CONTRACTOR STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this , 19____ by STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this , 19_____ by who is personally known to me or who has produced as identification and who did/did not take an oath. who is personally known to me or who has produced as identification and who did/did not take an oath. (Signature) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC I ~.,-, ; !r~-< II~!I ~ . .... - I) ':::- ~~,- ~/<< ~ 1 \[) c_ h~c.Q~Jj:C :] ro'J S J1^..e.J I cJ. (}-fr~ '~J 'PIA. 11S'(0 >- ~ -- , . R D t;JV-- -=#=-11' ~ ..Roor ./I~ ,,~ .- ,.~~. , .1 .-.. i- i 1 . . .*~.. · c. 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'. -.-4 I ! ; . @COf7~c.feJ. 1'0 (f)iby.:o~: ~/,/ ~oIlJu;f I I ! ~ ' 1 : r I _.1._ !_ _.i._ j ._; ._. j ~_.; I I ilL ...-1.1..! .1.1 .~; . ~ : ; I . . , I I I ; I , : I ., l' , I . . ! @ ~,K '5' l( 4 -s e,?,,- rece.,Sw j LJ-!5 t- a. 1,0 ve <; [oor w ;f~ Me.. : : ;.~ Kf\~c.~ot.\.+- If). Cover; l/J/~ C~~ nlff/~ ~ /DC.J'Ilt.A..-r , j I ~ l ~ ! . I.. I .!.! .! I @ (,QM\~+eJ ~oQ> 101' Of1e. :1.." CMdu;+ J 1 !! 1 : J I I I . ! . i . I . . @ ~xf.o X rz.. ::J go~ 'recessed /A C1li I,^C( u)1'-).~ :~i ...: ;S+et j tdi.s $ ~ Ccver' o~ O".Jl... ;.:l..~1 1<~GJ<oL-( t- WI-..;.L .~ ': j 'I ;C~~.$e ~lffJ~ ~ '/ock~u.r ~~~oJe,r i ; ~ 1- -.- 1 ~_. ~ . . - J J. ., : I l u : ~ . t . J : I I Ii, .J - j; @) G, 'I.. :(., ~ I L. '::r;- Bo~ r ec.e!5S ~J: It-. c.ruP,;,.~ W; 'I{ _ ..J .! ; ; , ; .sf-~ le...ss oS ~I ic.ove/:~ on. e.. . <J ~/'l<l1oc..kolAt j. l ! I 1 l' f' . . l , . :. : , 'I I ' ! J V I I I LL J , I C _'.-..- ,...'11 j..,... -'. ,LJI-lJ..... Jc~e,.' ^,pl).,e: oJ...t.b' 16c.f<.. /tI.(T !/r1. over jl,HL-!-+!Jli,lr'.'i.:I;; J -- \) .~j.2t/~ M-~u~-bI. Jcp.il'~l/y;" !~oj! re;k/l · s.h:eeffo.,;~<; --!i:J,;~L~t~m1~~r,~i~;fi~{~'J~j(;f~~~\" '*.,. ..~~..7......' . ...\. Yf ecnomed USA BAY SHORE MEDICAL EQUIPMENT CORP. "- . Plurimat TRAUMA STAND ~-----t-. ---~ 'I _-..J<k.'-'" . ),<- J ~r: \ , ,.- I '" tJA~. '-: I / ...... . ",' .~- . :.",~. . , ~. " :11: . eo. . . . . , . - ~ !. .~..: ~ ~( ,:.:.--~--:.::~ :..:I;:~ \ '" : ____-. I ...__....-_,..~____I:..J ~ .:; :.;~....' I '~'."Jl'" ":;;; I 1 ,...~ ..' . ~ !' . ;": J \ - ;,' I an ! ' " . ~( . f...J I..' . ~ \ ,r\-d~.. -~l I~ .. . [:;1. ~ ;\" :..-""-'.,,, ~r'-"-:~'~J .r 'l ;\- ,- -'"\./ 1....) .,' :~ -' CO:; I ; :u ~ 01 iI ,^^". u ,.- SPECIFICATIONS Motorized variable SID Vertical movement of the Isocentrlc pivot arm from floor level: Bucky angulatlons: from 35" (9Ocm) to 73" (185cm) 25~5" (65cm) to 67" (170cm) z 450 ..,,~ ... . .f'- .2'. "'..- I:' /,-~:" .,-.... :....... Ut :. "f, . /:;! . ~ . C' ~.......~ 41 "'_ i . . - - ...1..1 '... -.. 'r"'" t' 't I :; :.:.... :' :.",. .~hfI _ . . , , Not to scale POWER REQUIREMENTS To power supply module: 120/240V AC 2/1 amps To universal stand: . 24 VDC 4 amps Bucky requires normal Interface. WEIGHT 820 pounds (373 kg)