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Home My WebLink About95-5434 BUILDING PERMIT-- CITY OF ZEPHYRHILLS Permit N!. (813) 788-6611 -:- - 5434 I!J Date / d.. - l./ - 9 ~~ .- I ~ P,opertyOwne" t/~ b ;i(.<?nd Job Address: b_ ~ ELECTRICAL PLUMBING MECHANICAL Sewer Conn Water Conn: Water Meter: T.I.F.'s: Parcel I. D. # Zoning: Energy Code: Radon Gas: Description of Wor; ~ A.ry A-<-/q': .-">_ NO OCCUPANCY BEFORE C.O. FINAL C.O. ,...{;-17 DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. DATE Inspector Permit Fee Signature Company Address Telephone# #~) Valuation or Contract Price 9!/~'-. G7D . City License Registration # c2 7 ~ State Certified License# C K;1M14-M (;1/1# BUILDING ELECTRICAL PLUMBING MECHANICAL Ftr. Pre SLB /' Lintel i rJr/ FRM. \ 0 '? Insul. CL1l~ WL ''b \ \;"-/ Breakers Ducts Ins!. Compressor Final Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer 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. APFLICATION FOR PERl-lIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT~ Y. fv'\ A rJ (10 (\)''''''-~1<.LAC~() ,J ADDRESS ~,:-~~ --5'\ '3:}S S Q, ~lt \.A).Z. h.l ~PlIONE 7'( 2- OWNER -=rNDCpeN DA~+ ~be ~-W l+h JOB LOCATION lo~.:>lS- l\J. GAlt ISluD &Oq4- LOT SIZE_~ AREA SQ,FT, LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1.D.'.' b~- 2<0 _.~ 1-0010 - O~400/00o.3o ~:air Inst3l! WORK PROPOSED:____New Construction ____Addition ____Alteration ____Sign/Temp, ____Sign _Move ____Demol,- PROPOSED USE: ____Single Family ____M/F ____II of Uni ts ____~l / H ____Commercial ____Indust. ____Swim, Pool Othel ~. ____Restaurant & Health Department Approval BUlLDING SIZE: X_I Square Fee t. He q:.:I:' RESIDENTIAL: COM.'1ERCIAL ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FO~~S. ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOR~IS. ,'d **COpy OF CONTRACT REQUIRED. 0"P Al rz... PERMITS REOUESTED ~e>c>+ - BUILDING $ Valuation of Total Construction ELECTRICAL AMP Service Florida Power Corp, _I';,R,E,C, ~t _~ECH:\NICAL $ Valuation of Mechanical Instull3tion _PLl~BING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block ____Frame ____Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration ff ****************************************** BlIILDER Signature ETECTRTCTAN Company State Cert, or Regist. 0 City License Registration 11 ****************************-************* Si!Cnature PIl:~lBrR Company State Cert. or Regist. n City License Registration :1 **********************~*************~**.*~ Si~n3ture MECH<\NIC:\! Company State Cert. or Regist, I' City License Registr;)ti.on 'I **.***~.*************.**********~********* Sign3ture OTHER Signatu~- ~ ..---. Comp3ny R':jl'Y\A-~ CO '\.H~~v\.{ ~O.0 I'I,(J State Cert. or Regist, II p-c.. OC)(P/(P4fJ City License Registration II SP:.> ..l 7:!::> ****************************************** APPLICATION APPROVED BY PER~l IT OFFICER. .' . ."...,.#....."'.,'.....,..........,~H'...'>l'..~--....-.....-,........... CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Tbe undersigned understands tbat this pen it lay be subject to "deed restrictions" wbich lay be lOre restrictive than City regulations. Tbe undersigned assUles responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONS!BILITIES If the owner has hired 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 lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813) 788-6611. Furthermore, if the owner bas bired a contractor or contractors, be is advised to bave tbe contractor(s) sign portions of tbe "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 r~sponsible 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 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, bave been provided with a copy of "Florida's Construction Lien Law - Hoaeowcer's Protection Guide" pt'epared by the Florida DepartJIent of Agriculture and ConsUler Affairs. If the applicant is SOl_eone other than the "owner", I certify that I have obtained a copy of the above described docuaent and pro.ise in good faith to deliver it to the "owner" prior to couenceraent. E. CONTRACTOR'SjOWNER'S AFFIDAVIT I certify that all the inforlation in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning, and land developlent. Application is herehy 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 perforJed to .eet standards of all laws regulating construction, City codes, zoning regulations, and land development 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 my responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to: * Department of Environmental Regulation - Cypress Bayheads, ~etland Areas and Environaentally Sensitive Lands, ~ater/~astewater Treatlent * Southwest Florida ~ater Manageaent District - ~ells, Cypress Baybeads, ~etland Areas, Altering ~atercourBes * Army Corps of Engineers - Seawalls, Docks, Navigable ~aterways * DepartJent of Health & Rehabilitative Services, Envirolllental Health Unit - ~ells, ~astewater TreatJent, Septic Tanks * US Envirolllental Protection Agency - Asbestos abatement I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood tbat a drainage plan addressing a "cOlpensating volUle" will be submitted which is prepared by a professional engineer registered in the State of Florida prior to permit issuance. A permit 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 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 perJit issued shall becoae invalid unless the work authorized by such perlit is comaenced within six IOnths of issuance, or if work authorized by the pertit is suspended or abandoned for a period of six IOntbs after the tile the work is camaenced. One 90 day extension of tile, aay be allowed for the peflit 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 lOoth period, or the project will be considered abandoned. WARNING TO O~NER: YOUR FAILURE TO RECORD A NOTICE OF COKHENCEMENT HAY RESULT IN YOUR PAYING TWICE FOR IHPROVEMEHTS TO YOUR PROPERTY. IF YOU INTEl/D TO OBTAIN FI.NAHCIHG, CONSULT ~ITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND' POST A "NOTICE OF COKHENCEHENT". ~< SIGNATURE: OWNER OR AGENT ;?~ SIGNATURE: CONTRACTOR not STATE OF FLORIDA c:> _, COUNTY OF ~ J:\~ C_ Q The foregoing instrument was acknowledged before me this ~c... l . , 19 9 r by \::.1: IU"-'~ I<'R~' N ~k~ who is per nally kno to me or who has produced Qi~~ as identification and who did/did not take an was acknowledged , 19.3..L"' by who has or Stamped) PROPOSAL ""'";Z!'>. '....,. ... .. ^>~.);/?A/ I!{)O;~'I/V(; No. 373.2.5 57. Z/-jJI. )112 A ' / / 5 . I?d 59' IAJ r J. JJ541 Date //- .10 - :; 5 Sheet No. 7 c? ;l. - /;; () 9 Y' Proposal Submitted To: Name ;z:;,/{}~?.t:/!,/J//l1 Av.'/_~~.-9ff.A C/lLl,G Street I.; 5>'5 /l/, (-.P// 13/i/~ City Z.r?f.,...tl;'. lis State r I Phone 7 f'! - /s't-,t- Work To Be Performed At: Street City Date of Plans Architect State We hereby propose to furnish the materials and perform the labor necessary for the completion of I?E/7/U'{//f I /. /' (.// /~ XI S7l/V'j b{/ /;;{Il/ tJ- Cl!fit/// /?(}O/" Aj/X T 70 /J1 /h.t /.r'~1 / iJO{li 7.;v;7,!9// /Dlw {)/ (1. L! - , L ),1/1.'/ - /.),< v/. / .'V):;////#&- I 4{e:p,. 477;9A! /JA/LJ //-CJ/~1 ,i"hss J:." ""00 i'-/,v 6-- -r /0 L'/~ ,fiN A<~1/o /~ PSh".vrj /C;iJ/= "/6"1/<:-: " 4;~7' y' iJ (J 7(;7/9/ JjjLJ - 7":;, -- All material is guaranteed to be as specified, and the above work to be performed in accordance with the specifications submitted for above work and completed in a substantial workmanlike manner for Dollars [$ drawings and the sum of -. J. with payments to be made as follows: ,/',',../..;, I Any alteration or deviation from above specifications 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 upon above work. Work- mens Compensation and Public liability Insurance on above work to be taken out by Respectfully submitted /i ./1 _ .A" Y /,";1 /'9A/ ;<::(:)c)/ //,/1.:'- ..-./~-' .--2/ . / . ,-1.~//1 j~-;;r-t''J~~'''f. Per Note-This proposal may be withdrawn by us if not accepted within /CY. days. ACCEPTANCE OF PROPOSAL bO~Fflfteo - d C~lons are satisfactory and are hereby accepted You are 9Uphorized to do the work as specified. nlw.J!Lbe ade a ne . /;L./ r '... ./ /;. / / . Signature /~ //. ./ 5~ /./~;-:) ,~/' ! Signature ~ FORM 3850 DUPLICATE LITHO IN U. SA