HomeMy WebLinkAbout95-5451
BUILDING PERMIT -..
CITY OF ZEPHYRHILLS Permit II!
(813) 788-6611
~-5451A
.-
Date J;2 - d' ~ 7' ~
~ ELECTRICAL PLUMBING
::::,::~? ~:;i~ '-'ff:i;
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Parcel I. D. #
Zoning: ~ E.2P~Y Code:.,
Description of Work M_f{/ e.~Ai
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
2-7,0 -1,-)
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#
z;J3
Pe,m;tFee-tfrO . ;Jf
Signature l g 0 _)
Company
Address
Telephone#
Valuation or
Contract Price
9'73 ' o-'b
f)f~ 2/~4
BUILDING
ELECTRICAL
PLUMBING
-
MECHANICAL
Ftr.
Pre SLB
Lintel -c::-
FRM. j-1' ~fr~~ ~
Insul. CL-, ?/,1Y
WL \ ~ tl,.l:/
Driveway
Tp. Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
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 NAME CO n r \ \"Q Ce.h-h? W": ~
Th(,.
PHONE 7~3 ~ c.f.qo
OWNER'S ADDRESS 7 3:S c;- a-c I ( E? J u 01 ::r:::b- "2-
JOB ADDRESS -; 2.. ~+ ~~ / ( g I vel
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I.D.'
(OBTAIN FROH PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition *-Alteration ~epair _Install
~Sign
_Hove
_Deaolish
PROPOSED USE: _Single Faaily
-X~erCial
~/F
_' of Units _H/H
_Indust.
_Swia. Pool _Other
_Restaurant Ii Health Departaent Approval
DESCRIPTION OF WORK:
BUILDING SIZE:
x
Square Feet.
Height
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS Ii (2) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERKITS REOUESTED
~UILDING
$
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBING GAS ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fraae _Steel
Other
FDITSBED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
CONTRACTOR SECTION
BIITT.nm
COMPANY
State Cert. or Regist. .
City License Registration .
******************************************
Signature
RT.RCTRICIAN
COMPANY
State Cert. or Regist. #
City License Registration #
******************************************
SilmAture
PLUMBER
COMPANY
State Cert. or Regist. .
City License Registration .
******************************************
Signature
MECHANICAL
COMPANY
State Cert. or Regist. #
City License Registration .
******************************************
Signature
OTRRR
)Quil
COMPANY IY\ o~ llS Jlr.
State Cert. or Regist. ,
City License Registration ,
******************************************
.2.:2 ?
Signature
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this pemit tay be subject to "deed restrictions" which lay be lOre restrictive than City
regulations, 'l'he undersigned assUles responsibility for COIIpIiance with any applicable'deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake wort, they tay 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 lisdl!leanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
reguirl!lents 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 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 wisbes you to sign
as contractor that.tay be an indication that be is not properly licensed and is not entitled to perlitting privileges in the
City of Zepbyrhills.
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 provideciwith a copy of "Florida's Construction Lien Law - HoIIemmer's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsUJer Affairs. If the applicant is sOleOne other than the
"owner", I certify that I bave obtained a copy of the above described docUJent and protise in good faith to deliver it to the
"owner" prior to COIleRCeleRt.
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 bas cOllenced prior to issuance of a petlit and that all work will be perfoIJed 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 goveIlllelltal agencies laY apply to the intended work, and that it is
IY responsibility to identify wbat actions I lUst take to be in cOlpliance. Such agencies include but are not lillited to:
* Departlent of EnviroRleRtal Regulation - Cypress Baybeads, Wetland Areas and EnviroRleRtally Sensitive Lands,
WaterfWastewater 'l'reatlent
* Southwest Florida Water Hanagetent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
* AllY Corps of Engineers - Seawalls, Docks, Havigable Waterways
t Departlent of Health & Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater Treatlent, Septic 'l'anks
t US EnviIODlental Protection Agency - Asbestos abateleDt
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 "cQlpeDsating volDle" will be sublitted wbich is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A pemit 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 pemit prevent the Building Official frot thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every pemit issued sball beCOle invalid
unless the work authorized by such pemit is COIIeIlced within sillOnths of issuance, or if work authorized by the pemit is
suspended or abandoned for a period of six IOnths after the tille the work is ~ced. One 90 day extension of tille, lily be
allowed for the pemit with fee charge of $15.00. 'l'he extension sball be requested in writing to the Building Official. An
approved inspection lUSt be logged during each sixlOnth period, or the project will be considered abandoned.
WARHIHG TO OWHER: YOUR FAILURE TO RECORD A NOTICE OF COMHDCEIIBH'I' HAY RESULT IN YOUR PAYIHG TWICE FOR IHPROVEIIEII'I'S TO YOUR
PROPER'I'Y. IF YOU III'I'EHD TO OB'I'AIH FIWCIRG, COlfSUL'I' WITH YOUR LlHDIR OR lIf AftORDY BEFORE RECORDIRG YOUR HO'I'ICK OF
COMMEHCEMENT. JOBS UlfDER $2,500 IJf VALUE 00 ROT NEED TO RECORD lIfD POST A "ROTICK OF COHHIlRCEHENTII.
SIGHAMI: OWIfER OR AGENT
SIGRA'I'URE: CONTRAC'I'OR
STATE OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before me this , 19____ by
S'I'ATE OF FLORIDA
coum 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)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
C()~C~I?IE
CmE~TEWQ'C!l
~
Shopping Center Developers
..
c.
Friday, December 01, 1995
City of Zephyrhills
5335 8th Street
Zephyrhills, FL 33540
Dear Gentlemen:
Please consider this a formal authorization to allow Gulf Coast Signs to pull necessary
sign permits for Piccadilly Fish & Chip, which is to be located in Townview Square
Shopping Center at the following address: 7254 Gall Blvd, Zephyrhills, Florida 33541.
If you have any questions, then please give me a call.
{2'
CbadM~
Leasing Man ger
Merchants Square · 7335 Gall Blvd. # 2 · Zephyrhills, Florida 33541
813-783-8490. FAX 813-783-8489
~s(
lese MemtM!'r
SILCOX ENGINEERING, INC.
5409 Nebraska Avenue
TAMPA, FLORIDA 33604
Phone (IU) 238.1755 CHECKED IV
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GULF COAST SIGNS
25224 S.R. 64
LUTZ, FL 88649
972-8685
PROPOSAL
GULF COAST SIGNS agrees to provide the following products and service to:
CUSTOMER: F/c c. q d I "//7 /..::;.;;.-< j eh J /J.3
PHONE NUMBER & CONTACT: . Fry Oc..- U Jd J '-1 71ft? 81 {.. 3
ADDRESS: 725"4 &//6/<./d 2. hJ-Ils
DATE: ;1 2? q;;,-
.......................................................
Description Of Sign
cha/?/7e/ L..:.#&S 0'->1 ~:>/J rec:e vJo,
Jrau),'5
(~'({' ccl,d
/-=:~ <!...h'r~5 pGY' l2c..s A ~ t'l-~.
.......................................................
NOTICE
All product manufactured and installed by GULF COAST SIGNS are guaranteed for one year.
Title on sign(s) does not pass to buyer until seller has been paid in full. SELLER reserves the right to
remove any sign from the buyer's locations if that sign is no paid for as per the terms of this agreement.
In consideration of this agreement, the BUYER does hereby agree, jointly and severally, to pay for all goods,
wares, merchandise and services supplied to any of us and lor the named business. In event it becomes
necessary to place the account with an attorney or agency for collection, IJwe, the undersigned, agree to pay
all cost of collection, including reasonable attorneys fees.
Unless other wise specified, fmal PAYMENT on work is C.O.D. Please be prepared to make payment at time of
delivery or installation of your sign.
.......................................................
9c1J. 7'- ()
.:s1,60
~<5L> I <~
;.;>' .-
Selling Price:
Tax 6%:
Less Deposit:
Due On Completion:
6Ob. rJ"V
Buyer's Name And Title (Please print)
4i= /0 I'i?'
~,of f~cJZ), ~AJ
oJ
A=P~BY;g(k hQ
Accepted By S er (Owner)