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Home My WebLink About96-5572 BUILDING PERMIT --- CITY OF ZEPHYRHILLS Permit 11! (813) 788-6611 I ~ 5572~t) Date 6) -.s.....-rL. ~ Pwperty Owne" ~ ~ Job Add,.." '-? _<f:f - ~ . __ _ r<- ELECTRICAL PLUMBING MECHANICAL Sewer Conn Water Conn: Water Meter: T.I.F.'s: Parcel 1.0. # Zoning: Energy Code; ~ Radon Gas: Description of Work j\?7L-~-P ._-;;t.. -ri ex.. d~.A NO OCCUPANCY BEFORE C,O, FINAL C,O, '3 Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. Inspector UJ Permit Fee Signature Company Address Telephone# .;t LJ. I/O ~- Valuation or Contract Price '-!.3 C7V. o-D City License Registration # J b 7 ? State Certified License# "}I~-'l-AAAA7_P,' ~~ BUILDING ELECTRICAL PLUMBING MECHANICAL Breakers Ducts Insl. Compressor Final Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Ftr. Pre SLB Lintel FRM. Insul. CL WL 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 NAl1.E l/rt p( 0 t- D OWNER'S ADDRESS .?,f tf I 1 rT Ft= ~ .s rJ:{ ;7tJC ~ PHONE ltf:2 .;J ft 7 JOB ADDRESS LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I. D. t / / - d- 6 - ~ /... t!J / lJ /- $/6 .... C 00 -/1ff OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition ~teration _Repair ,/' Install _Sign _Kove _DeJIOlish PROPOSED USE: l..----"'Single Faaily _KIF _' of Units _K/H _ec-ercial _Indust. _Swia, Pool _Other _Restaurant & Health Departaent Approval DESCRIPTION OF WORK: /1 t=-jJ L.4 C-b / 0 IJ, If} {)(;Jc.) -! f;:; .Doo~ J BUILDING SIZE: x Square Feet, Height RESIDENTIAL : COMl1.ERCIAL : 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. PERl1.ITS REOUESTED V"BUILDING $ L.I d tTb < lJ7J Valuation of Total Construction _ELECTRICAL AKP Service Florida Power Corp. W.R.E.C. -"ECllANICAL $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CORSTRUCTION: _Block _Fraae _Steel Other FDlISHED FLOOR ELEVAnONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** BIJTT.DER CONTRACTOR SECTION COKPANY J0JV~ ~Vc.IC ~cYJM I~VI'Vf ~ ~ State Cert. or Regist. , C. c. 0-1fj~? . ~ City License Registration t /. ****************************************** Signature ELECTRICIAN COl1.PANY State Cert. or Regist. # City License Registration , ****************************************** SiRnAture PLUMBER COl1.PANY State Cert. or Regist. , City License Registration . ****************************************** Signature tlEGHANICAL COl1.PANY State Cert. or Regist. . City License Registration * ****************************************** Signature OTRF.R COl1.PANY State Cert. or Regist. , City License Registration t ****************************************** Signature APPLICATION APPROVED BY PERl1.IT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Tbe undersigned understands that this petlit lay be subject to 'deed restrictions" wbieb laY be lOre restrictive tban City regulations. Tbe undersigned assUles responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner bas bired a contractor or contractors to undertake wort, 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 lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing requirelents laY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813) 788-6611. FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the RContractor Sectionsn of this application fonfbieb 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 peIlitting 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 'Florida's Construction Lien Law - HOIeOIIDer's Protection Guiden prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleQne other than the Rowner", I certify that I have obtained a copy of the above described docUleDt and pra.ise in good faith to deliver it to the "ownern prior to couenCl!lel1t. 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 developleDt. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation has co.aenced 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 goveIDIeDtal agenCies laY apply to the intended wort, and that it is IY responsibility to identify what actions I lUst tate to be in cOlpliance. Sueb agencies include but are not lllited to: t Departlent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDleDtally Sensitive Lands, Water/Wastewater Treatlent t Southwest Florida Water Managl!lel1t District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways t Departlent of Health & Rebabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater !reatlent, Septic ranks t US EnvirODleDtal Protection Agency - Asbestos abatelent I also certify that, if fill laterial is to be used in Flood ZOne RAn or RA,etc.n, it is understood that a drainage plan addressing a 'cDlpeDsating VOlUleR will be sublitted whieb is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A pertit 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 sball issuance of a petlit prevent the Building Official fra. thereafter requiring a correction of errors in plans, construction, or violations of any code. Every petlit issued shall beCOle invalid unless the work authorized by sueb petlit is COllenced within six IOnths of issuance, or if work authorized by the petlit is suspended or abandoned for a period of six IODtbs after the tile the work is co.enced. One 90 day extension of tile, laY be allowed for the petlit with fee ebarge of $15.00. !he extension shall be requested in writing to the Building Official. An approved inspection lUst be logged during eaeb sillOnth period, or the project will be considered abandoned. WARMING TO om:R: YOUR FAILURE TO RECORD A NOTICE OF COMMElfCHMEHf MAY RESUL! IN YOUR PAYING !VICE FOR IMPROVHMEIft'S TO YOUR PROPERTY. IF YOU IJI'J'BND TO OBTAIN FINAlfCIIG, CONSULT IIITH YOUR LINDO OR AN AnORNBY BEFORE RE.CORDIIG YOUR JlO'fICE OF COMMEJlCHMEJIT. JOBS UNDER $2,500 II VALUE 00 lOT NEBD TO RECORD AND POST A "NOTICE OF COJOmJICKMBJI'J'R. ~e~ P SIGJlA!URE: OWJIBR OR GHII'J' ~~ SIGJlAT : COJl'J'RACTOR STA!E OF t:J.ORI~ coum OF . ~ The foregoing instrument was acknowledged before me this ~ - 5 , 1991r~ by - . c:::----~ ----..' \. . ~ F~~ ~ ~~ . . .-- 't -r who j.B--peI1J(f..- ...) own to me or who has prod1Iceli. h. .. as identific~and who take ~~~~~U The foregoing instrument was acknowledged bf!J.ore..llIe this ~- S , 19 c1 6 by to me or who has r.;r;::r-t, 1j'~'~.i r'j',' CONTRACT rOil,. Besr/f/l'estme1l1 ALUMIN ry6>~ 35 Years Experience Winter Haven: (941) 965-5588 * VINCE BROCK Bonded . Insured S tate Certified Bonded Lie. #CRC045787 P,O, Box 3183 Winter Haven, Florida 33881 Insured Toll Free: 1-(800) 282-7255 CONTRACT submitted to Street ~'( r f , I I Job Name Job Phone Diagram Special ~ ~ Otleph~ih;1J -<- lD-# it - ~U -,~ I to I 01 4(..v :- C().J /4-0 I., ../!: We will hereby furnish material & labor in accordance with above specifications for the sum of: \- In.\..r- 4- '" 0 ~ t... ,",,-cf fA (' e e. II k-I'l.clr (' I dollars ($ . payment to be made as follows: ".. ,:'(;"' ..~, ' "," D.eJ., LA, &1\ (~ _ t'}M "'( ^ K4 IJ U':. 'v , - ~ 3D 0 . , :""J/lc'" f~ ) l'>,1'T" (:t':~r\.,[.,:;. <" ~.t. ~ tHiSiStqA))ViSEI;QV!I1A.]tg~A.!{~~!qt;E~:r~~!I!I!\' FLORIDA H.oME IMJlR.()"~M~t.A.CTjt.1NPE;t{t~E;~P~'!ToB~~!~$tQ~!\~[....., PLEASE READ BEFORE SIGNING: Wort men art! C<JVert!d by wortman'. compensation insurance and liability immrance. , Company is bonded and insured. An accounts to be paid by cash, unla. f'manc:illl i.available. 10% deposit and balance due upon completion. No verbal ..~nts wiD be honored. I % per month service challle on an pad due aCCOlJJlU unlets otherwise agreed in writing. plus attorney's fees, I yearlabor warranty. Subject to rmal approval of ~ Off'1Cer: Authorized Signature 7/i1t/- - · Biti:K ALUMINUM. INC. Signature ~~~ &;~ Signaturt! o..e nil. fu.... .,""'4\ _--.....:.,:~~...c...-~_=._..._.~....;,~._._