HomeMy WebLinkAbout96-5682
BUILDING PERMIT ......
CITY OF ZEPHYRHILLS Permit lt1!
(813) 788-6611 ~5' v3-- Date
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J~5682!7(
(3- ~6 -9p
Zoning:
Description of Work
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tIe!- 1i41IZs
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NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
4- \ c)\;,
D TE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Valuation or d /7 _ ",-Ill/') . 0 V
Contract Price L +J~:k C./~
City License Registration # /7.2 9'
State Certified License# ar:; ~6 ~ 9,t;[)
Inspector
Pe'mit Fee #. 50' QE-.. ~
Signature V".,IJ ;J. -[ -
Company --1t-01/ (f7J ~fc...}- ~~
Address f' 0 I}fJY ~<y-~I "1f'c/,.......~1( FL..
Telephone# 7 'il'- t c. )'- Lfr7t. rvcJ
DATE
-1>
BU
ELE
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
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 ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
f1AP-25-' 96 t'lCit~ 16: :1:Ll.P..: H~,I)AHCED ..8 I F: ~, DCiCJF::::; TEL HCi: 6E:.5-41::176
~321 F'Dl
~
PURCHASE ORDER w ACKNOWLEDGEMENT REQUIRED
P.o.f.lOX 2551
[('f 'f 0 N P 1'1 R K
Fl
~; ~:. l\ fi 0
.
PURCHASE ORDER NUMBI:R: "1 :3 0 1 f) {j
REQUISITION NUMBER: -l0!, 11 S f:l
FOR DISTRICT NUMBER: t\14li0
FOR STORE OR UNIT NUMBER: 0:'1 :)(1
ORDERING DIST. OR UNIT: 9 ~10;2 '1
CIRCLE K STORES INC.
TO: ADVANceo AIR COND.& RcrR.
BILL TO: CIRCLE j( ijTOAES INC.
"TiN;
FIXED ASSETS-QC 26
ADDRESS:
PO BOX !;>208S
CITY
PHOENIX
STATE liP
AZ 85072 -~:0f35
SHIP TO: CIRCLE K STORES INC,
A'fiN:
S TOP C ~\ i-i NAG U?
ADDRESS:
1?01 f:Ir..IY !,4(\ L(\;:
CITY
Z[f~II'r'fHIII_LS
& WIRF
srAre ZIP
FL 33599
DATE ORDERED:
JO~ NUMBER:
07D300lr
03/12/96
DATE REQUIRED: 0 lj /j (1 / ;) c.
PAGE:
1 or
1 1 lC, B S E:, G f~ ~) G
FREIGHT - PREPAY & ADO !
SHIP VIA:
SPECIAL INSTRUCTIONS:
~ ~
!) r: n ~.1 E S SAG E
2 A C U NIT PAC K f\ () F,' C (J fr\ P L El f:. ,
l,b00.e
S.,TON
ANY';'S
CONT: PENNY MQORt
@ (8 1 3) 7 Ii I) .' 5 ? ? '3
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VE~OORS INSTRUCTIONS' COpy 1 IS FOA YOUR R~CORDB COPY ~ MU$T Il! SIGNEO E1Y AGENT ANO F'l!!TUP'.NI1D TO I
l1-lt! ABOII! SILL TO ADDR!SS. ANY CORRECTIONS TO PURCHASS ORDER WHETH~R IN pFlIC~ I
OR ORDER MUST BE NOTATeD BEFORE RETURNING copy 2.
1.::'00.00
T01Al
~ ,,~ aQ'..8Il 10 Int;>>IMtI'i and _ hatm~aa CIRCLE K STORli:$ INC. a!'le ~e 1111""", F\.p'.~n"'~." and ~",plOY." "0'" an,/ .". .11
~.r..'"'Qli8. Cie'ms, ewau,le. atto~ f~8 or O1r.r ~1enH tM' and eoUfWi of Z.C!IOl"l by thlrQ p&rlO"S, Including but "01 !i!T1:t.d to &~1i9.
"'.,.....~, and eM~I0ye98 of ttI. V6r\dot ~nl;l 01 CIRCLE K eTO~I!S nee. ~...K1 ujj')l\ or Qr1i1ng out of aI'''' a.rnag4!l$. 1D88(tg, el(.pen~f
OM:~. ~. "'Juries Of U1nna ,1,I&tained Of l~rr.o by IUCh pef"l(X1 Or pe:'80n~ r.suI\Jn~ from. or In .ny ''''i'!. Olr"e'ly or if"lt:lif8'Uy. con....~'!d..
..", 1he ~1"ttel. pt'tJduotft. .yppl.... .quipment: or ",educt Clle~l,y, Dr an&lrtog Ol"lt Of tM de1ectlil Q4' &lktQM defe;!t" in Mid COfTlrnQClt1e&
crocI.-, ''-'?P'ofIe, eqlllllf'l1'''' or prcclllC1 d~'(II twI,...iIll 8QId O~ too V.ndOr to CIFtCL~ K !3TOI'lES INC. aM th. P",fO,",o"CG O'
~J'to~noe of ,"'Ie aQ'~nt or at the: V-t'f'\dln~."!'VioM provided fol' ~eor.""nQef, or tM oerfOm'lance of Dr n<<lvr. to perform .ny wOril. or
OC'* ~ f9~..tltd to auen V9~"Sl a&l"Yteel ~r~, however. that not.Y11r19\lInt;lln; the forr,golng. th., Venoor tlO4l' r'W:lt aQ'-i8 to lnd~~n;~y
S,....: .... 1"'*'""_ CIRCLE K 5TOflES INC., Ita '\\110"'" R~,....n18t.,.., .no EmPlOY." 're'" any ch~rQ'" 01ai"'8 or '(ll;on. Mll'la opon or
....~ c.....-: d &r-f)- da~OQ~. toMell, da,iM8. QxpenUs., enargq$, colllS, In jurle15 or Illness !.u~l"ed Qf incurred IU ",e .olb l'eeUn 01 th. n~gllQ9r.{6 of
OqCl~ <( ST~ES INC., 11. Agente, A.....ntAtj~. or Emplcytrel. l~ \,.. .vont a ctia,lm III 11~.d lI~if\8t CIRCL~ K SjORES INC. fer ..,1'lct'I
_ ~ ., .............. .~ .~ _ ......."'" ll..44 I'",^-" ..... t.."""1It f\f t'o.lP 1IlQ~.l"Il CI01.CL~ k. S":"OqES ,NC, ....1'1 prnl"l"lntl'j nollt.oI th'3 V~M~ ~f .'.Joh d:!t"""' ~f"tC
I TI>.NT, O~' OAi:iE1lfi~<~RO"~ LINVO'~~.
."C.v. "_ -E'[.G- "l.li NOTII"I US IltlM O,A. f: IF 'Vl. ~.J Ut<<8Tf TO
$;;"0 ~_rE ORO~ a~ DATE SPEC' I~D
V:!'oIOOR OR VENOQRS AGENT MUST SIGN HERI'
J
HW'r ,? 'tit I
J- ~ VT[--I
.m..'...'m.............,..........m..........,..........jl
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m.m11
II
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m'm II
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II
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2-TCC060FI00BA PACKAGE
.. ..m......... m. 2:::-BAYCU~BS ...... .....u..".
2-ACUSTATS 72/74
"m ..27CQMM.FIRE STATS
2-PIG TAILS
..10.:::-10"5 UPPLX ..DUCTS
10-10"SUPPLY GRILLS
... .... m"m 4:::14.,.'RE'l'URNuGB.I.LuL.S.."..uum.n...u,n
8-14"RETURN COLLARS
... ...m....... m..........~O',-::.;L..Q'.'.$ypy~X ..c:;Q~,~,AR$mmn
2-BOXES 20x20xl FILTERS
m.... 'm9..::,Pc::$......:J,.... .,..:J,.L2..'~,QY.c:;T....I?QA,B.:P...n
2-LOW VOLTAGE WIRE
'm"UuUn I.-CRANE ,,$ERV:j:CE.umm....,m,
I-ELECTRICAL
I-LABOR
iUr proposr hereby to furnish material and labor - compiete in accordance with above specifications, for the sum of:
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II
II
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II
II
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II PRICE INCLUDES ALL MATERIAL ,ALBOR, PERMITS AND CRANE SERVICE TO COMPLETE WORK.
II'
A:l rrate!":a! is g'.,;ara~teed to te as s;:e.::~;ej. All wc~k. to te cCr~;:'e!ej in a ,^::>;k,"'T';a~U...e
II' """',ar:.r:er a:::corjlng 10 s!ancard ~'~a::,:€s A;l,' a~:e~a~ion o~ de..:at'or. frorr. above s;-.e::1fi.:a:;or:s Authorized
~ ;mol,-:ng e~'a ccs!s ...:11 be exe=~~e~ :"-1)' up:n '",,~an c'je's. aod ,,'iI be:or->e an e<:'a S'\;"\a~ure
I cr:arlie o\er 8'1d above the es~ ""1;+e All a~'eerr,e"1ts con!tl""'g~:!t u;x>n s!rJ:es, a=c de"ts
or de'ays be)c"d Our cont'ol O""e' 10 ca'')' !.re, t::lrr,ado a-j 0:'1", oe:essa')' ms_'a~ce . No~e: Th:S p'oposa! may be
Our v.orl.e-s a'e lul!y ccvered to) \'io"..,a-'s Compe~sa"o~ I-so-a~ce. w!thd'awn by us if no! a:cepted w,thin
~ '
r0 r r l' p t u 11 reo f V r 0 p 0 5 U 1 - The atove prices, specificat,u~S
'I a~d cord'liuns are S3l;s'acto'y a-,d a'e here!:')' accepted. You are a~thori:ed S:g~a~"'e __~_
!' to GO t~o. \....nrk =o.C" r"r-.~,?'.I~.... ......
~ . .
. ~","I. ......, - .. '" -. - - ---.
..0;!. RECYCLED P.o.?EA
. "'6;Y Conle:"'lts; ~. Pr.-COf"$;..Ir-.C.f.1 1 O'er. Post.Consurr.er
IJropo5ul
Page No.
~f
(
ADVANCED AIR CONDITIONING
& REFRIGERATION,INC.
P.O. BOX 2551
EATON PARK, FLORIDA 33840
PH.(941)665-4876
s-r
1'\.0 SY'[
V~fl1J
I
11"0'0'" "'""""0 C I RCL E K CENT RAL F La R I DII
I: S7R"ET
II 5650 BRECKENRIDGE PWK SUITE 300
II' CITY, STA~E a'd Z,P CO;)E
TAMPA,FLORI9A
PHO~,E
DA7E
744-5249
2/13/96
JC6 ....A.~ e
~- 7'8l"L/~&1
CIRCLE K#7130
JOB PHQr.E
: AR:HliECT
I
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i ~mm,..,..
DATE 0= P~!\S
ATTN:BERNIE JARKA
ZEPHYRHILL,FLORIDA
We hereby sobmit spe:ifica!,ons an:: estimates lor;
7r5"()
J
. .m.... EQUIPMENT ,REPLACE.M.E,NT.. ,.
STORE HAS TWO SPLIT SYSTEMS,ONE COMFORTMAKER CONDENSER,ONE
HElL CONDENSER,ONE APCO AIR HANDLER AND ONE SUNDIAL AIR HANDLER,
REPLACE WITH TRANE 5-TON PACKAGE ON ROOF..
EQUIPMENT LIST:
0-25 AIR DAMPER
~~'l'~;;;;~ROOF"~ FLAsHteuRBS'}
I-ROOF CUT-ins
..,.*..,*..*..,*.. ~.~.~... IF,CTRCLE.K.FURNJSHES,..EQJ) l.PMENT...PRICE.
TO INSTALL WILL BE $4,500.00
SEVEN THOUSAND FIVE HUNDRED ********************* doHars ($ 7,500.00
Pajr~ent to be maje as fo:[o",s:
NET 30
Pages
I
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day~
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APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER'S NAME
~c6
K e; ~t~ PL
11../l.R~,1U' PF~Y
y
rtWy S-Y Ct:...;T
PHONE
OWNER'S ADDRESS _ 5':;- ()
JOB ADDRESS '7? ') () I
~Q ?Pt.1 Tt1'1-r /11'1- PL,
"7- f::;f'1t 7 tf.. 1-/' ~L.l-
-
r(.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 1. D.' {))... !2.. G 21 00) 0 0 CloD () 0 00 (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition _Alteration V-;:epair _Install
_Sign
---"ove
_Deaolish
PROPOSED USE: _Single Faaily
~eo..ercial
_H/F
_' of Units _M/H
_Indust.
_Swia. Pool _Other
_Restaurant & Health Departaent Approval
DESCRIPTION OF WORK: ~~J~ OLA-f (2) :; ..7~
/1 C-,
~
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 REQtnRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
AMP Service Florida Power Corp.
$ ~!J -rJ 0 \ (J 0 Valuation of Mechanical Installation
W.R.E.C.
_MECHAIIICAL
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fraae _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
CONTRACTOR SECTION
Signature
COKPANY
State Cert. or Regist. .
City License Registration .
******************************************
BUILDER
SiQllAture
COMPANY
State Cert. or Regist. t
City License Registration t
******************************************
\
F.l.F.CTRICIAN
COMPANY
State Cert. or Regist. .
City License Registration .
******************************************
PLUMBER.
Signature
MECHANICAL
Signature /5;
___ COMPANY ftPVIhVl' 01) tf7 ~c d- Ik/-
-z:- ~ State Cert. or Regist. t I' fTe- 0.7-6 i .2..0
L- City License Registration' 17~ 9
******* ********************************** . /
OTRRR COMPANY
State Cert. or Regist. t
Signature City License Registration t
******************************************
APPLICATION APPROVED BY PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit lay be subject to "deed restrictions" which lay be lOre restrictive than City
regulations. Yhe undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
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 Jay be
cited for a lisdeteanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building DepartJent, (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 Sectionsll 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 lay be an indication that he 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, have been provided with a copy of IIFlorida's Construction Lien Law _ HOIeowner's Protection
Guide" prepared by the Florida DepartJent of Agriculture and ConsUler Affairs. If the applicant is sOleone other than the
lIowner", I certify that I have obtained a copy of the above described docUJent and prOlise in good faith to deliver it to the
"owner" prior to couencelent.
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 cOlpliance with all
applicable laws regulating construction, zoning, and land developllent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has CDIIeDced prior to issuance of a perlit and that all work will be perfOIJed to teet standards of all laws
regulating construction, City codes, zoning regulations, and land developllent regulations in the jurisdiction. I also
certify that I understand that the regulations of other goveI1llental agencies Jay apply to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
t DepartJent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands,
WaterfWastewater YreatJent
t Southwest Florida W~ter Managetent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t ArlY Corps of Engineers - Seawalls, Docks, Havigable Waterways
t DepartJent of Health & Rehabilitative Services, EnvirODlental Health Unit - Wells, Wastewater YreatJent, Septic Yanks
t US EnviroDleDtal Protection Agency - Asbestos abat8lent
I also certify that, if fill laterial is to be used in Flood Zone "A" or IIA,etc.", it is understood that a drainage plan
addressing a uCOlpensating volUle" will be subJitted which is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A perlit 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 per.it prevent the Building Official frOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perli! issued shall beCOJe invalid
unless the work authorized by such perlit is cOlIBnced within six IOnths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of sillOnths after the tile the work is coaenced. One 90 day extension of tile, JaY 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 lUst be logged during each sixlOnth period, or the project will be considered abandoned.
WARHING TO OVlfER: YOUR FAILURE TO RECORD A HOfICE OF COHHEHCEMEH'f MAY RESULT IN YOUR PAYING fIIICE FOR IMPROVEMENfS TO YOUR
PROPERTY. IF YOU IH'fEIfD TO OB'fAIH FIIWfCIHG, COHSULT WITH YOUR LENDER OR AIf Anomy BEFORE RECORDIHG YOUR HOfICE OF
COMMEHCEMEHT. JOBS UlfDER $2,500 IH VALUE DO HOf HEED TO RECORD AND POST A "HOTICE OF COMMEHC~
I?~ "E, ~ tJiifl r ~
SIGJlAtURE: R OR AGEHT SIGHATU . COH'fRACTOR
STATE OF FLORIDA
COUHTY 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)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC