The URL can be used to link to this page

Home My WebLink About96-5719 BUILDING PERMIT~- CITY OF ZEPHYRHILLS perrTIit"W! (813) 788-6611 i-~57iQ /1 BUILDING ~(J, crV ~~~RI~ Date '1-7-rc, PLUMBING .5 () , c'T"D ~AN~ Sewer Conn Water Conn: P,opertyOwne" .:t~9' (~ Job Address: h / ~ Parcell.D. # ;L-J-6-J-/- ..5,-- 0 Water Meter: T.I.F.'s: Zoning: ~y Code: Radon Gas: Description of Work--. r . A ~ A- / L- '-- 4'1 L~ NO OCCUPANCY BEFORE C.O. FINAL C.O. Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. City License Registration # State Certified License# I~ Inspector P~rmit Fee ,-jU.) rh, _ S,gn'Me 4- ~L/ . /- ~~ Company _ - I...- Address Telephone# Valuation or Contract Price .5 trzTV. t7V / BUILDING ELECTRICAL PLUMBING ~/~~ ~ MECHANICAL ~~~rLJp 7:2 . - 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. APPLICATION FOR PERKIT CITY OF ZEPBYRBILLS BUILDING DEPARTKEHT OWNER' 5 IWtE ~ a A..I C6>U -IJ--r OWNER'S ADD'RESS G / ~ ( U7J2-Jlv L <) rI ' PHONE? g,,;Z - S-'y / Y JOB ADDRESS s'"Ci /44 e LEGAL DESCRIPTION: LOT(S) BLOCK PARCEL LD.' Ol - ciZG - .;;1.., 1- ~ - 0 SUBDIVISION (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction .-!addition -----Alteration _Repair _Install _Sign ---.Hove _Deaolish PROPOSED USE: _Single Faaily ---"'/F _' of Units _K/H _ec-ercial _Indust. _Swia. Pool _Other _Restaurant &: Health Departaent Approval DESCRIPTION OF WORK: J 7 t!J,.J A;/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 REQUIRED FOR ALL NEW CONSTRUCTION. PERKITS REOUESTED _BUILDING $ Valuation of Total Construction ':::---HEClWllCAL $ AIIP Service "5 tr8tJ _ cJb Florida Power Corp. W.R.E.C. RT.RCTRICAL Valuation of Mechanical Installation _PLUMBIBG GAS ROOFING SPECIALTY ~.<~:'fjOo.~.,. ' .4 ",. , i ... (;~,'!,J TYPE OF COIiSTRUcnOIi: _Block _Fraae _Steel Other FIllISBED FLOOR ELEVAnOIiS: Fl. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** COIiTRACTOR SECTION BIITT.DER Signature COKPANY State Cert. or Regist. . City License Registration . ****************************************** RT.RCTRICIAII.j COMPANY~<:::iM<'d (;kA..tr/~,t.tL t?L'~?TI'.lI<.' c:oJf./7" /\// . / // /'l ') 1 State Cert. or Regist. . SionAture / v{ ck-<t~ LA..t:f.'i!---e-jc!.ej City License Registration' 0 70( I ****************************************** PLUMBER COMPANY State Cert. or Regist. . Signature City License Registration . ****************************************** IlECBANICAL COKPANY State Cert. or Regis . . Signature City License Registration f ****************************************** OTRRR COMPANY State Cert. or Regist. . Signature City License Registration . ****************************************** APPLICATION APPROVED BY PERKIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS 'l'he undersigned understands that this pel'lit JaY be subject to .deed restrictions. which Jay be lOre restrictive than City regulations. !be undersigned asSUles responsibility for COIpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner bas bired a contractor or contractors to undertake work, they JaY 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 what licensing requirl!lents laY apply for the intended work, they are advised to contact the City of Zepbyrhills Building Departlent, (813) 788-6611. Furthel'lOre, if the owner bas hired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the .Contractor Sections. of this application for which they will be responsible. If you, as the OIIIler 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 JaY be an indication that be is not properly licensed and is not entitled to penlitting 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 provided with a copy of .Plorida's Construction Lien Law - HoIeoImer's Protection Guide" prepared by the Plorida DepartJent of Agriculture and ConsUlet Affairs. If the applicant is SOIeOne other than the .00000er", I certify that I have obtained a copy of the above described dOCUlent and prOlise in good faith to deliver it to the "owner" prior to COll8llCelellt. 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, loning, and land developlent. Application is hereby Jade to obtain a pel'lit to do work and installation as indicated. I certify that no work or installation bas ~ced prior to issuance of a pel'lit and that all work will be perfolled to leet standards of all laws regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also certify that I understand that the regulations of other goveIDIeDtal 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 lilited to: t DepartJent of EnvirolllleJltal Regulation - Cypress Baybeads, Wetland Areas and EnvirollleJltally Sensitive Lands, Water/Wastewater 'l'reatlent t Southwest Plorida lIater Hanagelellt District - lIells, Cypress Baybeads, lIetland Areas, Altering Watercourses t AllY Corps of Engineers - Seawalls, Docks, Mavigable Waterways t Departlent of Health & Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater !reatlent, Septic !anks t US EnvirODleDtal Protection !!Iency - Asbestos abatl!lent , ,;I also certify that, if fill laterial is to be used in Plood ZOne IA. or "A,etc. ", it is understood that a drainage plan , addressing a .COIpenSating vollllea will be sublitted wbich is prepared by a professional engineer registered in the State of ,':;.jlorida prior to perlit issuance. , , fI", ~. A perlit 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 petlit prevent the Building Official frOl thereafter requiring a correction of errors in plans, construction, or violatioDS of any code. Bvery pmit issued shall beCOle invalid, unless the 1fOrk authoriled by such pel'lit is c~ced within sillODtbs of issuance, or if work authorized by the peIlit is suspended or abandoned for a period of sillODths after the tile the work is co.enced. One 90 day utension of tile, laY be allowed for the petlit with fee charge of $15.00. rbe extension sball be requested in writing to the Building Official. An approved inspection lUSt be logged during each sillODth period, or the project will be considered abandoned. WARJlING ro omR: YOUR PAILURE '1'0 RECORD A MOrICH OP COMMDCBMDr MAY RESUL'I' 1M YOUR PAYIIfG fWICH FOR IMPROVIIIDI'S ro YOUR PROPERTY. IP YOU III'I'BRD '1'0 OB'J'AIM PlIIAJICIlfG, COISUL'I' WID YOUR LIlIDBR OR All AnOIlJllY BIPORE RICORDIlfG YOUR lforlCH OP COMMEMCEMBIft'. JOBS UlmHR $2,500 IN VALUE 00 Mor HIED ro RECORD AJID POsr A IMorlCH OP COHMERCEMBM!I. ~!JGm~ ,~~ S'I'A'I'H OP FLORIDA ~ coum OF '-r-- ~ The foregoing instrument was acknowledged before me this '/ - ''I' ,19? ~ by S'l'A'fI OP FLORIDA COUlfIY OP IJ,,4 sc!.. c The foregoing instrument was acknowledged before me this ~~ ~ (19~ by ~e,qn ~a.~ C..DlA...Lt e ~ who is personally known to me r who has produced 'M~~ ~'An -U 1"':L14!E. ~c.~nS-e a . dent. . ation and who did/did not e. oa who i personall own to me or wbo has produc as identification and who did/did not ta~~ath. O. 'fh ~- () (Signature~ ~ J _d f't c-~ A. uoo r- (Name Typed, printed/or/stamped) NOTARY PUBLIC ".~~\~~ LINDA JEANNETTE NEWSOME f.: :*E MY COMMISSION' CC <482467 '~"l EXPIRES: July 20, 1999 )f," 80ndIId ThIu NolaIy PubIc IMcIItwritIII ,\\~'.::~U'"" .'.D'....rpg.. N A h~..~ ancy . Mo/)(~I ~~ E:ffi MY COMMISSION /I CCs:!.!.' ;'J.:r'F'''~''' February 21, ~", > .JI,..fl'. IlONOeD THRII TROY FAIN IN5U:" ':, ---~-~~~ - '---~.--/~' -'-}--- ~~ ~~ / // ~ 11::> ;;;. .l.~{ . KINSEY CENTRAL /'-';7ouL/y HEAT & AIR-CONDITIONH i r; fi ~ r; ~ P.O. Box 2209 7718 Fort King Highway ZEPHYRHILLS, Fl 33539.220' \ (813) 782-2300 BILL TO -- i=.sL. OflKS//\c NAME--r- (l-r- - J €AU OlA 'elL- STREET~ /;LI .- u_ ... ~ L .s.7 >~. UdJ 3S5 'i6 PH2!J/ Q ;2 - 5 'I I '-I CALL BEFORE TECHNICIAN AUTHORIZED BY WORK TO BE PERFORMED QTY, "'D UNIT MAl .........."..., REb~'R~J*-/eu~? ... .".. ,....".? : /j/i./c :".IJ.?A"!-' i/ , : I ,/",...,...... I I ' , / {" )/~,~V' ,}.- ~ .u.....,'."... y ,....,. I I ,.>.":/~ / I -:r I .'~' ~~<-~'-"I - I I I .::;./ .' I FILTERS I.....,'. .... ....,..,...""....,. > FILTERS .....,. BELTS I TOTAL MATERIALS IHRS. LABOR I I I ! TOTAL LABOR I 1 . MATERIALS & LABOR MAY BE CONTINUED ON OTHER SIDE TERMS . :3~1/9t, Pij6M1 SED D A,M, D P,M, AMOUNT I I I ! I ....,.. I, AMOUNT I I I : ' [ I I I I I have authority to order the work outlined above which has been satisfactorily completed. I agree that Seller retains title to equipment/materials furnished until final payment is made. If payment is not made as agreed, seller can remove said equipmenVmaterials at Seller's expense. Any damage resulting from said removal shall not be the responsibility of Seller. _" L-- I / I ,-/:j'/ j:::.: ~ L_-"'--' _-<...</C-/ l-l..!.-/ -.J. ~::...- 'Cv$TOMER SIGNATURE ~ j( DATE .'" ....., HVAC SERVIC:E ORDER INVOICE RECOMMENDATIONS 2;~;'~~~~~~ ;E~>~ lfpC2! ~,) t :::~:~CEE: ~,~: l,( / ,,/ G /., (', !c{ ~:>'<.,j. [~I</<' REPLACED CONT "I {I.. f.. IX:: , I / - ': 1 l'~ U -€ r fto I ,., . - ,uO I ' FILTERS LJMITSJ;> )IlfA fI!SA.-N.T;V:,A II '!late rials, parts ~~rn6rit~1'€ r-'wM~nted by the manufacturers' or suppliers' written warranty only. All labor performed by the above named company is warranted for 30 days or as otherwise indicated in writing. The above named company makes no other warranties, express or implied, and its agents or technicians are not authorized to make any such warranties on behalf of above named company. THIS WORK IS TO BE D C,O,D. MAKE MODEL SERIAL NUMBER \ t"u!::t"V OTY, D RECOVERED D RECYCLED D RECLAIMED [J RETURNED L DISPOSAL DISMANTLED - [J CHANGED OUT/REPLACED TOTAL $ DESCRIPTION OF WOI1K PERFORMED . -7 1']1/ // .~ ....,. .(C' /"J..... .,f(~ ,', J' ./ ..-. ~ 1"-1- ,/ ['<f'---'!I fC" cLL, E.-' 7/"'/1 n .,' ,- _./ C' "",' (...'?> t-f/c: + I ~ -:;.r/ ~-. w=~.,.,...~. 2Zi!f1.2 ~t. 7~~ I I ' - ,- ~) _-v-- TLp.w -,' Z<iI, L .,......,. dJ..~;<~=~~~=() : I I I I S1~ -.; I : I I D REGULAR D SERVICE CONTRACT D WARRANTY CYU cyew D CHAF1GE MAKE MODEL SERIAL NUMBER CONOENSING UNIT LEVELED CLEANED COIL CHECKED CHAFIGE REPAIRED LEAK IN COIL REPAIRED LEAK IN COPPER # REF. CHECKED MOTOR CHMIGED MOTOR REPLACED BELT ADJUSTED BELT REPLACED CONTACTOR REPL. START. ~! REPL. START. CAPACITOR REPLACED RUN CAPACITOR CLEANED OR ADJ. GONTACTOR REPAIRED WIRING REPL"-CED FUSE REPLA.CED COMPRESSOR EVAPORATOR COIL REPL4.CED EXP. VALVE ADJUSTED EXP. VALVE AEPL4.CED CAP. "rUBE CLEA::=jED CAP. -.UBE REPA RED COIL LEAK REPA RED COPPER CONN CLEAI\IED COIL LEV"~ED COIL ELECT. HTR. REPL,:I,CED LINK TOTAL MATERIALS TOTAL LABOR TRAVEL CHARGE 1.", ,<\ f) jL~ e.::. D NO CHARGE n..., CONO,SATE DRAINS CLEANED MAIN DRAIN REPAIRED MAIN DRAIN CLEANED PAN DRAIN REPAIRED PAN DRAIN FURN, OR FAN COIL REPLACED BELT ADJUSTED BELT REPLACED PULLEY ADJUSTED PULLEY CLEANED BLOWER REPLACED BEARrNGS OILED MOTOR OILED BEARINGS CLEANED HEAT EXCH. REPLACED HEAT EXCH. CLEANED OR ADJ. PILOT REPLACED THERMOCOUPLE REPAIRED VALVE REPLACED VALVE CLEANED BURNERS DUCT REPAIRED ADJUSTED THERMOSTAT REPLACED ADJUSTED CLG TOWER CLEANED PUMP(S) GREASED REPAIRED l"" CLEANED REPLACED ., '" "..,....." TAX I I I ,~t'J 75:0-0 I I I I TOTAL 70 75T~