HomeMy WebLinkAbout96-5731
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(:/' ELECTRICAL PLUMBING
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BUILDING PERMIT--
CITY OF ZEPHYRHILLS Permit II!
(813) 788.6611
~~573~B'
Date
Jf- /~- -:9 b
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
Parcel 1.0. #
Zoning:
Description of Work
:p:J1:Y C:Zj A,
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Pe,m;t Fe~ - W
Signature Co.
Company
Address
Telephone#
Valuation or h ,0
Contract Price ~ / -S'/, ?'V
City License Registration # / 7 :J.... c)
State Certified License#
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BUILDING
EJ.,ieTRICAL
r
PLUM~
/--
ME~ ~J1cM:'
Ftr. ~'l\C;. ~
Pre SLB
Lintel
FRM.
Insul. CL
WL
..",...
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
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 ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
APPLICATION FOR PERKIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER'S NAKE mo..r- k '1.Jn I} a k
OWNER'S ADDRESS 2 fq' ~ <S 00.. k S '2:,/ v r~
JOB ADDRESS 5~4 '?J ~\\ 1A{ll cJ
PHONE 7<6D /4-2-'8:
L...,d) D k~/~" 545&.'9
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I. D.'
(OBTAIN FROK PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction ~ddition _Alteration _Repair _Install
1Sign
--.Hove
_Deaolish
PROPOSED USE: _Single Fallily
i~ercial
_KIF
_' of Units _K/H
_Indust.
_Swia. Pool _Other
_Restaurant & Health Departaent Approval
DESCRIPTION OF WORK: r- Y)~-k I \
5X \0 \=>o\e... 'S.; 5.......
BUILDING SIZE:
x
Square Feet.
Height
RESIDENTIAL:
COMMERCIAL
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
ATrACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQ~ FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTED
_BUILDING
,$
Z 7 59 . be)
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
_MECHANICAL
$
Valuation of Kechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fralle _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
'.
YES
NO
************.......*......................
CONTRACTOR SECTION
BUILDER
COMPANY
State Cert. or Regist. .
City License Registration .
*.*.*....*...................*............
Signature
ELECTRICIAN
COMPANY
State Cert. or Regist. f
City License Registration f
*..........*..*............**.............
\
SiimAture
PLUMBER
COMPANY
State Cert. or Regist. f
City License Registration f
......*............*....*...**....********
Signature
MECHANICAL
COMPANY
State Cert. or Regist. f
City License Registration ,
**.*.*****..*************.**...***********
Signature
OTRF.R
li COMPANY \-l-"''^'''''-IIi>...... <S,?i""....... i.~Q,.,
~ 0 State Cert. or Regist. f
J.. City License Registration # \ 72-0
******.*.**..*******.****.*****.**********
Signature
APPLICATION APPROVED BY
PERKIT OFFICER.
.' CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perJit lay be subject to "deed restrictions" which lay be lOre restrictive than City
regulations. rhe 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 lay be
cited for a lisdeteanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requiretents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
188-6611.
FurtherlOre, if the owner has hired a contractor or contractors, be 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 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 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, have been provided with a copy of "Florida's Construction Lien Law - HOIeOWJ1er's Protection
Guide" prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs, If the applicant is sOleone other than the
"owner", I certify that I have obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
"owner" prior to COIleDCetent,
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 has cOllenced prior to issuance of a perJit and that all work will be perfolled to teet standards of all laws
regulating construction, City codes, zoning regulations, and land developteDt regulations in the jurisdiction. I also
certify that I understand that the regulations of other governJental agenCies JaY apply to the intended wort, 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,
Water/Wastewater TreatJent
t Southwest Florida Wqter Managetent District - Wells, Cypress Bayheads, Wetland Areas, Altering watercourses
t ArlY Corps of Engineers - Seawalls, Docks, Navigable Naterways
t Departlent of Health & Rehabilitative Services, EnvirODlental Health Unit - Wells, Wastewater rreatlent, Septic ranks
t US EnvirODlental Protection Agency - Asbestos abatetent
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 uCOlpensating volUle" will be subtitted 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 tbe 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 frot thereafter
requiring a correction of errors in plans, construction, or violations of any code, Every perti! issued shall beCOle invalid
unless the work authorized by such perlit is cOllenced within six IOntbs of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six IOnths after the tite the work is COllenced. One 90 day extension of tile, JaY be
allowed for the perJit with fee charge of $15.00. Tbe extension sball be requested in writing to the Building Official. An
approved inspection lUst be logged during each six IOntb period, or the project will be considered abandoned.
WARlfIHG TO OWNER: YOUR FAILURE TO RECORD A NO'l'ICE OF COMMBNCEMElft' MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMEMTS TO YOUR
PROPERTY. IF YOU Ilft'END TO OBTAIH FIIfAIICING, CONSULT NITH YOUR LElfDER OR All AnoRIfIY BEFORE RECORDING YOUR NOTICB OF
COMMBIfCEMBlft'. JOBS UNDER $2,500 IN VALUE DO NO'l' NEED TO RECORD AlfD POST A "NOTICE OF COMMEHCBMBNT",
~~~4
SIGIfAfURB: MER OR AGENT SIGNA~ CO C'fOR
STATE OF FLORIDA
COUH'fY 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_
STATE OF FLORIDA
COUH'fY OF
The foregoing instrument was acknowledged
before me this 'I-.;:L , 19 9 ~ by
~L 'JJ~,
who personally known to me or wh~ has '
produced (,JJ...66 - Y/'.3-Sl>'~ 0 cu.- - D ll. L~
as identification and who did/did not
take an oath')1 IA .
(SZl~1 /h~e--(\
&0
(Name Type , Printed or tamped)
NOTARY PUBLIC
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
"~i'*'fi:k', Nancy A. Moody
f.,f .''f~ MY COMMISSION # CC534806 EXPIRES
c.'. :~: February 21, 2000
:r)i~~~"'''' BONDED THRU TROY FAIN JNSURANCE. INC
GULF COAST SIGNS
25224 SA 64
LUTZ, FL 88649
972-8685
PROPOSAL
GULF COAST SIGNS agrees to provide the following products and service to:
CUSTOMER: J-.ok~.:5 '~vt:-I
PHONE NUMBER & <;ONTACT: q 73 4c/ /1
ADDRESS: 5<g.:/-Y ~.:/I B/l-tl 2-- H/ /d-
~~~:. :{~%: f.. ... .. . . .. .. .... .. . .. . .. . . . . . . . . . . . . .. . . . . .
Description Of Sign
pfobr/eC! -A:: qno/, ~ -:s*-//-, .
iJo~6/e 8,o/<<c>t P.{,.s-h~..> ,/4....., j s)/lsk. role
rlr 0t:s-f,,'97tY"'~ oI~w'l7.S ~ t?/l Clushl"le'd
per P /CJ-f plo",-
R/eSi9./1
p~/-I;:
........................................................
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. SELLElt reSl:;!"ves the nghc c"
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 cmd ,,:~ven.Jly, to pay Icn tiJJ gc.
wares, merchandise and services supplied to any of us and lor the named bUSlII,:S::', ,II t:vt:;nt It lJeUJIllc:;
necessary to place the account with an attorney or agency for collectlOlI, l;wc~, Li Ie wider-signed, agree to ! l,;
all cost of collection, including reasonable attorneys fees.
Unless other wise specified, fInal PAYMENT on work is C.O.D. Please be prel'>tred :0 make paymem a: j
delivery or installation of your sign.
......................***......****....**************.*
S..n...,.. Price.' $ 2. 7 5'7 .5'<:,..) ..., (.J :?-<-'
-. %k( .D'-'ce C rCJ ,CJ 7
Tax eeJ,: I CR S-, ~- 7 r
Lees Deposit: > / 3 7'7 ,/ S
Due On Completion: '" -I:
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Buyer's Name And Title (Please print)
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Accepted By Buyer
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Accepted By Se r (Owner)
WESLEY B. lkOAOE,P.E.
1203 CEDAR TREE LANE
SEFFNER, FLORiDA 'J:i58A
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SHEET NO. , OF 1
CALCULATED BY 1fJ, M.. ~ A.t:\\~ DATE \~ ~ \- g Co
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Gulf Coast Signs
Established 1975 Licensed. Bonded. Insured
Complete Sign Service. Computerized Vinyl Leners
illuminated Signs & Letters
Professionally Installed
972-3685
25224 S.R. 54
Lutz, Florida 33549