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Home My WebLink About96-5760 BUILDING PERMIt-- CITY OF ZEPHYRHILLS permit" (813) 788-6611 '-5760 .8 Date 7!-r2;)-9~ ~~ ELECTRICAL PLUMBING Property Owne" \ ~~ ) Job Address: 0'"3. 1 ./'L---- Parcell.D. # MECHANICAL Sewer Conn Water Conn: Water Meter: T.LF.'s: Zon;n" ~' Description of Wor~ KU' . Radon Gas: FINAL NO OCCUPANCY BEFORE C.O. Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. Inspector w City License Registration # State Certified License# Permit Fee J~ L 0-0 Signature ~::"i!>~ ~-.,~ Company Address Telephone# Valuation or Contract Price \..~ 7 ffz9 - cr-o ;J~("" rf?~~~ '(~t BUILDING ELECTRICAL PLUMBING MECHANICAL Ftr. 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 PERMIT CITY OF ZEPllYRBILLS BUILDING DEPARTMENT OWNER'S NAHB~..... ~ ~ ~~.A')6I..~ " OWNER'S ADDRESS S Sb C,o ~~ ~L.-vJ-Q.. JOB ADDRESS ~ ~ PHONE '7 &? J-:5> . ~ cte, "7 ~ c, L~ LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1.D.' (OBTAIN FaOM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction Q>L--~ _Sign _Addition _Alteration _Repair _Install _Move _DeIIOlish PROPOSED USE: _Single F8JlUy _H/F _' of Units _M/H _<=<-ercial . _Indust. _Swia. Pool _Other _Restaurant & Health Departaent Approval DESCRIPTION OF WORK: l62 - ~ BUILDING SIZE: x Square Feet, Height RESIDENTIAL: COHHERCIAL 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. PERMITS REOUESTED _BUILDING $ Valuation of Total Construction _ELECTRICAL AHP Service Florida Power Corp. W.R.E.C. _MECllAlfiCAL $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fr8JIe _Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? ****************************************** YES NO CONTRACTOR SECTION BUH.DRR COMPANY State Cert. or Regist. , City License Registration , ****************************************** Signature ELECTRICIAN COMPANY State Cert. or Regist. , City License Registration , ****************************************** SiMtJlture PLUMaER COMPANY State Cert. or Regist. , City License Registration , ****************************************** Signature MECHANICAL COMPANY State Cert. or Regist. , City License Registration , ****************************************** Signature .: CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Tbe undersigned understands that this perlit lay be subject to "deed restrictions" wbicb laY be lOre restrictive than City regulations. Tbe undersigned assUles responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner bas hired a contractor or contractors to undertake work, tbey 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 Zephyrhi11s Building Departlent, (813) 788-6611. FurtberlOre, if the owner bas bired 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 owner sign as the contractor, you are indicating that you, ratber than the contractor, are responsible for the work. If the contractor wisbes 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 Zepbyrbills. 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 - HOII!owner's Protection Guide" prepared by the Florida Departlent of Agriculture .and Consuaer Affairs. If the applicant is SOI8Qne other than the "owner", I certify that I bave obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the "owner" prior to cOllencelent. E. CONTRACTOR'SjOWNER'S AFFIDAVIT I certify that all the inforlation in tbis application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land developlent. Application is bereby 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 perlit and that all work will be perfol'Jed to leet standards of all laws regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also certify that I understand that the regulations of other governl8ntal agencies laY apply to the intended work, and that it is If responsibility to identify wbat actions I lust take to be in cOlpliance. Such agencies include but are not lllited to: t Departlent of Knvironlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater Treatlent t Southwest Florida Water Hanagelent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways t Departlent of Health & Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater Treatlent, Septic Tanks t US EnviroDlental Protection Agency - Asbestos abatelent 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 "corpensating volllle" will be sublitted wbicb is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. 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 sball issuance of a perlit prevent the Building Official frOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beCOle invalid unless the work authorized by such perlit is cOll8nced within six IOnths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six IOnths after the tile the work is coaenced. One 90 day 81tension of tile, lilY be allowed for the perlit with fee cbarge of $15.00. Tbe 81tension sball be requested in writing to the Building Official. An approved inspection lust be logged during each six IOnth period, or the project will be considered abandoned. WARMING TO OWNER: YOUR FAILURH TO RECORD A NOTICE OF COHMDCHHEIft' HAY RESULT IN YOUR PAYING TWICE FOR IHPROVRHBIft'S TO YOUR PROPERTY. IF YOU IIft'BHD TO OBTAIN FIHAHCING, CONSULT WITH YOUR LEIDER OR AM AftOllHBY BEFORE RECORDING YOUR NOTICE OF ::::~500 IHm~oo~_:~~~" . SIGllA1D1lll: 0IllIEII' SIGlll'llllE~'~ STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this , 19____ by STATE OF FLORI~ COUNTY OF ~ The foregoing instrument was acknqwledged before me this 1/ - ;} d- , 19 ~ by who is personally known to me or who has produced as identification and who did/did not take an oath. who iS~~own to lie or who has produce as identification and who did/did not takY1'~ (j. [JJ <h"fr (Signatur~ . cr. )1 I &iLc..v A ODclv (Name Typed, PrUited or Stamped) / NOTARY PUBLIC (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC "~~1'l:l:& A~' :~ Nancy A. Moody ~;. J*~ MY COMMISSION' CC534. !1J. 'iC. ..' .... 'i.,- Feb ~"f.""'~'o I1laIy 21 2(;!' 'I/f..fl\ . BONDED TliRU TROY FAIN INS';';!" ..." u... u ::u.u.. RYMAN CONSTRUCTION INC. (ROOFING DIVISION) 37325 SR 54 WEST ZEPHYRHILLS, FL 33541 PHONE:813-782-6094 LICENSE: RC0061648 [Jate Sheet No, Proposal Submitted To: Name \~" ~ ~ f~<Tl ~ Mtt~ City ~~~ Phone 18<& ~ '-\ lo ~ "'I Work To Be Performed At: Street 5 ~o~ Street State ~\ City State Date of Plans Architect We hereby propose to furnish the materials and perform the labor necessary for the completion of ~~~ U~-\- ~ c...S2.Q... ~ ~~~ q f>~~ ~tO~ 1.) 2. ) 3. ) 4. ) Complete tear-off of eXisting shingles. Roof dried in with 15 lb. felt. Bad plywood replaced at a cost of $35.00 per sheet. Installation ,of new 2x4" lumber and lx.6," fascia @$L50 per lineal ft. Install all new valley metal with 20" galvanized metal. ~m:mm~ ~~ ~:: ~F~::~=~:m~~:~~~E~F~~~ngl f :l5~~ All debris removed from the job site. ~s Five year leak warranty. All materials ,and labor furnished. 5. ) 6. ) 7. ) 8. ) 9.) 10. ) lL) PAYMENT .DUE UPON COMPLETION OF JOB. ~o.~A'c:)-::::::< ~~\~\y<-<,.-", k",-,<;::. "",~'$ 0 'LdU All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications submitted for above work and completed in a substantial workmanlike manner for the sum of with payments to be made as f~II~~~....~~~==<=:==::,.....:..~~II~.~~~~_~ -=~.~ Any alterat:on or deviatio.n from above specifications involving extra costs, will be ex€cuted.only upon ,written orders, and will become an extra charge over and above the.estimate, All agreements contingent upon strike.s., accidents or delayS beyond our control. Owner to carry fire, tornado and other necessary insurance upon above work, Work- men's Compensation and Public Liability Insurance on above work to be taken out by Respectfully submitted., .. ........ y.. ...... ..... ........ . ...."..". pec.~::-.,,~ Note-This proposal may be withdrawn by us if not accepted within days. Date Signature '\tJ'ops, FORM 3850 ORIGINAL MADE IN U,S,A.