HomeMy WebLinkAbout96-5834
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Date b - - /~- - 9' b
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
PmpertyOwne" .~ ~
Job Address> ?' 7 / ' .;I - h. . ~
Parcell.D. #
Water Meter:
T,I.F.'s:
Zoning: Energy Code: radon Gas:
Oe'CriPtionOfwo~,....-",_7;~:".. ,pIA ,gf"A't..4.. (7.L~ ~ l
/ / -'
f~ r~C f~ 11-4-1'.4 J/~ UJ/J 5.5'....s
NO OCCUPANCY BEFORE C.O.
=
DATE
FINAL
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
VJ2.J2.L f1~1 ~..:iF.!>-d-iO t3
c.o. -1
City License Registration #
State Certified License#
/~3
Permit Fee
Signature
Company
Address
Telephone#
Inspector
Valuation or
Contract Price
I~A.JJ~.~
BUILDING
,-- >>~4 ~6 7
ELECTRICAL
f.../1u8,fr/t,6 j~~
~b
, PLUMBING MECHANICAL
SLB
Tub Set / ~ "If' !Jw(S/!t
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
Tp. Servo
Rough In /p,f~Jt~.p/1f)
Meter Can
Const. Pole
Pool
Pre-Meter 11- '1- 9" CaP'
Final
Ftr.
Pre SLB
Lintel ~ ~
FRM. /q. B I b~
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.
APFl,U:Atl0M r(,n rRI\HIT
CITY or ZEFH1RH1LLS
bUILDING DEPARTMENT
~~t q0 .
2~ [) ..
, ........ ..
OWNER'S N>>lIL-__L.J::!,L_.H,aKao_~.,__,._,_____________~___PHONE '(;13' Q'/3.. 5'56'
OWIBR'S AUPUNI P (.1.&'10 .::i...2..8, ,Ne.~ ?~T /2"~kV, 1=/ ,'-J("''5"'" Q"":~A
JOB ADDRZS8 j=3g I ';/: I ~ ..,.. h I~~E..,
('),-/ 'J ,:, 1 - ~ . __
LB<W. PISCRlJ'TION; J..OT(S)_~
PAROEL 1. D. f I,~ -_.&1..,..;.A..l..:_.,_o_
__BLO~
.SU8DIVISION
(OBTAI. PROM PIUP"'" TAX "QTICR}
WRIt PROPOSl1h-LNftV Cotl.ot.ruetioQ ----J'.ddltlon -L':.ALterauon _.Jepalr _last.i!
..-..-..81811
_.._Jtu"t!
_"p4'!IIol ish
PROPOSED USE: -L.J3 inale Fa Uy
--1J/F ...JJ_.t of Units ..-Jl/B
__eo..ecclAl
__Indu!lt. .__swia. Pool _other
__....Re.taur..nt , IlcAlth Vepu:rtAent APprove1
DBSCRIVrlOH 0' WORJ,;_-......s...e..,;:....-f))'I iO.~1"" F-:-t.> WI<:., IE. - ~ ~ PLAN";)
BUILDING SIZI:
J..
."____..___Slluare Feet,_.. ...--_.Hei8ht
RBSIDBI1TIA.L:
ootIKRRClAL =
ATTACH (2) PLOt PLANS & (2) SBTS OF BUlLDING PLANS' (1) SST BNBRGY PORMS.
ATTACI1 (3) SBTS OF BtJILDlRG PLANS, (1) SRT BNBRGY FORKS.
PROPIRTY SURVlY REQUlIl&D FOR ALL NEW CONSTRUCTION.
llMUj I\BOV.BfilU
~UlWIRG
./' IUEC11l1tAL
LJmawnc;:AL
/~tltR~.G
$___,S8,..:i~~~~~_Va1uaUon of Total Construction
~ ' t:I. ~p Sent J ce
_._--...;F 10t1OO Power COrp.
I W.R.E.C.
S..___._~~___~_V.luatioll or tlechl!ln1,cal 1000taUation
___.~GAS
./
~_,....__~OOFI NG
_____._Sl'scUJ..TY
TYP! OP OOIISftUCTlOM: L.l'lock _Fra.e _steel
. other
nHUIID n.ooR BLBVAtloNS=___..FT.
IS PROJECT IN FLOOD ZONB ARIA'
YIS
-
NO
................*.........................
CORIMJ4IU.1LS~QI.I.Wi
V / (:utltAML-.Cla1?..uc.-Harn.e'il q ])~lJ. R'f LAR./t;,.\/'l!
-/,,;/~__.____,JU:Allle C~r.t. or ~e8I,.t.. CB (!O ~~.,o.Iq
.~Y.;:l!X!__._-,_._... Ulty l.l(:@'ftsl@! Re8iBtr..Uon . /9..3
....................**...*~...............
4L41/
/ COMI)ANY_.._._fLtig~~r;~'TR.' c-
, State Cel't. or a.8let.' ~.R. oO~.Q.aq
. ctZ.'bI_.-_..---.--,--- City LicenrJl! RI!8istratiou . ~<.. q
~..............................****......
==--
IJdlPa A" ~/ C;OMPAtfY_~__i:.~ TA'/IiSS
",/ StAte Cert. or Re8ht. '_!3.f- (. 4l:, ~
SJgnAtw:e .....M ...___.._ City LicanJIIn ftfegiaUation' /b ;;
.. ...................**................
IL ~
KECBAIIlcAL . a" OOHPANY_~,...Si"I<Ti::;tEJ'ltl:t ~fT'ECI~r EN"1*".
" f" St...t.f! Cr.TL or Real.t.' KAI=! ()onp 9
8lpat"". 7~- :3:1- ~---- City 1.l.cens. ...istration t 5'"
.~~... ..t~..................*.*.**......
O'I1IER _ Kot> F . ~OO"PANY_ C 1A:<riJ..-;-8~/'7\c!> / :DE.), 8,'1 ~tt.tI-'N
. State Cert. l)r Regt.t..' Ceca Y~B{.1.
SilJD8.ture tl:I't __ City Llce1.l8e Reaistl:atioll . /- t6J-
.........................................
APPLICATION APnOV1!:b BY __..____._,."'---~,~--
PDMtT OPFICER.
... .. CONJJJ'rlQNS Of' I'EJ1Ml'r AFf'!UAVI1'
A. 1!U71f;J OF D8m JtKSTnIC'l'10.NS
lite -.iiIiall1 iDa'l'lt'Gd,iiiribi.;;i'BIt liliii"iubJect to ~c1erd rulricUone" "hlcb ~r be IIOr. rfltrlc1h. tIIu Cit,
reguJltioal. fbe UDdlllfgnld aIIO." re8ponsibllity for eOIpJI~dC' with en, Bppllc.bl. deed :ult~letJODI.
B. UNL.lCB.tfSBD COIfTRAC',l'ORS MD CONTRACTOR nF.Sl'ONSI8ILl'1'lBS
If tIIlon,.. .u ~hei'i.COiitiiclororcOiltritdoi8-t,o bll~..rtaltiwoi:I,-ii1~i, bl! r.oUIr!CI toiilIIe'"11lc1 illlccor4uc. 11th
,tit. and local revuletioRl. If the eonlnclor I, not IJc811sed 18 r~IlJrf!1I "1 In, bolb thl owner anc1 COIltnctor ., be
cited for I 111d"'IDor ,Iolltion undot ~taLe law. IC tbe OHner or Inten~f4 contractor er, unoerlall I' to wblt Ilcllllng
retulreltftt. II' IPPll for lb~ Intended wor~, thr., are advls.d tu cuntact the City of lepbfr~J1II Bulldllg ~tleat, (.13)
788-66U.
rurlbe~r., it lbl owner he, blr~ 8 contrfclor or contractore, he 1ft 8dvlBed to ha,. the contractor(.) .IQD portiGal af tat
'Cootr.ctor 'ectJgne' of this .pplicatlon ror .hjc~ tbey "111 bt r~~pon"lbl~. If JOu, al the OInBr .Iga .. the contractor,
fOIl H' 1nc1letUng ~t fOu, nther tban tb. r.ontractor, art' t'1!8l'OnllJblt for the IIOd. If the contractor .I.~.. JOII to .Ign
U l'Ofttrlctor that la' be an lodlclltlon UJaL be Ie nol propflrly JlunRp.d ~n~ .. not ,ntlUed to PHlltUn, 'rbU.... J. tilt
City of Zepb,tblll..
c.
TRANsrOR1'A'l'IOH 1t~PAC'r FEES ANU UTILITY CONNBCTION FEES
._-""--_._~- " ..... -.--.........---... -------. ..._--~-_._--,~-
D. CON.u.rRU(;1tlON LIlLN I,AW (CIUW'1EIt '113, Fr,OUID1\ B1'1\'fUTE8, AS AMBlfDIfD)
I certl" u.ari;Thi IPPllcatil-;-bne bA~n pro'I/1ol1 .Uh a copy of .Plorlda'" Coneuuctlon Lien Law . --er', Prot.ctlon
Gul~e' prepared by the florlda o.pert",nt of ~9rlcuJturl! and ConnlJ"l:lr MhlrlJ. If the .ppJJclllt f, 'OIeOne otJter Un Ute
lOIftlrl, I eartier that I ~'8 obtllned I copy or th! ahov, dlBcrlb,a dor.~'~"t and prOlil! fo good flith to dtll'll It to tbt
lowner' prior to COIIenCARent.
E. COJqRAC'rQ!t,~~.lP~"~n I ~l'FF..lJLAVl~:
· certjrr tDafilll~ InfOflltfon In tblR applicatIon 11 IccuratP. an~ that all worl will be don. in COIplfaace .I~ III
epplJeabl. Jill reguJltlng construction, loni"9, pnd la~d developlBnt.
Appllc.t1oo 11 ber.br ~d9 t.o obtAin a ptr,it to do work and InetBlletlon as ind'clt!d. I certlf, tbat no IOrl Ot
In.tell,tlon ... CDIIenced prior to 188unnce of a per.Jt Ind that all .ork will be perfotltd to !eet .tanO.r4a of .11 111I
regulating con.tructJon, eltr code., loning regulation., and laod dQvel~p'!nt regalatlon. In the Jurl.atctloa, I alto
certlf, that I undtl.tand that the rlgulatJOftI of olblr gO"tnlentel agenct.. III .pply to th, lDtlDled lOr., an4 tbet it I.
., ruponefhlUtr to Identif, "bat IcUon. I lUet tekl! to be in CO,pUlnr,e. Buell .gencJe.e Incluae but are DOt U.it. to:
· ~rtlent of InvlrORlental Regulation - Cypr8s1 Ba,heldl, Wetland Are'l Ind In'l[onJP~taI11 8en.ltJ,. Laa48,
" lI.ter/lfaetfnfater rreat.l!f!nt
t ioridl Watlr M.OI II!Dt Di.t~!ct - kelle, Cyptesl B8rbeads, Wetland Ar881, Altering latercoureea
I tin. eil'" 18, , ""'gable lahllflY,
· . · leblblUtathe SerdclI, lnyjrOlllOntl1 Hedtb Unit - kelle, Wllte"atl( Ittltlent, 8tptia ,....
· ~tI ,rvttctl!!!J.LeftCr - ~li9BtoB e".ip;;,jf--------.- ,
lillOcertIlltlJat;-lniillllt,ifal hi to bl! 0110" in flood Ion!! 'A' or "ft,etc.., It It und.ntoocJ tIt,t II tka_ plan
.ddreaelft9 I lCOIpIaI.tln, fOlule' will b9 ,ublltt,a whiCh II prep3rea br 8 professional engineet regJlt'lld In the 'tet. of
'lorla. prior to pertlt 1..uftDce.
A pItItt 1.laed lbaJI be cun8trutd to bo I Ilcen.! to proceed -llh the _ark and not a. .utborltf to ,Iot.tl, eIdOIl liter, or
lit Illd, en, provllloal of the technical CodIB, nor Bhall I'RuGne! or 8 perllt prevent the lulldJng Orflcl.l frot tterllft.r
rtqUlrlftg a correction of Irrorl in pl.na, construction, or vIolations of InJ code. .v.r, pttllt 1.,UId Ibell beooII 1.,.11.
IIIIle.. tbt lOr. .ut.llorlltt1 b, 111m pe~lt i, co.ne" Ilthln III IOntbl of 1II8UMce, or If IOrl lattJorlleG ., tilt _It I.
'UlpeDde4 Dr IbInc10ueG for I perlocJ of .1IlDnths .fttr the tlllt lbe lorl II ~enCflJ. Oa. 90 te, IIt.JelI of t..., .J lit
I1Jowtd for tbI ~t lith fee charge of '15.00. 'he 'Iten.ion .baJI be r!que.lld In writing to tbI lullll.. Offle1ll. AD
apprfytt lultCUCII allltbe logO.~ 'urlng eacb aillOlIU pedoc1, or lb. plOJgct "111 be con.II1BrI!t 1INmdon1d.
_In to -Ill YOUlf' r LUII-IQJISCORD A IWl'lll 0' mamleBlll'" MAY RESULt 11 YOUR PAfllIQ !WIll ... IIIPIIOVIm'rIIO lOUR
,lOPun. I' IOU J IV 01"111 n CrIfG, COIl80l.' WilY YOUR LIIIDIR OR All AnORIIJ II 110 tooIlOJJCI 0'
CDIII~. '2,500 II VI DO 1I001fBID ro RECORD AIftJ posr A "flOfICK
BI"I or FLORIDA
coom or
The forego!1I9 IilitrUie.nt wai8C1r.nowledged
before .. thh ___~_~, 19_ by
who .t. PiiriOii'ii'UY'kDOWilto-ilo'or'.;hOlias
:~O::::1l1catioDftndWbOdldidjd DOr-
take all oalb.
m~~-- '------"---'---..-...-
("ue Typea;-jiiliite,ror--SiBilpftd j' -----' "-
ROTARY PUBLlC
StAn OF PtORJDA <:-)
CotlHfY or __ ( 7 ~''2
The foregoing in8trument wal Icknowlldgld
before me thla j?CY-~/9Y.ll)iY I9a by
_...,.Q~.. '.
who 1 fJ ~~~~I_~. l~own to __ Ot' who ..
prOduced __'__, ~
~=k~d.nl~:i1'~~eDd "~ dl. d 110 _ '
T-I-_L~ ~
8 g~.) -<:.U ' .
t;8Jl.iL ex. -- w~ X-/l ~
(Nami T p~d, Printod or St~~
NO~l1Y PUI}.~j!;
\U.I'~,.._
.."iJIi' :~~ Bobble S, Swetland
N :*1 MY COMMISSION' CC534927 EXPtPf'
'~~'" . ~~"l FebruaJy 22, 2000
?;iif.,r..~" BONDED THRU TRDY FAIN INSUIIANCE, INC.