HomeMy WebLinkAbout96-5849
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Parcel 1.0. #
Zoning:
Description of Work
Energy Code:
??e~
Radon Gas:
(fd./\ r.. f 0
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.
Inspector
IAJ
P~rmit Fee rfJ-D ~... ~ ,~ /lrY-I)' rY.0
Slgnature~~
Company
Address
Telephone#
Valuation or
Contract Price 6 9' d.. - tTV
City License Registration # ~ g--
State Certified License#
)JL~ t~aA
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 Ins!.
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 ZEPHYRHILLS
BUILDING DEPARTMENT
PI:; f.' 2--
APPLICANT
\/?Iwe, I (\1\ ~
\!J'))I Us 3D\
~LAYY\/\ \~ I ~\Ad,~
5 24~ ~ S ~ ~+reeJ-
J)oJe
( .~ 33S2:~ . .
.,: I QpHONE "SLcrl Lot14 7
ADDRESS
OWNER
JOB LOCATION
LOT SIZE
x
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUbDIVISION
PARCEL I.D.4~
I~l!..- K"D\:"
WORK PROPOSED:____New Construction ----Addition ----Alteration ~epair ____Install
_Sign/Temp.
_Sign
____Move
..-Demolish
PROPOSED USE: _Single Family
---.JI/ F
____ft of Uni ts
.-M/H
____Commercial
____Indus t .
____Swim. Pool
~
Other
----Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Fee t ,
Height
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOR}lS.**
**COPY OF CONTRACT REQUIRED.
PERMITS REOUESTED
...b-BUlLDING
$ (n 32. . 00
Valuation of Total Construction
____ELECTRICAL
AMP Service
Florida Power Corp.
_W.R.E.C.
--"ECHANICAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block ____Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
CONTRACTOR SECTION
Company
State Cert. or Regist. #
City License Registration #
******************************************
BUILDER
Signature
ET.ECTRTCIAN
Company
State Cert. or Regist. #
City License Registration #
******************************************
Sillnature
Company
State Cert. or Regist. #
City License Registration #
******************************************
PI.UMBER
Signature
Company
State Cert. or Regist. #
City License Registration #
******************************************
MECHANICAL
Signature
Signature
Comp,ny ('i"\~d( (IYYI&t'rurh,)V) \V\C-
State Cert. or Regist.# Rc.. li)c,S21';-
City License Registration #
OTHER
Kt")l) FIMo
******************************************
APPLICATION APPROVED BY
PERMIT OFFICER.
A. NOTICE OF ~EED RESTRICTIONS
The undersigned underitana~ \hat this perlitlay be subject tD .deed restrictions" which lay be lore restrictive than City
regulations. The undersigned aS5utes responsibility for co.pliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If tbe owner bas bired a contractor or contractors to undertake work, they lay be required to be licensed in accordance Mitb
state and local regulations. If tbe contractor is not licensed as required by law, both the owner and contractor .ay be
cited for a lisdeaeanor violation under state law. If tbe owner or intended contractor are uncertain as to what licensing
require.ents lay apply for tbe intended work, they are advised to contact the City of Zephyrhills Building Departlent, (9131
788-6611.
Furtb.raore, if tbe owner has bired a contractor or contractors, he is advised to have the contractor Is) sign portions of the
"CoAtractor 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 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 tbat I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - HOleowner's Protection
Guide. prepared by the Florida Departlent of Agriculture and Consu.er Affairs. If the applicant is so.eone other than the
.owner., I certify that I have obtained a copy of the above described doculent and pro.ise in good faith to deliver it to the
.owner. prior to COllencetent.
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 develop..nt.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has cOlllnced prior to issuance of a per.it and that all work .ill be perfor.ed to .eet standards of all laws
regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction. I also
certify that I understand that the regulations of other govern.ental agencies lay apply to the intended work, and that it is
.y responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not liaited to:
f Departlent of Environaental Reaulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
Water/Waste..ter Treatlent
t Southwest Florida Water "anaaelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of EnQineers - SeaNalls, Docks, Navigable Waterways
I Departlent of Health L Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
f US Environaental Protection Aaency - Asbestos abateaent
I also certify that, if fill laterial is to be used in Flood Zone .A" or "A,elc.", it is understood that a drainage plan
addressing a .colpensating voluae. Nill be sublitted 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 Mork 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 froa thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perait issued shall becoae invalid
unless the Mork authorized by such perait is cOlaenced Nithin six lonths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six lonths after the tiae the work is co..ented. One 90 day extension of tiae, .ay be
alloNed for the perait .ith fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection lust be logged during each six lonth period, or the project will be considered abandoned.
WARNIN6 TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COKKENCEKENT KAY RESULT IN YOUR PAYING TWICE FOR IKPROYEKENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCIN6, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
~' 1885 UNDER $2,500 JI 'OlUE DO lOT IEED TO RECORD AND PO~ A 'NDTI~ OF CDKKEACE.ENT',
.v ~~.M% .Y~ --t t11~
SI6NATURE: OWNER OR AGENT SI6NATURE: CONTRACTOR
STATE OF flORIDA
COUIITY OF "PAbLv
The fc.regoing instrument was ao:nowledged
before me this Oshs , 19~ by
,
~~/Q... L~ ~Jvl
who is personally known to me or who ha~
produced N f\
as identific and who did/did not
take at
STATE OF FLOR~A
COUNTY OF f a oS u::'
The foregoing instrument was acknowledged
before me this OSII'5" ,19~ by
I
~ MY to I lY1l4-DV\
who is personally known to me or who has
produced ~
as ~d~~~~ and who did/did not
tak~ a.fi:
(Signature)
(Name Typed, Printed Dr stamped)
NOTARY PUBLIC
DAVID R. ABLA
Notary Public, State of Florida
My Comm. Expires Aug. 23. 1998
Comm. No. CC 402501
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
DAVID R. ABLA
Notary Public. State of Florida
My Comm. Expires Aug. 23, 1998
Gomm. No. CO 402501
~ H~l'Yl#LI:.U ....At"'t:H
_ _ '6~ontents: 4-0% Pre-Consumer. 10% Post-Consumer
c=~
'roposul
Page No.
1 of 1
Pages
~
/DI:7~ ~
Melnber of the Aorida
Roofing and Sheet Metal
Association
J@J
MilBar Construction, Inc.
Roofing. Concrete' Commercial' Residential
15911 US Hwy. 301 North. Dade City, Florida 33525 C>c
904/567-6047 800/562-2393 FAX: 904/567-4454
State Certified
Builder #CBC023221
State Certified
Roofer #CCC051562
State Registered
Roofer #RC0055215
U.S. Intec Certified
Platinum Installer
#5204
PROPOSAl SUBMITTED TO
Andy SUmile
STREET
5243 - 5th street
PHONE DATE
813/788-6817
JOB NAME
Sumile Garage
JOB LOCATION
5243 - 5th street
DATE OF PLANS f'
Zephyrhills, FL
04/22/96
CITY, STATE and ZIP CODE
Zephyrhills, FL 33541
ARCHITECT
We hereby submit specifications and estimates for:
JOB PHONE
WW ..............w '_'_.w .................. ...... W ....ww.. Ww .......... ..... ..:RfClUP."".Slingles..
::=:f:::~::::=~::::T:::~~:::~~=
color. GAP shingles have a 20 year warranty on labor and materials.
wi."wwRepiaceaii'damaged flashings (valley, vent, or
w5~ -"PrOvldearidliiStall new lead boots for the plumbing vents.
6 . PiovldEia.rid
to choose
7 . Ariyrotten or,wdaItlaged wood (roof deck, fascia, or trim) will be replaced on a
w..~~=p!~....~.:i.:;;;..~y.~...~~Y9I?4....th.~...9.9J,}:t::.~~Gtp;r;;i.,q~..... .
8. ........~!~.9?~~qt:::i,9.~/w.....:J::!:l:9!..w.t9.P:r9Y,i.,g~ .......~......yl?{l,r ...war.rantY.......on .....workmanship;......exclusions.:.
stonn damage, work or damage done by others, tree damage, and/or structural damage
to roof deck. .
9. .w~~J;t:.l:>PJ:."c:>y:i,~~c:~!?;;;~9.:r~J,JY~J:"Y. tl:"\lGJ(I?.:t::.9 ..Cill9Wr09floadinglunloading for the
... entire roof area.
1 0 . MiIBirwcoriStriiction, Inc. to provideGEmeraiLiaI;ili ty and Worker's Compensation
Insurance ($1,000 000 limit) and re-roofin rmit.
lit 'rOpOBt hereby to furnish material and labor - complete in accordance with above specifications, for the sum of:
Six hundred ninet -
Payment to be made as follows:
Due u letion.
---- ----------- dollars ($ 692 _ 00
).
B
All material is guaranteed to be as specified. All work to be completed in a workmanlike
manner according to standard practices. Any alteration or deviation from above specifications
involving extra costs will be executed only upon written orders, and will become an extra
charge over and above the estimate. All agreements contingent upon strikes, accidents
or delays beyond our control. Owner to carry fire, tomado and other necessary insurance.
Our workers are fully covered by Workman's Compensation Insurance.
Authorized
Signature
Note: This proposal may' be
withdrawn by us if not accepted WIthin
30
Acceptance of 'roposal- The above prices, specifications
and conditions are satisfactory and are hereby accepted. You are authorized
to do the work as specified. Payment will be made as outlined above.
4'1~- ofl9 - 9'''
Signature
~Jf?~
.
days.
~
Date of Acceptance:
Signature