HomeMy WebLinkAbout96-6229
BUILDING PERMIT
N!
Permit
CITY OF ZEPHYRHILLS
(813) 788-6611
--6229/S
;l ~ --- (rO
BUILDING
Date
//, t;-J'b
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
:::::,~s:~.~fp-~-
Parcell.D. #
Water Conn:
Water Meter:
T.I.F.'s:
Zoning: Energy Code:
Description of Work ,fi /~
Radon Gas:
)1/ '~p~
NO OCCUPANCY BEFORE C.O.
FINALS --13 -
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
c.o.
DATE
Valuation or
Contract Price
/0 96
"
era
Inspector
City License Registration #
State Certified License#
)Jf 97
, ,
;J~\<p~
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 ($15.001 shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f, Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
A~ q- (tltz-~ P/lf~dc. ;(I).~
lfftf I I ~f1'I g,
9tm~
3,'fd-$
PHONE
?4fMM1/c..lS
7 ~'?1S3
fi 33Scro
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OWNER · S NAME I
!
OWNER · S ADDRESS
I
JOB ADDRESS !
I
I
I
LEGAL DESCRIPTION: LOT(S)
PARCEL I:D"' I
I
WORK PROPOSED!: New Construction
,-
I_Sign
7~
'Tt:) Of
'J.,n,uJ
(OBTAIN FROM PROPERTY TAX NOTICE)
----Addition ---^lteration ~epair -6.Install .
BLOCK /;). SUBDIVISION J!\1~ ~ I!.r .lJoo
--1Iove
_Deaolish
PROPOSED USE:. _Single F8IIily
--1I/F
_' of Units ----1l/H
!
i _~ercial _Indust. _Swia. Pool _Other
l--.J<estaurant I< Health Departaent Approvsl
DESCRIPTION OF WORK: ~'fftt.A..,rf~ P, fiJcL
! -
BUILDING SIZE~ X, Square Feet, Height
I
RESIDENTIAL: ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS.
COMMERCIAL: ATTACH (3) SETS OP BUILDING PLANS &: (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED POR ALL NEW CONSTRUCTION.
PERMITS REOUESTED
~UILDIHG
$
r 09b ~
Valuation of Total Construction
_ELEC'fRICAL
I
----1fECIIAlO.CAL $
_PL~~G I" GAS
TYPE OF CONSriUCTION: _Block
I
FI.R1SHED FLOOR ELEVATIONS:
I
1
I
I
i
;
AMP Service
Plorida Power Corp"
W.R.E.C.
Valuation of Mechanical Installation
ROOFING
SPECIALTY
_Pr8lle _Steel
Other
Fr.
IS PROJECT IN FLOOD ZONE AREA!
YES
NO
..........................................
Signature
CONTRACTOR SECTION
COKPANY_(5 \lAAorl" (i,Jct 0> J:r
State Cert. or Regist. ,
City License Registration ,
..........................................
/,~ 1
BIJJIJ)ER
RT.RCTRICIAH
COMPANY
State Cert. or Regist. ,
City License Registration ,
..........................................
SilmAture
PLUMBER
COMPANY
State Cert. or Regist. ,
City License Registration .
..........................................
Signature
ttECBANlCAL
COHPANY
State Cert. or Regist. #
City License Registration f
..........................................
Signature
OTRRR
COMPANY
State Cert. or Regist. ,
City License Registration ,
..........................................
Signature
APPLICATION PROVED BY
PERMIT 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. the 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 lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
788-6611.
FurtherlOre, if the owner has hired a contractor or contractors, he is advised to have 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 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 that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - HOIeOWDer's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleone other than the
'owner", 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 COllencelent.
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 perlit and that all work will be perforled to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other goveIDIental agencies lay 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 li.ited to:
A Departlent of EnviroDlental Regulation - Cypress Bayheads, Vetland Areas and EnviroDlentally Sensitive Lands,
Vater/Wastewater Treatlent
t Southwest Florida Vater Hanagelent District - VeIls, Cypress Bayheads, Wetland Areas, Altering Watercourses
t ArlY Corps of Engineers - Seawalls, Docks, Navigable Vaterways
t Departlent of Health' Rehabilitative Services, Environlental Health Unit - Wells, Wastewater TreatJent, 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 .cOlpensating volUle" will 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 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 lrOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perJit issued shall beCOle invalid
unless the work authorized by such perlit is cOlleDced within Sil IOnths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of sillOnths after the tile the work is cOllenced. One 90 day utension of tile, IilJ be
allowed for the perJit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection lust be logged during each sil IOnth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHBHCEllEH'l MAY RESULT IN YOUR PAYING TWICK FOR IHPROVKJIDfS TO YOUR
PROPERTY. IF YOU IH'lEND TO OBTAIN FINAHCING, CONSULT WITH YOUR LENDER OR AN AfTORHHY BEFORE RECORDUm YOUR MorICE OF
COHHENCEHEHT. JOBS UNDER $2,500 IN VALUE 00 NOT NRRD TO RECORD AND POST A "NOTICR OF COHHKNCKMRH'l". .
SIGNATURE: CONTRACTOR
SIGHATURE: MIlR OR AGENT
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
before me this , 19____ by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
before me this , 19~ by
wbo is personally known to me or wbo bas
produced
as identification and who did/did not
take an oath.
wbo is personally known to me or who bas
produced
as identification and who did/did not
take an o~tb.
(Signature)
(Signature)
,~, :
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
PRODUCER ,. THI9 CERllF1CATE 19 IS9UED A9 A MATTER OF INFORMAll0N
COMEGYS INSURANCE CORNER ONLY AND CONFER9 NO RIGHT9 UPON ntE CERllF1CATE
j HoLbER. ntlS CERTIFICATE bOES NOT AMEND, EXTEND OR
. ALTER THE COVERAGE AFFORDED BY ntE POLICES BELOW.
P 0 BOX 6 0 3 0 9 COMPANIES AFFORDING COVERAGE
ST PETERSBURG FL 3 3 7 8 4 COMPANy
A SHELBY INSURANCE GROUP
-- --
INSURED COMPANY
BURTON FENCE INC B INSURA PROPERTY & CASUALTY
ELLEN BURTON COMPANY sip
1 9 0 0 3 4TH ST SO C C R I M C A SOLUTIONS
ST PETE FL 3 3 7 12 COMPANy
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1HIS IS TO CERTIFY ntAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED MOVE FOR THE POLICY PERIOD
INDICAlED, NOTWI1I~STAND'NG ANY REQUIREMENT, TERM OR CONDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THI9
CER1Ir1CA1E MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE Al=mADED BY THE POLICIES DESCRIBED HEREIN 19 SUBJECT TO All THE TEAMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE 'OUeY NUMBEn 'OUCY El"FEeTlVI! "OUCY upmAnoN lIMrn
Lm DAT1! (MMIDDfYY) DAll! (MMlDDfYYI
7\ GENERAL UAIlILO-Y AML7 9 2 8 7 0 5 0 1 0 5 0 1/0 1/9 6 0 1/0 1/9 7 GENEf1AL AGGREGATE .2 , 0 0 0, 0 0 0
---
X COMMERCIAL GENERAL LIABILITY PROOUCTS COMPIOP AGG '2, 0 0 0, 0 0 0
- __J lKJ .1 0 0 0 0 0 0
CLAIMS MADE occun PERSONAl & ADV lNJuny , ,
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE 11,0 0 0,0 0 0
- _.
FIRE DAMAGE (Anr - nrel . 5 0,0 0 0
-- --
MED EXP IAnr - !>erlOnl . 5 , 0 0 0
3 AUTOMOBILE UAIlIUTY AB I 7 9 2 8 7 0 1 0 2/0 5/9 6 0 2/1 0/9 6 5 0 0 , 0 0 0
-- COMBINED SINGLE LIMIT .
X ANY AUTO
.-
ALL OWNEO AUTOS 80DIL Y INJURY
- .
SCHEDUlED AUTOS IP.r penonl
--
X HII1ED AUTOS AOD"-Y INJUny
.
X NON.OWNED AUTOS IP.r .odden!)
--
- PROPERTY DAMAGE .
OAnAOE UA8IUTY AUTO ONlY . EA ACCIDENT .
-- ,
ANY AUTO ornER THAN AUTO ONlY:
-
-- EACH ACCIDENT .
AGGREGA TE .
EXCESS UA81UTY EACH OCCURRENCE .
~I,UMBREUA FORM AOGREGATE .
OrnER mAN UM8REUA FOnM .
("1 WORKEnS eOMrEN9AnON AND 5 0 3 1 9 2 7 9 0 0 0 0 1/0 1/9 6 0 1/0 1/9 7 XI STATUTOny LIMITS .
EMPLOYER9' UAIlIUTY .1 0 0, 0 0 0
R EACH ACCIDENT
THE rnO"n1ETORl INCL DISEASE . POlICY LIMIT . 5 0 0 0 0 0
rARTNERS/EXECUTIVE ,
OFFICEns AnE: EXCL DISEASE EACH EMPlOYEE .1 0 0, 0 0 0
omEn
DE9CRIf'TlOH OF OPEnA nONSILOCATION9IVEHlCLES18PECIAL IT1!MS
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C i tv of 7 e phvrhill R SHOUlD ANT 0.. 1lfI! ABOYI! Dl!.8enlBED 'OUCII!I II! CANCEll.I!.D IUORI!
I" 1HI!
B ui 1 eIi ng De partment EXPlRAnON DAn! ntEREO". 1HI! I8SUIflQ COMPANY WILL ENDEAYOR TO 1IIA11.
.lL DAYI wnrm.. MOTICI TO THI! cmnncAn! HOlDm NAMED TO 1HI! t..IJrT.
~'3 '3 S 8th ~:;t . IUT I'All.Unl! TO MAlI. IUett MOTICI! lHAlL IMI'OSI HO OBUOATION Oft UAIIIUTT
OF ANY kINO Upolf tHI! COMPANY, rn AOEHTI on nUnl!.8l!.HTAllVU.
'-' e phyrhi 11 s , Ii' 1 . AumonlZED hl!I'nUI!H1'ATlVI!
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"'~...
No. 2-962913
FENCE ESTIMATE CONTRACT
'.11315 S.R. 52 ;:;(>1. IV 'I
, . Hudson,"r=lorida 34669 11)\ ~, Inv. N . 1 'I"
. . C d L t t?~~, >-
Pasco (813)857-1118 Pinella8 (813) 843..0155 ,,1~ an y oca e. . ",
Hemando (352) 888.3151 ZePhYrhil.IS (8.13) 780-1747 ~'lI1I P e .t.'"
Fax: (813) 858-8774 ~" e ow .0 s J I ~
,,\ ,)~1k . _ D ~ 3 f)0'-1. ill..":;;' Referral,. I (K
\ .. () / "'_...., 1.. :\" '\ ~ DRepe.tCust
Proposal Submitted to (V1 t; WI ~ ~.' ~J~ / c.uu:.J 'N U, (1 1J Other
Address '13'11 - - --
'L.- 1-1.."/1.. riA.. ~~5q6 ~AFA EtN'51-211177e4
Job Name & Location ~;"""~. .... 0 ~ ~
Job Phone -rg~-,:!) 15"'3 Contact C.1'1C L. ~__,. ~
Date Submitted If 11.../9(,. If "'"~ ""_lion
We hereby submit peclfl~atlons and estimates, subject to all terms a~d ~ndltlons as set forth as follows:
TYPE FENCE
f,Y(~tft'5S (/;ryd-
..
~l"'IER
Suncoost
Better
9ulfnest
Council
REAR
SPECIFICATIONS
Top rail oIlenee to fonow ground
Overall Length
Overell Height
I~O'
l' / p sllIl( !3DIID;'1 ~ _ .
~~SicfJ /lJilt~ 6fJ ~~S,..
/1J<i./Al l.oJoof) ~
Lines clesr 01 obslructlons
To be lever with lowesl grade
To be level with highest grade
Split the Grade
Drtve Oate
oa~
Roll
Oa.e
$0'
In Flnleh Side of Wood '-;;,-)
d.
f?,."",
SPECIAL INSTRUCTIONS
CUnC.vI ~A/~ /#J. (.5
/;ulv 'J'<~#<::)
~
-(
r 5~'
Ho"S~
FRONT
SPECIAL WORK TO BE
PERFORMED BY CUSTOMER
WI,e Gauge
o 11'1,X2'/,.
o 12'/,X2'/,.
o 90A.X2.
Well
Thickness
Tie Ons @ Buildings [ _-__.1
~:'::~;7':.:~1 0 Walk Gate rr 0
ExlsUng Fence -IHHt*- Double Gate a'" '0
Bushes
T,e.s
Q
.r\.
FENCING
DIAGRAM
Key-
Fenee Line to
be e,ected
o t~ D1'll1
CdNOITIONS: All material Is guaranteed to'be.1 .paclfled. All work Is 10 be completed In a workmanlike manner according to standerd prectlc"'s. Addillon,,1
charges may occu, II any alterallon or devlallon. IncludlnO unusual ground condlllons fnvoMng .xtra costs, wiN be executed only upon wri1len orders, and will become
an extra charge over and abovelhe .1I1m.ta. Ul'IUsueJ ground oondltIona may be rock lormatlonl, hidden found.tlons. tree roots, and other IImNa, obstacles. II such
obstacles top complellon of job, only labor and matartale U8ed wtlI be chlrged. AN .greamenta contingent upon Itrikes. accidents or delayl beyond our conlro/.
Purchaser la aolely rnpon.lbla lot lhe locetIon Of the fence In thl. propoul and will dllend Burton F.nee, Inc. end relmburH them for .11 coata In
connecllon with any cl.lme made by a~1lfttI about the IoCaUOri Df the fenca. Puroh..... will notify aurton Fence, Inc. of eny Underground obe1rucllon.,
aprlnklera, ..were, and .ny prlv.ta line not marked by public utlllty '-ling will be the ..epon.1bl11ty of the cu.tomer, .nd the cUllo,,",r I. rnponalblelor
property plat eheel. Purchaser Is responlllble lor any apeoIal work deecrtbed In proposal. The partlealflrBe that, In the .vent the purchaser does not pey a" slJf'i$.as
listed on this contracllO Burton F.nce, Inc.; It may bring 8uIt .0I11l111he purchaM' and the purchaser IflIHI to ply all COI18 01 collection, Includlng a rBasoneble
allorney's fee. The purcha.., doe. hereby .gr.. to grant "'f8DUIlIy /nIeiNt to B\lrtorI Fence, Inc., and doealurther egreelhat a lien ah.n be placed 198inat the atyf8.
described property loraUsume dualnllfuillnO COllI of ~~ftd. rBa-.llbteJlllomey',..'" "d8l8rm1oed ~." ..........~..,~ ,> ....
SUBDIVISION MMfu:l~(}L.Rf'-^1P~jl;'-II~~'tt -:'/4 t') BlOCKl;;;.:J lOT SIZE . "f"~
W;..-e."opose hereby 10 fumlsh malerlal and I.bor ~te In accordence with above Speclflcallons, Jor Ihe Bum of:
'JA / r
9(.,00 .
Authorized Signature
Ace E PTE 0: This above prfces spaclflcaUons .nd conditions arB satlsnactory .nd hereby ICCllp . Burton Fence. Inc. Is authorized to do work as specllled.
Payment wUl be made as outlined below. Twenty F~e percent down Is required on .11 panel weave. wood. special cut. 0' special order i:ms:
SO""" . t;.a~ 'l~+-. ___LII~ " lie
f .- ~ / o~~
DOWN PAYMENT ;;);CASH ON SET BALANCE ON COMPLETION ~ "i.:J. I
PAYMENT OPTIONS: ~ 0" 0 SF FINANCE 0 FINANCE OTHER
DO NOT SIGN BEFORE READINO THIS AGREEMENT OR IF ANY 8~'CES INTENDED FOR AGREED TERMS ARE LEFT BLANK. RETAIN YOUR COPY.
CC8 Lf"-1X'<iI ol'rl; (pOOl (,~~;t EXp.oY/-'il ISSUING BANK -S-l.m'/f{l.A<;r
PLEASE CHARGE MY VISAlMC AS INDICATED ABOVE IN THE AMOUNT OF S ~ 7 ~
<IV /1 ,.;.?
X i -"?'C-'1 n'?1 .""",~~~'-'7'~
. CARD HOL ER'S SIONATURE / to< l,4 ,I
NOTICE TO CUSTOMER: BE SURE YOUR CONTRACTOR HAS WRITTEN WA~S AND GAUG~ OF ALL M~TERIALS SPELLED OUT AS AN INTEGRAL
PART OF THIS CONTRACT. -::J-..-v ~J/k,) c. t;.'" /,,f,'r */ OJ(;' ~..'-
CH^I~U~K,: q1VR.. fJ .5 ,VR: [] . ~~.v~~~ _ G.u~~~~~~,~~.~I~~!~R~ST.~ e~~~~~?~~.... A ~ A '''''T ""T . "'1=1' AV ;'~I ""~C:C:IIRF. TI1F4TFO.
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