HomeMy WebLinkAbout96-6309
BUILDING PERMIT N!
Permit
630~
CITY OF ZEPHYRHILLS
(813) 788-6611
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Property Owner: . ~
Job Address: h h L./ . ~O.
Parcell.D. # cJ-;;l.b",;2 - 0 O-lJ 0000- /;}-f 0
Date
l.;l -..3 '-7 b
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s: .
Zoning: ~ergy Code:
Description of Work__~ ~ . ~ -
Radon Gas:
_o~AT~ -(J ~ -./-' -a.d/J
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
2-15- CjJ
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
City License Registration #
State Certified License#
,.) '7 y-
,
Permit Fee 5' J....~:v 3-.5~ Pz}
Signature~~ ~-~
Company
Address
Telephone#
Valuation or
Contract Price
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BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Servo
Rough In /2. --s--t:rlo &JJ
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Ftr.
Pre SLB
Lintel
FRM. 12....$-Gi~Bp$
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.
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APPLICATION FOR PERKIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
~r r,h
I" ~
OWNER'S NAKE eo If ('() 9 L\ l1 U.e 1.X'Yl n
OWNER'S ADDRESS lDt 1>4-4 ~l~ {1f" of OJ-.
JOB ADDRESS &:un..o ,
PHONE 'I~D-qLi>33
, . .
'br\~t-AIN~Jd:t!P 7;-.\:H O~S
LEGAL DESCRIPTION: LOT(S)
.BLOCK
SUBDIVISION
PARCEL I. D.' ad - ~Lo'- ;;) 1 - 0 d- \ D -- f'f'mr\ - ,~\ CJ (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction ----.Addition ----Alteration ---x'-Repair _Install
_Sign
---..Move
_Deaolish
PROPOSED USE: ---13ing1e Faaily
---..MIF _' of Units _"/H
_ec-ercial
_lndust. _Swim. Pool _Other
---..Restaurant &: Health Departaent Approval
DESCRIP'l'10R OP 1iOlIK:_TtlRTAU 9,//'Bs Kn,Y'!L. L~<J~" ~J
BUILDING SIZE: X Square Feet. 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 FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTED
-X.BUILDING
$--.a q as. OD
Valuation of Total Construction
_ELEC'llUCAL
AMP Service
Florida Power Corp.
W.R.E.C.
_MECHAliICAL
$
Valuation of Mechanical Installation
_PLUHBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block. _Fraae _Steel
Other
FINISHED FLOOR ELEVATIOBS:
Fr.
IS PROJECT IN FLOOD ZONE AREA?
.................*******..***.************
YES NO
CONTRACTOR SECTION
BUILDER ~ alIJPARY ~<-- ~~
~ State Cert. or Regist. , c.~C"os-.C 13. 't
Signal: '- City License Registration # .0'" l\
*.**.************************************
~~ COHPARY\1I~ (~u
- . State Cert. or Regist. '* E; (l- 00 \ s..(4-,
. .~ City License Registration * ~ '(
***************************************
PLUMBER
COMPANY
State Cert. or Regist. f
City License Registration ,
*********..*******************************
Signature
MECHANICAL
COMPANY
State Cert. or Regist. #
City License Registration t
**.***************************************
Signature
Signat
.2I.IIJ::B_
COMPANY
State Cert. or Regis
City License Regist ion #
********************~***~**.**********
UI\J.
APPLICATION APPROVED BY ~ ~~
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this peflit lay be subject to "deed restrictions" which lay be lOre restrictive than City
regulations. !be undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSEP 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 DepartJent, (813)
788-6611.
Furthermore, 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 wbir.~ tbe}' will be respunsible, 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 - Homeowner's Protection
Guide" p{epared 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 docUllent and pl'Olise in good faith to deliver it to the
"owner" prior to couenceJent.
E. CONTRACTOR'S/OWNER'S AFFIDAVI'f
I certify that all the inforlation in this application is accurate and that all work will be done in compliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a permit 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 perfofled to _eet 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 govefnlental agencies lay apply to the intended work, 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 Treatlent
t Southwest Florida Water HanageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t AflY Corps of Engineers - Seawalls, Docks, Navigable Waterways
t DepartJent of Health & Rehabilitative Services, EnvirODlental Health Unit - Wells, Wastewater rreatJent, Septic Tanks
* 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 procf;~d 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 frOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall becOle invalid
unless the work authorized by such perlit is cOllenced within six JOnths 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 cOllenced. One 90 day extension of tile, JaY be
allowed for the peflit 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 six IOnth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE ro RECORD A NOrICE OF COMMENCEMENT HAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
PROPERTY. IF YOU IMTEllD TO OBTAIN FIMAMCIHG, CONSULT WITH YOUR LENDER OR AM ArTORMEY BEFORE RECORDING YOUR NOTICE OF
COHHENCKKEH'f. $2,500 IN VALUE DO NOr NEED TO RECORD AND POST" OF COMKENCEHBMT".
STATE OF FLORIDA P I ('
COUNTY OF '/)~ l 0
The foregoing instrument was acknowledged
before me this /J20tJ .1'\ , 19..!/.J;L by
STATE OF FLORIDA P
COUNTY OF 'J1 S C 0
The foregoing instrument was ac~owledged
before me this NOcJ 9.~ 19!1L by
who is personally known to me r who has
produce
as identification and who did/did not
take an ~ '-'JyJ. ~ _
(Signature)
or who has
and who did/did not
(Signature)
or Stamped)
(Name Typed, Printed
NOTARY PUBLIC
r.,rJtY P*.
~n"'"
*ifI*
'?tItQfA.tI"
or Stamped)
(Nam~ Typed, Printed
NOTARY PUBLIC rJtv I'tI.
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DONNAMSINCLAIR
MyCO~CC38261"
~xpires Jun. 14.1988
OQNttAM SINCLAIH
My CorrrmlNion CC38261 Ii
Expires Jun. 14. 1998
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CARBON LESS
FORM 3850
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P.lU!,.l!U~J"l
IRIPUCATE
HYMAN CONSTRUCTION f~C?POSAL
(ROOFING DIVISION)
373'25 SR 54 WEST
ZEPHYRHILLS, FL 33541
PHONE: 813-782-6094 LTCENSE:
No,
B-223
Date
/$ r ..?Jr _y~
HC006164 &!heet No.
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Proposal Submitted To:
1> j
Name ( Ol" FV\ e /Y".q
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Street !o (, y
Work To Be Performed At:
/17 C' c-,h--a ...J
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Street
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City ..2 ~,rf'!
Phone hl';.('1 tJo~
State';;::->;;;;'
7 ~:iY . (:;! __' :;) '2
,C 0 -' /' ~, '..J_..".>
City
State
Date uf Plans
AI'chltece
We hereby propose to furnish the materiCJts and perform the IClbor necesscll'Y for the completion of
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All material is guaranteed to be as specified, and the above work to be pel'formed in accordance with the dr'awings and
specifications submitted for above work and completed in a substantial workmanlike lTlanner fcll' the sum of
" , 1," ,)()
Dollars [$ ~.~ ',:/ j. -:;', .;~..,--l
with payments to be made as follows: f.t-.,J
,JaJ<1/:'f' ~ 0 ~ .'2/[;'00. Q~
h~\..,.:h.,) r/..:257 vC)
D ~ .. tl""""-l:) h "\ '.0 .oJ
(' ~.$. /0r:.1
Any "Iteration or deviation from above specifications. involving extra
costs, will be executed only upon written orders, al)tl will become an
extra charge over and above the estimate, All agreements contingent
upon stl'ikes, accidents 01' delays beyond our control. Owner' to cal'ry
II/'e. tornado and nther necessary insurance upon above work, Work.
I1len'~j Cnl1lpr.nsDI;lon al1(j Public Liability Insur~anc~! Ofl ;]bove WOI+' to be
token uuL by
Respectfully submitted
,; J
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Per
Note rtwo pf'lJpDsul lIIay be wil:I1L1I'i1wrl hV W3 !f rlLlt (Ii.:ceptud
WI tI 1111 day:;
'--
I: ' .. .--.---------....-
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are satisfactory and are hereby accepted. You. fwe authorized t9-,dO. t'he wor.k'. as s.p eClfied. I,
f-J......'\ "...J~?p ...
Payment will be made as outlined above. ,(V .~, XJ:~,., /rt~.Jv~;.z+,_-,
Signature ._<L/I-' /') \.a.... . I
-------- -~-----_.~,..._~--~~,.._._-------'
"
NOTI CE OF COMMENCEMENT
11111111111111111 11111 11111 I1III II'" IIIII I'" 1III
96124875
6.00
0.00
Dpty Clerk
Rcpt: 11605001 RecIT =.
DS: O.
11/27/96
Permit No.
State Of
FLORIDA
County of
PASCO
THE UNDERSIGNED hereby gives notice that improvement will be made to Certain
real property. and In accordance with Chapter 71 J. Florida S ta tu tes, the follow i ng
information i? provided in this Notice of Commencement:
"
,~
1. Descri plion of Property: Pa reel No, 0.2-:2 ~ - 2 /_ t:J:I NJ _ (10 00 () _ 1:1. 1.0
(Legal' ~e~~Ptto~ ~?';f..~o~'~n;dtesht? ~~'I
2. General Description of Improvement l IlSUl-tL ~ YDOlLj
.TED PITTIIAI, PASCO COUITY CLERk
11/27/96 09:51a. 1 of 1
OR DK 3663 PG 17.1.7
:~--
"
"
J. Ow ne r I n forma t ion: Name Co./ mtl,1 Q lkthQ.() __
Address ~(1A4 --Iu01J?fY l'J-. CitY~State fC
I ntere'st in Property: ()"" \'l..}t a..-
N,.ame of Fee Simple Titleholder:
(I f other than owner)
Address
f~:~:'~~~> 4 .
\.'1""
~ {
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Contractor:
City
State
~.:.>
Address
Name RYMAN CONSTRUCTION, INC.
5. Surety: Name
Address
Amount of Bond: $
6. Lender: Name
Address
7. Persons within the State of
or other documen ts may be
Statutes:
37325 SR 54 WEST
City ZEPHYRHILLS
State FL.
33541
--
Ci ty
--
State
------.
City
Slate
Florida designated by Owner upon whom rlotices
served as provided by Section 713.13 (1) (a) (7), Florida
------
Name
Address
City
State
8. In addition to himself, Owner designates
of to receive a copy of the lienor's Notice
as provided in Section 713.13(l)(b), Florida Statutes,
9, Expiration date of Notice of Commencement (the expiration date is
the date of recording unless a different date is specified.)
year from
~~
day of '1tol) .
Signature of Owne7
Sworn to and subscribed before me this 9.'"1
19f1t. ~
Notary Publ~ ' , '
l .~ 'des "Jldxg
". SC:lO OUO!.~oo-<l"I
My Commission Expires: .1II~~'t\1oI1NI".:J""
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