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HomeMy WebLinkAbout96-6333 BUILDING PERMIT N! Permit CITY OF ZEPHYRHILLS (813) 788-6611 --6333-18 Date / J- - / d. -? t,.. ~, ~nl~ ELECTRICAL PLUMBING MECHANICAL Sewer Conn Property Qwne' 2Ji C-.. tL"jJ J! ~ ~ Job Address: ..:..1 gr-~--V A Clt.--e- Water Conn: Water Meter: T.I.F.'s: Parcel I. D. # Zoning: Energy Code: Description of Work -X, 0 ~ Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL C.O. /- Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. DATE Inspector Pe'mitF~~n~ Signature t C1.~J.;J(.{ Company Address Telephone# Valuation or Contract Price '- /0 :J ~;2, o-v J City License Registration # ~;;) I)?' State Certified License# /~</ /3~A BUILDING ELECTRICAL PLUMBING MECHANICAL Breakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final Ftr. Pre SLB Lintel FRM. 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. APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER'S NAKE ~ot.tUA ~u.rtl\'ll(j \\n'M~~ crf. 2. h~ \l~ PHONE OWNER · S ADDRESS 5\)0 \N\V'\d~ ~ ~"aL-e. ~ 3Bl~ 'IA" A\Jrnu.~. . (u.\tt. uS I Mn"\-\lY\~ I ~l. 2f'Ph'irhU\~, ~l. 3354\ ~ l..'S \ JOB ADDRESS LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D.' (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition _Alteration ~eP.8.ir _Install ~-~"'" _Sign _Move _Deaolish PROPOSED USE: _Single Family _H/F _' of Units _M/H _C~ercial _Indust. _Swim. Pool LOther '-JlA.r6i",'i M,,,,,, f ____Restaurant & Health Department Approval DESCRIPTION OF WORK:--ReMo.ft ~l~H~ r7)t1tlYl.~) lrlsnll Vltl.uJ 15"~ ~\tj ~buj\i~~ ~hil'1.~\o~ ~\u..~\l\I4.'" n.vt..c:lf l..p BUILDING SIZE: x Square Feet, Height RESIDENTIAL : COMMERCIAL 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 ...p..BUlLDING _ELECTRICAL $ IS I "Z.u '2. . SO Valuation of Total Construction AMP Service Florida Power Corp. W.R.E.C. _MECHANICAL $ Valuation of Mechanical Installation ____PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUC'l'ION: _Block _FrOle _Steel Other FIRISHED FLOOR ELEVATIONS: FT. IS PROJEC'l' IN FLOOD ZONE AREA? YES NO ****************************************** CONTRACTOR SECTION BUILDER COMPANY State Cert. or Regist. t City License Registration . ****************************************** Signature F.l.F.CTRICIAN COMPANY State Cert. or Regist. t City License Registration t ****************************************** SismAture PLUMBER COMPANY State Cert. or Regist. t City License Registration # ****************************************** Signature MECHANICAL COMPANY State Cert. or Regist. t City License Registration , *************~**************************** Signature Signature COMPANY_M'I \Ba..... ~~rLld ~ .tzc.. State Cert. or Regist. # ODS':; LIe::- City License Registration # ~~ ****************************************** OTHF.R APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Tbe undersigned understands tbat this peI1lit lay be subject to "deed restrictions" wbicb 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 bas bired 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 lilY be cited for a lisdeteanor violation .UDder 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 tbe City of Zephyrhills Building DepartJent, (813) 788-6611. FurtberJOre, if tbe owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the "Contractor SectionsD of this application for whicb they will be responsible. If you, as the owner sign as the contractor, you are indicating that you, ratber tban the contractor, are responsible for tbe work. If tbe contractor wisbes 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 Zepbyrbills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, tbe applicant, have been provided with a copy of DFlorida's Construction Lien Law - HOIeowner's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleone other tban the Downer", I certify that I have obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the "owner" prior to couencelent. 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 bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation has cOIIenced prior to issuance of a perlit and that all work will be perf oIled 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 governlental agencies lilY apply to tbe intended work, and that it is If responsibility to identify wbat actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to: * Departlent of HnviroDlental Regulation - Cypress Baybeads, Wetland Areas and HnviroDlentally Sensitive Lands, Water/Wastewater Treatlent * Soutbwest Florida Water Hanageaent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses * ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways * Departtent of Health & Rehabilitative Services, HnvirODlental Health Unit - Wells, Wastewater Treattent, Septic Tanks * US Hnvirontental 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 tbat a drainage plan addressing a .cOlpensating volUle" will be sublitted wbich 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 tecbnical codes, nor shall issuance of a peIlit prevent the Building Official frOJ thereafter requiring a correction of errors in plans, construction, or violations of any code. Every peI1lit issued shall becOJe invalid unless tbe work authorized by sucb peI1lit is cOll8nced witbin 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 cOlll!nced. One 90 day extension of tile, lilY be allowed for the peI1lit with fee cbarge of $15.00. The extension 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. WAIUlING TO OIUfHR: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT HAY RESULT IN YOUR PAYING TWICE FOR IHPROVEHEJITS TO YOUR ~~F 100 lJ\'IlIlIJ fO OfI'fill FIII.!IICIIG, COIISULr 11Im YlIOR LIIIDIlIl OR All AIrOIlI. BY BEFORE RECORDING YOUR NOTICE OF ?~. JOBS ~R VALDE 00 ROr IIIED fO IlIlOIIlIl AIID I'CSr A )IOrICE OF CllIlEICEIIEIIf'. SI~1ff ~y ~ Pc."oY\~ 1\'1 \c..W\I:JW~ -\\I Me. . y- \>~~\ l"1 ~'""~ -tb M< . STATE OF FLORIDA STATE OF FLORIDA COUN'lY OF ::Pa!.,~ coum OF 'PUca The foregoing instrument was aCknowledged The foregoing instrument was acknowledged before me this l~,h. , 19~ by before me this Q..~ fu. , 19~ by ~~:d a y J\~ ~6\\(L ~. MIl \\-M \jM\c.e L~ M~ \~ who is personally known to me or who has who is personally known to me or who has produced j.J p.r- produced.,J ,... as identificatio a~ who1lli/did not as identification and who~/did not take an oath. take an ""th. J2;~ ~ (Signature) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC OU1llAA.LOVETT .., Notal'J Pulllic, State 01 Flonda 0 My comm. expires July 28).200 Gcmm. No. CC572910 OLMA A. LOVETT _,. ~~"'d. Notal'J Pu9lic, State of Flonda :; ': My comm. expires July 28). 2000 % " Comm. No. CC572910 :/'.. .....f~. '...".....,.".,,; vJ STANDARD SUBCONTRACT AGREEMENT FOR BUILDING CONSTRUCTION , ~ ---'-. _J DEe 0 5 ~ This Document has important legal and insurance consequences; consultation with an attorney and insurance consultants and carriers is encouraged with respect to its completion or modification. ( . 't~ l)!- 2 -l1 '\ \ Ie; This agreement made at Altamonte Springs, Florida this 20th day of November, 1996 by and between Poole Construction Company, Inc. 544 Douglas Avenue Altamonte Springs, Florida 32714 hereinafter referred to as the Contractor, and Milbar Construction, Inc. 15911 U.S. Hwy. 301- North Dade City, Florida 33523 (352) 567-6047 hereinafter referred to as the Subcontractor, to perform part of the Work on the following project: PROJECT: Zephyr Haven Nursing Center Zephyrhills, Florida 33541 OWNER: Sunbelt Healthcare Centers, Inc. 500 Winderley Place Suite #115 Maitland, Florida 32751-7206 \)t(~. tf J _....--.-~.;::e~::!...f~..':...".., ~ yV Subcontractor's employment by delivering written notice of termination to the Subcontractor. Thereafter, the Contractor may take possession of the plant and work, materials, tools, appliances and equipment of the Subcontractor at the building site, and through himself or others provide labor, equipment and materials to prosecute Subcontractor's Work on such terms and conditions as shall be deemed necessary, and shall deduct the cost thereof, including without restriction thereto all charges, expenses, losses, costs, damages, and attorney's fees, incurred as a result of the Subcontractor's failure to perform, from any money then due or thereafter to become due to the Subcontractor under this Agreement. 11.3 If the Contractor so terminates the employment of the Subcontractor, the Subcontractor shall not be entitled to any further payments under this agreement until Subcontractor's Work has been completed and accepted by the Owner, and payment has been received by the Contractor from the Owner with respect thereto. In the event that the unpaid balance due exceeds the Contractor' s cost of completion, the difference shall be paid to the Subcontractor, but if such expense exceeds the balance due, the Subcontractor agrees promptly to pay the difference to the Contractor. ARTICLE 12 - CLAIMS 12.1 All claims, disputes and other matters in question arising out of, or relating to, this Subcontract or the breach thereof shall be decided by Arbitration in accordance with the Construction Industry Arbitration Rules of the American Arbitration Association then obtaining unless the parties mutually agree otherwise. This agreement to arbitrate shall be specifically enforceable under the prevailing arbitration law. The award rendered by the arbitrators shall be fmal, and judgment may be entered upon in accordance with applicable law in any court having jurisdiction thereof. 12.2 In the event the Contractor and Owner or others arbitrate matters relating to this Subcontract, it shall be the responsibility of the Subcontractor to prepare and present the Contractor's case, to the extent the proceedings are related to this Subcontract. 12.3 Should the Contractor enter in arbitration with the Owner or others regarding matters relating to this Agreement, the Subcontractor shall be bound by the result of the arbitration to the same degree as the Contractor. IJII1 ' 12.4 The Subcontractor shall carry on Subcontractor's Work and maintain his progress during any arbitration proceedings. ARTICLE 13 - PREVAILING LAW This Agreement shall be governed by the law in effect in the state of Florida. IN WITNESS WHEREOF the parties hereto have executed this Agreement under seal, the day and year first above written. ATTEST: ((J~ WITN S SUBCONTRACTOR: MlL~ON.INC. By /l.,-~ DAVID R. SIGNATURE ABLA ATTEST: CONTRACTOR: ~Nco..INC. By CHA ES D. E, PE, PRESIDENT .. -..-., ~'<'."."'. . .' , .f ,< ~l ATTACHMENT "A" PROJECT: Zephyr Haven Nursing Center Zephyrhills, Florida 33541 PROJECT NO: #394 DATE: 11-20-96 I. Monthly applications for payment must be submitted on Poole Construction Form. 2. Drinking Water & Ice for subcontractor's employees will be the subcontractor's responsibility. 3. Base Quotation $ 15,262.50 Total Contract $ 15,262.50 4. No performance bond will be required. 5. All construction trash is to be placed in the dumpster at the jobsite on a daily basis. 6. Five year Warranty of Leaks , to be provided <:JR.A .. END OF DOCUMENT NOTICE OF COMMENCEMElrr I/Alr: #- ZoO <c B . \ \\\\\\ \\\ft'''\\\ \\'" II" \\\U \ll" \\\\ \ll\ 961303"18 19055 Rec: 10.50 Bcpt: 1 00 IT. 0.00 OS: ~ O. . Dpt, Clel 12/12/~ ASCO COUIlTY CLE .lED PI~' P 1 of 2 12/12/96 01:"5p. PG 64: OR Bit 3670 This Instrument Prepared By: ?fame: Address: Permit No. STATE OF Fl Dr; o;:! COUNTY OF Pasco TIlE UNDERSIGNED herby gives notice that improvement will be made to certain real property. and in accordance with Chapter 713. Florida Statues, the following information is provided in this Notice of Commencement. 1. Description of property: (legal description of property, 6nd street address if available) See Attached. Zephyr Haven Nursing Home 38250 "A" Avenue Zephyrhills, Florida 33541 -'" 2. General description of improvement: 3. Owner information a. Name and address: b. Interest in property: OWner c. Name and address of fee simple titleholder South Central Nursing Homes of 500 Winderly Place, Suite 115 Maitland, Florida 32751 (if other than owner): Zephyrhills, Inc ~ Same Contractor: (name and address) Surety a. Name and address: N/A Poole Construction Company, Inc. 544 Douglas Avenue Altamonte Springs, Florida 32714 b. Amount of bond $ 6. Lender: (name and address) N/A 8. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7. Florida Statutes: (name and address) T S tt om u on South Central Nursing Homes of Zephyrhills, Inc. In addition to himself. Owner designates the following person(s) to receive 6 copy of the Lienor's Notice as provided 1n Section 713.13(1)(b),Florida Statutes: (name and address) 500 Winderly Place, Suite 115 Maitland, Florida 32751 7. 9. Expi ation date of notice of commencement (the expiration date is 1 year froDI of reco ding unless a different date is specified) T/A.e, ",,\-.+5 E -;;;;u.+f.r:v- (Print Owner's Name) Owner's Address: 500 Winderly place, Suite 115. Ma;t:l;:!no FT. 1?75l The foregoing instrument was acknowledged before me thiS~/~/~bY 1/,()f}~ ,thE SuTlv/') who is p=.:sonalll k~. to~e/who produced as ident~cation and who did not take an oath. Coufty of <L})A,~ ~ Commission t CCS,S3"3J? /, Commission Expires: .5 - I q - d (> () c) All Information Must Be Typed or Printed Legibly to Comply With Recording Requirements J .., ~ 7/' . .> OR BI 3670 PG 2 of 2 642 ") Schedule A .J A portion of Blocks 12, 13 & 14, MOORE'S FIRST ADDITION, as recorded in Plat Book 1, Page 57, Public Records of Pasco County, Florida, being further described as follows: Commence at an iron rod situated at the Southeast corner of Lot 9, Block 14, MOORE'S FIRST ADDITION, for a POINT OF BEGINNING; thence run N.89D54'10"W., along the South boundary of said Blocks 14 and 13, 371.52 feet; thence run N.OID32'52"W., 73.08 feet; thence run S89D26'28"W., 17.90 feet; thence run N.OIDOl'26"W., 292.83 feet; thence run N.15D22'00"E., 35.63 feet; thence run N.55D05'09"E., 31.41 feet; thence run N.89D41'06"E., 79.04 feet; thence run N.00D08'25"E., 241.41 feet to an iron rod positioned on the North boundary of Lot 5, Block 12, of MOORE'S FIRST ADDITION; thence run S.89054'10"E., along said North boundary, 89.03 feet to an iron pipe situated at the Northeast corner of said Lot 5; thence run S.00oI0'54"E., along the East boundary of said Block 12 (and across a portion of the vacated right of way of Avenue "A") 260.00 feet to an iron rod positioned on the South right of way line of Avenue "A", MOORE'S FIRST ADDITION; thence run S.89054'10"E., along the South right of way line of Avenue "A", 191.49 feet to an iron rod situated at the Northeast corner of Lot 16 of said Block 14; thence run S.00004'35"E., along the East boundary of Lots 9 through 16 of said Block 14 to the POINT OF BEGINNING. TOGETHER WITH AN EASEMENT FOR DRAINAGE AND MAINTENANCE of drainage facilities described as follows: Commence at the Southeast corner of Lot 9, Block 14, thence run N.89D54'lO"W., 371.52 feet along the South line of Block 13; thence N.01D32'52"W., 68.08 feet for a POINT OF BEGINNING OF EASEMENT; thence N.46D03'12"W., 7.13 feet; thence N.89D26'28"E., 5.00 feet; thence S.01032'52"E., 5.00 feet to the POINT OF BEGINNING OF EASEMENT. r. ~ - Q:o..YL ~ F'~~ ~. L ~;.~~;~.~~ : \ 5~ I \ \) . S. 30 I "l k'1. :.~~. '))oJe L~l~ I R 3 3~.;t3 ~T,A.TE OF n ORIDA -...~ .. ....;' COUt~~f\/ OF (~j\~~(~D .j File No: 96-03-33 THX; rH~ (;~:f!r:r3~!r~G IS'~ 1"._ !;.. -~~ V' c:- (<c: ~)i\>i;l;:::j:-( iJi,; :'!L~, r;'" (1"~ ".., --~ ;"-,1 1:.\;<' Ci<;-},C:;:' \~,!;'(;\;E;~;3 l\fl .I:J, ~~.::, r r; "'::"; .JL. :~~;,' ;.' ,:Z _ iX, OF ~~._..~FIE'~-' . ~'E':':"'j ':";'I"'~l:":"~' ;:;',i,':;::!;r;U;1'OiJRT .. "-' J \ ': ,} .. . ~ ~. _ . , "8 ' . }- D.C.