HomeMy WebLinkAbout96-6335
BUILDING PERMIT NO
CITY OF ZEPHYRHILLS Permit.
(813) 788-6611
6335-l5
Date
1.2 -/c;l -f/6
~)
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcel I. D. #
Zoning: Energy Code:
Description of Work ~ ~f &.....-z/~
;}~ <;' b
~O'/"", ~
Water Meter:
T.I.F.'s:
Radon Gas:
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.
DATE
Inspector
City License Registration #
State Certified License#
L399
,
Permit Fee
Signatu re _ _______ -c:::::.--
Company
Address
Telephone#
~~ cJ-U
..
C;;~L
Valuation or
Contract Price I ~ JV . crV
(jJ~~/ J1/f
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
-11; '-
fJ _I.D Yh
CA~;y/ .
OWNER'S NAKE -:sa IVtt.S M ~ f v,' V\
OWNER · S ADDRESS G:, l() l r e.~ ( L ~ ..
JOB ADDRESS d ~
LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION 0 ~ \Ls I tk...
PARCEL LD.' c2-J.-fo-LI-ocl..C- C:03.o0-DO) D (OBTAIN FROM PROPERTY TAX NOTICE)
PHONE 7ff..I:J ~~ O~
2-1 H-l U '::> 8-( 3> 35l..{ \:)
t
WORK PROPOSED:_New Construction _Addition _Alteration -LRepair _Install
_Sign _Hove _Deaolish
. LM/H
PROPOSED USE: _Single FOlily _H/F _' of Units
_eo..ercial _Indust. _Swta. Pool ___Other
____Restaurant & Health Departaent Approval
DESCRIPTION OF WORK: A.\tAr\I\:r\~M e.oc f=--oJt/L N\0b~\e ~fl'\5L
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
.+BUlLDING
$ Il{ 00 . D ()
Valuation of Total Construction
_ELEC'J"RlCAL
AMP Service
Florida Power Corp.
W.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF COBSTRUC'l'ION: _Block _FrOle _Steel
Other
FlNISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
Signature ______ <.:-
~1'1
CONTRACTOR SECTION
COMPANY AJU(A.v\~cP {\tobl'~ t\vr'NL~ j~..s
State Cert. or Regist.' CE-C- 033 It
City License Registration' .:.5 '1 r
******************************************
BUTT.DER
F.1.RC'l'RICIAN
COMPANY
State Cert. or Regist. #
City License Registration #
******************************************
SilmAture
PLUMBER
COMPANY
State Cert. or Regist. .
City License Registration .
******************************************
Signature
MECHANICAL
COMPANY
State Cert. or Regist. ,
City License Registration t
******************************************
Signature
OTIIRR
COMPANY
State Cert. or Regist. .
City License Registration t
******************************************
Signature
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Tbe undersigned understands tbat this perlit lay be subject to .deed restrictions" wbich aay be lOre restrictive than City
regulations. Tbe undersigned assUles responsibility for coapliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas bired 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 lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requireaents lay apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
788-6611.
FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
DContractor Sections" of this application for wbicb they will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, ratber than the contractor, are responsible for the work. If tbe contractor wisbes you to sign
as contractor that lay be an indication that be is not properly licensed and is not entitled to peraitting 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, the applicant, bave been provided with a copy of "Florida's Construction Lien Law - HOIIeOWDer's Protection
Guide" prepared by the Florida DepartJIent of Agriculture and Consuaer Affairs. If the applicant is SOIeone other than the
"owner", I certify that I bave obtained a copy of the above described docuaent and prOlise in good faith to deliver it to the
"owner" prior to couenceaent.
E. CONTRACTOR'SjOWNER'S AFFIDAVIT
I certify that all tbe inforaation in tbis application is accurate and that all work will be done in coapliance with all
applicable laws regulating construction, zoning, and land developaent.
Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation bas COIIeDced prior to issuance of a perlit and that all work will be perforaed to aeet standards of all laws
regulating construction, City codes, zoning regulations, and land developaent regulations in th~ jurisdiction. I also
certify that I understand that the regulations of other governaental agencies aay apply to the intended work, and that it is
IY responsibility to identify wbat actions I lust take to be in coapliance. Sucb agencies include but are not lilited to:
t Departlent of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
Water/Wastewater Treatlent
t Southwest Florida Water Hanageaent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
t Aray Corps of Engineers - Seawalls, Docks, Navigable Waterways
t DepartJIent of Health & Rebabilitative Services, Environaental Healtb Unit - Wells, Wastewater Treatlent, Septic Tanks
t US Environaental Protection Agency - Asbestos abateaent
I also certify that, if fill laterial is to be used in Flood ZOne DAD or "A, etc. ", it is understood that a drainage plan
addressing a uCOlpensating VOlUleD will be sublitted wbicb 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 tbe technical codes, nor sball is~uance of a perlit prevent the Building Official frCl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perait issued shall becOle invalid
unless tbe work authorized by such perlit is COIIenced within six IOnths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six IOntbs after the tile the work is cOllenced. One 90 day extension of tile, aay be
allowed for the perlit with fee cbarge of $15.00. Tbe extension shall be requested in writing to the Building Official. An
approved inspection lUst be logged during eacb six IOnth period, or the project will be considered abandoned.
WARHING TO MER: YOUR FAILURE TO RECORD A NOTICE OF COMHBNCEHEHT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FIKAHCING, CONSULT WITH YOUR LEHDER OR All AnoRm BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT. JOBS UHDER $2,500 IN VALUE DO NOT NEED '1'0 RECORD AND POST A "MOTICE OF COMMEMCEMEH'I'".
______ ~. ~;t I ;;'7T~
SIGJATURB: OWNHR OR AGEII'I'
____-<- ~-t ( t:~
...- SIGNATURE: CONTRACTOR
STATE OF FLORIDA
COUH'lY OF
The foregoing instrument was acknowledged
before me this , 19____ by
STATE OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before me this , 19_____ by
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
INSTALLATION AGREEMENT
.
ADVANCED MOBILEHOME SYSTEMS
AMS IV, INC.
13764 W. Rena Drive
Largo, FL 33771
CONT. NO.
TRA3010
~r~
s-,f-iV WcYelC
d ~ ----
-- ,
PRODUCT
: I . :
SOURCE
CG C033977 CC C042787 b';~ _
Buyer OWNER: ::r~6'5 N#V'/U Dat~19 96" Phone # (s?/d) 78/ -c!980SJ
Address: 6;20/ P'eJ-J?,L.:5/ City:.~//YL'ij/L.C~ zip3ir"v Lot#_Par~~,c-.o-/~
County ~&'"eD Home-own t./" Rent Land'Own Rent /' RIP #
Address
(out of Florida):
City
State
Zip
Phone # L--...J
(out of Florida)
AMS~, INC. l"AMS") proposes to furnish all materials and labor for the iob(s) specified below:
~OF JOB DESCRIPTION. Install Weather-Lok~ Roof system (Pat. #4,548,002), consisting of 2" Polystyrene insulation and .024" aluminum roof with
baked white enamel finish, over existing roof. Remove and replace fan & plumbing vents. This does not include gas appliance stacks.
o OTHER. ~#S!7&G ~ ~r.p~~"e ~Or- t!)pI~~j/...,J
_~CJ~~ .4-s /~ ~ / Lhr/""- ~ //~~ ~S?"...?..a:- PL~/9/..t/~
(R8:r'vc-e;#~ #~/?Pd'~1) <::?&/tJ~?:'S~ ~^ :r#6 #/('6"-
, ~
-p(,!t!G-O/J~ ~A) ~~,I1J/J ,A/r~~&- W/l.c~/T.0 . ..::7'0.,0 ;r"OrLSd'""'
~~/J~e;rr8j/.::rA-~r/Hi/ /5": /9?7'.
, ,,'"
o Check here only if space above is insufficient for complete specifications, description of work, or materials. Any additional specifications or plans are
attached to and incorporated into this Agreement.
AMS requires a 30% non-refundable deposit, payable when this Agreement is executed, but may at its oPtion vary said deposit.
balance is due upon job ~J~etion. AI~Rf th~ 'fC!rk tp.J!,g comple.led as described above for the sum of:
TOTAL $ a~ /#dtlr~p /V /"c,6 t7't',.u)~ (U.S. DOLLARS $) ($
Sale. Tax S
The entire remaining
TOTAL S
//J.ls2
/ 9CJCJ. 00
~CJP , O~
CHK #
SoZ
CASH
Deposit Amount $
Balance Due o~ Completion ~ /f/ CJ.CJ ,. C/O
A separate written warranty relating to the Weather-Lok ~ Roof system will be mailed when contract price is paid in fu II and a completed application for warranty
is received. A copy of the form of this warranty is available upon request.
AMS is authorized to furnish all materials and labor required to complete the work described in the above proposal, for which I/We agree to pay the full amount
specified in said proposal, and in accordance with all terms of this Agreement.
THE UNDERSIGNED ACKNOWLEDGES THAT BEFORE SIGNING HE HAS READ, UNDERSTOOD, AND RECEIVED A COMPLETED, LEGIBLE COPY OF
THIS AGREEMENT AND OF EVERY OTHER DOCUMENT INITIALLED OR SIGNED BY ME DURING CONTRACT NEGOTIATIONS, AND AGREES TO BE
BOUND BY ALL THE TERMS THEREOF. INCLUDING THE TERMS AND CONDITIONS ON THE REVERSE SIDE.
This Agreement shall be binding upon the Buyer's written acceptance hereof in the space provided below or upon the AMS's commencing performance. Upon
such acceptance or commencement of performance, this Agreement shall constitute the entire contract and be binding upon the parties hereto, there being
no covenantll, promises, warranties, or agreements, written or oral, express or implied, except as herein set forth or as created by applicable law.
f- Nm:O BUYER: THE TERMS AND CONDITIONS ON THE BACK HEREOF ARE PART OF THIS AGREEMENT.
(INIT.) X x EVERYTHING PROMISEDASPARTOFTHISCONTRACTISCOVEREDINTHEABOVE.
RESPECTFULLY S~~ _/ .
CEPTED AND A REED: _ / By AMS Ri::P. II otNI ~L--
ate / ~ ~ I~ SOCIAL SECURITY #
v .
Date
19_ SOCIAL SECURITY It
.
AMS,. Layout Sheet
CUSTOMER ..::r~ /7;'#L///#
Address: b;L CJI ~)fii' L- Sr
City: Zifl/!//~/~CS State P'-
t'
CONT. NO. ~A- .3::)10
Phone # ?tfYJ- 9J'cJ~
Zip 3.$SPO
Lot #
PG. 01_
Date /P?7~
parkC"#CS/~
.~
/,<
Jil!tJ
/;< "
'-- ..~
/~
S{J~~.C!/J
/C"i9()//l--'
/4/ If/"v
/#/~~
,
~
<' ~.-,
"
(!/.JeptJ,e,
~
\\0
~
/J/)#
f~F
,
~
@
e
@
rg
~
x
" Gutters
" Spec. Lunber
Un. Ft. _ D.S.
Ft.
Pan Size ~ "
Vents
Plumb
Fan
Kit
Heat
A .2%"_ A
" Is-.e:L
'c.e"_
Ss
_ Ft
A -2W'_ C
IS.
'c - 8':-
x
01
1St. -
O~
O~
Center Cap _ HI.
Height
Urethane_
ROLLS TO ORDER
~ ~ ::2~ ,-'
.:9i_' ~ .- "x.6!r... !::!!~
,'" , , "
C/ (/ X /~ 0
X
Sp. Buildup 1" _ Sht. 2" _ Sht.
A-2W'_ B
's-L..
'c . e"___
S
Ft.
A-2~"_ 0
IS -
'C .8"_
Ft
"
:USTOMER Signature
ADVANCED
Ft
MISEDAS PARTOFTHISCONTRACT ISCOVERED IN THE ABOVE.
Date 1/- :2 1 - 96
, . --
.....
4- _
CGC033977
I
~~~ ~
~~~ A
~i~ i
~ (
r. ,.~ I
~
i
~~~
~~ g~~
~~~ ~fJ~
~MS ~~I
~H~ ~
-J
'0
~'
~
~
~
:-u
o
o
"T\
(I)
fT1
o
:::l
o
z
. ~~
~:~
~~I ~ ~
.~i~~i .
J:: 0 ...
~ ~.
~~
~S
]s
~l!:
.~
~.
~
P"
I;
- . .
---......
.'
,.
. e'
.'
, '
I
, , ,
! .. I, . /..
PIIONE, (:105\..74-1\:"'''
,
1----1
~i
!m
r~ ~~
~R ~~'I
.lD ...~
",a ,~
o Oil'
fl~ P
p
.
'.
,
~~~ ~~
,,'Vb ~
. !:I~8 p"
... r> 1 .
l~~ ~
r
l~r'
~~:.
. %
~~ .
r -,-.
l!i~
i--' '\/~~!~.
:1. ~~ ~~ ~ ~8 I
il Ii ~ i ~p j
~~~
~ .~~
o
il
Ba~
':~:'l
,"~
~iY ~~:~"-l
i,~g .-) ~
s
.~
1'1;
r11 ~:--. ~ ~
I . ~ ~.
8") I.... '~i1 '-:::-
rlS 10....6 %
~ ~ 8~ . ~;o ~
~l:' U !~ i~~ ~
,n ~~ m ~
~l ~~
.. t'
o
P
r
.- i
.
. ..- -=--.- -~._--_._-----_..._-=
...
-
01
X
i
I
~
I
S :.. . "
~. ,'. '. .~r"~,'
;u.~" . . ~ ~O,!
ffi"" ,2~III';
ro ~-~
. ~~(ji
. ~~
. ~~~~
~~ ~,
, f~f~
, .,",li~~
'----
__4 ..;
. '. . I '(-~
,.. '..
. -';'l~
~l
t~
o
p
--....
'-
~'I
~~
.......-- ." ~]
.J ~ ~
I..-~ ~ l- ~
.~~ s.
~)J l UtI
~ ~fi'~. ~;
i':~ reI
.~ "
. f,. &
... :1
c.' "'1'
F _ fl
......
"'~
0'-
p
... -_..' -- - -----
'" " fi Q
~ ~ (I ~ .....l'.l"ti"t':"z
. .. ~ ~ ~d~iijiji~~i~, i' ~~~l! ~', A
'~-oS:c~r.I~ 1i ~.:w ~
f; ~ . iii~l~iiii~; . I ~ il~' f i
'u <> &1 ~~~~lii I ~ "
r. ~- i) ~.!"" -<~gi~;g: ~ i - H 1--- i
~: ~I ~";oo ~:ii9a;t:l;,!;1 ~ IS '.II~
g IDcr:x'2hl"h~)o~ :: ~
t-' &;\;~;'::~~~~l~~ !! ~ ~
U :~ - 5 ~ ~ ~ III ~ ~ g ~ I ~ ~B ~ ,~
~ ~~ ~ ~ ~ ~ ~ ~ ! ~ ~ n ~ ~ ! ~X' ,J ~ ~ ~
>~e~"~<~~8~ i Ii i 8 -~
~m~~!iii . i~ ~I~ ~J
~,~ _ ~ mglll"'~~o;u 0
~h.!C}'~~~.2 ..:~~~i5ID~i~~ Q
() I;] 'u ffi. ~ n'm a i!i ~ - - ~
"'I~ c .... 0 '" ~ ~ 1::\', ~ !C
~'i!~ ~~ :.~12~~~~' .
. ~ ~ j.\ , ~ :~~,~,:~:.:.' .~.; ~~~~~i' .
. !Ju ~ I"!l,,\~' l'll' "I'.r:~. . .
I" tJ) .)~'II '~S"'i.t;..". ,1:'. ....0.'
I~ ItI '.~. I tll :": .. "I, I ..
::> \ . I" C.' \' 1 ,~" I.. ~ .0;.. i
~ ! ~~~'?i' 'I I" ~l\';',! i! i; "
. ."U~,. .I~ . ll~!.,
. y ,-t. ~.
O~II .':;',.1.~ ::.~' . .~.ES. nUSHOUSE P .E. :,',
CllI('O I IlRvle. FI.
~
~
III
~
. ~!I;. ~~,
11 ~~S~::1 ~g
~ I~ ~~il ~n;
I ~ \\ ~ ) ~ ~ N~ . \
. ~ \\~. ~ :1.~ ~~ ..,1
~ \\ .:' o~ 1= 0
F g __I t ~'5 H :
~ ~ ~~ ,..- 8 ~
~ r....~
~ Q~~~ ~
2~~ .~ ' -'
-' ---
~-~ -
",ir.~ _ \.:----
. COMM. NO. I ADVANCED MODlI.ElIOME SYS'rE
941 S.W. 8th Strut
. Jj: q/7 Pompano Dcach:. Florida 33069-00:
.
, i. I . ... . . . '.''' ......, . . "' t4- 'f '\'11I I .
, I ......._,.....,.""'..~., ," .f' ~"'11~t:'~u;.!"'~~""!~'" . ,...,.." c",!' ,.....".....'.,'1,..-.(.....,.... ""':it' . .. ~.,. .....
~,',' I . .", t," ,:1... . ':. _\.. ~. - ~ .. ....:..,..-:0:. ~:...:::'-, - ~:.~~::=:..a::::,_..::.....A...