HomeMy WebLinkAbout97-6426
BUILDING PERMIT N~
Permit
CITY OF ZEPHYRHILLS
(813) 788-6611
-- 642613
Date
/-3tJ-7~
~ ELECTRICAL PLUMBING MECHANICAL
Pmperty Owne" ~ ~
Job Address: h~
Parcell.D. # d'd-6 -dl- 0 ocl 0- CJ 0..3 0 t) -- D cJ / 0
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning: Energy Code:
Description of Wor;-- t'((~ ~ --'
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL 2- /' c,,r- f
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
c.o.
DATE
Inspector '?L
OJ
Permit Fee ,2.. c........., d'-'
Signature _____~- G'a: )
Company
Address
Telephone#
Valuation or
Contract Price
1~~3-(}--v
,
City License Registration # <.....?" 9
State Certified License#
{) ~A-vJu..e/ 11 If --4~
BUILDING ELECTRICAL
PLUMBING MECHANICAL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
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 DEPARTKENT
J - ( 10 -n
"';"'"'- ,
OWNER'S NAME .J 0 ~ ""-
OWNER'S ADDRESS G i If \..(
JOB ADDRESS C~ G~
LEGAL DESCRIPTION: LOT(S) BLOCK
PARCEL I.D.' 2 --LG -1~ - (; 0 L~ -(0 {,.Q; - 00 10
Mo{~\
P .Q (', ( L
2-(f{\l!)
PHONE ~I~ ~ '-1 .:s 7 .3
fC-( ~3.Sy()
SUBDIVISIONt) Y-l-JWi ,rJX.. M WI
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:____New Construction _Addition _Alteration f---Repair ____Install
_Sign
____Move
_Deaolish
.
PROPOSED USE: ____Single Fallily
_H/F
____, of Units f--H/H
_Swia. Pool ___Other
_eo..ercial
____Indust.
_Restaurant & Health Departaent Approval
DESCRIPTION OF WORK: {\\l,\.l'\\1 r\.\Av,\ I2ct t=' -V0(~,,- (V\ () 0: ~
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL:
COHHERCIAL :
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
YBUILDING
$-.J 913. ~2-
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBING GAS ROOFING
SPECIALTY
'llPE OF CONSTRUGTION: ____Block ____Fralle _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS 'PROJEGT IN FLOOD ZONE AREA?
YES NO
..........................................
BIITT.DER
CONTRACTOR SECTION
COMPANY A)/iAVll;.J !J1c);lx. ~JL Jvfin-;J
a -r State Cert. or Regist. t (j,....'<:-D !- 3 '17 7
r:~ ~f I City License Registration t -s' 7 {
..........................................
~
Signature.______e-
RI.F.CTRICIAN COMPANY
State Cert. or Regist. f
SianAture City License Registration f
..........................................
PLUMBER COMPANY
State Cert. or Regist. f
Signature City License Registration f
..........................................
KECHANICAL COMPANY
State Cert. or Regist. f
Signature City License Registration ,
..........................................
OTRF.R COMPANY
State Cert. or Regist. ,
Signature City License Registration ,
..........................................
APPLICATION APPROVED BY PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Tbe undersigned understands tbat this pertit .ay be subject to -deed restrictions" wbich .ay be lOre restrictive than City
regulations. Ybe undersigned assutes responsibility for COIpliance 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 tbe contractor is not licensed as required by law, both the owner and contractor tay be
cited for a .isdeteanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requiretents lay apply for the intended work, they are advised to contact the City of Zepbyrhills Building Departlent, (813)
788-6611.
FurtherlOre, if the owner bas hired a contractor or contractors, be is advised to bave tbe contractor(s) sign portions of the
-Contractor SectionsR of this application for whicb 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 tbe contractor wisbes you to sign
as contractor that laY be an indication that be is not properly licensed and is not entitled to pertitting privileges in the
City of Zepbyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN ~AW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, bave been provided with a copy of -Florida's Construction Lien Law - HOIeowner's Protection
GuideR prepared by tbe Florida Departlent of Agriculture and Consuter Affairs. If tbe applicant is sOleone other than the
-ownerR, I certify that I have obtained a copy of the above described docUleOt and pro.ise in good faith to deliver it to the
"owner" prior to cOJllenCetent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in tbis application is accurate and that all work will be done in co.pliance with all
applicable laws regulating construction, zoning, and land developllent.
Application is hereby .ade to obtain a per.it to do work and installation as indicated. I certify that no work or
installation bas cOlleDced prior to issuance of a pertit and that all work will be perforwed to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also
certify that I understand that the regulations of other goverDleDtal agencies laY apply to the "intended work, and that it is
.y responsibility to identify wbat actions I lUst take to be in co.pliance. Sucb agencies include but are not It.ited to:
t Departlent of Environtental Regulation - Cypress Baybeads, Wetland Areas and Environtentally Sensitive Lands,
Water/Wastewater Yreatlent
t Southwest Florida Water Hanagetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
t Arty Corps of Engineers - Seawalls, Docks, Navigable Waterways
t Departlent of Health & Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater Treattent, Septic Yanks
t US EnviroRlental Protection Agency - Asbestos abatetent
I also certify that, if fill laterial is to be used in Flood Zone RAN or "A,etc.", it is understood that a drainage plan
addressing a RCOlpeDsating volute" will be subtitted which is prepared by a professional engineer registered in the State of
Florida prior to per.it. issuance.
A pertit 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 technical codes, nor sball issuance of a pertit prevent the Building Official frOl thereafter
requiring a correction of errors in plans, construction, or VIolations of any code. Every pertit issued sball beCOle invalid
unless tbe work authorized by such per.it is COIIeDced within six IOnths of issuance, or if work authorized by the peIlit is
suspended or abandoned for a period of sillOntbs after the tile the work is cOllellced. One 90 day extension of tile, lay be
allowed for the pertit with fee charge of $15.00. Ybe 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.
WARlfING TO 0IUfER: YOUR FAILURE TO RECORD A NOTICE OF COMHBICEMEIn' HAY RESULT IN YOUR PAYING TWICE FOR IHPROVEMEIn'S TO YOUR
PROPER'l'Y. IF YOU IIn'BND YO OBTAIN FIHANCING, COHSULT WITH YOUR LErmER OR AM AYYOmY BEFORE RECORDING YOUR HorICE OF
COHHENCEHKlff. JOBS InlDER $2,500 IN VALUE DO Nor NEED fO RECORD AIfD POSY A "NorICE OF COHMEffCEHKIn'".
SIGNAYURE: OWIfHR OR AGEIn'
SIGNATURE: COIn'RACTOR
STATE OF FLORIDA
coum 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)
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
. li~_T~I,f~'fleNAGREEMENT
ADVANCED MOBILEHOME SYSTEMS
t"AMS IV~iINc::;!' Z - 7.-' l ~ L J. C)CJ 2 c ~ 00 ~ u v'
13764 W. Rena Drive
Largo,. FL ,33771-
TAK3027
CONT. NO.
-tDI L:'
PRODUCT
SOURCE
~-
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CG C033977 CC C042787
IER: 3'~k 1\ MOf'e:t::-
~Lt4 . Pec..f'['
./ Date I - CJ 19!1.:l- Phone # ( 913) -2,R'e--Cf:$9 ~
CltY:~jlJ.:YRllil.lS Zip ~LOI. Perk ~i*IlfJ(JJ~
~$~O
Home-Own ............. Rent
Land-Own
Rent L/' RIP _.
~a): I(r, 3g 80tcl ::,-4 ~
Clty~Lao9~tl"'1lS: State a- Zip 'ISlIU. Phone #($'0'-) e~-3 30:'
(out of Florid.)
("AMS") proposes to furnish all materials and labor for the job(s) specified below:
DESCRIPTION. Install Weather-Lok" Roof system (Pat. :#4,548,002), consisting of 2" Polystyrene insulation and .024" aluminum roof.
" enamel finish, over existing roof. Remove and replace fan & plumbing vents. This does not include gas appliance stacks.
.:r1U s rltLL We.ai:J...~II.t.D~ ~DO~ "tJ~tt M1+I,..,) Coo...c:..~
~ 0 rr r:. IJ.s I AJ 0 P 'f'^-J A Jet%t c;
FLA-sH- TO C.ARPotl r+- F'L'Pt RooW\
r<~~ \I~ 1lJi6uJt:-
J..., ~eTIYhe.. Wet ff'&OJ7}..
-
J () B To Ge. ~1M~le't;e
.
~'I
1-3J.LJ 7
'~~1Ot"r fW;'~.
1,-',"
" }~:
< .~;;/~~." :_'~ t.c; , ,;,: 'Y'kl~ .~
a only if space above is insufficient for complete specifications, description of work, or materials. Any additional specifications or plans
) and incorporated into this Agreement. "'" ,"
a 30% non-refundable deposit, payable when this Agreement is executed,but may at its option vary said deposit. The entire remau
, upon job completion. All of'the work to be completed as described above for the sum of:
AJ/lJe.1'1!!elJ Huuo~.:tt:lJ.hA:Je'ty'Hut~R().-:-' (0.5. DOLLARS.) (S
700
S8.e. T8X .
TOTAL'
1'l7B.O(.
/2-1,74
Iqq4.~fj
hoO.OO
/3Q4.l(O
~
CHK#
/7toL.
CASH
Deposit Amount S
Balance Due on Completion $
ten warranty relating to the Weather-Lok" Roof system will be mailed when contract price is paid in full and a completed application forwarrar
copy of the form of this warranty is available upon request.
~ed 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 amo~
id proposal, and in accordance with all terms of this Agreement.
IGNED ACKNOWLEDGES THAT BEFORE SIGNING HE HAS READ, UNDERSTOOD, AND RECEIVED A COMPLETED, LEGIBLE COPY \
lENT AND OF EVERY OTHER DOCUMENT INITIALLED OR SIGNED BY ME DURING CONTRACT NEGOTIATIONS, AND AGREES TO
_L THE TERMS THEREOF, INCLUDING THE TERMS AND CONDITIONS ON THE REVERSE SIDE.
lot Sheet
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CONT. NO. T>>-~ 3" 2.. 7
Phone # 7gg- 9&93
PG. / of I
Date / -9..q 7
Park (Jltc~/lJr
State FL
Zip 3&~c
Lot #
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. -,. ',,..'.. '...-- -,- "<,... ~ '~'-"""'~T''''!'-'''''''''''V'~'''_ ~,.,"'''^ ~ ,~^"",.....,..,_'~,~;.. --"",""';,,". .~...~
Center Cap -L2..... HI.
Height
Urethane
A -21h" _ C
18 -
'c - 8'~,
A -2112" _ A
" 18--L
" c - R'~
--
CONDITIONS OF PERMIT AFFIDAVIT
A. 'NOTICE OF DEED RESTRICTIONS
, The undersigned understands that this perlit lar be subject to 'deed restriction8" which lar be lOre restrictive than City
regulations. The under8igned aS8U1e8 responsibility for co.pliance with any applicable"deed re8trictions.
t
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 tbe contractor Is not licensed as required by law, both the owner and' contracto~ la' be
cited Cor a lisdeteanor violation under state law. If the owner or intended contractor are uncertain as to what 'licensing
requirelents .ay apply (or the intended work, they are advised to contact tbe City of Zepbyrhill. Building DepartJent, (813)
780-6611.
Further.ore, i[ the uwner has Ilired a contractor or contractOrB, he Is advised to have the contractor(s) sign portions of the
"Conlractor Sections' of thi8 applicatIon for which lhey will be re8ponslble. If JOu, a8 the owner Ilgn a8 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 tbat be is not properly licensed and is not entitled to per.itting privileges in the
CiLy of Zephyrhi1ls.
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 ~itb a copy of 'Plorida's Construction Lien Law - HOIeOIDer'. Protection
Guide' prepared by lhe Florida Departlent of Agriculture and ConsUler Affairs. If the applicant il 10leone other than the
'owner', I certify that I have obtained a copy of the above described docUJent and prOlise in good faith to deliver It to the
"oNner' prior to co..encetent.
E. fOl!TUAC'rOR ' S/OWNER 's AFFIDAVI'l'
i cerlify that all the in(orlation in this appiication is accurate and that all work viII be done in colpliance vith all
applicable laws regulating construction, loning, and land developlent.
Application is hereby lade to obtain a per.it to do work and installation as indicated. I certify that no work or
installation has co..enced prior to Issuance of a per.it and that all work will be perforled to leet standards of all laws
regulating construction, City codes, loning regulations, and land developlent regulations In the jurisdiction. I also
certify that I understand that the regulations of other goveIDIental agencies .ay apply to the intended worl, and that It is
.y responsibility to identify what actions I lust take to be in cOlpllance. Such agencies Include but Ire not li.ited to:
A Depart.ent of HnviroDlental Regulation - Cypress Baybeads, Wetland Areas and InviroDlentally Sensitive Lands,
. WaterfWastewater Jreatlent
A Southwest Florida Vater Hanagetent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
A Ar.y Corps of Engineers - Seawalls, Docks, lavlgable Waterways
A ~~~artaent of lIealth , Rebabilitative Services, InvlrOOlental Health Unit - Wells, Wastewater Yreatlent, Septic lanks
· US RnviroDlental Protection Agency - Asbestos abate.ent
I also certifr that, if fIll latetial is to be used in Flood Zone 'A' or "A,etc.', it is understood that a drainage plan
addressing a 'co~pensating lolUle' will be Sllblitted which is prepared by a professional engineer registered in the State of
Florida prior La per.it issuance.
I'
i
A per.it issued shall be construed to be a license to proceed with the work and not a8 authority to ,101ate, cancel alter, or
Get aside any provisions of the technical codes, nor shall issuance of a per.it prevent the Building Official frOt thereafter
requiring a correction of errors in plans, construction, or violations of anr code. Iver, perlit ilsued sball beCOle in,alid
unless the work authorized by such per.it is cOllenced lithin sil IOnlhs of issuance, or if work autboriled by the perlit is
suspended or abandoned for a period of sil IOnths after the tile the lorl is cOllenced. One 90 da, ealension of tile, Jal he
allowed (or the per.it with fee charge of $15.00. the extension sball be requested in writing to the Building Official. An
approved inspection 'UBt be logged during each six IOnth period, or the project lill be considered abandoned.
W^RHIHG TO OlfIfER: YOUR FAILURE to RICORD A 10nCI OF COHtIERCBltBNT MT RISULT III YOUR PAYlIG filCH FOR I"PROVIKBITS TO YOUR
PROPERTY. IF YOU lNTIiND TO OBrAII PIIAICIIIG, (OISUL' WnH YOUR LBIfDBR OR All AITORIfBY BIPORI RICORDIIIG TOOl IOfICI OP
COHHEICKHBHT. JOBS UHDRR U,500 IN VALUI DO ROT NIID to RICORD AHD POST A 'NOTlCI OP COIIIBIClIIKIITi.
~"R~~~ SlcW~
STATE OF FLORIDA
COUHTY OF Pa.Sc.o
The foregoing instrument
before me this " ::JAAJ
was acknowledged
, 19..92- by
STATK OF FLORIDA
COUIIY OF .J..h Lf. s 8 tJ ~o ~ J J..
The foregoing instrument WBS acknowledged
before me this q .::r~ , 193'2.- by
h' (~ .
w 0 18 P ally known to me or who has
produced
as identification and who did/did not
takeaalL ut
(Signature) .
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
who is personally known to me or who has
produced
as identification and who did/did not
take an o~th. ,/ ~
aJ~J:-_p ~
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
o IC L NOTARY SEAL
. ALLAN KELLY
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC473399
MY COMMISSION EXP. UNE 26,1999
OFFICIAL NOT AR SEAL
ALLAN KELLY
NOTARY PUBLIC STATE OF FLORIDA
I COMMISSION NO. CC473399
MY COMMISSION EXP. JLNE 26,1999
.
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