HomeMy WebLinkAbout97-6520
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N!
652DJ3
Date ...3 - S - <7 '}
~3 ELECTRICAL PLUMBING MECHANICAL
pmpertyown..~ ~ I"L,AA'L
Job Address: ~'- -/ () - / ~..
Parcel I. D. #
Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
Zoning: Energy Code:
Qe':;J~WO"',.~L: L ,~~
! \J
Radon Gas:
~f~~(j ~~
....
~ A 1L.c....A..
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances.
FINAL
C.O.
DATE
NO OCCUPANCY BEFORE C.O.
DATE
Inspector
Permit Fee
Signature
Company
Address
Telephone#
~~~!~
/!J(;M.~ ~ c e
Valuation or
Contract Price
'f 9' K, tJD
City license Registration # / b 9 to;
State Certified license#
13..v X~_
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 ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
APPLICATION FOR PERKIT
CITY OF ZEPBYRHILLS
BUILDING DEPARTMENT
;tPr
OWNER' S NAKR
~IU:S6jfOt-tAN 6ri~~11 PHONE
~IO . tqrH S',- 7~HiiLHlLi8
~t
1 g-;r7l/ J d-
~ 33S"~o
OWNER' S ADDRESS
JOB ADDRESS
LEGAL DESCRI.P'IION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I.'D.' (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:~New Construction -.-Addition -.-Alteration -----Repair _Install
_Sign
--"ove
_Deaolish
PROPOSED USE:i _Single Fsaily
--,,'F _' of Units --"/H
I
i _ec:-ercial
_Indust. _Swill. Pool _Other
DESCRIPTION OF WORK:
. _Restaurant I( Health Departaent Approval
~srA1J- 3bt ~ G' CHthN l.i~k AM- ct IW4U<. jJrrt.
(If.A7L OF t$ACL-l)I'1
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL: ATTACH (2) PLOT PLANS I( (2) SETS OF BUILDING PLANS &: (l) SET ENERGY FORMS.
COMKERCIAL: ATTACH (3) SETS OF BUILDING PLANS I( (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERHITS REOUESTED
~UILDING
,$
Lf9~~
Valuation of Total Construction
_ELEC'fRICAL
AtIP Service
Florida Power Corp.
W.R.E.C.
~CIIANlCAL
$
Valuation of Mechanical Installation
~UMBDfG
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fraae _Steel _FetJcE
Other
FIBISHED FLOOR ELEV~nONS: Fr. IS PROJECT IN FLOOD ZONE AREA?
..........................................BURTOftNC~~NC.
11315 STATE RD. 52
HUDSON, FL 34669
PHONE 813-857-1118
FAX 813-856-6774 .
CONTRACTOR SECTION
Signature
COKPANY
State Cert. or Regist. .
City License Registration .
..........................................
BUrl J1ER.
'" 97
RI.RCTRlClAN COMPANY
State Cert. or Regist. .'
SianAture City License Registration .
..........................................
PLUMBER COMPANY
State Cert. or Regist. .
Sigoatuxe City License Registration t
..........................................
KECHANlCAL COMPANY
State Cert. or Regist. t
Signature City License Registration f
..........................................
OTRRR COMPANY
State Cert. or Regist. ,
Signature City License Registration .
..........................................
APPLICATION APPROVED BY PERHIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this peClit lay be subject to "deed restrictions" which lay be .lOre restrictive than City ,
regulations. rhe unders~gned 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 Zepbyrbills Building Departlent, (813)
788-6611. '
FurtherlOre, if the owner bas hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
"Contractor Sections" of this application for whicb they will be responsible. If you, as the owner si90 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 - ROIeOWDer'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 couencelent.
E. CONTRACTOR'SjOWNER'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, loning, 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 perfoCled 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 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 liJited to:
t Deparblent of EnviroOlental Regulation - Cypress Bayheads, Wetland Areas and EnviroOlentally Sensitive Lands,
Water/Wastewater rreatlent
t Soutbwest Florida Water Hanagelent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
t Departlent of Health' Rehabilitative Services, EnvirODlental Health Unit - Wells, Wastewater rrealtent, Septic ranks
t US EnviroOlental 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 subtitted 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 frol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every peClit issued shall beCDle invalid
unless the work authorized by such perlit is cOllenced within sil IOnths of issuance, or if work authorized by the peClit is
suspended or abandoned for a period of sillOnths after the tile the work is cOIIenced. One 90 day extension of tile, lilY be
allowed for the peClit with fee charge of '15.00. rbe extension sball 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 NOrICE OF COHHENCEMBNT MAY RESULr IN YOUR PAYING !WlCE FOR IMPROVEMEJIJS ro YOOD
PROPER'lY. IF YOU IDEND ro OB'AIN FINAJlCING, CONSUL' WI'H YOUR LENDIR OR AM AYTORNBY BEFORE RECORDING YOUR NorICI OF
COHHENCEHENT. JOBS OMDER U,500 IN VALUE DO NOT NEED fO RECORD AND POST A "NOfICI OF COMHENCKMED".
SIGNATURE: OWNER OR AGED
SIGNATURE: CONTRACTOR
STATE OF FLORIDA
COUIITY 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
COMEGYS INSURANCE CORNER
..........II.llllllj:IIIII..II.i.!IIIIII.IIIIIIIIII'11:lil;;..:1;itll,lilllfj:I;I;I!I,i~I!!!illlll'lililii:I::1:.;;;.I,!il,\I\iil;....... ;~~~~ml~~ ..
... .. . ...... . ... THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
. A CORD..
PRODUCER
POBOX 60309
ST PETERSBURG
FL 33784
COMPANY
A
GENERAL ACCIDENT INS CO
INSURED
BURTON FENCE INC
COMPANY
B
1900 34TH ST SO
ST PETE
I
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THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO All THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
COMPANY
C
FL 33712
COMPANY
D
CO
LTR
TYPE OF INSURANCE
POLlCV NUMBER
POLlCV EFFEC11VE POUCY EXPIRATION
DATE (MMIDDIYYI DATE (MMIDDIYYI
LIMITS
~ 'GENERAL LIABILITY CPP114 81 0 9
X COMMERCIAL GENERAL LIABILITY
'~_ __J CLAIMS MADE [j{] OCCUR
OWNER'S & CONTRACTOR'S PROT
-~
r---
1/01/97
1/01/98 GENERAL AGGREGATE $2,000,000
PRODUCTS - COM PlOP AGG $ 2 0 0 0 , 0 0 0
PERSONAL & ADV INJURY $ 1 0 0 0 0 0 0
EACH OCCURRENCE $ 1 000 000
FIRE DAMAGE (Any one fire) $ 5 0 0 0 0
MED EXP (Any one perlOn) $ 5 , 0 0 0
1/01/98 500,000
~ AUTOMOBILE L1ABIUTV BAa 2 52007
X I ANY AUTO
I ALL OWNED AUTOS
i SCHEDULED AUTOS
~ X ! HIRED AUTOS
X NON,OWNED AUTOS
I
1/01/97
GARAGE LIABILITY
ANY AUTO
EXCESS L1ABIUTV
lUMBRELLA FORM
: OlliER lliAN UMBREllA FORM
A. I WORKERS COMPENSATION AND
EM PLOVERS' LIABILITY
, lliE PROPRIETOR! I ~11N
: PARTNERs/EXECUTIVE __ CL
i OFFICERS ARE: EXCL
OTHER
WC0138115
5/21/96
EACH ACCIDENT $
AGGREGATE $
EACH OCCURRENCE $
AGGREGATE $
$
5/21/ 9 7 X I TORY LIMITS I I~W'\ ....................... ......
El EACH ACCIDENT $ 1 0 0 , 0 0 0
EL DISEASE.POLlCY LIMIT $ 5 0 0 , 0 0 0
EL DISEASE-EA EMPLOYEE $ 1 0 0 , 0 0 0
DESCRIPTION OF OPERATlONSILOCATlONSNEHICLESISPECIAL ITEMS
~EATlfI9~r~%.'ffQ.tP~R.....
", .. . ....., . ....
..,..,.................................................
. . . . . - . . . . . . . . . . . . . . . . . . . . . . . .
........... ...............
'.:.:'):rrri::::..:::.rmm:.:::m:m:m:::w:m::'.:m:.:::r::.:~~~~~np".:t::....::t::.{::mmm..:..:::.m:...:trrr:m:mt.::m.{{'..r:m.m:{::::::.:{:m.rmmtrtt.:m:m.::ri:m{.::tm{:tm:m:::r?:
SHOULD ANY Of' THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOf', THE ISSUItG COMPANY WILL ENDEAVOR TO MAIL
.:LL DAYS WRrnEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAIWRE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY ITS AGENTS OR REPRESENI'ATlVES.
AUTHORIZED REPRESENTATIVE
. I .. .... ... ...... .... . ..
ACOfU)~~h$.n~$)'<>.."..
.-.-..,.. -...P..,......
. . , . . . . . . . . . , . . . . . . . . . . .
..........................
................ .........
....,""',........................:.,. .:,.....", ...... ..::::\:}./:mm:::':.~:~i.:m.:i:::i.t.:.:0:~:;.i~:.~i:f:r''.:':"'~:0:'~' m~iii.ijdijij:.:.C.t~QMlib.Nm.l.ji
No. 2-970076
~3 \~!t'1lnv. # ~]01?___
Candy Locate __JJiI,G_ ,..
FfJ~E.
(1. ) p-1"
U Yellow Pages
U Referral
U Repeat Cust
U Other
~_- ..... '''l~,__.rt1"...-, ,~._ "
_ ~~_ _ Pasco (813) 857.1118 Pinellas(813) 843-0155
Hernando (352) 688-3151 Zephyrhills (813) 78~174. 7 ("
. <~""~j ',;.--:, Fax: (813) 856-6774 trf.ifl11
- .' (,"/", ' .. ~\ FENCE CONTRACT '
," , u, ~1 IV
proposa~\:;~~~o~~~ "f.) ..:...s: iP-~c.. tf~k-A..I"'/II ChL<'~c L, .
Address -~ ~ ...... 55/ () /'7 M Sf-
____~.......... /e'tt.jA t,.II~ rL
Job Name & Location gArY1~
Job Phone 7'(2-7<-//2_
/-2 y-97
BURTON FENCE, INC,
11315 SR 52
Hudson, Florida 34669
33..>VO
~~AFA EIN *59-261
~~_~ :;:c~'""
A..oelaUon
7794
Contact
MEU9El
SUf"Icoosl
Be tIer
eU$lre~~
Cour(:1
Date Submitted
TYPE FENCE REAR SPECIFICATIONS
/:.'>"', ....1- ( Top r ;111 of Ipnr_1"
(J / -""',) //_JI::: 10 follow qrol1w1 y/
Overall Length Overall Height To hI" IpliP! '''/IIh
towP.", grrloP .J
To bp. Ip"pt ....,11,
Sf- b !l'Qhp", Qf;J(jr> .J
Spill 11lf' qr;-'"j,. .J
Walk Gate Drive Gate IlIlf~" c!P;H nf
.oil I Swing nbslflJl,llon<:, .J
/- l.x '-I Gate
/ '?11 Roll
Gale Finish Side of Wood
linePosl Type Top In 0111
SpaCInQ --- .
I~kle 0 Pointed 3/>
I u IJA./tx... U Sarb,Up 0 Flat. Top SPECIAL INSTRUCTIONS
U Dog Earred 0 Qthe, If
Pickets: Stringers
Wire Gauge Dia, Term, Post SPECIAL WORK TO Bf
PERFORMED BY CUSTOMER
c9Yz. Post
l!r' 11112 x 2 318' Size
!.J 121/2 x? 2/8" Wall
.J 9 GA x 2" . as- Thickness
Line Post Top Rail
() II Posl '~JIB [} 1 5/8
0 Size
~ Wall "C:bS ,Wall FRONT
L>C~,-> Thickness ThIckness FENCING Key- tie 0", @ Bulldlnos C_-_) Bu,h~S c:;}
DIAGRAM Fence line 10 loet pefl'llulonl 0 WilliG_Ie ero T,ees ^
Terml"_' Posl
I be erected -,. .. E.Isllng Fence ~ Double Olle ff" '0
TERMS AND CONDITIONS: (1) All work shall b" completed in a workmanlike manner according to sland,ud practices in the indllslry USing Ih(l maleri;"lls "(1('[,1'('(1 ,1h','"" '2) AeJd.1!"11.11 r:~';1''J''~.' 1,1, to,' "1.1'1'
br~Gl(I<;P. of ;Joy ch;mgcs in srcr:ilic:ttions for Ihe work or based upon unusual ground oondihons (including rock 'ormations. hidden found:=Jlions. IreI'! roots. waler lines. ;Inn rW!",on;ll '.JI,,,'.I"r 1"11'<; tlt,I"I', I",
Oll'>!rl)cbons) involving I'!xlra ,,051... and ;lny additional chargns shall he evidenced by a wriUen chang!'! order. "sllch onstades prevent completion of work. the clIslomP.r w,1l hp. chmgr-n onl', I~" I.,~"" ;)"'1 "\.11"'"1'
B<lrln" Fl'!nr:f!. Inr: sh.<lll nol be liable for dclays in completion of Ihe wortc. caused by even!s beyond ils reasonahle control (4) Customer is solely msponsih!l! lor Ihe location fo, rt:=Jr:l'!rJlf'n: 0f th" r"""-,, ,n I!' " 1""r"
indemniry and hold BlJrton Fr.nr:e, Inc. h.<lrmlcss from any clAim by any third party pertaining 10 the fence lor,ation (5) In Ihe event that cuslomer shilll r"il In tlmflly nay "ny arnrmnllo h,"'rnmf' [lu/"> I!lvJr"
Clr"Iompr shall pay 10 Burton Fen"e, Inc. all cosls of collection, including court costs and a rea!'.onable atlorncy""'en. togelher wilh ;nlnreslupon Ih(! llnpilid "moun!;)1 lhc m"Xlflll1lT1 J,llr pf'fIlllll"'1 h' 1;1.\ AlI"';l"".!'
rN!l"l!n lhl'! property of Burton Fence. Ine untillinal payment is made by customer, and SImon Fence. Inc shall have Ihe right 10 remove soch materials in the even! lhal fin:tl ri'lyment i'; ''''I 1"'1"1; "1.1,1""
!hill A<1I1nn FenCl"'!_ Ine shntl h:tv!"'!:=1 li!"'!n nod ~cr.'Jrity inlmn~1 upon and agl1inst ctlstomer"s real property (the job silrl), and IIml :;uch licn shall hI' !'.tlhjr.et 10 r'fl'nrr.rlmrmt ;"Ind Inr!"'!rIPSIJH' r"lr"""'1<"1<; ~'I!r<.'),l'" ~'1 'f.,. ['r"
r,! f-IOlld,l Sln1111!'s Ch:=1plN 71:l in th(> eV!"'!ol of non-payment by customer
51 JW.11l TEO on Ihe
dnyor
199
//q 00
We propose hereby to furnish material and labor complete in accordance with above specil1cafions, for the sum of: ____.__~__f__O ..-
Authorized Signature: -~-~~dk..
Note. This proposal may be withdrawn if not accepted in 10 days.
ACCEPTED: Customer hereby accepts alllerms and condition stated above, and authorizes Burton Fence, Inc to commence the wmk as speCIfied
Slgnature.i::- t'i-lA."c/L--C~ ~ a~ Date ______________ _
DOWN PAYMENT __--1.::1 s:,oo CASH ON SET BALANCE ON COMPLETION . :'SZ ~ (j <-
PAYMENT OPTIONS: U i:E1 u 0 BF FINANCE U FINANCE OTHER
DO NOT SIGN BEFORE READING THIS AGREEMENT OR IF ANY SPACES INTENDED FOR AGREED TERMS ARE LEFT BLANK. RETAIN YOUR COPY.
CCO EXP. ISSUING BANK
PLEASE CHARGE MY VISNMC AS INDICATED ABOV.E IN THE AMOUNT OF $
x
CARDHOLDER'S SIGNATURE
NOTICE TO CUSTOMER: BE SUREYOiJR CONTRACTOR HAS WRITTENWARRANTYSAND GAUGES OF ALL MATERIALS SPELLED OUT ASAN INTEGR^L P^RT OF THIS COIJTRt.[T
CHAINLlNK: U 1 YR. U 5 YR. U 10 YEAR GUARANTEE AGAINST RUST & CORROSION. WOOD: U 5 YR. GUARANTEE AGAINST ROT & DECAY ON CYPRESS.
, '0 vn ",,^"^.ITP' ^" ""~T nnT P n"r-^Y mJ pnF~~lInF TRI'ATFn. I i\ROR GtJARANTFF ON ALL PROntJr.T~ I~ mIl' V", '1