HomeMy WebLinkAbout97-6913
, ,
BUILDING PERMIT N!
Permit
6913/1
CITY OF ZEPHYRHILLS
(813) 788-6611
Date
~- / '1- 7 7
BUILDING
cQ ,s.-. <./D
ELECTRICAL
PLUMBING
3-S. J0
MECHANICAL
Sewer Conn
Water Conn:
Pmperty Owne' ~f;.~~ -4. ~5
Job Address: "~___- /;--'
Parcel I. D. #
Water Meter:
T.1.F.'s:
Zoning: Energy Code:
Description of Work~~ 11 C-
Radon Gas:
FINAL
~
DATE
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Perm;. Fee ~~
s;gn..u,~ ' ~
Company
Address
Telephone#
Valuation or
Contract Price
~, y r6. crlJ
~
City License Registration # {)"'/5-o
State Certified License#
II ~ eJ.-/.s-/
,
12 ,JJtL
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 ($15.001 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.
...
l f,
APPLICATION FOR PERMIT
CITY OF ZEPHYRBILLS
BUILDING DEPARTKENT
OWNER' S NAME k /l/o/l"c}- ~;i/V
S-J~- /tl $ ~
~€
PHONE
; 7r!'3 3~~~
r ;
OWNER' S ADDRESS
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I. D.'
(OBTAIN FROK PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition ----A1teration ~epair .../6J.ns tall
_Sign ~ove _Deaolish
PROPOSED USE: _Single Faaily _KIF _' of Units _K/H
_eo..ercial _Indust. _Swia. Pool _Other
~estaurant & Hea1th Departaent Approval
DESC1lIPT10B OF 1ilI1lK: ~ZNL-. ~ 4;;J d4f7f;,/ ; ~~
X .?..rD Square Feet, .7~eight
JS~/~
BUILDING SIZE:
RESIDERTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS.
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
~CllAllICAL
$ c2., Y g6 . (/i)
,
Valuation of Mechanical Installation
_PLutlBING
, GAS
ROOFING
SPECIALTY
'lYPE OF CONSTRUCTION: _Block _Fraae _Steel
Other
FIllISBED FLOOR ELEVATIONS:
F'f .
IS PROJECT IN FLOOD ZORE AREA?
YES NO
..........................................
CONTRACTOR SECTION
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
RITTI.Dn
Signature
~ ~ COIlFABY d- ;:Oks ~/S/
.,/. / State Cert. or Regist. t
e , . ' A . City License Registration'
....~~..............................
PLUMBER COMPANY
State Cert. or Regist. .
Signature City License Registration t
...................................... ..
COMPANY
State Cert. or Regist. f
Signat City License Registration .
..............................
OTRF.R COMPANY
State Cert. or Regist. f
Signature City License Registration f
...................................**.***.
APPLICATION APPROVED BY PERMIT OFFICER.
~ CONDITIONS OF PERMIT AFFIDAVIT
.' A. NOTICE OF DEED RESTRICTIONS
lb. und.r.igned under.tands thot tbl. per.lt .ay b. ..bject t. 'deed r..tricti.... shieh oay 10 ..ro r..trlctl.. l60s City
regulations. The undersigned assUles responsibility for co.pliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If lbe ..... bun bired a cootractor or contractor. t. und'rtal. worl. tb.,.., Ie reg.ired to be 11....01 10 accordauca .111
.Iate and local reg.latl.... If lbe contractor I. not Ilcen.ed a. r",lred by I... boll lbe ..... and CODlraclor .., 10
cited Cor a Iled"'..,r oColatlon WId.r .tat. la.. If lb. ....r or intended contractor are "cortala as to abat II....jqg
regolr....t. .., appl, Cor lb. intended 8Orl. lboy are adolsed t. contact lbe City of Zepbrrblll. Building Oeparlooot, (813)
788-66J1.
Furtb.r..re. If tie o.nor baa bired a cootractor or cootractor.. b. i. adoiaed to bao. the contractor(.) .Iga portl... of 1Io
'Cootractor Se<:ll.... of Ibis applicall" for shieh tb., .iII he r"_lbl.. If roo. as 1Io ...or alga as 1Io ....tractor.
you are lodlcatlng !bat you. ratb.r than lbe contractor. are r'.po"lbl. for the aorl. If 1Io ....tractor llabea IOU to .Iga
as contractor !bat oa, be .. indication that b. i. not proper I, liceosed ..d I. not entillol to peraitllog privileges In lbe
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND U'l'ILITY CONNECTION FEES
, t'
.
D. CONSTRUCt'ION LIEN L'l\W (CHAPTER 713. FLORIDA STATUTES, lIS lIHIlNDED)
I certify that I, the applicant, have been provided with a copy of wFlorida's Construction Lien Law _ BOIeOMDer's Protection
Guidew prepared by the Florida DepartJent of Agriculture and ConsUler Affairs. If the applicant is sOleone other than the
........ I certlC, that I bao. obtai oed a copy oC lb. alo.. d..crlbed docuoent ..d prOlI.. In good lallb to dol I v.. It to 1Io
wownerw prior to COalenceJent.
E. CONTRACTOR r S/OWNER' S AFFIDAVI'l'
I certify that all the infor.ation in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, loning, and land develop.ent.
I
Application is hereby .ade to obtain a per.it to do work and instailation as indicated. I certify that DO worl or
lnotallatlon baa COIIOROed prior tn I.....ce of a perolt aDd that all IOrl will be perCD<8Oi to ...t llaodorda nf all Iaoo
regulating construction, City codes, loning regulations, and land developlent regulations in the iurisdiction. I also
certify that I understand that the regulations of other governtental agencies .ay apply to tbe intended worl, and that it is
,y responSibility to identify what actions I .ust take to be in cOIpliance. Such agencies include but are not lilited to:
· DepartJent of BnviroDlental Regulation - Cypress Bayheads, Wetland Areas and Bnvirontentally Sensitive Lands,
Water/Wastewater Treattent
· Southwest Florida Water HanageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
· Ar.y Corps of Engineers - Seawall's, Docks, Navigable Waterways
· De arttent of Healtb & Rehabilitative Services HnviroDlental Health Unit - Wells, Wastewater rreallent, Septic rants
· US EnviroDlental Protection Agency - Asbestos abat8lent
I also certify that, if fill .aterial is to be used in Flood Zone wAw or wA,etc.w, it is understood that a drainage plan
addreSSing a wco.pensating VolUleN will he sub.itted which is prepared by a professional engineer registered in the State of
Florida prior to per.it. issuance.
. I perllt IBlUOd shall b. cno'lrued tn be a lice... to prncoed wllb the warl and ont as aulbnrlt, to 'Inlatn. cancel BIter, or
set aside any provisions of the technical' codes, nor shall is~u~nce of a per.it prevent the Building Official frUl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Ever, petlit issued &ball beCOll invalid
unless the worl authorized by such per.it is cOlIBnced within six IOnths of issuance, or if wort authorized b, the petlit is
suspended or abandoned for a period of six IOnths after the tite the wort is couenced. One 90 day eatension of tille, II' be
allowed for the per.it with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection .ust be logged during each six IOnth period, or the project will be considered abandoned.
WARNING TO OWRER: YOUR FAILURR TO RRCORD A NOTICR OF COHHBNCBHHNT HAY RBSUn IN YOUR PAYING nlIa FOR DIPROVIIIm's ro YOUR
PROPRRTY. IF,.OU IIfTRND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDRR OR AH AnORIBr IEFORB RlCORDING YOUR BorlCl 01
COHHINCBHINT. JOBS UNDRR $2,500 IN VALUR DO NOT NERD TO RRCORD AND POST A wNOTICI OF COMMDCKHIlfrN. .
SlGNArURE: ONKRR OR AGRNT
.' I
SIGNATURE: CONTRACTOR
srArB OF FLORIDA
COURTY OF
The foregOing instrument
before me this
was acknowledged
, 19_ by
STATB OF FLORIDA
COUNTY OF
The foregoing instrument
before me this
was acknowledged
, 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 bas
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
r-i.L: =, i::"
F'AI3E 02
~:..--kllbl2/J f-Lt4f27u[r!11tt! Abt S~ /J I ,j /' tj
't-k (- . TAMPA-L1THIA ~!:~~~-4" ?7
lOORESS_ ..s- S:c;;;?..5*'" . l() . .~~T., AIVERVIEW /J - /:(
HONE' --It:.a __ 3 Lfl? (813) 874-3822 SALuENGlNnR~~q~~
. _L."'" .'. - . ___u. (813) 689-5594 ~ I '11- ~ ~ [) P
7.f. PI-i&i:I- f LLiS c::7'--a /7J N 7 crFT r-'(.J /Yl
,.:,,, .~JI~ MOcHl S.ri~' BTLJ Aetinv
(:,T..'cL!;;~___ ~PLA:OWM.ov _.~~-~=-1j{~~ tf,t1'?2
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. _ .__ "U--- L- _
cOP . .3_
!qU'P""fl"
L.ocetion of tiquip",.nl
:ond. U';t/Hedt Purr;:
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'herf11ost"t
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AMC AIR SYSTE/IlS
PURCHASER
ERMITS
qUlpmer"\t'Foundat:~I' Sliill
:Illctrlcal ('.Qf:.jiJ EC\nl.5n
:arpentry
nsulation - Floor .A:-ic
,1iscellaneolls
,. ..... -t- ---~--~:-~-::F::::::--,-_.
,. :;:: i '-..,..:. -\-.~-:c t:-~;j;-~;r ..'-'--- ~~'-:------=iT".--_. ......... .-.
je ._~. I'J I J (\j (-:> ..c'9 - ---0. t-"-' ~.=.-===~=--::--' '~==="--9L/.'~-'~~'
'-~-'- =------ -
_____~~~ I. .j P _:--------r .__.=t-_.~--
~~)~
: If tl...if,k., -t' & o~.,.oj A {.,(,-
'r:en1r.'J'5 and 1!gttteri as follOwli
D,d:-~ M9tf?I'~~
Vtti"! ____......___._...
F-lb,'~I... ___.._~.::,,_....
;..;':.t S, ,~e~ ...
')f"I,: ';'
RA Gtill~
f /.:.?...S0'.. u
I
')llfoJ
, c.'" --roO -'KtT=r:=oi4=M,aR~_LM aAT_tiLJI R~. i ~-; .B,RM ~_'8~~'
- -rl-. I i "-i=__l 1- -...1--1-.-1 . _~.._.._
I !' . 7",/ I
1/0Z __.L. ._il~hl!~~_L__.
WARRANTY: NET CASH PRICE
I part." labor
!'!Al!
l f.~ n t
\mount
/
,ize
LOcation
_--L-...___
CARPENTRY
,'"\
" ,
/-}},$<~~~:'.(..
_. .,I--'h---T"'1--
1.//'.1
II,--t~~_!t /n _
/
-.-'--
6' year on compreSlor
(p.r1 only) /' A/C'~() l><-...J c;.
(!_IJIJIJ v:- f:u.4P (2LJ ( /__t
INSULATE A TTlC
ELECTRIC
MISC.
..J.~rk.m~'~-;~
V\/I)(\ 'r. "',1-' r....:.;.
Wlloranly
Sf!Ue, e:..tend ~ f ~,."
.,.,.11" rebtH~~"r r'. j':, ,.,.
Includ~ ~~f:' r~pd:"'A" (~
T"E aV€lraije !~ry'tf".)i'j'"
$UMME~ :'l'f~.,'l'" f,.
V\lINTEH 1_'U\Sl'1to I~. '., ~~'
T~e~e al.r- Ib~ .:~:j'h ...1....
.., 'r.~r o7lr,d will ccnq)ly with ew,.st;ng Codt~ ~l1d reguJ~~ (.,;~~
TOTAL
r=-A4tR~'~
'.. .....~ t:'quitjment as the fTlarluf6lctl.lrer grant~ If"! C~fI~1IcatA oJ' N~r's.nt;' In addition, the seller wlU'an.", It'\o 1.~I:d .'1'
'.....'\'{~ wo~',(rnar.s"'ip cine meterlal 'or a P~"')(J 0' ':'=1~ \-e~r t'/lm va~~ Of compte-tlon of installatlOf' ~,.r~ ~.
h~
OPTIONS:
rECO REBATE
. ":-,,_~ WIll t)~
'.'" :', !a"
'i 75~'
NET COST
----.-. .--'
':''''1' mated::.' .."~ "C""
AI!! be:,:.;:1C:.1" ....1 .
re;>res9ntflt.-.'
. ' ~J'. Ire \A R.1.l ,Ame"ClIn Aefrigeratiol'\ 1<1'1 'It,le
'r"3f -eQlIl'ed In this prtJPosal wll, !Ill paid for by ;:>"'G~ilSe' as ..In ~~tra al AMC Air SY$lems' /'Iorm,1I r"!~' p.,< r"" ; ~,
-:... tI~. .' *(:t:;~pted by PUf(:ha.se' and rh~rea'!~r .:-tc,o'oved a:-.d ..c<;~plp.d in .....,."11f'Q b'" A~C Air SYS!'!:tr~1 !:1. , : I~t.
For ^"'I('r" I .;1.lf..........
:;:/.' (/. /
$ <<CJ 6 &.,
--- 7if.~7ff=~:,..=d_.-:::::-~.,=~-;---;- (73 -,~..,-;-:..-._...
___~ _~____.__ ;Ja~at)l~ ~ __. ___ _~ 1..___.. _.' '._ ____.__.._ nOWI' :.", !.,.;"
.1i;<11.;ttl(:-'
The tit'e (I '~.~II' . <,'.. . r:
m) ~a.i1u'f' '\< :r~".,~ !.. ~
rogn, 10 ta.~ :,.,.,.......,..
I fo'th~r 1.10'.,.... .".""..
:-:"'a;;e :"Jr. Ih~' \~ ," ,.,
Da~' :ill ~~C!.-: ",' '.;c....
'1 liMe Ai, Sy~le"'" 0' its 9Uccog~l'or9 """!' '''" -1 "'0 'J " , 01 ptJ'cnase fTlorey ahal; have been piud ",,,I ,., . :....
" !b" wnole unpaid balance <lhall OOco"'" (lue S",O paYll')!~ sf o"ce. 1"0 t"e ...d "Me A" SY5tem~ ~"." ,,, ,.' ..
u "",n,ou: "'11 le~ai process. and ,,/I payl"'"lCoIS ~h:;" be ar,plletl <IS ,~"t for ""lid property or to' de"''''',M,' ,.. ." . . <
",l~~ Dy on.. "OM Ine abov<9 :!I(l II er. durin.. :r.. \,"'e ,",'s cen"..(' 'S on effec, 0' prror \0 1t,. tiMe it I~ :>:0" 'I
, ., -a,t 0' l~"f. 30reel'"'erll ar<l snolJ1c II b~'~'.l""P. '.f!o:eS!i!') Ie enfcr,,~ lt1IS "'greemenl Dy lella'l""'''' ,.: ..
..... steEl _ ()
./'/ f1eSt;8ctfufl. $ubmilled by 1. I.
< . Sales E"g'~"e.1 . _~ 1/ _
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RUG-14-'97 THU 13:34 ID:
TEL ~~:8139607647
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