HomeMy WebLinkAbout97-6940
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
Ii!
6940l
Lf-S. -~ CJ7)
~ICo~
Date
tj - .,s.'-- 7 I'
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
P,"perty Owne" t~, 1jp J1.zE
Job Address: b ~
Parcell.D. # '-? -,;)...6 ,-;)..j - 0 I 7' 0 -- 0 Q 0 rJ c.J - 0 0/4-
Zon;ng' ~ne,gy Code, Radon Ga" j "y
Description of Work ~ A J? e ~ ..-1 ~
Water Meter:
T.I.F.'s:
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
City License Registration #
State Certified License#
;>0
Permit Fee
Signature
Company
Address
Telephone#
D,\{
Inspector D
{tV ~J ~
Valuation or
Contract Price
/ 7' 96 - o-v
/
_~~ t;=ft~
BUILDING
CJ /% Je; 1
ELECTRICAL
PLUMBING
MECHANICAL
Ftr,
Pre SLB
Lintel
l;l\
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Insl.
Compressor
Final
FRM.
Insul. CL
WL
SLB
Tub Set
Water
Sewer
Final
Driveway
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of p',r ..J Ie, 1188. III S ($...-0) shall be made for each trip for each trade:
~: GTi)
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 ZEPHYRBILLS
BUILDING DEPARTMENT
GjJ'Cf7'
8'?- .'
JOB ADDRESS
~ '11 utE. -r. H /teSt? A./.
b Cf t ~ ,L/J()~ L lJt:b])
s-'1f7f: '
PHONE ;777. tJ63 '7'
} fZ z..kf, CLS. FC
:5 I LV ete- C> .fK5
OWNER'S NAKE
OWNER' 5 ADDRESS
LEGAL DESCRIPTION: LOT(S)
C) .3 JL~ J.--( Ol? ()
BLOCK
SUBDIVISION
aD; A-- (OBTAIN FROK PROPERTY TAX NOTICE)
PARCEL 1. D. t
{)(j)Oo
WORK PROPOSED:_New Construction _Addition ---Alteration _Repair _Install
_Sign
_Kove
_Deaolish
PROPOSED USE: _Single Faaily
_KIF _' of Units ----1t/H
_ec:-ercial
_Indust. _Swia. Pool _Other
_Restaurant & Health Departaent Approval
DESCRIPTION OF WORK: % Po UI!-
13)t13
5' LIIj1 ;
/"
13)t/3 C.(Jl7foS I~ 46P tL Sc..etiW /J;fJl(
BUILDING SIZE:
x
Square Feet,
Height
RESIDEHTL\L: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS.
COMKERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERKITS REOUESTED
_BUILDING
$
199' < t5D
Valuation of Total Construction
_ELEC'l'RICAL
ANP Service
Florida Power Corp.
W.R.E.C.
----1IECIIAIIlCAL
$
Valuation of Mechanical Installation
_PLUMBING GAS ROOFING
SPECIALTY
TYPE OF CONSTRUcnON: _Block _Fraae _Steel
Other
FIllISHED FLOOR ELEVATIONS:
FT.
IS PROJEcr IN FLOOD ZONE AREA?
YES NO
******************************************
Signature
CONTRAcrOR SECTION
~-:...._.:: ..... .... COMPANY S/ thJ 3 7}tfr;e.
. ,"'- -- -~=-;//?f State Cert. or Regist. t
(-:".,-: ..... .. City License Registration t
-_.- ..' ******************************************
Itwl'( /VJ'1.
70
BIJIUlER
(
F.T JO:CTRICIAH
COMPANY
State Cert. or Regist. t
City License Registration t
******************************************
SilmAture
PLUMBER
COMPANY
State Cert. or Regist. t
City License Registration t
******************************************
Signature
MECHANICAL
COMPANY
State Cert. or Regist. .
City License Registration t
******************************************
"
Signature
OTRRR
COMPANY
State Cert. or Regist. .
City License Registration t
******************************************
Signature
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
. A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this per.it .ay be subject to "deed restrictions" which .ay be lOre restrictive than City
regulations. The undersigned assUles responsibility for co.pliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they .ay be required to he licensed in accordance with
state and local regulations. Jf the contractor is not licensed as required by law, both the owner and contractor lal be
cited for a .isde.eanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
reguirelents .ay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
788-6611.
Further.ore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
"Contractor Sections" of this application for which they will be responsible. If you, as the owner sign as the contractor,
you ~re indicating that you, rather than the contractor, are responsible for the worl. 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. CONSTRUC'I'ION LIEN Lf\W (CHAPTER 713, FLORIDA STATUTES1 AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law _ HoIeoNner's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If tbe applicant is sOleone other than the
"owner", I certify that I have obtained a copy of the above described docUlent and pro.ise in good faith to deliver it to the
"owner" prior to COllenCelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
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, laning, and land developlent.
,
Application is hereby .ade to obtain a per.it to do worl and instailation as indicated. I certify that no wort or
installation has cOIIenced prior to issuance of a per.it and that all work will be perforled to Jeet standards of all IllS
regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other goveInlental agencies lay apply to the intended wort, and that it is
,y responsibility to identify what actions I .ust take to be in co.pliance. Such agencies include hut are not lilited to:
· Departlent of Environlental Regulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treatlent
· Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
· Ar.y Corps of Engineers - Seawalls, Docks, Navigable Waterways
· Departlent of Health & Rehabilitative Services, EnviroDlental Health Unit - Wells, Wastewater TreatJent, Septic Tants
· US Invironlental Protection Agency - Asbestos abateJent
I also certify that, if fill .aterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
addressing a .co.peDsating voluteN will be subtitted which is prepared by a professional engineer registered in the State of
Florida prior to pertit. issuance.
. A per.it issued shall be construed to be a license to proceed with tbe work and not as autbority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall is~u~nce of a per.it prevent the Building Official frOl thereafter
requiring a correction of errors in plans, construction, or violations of an, code. Ever, petlit issued shall hecoIe invalid
unless the worl authorized by such per.it is cOllenced within Sil IOnths of issuance, or if work autborized by the perJit is
suspended or abandoned for a period of six IOnths after the ti.e the work is cu.enced. One 90 day 81tension of tile, ., be
allowed for the per.it with fee charge of $15.00. Tbe extension shall be requested in writing to the Building Official. An
approved inspection .ust be logged during each six IOntb period, or the project will be considered abandoned.
WARMING TO OlOIIR: YOUR FAILURE TO RECORD A NOTICE OF COHHINClJlBNT KAY RESULT IN YOUR PAYING TIIICS FOR IHPROVIIIBIIS '1'0 YOUR
PROPERTY. IF YOU IIITIND TO OBTAIN FINANCING, CONSULT WITH YOUR LBNDER OR AN AnORIKY BBFORE RlCORDIIfG YOUR IfOTICS OF
COMHENCBHENT. JOBS UNDER $2,500 IN VALUI 00 NOT NEED TO RICaRD AND POST A "NOTICI OF C~~~~L'
..' _...._...-:.:'::::.::"""":""7---"....~ .,...._~
C:~..'" _f~~f.0:~2"'5':S'" j
SIGNATURB: OIIMER OR AGENT SlGffATURi:' CONTRACTOR
. I
STATE OF FLORIDA P
COUNTY OF ! /fS CO .
The foregoing inst~egt was acknowledged
before me this ~~ , 19~ by
STATE OF FLORIDA P
COUny OF /" ~ Co
The foregoing ins~ent was acknowledged
before me this ~?--:f , 19--2Z- by
{
who is personally known to me or who has
produced
as identification and who did/did not,
take an oath. r:::: K ~
(Signature)
who is personally known to me or who bas
produced
as identification and who did/did not
take an oath.~rf' ~
(Signature)
(Name Typed, Printed or Stamped)
NOTA KEITH CORREIA
MY COMMISSION' CC ~1416
~l EXPIRES: May 13. 1999 ~
..' Bonded Thru Notary PIlbllc lhIelWltlll'l ;
(Name Typed, Printed or Stamped)
NOTARY., ....,. KEITH CORREIA
/~~ifl"l'~~ MY COMMISSION' CC 451416
~~~ J<lf EXPIRES: May 13. 1999
"~~'" ;..:<t->" Ilor1ded Thru NotIIY PublIc lIndelWllllrs
',RlfI'"
'roposal
SUN STATE AlUMINUM~ iNC,
375;:8 State Road 54 West
ZEPHYRHILlS, FL .3354 (
;S 13) :<'88.7308
PROPOSAL SUBMITTED TO
c
.I
STREET
JOB NAME
/ J'
CITY. STATE and ZIP CODE
JOB LOCATION
ARCHITECT
DATE OF PLANS
We hereby submit specifications and estimates for:
\,
,- "
I \.~,'
Page No.
D
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of
JOB PHONE
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t'Dr 'roposr
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hereby to furnish material and labor - complete in accordance with above specifications, for the sum of:
.:)
,I
Payment to be made as follows:
All material is guaranteed to be as specified, Ail work to be completed in a workmanlike
manner according to standard practices, Any alteration or deviation from above specifications
invoiving extra costs wiil be executed only upon written orders. and will become an extra
charge over and above the estimate. Ail agreements contingent upon strikes, accidents
or delays beyond our control. Owner to carry fire. tornado and other necessary insurance.
Our workers are fuily covered by Workman's Compensation Insurance,
Authorized
Signature
Note: This proposal may be
withdrawn by us if not accepted within
Acceptance of 'roposal- The above prices, specifications
and conditions are satisfactory and are hereby accepted. You are authorized Signature.'
to do the work as specified. Payment will be made as outlined above.
;
.t',: ,../ /s~
Date of Acceptance:
Signature
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INCWD'NG APPUCABLE 'MNO LOADS AND PROIIISlONS
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SCREEN I VINYL WALLS
SOLID COVER
THE DESIGNS AND SPANS S/fDMI ON nlEs[
lWA:m!CpOl."rO\'~~~~: nlE LOAD REOUIROIEIITS
I. STANOARD BUtLOIHO COO( 199. ED, CHAPTER 10
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