HomeMy WebLinkAbout97-6993
BUILDING PERMIT
Property Owner:
Job Address:
Parcell.D. #
./ -oy...
/~-"
VLECTRIC.I-\L)
-
. ~ter Conn:
~ ") ,.~ . ;) -
tJi. b~'j>,J1fJ2s 8~,-<<,~(:gL . "e,Mete'
$2 - ~y S- '
s ~-. -!J ;. ~ T.I.F.'s:
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N!
BUILDING
PLUMBING
./"E---
~....
~ANI~.~1
Date
Sewer Conn
Zoning:
DescriPtion of Work
Cr-t7rgy Code: . "'_
)1<1<47""-- - 0,< I)
. R ad}~~
. ~ :p./t'~
FINAL
C.O.
/0-6-97
DATE
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Permit Fee
Signature'
Company
Address
Telephone#
Inspector
Valuation or ~ () 0
Contract Price T ,2; 1/ j~ ., -
City License Registration # ctl3 /
State Certified License# e A C!. DS ~ 7"5 I
BU I LQJ.Wa-.
...-
C~:~C~~
g) 0(1)~~
_ ~/ . ME~HA~I~A'_'.
SLB Breakers
Tub Set Ducts Insl.
Wa~r Compreswr
Sewer Final
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Driveway
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of -- . _.,J.. T - . - tift !I_liars ($leIII()) shall be made for each trip for each trade:
.;l.~';pt)
Wrong Address
Condemned work resulting from faulty construction.
Repairs or corrections not made when inspection called.
Work not ready for inspection when called.
Permit not posted on job site.
Plans not at job site.
Work not accessible.
a.
b.
C.
d.
e.
f,
g.
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 ZEPHYRHILLS
BUILDING DEPARTKEHT
OWHER'S NAME ~/ ~ L1zA(JETJ1EPfC-Of/AI {'I!V!?rf!
OWNER'S ADDRESS 5' f5.r:;~5 /610 5/
JOB ADDRESS 51'./VJ f d.~ /Y hI} v~ ,
PHONE
,?y)- /;LO 7-
LEGAL DESCRIPTIOH: LOT(S)
BLOCK
SUBDIVISION
PARCEL I.D.' , (OBTAIH FROK PROPERTY TAX NOTICE)
WORK PROPOSED:_Hew Construction _Addition V Alteration ~epair _Install
_Sign
_Kove
_Deaolish
PROPOSED USE: _Single Faaily
_KIF
_' of Units _K/H
_~ercial
_Indust.
_Swia. Pool _Other
_Restaurant & Health Departaent Approval
DESCRIPTIOH OF WORK: e /;.-y /}! -e 0 vt- A e 4' r /J t/ A-J /:J
r I !
BUlLDIHG SIZE: X Square Feet, Height
RESIDEHTIAL:
COMMERCIAL
ATTACH (2) PLOT PLAHS & (2) SETS OF BUlLDIHG PLANS & (1) SET EHERGY FORMS.
ATTACH (3) SETS OF BUlLDIHG PLANS & (1) SET EHERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL HEW COHSTRUCTION.
PERKITS REOUESTED
_BUlLDIHG
$
Valuation of Total Construction
$
AMP Service Florida Power Corp.
1 Lla.cl/~
r ~{ 7 .;, Valuation of Mechanical Installation
W.R.E.C.
_ELECTRICAL
~GlWUCAL
_PL~IHG
GAS
ROOFIHG
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fraae _Steel
Other
FIliISHED FLOOR ELEVATIOHS:
FT.
IS PROJECT IN FLOOD ZOHE AREA?
YES NO
******************************************
COHTRACTOR SECTION
BlrrI.DER GOKPANY
State Cert. or Regist. .
Signature City License Registration .
******************************************
RI.RGTRICIAR ~COMPANY (!'~)l1-l-.e 1.?l~u"!r"'~L
s,~.:..~~ ~r.~\~~:';eO~:~:~~:~i:" . ({z7...
**** -**********************************
PLUKBER
COMPANY
State Cert. or Regist. .
City License Registration t
******************************************
Signature
~
MECHANICAL
COHPANY (J'tJ a//4I/4/) ~,4 ( !!It e-
State Cert. or Regis t.' ;;; t~' 0 5" L( ? ? /
~L City License Registration' ~ '3 I
************~***************************** ~!'
Signature
OTIIRR
COMPANY
State Cert. or Regist. ,
City License Registration ,
******************************************
Signature
'''ION APPROVED BY
PERM.1T OFFICER.
--
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit lay be subject to Pdeed restrictionsP which JaY be lOre restrictive than City
regulations. the undersigned assOles 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 lilY be
cited for a lisdeeanor 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 DepartJent, (813)
788-6611.
FurtherlOre, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
PContractor Sections. of this application for wbicb 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 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, bave been provided with a copy of PFlorida's Construction Lien Law - HOIeOWJler's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsllleI' Affairs. If the applicant is semeone other than the
Rovner", I certify that I have obtained a copy of the above described docUJent and premise in good faith to deliver it to the
"ownerP prior to CODencl!leIlt.
E. CONTRACTOR'SjOWNER'S AFFIDAVIT
I certify that all the inforaation in tbis application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby Jade 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 perfoIJed to aeet 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 goveruental agencies laY apply to the intended work, and that it is
If responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
* Departlent of EnviroDleDtal Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands,
Water/Wastewater TreatJent
* Soutbwest Florida Water ManageJent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
* ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
* DepartJent of Health & Rehabilitative Services, EnvirODJeDtal Health Unit - Wells, Vastewater !reatlent, Septic Yanks
* US EnviroDlental 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 .cOIpensating volOle" will be sublitted wbich is prepared by a professional engineer registered in the State of
Florida p'rior 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 froa thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every peIlit issued shall beCOle invalid
unless the work authorized by such perlit. is cOlleDced within six IOnths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six IOnths after the tiae the work is cOBenced. One 90 day eJtension of tiM, lilY be
allowed for the perlit with fee charge of $15.00. the extension shall 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.
WAIUllffG TO OWlfBR: YOUR FAILURB TO RBCORD A NOTICE OF COHMDCBIIEII! MAY RESUL! Iff YOUR PAYING filCE FOR IMPROVEMBIl'S TO YOUR
PROPBRTY. IF YQU III!BIfD TO OBTAIN FIUNCING, CONSULT WITH YOUR LBlfDER OR All Anomy BEFORE RECORDIHG YOUR HOTICE OF
COMMENCBMBII! . JOBS UNDBR $2,500 IN VALUB DO NOT KEBD TO RECORD AHD POST A "NOTICB OF COMMEHCEMEII!".
SIGffA!URB: OWIIIlR OR AGEII!
SIGHATURE: COII!RACTOR
STATE OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before me this , 19____ by
STATB OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before me this , 19_____ by
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
(Signature)
(Signature)
(Hame Typed, Printed or Stamped)
NOTARY PUBLIC
(Hame Typed, Printed or Stamped)
NOTARY PUBLIC
iJI. .
Pro osal Submitted To:
PROPOSAL
O'DONOVAN'S AIR CONDITIONING
. . AND HEATING
6610 16th St.
Zephyrhills. FL 33540 Sheet No.
.~( 1 7 -407Suvork To Be Performed At:
No.
Date Sept 18,
1997
CAro )~?3/
Name Saint Elizabeth Episcopal Church
Same as left
Street 5855 16 th St.
Street
City 'Zephyrhills
I.
Stat~_ Fl.
..,
City
State
Phone 782-1202
Date of Plans
Architect
~ \ We hereby propose to furnish the materials and perform the labor necessary for the completion of
Estimate to replace present package heat P*-P with 3 ton Bryant
split heat pump system,
~neyear warranty on parts.
Two year warranty on
on labor. Five year warranty on compresser. Price includes
split system unit, lb~mastat (digital), new copper lines,
Will close hole on
of church with plywood and paint
~J
and taxes.
with whi~e paint. er will need to consult carpenter
or block mason to permi..ntlY coveJ:" the hole where the
pacl<aged a i rcon d i t i one~ wi 11 be rerooved {i'" fI; 'f '} )
11 SEER Heatpump with 5 K.W.
backup\heat with TXV valve.
------4-2,495.
All material is guaranteed to be as specified. and the above work to be performed in accordance with the drawings and
specifications submitted for above work and completed in a substantial workmanlike manner for the sum of
Two thousand four hundred nt~yy fi ve---------------------- Dollars [$ 2,495. ].
with payments to be made as follows: Halt before starting. Inffull upon
. pomplet~on of work. !
r
Any alteration or deviation from above specificatlons'lnvolvlng extra
costs. will be executed only upon written orders. and will become an Respectfully submitted
extra charge over and above the estimate. All agreements contingent
upon strIkes. accidents or delays tleyond our control. Owner to cilrry
fire. tornado and other necessary insurance upon above work. Work-
men's Compensation and Public Liability Insurance on above work '0 be
taken out by
.'
Per
Note-This pro os
within
may be withdrawn by us if not accepted
days.
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified.
Payment will be made as outlined above.
Signature
Date
(1- c3.3 - C; I
~..
..... FD
DUPLICATE
MADE IN..lJ. S A.
'.''''LJL.. II. U.<..J.I""'I.