HomeMy WebLinkAbout97-7067
BUILDING PE,RMIT 7067
Permit
CITY OF ZEPHYRHILLS
(813) 788-6611
/3
/ ~~ - I b - 7 >
Date '-'
C BUI~' ELECTRICAL PLUMBING
P,op,rty Own", ~ . cti.".e-
Job Address: ,,-'3 )5 - 9'.;:1)( _
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Parcel r. D, #
Zoning: Energy Code:
.-~ .
DescriPtion of Work / ~~~
?~~
Radon Gas:
~ .AL &<....A.-
NO OCCUPANCY BEFORE C.O.
FINAL
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances,
DATE
City License Registration #
State Certified License#
J ~ 77
Inspector
Valuation or
Contract Price
93 9. tiV
13~~ '7~JZ
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
Driveway
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons. a
charge of Fifteen and 00/100 Dollars ($ MMlQI shall be made for each trip for each trade:
~":pt)
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 ZEPHYRHI~~ (
OWNER'S ~ M~ ~ M ~ B:P;;;;:J
OWNER'S ADDRESS "?'l1..n.Y'1- 9 ~ ~
~krY1C:-
PHONE
7g,2- lo3sn
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
PARCEL I"D.'
BLOCK
SUBDIVISION
(OBTAIN FRO" PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction --.Addition --.Alteration -.Jtepair _Install
_Sign
--'love
_DeJlolish
PROPOSED USE: _Single Faaily
--'lIF
_' of Units ----1f./H
_ec:-ercial
_Indust.
_Swia. Pool _Other
DESCRIPTION OF WORK:
_Restaurant & Health Depart.ent Approval
FevcE
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL:
COHKERCIAL :
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
-BUILDING
$-
Valuation of Total Construction
_ELECTRICAL
AKP Service
Florida Power Corp.
W.R.E.C.
--1IECBAliICAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fraae _Steel
Other
F1IUSBED FLOOR ELEVATIONS:
Fr.
IS PROJECT IN FLOOD ZONE AREA!
YES NO
..........................................
CONTRACTOR SECTION
BITTI.DER
cotIPANY
State Cert. or Regist. ,
City License Registration ,
..........................................
Signature
F.I.RCTRICIAR
COMPANY
State Cert. or Regist. ,
City License Registration ,
..........................................
SilmAture
PLUHBER
COMPANY
State Cert. or Regist. ,
City License Registration ,
..........................................
Signature
MECHANICAL
COMPANY
State Cert. or Regist. t
City License Registration f
..........................................
COHPAH~N 1Ov~" kc.-p
State Cert. or Regist. ,
City License Registration I J /J'I7
..........................................
Signature
OTIIRR
Signature
APPLICATION APPROVED BY
PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit lay be subject to "deed restrictions" which lay be lOre restrictive than City
regulations. The undersigned 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 reguired 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 lisdeteanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requirelents lay apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
788-6611.
FurtberlOre, if the owner has hired a contractor or contractors, he is advised to have tbe contractor(s) sign portions of the
"Contractor Sections" 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 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 "Florida's Construction Lien Law - HOIeOWDer's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOl8One 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 couencetent.
E. CONTRACTOR'S/OWNER'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, zoning, 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 perforled to teet standards of all laws
regulating construction, City codes, zoning regulations, and land developlent regulations in tbe jurisdiction. I also
certify that I understand that the regulations of other governtental agencies lay apply to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
t Departlent of BnviroDlental Regulation - Cypress Baybeads, Wetland Areas and BnviroDlentally Sensitive Lands,
Water/Wastewater Treatlent
t Southwest Florida Water Hanagetent 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 Treatlent, Septic Tanks
t US BnviroDlental Protection Agency - Asbestos abatetent
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 sublitted whieb 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 fIOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beCOle invalid
unless the work authorized by such perlit is cOllBnced witbin sil IOnths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of sfllOnths after the tile the work is cOllenced. One 90 day extension of tile, lily be
allowed for the perlit with fee cbarge of $15.00. Tbe extension sball be requested in writing to the Building Official. An
approved inspection lUst be logged during eaeb six IOnth period, or the project will be considered abandoned.
WARRING '1'0 OIIlfBR: YOUR FAILURB TO RECORD A NOTICB OF COHHBHCBHBHl' MAY RBSULT IN YOUR PAYING TWICE FOR IHPROVIMEIIS TO YOUR
PROPBRTY. IF YOU IUBID TO OBTAIN FINAlfCING, CONSULT WITH YOUR LIIDER OR AM ATTORlfBY BEFORE RECORDING YOUR JlorICE OF
COMMENCEMBNT. JOBS UNDBR $2,500 IN VALUE 00 NOT HEED '1'0 RECORD AND POST A "NOTICB OF COHHENCBHBU".
SIGNATURE: OIfIfIR OR AGENT
SIGNATURI: CONTRACTOR
STATB OF FLORIDA
COmy OF
The foregoing instrument was acknowledged
before me this , 19____ by
STA'I'E OF FLORIDA
COUNTY 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 bas
produced
as identification and who did/did not
take an oath.
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
::.A.~.Dlllt......i1'..leBml'II:IIII::11::::II:!;::,INSJJ.B~Nla':':!:[.;:,::::::'::.:!::::.:::,::::;.::::1,:::!::':::::::::;11:::,::::::;..:;.::::\::::.:::::::.:::.:!:::,:\.:::::::::[..:::...j:.:i: DA~IMMmolYY) ~.
~~~~~~~~::.::..::.~....:::;:;:,:::::::::::::::.:=::}=:,:,':,:/:::;:::=:)l:=::::::::::::::::::~>,:::::;{~::i:~~~:::::;:@ll::::::::::j:,~::l:,?i;'~:i:::::bi<:~.:::::::'::::::::'::..<:~T~;9:'i::~~.R;:J~~:;::::~;:~:::::::~::~;g:::::~}::,~:j::::~:ri~~:<::6F Ol~/O~~-~ ~gH ~,
ONLY AND CONFERS NO RIGHTS UPO" TItE CERT1F1CATE
HOLbER. THI9 CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY TItE POLICES BELOW.
COMPANIES AFFORDING COVERAGE
COMEGYS INSURANCE CORNER,
POBOX 60309
ST PETERSBURG
FL 33784
COMPANY
A
SHELBY INSURANCE GROUP
1N9UnED
COMPANY
B
INSURA PROPERTY & CASUALTY
BURTON FENCE INC
ELLEN BURTON
1900 34TH ST SO
ST PETE
I
qqY~tt~~~~::t\:\\\t::1:::\I\??::!::;?::!:'m\:,:r:\r:\!tt::;:'::::i\:{r:\?:m~?w:':{:1:1:{::::;:?\::;\rltWlml:m::l::~i]r.:::81WMfWliM{{:l:{:W\1::!{1??1:\:iWW?\:?f:t'I::t:???W?W:k?:\/t=:t:::t::II::::':iWiWWWWWMi:
mls IS TO CERTIFY ntAT THE POLICIES OF INSURANCE USTt:D BElOW HAVE BEEN ISSUED TO WE INSURED NAMED ABOVE FOR ntE POLICY PERIOD
INDICAtED, NOTWlnlSTANDINO ANY REQUIREMENT, Tt:RM OR CONDmON OF ANY CONTRACT OR ornER DOCUMENT WITH RESPECT TO WHICH ntlS
CERTlrtCATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY tHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL rnE Tt:RM9,
EXCLUSIONS AND CONDITIONS OF SUcH POLICIES. LIMITS SHoWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
COMPANY
C
C RIM S/P C A SOLUTIONS
FL 33712
COMPANY
D
co
lm
TYPE OF 1N9UnANCE
"OUCY NUMBER
POUCY EFFECTlVI! POUCY ElIPmAnON
bAn! (MMlDbfYV' DAn! (MMIODfYV'
lIMns
~
OENEnAl UAllft.ITY
X COMMEnCIAl GENERAL LIABILITY
_~ ~ CLAIMS MAOE 13[] occun
OWNEn's & CONTRACTon's pnOT
AML79287050105
01/01/96 01/01/97
GENEfW. AOOREOATl! .2 , 000 . 000
PROOUCTS COMplOP AGO .2. 0 0 0 . 0 0 0
PERSONAl & ADV INJURY .1 , 0 0 0 , 0 0 0
EACH occunRENCE .1. 000,000
FInE OAMAGE !Any one ...1' 5 0 . 0 0 0
MEO EXP (Any onlI person,' 5 , 0 0 0
500,000
COMBINEO SINGLE lIMIT ,
B
AUTOMOIlIlE UAIlIUTV
ABI7928701
02/05/96 02/10/96
X my AUTO
ALl OWNEO AUTOS
BOOll Y INJURY .
11'.' penon,
nooll Y INJURY ,
11'., eccIdenl)
PROPEItTY DAMAGE ,
AUTO OM.. Y . EA ACCIOENT .
ornER THAN AUTO OM.. Y: .. . .-
EACH ACCIOENT -'
AGGREGATE .
EACH OCCURRENCE ,
AGGREGATE ,
.
SCHEOUlEO AUTOS
---
X HlnEO AUTOS
X NON.OWNEO AUTOS
GAnAGE UABIUTV
_ my AUTO
EXCESS UABIUTY
olUMBnEllA FonM
-lornEn mm UMBnEllA FORM
wonKEns COMpEN!lAnON AND
EMplOVEn9'UABIUTY
--'i
50319279000
01/01/96 01/01/97
X I STATUTORY lIMITS . ..... .... .
EACH ACCIOENT ,1 0 0 , 0 0 0
DISEASE. POlICY lIMIT , 5 0 0 , 0 0 0
DISEASE. EACH EMPlOYEE .1 0 0 . 0 0 0
TIlE "normETOnJ
""nmEnSIEXECUT1VE
OFFICERS AnE:
omEn
1'!NCl
II EXCl
DE9CnlpnON OF opEnAnONS/lOCAnONS/VEHlCLESIIPECIAL MMS
B . II . I) t t I!XPlltAnoN bAn! THEREO", lHI! ISSUING COMPANY WlU. ENDUVOR 1"0 MAl..
. 111 olng epar men, 1 n
~ bAYI WRfTT1!" NOTICI! TO lHI! CERT1FICAn! HOlDER NAMU TO 1HI! L!I't.
BUT "AIlURI! TO MAIL IUcH NOTICI! 1tWJ..lMpOSI! NO OBUQAOON OR UAIlun
OF ANt kINO lIPo" tHI! COMPANY. ns AGEHTt on REI'nElEHTAT1YU.
AumORIZED IlEPREII!HTATlVI!
~)lS 8th St.
'.J ephyrhills,
Fl.
..^CP.ijij::::;~.;!(;;:(~(j'J.n!!;::::!!:!:r;;;:!;::::i{;;;;::::t}f:::;tmm::::::::::;:r:::::::f:::::;::::::i:%:m:::::::r::::mit!iPWWJfM1ilim:mMWiH;=~~milii.:i;~li:~~~i~ii;irHr!;i;;!lr:;Wa:A~Qtf;;!:l;;A#()~flOU.;ajli
..
..
BURTON FENCE, INC.
11315 S.R. 52
Hudson, Florida 34669
No.2-971h56'
Inv. # q ~-H::')l~ ~"l::.~_:
Pasco (8131857.1118 Pinellas (8131843-0155 Candy Locate. C)--/ (0 3 d;!~_~
Hemando (352) 688.3151 Zephyrhills (8131780-1747
Fax: (813) 856-6714 \ q, [J Yellow Pages r \ <, ~J" r ,-
FENCE CONTRACT \ r... '1,0 .8 Referral i Go.- , nl
. l \ \ " [J Repeat Cust v \' . ~.',; ,r,-,I
proposal SUbmi~~d to f~ ~ \' AI'J S 0 IV U Other ---------\f>.G -l:....' ' .;
Addc." ':;CjD1;- ~I~~~~; ~apL1- ~~AFA EIN.-.,7764
~::::n:~~: io~ .., - Contact eb-::1 c~~~t~ t.J~ . ~-7J2" ~~-~ ==.
Date Submitted 10/ 1- 7 2 D S-{-
I
TYPE FENCE
r1 . <'
-I
.;. SPECIFICATIONS
If c:')/f!' /- ,.
Top r~il" fe c. I1ft:1.
to follow grouod ~ I~' "
REAR
(0'
u
2{3.1 (p I
Walk Gate Drive Gate
tf II -- Swing
J/(cr~ l- ....- Gale
Roll
t
Une Post Type Top
S aCln
Ct1 lIB. '.~ ~~. cae
4/'J rf,. /ll'Itldv
To bp. leve' with
highest grade
r.J
Spill the gr",de
....1
Linp<; dp.rJr of
obstructIons -...I
1.-:".,
, ,
Finish Side of Wood
In ~.)
.......".....
<t
U Knuckle
U Barb-Up
~ Dog Earred
[J Pointed
D Flat-Top
U Olher
Wire Ga,uge
l-t 01.4 S!
Iff;
"+-
, . I II'
.1
~ "
SPECIAL INSTRUCTIONS
C C,n ('.....1;'3!1 f~
pesh; I~ ......
tJ f!-. () '.4 1'-'/
Pickets:
3Jq:t-&'p-
U 111/2x23/8'
iJ 1;> 1/2 x 2 2/8"
U 9 GA x 2'"
Post
Size
e/) o).J L ,,~Co.h I
pCl-s.t set ~ia(Clh
/'It -,rf -/-0 ~Ji)f 1<-" J
SPECIJ\L WORK TO BE
PERFORMED BY CUSTOMER
It/ I C le/:/?/ <,(
"cR(iSS' /?)T\ C
a,....s/,6)
Wall
Thickness
Line Post
Top Rail
Post
Size
W 13/8 U 15/8
Wall
Thickness FENCING
DIAGRAM
Key-
Fence line to
be erected _______
T" OM @
~:.::~~~.:r" 0
Exllllng F.ne. ........
,- --;
8ulkllngl .... _ _.1 .
W.I~ G.le cr' 0
Doubl. Gal. if b
Bu."'.' C)
Tr... ^
TERMS AND CONDITIONS: (1) All work shaU be completed in a workmanlike manna' according to standard pr8c1iceS in Ihe industry using lhe malerials specified alx>ve (2) Adrtillon~1 r."~'9"s may h~ m~rt~
bpC.311!'>P. of any change~ in specifications for the work or based upon unusual ground conditions (Including rock formations, hidden foundations. tree roots, water lines. 9pd personal sp,ink.ler linp.s. utility lines or ottw-t rn;Jtet'I;t1
oo!;lructions) involving extra costs: and any additional charges shall be evidencAd by a written change order. If such obstacles prevent completion of work, thft cuslomer will be charged only for tahor and material<; ll"'e<t (.1,
Burton fence, Inc. ~hall not bn liable for delays in compkttion of the work caus~d by events beyond ill reasonable control (4) Customer is solely responsible for the tocation for placement of the fence in thiS propoS;)1 ;"Jno WI!!
indemnify and hold Burton Fence, Inr. harmless from any claim by any third party pertaining to the fence k>catlon. (5) In the event that customer shalt faft to timely pay any amount to become riue under this r;ontr~(.l th('n
clJstomm 5tmll PAY to Burton Fence, Ine all costs of collection, indudlng court costs and 8 reasonable attomflY's fee, together with Interest upon the unpaid amount at the maximum rale permitted by taw All matert"'" ...h:.lll
mnmin the property of Burton Fence. Inc. until final payment Is made by customer, and Burton Fence, Inc. shall hays the right to remove such materials in the event lhat final payment is nollimely m~dp Cur.t()f"fWr ilgmp<;
!lUlt Burton Fpnr:p. Inc ~IHlll have a li*'n and security interest upon and against customer's real property (the job site), and that such lien shall be subject to enforcement and foreclosure proceedings pursuant to the PIOv1?;ions
01 Fln,id~ S'et,,'es Chap'e, 713 in the event 01 non.payment by customer. J ,ftll.ldfJ. ~1 5
sIJBM,mDontlle:3_dayol__fld-~--,199::1- . Lot; t.!wlf..(f(L W ov/)
Aulhorized Signature: _
ACCEPTED.: (~s'fm. .er hereby accepts a~. ~e s and condition )tated above, and authorizes Bu ence, Inc. to commence the work as specified
S~"'lureX__,.l4J~ '?JZTI1f;drflV DaI.-----.J~j1 7 ---~-, "
DOWN PAYMEN'r 2'S/~50"" 3: ~<eASH ON SET . BALANCE ON COMPLETION :n -,;;?..~--=
PAYMENT OPTIONS: 0 0 0 SF FINANCE 0 FINANCE OTHER
DO NOT SIGN BEFORE READING THIS AGREEMENT OR IF ANY SPACES INTENDED FOR AGREED TERMS ARE LEFT BLANK. RETAIN YOUR COPY.
CCIt EXP. ISSUING BANK
PLEft.SE CHARGE MY VISA/Me AS INDICATED ABOVE IN THE AMOUNT OF $
CARDHOLDER'S SIGNATURE
o~
x
NOTICE TO CUSTOMER: BE SURE YOUR CONTRACTOR HAS WRITTEN WARRANTYSAND GAUGES OF ALL MATERIALS SPELLED OUT AS AN INTEGRAL PART OFTHIS CON TRACT
~INLlNK: U 1 YR. 0 5 YR. U 10 YEAR GUARANTEE AGAINST RUST & CORROSION. WOOD: 05 YR. GUARANTEE AGAINST ROT & DECAY ON CYPRES...S.
I 10 YR. GUARANTEE AGAINST ROT & DECAY ON PRESSURE TREATED. LABOR GUA~NTEE ON ALL PROD.UCTS IS ON. E YEAR. a ~(J /
OTALPRICESINCLUDE:~MATERIAL~LABOR OTEAR.OOWN.HAULQ4PERMIT@ l\'l~)/3P.-J(. l-AJ/Sob l'1i)1) \K.) - t'