HomeMy WebLinkAbout98-8025
BUILDING PE,RMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
8025 11
Date
1& -}J..-9J-
BUILDING
ELECTRICAL
PLUMBING
~A~
Sewer Conn
:::,~.:~etl t;L--JJ:;:l~~ f)A-
Parcell.D, #
Water Conn:
Water Meter:
T,I.F.'s:
Zoning: ,Energy ~~
DescriPtion of Work ~ / C- J C?
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
DATE
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
p~'mit Fee 2 ~.z ~
Signature a. ~ ~
Company
Address
Telephone#
Valuation or '/ to,
Contract Price d;/ I. 0-0
City License Registration # ~~
State Certified License#
11,1'
VS1~t
/.J- Cd!' I' 0
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 ($ 25.001 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.
Ofd-o CJ:JcJOCJ e8SV
N~ 102282
PINELLAS: 397 -0500
PASCO: 845-3767
HILLS.: 877-1965
MANATEE: 750-6626 '.
ALL OTHERS:
1-800-570-5665
DATE ~ ~ '? ~
f
ST
CALL
HEATING & COOLING, we.
1174787TH STREET NORTH
LARGO, FLORIDA 33n3
C3 d-6 d /
Carrier
fiVE STAR DEALER
~
,
NAME
ADORESS
CITY
~/
JOB LOCATION
EQUlPMFG(2)
OlliER WORK PERFORMED
COMPSIN
22 JOB
COMPLETE?
COST SOURCE QUAN. DESCRIPTION PRICE ITEM COST HOURS r CHARGE
/ 1Ri,( .3{ T /#' ~.o. REG. HRS ?T 2/'77: co
, - .
7 OT HRS
/ MATEAlALS
lISe. SlJ'PI.V CHG.
VO_" .-CI dl. (ll +Lt:1) 4~ \I ~ ~
I ~ 0.- ,.-.f) CODE
-" -:::: ~ ~7":r"" f /. ///:2 -1)!
SUB TOTAL V~"/ df)
.
FLTAX -
TOTAL BIWNG 2/71,tffJ
AMOUNT COUECTED ~
77!-U t?AI.tJ ~( ,/ ~uJBALANCE DUE rf .2 /'77. 0"0
, /
$20.00 CHARGE FOR RETURNED CHECK.
BUYER'S RIGHT TO CANCEL
Thie Ie atona 1ClIIcilIIIIon..... and If you dllllClt wanlllla gooda or ..w:aa. you may cancal thIa agranent by provkIng wriIlan nolk:e 10 lIla lIlIller In pnon.
by talagram. or by mall. ma nolIca muallncll<<:* thai you dllllClt went lIla gooda or ..w:aa and mual be deIlvwed or posImarked before midnight ollila lNrd bualnesa
tat aIIar you aIgn thIa ~ If you cancal thIa agranent. lIla....., may llClt kllllp .. or pert 01 81ft caah down peyment.
RacaIpt ollila IaragoIng Iluyat'a AIs;IW .n Cencella hereby ackllowledged on . 18 -.
TIME ON JOB
ON
OFF
TRAVEL llME
TO
FROM
SHOP llME
ON
OFF
I have authority to order 1he work. which has been satisfactorily perfonned, as outlined above. It Is agreed "Thank you
1hat 1he seller will retain thle to any equipment or material 1hat may be fumlshed until final payment is made, for thl. opportunity
and If settlement Is not made as agreed, 1he seller shall have 1he right to remove same and 1he seller will be held to .erve you. ..
harmless for any d~S resul1lng from 1he remo ereof.
You are ~ot obll eel t Y any mone~ unl you sign this contract and return It to the seller. ~
Customer's Slgnatu ~ Technician's Slgnatur~/ ~
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CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Tbe undersigned understands that this perlit lay be subject to Ideed restrictions I whicb lay be lOre restrictive than City
regulations. the undersigned assUles responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas bired 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 wbat licensing
reguirelents lay apply for the intended work, they are advised to contact the City of Zephyrbills Building DepartJent, (813)
788-6611.
FurtherlOre, if the owner bas bired a contractor or contractors, he is advised to bave the 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 the contractor wishes you to si~n
as contractor that lay be an indication that be is not properly licensed and is not entitled to peraitting 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 - HOIeowner's Protection
Guideu prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sO.leone other than the
lownerU, I certify that I have obtained a COpy of the above described docuaent and prOlise in good faith to deliver it to the
lownerl prior to COIIeDCetellt.
E. CONTRACTOR'S/OWER'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 cOMenced prior to issuance of a perait and that all work will be perforaed 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 governaental agencies laY apply to the intended work, and that it is
.y responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
t Departlent of EnvironleDtal Regulation - Cypress Baybeads, Netland Areas and Environaentally Sensitive Lands,
Nater/Nastewater Treatlent
t Soutbwest Florida Nater ManageJent District - NeIls, Cypress Baybeads, Wetland Areas, Altering Natercourses
t ArlY Corps of Engineers - Seawalls, Docks, Ravigable Naterways
t Departlent of Health' Rehabilitative Services, EnvirODJeDtal Health Unit - ~el!s, Wastewater TreatJent, Septic Tanks
t US EnvirODlental Protection Agency - Asbestos abateJent
I also certify that, if fill laterial is to be used in Flood Zone IAI or II,etc.l, it is understood that a drainage plan
addressing a vCOIpeDSating volDleI will be sublitted which is prepared by a professional engineer registered in the State of
Florida prior to perait issuance.
A perlit issued sball 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 perlit issued shall beCOle invalid
unless the work authorized by such perlit is couenced within six IOnths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six IOnths after the tile the work is COIIeIlced. One 90 day stension of tile, lilY be
allowed for the perlit with fee charge of $15.00. Tbe stension sball be requested in writing to the Building Official. An
approved inspection lust be logged during eacb six IOnth period, or the project will be considered abandoned~
NAIUUNG TO OWNER: YOUR FAILURE TO RECORD I ROTICE OF COHMI!ICIDIENT MAY RESULT IN YOUR PAYIRG !NICE FOR IMPROVBHEHTS TO YOUR
PROPERTY. IF YOU IIl'I'BIID TO OMAIR FlRARCIRG, CONSULT NITH YOUR LlRDER OR Alf In'ORIIEY BEFORE RECORDING YOUR HOtICK OF
COMMERCBHEHT. JOBS UNDBR $2,500 IR VILUE DO ROT REED TO RECORD AND POST I IROTICE OF COMMBRCBMmI.
SliJ*1mJ2/-
(/U ;/ kZh
IGNATURE: ~Il'I'RACTOR
STATE OF FLO~I . ~L- /:?
coum OF ~5CO
The foregoing inst~jPt was acknowledged
before me this //1 I. , 19 ;;.P' by
-:Tif~ 1h4!6~ ,
who is personally known to me or who nas
produced f)A!.(Vas- J.(t1'Nrr
as iden 'fica ion and who did/did not
take th.
STATE OF FLORIDA
coum OF 'fit ,.: I~'~ ~ s-c d
The foregoing inst~ent was acknowledged
before me this It) I.).... , 19.2cL. by
(Si
'" ~ ,
(Name, Typed, "~~~t~4.,,Q.~,,~~9..~ '~\\\\\\\\\\"I'
NOTARY PUBLIC: ,,~l\V "U4. John J. Aaron ~
, : ~~r Notary Public, State of Florida ~
: . ~W1_~ Commission No. CC 578428 (
:: ~ OF f\.\\~ My Commission Exp. 09/3012000 ~
.: I-SOO-3,NOTAIlY - Fla. Nolaly Servi"" ole BonoIina Co. (
, ((((((((((((((((((((((((~((((((/(((<.':', '((1((1((((( ~
,.)
(Name Typed, Plbt't~P"~"-&taIOpe , ,",\\\\\\\\\\\ ~
NOTARY PUBLIC': ~Iol\ u#<.... Jo~ J. Aaron . (
'. .. ~.. Notary Pubhc, State ofFlonda ~
: . ~.,~ Commission No. CC 578428 (
:: ~ OF f\.\\~ My Commission Exp. 09/3012000 ~
': 1-800-3-NOTAIlY - FIa, Notary Service ao BODdilIa Co, ~
',((((((((((((((((((((((((((I'((a,~<'/(a.~(((It(((((((. (
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