HomeMy WebLinkAbout98-7939
BUILDING PE.RMIT
Property Owner:
Job Address:
Parcel I. D. #
CITY OF ZEPHYRHILLS
(813) 788-6611 ;-
AFTER HOURS PHONE NUMBER !fV
(813) 788-526.2 ~._~
E~".. ~ '= FCHANI~ Sewer Conn
r--2 Y -liJt '1' (J -ttY=Z - - - ::::, ::,:,
:3 -_~ 7~, T_I.F.'s:
Permit
7939 III
f- 1-9i/
Date
~...
Zoning:
Description of Work
FINAL
NO OCCUPANCY BEFORE C.O.
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
~oh
7 iJ<2- ~?a-o
7f4Li(]~
PLU~"-' CHANICAL
--
City License Registration #
State Certified License#
~ /OO'o~
!~;L
Valuation or
Contract Price
BUILDING
-../
ELECTRJC-At:'~ .
.---
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 ($+6.E)()) shall be made for each trip for each trade:
ot~-:(JV
a.
b.
C.
d.
e.
f.
g.
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.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
> '."'.,,_,.,.c__.... ,:. ..."...~~"~'""'" .'""""'I..~.,.4.1JO.'-~41-....-.....~
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Kinsey Central
Heat & Air-Conditioning
P.O. Box 2209
Zephyrhills, Florida 33539-2209
(813) 782-2300
APNmIlNT
_ss
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, '_~1
CITY
-
IIOOll
1llI1Al1O_
o ESTIMATE
o CASH
o CHARGE
NATURE Of
SERVICE ~
REQUEST .
QUAM. PART NO.
DESCRIPTION
PRICE
AMOUNT
~
I.~
r', , t,
,-'
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(7
.f
/ ~ r
_<",4 -( '-',
( I ,>.d
c - ,) " I - ~,
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SERVICE PERFORMED lOTAl
1IAlPW.
ltQM:M.
IlEIMCE TM
TAX
7'-' t--'
1IA1I CllIIPlElBl
CASH ::-m--+
TOTAL
lECHNICIAM\
CUSTOMER'S SIGNATURE
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
JOB ADDRESS
ff' -l
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. ~..s2
v<-Cz'."
C;-~ .a
PHONE
,?DO
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70..2..6
OWNER'S NAME
OWNER'S ADDRESS
LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION
PARCEL 1. D. t / /-,2/, - !X.. 1-- ~O( /') -;Y 6.R D t> - t!)() 10 (OBTAIN FROK PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition ---""Iteration _Repair _Install
_Sign.
_Kove
_Deaolish
PROPOSED USE: _Single Faaily
_KIF
_t of Units _K/H
_eo..ercial
_Indust.
_Swim. Pool _Other
Restaurant & Health Departaent Approval
- IS-
DESCRIPTION OF WORK: {1!,1F"~ 1""07'./01 L/AI;I Cha~__ ~
BUILDING SIZE:
x
Square Feet.
Height
RESIDENTIAL:
COMMERCIAL :
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
_ELEC'fRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
_MECHAIflCAL
$
57 ~ O,~ Valuation of Kechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fraae _Steel
Other
FIRISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
CONTRACTOR SECTION
COMPANY
State Cert. or Regist. t
City License Registration t
******************************************
RUTT.DER
Signature
SignAture
COMPANY
State Cert. or Regist. .
City License Registration t
******************************************
F.l.E.C'fRICIAR
COMPANY
State Cert. or Regist. t
City License Registration #
******************************************
COMPANY ~j<.)sy C~p';r~
State Cert. or Regist. f c?CJ s-y / .\..
City License Registration t / 8 ~_
******************************************
PLUMBER
Signature
MECHANICAL
Signature
,~~.
OTRF.R COMPANY
State Cert. or Regist. .
Signature City License Registration f
******************************************
APPLICATION APPROVED BY PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
rbe under.lgoed undersland. lbel thl. penoil ..V be .ubJecl 10 'deed r..lrlcli.... vbieb ..V be sore restrlcll.. !has Cily
regul.lion.. rbe uoder.igoed "'Wle. re.pon.ibilily for coopllance vllb any .ppl/cable deed r..tricl/....
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
ff lbe ...er bas blrol · oootr,clor or coolr.clor. 10 uoderlale ..rl. they ..V be reguirel to be Ilceosed 10 accordaoce vlll
.1.le and local regol.I/.... If the contr.ctor I. 001 Ilceo.oI .. regoired by I... both Ibe ....r and onotractor .., be
cfted Cor · .I.d....oor viol.l/on under .lale I.v. IC the ....r or lolended conlr.clor .re ..certalo as to viol II....fng
regolr....l. IO, .pply Cor lbe lolesded vorl. they .re .dvl.ed 10 cool.cl lbe CII, DC Zepbyrblll. Building Deparbossl. (811)
788-6611.
FurlberSDre. IC lbe Wloer bas bired · conlr'ctor Dr coolr.clor., be I. .d.l.oI 10 10.. the CDotractor(.) .Igo porll... of the
'Coolraclor Secllon.' oC lbl. 'ppllcati.. Cor vblcb they viii be responsible. If roo. as the own" sign .. the cootraclor.
you are indlc.llng lbal YOU. r.ther !ban Ibe CDolr.clor. .re r..ponslble for lbe vorl. ff the contr.ctor vishes you to .ign
.. coolr'clor thel .., be .0 1001c'llon Ib.1 be i. 001 properly Ilc....d and I. 001 enlllled to peraJlliog pei'iloges 10 the
City of Zephyrhil1s.
C. TRANSPORTATION IMPACT FEES AND U'l'ILI'l'Y CONNECTION FEES ,,~
D. CONSTRUC'I'ION LIEN M\W (CHAPTER '113, FLORIDA STATUTES, AS AME1fDED)
I cerlif, lbal f. the .pplicanl. ba.e been pro'ided vith . copy oC 'Florlda'. Coo.trucll.. LI.. Law _ BOIeovoer'. Protecllon
Guide' prepared by Ibe Florid. Deparlleul uC Agricullure and Coosover Aff.ir.. IC lb. appllcanl I. ....... otler tban the
.....r.. f cerllCy 1b.1 I be,. obl.loed · copy DC Ibe .10.. d..crlbed do.....1 .od prooi.. 10 good f.llb 10 deliver II to the
"owner" prior to co..encelent.
E. CONTRACTOR' S/OWNER' S AFFIDAVI'l'
I cerllfy lbel .11 the 10fo,,"1100 10 Ibl. .ppllcalloo I. .ccur.le and lbol .11 ..rl viii be done io COOPllanc. vllb all
applicable laws regulating construction, loning, and land developlent.
I
Application is hereby lade to obtain a perlit to do wort and instailation as indicated. I certify that no worl or
10.1.11.1100 bo. COIIenced prior 10 i.....c. of . persil and lbal .11 vorl viii be perforoed to 1001 .laodarda of all I...
regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. lalso
certlf, 1b.1 I uoder'l.od lbal the regul'lioo. of olber guv'rnoeolll .genel.. IO, .pply 10 the inleolol VOlt. and 1101 II I.
Iy responsibility to identify what actions I lust tate to be in cOlpliance. Such agencies include but are not liJited to:
· Deportoeol of Eovir.....I.1 Rooul'llon - Cypr... 8aybeads, Kelland Ar... and Ro,lrooooolall, Sonslll.. lands.
Nater/Nastewater Treallent
t Southwest Florida Nater HanageJent District - NeIls, Cypress Bayheads, Wetland Areas, Altering Watercourses
t ArlY Corps of Engineers - Seawalls, Docts, Navigable Waterways
· De arloonl of Reqllb , Rehabllilali,. Ser,/ces Rovir.....I.1 Health Boil - lell.. IOsI...I" r,,"loonl, Septic ranis
t US InvironJental Protection Agency - Asbestos abatSlent
I .1.. cerllCy thol, If IIII ..leri.1 I. 10 be uooI In Flood Zooe 'A' or 'A.elc.'. II I. underolood 1101 a dreloage plan
addr...iog a 'COIpens.llng ..I.... viii be 'ubaltled vbleb I. prepared by . profession.1 engineer regl.terol Ie 110 Slate of
Florida prior to perlit. issuance.
. A per.il f..oed shall be conslrued 10 b. · licoo.. to proceed vith tbe vorl ..d nol .. antborll, to 'iolate, COOO!l alter, or
'.1 ..ide ao, pro,l.i... oC tbe lechoical cod", onr .ball i.suonce of . perlil Preveol tbe Building Official fVOl tIoroofter
r.qulring a correction of error. io pI.... coeslruclJoo, or ,ioi'li... of any code. RIOlJ IOCIit Issued shall becooo Ioralld
uol... Ibe vorl authorilOl by sucb POllII I. c.....cod vlthin .1, IOUth. of I......., or If ..rl IOtborlaol by the IOCIiI i.
.- or abaodooed for · periol of .ia IOUlbe .fler th. tile the vorlie .....cod. !me 10 da, OIleeslon of tile, .., be
.11...d Cor tbe perolt vith fee cbarg. of li5.00. Tbe OII...lon sball be reqeOlled 10 vrlllng to 1Io Bolldleg Official. Au
approved inspection lust be logged during each six IOntb period, or the project wiU be considered abandoned.
IlARlIIIIG YO 0I0I1ll: 1001I FAILlJRR YO RRCOIlD A IO'IICB OF CIAIIlBRCBIoln lIAr IIIlSULr II 1001I YAnllG filCH FOR IIIFIiOVIaIms 10 100I
PROPIRTY. IF YOU INTIND TO OBTAIN FlIfANCING, CONSULT NITH YOUR LINDIR OR AN ATTORIIY BIFORl RlCORDING YOUR NorICi OF
COHHIN~HENT. JOBS UNDER << ,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTlCI OF COHMINCIDIINT".
-SIGNATURI: CONTRACTOR
. I
STATE OF FLORIDA
COUNTY OF -r~, C-O
The foregOing in~ument was acknowledged
before me this \ , 19 -9.B by
T e ('( L..\ ~,\ ~E(d.\ ~ (" :;-
who is per~onal y known to me or who has
produced V'rrL~ Y'I Th ~
as identification and who did/did not
~e~an 'oath\ \
i. () L-... ;:) \. ,
( S.,igDature) ~
t\ \ep~ l::::>e{~\.,\~~
(Name Typed, Printed or Stamped)
NOTARY PUBLIC EILEEN W. HERMAN
MY COMMISSION , cc 418846
EXPIRES: AprIl 30. 1999
IlCIlldId Tllnl Nl*IY NIle l)IdrMIIIII
STATE 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.
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
111111111111111111111111111111111111111111111I1111
~81060~6
Rcpt: 265631 Rec:
DS: 0.00 IT:
0~/01/~8
6.00
0.00
Dpty Clerk
NOTICE OF COMMENCEMENT
state of
F(~.
County of
P/i-~co
TUB tmOERSIGNBD hereby gives notice that improvement will be made to c~rtain
real property, and in accordance with Chapter 713, Florida Statutes, the
following information is provided in this Notice of Commencement:
1. Description of Property: Parcel No.
II-~b -~/- OO(tJ- 111 BtJO - Ot)/O
(Legal descript10n of the property and street address if available)
2. General Description of Improvement
/? /o-x> ~, UP; f
Ch#,,-,$P
~
O"ncr Information: Name , S"'A j, -/....' 1>-7 ~
Mdress :?g~~o ~ ""-<-City .2Y7,),/I:
Interest in Pr.operty: t9 W NliJ../
/C/~
I
state ;ch.
3.
Name of Fee Simple Titleholder:
(If other th~n owner)
JED PITTMAN, PASCO COUNTY CLERK
09/01/~8 02:22p. 1 of 1
OR BK 3998 P6 1534
Address
City
State
R
Contractor: Name
Address
5. Surety: Name
Address
City
State
Amount of Bond:
6. Lender: Name
Address
City
State
7. Persons within the State of Florida designated by Owner upon whom
notices or other documents may be served as provided by section
713.13(1)(a)(7), Florida Statutes:
Name
8.
State
Address
9. Explrat..ion dnta ot Notice or Commencement. (the expiration cat.e is 1 year
fr0m the date of recording unless a different date is specified.)
~gnature of O\olner:
Sworn to and subsc
,-r-r:: 0 o_u. I U C
c;. ""I (...... r,lL.r~'-rnrJ(,-
this
day of ~ j ~ L..Q..... \::. ,
19~.
Notary Public:
lD ~~~
fit COMMISSION' co 458845
EXPIRES: ApfI30. 11189
My Commission Expires: