HomeMy WebLinkAbout98-7763
BUILDING PE,RMIT 7163 13
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
Date --5 -- 1~-)9 r-
~IL~
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
::~::::.:~e'zj(7r ~,/
Parcell.D. #
Zoning: Energy Code:
DescriPtion of Work~ d '~7
Water Meter:
T.I.F.'s:
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
- e-2-
DATE
Complete Plans. Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances.
City License Registration #
State Certified License#
ol-/f-
Permit Fee
Signature
Company
Address
Telephone#
Inspector ::z::;::DATE
~~~
Valuation or
Contract Price
[ tj ~:? o-v
I~,~J :13/1/1-
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
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 ($4-&:'60) shall be made for each trip for each trade:
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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 PERKlT
CITY OF ZEPHYRBILLS
BUILDING DEPARTMENT
@
OWNER'S NAKE
6cxf.. " (--all ~
llSD h~\t Bhd)
1 \4L\ 1\.\\1 lCWl tl
PHONE
'7gZ. P\~
OWNER t S ADDRESS
7 '~H\\~ , fL ~354-1
.
J)'f\\i{2' ",",'\\ \~
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I.D.' (OBTAIN FROM PROPERTY TAX NOTICE)
Roe .,f2vcf'
WORK PROPOSED:____New Construction ____Addition ~teration ~Repair ____Install
____Sign
--"ove
____Deaolish
PROPOSED USE: ____Single Family
____M/F
____, of Units ____M/H
_eo..ercial
_Indust.
_SwiJR. Pool _Other
_Restaurant & Health Departaent Approval
DESCRIPTION OF WORK: ~\J \~ \~ RQ' ~()uf () ~ "'1,.:)
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
$~1. U\)
Valuation of Total Construction
____ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
____HECHAlfICAL
$
Valuation of Mechanical Installation
____PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ____Block ____Fralle _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
....*.*.*************.*********.*.********
CONTRACTOR SECTION
BUIIJ)ER
Signature
COMPANY
State ~ert. or Regist. f
City License Registration .
***************************.**************
ELECTRICIAN
SianAture
COMPANY
State Cert. or Regist. f
City License Registration ,
******************************************
PLUMBER
COMPANY
State Cert. or Regist. f
City License Registration f
******..*.*******.*.*****.**.***.*********
Signature
MECHANICAL
COMPANY
State ~ert. or Regist. #
City License Registration ,
*******.**********************************
Signature
Signature
~ - COIfPANY IJ'J, I jj~>, {/M<:!rJ ,/II v'l, I /~ <
i ~. State Cert. or Regist.' t, QiJ5SLI'<;
. City License Registration # 21.5
******.*.******************..**.**********
OTRRR
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PEJ~IT AFFIDAVIT
A. NOTICE OF DEED HES1'IUC'l'IONS <
The undersigned undersLands L1lat L1lis per.it .ay be subject Lo "deed restrictions" which .ay be .ure restrictive than City
regulations. rile undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CON'l'IU\C'l'OnS AND CON'l'HAC'l'On UESPONSIBILI'l'IES
If tI,e owner I,as I,ired a contractor or contractors to underLake work, they .ay be required to be licensed in accordance with
state and local regulations. If the contractor is not licensed as required by law, buth L1,e owner and contractor .ay be
cited for a lisdeleanor violation under state law. If L1le owner or intended contractor are uncertain as to what licenSing
require.ents .ay apply for the inLended "orl, they are advised to contact the City of Zepllyrhills Building Depart.ent, (813)
788-6611.
FurtherlOre, if the olfner has Ilired a conLractor or contractors, lie is advised to have t/le contractor(s) sign portions of the
"Contractor Sections" of this applicatiun for which Lhey will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, rat/ler t/lan L1le contractor, are responsible for the work. If the contractor wiShes you to sign
as contracLor that lay be an indication that he is nut properly licensed and is not entitled to per.itting privileges in the
City of Zephyrhilis.
C. TRANSPOH'l'A'l'ION IMPACT FEES AND U1'ILI'l'Y CONNEC'l'ION FEES <",
D. CONS'I'UUC'l'ION LIEN L1\W (CIIAP'l'EH 713, FLOIUDA S'l'A'rUTES, AS AMENDED)
I certify tlla~ihe appIica~i~ve-been provided with a copy of "Flurida's Construction Lien Lalf _ Ho.eowner's Protection
Guide" prepared by the Florida DeparL.ent of IIgricuHure and Consuler Affairs. If the applicant is so.eone other than the
.owner", I certify that I have ubtained a copy of the above described docu.ent and pru.ise in good faith to deUver it to the
"owner" prior Lo co..ence.ent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infor.ation in this application is accurate and that all work Ifill be done in co.pliance with all
applicable laws regulating constructiun, loning, and land develop.ent.
I
Application is hereby .ade to obtain a per.it to do wort and instailation as indicated. I certify that no work or
installation has cOllenced prior to issuance of a per.it and that all work will be perfor.ed to .eet 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 governlental agencies .ay apply to the intended work, and that it is
IY responsibility to identify wllat actions I lust take to be in co.pliance. Such agencies include but are not li.ited to:
I Depart.ent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and Bnviron.entally Sensitive Lands,
WaLer/Wastewater Treat.ent
I Southwest Florida Water Hanaqe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
· Jr'l Corps of Engineers -Seawalls, Docts, Navigable Naterways
· De arttent of lIealth & Rehabilitative Services EnvjronJental Jlealth Unit - Wells, Wastelfater Treallent, Septic Tanks
· US Environ.ental Protection Agency - IIsbestos abate.ent
I also certify that, if fIll laterial is to be used in Flood Zone "II" or "1I,etc.", it is understood that a drainage plan
addressing a "co.pensating volUle" will be sublitLed whicll is prepared by a professional engineer registered in the State of
Florida prior to per.it. issuance.
. A per.it issued shall be construed to be a license to proceed with tbe work and not as authority 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 trOt thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becOIe invalid
unless the work authorized by such per.it is cOllenced within six lonths of issuance, or if work authorized by the per.it is
suspended or abandoned for a period of six .unths after the ti.e the work is co.lenced. One 90 day eltension of tile, lay be
allowed for the perlit wilh 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 .unth period, or the project will be considered abandoned.
WARNING TO OWNBR: YOUR FIIILURK TO RECORD A HOTICH OF COHHBHCBHHHT HAY RHSULT IN YOUR PAYING TWICR FOR IHPROVEHRNTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTIIIH FINIIH lNG, CONSULT WITH YOUR LBNDHR OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
ClIIIIINCEIIIlNr. JOIIS DIOIR 12,500 IN VIL 00 IlOf RJ RIlCtlllIl 8JI~ rl<< JCiMUr. .
~-fuUHE: CONTRACTOR
STATB OF FLORIDA
COUNTY OF P~i-O
The foregOing instrument was acknowledged
before me this g 1YJJy, 1~ by
~{f Lv m JWV]
who is personally known to me or who has
produced
as identificati
take an oath.
STATR OF FLORIDlI
COUNTY OF ~. ~ ()
The foregOing instrument was aCknowledged
before me this g m~ ' 191ZL- by
V CYW:i' I L fV} I/fv~
who is personally known to me or who has
produced
as identification
take an oatl
(Signature)
OLlIJ1A A, LOVf: Tf ,
.;t~'"v. Nota, ry Pu~lic 3tate of FlOrida
'" ~ My c>mm eX;Jires Julv 28, 2000
~ . -' ;; I' Ccmm, No, CC512916
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC O' .,,~ A' "'.I"ll
d\~-h. . Lv ...: 'd
"'~AG<. Notary PlJ~:iC.' :ta~e o. Fle:l}
",'" .-~ M '~'Tlm 'xpi'~s Julv 2oj. 2<100
I ~ ~I ~:;mil~ Nc'CC51291o I
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
~...
_':U .LBar Const. r uc.t. ion, I nc..
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~ MilBar Construction, Inc.
Rooflflg . ~ . Conwnen:lII' ReIlderAiIl
lsen us HWY. 301 Nolth. Dade City, F10ricja 33523 Oc
352/567-6047 . 800f502023t3 . FAX; 35215tS1-4W54
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U.S. tntec Certifted
PlatInum Inttallet
15204
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Roo" #CCC051562
State FleQistered
Roofer .RCOOS5215
Rei ReglwtereQ
Roof CoMUttant 10149
FAY GORE
STReeT
I"'HONe 0'-' TIi
813/782-121~ OFFIC 03/25/96
JOB NAMIO
~ sullMlTTeO TO
77" GALL BLVD. GORE RENTAL PROPERTY ,
ClTY,STATUndllPCOoe-' J08LOCATlON AL.PHA VILL.AGE \
ZEPHYRHILLS, FL 33S41 7144 ASHLARD DRIVE
AACHlTeCT O^ TE Of PlANS Joe PHONI I
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.~:..:.~;~i;=1~~:d. iia_u.~.~.y: :~i.ting . on..__i:~:=.hi~gl. . roof in. .y.t~';;~C1;;~"~::r:..r.. ]1
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'coior'~""""-GAf' .bingle.' ba'Ye a 20-year ".rranty on labor and _at"rials. I:
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9. :~~~: t~~:~o:~::~ica-.'..--f'or---"ci;frv-.r'Y"'-truCkli"''''tc'-'"'.1"1'0.''' 'rooi'''To.dIng7unfo-.aIng'''1or''the"--''''ll
BIt propos' hereby to furnish material and labor - complete in accordance with above specifications. for the sum ~\
SEE PAGE TWO. .!
P~lIO be made .. foIlow5; -- (lOII<<~I'l;~' ' ), \
".-. '"'4-~'''-''-''-R.'piace'-'ai'i-'d.'.ilia'ged' '"i i .eb'i ngB<v'ai i.y ~'''''vent ~.._" or" "an y wall ! i..h'i'rlg')'~'
I"" ""~L"'''''''- pr'ov'id.' "..'nd-""i'n.t-.ii'''ne',i''-'lead -'boots" {'or ..'t'h."p'iu.bing' vvnt..
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\ mariner ~cIIng to ''-''Ow "'~, Arty elIeratlon or devia1ion lrom allOY. .pacifiQdon.
~ invOMnll elCtra OOIla will t>. b:ltCvted only upon Wl1ll1n orlMr.. and """' lIeCOme an em.
L eharQe over .,,0 aDOVe \I'le ntImate All ag~lS CQnlinQent upon ..,Ik... 1ICll:l0en\5
or detayllMyonO our control. Owner to oarry fir.. lOrNldo ana otner ~.ry I/'\5Urance
Ou, work.,. IItI fully COY9I'14 lly WorlcrNn'a Compen$8tlOn Insurance
~ 1\ rrrnt "-nt'" nf "rnnn~"1 I
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Note: This r.0p0s81 may be 30
withdrawn by ua if no accepted withIn
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I MIISsr Construction, Inc. Rooter .cocos' 562 ,
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I U,8.1ntec ~ I'looIlng . ~ . CcammlrdII' Rni<lenI..1 Stale R~f4l<l i
PIallnum I . 15911 US Hwy. 301 NoItI,. Cede City, Florida 33523 <> Roofer IR 52 t ~ I
#5204 Rei Registllred I
352J667~7 . 8001'82.23t3 . FI>:j.,: 352JS67.44~ RoofConfUlant~14~ i
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Pl\QPOSAl. SUIII.PT~[) TO I ~ON! Il).t.T~ i
FAY GORE 6131782-..~~J~. Of"Fl<f: 03/25/'38 i
STRE~ .1011 NAM~ ..-1
77511 G.LL BLVD. GORE RENTAl. PROPERTY .--........-
CITY. STATE ,nd ZIP CODe I Joe l<:lc.1"OO'" ALPHA VILLAGE
ZEPHYRIILLS. rL J3~41 7144 ASHLAND DRIVE
AACHITECT OAT!: 01' ~ I JOB PtiONe
I ZEPHTRH I I..Ui.
1 I FL
, W, h.r.by ...bm~ ~e6li<ln' and ..t"""'.. \0'.
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In.uranc. (.1,~00,ee0 limit) and re-roo11ng p~rm1t, I
Ill: -~~-IO.~~;1:;.~=;~.t. ,0'0 1.1. 01 0.'.'.: h ~'.h.d .1 om,... ,i... v.~t; - ADD . Ii
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.t 'roPOIf hereby to furnish material and labor - complete in accordance wit" 8t:love specifications, for the sum 0.': r
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OlE THDUSAND tIGHT HUNDRED FIFTY-NIKE AID ee/lee----------------- ($ 1 8~9 ee 11.l M.~bcQe
~oIlars ,. 1
paymenttooem.,..folloM: 9~,C~ljL' ~
DUt UPOI COKPLETION. (,' iJ0
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II ~:':':onnIWdtobe.. or'-or "'rroma_~on..
I ~ ... -- wi' be ...~ only upon wriII... 0'.", ..ul WIll beo:orM .. .-
l c:lOIlroe over .m lItIcrw ". ..mete ,t,I1 ...",.-.ts oonfI"llf'II upon mk_, II:lCiQeI\lI
or CI8I..,. Deyond OUf control. owner 10 cry fire. ....""ClC> and 0IMf
Our worKer. .. Iullr CllI\IWIIO !IV Worlvnan'S . ,
" ... .w'." . .,.--
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'/ ""eplant! of 'rapollIl- Theeb~ pri=U, spe<:lflutions
.nd conditian, are ..tt".ctory .IId ..-e hereby acceD~Cl, You 'lIiillf . iId Signature
10 do ltlt work as specified. Psyment will be mlde ., outlined abCM!,
Dat. of~: Signature
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