HomeMy WebLinkAbout99-8871
BUILDING PERMIT
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CITY OF ZEPHYRHILLS
(813) 788-6611 "..
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Permit
8871
Date
1/- 1- 9:7
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Parcell.D. #
4~
,
FINAL
NO OCCUPANCY BEFORE C.O.
Complete Plans. Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
V I' -4- 0 vc;
a uatlon o~ . ~ c5? {{,'-
Contract Prrce
ignature
Company
C;tv Uconso Rog;"'.';on · -:n~fiJf;; V Adere.. :;;
State Certified License# c.. ~ -' ~ ~elePho~#) 7?/2... s'1."6'~
- CC)Y~ ~
~~u~ L~ MECHANICA~
BUIL~-
~
ELECT~.e'
..---
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
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 ($ 25.00) 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.
HARPER
since 1911
5401 benchmark lane
sanford, florid a 32773-6433
phone (407) 321-8100
fax (407) 323-7007
September 3, 1999
City of Zephyrhills
Building Department
Zephyrhills, FL
Re: Mechanical Permit for
Zephrhaven Nursing Home
Gentlemen:
Please accept this letter as my authorization for Mr. Jack Winter
to apply for and pick up the Mechanical Permit on the above
subject, in my absence, as I am the undersigned state certified
license holder for Harper Mechanical Corporation.
Very~, y yours,
//'~~X4/~C~
Russell E. Moore
Manager, Design/Build Services
Mechanical License #CM C042548
HARPER
since 1911
RM:tl
STATE OF FLORIDA
COUNTY OF SEMINOLE
The foregoing instrument was acknowledged before me this 3rd day of
September, 1999 by Russell E. Moore who is personally known to me
and who did not take an oath.
~-~ ct, -L~~~~
Terri L. Licking .J
Notary Public, State of Florida
My commission expires:
..."~ Terri L UCkiI'l9
;~~ *My commiSsion CC826000
.....~ ExpIres May 21. 2003
l't"","'-
MAY-25-'99 TUE 09:59 ID:
TE:.. t<i:
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~c:r.n~ I'CIIl P..a'r
eIft ar KDD1UrXLLa
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taft ~....
~ M\'DW ..
OlIIi/ER' II NAME
ZEPHRHAVEN NURSING HOME
38250 AVENUE A ZEPHYRHILLS, FL
':
PHON&
813-782-5508
JOB A!)~RUII
UGlU. IlEScru P'J'ION: LOT' 5 I
BLOCK
SUBDIV1l101f
PARCEL II> ff
IfORJ[ PllGpamh ON" CONSftl1CTION
DSIQI
tna.,.A.TIf rRtW >>an.RIPPY 'Pay .""'T~l
1:lA!)~I'.l'ION
o Hem
gJALUlwnow
C DIMOLISB
o RBPAI~
C IIISTA1.1.
PJtOPOSI:D USE: DSGL P'APlILY D1fE:LLlflG
~RCIAL
CKU1.T:-F.\NILY
[J DlW.TRaL
O. or UHI'J'S
~~HImIG I'OOL
o MC$IIZ BOllE
OOftlI:R
BUILDING SIU
r:::::1 RESTAUMHT , m:.\1.TK DEPAIt'l'MDrr APPROVAL
NEW SUPPLY AND RETURN AC DROPS
D!:SCRlP'J'ION or WOM
SQUARE rooTAGE
D:tGII'1'
RESII>BN'2'IAL:
CXM(ERClAI.,
A'J''rACII (2) PLOT PLMS .. 121 SZ'!'S or aUILIl:i:t1li PLMa , (11 aft !2fI:JlGY PORMlS.
A'l'1'ACII 131 afts or JlVI1.DING PIMS , 11> an ENERGY 1'OllM5.
PROPI:R'1')' Sl1J1WY REQUIRED FOR ALL IlB1f CONSTRUCTION.
REF:
8777
PZRHITS REOOI:Sn:O
o IIUILPllfG
o E1.BC'!'RIQI.
C P:LUMBIHG
m M!:CIL\NYCN. $
C CiM OROOf'ING
.
VALUATION OF' 'J'O'!AL CONSTJWC"J'IC>>l
AMI' SEIWICE
o n.oRI~ POW!:R
o ..~.E.C.
$1 ,286.00 VAIrUA'J'ICIH OF HSCHAHcIAL IHlI'J'Al.1AnOlf
o BPBCL\L'.l'Y
o 0'1'HD
C1 TAAHE
O$':'EtL
o OT1llJl.
TYPE or CON5'l'II.UC'!'IOff: 0 BLOCX
FINISHED FLOOR ELZVA'.l'IONS
IS PROJECT IX FLOOD ZONa ARaO ns n NO
1,,;':'i;;n.r7:;;:!lf!~~:,f~;;;~~~!~~~~,.~
IIlnUlml COMtAN~
"ME CER'1' OR UGIST ~
SIGNA'1'lIIU: C::Z'TY PJtOCESSIlIIG I
~................+.........,......................................
~C1U
SIGNATURE
COMPMN
S'1'ATI aRT OR UGIS'l'
CITY tAOC:ZSSIN~ .
...........~................_..*.*........+.......................
~ COMPANY
STATE CiR'J' OR RlGIS'1' t
eIllJIATUU CI':Y PRO:ZSSING .
){!;- ......... ~.........~~..4.................._.......................
~~ - ~~ HARPF.R MF.r.HANTr.AT
~L C; l---v7A1zl.d' STAT! CER'1' OR IWaZST t r.Mr.nL..7'iL...Q
SIQUl.'1'I1RE v' ?- / / tz,.-P'j''L C~TY PROCESSING I .:39J.-
.................................................................
0Da
S!CMATUR.!:
roOM"""""
STAT! C&Rr OR REGIST I
C1TY PROCE$SIXG .
_.+.....*...*.*........'....'i.......~..............~*...........
norr-25-'99 Tl.E 1(l:00 ;r':
T=_ ,,<I: _ .
tl79-<l P03
CONOjTIO~s OF PtRHIT AFFIDAVIT
A. "onC! or DEED RSSTJl.ICr;rOHS
"he und.ezajlJfled unde..at.neb th.t thia penlL1t IUY!)e su!lject to -deed reatriction." which
-Y be _r.. ....atr1et1". than City re1J"lation.'" The ,u,d.raiVned ...~. re.panaibility fOr
~llano.. ~th afty .pplieable deed ....t~1ct1~ll..
a. UNW!=DlS!D cmrrAAc:'rDR.5 AIlI) COIfTRAeTOM USPOt;U8ll.ITIES
If ~.. ONDer ha. A1Z9d .. oontractor or COfltractors to undertake work, tbei.., be r.qyired
to be lioanaed in accordanoe with .tate and loCal re9ula~iona. If the contractor i. not
licenaed .. ..equ1recl by l.w. !loth the owner and contrec:to.. _y he ci ted for . al.~DOr
violation WIele.. etate law, If the owner or ;.ntended contractor are \moeZ'tUD .. to "bat
110enaiD, Z'equ1~t8 -y IIpply tor the intendtld work, they are adv.1.ed to aontaClt the
C1ty of Zephyrh111. Building Dep.r~nt, 813-7'8-6611.
rurthe~re, if th.. own..r ha. hired. contractor or coatractora, he i.. advieed to have the
contr.c:tor(.) .ip portion.. of t).e "contuctor SectJ.on.- of thi. app11oeuOII. for WIlJ.ab they
w11l be reaponaible. If you. a. the owner ai9ne aa toh. contractor. you are UMU.OIIt1.hg tha~
you, rather than the contnctor. axe rellpOh!lUlle for the wort, If the conuac:tor Wig..
yoll to Dtn a. CGI1t.tacto.t that may be an ind1c:.uon that he 1. not properl]' Uo.ued aDd 1.
hot uti1:lecl to peDai.tUng privllepa 1.n the City of Zephyrh1lla.
C, TlWfSPORDnCllf IMPACT n:a AND U'l'ILI'J'Y CONKscrJCfi PUS
D. OClNaTJtUCnrlON LID LAW (CHAPTER "B. n.olUM STAT\.."'l'ES, AS ANDlDJ:D)
I ~ufy that I, the applicant, have been provicied vith a copy of ~Floricla' a CohatnactJ.on
lio 1.a.. - ___.r' a Protection Guide" preparecl by the Florida Depa.rt..nt of ~d.ClU1t;u...
aJaCl Con._r ~fair.. If the applicant i. a_. ot.her th.t. t.he .._~, I C*d.fy th&t I'
ha_ obta1J\ed a copy of the abo"e deaedbllCl documellt and prOlll1e.. 111 ,ood faith to _11_r
1t to the .owner- prior to c:aa..n~nt.
B. CXlJl'!'AAC'J'oR' 'fOlINO's AFr'IDAvrT
I certify that .11 the 1nfo~tion in thi. application is accyrat. and that all wor_ will
be doDe in OGaFli.nce with all applioable law& regulating conatruction. Zoning. aDd land
develop.ant.
~l1cati_ 18 hereby..de to o!lt.in a penut to do work .nd lIwtallat1_ .. 1ncl1cated. I
certify th.t no wort or .1netallat1on has co.menced prior to 1..uance of a per.dt &Ad that
all work Will be perfoDllllCl t.o _.t IItandards of all la... r.VU1a1;.1ng OOIlIItruClU.oD, C1ty
cod... &0n1n9 r.gul.tiona. and land development rSVl.llationa in the j1lZi.dict1oJl. I alaD
certify that I undentand that the J:evulation5 c! other ,ove-"-tal .,ftG1... _y apply to
the intended wort, ancl t.hat it ia my reeponaibili ty to identity Nbat: eeuon. r lllUet tan to
.1:1. 111 ~11ance. Such .gallein include but lire not 111l1tecl to: .De~t of
Bavlron.eJltal Regulation-Cypreaa Baybeacla, Wetland Nea. and Bnvi~o~tally hnait.lve
LancIa, -aterlWa.tew.t.r Tr.atment
-Soutb_.t r1oz1da Water Nalla,ement Di.trict-Wella, Cypre.. Bayh..da. Wetland Are..,
Alt.t1ng ..t"~couza"a
-~ Cocp. of cn,1n..r..-aeawallll, DOCk.., H.V19able W.terwa,.
-l)epartment ot lleaJ.tb , Rehabilitative Service., EIlvironJlleJ)taJ. H..lth Un1t.....lla,
W..t....t.z ~....t.eDt, Septic ~Aftka
.U.I. ltftV1t_tal Prot..eUon Ageacy-Asbe.t:o. &bat._at
I alao certify that, if fill _teri.l ia to be uaed in Flood %one .A" OJ: .A..to.... it 1.
underetood that a drainaoe pl.n addressing a -caqpenaat1ng VOlum8" w111 be ~tted which
ia prepared by a profe.aional enoiaeer registered in the State of Florida pr.1or to pe~t
ia.lUUlce.
A peZlll1t .i..Uld ahall be construed to be a license to proceed wit.b t:ba wort anc:I alot &8
aUt)aor.ity to V1olate, cancel, altar, or ..t .aide any provi.1-. of the teclmical codea.
Dor ahall i.suance of . pem1t prevent the 8u1lc11n9 Official frca thereafter hQU1zoUlG e
cOJ:rect1on of errore in plans. l;:lmatrur:tloA, or v10latlona ot any oode, Ewizy P.DI1t
i.a1led .hall be_ invalid =le.. the work authorized by al.lch pe~t 1. ~c:ed with1:a
IlU -.on1:ha of 1..1IancI, or if work lluthorized by the pendt ia euapelKled or ab~ecl fer.
period ef ..1x Montha .fter t.he time the work ill =--need, One 90 clay enenaion of t.s...
may be allowed for tbe permt with fee charge cf $15.00. '1'h. axteuioc .hall be r.qu..ateet
in "ritin, 'to the BUildinv Offidal. An approved inspection llIUat be l09~ duriJlO e.ch au
_ft~h periocl. or the P"j.~ will be cDna1dered abanciODed.
DJlHI)fl: 'J'O OIINER, YOUR DJl.URE TO RECOJU> A HOTIe!: OF ~ KIU" JlUDL'l III YOUR
PAYING TWICE rDR IMPROII!:HD."'l'S TO YOUR PJIOPz:RTY. 1 F YOU IH'1'EIfD '1'0 08'J'AIN FIKMCDlG, CONSULT
10TH YOUlt l.oDnlBR 0;;' AN A:r70flNE~ B&P'OR!: RECOJlD!)lG rOt:Jl NOTICE or CC*MDICDIBrfT. Jems WEIER
".>DO ,. v..."" DO ... .... "" """DHl> AN. "'OT ^ ..". Dr ~'.
~f/J1c;-cJyt
S:CONATURE: OlQIIER OR AGDlT llI:oAATURE: cotI'1'JUt.CToR
STArE OF f'LOIUDl'.
CouNTY or
The fo~egolft' .in.trwMent well ackhowl~dged
Before me th1e_ day of " lL.,
!ly
(name of par.on .~knowla4;.d)
[:] who .h per.oDall)' known to me, or
a whQ hea proC:hac.cS
(type ot identification)
and wboO did Oaic! not take al>. oath.
S!ATf; OF nORI~
CotrnTY or
The for~oin9 11>.8trUDeftt va. aekftewledfed .
Before.. thie --Slay of . 19...:....
hy
'name of penon ackD_le4gecll
c,ho ia peraonally known to _, Dr
Cl who baa pzoclucad
(type of Ldemtificat10nl
.Old who Odid O:lid aot take an oa~
S1qnatllte of per.on tekin9 acknowledgement
S;gnature of peraon tak1n, acknowled,..nt
)1--. typed, printed or at-.ped
M~e typed. pr1ctad or .taaped
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