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Home My WebLink About01-0354 BUILDING PERMITN~ BU~G Property Owner: _f 4 ~ ~ Job Address: 7 D 'S" <:> Parcell.D. , P~BING ~~~D /1tol\af /?I vd ELE~CAl ~l\ CITY OF ZEPHYRHILLS (813) 788-6611 r::J!J ' f.!(~. 6eJ.~ MECHANICAL (e.....4e,..- 0354 Permit Date S/J//'{)( , Sewer Conn Water Conn: Water Meter: T ,I.F.'s: Energy Code: '~L Radon Gas: I" S ~ U I {", 000 -..L@ ( ~""I< Zoning: Descriotion of Work NO OCCUPANCY BEFORE C.O. FINAL C.O, Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. Valuation or Contract Price City license Registration # State Certified license# Ftr. Pre SlB lintel FRM, Insul. Cl Wl Driveway ~ ~ I ~ ~~ 00 - 1- Signaturt Company EL TRICAl Tp, Servo Rough In Meter Can Const, Pole Pool Pre-Meter Final SlB Tub Set Water Sewer Final MECHANICAL Breakers Ducts Insl. Compressor Final rUFl 71P~ of( 6 -t-9JR-, fJ .k4'f~ ~r oIL (, -7fR REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of Twenty Five 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. :=:~:s:~g~m(,ih) · CITY OF ZEPHYRHILLS PERMIT APPLICATION BUILDING DBPARTMENT 5335 SU STRBBT ZBPHYRHILLS, FL 33540 Phone:S13-7S0-0020 Fax:S13-7S0-0021 DATB RBCBIVED PLANS REVIEW FBB PHONE CONTAC~1-1-b q - SS9~ LEGAL DESCRIPTION: LOT(S} BLOCK SUBDIVISION PARCEL ID # (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPSED: [JNEW CONSTRUCTION [JADDITION [JALTERATION [JREPAIR )(INSTALL [JSIGN [JMOVE [J DEMOLISH PROPOSED USE: [JSGL FAMILY DWELLING [JMULTI - FAMILY [J # OF UNITS [J MOBILE HOME [JOTHER [J COMMERCIAL [J INDUSTRIAL [J SWIMMING POOL DESCRIPTION OF WORK CJ ,~DJ Q RESTAURANT & HEALTH DEPARTMENT APPROVAL ('6)CCLJ~ BUILDING SIZE SQUARE FOOTAGE HEIGHT RESIDENTIAL: COMMERCIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (I) SET ENERGY FORMS, ATTACH (3) SETS OF BUILDING PLANS & (I) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. [J BUILDING PERMITS REQUESTED $ 80 J l::,d~ . 0 0 VALUATION OF TOTAL CONSTRUCTION [J ELECTRICAL AMP SERVICE [J FLORIDA POWER [J W.R.E,C. [J PLUMBING [J MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION [J GAS [J ROOFING [J SPECIALTY [J OTHER TYPE OF CONSTRUCTION: [J BLOCK [] FRAME [] STEEL [] OTHER FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREA[] YES [] NO BUILDBR COMPANY A-c..,+? ~p JJ ~'MQ STATE CERT OR REGIST # . 0.3<6 CITY PROCESSING # **************************************** BLBCTRICIAN COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE **************************************************~*************** PLUMBBR COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ****************************************************************** MECHANICAL COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ***************************************************************** OTHBR COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ***************************************************************** CONDITIONS OF PERMIT AFFIDAVI~ A. -NOTICE OF DEED RESTRICTIONS The undersigned understands that this permit may be subject 1:0 ~deed restrictions" which may be more restrictive than City regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions, B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertiike work, they may 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 may be cited for a misdemeanor violation under state law. If the owner or intended contrac'tor are uncertain as to what licensing requirements may apply for the intended work, they are advised to contact the City of Zephyrhills Building Department, 813-788-6611. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the ~Contractor Sections" of this application for which they will be responsible. If you, as the owner signs as the contractor, you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign as contractor that may be an indication that he is not properly licensed and is not entitled to permitting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTUION 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 - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other that the ~owner", I cerify that I have obtained a copy of the above described document and promise in good faith to deliver it to the ~owner" prior to commencement. E. CONTRACTOR' S/OWNER' S AFFIDAVIT I certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning, and land development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other governmental agencies may apply to the intended work, and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: *Department of Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment *Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses *Army Corps of Engineers-Seawalls, Docks, Navigable Waterways *Department of Health & Rehabilitative Services, Environmental Health Unit-Wells, Wastewater Treatment, Septic Tanks *U.S. Environmental Protection Agency-Asbestos abatement I also certify that, if fill material is to be used in Flood Zone ~A" or ~A,etc.", it is understood that a drainage plan addressing a "compensating volume" will be submitted which is prepared by a professional engineer registered in the State of Florida prior to permit issuance. A permit 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 permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction, or violations of any code. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of issuance, or if work authorized by the permit is suspended or abandoned for a period of six months after the time the work is commenced. One 90 day extension of time may be allowed for the permit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection must be logged during each six month period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR acknowledged 19_ STATE OF FLORIDA COUNTY OF , The foregoing instrument was Before me this _day of by STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _____ day of by acknowledged 19 (name of person acknowledged) Dwho is personally known to me, or (name of person acknowledged) [Lho is personally known to me, or of identification) take an oath. o who has produced (type of identification) and who Ddid D:l.id not take an oath o who has produced (type and whoD did 0 did not Signature of person taking acknowledgement Signature of person taking acknowledgment Name typed, printed or stamped Name typed, printed or stamped PAGE: 1 OF: 1 ACTS CONSTRUCTION, I NC,DATE: 4/24/01 SPECIALIZING IN THE PETROLEUM INDUSTRY PAYMENT TERMS P,O. BOX 68_0427 ORLANDO, FLORIDA 32868 (4071578 - 4822 I.A~~~~ REP: Sene Snow State License #CGC 008402 PCC 045038 - Upon Receipt of Invoice VALID FOR 30 DAYS TO: Harper Mechanical : 5401 Benchmark Lan~ : Sanford, FL 32773 LOCATION: East Pasco Medical Center : Z e ph y rh i 11 s, FL . . . . ATTN: Gene Sikes FAX: 407-323-7007 . . PHONE: 407-321-8100 QUOTATION AND CONTRACT: S-353 REFERENCE: We are pleased to submit proposal ,as follows: 1. Obtain necessary tank installation permits. 2. Excavate and install 1-15,000 gallon doublewall fiberglass fuel tank per plans and specifications. 3. Haul off excess fill dirt and debris. 4. Furnish and install fuel piping per plans and specifications. 5. Furnish and install Veeder Root Electronic Tank Gauge. NOTE : No Provision For Unknown Underground Obstructions. No Day Tank. No Fuel. No Concrete at Grade. No Asphalt Paving or Sidewalk Repairs. No Electrical Power or Control Wiring. No Sheet Piling or Shoring. If Necessary to Wellpoint Add $ 3,200.00 ( Initial if Accepted) If Deadmen Tank Anchors Are Used In Lieu of Concrete Slab Deduct $ 3,000.00 TOTAL: $ 86,622.00 AUTHORIZED SIGNATURE Please sign acknowledgemenl and retum copy at lOOn . poa.__. ACCEPTANCE: Thil pt'OpOsaJ, when accepted by the Purchaaer. and final approval of Sallen OfficIal Office, wit Cl:InatItUl' a bonaIId. contract betwe,n UI, IUb/let to a" term. and COndlUon, on th. reverse aidl. It iI expra,.1y agreed that th.,. ar. no ptamiae,. agreements, or understanding" oral or wrinln. not 'PICifIId In ttUa proposal. oo~~ ~~ ACCOUNT MANAGER