HomeMy WebLinkAbout01-0060
BUILDING PERMITN~
0060
CITY OF ZEPHYRHILLS
(813) 788~6611
Permit
Date
'/zi/Of
'")cJ.O$
BUILDING ELEC~CAL PLU~ING
Property Owner: ll+l~I A.+ k.,,, <;':01"\
Job Address: b '22 I A5tt~ Sf,
Parcell.D. # 02. ') ~- 2 " 00 ~ 0 - 00 "10 0 . 00' b
MEC\e.NICAL
Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
Zoning: Energy Code:
DescriPtion of Work ~ 0 Ver -Co r
Radon Gas:
J4'1lOb; ,~,....e
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
Valuation or
Contract Price
19>9. ~
Permit Fee
-. Signature
'!o OJ? ~
K~J~ o/VeIL
City License Registration #
State Certified License#
Company
Address
- Telephone# 8-) 3 -S"Il:,- cA 3~
fer m'\ (3, ~c;. reA
BUILDING 7 if
ELE TRICAL
ING
MECH NICAL
Ftr.
Pre SLB
Lintel
FRM.
InsuJ. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
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 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.
APPLICATION FOR PERMIT
CITY OF ZEPHYRBILIS
BUILDING DEPAR'l'KENT
OWNER'S NAME ES~en
OWRER'S ADDIlESS f.o a. ~ \
AtK, t..)SO N
A~A\E -::J'\.
PHONE ~ ~ d-4~~ 1
"Ze \*1\{I.' \'\ II \.s I FL,
JOB ADDRESS --:SA I\A~' A-S A b/") \J C
LEGAL DESCRIP'l'ION: LOT(S) BI.OCL..-.SOBDIVISION G~~S I OE'-
PARCEL I.D.' ~- ~~ ~62{ -~D-oo~CO -~/h (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:~ew Construction ---..Addition ~teration ~pair ~Install
_Sign
---1Iove
-Deaolish
PROPOSED USE: _Single Faaily
---1i/F _' of Units ---1i/H
_ec-ercial
_Indust. _Swia. Pool _Other
--Restaurant Ii Health Departaent Approval
DESCRIPTION OF WORK:
TYlo &Iur "'n-vvt <- f rn F- ~LJ~
7,~ ~re Feet. Height
BUILDING SIZE:
x
IlESIDERTIAL: ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET EHERGY FORKS.
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
-BUILDING
$
Valuation of Total Construction
_ELEC1'RICAL
AHP Service
Florida Power Corp.
W.R.E.C.
--.JIEClWllCAL
$
Valuation of tlechanica1 Installation
-PLUMBIliG
GAS
ROOFING
SPECIALTY
TYPE OF COIJSTRUcnON: _Block _Fraae _Steel
Other
FINISHED FLOOR ELEVAfiOlfS:
Fr.
IS PROJEct IIi FLOOD ZOO AREA?
YES NO
..........................................
CONTRActOR SEctION
BIITI.DRR
COtIPAIIY
State Cert. or Regist. .
City License Registration .
..........................................
Signature
RI.RCTRICIAII
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
SiMaJllture
PLUMBER
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
Signature
KECBANlGAL
COMPANY
State Cert. or Regist. .
City License Registration f
.....................................~..~.M~
P1$t<f"v-\ ~~
COMPANY ~ ~ ) ~ 04
iY/VfJJ.Av State Cert. or Regist.' (' I~ . O~3q "11..-
City License Registration f
.........*................................
Signature
OTRRR
Signature M,~
APPLICAfiON APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
!be undersigned understands that this pemit JaY be subject to 'deed restrictions' wbich lilY be lOre restrictive than City
regulations. !be undersigned asSUll!S responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If tbe OImer has hired a contractor or contractors to undertake wrt, tbey HY be required to be licensed in accordance with
state and local regulations. If the contractor is not licensed as required by law, both the 0IIJler and contractor taY be
cited for a .isdeEaJlor violation under state law. If the 0IfIU!l' or intended contractor are uncertain as to what licensing
requirl!ll!Dts tay apply for the intended wrt, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
788-6611.
FurtherlOre, if the owner bas bired a contractor or contractors, he is advised to have the contractor(s) sign portions of tbe
'Contractor Sections' of this application for wbich 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 wrk. If the contractor wishes you to sign
as contractor that tay be an indication that be is not properly licensed and is not entitled to perlitting privileges in the
City of Zepbyrhills.
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 'Plorida's Construction Lien Law - lIoIeoImer's Protection
Guide" prepared by the Florida Departlent of Agriculture and COnsUler Affairs. If the applicant is SOIeODe other than the
'owner', I certify that I have obtained a copy of the above described dOCUleDt and pnllise in good faith to deliver it to the
'owner' prior to COIIeDCl!Il!Dt.
E. CONTRACTOR'S/OWHER'S AFFIDAVIT
I certify that all the inforlBtion in this application is accurate and that all wrk will be done in COIpliance with all
applicable laws regulating construction, loning, and land developleDt.
Application is hereby tade to obtain a pemit to do work and installation as indicated. I certify that no work or
installation bas ~ced prior to issuance of a perlit and that allwrk will be perfoIJed to I88t standards of all laws
regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
certify that I understand that the regulations of other goverDlll!Dtal agencies tay apply to the intended wrk, and that it is
If responsibility to identify wbat actions I lUst take to be in COIpliance. Such agencies include but are not UJlited to:
t Departlent of Envil'Olllelltal Regulation - Cypress Bayheads, Wetland Areas and EnviroDleDWly Sensitive Lands,
Water/Wastewater !reatlent
t Soutlntest Florida Water Managl!ll!Dt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
t AI'IJ Corps of Engineers - Seawalls, Docks, Havigable Waterways
t Departlent of Health i Rehabilitative Senices, InvirODleDtal Health Unit - Wells, Wastewater !reatlent, Septic !ants
t US InviI'ODleDtal Protection Agency - Asbestos abatl!ll!Dt
I also certify that, if fill taterial is to be used in Flood ZOne "A' or "A,etc.', it is understood that a drainage plan
addressing a 'COIpeJl8ating volute' will be sublitted wbich is prepared by a professional engineer registered in the State of
Florida prior to pemit issuance.
A perlit 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 pemit prevent the Building Official fnll thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perIIit issued shall becoIe invalid
unless the work authoriled by such pemit is ~ced within sillODths of issuance, or if work authoriled by the perlit is
suspended or abandoned for a period of sil IOIltbs after the tile the work is co.enced. One 90 day utension of tile, tay be
allowed for the perlit with fee charge of $15.00. !be utension shall be requested in writing to the Building Official. An
approved inspection lUSt be logged during each sil IOIlth period, or the project will be considered abandoned.
WAJUUHG TO OVHER: YOUR FAILURE TO RECORD A HorlCE OF a>>lMDCBIIBII! MAY RESUL! IH YOUR PAYIIG !IIICE FOR IMPROVBIIII!S TO YOUR
PROPERTY. IF YOU IIfIlfD TO OB!AIIf FIIUCIHG, COISUL! WI!B YOUR LBJIDIR OR D AnomY BD'OHB RECORDIIG YOUR DICE OF
COMMEICEMElfI. JOBS UHDER $2,500 IH VALUE 00 Hor HEED TO RECORD AID POST A -MorICE OF ClBDIDCBMIH'.
.~;
" ~..,..
SIGU. R ~
wf1'
STATE OF FLaR
coum OF 'AJ 2 J LI ,,)
The foregoing inst~ent was acknowledged
before me this I L/ ,.~ by
{tf A gft-!iJ.~
:~o persona 1 kD to me or who has
as identification and who did/did not
take an oath. ~~
~/1"db 70 d4?7,/.I1()4f ,
(i ature)
L /AidN P mf}~'1ljlC~~
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
p..\lY PlJ. OFAClALNOTARYSEAL
0'" <9<-., UNDA E MABTERSCW
. ~ COMMISSION NUMBER
... <( CC903839
~ ~ MY OOMMISSION EXPIRES
OFf\.o.,..,~._, !' t.l.Z'-.2004
O....p..\ly PlI6' OFFlClALNOTAAYSEAl.
W~ UNOA EMASl'ERscw
... ~ COMMISSION NUMBER
~ S CC90383g
OF f\.O<:f. MY COI.4ldlSSlON IiXPlFlEa
-, ,JA,,!. 2
AMS., . layout Sheet
Address:
6 2.. 1... J
A 60.. -t-e S T
ONT 0 TAt:. '311 7
C . N. _ _
Phone # ~ 1"3 . 7''''2--</ 719
PG.
I' of /
1111..rlao
,
CUSTOMER ~s. ret A.:i(/1\J s. ~ A)
Oate
City:
State r=L
Zip '33s-t./D
Lot #
.
Parkf\~n/4 C
1Gb 7 Hi (.t~ r
J l1.-
-
'2~
\
-{
o
.--
"'1..4
.~
.-(D ..
-.:~ ^~n___._..c.__^___ _
--
--::>
'.~ -
17
_..,u___~ - ,.~.'.,~, -
01 J Center Cap _ HI. A -2Y2" _ A A-2Yz"_ C
ROLLS TO ORDER Height " ~- ~
~X--Y1.. Je. GYI= - I . C -S':-
" I Urethane C - S.:....-
, " , " O~
X Ft. Ft.
0 ~ Pan Size "
, " , "
X Vents A -2W' _ B A -2W'_ 0
, " , " Gutters - Un. Ft. _ D.S. Plumb ~ ~ t
X Spec. Lunber Ft. Fan C-S"_ C-S"_ r
" " Kit Ft. i
X Sp. Buildup 1" _Sht.2" Sht. Heat Ft.
Gutters
D/S
Brn.
Brn.
Who
Who
Co!.
Col.
EVERYTHING PROMISEDAS PARTOFTHISCONTRACT ISCOVERED IN THE ABOVE.
~USTOMER Signature t=.~ /1:1\ ~ Date I J fl,rfoo
ADVANCED MOBILEHOME SYSTEMS CCC042787 CGC033977
OWNER: Mr.
c; ~ C/ t1
INSTALL..ATION AGREEMENT CONT. NOrAK3 71 7 DATE tllur/oo
. CG C033977 · CC ~042787 SOURCE -#BtJ: PRODUCT ~or
1-800-282-3572 Phone # ( ~) 7l?2- 47 Z C}
E'S~IZ LAST NAME !J:rf(J/.JS6I.. J
ADVANCED MOBILEHQME SYSTEMS
AMS IV,INC.
13764 W Rena Drive · Largo, FL 33771
& Mrs.
Address: b '2 "'2../ A- 6 ~re. oS r City: Z c.p Ivy (ll-J It l .!
Zip "3 3 S''Ill Lot #
Park OA-I<.s I t) ~
County () a.S' c. 0 Home-Own ~ Rent Land-Own
Address .
(out of Florida): AJ I\- City State Zip
~INC. (UAMS") proposes to furnish all materials and labor for the job(s) specified below:
~ CIon/I:; If;;',~:....:, "'-"'S t<oor
_ 1=L~H PA-_ R_o~
~ Pe~MII
L I ~ e. T7 J1;1 e f--D Do ,. r (', ^'" .,.,.;
Rent ~ RIP #
Phone # ( _ )
(Out of Florida)
C.()SfW/Ll CALL. n ~c.,/....ecJ(Jt.-O.- IAJ:r~.v
~ATE GAS VENT C. 111.~ ~RNING UNIT HAS OR WILL BEEN REMOVED BY CUSTOMER c-. "'YYI..~
INIT. INIT. INIT. INIT.
Q SEE ADDITIONAL SHEETSFOR ADDITIONAL SPECIFICATIONS INCORPORATED INTO THIS AGREEMENT
AMS REQUIRES A 30% NON-REFUNDABLE DEPOSIT, WITH THIS AGREEMENT AND BALANCE DUE ON COMPLETION
CONTRACT AMOUNT S Cl6H~W I-/t;AJfJ~('.1J ~/A..~o/ ~ (U.S. DOLLARS $) S / ~30, ~
, Sales Tax S ItJ9. YO
Jot39.ro
Deposit Amount S b~ D. ~
Balance Due on Completion S { :1 3~, fa
A separate written warranty relating to the Weather-Lok™ Roof system will be mailed when contract price is paid in full and a completed
application for warranty is received. A copy of the form of this warranty is available upon request. ~
AMS is authorized to furnish all materials and labor required to complete the work described in the above proposal, for which I/We agree to
pay the full amount specified in said proposal, and in accordance with all terms of this Agreement.
THE UNDERSIGNED ACKNOWLEDGES THAT BEFORE SIGNING HE HAS READ, UNDERSTOOD, AND RECEIVED A COMPLETED, LEGIBLE
COpy OFTHIS AGREEMENT AND OF EVERY OTHER DOCUMENT INITIALLED OR SIGNED BY ME DURING CONTRACT NEGOTIATIONS, AND
AGREES TO BE BOUND BY ALL THE TERMS THEREOF, INCLUDING THE TERMS AND CONDITIONS ON THE REVERSE SIDE.
This Agreement shall be binding upon the Buyer's written acceptance hereof in the space provided below or upon the AMS's commencing
performance. Upon such acceptance or commencement of performance, this Agreement shall constitute the entire contract and be binding
upon the parties hereto, there being no covenants, promises, warranties or agreement, written or oral, express or implied, except as herein set
forth or as created by applicable law.
BUYERS RIGHT TO CANCEL
THIS IS A HOME SOLICITATION SALE, AND IF YOU DO NOT WANT THE GOODS OR SERVICES, YOU MAY CANCEL THIS AGREEMENT BY
PROVIDING WRITTEN NOTICE TO THE SELLER IN PERSON, BY TELEGRAM, OR BY MAIL. THIS NOTICE MUST INDICATE THAT YOU DO NOT
WANT THE GOODS OR SERVICES AND MUST BE DELIVERED OR POSTMARKED BEFORE MIDNIGHT OF THE THIRD BUSINESS DAY AFTER
YOU SIGN THIS AGREEMENT.IFYOU CANCEL THIS AGREEMENT, THE SELLER MAY NOT KEEP ALL OR PART OF ANY CASH DOWN PAYMENT.
NOTICETO BUYER: THE TERMS AND CONDITIONS ONTHE BACK HEREOF ARE PART OFTHIS AGREEMENT.
(INIT.)$" e. #(. a... X EVERYTHING PROMISED AS PART OF THIS CONTRA T IS COVERED IN THE ABOVE.
ACCEPTED AND AGREED: BY AMS REP.
~ &. AA.rA- m. a ~~ SOCIAL SECURITY #~ 'i J - I ~ - ~6 .!:J-S
CHK#
CASH
ISO 3
TOTAL $
Date
x
SOCIAL SECURITY #
(BUYER'S SIGNATURE)
Date
19
AMS, layout Sheet
-
CUSTOMER ~S.~f A.:r(oJs.~A.1
Address:
b 2.. '2..1
A6a.t:'e s r
City:
HIll~r
-
\
--
.~
2b
\
-
ROLLS TO ORDER
--LL.-LLx-E L. /D "
x
x
x
" Gutters
" Spec. Lunber
x
O TA.t. '3 71 7
CONT. N. _ _
Phone # &" I "3 ..., f"2...- C/ 71..9
State 1=L
Zip '33S"t/D
J 11..-
...L7
Gutters
D/S
PG.
I' of I
1111..r/ao
I
Date
Lot #
.
Parkl'\~n I f) ~
uu{.
"'1.4
8rn.
8rn.
Who
Who
Col.
Col.
-
I Center Cap _ HI.
Height
I
Urethane
A -2'12" _ A
" IB
,-~,--
A -2'12" _ C
IB -
"c - S''--
Ft.
A -2'12" _ 0
IB-_ 1.
'C-s"_ .
!
Ft. !
01
~
o~
o r-------,
Pan Size
Vents
Plumb
Fan
Kit
Heat
Lin. Ft _ D.S.
Ft
Sp. Buildup 1" _ Sht. 2"
Sht
Ft.
A -2'12" _ B
IB-
"C - 8"_
Ft.
EVERYTHING PROMISEDAS PARTOFTHISCONTRACT IS COVERED IN THE ABOVE.
:USTOMER Signature tt=.~ ~,~ Date III>-doc
ADVANCED MOBILEHOME SYSTEMS CCC042787 CGC033977
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