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BUILDING PERMITN2
0162m
CITY OF ZEPHYRHILLS
(813) 788~6611
Permit
-
Date
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Sewer Conn
Property Owner:
Job Address:
Parcel I. D. #
Zoning: _}nergy Code:
Description of WorkC-',J.....Af ffJ1/
V~~t;~~~k_.
Water Conn:
Water Meter:
T.I.F.'s:
~s: ~
$1 ~ ( ~)
FINAL
NO OCCUPANCY BEFORE C.O.
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
c.o.
DATE
Inspector
Valuation or ~ L/
Contract Price 1f ' T; _"'J..:35 . -
.
City License Registration # c2??' 6-
State Certified License#
19....fw.t.~~~. (l.h:i.
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P~ MECHANICAL'
,
BU U..Dlf'lG---'"
EL~"-.
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 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.
SUNCOAST SERVICE CENTER. INC.
5406 N. ROSEMONT,
AT W. HILLSBOROUGH
TAMPA, FL 33614
(813) 879-0281 - Lie # RM0030862
_____ . AIR COND~POSAL . SALlES CONTRACT
NAHB: (.ct .~ DATE: /' 0 r 0
",,""'NO AD:,," 7 ~ i 03 '1 t:- ((;d JUS ADORBSS
CITY/ST/ZIP: / -- /~ /~".,f
~~~~~;;~-~~~::~:;;~~----------------~~~--;:-----------------
PACKAGE tmI~ ~ W
f~. ~ .. ~,e~ ?-.. 'cb~ ~.
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~
CITY/ST/ZIP;
--------------------------------------------------~------~-d-------------------------------------------____
WARRAN".l'Y BY NANUFACTURBR: / If ~U~ /U:'~ V ~
LABOR nRRANTY BY SUNCOAST SERVI CENT~' Wifc.:
OPTIONAL EXTENDED WARRAN".l'IES: 10 YEAR PAIU'S " LABOR*
*BXTBNDED WARRAN"l'IES ARE COVERED BY A-S Y
5 YEAR PAIU'S " LABOR*
----------------------------------------------------------------------------------------------------------------
THIS PROPOSAL MAY BE WITBD~ IF NOT CONVERTED INTO A CONTRACT WITHIN 30 DAYS.
Te~: After installation is completed, a qualified representative of this company will start, test and certify
to our office the correct operation of the equipment covered by this contract. That action will establish the
date of completion of our contract, except the warranty, and any further adjustments, replacements or repairs
will be performed by us under the terms of the warranty as stated above and on the back of this contract.
Payment is due immediately upon completion of installation. However, if payment in full is not received by this
office within 5 days from the date of our invoice, the warranty will be suspended and interest at the rate of
.00049315 will oe charged on any unpaid balance. The warranty will not then be reinstated until the unpaid
balance and the interest have been paid in full. The interest stated above will be charged each day and is
based on 18% A. P. R. A late feel m~ituted instead of interest at the~i~~: t;e~~3 ~
Options: 1.~ ~~ .~
2.
The installation and equipment above mentioned are subject to conditions and warranties on the reverse side of
this Agreement the same as if they were printed above and those conditions and warranties constitute a part of
this Agreement.
CONSTRUCTION INDUSTRIES RECOVERY FtJNII)
Payment may be available ~rom the construction industries recovery ~und i~ you lose money on a project per~ormed
under contract, where the loss results ~rom speci~ied violations o~ Florida law by a state licensed contractor.
For information about the recovery ~und and ~iling a claim, contact the Florida Constructioh Industry Licensing
BOARD AT: eILB, 7960 Arlington Bxwy., Suite 300, JacksonVille, PL 32211-7467 or Phone (904)727-6530.
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APPLICATION FOR PERNIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT
ADDRESS
OWNER ~~ ~~
JOB LOCATION_. ~ ~ S J.:3 - h~ ~
PHONE 7?7'- cf'tJ 7S
LOT SIZE_X
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 1. D.;F
WORK PROPOSED: _New Construction _Addition _Alteration _Repair _Install
_Sign/Temp. _Sign - Move _Demolish
PROPOSED USE: --/,.L.S ingl e Family _M/F _IF of Units ._M/H
_Commercial _Indust. _Swim. Pool Other
~
,.
_Restaurant & Health Department Approval
BU1LDING SIZE:
x
Square Feet.
Height
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FO~~S.**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
**COPY OF CONTRACT REQUIRED.
PERMITS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
V '11
4-MECHANICAL
AMP Service
Florida Power Corp.
_\\i.R.E.C.
$
t..IPJ;tr: & [)
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block
v-/
_Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
Signature
CONTRACTOR SECTION
Company
State Cert. or Regist. #
City License Registration #
******************************~***********
BUILDER
ELECTRTCTAN
Company
State Cert. or Regist. #
City License Registration #
******************************************
Signature
PLUMBER
Company
State Cert. or Regist. #
City License Registration #
**********************ft*******************
Signature
~ f2.i ~
MECHANI . '.. R kA: Compan .
.. . State Cert. or Regist. t
Signature. r ~ City License Registration
******************************************
OTHER
Signature
Company
State Cert. or Regist. #
City License Registration #
******************************************
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perait aay be subject to "deed restrictions" which lay be lore restrictive than City
regulations. The undersigned assuaes responsibility for coapliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake 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 lay be
cited for a aisdeaeanor violation under state IaN. If the owner or intended contractor are uncertain as to what licensing
requireaents lay apply for the intend@d work, they are advised to contact the City of Zephyrhills Building Departlent, (BI3!
788-6611.
Furtherlore, 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 sign 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 lay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
City of Zephyrhills.
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 "Florida's Construction Lien Law - HOleowner's Protection
Guide" prepared by the Florida Departaent of Agriculture aod Consuaer Affairs. If the applicant is sOleone other than th~
"owner., I certify that I have obtained a copy of the above described doculent and promise in good faith to deliver it t" the
"owner" prior to coaaenceaent.
J
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforaation in this application is accurate and that all work will be done in coapliance with all
applicable laws regulating construction, zoning, and land developaent.
J
Application is hereby aade to obtain a per.it to do work and installation as indicated. I certify that no work or
installation has coaaenced prior to issuance of a perait and that all work will be perforled to leet standards of all la_s
regulating construction, City codes, zoning regulations, and land developaent regulations in the jurisdiction. I also
certify that I understand that the regulations of other governlental agencies lay apply to the intended work, and that it is
IY responsibility to identify what actions I aust take to be in coapliance. Such agencies include but are not lilited tc,:
f Departlent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treat.ent
f Southwest Florida Water KanaQe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f Aray Corps of EnQineers - Seawalls, Docks, Navigable Waterways
f De art.ent of Health ~ Rehabilitative Services Environ.ental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
f Environ.ental Protection AQency - Asbestos abateaent
I also certify that, if fill aaterial is to be used in Flood Zone "A" or "A,etc.., it is understood that a drainage plan
addressing a "colpensating volu.e" will be sub~tted which is prepared by a professional engineer registered in the State Df
Florida prior to per.it issuance.
A pertit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alte,. or
set aside any provisions of the technital codes, nor shall issuance of a perlit prevent the Building Official fro. thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall becole invalid
unless the work authorized by such per.it is co.tenced within six .onths of issuance, or if work authorized by the per3Jt is
suspended or abandoned for a period of six aonths after the ti.e the work is cOI.enced. One 90 day extension of tile, ~df be
allowed for the perlit with 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 lonth period, or the project will be considered abandoned.
\IARNING TO OIlNER: YOUR FAILURE TO RECORD A NOTICE OF COMtlENCEKENT KAY RESULT IN YOUR PAYING TWICE FOR ItlPROVEl'IENTS TO 'lOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT III1H 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 COMl'IENCEtlENT".
--2 ~~ n~&-L
'---S~GENT SIGNATURE: CONTRACTOR
STATE OF FLORIDA ,,~ /.1A1 ~. ;f __ ~ _ /1'
COUNTY OF l&:!::::~"~/ f,.,
. The forego i ng i ns ~ru~nt vJas ac knovJl edged
befol-e me this 11~ S- , ;)(j')...&...L by
wzti ~on~ ~ kn~"'"' ho.
pn;! at!....",.:]-
ntification and who ~/did not7.
a oath ..11 ~
STATE OF FLORID~ ~ ~
COUNTY OF Y ~
The foregoing ins~5um~nt ,s acknowledged
before me this ?)'~ by
T ~-
whc, iS~nallY known to me or who. has
produced
as identification
t {e n oat't A
a tLll-e)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
Typed, Printed or Stamped)
NOTARY PUBLIC
Q)JOSEPH WHITE HOPE, SR.
MY COMMISSION (# CC 984805
EXPIRES: Dee 13,2004
l<<X1-3-NOTARY FL NolaIy Service" Bonding, lnc.
O)JOSEPH WHITE HOPE, SR.
, MY COMMISSION (# CC 984805
. ./ EXPIRES: Dee 13, 2004
l.flOl>>.N()TARY fL Nol.-y SeMce " Boncling, tnc.