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Home My WebLink About01-0462 - BUILDING PERMIT~~ 0462 CITY OF ZEPHYRHILLS (813) 788-6611 Permit Date 7- 3.1-0/ ~- EL;.S!fUeA1/ P~' ~Al P'operty Owne' c0~ rj1~ ~: Job Address: ~L~_ _ --~- .:....-.- Parcel 1.0, # Sewer Conn Water Conn: Water Meter: T.I.F.'s: Zoning: Description of Work ~;:J ~ R~on ~ar/1 ~ 27f1'r. ~~ ./~*/t1~t~) FINAL t...;;z f- {) DATE 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, Inspector Valuation or 41/ / /)/ Contract Price 'if U:? lr (0 - City License Registration # S 1.,3,. ~r""" State Certified License#' elePhone~ 0~~ (~~~~ ~C- ~ BUILDING ELECTR CAL PLUMBING Permit Fee ~), Company tifjou ' '" :Li~ , i/3 '/12.. 71/7 MECHANICAL Breakers Ducts Insl. Compressor Final Tp. Servo Roughtn Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Ftr. Pre SLB Lintel FRM. Insul. CL WL Driveway 1i~.t~ <;;-';"-0 151< REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of Twenty Five and 00'100 Dollars ($25.00) shall be made for each trip for each trade: a. Wrong Address b. Condemned work resulting from faulty construction. c. Repairs or corrections not made when inspection called. d. Work not ready for inspection when called. e. Permit not posted on job site. f. Plans not at job site. g. Work not accessible. The payment of inspection fees shall be made before any further permits will be issued to the person owning same, FROM : ANHIE nARGlLIS FRCN ; TEl'; .9R I NK AND ASSI2lC FAX NO: 813 717 9547 PH~ NO. : 8:3 715 9119 J~J. 24 2001 07:59AM P4 SuI, 2320e1 04:31PM Pt .. ,.1.._ 'I~' Suburban PrQP....IJt.~ .~ A. ~1W;f . ~ d, ~~ I'~ ~'" 71 A.. If It(" tI.JIp fV,/.",i/8 I f1w"", ~41h ~ r.;d h h,,1c. /), ..J:Nhll IQ,,* ~ r~{.(/,,~ t'. ,q1J..;ffAJ ",,,It. I"~ ~ fl.r 'Y/I.s ~~~ IF "7~ 6-. ;:~,:;'f}'fjl ~)J?rJtJk~ LJf 5 ~~J. 1-/. " 6-10 tS~ /I ,o/~ ~"f ~~ · ~~f~"~ 6ddd "'~A ' I AlflWer W.II J"w/ " .' I "!.$J., ,;, MtJeI: ~v ~ ~':t::~:;;l:'/~~ z.,lr '..~ Z,I J(lft114. '. IS11.4f} ~ "tJ~ a 1IIat S.O.... llflCInQ Itlcl ~ 8CIllKUe <U1talll8 ~ II'1CIIlf;apri~ __ inlclrrftlllon, IIl'lI: SurBr aOf8ee ROt .. /WIllI. ~. or ~"... Mkf ~ . -.rv_ ecN41M or p~ ~na IllfOfAltan III ~ pII'IM et ~ ., '*" ~...~ ~/1il ~r 'M1Ien~ or' ...... n.1J"OI fit,..,.. il 'UbjeCt 10 .....-.IO.IQOn ~ ~ ... Nrt..... or ....., flOll' -- ~Ont l~ ._ <<lIlI Will ~ ....., lOr UIlQft writtDri ar--. es1CI WI ~ Ill..,. ~""".......,............ AI ~ 1ZlII8ngIr\t UflCI"I---. ~ Gl' ~ ~ our 00M'l:ll. Ownerkl ~ fiN. torNdo ~ Olt\er -11 II! T l~ ~ce Cl/ ItM ~ ia ~I IollGfl """'- "'"~ . SlJt>lbtMn '!'OWne Gal SalIIa~~ vt/.QO 1,e$.<<J W.tio !N:tJ(J ';s1. I. '. ./JR.~t!) ,4- II $. tI" ~- \. Wt lJt--' IQ flirt...., .... ClrM .-.ed ~I, l'Or tilt tIIII'IoQt. .~ ",~~ - ...,._l~-~-,,,,_. ~ - "".Ibow ~ .........,. end OM!ItIeo\'_~~~']W_ ~to de !he..". _~. ~to a........._ ~~ t .iU(.(1~~,I/*- ~ :-_TIJAI - 1 I~ ~~~f ~ !~~I rr_NCl._ ~'.., ~ ~. e.....- ...~. OAto.....__...~, ..... )l,i141 DISTRICT: 1565 S E R V ICE W 0 R K 0 R D E R PAGE:' 1 DATE: 07/27/01 TECHNICIAN: BODIE ASST. TECH: PRIORITY: 1 SCHED TIME: AM CUST: SUB: ZONE: LOCN: 0125112 001 903 0035 NAME: ADDR 1: ADDR 2: CITY/STATE: ZIP/PHONE: TEN BRINK CONSTRUCT I 5131 22ND ST DOUGLAS RESIDENCE ZEPHYRHILLS FL 33540 (813)782-0678 LAST GAS CHK: FUEL TYPE: M04 PRICE CD/PRICE: 08 1.980 ACCT BALANCE: 0 . 00 CALL RECVD BY: AC SERVICE ACTIVITY 04 MISCELLANEOUS EQUIPMENT TYPE o OTHER COMMENTS: ROUGH IN FOR FIRE PLACE DATE: 7-':;'?~Oj BILLABLE SERVICE: (Y/N) TECHNICIAN: ~.--;- NON-BILL CODE: ASST. TECH: -- /..J MERCHANDISE INVOICE NO: DEPART TIME: (0: ~o it ~ lfS" PERFORMED (Y/N): SYSTEM TEST SAFETY CONDITION CODE: GASCHK ARRIVE TIME: TNK PCT: RESCHEDULE CODE: COMMENTS / NOTES / APPLIANCE INFORMATION J<" Ur 11 - /;'; Fe R.. G=A?i 1/ ti- -I. j:> , SERVICE WORK PERFORMED ACT/EQUIP CODE ACTUAL TIME /Vb 1lJ~ ~t!1/VJ11 r - JU ~ If:> . F-.6U"# --/A-J / Tn? ( J/t!T / //)o F.p. (I SINGLE STAGE INTEGRAL LEAK TEST (3 Kin) SUB PRESSURE TEST (10 Min) ___ SYSTEM TESTS TWO STAGE THREE STAGE --YRESSURE TEST (IOMin) OPERATING TEST START FINISH START FINISH EQUIP USED EQUIP USED EQUIP USED 1st TIME TIME WC/PSI FLOW STAGE WC/PSI WC/PSI LOCKUP EQUIP USED EQUIP USED EQUIP USED 2nd TIME TIME WC/PSI FLOW STAGE WC/PSI WC/PSI LOCKUP EQUIP USED EQUIP USED EQUIP USED 3rd TIME TIME WC/PSI FLOW STAGE WC/PSI WC/PSI LOCKUP -------------------------- ---------------------------------------------------------------------------------------------------------- The undersigned: - Knows how to turn off the propane gas supply valve in case of emergency. - Have received the consumer safety information and material. - Has smelled propane and detect its odor. - Understands the service that has been performed. CUSTOMER - Has read and understands the above statements. SIGNATURE CITY OF ZEPHYRHILLS PERMIT APPLICATION BUILDING DBPARTMENT 5335 Sth STRBBT ZBPHYRHILLS, PL 33540 Phone:S13-7S0-0020 Pax:S13-7S0-0021 DATB RBCBIVED l' - :9-/~ 0 I PLANS REVIBW PBB OWNER'S NAME:.,/' ~~ ;:)";11 k ('euS.I-,vc-t/~ JOB SITE ADDRESS V-" S/ 3 I :22 '^ d Sf- 2 ~A Y r 4 ,'II... PHONE CONTACT rg-I ~ - 792.- &4>") S- J= ( J 3 r-L/ I LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 10 # WORK PROPSED: ONEW CONSTRUCTION (OBTAIN FROM PROPERTY TAX NOTICE) o ADDITION o ALTERATION o REPAIR o INSTALL OSIGN o MOVE o DEMOLISH PROPOSED USE: OSGL FAMILY DWELLING OMULTI-FAMILY 0# OF UNITS o MOBILE HOME o OTHER o COMMERCIAL o INDUSTRIAL o SWIMMING POOL CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL DESCRIPTION OF WORK L..---" L -I:': 6'4. 5 J'" s /a.llt:tr-, (h ~ BUILDING SIZE SQUARE FOOTAGE 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 REQUESTED o BUILDING $. h 910 VALUATION OF TOTAL CONSTRUCTION o ELECTRICAL AMP SERVICE o FLORIDA POWER o W.R.E.C. o PLUMBING o MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION W'GAS o ROOFING o SPECIALTY o OTHER TYPE OF CONSTRUCTION: 0 BLOCK o FRAME o STEEL o OTHER FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREA 0 YES o NO BUILDBR COMPl,lliY STAT~ CERT OR REGIST # CITY PROCESSING # SIGNATURE ****************************************************************** BLECTRICIAN COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ****************************************************************** PLUMBER COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE MECHANICAL ****************************************************************** COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE OTH1lR /J~t~ (J. t3r~ SIGNATURE' a-L ",J If;.. ' Z? ***************************************************************** COMPANY Su hvrbai,t STATE CERT OR REGIST # CITY PROCESSING # fJr" PCZI1 e.. , ***************************************************************** ^3 /~~ CONDITIONS OF PE~IT AFFIDAVIT -A. 'NOTICE OF DEED RESTRICTIONS The undersigned understands that this permit may be subject to ~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 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 may be cited for a misdemeanor violation under state law. If the owner or intended contractor 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 wtlat 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 -----Pay of by STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _ day of by , (name of person acknowledged) Dwho is personally known to me, or acknowledged 19 (name of person acknowledged) C1ho is personally known to me, or o who has produced (type and whoD did Ddid not of identification) take an oath. o who has produced (type of identification) and who Ddid DUd not take an oath Signature of person taking acknowledgement Signature of person taking acknowledgment Name typed, printed or stamped Name typed, printed or stamped