HomeMy WebLinkAbout01-0632
BUILDING PERMITN2
0632
~L~
ELECTRICAL
CITY OF ZEPHYRHILLS
(813) 788-6611
'-0
&2.-~
PLUMBING
Permit
o
2210.~
BUILDING
Date lo~ if -0 I
ICP ~
MECHANICAL
Sewer Conn
Property Owner: fr/^yr "'-: II {
Job Address: Y. ~ 0 '1 ~
80# Izj
S'..h
Water Conn:
~..kr-
Water Meter:
T.I.F.'s:
Parcell.D. #
Zoning:
Descriotion of Work
Energy Code:
(;--e 10 g:-:ld..,'J
Radon 9fs:
I-' od, , +- i (.al, 0'"
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
City License Registration #
State Certified License#
Inspector
Permit Fee 1r 04. ~
Signature~'1/~
Company T, II- . {.,.
Address
Telephone#
Valuation or U ~ 0 000. a:>
Contract Price J v ,
BUILDING
,F. Lee
2570
ELECTRICAL
er
"T~e ~'>~ II
382
MECHANICAL
Ftr.
Pre SLB
Lintel
FRM,
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
~,L/f; /I-/.s-o/ ~
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.
l-.~irnformation
~.". .To Build On
Engineering. Consulting. Testing
~,~~e
PROJECT:
$~
j}q
(' 10 /,
~ftJy ~pP (,
ZEPHYRHILLS WATER BOTTLING b ~ ~
PLANT EXPANSION/V.
REPORT OF CONCRETE COMPRESSION TEST
TESTED FOR:
BOBBY L. BAKER
THE HASKELL COMPANY
P.O. BOX 44100
JACKSONVILLE, FL 32231-4100
DATE:
December 14, 2001
REVISION #1
OUR REPORT NO.: 779-00236-220
FIELD DATA:
LOCATION OF PLACEMENT SLAB ON GRADE - SOUTH PANEL PAD
DATE PLACED
TIME
SLUMP, IN.
AIR CONTENT, %
AIR TEMPERATURE, OF
CONCRETE TEMPERATURE, OF
DATE RECEIVED IN LAB
FIELD DATA SUBMrITED BY
MIX DATA SUBMrITED BY
December 14, 2001
07:00 am
3 1/2
67
82
December 15, 2001
PSI\SE
CEMEX
SUPPLIER
DELIVERY TICKET NO.rrRUCK NO.
MIX NUMBER AND PROPORTIONS
CEMENT
WATER
FINE AGGREGATE
COARSE AGGREGATE
ADMIXTURE
CEMEX
723316
10055017
NOTP.. APP11~ARf P. A~ ~ANnARn.c; lTNt F!~C: O'rH'P.:RWlS'FlINnICATF.O' ~ lIMP-: CI4'.Q7. AIR CONTP.NT. Ml1.Q7IPY("11mINO !;Fr 1fI. TF.f\..fPF-1U.TtJ1lP.' CHI64..WRCm. ~ 'NnP.R~' MI.1M (F.]('CllInrNO.!me Q '2 'll' AA,t.A'JltTNO. (';172.97
CO:MPRESSION TEST RESULTS
ASTM C39-96; CI231-93
SPECIMEN TEST TOTAL CYLINDER CYLINDER COMPRESSIVE
LABORATORY IDENTIFICATION AGE DATE OF LOAD DIAMETER AREA STRENGTH
NUMBER OR SET NO. (DAYS) TEST (LBS.) (IN.) (SQ. IN.) (PSI) TYPE OF BREAK
115 A 7 12/21/01 135000 6.00 28.27 4780 Shear
115 B 28 01/11/02 178000 6.00 28.27 6300 Shear
115 C 28 01/11/02 165000 6.00 28.27 5840 Shear
l1S D H HOLD
SPECIFICATIONS
28 5000
REMARKS:
X Cy1iDdon ~ickcd up by PSI
_ rcpraoDLaU"'C.
1f. CyliDckn made by PSI rcp......ntalivc,
CyliDckn made by Atc:bilcc:t'o or
CoalnClOl"o repreoealativc.
X
Teal rcsulll comply whh oppUc:abk>
OpccilicatiODl.
_ CyliDckn deliven:d to PSllaboralory.
T eel ""\1110 do IlOt oomply with
opplicablll opociIicatiOl1ll.
TECHNICIAN: SE
cc: HASKELL - K. KETT; JOB SITE - K. DEAN;
KIMMINS CONTRACTING - R. ALLEN; CONCRETE - SUPPLIER
TIIESI! TI!SI' RESULTS APPLY ONLY ro TIll! SPECIPIC SAMPLES TUI1!D AND MAY NOT BE INDICA'I1VI! OPTIlI! EN1lRE CONCRETE P1AC
JlIlPORTS MAY NOT BE REPRODUCED. EXCEPT IN PULL, WlTIlOUT WRlTIEN PeRMISSION BY PROPESSlONAL SERVICE D<DUSTRlES, IN
eith L. ts,..
District Manager
Florida Registration No. 53986
Florida Engineering Business No. 3684
I'SlA-~(IS)P Professional Service Industries, Inc.. 5801 Benjamin Center Drive, Suite 112. Tampa, FL 33634. Phone 813/886-1075. Fax 813/888-6514
l-- tS -llnforrtUltion
~.,. .To Build On
Engineering. Consulting. Testing
REPORT OF CONCRETE COMPRESSION TEST
TESTED FOR:
BOBBY L. BAKER
THE HASKELL COMPANY
P.O. BOX 44100
JACKSoNvILLE, FL 32231-4100
PROJECT:
ZEPHYRHILLS WATER BOTTLING
PLANT EXPANSION
DATE:
August 27, 2001
OUR REPORT NO.: 779-00236-188
FIELD DATA:
LOCATION OF PLACEMENT LINE C.6-5, B.6-4, F.5-3, F.5-4, AND F.8-2 (NEXT TO CHILLERS)
DATE PLACED
TIME
SLUMP, IN,
AIR CONTENT, %
AIR TEMPERATURE. of
CONCRErB TEMPERATURE, OF
DATE RECEIVED IN LAB
FIELD DATA SUBMrITED BY
MIX DATA SUBMl'ITED BY
August 27, 2001
01:50 pm
3 1/2
90
91
August 28, 2001
PSI\SC
SOUTHDOWN
SUPPLIER
DELIVERY TICKET NO.frRUCK NO.
MIX NUMBER AND PROPORTIONS
CEMENT
WATER
FINE AGGREGATE
COARSE AGGREGATE
ADMIXTURE
SOUTHDOWN
792533
10054020
NnTP:o APpt]t"A"'RA-fttv m'ANnA'DM trNTp.!littn'I'RP.R.wum.rN'ntt"-.A~ KlUMP. ~t.\..crr. Ant mNTRNT! M\I.Q'7(M(MtmrNn lair! IIC\. 'T'P.LtlrImA'MI'DP... t.!tMLIN'ln" t!YTrwnPR~ MIAlHRrl!tUnr'Nn ~ 01: '!'I. DVPrJMn. r1'7'UI1
COMPRESSION TEST RESULTS
ASrM C39-96; CI13I.93
SPECIMEN TEST TOT AI.. CYLINDER CYLINDER COMPRESSIVE
LABORATORY IDENTIFICATION AGE DATE OF LOAD DIAMEI'ER AREA STRENGTH
NUMBER OR SEI' NO. (DAYS) TESt' (LBS.) (IN.) (SQ. IN.) (PSI) TYPE OF BREAK
103 A 7 09/03/01 125000 5.99 28.18 4440 Shear
103 B 28 09/24/01
103 C 28 09/24/01
103 D H HOLD
SPECIFICATIONS 28
4000
REMARKS: X CyllD<lonmodebyPSI___tlw.
X Cy)iDlcn picb04 up by PSI
_ "'J'l'CDeaIIlM.
Teal roiu1la _If wlth applicable
.pocificalla..
CyUadeIl mado by Arc:bitecl'. or
Coa\nClOr'. ___tlw.
_ Cyliadoll ~ to PSI laboratory.
Teall'Oll1l!ls do 1lOl OClDIply wllh
applicoblo opeoiIicalloos.
TECHNICIAN: SC
eith~, u s, . .
District Manager
Florida Registration No. 53986
Florida Engineering Business No. 3684
cc: HASKELL - K. KETT; JOB SITE - K. DEAN;
KIMMINS CONTRACTING - R. ALLEN; CONCRETE - SUPPLIER
TIII!SB TESI'RESULTS APPLY ONLY '1'0 TIIESPBClI'lC SAMPLI!S TI!STIlD AND MAY NOTBEINDlCA'I1VEOP TIlE mmRll CONCRETll PUC!MEN'T.
REPORTS MAY NOT BE IUiPIlODUCIlD, 1lXCI!PT IN PIJLL, WInIOUT W\lITI'IlN PERMISSION BY PROPllSSlONAL seRVICE lNDUSI'IlIIlS, INC.
PSlA.:z00.4(6)P Professional Service Industries, Inc.. 5801 Benjamin Center Drive, Suite 112' Tampa, FL 33634' Phone 813/886-1075' Fax 813/888-6514
PSlA-:z00.4(6)P Professional Service Industries, Inc.. 5801 Benjamin Center Drive, Suite 112. Tampa, FL 33634. Phone 813/886-1075' Fax 813/888-6514
The Haskell Corp,
Line #10 Bldg, Modification
SQ. FEET PRICE
MAIN OR LIVING: $ 40.00
OTHER AREA UNDER ROOF: $ 15.00
OTHER: $ -
V ALUA TION $ 450,000.00
FEE SHEET $ 1,520.00
ADDRESS $ -
DRIVEWAY $ -
BUILDING: $ 2,280.00
CREDIT: $ -
BUILDING LESS CREDIT: $ 2,280.00
ELECTRICAL: $ 41.80
PLUMBING: $ 82.50
MECHANICAL: $ 100.00
RADON: $ -
TOTAL $ 2,504.30
SEWER: $ -
WATER: $ -
IRRIGATION: $ -
TOTAL: $ -
I
I
I
I
I
WATER METER:I $
IRRIGATION METER $
SIPS'I $
97.5% $
2.5% $
I
2,504.30 I
- I
- I
2,504.30 r
SUB-TOTAL $
TIF'S'r
99% $
1% $
TOTAL: $
I-'N<(~ i(.,
Y,.
;'l10L~( h(Clf)i:-Y ~
..CITY, OF ZEPHYRHILLS PERMIT APPLICATION
C-~IL.D I..NG.D.B'~TMBNT 5335 8th STREET ZEPHYRHILLS, PL 33540
. II -, / P one:813-780-0020 Pax:813-780-0021
I'.c.~ /
~... c II 'j 1 . DATE RECEIVED
I ') 1./ I ,/ PLANS REVIEW PBB
---
OWNER'S NAME 2eP,'t/'~1 ((,;;> Ffo,~, d'l
. )
JOB SITE ADDRESS '1330'" dOf*l '?{<t:c f
PHONE CONTACT QO'1-- K (-'-f ::00
0- '1r 3tf'
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID #
WORK PROPSED: [JNEW CONSTRUCTION
(OBTAIN FROM PROPERTY TAX NOTICE)
[JADDITION
r&IALTERATION
[JREPAIR
[J INSTALL
[JSIGN
[JMOVE
[J DEMOLISH
PROPOSED USE: [JSGL FAMILY DWELLING
[JMULTI - FAMILY
[J# OF UNITS
[J MOBILE HOME
[J OTHER
[J COMMERCIAL
o INDUSTRIAL
o SWIMMING POOL
DESCRIPTION OF WORK
o RESTAURANT
OG"1C> <;. \:t b M!.-..v
J
& HEALTH DEPARTMENT APPROVAL (Sf~ \ ' . L ,
r>fC[';:o v'( f L",.yJ CN'.r H',I.., ''''-(,_~
(O,x-r<.nc. Fov>,.::Iqhc.v>> ,f;- ,ix, (('yluo/<!Ij te;dc,<v >t:;5
BUILDING SIZE
SQUARE FOOTAGE p..; /4
HEIGHT /A-f'e-.,
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. t~ _ n/~
:::f;1Jl IL ..," P"" ~~
f (5) .f 0... j ~~/7/5'
.cf. ~ Of? '1/ .:
VALUATION OF TOTAL CONSTRUC ON '1 ~ 'f' ____
o FLORIDA POWER ~ 11,9
- <f~:J>>c~/)t/ 1ql
VALUATION OF MECHANCIAL INSTALL~TION to'>>, J,r ''''r c,f~.rS,
PERMITS REQUESTED
g) BUILDING
$ J '1~Dt<.
gj ELECTRICAL
19 PLUMBING
[J C;,(:. SF, Cw GF
MECHANICAL
AMP SERVICE
$
[J GAS [J ROOFING [J SPECIALTY [J OTHER
p{vo, \>"1e
TYPE OF CONSTRUCTION: B BLOCK [J FRAME
[J STEEL
[J OTHER
FINISHED FLOOR ELEVATIONS
A~/A
IS PROJECT IN FLOOD ZONE AREA [J YES [J NO
~ COMP~Y ~:>K:e-ll
- STATE; CERT OR REGIST
--, -_______ CITY PROCESSING #
~.........;...........................:.......................
4 ~COMPANY t=.P~
. . ___~ ~ STATE CERT OR REGIST #
------------ ,------------- CITY PROCESSING #
. . /'
******************************************************************
BUILDBR
SIGNATURE
BLBCTRICIAN
SIGNATURE
PLUMBER
~/5't= It 7T1I~/1lF/.}r
COMPANY Ik-r.;:x-r fl1e~icq( /
STATE CERT OR REG 1ST #
CITY PROCESSING # ~ <;!,3 r--
JD~~
Jj::t
SIGNATURE
KBCHANICAL
******~***********************************************************
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING # }f;J
*****************************************************************
SIGNATURE
OTHBR
SIGNATURE
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
*****************************************************************
CONDITIONS OF PERMIT 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 aocument 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! 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 NOTIC COMMENCEMENT. JOBS UNDER
$2,50 . ~E pO T D TO RECORD AND POST A ~NOTIC F CO ENCEMENT".
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by
FLORIDA
COUNTY OF
The foregoing instrument was
Before me this -----pay of
by
acknowledged
1!L-
acknowledged
19
(name of person acknowledged)
[1ho is personally known to me, or
(name of person acknowledged)
Owho 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 [}lid not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
:lJ ?~/.'w Ii', i> t..r~ (:~ t. 'r'~ ~.
AUG-08-Jl WED 05:45 PM ~ARPER MECHAN:CAL FAX NC. 4073237007
~'!lH.i'-Cl:::;'-U 1. (J 1 ; ~;:!; P.:;..~:h 'Lt;l~~~1tI~.tHiLLS PERMIT APPLICATION
.11'. . "iV'
lmn..:otNli !I]UlUTWJNT 833 5 8~ft STkur tllrHYi.lfILLS, .L :nUO
Phon.t Ul -7 SQ-QO:iD PaJU 811-'18D -00 :21.
~T. '..C:JlIVan
I'LARJ QVIJlW .....___._ y
"HONK CO~T1.C1' ~..,,; ,.~(( -~t ~~}(,~ ~
....(t. .., TL 39'
P. 09
(JHblJ!;R' ~J HA."I8 _;~!!./::'1t[~j -~[~7 E..b:~-:L1k(
,J09 arTS AV1)FES9 n.4j.?2Q:' .)f;!~2!~r
[.."U'.ltl. fJia;cICHlPrIC\~h LOT(S)
BLOCK
SUa[)IV:':SIO~
l?)\RC.h:J, 1f.) j;j.
_..._~.~...,-,_..~...---------- -.-.
(OBTJ\!N f'RO'" PROPB:l\TV TAX Nonc!}
HOld~ l';U)l-'iH:i:DI ONft.W CON9'rRUC1.'J:ON
r1SIIGN
o ADDITION
D MOV&:
1&IALTE RAT ION
o Di:MOLHlH
o Ri!PAl.R.
o !l't.9TAl..L
lilitOtJO[J.(I} l.lr:H;: [JSGL 1.'J\.MH,y l.lWI:l.tJI~a
OCONMERClAL
DMULTI -F1l1ilLY
o WOUBTR1AL
0# OF UNITS
o SWtMMING POOL
o MOilH.! iiOME,
o .OTHr.R
SitlUP!lkl n:rze
CJ RC:S1'AUllAN'l' " HEArJTIi DEPARTMENT A.PPROVA.L (>ttV\'" 6:. :
"".;":a:,;.,'1' f J:..f '~I ( . r""'l -,: :,~,
J')~"."1~~!~L~""" cot-....,;~~ f'~'.\/'i~",:,--? ~:...JP":""J 1v...n".'. /''''"I''A</. >1;"(
If ,-, _
SQUARll: rOOTAOE __~_.__ H'UGilT . (,t:1 .',t' ..,.
[IEli~C.RH.'~.U:lN OF W01l.1C
....-..-..-... _.__....._.,--,~--
Jum Ul,l!Wr 1 H'I
C()MM!i:I~C:IAT.t
).,'l"l'AC!i (:;I) PLO'I' pl..A.~a &; (;.1) 5~'rS OF BULI..OING Pu..NS . (1) BBT ENnQY 5'DRMS.
~:n:'AC!,l (3) Bi:'l'B OF au fLDnm PUNs " (1) SET ~NU:GY FOfUolS.
~'Ml'hlkl'i" SURVEY agOUtRED Fon ALL l-lEW CONSTRUCTION,
P~~IIS BIQVISTED
Ul Bl.').:Lrrmo
$ -~.JS~'L_,__~ VALU]l.'l'ION OF TOTAL CONl,i'.L'kUCTION
~<~ HLli"~r~~.r.e!\L
~.f pt.l,m~ INi';~
['J 'C;'X '",;'" ~ '( fr
I1}JlC('U,.NrCiA.l..
Nfl? SIR-VICE
o rLORIDA ~OWER
o ~.R,..C,
L,___.._____.._ VALUATION or M~CHANCJ:M.. INSTALI.ATION ~I\oo), -'7' f'r c,:;:>f0;,.
[1 QAD [J kO.::, F ING 0 S ~~cn.l"l Y 0 O'I'H ER
p(.... IMr'
'rnfi; 011 'CCI~5T./l.f.JC'UON I t21- BLOCl<_ [j rJUUoUll
llJ:NIBt'L';t") f"U;,CJR E:LEVAT!O~IS lili./!
-~~--
o STEEL
o OTH~R
IS fROJECT IN FLOOD ZONE AR&AO YiS 0 llO
, /2
.Ntl';(Ll'>~:ii
In Gl'1.h'j mu-:: __h.._.-0~,$~~~I~~_-
,I
.{t'J*j*.,&~..*g*".'.l'.'*'*'**tt.t'*t"jt"*"'...I'..,.***...,.
. /'
//'
:st.1ilCT,;':Jr,;'l.....n ~, .-'""/ /'
fltqUt..'I.~lr~.~ ---._..L...... /' ~~
,.IJWi1 nll~,' I!'~l ..~71JI,lI:" , ;in;tfli~ ":'-" . .~:+, ';rr".~f'I,.J;",;.~':~' .i;':~JIi~11 r,~iJ~~jPI.(nI'W~'::I!';:.i.llj.;rll:,"':':t...'t~j!-0o\;I~\J':1;]
;i~, It~1tI;t(t ~ ',~ ~\Cj~~HY~ 'IJfW ~~rlf.' t 1.' I ,tl~. -, '/":',_7.' '.. ,1..(' ,I ~.r ',I''\'lfl~jj\', 1 h,~!~II~L.l~l,~h kjIJJiWlIWI,~::hh':.f~1~:~ "I;"
COMP~Y ~ 1f..L':'.l':'<.~""""'~J~"I
BTA~~ CERT OR a~QraT ,~ ,
CITY PROCES8lNa ~
-:.
COM:PJ\N'i~~"""'~ _
STA~~ CiRT OR RKOIST #
~CITY PROCEssINa #
f::-f- d6 ~ &rtJ ~
rl,
*'l..~4..***.a*~..l.....*.'...*i'**..."..O'.'.....*.*............
'ti. 'If 'IIll'.o'~''''ll> "I~ 1'\,
, AUG-08-Dl WED 05:46 Py. 4ARPER MECHANICAL
. ---'~'-'..o .
. /':; , ,:(, - - /. . ~
f.H(li.X~TJM '. ,..iL. ;(;t.~,:jf;;/Z~t ;;l1..~~
___ _. .__~AX ~O. 4073237007
8Tl\'1'E ClLRT OR REGIST # ~ t
CIT~ PRQCGSSINQ *
P. 10
\:.. o~)'-'.) '6 \{I Q~,
I
,~,..t~..*.......,*...t....*.t....*tt."""t*'_"""...a.....t..
IGC:tLUl'!Ci,l. ~
9rt~~A tu.Rl: ,",. ,.,,(S'l":tf-t;a, r?~_222.i'-..~
COMPAN~ - ~ X i
St'ATS: CitRT OR REGUT . ... ~ l\i~ C O-::.} ~ S t{ J_:
CITY pJl.Oc~aSINa *
.t,~t***.**.....t".'**""**'~"'*"'t.t""""'*'"..........,
01'll' U;.
, ...,'_...__._...........__..-~--..~,._-,-,---
COM~1INY
STATE CZRT OR ~OIST *
CITY PROCB9SI~O #
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AUG-08-01 WED 05:46 Pt1 'lARPER MEGHf:NICA~ FAX r-;O, 4073237007 p, 12.
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fll:)("~.-O[: "U 1 1;11;~;: ~~ Pl'l Tto "" H":::.:}_~~'.L .,j....l'~ '1.." k'~AAIT AFFID,Wl'l'
'...,' fH)'nCI~ O!! Dn~Il .R1e.'3'r~l<:'l'IONS
'1'1.::; l~rld'~:':rll\.:ln~d unde:CJllt"l".ds UI~,t '::hie PQCIIIl..t JlUtf b., "~k>j$ot; to "de.,d .~.tJ;!r;t;i~m,N whic..i
IU'J bl!!: l~(.)l:I:, ...~t' tieti\ie than City l;'llIg\11atl<lt15. Th.. undeni;nad a..wnell re"ponlli'b1Ucf for i
c~iJ.Uf!\nif:: ~Ilth il.l~,Y applicable de.;;!j nllltrictJ.0118,
n. UNL.!Cf;:}~,9~tl CON':rAA.CTORS NID CON'tAACTOF, RE3PONSIBILITlt.3
H thflj ;~,"n~:; hall! t'..1.red - c:ontn,t:tor or contEiJr.ltorl! 9;1) Utlde:tll.ko work, they m..y b" I:~Ciuiud
t~ b. 11c~nN~d in &eC~rdDnce with ~tate and leeal ~eg~l~tions. If ths contraeto~ i. net
li<;~hllll;."d fdl nj~u:trlllr.:1 by law, beth the o\oma.t and oontrlleto:l: lnll~ be e.ited tor.. J1liaid-rn.41nor
vlo.h,tlal, lHider atoll.\:;i 1;0107, It. th4 Q\oo'ner 1:11': l~t;ended. CQtltr;Il<.:tc:r ..:.::e uncertd.n .. to what
UC€lt.udng '..C!Ui'>:(llt,i!:'11ls m~y iIItl.p)_y for;; tho intended work, th.y axe advised to contact the
C,I.ty of h~ll"jYl';hU..lil Il\l:11d1r.q P~'partlllltnt, 1l13-76B-5oll,
rUt:t:.hu.-I'!l<;>["~', if thw OW~Q.t' hot:' hir,~:::\ a conttac:~or or conttilctot.. he 18 advl.ed to hll1,re I:h_
cl:>rlt.rl,r,:i;'r,~t:(1'J1 1I19Tl flJ,ttiol\8 of th~ "Contractor S~ct1cnIlN of this ll,PpU.Clat!('Jn rQr; .which th.~ I
wUl 11(:: l'''sp(m~j ble. If YOll, lill thl'! owner signg at! t:he conttllctor, you are :l.nd1c:.,t:lng that
l'(>IJ, JC<\tb!>r 1:1".1:1.11 the cQnt;racto~;, ate u8polHlible for the work. If the c;onttll;tot wllhe8
J'QU to !liS Q!. kI~ C.~Ol"ll.:t'.t1.ctt)r thso.t Irl_Y bl8 an 1r.diea\:.lol'l that he .1. not p1Copedy lic.rued a.nd 1.
not ~ntttJ~~ to pe~t~ing privileges in the City of Zephyrhille.
c. 'rIU\il\'r~~C~:O\:l'tON IMPAct 1'El!19 AND tJTILI'1''t CONNECTION rJi:l!S
n. CCiml'lr<.~,lCnIJ:ON LtErl LAW (l';rt.\FTF,R 113, F'LORttlA StATU'!!:S, AS AM~NDZPl
1 l.~lfrl:if.y t hilt I, the applil;:'!nc. have b.no. pJ::l;lv.1dflQ with. QOp'y ot ""l'.lr1tlll'. Con5~ruet:ion
31,,.1, l,,,',~ ~ r1:.;.m~Q',mor' II F.r:otlllctlc:'l. Guido'" preptl~ed kl)' t.he E'lQ~:l.~ IlepillI:\;ment of Agt1c1.I.lcun.
lHid COJ"tt!H:r,lo!';X' A t,t: a 1r.1Il , I( th_ ,:ipplicllnt 18 someon~ other th.t the "o.WTlerH I I ceJ:L!~ th4t I
h'3.Vi! I:>btd"r.e~i a copy ot the IIb~v" described document And prom!lIel .in qoocl faith to delivu
H; to tl1f~ ....Cl;;nnr... prior to corrrrTlene~I'lf!~n.t.
t!:. C.C>NN\J\CTOfl.' 5/CwNlUl.' S Ai'rIO.W.f.T
1 cGrtl!y that ~11 the intormntiQn in ~hl~ applld~tion i$ &ccuc.te and that all ~ork will
b$ don;!: in co",,~li"'Ilt:1ll with .11 applicolbl. laws .u'11J1atin'l cQnllil:.ru.ctlcm, zoning, l!J.l1d hl.na
d.ev~lcl.;;T;enl.: .
Aj;Jr,UcA.tic,lI i.o: hereby made t.o ohtain a p"unit tl'J do work and installation .1 indlcated. I
Cill:t.ify l;l);tt tlO wo.t'k er intlt1ll11at1on hu corrrt~n<::ad pric:: to iai'lLlanc. of ;I p.;mit li.na th.llt
all ~od~ to1t 11 1:;,; pB.rfor~d to J1'\tlr~t ;tQlldardl'l of a.11 lawlI re'jJuhtlnQ conatruction, City
cr.rrle=, :l.t)rJJl111 t:l;:9'u14tlotu1, I!I,ncl land'devdgpment. requb.tlons in tho ju.tiacliotlon. I ..1".0
ce.l:tify l~ht~t .%: lJl1u'Hsl;;and that. the r~gUlal;ion.!j of othor gov.unInAntal aSllnclu may apply 1;0
th<', i.nh~:di!>:i wUJ;k, and thllll; it lis my uapQntlibil1ty to identify "'.I1ul:: acUontt I 1lIU,'"t take to
hll in ,~qrr'flllanc~, .sueh agATlCle5 includ.e but are not lim.ited tOI *Depolrtrnent of
rn.V1..t0l.'\rr;1;n':~\1 R~I~jLlla tion-CypIeu Bayheadlll Wetland J\Ul\~ llnd En'll. rQl'l1I'il:ln t.lly hl'l.ei t1 Ve
T,.and!l, W:1lhH/W<l~r;ewater'''rr.atnol1l: . .
'Il3Q(lthwe.;;t: n,{)~id/J W.ate.t Haha~elnent DiRtdct-welh. Cypr~o!ll Bayheeda. Wetland Areas,
}..11.:.11:r i'il;i 'Wt'ot III C(Ju:nl@!!l
"'Atl:\,y' C<:il,!'1I ot .tn'NineeL".-5t:ilw~.11a, Doc-k/l. Nav1\J~1'" WI&t:eZ:Wf.YII
.D~l:lu.t.;r:ent; ot H~3,lth /:, Rehabjlitatlv~ 5et,v1-::es, El'lv1.tonmotntel Health Unit-Well.,
W$~L~wat9t TteAtq~nt1 aap~io Tank~
"'U..~. ~,nvil::(mmfllr..tal 11 roteotiol; ~ql!!!nc:y~~bElatla abatlllm.nt
I 11ll~..~ n~(,\;U':; ~tlat. .1,t fill Z1S.ter1lS1 ii!l to be ulJed in flood Zone "A'; or "A,etc.", it: 1.
IJndltrl;;tCc.d thi"lt i'I d.ra1t)lIqQ l'llm ;t,ddullSing .. "CQlllpl:lnu.t1ng volume'" will be 8:Jbmltte~ which
is lJj:"~"\.t'<td. b~ " p.t(lfe/.u:icn~l Ilrlq.irleer regi!lte:tad in th" Stllte of rlQ1;'ida. pdor tQ pem!t
:i..lUlUo!l.n....;~,. .
}~ f"'.I:!'"U i."'uo!d ~hall be ecnnt~\lt\d to be << lil;en~e to pro;;ce4 ~ith the work and not u
~uthoEI.ly to vlo1at~t cancel, 8lt~~, 0% tiet a.ld$ any provi.1ona ot the technical code.,
not iO}lldl .It:aual'lc.,, of II. P(l.t'irLtt plovent .the SUlldinq OHichl from thct'eilth~ nql.llr1n; .
r.otl:.l1cl.lml of IH::rou 1n planll, CQOllt.U<:tJ.Ol'l, Qr viQlaUon. of any ClO9,e. Every perirdt
.htll,\l:/.rl. ah.;jl,U b4lC01<:le 11\vall,j ll.'lleCllll .tho_ w<:l~k authorized by "uoh pe.;rndt 10 CCllnnllRc::ed Mithln
111lx m~'nth.~l of. JIl!!l.li1nCe, or if work l'1uthoriz:ea by t:h. p_mJ.~ 1. 8u.p'.nde<t CI:' abandoned to]; . :
))eder.J. ~lf Iilix t'rlt:')"ltth. Qfter the tinl" the WOtX 'i~ commenced. OnQ 90 day tlxtendon or t1me
lll~l" l',~,,',llo""od f.~.a' t:h~ pe.mJ.t 'With fee. c:hcl:'g~ of U5.00. '1'he e~tetlalCln .hall be nquutod
in ~rH~,r;q to the BQlldll'1.g ot.t'j,o.hl. An appl"ovttd inl!lp12ctior. ITII.Ult bo lo;ged during- ur:h dx
l\'Ictll'.:h ~'l:r:iOd, O~ t.hl'! project will be conddor.q abandoned.
~N~lrNG ~O OWN~RI YOU~ rAII~RE TO RECORD k NO~ICE or COMMENCEMENT MAY RE5ULT IN YOUR
l'AYUiO 'hltC!: FOll. nH'ROV~ENT.t'l TO '{OUR PP.OPEl".TV. U" YoU :INTEND '1'0 OBTAIN' f1WANCING, CON,ULT
~J:'l'11 YO~Jj.. LF.NOft.t\ OR M ^'r:l'mU';E't azrORE Rr.cOtl.Ol'NG YOUR NOT:t~~COMMENCi:HENT. JOBS UNOER
l>,~~~,"rl /?U' '0 RECO'O ""0 POST A "NOT!C . or C07'NC.....rr.~
.&d~ ~__~ / ~
SH.iNA'l'lJf'J.: owram OR MENT SIGN'ATU~., ,CnJ.t't'~lI.l''I'f'I11
AUG-08-01 WED 05:46 p~
?,ARPER MECHANICAL
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FAX ~.O. 4073227007 p, 1 L
STA~1\"C:;LORIDJ\
COU~~~I'
The tocegQ~n~ Inst~~~ent was acknowl_daed
Before mil thil!l __sillY o!-----, 'l.9-.:...
by .
lnamt at per8cn &cknQwledqedl
[1hO 10 personally xne~n to m~r or
Owho bu produoed _~
(type of ident1fi~.t1~nl
and who Ddid DUd not t.ke an oath
S1gHiltu:re ef ptlrlfOfl taldn!J ."lcnowledgml!'l'lt