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HomeMy WebLinkAbout01-0684 Property Owner: W: \ (: c"'" 6 Co,,....-eA + Job Address: S- c; 0; (~rfL ~ 8,...: 1'",,. G Parcel I,D, # lo~ 2"2' - 0120.. 00000 - O~O Zoning: Energy Code: Description of Work ~ It' c...\v-: (. ~.- BUI~NG BUILDING PERMIT tf! 0684 CITY OF ZEPHYRHILLS (813) 788~6611 Permit 10 - J ~ _0 ~ Date 'J S, <.f;! ELECTRICAL PL~BING MECHA~CAL Sewer Conn Water Conn: Water Meter: T.I.F.'s: Radon Gas: ~ k L/. .f.te.r So NO OCCUPANCY BEFORE C.O. FINAL C.O. 0-(.) / DATE Complete Plans, Specifications and Fee Must Accompany Application, All work shall be performed in accordance with City Codes and Ordinances, Valuation or Contract Price DATE '}. ol!J .,(UQ. '- City license Registration # State Certified License# Permit Fee >< Signature Compan Address ~ Telephone# ?Oo..6'37'?ro.s:x~/ i Ftr. Pre SLB Lintel FRM, Insul. CL WL Driveway Vc.1 (,0 ~ Breakers Ducts Insl. Compressor Final ELECTRICAL MECH Tp.Serv, Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of Twenty Five and 00/100 Dollars ($25.00) shall be made for each trip for each trade: a. Wrong Address b. Condemned work resulting from faulty construction. c, Repairs or corrections not made when inspection called. d, Work not ready for inspection when called. e, Permit not posted on job site, f. Plans not at job site. g. Work not accessible. The payment of inspection fees shall be made before any further permits will be issued to the person owning same, APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER' S NAKE (Mr/htzt ,r9os- ,~()S (;'11 !l.J?& t r- ~~O;t) g;;,~R rT 6$~~uft.A ,'A R (/ 7 ~Y.)/R /;"(1.5.. F~ S5S.Y'/ SUBDIVISION lAAOJ5, (0 U/ho j) It( If M.It.. PHONE ;7i?D - d-.?7,6 OWNER I S ADDRESS JOB ADDRESS LEGAL DESCRIPTION: LOT(S) BLOCK PARCEL 1. D.' !f) ~ ~ In . ~ 1- IJ I;).. () - tJO C)(?)("l- ('J s;-~ ~(J (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition -U-Alteration ~epair _Install _Sign --1tove _Deaolish PROPOSED USE: _Single FSIIily _M/F _' of Units _M/H _eo..ercial _Indust. _Swia. Pool _Other _Restaurant & Health Depart.ent Approval DESCRIPTION OF WORK: Allf^-- E;{:r;.1flt 'r h tv, ~ P ("JlV'e 5 4/1',o/L t' BUILDING SIZE: x Square Feet, Height RESIDERTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET END.GY FORKS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. _BUILDING lX-KLECTRICAL $ C*JQ. PERMITS REOUESTED Valuation of Total Construction AMP Service Florida Power Corp. W.R.E.C. -1IECIIAlIICAL $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fralle _Steel Other FlBISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? ****************************************** YES NO CONTRACTOR SECTION BUTI.DRR COMPANY State Cert. or Regist. . City License Registration . ****************************************** Signature :::~CI"" f'~ COMPANY!/A~ E-AO- pf51l Rn//lrM1Y ~ State Cert. or Regist. , ~ ef7 - City License Registration' ?,~t.. ****************************************** PLUMBER COMPANY State Cert. or Regist. . City License Registration . ****************************************** Signature MECHANICAL COMPANY State Cert. or Regist. . City License Registration . ****************************************** Signature OTRRR " COMPANY State Cert. or Regist. , City License Registration , ****************************************** Signature APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A: NOTICE OF DEED RESTRICTIONS The undersigned understands tbat tbis perlit lay be subject to "deed restrictions" which lay be lOre restrictive than City regulations. The undersigned assWles responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CON1'RAC'l'On RESPONSIBILI1'IES If the owner has hired a contractor or contractors to undertake work, they lay be required to be licensed in accordance with state and local regulations. If the contractor is noL licensed as required by law, both the owner and contractor lay be cited for a lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing require.ents lay apply for the intended work, they are advised to contact the City of Zephyrbills Building Departlent, (813) 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. ~ONSTRUC'l'ION LIEN L'l\W (CHAPTER 713, FLOlUDA STA'l'UTES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law _ HOIeONDer's Protection Guide- prepared by the Florida Departlent of Agriculture and ConSWler Affairs. If the applicant i8 sOIeOne other tban the -owner", I certify that I have obtained a copy of tbe above described doculent and prolise in good faith to deliver it to the "oNner" prior to couence.ent. E. CONTRACTOR' S/OWNER' S AFFIDAVI'l' I certify that all the inforlation in this application is accurate and that all Nork will be done in cOlpliance with all applicable laws regulating construction, loning, and land developlent. I Application is hereby lade to obtain a perlit to do work and instailation as indicated. I certify that no work or installation has cOllenced prior to issuance of a perlit and that all work will be perf oIled to leet standards of all IllS regulating construction, City codes, loning regulations, and land developlent regulations in Lbe jurisdiction. I also certify that I understand that the regulations of other govefDIental agencies lay apply to tbe intended work, and that it is IY responsibility to identify what actions I lUSt take to be in cOlpliance. Such agencies include but are not lilited to: t Departlent of EnviroRlental Regulation - Cypress Bayheads, Wetland Areas and RnviroDlentally Sensitive Lands, Water/Wastewater Treallent t Southwest Florida Water Hanag8lent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t Arl' Corps of Engineers - Seawalls, Docks, Navigable Waterways t Deparllent of Health' Rehabilitative Services, RnviroRlental Health Unit - Wells, Wastewater TreatleRt, Septic ranls t US EnviroDlental Protection Agency - Asbestos abate.ent I also certify that, if fill .aterial is to bl! used ill Flood Zone "A" or "A, etc. ", it is understood tbat a drainage plan addressing a "colpensating volDle" will be sublitted wbieb is prepared by a professional engineer registered in the State of Florida prior to perlit, issuance. . A perlit issued shall be construed to be a license to proceed with the work and not as autbority to violate, cancel alter, or set aside any provisions of the technical codes, nor shall is~u~nce of a perlit prevent the Building Official frOl thereafter requiring a correction of errors in plans, construction, or violations of any code, Every perlit issued shall beCOle io,alid unless the work authoriled by such perlit is cOllenced within six IOnths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day eJtenaion of tile, lay be allOlfed 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 IOnth period, or tbe project will be considered abandoned. WARNING TO OWNER: YOUR FAILURK TO RECORD A NOTlCK OF COHHIlNCKHBNT HAY RKSULT IN YOUR PAYING TlfICI FOR IHPROVIIIHIIIS TO YOUR PROPKRTY. IF,.OU IH1'IlND TO OBTAIN FINANCING, CONSULT WITH YOUR LINDIR OR AM ATTORNKY BlFORB RBCORDING YOUR NOTICI! OF COHHKMCEHKNT. JOBS UNDER $2,500 IN VALUI DO NOT NEKD TO RKCORD AND POST A "NOTICE OF COHHKNCRH1lH1'-. ' , I' SIGMATURIl: OWNER OR AGENT SIGNATURE: CONTRACTOR STATK OF FLORIDA COUH1'1 OF The foregoing instrument before me this was acknowledged , 19_ by STATK OF FLORIDA COUNTY OF The foregoing instrument before me this was acknowledged , 19 by who is personally known to me or who has produced as identification and who did/did not take an oath. who is personally known to me or who has produced as identification and who did/did not take an oath. (Signature) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC PERMIT NUMBER NOTICE OF COMMENCEMENT !O-J.,J-J..l-OIJo-atCXl.' o5'Si PARCEL 1.0, NU mER STATE OF FLORIDA 1111111111111111I11111111111111111111111111111111111111111II 2001148088 The UNDERSIGNED hereby gives notice that Improvement will be made to certaln real property and In accordance with Chapter 713, FLORIDA STATUTES, the following Information Is provided In this Notice of Commencement. LEGAL DESCRIPTION ~ / r(,vrd-JPI1/m~ b NAN"A tlAft ~{> I tJ..:J.. Rcpt: 538481 OS: 0. 00 10/24/01 Rec: 6,00 IT: 0.00 Dpty Clerk JEO PITTMAN! PASCO COUNTY CLERk 10/24/01 0 : 0!pm 1 of 1 ORBk 475't PG 1813 OWNER INFORMATION NAME \V iLL""'''' L . GAlU...ft 1T' INTEREST IN PROPERTY CJt{j A!{\ IL NAME & ADDRESS OF FEE SIMPLE TITLEHOLDER (if other than owner) ADDRESS S-1o~ Ge.~~1 All. <-T ~'Y L.fZ..Pt\--{,(HI '-L~ ~11 ~~tfl '-.s2'~ Nit ..., ,L, GE7AL DESZ,TION OF IMPROVEMENT J IV 51A It . ~ 1fyJ I\-.. -- , BOND AMOUNTS Jerry Hicks, Valco Enterprises Ltd, DBA RoIl-a-Way Qualifier /!fJ --. Nfl /1/1+ CONTRACTOR NAME ADDRESS NAME & ADDRESS OF SURETY 10601 Oak Str. NE, St. Petersburg,FL.33716 /V/J- LENDING Cll:lGANIZATION (Name and Address) NAME Persons within the State of Florida, designated by owner upon who notices or other documents may be served as provided by SECTION 71~3.13 (1) (a) (7). FLORIDA STATUTES. . IVP- , (l/A . I , ADDRESS In addltfon to himself, owner designates of /l/fJ '(Address) jne year from date of recording. unless specified) Printed Name CERTIFICATION STATE OF FLOf'2.Il) A COUNTY OF ,. P I rlIL"'lI~, C; The foregoing Instrument was acknowledged before me this Q day of () c.. r , 200 I, by who Is personally known 10 me or has produced as Identification and who (did) (did not) take an oath. Commission Number (Stamp) I~ iL:. '" ,,..... F'(h .. ..~c ......."~ * "'", ". 'f~OFF...fl:-f) ANDREW J. AYERS MY:~MISSION , DO 036121 eXPIRES: June 24, 2005 Bonded Thru Budget Notary Service. SlIlcs AgrcclIlcnt .,.... IL ~~.:!:~ NATIONAl HEADOUARTERS _ MANUFACTURING FACILITIES 10001 Oak Snot, NE, SI. Pelel>burg, FL 33716 Sl PetefTampo (727) 576-1"3, (8001683-9505, Fex (727) 577-5026 ~: "'foOroll...-w.y.com ~: www.rofl+w.y.com HORIOA OFFtCES H MYlm - 3800 Fowlftf Ave_. Ft. Myert, Fl 33901 (94'1275-7587, (8001505-7186, Fax (94') 275-3528 Pompano Beach - 915 S. Dixie Highway East, Pompano Beach. FL 33060 (9501) 978-0992, (800) 667-0030, Fax (954) 782-3309 Fl Stale lio' SC C049534 _ BOO 2228 Produc1 of Vak:o Entonvises lid. dIbIa Ran-a-wav Storm & Seadv Shutlers SALES REP, P.KDj ~-I~ '::. DATE ,~-17- D \ PAGE--1-0FL ESTIMATED TIME OF INSTALLATION ?.. WI "'-~ WEEKS JOB NO. ..-- HOME PHONE ~\ ~ ,~ 7~ - 2.~q Ct> OWNER'S NAME \IV I LL, ^ I") L GAr..~ I , ADDRESS ~OS t~;;:O;~B(G.\ D.~ f....'-r WORK PHONE ~ (~ - l.l'q - 17S,? CITY 7 fl?~\:C2...\.\\\"'\..S STATE r.L ZIP '"],S<4I E-MAIL ADDRESS JOB ADDRESS CONDO/ASSOC. # PHONE ELEV. Valco Enterprises Ltd. d/b/a Roll-a-wayl8l (the "Seller") will furnish all labor, materials and equipment necessary to Install the followln roducts at the above address: Shutter Classification: ~olarShade 0 Security 0 Hurricane Protection Scaffold Reauired: 0 YE~O Type Colors: (WH) White; (IV) Ivory; (BZ) Bronze; (BG) Beige o erators: 1 Pull Stra 2 3:1 Crank w/Stra 3 Gear & Crank Handle SIZE SHUTTER SLA TIBLADE PURLlN COLOR , OPERATOR INSTALL LOCATION NO, W X H TYPE TYPE CODEfTYPE FRAME HOOD SLATS TYPE (#) \ -" X o...LJ ~"'o iT 0-77 [\T- 2.3,-7-" \lilt-{ "V 1-\ I1IH o::r SL.I DU<. X X ~ ~ V X "".....:: ~ X '- 7 X ~ 17 X """ ./ X ~ ./ X ........... ? X ~ X /' t--.... ~ Total number of openings to be cove,red (multiple sections count as one), Units are numbered from left to right as viewed from Inside 0 Outside 0 ADDITIONAL SCOPE OF WORK AND OPTIONS NOT SHOWN ABOVE: TERMS ~40%) DEPOSIT, Make payment to sales rep to submit with the order, (40%) DUE ON DELIVERY OF SHUTTERS, make payment to inslaller, (20%) DUE ON COMPLETION, make payment to inslaller, o FINANCING 8. DEPOSIT CHECK NO, .,.g CASH 0 CIRCLE ONE: MC VISA @W AMEX ACCOUNT NO. G.6/1 ~- G~ -"'V63 EXP.DATE ~V MAKE ALL PANTS TO ROLL-A.W A Y SHUTTERS CONTRACT AMOUNT $J~.oo DEPOSIT PAID WITH ORDER (40%) $ 7 '-Ill. 00 AMOUNT DUE UPON DELIVERY (40%) $ 7~t.J ,OD AMOUNT DUE UPON INSTALLATION COMPLETION (20%) $ 1.., Z. . Co You may cancellhls Sales Agreement, without any penalty or obligation within three (3) business days from the above'date, If the owner stops the contractor from beginning the work after tha end of any cancellation period which the owner has under applicable law and/or regulations or ordinances, the owner will be liable to and pay the Seller for all costs and expenses InCUrred (10% minimum) arising oul of or In connection with the work, including but not limited to the execution of this contract and any preparallon and purchases made for the wori<, To cancel this Sales Agreement, you must timely send via certlfled or registered mall delivery a signed and dated copy of lhis cancell"f'llfl no~_or any 0 er written notice, or send a telegram, to ROll-a-way, 10601 Oak St. NE., St. Petersburg, FL 33716 no later than midnighl of (dale) \J - ''0 '.0 l/We hereby cancel this lransaction (dale) Owner's Signature NOTICE OF CANCELLATION l!We understand that this Sales Agreement pertains 10 the purchase and sale of specially manufactured, custom made goods to conform to spec/ficatlons relating to my/our property, Upon acceptance of this Sales Agreement In the manner set forth below, Seller is expressly authorized to take such steps as it deems necessary to perfect Its lien rights under Ch pter 713, Florida Statutes to secure payment of the outstanding balance due hereunder and Is hereby authorized to obtain my/our credit port from a It reporting agency, Additional terms and conditions are contained on the reverse side of this Sales Agreement.l/We hereby ~i~th t'lI\Ne hav understand a 8ccept this Sales Agreement. l/We have been fumlshed a copy of the Consumer Rights Notice required by S)/'tm:j;lr;a d two cop' Is agreem~~t ndudlng the above notice of cancellation: , Owner'sSlgnatur' '''"\ ''Oh ss# j?9-Q:c'-4Lf7:/ Date rU/'llol I ' SS# Date Salesman The onler for a ny ured good. aet forth In "'to Se," Agre&rnent and any aub88q1Jenl chenge onlers hereto ahan become a binding COI11nIcl only when ""0 SOl8o Agreement or any change onler hereto I pled by S_, el no home oII1ce, as refl8<:ted by the llCCOptsnce and algnoture or a CDmpony 88180 menager or corporate oII1cer, and .ubject to the expres. I vel ofth!! Com.e..~~_ __~ssfonlr engineer, tf appllr..able, An InlerP-sf r;harOft nf 1 5% ~r mnntl1 will ~ ~rlrl"'rl I... .Ill" ('\1""'"1.,-11"" :\"'l"I"l"~ "''''''''"l'',t!..~ "...... ....,i"" .... fh" fl...,... ,,' j...o:t.."....;"'... Accepted By Date ...:. IL ie~~..:!:!@>: ORDER NO, ORDER DATE SALESMAN ~ MDt ", ,,^y~lL~ PAGE ESTIMATED TIME J OF INSTALLATIOI\C2"2 ~cS DIRECTIONS , J 0 ~.,.~ +.- 0 J \ OF ,; SALESPERSON WORKSHEET #05-03 CUSTOMER NAME .~, ~L. .An ,-.I.i '-,bA ~ t HO PHONE '~~J 3'",,:, 7.a~ ... z ~L ADDRESS Q./r<" -~;;~..tJ~i lAd,,' i.. t~~1f t:..- .~ US. -';-- ":~ "q~ -(i. - - -- A'~" ~~ (U' I ,- CITY 7~P...tv/l..'../ll L~ X 33~41/ STATEF=:.L. ZIP~'IJ -P- 'RE'SIDENTIAL 3~CONDO ~DO N~ j t...ot)P OUT OF TOWN ADDRESSZ:::~ ~;".::: ~ ~ /~;"". ... . PH~NE PROTECTION: ~ SO~V_ SECURITY (-h~ ) NE ~ (IF OTHER THAN PER CODE) SHUTTER ZONE: ( Al; COASTAL: ( ( ) EI OZONE 1 ( ) ENDZONE 2 MILES FROM COAST ~~, :X ..?' BLDG HEIGHT: ( ,~,I ( ) > 60 FEET /l"-:" BLDG STORIES; HUTTER LEVEL: FLOOR; ROOF SLOPE. ( ) < 10 DEGREES ( ) >~E~~OL~RS. (WH) WHITE;'(Ivt.I~RY, (BZ) BRONZE, SPECIAL COLORS: SLATS u~ MULLS WH PURJ,JiQ !V\.J- TR CK WIT He 'D~tvl,L.. BACKPANEL'LA:t' BTMSLATw17' ./ ..../ /' ,/ SLAT TYPE ../' REBAR SPACING / WIDTH: T - Y TRACK ~GHT Stj,LJ'frERZONE LOCATION QFOTHER~ABOVE) ,1---6PERATOR TYPE CODE \) OVERRIDES YES 1 NO $ SHUTTER NUMBER # I , # #<. ~ # # # I / / X / / / / V '{;. / \/.' \ IA\ \ / .\. I"~ \. '. 1\ 'i.. \ '\ \ r\ \ SHUTTER TYPE I 'L I/~ ;, I.-,=] NO ?2 I2tJ ~ - ') \ \ ' _., \~ U"'~ \ ~ " I N' t\:\ "\\ \ - - -";:- ._~._.\,.... OPERATOR LOCATION (ISLO) UNIVERSAL TYPE - FIXED/REMOVABLE '4~ NO 'TL\O " ,) , i ., .-.l ~ " ~."t..o.~ ~"-- BACK PANEL YES 1 NO HOOD SIZE: 6,7,8,9,10,12 HOOD STYLE: 4/5/6 SIDED fr- . ) i'\. ^.-.; ~ ,,~t\ \.,~. , - a" -, ~ ~ .~. ,,' , ~b .rit> ,.,tt It n, "- ,., - _~ 1;1 ,. '-"_ L;;-. ~ - .A '(...,1\ Q.. ~ 1',1"'" ~ : / ~/ .\ i A SOFFIT - RECESSED POSTS YES 1 NO ~. 71 SWITCH TYPE (MO or MA) PURLlN CODE PURLlN SIZE FIXED OR REMOVABLE - " ---- - L -' 1 ' . " .. SPECIAL INSTRUCTIONS & DIRECTIONS: .. COLLECTION ARRANGEMENTS: This worksheet is an internal company document intended to be used for preliminary internal purposes only, All figures and information contained in the worksheet are sUbject,to change at any time and may not be relied upon, in whole or in part, for any purpose by the customer, Under no circumstances shall this worksheet or any of the information c6niained therein constitute a contract document, nor shall it be regarded in any manner as a document which changes, contradicts, varies or modifies any contract between the parties, ROLL-A-WAY /PRIME WINDO Storm and Security Shutters Aluminum and Vinyl Replacement Windows Corporate Headquarters * 10601 Oak Street N.E. * St. Petersburg, FL 33716 (727) 576-1143 Toll Free (800) 683-9505 FAX (727) 576-8477 SOLARSHADE/SECURITY DISCLAIMER By signing this document, the Buyer acknowledges that he/she is aware that the product being purchased for opening #s \ is only designed for sun control and security protection in accordance with the prevailing building code in the Buyer's municipality. The product is not tested to withstand hurricane force winds, therefore the Seller would not recommend relying on such product for hurricane protection. Customer Signature: Printed: l -- ~ 1 ~ - L - :r I '-.0 J , ~ a .tr a tl c::P ~ V cO I-. I BUILDING SPECIFICATIONS FORM (FOR PERMIT APPLICATION) CUSTOMERNAM;E WILL.IAM __ /..., PROPERTY OWNER YES ~O ADDRESS ~ 65' G./2..I{,f,f &u A P.. CITY, STATE '2a..PI-/ 1/ f\ /1, LL ~ / STRUCTURE: MASONARY_WOOD ~E_ALUM._OTHER_ 'WINDO\V FRAME: DOES MATERIAL DIFFER FROM ABOVE? TYPE · ROOF SLOPE: <10 DEGREES_ >10 DEGREES~ . . FIRE SPRINKLERS: YES_ NO-lS: FLOOD ZONE: YES_ NO '< BLDG.#OFSTORIES ( ARE SPECS AVAILABLE YES~NO~ CONDO/ASSOCIATION APPROVAL: REQUlRED_ NOTREQUIRED~ . . ** All drawings .!!l!!ll.indicate: Correct shape of building - Room type (bedroom, kitchen, etc)- \Vhere shutters are to be installed or openings to be replaced - If manual or electric shutters- Manual override location - Main street, if other than customer's address (pertains to condos and Townhouses) - North, South, East, \Vest Direction Indicator ***Drawings may be done on the reverse of this form. ....