HomeMy WebLinkAbout02-1392
.;tJILDING PERMIT
CITY OF ZEPHYRHILLS Permit N2
(813) 780-0020
1392
Date
g~ 1'-0:2
BUilDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcel 1.0. /I
Zoning:
Descriotion of Work
6'NY~ 5h\;~
S"J.. 3':l 5~ 5"1-.
Water Meter:
T.I.F.'s:
Energy Code:
(l~ ~
Radon Gas:
~-T~
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
FINAL
C.O.
DATE
NO OCCUPANCY BEFORE C.O.
DATE
Inspector
City license Registration #
State Certified license#
/8:2.
~~.. 90
Permit Fee y
)$ignaMe ~ )t'y: -
Company ---'----- _ .
Address
')telephone# ? f ;2 - .,;z..? IJ 0
Valuation or
Contract Price
{J" q lH) " 9V
Ftr.
Pre SlB
lintel
FRM.
Insul. CL
Wl
Ie,;, s -<-J L~~I
SlB
Tub Set
Water
Sewer
Final
MECHANICAL
BUILDING
ELECTRICAL
Tp.Serv.
Rough In
Meter Can
Canst. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Insl.
Compressor
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.
Kinsey Central
Heat & Air-Conditioning, Inc.
P.O. Box 2209
Zephyrhills, Ronda 33539-2209
(813) 782-2300
I~NErt"9-/.flo I
~
-
I
RAO056288
~;~
DATE PROMISED
APAAlMEIiT
CITY
MAKE
MODEL
SERIAL NO.
~TE
o CASH
o CI-lARGE
NATURE OF Q
SERVICE
REQUEST
QUAN. PART NO.
S '('
DESCRIPTION
PRICE
AMOUNT
dO
I
SERVICE PERFORMED
TOTAL
MATERIAL
TEOiNICAl.
SERVICE TIlE
A charge of 1.5% win be made on all unpaid baIuu:es after 30 days, wbiclJ is an annual pen:enlage rate
of ] 8% applied to pas& due baIanc:cs. Cus_ is liable for any cbarges incum:d in cnlieding this bill.
DATE COMPlETED
TAX
7"'-' t.J
CASH ~=-=ON_
TOTAL
TECHNICIAN
CUSTOMER'S SIGNATURE
1394
~
105'
BUilDING
(813) 780-0020
35.tH)
elECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcel I. D. /I
htl83
Water Meter:
T.I.F.'s:
Zoning:
Descriotion of Work
Energy Code:
p~ J-~
Radon Gas:
~
3,,??
FINAL
C.O.
,- t1 :l.
DATE
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
DATE
RL r //JO
Valuation or
Contract Price
9 .5-~
,
~
Permit F
XSignat re-"
Company
Address
~elephone# .5 , ~7
City license Registration #
State Certified license#
7 J:;. -}...(P) r
fh~ /llu P"tV-
OIA.J~
Ftr.
Pre SlB
lintel
FRM. ';;"r22~02 Itl", /.ffJ""o
Insul. Cl
Wl
~.~N. S~
Rough In.l'lO ..;a-lJ:1.. f~''f, Jd'Dfub Set
Meter Can Water
Canst. Pole Sewer
Pool Final
Pre-Meter
Final ~ 1(- V - f) 2. (<( y
Breakers
Ducts 'nsl
Comp
Fi
BUilDING
ELECTRICAL
PLUMBING
Driveway
5~ -%"-Ift;-o:l RL~
REINSPECT~N 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.
s.
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1
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8~ STREET ZJlIPHYRHILLS, FL 33540 /
Phone:813-780-0020 Fax:813-780-0021 ....) /8/ oL.
DATE RECEIVlm ~
PLANS REVIEW FEE
OWNER'S NAME p~ l lL.. .
JOB SITE ADDRESS ~ s.otS
~ \ ~ a.,A Q
~ ~ L ~ l... h, \ -\--<::.-~
d~
PHONE CONTACT ~ l3 - L 1 q -It s ~ ~
L')-t-.~ \;C;~
t='~~Y't" \~) ~\Y\+~
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID #
J ADDITION
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: DNEW CONSTRUCTION
o ALTERATION
o REPAIR
o INSTALL
DSIGN
PROPOSED USE:~GL FAMILY DWELLING
o COMMERCIAL
o MOVE
o DEMOLISH
DMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
o RESTAURANT
DESCRIPTION OF WORK 7~~\ C) ..v
BUILDING SIZE \ \ 'I- d... \0
& HEALTH DEPARTMENT APPROVAL
R.()~ rr-.. k ~ /~ \ ~\ ~r-J
SQUARE FOOTAGE ~ -g ~
HEIGHT
'K'
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.
o BUILDING
$
PERMITS REQUESTED
q 5 v (::) -U-==- VALUATION OF TOTAL CONSTRUCTION
.
o ELECTRICAL
AMP SERVICE
o FLORIDA POWER
o W.R.E.C.
o PLUMBING
o MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
o 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
.~
~
"t
"-
J
....
,~
@
~ ~,
~"
COMPANY ~ c,\t / .C\ I v.,lIY'\' i lJ u. rv---. 'q.J G::, t"\ t. fT "''-^-
STATE CERT OR REGIST # C. R c:..,C) ~lt(t '& C')
CITY PROCESSING #
******************************************************************
BLBCTRICI~
SIGNATURE' r ~ D r
~.
COMPANYVC>LO~
STATE CERT OR REGIST #
CITY PROCESSING #
********************~*********************************************
PLUMBER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
MECHANICAL
******************************************************************
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
OTRJlIR
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
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 regula t:ions. The undersigned assumes responstb:l,li ty for
compliance with any applicable deed restrict:ions.
B. UNLICENSED CONTRACTORS AND CONTRACTOH Rft~SPONSIBILITIES
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 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 OBTA INANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NO~~ EM JOBS UNDER
$2~~g;Q:~ TO RECORD AND POST A "NOT Ei/ ~ TN.
~~URE: OWNER OR AGENT RE: CONTRACTOR
STATE OF FLOlUDA
COUNTY OF +>AS C D
The foregoing instrument was acknowledged
Befo~ III;e . this ~ day of Au..c~ <".,-r , :1f'QQ..2..
by t:: \r. \ \ \ ~o.A
....../ (name of person ackn()wledged)
Lawho is personally known to me, or
STATE OF FLORIDA P
COUNTY OF Asc D
The foregoing instrument was acknowledged
Before me this ~ay of p<u...Gc.i.A...S.. , :Lt'..QO
by "12:A-Y "])Al-.I I e:L3
~ (name of person acknowledged)
ELho is personally known to me, or
acknowledgement
o who has produced
(type of identification)
and who Ddid [}:lid not take an oath
~-tt~ fl &d7~ ~
Signature of per n taking acknowledgment
o who has produced
(type
and whoD did Ddid not
of identification)
take an oath.
A
NameltVD~~' Drint.~<ih,A.I:i"~",,pe
..~ ~~ "'KATffL~-I...
~~: MY C.<.)Mt\1iSSI.Ui'!1;' (_'t, ~:25469
~~.tl~ r\;'/";!HrS
W~ ~
1-800-3-NOTAtTl F~~
.:.:~~;l.~~i;:..:,-~c,'t,,';'\;
~PcT1-lI l~tJ. ,:J'. ~ R.ovJ tJ
Name typed/" p..,I::;LP.' t' ea'....o.''f''..~st.~. "."'._
~.\~" -' 11,f _ ,:\", ',' _ . . .
""If .~rnr<-'-:,... t~~/ ,. j I' ',-"I .! R()t~ ',,",
~~,~.M ':;,' il~'( ,;;~:"
l,_,>c 1.8,);)-,'~:'.:,} c . ',: {I.t L>:-:t,;,)3
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111111I 111111111I1111I 1111I111111111I1111I11I1111I11 1111111I
2002120631
Permi t No.
Rcpl: 608468
OS: 0. 00
08/06/02
Rec: 6.00
IT : 0 . 00
Dpty Clerk
state of
/~.
NOTICB OF COMMENCEMENT
County of
~~~
TUB UNDERSIGNED hereby gives notice that imp.&."Qvement will be made to cC!rta1n
real property, and in accordance with Chapter 713, Florida Statutes, the
fc:"lowing,information is provided in this Notice of CommoncnJlIcut:
1.
., .... ~,
Desl~ r. ipt10n of Property: Parcel 'No.
..::IS 0 Y //lAe/&- tL . Ldr::?--.J .
(Leg" eser p tIe proper y and str~t a ress ~r ava~ab eJ
G~luHal Dascrlvtion of Impro'\,9C!mcnt ~Z.5:!. _ -d- 0.-u-JD lJ C~
2.
"
3.
OW"".:~Inforolationl Name ;4;j~ / ~ ~%~ZJ
Address 3~Vlr ,4?RZzP/#CJJ,1lCity ZCV~ 4/ft
state;C ~ J
Interest in Pr.operty:
Name of Fee Simple Titleholder:
I :~ f other th~n owner)
JEO PITTMANft PASCO COUNTY CLERK
08/06/02 0~:39am 1 of 1
OR BK 5028 PG 1059
Add)' :\SS
1 c..e '
I
/1(70 /J~/A../~
~D 1Jt..v~ City 2-c7J~4/d
City
State
4.
H
Contractor: Name
Addrc-!ss J g-.( 7.-<(""
5.
Succ;.f".y: Name
State 7..k "()
3351
Add':f:,SS
City
state
Amount of Bond: $_
6.
LendQr: Name
II
Addr€!ss
City
Stute
7. Persons within the state of Florida designated by Owner upon '-111011I
not '~~es or other documents may be served as provided by Sect:.l.on
713. '13(I)(a)(7.), Florida Statutes:
Namo
Addr'::lJ B
City
State
r6j f)/fN'c4
8.
In addition to himself, Owner designates
of .b ~C: ft~ .
Lienor's Not ce as provided in Section
to receive a copy of the
713.13(1)(b), Florida statutes.
9. I':Xl'l111l.lulI c..J"Lo or Nutlt.:o of CUI.1I110IlCOJIIOIIL (Lho oxplratlulIl.Into 181 year
fr,::>m the date of recording unless a different date is specified.)
~~
Si9naturel)fOWnerl~JO~ ( ~...&O
Sworn to ,.'"d subseri~ed before me th~ . ?:2. ~d;tX_9f /'tv--,
ill~-;';:'" RiCI/;\/W D;Ii:ICLS
Q~ . \.. .. :/:....~ ........~.~.~.{: Notary ['uulle. St;lt,: of Fir, it" ~
'. : -;: '.-. /~ My Comm. Exp. Au~ 31. 2Dl"
(i ". ..:';;c;.. Comm. No. 771~91
. I .............._
Notary Pub.l ic :
. My Coonnlssion Expires:
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VELOCITY (3 SEC. GUST) EXPOSURE: 3.
VOID AFrr:R 2-1-03