HomeMy WebLinkAbout02-1410
BUILDING PERMIT
Permit N!
CITY OF ZEPHYRHILlS
(813) 780-0020
1410
Date g - hl.-o- tlO?.
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcell.D. ,
Zoning:
Description of Work
~~ ~
S~/~ ~~ 5t.
Water Meter:
T,I.F.'s:
. Energy Code:
'P~ -~
Radon Gas:
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
Inspector
City license Registration #
State Certified license#
Permit Fee
~ignatur
Company
Address
~Iephone# / - fI IP3 ~ LJ;:;'s... 399 (,
Valuation or
Contract Price
~ "/75' . t)-o
,3tOf) 7
(1""".v M" K s
I .
BUILDING
Ftr.
Pre SLB
lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. P e
Pool
Pr
Inal
PLUMBING
SLB
Tub Set
Water
Sewer
Final
reakers
Ducts Insl.
Compres r
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.
I OWNER'S lifAME L.es tf'/'
JOB BITE ADDRESS ~~/~
CITY OF ZEPaYRHILLS PERMIT APPLICATION
BUILI>ING IJBPARTMBNT 5335 8th STRBlB'r ZBPHYRHILLS, P'L 335fO
Phorte'813-780-0020 FaxI813-780-0021
DATa RICBIvao
PLANS a.VIR" rl.
,
).. ~X
Lft!1 ~-I.
PHONEl CONTACT
LEGAL DESCRIPTION, LOT(S)
BLOCK
SUBDIVISION
PARCEL ID #
WORK PROPSED f ONEW CONSTRUCTION
(OBTAIN Ii'ROM PROPI!IRTY TAX NOTICE)
o ADDITION
o AL'fIllRATION
o DEMOLI SU
o REPAIR 0 INSTAI,Il
1?1'f'b()F
DSIGN
o MOVE
PROPOSED USE I OSGL FAMILY DWELLING
(J COMMERCIAI,
OMlJLTI -FAM!LY
o INDUSTRIAL
On OF UNI'rS
o SWIMMING POOL
o MOBII~lll HOMIll
OOTIIER
o RESTAURANT & HllIALl'U DEPARTMElN'I' APPROVAL
D08CRIP1'ION OF NaRK .:I/.a- rer'/)/).F ...s h; "i k $
BUILDING saE SQUARE FOOTAGE -'--!l"IJ
"mIGHT
RESIDllINTIALI
COMMERCIAL I
ATTACH (2) PLOT PLANS & (2) SETS OF Bun/DING PLANs & (1) SET ENERGY FORMS.
ATTACH (3) SETS OF Burr,DING PLANS & (1) SET ENERGY FORMS.
PROPER:TY SUitvEY RBlQUIRllID FOR ALl, NEW CONSTRUCTION.
o B(JIMlING
~ERMITS REOUmSTED
$a; y7S, '(YO VALUATION OF TOTAL ConS'l'RucTION
[] EI,EC'l'RICAL
AMP SERVICE
o FI.ORIDA POWER
o W.R.E.C.
[J PLUMBINf1
o MECHANICAL $
o GAS ~OFING
VALUATION OF MECHANCIAI~ IN8TALI1ATION
o SPECIALTY
o OTHER
'l'YPIll OF CONS'I'RUCTION I 0 BLOCK
o FRAME
o 8'1'EEIJ
o o'rnER
FINISHED Fr~OOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES 0 NO
BUILDBR
COMPANY
STATE CERT OR REGIBT #
CITY PROCESSING ft
B IGNATUREl
******************************************************************
JlLJlCTRICIAN
S I GNA'l'(}RIll
COMPANY
STATE CERT OR REGreT #
CITY PROCESSING #
-----
.
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~ '.... ';t ~ ~
PLUMBIIt
COMPANY
STATE CERT OR REG 1ST #
CITY PROCESSING #
SIGNATURE
MBC8ANICAL
~***..*.***********************************"'**************i*",*****
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
**********"''''********'''***'''*********'''*********''''''***'''''''''*************
OTHIR
COMPANY Gc::t'" , Nf<.K'..s
STATE CERT OR REGIST # C ~ ~
CI'I'Y PROCESSING # t ~11ffl
*************"'*********************************************
SIGNATURE
CONDITIONS OF PERMI~' AFFIDAVIT
A. NO'rICE Oil' DEED REB'l'RIC'I'lONS
~lhe UtAdersigned understands that this permit may be subject to "deed restrictions" whi.oh
lIIay be lIIore restrictive than City regulat.ions. 'l'he undersigned assumes responsibility for
complj,ance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CON'l'RAC'l'OFl RESPONSIB~LI'I'IE'Jl .
I f the owner has hired a contractor or contractD~.t~ \Ill?e.ftakf"~o?j{;", J;:qey may be requjred
; to be licensed in accordanoe with state and l,oc.al refgl~J,atJons. . .~..t:be contraotor is not
licensed as required by law, both the owner and, contractor may~. ,ci\t6d for l!l misdemeanor
violation under state law. If the owner or intended contractor are uncertain as to what
lioellsingrequirements may apply for the intended work, they are advised to contact the
City of Zephyrhills Building Department, 613-788-6611.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
oontractor(s) sign portions of the "Contractor SectionsH of this application for whioh they
will be responsible. If you, as the owner signs as the contractor, you are indicating tllBt
you, rather than the contractor, are responsible for the work. If the oontractor wishes
you to sign. as con~ractoJ: that may be an indication that he is not properly licensed and is
not enti tlad. t;e-;l>~.t1llitting privileges in the CJty of Zephyrhills.
C. 'l'RANBPOR'l'A'rION IMPAC'l' FEES AND U'l'ILITY CONNEC'l'ION FEES
D. CONSTRUe'fUION I.IEM LAW (CIfAP'I'ER 713, FLORIDA S'I'A'I'UTES, AS AMENDED)
I certify that I, the applicant, have been provi~ed with a copy of "Florida's Construation
l1.an Law -- Homeowner's Protection Guide" prepared by the E'lorida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "owner", I oed,fy that I
have obtained a copy of the above described aocument: and prorllise J.n good faith to deliver
it to the "owner" prior to cbmmenO~mer!t. ,t' t ,'. .
E. CON'I'RAC'l'OR' a/oWNER' S A~f:OlWUA \1 .' .
1 certify that all the information in this application is accurate and that all work will
be done in compliance With.~ll'iapplioable laws regulating construction, zoning, and land
~evelopment.
J\ppl1aation is hereby m~de to obtain a permit to do work and installation as indioated. I
certify that no work or installation has oommenced pripr to issuance of a permit and that
all work will be performed to meet standards of all laws regulating oonstruction, City
codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify tllat'I understand that the regulations of other governmental agencies may apply to
the lntended work, and that it is my r~spons;t.bility to identify what actions I must take to
be in complianoe. Such agencies include but are not limited to: *Department of
Envi.ronmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensit.ive
Lands, Water/Wastewater Treatment
*Bouthwest Floricta Water Management District-Wells, Cyp.tess Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater Tre.tment, 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,eta.", 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
issuanoe.
A pennit issued shall be construed to be a license to proceed with ~he work and not as
autllority to violate, oancel, alter, or set aside any provisions of the technical codes,
nor shall issuance of a permit prevent the Building Official from thereafter requiring a
correation of errors in plans, oonstruatiop, or vio~ations of any code. B1very permit
iuued shall become invalid unless the work authorized by suoh permit is oommenced withln
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 thile
may be allowed for the permit with fee charge of $15.00. The extension shall be requested
in writing to the Building offioial. An approved inspection must be logged during each six
month period, or the projeot will be considered abandoned.
WARNING '1'0 OWNERI YOUR FAILURE TO RECORD A NO'l'ICE OF COMMENCEMEN'l' MAY flESH!.'!' IN YOUR
PAYING TWICE ll'OR IMPROVEMENTS TO YOUR PROPER'ry. IF YOU IN'l'END TO OB'l'A!N FINANCING, CONSUL'I'
Wl'l'U YOUR 1.I!lNUER OR AN A'I''l'ORNEY BEFORE RECORDING YOUR NOnCE OF COMMENCI!lMEN'l'. .JOBS UNDER
$2. 500 IN VALUE no NO'r NE'D TO RECORD AND PO",' A "NOT1 OF CONMENC~~______
SIGNATURE I OWNER OR AGENT CONTRACTOR
f:l'I'A'l'E OF FI.ORIUA
COUN'l'Y OF
'Jlhe foregolng instrument was
Betore me this ___ day of
by
acknOWledged
, 1!i-
STA'l'E OF FLORIDA
COUN'I'Y OF
The foregoing instrument was
Before me this -Jiay of
by
acknOWledged
, 19~
lname of person aoknoWledged)
o who is personally known to me, or
[Jwho has produced
(type of identification)
and whol] did P~i,q,! Jrlo,t;.. i~ ta.k~ 4a~ joa th.
"'II ~ ~, ~ .,~ . j
8j'1na~'ute ....of penGIt\~,king acknowledgement
(name of person acknOWledged)
C1ho is personally known to me, or
Owho has produced
(type of identifioation)
and w}lo Odid .. [}:lid noe. t'p.ke . an oath
.~ 1 J. /""
',; .~'
Signature of person taking acknowledgment I
-
Name typed, printed or stamped
Name typed, printed or stamped
CONTRACTORS INVOICE
FROM: GARY M. NICKS LIC#CCC057600
3545 WILLIS RD.
MULBERRY, FL. 33860 1-863-425-3996
NO.
TO:
/. es ~r 1-.
0-<;'/3 .-<.j t!t s;.
I~'S Fi, 33sl/J
WORK PERFORMED AT:
5-'1/5 ~00f,
2Pfl)'fy)"J/S, Fief. 3 3 -5</ I
YOUR WORK ORDER NO,
OUR BID NO.
DESCRIPTION OF WORK PERFORMED
hv
c) "c- ~
s
IS'
4-.) f} t/
c
-v 75 d
All Material is guaranteed to be as specified, and the above work was performed in accordance with the
drawings and specifications p!ovided fO!i th. e above work and was completed in a ststantial workmanIike
mannerfortheagreedsumof Ill//) 7h~/1,~4h/1 ~,y JAIJ,,/rt"clS~t/e>/'J t..; r/ue Dollars
(~ ~J 7~ t?;:). . / /
This is a 0 Partial [i;!I Full invoice due and payable by:
in accordance with our ~ Agreement 0 Proposal No.
Month
Day
Year
Dated
Month
Day
Year
· E-Z CONTRACTORS FORMS FORM NO. EZ 122
'/ :' "- ',>
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ARBOFfBUILDING CORPORATION
','!:,...q \.,1. "..' ,',l',.l,( i P.O. BOX 14425
\" <~1!) (1"('" f"... r(r\/." .;('\ BRADENTON,FLORIDA34280
, ) .. t".J FLORIDA STATE L1CENSE# CG-C052053
Ifl" !(J('P .',: 1 \ III 'I' , I ~ 'flHONE 941-778-0984 FAX 941-778-1354
X ~"~.....J...,<~",:~,:)~~"",:":'"'l'..'.' ""'"i(J:,:.~{.~OLL FREE 1-866-410-7300
ARBOR BUILDING CORPORATION agrees to furnish all materials and labor necessary to do modernization work as
set forth below on the premises located at the following address:
, -.
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'Fhe Seller agrees to use their best efforts to coml1)ence work approximatelyI' -:: days from the date hereof '
and to complete same approximately .: (f) days from date of commencement for the following cash sales t ...,~
price or tlma sales price as elected by buyer. " /"\ .. \ j
Owner agrees to pay Contractor for all labor and material and services to be furnished by Contractor to Owner, under 'f') , ~
the terms of this Contract. , \ ~ ~')
All for the sum of ," l! .."<.' j'l \ 1 ,.I ( l, " \, fA ,,( "" (/ $7 r~;-(r ( ..,::.~:;;: '\( ,.\
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Deposit (,:v' 6' \\"'<"~ ~:' (, /. j, ". f ,tt- oj I ' $ t,!j 0 (". '..-!~ T
Balance and due Date ')~II Y {J J.J! If t~ \..-.Ih/ ~ t / l..-t'\, (I c.:. \j "~ $ ((J -~ ' 0 (- . "'~" r
(a) Seller shall not be liable for dela'ys occasioned by causes beyond his control, Including but not IIrnlted to the r'\
elements, labor strikes and other labor unrest, riots and other public disturbances, acts of God, accidents, and I"
delays; occasioned by suppliers not meeting shipping schedules. If seller shall be unable to so perform within ;~ \1
hlne(y (90) days of this contract, either party shall be entitled to caricel same. _., f,
(b) The entire understanding and agreement between thep arties ~~ntai~ed he "1IJ,JJAI@rbalagreemenls_",'.'
recognized. This agreement subject to office approval. ( /j /:,) ./' "(f-"'2 ( 's <)' \ ' )1 i
(c) Workmen's compensation and public liability insurance..ar.e- v 9cffof 'ork to be performed und:I \ \ "
contract. r- .-- ,---.., F::-, '. . \;
(d) Even if no other security interest is given by Buyer to S r, ~a~1I ri~ by FI~ a Georgia:' ,\
regarding mechanic's liens. ~ .- 2-, C.i -- C) c~-- " f
(e) Upon signing this contract It becomes legal and binding and may n~ cancelled without written authorization of '.
all parties Involved.
.1\ ,
(1) All cheeks must be made payable to Arbor Building Corporation. \ 'f
(g) In the event Arbor Building Corporation shall file suit for the collection of any funds it contends is owned under this ~ (.!
Agreement, or for any default or miscarriage arising out of the execution of this Agreement by Arbor and the owner, then \'1
Arbor if it prevails In Its action, shall be entitled to a reasonable attorneys fee for services of its attorneys, plus Courtj ;
costs. Said Agreement shall also include attorneys fees In Appellate proceedings. ,~ f
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Work Phone
Home Phone
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NOTICE TO THE BUYER:
1. DO NOT SIGN THIS AGREEMENT BEFORE YOU READ IT OR IF IT CONTAINS ANY BLANK SPACES. (': \'
, \,\
2. YOU ARE ENTITLED TO AN EXACT COpy OF THE AGREEMENT YOU SIGN. KEEP IT TO PROTECT YOUR (
LEGAL RIGHTS. j ,
BUYER ACKNOWLEDGES A RECEIPT OF A FULLY COMPLETED COpy OF THIS CONTRACT EXECUTED Bl r
BOTH SELLER AND BUYER AND CO-SIGNER ACKNOWLEDGES RECEIPT OF COPIES OF THIS CONTRACT AND,.;;.Jr-'
OF CO-SIGNER ~TATE~~NT.-. .!
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Owner
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Representative
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Owner's Spouse
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ARBOR BUILDING CORPORATION shall not finance in any manner a contract with any of its' customers. The i\
corporation may refer the customer to a bank or any lending institution for financing. The decision to finance this~ t
contract is at the sole ~'s.c:~~t~n of the len~,r. i' ~ \ 1
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