HomeMy WebLinkAbout02-1567
...
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N!!
(813) 780-0020
1567
--
/
'/!3-
,~--"'
( '-!~ EI.>>€'l1liCAl Pl~~
::::~' JI!/1g;'11~~1(~
Parcell.D, # I'/-,:J. t --t7-I-O 000'- (OD~t'Jo-c) 000
Date
10 - 17-0 /'
~I~AL
Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
Zoning:
DescriDtion of Work
FINAL
Complete Plans, Specifications and Fee Must Accompany Application, C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
DATE
tJ6
Valuation or i
Contract Price
~t;a2-
4-9-
Permit Fee
~~~~~-
5-
ou
-T""'---=
Addres-s----~
~h"~~~~~--~OO- ~31- b" ~~-;'R I C.K
\ -fl/YJ/~/;&') ~/)t1l~tb~
City License Registration # A f) 7
State Certified License#
MECHANICAL
------
Breakers
Ducts Insl.
Compressor
Final
BUILDING
ELECTRICAJ.:.-'/ "
~
PLUMBING
------
SLB
Tub Set
Water
Sewer
Final
Tp.Serv.
Roughtn
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Ftr,
Pre SLB
Lintet
FRM.
Insul. CL
WL
Driveway
REINSPECTlON 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.A.O..a......Ld:t .. .....Io'Olll.a.-J.-,U:".t'.LI.a.\,;A-.l..a.U~
DBPARTMlmT 5335 Sth STRBft ZBPBYRHILLS. WL 33540
Phone.S13-780-00JO Wax.813-7S0-00Jl'
DATB .BCBIVE
PLAKS RBVIBIf WB. ,
BUILDING
...
OWNER'S NAMB Ge r f rLA.-d c-
.JOB SITE ADDRBSS '1 f I[) 7......0
- G- ,,' V\ C] r , 'c L,
E tv j) ,4v,
PHONB CONTACT J? / J -- 1 Reo ~ 'Ill
W " VI. -HX r:}>C>d- Lr 1'1 H P
LBGAI. DBSCRIPTION I LOT (S) BLOCK SUBDIVISION
0000
PARCBL ID # r 4 - L b- L l..:- 0000- 0-.0'700- (OBTAIN FROM PROPBRTY TAX NOTICB)
WORK PROPSBD: o NEW CONSTRUC'nON DADDITIO~ DAI.TBRATION o RBPAIR o INSTAI.I.
OSIGN o MOVE 0 DEMOLISH
PROPOSED USE: ~. FAMILY DWELLING DMUI.TI - FAMILY 0# Oli' UNITS w-r.6BILE 1I0MH
o COMMERCIAL o INDUSTRIAL o SWIMMING moL o OTHER
BUILDING SIZB
c:J RBSTAURANT & HBALTH DBPARTMENT APPROVAL
, r' I f'
\Qv-L V" -( (j n vt M..{ -to\ v-o Dt
SQUARE FOOTAGE 7 Of 2
w
DBSCRIPTION OF WORK
HEIGHT
RBSIDENTIAL: ~TTACII (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SBT BNBRGY FORMS.
COMMERCIAL: A17ACH (3) SBTS OF BUILDING PLANS & (1) SBT ENERGY FORMS.
PROPBRTY SURVEY RBQUIRBD FOR ALL NEW CONSTRUCTION.
o BUILDING
PBRMITS RBQU.~TBD
$ Y t b '3 L'~ VALUATION OF TOTAL CONSTRUCTION
o BLBCTRICAL
AMP SBRVICB
o FLORIDA POWER
o W.R.B.C.
o PI,uMBING
o MBCHANICAL $
o GAS ~OOFING 0 SPECIAI:.TY
VALUATION OF MBCIJANCIAL INSTALI,ATION
o OTHER
TYPE OF CONSTRUCTION:' 0 Br.qCK
o FRAMB
o STBBL
o 01'OER
!<'INJSHED FI.OOR BI,BVA'rrONS
IS PROJEC'r IN FLOOD ZONE AREAO YBS 0 NO
(,\--:, - I I, - I - - '. - ", I' ,I " - ': :,:," ~ ,fi'(lt
\ If' ,I , , " , , , ' , : I' r . J: 1'1}
BUILDBR COMPANY ;r" II: n ~ i 61 e. AS" 5 a L
4? / //_ _ ' . STATB CERT OR REGIST # C <:: c. 0 L( 9 3 b 7
SIGNATURE ~ ~ CITY PROCESSING # ~3 0 ~
" ~JL-
................................................~:.i..........w.
BLBCTRICIAH
SIGNA1'URB
COMPANY
STATB CERT OR REGIST #
CITY PROCBSSING #
..................................................................
PLUHBBR
COMPANY
STATE CERT ORREGIST #
CITY PROCESSING #' ,
SIGNATURE
HBCIlAHICAL
..................................................................
COMPANY
STATE CBRT OR REGrST #
CITY PROCESSING #
SIGNATURE
.................................................................
OTBB.
COMPANY
STATE CHRT OR REGIST #
CITY PROCESSING #
SIGNA'I'URB
.................................................................
CllliOlTI0NS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The u!1d'ersigned understands that this permit may he subJect ,to "deed rei'll: d,cllons" whl ch
'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 rrUsdemeanor
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. wish~s
you to sign a8 contractor that may be an indication that he is not properly IJcensed and 18
not entltled to pennitting privileges in the City of Zephyrhills,
C, TR1\NSPOR'fNfION IMPACT FEES AND U'.fn.I'fY CONNEGTION FEES
D, CONS'fRUC'fUION 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 Gulde" prepared by the Florida Department of Agricultur.e
and Consumer Affairs. If the applicant is someone other that the "owner", T cerlfy thAt I
have obtalned 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 1s hereby made to obtain a permit to do work and installation as indicated, I
certity 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 constructlon, City
codes, zonlng regulations, and land development regulations in the Jur..1 sdlctlon. .I a lAO
certify that 'I understand that the regulations of other governmental agencies may appiy to
the intended work, and that it is my responsibility to identify what actlons I mllst take lo
he in compliance. Such agencies include but are not limited to: "Department of
Envlronmental 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 & Rehabllitative Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if f{ll-materlal is to be used in Flood Zone "A" or "A, etc.", ,it is
understood that a drainage plan addressing a "compensatlng volume" will be submitted whioh
is prepared by a professional engineer reglstered in the State of Florida prior to pennlt
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 authorJ.zed by such permi t is GOllnnenced wi th In
SlK months of issuance, or if work authorized by the permit ls suspended or abandoned for a
period of eiK months after the time the work is commenced. One 90 day eKtenslon of time
may be allowed for the permit with fee charge of $l5.00, The eKtension shall be requested
in wrlting to the Building Official. An approved inspection must be logged during each six
month period, or the project will be considered abandoned.
WARNING '1'0 OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUL1' IN YOUR
PAYING '1'WICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND '1'0 OBTAIN FINANCING, CONSm,T
WI'l'H YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. ,JOBS UNDER
$2,500 IN VALUE DO NOT NEED '1'0 RECORD AND POS'f A "NOTICE OF COMMENCEMENT".
if iJ/. ~\
SI ATURE: OWNER OR AGENT
~~
SIGNATURE: CONTRACTO
STA'rE OF FLORIDA 1\' VI"( ((Of J
COUNTY OF '
The foregoing instrument was acknowledged
Before me this -1J...!:::--day of '0 c.. +0 (,.... r, ~.o z..
by \() S C A(l.... ~. E'Od::il. v If l2.. 'l
(name of person ackno~ledged)
or,;ho is personally known to me, or
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was ~cknowledged
Before me this ~ay of ~1-'" v<v, ~ c....o O'L
by %V' \'t(~ S+.ou<'1r
(name of person acknowledged)
~ is personally known to me, or
owledgement
roduced
(type of identification)
lid not take an oath
roduced
(type of identification)
did not take an oath.
ame
Name t.yped,
c "
,
TO BE COMPLETED IF ;CONSRTUCTION
'TATTTT""OT"'l...r_____.-_ _.
I "'VI"'CIBLE
State Certified License # CRCOI5276
Owner's Letter of Authorization
I hereby authorize the below named individual to act as my agent to
obtain all necessary permits for residential V'l~iJUI8lV work for:
f ~~
Owner: b..ev--frr ~d ~ G- ('tA 3 r l'C ~
At this location: SJJ020 ~N:D Av E. 2e.plA'1 r f{ d(SL fL '3 $S4/
This person is also empowered to obtain, complete, and sign all'fOlTIlS,
applications, registrations, and documeotation, with this limited power of attorney,
on behalf of me that may be required to accomplish the issuance of any permits
that may be required in any jUrisdiction throughout the State of Florida.
'.\.0"
Authorized Person: 0 S CA Q lV. E ~ E 'R \I A R Y
Authorized Person's Signature:
t1L' (/,
-------,
---r-- ]
Owner's Signature: ~'41:Au,a.'_~7#~A
'<,
, INVINCIBLE ASSOClA TES
10931 75TH ST, LARGO,FL 33777 727/545-1800 800/937-6635
II ~
__n__,__ ---r,-r-'
I
(r ~ .. ,"' 1/25/02
~INVINCIBu:@l _ ."
, W.S.II
INVINCIBLE ASSOCIATES, INC. ~NERGY STAR
10931 75TH ST. · LARGO, Fl 33777
( ') 727/545-1800 · 800/937-66,35 · STATE CERTIFIED LICENSE #CCC049367
~ MAKING FLORIDAA BETTER ~E TO LIVE SINCE 1987.., ONE HOME AT A TIME
Name(s): I V"v l4( C-{!....v.:~L/d-e t., e,\"te.~hone: (H) ~/3 7:fj(JfP(/~)
MailingAddress:380a.,.Q Cflt6. 4-'1../ City:~ k.(1..kcounty 'Pq.....treJ State:f7zi~
(If Applicable) MHP: W l~-,eV'" PC"t..V'"I"\ Lot #: ,I\-'f i
Alternate Address: ,q ~ S-- lO << City: M c......ll '" Stat~ziP~Phone:
I/We, the owners of the premises described below, hereinafter referred to as "Purchaser" offer to contract with INVINCIBLE ASSOCIATES, INC" herinafter
referred to as "Contractor" to furnish, to deliver and arrange for installation of all materials necessary to improve the premises located at:
" .t
JobsiteAddress: & Ot.w..-e... City: State:_Zip:
according to the following specifications&..
_..~ (J."
(STEY-E~E ~.e> STEVENS TAN EP · STEVENS LIGHT GRAY EP · EREZ TAN · EREZ WHITE . EREZ GRAY
'COOLEY TAN ILLUSIONS · COOLEY GREEN ILLUSIONS · COOLEY CHARCOAL ILLUSIONS . COOLEY WHITE TPO
CIRCLE MEMBRANE TYPE:
1, PROVIDE ENERGY-SAVING INSULATED WATERPROOFING SYSTEM FOR THE FOLLOWING AREA(S):
\\ i-1-o J'Yt kL-, ~ ,S L-", Vo:.o- h-..
2, INCLUDE ENERGY-SAVING DOUBLE-FOIL FACED INSULATION AS INDICATED:
"IIklOLD: DELUXE 1-1/4" INSULATION 0 SILVER: 3/4" INSULATION 0 BRONZE: ~
3, INCLUDE NEW SPUN ALUMINUM VENTS: ~ALL ~1.:ARGE
4,INCLUDE UP TO 100 SQ, FT. OF NECESSAR'tDECK REPLACEMENT.,~DDITIONAL DECK
REPLACEMENT TO BE INVOICED SEPARATELY AT $2,00 PER SQUARE FOOT.
S, INCLUDE ALL REQUIRED PERMITS,
6, CLEAN UP AND REMOVE ALL JOB-RELATED DEBRIS FROM JOB SITE,
7. MAIL OUT LIFETIME, NO-LEAK, NON-PRORATED, TRANSFERABLE WARRANTY FULLY COVERING ALL LABOR AND
MATERIAL, INCLUDING ALL STORM DAMAGE FROM RAIN, LIGHTNING, HAIL AND WINDS UP TO 170 MPH.
*NOTE: BRONZE SYSTEM (NO INSULATION) RECEIVES A 1- YEAR. LEAKPROOF WARRANTY.
8, ADDITIONAL INFORMATION: . "I
S C/h ((OO(.lh cr H-Oi4t v.- 10 1 (p
9, IT IS UNDER~TOOD THAT THE FOLLOWING AREAS WILL HQI
BE INCLUDED IN THE COVERAGE PROVIDED BY
THIS AGREEMENT (See Drawing at Right):
~T"R
INITIALS FOR
SYSTEM
OTHER NOTES: eJ ~L I
' ,.
4.-, '-1.. cL
r. ~7~)cn...:~J-
L 6i.~ W-~
SHOW ALL AREAS OF HOME. DRAW ADDITIONS AS
NECESSARY. WRITE "YES" IN AREAS TO BE COVERED.
WRITE "OMIT" IN AREAS NOT TO BE COVERED.
n l(~
- ~
d-S" ~
~,
e.-3
q
~~
INITIALS
.-
"3(P1
NOTE: RETAIL SALES TAX MUST BE CHARGED UNLESS THE CUSTOMER SIGNS THE FOLLOWING:
L I certify that I own the land on which the structure I am improving is permanently affixed, Furthermore, I have filed a
? declaration with the Property Appraiser requesting stru ture be asse as realty and it ears an "RP" decal.
SIGNATURE:
The CASH CONTRACT PRICE for all Labor & Materials (including any applicable discounts) is $ q,. 5,<0
' ceO"''V 8-~6"'-:o ;;LG7a:, '''l",
Terms: 0 Cash ~redit (Subject to the approval of the Credit Sales Department) - 'V101. ... Sales Tax $ 0'-.)
If ~;, ,,, ",,'h 1m""''',,". 'h. '""""" ,,', ,'''"''' "Id " follow, ft.t.OO'~ ~ ~ .S Ol- ....,
Cash down Payment (Minimum 33%) $' ;)..'0 Balance Payable $, '-J Total Price $ ...
If this is a credit transaction, the agreement for cr it is contained in a separate document w ich is incorporated herin by reference and a e a part thereof.
l!We the undersigned are hereby authorizing INVINCIBLE ASSOCIATES, INC, to verify and review my/our credit record with an independent credit reporting
agency and release them from all liability incurred from inadvertent omissions or errors,
Verbal understandings and agreements with representatives shall not be binding, All understandings and agreements must be set forth in writing in this
Contract. ADDITIONAL PROVISIONS ARE STATED ON REVERSE SIDE AND ARE PART OF THIS CONTRACT.
IN WITNESS WHEREOF Purchaser(s) have hereunto signed their name(s) this _:--'0=: day of _ <:<s <::---r-
and acknowledges receipt of a true copy of this Contract.
UNLESS OTHERWISE SPECIFIED, IT IS UNDERSTOOD THAT THE OWNER(S) IS/ARE READY FOR THIS WORK TO BEGIN, THE PURCHASE PRICE
QUOTED ABOVE Will BE HONORED ONLY UNTil _____ ' Purchaser(s) understands and agrees that if this agreement is cancelled after the
rescission period, the Purchaser is liable for twenty five percent (25%) of the total sales price as damages to the Contractor. In the event this offer to contract is
not accepted by Contractor, any payment made hereunder shall be refunded to the Purchaser(s) and this proposal shall be null and void and of no effect.
Contractor is not responsible for existing structural defects, dry rot or other factors beyond our control. No repairing, plastering, painting, carpentry, or decorat-
ing is included unless specifically charged for and specified in writing herein, If Installation is not completed, Purchaser may withhold a maximum of 10% ofTotal
Price until completed, The remainder of Total Price is due upon installation or as otherwise spe 'fied,
r----------______~--- _
I ~ A. / ~ 16 .' ai-
I SUBMITTED BY: R4enta~ -.11/ ~ A
I
200~
I
I ACCEPTED BY:Authorized Signature for Contractor Date ACCEPTED BY: Purchaser Date I
L___________________________________~--~
[INVINCIBLE]
Customer Q t?1C /I'U,,/<. . I "!:J e.v '" I.
MHP C--R.J'I..//lL ~t k JobAddress 380cJ)i) f2cf Ave..-
City .7/Jphel' ht lis Zip 3"6)4/ _ Phone (~/3 ) 7&?- 61162
SYSTEM: ~ ULTRA GOLD-l-l/4" Insulation 0 Silver-3/4" Ins, 0 Bronze-Membrane only
VENTS: Small 6) Large 62 STUFFERS: Quantity Size: ~
SKYLIGHTS: Quantity Size: _ X _ GABLES: Quantity _ Size: LD
Hi.Tuff/EpTM
WORK ORDER
SHOW ROOF PROFILE HEREI
Show Ridges, Drops, and Flaps INCLUDING Dimensions!
( )
( ) I RIDGE ,(
If roof is a Double-Wide, CIRCLE:
( ) DROP
show width of EACH half! I <<< FLAP
DIMENSIONS
Must include Over-Seals,
Ridges, FI.QQs and Drops
Home: cJc:O x 3~7-
FI. Room: 9 x J)5
Carport: .A/ 0 x-
Other: ,/L/<J x---
ROOF DIMENSIONS: Show all Lengths and Widths to be covered, includin9 Over-Seals of
6" each Side and 6" Front and Back. If Main Home is Double-Wide, Show Width of Each Half!
Main Home INCLUDING Over-Seals: NOTE: INDICATE SOFT DECKING
o l-W~de W!dth = AREAS WITH "X"s ON DIAGRAM!
o 2-WldeWldths =_+_=_ I
Length =- )07~ 'r::r-
<<FRONT
1,-10
ALL WORK DONE TO SATISFACTION
Customer Signature: y
COD Amount: $
Date:
Crew Leader Signature:
Work Order Submitted By: -?72}~Aar~c::.:r~R,t?Date: _10/--1510:2 .
, .. I
j
10/1 0/97