HomeMy WebLinkAbout02-1634
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N!
1634
B~-G
ElESJRfCAl
(813) 780-0020 &p
I/O ~
~-')
P~BING ~CHAN.!.S~
Date
//- >?-D--~
.
Sewer Conn
P,operty OW"", ~b ~1;~7~;~lffrj Jt-
Job Address: ~ . .
Parcell.D. ,
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
DescriPtion of Work
E4V Code:
, (l
~
,
2 Radon Gas:,
{~T-GUT-
NO OCCUPANCY BEFORE C.O.
FINAL -O~
DATE
C.O.
DATE
Inspector {(t, t! I-I:JO
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Permit Fee
~~-~
Company
Address
~<i1 ~-(QI:Wr ;;0-%
{l1~~ /If!.<i-I!M.
/ ~
~foO~"
d.L ----
City license Registration # ~
State Certified license#
Valuation or
Contract Price
BUIlDINCi-.-/
------
ElECTRI~--
-----
Pl~-
---
MECHANICAL
Tp.Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Ftr.
Pre SLB
lintel
Breakers
Ducts Insl.
Compressor
Final ~/ 1(-13~- 02- ;<tf
/f-Jv'
FRM.
Insul. Cl
Wl
SlB
Tub Set
Water
Sewer
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.
~-
Ace Air Conditioning & Electric
923 West Memorial Blvd,
Lakel and. FL 33815
(863) 688.2238 Fax:(863) 686-9798
"7ork Order;. 9798
November 5,2002 8:24 am
Work Location: 5402
MARJORJE JORNLIN
5628 5TH STREET
ZEPHYRHILLS. FL
(8J3) 783-7241 Home *
Bill To: 5402
MARJORIE .10RNLIN
5628 5TH STREET
ZEPHYRHILLS. FL
(813) 783-7241 Home *
Callin Date: 11/512002 8:15:00 AM
Requested Date: 11/812002 8: 16:00 AM
Scheduled Date:
Caller: MARJORIE JORNLIN
Taken By:Rose
Department: Air Conditioning
Call Type: NC install-Man. Housing
BilIingTerms: COD
Priority: Ready to be done
Status: Unassigned
Arrived'
. Started:
Completed:
Total Hours.
Authorized B~'
Trouble Reported:
(0 hrs) AA-HEIL
(4 hrs) AB- PACKAGE UNIT
(0 hrs) AC- 31DN 10 KW
Notes:
UNIT ONLY CHANGE OUT
Date
Lead Technician
DIGITAL T-STAT W/L1GHT
STANDARD WARRANTY
TAX
PERMIT
COD $1605
( $1000. NOW REMAINDER IN 30 DAYS)
Page I of I
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C()l\T:JIT!C)YS ~J~ PS~?~L~T l\FFT.DAVI'~
A. NO'Hem OF DEED RESTRICTIONS
The'unde~signed understands that this permit may be suhject to "deed restrictionsn ~hich-
may be more rel'ltrictive than city r'egulations. Th.:! '\ndersigned assumesrespoTleibility for:
compliance with any applicable deed restrictions.
B. tJNt,ICENSED CON'fRACTORS AND CON'I'ru\CTUR RESPONSlBILITIES
If the owner has hired a contr~ctor 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 miAdemeanor
vio.1.atton under state la'-'1. If the' owner or: intended contractor are uncertain as to Nhat
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 contrRctors, he is advised to have the
co"tr~ctor(s) sign portions of the "Contractor Sectionsn of this application for whicll they
will b~ responsible. If you, ~s the owner Rign~ as the contractor, you are indicating that
you, rather than the contractor, ate 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 elltitled to permitting privileges in the city of Zephyrhills.
C. TRANSPORT1\TIoN IMPACT FEES AND UTILITY CONNECTION FEES
D. CONS'1'RUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Constructj.on
lien l,aw - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
alld Consumer Affairs. If the applicant is someone other that the "owner", I carify that!
have obtaifled a copy of the above described document and promise in good faith to deliver
:I.t to the "owner" prior to commencement.
E. CONTRAC'l'OR' S/OWNER' S AFFIDAVIT
J certify that all the information in this application is accurate and that all work will
be done in compliance with all applicable laws regulatin~ construction, zoning, and land
development.
Appl1dation 1~ h~teby made to obtain a permit to do work and installation as indicated. I
certify that no work or insti:\llation has commenced prior to issuance of a permit and that
all work will be p~rformed to meet standard~ of all laws regulating construotion, City
codea~ zoning regulations, and land development regulations in the jurisdiction. I also
certify that t understand that the regulations of other governmental agencies may appJ.y to
the .intended work, !'Ind that it is my responl'libil1ty to identify what actions I must take to
be In compliauce. Such agencies include but are flot limited to: '\'Department of
F.1nvironmeutal Regulatlon-Cypress Bayheads, Wetland 1\reas and Environmentally Sensitive
Lands, Water/Wastewater Treatment
.Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
l\ltering Watercourses
kArmy Corps of Eugiueers-Seawalls, Docks, Navigable Waterwaye
.Uepartment of Health & Rehabilitative Services, Environmental HeaJ.th Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.8. Environmental Protection Agency-Asbestos abatement
r also certify that, if fill material is to be used in Flood Zone "An or: "l\,~tc.n, it is
understood that a drainage plan addressing a "compensating volume" will be submitted whlch
is prepared by a professional engineer registered in the state of Florida prior to permit
issuance.
1\ permit iss11ed shall be construed to be a license to proceed with th~ 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, construotion; or violations of any code. Every pet~t
ieaued shall become invalid unless the work authorized by such permit is commenced wlthi.n
~lK months of issuance, or if work authorized by the permit is suspended or abandoned for a
period of six months after the time tH.e work is commenced. One 90 day extension of time
may be allowed for the permit with fee ch~rge of $15.00. The extension shall be r.equested
in writing to the Building official. An approved .inepection must be logged during each eiK
mOflth period, or the project will be considered abandoned.
WARNINt; '1'0 OWNERI YOUR FAII,URE TO RECORD A NOTICE OF CoMMENCEMENT MAY RESUW' IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OB'l'AIN FINANCING, crJNSlJL'r
WITH 'fOUR l,ENIJER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF C01'-ft1ENCEMEWl'. ;roBS UNDER
$2,500 IN VALUE DO NOT NEED 'fa RECORD AND POST A "NOTICE OF COMMENCEMEN1"'.
~~
kj~., .
SIG ATUREI OWNE OR AGENT
SIGNATURE:
CONTPACTOR
STATE OF FLORIDA
COUN1'Y OF
The foregoing in~trument Was
~efor.e me this __ day elf
by
acknowledged
19_
ST1\TE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _day of
by
acknowledged
19
(name of person acknowledged'
o who il'l personally known to me, or
(name of person acknowledged)
Chho is personally known to me, or
Dwho has produced
(type of identification)
and whoD did 0 did not take an oa th.
Owllo has produced
(type of identification)
and who Odid DHd not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped