HomeMy WebLinkAbout03-1739
BUILDING PERMIT
Permit N~
Property Owner:
Job Address:
Parcell.D. ,
Zoning:
Description of Work
"..
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~
CITY OF ZEPHYRHILLS
(813) 780-0020 I/~ - . Date 1-,.5 -0 ~
~ Sewe, CO""
'.. Water Conn:
1739
B~
Water Meter:
T.I.F.'s:
FINAL
C.O.
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.
DATE
Inspector
Valuation or :rI-
Contract Pric
,co
;;. ~ Cf5 ,-
> tJ~
~~'
~O
City license Registration #
State Certified license#
~
Ftr.
Pre SlB
lintel
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Finall/I-~x- 03 R( 11~H3i)
5e..-1I1 ('e c/~ 1-10-03 RL7
~// J 3 -M. t!. .A:n !,J:V 5 f(;f-
tr -/V-O ff(LY(/Yvut-
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:
FRM.
Insul. Cl
Wl
SlB
Tub Set
Water
Sewer
Final
RL l( J /ltTt)
Breakers
Ducts Insl.
Compressor
Final ! /1- ;l [f-'D)
Driveway
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.
C()Lt:'S 4I1J C()~().T.()"".~t;
~I) t1t:AT.~t;
37338 Kossik Road
Zephyrhills, FL 33541
(813) 783-3723
PROPOSAL
No,
Date
I - 2- -0.3
St Cart #CAC042667
Sheet No,
Name
Street
City
State
Phone
e-~ ~ (V..::~
i.j B 2. c:; 5"Wo- .51.
z;t:-p J+y 0 .- I JJ,
H "V'. Oill,. ,
7 ) '7 9 1. f~
Work To Be Performed At:
/'
Proposal Submitted To:
~~6-~
Street
City
Date of Plans
Architect
We hereby propose to furnish the materials and perform the labor necessary for the completion of
h.t. ,l.ji.h -; I.., 'I. I:,.; t~ L.':- c. ~r e 2.~....J "}/ J. . 1- > J J J-~ 5Hl.') M
~ ~.11 u;,~ l,,~~,&k!;:;';::;. .:-;::~.? i5=1:.:7~';,.'~ f-::t;}I:t
K r={un--i" ~.~,~ L...AL.. C~J..Je-I... ~ f).h}*",- ,~. 1.1. ~ 87
- ~ ,*" 2::.tz:~ i c. 0 E:.d..c. h1" ~ $'kl-uu ~
~'J! D~ ..,;, I' :>-;j ~.(O. ,Pete ,~o J, ~ 8""+ '""' ~
~)~iLl1f1-Jt; ~t'r. 7~ ,P",-~ "[;>.(lOlL f, c.~
=--..1 /... e.- t": j +/r: 0 v )'1 (
~4,'he.y-d"r~ ~ jJA-r-A ~.4./-/7 L.':", 'I-:"
{J 1 ,-r ;+-Lry - -r;;. -' ,
All materIal is guaranteed to be as specified, and the above
sp'~s;t:::;:;;~;:Jo;tl~ed
with payments to be made as follows:
work to be performed in accordance with the drawings and
in a substantIal workmanlike manner for the sum of
11.- ~ c. Dollars ($.J3r5..'!::-~ l.
lO~ -4
Any alteratIOn or deviation from above specifications involving extra
costs, will be executed only upon written orders. and will become an
extra charge over and above the estimate. All agreements contingant
upon strIkes. accidents or delays beyond our control. Owner to carry
fire. tornado and other necessary insurance upon above work. Work.
men's Compensation and Public Liability Insurance on abova work to be
taken out by
Respectfully submitted .7~ ~ ;If &/~
pe~ ~~,;1
Note- This proposal may be withdrawn by us if not accepted
within.:J"D days.
ACCEPTANCE OF PROPOSAL
The abolte pr'ces, speCIficatIOns and conditIOns are satisfactory and are hereby acceP.i1' You are authorIzed to do the work as specified,
Payment won be made eo outhned at"we. . #/I'~ /) ! A
Signature ~:t 4- ~ ~ ,,1'L0 J-.-
J-,~- /i 7
Signature
Date
\.
./
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DBPARTMENT 5335 8~ STREET ZEPHYRHILLS, FL 33S40
PhoneI813-780-~020 FaxIS13-780-0021
IH\.TBI RIllClllIyJiJo
----.--- .~....... ,:...-...."'-~..
PJ,ANS RIlIYIBlW B'BlIli_o_____'Ud
OWNER' 8 IIA".----6C:Rdld;>~~? ~lS (} E-1Yr;- ~ c _~ _~_ ~__ _ _ ~~ _~_, ~_ P 1I0N8 "ON'j' A"',_2 ;ZCf-9~1"f
,J08 8 ITHl ADDRESS .. -.~-l8--:;).....'7- .--2..c:;t-'_M.:.______.___.____..______.______ . ..________.__
LBl(]lIL J)Jl]SCRIPTH)/o), LOT(S)
B U)(~ K
SUBD IV I 8 lotI
---.--..-.-------
P AR'lIDL rn '1_ / <( - :A \,: d- '-=. Q ~oLq-",ill 'f 0 0 ~ 1Lo ~ 'i)~~O~ :",nl_~ROM--",,~ P8R"_'I_ ~':.K ..~":~H"_I ~..
HURK PRnpSEfll [JNBlH C'ONS'I'RlJCTION [] AflDI'l'ION o AUrERATION [) RBlPAIR ~ INSTAJ,!,
--.--------.--.~..----....--._-_.__...,._ 0__-
[]SHm
o MOVE
[J DEMOI,ISII
PROI:'OSFJIl USEJ I p\fs r:H , FlIMILY DHEl,IJI11G
f:.J Cot'1MEJRC! lA r,
[J ~1tJI,'r I . F At>1 I I, Y
0# UF lINl'I'S
[J SHn1~HNG POUL
{] M08 II.El IfOf11ll
f] OTHER
o INDUS'l'R1AfJ
C:J RE18'fAlJRANT & HElAI,TII D@PJ\RTf1ENT APPROVAL
!JBJ8CRIP'I'rON OF NORK
---_._--._--_._--~--
J N~7":.~_.2-~r Cer-lll..~ 4-/c---'LIi.~dt~_.~.!t~ ' __._____....__ '______
SQUARE FOOTAGE ___.______ HEIGH'r -"..___._____
BUILDING SIZEl
RESIDENTIAL,
COMMBlRCIAf, :
A'I"rllCH (2) pI,o'r PI"AI18 & (2) SElTS OF BtJIftlJING Pf,ANS & (1) 8El'l' ElNElRrn FORMS,
A'I"l;A(!!l (J) SElTS OF BUILfJING PLANS & (1) SEl'r ENElR(N FORMS,
PROPElRTY SURVEY RElQUIRElD FOR ALL NEW CONS'I'RUCTION,
~ERMITS REQUESTED
r:J B I J TI./JI Nc3
$
-.. - ~------------
VALUATION OF TOTAL COHS'rRlJC'rION
ik1 BlLBlC'l'RICAI.
[] P LIlt/18 1NG
- --------------'.. A~1f P S El R V Ie EI
[) FIl.1RlfJA POHER
[J W,R.EJ,n,
~ HBlUHANH.!ATJ
[J (3A8
[] ROOFING
$-_.?- '39~~__ VAI,UATION OF ttlE:C'IlANCIAI, INSTAI1IJATTON
[J SI?ElC!1AI/l'Y
Cj OTHER
'l'Y'PEl OF' CON8'1'RUC!'fWN: 0 BLOCK
[J FRA1t1El
[J STEEL
[J OT!lER
FIN ISHBln FLOOR EJIJEVATION8
---------
IS PR(XTElCT IN nOOf) ZCJl-TEl AREA. [) YElS
[) NO
BUIUH!lR
Blr.J1Cl'rRlc:r:
******************************************************************
C()r1PANY_~'~n_____
STATE CERT OR RE(HS'l' liE ~ CJo CJ ~.s- 70
--'--..-- ....---------- CITY PROCESS IN(~ II__?~~~---=-.~-~~.~-.--=~=..~.______
COftl PAN Y---..-.-__.__.______.__.. '_'_d__.__ .. _.___.__.____.____
STATE CEJRT OR RElf3IB'I' # --.-.--.----...-_d________, .______
CITY PROCElSSINf3 L..___._..__.__._______._____._______
81lJNATtJRE
~...._-_._-'-~_.._--".._---_.----_........._-----
8 JC3lTA'l'tJREJ
PI,UMBER
~*~**~~**~***********"'************************~********
--- ._'---_.--~-"--"-_...._-- -----
_.---_._-~._--_._---
COM PAN Y -.-..--..-----.--..----.,---___n____....._. "__'__. ._____________..._
STATE CElRT OR REJf3IST # ________..._._______.._____..
CITY PROCEl8SINf3 #
S WHA'I'tJR EJ
------.- ~--_.----..._--~-----
... ............. .................. ;!~~~;;,~'..:..~L11~~-.-~-~_"'~-~.. __ "
STA'rEl (!ElRT OR RElGIS'r # -----.-.-fI2.6~_?:.._____.._._
CITY PRUC'ESSINc3 # /..@.
....---..-------- /" --~....:._--~._-_.__.~_._-_._- -_.__..._~_.-
* '~ * * * * .. .. * * * * * '" * * '" * * * '" * * * '" '" .. ~ * '" * '" * * * * * *.* * * II ~* r * * * * * * II * ~ * * .. * * '"
(.!OIvIPANY
'---
S'l'lI'I'E CElRT OR REGIST #
CITY PROCESSING #
_.._.__.._-------~._----_.- -----._._-_.~.._---..-
OTUlllR
S WIIATURE
n---..__.._.____._.___~.n ~_." ._... .___ __
--------------
--'-- ._-"_.._------_.~._~-_._- --.. -
*************************************************"'***************
----------..-.-------.-- ~.,----.."--------.
CONDITIONS OF PEFNIT AE'E'IDAVIT
A. NOTICE OF DEED RESTHICTIONS
'l'he undeJ::signed understands thqt: Lhi;~ p~nnit may b'3 subject eo "deed restrictions" which
may be more restrictive than City regulations. Th~ Ilndersigned assumes responsibility for
aompli,mce wi tb any applicable deed t>=st:r:ictiotll:l.
B. UNLICENSED CON'I'RACTORS AND CON'l'RI.\CTOR RESPONSIBILI'l'IES
If the OHner has hired a contractor or contractors to undertake work, they may be required
to btl Ii aensed in accordance ~1ith state and local regulatloIls. If the contractor is not
licensed as required by .law, both the oVlner and contractor llIay be cited for a miadellleanor
violation under state laH. If the owner or intended contractor are uncertain as to vlhat
licensing requirements may apply for the intended work, they are advlsed to contaot the
City of Zephyrhil1s Building Department, 813-788-6611.
Furtherlliore, if the ovlller has hired a contractor or contractors, he ls advised to have the
oontlactor(s) sign portions of the "Contractor Sections" of thls application tar Hhich they
will be responsible. If you, as tlle owner signs as the contraotor, YQ4 are indicating that
you, rather than the contractor, are responsible for the Work. If the contractor wlshes
you to sign as aontl:"actor that may be an indication that he is not properly licensed and is
not entitled to permltting privlleges in the City of Zephyrhllla.
c. 'rRANSPOR'l'ATION IMI?AC'l' fEES AND UTII,I'l'Y CONNECTION E'EES
D. CONS'l'RUCTUION LIEN LAW (CllAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
1 certlfy tllat I, the applicant, have been provided with a copy of "Florida's Construction
lien l,aw - Homeowner's Protection Guide" prepared by the Florida Department of Agrlculture
and Consumer Affairs. If the appl.icant is someone other that the "owner", 1 cerify that I
have obti:lined a copy of the above described Qocument and promise in good faith to deliver
it to the "owner" prlor to COllunencement.
E:, CON'rRAC'l'OR' a/OWNER'S AFFIDAVI'l'
I certify that all the information in this application is accurate and that all Hark will
be done in compliance with all appllcable laws regulating constructi.on, zoning, and land
development.
Application is hereby made to obtai.n a permit to do work and installation as indioated. I
c.:e~ti fy that no Hork or installati.on has cOllunenced prior to lssuance of a permit and that
all work will be performed to meet standards of all laws regulati.ng aonstructlon, City
aode.s, zoni.ng regulations, and land development regulations in the jurisdiction. I also
certify that I undel:stand that the regulations of other governmental agencies may apply to
the intended work, and that it is my responsibility to identify what actions I IlIlISt take to
be in complianoe, Such agencies include but are not limited to: *Department of
Environmental Regulation-Cypress Bayheads, Wetland Area::> and E:nvlronment.ally Sensitive
Lands, Water/Wa::>teHater Treatment
*Southwest ~lorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Alterlng Watercourses
"Anny Corps of Engineers-SeaVlal.1.s, Docks, Navigable Waten-Iays
*Department of Health & Rehabilitative Services, Envl.ronmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.8. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone "A" or "A,eta.N, it is
understood that a drainage plan addresslng a "compensating volume" 'will be submitted Vlhich
16 prepared by a professional engineer registered in tile State of Florida prior to permit
j SSUcHlce,
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 l.ssuance of a permit prevent the Building Official from thereafter requirlng a
correction of errors ill plans, construction, or violations of any code. Every permit
is~ued shall become invalid unless the work authori:lled by /:Such permit is oOllulIenced Vlithin
six months of issuance, or if \~ork authorized by the permit is suspended or abandoqed for a
period of sllt months after the time the work is commenced. One 90 day extension of time
may be alloVled for the permit with fee charge of $15.00. '1'he extension shall be requeli~ed
In writing to the Buildi.ng Official. An approved inspeotion must be logged during each six
month period, or the projeot wlll be considered abandoned.
WARNING 'ro OWNER: YOUR FAIJ~URE TO RECORD A No'rIcE OF COMMENCEMENT MAY RESUW' IN YOUR
PAYING TWICE FOR IMl'ROVEMEN'l'S TO YOUR PROPER'l'Y. IF YOU INTEND TO OB'1'AIN IfINAlH':;INq,G(!,NeUL'I'
WITH YOUR LENDER OR AN AT'rORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
$2,500 IN VALUE DO NO'!' NEEEl '1'0 RECORD AND POS'l' A "NOTICE OF COMMENCEMENT",
--.------.-..-------------
S 1 GNA'l'lJRE I OWN ER OR AGENT
SIGNA'l'URE: CONTRACTOR
acknowledged
,19_
STA'I'E OF nORIDA
COUNTY OF ---------
The foregoing instrument w~s aoknov/l edged
Before me this --sJay of-----, 19 _:.._
by....-..-
(name of person acknowledged)
[1ho .is personally kno\'ln to mCl, or
o Vlho has produced_.
(type of identifioatlon)
and Vlho Ddid DUd not t.ake all oath
S'I'ATE OF FLORIDA
CDUN'rY OF-
The foregoing instrument was
Before me thls __ day of
by_
(name of person acknOWledged)
DVlho ls personally known to me, or
[1 who has produced
(type
and who[] did []did not
of ldentification)
take an oath.
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Hame typed, printed or stamped
Name typed, printed or stampt=d