HomeMy WebLinkAbout03-1745
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BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N!!
1745
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(813) 780-0020
Date
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~^NICAt
Sewer Conn
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Zoning:
Description of Work
Water Conn:
Water Meter:
T.I.F.'s:
FINAL
1-;; -03
DATE
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Valuation or
Contract Price
~ 'IDD -
Inspector
IfJtJ
City license Registration # .:5 D r
State Certified license#
Company
Address...-._
~#~f"oo-9JJ/66 35
~~}J~a':JUc./ ~(1J'
BUilDING
ElE CTR.LCId:'-
--
Tp. s-e?
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
~--~.~
PLUMBING
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-
MECHANIr.b.1
Ftr.
Pre SlB
lintel
FRM.
Insul. Cl
Wl
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
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.
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUII,nnw IHlll?ARTMElNT 5335 8th STRl!JElT ZI!Jl?HYRHILI,S, FL 33540
Phone'813-780-~020 Fa~1813-780-0021
lJA'rB1 RBcJiJrVI!ID /~-~~~cE~.J.___
Con I '1 N Pl.AHS RHlVIBIW rg..___.__.__. ":_____. .
CMNEJR I S !lAME! ___~ _._~~_.~_~_ _,~_~~.__ ___ ________. _ ___._._____._ PHmm CON'l'1\(~'!.__:2. '~,.:?~.?.~ '11
,TOB S I'l'El ADDRESS ..Lj_'1_9....$_.. ._L.1L it-g-~e.._._~-t_..____. ___ _____ ... ______'___ ______ _. _. ___.
LEGAL DEJSCRIP'I'IUI1: LOT(S) BU)CK SUBIJlVISJotl W~_f\~_~__~_~...____.__._
--'------_._-~._._---
PAR""" III 11_' Lj~:;) 1, ~~ ~L::- ~ ~ eo -~ O~ 0 () - O()..2 \:l ~...t.OBTAI!'~~FROM!~(~P:'~~y ':.. u~".~I"".)~
~~(JRK PROPSEVI [JNBlI1 r.'ONS'l'Rt1CTION [] ADDI'I'ION OAI/I'ERA'I'ION [J REPAIR IJ INSTAT,I,
USfGll
[] ~10VEl
o DElWJl,ISII
PRtWOSEJIl USE: I LlsmJ FAt-lILY DWELI,Ilm
n ['1lJ un, F Af'-1 rr., Y
[J# UF lJlUTS
~MOBII.EJ Hot-1E
[] CClt-1f\1ElRC! fA IJ
[J INDUS'l'RIAT,
fJSNH1MIW) POOL
LJ OTHElR
!
~4. F L(;jt {~G\ Q.OO)V\ CJ RE18TAlJRAH'I' & IIElALTIl DElPARTt.1EN'I' APPROVAL
IlESCRIPTION OF "OR;-.~ R ~~~-...J.o:!)il~ )efly .Q "J,b..!:L.~_~b_~ l\.~
3 3/
B!JILTlING SIZE
-------_.-._---~~
SQUAREl FOOTAGE
RElSIDElNTIJ\TJ I
COMMERC!tAIJ:
-.-- ---------
HElIGH'I'
ATTACH (2) PLO'I' PIJAllS & (2) SETS OF BlIUDING PI,ANS & (1.) 8E1T ElNElRny FORMS,
A'I''l'AC!H (.3) SE1i'I'8 OF BUII,TJING PLANS & (1) SElT ElNElR(N FORMS,
PRoprnRTY SURVEY REQUIRED FOR AI.L NEW CON8TRU~I'ION.
.__.._-~- -'---------
L1 Blnr.IJINrl
iERMITS REQUESTED
$-----1.._'-/ 00__. _, VALtJATJON OF TO'l'AL CONS'fRlJc'rlm~
L1 EI,ElC'I'RlCAI.
-.----..----_~ At-11? SERVICEI
[] FLORIDA POWElR
D W,R,EJ.n.
[] PI,lJt-1BING
o I1BJ<.!HANWAT.
[] (lAB
~ROOFING
,
$--~-.._------_. VALUATION UF tIJEC!lANCIAI. UIS'l'AIJIJATTON
LJ SPEC!IAL'l'Y
[J OTHER
'l'YPEl UP' CON8'I'Rl1L!TION: [J BLOCK
[J FRAME
[] STEEl!'
[J OTHER
F 11\1 ISBElll FLOOR ElI,ElVATIONS
------~--
IS PRO,TElC'I' IN FLOOD ZONEl AREAD Y'H!S
o No
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Cot1PANy__IA.!b'._!'f~L J.~----'_H~.~~c..b-i------ _'.
STATE: CFJRT OR REGIS'!' # '-'-C;::-b~.QuCd.-.J._....____
CI'l'Y PROCElSSING tL_.--~-~9__L__________._.._.n_.,___.
Er.B1C'rRICIAN
"... ...-..----.----..------.-.-.- "'--..-.--.--. --- _."._--_.~---_._-.
CO~1PANY ____.. .__ .._._.___._____._._____.._.__.__._...._.._. '__ '___
STATEl CBRT OR RE~TS'l' #
CITY PROCESSINll #
--~_._<-- ----....- ~ .-.-...-..---..-.--- ...--..-.--. -. .-
S JC3l1A'l'IJREJ __'"
p r .UMB B1R ( ~(jt-1 PAN Y ___________ ._______ _______.____.,__.._.. ___.._______.._
STATEl CBRT OR REGIS'I' # ________'__._____,__._~____.
SI(mA'I'lJRBl (;J:'1'Y PROCESSING #
* h * * * * * I< * * h * *. * * * * * * * * * * * * * * * * * * * * * * * * * *. * * * * * * * * * * * * * * * * * * * * * * * * * *
---.-.----...-. --. ._..~~_._._..._.. ---. -"-_.--"---,,"-,-~-
MECHANICAl.
***********1.******************************************************
COI',1PANY ________.___ .________________...__..____
STATE (~HlR'r OR REGI ST #
CITY PROCESSING #
-------.-------.-- ._.-._-.~--_ ..~__._._u~
SWl'lA'I'tJREl
-.----.--.----..------..------.----.....-----------..--.----
**************************************~**************************
_.__..._--_.~--_.__.__.._------~-
OTUBlR
----.-------------.
..----
(;Ot.1 P ANY
S'1'A1'El CElRT- OR - RElmsT#----------------.-.-------
CITY PROCElSSING # ------__._____._____,_______.
S WHA'l'URE
._-------"-~------
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--~--~-_.._.._-_._----~---_....._._-~---~. ---
CONDITIONS OF PEF].\1IT AFfIDAVIT
01\- NO'!'ICE OF DEED RES'l'RIC'fIONS
The undersigned understands thijt Lhi~ parmit may be subject ~o "deed restriotionsH wbjc~
may be more restri cti ve than City r:e9uli:ltiol1s. 'I'h,= 1ll1d,=r:si9ned assumes responsibili ty for
CJompliaHce with any applicable deed (.=st:eictions.
B. UNI,ICENSED CON'l'RAC'I'ORS AND CON'l'RI\CTOR RESI:'CJNS lBIl,['l'U:S
I f the o\'>/ner has h.ired a contracto!: or contractors to undertake work, they llIay be requiu:H.l
to be licensed in accordance wi.th state and local reglllati.ons. If the contracl:or is not
licensed as required by lav~, both t.he o\mer- and contractor may be cJted for a lIIi.sdellleanor
violation under state laH. If the ownet' or- .intended Cl.JfltrClctor a!:e uncertain as to vJhat
licensing requirements may apply for the intended work, they an. advi.sed to contact the
City of Zephydlills Building Department, 813-788-'6611.
Furthe.l.'lllore, if the owner has Idr'ed 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, YQ4 are indicating that
you, rather than the contractor, are responsible for the work. If the contractor wishes
you to sign al:l contractor that may be an indication that he is not properly licensed and is
not ellti tled to permitting privileges in the City of Zephyrhi.lls.
c. TRANSPOk'l'A'rION IMPACT FEES AND U'i'ILI'l'Y CONNECTION IfEES
D. CONS'l'RIIC'rUION LIEN I.A~l (CHAPTER 713, FI.ORIDA STATUTES, AS AMENDED)
1 certi.fy that I, the applicant, have been provi.ded with a copy of "Florida's Construction
lien Law - Homeowner's Protection GuideH prepared by the Florida Department of Agriculture
and Consumer Affair's, If the appli.cant 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 conUllencement.
E. CONTRAC'l'OR' a/OWNER'S AFFIDAVl'l'
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 permjt to do work and installation as indicated, 1
certify that no Hork or installation has commenced pri.or to issuance of a permit and that
all work will be performed to meet standards of all laws regulati.ng construction, c.ity
codes, zoning regulations, and land development regulat.i.ons in the jurisdiction. I also
certify thatl 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 i.nclude but are not limited to: *Department of
Envirollmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/waste\'>/ater Treatment
*Southwest Inorida Water Management District-Wells, Cypress Bayheads, Wet.1and Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of Health & Rehabllitative Services, Envi.ronmental Health Uni.t-Wel1s,
Wastewater Treatment, Septic Tanks
*U.S. Environmental I?rotection Agency-Asbestos abatement
I also certify that, if fill material i.s to be used in Flood Zone ~AH or "A,etc.H, it is
understood that a drai.nage plan addressing a "compensating volume" 'will be submitted Hhiah
is prepared by a professional engineer registered in the state of Florida prior to permit
issuance,
A permi.t 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 slla11 issuance of a permit prevent the Building Ofticial from thereafter requi.ring a
correction of errors ill plans, construction, or violations of any code. Every permit
iStjl1ed shall become invalid unless the work authorized by such permit is cOllullenced within
six months of issuance, or i.f work authorized by the permi.t is suspended or abandol1ed for a
period of si.x months after the time the work is cOllunenced. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extensi.on shall be teques~ed
in writing to the Buildi.ng official. An approved inspection must be logged during each six
month period, or the project will be considered abandoned.
WARNING '1'0 OWNER; YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUI!I' IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OB'I'AIN InNAN(~ING, ~qN~UI:l'
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. .JOBS mHlER
.2,500 IN VALUE DO No~eORU AND POS" A "NOTICE OF COMM Ne""EN'!"'.
~AA
SIGNA'l'lJRE; OWNER OR AGEN'I'
STATE OF FLO~~ .
COUNTY OF _-'-U 51" L) COUNTY OF
'I'he foregoing instrument was acknowledged The foregoing instrument w~
Bef3l1\~hiS -4z....'Y~ d~y of _ ~~., ~tJ~ Befor~II"If:c;-2~s 1a . of ,
by. _~t ~~t'Tt ~ by~'
(name of person acknowledged) (name of person acknowledged)
o who is personally known to me, or D~ho is personally kno~m to me, or
~WhO has produced...E:L..7).. L. 04:20 -'197-t6- ~I,I..O has producedflD L .!Jfr20'_."79.'7-lf
. JtYp-e of identi.fi cationl?~7-D /.-....__.-~.J: (t:ype~Of i~entifioatien! .
al.19.--wfiOT.,,~d ~i?,no~"",-,.ftake an oath./,,/ and ".h,..O, , [Jd,i.,..cjj ~. id, nrt.t~ an 01t~.?f7. (..
_! '--7Q~~ ~a~x~~CM7~_..~< l_ / ~2{;~
signatur'e of person taking acknowledgement Signature of person taking acknowledgment
\\\111I1', ,....~';i~:rv.:'~ Bobbie Swetland
~'f~ Bobbie Swetland f""f'~\ MY COMMISSION # CC893160 EXPIRES
{t~~y~~?i~~:~~j~~~6$iXP~~amped -.------ Hame il PfO~6~t~~~;I~~--'-'---"-----'-
"lfp.f.,~~'" BONDED THRU TROY FAIN INSURANCE, INC '. ......... -
STA'l'E OF FLORIDA
CONTRACTOR
.---.~
2{Jf~
S I GNA'J1URE :
hl1ff} ~llm&I!&".J
<<(-I~IVI~ICIBLE@]~ ~~.. ''''''''
t~!!'!!~~ ~ I,. I,. P ...
Cooley! Building Products INVINCIBLE ASSOCIATES, INC. ~ENERGYSrAR
10931 75TH ST, · LARGO, FL 33777
727/545-1800 · 800/937-6635 · STATE CERTIFIED LICENSE #CCC049367
, MAKING FLORIDAA BETTER PLACE TO LIVE SINCE 1~7.?grE HOME AT A TIME
Name(s): /11):(5";) WIJ~ CO/V tAN Pho~ef&L7 8'2.-7:1. Cj lw)
Mailing Address: 1t9og' Cc.?7tl},l-/f Sti(Y:, Z,r;~1ft&~b~tiPA$"CP State:?')) Zip:E5.
(If Applicable) MHP: W, fll/Tl"J< "$' 51,. !-/omlot#: '1t10g'
Alternate Address: 3 'j' 0:1.< h/, "1-6#( IJ~- State:_Zip:_Phone:
IflNe, 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:
..-
1. PROVIDE ENERGY-SAVING INSULATED WATERPROOFING SYSTEM FOR THE FOLLOWING AREA(S):
?L-. t> r.< ,I [) C/ JVL
2 INCLUDE ENERGY-SAVING DOUBLE-FOIL FACED INSULATIO S INDICATED:
\ GOLD: DELUXE 1-1/4" INSULATION 0 S/~ER: 3/4" IN LATION 0 BRONZE: ~
l ~. INCLUDE NEW SPUN ALUMINUM VENTS: ~SMALL Y_LARGE
. INCLUDE UP TO 100 SQ. FT. OF NECESSARY DECK REPLACEMENT. ADDITIONAL DECK
REPLACEMENT TO BE INVOICED SEPARATELY AT $2.00 PER SQUARE FOOT.
5. 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:
CUSTOM!:R'
INITIALS FOR
SYSTEM
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Jobsite Address:
according to the following specifications:
City:
State: _ Zip:
STEVENS WHITE EP STEVENS TAN EP · STEVENS LIGHT GRAY EP · EREZ TAN . EREZ WHITE . EREZ GRAY
COOLEY ILL SIONS · COOLEY GREEN ILLUSIONS · COOLEY CHARCOAL ILLUSIONS . COOLEY WHITE TPO
CIRCLE MEMBRANE TYPE:
9. IT IS UNDERSTOOD THAT THE FOLLOWING AREAS WilL NQI
BE INCLUDED IN THE COVERAGE PROVIDED BY
THIS AGREEMENT (See Drawing at Right):
'5 1-1 ElJ /'oR,C H if' In J:J I~ ,tJV
SHOW ALL AREAS OF HOME. DRAW ADDITIONS AS
NECESSARY. WRITE "YES" IN AREAS TO BE COVERED.
WRITE "OMIT" IN AREAS NOT TO BE COVERED.
OTHER NOTES:
r I) P J? e rbv1 /-.bA k.
J
t1 TV ?LY T( J ~11 er c.oo/" Pp)v.
A'C7(7)n
tJrnl~
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CUSTOMER
INITIALS
NOTE: RETAIL SALES TAX MUST BE CHARGED UNLESS THE CUSTOMER SIGNS THE FOLLOWING:
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 the structure be assessed as realty and it bears an "RP" decal.
SIGNATURE:
The CASH CONTRACT PRICE for all Labor & Materials (including any applicable discounts) is $ I
Terms: 0 Cash 0 Credit (Subject to the approval of the Cre' ales Department) ~ Sales Tax $
If this is a cash transaction, the purchase price s I ~JIoQid ws: /33 II ' .
Cash down Paym~nt (Minimum 33%) $ {;// Balance Payable $ 7, Total Price $ I
If this is a credit transaction, the agreement for credit is contained in a separate document which is incorporated herin by reference and made a part thereof.
I/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,. A~PART OF T. HIS CONTRACT. } .-~
IN WITNESS WHEREOF Purchaser(s) have hereunto signed their name(s) this . _~_ day of. _ 20 ~
and acknowledges receipt of a true copy of this Contract. ~
UNLESS OTHERWISE SPECIFIED, IT IS UNDERSTOOD~16. E OWNER(S) IS/ARE READY FOR THIS WORK TO BEGIN, THE PURCHASE PRICE
QUOTED ABOVE WilL BE HONORED ONLY UNTil -I. _ . Purchaser(s) understands and agrees that if this agreement is cancelled after the
rescission period, the Purchaser is liable for twenty five per nt (5%) 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% otTotal
Price until completed, The remainder of Total Price is due upon installation or as otherwise specified.
IX -4;;;- -;;;;;~;p ;;/.1 "i1*u iv~:~-~-::Z;- ---1
I SUBMITTED BY: Representative Date ACCEPTED BY: Purchaser Date I
I I
I ACCEPTED BY:Authorized Signature for Contractor Date ACCEPTED BY: Purchaser Date I
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