HomeMy WebLinkAbout03-1794
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N~
(813) 780-0020
1794
Date I-;;l '7- tY3
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcell.D. ,
i!J-;:: 5/~
:;- S 6lc.( /~.,4-. :iT
Water Meter:
T.I.F.'s:
Zoning:
DescriDtion of Work
E"frgy Cod~: ~
p- :e
Radon Gas:
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
FINAL
C.O.
DATE
NO OCCUPANCY BEFORE C.O.
DATE
Inspector
:$!i. CJ CJ
Permit Fee u .---
)7Signature _ ~ IlI)6l-
Company
Address
~Iephone# S-, 7,..- S 03 ?j
,
Valuation or -1 3 .. pO
Contract Price 0'/ l?-O
City license Registration # ! I h
State Certified license#
{;/~/~ ~FI;"3
BUILDING
Ftr.
Pre SLB
lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Met
Final.
SLB
Tub Set
Water
Sewer
Fin
Breakers
Ducts Insl.
Com~
Fi
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 ($25.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
. ...
CAV1N ROOFING
po. Box 1363
DADE Ci ry, FLA 33526
Lie. t1=PCC04624 J BondfJC !n<,ur~d
PROPOSAL
Page No.
of
Pages
(352) 5675034
2 YEAR lEAK WARRANTY
,JOB NAME / NO.
LOCATION
To:
PI lONE
DATE
I
i
/
We hereby submit specificalions and estimales for:
WE PROPOSE hereby to furnish material and labor - complete in accordance with these specifications, for the sum of:
dollars ($
Payable as follows:
j,
./,
^11 materia] is ,l..{tl~lI-aIJlt'('d [0 be as specified. All work 10 be completed ill a workmanlike
Illdllllt.T according In standard practices. All)' alterations or deviation from above specifiea-
liOlIS iIIVO]villg ('xlra cost \vHl be l'xl'l'uled only upon writ tell orders. and will becollll' all
c:\lra charge over and above the l's(i!11<Jlc. All agreements l'oIlLingcn( upon strikes. UlTidcIlls
or dl'iays heyolld our control. Owner to curry fire. tornado, and other Ilccessary inslIralllT.
Our \\'orkcrs are fully ('overed b.y Workmen's CompCI1S<llioll Insuranct'.
Aulhorized
Signature
NOTr;: This proposal may be wilhdrawn
by us if nol accepted wllhln
days.
ACCEPTANCE OF PROPOSAL - The prices, specifications and conditions are satisfactory and are hereby accepted, You are authorized
to do the work as specified, Payment will be made as outlined above,
Signature
Date
Signature
Date
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMElN'r 5335 8 th S'rRllllllT ZlllPHYRHII,I,S, FL 33 S 40
PhoneI81]-780-~020 FaxI813-780~0021
fJATBI RII<1JlIIVIlJO ~_~_"...:..""', _.____
InANS R!llVIBlW Jl'JlIB_,-,__~..tJ___ ._.
Ul'lNEJR' S I1A~1EJ 13/ 5/11rf1/2- r PHONEl CON'l'AC'!'______.__,_.:>l..:._____
------_.._-_....__.__._-~---_.~,--:::--_._------_._------
,TOB SITEl ADDRESS -.X2..__!!i______/c ~h_---_~-~:____._____.__n_._____ _________________._ ----___...u
IJ8lC1AL !)BlSURT PTIDl1: LO'r (S)
BIDC'K
SUBDIVISION
---.-..--.-----
_m________ ,.___"__ ._._________
PARC!EIJ In #
-..-------.-----.------------.
(OBTAIN FROM PRnPEJR'I'V 'I'l\){ NO'l'WfJI)
o A I~'~E R-~; I 0;-'--- [~ ;;~;--"--'I;-~-;;;;;;:~--.'-
NORI< PROPSEIJ I [J NEN l'ONS'l'Rt1CT ION
o ADlJI'l'ION
[JSHm
o MOVE
o DElMOI,ISI!
PRlWOSFJll USE I [JSGlI, FAf.1I!JY nWELrJIl1G
[h1tJt/I'I. FAI1U,Y
[]# (IF lINI'I'S
1JSWn1MING POUT..
IJ MOBII.El lHJt1m
I] OTHER
o COt1MI1IR(! JAI,
o INDUS'rRIArJ
llEJ8CRIP'l'ION OF WORK
o Rel8TAURANT & HI1IAI.Tl1 DEPAR'Il1I11NT APPROVAL,
__-.XG- ____It. Cc ~~y(;..,.._.__
J) rj
/ ..._-_.._~--- _._-------._._.~ --------.-------...-.. -.-..-.----.- ..._-_._~
BlJIr.fHN(~ SIZE!
-----'----
SQUARE! FOOTAGE!
-----------
HBlJOH'r ._.________
RlllBIt1BlNTIAfJ I
COMMIlIIWIAIJ I
A'I"l'1\CH (2) PI,OT PIJ1U1S & (2) SETS OF BUIJ/DING PI,ANS & (1) sEI'r IllNElROY FORMS.
AT~ArH (3) 8~T~ OF BU!LDING PLANS & (1) SE!T ENERGY FORMS,
PROPBlRTY SURVEY RBlQUIRBlD FOR ALL NEW CONSTRUCTION.
t1 BllII.IJIN(~
II l'ERMITS REQUESTED
fJ/~ ~~
$-_.~ O(} .______ VALUATION OF TOTAL CONS'rRlJCTION
[J ElLBlC'I'RlCAI,
- ---....-'"------..
At1P SElRVICE]
o
FI,oRlnA POWER
o
W.R,E.n.
[] P l,tJt"B INl~
U HEUHANIt!AIJ
$---- _.'
- VALUATION OF MBlCHAHCIAI, U1STAI,lJATTON
[] C~A8
f] ROOFING
rJ 8J?EJCJIAUry
[J OTHER
'l')!'PaJ OF CONSTRUCTION I [J BLOCK
[J FRAMEl
rJ STEEr J
[J OTHEJR
FINISHErJ 'T,OOR IlIIJElVATIONS
------------
IS PRO,TElCT IN FLoon zemEl AREA 0 vms
o NO
~
BUIWIllR
8tGNATlJRIil
-..-.-.......-..~""'------.
.------__.r__
COHP AN Y -.---.---~___.___ ____. .__... _.__n__ _ _ _________ ___ ___
8TA'I'Bl CERT OR RElGI8T # ____._____.__..______._0.___.__
CITY PROCESS ING L.__ .----------..-_______u ___.___._____
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!III,!IlCl1rRICIAN
8 WllA'1'IJREJ "'_._.
.--.-.-.-. -'-'~-'_.---'---'"'---------_._-_._----,.__._----,---
CDt1PANY _____.________________..__________ _____
STATE C'EiRT OR RE(HS'I' #
CITY PROCESSING #
'--_.. -.,.--.-- ~ -.------------ ---"-- _. -,--
******************************************************************
--------. -"----"."'-'-- -'. ---.--...._0.._-
PIJtJMBBlR
--....y.....__n.._~_..._4__~_ _____
(!OM P ANY --______.______-,--__________._..___._._._ ____.____..__
STATE CER'!' OR REiGIST # ________~________..
CITY PROCESSING #
8 WNA'l'lJREl
MBlCHANICAf,
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-_._--.._._-------_.~--_..._----,----- .-
-....._----~----------_..__..----....-
COIv!PANY ____________.._.____.____.____._____.__
STATE CrnRT OR RElGIS'r # -_.__.hh__.______________
CITY PROCESSING #
8 IGNA1'lJ~El
************************..***************************************
- ~
OTUJlJR (~O"1PANY C/ft/i;J i!OOhN? ,
--..---T9--.T-;-.-- /1 . LJ~---- STA1'E eERT OR 'EOIST if .gc_!!!!ilj.'"ilZ---'--
."lNATU'E '--KZ ~' t:/!fvz' CITY PROCE..'NO # _5JJ .___.__=.=--=:.=::
***********************************************************~*****
CONDITIONS OF PER11I'I' AFFIDAVIT
A. NO~ICE OF DEmD RESTRICTIONS
The undersigned understands th~t this p~rmit may be subject to "deed restriotionsU wllieh
may be more restrictive than City regulations. Tile undersigned assumes responsibility for
oomplianoe with any applicable deed J:estrictions.
B. UNLICENSED (;ONTRAC'l'ORS AND CON'l'RACTOR RESPONSIBIJ,I'l'IES
I f the m>lner 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 Ilot
licensed as required by law, both the OHner and contractor may be cited for a misdemeanQr
violation under state law. If the owner or intended contractor are uncertain as to Hllat
li cansing requirements may apply for the intended work, they are advised to contilPt the
City of Zephyrhills Building Department, 813-788-6611.
Furtherlllore, it the owner has llir-ed a contractor or contractors, he is advised to have the
contractor(s) sign portiDns of the "CDntractor SectionsH of this application for which they
will be responsible. If you, as the owner signs as the contractor, YQl! are indicating that
you, rather than the contractor, are responsible for the work. If the contractor wislles
you to sign as contractor that may be an indication that he is nDt properly licensed and is
not entitled tD permitting privil~ges in the city of Zephyrhills.
C. 'I1RANBPOR'I'ATION IMPAC'l' IfEES AND UTILITY CONNECTION FEES
D. CONS'l'RllC'l'UION 1,IEN LAvJ (CHAP'I'ER 713, FLORIDA STATUTES, AS AMENDED)
I oertify that I, the applicant, have beeQ provided with a copy of "Florida's ConstructiDn
lien Law - HDmeowner's PrDtection Guideu prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "ownerH, I aerify that I
Ilave obtained a copy of the above described document and promise in good faith to deliver
it to the "owner" prior to commencement.
E. CON'I'RAC'l'OR' a/OWNER' a AFIi'IDAVI'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 constr-uction, zon1ng, and land
dev~lopment.
Applioatioll is hereby made to obtain a permit to do work and installation as indicated. I
ceq:ti fy that no viOrk Dr installation has commenced prior to issuance qf a permit and that
all wDrk Hill be perfDrmed to meet standards of all laws regulating construction, City
oode~, zoning regulatiDns, and land develDpment regulations in the jurisdiction. I also
certify that I understand that the regulatiDns of other governmental agencies may apply to
the intended work, and that it is my responsibility to identify what actions I IIIllst take to
be in compliance. Such agencies include but are not limited to: *Department of
Environnlental Regulation-Cypress Bayheads, Wetland Areas and Environmentally SensJ.tive
Lands, Water/Wastewater Treatment
.Southwest ilorida Water Management District-Wells, Cypress Bayheads) Wetland Areas,
Altering Watercourses
.Army Corps Df Engineers-Seawalls, Docks, Navigable Waten/ays
.Department Df Health & Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater Trea~ment, Septic Tan~s
*u.s. Environmental ~roteation Agency-Asbestos abatement
I also certify that, if fill material is tD be used in Flood Zone ~Au or "A,eta.H, it is
underatoDd that a dratnage plan addressing a "compensating volume" 'will be submitted which
is prepared by a professional engineer registered in the State of Florida prior to permit
isauance,
A permit issued shall be construed tD be a license to prDceed with the wDrk and not as
authority to violate, cancel, alte.t:, or set aside any prDvisions of the technical codes,
nor shall issuance of a permit prevent the Building Official from thereafter requiring a
cor~ection of errors in plans, con~truction[ or vio~ationa of any code. Every p~rmit
is~ued shall become invalid unleas the work authorized by such permit is oOlluulinoed 'within
slxmonths of issuance, or if work authorized by the permlt is suspended or abandoqed f9r a
period of sLIi months after the tillle the work is commenced. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be requea~ed
i n ~'iri ting to the Buildlng Official. An approved i.nspection must be logged during each fiix
IIlDnth period, or the project will be considered abandoned. .
WARNING TO OWNER I YOUR If AlLURE TO RECORD A No'rICE OF COMMENCEMENT MAY RESUL'I' IN YOUR
PAYING 'rWICE FOR IMI?ROVEMEN'l'S TO YOUR PRO~ERTY. IF YOU INTEND TO DB'l'AIN FlNANqINq,CqN~uL'r
WlTH YOUR LENDER OR AN A'I"I'ORNEY BEIfORE RECORDING YOUR NOTICE OF COMMENCEMIilN'I'. JOBS UNDlllR
92,500 IN VALUE DO NOT Nl!:IilD TO RECORD AND POST A "NonCE OF COMMENCEMENT".
SIGNA'l'UREI OWNER OR AGENT
SIGNATURE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument w~s aoknowledged
BefDre me this_~ay of-------, 19
by
(name of person acknowledged)
Gho is personally known to lIIe, or
Dwho has produced
(type of identifiQation)
and vJho Ddid DUd not t.ake an oiilth
S'I'A'l'E QF FLORIDA
COUNTY Ot'
The foregoing instrument was acknowledged
Before me this __ day of , 1!L-
by ____.
(name of person aakno"l~dged)
DwhD is persDnally knDwn to me, or
o \'iho has prDduced
(type
and who[] did Ddid not
of identificatiDn)
take an oath.
Signature of person taking acknowledgement
Signature of person taking aoknowledgment
Hame typed, printed Dr stamped
Hame typed, printed Dr stamped