HomeMy WebLinkAbout03-1931
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N2
(813) 780-0020
1931
Date
3-16-- tJ 3
BUilDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcel I. D, ,
Zoning:
DescriPtion of Work
Y~VV'I'J
3)< 7/1
~~d:
(1~~
Ave.
Water Meter:
T.I.F,'s:
51 ;",vit
u
Radon Gas:
p,~ R\I~0bfW VY\.~~
Energy Code:
t1e.-~
FINAL ('- -~ 3
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
Inspector
/IJt>
Pe<m;t Fe.~ QQ
YSignature j -L)~
Company
Address
~Iephone# ~ * q.:; ,- G, (i)S
Valuation or 8"0
Contract Price----l 3 @--Q .
City license Registration #
State Certified license#
~\JIt'\C(/o{~ /issoc.7I^(,
BUilDING
elECTRICAL
PLUMBING
MECHANICAL
Tp. Servo
Rough In
Meter Can
Canst. Pole
Pool I
/
Pre-Meter i
Final
SlB
Tub Set
Water
Sewer
Fina
Breakers
Ducts In I.
Compr
Final
Ftr.
Pre SlB
lintel
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.
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUUDING nEIi'ARTMEN'r 5335 8 tll S'rRBlm'r ZIllI?HYRHILI,S, r1. 33540
PhoneI813-780-~020 'axI813-780-0021
!JA'rBJ RIllCB1IVlllo ~_.__ ....... _,=
PI.ANS RIllVIBlW Jl'J!l1l
"
. _~._.,__._h~ _.
Ul'ltlEJR I S ITM1E__~(~L_.Y~u~_.____.. ________.._.__._ .____._____ _ PIWNIil CON'l'Ar!'!' ?r.!p-~?fJj-:l9.~J
,roB SITE ADnRBlSS_~ ..'i...']~7_n__CJ1~~~~__,q._~~____..____ _...____ -------_____.n_________. _ "_..__ __n._
IJE)(J1\L DE1SCRIPTIDN:LOT(S)
B U)(! K
SUBlJIVISlON
--.....--.--.-..-.. _ ....___...4'.__~ __._.._.___~__
PARC'ElI, III 1I-~.'J>~_-.2S__:'J:l~_Q_Q.5..d_:::.~_ -Iu:_o ___~.~~TA.~~l__~~R(~_~~.<2~!~~~:..._'~~~._.~~I~~.CE'~~.__
WORK PROPSBlfJ I [JNBlW CONSTRUCTION 0 AlJDI'I'ION o AUI'E1RA'rION [J REPAIR [J INSTAIJI,
r.:::JsIcm
o "10VE
[J DElt",or,I811
PROPUI3FJil USE: I [}Q SGJ I FAMILY DWEl,I,I11G
L1cm1MIllR(IIAII
[h1Ul/J'I - FAl"IILY
[]# UF tlNI'I'S
[] MOBIIrEl IlOf11ll
[J INDUSTRIAl,
[JSWHIMHlG POUL
IJ O'l'IH!lR
DESCRIPTION OF \^lORK
o RElSTAlJRAUT & HEAlml DHlPARTt.1ElNT APPROVAL.
fte, lo~-_-5i.~c..f2i:f--tZ r..Il2l2~~_.r!1c~~~1ft.~~__._.._____.__..___. _.____
SQUARE FOOTAGE __I!i.5....___
HElIGHT
BUILfHN(~ ElIZEl
----_._----.-._-~--_.-
---_..__..-~.--.._-_._..-
RES IDHlN'l'IAJ, I
(~OI\1MElR(!IAT, :
A'I''f1\CH (2) PI,OT PIJAHS & (2) SElTS OF BUIJ,nING PI,AN8 & (1.) 8E1'l' ElNElRny FORMS,
A'!"r1\C!H (3) SElTS OF BUILf)ING PLANS & (l) SET ENERGY FORMS.
PROPERTY SURVEJY REQUIRED FOR ALL NEW CONSTRUCTION,
C1 81 II LLJINC3
IJ ElLBlCTRl CAl,
[] P!,ut1BING
LJ J,1ECHAN I (!AL
~ERMIIS REQQmSIED
$______\'2..""^ ~._...._. _
-- _....J<..!V - _ __ VALUATION OF TOTAI~ CONS'I'RUC'rrOll
--.-.--___.___ AMP ~ERVrCEl
o FIDRIDA POWER
[J VI , R . EI . c~ ,
$----..-------- VAI,UATION OF ~IJElCIIA.HCIAr, UlSTAI,IJA'l'TOH
[] C3A8
LJ ROOFING
[) SPEJr.!tAW'Y
[J O'I'HER
TYPE OP' CONSTRUCTION I [J BIllCK
[] FRAJIJEJ
[J STEEl!.
[J OTHER
FINISHHlTJ FLOOR ElfJEVAT IONS
18 PROlfEC'f' IN FLOOD zemEl AREA n YES
o NO
BurUHll~
C'O~IJ PAN y;:E.f4!t.lP Ci~/~L_ J4~;S.~~u_::f~.f:_' _ ____... ._.___..._
~OwA.j .A. "~ BTJ\TEl CEJRT OR REGIST # ..~~C!~(9.J_<R._2__..____...__
81 CHTATlJREl "~~~JI'----L:'l.L_~_._-------------- CITY PROCElSSING ff..._______..___......______ ... .._.._._._....__
******************************************************************
B1I.Blc'rRICIAll
- .~ -,_. -,--.-. ...-.....~..._.-. .".. .__..____~__. .0-
COl1PAN Y._.___u____ .______ ___________...._..___.______... .____..
STATE: e'ERT OR RE:CHS'l' II
CITY PROCE8S11'W II
-----.---. .-.-_.- ----...~--.----_._-_....~ . -"-"'-.
8 J <311A'l'IJREJ .__
'*"*"***"*'*""'*"**"***"""""'**"'*'*"***'*""**'***
---.-...-... ------~.._-- .~- .-'-' ---...- .- -.._-~.. -......._._-~..~----_.
Ii' r. UMB B1R C(J~1 PAN Y _.___._______.________....______..____. "H"_._ .._____.___
STATE r.!ERT OR REGI8T # ___.____..__...___._._.._____..
8 I(~NJ\'1'IJR El C I'l'Y PROCESS ING #
..__.~......_-- .".........------.- -.--------.--------------------- .--~--.--- '-'- 4_.____._._~__ --~.._..____~_4_._.>.~_
MIllC!HANICAJ.
,.'*********"'**'*'*'*"*'**'***"'**"**'***""*'*'*"'**'*'**'
--._,.~----~--~----_.__.~-----~_.,..._-~.,_._-----
C!ol"l PAN Y ---------._________ . '__.. ~_'_______. '.H_. _......._ .._.__
STATE CElHT OR RE1CHST #
(!I'l'Y PROCESSING #
-.------.-..--- '--. _.______ n._._~_______-._ ._._____.
SWNA'l'IJREl
*,*,**"'*'*'******"*"*'**********'**********************"***'
~.- ------.-.---~_._____u____.._..__..._ "__"~_'___'.__'_
OrrUBJR
---._--....._--_._~----~.~-
rXJ!,1PANY
STATEl C'ElRT OR- REGIST #-------------..-----.---.-......--
(Try PROCESSING # -.-...---- -.------..-.-------_
-_.__._._..~--_._--------'----_._--_._-------
s umA'l'UREl
**"****"**'*******'*****'*******"*'*'***"*'***'*'******~'****
'---'._'-~-'-- ---"-_._.~~__~'___."4h_4~ .. _~~__. .n +_,
CONllI'l'IONS OF PERlI1I'l' AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
~rhe ulldersigned understands thqt this permit may be subject to "deed restrictions" vJllich
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNLICENSED 'CON'I'RAC'I'ORS AND CONTRACTOR RESPONSIBILI'l'IES
I f the ol'Jner has hil'ed a contractor or contractors to undertake Hark, they may be .required
to bl:: U ceused 1n accordance Hith state and local regulations. If the contractor is not
11cellsed as required /Jy lavJ, /Joth the ovmer and contractor may be oj ted for a urll:ldemeanor
violation under .state laH. If the owner or intended contractor are uncertain as to vlhi:lt
licenslng requirements may apply for the intended work, they are advised to contact the
City of Zephyrhills Building Department, 813-788-6611.
Furthermol::e, 1 t the owner has hired a contractor or contractors, he 1s advised to have the
oontractor(s) sign portions of the "Contractor SectionsH of this application for which they
wIll be responsible. If you, as the owner signs as the contractor, yo!.! are indicating that
you, rather than the oontractor, are responsible for the work. I f the cont.t:actor wishes
you to siyn as contractor that may be an indication that he is not properly licensed and is
not elltitled to permitting priv11~ges in the City of Zephyrhills.
C. 'I'RANSI:'OR'PA'l'ION IMPACT ~'EES AND lJ'I'ILI'I'Y CONNECTION FEES
D. CONS'l'RIIC'PUlON LIEN LAv~ (CliAP'l'ER 713, FLORIDA S'I'ATUTES, AS AMENDED)
I certify that: I, the appli.cant, have been provided \'-lith a copy of "Florlda's Construct:lon
l1en Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affair's. If the applicant is someone other that the "ownerll, I oerify that I
Ilave obtained a copy of the above descrlbed document and promise in good faith to deliver
it to the "ownerH prlor to commencement.
E. CON'l'RAC'I'OR' S/OWNER' S AFFIDAVI'I'
I certify tllat all the information in this application is accurate and that all work will
be done in oomplianoe Hith all applicable laws regulating construction, zoning, and land
development.
Appllcation is hereby made to obtaln a permi t to do wor'k and installation as indicated. I
certify that no Hork or installation has cOllunenced prior to issuance of a.permit and that
all work will be performed to meet standards of all laws regulating construction, C1ty
codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify thi:lt I understand that the regulations of other governmental agencies may apply to
the intended work, and that it is my responsibility to idenUfy what actions 1 must take to
be in compliance. Such agencies include but are not limited to: *Department of
EnvirOlllljental Regulation-Cypr'ess Bayheads, Wetland Area.s and Environmentally 8ensjtive
Lands, Water/Wastewater Treatment
*Soutllwest florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*I.lepartment of Health & Rehabil.itative Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.3. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in flood Zone ~AH or "A,etc.", it is
understood that a drainage plan addressing a "compen.sating volume" 'will be submitted whicll
is prepared by a professional engineer registered in the State of Flot'ida pdor to permit
i Bsuance.
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 sllal1 issuance of a permit prevent the Building Official from thereafter requlring a
correction of errors ill plans, construotion, or violations of any code. Every permit
issued shall become invalid unless the w01:l~ authorized by such permit is oOllulIenced Hlthin
slx months of issuance, or if \'Jork authorized by the permit is suspended or abandol~ed for a
period of six months after the time the work is conunenced. One 90 day extension of time
may be allowed for' the permit Hith fee charge of $15.00. '1'he extension shall be ~l!lquested
in wd ting to the Buildi.ng Official. An approved inspection must be logged during each' si H
month period, or the project Hill be considered abandoned.
WARNING TO OWNERI YOUR FAILURE 'f0 RECORD A NO'I'ICE OF COMMENCEMENT MAY RESUL'i' IN YOUR
PAYING 'l'WICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IN'I'END TO Oa'rAIN l"INAN{1INq,~qNl.?UL'I'
WITH YOUR LENDER OR AN A'l"I'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'r. ,JOBS UNTlER
$2,500 IN VALUE: DO NO'l' NEED '1'0 RECORD AND POS'l' A "NOTICE OF COMMENCE'.MEN'l'II.
SIGNA'l'UREI OWNER OR AGENT
fJJ wUd--___...
CONTRAC'I'OR
STA'rE OF FLORIDA
COUNTY OF
The foregoing inatrument was acknowledged
Before me this ___ day of ___, 1~
by._
(name of person acknowledged)
Dwho is personally known to me, or
STA'l'E OF nORIDA
COUN'l'Y OF
'rhe foregoing instrument w~a aolmowledged
Before me this .-----Sjay of---, 19......:..._
by
(name of person acknowledged)
c:.1ho .is per:sonally kno\'m to me, or
o Hha has produced
(type
and who[) did []did not
of identification)
take an oath.
n Hho has produced.hL~/l.3' 707 -..2ff~~-=__
(type of identifiaat10nl
and who Ddid DUd not Lake an oath
Si.gnature of person taking acknoHledgement
Signature of person taking acknowledgment
-.-----..----.----..-.------~-.-----_._____v__._.._
I'lame typed, prlnted or stamped
Name typed, printed or stamped
a\"'~
w.e.1I
INVINCIBLE ASSOCIATES, INC. ~NERGYSTAR
10931 75TH ST. · LARGO. FL 33777
· 727/545-1800. 800/937-6635. STATECERTlFIEDLlCENSE#CCC049367
MAKING FLORIDA BETTER PLACE TO OVE SINCE /987. ONE ~'YJ!,T A TIME
Owner(s)/Purchaser(s): ()/iAII EI- ,f/;tJ/IJ G:'/ Phon~: (~ 7#t-1tJs/ (W) /'
Mailing Address: 38 7/q ()v.fPE/t) AvE City: 2EPJI (1lI/I/..5 County !f1fCO State: ;:-;: Zip: 33 S~~
(If Applicable) MHP: .:5iT'i5 Lot #:
Alternate Address: ,JA City:
t~r.~~tj"
~/Build;ng Products
(J~ ()
~ INVIN~IBLE@~
.
C{)
w
V\
State: _ Zip: _ Phone:
)J
V}
~
I/We, the Owner(s)/Purchaser(s) of the premises described below, hereinafter referred to as "Purchaser" offer to contract with INVINCIBLE ASSOCIATES, INC.,
hereinafter referred to as "Contractor" to furnish, to deliver and arrange for installation of all materials necessary to improve the premises located at:
\ JobsiteAddress: ~Mt City: State:_Zip:
according to the following written specifications:
......,.
,....--.-------..-
~VE~~X(HJI~"~STEVENS TAN EP · STEVENS LIGHT GRAY EP · EREZ TAN · EREZ WHITE . EREZ GRAY
COOLEY TAN ILLUSIONS · COOLEY GREEN ILLUSIONS · COOLEY CHARCOAL ILLUSIONS
COOLEY TAN 3.TAB LOOK · COOLEY GREEN 3.TAB LOOK · COOLEY CHARCOAL 3.TAB LOOK. COOLEY WHITE
1, PROVIDE ENERGY-SAVING INSULATED WATERPROOFING SYSTEM FOR THE FOLLOWING AREA(S):
l:JAr kftf!.. R{J()/~
.
2. INCLUDE ENERGY-SAVING DOUBLE-FOIL FACED INSULATION AS INDICATED:
f)l..GOLD: DELUXE 1-1/4" INSULATION 0 Sll-VER: 3/4" INSUL}.TION 0 BRONZE: ~
3, INCLUDE NEW SPUN ALUMINUM VENTS: --'L-SMALL ~LARGE
4, 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 TO ROOF MEM~RANE FROM RAIN, LIGHTNING, HAIL AND WINDS
UP TO 170 MPH. 'NOTE: BRONZE SYSTEM (NO INSULATION) RECEIVES A 1-YEAR. LEAKPROOF WARRANTY.
8, ADDITIONAL INFORMATION: .
CIRCLE MEMBRANE TYPE:
o
o
(f
~
CUSTOMER
INITIALS FOR
SYSTEM
9, IT IS UNDERSTOOD THAT THE FOLLOWING AREAS WILL tfQI
BE INCLUDED IN THE COVERAGE PROVIDED BY THIS
AG EEMENT (Also See Drawing at Right):
II fk.)l~ G
OTHER NOTEs:JJaJN ftt~l1l1lJr ON t!f!. .I'/lli
SHOW ALL AREAS OF HOME. bRAW ADDITIONS AS
NECESSARY. WRITE "YES" IN AREAS TO BE COVERED.
WRITE "OMIT" IN AREAS NOT TO BE COVERED.
/- .{ I --
~:-1 I
I
""-
~
)(..1))11 y
CUST9MER
INITIALS
t11J-MJ /ltl;l-fl;
t!tJfn;-'
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 flied a
declaration with the Property Appraiser requ tin 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 $ ~3tJ(} ~1.fJ
Terms: )&Cash 0 Credit (Subject to the approval of the Credit Sales Department) "J Sales Tax $ /'.
If this is a cash transaction, the purchase p,tipe,mal!iEJipaid as follows: . ~. /)/)/7 1:5'.. ~ hI/? fli!l
Cash down Payment (Minimum 33%) $ ~ Balance Payable $ f/l/lI, Total Price $ ,.Jl.f/
If this Is a credit transaction. the agreement for credit is contained in a separate docume which is incorporated herin by reference a d 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
Conlract. ADDITIONAL PROVISIONS ARE STATED ON REVERSE SIDE AND ARE PART OF THIS CONTRACT.
UNLESS OTHERWISE SPECIFIED, IT IS UNDERSTOJ2Q.J~Af THE OWNER(S) IS/ARE READY FOR THIS WORK TO BEGIN, THE PURCHASE PRICE
QUOTED ABOVE WILL BE HONORED ONLY UNTI~..:zM>I/JUcl.}, 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, Purchaser agrees to pay the Total Price In full upon Installation unless otherwise
agreed to In writing, If Installation is started but not completed the same day and the parties agree that the installation is not completed, Purchaser may withhold
10% of the Total Price until installation is completed, /~-, lA/.1..o "1) .
IN WITNESS WHEREOF Purchaser(s) have hereunto signed their name(s) this / ,_~ day of i v ",.Lel f 20 () .:s
~n!!.!~~~!I/~t 0~7.B of this contract./_ -;- - - - - - . - - - - - - -,- _ _ ":'/:-' _,
I .~ ~~ ;;7' ~. .' 1 (.1.;:r ',. ; './ 'II. ~.~...: ..~ $, .ff 1.131
I UBMITTED B,: Re resentatlve 0 te ACCE D BY: Purchaser ate I
I ,/ I
LACCEPTED BY:Authorlzed Signature for Contractor Date ACCEPTED BY: PurchaserlOwner Date.J