HomeMy WebLinkAbout03-1961
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N~
1961
ft) I~
(813) 780-0020
Date
,.3- :2B-~
BUILDING ELEC"!!UCAl PL~- MECt1ANICAL Sewer Conn
~...--- ~ fLI /7^ J:'ater Conn:
P<op."" own"~j~~'Y4~1. ~"A1""" i Um""t....~.t..
Job Address: _ ___ /9 ?-:...# _ T.I.F. s:
Parcel 1.0. " //- ~h:/~L - OD ID- 5l/6 nO -0 laD
Zoning: / "En rgy Code: . Radon Gas:
Descriotion of wob ~
- 0.:!3,
NO OCCUPANCY BEFORE C.O. DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
City License Registration #
State Certified License#
0) p5j (}::;J
BccifDI .
/60
.
Permit Fee
C:=-Signat~ ,-.
Company
Address
~
Teleph~ ) 8/3 - '773 - 4/ '7/
\/alwatisf'l sr
Contract Price
t;c.;
~I !J-& 9
-rI:. ' ~ 7" 11
'Y1' ~1 7 ~~. -
ELECT~----
~
Tp, Serv,
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
P~-
-
_ 1~4.e.GHAr(,lII...AL
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.
PROPOSAL
CROSS CONS'I'RUCTION COMPArtY. INC..
PO BOX 7108
WESlEY CHAPEl.. RORIDA DS44r0101
PHONE: (1113) ~U1
FAX: (813) 973-434a
Prf1QD$6/ SU/Jm/IlI:d 7l2:
of
AIltltess:
5335 Street
~ ~ JlldZJl' QIde
ills FlorIda 33542-4312
PIIDM:
813-780-0020
Prr1jt!Jt:t NiImt::
1 ResIdence
"""led LDatIan~
5013 19Ut Street'
Rlx:
813-780-0021
LlIrlr
3 03
Aan:
8111 Bu
M'Htn/1y~~DMIt1~For:
CIty,.-e:. M1I4J Gl:llM:
Ills . Florida
We propose to furnish all skilled labor, material, equipment, license, insurance, and permits necessary
for the complete demolition of the above referenced project.
#
1.3.1
4.1.1
4.13.3
4.15
ITEM
1 concrete bJod< 0-1 500
slabs < 6"
Peumber
Wet demolition
Remove translte sidi
QUANTITY
1 020 sf
1 020 sf
Shrs
1 020 sf
TOTAL COST
1 479.00
1 020.00
165.00
255.00
50.00
TOTAL PRICE:
1ft ~ HtIIW1yttJ FumItIh JI8/&iiJj iJl1d 1..ilIJtr~ In ~ ,."" AllDM!r ~IS FOr the Sum at:'
THREE THOUSAND FIVE HUNDRED SIXTY-NINE DOLLARS AND 00/100...............$3,569.00
~to be..... iIII.Ii:Iba:
UPON PlETION AND ACCEPTANCE
MlDi8NIls"'*.....-i8J'-..~ M......ttJ_o..Q,,~ In it ~
tr1/WInt!t' ~ 8J ..,.". ptKtJta Ad)' 4IIIntIan Of' ..... 1tfJm 8I1t1w
~ ~ 8InI alI!It!r.. bee1ff!Cled 0fttI upon 4WlaMlttMII /JeaJme."
ednt r:Mn}t!! 0fI!P' 8ntI.atIDIe the ~ AI ~.aJt~4 upon ~
~ ar ~ l/eJIrInd - l2lIOthIt. 0MinI!r to carry ~ ~ MItt ~
,... 'Y -....:a 0Ir~".. l'UIItr CDIIer!d by ~ ~
~
..ttr:EIfl'MCE ~
11Ie atloM!o ~ ..,_....c~ WId ~ drI!' -~'r iIIId ~ fItft/Jy
~ ~ Me iItItIIDttMd !D do tI>> IIOlt' as specJ/Il!d. ..,.".. wtIJ ~ mII2lt .IS
lJIIIJ1IIed tlItIoIe.
Authorllt:d
.4Ita!: 71B IJI'lJI1QfiI/ """, be ~.." /1'11<< 6C1:Ef;1Iat IIIIith 3D diIJ5.
AfXB'TlD BY!
/"'-
~ n!tzJm antr str;Jned DWfI/nIII ft:t OQIS an&....tIf;". ~ Jnc.
LlImd~
/ I }
-::' //ol:..-Z; . J
...-<" -;
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUII"DING IllIlPARTMlllNT 5335 8 th 8'fRBlBl'f ZBlPHYRHILI,S, FL 33 e 4 0
Phona/813-780-Q020 FaxI813-780-0021
IJA'fm RBC1B1IVBlD __.__~_ ._____
PLANS RIVIBlW re!
OI'lNEJR '8 HM1El__ C ~:r.'!.._....~r . Z6P.J.I.'t~.H IL:.~~___.____________~ PHONE: C!ON'l'lV~'!'_____.___ __u_.._ ___
,TOB SITEl ADDREBS ____5:ols____iCJ ~~-_s...7:_____________ _________.___.______________.
LEGAL J)B18CRTP'rIOl1l LO'r(B)
BIJOC!K
SUBDIVISIOt!
--'~---~. -'~-~.._-_.._~---_._-
PARCElIJ In #
---.---*.---.--------------------.-.--~-,-.--.-~--______w.~__._..,P.._.........._____..._
(OBTAIN FROM PROPElRTY ,!'A}{ NO'l'ICEI)
WtJRR I?ROPSElDI [JNElN CONSTRUCTION
[lsnUl
o ADm'rImr (JALTERATION [J REPAIR I] INSTAl,!,
o MOVE d(f DEJrlfOI,ISII
[h1UW'I.. FAMIl.Y [)# OF lIlU T S [] MOBlItEl lIor1Hl
rJ INDUS1'RIATJ [J SN !t1MING POOL lJ OTHIllR
PROtJOSEJn USE I []secH, FAMILY DWELl,l1m
[] CCJt1MBlR(!IAT,
D RMTAURAN'l' & HBlAlml DElPARTt1EN'l' APPROVAL
llBJSCRIP'l'WN OF NaRK __ D~Ot.d1'"'Ic//V...at:...~XI..51IAJC;__5.TgL!.C::_rv~~______._______._____. .____
BlJILfl!N(; SHIE
---.-_...__.M___----....
SQUARE FOOTAGE _.Io~l2____
HElIGH'f
RESIDENTIAT"
CO~'MEJR(;IArJ I
.~--_._-.'- --..>-----
A'I"l'ACH (2) Pl,o'r PTJAl1S & (2) SElTS OF BUIJ ,DUll) PT ,ANS & (1) BEl'!' ElNElRny F()R~18,
A'r'I'M!!! (3) SETS OF BunDING PLANS & (1) SElT ENER(W FORMS,
PROPElRTY SURVEY RElQUIRElD FOR ALL NEW CONSTRUCTION.
FERMITS REQUESTED
[] 811ILIJINr~
L..______.____ VAl,tJATION OF TOTATJ CONS'rRlJC'rION
L1 BlL!!JC'I'RlCAI,
--.-.--_._.___ J\t.1P SElRVICEI
o Fr.oRIfJA POWER
[) W , R . III , (1 ,
[] PWt-1BING
o I-1BJt:UANH!AT,
$ - - _..
- VAJ.JUATION OF ttlBlCHANCIAI, UIS'I'AI,I,ATTON
[J (~A8
LJ ROOFING
[] SPElCIAUry
o O'T'HER
'T'YPEl OF CON8TRtJC!'rrON I LJ BLOCK
o FRAME
[] STEElL
[] OTHER
FINISHED FI~OR ELEVATIONS
----------.-
IS PR(XTECT IN FLOOD ZONEl AREA [) Yals
o I<lO
SUltn!lR
BIGNA1'UR. _m~, e ~_~_____~
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COttl P AN Y-_t':teu~s_...e.z/Vsrp.':!!:'-I1~/Y.._.ce, -~_IN.~__.._
STATBI CElRT OR RElGIS'l' # __.________..________.__.__._.
crry PROCESSING #L_/~Q_._.___~_____._..___._.._._ _._
BlY,!IIC'rRICIAN
S"I G1lATUREJ .____
"---'.,_~ .__'4_,_____..___""'-__._._..~,_____ _'_..__.~____~
cot1PANY______.._________.________. ._ ~________ __ ___
STATE e'ERT OR REleHS'!' It
CITY PROC!E8SIN(~ It
"--'-..- -. .__.~- . .. ._--'~---~-_._-- -......" '--.. _. ---
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._-----~_..__.__._._.._-_.- ..._._~._.,------
PI,UMSBlR
-_.~._-_._-~-,---_..._----_._.-
C'OMPANY---__________________.._____._________
STATE e'ER'T.' OR REGIST # _________..____.._____.
CITY PROCESSING #
S IrJNA'I'l1R Hi
MBlCHANICAY,
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.---_._.~.._._-------_.~.__._---_._----~
--_._.---------~~-------~..,..__..----........-_-
COlvlPANY _________._...._________....._ _..__.._...
STATE C'IDRT OR REGr8T #
CITY PROCESSING #
--------..-------...-.--.---- ....-------
SIGNA'T'URE!
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--'--~'----'---,--,-- ~.__._----
OTIIBlR
w______._.._____
(~miJPANY
STA'T'E CElRTCJRRECnST #--------------------..----
CITY PROCESS ING # ---...-----...-_._______
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S WW\'l'URE:
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-~-'-----..__._---._~--.__._,-_._-._._---
CUIW1'1'lONS OF PERMI'f AFIi'IDAVI'l'
- A. ~OTICE OF DEED RESTRICTIoNS
The undersigned understands th~t thi5 p~rmit may be subject to "deed restrictionsU which
m~y be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNLICENSED CON'l'RAC'l'ORS AND CONTRACTOR RESPONSIBIJ.I'I'IES
If the ol'mer has hit"ed a contractor: or contractors to undertake work, they may be required
to bi:! licensed in accordallce with state and local regulations. If the contractor is not
licensed afi required by law, both the ovmer and contractor may be cited for a miademeanor
violation under fitate law, If the owner' or intended contractor are uncertain as to Vihat
licensill9 requirements may apply for the intended work, they are advlsed to contact the
City of Zephyrhills Building Department, 813-768-6611.
Ifurthe.t:ll1o:re, if the ovmer has hired a contractor or contractors, he ia adviaed to have the
contractor(s) sign portions of the "Contractor SectionsU of this application tor which they
will be responsible. If you, as the owner signs as the contractor, YQ4 are indicating that
you, lather than the contractor, are responsible for the wor'k. I f the contractor l^lishes
you to sign as oontractor that may be an indication that he is not properly licensed and is
not entitled to permitting privileges 1n the City of Zephyrhills.
C. 'I'RANSPOR'I'ATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONs'rRUC'l'lJION LIEN LAW (CHAPTER '713, FLORIDA STATUTES, AS AMENDED)
1 certify that I, the applicant, have been provided with a copy of "Florida's Constrllction
lien Law - Homeowner's Protection Guideu prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "owner", I cerify that I
have obtained a copy of the above described document and promise in good fa1th to deliver
it to the "owner" prior to conunencement.
E. CONTRAC'I'OR' S/OWNER' S AFFIDAVI'I'
r certify that all the information 1n this appl1cation 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 permit to do work and installation as indiaatsd. 1
cert1fy that no work or installation has commenced prior to issuance of a permit and that
all work \-Jill be performed to meet standards of all laws regulating construction, City
codefi, zoning regulations, and land development regulations in the jllrisdiction. I also
certify that I understand that the regulations of other governmental agencies may apply to
the intended work, and that it is my responaibility to identlfy what actions I must tal,e to
be in compliance. Such agencies include but are not limited to: *Department Df
Env1ronmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sens!tive
Lands, Water/Wastewater Treatment
*Southwest Florida Water Management District-Wells, Cypresa Bayheads, Wetland Are~s,
Altering Watercourses
*Arlny Corpa of Engineers-Seawalls, Docks, Navigable Waterways
*lJepartment of Health & Rehabilitative Services, Environmental Health Unit-Wella,
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 ~Au or "A,etc.u, it is
understood that a drainage plan addressing a "compensating volume"'will be submitted whioh
is prepared by a professional engineer registered in the State of Florida prior to permit
issuance.
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 issuance of a permit prevent the Building Official from thereafter requiring a
correotion of errors in plans, construc~lon, or violations of any oode. Every permit
is/.iued ahall become invalid unless the work authorized by such permit is cOllunenced within
slx months of issuance, or if work authorized by the permlt i8 suspended or abandoqed for a
period of si~, months after the time the work is commenced. One 90 day extension of time
may be allowed for ttle permit with fee charge of $15.00. The extension shall be requested
in writing to the Building Official. An approved in:>pection mu:>t be logged during each six
month period, or the project Hill be considered abandoned.
WARNING '1'0 OWNER: YOUR FAIWRE '1'0 RECORD A NO'rrCE OF COMMENCEMENT MAY RESUL'!' IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO os'rAIN r'INANqINq, C9N~UL'I'
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'!'. JOBS UNDER
$2,500 IN VALlJ&: DO NO'l' NEED '1'0 RECORD AND POS'l' A "NOTICE OF COMMENCEMEN'I'''.
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
S'rA'l'E OF FLORI DA
COUNTY OF-
The foregoing instrument was
Before me this __ day of
by
acknowledged
19_
STATE OF FLORIDA
COUNTY OF
The foregoing 1natrument w~s
Before me this ------.J.iay of
by
aoknowledged
19
(name of person acknowledged)
Dwho is personally known to me, or
(name of person acknowledged)
Qho is personally known to me, or
Owho has produced
(type
and whoD did [J did not
Dwho has produced
(type of identifiQation)
and who Ddid OUd not t,ake an oath
of identification)
take an oath.
Signature of person taking acknowledgement
Signature of person taking acknowledgment
N-~-I~; ty"p";ci:---prlnted ~~-stamped
Hame typed, printed or stamped