HomeMy WebLinkAbout04-2829
CITY OF ZEPHYRHILLS
5335-8th Street
(813) 780-0020
ELECTRICAL PERMIT
2829
Permit Number: 2829
Permit Type: ELECTRICAL MISC
Class of Work: ELECTRICAL MISC
Proposed Use: NOT APPLICABLE
Contractor: MORTON ELECTRIC
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 3/15/2004
Total Fees: 44.00
Amount Paid: 44.00
Date Paid: 3/15/2004
Work Desc: POWER SUPPLY FOR CATV
Address: 39100 SOUTH AVE
ZEPHYRHILLS, FL.
Township: Range:
Lot(s): Block: Section:
Book: Page:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Name: MANUEL LUNA
Address: 39100 SOUTH AVE
ZEPHYRHILLS, FL. 33542
Phone:
------~-----
ROUGH ELECTRIC
FINAL
--------"---------.------------.-----.--------- -----------------------------..--_.__n_______________________.__________.._
.KIHN::;J:'~C"l'.LUN .to'~~.s: ---w11efiexcra -rnspect::Yon Ertps--arenecessary(:nre~L:.o_anY-ofie -OIl:ne----~--
I following reasons, a charge of Thirty-five dollars ($35.00) 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
-nwarnUig-t:o-owne-r: --Tour-fa].l ureco-~recora-a- noe-:Lce---o-r-commenc-emen-,:-may-resun-:Lnyour'----~
paying twice for improvements to your property. If you intend to obtain financing, consult
with your lender or an attorney before recording your notice of commencement."
Complete Plans, Specifications and Fee Must Accompany Application. All work shall be
performed in accordance with City Codes and Ordinances.
f-
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----------------..--------------
CONTRACTOR
CALL FOR
JtW
~
PERMIT OFFI
INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS
5335-th street
(813) 780-0020
ELECTRICAL PERMIT
2829
Permit Number: 2829
Permit Type: ELECTRICAL MISC
Class of Work: ELECTRICAL M ISC
Proposed Use: NOT APPLICABLE
Contractor: ATA ELEC. CO.
Square Feet:
Est Value:
Improv. Cost:
Date Issued: 3/15/2004
I Total Fees: 44.00
Amount Paid: 44.00
_Qa~e Paid: 3/15/2004
Work Desc: POWER SUPPLY FOR CATV
Address: 39100 SOUTH AVE
ZEPHYRHILLS, FL.
Township: Range:
Lot(s): Block: Section:
Book: Page:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Name: MANUEL LUNA
Address: 39100 SOUTH AVE
ZEPHYRHILLS, FL. 33542
Phone:
ROUGH ELECTRIC
FINAL
: CONSTRUCTION POLE
I
I
I
!~-----~-----~~---__~1___~ ~_ ____~__------'-~____~~___~___~~
~ R~.LN::;l:' ~(: l' .LUN !"~~::; :--when-exf:ra--mspec-t ~orCEr1.ps-are necessa.ry-dUe-1:b-a~ny--orle--or-tne------~-
following reasons, a charge of Thirty-five dollars ($35.00) 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
---.rwarnTng--eClO'Wiler-:--YOur-Ya1l ure ~1:o-recoraa-notrce-or-conunencemen1:-~may-resun:-ri1-Your----
paying twice for improvements to your property. If you intend to obtain financing, consult
with your lender or an attorney before recording your notice of commencement."
Complete Plans, Specifications and Fee Must Accompany Application. All work shall be
performed in accordance with City Codes and Ordinances.
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CONTRACTOR
CALL FOR INSPECTION - 8 HOUR NOTICE
PROTECT CARD FROM WEATHER
~
PERMIT OFFI
REQUIRED
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8D St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECE IVED
PHONE CONTACT FOR PERMITTING
OWNER'S NAME J17 fJn lJ,f,j L L(lliL / IJ r; q h f !I-o l{ ~p
JOB ADDRESS 3Cfj 00 5wth Ave...,
PHONE
Ill-A
7.l7-Q"3'1J -73-J,y
LEGAt DESCRIPTION: LOT(S)
7
BLOCK 7)
SUBDIVISION
PARC~L ID # 1.3-J..~ -::21- 0100 - J2f -0070
(OBTAIN FROM PROPERTY TAX NOTICEl
WORK PROPSED: []NEW CONSTRUCTION
[] SIGN
PROPOSED USE: []SGL FAMILY DWELLING
[] COMMERCIAL
[] ADDITION
[]ALTERATION
[] DEMOLISH
[] REPAIR
fH-INSTALL
[] MOVE
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
[] SWIMMING POOL
[] MOBILE HOME
[] OTHER
DESCRIPTION OF WORK
o RESTAURANT & HEALTH DEPARTMENT APPROVAL
CAlif
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
CO~RCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
o BUILDING
t1 ELECTRICAL
$
VALUATION OF TOTAL CONSTRUCTION
60
AMP SERVICE
~ FLORIDA POWER
[] W.R.E.C.
[] PLUMl3ING
o MECHANICAL
$
[]GAS
[] ROOFING
[] SPECIALTY
VALUATION OF MECHANCIAL INSTALLATION
[] OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
[] FRAME
[] STEEL
[] OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREA[] YES 0 NO
~(>~g~~}SECTION
BUILDER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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ELECTRICIAN
::f?JjJlukcJ
/Jr A EJ'ecf,;'c
STATE CERT OR REGIST # ~~S1~
COMPANY
);;C.
SIGNATuRE
******************************************************************
PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
MECHANICAL
******************************************************************
COMPANY
SIGNATURE
STATE CERT OR REGIST #
*****************************************************************
OTHER
COMPANY
SIGNATURE
STATE CERT OR REG 1ST #
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictions" ~hich
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner 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 not
licensed as required by law, both the owner and contractor may be cited for a misdemeanor
violation under state law. If the owner or intended contractor are uncertain as to what
licensing requirements may apply for the intended work, they are advised to contact the
City of Zephyrhills Building Department, 813-780-0020.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign po~tions of the "Contractor Sections" of this application for which they
will be responsible. If you, as the owner signs as the contractor, you are indicating that
you, rather than the contractor, are responsible for the work. If the contractor wishes
you to sign as contractor that may be an indication that he is not properly licensed and is
not entitled to permitting privileges in the City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction
lien Law - Homeowner's Protection Guide" 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 faith to deliver
it to the "owner" prior to conunencement.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
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.
Appli~ation is hereby made to obtain a permit to do work and installation as indicated. I
certify that no work or installation has conunenced prior to issuance of a permit and that
all work will be performed to meet standards of all laws regulating construction, City
codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I 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 include but are not limited to: *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment
*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone "A" or "A, etc.", it is
understood that a drainage plan addressing a "compensating volume" will be submitted which
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
correction of errors in plans, construction, or violations of any code. Every permit
issued shall become invalid unless the work authorized by such permit is conunenced within
six months of issuance, or if work authorized by the permit is suspended or abandoned 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 with fee charge of $15.00. The extension shall be requested
in writing to the Building Official. An approved inspection must be logged during each six
month period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
$(/ VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
'2$J;J::;(\ -
SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
Before me this _ day of , 20_
by
(name of person acknowledged)
Dwho is personally known to me, or
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _day of
by
acknowledged
,20_
(name of person acknowledged)
C1ho is personally known to me, or
Dwho has produced
(type
and whoD did 0 did not
of identification)
take an oath.
Dwho has produced
(type of identification)
and who Ddid Q:iid not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
~'AIL 10: . " "
~..tCO COUNTY DEVELOPMENT' REVIEW
. .
WEST f-"ASCO GOVT. CENTER S-230
7530 L~ITTLE ROAD
NEW PORT RICHEY, FL 34654
(727) 847-8142
(352) 521-5144
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,;;, RIGHT-Of.WAY USE PERMITI ' t
PA~CO CQUNTY - /,: i :?) l ~-:-
- USE PERMIT - "Sunshine-One b~II"
(800) 432-4770
- 48 hours prior to excavation -
GENERAL INSTRUCTIONS
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No con8tructlon, under ground or above ground, bf any lacility, shall be accomplished on any County Rights of Way without wrlllen approvallrom '
'the County. Any application lor approval of construction operations on any County owned Rights 01 Way shall furnish a detailed drawing showing the
comptete scope of the proposed work in quadruplicate to the County lor review and approval prior to the commencement of any work. A copy 01 thl.
permit mu.t,'b. k.pt r.adlly avaUlIbl. at tha alt. of the work at all tlm...,. i' \'
Sec. No, T ~ R County Road J, ;" "I"~'i '~'~)T Dale _--.:..(0 "~/' D.3
Permit For ,. .{,.;: /;'J'~~L/rk..IV/- t!"',-~
(Project Name)
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LOCA nON (Legal Description)
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Permission is hereby granted to
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~/~I{ / St.. AI;. /)tk~K:.$
(Name of P!~millee)
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lor the construction and maintenance of
of
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subject to the following condllions:
1, The construction and maintenance of such utility shall not interfere wilh the property and rights of a prior occupant.
2, All work shall be done in keeping with the standards 01 Pasco County and at the satislactlon of Pasco Count)', who will be notified alleasl
one day prior to commencement 01 construction.
3. All m.erials and equipment shall be subject to Inspection by Pasco County,
',; t, DurinQconstructlon all safety regulations 01 the Florida Department of Transportation shall be observed; and Pasco County shall be relieved"
of all responsibility lrom damage 01 any nature arising Irom this permit. Subject to the same terms and conditions. the permil holder may take such
safely mMSUIleS, including placing and display of caution signs, as it may deem necessary in conduct of construction and malntenance work hereunder,
5. All private and all Pasco County property shall be restored to its original condition as lar as practical, in Ihe opinion 01 Pasco County.
6. All unclerground crossing installalions shall be laid al such depth as may be specified by Pasco County, unless otherwise authorized. In.talla-
"em 0' utUIt'-a under County roeda shall be by lacking and boring only.
7. The sk.tch (lour cople.) covering the details of this installation shall be made a part 01 their permit. This permit is granted with the understanding
thlit the aP.PlIcj:anl has noUned all other utility users In the area covered by the permit and takes full responsibility for any damage incurred by prior
installations all a result of his operations. He also takes lull responsibility lor notifying any and all utilily or underground users of his proposed operations
in order that they may safeguard their inlerests.
8. '1I,Is ell pressly stipulated that this pBfmit is a license for permissive use only and that the placing of facilities upon public property pursuant
to this permit! shall not operate 10 creale or to vest any property righl in said holder. "
9, Whenever Pasco County decides to lurther exploit the County Rights 01 Way, any or all 01 said poles, wires, pipes"cables or other lacilities
and appurte,..ncel authorized hereunder, shall be immediately removed from said Rights 01 Way, or reset or relocated thereon as required by Pasco
Count~ at th4$ expen.. 01 the holder of this permit.
10, The hplder shallaave and keep Pasco County harmless from any and all damages, claims, or injuries that may Ql;cur by reason 01 Ihe construc-
tion. malnte,.nce and operation 01 said facility. '
_.....-~............~.....
11, The l'lolder ahall complete the requested work withi~ieO/~P ~,~r this permit shall become null and '1oid. In the event the work re-
Quested is ~ completed upon the expiration date of this permit';"'PI ' ' County shall have the right to complete such work and to charge the holder
01 the permit.for all costs incurred In completing said work,
" 12. )The permlUee shall post a cash or surety performance guarantee with the County Clerk. Based on a cost estimate prepared by the permiU..'s
\. ltf)gineer and!lPP"oved by the Counly. The amount of the guarantee Is to be an amount equal to 125% of the coat to construct lhe permlhd Improvements.
":rIft he event. aurety bond II posted, the said surety bond shall be made payable to Pasco County and shall obligate the aura4y to hold the County
('harmle..ln tbe event the holder of this permit should fail to meet any of its obligations, hereun, der. The bond shall also i~ Pasco Counly lor
all court cost. and reasonable attorneys lees in the event legal action is required to collect or said bond.
1 13, The permittee shall post a cash or surely maintenance guarant.e wilh the County Cle~k based on a cost estimate prepared by the permittee's
I engineer and IIpprovec:t by the County. The amoung 01 the guarantee is to be an amount equal to 15%-of the_cost to construct the pemUated Improvements, ",
\In the event. surety bond is posted it shall meet all the criteria stated in No. 12 above. I , "'1.}./" ,
, . 14. SPE~AL CONDI1IONS' /',; /<,./ '-,Tt>.~ r;j(fj". (~::(,.,~:{...vA,,f'~:; (l: :/.,-",,,,,f IJ};f;L"B,rf'~tl(I/..t.),\,)
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APPROVED B:.t...)q [; i '" ~;ti'
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Utilities Servic'8s~' ,,' '" I
Traffic ReVieJ), t".., I I l j
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. roject ~an~ent: / ,~: y, I ,( , (
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Signature
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SUBMITTED BY:
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Print Name and Title
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:..~,<:' ~:;. yl I,>(.:~:...i./:.;':/ t. ,~./~~t.f'" . -.',~'.-, .~.-..) -r-,:,~
Mailing Address (Street. Ci~, State)
. Public Workst
Guarantee E$timate Review: ,
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Developmen~ Review Approved: /.+...
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fee $ ---t' .
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BRIGHT HOUSE NETWORKS
GENERAL RIGHT OF WAY PERMIT
EXHIBIT" A "
Bright house Networks daily activities that do not require a specific right of way utilization permit
when working within the boundaries of Pasco County right of way
llew Customer Service
1. Installation of service drops from serving location
2. Installation of new aerial distribution cable from existing poles.
3. Installation of a second aerial distribution cable from existing poles.
4. Extension of existing aerial distribution cable from existing poles.
5. Installation of a new buried distribution cable that does not cross or begin in the pavcoment.
6. Extension of an existing buried distribution cable that does not cross or begin in the pavement.
7. Installation of two way four inch conduit system that does not cross or begin in the pavement.
8. Extension of a two way four inch conduit systam that does not cross or begin in the pavement.
9. Installation of a new pole line.
10. Extension of existin& pole line providing it does not encroach into an underground utility area.
11. Adding of new equiptment to existi.ng cable.
12, Pulling in new Wlderground feeder cables in an existing permitted manhole and conduit system.
13. Digging of a splice hole to splice a new cable or changing equiptment.
14. Diuing of a splice hole for cable acceptance testing for quality.
15. Digging of a splice hole to change the size of a cable leg for new service.
l4alntenance of E~tin.e CATV Facilities
1. R.eplacemc:nt of existing service drops,
2. Rcplacementl repair of an existing aerial cable providing other aerial utility service still exist.
3. Replacement of existing poles providing other aerial utility service still exist
4. Replacemcntl repair of existing equiptmcnt.
5. Replacement! repair of an existing undergr01U1d feeder cable in an existing permitted manhole
and conduit s}'Jt.em,
6. Pumping water out of a manhole to maintain wdergrowd cables in conduit system.
7. Digging of splice holes to locate and repair damaged cables.
8. Digging of a splice hole to change the size of the cable.
9, Diging of a splice hole to add a side leg off feeder cable,
1 Q. Disging of a hole to repair broken canduits.
11. Diging of a splice hole for cable acceptance testing for quality,
12. DiSBing of a splice hole to repair damaged cable.
13. Digging of a hole to verify the location of buried facilities,
141. Removal of facilities no longer needed for service.
15. Tree tri.mming to clear aeri,al facilities.
16. Adjust aerial facilities to accommodate other users of pole line WId! or to meet National Electri
Safety Code.
BRIGHT HOUSE NETWORKS
GENERAL RIGIIT OF WAY PERMIT
EXlDBIT If B If
A GENERAL RlGH OF WAY PERMIT (GRP) - is given for certain routine repetitive work not requiring
a specific permit defined on Exhibit" A " that is 5 feet or greater from back of curb (BOC) 01 edge of
pavement (EP),
No roadway will be open cut or directional drilled with this peunit.
Upon completion of work the Pasco County Inspector shall be notified for a final inspection of the
project.
~._r
Best Management PractiCes (BMP) will be observed at all times.
NotitY SW1Ihine.Sta&e One Call of Florida at 1-800-432-4770 not less than 48 hours or more than
5 days prior to construction.and all other requirements of Florida Statute 556 will be observed at
all times.
MAINTENANCE OF TRAFFIC
· All activities in accordance with this agreement will require confonnance to the "Manual of
Traffic Control and Safe Practices for Street and Highway Construcion, Maintenance and
Utility Operations." (Chapter 316, Florida Statues)
· Pedestrian. bicycle and handicap traffic must be safely maintained and must not be redirected
into the roadway or into ditches. Use of sidewalks may not be impaired or closed for greater
that 60 minutes. When a sidewalk is to be removed means of rerouting pedestrians, bicyclists
and handicapped people must be constructed prior to sidewalk removal per Florida
Department of Transportation (Foon, Manual on UnUonn Traffic Control Revises MUTCD
and American DjAahilities Act (ADA).
· No street shall be closed without the prior written peI'Iflission of Pasco County Inspector. At
least 2 normal working days (Monday thm Friday) advance notice is required. All
maintenance of traffic plans are to be sulmitted to the Pasco County Inspector for approval
prior to commencement OfcC8lStru.ction. Appropriate worJc zone safety is to be follo'A'ed at all
times.
· All construction activities shall include traffic control through the work zone in accordance
with FOOT" Roadway and Traffic Design Standards" Indexes 600 Series titled .. Traffic
Control Through Work Zones."
Where it is discovered that a &ite specific pennit will be required, i.e., during excavation existing faoilities
become less that 5 feet from BOClEP.
1) The Construction Supervisor will notit)r the Bright house Networks Engineer that a project
Cannot be COOlp!eted W1derthe GRP.
EXlllBIT .. B .. continued
2) The Bright house Networks Engineer will notify the Pasco County Inspector of the situation
and schedule a field meeting. (Every effort will be made to arrange the field meeting within
a time frame that will not require the Construction Crew to leave the site and reshedule the
work.)
3) The Bright house Networks Engineer will be responsible fur notification all appropriate
personnel of the time and location of the field meeting,
4) A mutual understanding of the scope of work required to complete the project will be achieved
at the field meeting.
5) At the Pasco COWlty Inspector's discretion, a verbal approval of the work may be issued
allowing work: to resume.
~
6) The Bright house Networks Engineer shall apply for a .ite specific Permit inclusive of all
details as agreed upon at the field meeting. (If a Verbal4pproval was granted, the site specific
shall be submitted as an" After -the-Fact" application.)
7) Upon completion oftb.e work, the Pasco COWlty Inspector shall be notified for a final
.inspection of the project.
---RIGHT OF WAY RESTORATION
· All distwbed areas in the right of way will be sodded unless otherwise directed by Pasco
County Inspector. Sod must be maintained Wltil it roots, a minimum water of2 weeks.
· Vegetation, other than sod, will be restored to its pre-construcion condition.
· Prior to disturbing sprinkler systems, plants and mailboxes that may be disturbed during
construction, notitY property owners, Replace those items that are damaged by peunittee,
· The pennit1'ee shall be responsible for handling all complaints regarding the construction
project.
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CITY OF ZEPHYRHlLLS - RtJILI)(NG DEPARTMENT
IUGlfJ'-OJl'__JV ,U:'JISE P 1tl!l\'1JJ:
PERMIT#
Ntl ('ml~frlll'lll," Iln,ll'r ~rnlllld or "'Hln! j!rollnd I)f n"~' fll<'IIlI)' ,_hllll hI' "c(,oll\pll~hl'll on nn.\" C1t~. RI~hh nf Wn~' without wrltlrllllflprOYAI fl'nllllhl'
Clt~" nlllldln~ "rpMInll'nl, Any nrl'IIC'Atlon for "1'pl'III'11 IIf ..IIndnlrtlon opetnllon1 0" ,,"y C'1i)' ""'11<'11 Rlghh IIr Wn)' .hnll fIlml1h n dl'tllllNI dl'llwlng ohllwI"R
the .."mrll'll' oeopl' IIr Ihl' IlI"opn.rd wllrl( In h'lpU<'1I1e hI Ih.. om"" IIr the RlllldlnR Omdnl for nrpr",'nl p..lllr tll Ih" rOmml'lICeml'lIt nf nn~' Will"" A "np~' IIf thl"
rl'rmll I. tll hI' 1(l'llt I"I'lldll)' nl'nllllble nt th(' .lte of the WIII'I( lit nil thlle1.
PAReF,1, I,D. # 13- ;).,[,r;;(/ - Dloo _ I/J_ DO-tO
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CITY ROAJ)_.::-;;QYI~~.!\v<;_~,,_~__.__
OATJi:
LOCATION (I ,l'llnll)e'('l'lplloll) ~
__..__~_u,_...__..__._._...._.__.___~.___._. ~.___._._._.____.__.u___'.....~__.__.. .~....___~~.__.,_.._____.________.___,____.._____._.__.____.,___________~"__..___
-.'. -"--~-' -..---,..._--._-...._..-.~-.--,-----.._+.-,-,----.-__._.__....__......_._._n_...___ ..._.._...~_._._~_."'___._____.________________
----........_---_..,._._._.,-~."--,,._-,._._-_._- ._-"_._'--_...-~.__._.~._~...._._~--.__._---_._-.~.._--------.---.---------.----------.---..-----------------
re"l"h~h'n I~ hprcl1y 1ll'nl1tNI to.._..,____.._____ "..____~_,_______,__,....,_..,______"f ______'_'_________._'________________--'--_______________
fl)r Ihl' enn~h'II""olI ""d Il1nllltf'lIAnee IIf
;;;lli~~t f~th~ i.;";;nt;;~;~~~ijii;;-~~-;-~--'- .--- ------,
.--....-"'.--.~------..----.----.---.-.---..--..-._.--.-~-_._-+.._----_______n__..__.____._____.._._.._______.._..._______._
..._-~.......-- ._._-_._.-..._.,...._,._.~..._...._-_._.._----_._----_._...._-_.._--~....__.__..._---_._--,_.__.._._._-._-.-.,_.._---
I, The I'III1~tnl(~lloll nn.l ,"nllltennne!' of ,om'h Illlllty ohllll 1I0t IntE'l"fere with the rrop.-rl,\' Illld I'l~hh IIf n P"'"I' IIeell)lnnl,
2. All w,"'I( ohnll he dOliI' In l(eerlll~ with Illl' ~tnllllnrll~ IIf Ihe City SIreet. Dppltl'tment nlld nndl.'r the 1uJlenl.lon of the Ctt~' Bull.llnll Oml'lnl, wllo
IllII he ""Hn('{l,,t IpnRI IIn;;. dn," 1'1'1111' tll ellmmem'ement IIf ellmh'udlon.
,l, All IIIntl'lln" nll'll'lJulpmcnt .hllll he ~nb,leet to hupeellllll h)' thp ell,l' Bnlldlllll Officlll!.
4. I>mlng 1~"I1~lrnd'"11 nil ~lIfetl "!'~IlIJlflom of the J)ellnrhllellt of Tl'nmJlortlltlou _lmH he oh'I'I"I'eIIAI1I1 tlte Clt~, .hnll he rrUew,I IIf nil
1'1'~llon1lblltty fl'nlll I'nmnge of nll.V nllturl' ..rl1lng rl'om thl. retmll, Suh,Jeet to tlle_lIl11e term, Itnd I'onllltlon., lite lu~rmlt hohlpt mllY tnlteml'h .nfel)' melUUI'I",
IlIellulllllR )I'nelng nlld ,1I'r'n)' of <,nnUon ~IRn., "' It ll\A~' dpP'lI1 ne"e1~l\ry III eOllduet IIf eOIl.truetlon nllfllllnllllennlll'e worl( hereunder, It I. the I'e."omlllllll}' of
the IIl'l'IIll1tpl' to plllcr, mnlntnln, nil" 11lpenl1e nil ttllfn<' cllnlt'olllnd del'lcl',~.
~, AlIllIh lite Alld nil City pl'IIppl'ly' _hnll Ill' re_tlll'ed tll lh IItlllhllll condition Il~ fill' 1I~ I'rAetkllll"lhe o"lntll" of the CIty R"lId'"j! Omelll!.
6. All 111I11 I' I'llnllllll' ('\'0..1"~ In,tlllllltlom .hnll h", IIIld nt .nC'1I deflth M mny he .,leelne,1 hy the CI~' Rulldlng Omd,,1.
7, The .I(!'teh ('OI'I'r1nR IIII' ,Iptltll, of Ihh '"dllllnlhm .hnll he III II ,Ie n "nI'l of thl. pHmlt, Thl, rel'mll 11 llrnnlell wIth the nllller~tllndlllg thAt th('
nllpllellllt hn. ""111l",1 nil II1hl'\' njlll~' 1l11'1'. In thp AI'pO "01 ",'p.II h)' the retmlt nndlnlle. fnll te.pn,,"Ihllll,\' fnr IlIlY dAmnge IlIeurrpd h~' ptlnr In,tllllnllll"' a, II
!'p""U IIf hi. npemUlm, hI IInll'l' thAt Ihl')' iliA)' ,"fe IlUnnl thdr Intue.t"
R, It I. p'pl'l'.,l.\" .tll!llllllrd thnl thl~ I'l'I'IIIU I, A ",'e",e fnr 11('1"'11.,"'0" "'1' III1I~' 1111I1 thnt the plnelnR IIf fllclllt'..~ IIPll" pnhlle pl'n)lert). )lnr.,mnt to thl.
rl'l"lnU ,hnll IIot nllHllh' to I'tente or to le.t lIU,V vmpnty .Ight In .nM hoMl'r,
II, Wh\'lleIP!' the C11.v drdd"o 10 fllt'lhH l"Illolt fh" Cit)' RIght, IIf WilY', "IIY Ill' 1111 ,'A'" 1'"11", ,,'h'('o, 1.111",', ('lIhle., or lither fn"'"tl('. nlld
nrp"l'fennlll'e. IInlhllrl.,,,,1 h!'I'Pllllder, .hnll h" 11I""l'IlIntel)' !''''\Ioved h'IIl11 .nld Right. IIf Wny', 01' I'('.et or I'pllleAt..,1 Ihrr-elln 111 ,'plJuh'ed hy the City Bldldlng
OffielAI nt the e'\prll.e IIf th(' I...ldel' IIf 1111. permit.
to. Thl' holdl'l' Rhnll,oltH "IIOll<l'l'p tI,(' (."11.1' hAl'Il1le". fHlm nny 1l1ll1 All dnIllAge,_, "Ill 1m., ol'lnlllrle. thAt m"y "cellI' hynn.n" of the ellll.tn,ellllll,
IIIAlnll'nAlIl'l', Ilml IIpemtllln IIf .nld fnelUt,I'.
11. The holder Rhnll I'II'"pl"le the 1'(''111I'Rted WIII'I{ within ,___, __.._,_... ,In)" Ill' thl, rel"llllt .hAIl hel'II",1' mIll nll,l ,"M. In Ih(' I'nnt Ihl' Trlld{ rl''l"eotl'd
I~ not ('<lmpletellnllon the e'llhntlllll ,Inlp IIf thl. rpl'mll, t11(, City .lInll hnYp Ihe rlllht tll elllllpl",'e ondl ""l'k nl,,1 10 dIn I'llI' the holder nf Ihe IIPI'mlt ffll' 1I1l elld1
InclIl't'l'!I III eolltl.leU"~ RAid "'01'11.
11.. Th" hol<ler .hnll IIII~I A en.h "I' .m'I'I)' hll"d with th" CIty MAMller III the .lIm IIf $ __~__ ___~_ ""lln.." to ~IUlrAnle" perforlll,,"rl' IIf tI,,, """glltl,,",
lIHI'''I, Alld tll !!.""t'Alltee '"nllllpIIAII('" or the rIRhl-of-"'ny de.edbl'll herein fOl' n )11'1'111" IIf 11111.' (I) )'rlt., rllllllwln~ ellmplellOIl of the te'l',le.ted IlI,Rtllllntllln, III Ihe
nelll II '"l'el~' IIlI!1" b 1'll1tl'd, Ihe '"rely hfl"dRhAIt III) mnde pnrnhle tll thp Clly Itll" Rhnll nbllgntr the Rllt"ety to h..Id Ihe elt). hnrmll''' In the pI'l'nt the hohl!'1' of
Ihl. Ilerllllt .IIIlIIM fAll to mel'l nn~' of II. nbll",nllnn. here.mdn, Thp. lion" .hnll IlIRn Imlemlll~v Ihe City fill' nil emltt eORh nmll'l'nRonnhle nttornl'Y" fl'e, In Ihl'
l:nnt le.nlAe/11I1I IR l'e'luh'1'I1 tn ,,"lll'd on onld blind,
U, The I,,'rmlttee "hnll IIn\'1' n H hm,,' eml'...~rney "olllnd III1Il1I' nnd lllllllll('r lI.ted hel11l\'.
S1JBMlTTEJ) BY:
(peI'1IIIttl.'e)___'12R~6l1j:b.~_~-"---~--
Slllllnhlre &. Title __'__~~__,___...._~.... ,,__ '_.... .___.,_____"_..___..___~___.._..____..,_ '_~__"'__"_
Ad"re.._.,_,~__,__, _"_____~___, ____
-'--____"_.___...M_..._.____..~_________ .__,___,_,~
PhOlU'
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APPROVF.D BY:
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Clt~. MltbR~I'. .._'____~,__,__,.,_ _~______.___~__________...."'_____~____""_
I)ntp:__.._._..~~__, "__'___'__,__,~,_,_,~_____,__...., ....,.,'_____'_______________..___,..,___,....__.,__..
Zephyrhills Bldg.
Dep1:_
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F-.., KItty
Pouo:
l...aoo-e7'9-8004
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--- 813-7'80-0020
- 4/191.:2004
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,5231 1ST St
39100 South A.ve
Pennit#.2S25
PerTn~
~_2958
I='errn~
4826 Airport Rd
3Q34....4 Uncaln Ave
UO!+8euuo~ 81 !w!s~e~ ON (~.3
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t0086L900816
Xl AJoUJe~ 8839
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