HomeMy WebLinkAbout04-3001
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
3001
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
3001
MECHANICAL
AlC CHANGEOUT
NOT APPLICABLE
Address: 4801 AIRPORT RD STE110
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block:' Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
1,040.00
4/27/2004
40.00
40.00
4/27/2004 Phone:
REPLACE CONDENSING UNIT-~-
THEOD RE BRUNSON
4801 AIRPORT RD STE#110
ZEPHYRHILLS. FL. 33542
I
. _ . __---.1.. __~_~_..__-----,----__-___._-_.-~l-_-_---------
--REINSPECTION FEES: When eXtra inspection trips are necessary due to anyone of the following reasons, a
charge of Thirty-Five Dollars ($35.00) shall be made for each trip for each trade:
(a) Wrong address (b) Condemned work resulting from faulty construction (c) Repairs or corrections not made when
inspection called (d) Work not ready for inspection when called
(e) Permit not posted on job site (f) Plans not at job site (g) Work not accessible
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
"Warning to owner: Yourfailure to record a notice-of co-mmencement may result in your payingtwice-for----
improvements to your property. If you intend to obtain financing, consult with your lender or an attorney
before recording your notice of commencement." .
~-- ----Complete Pia 5; Specifications and Fee Must Accompany Applicati6n.~ ~----~--
All work sh e perf~~me(:Un accordance with City_ Codes anc! O~inal'!.ce~ _________ __
NO OCCUPANCY BEFORE C.O.
___ ..________________.____ .___ ..~_.~_._____._.____..____._____ _______...________m__
~
OR SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 89 st, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECEIVED
PHONE CONTACT FOR PERMITTING
LEGAL DESCRIPTION: LOT(S)
BLOCK
PHONE 7 S 1.,-{f7c.
2H~/I'~'-((~ .?r
SUBDIVISION
OWNER'S NAME rJ,f-~ Dol/;iJ. 1l/lJA.//$O ~
JOB ADDRESS c;Rot A-tll PoJ ~~ ~)do 4f./I'O
PARCEL ID # J'3'~' .2./-DI70... Dol 0\3... 110 Q
(ORTATN FROM PROPERTY TAX NOTICE\
WORK PROPSED: []NEW CONSTRUCTION
[] SIGN
PROPOSED USE: []SGL FAMILY DWELLING
[] COMMERCIAL
[] ADDITION
[] MOVE
[] ALTERAT ION
[] DEMOLISH
[] REPAIR
[] INSTALL
[]MULTI-FAMILY
[] INDUSTRIAL
[] # OF UNITS
[] SWIMMING POOL
[] MOBILE HOME
[] OTHER
BUILDING SIZE
CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL
? ?pLA.-Gc; C ~ ~ d.. Jc.,.~ lA.W(.f-=
SQUARE FOOTAGE
HEIGHT
DESCRIPTION OF WORK
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMMERCIAL: 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
[] BUILDING
[] ELECTRICAL
$
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
[] FLORIDA POWER
[] W.R.E.C.
[] PLUMBING
[] MECHANICAL
$
/ ...
fc)qP'~
[] SPECIALTY
VALUATION OF MECHANCIAL INSTALLATION
[] OTHER
[] GAS
[] ROOFING
TYPE OF CONSTRUCTION: [] BLOCK
[] FRAME
[] STEEL
[] OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREA[] YES [] NO
COlf.rM,GTO:R>SECTION
BUILDER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
ELECTRICIAN
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
ME eHAN I
******* *** ** * ~~~;:~ *** * r1Zn**#lJ*lIt:7iz rLC
,
STATE CERT OR REGIST # ClfCo rz.6{ 7
,
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OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictions" which
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 indica~ion 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 commencement.
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 commenced 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 commenced within
six months of issuance, or if work authorized by the permit is suspended or abandoned fora
period of six months after the time 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 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 OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENC
PAYIN T CE FOR IMPR EMENTS YOUR PROPERTY. IF YOU EN
WITH 0 L DER OR ATTQ Y BEFORE RECORDING YOU OTI 0
$2, 0 IN L DO N TO RECORD AND POST A ' OTICE F C
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____day of
by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this_____ day of
by
acknowledged
, 2~
acknowledged
,20_
(name of person acknowledged)
Dwho is personally known to me, or
(name of person acknowledged)
C1ho is personally known to me, or
Dwho has produced
(type
and whoD did 0 did not
of identification)
take an oath.
Dwho has produced
(type of identification)
and who 0 did D:Hd not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
PROPOSAL
~C>U'l"'12 ~C>Nl>mC>N.Nt7
.....1> "'un....., I- J- e
37331 Koulk RNd
Zephyrtlllla. Fl33541
(813) 783-3723
No.
Oate
3lz'tjtJ it
Sheet No.
Sl CeflICAC042667
Pro......- Su"mi~ To:
Na _ ~ t.4N
sC:: ":l Q' ; ? i. /tJ. La ....~c. PA-~ Da...
City L. I ,.y.. N \ A
State ..v\ I .... Q I ~ t..
Phone = '7~ '1- ~.I- IoSIJ
Work To Be Performed At;:
C~~'" 110
Str88t tltlol ",a. r.....-r ?~
City "?'~JI'I~J..i/lS ~ I
Oate of Plans ?~;I.. -I' 70
Architect
"""'I
wA-LU-w1
:;; rz:1!.~!e~~ ~!4.4-jAd-c-LiJ.~
Hl.,~J.,.",kL ~ r~ -#A.~ "~~~~SAC. ~N~ ~f
Mlhvi~
All material is guaranteed to be as specified. and the abolle work to be ~ tal med in accordance with the drawings and
s~cific~ns subm~ted for above work and completed in a substantial workmanlike manner for the sum of
~ /~.,1f1r'iI.. ~ ~~ (ilollar& ($ /01./0 ~ J.
with payments to be made as follOWS:
~ ;;:::~
5"0.00
IVrf a\WMItIOn 01" ,-illn tram ..",. ~ irwoIving utre
a8S, ";11 .. encuc.cI only upon written ardws. end will Mcarne .... Respectfully submitted
..,.. ch8rge _ ..., IIblw8 the _imete_ A1ll1lilrwmlll"ltS contif1lllll1t
upon .crik8a. IICCidIII"ItS 01" .. ~ our control. OM.- to carry
fire. tarnMID ..., ClthIIr' ,_ V i..-.:e upan ..",. -'to Work.
nwn'. ~ end PubliC l.illbihty "*-1C8 an ..",. work to ..
.." out by
~:!?:./:~..,e.~'" l/ "Q€:0
(3AlA-"-' .
~J..J A1.~H
Per .M~"1~
Note- This proposal mey be withdrawn by US if not accepted
within :Je? days.
ACCEPTANCE OF PROPOSAL
The above 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 II"~~
6>/l~
.
Date
3" :J,1-C/ If'
Signature