HomeMy WebLinkAbout04-3007
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
3007
Permit Number: 3007
Permit Type: MECHANICAL
Class of Work: NC CHANGEOUT
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost: 1,140.00
Date Issued: 4/27/2004
Total Fees: 40.00
Amount Paid: 40.00
Date Paid: 4/27/2004
-- Work Desc:REPLACE CONDENSING UNIT
Address: 4801 AIRPORT RD STE207
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Name: HARLAN BACK
Address: 4801 AIRPORT RD STE#207
ZEPHYRHILLS, FL. 33542
.L Phone:
----~--~-----'- ------------_---1"___ _~__~__________
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: Your-failure torecorda-"otice of commE!ncement may result in your paying twice for---
improvements to your property. If you intend to obtain financing, consult with your lender oran attorney
before recording your notice of commencement."
- ---------------Com!:iletePlans,-Specifications and Fee Must AccompanyApplication. --------------~
~1I~or~~~II_~~p~_rform~<:lJ!!~c:cordaf"lcewith City Cl?de~and Ordina~es_____ _____
NO OCCUPANCY BEFORE C.O.
-...------..----.---..--.--- ---------------------------.-----------.--....-------.
~
CTOR 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
OWNER'S NAME f/1f(l~1 6# ffCL~
JOB ADDRESS iBol .A/~~d.eJ ~~ d2€J 7
PHONE 7 cY 0 - 7 fjC~
~",j).{'/IJ /;/
SUBDIVISION
LEGAL DESCRIPTION: LOT(S)
BLOCK
PARCEL ID # ! 1,;J..(r,--:21 -0110 hf:J'Z004 ;}J"\?o
(ORTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: [JNEW CONSTRUCTION
DSIGN
PROPOSED USE: DSGL FAMILY DWELLING
[J COMMERCIAL
o ADDITION
o MOVE
[JALTERATION
o DEMOLISH
o REPAIR
o INSTALL
DMULT I - FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
DESCRIPTION OF WORK
SQUARE
HEIGHT
BUILDING SIZE
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
o BUILDING
[J ELECTRICAL
$
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
o FLORIDA POWER
o W.R.E.C.
o PLUMBING
o MECHANICAL
$
!lyO'~
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
[J SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES 0 NO
gQ~C:!l'():R\,SEC'1'IQN
BUILDER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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ELECTRICIAN
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
PLUMBER
COMPANY
MECHANI
SIGNATURE
STATE CERT OR REGIST #
STATE CERT
*****************************************************************
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.
Application 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 B Iding Official. An approved inspectio st be logged during each six
month peri e project will be considered abandone .
WARNING YOUR FAILU 0 RECORD A NOTICE OF M NCEME
PAYIN IMPROVEMEN PROPERTY. IF Y U NTEND
WIT N ATT E RE RECORDING YOU OTICE
$2 T N ORD AND POST A E bF
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
,20_
acknowledged
, 20_
(name of person acknowledged)
Owho is personally known to me, or
(name of person acknowledged)
[1ho is personally known to me, or
Owho has produced
(type
and whoO did 0 did not
of identification)
take an oath.
Owho has produced
(type of identification)
and who 0 did DHd not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
wu:'S AlI2 (;t)NI>ITIC>fIIII.~
~I)I1UnNt; A~C.
37331 K.slk AOIId
Zephyrtllls. Fl33541
(813) 783-3723
PROPOSAL
No.
Date
0/'6'1"1'1-
Sl CerlICAC042667
Sheet No.
Name
Street
City
State
Phone
Pro...... SU.....1Ued To:
~ "'-<..
? ~ Bo~".:a. c. 5""8 &od 1nI&....
f.f:t, I; ~c. n
S ~''''O
Se.'7 - .... 7 7. _'t $""'"
w..... To .. Performed At:
ST
eo N&!.O 20?
Street '4 i'o, "'11l- Pa..r eaiU
City '2~".~J..:" ~ ~ I .
Dete of Plans 71e... 7~ "'3
Architect
We hereby propose to fumish the materials and pet fun.. the labor necessary for the completion of
~AA.R"~~ ~~ iIJlViP :a..4.... ~--' STzt,l..r t!.~ c...:tw'"J'c..';'1
UA~T.f A)' G'~4a.u R~.c:..T 'To ~lt,..i'..., ~".,~..,.
L-~UtaJr"'7~ ~~.c:J ~r ~/~1IIl ~LI_j .r~/a 0
?~II Pt:1'M,r
~~~~
.1V6- ~ PA-J-s' ~(l. &, ~/~AItf-~,'I''''''''':J
A-MI. # ~ /") U- eo.
~fhe_Jt-<- ~y~~ t:I~I'~$ -It. """-Iy 417
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All matenal is guaranteed to be as specified. and the above work to be performed in accordance with the drawings and
specifications submitted for above work and completed in a substantial workmanlike manner for the sum of
~ 7A-~~ ~6- ~". ~c,:. .... c.ll8rs ($//;.o..!.e ),
with payments to be made as follows:
lint eIter8c_ or deviation tram ___ ~a. irwohnng ucr.
=-s. will be encutell only upan WI'itt8n CII'GIrS, end will '-ame en
..... ch8rge - encl __ the ..cimeta. All. .......4. c:anti~
upan .,...., eccidenta or ...,. t.,and our CIlIltrOI. Ownr to ClIn'y
fire, torrwdD InCl other ~ I lIry il'l8U1'8IlCe upon lIbove work. Worlt-
men'. ComPMlMtIOn end Public Lillbibty In&unl'- on above ~ to be
tlIk8n out by
Res.-:tfully submitted
~~1hLD ". &/t!'
A1~~
Per
Note- This Proposel may be withdrewn by us if not accepced
within 30 days.
ACCEPTANCE OF PROPOSAL
The abolfe prices, specifications end conditions ere satisfactory end ere hereby eccepted. You ere authorized to do the work as specified.
Payment will be made as outlined ebove.
Date 3 - J..~- 0 Y
Signature)/~__~ 3-~b-Oj/
Signature