HomeMy WebLinkAbout04-3008
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020
BUILDING PERMIT
3008
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:
3008
MECHANICAL
NC CHANGEOUT
NOT APPLICABLE
Address: 4801 AIRPORT RD STE208
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
1,140.00
4/27/2004
40.00
40.00
4/27/2004
REPLACE CONDENSING UNIT
Name: DALE WERNECKE
Address: 4801 AIRPORT RD STE#208
ZEPHYRHILLS, FL. 33542
Phone:
i
i _.
I----------~-___________.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
i (e) Permit not posted on job site (f) Plans not at job site (g) Work not accessible
I
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
"-Wanung to owner: Your failure to record a-notice of commencement may result inyour paylng-twice-for- -
improvements to your property. If you intend to obtain financing, consult with your lender or an attorney
before recor . g 'four notice of commencement." ____ ___ ________ _____ _
Complete Plans, Specifications and Fee Must Accompany Application. - - -- ---
Ail rk s I beuperfo~l'l"ledi_11 acc:~rdance with City ~od~~ and Ordinarlces_ ____
NO OCCUPANCY BEFORE C.O.
._-_..,.._----~._~._---..__...,"------- ---....------.-.--.---.--
~
RACTOR 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)IJLt;, ()/3-II.f'/'#
JOB ADDRESS CfBDII1-(fl.-f!.r4 ~"eI ~ ;;Joe
LEGAL DESCRIPTION: LOT(S)
BLOCK
PHONE 7't 2- >'fJS-
7Kj?~et::Ils/~
SUBDIVISION
PARCEL ID #
/?,z.." -2.-/-0/10... Ot> Zoo - ::z.nP. 0 (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: (JNEW CONSTRUCTION
(J SIGN
PROPOSED USE: (JSGL FAMILY DWELLING
(J COMMERCIAL
(J ADDITION
o MOVE
(JALTERATION
(J DEMOLISH
(JREPAIR
o INSTALL
DMULTI-FAMILY
o INDUSTRIAL
(J# OF UNITS
(J SWIMMING POOL
o MOBILE HOME
(J OTHER
DESCRIPTION OF WORK
BUILDING SIZE HEIGHT
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
(J FLORIDA POWER
o W.R.E.C.
o PLUMBING
o MECHANICAL
/ /If()'~
$ .
(J GAS
(J ROOFING
(J SPECIALTY
VALUATION OF MECHANCIAL INSTALLATION
(J OTHER
TYPE OF CONSTRUCTION: (J BLOCK
(J FRAME
(J STEEL
(J OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREA(J YES (J NO
CON'rRAC!1'O:R,LSECTION
'. . '..........;...'..'1.. ::.,:;'" ,"..'...'.
BUILDER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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ELECTRICIAN
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
ME CHAN I
COMPANY
SIGNAT
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" whic~
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 for a
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, he project will be considered abandoned.
WARNING TO WNE. YOU FAILURE TO RECORD A NOTICE OF CO
PAYING ICE F IMP V. ENT 0 Y PROPERTY. IF Y IN 0 TO OBTAIN
WITH UR L ER 0 TT EY EE RE RECORDING YO NO CE OF
$2, IN LUE N R ORD AND POST A "OTI ~CO
acknowledged
, 20_
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____day of
by
ATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____ day of
by
acknowledged
, 20
(name of person acknowledged)
Owho is personally known to me, or
(name of person acknowledged)
C1ho is personally known to me, or
of identification)
take an oath.
Owho has produced
(type of identification)
and who Odid DUd not take an oath
Owho has produced
(type
and whoO did 0 did not
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
t;vli'l All) OO....I>ITIC>.........t7
.....1> l1un....t7 L L- c..
37331 Kaaalk Ro8d
Zephy...... FL 33541
(813) 783.3723
PROPOSAL
No.
Date
3/3110 'f
, I
Sl CerlICAC042667
Sheet No.
Proposal Submi~ To:
Name 0 A- L." W~R.r-I"C.k rG
Street (='0'<& 0 "l 1.0 '85
City J.. n. c. R 0" '5 e
State ~ ~ 5 u Coo "2-
Phone wos- 7i'Z.- 5u~~
Work To" Performed At:
Street
City
Date of Plans
Architect
All material is guaranteed to be as specified. and the above work to be PIll fOlIl.ed in accordance with the drawings
specifications submitted for above work and completed in a substantial workmanlike manner for the sum f
OIVb- TA .~$t+Nc! f!)N6- ~c.tAJJ..tlLc.O Fo~ tI ~ - lJQI~ars ($ 111/O'~
with paymentS to be made as follows: Qo
l./O -
..., "'1QI'l or __ban from ... ~ irwohnng IIIlUa
-s. will be _UC8d only upon wriU8n ........ end win IIIIcIIm8 ..
en,.. dlerge aver end elxMI the eatimece_ All egreements contingent
I upon lItrik-. eccidents or ....,. beyond our contnJl. awr.r to cerry
lire. tarnedD end Clthr"- 111'1/ onIUr8IlC8 uPOn IIbolIe -'. WarIl-
_'s ComperwebQn end Pubhc l.ieboloty INurence an __ wart to be
..... out by
Respectfully submitted
Per
Note- This propose' mey be withdrawn by us if not accep
within :3 0 days,
ACCEPTANCE OF PROPOSAL
The above prices. specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specif
Payment will be made as outlined above.
- III
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Date