HomeMy WebLinkAbout04-3010
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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost: 1,040.00
Date Issued: 4/27/2004 Name:
Total Fees: 40.00 l Address:
Amount Paid: 40.00
Date Paid: 4/27/2004 Phone:
-- Work Desc: REPLACE CONDENSING UNIT
3010
MECHANICAL
NC CHANGEOUT
NOT APPLICABLE
Address: 4801 AIRPORT RD STE216
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section: .
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
LAURTIZ JOHNSON
4801 AIRPORT RD STE#216
ZEPHYRHILLS, FL. 33542
---- - - I _________________ _____._----'----~___~__~_____
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 to record anotice 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." _
--~---~----- --n-Complete- Plans,SpedficiitionsandFeeMust Accompany Applicatio--n.-~------n_--
_Al'_work shall.E.~_p~r1ormed in acco~dance with City Codes and Qrdinanc~_ n____________.
NO OCCUPANCY BEFORE C.O.
_.._~.~---.._~~---~~._-- -'~--"--_. -----.--------.---..,-----..--
~
R GNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8ft St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECE IVED
PHONE CONTACT FOR PERMITTING
OWNER'S NAME L 4't.~,.r; To".vs~"c/
JOB ADDRESS ~Bo ( Pcl-~t--:f&N~~""..1jt
PARCEL ID # /3 ,..?~ -.2./- n/7 0 - tic 2()o .; 7.-1 (, 0
PHONE 7 7~ '1( //~
?~'t'.(,~' .
SUBDIVIS ON
LEGAL DESCRIPTION: LOT(S)
BLOCK
(ORTAIN FROM PROPERTY TAX NOTI~EI
WORK PROPSED: (JNEW CONSTRUCTION
(J SIGN
PROPOSED USE: (JSGL FAMILY DWELLING
(J COMMERCIAL
(J ADDITION
(JALTERATION
(J DEMOLISH
(J REPAIR
(J INSTALL
(J MOVE
(JMULTI-FAMILY
(J INDUSTRIAL
(J# OF UNITS
(J SWIMMING POOL
(J MOBILE HOME
(J OTHER
DESCRIPTION OF WORK
o RESTAURANT & HEALTH DEPARTMENT APPROVAL
jl.t:fJ~ ~~. 4'j; t~-:-/
SQUARE FOOTAG
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
(J BUILDING
$
VALUATION OF TOTAL CONSTRUCTION
(J ELECTRICAL
AMP SERVICE
(J FLORIDA POWER
(J W.R.E.C.
(J PLUMBING
(J MECHANICAL
(J GAS
(J ROOFING
/:. eo
$ {O~O'--
(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
C:Qw.rR1l.QT()~i.SECTION
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 #
COMPANY
STATE CERT OR
*****************************************************************
OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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 fo'r
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 portions 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 per' or the project will be considered abandoned.
WARN TO NER: YOUR FAILURE TO RECORD A NOTICE 0 OMMENCE
P NG TWI FOR IMPROVE ENTS TO YOUR PROPERTY. YOU IN 0
TH YOUR ENDER A TT NEY BEFORE RECORDI YOUR NO CE 0
$2,500 V N N TO RECORD AND POST E OF
acknowledged
, 2~
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____day of
by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by
acknowledged
, 20_
(name of person acknowledged)
C1ho is personally known to me, or
(name of person acknowledged)
Owho is personally known to me, or
Owho has produced
(type
and whoO did 0 did not
of identification)
take an oath.
o who has produced
(type of identification)
and who Odid O:iid not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
WLrls .4112 WJIIlIII>lTlt>....Nt;
.....1) ttUn~ ~ LC.
37331 Kaulk Road
Zephyrhllls, FL 33541
(813) 783.3723
PROPOSAL
No.
Date
3/~//o V
, ,
Sl Cerl tCAC042667
Sheet No.
Name
Street
City
Stata
Phone
Pro...... Submiu.d To:
It. ,-r.. o,,~. rJ
/0 ~ LJ~ 'T Lc cl:t.. ~...-.~ S uJ
'8 -"L. 0 tv
/>?~. "'''1'11 . S"'s<! L.C)
5 ~ 'l- ?75'" (./'''1
Work To" Performed At:
r-- ~IVL.o t/L. 1(,
Street gJlo/ Allr. P.o~ ~-It-,[
City ~PN~.'/S r/.
Date of Plans
Architect
We hereby propose to fumish the materials and perform the labor necessery for the completion of
e..:~;Lct:r;:~u ~~:.,u:;,t ~:~::;~~~:~:-;::~
U~; (~~.Cr-.JI.'''j Fh,~ As/~1l- L.A'.~ /0.0 54!!-~~
~,,4f-~~r
41P," y~ PA-Jt.:IJ rL./MoL A'f {J,/h ,l.,A..G,/J,'h~uJj
J#IVL ,#f1:-A-7i,."., L Lc
4-J./,.,J.~NIt-l.. ~y~ ~!UU_1t. D~ t7;
A'1~II"'''f~fu~~.
,.
All material is guaranteed to be as specified, and the above work to be pel formed in accordance with the drawings and
specifications submitted for above work and completed in a substantial workmanlike manner for the sum of
tJ/I/~ /A#uS/htl'4 r:o'!!7 # ~ 0 ~rs ($ /OWJ,!l...- ),
with payments to be made 8S follows: QO...-
Respectfully submitted
an, -"1CIn or cIawietian fram ... ~ itwoMng ucra
costs. will be executed only upon written orders. end will become en
at... cherge 0\181' end ebDww the eKimete. Allllgl eements ClIIltiIlgllnt
upon etrikell. eccidenta or ~ beyond our controI_ awn.r to cerry
..... tarnmo end ottwr ,- W iMur8nce upon... -'- Worll.
,,*,'. Carn.--tICIn end Public l..iebilttw ,_ on ebowe wart to be
r.tren CIl4 bw
Per
Note- This propose' mey be withdrawn by US if not eccept8d
withincft7 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.
Date
4-/2 -6Lj
~_..~rfrP-~ ·
Signature