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I-
I
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
3012
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost: 1,040.00
Date Issued: 4/27/2004 ,Name: ILEEN SWEENEY
Total Fees: 40.00 l' Address: 4801 AIRPORT RD STE#219
Amount Paid: 40.00 ZEPHYRHILLS, FL. 33542
Date Paid: 4/27/2004 Phone:
--WorkDesc: REPLACE-CONDENSING UNIT ------- _n_________
3012
MECHANICAL
NC CHANGEOUT
NOT APPLICABLE
Address: 4801'AIRPORT RD STE 219
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
I I I
-------n-------------~---~n-____L.___________L_______n________
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 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 rec ing your notice of commencement." .
..-----~----COmplete Plans, Specifications and -Fee Must AccoITlpan')'-Applicatio-n~------
__""c:>.rk sh~!lJ:>e_performed in a~cor~i:lnce.with_ City C:Ede~_and_Qrdin9nce~ _ _______
NO OCCUPANCY BEFORE C.O.
.~-_.-.._-----'-_._.__."-----~._----~.._--_...._--,._-----------------..-
~
SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8m St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECEIVED
PHONE CONTACT FOR PERMITTING
OWNER'S NAME r ;'~/V .5{ ~ J t2rr tv (2.. ~
-- I
JOB ADDRESS ~BOf AIlt?oi:l ~1Jh{ ~
4/ ;(19
PHONE -Zl2 -/7~7
Z?i>fI~pt.. f/ 5
I
SUBDIVISION
LEGAL DESCRIPTION: LOT(S)
BLOCK
PARCEL ID #
I 'J ,.~(.~ ;J.,(. 01 J 04 0 02.0D ~ 2., 9 0
WORK PROPSED: [JNEW CONSTRUCTION [J ADDITION [JALTERATION [J REPAIR [J INSTALL
[J SIGN [J MOVE [J DEMOLISH
PROPOSED USE: [JSGL FAMILY DWELLING [JMULTI-FAMILY [J# OF UNITS [J MOBILE HOME
[J COMMERCIAL [J INDUSTRIAL [J SWIMMING POOL [J OTHER
(OBTAIN FROM PROPERTY TAX NOTICE\
BUILDING SIZE
CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL
If?(~ (;~C-t/S(~ I./Mrf
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 & (l) SET ENERGY FORMS.
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
[J BUILDING
[] ELECTRICAL
$
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
[] FLORIDA POWER
[] W.R.E.C.
[] PLUMBING
[] MECHANICAL
$
0.;;;)
/0'10' ;--
VALUATION OF MECHANCIAL INSTALLATION
[] OTHER
[] GAS
[] ROOFING
[] SPECIALTY
TYPE OF CONSTRUCTION: [] BLOCK
[] FRAME
[] STEEL
[J OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREA[] YES [] NO
C()~~~.._..iSEC'1'ION
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 #
...........~;;.;;:;;/..*(]~fc*;/J(*.;y6 . U-C
STATE CERT OR REGIST # c;tccJf/-z..( t. 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
may be more restrictive than City regulations. The
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 ilding Official. An approved inspection mu logged during each six
month period, r t project will be considered abandoned.
WARNING TO NER' YOUR FAILURE TO RECORD A NOTICE OF COM NCE
PAYING T CE F IMPROVEMENTS YOUR PROPERTY. IF YOU NTE
WITH YO R LE N TTO BEFO ECORDING YOUR OT OF
$2,50 IN NE REC 0 NO POST A "NOT C OFr:O
- -
subject to "deed restrictions" wnich
undersigned assumes responsibility for
acknowledged
, 2CL-
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____day of
by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____ day of
by
acknowledged
, 20
(name of person acknowledged)
C1ho is personally known to me, or
(name of person acknowledged)
Owho is personally known to me, or
o who has produced
(type
and whoO did 0 did not
of identification)
take an oath.
Owho has produced
(type of identification)
and who Odid DEd not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
. -. ...'
PROPOSAL
(;CU'I AlI2 c;C~I>ITIC~.~
~I) tlUn~6
37331 Kouik RoM
Zephyrhllla. Fl33541
(813) 783.3723
No.
Dete 3/z ~ f.-
Sl CerlICAC042667
Sheet No.
\.
Work To" Performed At:
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Streat ~JJ.' ~LP.a."" ~A.J
City ~NJ<~/".'I~ I ~/
Date of Plens 7 p;1- - J '7 7 7
Architect
P.......... SulNnlUed To:
Name -r L tkE-1I\ SfJ ~..y
:e,
Street ~v ~~ 6- Ua U~ .."
City l ~ J -...w.to.-
State 'r:.A S"' -.,? ;a..
Phone ~C.!. S " A - 2.,,, & .
We hereby propose to fumish the materials end perform the labor nece&88ry for the completion of
h-cll",,~" t/ z.,.?'.H{ 19-, ~r..1!!. 5:T,e'ylor ~.,' c.....c.~
tI",.'" tJ., G."CNlI. PtU::.dAl,.,a.c..T' ;6 ~,~7:. r~N~'
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All materiel is guaranteed to be as specified. end the ebove work to be perb,..ed in 8CCOl dence with the drewings end
specifications submitted for above work and completed in a substantia' workmanlike manner for the sum of
<<91'6" 7APA4~ f1g~ IT' ~ ~ OoIlars ($IO'f(J'~. ),
with paymentS to be made as follows: ,.......
"/O~CJ' t!:! I!Jr';L}I~tPFCI,fJ(hf f~~B~Vf
An, ..ar._ Dr devietian tram .... ll*ibtiarw irwoIving utI'lI
.-.. will ba eacut8d anly _ ~ ....... ... wilt baaome 11ft
IIIltI'll c:herge _ end ... the ..ci..... Al1llOl...".1t& ~
upon .,;ka ~ at' ...,. ~ our control. awn..- CD cerry
..... tarnedg ... attw..... _ 7 u.urence upon IIIIIMI work. Warlt.
,,*,'. ~... Public I.iebiltty ___ an IIIIIMI warlt CD"
tIIIlen aut by
Respectfully submitted
Per M~ Irlt,
Note- This propose' may be withdrawn by US if not ~
within 1 I:} days.
ACCEPTANCE OF PROPOSAL
The abo\le prices. specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified.
Payment wm be m_ .. oud'.... .- (\ f) (/
Signature ~/~ \3.~~
Dot. ~ ~ J.,. ) Q If Sig,,""'.