HomeMy WebLinkAbout04-3484
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
3484
Permit Number: 3484 Issued: 10/19/2004
Permit Type: GENERAL BUILDING PERMIT
Class of Work: GAS TANK REMOVAL
Proposed Use: COMMERCIAL
Sq. Feet: Est. Value:
Cost: 26,268.00 Total Fees:
Amount Paid: 165.00 Date Paid:
Address: 5046 GALL BLVD
ZEPHYRHILLS, FL.
Township: Range:
Lot(s): Block: Section:
Book: Page:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Name: ANDREW BELL IN
Addr: 1119 BAY ST
OCOEE,FL. 34761
Phone: Lic:
Work Desc: REMOVE UNDERGROUND TANK
ROBBYS LI U RS III
5046 GALL BLVD
ZEPHYRHILLS, FL. 33542
Phone:
DUCTS INSTALLED PRE-SLAB CONSTRUCTION POLE 2ND ROUGH PLUMB
DUCTS INSULATED LINTEL PRE-METER WATER
SHEATHING FRAME MISC SEWER
MISC INSULATION WALL MISC MISC,
MISC, INSULATION CEILING MISC, MISC,
MISC, DRIVEWAY MISC, MISC,
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 callecl
(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 recording your notice of commencement."
NO OCCUPANCY BEFORE C.O.
~~ ~
L CONTRACTO SI NATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECE IVED
/O/;5/0f/
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OWNER'S NAME
PHONE CONTACT FOR PERMITTINGq' 0 7 CJl{~-B ..;29'3
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G/1 m b~y(tU( rr:trf'J1~ 1(0 rvb1e'4 PH6NE If
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JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID #
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: DNEW CONSTRUCTION
o ADDITION
OALTERATION
o REPAIR
o INSTALL
o SIGN
o MOVE
o DEMOLISH
PROPOSED USE: 0 SGL FAMILY DWELLING
o COMMERCIAL
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK R-emtJt/t' t^-Itdv!-y YYf1I.vnd .'5.f~f'Pfe fan 1<-
BUILDING SIZE SQUARE FOOTAGE HEIGHT
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
& (1) SET
FORMS.
~4
ENERGY FORMS.
/ lLJC;,
'"
c~
o BUILDING
PERMITS REQUESTED
$ ;;zf;t ~ 'br ttv VAL~ATION OF TOTAL CONSTRUCTION
AMP SERVICE 0 Progress Energy 0
o ELECTRICAL
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
W.R.E.C.
"-~
...-.,;J----
?/
/'
/; 3064 '
o PLUMBING
o MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATIO
o GAS
o ROOFING
o SPECIALTY
o OTHER
IS PROJECT IN FLOOD ZONE AREAD YES 0 NO
FINISHED FLOOR ELEVATIONS
~/
BUILDER ,.,,/ .
SIGN ./ _ _~ STATE eERT OR REGIST i Pt!-~3f
~ ******************************************************~*:t? tJ~~~~~?
~ ~!
ELECTRICIAN COMPANY CYr~~~
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
MECHANICAL
COMPANY
SIGNATURE
STATE CERT OR REGIST #
*****************************************************************
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 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 som~one 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 corrunencement.
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 corrunenced 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 corrunenced 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 corrunenced. 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 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 RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
acknowledged
, 2U-
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)
Owho is personally known to me, or
(name of person acknowledged)
C1ho is personally known to me, or
o who has produced
(type
and whoO did 0 did not
of identification)
take an oath.
o who has produced
(type of identification)
and who 0 did OEd not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
Oct 08 04 02:31p
RndrQw 8ell
407-(;5(;-9099
,..2
STATE CERTIFIED
#PCC048399
tNSTALLI\T!ON
TANK REMOVAL
ANI>REW 'ELL, INC.
PeJrOleu"" Equip""""f &rulce.
Proposal-Conn-act No, 041271
Page 1 of 2
OctOber 8, 2004
C'IDlbc:rl~ F~ms, Inc.
177 Dedham Street
Canton, MA 02021
R.o: CumbedaDd hnm # 1 0 15
5046 Gall Blvd.
ZephyrbillB, IfL 33~41
Ann: Mr, R.L Theroux
Andrew ed1 ~. ~ pk~ tP l!\!bmit thjs propo~-cQQt(QCt fQr ~ kx:alion referc:nced
a.bove:
Obtain permit (owner to provide site plan),
Remove, clean and dripo8e of(1) 8,OOO-gaUon uodersrouod storage tanks and associated
piping.
Remove 811d dispose of aU concrete tank and drive mats.
Remove and properly dispose of26' x 35' canopy.
Remove and properly cfiolpose oftmk bottums and sludge up to 4",
Remove and .,~y dispose of all dispensers, concrete islancis and associated pipinS.
Back fill excavation with clean fin and iestore asphalt paving.
Bnvironmernal samplina and Closure Report by others. '
Existin& coraminatJon ~ not addressed in this proposal-contract.
U~und Q~iQg( ~cb ~ ~ l~. sewer lines, conduit and etc. sbal.l be
handled on a time and matcri&1 basis.
Price: $26, 268.00
Terms: Net 30
Respectfully submitted ~ W
Note-tlilii pro~contract may be withdrawn if not accepted within 30 days
Po. 80- 809 . o~ou, Flo.,d.l 3476]-0809 . [4(7) 877.8892 . "".: 1407) 656-8089
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Oct 08 04 02:31,.
Andrew Bell
40?-6S6-80a~
p.3
Proposal-Contract No, 041271
Cumberland FaIm'i IHOl S
Page 2 00
Acccpt8llce:
1k above ~ spe(:i11caJt~ lm4 COOditlQll9 8(~ sat1~~100' aM ~ ~y a~led. This proposal-
contract win COl1Stimu a 000. Fide Ccnnct between Andrew Bell, Ine, and pUl'duaSCl', It ili exp'eg;ly
agreed that there BlC no promlses, &grttmOlts cr U!ldcr5taodiDgs. <nl or wrim:n. not specified in this
contract.
Payment~ and Terms: Payment iK due upon compled.on of work snd should be made to !he priru:ip1l office
of Anckew Bell, IDe;, tq ()apie C<MLty fl" QnJy past due <I' unpaid balance sbaU ll<<l'Ut the 1n{crest at the
rate of 1-1/2% J;ICI' 1IlODIb, Ptrclwer funha- agrees to pay Andrew Bell. IDe, rcasoaable attorney' 5 fue5 and
court coos if this accoUlu Is plact:d In the hands of a c;y fur collc:cliOll,
Date 10{ 1"3 Joy Signature
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