HomeMy WebLinkAbout11-11584 CITY OF ZEPHYRHILLS
5335-8th Street
(813)780-0020 11584
ELECTRICAL PERMIT
Permit Number: 11584 Address: 38630 SOUTH AVE
Permit Type: ELECTRICAL MISC ZEPHYRHILLS, FL.
Class of Work: ELECTRIC SERVICE REPLACEME T Township: Range:
Proposed Use: NOT A�PLICABLE . Lot(s): Block: Section:
Contractor: �,(,�S �2t� �� Book: Page:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number:
Improv. Cost: 800.00
Date Issued: 3/02/2011 Name: BERTRAM, MARYANN
Total Fees: 40.00 Address: 38630 SOUTH AVE
Amount Paid: 40.00 ZEPHYRHILLS, FL. 33542
Date Paid: 3/02/2011 Phone:
Work Desc: SERVICE UPGRADE 100AMP TO 200AMP CALL INTO PROGRESS
ELECTRICAL FEE 40.00
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ROUGH ELECTRIC
CONSTRUCTION POLE
PRE-METER
FINAL � �
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REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection trips are
necessary due to any one of the following reasons: 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.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
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."
Complete Plans, Sp.ecifications and Fee Must Accompany Application. All work shall be performed in accordance with City
Codes and Orc�ir�p(ces.
. , �
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NT C OR PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
03/03/2011 21:51 FAX f� 0001/0001
A� � CERTIFICATE OF LIABILITY [NSURANCE °�'�''"""°°�""�'
3/3/2011
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOttMAT10N ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFlRMATNELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANGE DOES NOT CONSTiTUTE A CONTRACT BEi'WEEN 1'HE ISSUING IN3URER(S►, AUTHORI�D
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: ff the c�rtificab� holder is � ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROCaAT10N IS WANED, subjeet to
the terms and conditions ot tltie policy, certain policies may require an endorsemerrt. A statiemeat on this certlficabe does not cwrfer rights to the
eertlficate hold� � lieu aF such endorsemeM(s).
vrtoouc� Houae 8ouse
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Neighborhood Insurance Service �� •
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IqSIIRER E :
Wesley Chapel FI, 33544 w �� F ,
COVERAGES CEI2ilFICATE NUMBER.�+113303307 REVISION NUN�ER:
THIS IS TO CERTIFY THAT 7HE POUCIES OF INSURANCE LiSTED BELOW HAVE BEEN ISSUED TO 7HE INSUREO NAMED ABOVE FOR THE POLICY PERIOD
INOICATED. N0TIMTHSTANDING ANY REQt11REMENT, TERM OR COND{TION OF ANY CONTRACT OR OTHER DOCUMENT V1flTH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUEO OR MAY PERTAIN, 7HE INSURANCE AFFORDED BY TFiE POl.IC1ES DESCRIBED HEREW IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AtJD CONDITIONS OF SUCH POUCIES. LJMITS SHO1M� MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LT�R TYPE OF INSURANCE POLJCY NUYBER POIJCI' PO EXP Wlrt'8
��� �►��TM enc►+ ocCUw�wce s 500 , 000
X� COMMERCIAt GENERAI UABILITY � E 100 � 000
A ctna�s�Anoe � occuR 90410003623900 /5/201i /s/2012 p�D Exv (nny a,e paraan a 5, 000
pEaspwu. a nov i�uur a 500 , 000
' �wu.,�r�cn� S 1,000,000
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GENL AGGREGATE LJM1T APVL�3 PER: PRODUCTS - COMPlOF AGG i �l � OOO � 000
' X POLICY � LOC s
AUTONOBILE UA&U7Y COAABINED SlNGI.E LqdR
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� �� BODILY INJURY (Per persm) � S
All ONMED AUTOS BODILY INJURY (Per accidxit) i
SCI1EOUlED AU70S PROPERTY DAMAGE
HIREO AUTOS �� 800 �) $
NON-0WNED AUTOS S
S
UNBRELLA LWB � OCCUR EACH OCCURRENCE S_
� � CIJ1aAS•MAOE AGGREGATE S
oeoucrie� s
�rna, s s
YYORK6tS COMPENSA710N WC BTATU- OTIi-
Af�IP EAIPLOYEftS LIABILIiY
������ Q N/ A E.L EACH ACCIDENT S
OFflCERJMFJ�tBER E)CGLUDED9 —
(Mandatery in NH� E.L DISEASE - EA EMPLO S �
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DESCRIPTION OF OPERATIONS helow EL DISEPSE - POI.ICY LMuIIT S
pE8CPoP710N OF OPEttA710NS ! LOCATONS ! VEItlCLE3 (Afoach ACORD 107, Add4bral RaMrks 8c1�ie, N moro ipacs la raquireA}
CER71FiCATE HOLDER CANCELLA7'ION
(813) 780-0021 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES � CANCELLED BEFORE
7HE EXPIRATION DATE TNEREOF, N0T10E YYILL BE DELNERED IN
CITY OF ZEPHYRHILLS ACCORDAMCE 1MTH Tt1E POUCY PROVISIONS.
5335 – 8th STREET
2EPHYRHILL3, ET, 33542–A312 �'�
ACORD 25 (2009/09) � 7988-2009 D CORPORA710N. AII rights reserved.
INS025 �zooeae� The ACORD name aod logo are registered marks of AC
813-780-UUZU c;ity or �epnyrnnis rermit Hppucaiion rdx-o�o-�ou-vu��
Building Department
Date Received
Phone Contact for Permittin -
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Owner's Name �/� �/'- r�c Owner Phone Number
Owner's Address �� �� �OV'� S'��� �/f7�� Owner Phone Numbe�
Fee Simple Titleholder Name ���� �'�—� Owner Phone Number �
Fee Simple TitleholderAddress
JOB ADDRESS o 6 .� SoL .S`���-� ,.,- ��r i� �� LOT # �
SUBDIVISION � , PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEW CONSTR 8 ADD/ALT [� SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM 0 OTHER
TYPE OF CONSTRUCTION � BLOCK Q FRAME � STEEL Q
DESCRIPTION OF WORK S ���C'� � "���'� 1�,�- %� �CU� � �- I� .
BUILDING SIZE / � SQ FOOTAGE /��� HEIGHT
QBUILDING $ � VALUATION OF TOTAL CONSTRUCTION
�ELECTRICAL $ 9 1'J AMP SERVICE �� � PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $ � � _
OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ' I �� �
QGAS Q ROOFING Q SPECIALTY 0 OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
Address ' License # °� ���j s'�� a�
ELECTRICIAN "" COMPANY �/ C� C� �ZG°'�1711C Ll L
SIGNATURE REGISTERED N FEE CURRE� Y/ N
Address � �� � � License # �� � �G �� �'� 9
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
Address License # �— �
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
Address License # r
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
Address License # �— —�
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new consUuction,
Minimum ten (10) working days after submittal date. Required onsite, Construcdon Plans, Stormwater Plans w/ Sflt Fence installed,
__ Sanitary Faciltties & 1 dumpster; Site Work Permit for subdivisions/large projects