HomeMy WebLinkAbout13-14029 CITY OF ZEPHYRHILLS
' � 5335-8TH STREET
(sis)�so-oo20 14029
DRIVEWAY PERMIT
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Permit Number: 14029 Address: 1 4 ��,�. �>'
Permit Type: DRIVEWAY ZEPHYRHILLS, FL.
Class of Work: DRIVEWAY/NEW Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number:
Improv. Cost: ;,`�.��� � ;... � ,, ��,�°�,;�;°;,.� �<;,
Date Issued: 3/28/2013 � �� Name: CITY OF ZEPHYRHILLS
Total Fees: 00 ,�j,��tii Address: 5335 8TH ST
Amount Paid: 00 ZEPHYRHILLS FL 33542
Date Paid: 3/28/2013 Phone:
Work Desc: DRIVEWAY FOR LIFT STATION #14 35 X 14-FEE WAIVED-PO#19538
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MORRIS &ASSOCIATES INC DRIVEWAY 30.00 ,;
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FINAL
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 inspections called d)work not ready for
inspection when called e) permit not posted on 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."
NTRACTOR PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
M, ' .
PERMIT APPLICATION � '
DRIVEWAY PERMIT APPLICATION
CONSTRUCTION WITHIN PUBLIC RIGHT-OF-WAY
All information must be filled-in completely
City of Zephyrhills
5335 8"'Street, Zephyrhilis, FL 33542
Telephone 813.780.0000 Fax 813.780.0005
�ate o��pli�oiil: , ���i.ror��tairiuecfiy) . ��`� . - �
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PR07ECT )OB SITE: PROPERTY OWNER
Address: u Name: � � — ,�
Unit#: Address: ,4�r,� � nit:
Parcel Identification Number: Ci State Zi ' 2� ,�� =�
Phone: ��, ax:
CONTRACTOR:
Company�"iI���2.�.5 f A��n� _
Name. DA v,,� S�c � r !�
_Contractor's License #: ("�% - O.,�b 7�l'7 E-Mail•
Phone.3Sa. 3ay��0 3 � Cell:����-Z��� Fax•
ARCHITECT/ENGINEER:
Name:,I* Firm Name:
Address: Citv' State• Zip.
State ucense #. Phone: Cell: Fax:
A�rintion of Proiect
TYPE OF DRIVEWAY �LENGTH OF DRNEWAY CULVERTS NEEDED
_�Ij�SIDEMZ4L DRNEWAY �WIDTH OF DRNEWAY ( )REINFORCED CONCRETE
��COMMERCIAL DRIVEWAY EXCAVATION ( )CORRUGATED MAIERIAL
PUBLIC ACCESS DRNEWAY �DE�pTH LINEAR FEET ( )BOX CULVERT
CONSTRUCTION MATE��L c��CUT R�OUI ED O OTHER(DCPLAIN)
ASPHALT YES L�b
_�EONCRETE
HEADWALL OUI DT YES �
NOTIC�TO APPL - NT: If actual work exceeds scope of this description,additional permits or drawings
will be required.
UTILITY LOCATIANC aFn��TaFn• CALL BEFORE YOU DIG: 1.800.432.4770
Page i of 3
PERINIT pPPLICd1TION
UTIL,ITIES LOCATE CONFIRMATION NUMBER:
PROVIDE SKETCH IN TNIS AREA, IF ADDITIONAL SPACE IS REQUIRED, ATTACH TO THIS
APPLICATION.
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AFFIDAVIT: Application is hereby made to obtain a permit to do work and installations as indicated. I certify that all foregoing
information is aaurate and that all work will comply with all applicable codes. I understand these codes shall take precedence over all
approved construdion documents,and issuance of this permit is verification that I will notify the property owner of Florida Lien Law
req.,F.S. 713.
The issuance of this permit dces not ensure compliance with deed restrictions and I understand that additional deed
restrictions may apply to this property.
All work shall comply with the current Florida Building Code, Public Works Design Manual and FDOT Design
Standards(if applicable). (Public Works Design Manual online link: www.ci.zephyrhills.fl.us/public works.asp)
APPLICATION IS VOID UNLESS SIGNED WITH PROPER IDEMIFICATION AND WITNESSED BY A PERMIT
TECHNICIAN OR NOTARY PUBLIC.
NOTE: The City of Zephyrhills is not responsible for mainbenance or repairs of driveways. Driveways shall not alter/
ir�terfere with existing sbormwater treatment and/or conveyance.
PROPERTY OWNERS: By signing this application: I certify that I have read and understand the owner/builder disclosure
Statement. (please initial) _
o ���� �,� � T � �-�=_- �-;�- � 3
Applicant Print Name Applicant Signature Date
Permit Technician Signature (or) Notary Signature Date
Applicant is( ) personally known to me or produced as identification.
(type of identification)
Page 2 of 3
PERMIT,APPLICATION
OFFICE USE ONLY
PUBLIC W�RKS USE ONLY
Concrete (min. 6'� Y N � �-r�o iNC�.vc� w.u�.�_ ,,��T��u p
Asphalt Base(min. 6'� Y N
Asphalt(min. 1�/z'� Y N
Length (min. 19� Y N
Width (10'min—20'max) Y N
Existing sidewalk. Y N
New sidewalk. Y N
ADA compliant. Y N �
Expansion material required. Y N ST,� T � T '� p�,
Contiguous parking pad. y
Triangular flare(3'W x 7'L) Y N
Visibility triangle o.k.? Y N
Side set back(3'min. R.O.W.) Y N
Plan Review Fee
Additional descM of work as deAned b Publlc Works D1r+ecb�r and or nee:
Permit application approved by: Date: q �p� t 3
Page 3 of 3
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CITY OF ZEPHYRHILLS
UTILITIES DEPARTMENT
Pursuant to Rurchase Order 19538 and 19539, issued to Morris and Associates, inc. on February
1, 2013 a determination had been made by the City that there is a need for the performance of
or rendering of services by Morris and Associates, Inc. of a certain "Task Order" under the
purview of said Contract. The issuance of this Task Order hereby authQrizes Morris and
Associates, Inc.to perForm or render the particular services of work described as foliows:
TASK ORDER NUMBER: L513-03 and I.S13-03 Change Order No. 1
Morris and Associates, Inc. shall perform tasks as more specif�cally detailed in the attached
"Proposals" dated December 18, 2012 by Morris and Associates, Inc.
Compensation to Morris and Associates, Inc. for rendering all of the identified services and
products shall not exceed 19 448.75 under this Task Order and 7 741.25 under Change Order
No. 1 unless authorized in writing by the City of Zephyrhills in accordance with the stipulations
set forth in Bid 11-11-07. Furthermore, compensation for the tasks shal[ not exceed the
amount set forth as follows unless authorized in writing by the City of Zephyrhilis in accordance
with the stipulations set forth in Bid 11-11-07:
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30 37219 Geiger Road $19,448.75
30 Change Order No. 1 $7,741.25
`�,���I''ease-�,i nirotce�;ea'cli�p,u rcl�ia�se$:o ride rs.sepa cately:
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Bv� ~g -� �9 I3
avfd E. Henderson Date
Director of Utilities -
,. . PURCHASE ORDER
�i'��r �f Z eph�rrhills _ No. 00019538
L'F
i.
1�'l.
VENDOR: SHIP TO: BILL TO:
Morris&Associates Inc. Wastewater Plant City of Zephyrhills
Commercial Business Finance 39825 Alston Avenue 5335 8th St.
PO Box 1209
Winter Pazk,FL 32790- Zephyrhills,FL 33542- Zephyrhills,FL 33542
VENDOR NO. VENDOR PHONE NUMBER TERMS DATE REQUIRED DELIVERY DATE
Morris&A ( ) - � 0 02/Ol/2013
SHIPPING INSTRUCTIONS
(none)
ITEM QTY U/M DESCRIPTION/TASK PRD CODE ACCOUNT UNiT PRICE AMOUNT
1 U.00 Sanitary Sewer Manhole and 041-3500-535-6322 19,448.7500 19,448.75
LS Rehabilitation. Task
Order#LS 13-03 for LS#30
Rehabilitation. Not to exceed
total cost of PO.
IMPORTANT: OUR ORDER NUMBER MUST APPEAR ON EVERY INVOICE AND PACKAGE
This onier is given upon the representution and guarnnty of the manufnclurer or seller U�at.no breach of any State or Federal Law or Regulation has occumed in
connection with the manufacturing,pracessing,branding,labeling or uansportulion of the me�handise herEin raentioned. If such breach occurs or is charged by any
legally consiituted State or Fedetal authority,the buyer shult be enlided lo rescind the order und return the unused merchandise und shalt also be held htumless by the
manufacwier or seller against nny penalty incurred and/or lhe cost of defense of any proceeding designed to penaliu the buyer therefor.
Page.Z Purchase Order No. 00019538
ITEM QTY U/M DESCRIPTION/TASK PRD CODE ACCOUNT UNIT PRICE AMOUNT
SLBTOTAL: I9,448.75
TAX: 0.00
S}iIPPING: 0.00
TOTAL: 19,448.75
TAXABLE: No
CONFIRMING: No
���t�+�►*,.w,—.^
AUTHORIZED SIGNATURE
SPECIAL IIVSTRUCTIONS:
IMPORTANT: OUR ORDER NUMBER MUST APPEAR ON EVERY INVOICE AND PACKAGE
This order is given upon the repiesentaiion und guaranty of�he munufacturer or ssller thnt no bceach of any State or Federal law or Regutation hns occuned in
connecdon with the manufacturing,processing,branding,labeling or trensportation of the merchandise herein cncndoned. If such breuch occurs or is charged by any
legally constitutod Stute or Federal authority,ihe buyer shall be entiNed to rescind the ordet and relurn thc unused machandise and shall a�so be held harmless by the
manufacturer or seller pguinst any pennity incurred and/or the cost of defense of any proceeding deslgnett to penalize tl�e buyer tl�ecefor.
PURCHASE ORDER
�it� �f Fephyrhills ;=:' ���
No. 00019539
�
r
VEiVDOR: SHII'TO: BILL TO:
Morris &Associates Inc. Wastewater Plant City of Zephyrhil[s
Commercial Business Finance 39825 Alston Avenue 5335 8th St.
PO Box 1209
'Winter Park,FL 32790- Zephyrhills,FL 33542- Zephyrhills,FL 33542
VENDOR NO. VENDOR PHONE NUMl3ER TERMS DATE REQUIRED DELIVERY DA'1'�
Morris&A ( ) - 0 0?J01/2013
SHIPPING INSTRUCITONS
(none}
ITEM QTY U/M DESCRIPTION/TASK PRD CODE ACCOUNT UNIT PRICE AMOUNT
1 0.00 Sanitary Sewer Manhole and 041-3500-535-6322 7,741.250Q 7,741.25
Lift 5tation Rehabilitation.
Task Order#LS#13-03,
Change Order#Ol,for LS 30
Rehabilitation. Not to exceed
total cost of PO.
IMPORTANT: OUR ORDER NUMBER MUST APPEAR ON EVSRY INVOICE AND PACKAGE
This order is Bven upon the�reseatation and gueranry of the manufacturer or seller that no breach of uny State or Federnl Law or Regulation has occumed in '
connection with�he manufacturing,processing,brnnding,labeling or transportation of lhe merchandise herein mentioned. ff such breach occurs or is charged by any
legully constitutcd Stete or Federal authority,the buyer shall be entitlecl to rescind the order and cetum the uaused merchandise and shall also be hetd hannless by the
manufacturor or seper aguinst any penalty incurrai and/or the cost of defense of any pmceeding designed to penalize the buycr therefor.
Page:2 Purchase Order No. 00019539
ITEM QTY U/M DESCRIPTION/TASK PRD CODE ACCOUNT UNI,T PRICE AMOUNI'
S U8'I'OTAL: 7,741.25
TAX: 0.00
SHIPPING: 0.00
TOTAL: 7,741.25
TAXABI.E: No
CONFIRMING: No
f����--�-^•
AUTHORIZED SIGNATURE
SPECIAL INSTRUCTION5:
IMPORTANT: OUR ORDER NUMBER MUST APPEA[t ON EVERY INVOICE AND PACKAGE
This ardcr is given upon the representntion and guarenty of Ihe munufacwrer ar seller that no breech of Any Stule or F'edera[Law or Regulation has occur�ed in
connecflon wilh the menufacturing,pmoessing,branding,lnbeling or trnnsportadon of the mcrchpndisc herein mentioned. If sucb breach occurs or is charged by Any
legally constituted State or Federal aulhority,the buyer ahall be entitled to rescind the otYkr and retum the unused merchandise and shall also be held b:umless by the
manufacturer or seller against any penalty inc�med and/or the cost of defense of nny proceeding designed to penalize the buyer thcrcfor.
MO RR.I S &
ASSOCIATES
INC.
800 Citrus Avenue 352-324-4037 Fax 352-324-3120
Howey in the Hills, Florida 34737 Cell 352-603-0034
ImorrisCa�morrisassoc.inc.com
Website: Morrisassocinc.com
December 18, 2012
Mr. David Henderson
Director of Utilities
City of Zephyrhills
Todd Hiscock
Wastewater Manager
5335 8T" Street
Zephyrhills, Florida 33542
Re: Sanitary Sewer Manhole & Lift station Wefinrell Rehabilitation
Bid # 11-11-07
Lift Station # 30
Good Morning Dave & Todd:
Please find attached the proposal for the change order items necessary for rehabilitation of
Lift station # 30 per the site visit.
Unit of Unit Total
Item # Description Quantity Measure Price Price
Construct P Trap 1 EA 750.00 750.00
Upper Guide Rail Brackets 2 EA 275.00 550.00
Guide Rails 2 EA 600.00 1,200.00
Remove & Replace 4" Pump
Bases 2 EA 620.00 1,240.00
Install 4" Concrete Driveway
Concrete & Form Board by Owner 1455 SF 2.75 4,001.25
TOTAL CHANGE ORDER 7,741.25
SCOPE OF WORK:
1. Set Up & Maintain Bypass Pumping
2. Clean Wetwell
3. Install Sewer Plugs
4. Seal all Infiltration Leaks
5. Point Repair Walls as Necessary
6. Coat Interior Walls of Wetwell & Valve Vaults with '/2" Pure Fused Calcium Aluminate Mortar
7. Set Up & Maintain Traffic Control
8. Perform Work as per the Above Proposal
If you have any question please do not hesitate to contact me.
Sincerely,
�/. ii'�.��
Larry B. Morris
President
CERTIFIED GENERAL INFRASTRUCTURE,UTILITY&DIRECTIONAL DRILLING SPECIALISTS CERTIFIED UNDERGROUND
CONTRACTOR CGC 056787 CONSULTANTS ESTIMATORS MANAGERS CONSTRUCTORS UTILITY CONTRACTOR CUC 43116