HomeMy WebLinkAbout15-16258 K CITY OF ZEPHYRHILLS
5335-8TH STREET
�sis��so-oo20 1625
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 16258 Address: 4803 6TH ST
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: MOORES FIRST ADDITION
Est. Value: Parcel Number: 14-26-21-0010-03400-0010
Improv. Cost: 10,955.00 OWNER INFORMATION
Date Issued: 5/07/2015 Name: SHANKS, RICHARD & KIMBERLEE
Total Fees: 90.00 Address: 4803 6TH ST
Amount Paid: 90.00 ZEPHYRHILLS, FL. 33542
Date Paid: 5/07/2015 Phone: (813)363-8312
Work Desc: A/C CHANGE OUT3 TON
CONTRACTOR S APPLICATION FEES
SIMPSON MECHANICAL N Air C CHANGEOUT / 90.00
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Ins ections Re uired
D TS INSTALLED •
DUCTSINSULATED
FINAL�'�" � Z.� - � �
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� 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 properly 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. '
"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,Specifications Must Accompany Application.All work shall be performed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFO C.O.
CO TRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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e�aasaoozo City of Zephyrhills Permit Application FaX-e��-�saooz�
• Building DepaRment
• Date Received �j�� SJC�'i''��S�
Phone Contact for Pertnitting o
Owners Name ����✓[y J'�(,i Owner Phone Number O l 3 � g'`f�7�p
i �/'/� /� p�
Owners Address �b V� L{J � . Owner Phone Number /"/�
Fee Slmple Tilleholder Name N �-- � Owner Phone Numher � �
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Fee Slmple TlUeholder Address N ✓�'
JOBADDRESS y�d3 OL�• � rhi�� rC • 33�z LOT# � ¢ �
SUBDIVISION J,I�f�S «� /-��L(� pARCELID# lu-a��ai-ovlo•d3y�- o6cD
(OBiAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED � NEW coNSTR 0' ADD/ALT Q SIGN Q Q DEMOLISH
INSTALL ` REPAIR
IPROPOSED USE � SFR U COMM Q OTHER
TYPE OF CONSTRUCTION Q BLOCK � FRAME Q STEEL Q
DESCRIPTION OF WORK ��U A l.. �Q�{A L �'�J�� �CiLT
BUILDING SI2E SQ FOOTAGE ���� � HEIGHT �
QBUILDING $ VALUATION OF TOTAL CONSTRUCTION
—�.
QELECTRICAL $ .— AMP SERVICE �PROGRESS ENERGY I/I W.R.E.C.
ir—, `��
QPLUMBING $ ��
�MECHANICAL $ ���SS VALUATION OF MECHANICAL INSTALLATION � ��
QGAS Q ROOFING Q SPECIALTY � OTHER �' l�
FINISHED FLOOR ELEVATIONS �� FLOOD ZONE AREA QYES � �
— 1174i1t9031iaoaoo � oo � YilQiQ—i-i
BUILDER OMPANY
SIGNATURE REGISTERED Y/ N FEE CURREA Y/N
Address License# / '
ELECTRICIAN COMPANY //
SIGNATURE REGISTERED Y/ N EE CURRE� Y/N
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREA Y!N
'� -
Address License#
MECHANICAL ' COMPANY L .S� /`i'�N
SIGNATURE REGISTERED Y N FEE CURREA Y/N
Address 'a-�j�� e (Q�Cl� �}Q,/ License# ��J�iU "n17�
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIItllllllllllllllllllllllllllllllll
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns;R-O-W Permit for new consWction,
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Starmwater Plans w/Silt Fence installed,
Sanitary Facitities&1 dumpster,Site Work Pertnit for subdivisions/large projects
COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construdion.
Minimum ten(10)warking days after submittal date. Required onsite,Constniction Plans,Stortnwater Plans w/Silt Fence installed,
Sanitary Facilities 8 1 dumpster Site Work Pertnit for all new projects.All cammercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
""PROPERTY SURVEY required for all NEW construction.
Directions:• •��� �
Fill out application completety
Owner&Contraclor sign back of application,notarized
If over$2500,a Notice of Commencement is required. (A/C upgrades aver E7500)
" Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMIT'fING (Front of Application Only)
Reroois if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
Driveways-Not aver Counter'rf on public roadways..needs ROW
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NOTiCE OF DEED RESTRICTIONS: The undersigned understands that this.p�rmit may be.sub)ect ta`deed'restrictlons°
which may ba<more r.eatcictive Rhan Gounty regulatlons.'7he Undersigned assurries responsl6JNty for camptlance with any
appllcable deed res#rlcttons.
UNLICENSED CONTRACTORS ANp CONTRACTOR RESPQNSIBMLITIES: �If the owner has hired a contractor or
contractors!o undertake work,they may be requlred.to be:licensed in accordanae with state.and�local regulatlons. If ths
contractor ts not ltcensed as requlred by law,both the oumer and canti�actor msy be clted tor a misdemeanrn vIolation
under state law. If the owner or Intended contrector are uncerteln as to what Ilcenaing requirements may apply ior the
Intended work,they are advised to contact the Pasco Caunty Bullding Inspectlan Dlvislon--I.icensing�ect(on at 727-847-
8009. Furthermore, N U1B OWCiB� FI88 ItI�B� 8 GO(}tr'dCtOf 4t C0�1tt8G�015, he Is advlsed fo have the cantractor(s} sEgn
portions oi the"contractor Biock'af ihia epptice8on far which they will be responsibte. If you,as the owner stgn as the
conUaaior,that may be an indication thet he Is not properly Ilcensed and is not entlUed to permitting privileges in Pasco
Gouniy.
TRANSPORTATiON tMPACTNTiLiTIES iMPACT AND RESQUItCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees.and.Recourse Recove.ry Fees mayapply to the constructlon af new bulidin8s,change of
use fn exis#ing buildtngs,or.expansion of ezis#��i�•6uildings,as specffted ire Pae+e�County Ordinance number 89-07 and
90-07,as amended. The undersigned also understands,fh�t such fees,.as�may be due,.wiil be identified at the time of
permifling. It Is further understood thel Transportatlon Impact Fees artd Resource Recovery Fees must be pald priar to
recefiring s'certi#tcate of occupancy"or flrtai pawer retesse. Jf the pro�ect does not invoive a cert�ic�te of accupa�cy or
finai power release,the fees must be paid prior to permN Issuance. Pu�thermore,I�Pasco_County iNaterlSewer Impact
fees are due,they must be pald prior to permit iss4ance�in accordance with appllcable.Pasco County ordinances.
GOMSTRUCTION LlEN LAW(Chapter T13,Eto€1da Statutea,aa amendedj: if vatuation ot work is$2,50Q.OQ or more,1
certify that i, #he sppticant, hsve been provided wfth a capy ot the "Fiorida ConstrucUon Llen I.aw—Nameowne�'s
Proteclfon Guide'prepared by the Florida Department oi Agriculture and ConsumerAifatrs. If the applicant Is someone
other than the"awner",!certify that!have�obtatned a copy of:the abova descrlbed dacument°and.promise in.good fal#h to
deliver It ta the'awne�'pdor to commencement.
CONTRACTQR'SIOWNER'S AFFIDAVIT: I aeitify ttiat all ths Information In thls applicatlon(s accurate.and that ell work
wil!be done in complfance with al!applicabfe laws regulating construc@on,zoning and land cleveiopmen#. Appllcatlan is
hereby made ta abtaEn a.perm€t to da wotk..and Installa#Inn as Indtcafed: 1 cetttiy that no work or tnstatlatian has
commenced prlor to Issuance of a permit and that all work wrill be pertormed to meet sfandards af all laws regulating-
constniction, County and City codes, zoning regula0ons, and land development regtalaUona�ln the judsdictfon. ! also
ce�i€y that I unders#and#hat the regulatlons of other gavernment ageneles may apply#o the intanded wark,and that it is
I my responsibility ta Identfty.what,act(ons 1 must�take to be�In.carrlPliance. $uch agenclas include but are not Ilmfted ta:
Department of Ernironmenkal Prote�t[on-Cypresa Bayheads,WeUand Areas and Env(ronmentally Senstttve
i _ [.ands,WaterlVltasfewater Treatment.
Sauthwest Florida Water Managemenk Dfstrfat Wells, Gypress. Bayheads, Wetland Areas, Altering
Watercourses.
- Army Gorps oi Engineers-Seawalls,Doaks,IVavlgable Wate�uvays.
- Department of Health & Rehabllk�tive Servlces/Ernlronmental Health Unit Wells, Wastewater Treatment,
Septic Tanks.
- US Envlronmen#ai Protectton Agancy-Asbestos abatemenL
- Federa�Avtatlon Auihority-Runways.
I understand that the following restrictions apply to the use of flllr
- Use of fitl�S no#atlowetf irt Flood Zone'V"unless e�ressly psrmttted.
- if the fiil materiai ts to be used in F(ood Zone °A, it ls understood that a drainage plan addressing a
"compensating volume'wlll be submitted at Ume at permf�ing whlah is prepared by a professfonal engtneer
iicensed by the Sta#e af Flotlda
- ff th�filt materiai is fo ba used in Flood Zone°A°in�cannecilon with.a permitted buiiding using stem wall
constructlon,I certify that flll:wllt:he used only.to nll lhe area w(thln the stem.wall.
- if fili materiai is to be used in-any aree, 1 certtfy that use of such fill w311 �oi advetsety aEfect adJacent
praperties. If use af flfl is tound to edversely.aBeci adjacent�pr�perties,the owner may be cited for.viotating
the conditions of the building.permit Issued•under tha al#ached pertnft sppl(caUan,for lots less than one(1)
acre whtch are etevsted by flli,an er�gEneered drainaga plan is requlred,_
ff i am the AGEHT FQit TFtE OWNIER,I;promtse In good faith#o iniorm the�owner of the permitting conditions set torth in
i this afffdavit�pHor to commencing construction. I understand thet a�separake permit may be requlred for elecMcal work,
plumbing, signs,weils, pools,air condltioning,.g$s, or other Instatlatlons nat.spectflc:afty inctuded in.the appflcatlon. .A
permit lssued shaii be canstrued to be a ttcense to praceed with t�e work and not as authoflky to.vtalate,cancel,atter,ar
set aside any provisions of the.technical codes;nor shall Issuance�of a permit,prevent the Bulldirig OHiclal from thereafter
requlring a correction af errors In plans,constructton or vlolatlons ef any codas. Every permlt Issued shal!hecome invalid
unless the wodc authorized by such permi#is.commenced vuithfi stu mon#hs af permit tssuanea,or if work au#horized by
the permit is suspended or.abandoned for a pertod of six(8)months after the time the work ls commenced. An extenslon
may be requested,in wriking,nom the SuAding.Offlcial for a period not to exceed n(nety{90j days and witl demonstrate
]ustlfiable cause for.the extension If wark eeases for n3nety{90}canseeuthre days,-the Job is cansldered abandoned.
WARNING T4 OWNER: YOUR.FAIL.URE TQ.RECORQ A NOTlCEAF CQMMEMGEMEI�tT MAY RESULT!N YOtlR
FAYING 1WlCE.FOR IMPROYEMEt�t'#'S TO YOLIR PEtOPERTY. IF YOU,1�lTENE}`3'Q`OBTAIPI•F{NANGiHG�'C01+ISUI.T
WIT U D O TTO FO E ECO G C E
FLORIDA JURAi'(F.S.117.Q3)
� DWNER OR AdENT CONiRACTQ ' ""-�.._
Subsalbed end svrom to(or aflirmed)4efore me this S�a.lb,ed an swo a rtned)b ma fhi9
bY �!�
who isiate personaily isnawn to me ar haslhave praduced Who( p Uy� tg me or hasfiave pmdi�
estdentlflcaUan. t � sidsnHficaBon.
ry " .,�+�� . ^
� Note Pubitc � � j , �Uy� otary PubUc
Commlaslon No. Com Is `g�ijo •"= OmmISSI0f1 iF FI '
�`�px °:�'�` Bonded ihau Troy fain i�wtanau 8aJ•38S•7019
Name oC Notary typed,pdnted or efemped Name of , n or mpe
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T.ax.Fo3io No. ; �
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w:l�anse and address: .
b.Amoani of bond'�
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fi.Le.�dar
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a Name and address;
b.Pbone number:
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pJkf7tA 5.O'NEtL,FhD.PASGQ CLERK&GQMPTROLLER �ub1i�•�.s�o�f e Jo::d•_ � �`�. �.3ut S'�•��€� .
��Jxi/2ai� az:xs �a x o� 1 ,. �om�� .
31S'8 �:,,F�F��' � ����,��:�
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i.ORTT`.%SaiDriE�T�:SSriC O�VD:A[,�::�Ul7iio
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-�� ,��,,,.. • 123Q2 N.Nebraska Ave.,Tampa, Florida 33612
'��=` ^-•= �— � Phone(813)558-0858 Fax(813)558-8578 Toll Free 1-877-335-COOL
I .(�, www.simpsoncoolair.com
� CMCQ56976
Prap�osa91 Ag�eerne��
Ciient Date instaii Day t Date
Rick Shanks 5-2-15 5-6-15
Street Address City Stale Zip
48Q� 6th st Zephyrhills Florida 33542
Home# Work# E-Mail �
813 - 838-4476 -
Outdaor Unit � Condenser ❑ 9ndoor Unig ❑ Vertical � Horizontal
Package
� Replace existing unit � Rep(ace existing unit
� Mounting pad (� Electric heat 5 KW
❑ Discartnect- New ❑ Modify pienum
� Disconnect- Existing ❑ New return plenum
❑ New copper line set ❑ Modify suppiy pEenum
� Existing copper iine fiushed ❑ New supp(y plenum
� Required breaker Make na Amps 40 ❑ Supplies Returns
� Required breaker Nlake s�d�o Amps 35
Installation To include
�AU labor& required permits& inspections S�ec6a! lns�s�uctio�s
�Thermostat inf touch wifi
� Removal and proper disposal of ald equipment increase living room return
(, �Visually inspect duct system and seal leaks
� One year energy saving agreement 1-3pIy2Qx20
1-3pfV 25x20
indoor Air QuaDi�y
SYSTE64� OPT'90N�
['LATt�i1�l�ltf G{31L�D SILVER
BRAND NAME Carrier Carrier Carrier
CONDENSER 25VNA836
AIR HANDLER FE4ANF005
� HEATER SIZE 5 KW KW KW
ENEF2GY RATINGS 17. SEER 90.5 NSPF SEEFt HSPF SEER HSPF
WARRANTY 10 CdMP 10 PARTS 10 LABOR COMP PARTS LABOR COMP PARTS LABOR
GONTRACTAMOUNT $ �2,175.00 � $
t'OVt1EFt GOMPANY
CARRIER REBATE 1200,00
SIMPSOfV DISCOUNTS
NET CC75T $ 10,975.00 $ $
We Propose hereby to furnish material and iabor—compiete in accordance with above specifications,far the sum of: $10,975.00
Payment to be made as follows: ❑ Financed w/
❑ Cash ❑ MasterCard ❑Visa ❑ Discover Deposit at signirtg: $
❑ Check# ❑Account# Exp. Date CVC# Balance Due at Installation: $ 10.975.Q0
Accounts that are 30�past due are subject ta a 1'/:°/a per month service charge.
'�,,,,.„
Authorized �„��.�\���'� —'�� Date �I_ `/(""^,.�_
Signature �p �'b
Note: 7his proposat may be thdrewn by us tf not accepted within days.
Acceptance of Proposal–7he specifications,prices,condiNons and terms
noted in thEs proposa!are satisfactory and hereby accepfed. Stmpsan Air �.��"-- f,:�� �z��,,a�. �¢" /�
is autfiortzed to aarry out the work as specified,and will be paid as
specified in this proposal. SEE REVERSE SIDE FOR ADDI7IONAL 7ERMS. Signatu�e r� e
" ���� � GREATEP,
_���. � � � AI�/1P�
��G �� o I
� �
�� `�� �� �� �a�� CHAMBER OF COMMERCE
20U9 Small Business o(Iha Year Winncr
21-50 Employees
AUTHORIZATION LETTER
I, Garrv H. Simpson, contractor license number CMC056976; hereby authorize the following
person (s)to act as my agent in obtaining permits and register in the City of Zephyrhills,
Florida:
Paul Bundschu
Criss Adams
Paige Simpson
Garr .Simpson
Simpson Mechanical, Inc.,
DBA:Simpson Air
CMC056976
State of Florida
County of Hillsborough
The foregoing instrument was acknowledge before me this � day of �v��
by Garry Simpson, President of Simpson Mechanical, Inc., dba Simpson Air a Florida c rporation,on
behalf of the corporation. He is personally known to me.
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813-558-0858 • 12302 North Nebraska Ave. •Tampa, FL 33612 •www.thecoolestguys.com
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