HomeMy WebLinkAbout15-16281 CITY OF ZEPHYRHILLS
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BUILDING PERMIT �
PERMIT INFORMATION LOCATION lNFORMATION
Permit Number: 16281 Address: 5335 20TH ST
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work; A1C GHANGE4UT Tawnship: Range: Boak:
Propased Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRNILLS
Est. Value: Parcet Number: 11-26-21-0010-17500-0060
lmprov. Cost: 5,672.00 OWNER INFORMATtC1N
Date Issued: 5/1912015 Name: MILLER MICHAEL E & BRITTANY B
Total Fees: 65.00 Address: 5335 20TH ST
Amount Paid. 65.00 ZEPHYRHILLS FL 335�2-4624
Date Paid: 5/19/2015 Phane: 321-446-7320
Work Desc: A1G CHANGEOUT 2.5 TQN
CONTRACTOR S APPLICATION FEES
U QUE R IN CHANGE T 65.00
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Ins ections Re uired
D CT I TAL�ED
DUCTSINSULATED
FINAL
REINSPEC7�OPl FEES: Reinspectian fees will comply with Florida Statute 553.80 (2)(c)when e7ctra inspection
trips are necessary due to any one of the fotlowring reasons: a)wrong address b)condemned wark resulting
from faulty construction c) repairs or corrections not made when inspections called d)work not ready for
inspection when ca!!ed e) permit not posted on jab site f) ptans nat at job site g)work not accessible.
NOTICE: In additian to the requirements of this permit, there may be additional restrictions applicable to this property that
may be faund in the public records of this eaunty, and there may be additional permits required fram ather governmental
entities such as water management, state agencies or federal agencies.
"1Narning ta owner: Your failure to record a notice af cammee�cement may result in yvur payirtg twice for
impravements ta your property. If yau intend to obtain financing, consult with yaur lender or an attorney
befare recording your notice of commencement."'
Complete Plans,Specifications Must Accompany Applica#ion.Atl work shall be performed in accordance with
Ci Codes and Ordinances. NO OCCtJPANCY BEFO C.O.
CON CTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN fi Mt3NTNS {NITHt)UT APPR4VED INSPECTI�N
CALL FOR INSPECTION - 8 HOUR NQTICE REQUIRED
PRCITECT CARD FROM WEATHER
�nr��� Y�e�,� 'Cb Y�. �id ��-,V�. p�cIE2,� (�.
- 813-780-0020 City of Zephyrhills Permit Applicati99 fl -I Fax-813-780-0a0'21�,
• �� BuildingDepartment ��/�!, (/� ��}�+PI � �
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Date Received Phone Contact for Permittin
TTTTT , ` IT
Ownar's Name � � r�., M�� Owner Phone Number �P�"��+�7 ,�2-�
Owner's Address -�✓� � Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS L.S�/✓J � � r �'`I`I S �� LOT q �
SUBDIVISION PARCEL ID# �1���I�O��O^ '�D�vV�.QO
� (OBTAINED FiiOM�PROPEHTY TAX NOTICE)
WORK PROPOSED �NEW CONSTR e ADD/ALT 0 SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM 0 OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q
DESCRIPTION OF WORK I � ' C/� d•S� ��% ^
BUILDING SIZE S�FOOTAGE� HEIGHT �
TTr TTrTTrTTrTrTI"ITTTrTTrTTrTTrTTrTTr
QBUILDING $ VALUATIONOFTOTALCONSTRUGTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. ,
QPLUM8ING $
QMECHANICAL $ �� VALUATION OF MECHANICAL INSTALLATION i �S�
� �l
QGAS Q ROOFING Q SPECIALTY � OTHER � + �
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO
�-.��1.i-C��:-F:-Y-i-FF:i-�:-r.��F:-7��ITF7--�G��.+ i-:�F.i-:.-F�0-.7-F7-1-7-�FF�:..i-G.-F�F-FC��
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREA� Y/N
Address License N
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y I N
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
MECHANICAL COMPANY v� �,�.�G r�1•
SIGNATURE REGISTERED !X°�N FEE CURRE� Y/N
Address �� License# `�'"f�� 1�
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEECUARE� Y/N
Address License#
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIItllllllllllllllll
RESIDENTIAL Attach(2)Piot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction,
Minimum Sen(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster;Site Work Permit for subdivisionsAarge 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 construc[ion.
Minimum ten(10)working days after submittal date. Required onsite,ConsVuction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
"*"PROPER7Y SURVEY required for all NEW construction.
..�1.-F�1.-�I.�i-1-.{-{..�1-I..FI..Ia-1..1-1..1-FI..1-F.i..f-i-��I-�1.-FF4.�F-1-FI-.f-F-��4-FI--FFI-�' •....�.�1-.FF4-�4-F�
Directions:
Fill out application completely
Owner&ConVactor sign back of application,notarized
If over$2500,a Notice of Commencement is required. (q�C upgrades over$7500)
" Agent(for the con[ractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
� Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
� ,.
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
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 Pasco County Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the"contractor Block"of this application for which they will be responsible. If you, as the owner sign as the
contractor,that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings,change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands,that such fees, as may be due,will be identified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a"certificate of occupancy"or final power release. If the project does not involve a certificate of occupancy or
final power release,the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due,they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes,as amended) If valuation of work is$2,500.00 or more,I
certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
Protection Guide"prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the"owner",I certify 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.
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. Application 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, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other government 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 Protection-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.
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
- Use of fill is not allowed in Flood Zone"V"unless expressly permitted.
- If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating volume"will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
- If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
construction,I certify that fill will be used only to fill the area within the stem wall.
- If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties,the owner may be cited for violating
the conditions of the building permit issued under the attached permit application,for lots less than one (1)
acre which are elevated by fill,an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER,I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. 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 codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance,or if work authorized by
the permit is suspended or abandoned for a period of six(6)months after the time the work is commenced. An extension
may be requested, in writing,from the Building Official for a period not to exceed ninety (90) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is 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 YO INTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING Y NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F.S.117.03) �
OWNER OR AGENT CONTRACTO "�—
Subscribed and sworn to(or affirmed)before me this S bscribed and sworn t (or irme b f r is
by ���by �
Who is/are personally known to me or has/have produced ho /are personally known to me or has/have produced
as identification. as identification.
Notary Public Notary Public
Cammission No. Commission No.
I
Name of Notary typed,printed or stamped Name Noja4 yyrinted or stamR��A ZAFFINO
'2.' '."�c Notary Pubtic-State of Florida
:N„+ �a�; My Comm.Expires Jur 5,2018
�'%',FOFC�q;:' Commission#FF 130052
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� :r!�;,�� 1 tJ I � Installation Contract
`-� 877-247-7365
INSTALLATION ADDRESS BILLING ADDRE55
Name of Client Brittany&Michael Miller Brittany&Michael Miller
Address 5335 20th St 5335 20th St
City/State/Zip Zephyrhills,FL 33542-4624 Zephyrhills,FL 33542-4624
Phone Number 3214467320 3214467320
E-mail Address brittany015@gmail.com •
• � � INVESTMENT
Retail: $8,343
Utility Rebates: �$��
Manufacturer Rebate: �$0) Payment Details
Discounts: ($2,671)
Deposit(Ch'eck) $0
Amount Due: $5,672
Balance Due(Financing) $5,672
__ � _ - .-.- FINANCING � . ' _
Financing @ 18 Months No Interest(WF]
Est. First Month Minimum Payment: $199
POST INSTALL-REBATES TOTAL COST OF OWNERSHIP(TCO)
Utility Rebate: $p Est. 1 Yr Savings: $579
Other Rebate: $p Est. 10 Yr Savings: $5,796
Tax Credit: $0 TCO �$�24�
Net Investment: $5,672 TCO Monthly �$��
Buyer is the owner ofthe property at the Installation Address and is legally authorized to enter into this Agreement. Unique retains title to all equipment,parts and
materials used to improve the property until Buyer's full payment is received by Unique. A service charge of 1.5%per month(18%annual percentage rate)or the maximum
rate permitted by applicable law,whichever is less,will be made on all overdue amounts. Buyer responsible for attorney fees,where allowed,for amounts not paid. Should
any Instant Rebates provided under this Agreement become uncollectible,Buyer will be responsible for payment to Unique of such uncollectible Instant Rebates. Prices are
valid for 10 da s from issuance of this A reement.
,
Customer Signature CA Signature
Customer Name � �} , CA Name ��� ��r-��,�-�,�
Date �f� ���� Date ��/`�f�,�
-�—
051013 License numbers: CMC 041072 � CFC 1426265 � EC 13002942
SO# 702123 Thank You for Choosing Unique Services as your Home Comfort Specialist. ^'§;`��;�i�
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SYSTEM IIVF�RIVIATION ���� �� �� . EQUIPMENT FEATURES
System Level: Premier(Daikin) •Aluminum Evaporator Coil:It is more resistant to
Type: Straight Cool corrosion than one made of multiple types of inetals.
•ECM:An Electronically Controlled Motor that is quieter
Capacity: 2.5 and more efficient than the standard motor.
SEER/EER: 16.00 •Single Stage Compressor:A compressor that only
- -._.. �. __._...__..... __ .�.
_ provides the full capacity of the system during operation.
WARRANTI(� ---- --�� _
Compressor: 12 years
Outdoor Parts: 12 years
Indoor Parts: 12 years
Heat Exchanger: --
Labor: 12 years
_ �.. __. ...�.._.
--
AIR QUALITY �� � . � ADDITIONAL AIR QUALITY Y
Thermostat: Basic Digital
Filtration: None
UV Light: None
Air Purifier: None
DUCT MODIFICATIONS . , INSTALLATION DETAILS �
Needs new adjustable stand
Customer Initials ��
CA Intials ���
� GUARANTEES �
�Comfort*No Lemons�Utility Savings*$500 No-Frustration*Property Protectiorr*Satisfaction�
No surprises:The lnvestment quoted is what you pay:Customer respect: Our technicians wi11 not swear or use tobacco products while
on your property. They will tourteously answer any questions and leave your home as'neat as they found it. Code Compliance:The
installation will comply with all existing local codes..Drug Free:Your work will'be perforrried by our professional,highly trained and
drug-free associates. Satisf�ction:We will guarantee that your systerri meets or exceeds your expectations for�quality and reliability.�
051013
' SO# 702123 Thank You or Choosin Uni ue Services as our Home Com ort S ecialist. �����a'#
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C,�T�y o �
I, Robert A. Holsbeke, Mechanical Contractor for Unique Air, Inc., give permission to
Tim Thompson, Bobby Hill, Armando A. Diaz and Matthew Montgomery effective 08/31/14
thru 08/31/15 to record my state contractor license# CMC041072, create passwords, obtain
permits and file notice of commencements on my behalf.
If you have any questions or need additional information, please call (941) 377-0153.
Unique Air, Inc.
yn�b�� �, (��6��-
Robert A. Holsbeke
Mechanical Contractor
Date:��.�`� � �; 2,� ls
State of Florida
County of M�Na i C- E
Affirmed and subscribed before me this � g day of M�y 20 l S
by '�a$c�-�� A• N�LS gEi� C , who is ersonally known to me r who has
produced (type of ID) as identification.
,,,,,,,.,,
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SI t I"e Ota �IC� State of Florida ��=oe"YP6o<<;-� LISA ZAFFINO
: Notary Public-State of Florida °
=N,o aoQ; My Comm.Expires Jur�5,2018"
a� ��'%/�FOFFI�P��` Commission� FF 130052
Pri�nt;�T��=o°r�-Sta�rn�p��Na� - otary
�
4515 19`"Street Ct. E., Bradenton, FL 34203 P� 941-377-0153 F:941-378-1387 www.uniqueservices.com
, HVAC:CMC 041072 Electrical: EC 13002942 Plumbing: CFC 1426265