HomeMy WebLinkAbout15-16465 :
CITY OF ZEPHYRHILLS /
'� 5335-8TH STREET
�813>�$o-oozo �4`65
BUILD�NG PERMIT �
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 16465 Address: 5824 9TH 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: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-02400-0130
Improv. Cost: 6,299.00 � OWNER INFORMATION
Date Issued: 7/23/2015 Name: MONELL SHARON
Total Fees: 70.00 Address: 5824 9TH ST
Amount Paid: 70.00 ZEPHYRHILLS FL 33542-3612
Date Paid: 7/23/2015 Phone: 813-788-4207
Work Desc: A/C CHANGE OUT 3 TON 14 SEER
CONTRACTOR S APPLICATION FEES �
AIR RE CUE AIR O DITIO I G INC CHANGEOUT 70.00
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Ins ections Re uired
DUCT INSTALLED
DUCTSINSULATED �
FINAL � -S - (T
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 correctior�s not made when inspections called d)work not ready for
inspection when called e) permit not posted on job site fi) 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, andlthere 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 y� ur notice of commencement."
Complete Plans, Specifications Must Accompany Application. All work shall be pertormed in accordance with
City Codes and Ordina ces. NO OCCUPANCY BEFO C.O.
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CONTRACTOR SIGNA URE PERMIT OFFI R
PERMIT EXPIRES IN 6 MON�'HS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT �ARD FROM WEATHER
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� � Ho�a�Improv�ment Agreement "
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8i 3-&72-56Q� ', � 1 �� r,°`''�. Corperrate�ffice
(888)638-3792 �� F �r.,r �,,�,,.,.?: ,•.� 1429 Massaro Bivd.
State Lic#CA�1813365 �����:�� Tampa, Fl�33b19
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Propasai Date `�'� j ✓'°�j l--� � InstaH Date �`�' � � � t:°�.,���
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�ddress � �� � � �f� �!t �
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City �� � State �`---Zip Code :'��-��...� EYfiail
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Phone Num6er(tiome) --�^ f �3 � �_ �_�� (ce(1)
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i�Ofl�#�A�SEER Basic LAelux� Premi�m Optimum Size 'll�arrar��ies
13 SEER 1 S SEER i6 SEER 18 SEER
i !� Air Conditianer ❑ p ❑ O p 4 I � �" �' ���'�� �
/��leat Pump � ��" O I� ❑ f���C C,St��`
� ❑ Candenser/CoilOnly ❑ � 3'� �
� � S�Iesp��SOt�
❑ Furnace System ❑ ❑ p Vertical
p Package Air Conditioner ❑ � � orizontal � 2'S �m�r w�rr���y
p Package Heat Pump p ❑ � � 2
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Lifetime 5 Y2ap ❑ i.5 ( -, �
Air Delivery SysYem � G�een Q Siiver � � �t� l..0��!-��-���..-_
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p 2,OQ0 p 1,60q ❑ 1,400 ❑ 1,200 ❑ 1,000 ❑ 800 ❑ 600 � Replace Boots ❑ Grilles ❑ Mastic Seal
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70 obtain rrtaxltnam rated etfiriency from any NVAC sysfettt,tfie�quipr»ent and the a!r distr36ut�on rystem must compty wfth the manufacturer's
specificattans and requlrernents.AIr Rescue Alr Conditlaning con ohly be responsible far components Installed byAir Rescue Alr Condittaning.
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System Price (.,���� Custamer 5Egnature
TOtdl Addltion5-from customlzed pricing workslreet � IG.�� Custamer(Print)
5U8Tt}TA� (� Date
TEC4/FPL Rebate ,� t � ARAC Rep{Rrint} _,��� ! � ��/ 1
Mfg Rek�ate/ARAC Disc unt - � � CC� CW
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Total Price -� � � � Check# `t
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Minus Down Payment —z:�2 � Financing Type�C.` � � Amt Financed
Bel Uu�Upon Start Up j Uwe own the real property in which the equipment is to be insiaiied and have
authority to arder the work as outlined above.Terms:Balance due upon Startup,
ar in accordante v�it}�finanting agreement.See reverse side fnr addtYionat terms.
8uyers Right to Cancel:501.031 Thi5 is a horne solrcitalipn sale,and ifyau do not wnnt the goods or Setvices,you may Cpnce!lhis agreement by providing wriften notice to th2
sellerin person,by tetegram,or by moiL This nntire must indicate thai you do n�ot want the goods ar services and must be delivered or postmarked before midnight ofth,e third
husiness day afreryocl sign this agreernent.lf yau cancel this agreerrtent the sel�ermay nat keep a11 ar patt ofony tash down paymenr.
�f he install technician has reviewed this Home Improvemel t Agreement for installation of HVAC systems by Air Rescue Air Canditioning.
i, Customer Name(print} agree thet the agr�ement reflects my undetstanding of the scope of the job and the equipment
ta be instalied. Custamer Signat�re I
See a�tach�d foI ��ret �or� $3SC1 o�,g�ar�a��6�ty!
White-Uffice Canary-Installer Pink-Customer Gc�ldenrad-Accou��ti��g
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� �.- ,�i j�,�' — B ilding Department ' -
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pate Reoeived �'�� 2 �j r'
''i Phone.Contact fQr Pe�nittiq 13 Z � _ '`�'"���
Owner's Name ������ c�JV P 11 Owner Pho�e Numb r �t'S�3-'��8 - `l 2a�1
owner�sAddress ��� ��71''► 2-N►'t!S FL335`f UwnerPhane`Numb r C ' , �
Fee 8lmple Tltlehotder Name � Owner Phane�Namb r �.._.,_..._,�...,_..�
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Fee Simple TitishotderAddreaa
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JOB ADQRESS ��2-Y� S% Z.,G..P�+fz �f�ll S J�C � � �"`���- t»OT# 1� t`!, t�
suBOivisioN "Tc�wn� h�1 S PAR�EL IQ# t! -2�-2/-���p--C�2y p�-ca t 3 p
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WQRK PROi?03ED e NE CON57R 8 ADD/ALT Q' SION C] i0 DEMOLISH
IFVB ALL REP �tR
Pf20POSED USE {,� SFR Q COM� � O7HER
TYPE OF CON3TRUCTiON Q 6L0 K [� FRAA�E � STEEL Q
DESGRIPTlG1Nt}FWORK r.cA� �+ �C3� AIG 3'f"��3�J t�.S�E2 F�Eir`2ao�"Al. �,��s.l
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BUI�DlN(3 SIZE 3Q FOQTAC3E N�lGHT
[�BUI4DING $ VALUAI'IQN 4F TC?TA!CONSTRUCTIQN {
[,�ELECTRICAL $ ! AMP SER ICE [� PR00 E8S ENERGY Q W.R.E.C.
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[�PLUMBINO $ � �
[�MECHANICAI. $ /� VALUATIO OF MECHANICAI.INSTALLATIO '� ��/�
ip�-`��'!',L`?4
[�OAS [� ROO ING [� SPEC ALTY [�J OTHER
FINISHED FLOOR ELEVATIONS FLOO ZONE AREA C]YES NO
, BUILDER C MP'ANY
51CyNATURE R�GIST'ERED Y/ N : FE GURREA Y/N
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Address i Licens #
:LEGTRlClAN COMPANY
3lGNATURE R�GlSTEREQ Y/ N ; FE CURREA Y/N
Address � Llcens # �
'LUMBER C�tMPANY
�1C3NATURE ' REQlS7�RER Y/ N fE CURREA Y/N
Addrass Licens # � �
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tECHANlCAl. `� COMPANY 1"�" � �G�' `�'�La S� �C�.�� -t ey
IGNATURE �, l•�'/, �- I REOISTERED Y/ N �� CUft EA Y/N
Address t �Z. r�ss�.r�. (31�J T.e+�� F� 'a�3���"� Ucens # �C.A�. I�1��'��'',��
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aTNER CQMPANY
iGNATURE REQISTEREO Y/ N FE cuRtten Y/N
� �Addrass � � License# �
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ESlDENTIAL Atiach(2}Plot Plans„(2)sets o�Bullding Plans;(i}set af Energy Forms;R-Q-W Permlt for ew constructlan,
Minimum ten(10)working days fter submlt�al date. Requlred onsite>,ConstrucUon Plans,S om�water Plans w/8(Ik Fence Installed,
- Sanitary��acllldes&1 dump�ker Site Work Permlt for-siubdiv(slor�sllarge-prcJects� ---�°= -=--' � -�f`��- "-'�'—
OMMERCfA� At#ach(3)camplete sets of Buil ing Plans plus a Life Safe#y Page;{1)sa#of Energy Forms. •O-W Permlt foC naw construCtfon.
Mlnlmum ken{40}workfng dFrys fter submltta!date. Requlred onslte,.Constructlan Plans,S ormwater Plans w!S!!t Fence Instakled,
Sanitary Faoilitles 8�1 dumpster Site Work Permit for all new proJects.All commercial requi ments must meet�compliance
'GN PERMIT Attach(2}sets af Eng(neereci PI ns.
'•'*PROPERTY SUR1fEY requl d for ati NEW constructtart.
rectlons: � '�'
FiN aut appficat(an completely. !� �
Qwner&Contractor slgn back of appllcatlon,n tarized
If over E2S00,a Notice of Commencement I required. (A/C upgr�des over 57500)
Agent(for the contractor)or Power of Attomey for the owner)would be someone with notarized letter from owner authorizing sama
�ER THE COUNTER PERMITTING {Front o Appllcatlon Only)
:roofs i1 shingies Sewers Servlce Upgr des fVC Fences(P1ot/SurveylFoatage}
p�iveways-Not over Counter if on gubllc ro�ed ys..nseds RQW
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NOTICE OF D�ED RESTRICTiON�: he undersigned ynderstands that thls per it ma b�subject ta Ndeed"restrlatlans"' ,
which rnay be more resfrfotive than �Ca nfy regulattons. The undersigned assum s ces onsibiiity far compiianee with any
appllcabfe deed restrictlons. �
UNLiCENSED CONTRACTORS AN C4NTRACTOR RESPC?NS{BlLITlES. !f the owner has hlred a contractor or
cantractors to underEake work, they m y be required to be iicensed in accordance with state and iocai regulatlons, If the
contractor (s not !(censed as requlrc�d y (aw, both the owner and confractor may be it�d for a misdemeanor violatfon
under state {aw, if ths owner or fnten ed cantractoc are uncerlaln as ta what llcer�sin r�qulrements may apply for the
intended work, they are advised to can ac#ttr'e Pasco County Buiiding inspectlan Divisi n—Licensing Seotlon at 727-847-
8009. Furthermore, If the owner ha h(red a cantractor or contractors, he is advis d fo have fhe contractor(s} sign
portlons af the °cantractor Bloak" of' th s appUcatlon fot which they w1q be responsible, if you, as the owner sign.as the
contrac#or, that may be an indfcatian t at he is not properly Ilaensed and !s not entitls ta perrnitting prlvlleges !n Pasao
County. �
TRANSP�RTATION IMPACTlUTlLITI S lMPACT AND�RESOURCE RECOV�RY FE S: The undersigned undersfands
fhat Transpor#atfon impact Fees and ecaurse Recovery Fees may apply to the constr ction of new bu8d(ngs, change of
: use in ex(sting buiidings, nr ex'pansia of existing buiidings, as speclfled in Pasco Go nty Ordlnance number $9-47 and
90-47, as amended. The underslgne also understands, that such fees, as may be d e, wiH be idenfified at the time of
peemitting. It 1s further understood th t Tcanspartatlon Impact Feas and Resource Re avery Fees must be paid prior to
receiving a °cer#ificate of occupancy" r finai powet release, If the proJec# does not in olve a certfflcate of occupancy ar
fina( power release, fhe fees must be paid prior to permit fssuance, Furthermore, If asca County Water/Sewer lmpact
fees are due, they must be pald prlor t permit I"ssuance In accardance wi#h appiicable asco Caunfy ordinances.
CONSTRUCTI4N LiEN LAW{Cha�t r 713, Flarlda Statutes� as amende�d): !#valua lon af work Is$2,500.00 or more, (
certify that I, the appiicant, have be n provided wikh a copy af the "Flarfda Gon truction L.len Law=Homeowner's
Protectlon Gulde" prepared by the �lo Ida Deparfinent of Agrlcu{fure and �onsumer A airs. if the appiicant is someane
other than the"owner", ! cert{fy.khat I h ve ob#alned a copy of the above descrlbed doc mant and promise in good faith to
deiiver it fo the"owner" privr to camm ncement.
CONTRACTOR'S/4WNER'S AFFIID IT: ( certify that ail the information In this appli ation is accurate and that aN work
will be done In compllance wlth al! ap Iicable laws regulating consfruct(on; zoning an land development. Appliaation is
hereby made ta abtain a permit ta o wark and instaflatlon as Indicated. I certi that no wark o� installatfon has
commenoed prior ta issuance of a p rmit and that a1i work wiil be perfarmed ta me t standards of al! laws regulating
construction, County and Gity codes, xonJng regulations, and fand deveiopment reg lafions in the jurisdic#ion. f aisa
cerfify that I understand that the regul tians of ottier government agencie� may apply o the lnfended work, and that it Is
my responslbility to identify what actio s i must take to be in compiiance. Such agenc! s #izclude but are not lirnited to:
- Departmenf of Envlromm �tal Protection-Cy,press Bayheads, iiVefiand Ar as and Environmentaily Sensi#ive
Lands, WaterlWastewater Treatment.
- Southwest Fiorida Wat r Management Distr(ct-Wells, Cypress Bay e�ds, Wetland Areas, AlterCng
i Watercourses.
- Army Corps of Engineers- eawalls, Dacks, tVayigable Waterways,
- Department of Health & Rehabifftatfve 3erv(ceslEnvlronmen�al Health nit-Wells, Wastewater Treatmenf,
Septic Tanks.
I _ US Envlronmental Prot�cf on Agency-Asbestos abafement.
FederaE Aviatlon Authorlty Runways.
f understand fhat fhe follawing restricti ns apply to the use of flll:�
- Use of fill is not ailowed In Fload Zone uV"unless expressiy perm#tted.
- If the fl!! materlal Is tu e used in Flood,Zone "A", It (s understood t at a drainage pian addressing a
"compensating vofume° i!! be subm{tted ak t!►ne of permitting whlch Is p pared by a professional engineer
' licensed by the State of FI rida.
- !f th� fl!! materla( (s ta b used in Flood Zone "A" in connection with a ermftted buiiding usfng stem wall
consEructlon, 1 certify that !!wlll be used only fo f!f!fhe area withln the sfe wa(I,
- If fl11 material is to be u ed in any area, 1 .certlfy that use of such fl!I will not adversely affect ad�acent
propert(es. if use of flli fis found fa adversely affect adjacent properties, t e owne� may be c4ted for violat{ng
khe cond!#lons of #he bul! ing pe�mit Issued under the affached permit a plicafian, #ar iots (ess than one {1}
acre whlch are elevated b fllf, an sngineered drainage plan Is'requlred.
If i am the AGENT FOR THE�OWNE , ( promise in good falth to lnfarm the owner of t e permltting conditions set fo�th In
khis affldavit prlor to commeric(ng aa sfruct(on. I understand that a separate permlt ay be requlred for electrica! work,
plumbing, slgns, weils, pools,.alr co dltioning, gas, or other (nsfallatians nof specific 11y included in the app}icatian, A
permft issued shaH be construed to b a Hcense ta proceed with the work,and not as uthorify�to,ulolate, cancel, aiter, ar
set aside any provisions of tlie techni ai codes, nor shali issuance af a permit prevent th� 8u!ldlrtg Officla!from thereafter
requfr4ng a correc#lon af errors In plan , construck(an or violafions of any codes. Eve permit Issued sha{1 became lnvalid
uniess the work authorfixed by such ermlt is commenced within slx months of permi is;�uance, or if work aufhorized by
^ the permit is suspended�o"r apandane =far-a�period �f-s!x{6}.manths_after�he_tlme_the .ork Is._COmmenced. An extension
may be requested, In writing, fram fh Building Offlciai for a perlad not ta exceed nin ty {90) days and wll) tlemonst�ate
}ustlflable cause far the extension. If ork ceases for ni►tety(90)consecutive days, fh job is consfdered abandaned.
WARNING TO OWNER: YO.UR FA LUR� TtJ RECC}RQ A NQTICE OE COMMEN E4MENT MAY RESULT IN YOUR
PAYlNG 7WlCE FC�R f�lf'iPi'c0"d�i4�E g� Td�YOl�6t P�d�PIE�2TY� iF YOU(IVTEND T OBTAlN FlNANGING, GONSULT
wtTH.�I'fi?UR L�1DER oR AN AT o NE <B FORE REC- RDI G U O � F ° MMENC�M T.
FLORIDA JiJRAT(F,S.117.43) ,
OWN�R OR AtiENT GONTRACTOR '
�d�
Subscribed and swom ta(or affltrnedy befare a thls Subscrlbed and sworn to(or afflrmed before me tfils ,
�y bY
Who Islare pe�sonaNy known to me or hasihav produc�ed Who Is/are personally known ta me o has/have;praduced
as identlflc�U n. as Identl8catlon.
M1lotary Pab!!c Nofary Publlc
Commiss(on No. Commisslor�No.
Name of Notary typed,printed or stampad Name of Natary typed,printed'or sta p�d