HomeMy WebLinkAbout15-16474 CITY OF ZEPHYRHILLS
533�-8TH STREEf /
(8is)�so-oo20 16474
BUILDING PERMIT
I
PERMIT INFORMATION LOCATION INFORMATION �
Permit Number: 16474 Address: 38635 5TH AVE I
Permit Type: MECHANICAL ZEPHYRHILLS, FL. ',
Class of Work: A/C CHANGEOUT Township: Range: Book: !,
Proposed Use: CHURCH Lot(s): Block: Section: '
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-15000-0090
Improv. Cost: 20,590.00 OWNER INFORMATION
Date Issued: 7/29/2015 Name: UNITED METHODIST CHURCH
Total Fees: 180.00 Address: 38635 5TH AVE
Amount Paid: 180.00 ZEPHYRHILLS, FL. 33542
Date Paid: 7/29/2015 Phone: (813)788-4405
Work Desc: A/C CHANGE OUT 20 TON W/ ELECTRIC
CONTRACTOR S I APPLICATION FEES
NSEY CENTRAL HEATIN & C C CHANGEOUT 140.00 ELECTRICAL FEE 40.00
FIRST CLASS ELECTRIC INC
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Ins ections Re uired
DU T INSTALLED
DUCTS INS LA D
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� 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.
"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 AccompanylApplication.All work shall be pertormed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFO C.O.
�
, �.
� ONT OR SIGNATURE PERMIT OFFI R
(.__' PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
,:
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT C�ARD FROM WEATHER
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813-780-0020 City of Zephyrhitis Permit Application Fax 813-780-0021
Building Department
Date Recelved Phone-Contact f r Permtttln —
� ` / I
Owner's Name �l�[ 5 ��` r/ �� � S Owner Phone Number
Owner's Address ��o � � ���Q_ Owner Phone Number
.
Fee Simple Titleholder Name Owner Phone Number
I
Fee Simple Titleholder Address
JOB ADDRESS LOT# �
SUBDIVISION PARCEL ID#
(OBTAINED FROM PROPERTYTAX NOTICE)
WORK PROPOSED NEW CONSTR ADD/A Q SIGN Q Q DEMOLISH
INSTALL e REPAI
PROPOSED USE Q SFR � COMM Q OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME� Q STEEL Q
DESCRIPTION OF WORK o2-0 �Clh� /� C � � .
BUILDING SIZE SQ FOOTAGE��. HEIGHT
i
QBUILDING $ VALUATIO OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $
QMECHANICAL $ �-- � VALUATIO OF MECHANICAL INSTALLATION
oz-d 5crd.
FINISO FLOOR ELEVATIONS� ROOFING 0 FLOOD Z NE� OTHER YES NO
0
BUILDER COMPANY
SIGNA7URE REGISTERED Y/ N FEE CURRE� Y/N
�►ddress I License#
ELECTRICIAN I �
COMPANY ��j �(C�cj �"�
SIGNATURE � ReGlsrEttED Y/ N FEE CURRE� Y/N
Address I Llcense#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREA Y!N "
Address I License#
.
MECHANICAL /�� COMPANY /�S.s�. C�c��
SIGNATURE �� REGISTERED Y/ N FEE CURRE� /-N�
Address I License# r �.
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N.
Address I License#
RESIDENTIAL• Attach(2)Flot Plans;(2)sets of Building Plans;(1)set�of'Energy Forms;R-O-W Permit for new construcUon,
Minimum,ten(10)working days after.subrtiittal date. R�equired onsite,Construction Plans,�Stortnwater Plans w/Sllt Fence instailed,
Sanitary FacillUes.&1 du_mpster,,Slte Wor1c Permit for subdivisions/large proJects
COMMERCIAL Attach(3)complete sets of Buiiding Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Pertnit for new consUuction.
Minimum ten(10)working days after submittal date. Requtred onsite,ConsUuction Pians,Stortnwater Plans w/Silt Fence installed,
Sanitary Facili8es 8 1 dumpster.Site Work Pertnit for all new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered•Plans. _
""PROPERTY SURVEY required for all NEW constnfcUon.
Dlrections:
Fill out applicaUon completely.
Owner 8 Contractor sign back of applicaUon,notarized
If over 52500,a Notice of Commencement is requlred. (A!C upg�ades over ST500) ..
" Agent(for the contractor)or Power of.Attomey(for••the.owner)would'be sofneone with notarized letter from~owner authorizing same y
DVER THE COUNTER PERMITTING �� (Front�of.Application.Only); ' ;�•°,; �''� ' � - � ° ��� , �
Reroofs if shingles Sewers Service.Upgrades.A%C��-,�; Fenoes'(FIo.U$qrvey/Footage) '� � ' � ' • -, :,
, , , .. ' `i,:;,``...'�- 1 ,� ' - - , , ,. � .
Driveways-Not over Counter if on publ�c_roadways:.needs ROW�•-•�•���•*����_-� � ��� � ' � '��� � ' ` ' �
NOTiCE C1�DEED RESTRICTIONS: The undetstgned under�tands=:_th�t thi�.��rmif.may_be,sub�eaf to�deed�P83�F{G�IOfIS" ,
which may be:more�restricttve�than'County regulations. 'The undersigned�assumes responsibilt'ty fa��compliance with any
applicable deed restrictlons. . �
UNI.tCENSED CONTRACTCtRS AND _CC�NTRACTOR RESPONSIBtLITtES:� If the owner has hired�a cantrac#or or
contractors to undertake work, they may be re,qui�ed:ta:be:llaensed In accordance.wlkh-state.and�local regulatians. .if the �
contractor is not 1lcensed.as requlred=by law, both the owner and contractor-may be-ctted for a m€sdemeanar violation
under state law. If the owner or Intended>contr�ctor are uneertaln as ta what Iicensing.requlrements may�apply.�-far�the
intended work,they are advised to contact the.P'asco County 8uilding'lnspectlori Dlvislon—l.tcensing Sectio»at 727-847-
8009. Fur#hermore, 1f the owner lias hited a cantractor ar contractors, he is advl�ed to have the contrac#ar(s), sign y
porkions of the "contractar Black° of this application far which they will be .respo�slble. if.yau,_as.the awner sign as tlie
conlracfor, that may be an lndica#ion that fie Is not properly Ilcensed and ts nat enfitled ta parmitting privlteges In Pasco
County.
TRANSPORTATlC1N-IMFACTIUTIt:lTlES IMPAC�'ANb RESC?U�tCE RECOVEEtY FEES; The undersigned understands
that Transportatian ImpacE Fees and.Reco.urse Recove.ry.Fees may'-appiy�•to the consUuction of new_buiidings,:change af �
use in existing bulldings, or:expanslbn�of-�ezisting`buildings� as speclfled (n Pasco Caunty Ordlnance number 89-07 and
90-07, as amended. The undetslgned alsa understands, fhat:such fees.�s.�may�e due„w111.6e ideritlt�ed at the time of-
per►r�iktfng. It is furtHer understood that Transpartation Impacf Fees and°Resource Recovery�'Fees must be pafd prior to
receivfng a °cerfi�cate of occupancy" ar flnal-power._release, :I��tt�e pro�ect.does not invofve a cer#fficate af occupancy or
final power release, the.fees must be paid prtor to permit issuance. Futthermore;�lf Pasca� County 1NaterlSewer�Impact
fees a�e due,they must be,pald pNar to permiE-Issuance�ln accordance wtth appliaable Pasco'Counky oEdinances.
CONSTRUCTION LfEN t.AW{Chapter 713� Flor�da Statutea�aa amended): tf valuafian of work is$2,500.00 or mare, i
certifiy that I, the applicant, have.been provided with �a aopy- af the °Florida Constructian Llen.Law=Hameowner's
Protectto� Guide" prepared by the Flor�da Depa�tment af Agricult�re and Cansumec Affalrs. If the appltc�nt ts someone
other than the�owner", I certify that I have.abtained a copy of.the above.described document°and.promise in,good faith to
deliver it tp the°owner"prior M=commencement: .
CONTRACTOR'S/OWNER'S AFFtDAViT; i ce�tify that all the information in�thls application is accurate and that afl work
will�be done in compliance with all appitcable laws regulating construction, zoning and_land�deve�lopment. Appltcatian is
hereby made to obtaln .a permi# #o do work and installatlon as indtcated� :1 certifjr tha# no work�ar instatlation has
commenced prior to Issuance of a permit and that.all work wili be perfa�med to meet standards of all laws �egulating-
constr�ctlon, County and City codes, zoning regulattor�s, and land devefopment regulatlons-in the�furisdictlon. ! also
certify that t undersfand that the regutations of o#her government agencies may�apply�to the intended wark, and that it is
my responsibility ka identify�what.actions I must t�ke to be,in,cotrlpliance. Such agencies include but are.not Umited to:
- Depattment o# Etiviranmeritai.Prb#action-Cypress.Bayheads, 1Ne#lenti Areas and Environmenta8y Sensitive
Lands,Water/Wastewa#er Treatment. • ..
- Sauthwest Florida Watef Management .Dis#rlct-We#Is, Cypress. Bay.heads; We#iand Areas, Alter�ng
Watercourses.
- Army Corps of Er�gtneers-Seawalis, Docks, Navigable Waterways.
- Depar#ment of Health 8 Rehabi�itative SenriaeslEnv#ranmen�at Flealth Unit Weits� Wastewater Treatment,
Septic Tanks. .
- US Envlronmental Protectlon Age�cy-Asbestos abatement�
- Fede�al Aviation.Authority-Runways.
!unde�stand that the following.resfrlctlons apply to the use of f1A:•
- Use af fi11 is not atlowed in Flaad Zone"V"unless expressiy permitted.
- If the� fill material is to be used. In.�Flood Zone. "A°, It. (s understaod-that a drainage pl�n addressing a
"compensat#ng volume°will be submttted a##me af permttting whtch is p=epared by a professianai engineer
Iicensed by�he St�te of Florida. -' - -^- - _- �•_ 1r`- •JC.'
- !f the fl1! mater4al fs Eo be used !n Flood Zone °A° ins cannec�ion�with.a permltted�btalidtng using stem waii
� construction, I certify that fiil:v�ill.be used only#o.fitl the area within the�stem wati: ' '
- If fill materlal is ta be usad in any area� I �cerkify that use. of such flll wlll not�adversely affect adjacent
prope�ties. If use af fll) is f�und ta adversely:�ffect adJaeent��properties,.the owner may be cited for vioCating
the conditions of the bt�ilding,permit issued��under the attached permit applicatlon, for:Iots less than.one (1)
acre whfch arE elevated�by fllf�an engineet�ed dralnage plan!s requit�ed. .
If I am the AGENT FOR THE OWNER, I,:promise In good faith to Inform the owner of#he permitting conditions set.forth in
this a�davtt��prtor to commeracing constructlon. f understand that a-separate pe�mlt may be requtred far elect�ical wark,
plumbing, signs, welts,.poots; alr conditlaning,.gas, or other Ins#a1lallons nat.spec�icatly inaluded�in.fMe application. �A
permit Issued shall be aonstcued to be°a�Ilcense to�proceed wlth tfie work and nat as~authority to.vPolate, cancel� alker, or
set aslde any provlsbns af#he technical-codes;�nor shali issuance°of a_permE#.pr.event the Building Oiflcial from thereafter
�equiring a conecNon af errors In.plans, canstruc#lon or violallons of any cades� Every permit Issued shal) become invalid
unlsss the work authorixec!.by such permit.•is_aommenced�wtthin sGc months of permlk tssuance, or if wark authorized by
the permit is suspended ar abandoned foc e periad af six{8)months:after the#ime#he�wotk ts commenced. An extension
may be requested, in wrlting, from the Building,Official for a per(od not to exceed ninety (90)�days a�d will demonstrate
just�iabie cause for.the extension: If work ceases.for ninet}►{90}consecut�ve.days..the�ob�ls considered abandoned.
WARNING TQ QWNER; YC1Uf�.�AlLURE-TO.=REGOttD A NOTIGE.OF�COMMENCEMENT-MAY RESUl:T IN YC1UR
PAYING TWICE 1=0R iMPROVEMENTS-TO Y�UR�PRt�PERTY. IF�YO.U�IN'FEND�:TQ`OBTA1 �FII�tANCiNG;�CONSULT
1NIT _YOl1R MDE :.l'� AN-A7TalZN =l� FQRE� ECO ��I Cv' -01� ' 9.��� ' = E CE �f�-- _ — - ------ -
FIORIDA JUFtAT(F.S.1.17.03� _ .
'1
OWNER OR ACiENT � "'� � -'��_ CONTRACTO '`J .l�"'�"'"-•
Subsaibed and swo rmed)b re me this S�ibscribed and' �or afltrm }Eiefore m�thl� �
,. y .
Who is/are rs ally n to.me or has/have produced Who Is/are onall own M me or has/have produced
as IdenElflcation. � as iden�flcatlan.
, ' e � � `
����,� Ncte P biic � Nota Pubiic �
ry
,���,,,,
Comm n N . .�°ti�".:���•,, JAG �! LItJE BOGES Gom r� ,'Y�"''•- JAC UELINE i
-�` �*� Expires pecember 12,2018 =*� :�= Commission#FF i50422 ' �
;;; �a;; =�a� �q•: Ex ires becember 1 '
Name of Notary ss Nasne pf o. 'd.��Dnt�traty»pe�eoa�es-ra,s
- - - , -
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--.�____.-_.------ .------ - 2015110507
� NOTICE OF•GOMMENCEMENT . _ -
I Rcpt:1697037 . Ree: 10.00
Permit No. ' " DS: 0.00 I T: 0.00
07/13/2015 K. M. , Dpty Clerk
Properiy Identification No._ /� '�-� "�j - 6 G/ � j�-��Q �'�� �O�
. . i
TF�UNDERSIGNED hereby give informs you that tlie improvement wi'll be made to certain real property,and m accordance with m� '
Section 713.13 of the Florida Statutes,the following informafion is provided in this NOTIeE OF COMIVV�NCEMENT. ; o�� �
. • ' _ � �F+a
1.Description of properiy(legal description:) � w N
! �No
" a)�Street Address:. ,�. i7 S S-3" ; . �1. . 5' G ' �m
2.GeneraI description of improvements: J il�r`�,v �(��,=
' � . ,�m�
3.Owner Informatiori � �" �/ q'/ � �� } j�'G 3 Y S" v� P ���o
a)Name and address: ,�-3�^=.� (it,G�7-�,�� 1���?3�f�/l 6�tG�U'C/2 e���� Z-�2���/� !�a$
- b)Name and address of fee simple titleholder(if other than owner) t -� ; � o
c).Interest m properfy - � ' ; �F,�
•4.Contractor Information . /� � - • / ,,,./ � �
a)Name and address: %u L�u�i� ��i�3 lG ,��G� � . i�{ � �y� .� /. ��S 7 Cl ;�°,�,
b)Telephone No.: � �o�- `��I -Fax No.(Opt) 7� ' '�`,,o
S.Surety Information � . - • � � �
a)Name and address: - • ;N o
. b)Amount of Bond: ' � " ' �
r
c)Telephone No.: • � Fax No.(Opt.) �
6.Lender ` � - � 1 � -
- a.)Name and address:. � - -- - '
- � . Phone No. ' -�
� 7.Identity of person within the State of Florida.designated by owner upon whom notices or otherdoc�ents may be served:
� . _ a)Name and address: • � -
b)Telephone No.: I Fax�o.(Op�,) _
8.In addition to himsel�owner designates the following person i o receive a copy of the Lienor'sNotice as provided m Section " . •
713.13(1)(b),Florida Stafutes: , . •
a)Name and address: � � �
-b)Telephone No.: - " I -Fax No.(Opt) _ � ' ' �
9.Expiration date of Notice of Commencement(the e�iration c�ate is one'year from the.date.of recordmg.unless a diffefent-date is
specified): _ � - .
WAItNIl�TG TO OWNL�R: AIVY�PAYMENTS MADE BIL T�Q`�4iNL�R AlETE1lt THE ESI'IRATTON;-OF THE NOTICE=OF
COMIVV�NCEMENT ARE CONSIDERLD IIVIPROPER PAYII3ENTS UNDER�CHAPTER 713,PART I,SEG°iTON 7I3.13, �
FLORIDA STATUTLS,A1�TD CAi�T RESUI.T IN YOU�'.�PAXigIVG TWICE FOR IIVIPROVEMENTS�'O YOUR.PROPERTY. -
� A NOTICE OF CODIlVIL�NCEIViENT MUST BE ftECORDED AND�POSTED ON THL+'JOB S1TE BEFORE TAE FIILST
INSPECTION. IE'YOU INTEND•TO OBTAIN lE'INANCING,CONSULT YOUR LENDER OR AN ATTORNL�Y BEFO�
CO'M1V�NCING WORK QR RECORDING YOUR NOTICE OF MMENCEMENT. � .+�`�"�� ����'��
�� �'':���`��. ��ie
' I " � ,�� .4:,.!:�'r.�'.`� �' ,
��� ������������ �O �I�'�
SI'ATE O�FLORIDA " �Q� $'�'���,�p'' ���•s�, ��
, COiJNTY OF P I � ���.�%��� ° 4;' ��;,,,,..,';� ���.
;�tiM'r"1;�, •ROBERT L CRl1M . i of Owner or Owncr's Autho O�ar/Dieeclor/P � ag�, A�`,'.u� $w"' �
_.. .:= MY COMMISSION#FF 1 � — •� : d°'
EXPI ES:J '�• �R,;�M°.• � •� `��
� P-' R anuary 1 ois �C/CCNL��• �,lJ/L G l�=l!✓JS,� J IZ �.:w �;`'�`'. _ ;o .'�,
'�;;q�;f,:°•�r BondedThNNotaryPubficUndenvriters PrmtNeme . m��y�. � �-� �,� : ��
�`�
� - � / ' '�44• ������,�;+i� ��� '� �..,]
The foregomg instruaient was acl�owledged before me this � day of -} � L ' 20�� ,by ''���$� ~�!"'••••'E•���`•p .�
V��I �oV ��% - ,'�..:, � � ���
.,N /G�j� .as - I - type ofauthority,e.g.officer, .�bl��+e��+�qr r'�-
m fact)for - - (nami of party on�ehalf af whom insti�ument exe e�. ''`.':�-, h �
• C%� �,�;,,,.;�.:r;,•�
Personally Known OR Produced Identificafion � Notary Signat�e
. • � . . -
� Type of Identification P�oduced �� e� l-' Name(print) ���� � � �/`��.'' / '"
:�
Verification pursuant to Section'92.525,Florida Staiutes.Under penailies of perjury,I declaie ttiat I have read the foregoing�nd that -
the facts stated in it are trne to the best of my l�owledge and b i lie� . , _
, Sigoature ofTIahual Person Siguing Above ''
FORMSMOC,rvs�007 . •
' #� I
� P Kinsey Cent�al
i Heat �Air-Conditioning, lnc.
� P.O. �ox 2209
�. Zephyrhills. Florida 33539-2209
, (813) 782-2300 CA co5ss26
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