HomeMy WebLinkAbout15-16301 �
f ClTY OF ZEPHYRHILLS
r 5335-8TH STREET
t+ (813}780-002a 163 �
:
� BUILDING PERMIT
PERMIT tNFORIVIATION LC►CATlON INF'ORMATION
Permit f�umber; 16301 Address: 37526 NEW HORIZONS BLVD LOT 70
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: NOT APPLICABLE - Lot(sj: Black: Sectian:
Square Feet: Subdivision: GRAND HQRiZQNS
. Est. Value� Parcei Number: 34-25-21-Q09Q-QQOOQ-O7Q0
Improv. Cost: 8,987.00 QWNER lNFORMATIaM
Date issued: Name: JACOB50N SCOTT A& RENEE C
Tataf �ees: 80.00 Address: 1778 AUTUMNWOOD DR
Amount Paid: 80.00 MECHANICSBURG PA 17Q55-5'i97
Date Paid: 6/01/2015 Phone: 97$-857-7192
Work Desc: A/C CHANGE OUT 3.5 TON
CONTRACTOR S APPLICATIC}N FEES
A RELL HO E E 1C S 1 G CNAN E U 8 .00
� � [ � -ts
���
° Inspections Re uired -
D CT I STALLED �
dUCTSINSULATED
FINAL �g --- (Q_—L---_��—
REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c)when e�ctra inspection
trips are necessary due ta any one of the following reasons: a}wrong address b)condemned work resutting
from faulty canstruction c) repairs or correctians nat made when inspections called d}work not ready far
inspection when ca8ed e) permit nat posted on ja6 site� pians nat at job site g)wark not accessfble.
NOTICE: In addition to the requirements af this permit,there rnay be additiona! restrictions applicable to this property that
may be found in the public records af 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
improvemen#s to your properly. If you intend to obtain financing,consult with yaur lender or an attarney
befare recording your notice of commencement."
Complete Plans,Specificatians Must Accompany Applicatian. All wark shall ba performed in accordance with
' Cades an inances. N4 QCCUPANCY BEFCf CA.
GONTRACT4R SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MClNTHS WITHCIUT APPROVED INSPECTION
CALL FOR INSPECTIt�N - 8 HOUR NOTICE REQUIRED
PR4TECT CARD ERGM WEATHER
� ` -
r'� 613-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
6uiidir�g Department
Dato Received� ✓��,l�l � '�} � phone Contact tor Permitting � ��� ��S�../
7-C-ITi-(-7�-t- T1Ti..f.."rrfT'rrrr-r'r r-r-�- I-t-i-I-( 'TTT" � �-rrrr
Owner'sName JCo'l� iic"t� .e� �cabSo� OwnerPhoneNumber ��"`b'ps�^�Ir1�..
.�jyZ a�� �{'vCt�C�t!'y�,�n.3Ci''��+�V�+�`�S�fit ��S`1� ���� �t��„
Owner's Addrese � 7�ti°�% +vner Phane Number ( �`�
Fee Simpte Titleholder Name (-- I Owner Phone Number � �
Fee 5imple 7itleholder Address
JOBADDRESS Sr� N��'"�� C{1 S}JGL Z�� �11.SJ+7� � S�. Lt3T# ��
suepiv�siors sand�OCizonS Qkc,�21 PARGEL Ibtt 3 W-a�-ai-a�ao --oGa - ��ac�
{OB7AINED FROM PROPEftTY 7AX N4TtCE}
WORK PROPOSED e NEW CONSTR 8 ADDlALT � SIGN Q � DEMQLISH
INSZALL REPAIR
PROPOSED USE � SFR Q COMM � OTHER
TYPE OF CONSTRUC710N Q BLOCK Q FR.4ME � STEEL Q
DESCRIPTION OF WORK �1� �-��� a`�� � � t5 �
BUILDING SlZE �_� SQ FOOTAGE�� HEt�HT C`�
�BUILPING �� yq�UATION OF TOTAL CONSTRUCTION
�ELECTRICAL �� AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C.
�FLUMBING $ i{n��+�
�V
�MECHANICA� $ �?a sb�,� VAI.UATIQN OF MECHANICAL INSTALLATION �/,'jr
Z> , ��'ti/`
OGAS Q ROOFING Q SPECIALTY �J O7HER �
FINlSHED ELOOR ELEVAT(ONS �� FlOOL7 ZONE AREA �YES NO
BUILpER � � COMPANY � �
SIGNA7URE REGISTERED Y/ N FEE CURREA Y/N
Address License# �_ �
ELECTRiCtAN COMPANY �-_�
' SIGNATURE REGISTERED Y I N FEE GURRER Y 1 N
Address License# � �
PLUMBER � � COMPANY �
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address license# � �
MECHAHICA� � � COMPANY �',���'l' 41oMq �Q�1J1�-S�
�
SIGNATURE REGISTERED Y 1 N FEE CURRER Y 1 N
Address ��o'�d�•�sL�Q �2 T�`t5+ W 33b� License# ��.. ,�1� ��� �
OTHER COMPANY �
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address G'tcense# [---_!� �
IIIIIIIIIIIIIIIIIIIIIIIIItllllllllllltllllllllllllllllllllltlllllll
RESt0ENT1AL Attach(2}Piot Plans;(2)sets of Building Plans;(1}set of Energy Forms;R-Q-W Permit tor new construction,
Minimum ten(10}working days after submitta!date. Reguired onsife,Construction Plans,Stormwater Pians wt Siit Fence ins#alled,
Sanitary Facilities&1 dumpster;9ite Work Permit for subdivisionsllarge projects
COMMERCIAL Attach(3)compiete sels of Building Plans plus a Life Safety Page;(1)set of Energy Farms.R-O-W Permit Tor new construction.
Minimum ten(10}working days after sobmiital dete. Required onsife,Ganstructio�Plans,Skotmwater Pians w!Siii fence instailed,
Sanitary Facifiiies 8 1 dumpstec Site Work Permit for all new projects.AII eommercial requirements must rneet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
•••"PftOPERTY SURVEY required for ail NEW constructfon.
DireCtfons:•
Fill out application oompletely
Owner&Gontractor sign track of applicetian,notarized
Sf over$2506,a Notice of Commencement is reguired. (AtC npgra8es over$7500)
" Agent(for the contractor)or Power of Attprney(fpr the owner)would be someone wilh notarized lelter from owner authorizing same
OVER THE COUNTER PERMiTTlNG {Front ot Application ONy)
Reroofs if shingles Sewers Service Upgrades AtC Fences(PlottSulveytFootage)
Driveways-Not over Counter if on public roadways..needs ROW
�
N0710E OF DEEt9`RESTRlCTIONS: The underslgned under.stands that#his.��r:rrtit.may be_subject to"deed"restrlc#lans"
which may be.more restcictive than County regulations. �The undersignad assumes responsibiiity for compliance virith any
applicable deed restrictions. _ , �
UNI.ICENSEQ. CONTRACTORS .ANQ- Ct?NTI2ACTt�R RESPONSIBIL.lTtES: Ef �he awner has hired a cant�ac#or or
contractors to undertake work, they may be required to,be itcensed in accordance with state.and�local regulatlans. If the
contractor ts nai Efcensed as required by law� both the owner and contractor may be clted far a misdemeanor vlolation
under state law. If the owner or Intended contr,aetor are wncertain as ta wfiat (icensing requirements may appty far the
intended work�they are advised to contact the Pasco County Bullding Inspectlon Divlslon--Licensing Section at 727-847-
8009. furthe�more, IE the•owner has hlred a cont�actor or contractors, he is advised to have the contractor{s) s{gn
portians of the "contractor Black° of this application for which they will,be responsible. If yau, as:the owner sign as the
contractor, that may be an lnd9catlon Ehat he Es nat properly i�censed ar�d is rtot entltied to permitting pr�vlieges 1n Pasca
County.
TRANSPORTATION IMPACTIUTILITIES IMPACT AND RESOURCE RECOYERY�EES: The undersigned undarstands
that Transportation Impact Fees and Reaourse Recove.ry Fees may�apply to,the construction of new buildings, change of
use in existing buildings, or�;expansion�of�`exis#ing`buildings, as speclfied in Pasco Caunty Ordinance number 89-07 and
90-07, as amended. The undersigned atso understands, thaE such fees,.as:may�be�due;=wllt.�e identtfied at the time of
permitting, it is further understood that Transportation Impact Fees and Resou�ce Recovery-Fees must be paid priar-to
receiving a"certlficate of occupancy" or final�pawer release. :!f the;project.does not involve a.certi�tcate of occupancy or
final power release, the fees must be paid prior ta permit issuance. Fucthermore;it"Pasca�County WaterlSewer impact
fees a�e due, they must be-pald priar to permit-issuance=ln accordance with,appAcable Pasco.County ordihances.
CONSTRUGTICtN LfEN LAYV(Chapter 713� Flvrlda Statutes,as amend�d): 1f valuatlon of work is$2,500.00 or more, i
certify that I, the applicant, have. been. provi.ded .with a copy-of�#he °Florida��Construction 4ien. Law:Hameowner's
Protection Guide" prepared by tlis Florida Department of Agric.uiture anc! ConsumerAffairs.. If the applicant Is sameone
other than the"awner", I certify that t have obtained a copy,of the above descrlbed dacument and promise in,gaod faith to
deliver it to the"awner°�prior ta-commencementc '
CONTRACTOR'S10WNER'S AFFIDAVIT: 1 certify that�all.the infarmatton In this applicattan is accurate and that ai4 work
will�be done in aompliance with all.applicable laws regulattng construction, zoning and land development. Applicatian is
hereby made to obtaln _a permit.ta do worlc and Instaflation as Mcftcated. '1 certlfy that no wo�k or Instatlation has
commenced priar to issuance of�a permit and that.ail work will be performed to meet standards of all laws regulating-
construction, Caunty and City codes, zoning regutations, and land devetopmenk regulatlons in #he�jurlsdlction. _i also
certiFy that 1 uc�derstand thaf the regulations of ot�er government agencies may apply�to the intended work, and that it is
my responsibility to identify.what.actions I must take ta be,in.compliance. Such agencles tnclude but are not limited to:
- Departmeni of Envlronmental Protection-Cypress Bayheads� Wef�and Areas and Ernfronmentally Sensitive
Lands,Weter/Wastewa#er Treatmen#.
- SouthwesE Florida Water Managemen# District-Vlteiis, Cypcess. Bayheads; WetEand Areas, Altering
Watercoutses.
- Army Corps of Engineers-Seawalls, Docks, Navigabie Waterways.
- Department af Health 8 Rehabi#itative SerrrEceslE�ty3ronmenfal Health 11nit Vlteits, VNastev�rater Treatment,
Septic%Tanlcs: _
- US�nvlronmenta!Protectior�Agency Asbestos abatement.
- Federa{.Avlation Authority=Runways.
I understand that the following,restricfions apply ta the use of f1U:
- Use of�ll is no#aElowed in Fload Zane"V"unEess expressly permitted.
- If the fill materfa)-is ta�.b.e, used in..Flood Zone "A", it. Is understood that a drainage plan add�essing a
°campensaEfng volume" w�il be submitted at #ime of perml#ing which ts ptepared by a professionaf engineer
licensed by the,State�of Fiorida:
- !f the fill.material is`to be used in filood Zone °A" in�connectfon�with.a �ermitted tiu�lding usEng stem walt
canstructia�, l certify that fill:wilt:be used oniy.#o ti11 the area within.the stem watl.
- If fill mate�ial is to be� used in any�area, I certify that .use. of such fill will not adversely affect adjacent
propertles. If use of f31# Is fot�nd to adversely.afFect ad�acent�properties,.#he owner may be cited for violating
the conditions of:the,building..permit Isswed�.under the attached permit-application, far--lots_less than one (1)
�cr�whlch are ele�ated`by�flil,an engineerecf dra#nage plan is requEred, .
tf i ann fhe AGENT FOR THE t3WNER,e i;promise°in gaod faith to inform the�owner of�the permltting=conditions set farth in
this affidavit prior to commencing"c6nstruction. I{unde�stand that a,separate permlt.may tie requlred for electricaf work,
plumbing, s'sgns, we11s, pools,.air,condttianing,..gas,:or other-instaNatians„nof spec�EcaRy included-in the application. �A
permlt issued shall be canstrued:to be°a''license to pr`oceed with the work;and.not_as�autharity.�to.�iolate; cancel', al#er, or
set aside any prov�stons of the#ectiiitcaf�codes; nor shati lsstrance�of a permit_prevent the Buildl�ig t�#fitcial from therea#ter
requiring a aocrection af errors In.plans,-constniction or violatlons of�any�codes., Every;perm(Y issued sFiall became invalid
� ��"�"unless the v+ror[i authorizeii:by�sucfi�parinit�Is.commenced�wit�in s�c monfhs af permlffssuance;ar�f work authorized-by"_—-
the permtt is suspendad.or abandaned,for a period af,six{8)°months after,.the time tha work is commenced. An extension
may be requested, in writing, from #he:'Building,Official for a peNod:not to.exceed���ninetjr�(90) days and°will°demonstrate
�ust�iabte cause for the extensior�, If worlt ceases:for nlnety{90)cons.ecutive days,.the fob�is cons�dered aba�doned. •
WARNING TQ'OWNfR;� YOUR,FAlLURE.T.O,,.�;RE£ORD A-,NQTiCE�:OE�C_OMMENCEMENT NEAY�RESULT tN�Y+QUR
PAYING TWICE;FOR-iMPROVEMENTS:TO:YOUR<;P..ROPERTY.:�IF�YOU�iNTEND�TO OBTAIN FINANCING��CONSULT
WIT Y UR L DE O AN A�'TO N B ORE��t CO fllNG` OU ` O � C `O O E GE T
FlORlDA JURA7{F.S.1:?7.03j • � `- -"- - . � ` _ ', , ,
OWNER OR A�i - CONTRACTO - � "
Subsc►lbed and swom to{or a Rned)before rr�e thls Subscribed swom to{or afttrmed)�beforo me�thfs� -
by �by�:: - ° ; " ,
Who islare personaliy knovm.to.me,on•has/f�aye•praduced, Who Islar.a ,ers.onally known�to•me:or-has/have prad'uced: �
' `.as`lilertB�ca�ori. � as tden8ficatfon.
„ s*�Y�y,''f� C..EL . AGON
.'�tiy' ��''�.�. d� ota Publlc _'�. f*= a � � 7073 NotaryPublla
=; p une
,�' �9.; �q EXplres�Jurte 29,2018 t�t slon. '���r��0.�`' Bo�MM7lwTtayFeinlnsfxa�a80P-385dOt9
Co� lsston .,� . ` Co
�
.......,.�...�..�....
ame ot Notary typed,printed ar stamped 3Vams of Notary typed,pdnted or stamped
a�s-�aa-oazo City of Zephyrhills Permit Application Fax-813-780-0021
Building pepartment
Date Raceived , - Phone Gontact for•Permtttin - — �
Owner's Name,�.i. _ _ Owner Phone Number
. . � . .�.-........a ar.,o.._w�b•b-:.f.—•: +a`e... �
',; . � r , , c .�....3_.. - .. . '��� � .,.�...�r :�r . i.v� ..JI aY:
Qwner's Addres`s" - � ��;' ,. „�� ,, • � :Owner Phon�.Number�'t�- �
� �;s „ .., .. ,_ _ �{
Fee Simpte Tltieholder:Name�. __� � 1 �3 }, '�� �+µ •' �`(�- L�' ` � I
x:
,., ... ,... . , _ _
, � -
�Owner Phorie�Numb'er'�',�..__..��4
_ _,. ....... � , _.9.�.�- -.:��,,
Fee Simpie Titieholder Addre�s
JOB ADDRESS L.OT# ��
StlBDtVtS10H � ' �� PARCEl1D#
-- '-- -- ' -' -,--_ -'-_ -- ----(OBTAINEDFROh9-PROPER7'V-TAX-NOTICE)
WQRK PROPCtSEQ NEW CONSSR iRDDlAIT' Q StGN Q � Q DEMQUSN
INBTALL 8 REPAIR � ' �
PROPOSED USE Q `SFR � Q COMM �� OTHER
TYPE OF CONSTRUC710W Q BLOCK Q , FRAME � STEEL Q.
DESCRIPT10N=0F WOtttC
BUtLDING SIZE �� � SQ FOOTAGE��].. NEIGHT ��
QBUlLptNG �>--� -VA�UATION OF TOTAL CONSTRt1GT'ION ,
[�ELECTRICAk. $ ° �� : �AMP SER�IICE Q PRO{3RES8 ENERC3Y �Q W.E2.E.C.
� � �� '
QPLUMBWG $
��______�, .
QMECNANfCAI. ($ ------� VALUATION OF MECHANICA�iNSTAi»tATiON
�
QGAS Q RpQFING Q SPECIALTY � OTHER
FINISHED FLOOR ELEVAT�ONS � FLOOD ZONE AREA QYES NO
BUILDER COiVIPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
����5� License# �— �
E�ECTRtGlAN- . - . GOMPANY .
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/'N '
Address lfcense#•�— „ �
P�UNiBER .. COMPAHY �
SIGI+IATURE �REGISTERED Y[ N �E curtRE�� Y/.N
Address �_ License# � �
MECHANIGAL � � COMPANY
SIGNATURE ' ± ' " , RE�iSTEREO ..Y! N FEE CURRE�, . Y/N�
Address � . � License.#..�— ��
QTNER � . CQMPANY ' �
SIGNATURE ' � - � REGISTERED � Y/ N . FEE CURRE� Y/N,
Address -- � � � - - ' ` I:icense# � �
RESIDENTlAL:. . �-Attach{2�Plot Plans;.(2),sets�,of.Buitd'+iig!P..lans;(1}set of Energy Foims;R-0=1tV�Perenit for new cx�hstruation,
Min3mum#en.(,1fl}..wocking,day,s�after:submittat dafe:;;Requir�eii onsite,Cons#ruction t?lans;StoRnwater Pians w/5(it Fence installed,
� Sanita'ry Facilitles&�1 dumpster;Sike•Work�Permit farsubdivisfonsllarge projects�, �
COMMEFtCIAL Attach(3}�coinpiete sets of Buifdfrig Plans pitis a Life Safety Page;`(1)se#af Energy Forms.R-Q-W Perm9t for new cons�uc�on.
Mirrirnum ten(10}working days after submlttai date. Required onsite,ConsUvction Plans,Stormwater Plans w/Silt Fence i�stalled,
Sani#ary Facilitles 81 dumpster.Site Work Perm(t for all new..proJects:�All�commerolal requirements.must meet compliance
SIGN PERMIT Attach(2J sets'of Ertgfneered;Plans.._ ;.: � � _ -
""PROPERiY SURVEY required for`a(I NEW construction.
�Ireclions: - :
Fit!aut.applica8on completely.
Owner&Gontractor sign back of applfcation,notarized
!f over�25Q0,a Natice of Commencement Is requiree3. {AtG upgrades over ST5d0)
" Agent(for the contractor)•or Power nf Attomey(forthe�owner)would'be sort^ieone with notarized letter from owner authorizing same
�VER TNE COUNfiER PERM17'FlNG_ .,,_„{Front ot.Applfcafion..On1y} . �
�eroofs if shingles Sewers 5ervice Upgrades A1C Fences(Piot/Survey/Footage)
e - . ..
Drtveways-Not over Counter if an pubtic roadways:rieeds ROW � �
�
f�
M
y' �•�a��3 IV�-I��e ll�le
������ Tan3����,TL 33b��
P���e:�3�3-�1��.3-555�
� � T�a;s:£313-IIt36-2{�9�
���"�I���
COPBFORT,and SAV1FlGS far a L1FE1`IME
4/1�/ZO�.s
To Whom It May Cancei-n:
I,�ustin I-�arrell, owner of I�arrell Homes Se�-vices,holder of FL license#Ct�C1817177, do herel�y
authorize the followi,ng employees to pull permits and conduct other necessary business �s an
authorized agent for my company to super cede ail others:
Rita Ulbinas�U415-720-6b-b27-0
Gloria Esther�R16Q-285-70-563-0
TJ3amas Bawen �B500-824-89-190-Q
Rab Vela �-V400-721-68-412-0
If there are any questions or concerns, please contaet me at 8�.3-413-555Q.
Thanlc You
Just Harrell
� n y Lynne Welch
y��```' z ub'tic,Sta.te Of Florida
°' t�s
F� ,,*y� missionTvo EE 113U01
� rliy Gommissian Er,�ir�as:')�"•�'t]
�n y C!'
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�loriu�Sl2!vits,ll�a fo�p:��iq�;nionra(Ion is�ttavit(ed in Ihis NOTiC�DF COFhR46NGEtfiE�ii. '
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:.Orrn�r�pfom�atipn or Lesse�intprnictian iI (�,��rssee eonErcted€or lhe improvement: �T
. , a;!•'ac���rr1 a�dress: ' �t .��I���AI� '----.._..
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