HomeMy WebLinkAbout15-16096� CITY OF ZEPHYRHILLS
,. . 5335-8TH STREET
- (sis)�so-oo20 160
� BUILDING PERMIT
� PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 16096 Address: 38533 LANSING AVE LOT 127
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: SLEEPY HOLLOW MHSUB DIV
Est. Value: Parcel Number: 02-26-21-0260-00000-1270
Improv. Cost: 6,171.00 OWNER INFORMATION
Date Issued: 3/18/2015 Name: SLEEPY HOLLOW MOBILE HOME (ZHEL)
Total Fees: 70.00 Address: 38615 LANSING AVE LOT 127
I Amount Paid: 70.00 ZEPHYRHILLS FL 33542-6312
Date Paid: 3/18/2015 Phone: (904)514-5302
Work Desc: A/C CHANGE OUT 3 TON 13 SEER �
CONTRACTOR S APPLICATION FEES
AND SERVICES C CHANGEOUT 70.00 �
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Ins ections Re uired
DUCTS INSTALLED ,
DUCTSINSULATED
FINAL��Z C� -- �C'N
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 Plaris, Specifications Must Accompany Application.All work shall be pertormed in accordance with
' City Codes and Ordinances. NO OCCUPANCY BEFO C.O.
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CONTRA OR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
Ie��-�eaaozo City of Zephyrhilis Permit Application Fax-813780-OD21
Building Department
_� : °
' • ° Date Recelved �� � � Q., �1 (,' �1(�
� I Phone CoMact for PertnitUng O J �� _ / l�Z
Owners Name ��Yh� �'��( Owner Phone Number ���/��^53��
Owners Address � �3 1 °7-� '� Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOBADDRESS 3�533 `��"S�'� , v� LOT� / 7
SUBDNISION ����'-�y H��ICl) pARCELID# 0����'al��(�oO`Q��D' /a7O
(OBTAINED FRON PROPERTY TAX NOTIC�
WORK PROPOSED B NEW[oNSTR e ADD/ALT � SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM Q OTHER
TYPE OF CONSTRUCTION � BLOCK Q FRAME Q STEEL Q
, DESCWPTION OF WORK �T 1 C l�'��1.J � � �T��l 13 See�
BUILDING SIZE SQ FOOTAGE� HEIGHT ��
I QBUILDING $ VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.RE.C.
QPLUMBING $
QMECHANICAL $ � .� ' VALUATION OF MECHANICAL INSTALLATION
QGAS Q ROOFING Q SPECIALTY Q OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER COMPANY
SIGNATURE r�ciSTERm Y/ N �CUaaen Y/N
Address License#
' I
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE cuRrtEn Y/N
Address License#
PLUMBER COMPANY
SIGNATURE r�cis�tm Y/ N �cuwtEn Y/N
Addreae License#
MECHANICAL � COMPANY �`'�� SPeY�CpS li
SIGNATURE r�cisreaEO Y/N �cuw�r, Y/N
Address Sb�J � �J�C�� �� License/F
OTHER COMPANY
SIGNATURE REGISTERED Y/N �e cuRaen Y/N
Address License#
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RESIDENTIAL Atlach(2)Plot Plans;(2)sets oi Building Plans;(1)set of Energy Forms;R-O-W Pertnit for new construction,
Minimum ten(10)working days after submittal date. Required onsite,ConsVuctlon Plans,Stortnwater Plans w/Siit Fence Installed, �
Sanitary Facilitles 8 1 dumpster,Sfte Work Pertnit for subdivisionsllarge projects
COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;('I)set of Energy Forms.R-O-W Pertnit for new consWction.
Minimum ten(10)warking days after submittal date. Required onsite,ConstrucGon Plans,Stormwater Plans w/Silt Fence installed,
Sanitery Facilities 8 1 dumpster.Site Work Pertnit for ail new projects.All commercfal requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
""PROPERTY SURVEY required tor all NEW constructlon.
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Dircctlons:
FII out applicalion completely.
Owner 8 Contractor sign back of applicatian,notarized
It over 52500,a Notice of Commencement is requlred. (A/C upgrades over;7500)
" Agent(for the contraclor)or Power af Attomey(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 AIC Fences(PlotlSurvey/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 contractar(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 indicaUon that he is not properiy licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITtES 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 exis6ng 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 pertnit issuance. Furthermore, 'rf Pasco County WatedSewer 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"owne�',I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the"owneT 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 instaliation as indicated. I certiTy that no work or installation has
commenced prior to issuance of a permit and that all work will be pertormed 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 govemment agencies may apply to the intended work,and that ft is
my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
- Department of Environmentai Protection-Cypress Bayheads, WeUand 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-Weils, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
I understand that the following resVictions apply to the use of fili:
- Use of fill is not allowed in Flood Zone"V"unless expressly permitted.
- If the fili 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 pian 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 instaliations not specfically 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 Buiiding 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 pertnit 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 demonsVate
justifiabie 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 YOU TEND TO OBTAIN FINAN NG,CONSULT
WITH YOUR LENDER R AN ATTORNEY BEFORE RECORDING YOU ICE OF COMMENC NT.
FLORIDA JURAT(F.S.117.03) '
OWNER OR AGENT CONTRACTOR
Subscribed and swom to(or affirtned)before me thls S scri ed end swo a( ffirmed)bef e me thl
by :3 �'1 IS� by RRGfC �120$—
Who is/are personally known to me or has/have produced Who is/ re personall nown to me or has/have produced
es iden�cation. as identificadon.
Notary Public Notary Public
Commission No. Commission No. C���� �/ 3�
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Name of Notary typed,printed or stamped Name oi Notary typed,printed s
,�psn�u Notary Public State of Florida
' ���; Mary V 5tewaR
„ � My Commission EE 2'16630
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Installation Date: / � CAC 7816879,CFG1426685,EC73002594 �
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iTotal Investment $�_ (-) Rebates$ (-) Service Repair Refund$ f,
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� - AS Representative Date of proposal / / �
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; Customer agrees to pmNde free access to the work area arM a safe working envimnmenL The ebove prices,specifiptions,tertns,and contlitions are satishactory and hereby agreed M in IuIL �
I give authonzafion ta arder aforemenlloned woAc.Vou are aWhorized to Co ihe work as specified.Payment will be made as oWined.I urMerstand that you are not responsibla for events or delays
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