HomeMy WebLinkAbout15-16109 �~ CITY OF ZEPHYRHILLS
" 5335-8TH STREET
(si3)�so-oozo 16109
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 16109 Address: 6851 WIRE RD
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 02-26-21-0010-01200-0000
Improv. Cost: 4,995.00 OWNER INFORMATION
Date Issued: 3/23/2015 Name: ELKS LODGE
Total Fees: 60.00 Address: 6851 WIRE RD
Amount Paid: 60.00 ZEPHYRHILLS, FL. 33542
Date Paid: 3/23/2015 Phone: (813)782-4604
Work Desc: A/C CHANGE OUT 5 TON
CONTRACTOR S APPLICATION FEES
BAHR'S PROPANE AS& C,INC. C CHANGEOUT 60.00
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%
Ins ections Re uired
DUCTS INSTALLED
DUCTS IN�LAT�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 Accompany Application.All work shall be pertormed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFO C.O.
COf� OR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
a �
� ��s � ' PROPANE GAS Service Order�Proposal � � � �
� AND AIC �rvc. Air Conditioning&Heating
�it�e �988 813-782-5013 .-..
Sales, Service &-Installations WORN. QRDER#/SERVICEMAN J77�J c JUhI
DATE/T�IME TAI'.EN � ��/`0/1,., �`3:36
4441 Allen Rd. • Zephyrhills, FL 33541 TAN,E� PY SARAH �5
NOTES• . . DATE/T I ME F'ROM I SED
. - CUSTOMER#/LEJGATj01�1 AC4c39/4
F'HO(�IE# 78�-46�4
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ELN.S LODGE � ELIiS LODGE-BAR �#�
E851 WIRE RD. E851 WIRE RD
' #-x-SERV ICES� LRG LODGE ROOM** .
ZEPHYRHILLS FL ,3.j,�4� ZEF'HYRHI,�.LS FL..?,.:,�4�
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I�tOT COOL I NG. TSTAT SET AT 7c, N(7T� COOL I I�IG HELOW 78
• " '':DESCRIPTION'OF WORK , QTY. MATERIALS:B.SERVIGES:; - • UNIT PRICE AMOUNT
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� °RECOMMENDATIONS � JL� �✓LGt/oI' i i
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Annual Maintenance Recommended b,y AII,Equipment Manufacturers. � �
Pressures Lo HI T�tat i i
i i
RHFRIGERANT R-,• LBS. $per Ibs. , I I
FILTERS x x Changed Monthly I I
, FILTERS x x Changed Monthly I I
�❑ REGULAR ❑WARRANTY TOTAL.SUMMARY ,
�_Dehumidistat Settings`. When here"ON", When Away 60%, T-Stat 80° ❑ MAINTENANCE CONTRACT SERVICE i
LIMITED WARRANTY• •All materials,parts and equipment are warranted by the manufacturers' •ME�HOD•OF PAYMENT CALL ' i
or suppliers'written warranty only.All labor performed by lhe above named company is warranted for . TOTAL i
30 days or as othenvise indicated in writing.The above named company makes no other warranties, ❑CASH ❑CK# MATERIALS i
express or implied,and its agents or technicians are not authorized to make any such warranties on
behalf of above named company. ❑DEBIT ❑CREDIT ❑OTHER MAINTENANCE �
I have authoriry lo order lhe work outlined above which has been sa[isfactorily completetl.I agree lhat Seller
PROG. W I C �
retains litle lo equipmentlmaterials furnishetl until final payment is made.If payment is not made as agreed, CLAIM# �
seller can remove said eqwpmenUmaterials at Seller's expense.Any damage resulting from said removal shall
not he the responsibiliry ol Seller.NET 30 DAYS.A 1 tl2%SERVICE GHARGE WIIL BE ADDED MONTHLY 70 �
ALLUNPAIDBALANCESOVER30DAYS.NOREFUNDS DATE COMPLETED
TECH T� �
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CUSTOMERSIGNATURE DATE Cr/yG dLG TOTAL 7 ���
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Q,�-rp�-���U Gity of Zephyrhills Permit Applica#ion Fax 813-78U-0021
„ Buiiding departmant
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Date Recelvad � �3 ��� Phone Contact for Permittln
Owner's Name �� �B.d Owner Phone Number �f����
Owner's Address (� ��� W 'lL.� � t3wn�r Phone Number
Fee Simple T!tleholder Name � i Qwner Phone Nurnber �
Fee Slmple Titleholdar Address
JOB ADORESS ��M �- LOT# ��
SUBDNtSION r� � PARCE�.ID#
(OBTAINEP FROM PROPERTY?AX NOTICE}
WORK PROpOSED e NEw CONSTR 8 ADD/A�T � SiGN (� Q DEMOUSN
tNSTALt REPAIR
PROPOSED USE Q SFR Q CQMM [� OTHER
'fYPE OF CON5TRUC1'IOEI Q 81.QCK Q FRAME � STEE� Q
DESCRIPTION OF WORK �� �- J '�/ T -� J� �
BUILDING SIZE � � SQ FOOTAGE NEIGHT C___`__�
�BUILDING �� VAtUAT10N OF TOTAL CONSTRUCTtON
[�ELECTRICAL ($—�� AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
�
QPLUMBING �-�
�
�MECHANiCAL $ �/��-%O VALUATION OF MECHANICAL INS7ALLATION � ����
�
QGAS Q ROOFING [� SPECIALTY � OTHER
FINISHED FlOOF2 ELEVATtONS (��� FLOOd ZONE AREA QY6S NO
L
SUILDER COMPANY
SIGNATURE REfi�iSTERED Y t N FEE CURRE� Y/N
Address �^� `�` License# � ��
ELEGTRICIAN � COMPANY
SlGNATURE ( REGISTERED Y/ R) �EE CURRE� Y J N
Address Ucense# �^ `��
PI.UMBER � COMPANY
SIGNATURE REGiSTEf2ED Y/ (V FEE CURREt� Y/N
Address License# �' i�'�
MECHANiCAt �����R COMPANIf �!/r2�' �1L-° �^'L� Cr�d.s GI- C
SiGNATURE REGISTERED Y( N FEE GURREf� Y J
Address `�� License# �,��.f.,� 7 3��
OTHER COMPANY
SiGNATURE REGISTERED Y/ N FEE GURREr Y 1 N
Address Llcense# � ` i�
R6SlDENTIAL Attactt(2}Piat Pians;(2}sets of 8uilding Pians;(1j set af Energy Forms;R-O-W Permit for new canstruction,
Minimum ten(1d}worlcing days after submtttat date. Required onsite,Construction Plans.Stormwater Plans w/Sllt Fence tnstafled,
Sanitary Facilities&1 dumpster,Site Work Permit for subdivislonsflarge proJects
COMMERCiAL Attach(3}compiete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Perm(t for new construc8an.
Minimum ten(1d)working days after submittaf date. Required onsike,Construction Plans,Stormwater Pfans w/Siit Fe�ce instatled,
Sanitary Facilities&1 dumpster.Site Work PermR for all new pro}ects.AlLcommercia!req�lrements must meet comptEance �__ _
SIGN PERMIT Attach(2)sets of Engineered Pians.
""PROPERI'Y SURVEY required for ali NEW construcdon.
Direatians:
' Fitl ouf appticallon completely.
Owner&Contractor sign back of appifcation,notarized
If ovgr y2500,a Notice of Commencement ts requtred. {A!C upgradQS ovsr E75Q0}
" Agent{for the conUactor}or Power af Attomey{far the owner}woutd be someone with notarized letter from owner authorizing same
dVER THE COUNTER PERMITTING {Front af Application Only) ,. _ _ � , .,_, „ „t_ _,
Reroafs if shingles Sewers Senrice Upgrades �AlC`;',"Fences(PlotlSurv'sy/Faotage} , _� .
Drlveways-Not over Countar if on public roadways..neeiis RQW ' , � . , , , �
�OTICE OF DEED RESTRICTIONS: The undersigned under.�tands°�that this:p�tmit may be subject�to"deed" restrictions"
vhich may be:more.restrictive than County regulatlons. �The undersigned assumes responsibiltty for compliance with any
ipplicable deed restrictions. -. � -
1NLICENSED CONTRACTORS AND- CONTRACTOR RESPONSiBILITIES: if the owner has hired a contractor or
sontractors to undertake work, they may be required.to be:licensed In accordance with state.and�local regulations. If the
bntractor is not Iicensed as required-by law, both the owner and contractor may be clted for a misdemeanor violatfon
inder state law. If the owner or Intended contractor are uncertain as to what licensing.requirements may apply.�or the
ntended work, they are advised to contact the Pasco County Building Inspection Dlvislon—Licensing Section at 727-847-
1009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
�ortions of'the "contractor Block° of this application for which they will be responsible. If you, as.the owner sign as the
;ontractor, that may be an indication that he ts not.properly licensed and is not entftled to permitting privileges in Pasco
�ounty.
�RANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
hat Transpo�tatfon Impact Fees and.Recourse Recove.ry.Fees may apply to the construction of new buildings, change of
ise in existing buildings, or.expansion�of�existing`6uildings, as specifled in Pasco County Ordinance number 89-07 and
�0-07, as amended. The undersigned also understands, that such fees�.as may�be due, will be identified at the time of
�ermitting. It is further understood that Transportatlon Impact Fees and Resource Recouery Fees must be pafd prior to
•eceiving a "certificate of occupancy" or final power release. :If the project.does not involve a certiflcate of occupancy or
inal power release, the fees must be paid prior to permit Issuance. Fu�thermore; if Pasco County WatedSewer Impact
`ees are due, they must be.paid prior to permit issuance-in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713, Florlda Statut�s�as amended): If valuatfon of work is$2,500.00 or more, I
�ertify that I, the applicant, have.been provided with a copy of the "Florida Constructton L(en Law—Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and ConsumerAffairs. 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"owne�'prior to�commencement. '
CONTRACTOR'S/OWNER'S AFFIDAVIT: I ce�tify that all the Information in thls appllcatlon is accurate and that all work
�rili�be done in compliance with all applicable laws �egulating construction, zoning and.land development. Application is
hereby made to obtain .a permit to do work..and installatfon as Ind(cafed. I certify that no work or Installation has
�ommenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulaking-
oonstruction, 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 responsibllity to identify�what:actions I must take to be,in.carrlpliance. S.uch agencies include but are.not Iimited to:
- Department of Environmental Protection-Cypress�Bayheads, Wetland Areas and Environmentally Sensitive
Lands,WatedWasteanrater Treatment.
- Southwest Florida Water Management District Wells, Cypress. Bayheads; Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls, Docks, Navigable Watervvays.
- Department of Health 8 Rehabilitative Services/Envi�onmenfal Health Unit-Wells� Wastewater Treatment,
Septtc Tanks. -
- US Environmental Protectfon Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
I understand that the following restrictions appiy to the use of flll:�
- Use of fill is not allowed in Flood Zone"V"unless expressly permitted.
- If the fill material fs 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�
Iicensed by the State of Florida.
- If_the fiil materlal is�to be used in Flood Zone °A° in�connection�with.a�permitted building using stem wall
� const�uction.,.I certiry that flll will�be used only.to flll the area wlthin the stem wail.
- 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 flll is found to adversely:affect adJacent properties,.the owner may be clted for viofating
the conditions of the building.permit issued under the attached�permit application, for lots less than one (1)
acr�which are elevated�by flil,an englneered drainage.plan is required.. �
If I am the AGENT FOR THE OWNER, I,�promise in good faith to inform the owner of�the permitting conditfons set forth (n
this affidavit�prior to commer�cing construction. I understand that a-separate permft may be required for electrical work,
plumbing, signs, wells, pools, air condttioning, .gas, or other installatfons not specifically included-in-the application. A
permit lssued shall be construed to be a license to proceed with the work and not as authortty to,violate, cancel, alte�, or .
set aside any provisions of the technical codes; nor shall Issuance�of a,permit.prevent the Bulidirig Official from thereafter
requiring a correction af enors 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(8)months after the time the work is commenced. An extension
may be requested, tn writing, ftom the Buildtng,Officfal for a perfod.not to.exceed ninety (90) days and�will-demonstrate
justifiable cause for-the extension. If work ceases�for ninety(90)cons.ecutive days,..th�job is considered abandoned.
WARNING TO OWNER: YOUR.FAILURE�TO.RECORD A NOTI�E OF�COMMENCEMENT�MAY RESULT IN YOUR
PAYING TWICE,FOR IMPROVEMENTS-TO YOUR-:PROPER-TY. IF YO.U�INTEND`TO OBTAIN•FINANCING��CONSULT
WIT UR LENDE O ATT RNE B FORE�.RECO D G� OU O � C '°O ` E CEM T'
FLORIDA JURAT(F.S.1'17.0 �
. . OWNER AR IAOENT /-- - _ - -_^,@:N3'l4�+"CTC° --- -- -- � -- -- ---___ ----- — _
Subsctibed and swom t (or atflrr� ) efore me this Subscribed and'bwom to(or,.aftirrried)before me thfs
by ' y
Who Islare parsonally knovm to.me or haslhave produced Who Is/are personally knovm to me o has/have produced'
as Identlflcatlon. as IdendficaQon.
� Nota Public Notary Publlc
ry
Comml I No. Comml i No.
���„ ���,.,
.,oti�::e�"'•- JOEL E.BACON ,••:;�i�.:y��., JOEL E.BACON
Name (No �: � � :� ���
Name of N e
�a• ;�Expires June 9,2018 :�• Q; Expires June 2 ,2018
.,' ' oF 0.`� Bonded ThN Tro F�n Insurenee 800385d019
��p��°:` BondedTlwTroyFainlnswanee8W�385•7019. '��1,�����; Y