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Home My WebLink About15-16142� CITY OF ZEPHYRHILLS ' 5335—8TH STREET , • ' (sis)�so-aozo 16142 I BUILDING PERMIT PERMIT INFORMATION LOCATION INFORMATION ' Permit Number: 16142 Address: 37344 DERBYSHIRE DR LOT 97 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: 10-26-21-0120-00000-0970 Improv. Cost: 4,295.00 OWNER INFORMATION Date Issued: 4/06/2015 Name: DORWARD ALBERT L Total Fees: 60.00 Address: 37344 DERBYSHIRE DR LOT 97 Amount Paid: 60.00 ZEPHYRHILLS, FL. 33542 Date Paid: 4/06/2015 Phone: (813)395-6703 Work Desc: A/C CHANGE OUT 2.5 TON CONTRACTOR S APPLICATION FEES BAHR' PROPANE GAS& C,INC C CHANGEO T 60.00 s Ins e 'ons Re uired DUCTS INSTALLED DUCTS IIV ULAT D i 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 in�pections called d) work not ready for II_ 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 properly 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 performed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFO C.O. ONTRACTOR S GNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER � � 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department Date Recei�ed' ' C �� _ � � L� Phone Contact for Permitting Owner's Name �R�I�/Q.� ��Jc.°�2 Owner Phone Number O�� J� �p��3 Owner's Address � `.�� P�jB S,y/�� Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS ��T �eIQ/$ S�l�,'� ��Q� �'-�/GLS �3j��, LOT# � SUBDIVISION l/V�� L-°�C� PARCEL ID# I� �� l D��G/ �� i�� (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED B NEW CONSTR�ADD/ALT 0 SIGN Q Q DEMOLISH INSTALL REPAIR PROPOSED USE Q SFR Q COMM 0 OTHER TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q DESCRIPTION OF WORK �emo ve � �e `�� • � T/� � �G� /��- GC/y) BUILDING SIZE SQ FOOTAGE� HEIGHT � Q BUILDING $ VALUATION OF TOTAL CONSTRUCTION QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. QPLUMBING $ �'I' � QMECHANICAL $ �/��5-� � VALUATION OF MECHANICAL INSTALLATION � f `' T OGAS Q ROOFING Q SPECIALTY 0 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO BUILDER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# ELECTRICIAN COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# PLUMBER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# MECHANICAL ,�� , � COMPANY A�1Q S 6/�D �2CSfy'S �%C�° � SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N I Address � � /��1� • � �/��j License# C��}� �.��-� OTHER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construcGon, Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&1 dumpster;Site Work Permit for subdivisionsAarge projects COAIiMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance SIGN PERMIT Attach(2)sets of Engineered Plans. "*"PROPERTY SURVEY required for all NEW construction. Directions: I Fili out application completely. ; , � Owner 8�Contractor sign back of application,notari�ed j If over$2500,a Notice of Commencement is required. (AIC upgrades over$7500) " Agent(for the contractor)or Power of 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 A/C �"":Fences(Plot/Survey/Footage) Driveways-Not over Counter if on public�oadways..needs ROW'�:F , �i , , , as; • NOTfCE 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 CONYRACYOR RESPONSIBILITIES: If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance virith 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 contractor(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 indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County. � TRANSPORTATION IMPACT/UTILITIES INiPACT 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 existing 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 permit issuance. Furthermore, if Pasco County Water/Sewer 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 Statute�, 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"owner", I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the"owner" prior to commencement. CONTRACTOIt'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 installation as indicated. I certify 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 government agencies may apply to the intended work, and that it is my responsibility to'ident�fy what actions I must take to be in compliance. Such agencies include but are not limited to: - Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, WaterNVastewater 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-Wells, Wastewater Treatment, Septic Tanks. - US Environmental Protection Agency-P►sbestos abatement. - Federal Aviation Authority-Runways. I understand that the following restrictions apply to the use of fill:� - Use of fill is not allowed in Flood Zone"V" unless expressly permitted. - If the fill 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 plan is required. If I am the�1GENT 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 installations not specifically 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 Building 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 permit 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 demonstrate � justifiable cause for the extension. If work ceases for ninety(90)consecutive days, the job is considered abandoned. � WARNING TO OMPNER: YOUR FAILIJRE YO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE_F_OR__I_flIIPROVEMENTS TO YOUR PROPERYY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT 1fVITH YOUR LENDER OR AN�►TTORNEYIBEFORE RECORDING lfal7�NCiTI��F-C P�iENCEiIAENT:� -- = - FLORIDA JURAT(F.S. 117.03) � f OWNER OR AGENT CONTRACTO ��'��'e- Subscribed and swom to(or affirmed)before me thls Subscribed and s n to(or affirmed)before me this by Who Islare personally known to me or has/have produced Who Is/are personally known to me or has/have produced as IdentlficaUon. as identification. Notary Public � Notary Public Commission No. Commissi n , ':�'� y&:= Commission#FF 137073 Name of Notary typed,printed or stamped Name of otary � � '„ji�F;..` Bonded Thru Troy Fain Insurenea 800-385-7079; f Per r�t�` � �-�- j�'_ � c� � �- - ___ ,� �� j � PROPAI�E GAS —��,— • • • • � �l M�aintenance Order � AND !-1.f C INC. Air Conditioning&Heating , c�//lcE� i t�� 8��`7�2^."��.3 ._.. _ �c��2�5@NICB $c �flStr'�.��t10t1S ��1C:lE�K ('��L��[s�;'";k:.i='.t1�:��r�i�f'-! tr'��`_s �`,��, 4441 Allen Rd. • Zephyrhills, FL 33541 rar=�-��;T'i�1l"-. -f�r�dF;�_.r�� _„��,� i� t�+;�_,;. -- �T��!:E;h! �+'�' �,�j ��I t�# �'��?f �t�fi��Tl:i'�i�:. l�'tZI.�P�f:[yG:1;� ��i, %, �i`�:1i4,�' 1`a i�ifl�+�� NOTES �__.�i�,,�/ ' C'l.!:;.`! rJI�If::Fi#k�'l._�_.l�:.i?1'7:Cl1�l E=�C:''�3'=%J. {�F1-i�}'�E:� ' ;:�#.�:, �.;`�3_._(:,��:.:, #-i F'F-fGh>I��_'',#k , u!Fs� r`��c'_"r' _,;';`i`':� I' � ' �C?C1�"[:,�;aFl,? .# �ia,� � ' ' `� - .�� ' , , ' DC31�t�lAh�, i-�lt_T��{'"i' � i�L��4Ji�RT�, i�Li{�:i�°; � - . ;?��+�f I)F'R�`��iHTRE:: UF2 �;';'°_;��r+ DE�F�I�4'��f-I?F;E: L;f� • � " �;•�CiJ��Ir�t3(;�:1' �+'1f-�hl�l� G.�FI�••,1 1 I�S��L 4..L_iJ ��1... �l�l�..I4'I'1�� .�.iL.f.I"��I`Y !il—I��....L�� .. ��L.J4J��`'Ft_, , �.. ��-r r-��-�c.�� E�fir��-1-1Z(�NJ�t7-�a��pf�i , . FS{•�l..�l-i.'_4�.'��.{E-�L_ r� 1.iGI'�1'��11C��.7+:1K.�G1l�C'�L_ c} ' , . _. �l��-� (.:t��1��7�'-' ' ��'f7 q�'^ t t�`��G�i 4at&�{ Y . t-!4�5;� S� l,{, �' ,� mEa i.r�7-i.ra�ra�lr r..�-�F:��i�f tZ. ��:��'l�7 htl��l'E _ ' • ' DESCRIPTION�F WORK QTY MATERIALS&SERVICE� �,,,.-� UNIT PRICE AMOUN'f� " - J l� � qc �...�"j i�... ' ' �'� �" � � i i ; . , �^��' �S� I I �+ I I � • t ! I I a � CHECK LIS'T_ � I �, Tc�.,� T�N' S�Fa� 1.� �aE�c � � �ressures Lo HI Evap Coil Cleanetl Contl Coil �T Cleaned ��P {'j �� l,,,j�"�l� �'�► In � �1 (�� " i t ' �rnps Cond.Fan �� Biwr�� Comp�'� Heat Strip�� . � �� i :apacitors Gond.Farr-��-3 Blwr 'C�1 UComp�I3� �e �Ca e� �,��y� t� 'j�� i )rain Pan PrimarylCondition Cleaned SecondarylCondition!0 cieaned �f� �� f (,J ti'�� ,,) � i ��i v �-Stat Type ' T�f� �' Belt Type � � ' - RECOMMENDATIONS ° �.�r�1�- � �'� ��"} � Annual Maintenance Recommended byAlf Equipment Manufact�rers. {U H p� � i ° %GIC� i(� ° REFRIGERANT R- IBS. $per Ibs. ' � � ��-Fe__ ',�c 1�c1e �G � � �►�s��ll��<�,� . � � � L- , � f�(" �•�7C �� q tRn FILTERS x i I I �C�U `��j��,+�0e,,�,r � �/ �.�.�-�h �.) FILTERS z` gedMonlhly I . I' +��' CJ i �L� Sr�� vr�� ❑ REGU�AR ❑WARRANTY TOTAL SUIv1MARY )ehumidistat Settings: When here"ON",When Away 60%,-T-Stat SO° ❑ MAINTENANCE CONTRACT MAINTENAMCE � , IMITED WARRANTY- AA materiais,pads and equipment are warranted by the manutacturers' METHOD OF PAYMENT PRIGE i suppliers'written warranty only.All labor performed by khe above named company is warranted for TOTAL l days or as otherwise indicated in writing.7he above named company makes no other warranties, ❑CASH 0 CK# � • <ptess or impMied,and its agents or technicians are not authorized to make any such wartanties an MATERIALS � � >,halfofabovenamedcompany. ❑DEBIT ❑CREDIT ❑OTMER MAINTENANCE i �ave aulhorily to ortlar the work ouUmed above wh�ch has bean satlslactor0y compte�ed.I agree that Seller PROG. W ! C tains htle to oquipmenVmaierials fumished uniit finai payment is made.H paymen!is not made as agreetl, ��,IM# � il�er can remo�e saitl equipmenVmateriais at Setiers expense.Any damage�esulting fmm said iemovai shaii �, e+...�l�� I rt be the responsibdity dt Seller.NET 30 DAYS.A i 1!2%SERVICE CHAR wi��se nooeo MaNrH�r ro DATE COMPLETED PS .L UNPAI 8 ANCES pVE 30 DA .NO REF NDS ! -�- ---�� 4� CH � �r T� �-* , % I �sT s� Re DATE ,J�ZCUI2� �t2u TC}TAL \� � �