HomeMy WebLinkAbout15-16191 , _ a CITY OF ZEPHYRHILLS
5335-8TH STREET
- (813)780-0020 16191
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 16191 Address: 6546 NORTHLAKE DR
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: SILVER OAKS
Est. Value: Parcel Number: 03-26-21-0150-00000-0260
Improv. Cost: 5,500.00 OWNER INFORMATION
Date Issued: 4/21/2015 Name: CALL DAVID A& DELORES A
Total Fees: 65.00 Address: 6546 NORTHLAKE DR
Amount Paid: 65.00 ZEPHYRHILLS FL 33542-0615
Date Paid: 4/21/2015 Phone: 813-239-7564
Work Desc: A/C CHANGE OUT 4.0 TON
CONTRACTOR S APPLICATION FEES
A KETT C INC CHA GEOUT 65.00
Ins ections uired
DUCTS INSTALLED
DUCTSINSU
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.
CON TOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-T84-a020 City af Zephyrhiils Permit Applicatron Fax 813-T80-0021
4�'-�
8uildEng Department
Date Received Phone Contact for Permittin �d`'` c���- �� j j
Owner's Name �?' �C� L�! // Ownet Phoae Number
Owner's Address �� �D^��' �" � Owner Phone Number �— �
Fee Simple Titlehalder Name � � Owner Phane Number p� r„�%""�����
Fee Simple Titleholder Address
J08ADDRESS (O�� /�""�i''7f7 . � CYl� e �I�S 1.OT# ��i
SUBpIVISION ��`(/c°-rG ��� PAltCEl.ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PFtOPOSED , e NEW CONS7R 8 ADD/ALT �� SIGN Q Q DEMOl.1SH
INSTAL� REPAIR
PR4POSED USE Q SFR Q GOMM 0 OTHER
TYPE O�COMS'fRUCi'!t}N �.. BLQCK C] FRAME [� S7EE� Q
DE3GRIPTION OF WORK ,/'T G �G t �� G' y/'` i,.�° � tSYy� y 7� l'o��
BUILDING SI2E ���C..� � SQ FOOTAGE C�'���� HEIGNT ���
QBllILDiPfG �_-----� VALUATION OF TOTAL CONSTRUCTIQN
QELECTRIGAL �_-�--'� AMP SERV�CE Q PROGRESS ENERGY C] W.R.E.C.
QPLUMBlNG ($ —� ��t � �
L � �
�MECHANiCAt. $���Ot VAIUATION C}F MECHANICAL INSTALLATION -
[�GAS Q i200FlNG Q SPECIALTY [� OTNER
FINtSHED Fk.QOR El.EVATtONS ��� F�OQD ZONE AREA QYES NO
BUILDER COMPANY
StGNATRIRE t��iS7�f�� Y/ N FEE CURRE� Y/N
Address Llcense# �— �
E�ECTRICiAN GOM PANY
SIGMATURE REGiSTERED Y/ N FEE CURRE� Y/N
Addres� Ltcense# �� �
P�UMBER � COMPANY
SIGNATURE REGtSTERED Y! N FEE CURREt� Y/N
Address License# �^ ��
MECHANICAL COMPANIf
SIGNATURE � REGlSTERED Y I N FEE cuttt�� Y!N
Addres$ (�G��f /ptv� /`,� �G � ��"� License# ��G"�C���/,/`�G�' I
Q"fHER CBMPANY
SIGNATURE REGlSTERED Y i N FEE GURREt� Y i N
Address License# �y �
RESIQENTIAl. Attach(2)Plot Plans;(2}sets af Buiiding'Rlans;{1}sst of Enargy Forms;R-O-W Parmit far new canstruction,
Minimum ten{10)working days after submittal date. Required onsite,Gonstruoflon Plans,Stormwater Plans wl Silt Fence instalied,
Sanitary Facilities&1 dumpster;Site Work Permit for subdivisionsparge projects
COMMERC1Ai. Attach{3)complete sets of Building Pians plus a life Safety Page;(1}set of Energy Forms.R-O-W Permit for new construcHon.
_ Min[mum_ten{10)warking days after submlttal date. Required onslte,Construotlon Plans,Stottnwater P}ans wt S9tt Fence tnstailed,
Sanitary FaclliUes 8 1�dumpster.Site Wa�ic Permit for all new proJects.All cammercial requlrements must meet compllance
8lGN FERMlT Attach{2)sets af Engineered Plans. ,
'"'"PRQPERTY SURVEY required for al!NEW cansWcUon.
Directians:
Ftll out appt�cation completely.
Owner&Contractar sign back of appl(caUon,notarized
If ovar$2500,a Natice of Commencement is required. (AIC upgrades over 57500)
'* Agent(for the contractor}or Power of Attomey(for the owner)woutd be someone with notarized ietter from owner authoriztng same
DVER THE GOUNTER PERMiT11NG (Front of Appiication Onty)
Reroots if shtngies Sewers Service Upgrades AtC Fences{PtoUSurveylFoatage}
Driveways-Not over Counter if on public roadways..needs ROW
� --
. �
NOTICE 4F DEER I�ESTRICTlQNS:_The undersigned unders�#ands°th�t#his.permit.may.be,subject ta°deed"restrictians°
whioh may be:more�r.est�(ctive�than Counky regulaflons. �The undersigned assumes responsiblltty far compliance with any
applfcable deed testrlctbns. • � . �
UNt,ICENSED Ct�NTRACTORS AND CONTRACTOR RESPONSIBIL1TiES: If the ,owner has hired a contractor or
contractors to undertake work, they may be requ'Ired�to be<Itcensed In accordance.wtth state.anc!•local Fegutations. !f the
contrac#or ts not licensed as requlred-by law, bath the owner and cvntractvr may be aited�for a misdemeanor vtolation
under state law. If the awner or tntended�contractor�are uncertaln as ta whak Ilcensing.requlrements may apply��far the
in#ended work, they are advtsed to contact the Pasco County Buliding Inspect#an Dtvislon--6.icensing Secttan at 727-847-
8008. Fur#hermore, If the awner has fiired a aontractor or contractors, he Is advised ta have the aontractor(s) sign
porkfons of the "contractor Block" of thls apppcatian far which they will be responsfble. If you� as.#he owner stgn as the
can#ractor, that rr�ay be an lndication thatfie 1s not.properly Ilcensed and is not entitled to permit#Eng priviieges in Pasca
County. - - . =
TRANSPClRTATtON-IMRACTlUTIl.ITIES lMPAC�'ANb RESOURCE REGO�IERY-�'EES: The underslgned unders#ands
that Transportatian Impact Fees and.Recaurse Recove.ry.Fees may�apply�#o the constructlon of new buildings, change of
use in existi�g buildi�gs, or expanslon:.of��existin,g'�buildings, as speclfted 1n Pasco County Ctrcllnance namber 89-47 and
90-OT, as amended. The undersigned atso understands, th�It such fees� as�may_be�due,.wiil be identifled at the time of
permitting. It Is further understood that Tra�sportatlon Impact Fees and'Resowrce Reco�ery Fees must be paid prior to
receiving a "ce�#iflcafe of occupancy"or flnal pawer..release. :I#the pro�ect does not tnvolve a cert�Ecate of occupancy or
finai power release, the fees must be paid prior to permft Issuance. Futthermare; ff Pasco County WatedSewer.Impact
fees are due,they�must be pafd prior to permlt-lssuance-In accordance with appltaabie Pasco County ordlnances.
CONSTRUCTION LfEN LAW(Chapter T13� Elar�da Statut�s,as amended): .If.va�uatlon af work is$2,500.00 or more, I
certify that I, the. applicant, have been provided wlth a copy of the "Florida Construction Lien Law—Homeowner's
Protectlan Gulde" prepated by the Flo�fda Department of Agrlcultc�re and Consumer�Affairs, tf#he appllcant is someone
other than the"owner", I certffy that i have..obtained a copy.of the above.descNbed docurr�ent°and.p.r.omise in,g�od;faith to
de!'tver ft to the"owne�'p�ior to�commencemenE.
CONTRACTOR'S/OWNER'S AFfIDAViT: I cerfi[y tiiat a1i#h�information ln thls appilcatlon is accurate and that all work
will�be done in campliance with all applicable laws regula8ng construction, zontng and land developmen#. Appltcativn is
hereby made #o obtain .a permit to do wark and tnstailation as Ind[�aEed. 1 certity that no wark or tnstaltatton has
commenced pr(or to issuance of a permit and that.all work will be perfarmed to meet standards of ali laws regulating-
aonstructlon, Gaunty and City codes, zoning regulatic�ns, and land devetopmer�t regulations In the }u�istitction. 1 also
certify that 1 u�de,rstand that the regulations of ather government agencias may�apply�to the intended work, and that it Is
my responsfbility to'�ider.itify.what.acttans 4 must take to be,M:.contpUance; S.uch agenctes Inalttde bu#are.not llmlted to:
- Depar#ment of��Er�viranmental Pratection-�ypress. Bayhead�, Wetland Areas and Envtronmentalty Sensitive
Lands, WatedWastewa#er Treatmenk. �
- Sauthwest Ftorida Water Management l�istrlct 1Ne1#s, Cypress. Bay.heads; Vlte##and Areas, Altering
Watercourses.
- Army Gorps of Engineecs-Seawalis, Docks, ldavigabte Waterways, �
- Department of Health & Relaabilitative Sen�iceslErnironmentai Health Unit Welis, Wastewater ?reatment,
Septtc Tanks. .
- US Environmental Protection Agency Asbestas abatemen�
- Federal Avlativn Authority-Runways.
!understand that the following restrtctions appty ta the ase of fll1:
- Use of fitl is not allowed in Fload Zone"U"un{ess expressiy permitted.
- If the fiil material Is ta be used in �Flood Zone "A", It is understaod #hat a drainage plan addressing a
"compe�sating volume"will be submltted at time of petmitttng whlch Is prepared by a professianat engineer
Ifcensed by the State of Florlda.
- If the fiii materiai is to be used in Flood �one "A" in�connec�ian w3th.a �ecmitted building t�s�ng stem wall
construction, I certify tha#fill.:wlll:be used only.to.fill the area withln the stem walL �
- !f �ill materlal is to be used in any area� 1 certlfy that .use. of such fl!I wll! not adversely affect adjacent
properties. #f use af f#li is faund to adversely:�ffect ad�aEent praperties,.the owner may be cited far violaiing
the conditions of the building,perm(t Issued under the attached permit appl(catlan� for lots less than.one (1)
acre whlch aee elevated�by f�lt,an engineered drainage plan 1s required. .
If I am the AGENT FOR THE OIMNER, I,�promise in gaod faith to Inform the owner of the permitttng conditlons set forth in
this affidavtt'�prtor to commencing constructlon. I understand that a°separate parmlt may be reqetlred far et�ct�ical work,
piumbing, signs, wells, paoSs; air conditbning,.gas, ar athec install�fians not.spec�icafly�included-in.tMe application. .A
permit issued shall be construed to be a 9lcense to proceed wlth the work and not as authortty to,vialate� cancel,alter, or
se#aslde any provisEo�s of the technlcal-cod�s; nor shall issuance�of'a_pecmit.prevent th�Bu{Idtng O#flclal from therea#ter
requiring a correction af e�rors fn.plans; canstructlan or violatlons of any codes. Every permft issued shall become invalid
unless the work authorfzed by such permit is cammenced�wtthin sGc �ttonths af permlt issuance, or if work aaEhorized by
the permit is suspended or.abandaned#or a period af six f 8)mont�s after the time the�work as commenced. An extension
may be requested, in wrlting, from the Building.Official for a period,not to exceed ninety�(90) days and w111 demonstrate
just�fable cause fot tt�e extenston; If work cease�.for nir�ety(90}cans.ecutive:day.s,..the)ob�is considered aba�doned.
WARNlNG TO OWNER: YOUR.FAIl.URE�TO.,F�EC.QRQ A N4TIGE:Q��CQMMENGEMEMT NtAY RESULT IN YQUR
PAYtNG TWICE,�'bR iMPROVEMENTS TO YOUR:PROPERTY. IF�YO.U�IM'FEND�°TQ�OBTAIN�FINI�AN�ING;'C.ONSULT
WITH YDU DE O AN� �TORNEY FORE�� ECO D G' OU '� C 'QF� �" E �E T�
FLORIOA JURA,'f(F,S.117.03}— _ ----- — _� ' -- � - ' =--- _:_:__.__ ---- — ----�._ - —
OWNER OR AOENT CONTRACTO .�'�
Subscrtbed and swom fa�or aflfrraed}before me fhls Subsa'Ibad and {ot a ed'b' te ttie'ttils
by �bY
Who Is/are personally known to.me or has/have produced Who Is/are persanally�cnown tt�me or lia�lhave-�roduced
as tden�R�d4n. as tden��catian.
Notary Public . Notary Publlc
Commisslon No. Comtp{ssion No.
Name of IVatary tYP��P►inted ar stamped Nams of NofarY h+Ped�Printed or stamped
Trevel • `
JOB7IMEIN: SERVICE INVOICE DateotOrder � SACI�:ETT A/C 11VC.
,oBnMEO�T. ��-OateScheduledf/'�,� ��r3�,-,- (352) 567-2211 OR (813) 779-4161 -
,°` `; r r ., I
CusmmefsOrderNo. Phone Me����;:�Helper�� Date ; 36601 ROBERTS RD. DADE CITY, FL 33525
d :.f`
a�n ro � � � OrderTaken By
,,d�`���,�,rf � ,,a�''�"„-�� STATE CLASS "A" CONTRACTOR#CAC.058172
"'d`��''',�"e�,u�.�' ,����,~';�:,�,,,,� �� ooaYWO�� , RESIDENTIAL " Fast-dependable-professional-service" COMMERCIAL '
cnv ----�--�' o cooc�a« "
��i'%�`���� ❑After Hours Make Model p Cond. Serlal q(Cond.)
.-'` �..'/�,�r-?'' ^,,,".,� -,�- �
� Job Name and Lxatian r^"� � ,,,.s'°' ���
4� ,r� ,/����"�� �-�-�--"�i'�� __,� Make Model#(A.H.) Serial N(A.H.)
Work Ordered By: Job Phone
� I Dealer Da[e Purchased PARTS SERVICE
, ❑Warranry ❑ Warranty
' � � � � � �� ' ❑ C.O.D. ❑ C.O.D.
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{s, "F�r/ ,�?��'�+° / �`� �,� FREON RECLAIMED(LBS.) � - �."__,,.�9,r` �
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NooneHame , DateCompleted � NEWFREONUSED UNITPERFORMINGSATISFACTORILY
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- REUSED FREON Customer's Signature
� ❑ 7otal amount ❑ 7otal billing to anaTS wnRrwNTV MAKE CHECKS PAYABLE TO:SACKEI"f HEATING&AIR CONDITIONING
due for above be mailed after All parts as recorded are warranted as per manufadure specifica[ions. '
work,or completionofwork. �BORGUARAN7Y � � � . � I have the authority to order the above work and do so
This la6or charge as recorded here relative[o[he equipment serviced as outlined above.It is ag�eed that the selle�will retain this
noced,Is guaranteed fora perlod of 90 days.We do not,of course ; to any equipment or material furnished until final and complete payment is made,and if settlement is not made as
guaranty other parts then those we Install.If repairs later become agreed,the seller shall have the right to remove same and the seller will be held harmless for any damages resulting
necessary due to other detective parts,they will be charged separately , fro the removal thereof.Homeowner res onsible for 'lin warrant .
Whfte:Customer Yellow:Numerical Pink:Alphabetical Gold:Techniclan