HomeMy WebLinkAbout15-16512 CITY OF ZEPHYRHILLS
; 5335-8TH,STREET
(sis)�so-oo20 16512
` BUILDING PERMIT
PERMIT�INFORMATION - LOCATION INFORMATION
Permit Number: 16512 Address: 37120 CULLENS TRAIL
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section:
Square Feet: Subdivision: SILVER OAKS
Est. Value: Parcel Number: 03-26-21-0180-00000-0760
Improv. Cost: 4,295.00 OWNER INFORMATION � -
Date Issued: 10/26/2015 Name: COPPLE RONALD LEE &ALTIE SUSAN
Total Fees: 60.00 Address: 37120 CULLENS TRAIL
Amount Paid: 60.00 ZEPHYRHILLS, FL. 33542
Date Paid: 10/26/2015 Phone: 813-780-7977
Work Desc: A/C CHANGE OUT 3 TON RHEEM SFLIT
� CONTRACTOR S � APPLICATION FEES
BA R PROPANE GAS& C, INC. C C AN E UT 60.00
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Ins ections.Re uired �
DUCTS INSTALLED �
DUCTS INSULA ED' � ,
FINAL �,[� I�-1 � I
REINSPECTION FEES: (c)With respect to Reinspection�fees will comply with Florida Statute 553.80(2)(c)the
local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or
first reinspection,whichever is greater;for each such subsequent reinspection.
NOTICE: In addition to the requirements of this permit, there maybe,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 BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
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ONTRACTOR SIGNATURE 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 lPermit Application Fax 813-780.0021
` Building D;epartment
Date Received Phone Contact for Pi rmittin 1 � �c�2- — 'J'��� �
Owner's Name �L` �/� !� � ! Owner Phone Number �f�' �!�,_,7
Owner's Address � �. ,� ��L, I Clwner Phone.Number ^ �
Fee,Stmple Titlehatder Name �� i Owner Phone Number � �
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Fee Simple Titleholder Address � �
JOB ADDRESS ����� Z-l//f'1�� /�L �>,,�i�`G°��, � �j'��� LOT# ��
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SUBDIVISION JIYe°tQ GJ�fCS� PARCEL tD# � �� �� L1�0� ��Q� ���
j (QBTA4NED FRQM PRbPERTY 7AX NQTICE)
WdRK PROPdSEQ , e NEw GoNSTR� ADQlALT I Q SIGN Q (� DEMOLISH
INSTALL REPAIR �
PROPOSED USE Q SFR Q C4MM �0 OTHER
TYPE OF CONSTRUCTfON Q BI.00K �J FRAME � Q STEEL C]
I
DE3CRIPTION OF WORK � L ��f ��vr.e T" a3; �� /�l�l�'�rri S l �' � Gp d �it1
BUILDING SlZE � � SQ FOQTAGH�_ '' 1 MEIGHT C���
QBUILDING ��� VAI.UATIOiV OF TQTAL GONSi'RllCTIQN
QELECTRICAL $ �� AMP SERVICE j Q PROGRESS ENERGY Q W.R.E.G.
OPLUMBING � �
'!
�MECHANiCAL $ r��n�.. �� VALUATION OF MECHANICAL INSTALLATION ��Z� ? 2
�� 7
QGAS Q ROOFIM1IG Q SPECIALTY!� OTHER
FINISHED fLOOR EIEVATtONS FLOOD ZONE AREA QYES NO
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BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
AddresS I l.icense# � �
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ELECTRICIAN COMPANY
SIGNA'NRE REGI57ERED Y/ N FEE CURRE� Y/N
Address ! l.fcense# � (
PLUMBER COMP�
SIGI+iATURE �_�..,._.,_ �-__� REGIS7ERED Y/ N FEE CURRE� Y/N
Address i License# ( �
MECHANiCAL y�',,�=; � e ,l conna�►Mr ���1,���o,o�JN�' ��5�''���-�.�-�j�/�
I SiL3A1ATUF2E +G��f/`'� ���✓t✓ REGISTERED Y J N FEE CURRE� Y/N
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Addre�s 7��� /lenr /2� J7'�-,1"� License# ��—/������"� !
,_ �
OTNER COMPANY
SlGNATURE RE6157ERED Y I N FEE CURREA Y J IV
Address License# � �ii� _� �
RESlDENTIAl. Attach(2)Plot Plans;(2}sefs of Buitding Pians;(1)set of Energy Forms;R-O-W Permit for new construction,
Minlmum ten(1Q)working days after submittal date. Required onsite,Gonstruction Plans,SMrmwater Pia�s wt S�lt Fence installed,
Sanitary FaGlitles&1 dumpster,Site Work Pennit for subd(vislonsAarge proJects
CdMMERCiAI. Attach(3}camptete sets of Building Plans pius a Life Safety�Page;(1)set of Energy Forms.R-O-W Permit far new consUucUon.
Minimum ten(1Q)workfng days after submlttai date. Requlred onsite,Construatton Pians,Starmwater Pians wl Sflt Fence lnstailed,
Sanitary Facilides 8�1 dumpster.Site Work Permit for all new proJects.All commerGal requlremenks must meet com�!lance
BtGN PERMiT Attach(2}sets of Engineered Plans.
'•"PRQPERTY SURVEY requlred for ati NEW constcuo@on�
Directians: �
Fltl out appfication completely. �
Owner&Contractor sign back of applfcatlon,notarized
If over 52540,a Notice af Cammenaement Is requlred. (AIC upgrade i over 57500)
" Agent(for the contractor)or Power of Attomey(for the:owner)wauld be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Fronk of Applicatiori Only) �
Reroofs if shingles Sewers Service Upgrades )t%C -° Fences{F'Iot/SurveylFoatage)
,. � , -
Driveways-Nat over Counter if an public roadways..needs ROW. .,, „ . �
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NOTICE OF DEED RESTRiCT10NS: The undersigned under�tands th�t#his.pprmit.may be.subject to"deed"restrtctions"
which may be;more�r.estrictive-than Gbunty iivegulations. 'The uo�dersigned assumes responsibility for compliance with any
app#Icabl�deed resttictbns. �
UNLICENSED CONTRA,CTORS -AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a conkractor or
contractors to undertake work, they may be requlred-to be;ltcensed In accordance.a�ith state.and�loca#regulattans. !f the
contractor is not iicensed,as required by iaw, bath the owrier and cont�act�r-may be ctted for a misdemeanor viola#ton
under state law. If the owner ar Inlended-contractor are uncertaln as to what Ilcensing.requirements may apply�or the
fntended wark, they are adv3sed#a cantact the Pasco County Butlding tnspecflot� Dhrlslon-1_Icensing Section at 727-847-
8009. Furthermare, If the owner has hired a contractor or contraators. he Is advised to have the cantracto�(s) sign
portions of the "cantractor Black" o#thls appNcatlon tor which they will be responslbte, ff you, as.#he owner slgn as the
contrac#ar, #hat inay be an indicatian t#�at he is not.properly iicensed and is not entiNed ta petmitting priviieges in Pasco
County. � � �.
TRANSPORTATIUN IMPACTIU�ILITlES#NIRAG'�AN!?RESC�URCE RECOVERYfEES; The underslgned unders#ands
that Transportation Impact Fees and.Recourse Recove.ry.Fees may��apply ta°tF�e cons#ruction of new buildings, change of
use in existing buitdl�igs, or expanslon.of�existing°b�lldings� as speclfled tn Pasco County C?rdinartce number 89-Q7 and
90-07, as amended. The undersigned also understands, thait such fees�:as,may�be:due,.wili be identified at the time of
permitting. It is further understaod that Tra�spo�tation Impact Fees and Resource Recoaery Fees must be paid prlar to
receluing a "certiticate of occupancy"or tinal pawer releas�. �f the pro�ect:daes not Irnralve a ce�tificate of occupancy or
final pawer release, the.fees must be paid prior ta permit issuance. Fu�thermare;if:Pasco County 1Nater/Sewer Impact
fees ane due,they must be-paid pr�or to permlE-issuanae-in accordance wtth appiicabfe Pasco�County ordinances.
CONSTRtiCTiON LiEN U4W(Chapter 713�Florlda Statutes�as amend�d): 1f valuation of work is$2,50d.00 ar more, i
aertify that 1, the applicantt have besn provided wikh a copy of the "Flortda� Co�structlon Llen Law---Horneowne�'s
Protecttan Guide" prepared by the Ftor�da Department of Agricuttu�e and Consumer Affairs. (f the applicant is someone
other than#he"owner", I certffy that I have obtained a copy;of..the above.described docurr�ent�and.pcnmise in.gaod fai#h to
dei�ver it to the'owne�"p�iar to-commencement. '
CONTRACTOR'S/OWNER'S AFFIDAVIT: I certity that ail the Inf.ormatlon In�thls application is accura,te and that all work
will'be done in campiiance with all applicable laws regulating constructlon� zoning and land�development. Application is
hereby rr�ade to obtaln .a permit to do watk and installati�n as tndE�aEed.- 1 certify #hat na wark or Instailation has
commenced prior to Issuance of a perm(t and that all work will be pe�formed to meet standards of all laws regulating-
�i constructlon, County artd Gity codes, zoning regulatic�ns, and land devalopment regatations-In the jurtsdtction. 1 alsa
certify that 1 undeFstand that the regulatlons of other gavernment agencies may�apply�to the Intended wark, and that it is
my respanstbi#ity#o iclentify�what:actlons I must taka to betin_.conlpRance; S.uch agencRes Include but are not ilmitecf to.
- Departmen# of. E�rvironmentai Protection-Cypress.Bayheads, Wetiand Aress and Environmentally Sensitive
l,ands, WateNWastewater Treatment. �
- Sauthwest Ftarida Water Management� l�tsUtat Welis; CYPress. Bey.heads, Wetland Areas� Aitering
Watercourses.
- Army Corps of Engineers-Seawatls,Docks,Navfgable Waterways,
- Department af Health & Ret�abilitative Servtcesl�nvironmen#ai Health Uni#-Weti.s, Wastewater�Treatnnent,
Septic Tanks. � .
- US Enviranmental Protec#ion Agency Asbes#as abatement.
- Fede�al Aviation Authortty»Runways.
!understand that the following:restrictlons appiy to the use o#fll1:•
- Use of fiil is not allowed in F1oad Zone°V"unless expressly permitted.
- If the ffll materfal is to be used in �Flood Zone. "A". (t. is understaod that a drainage plan addressing a
"compensating volume"wlfl be subr�ltted at#ime of permftting w�tich 1s prepared by a prafessianal engineer
Iicensed by�he State-of Flor(da.
- If th� #iii material is to be used fn Flood Zone `A" in�connec�ion with.a permitted buiiding using stem wafi
� construction, I certify thak flii�:w111.6e•used only to.fill the area withln�the�stem�wali.
- If flll material is to be usad in any area� 1 certify that .use. of such fil! will nnt adversely affect adJaaer�t
properttes. !f use af fill is found tv adverse{y:�ffeat adjacent pr�perties,.the awner may be cited far vioiating
the condifions of the buiiding:permit Issued under tha attached permit applicatian, for lots less than.one (1)
acre whiah are eleuated by�11,an engEneered drainag�plan Is required, .
If I am the AGENT FOR THE OWNER, I,�prnmise In good faith to fnfarm the owner of#he permitting condi#{ons set forth in
this aNidavtt'prlor ta commenc{ng constructlon. ! understand that a.separate permft m�ay be requlred for elect�lcal work,
plumbing, signs, wells, paols; air candifioning, .g�s, or ottrer install�itions not.&pecifically inciuded in t�e appiication. A
permit Issued sh�ll be canstrued to be a Iicense ta proceed wlth the work end not as.authority to.vlolate� aancel, alter, or
seE aslde eny prov3slons ot the technEcal.codes; nor shall lssuartce�of a.permit.prevent the Bulldirig t?�icial from thereaiter
requirtng a correction af errors in plans�, constructlan or violations of any cades. �very permit Issued shall became invalid
unisss the work aathorized.by such permtt:�s.co�nmenced�wlthln siX months of permlt lssuance, ot If wark authorized by
� #he permit is suspended or.abandoned for a.period af si���6)monti�s.after the time the�wotk is commenced. An extension
may ba requested, In writing, from the Building,Officfal for a period�not to exceed ninety(90) days a�d will demonstrate _ _
�usE��bl�-cause-ioc the���enst��;–If-w��irceas�s:for-nlne�y{S0�cansecutive:�ays;..tF�e ja6 is�c�ansidered abaa�cined.v
WARN#NG 1'Q OWNER: YOUR.FAIl.11RE�TO,RECCiRD A NOTIGE OF•COMMBNCEMENT�MAY RE5U4�T IN Yt?UR
PAYING TWICE�'OR 1MPROVEMEN�'S TC1 YOUi�:PROPERTY. IR°YO.U�iN'�E�1D�TQ'+OB-TA1N�FiN�NCiNG,�CONSULT
WIT UR D A ATTO N � FORE� CO . G":i OU ° O �C <C� .` ,.• E CE
F�ORlDA Jt1FtAT(F. , � .,� :.� . -
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OWNEi!OR AOENT "2.C.._ ��ONTRAC70
Subscdbed and swom to(or rmed}before me th s Subscxlbed'and' M{ot afffmted)�b� ra ma�i1�
by �
Who is/are personally knovm to me or has/have produced Who.lsla eraone ovm to me or has/have�produaed
as tdentlflcaBon. as IdentificaUon.
Notery Pubitc . ����"�-- Notary Public
Commisstan No. Co
,,�.Q}yax nym��+ •
:.c :k=_ Commission#FF 150422
NartteoffVotarytyped,Ptfntedorstamped Na �,,p��,, aa�aeartuurr�,Fai�ms�,o��8eaa saais
�s � � PROPANE GAS Service Order/Pro�osal � �� � �
AND AIC ttvc. Air Conditioning�Heating
' �a�e �988 813-782•�O�t3 �,� ' - j- �� ° � � , � ��
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r��=?��€_ - �T T.h�lE� �r�_�;:E=rd ;.ti� i�_�% 4��, t =�:!��;
Sales, Service & Installations �-t.��,r-�, �;, , t,,-�. � k�
44�1 Ailen Rd. • Zephyrhills, FL 33541 r.}r=,�,��_: r i i��r�:. �-�-r;r���:t�::;��;.� , �:; ; �_, ; ;_ :{:�=^-�i; i
C'�._i��:l �ii�E:.:F;�4 '! i:��:�;T r C:�I'.± t={C��'f•���,•
�il NOTES• r��.:li:'i�•1!�� r� ; x ;'r_tin �,�;�,�;; ;.� �,
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+.�(�ih•a�, r`•.�f�I � r,�_i.��'•I�.tti • •���c.�--��I� i.i�il��I i_ I �=J :�:_.•-I.._�..1�.'.t.� '�:,,•- �.��� '_:'r :� I F�1. i� �.;'-.:
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DESCRIPTION OF WORK QTY. '.� MAT „IALS:8�.SERVICES.. ; ..UNIT PRICE; Ah10UNT •
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- �� - = .. .R�'COMM�fVDATIONS - . ,p ,�n i— `�� i�
Annual Maintenance°Recommended by.AII:Equipment.Manufacturers. . � �
Pressures Lo HI T-Stat i i
/�� � � . ✓r�IQ � . REFgIGERIWT:R-..,,._. ...LBS: ,. .._ .:. $��r lbs. _ _ �,. �
.5� cf� 4 tif ,c�' �
FILTERS x z Changed Monthly I I
, FILTERS x x Changad Monthly I I �
, � . � ❑ REGULAR ❑'WARRANTI'' ; -a `T�T/AC�SUMM/ARY`
Dehumid,istat Settings: When here"ON", When Away�, T-Stat 80°� 0 MAINTENANCE CONTRACT ,SERVICE ' 'i
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LIMITED WARRANTY: All materials, arts and e ui ment are warranted b the manufacturers' •, '
;
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P Q P Y ' '.-:',METWOD-:QF�PAYMENT _ � CALL i
or suppliers'written warzanty only.All labor performed by the above named company is warranted for TOTAL i
30 days or as otherwise indirated 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
behalfofabovenamedcompany. ❑DEBIT ❑CREDIT ❑OTHER MAINTENANCE �
I have aulhority lo order l�e work outlinetl above which has been salis(aclorily completetl.I agree lAal Seller ' '
PROG. W / C �
retains lille lo equlpmenUmatenals lurnished unGl Gnal paymenf is made.If payment is nol made as agfeetl, CLAIM# `� •
se11Et can remove said equipmenVmateriels al Sellei's expense.Any damage resulting from said removal shall
no1 be Ihe responsibiliry of Seller.NET 30 DAYS.A 1 1I2Y SERVICE CHARGE WILL BE ADDED MONTHLY TO �
ALL UNPAID ES OVER 30 DAYS.NO RE NDS DATE COMPt�TED
; I �- TECH: ' TAX - i
G,7i"__ '"� ' ���� � TOTAL--� � �
CUSTOME�iSIGNATURE DATE ��
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