HomeMy WebLinkAbout15-16554 �
CITY OF ZEPHYRHILLS
5335-8TH STREEI'
tszs}�so-aaza 16 4
BUILDTNG PERMIT
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�+ PERMIT INFORMATI4N LQCATION INFORMATION
�'erQnEt Number: 16554 � Address: 4618 BLQSSOM BLVD UNIT A BLVD 2
�ermit Type: MECHANICAL ' ZEPHYRHILLS, FL.
Ctass of Work: A!G CHANGEOUT � Tawnship: Range. Baok:
Proposed Use: NOT APPLICABLE � Lot(s): Block: Section:
Square Feet: � Subdivisian: ORANGE BLOSSOM RANCH
Est. Value: i Parcei Number: 15-26-21-017C-00200-OOAO
Improv. Cast: 6,000.00 ; OWNER INFORMATION
Date issued: 8131/2015 � Name: BLUME JACK&ADE�AIDE TflKA
Total Fees: 65.00 � Address: 4618 BLOSSOM BLVD
Amount Paid: 65.00 : ZEPHYRNILLS FL. 33542
Date Paid: 8/31/2015 ! Phane: 8134769846
Work Desc: A!C CHANGE OUT 2.5 TON !
CONTRACTOR� APPLiCAT10N FEES
ALL FLOR A APPLIAN E&A NC C CHA EOU 65.00
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Ins ections Re uired
DU S IN ALLED I
DUCTS INSULATED y,..-
FINAL�����,
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REINSPECTION FEES: (c)With respect to Reinspection�fees will compiy with Flarida Statute 553.80 (2)(c)the
local government shai! impose a fee of four times the;amounfi af the fee imposed for the initia! inspectian or
first reinspection,whichever is.greater;for each such subsequent reinspection.
NQTICE: 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 caunty, and therejmay be additional permits required from other gavernmentai
entities such as water management, state agencies or federal agencies.
"1Narning to awner: Your faiture ta record a natice of commencement may result in yoerr paying twice for
impravements to your property. If you intend to abtain financing, consult with your lender or an attorney
befare recording yaur notice of commencement."
Complete Plans,Specifications Must Accompany Application.All wark shall be pertormed in accordance with
Ci Codes and Ordinances. NO OCCUPANGY�EFORE C.O.
NO BCCUPANCY BEFfJRE C.O.
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CTOR 51GNATURE � PERMIT OFFI R
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PERMIT EXPIRES IN 6 MCINTH5INITHOUT APPRUVED INSPECTION
CALI. FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PRCfTECT CARD FROM WEATHER
613-780-q020 City of 2ephyfiills Permit Applicatian Fax 813-780-0021
` 8uifding Department
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Date fi'eceived l � ""2 �
'��,� Phone,Gontac#far Per'mtttin
Owner's Name e C,,. t� l� � , l Owner Phone Number
Owner's Address �C�[ � l'r�'��✓'"� � f � i dwner Phone Number -•
Fee Slmpla Tltleholder.Name Qwner Rhone Number
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Fee Slmple Tltlehalder Address
JOB ADDRESS S�'^'� Cj { �'j C h� 1 f�,3,� ��,�,QT# C�
SUBDIViStON �� � PARCEL tD#
! (09TAINED FROM PROPERTY 7AX NOTICE)
WORK PROPOSEp NEW CONSTR ADD/ALT , � • S1GN Q Q DEMOLiSN
INSTALL. 8' REPAIR
PROPQSED_USE Q SFR [� 'COMM Q OTNEft
TYRE OF CON3TRUCTION � Q' BLOCK ''}Q FRAME � STEEL Q
DESCRIPTION OF WORK �""1�%►'7�� ��I� ��. '�� ,� .� ��'^�""`�
BUtLD1NG SIZE �� ' � SQ FCIOTAGE HEIGHT �
- , -
[�BUILDING �� I ,
VAt.UATIt3N OF TOTAL CONSTRUCTION
QELECTRlCAL $ . AMP SERtttCE � Q Pt20GRESS ENEf2GY � W.R.E.C.
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QPLUMBING �& � . .
MEGNANIGAt. $ ' � VALUATION OF MEGHANIGAL INSTRLI,ATtQN
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QGAS Q ROQFING.. Q SPECtALTY Q OTHER
FINISHED FLOOR ELEVATIONS �� FLOdD ZON�AREA QYES NO
BUIl.DER � ��.~ CQMP� 1 l l t ! '�T ���G`�Y�C
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SIGNATURE � REGISTEREp Y/ N Fes cu Y/N
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Address � 3�� �L�% � .�L.�,' .i kicense`#�I ' �
EI.ECTRlClt�tid Ct�MP�
SIGNATURE T� REGISTERED Y/ N FEE CURRE� '-Y/-N
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Address � License# � �
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P�UMBER COMP.�
SIGNATUR� �REGISTEREp Y/ N FEE CURRE� Y/N
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Address � I.icense# � ��
MECHANICAL GOMP,�
SICiNATURE REGISTERED Y/ N FEE CURRE� Y/N
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Address � � � " License# � �
OTHER GOMPANY
S1GAIATURE� ' � REGISTERED Y/ N FEB CURRE� Y/N.
- ---- Addt6f38 - - -y - -' J� 1.IC8RS8# � �
REBtDENT1AL Attarfi(2}.P1ot:P#ans;.(2}set&:of:'Biiildiiig`Plans;°{�1)set of�Enetgy�Forms;R-t3-W Petmtt for new cans#ruc�on,
Mtnimum;.ten;_(:1.Q).war{cing,days:after"sudrriitta)date:.Required:onsite;Consduction Rlans;Stormwater'Rlans w/Slit Fence installed,
'SaNtary�Facilitlas:8�:1;,dumpster�•SlteWoric�.Penn(tforsubdiVislons/large�projects� '
COMMERCiAL Attach(3}cait�plate sets of 8u1liiing Plans plus a life Safe#y Page;(1}set of Energy Forms.R-0 W Permit for new.eanstruction.
Minimum ten(10)working days'after submlttal date. Requ(red onsRe,Construction Plans,Stortnwater Plans w/Silt Fence installed,
Sanitary FaciltUes 81 dumpster.Site Work Permit for all new projects.All commercial requlrements must meet compllance
SIGN PERMIT Attach{2)sets of Engltieered�Pians;,:: �-�: ~ „ , � .
""'PROPERYY SURVEY requfred for all NEW construcUon.l
Dlrecttana: ' . _`i ,
Fill out applfcaHon completely.
Owner&Coohactor s{gn back of appllcatlon,notarized
if aver�2500.a Natice of Cammencement i�required. {AtC upgrades ovar 57500) _ D -
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'• qqent(for ttie contractor)'or Power of"Attomey(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of A�pllcation•Only} � °, � : �-_; .,. =
Reroofs if shingles Sewers ,- Service Upgrades' NC�-". -Fences(PIotlSurvey/Footage) , . . , " ';' .
Drlvewaya-Not over Counter if on public�"r�oadduays::riseds RG3W;, • y � ~ . '` L, , .`� , �
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NOTICE OF DEED RESTRICTIONS: Th undersigned undergtands°:th�t;this;p�cmtt;:may_be,subject,to."deed"r,estrlctions° -
which may be--more.r.estcictive-•tha�n.Coun �=regulatlons:'�The�underslgned assumes�responsiblltty for°comptlence with�any �"
appUcable deed rest�ictions. ,,,-...- ...:....:: . .:... ��. • . - .
UNLICENSED CONTRACTORS AND ONTRACTOR�RESPONSIBILITIES: °If the owner has��hired �a �contractor or
contractors to undertake work, they may. ;e,cequi�ed:;to.:be;licensed_In�4accordance.with.state.and:local cegulations: �If the - •
contractor ts not ltcensed as�requlred�b law, b'oth�the owner and=contractor°inay be�clted-for��••misdemeanor violatton
under state law. if the owner or (ntende ��contractvr,•;ere,.uncertaln as to what Iicenaing.requirements:�may=apply�for°the >
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intended work, they are advised to.corita t ttie.Pasco County,Buildingjlnspection Divlsion.-Licensing Sectlon at 727-847-
8009. Furthermore, If the owner has li red a corit�actor. or"contractors, he ls advl�ed to have'the contractor(s)_.,sign ,
portfons of the "contrector Block°.of this ppllcation for which.they.will.be.,respoaslbie.--.If..you�--as-.the owner"sign'as tiie
contractor, tliat may be an indication�tha 'he is�nofi.properiy'licensed"antl�ls.not enti8ed;to pemiitting p�iiilleges In Pasco
County.
TRANSPORTA710N IMPACT1UT141TIES�IMPAC'r'ANb RE30URCE RECOVERY FEE3:�The unde�slgned understands
thatTransportation Impact Fees and.Rec urse Recove.ry.Fees may�apply��to�the.construction of new�bulldings��change�of� � '
use In existing bufldings, or:.expansi�n��o. iezistin;g°�6uildings, as spec�ied.in Pasco County Ord(nance number 89-07 and
90-07, as amended.,..The undersigned al o understands� thait°`such fees�:ias��may:�e��due;,�will:be tdentffied at the��time"of�
permitting. It is furtlier understood that ransportation Impact Fees and�Resource:Recovsry�Fees._must be paid prlor to
rece4v(ng a "certfficate.of occupancy" or nal.power•release. :If the proj�ct�..does.not involve�ca�certifloate of occupancy�or '`
flnal power release;the.fees mu�t be pa :prior to permit Issuance. F��thermore;�.if.Pasco.County�Water/Sewer-lmpact
fees are due, they:.must be-paid prior to p rmit�lssuance=in accordance with�appiicable.Pasco�County-ordinances.
CONSTRUCTION"LIEN"LAW:(Chapter 7 3� FloNda Statutes�as amended): If valuation of vvork is$2,500.00>.or more; i �
certify that I, the appiicant,_.have.been provided with-a copy� of the ".Florida Conshuction� Llen.:Lav�Homeowner's
Protectfon Guide" prepared by the Flo�id Departme�t�of Agric.ulture and Consumer Affairs. if the applicant is someone ,
other than the°owner", I certffy that,l:h�v. .ob�Ined�a�copy.of..the abQVe..des.cribed docur�ent�and.promise�in,good'faHh to
deliver It to the"owner"�.prior�to•cornmen` ment:"` � • ' ,
CONTRACTOR'S10WNER'S AFFIDAVI : I certify;;th�t:.all.th�,Informallon la thl.s applicatlon is accurate and that all work
will'be done in compliance with all applic ble laws regulating constn�ction, zoning and:land devetopment. Appiicatlon Is
hereby made to obtain .a.permit,,Co;do,,,: .ork;,,and �ihstallation as indicefed:-� `� ceKify that no work��or Installatlon-Has
commenced prior b Issuance`of�a permi and that.all work wlll be pertormed�to meet.standards of ali lauvs �egulating�
construction, County and City codes, zo ing regulatiQns� and land development regulatlons-In the Jurisdtction.. ( :also
certify that I understand that the regulatio s of other government agencies may�apply�to the intended work, and that it is
my responsibllity to identify�what.acttons I ust take:to be�in:.compllance.. S,uch agencles Include but-are.not i(mited_to:
- Department of Environmental-Protection=Cypress:'Bayliead�; Wetland Areas and Erntronmentally Sensitive
Lands,Water/Wastewater Tre tment.
- Southwest Florida Water anagement�.District-Wells, Cypress.`�Bay.k�eads, Wetland Areas, Altering
Watercourses. ,
- A�my Corps of Englneers-Sea all�,Docks, IVavigatile Waterways.
- Department of Health�'8 Re.abilitative,$ervices/Environmenfal Nealth Unit-Well.s� Wastewater Treatment,
Septic Tanks. ` � � • � _
- US Environmental Protectlon gency-Asbestos abatement.
Federal Avlativn-Autho�ity=Ru.ways: '
I understand that the following:reswlctivns `pply fo the use of flll:•
- Use of flll Is not allowed in'Flo_ d,Zone"V"unless expressly Permitted.
- If the�flll matierlal is to' be u ed::'In�:Flood. Zone. "A", it Is understood that a drainage plan addressing a I
°compensating volume"will b submitted at tlme of perm�ting which is prepared by a professional engineer
Ilcensed by the.State of Florid .
- If th� fill mate�lal is to be us_ d (n Flood �one 'A" (n�connec�lon�with''a �permitted building using stem wall
� construction., I certify that flll�-wl 1-b.e used only.to.fill the area within�the�stem�wall. i
- If flll material ts to be used n•any area, F�certify t#�at.use. of such fiil will not adversely affect adJacent ,
propertles. If use of flll is fou d to adversely:�ffect adJaEent��properties,.the owner may be cited for viofating �
the condifions of the building�. ermtt iss�ed�under the"at�aclied permit applieatlon, for lots less-than one (1) I
acre which-ere elevated�by flll,art engineered dralnage plan is required. .
If I am the AGENT FOR THE OWIVER, I;�p mise in good faith to inform the•ownerof��the permitting conditlons set forth tn
this atfidavit"prtor to commencing constru lon. 1 understand that a�separate permit may be requtred for electrical work,
plumbing, signs, wells,.pools; afr condlQo ing, .gas, or•other install�tions no�.spec�fically lncluded�in.the�application. .A
pernnit Issued shall be construed to be a Ii nse to�p�oceed w(th the v+wo�k and not as:authority to,violate,.cancel, aiter, or
set aside any provistons of the.technical. des; nor shall Issuance�of a.permit.prevent the Bulldirig Official from thereafter
requiring a conection nf errors in.plans�, co sfiruction or vlolatlons of any codes: Every permit Issued=sliall�become invalid
unless the work authorized.by such perml ��is-commenced•within six months of permlt Issuance� or tt work authorized by
the permit is suspended or.abar�doned for. ;period of�six(8)montiis:after the,time the�work�is commenaed. An extension
_ may_be requested,,in writing,_from tFie Bui ding.O_fficial for a period not to exceed nlnety�.(90)_days and will'demonstrate _ ___
justifiable cause for:the extensior�. If work eases;for ninety(90)cons.ecutive day.s...th�job�is considered abandoned.
WARNING TO OWNER: YOUR FAILUR �T�..R�EC.ORD.A;f�OTIGE OF•COMMENCEMEMT NtAY�RESULT IN YOUR
PAYING TWICE.FOR:IMPROVEMENTS:T .YOUR:.PROPER=7Y.: :I�°�YO.U-�IN'�EWD:`TO•��BTAIN�•FINA�1EliVG;'CONSULT
WIT UR D AM ATTO FOR�� � °O � f;-' O � �C ' �
FLORIDAJURA�•(F.S.1.17.03) ' '� � ` � ' °
OWNER OR AOE ^- CONTRACTO
Subscrlbed and swom to(or efore me thls Subecribed and'swom= rmed)�before me�U�l�
by �by '
Who is/are personelly knovm to.me or has/have produ ed Who.ls/are personallyknown to:me•or has/heve�produced •
as Identlncatlon. as IdenBBcaUon.
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-Note 'Public _ '•�-- � � Notary Public
Commis�i No. Comr�isslon-Mo. t
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I ;2q:�"N�,-; JOEL E.BACON j
137073 ' ,,,,"'",,
Nam 1 Nota �t�����8,2018 Name of No�r.y!' pe�d d� FF 137073
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QC�NQENSER CQI� 26211 Chianir�a Dr.,Wesley Chapel,FL 33544
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al parts ar woorded acevrarrarrted ae per There wlo be a 4 35.��chargeiar ell reLuned checka � �
�anufaaturerspecifloa�!ona There t 1 be i8%i on al�late paymenLs at 30 days.
fo do not,of saureey gueeAnbee olAer x �
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eeama naeeas�y�u�taatl�ee.defeetlYa
arls,fhey wiU t�cEiarQed eeperateiy. I cerli�p thet have pertortne�sarvices Indfcated. o�HECita cp,sH
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�N DRAIN LtNES x a��rY � wsA arc.aiscvveR