HomeMy WebLinkAbout15-16574 i
,;,, � CITY OF ZEPHYRHILLS
5335-8TH STREET
(sis)�so-oo20 16574
BUILDING PERMIT
I
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 16574 Address: 37737 C AVE
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: 15-26-21-0030-03100-0000
Improv. Cost: 5,965.00 OWNER.INFORMATION
Date Issued: 9/08/2015 Name: SOUTHSIDE CHURCH OF CHRIST
Total Fees: 65.00 Address: 37737 C AVE
Amount Paid: 65.00 ZEPHYRHILLS, FL. 33542
Date Paid: 9/08/2015 Phone: (813)783-2305
Work Desc: A/C CHANGE OUT 5 TON IN THE FELLOWSHIP HALL
CONTRACTOR S APPLICATION FEES
BAHR'S PROPANE GAS& C, INC. A/C CHANGEOUT 65.00
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Ins ections e uire
DUCTS INSTALLED
DUCTSINSU TED
FINAL
REINSPECTION FEES: (c)With respect to Reinspection�ees 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 management1 state agencies or federal agencies.
"Warning to owner: Your failure to record a notice ofi 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 BEFORE C.O.
NO OCCUPANCaY BEFORE C.O.
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ONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION — 8i HOUR NOTICE REQUIRED
PROTECT CARD �ROM WEATHER
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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
'' ' 8uilding Department
Date Received P a.Carrtac#far P�ri»I#1n �� - .��`
hon l�
Owner's Name �LaIG�"�J/�Er /�1QG�'r� d t.rTf�d S� Ow»er Phone Namber �� � �O-�° ca7eJ�J��
Owner's Addres� ���/ 1`4: �/ lJE'i Owner Phona Number � '� �
Fee Simple 7ltleholder Name � Owner Rhone Number' � �
, � �
Fee Simple Tltleholder Address
JOB ADDRESS �// J (.� f� �!� ' 6"'��GOLL�c'SdZi�'� � LOT# C��
SUBpIVIS10N � �� PARCEL ID
(OBTAINED FROM PROPERTY TAX NOTICE�
WORK PROPt3SED , e NEW CBNSTR� ADDlALT � SIGN Q Q DEMOt�ISN
INSTALL. FtEPAIR
PROPOSED USE [� SFR � GOMM � [� OTHER
TYPE OF CONSTRUCTION • Q BLOCK �' [� FRAME [�„� STEEI. [�
DE3CRIPTION OF WORK /1�lI7C��� t-- G�' /Q�ie �T/� �DD.l�Ji9�N /7 GA"' G� QN+-°/l�
BUILDING SIZE � � SQ FOOTAGE�� HEtGHT C�_____�
�8���'����"' I' � ^ � `VALUAT(ON OF 70TAL CONSTRUCT�ON
L� .J
QELECTRtCAI � � AMP SERiliCE Q PRt3GRESS EN6RGY Q W.R.E.C.
QPi.UMBlNG �� ' . .
QMECHAN2GA� $ � VA�UATION OF ECFtANfCAL 1NSTALIATION � 2 �U�
���i �,:
�cas � aaa��rv� ..p s�EC�a�..�rir � o�E�
FINISHED FLOOR ELEVATIONS � -� FLOOD 20NE AREA QYES NO
BUlLDER CLtMPA�dY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
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Address ' Llcense# � �
E�C7FtlC1AN- COMPANY
SIGNATURE Y' REGI$TER�D Y/ N FEE CURRE� •Y/N
' Addres� � License# � �
PLUMBER � CONIPANIY
SIGNATURE ,REaI$TERED Y/ N FEE CURREA Y/N
, ,
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, Addre�s ' License# ( �
MECHANICA[. ` �� '� �• " �COMPAl�lY /�1�S f' �'��- � Lai
SIGNATURE �'�'�� ���!�-�..-� REOISTER�D Y/ N FEE CURREP Y/N
Addres$ � � �� �1�E' �e id License# C�/7"La d 'T 3�' "7�'V�
� OTFiER COMP�
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SIGNATURE� � rtEGls7ert�o Y/ N. FEE CURRE� Y./N.
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Address ' Llcense#�� I
RESIDENTlAI;. Attach{2}PIof.Plans;{2}sets=of.Btiltdliig~Pians,�{1)set af Energy�Forms;"R-O-W Permlt for new«�nstruction,
Minimum;ten�(1.0)rworking days�after_subrrilttal date...Requlred:onsite,ConstiucNon P-Ians;Stormwater Plans w/Silt Fenc;e instelled,
_ Sanitary�FaciliUes.&�-1,,dumpste.r.,Site�Woric�Permitf.ersubdivisionsllarge projects�
COMMERCIAE. Attach(3}coinplete sets af 8ultding Plans plus a'I,ife Safety Page;(1}set of Energy Farms.R-O-W Permi#far new wnstruetlon.
Minimum ten(10)working days aRer submit�l date. Requtre onsite,Constructlan Plans,Stormwater Plans w/Silt Fence installed,
Sanitary FadliUas 8�1 dumpster.Si4s Wark Permtt for all new proJeats.°All commercial requlrements must mest compllance
S1GN PERMi'Y AttacFi(2)sets af Engineered�Plans..:. ��~ �� ° `
"'"PROPERTY SURVEY reGuired,for aII,NEW consVuctian.
Dtrectlans: • '
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Ffll out applica8on completely. I
Owner&Gontractor sign back of applicaUor�,notaclzed
if over�2504,a Notice af Commsncement is required. (NC upgrades over S75o0) .t
" Agent(for the cantractor)or Power of Attortiey(fo�the owner)would be somleone with natadzed letter from-owner authorizing same
DVER 1'HE C4i3NTER AERMI7'TfNG (�ront of Apptication Only} j "
Reroofs(f shingies Sewers Service Upgrades A/C Fences(ploUSurvey/Footage)
Drlvewaya-Not over Counter if an pubfic rosdways..needs ROW
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FIOYICE O�DEED Ri�3'�ReCYIORlS: �h�u�dersi�ned:u�der,�tands°�.th�t:thi�;.p�rmlf,.may;be,subJect to,°deed"restricttons° �
which may be more�rest�ictive th�n,Countjr'r+egulatlons."��'he'u�iuderslgned��ssumes�responsibtlity-fbr cce►►mpllance with`any
applicable de�d restrictions. ,. � :,- . � ' � '
UNLICENSED CONTRACTORS AND CONTttACTOR RESPONSI�ILIYiE�: -If the owner has �hirsd a contractor or
contractors to undertake work, they may be;requlred:.to.be Iicensed in.accordance:wlth state.and•locai regulattons. If the
contractor (s not Ilcensed.as requlred by I�w, both the owner �nd��cont��ctvr-mey�be�cited for-a�misclerneanor violation
under state lavv. if the owner or Intended:contractor.are�unce�taln as to wh�t iicensing.requirements may-apply�or the
intended work, they are advised to coritact the Pasco County_,Ba�ilding"Inspection Dhiision--Licenstng Section at 727-847-
SU09. Furthermore, ff 4he owner has�fii�ed�a contractor o� contractors, he �Is advised to have the contractor(s), sign
portions of the "contractor Block" of this application for which they.wfll. b�r.e�ponsible. If you,-as-.the owner sign'as the
contrac4or, th�t�may be an 0ndication�that�he is not�.properly 1ic�nsed and is not entitled to perinitting u�ivileges in Pasco
County. ` �
Tite4NSPORTATION IMPACTIUTILITIES�IINPAC'Y'AP1b�RESOURCE REC04/EttY�FEE3:�The undersagned understands
that Transportation Impact Fees and.Reco.urse Recove.ry.Fees may�apply��to�the construction of new b��lldings,:change�of
use in existi�g buitdings, or:expanslon•of:�ezistin;g'�buildings, as specffied in P�sco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands, th�t:such fees; as�rnay��e:�dne;,�wlll-be identlfied at the`time'of
permitting. It Is further understood that Transportation Impact Fees and Resource Recoaery"Fees.m�st be pald prior to -
rece4ving � °certi�cate.of occupancy" or final powec�release. :If the proj�ct.does not Involve-a certfficate of occupancy or
final power release; the.fees must b� paid prior to permit iss�ance. Ft��thernnore,�if Pasco County`Water/Sewer-lmpact
, fees�re due, lhey must be�pald.prior to permit-Issuance�in accaPdance with�pplicable Pa�co�County oriiinances.
CONSTRUCTION LI�N�I.I�W(Ch�pter 713� Elorld�S���ut�s,.��mended): If v�luatlon of vvork is�$i!,500.00 or more, i
' certify that I, the applicant,_ h�ve�been provided with a copy of the "Florida Construction Lien .L�w—Homeowner's
Protection Guide" prepared by the Florida Departmer�f of Agrlc.vlture and ConsumerAffairs. if the ap�licant Is someone
other than the°owner", I certify that I�h�ve.obtained�a�copy,of.the above..described docurr�ent°and.pmm�se in,good�faith to
deliver it to the`owner"prior�to�corn�nencement:' ' ' ' .
� CONT13�1CTOR'SlOd11P1ER'�AFFSDAVIT: I cert�fy.tFiat-�II the,lnforr�ation in this �pplicatian is accurat�s and that all work
will'be done in compliance with all.appilcable laws regulating constructlon, zoning and:land developm�:nt. Appitcation is
hereby made to obtain .a permit Co do:work:,.and�Installation as Indl�afed:� `I certlfy that no work��r Ins�allation Nas
commenced prior to Issuance of a p�rmif-and that.all work will be performed to meet standards of �II laws regulating-
construction, County and City codes, zoning regulatfans, and land deveiopment regulatlons-in the )urisdtction: 1 also
certiiy that I understand that the regul�tlons of other gov�rnme�t agencies may�apply�to the intended�o�k, and that it is
my responsibili�+to id�ntffy�what.actfons I must t�ke to be,ln:.corrlpilance._ Such agencles Include but-are►.not Ilmited to:
- Department of E�lvironmental�`Protection=Cypres�.B�yheads, VVetland Areas �nd EnvironUnentally �ensittve
Lands,Water/Wastewater Treatment.
- Southwest Florid� Water Management• Dis4rict-Wells, Cypress.f�Bay.heads; Wettand Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls, Docks, iVavigatile Wate�vvays.
- Departrnent of Health�'& ReY�abllita�ive Servlces/Environrraental Health Unit-Vllelis. WastHUVater-Treatment,
Septtc Tanks. ,
- US Environmental Protection Agency-Asbestos aba�ement.
- Federal Avfatton Authority-Runways:
I understand that the following.restrictions apply to the use of flll:•
- Use of flll is not allowed!n Flood.Zone"V"unless�expressly permitted.
- 9f the flll materfal is to be use"d:�in :�lood �one. tlA", (t. is under�tood that a drainage plan addressing a
"compensating volume" will be submitted at tim� of per.mift(ng which is prepared by a prot'essional engineer
Iicensed by the State of Florida.
- If the fill material is to be used in Flood Zone "A" in>connec�lon with'?a permitted buildin� using stem wall
� construction., I certify that flll<wlll=b.e used only.to.fill the area w(thin the�stem�wall.
- If flll materlal Is to be used in any area, i-�cer@l�jjr that .use. of such flil will not adversely affect adJacent
properties. If us� of flll Is found to adversely:�ffect adJacent�propertie5,.the o�nrner may be c0ted for viol�ting
the conditions of the buiiding�.permit Issued•under the"attached�permit application, for lots less than.one (1)
acre which are elevated�by flil, an engineered draln�ge plan Is r�quired. .
If I am the AGENT FOR TFIE OWNER, I;promise in good faith to inform the ovvner of the perrnitting cortdittons set forth in
this affidavit�prior to commencing constructlon. I understa�d that a-separate permit may be requtred for electrical work,
, plumbing, signs, wells, pools, air conditioning, .ga.s, or oth�r install�tions not.spec�ically Included�in tl�e appficatfon. .A
perrv�bt lssued shall be construed to be a Hcense to p�oceed v�ith tfie virork and not as.authority to,violat��;cancel, alter, or
, set aside�ny provisions of the technlcal codes; nor shall Issuance�of a.permCt.prevent the Buliding�icEal fcom thereafter
requfring a correction nf errors in.pl��s,-corisfiuctlon or vlolation�of�ny codes. Every permit issued sh�ll becorne invalid
, unless the work�uthorized by such permR�ls.commenced�withfn sfx months of permft issuance, or if vWOrk authorized by
the permit is suspended or.abandoned for a:pertod of�six(H)months.�fter the tirne the work is commenc;ed. An extension
ma be re uested in writin from the Buildin Officfal for � �riod�not•to �xceed ning 90 da s ancl w+ill demonstrate
Y 4 � 9� 9. P tY� ) Y
justifiable cause for.the extension. If work ceases��or ninety(90)cons.ecutive day.s...the job�is conside�ed abandoned.
UVARNI(VG TO OWNER: YOUR.FAILURE�TA.R�C.O�tD.A P��TIGE OF�CAMMENCEMENT��VFAY !t@SUL:T IN YOiJR
PAYING TdViC@.FOR:IMPROVEMEN.�'S TO.YOIIEt<PR�P@R'�'. IP°YO.U�INTEND�:TA��T�►1N��FIPI�AI�EIMG���CONSULT
9fiii�'N YfiUP��LE � d °aiP7�'PY��F�E"��i3"FG`�^�� �va-� - a�s`'Y�-"�'��.�. ����,��v :. .,n��r�� _ .�. . .� --- - - - —
FLORIDA JURA�(F.S. �, � � - '
' OIPVMER OPt�1�ENT �" CTO ^ l� � p�
� Subscrlbed and swom to(o a rmed)before me thfs Subscrlbed'and'swom (ot aflirtn�d)�before m thls -�?�"` l.-
by �by
�, Who Is/are personally k� to.me or haslhave produced Who.is/are personallyknowm•tn-me or haslhave-prodi�ced
as ldentlflcatlon. as identlficafion.
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Motery Public _ Notary Publlc
Commisslan No. Commleslon.No.
Name oF Notary typed,printed or stamped Name of Nolary typed,printed or stamped
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� _. _ _ _ . ce Order/PrOnOSa� 'Air Conditioning 8 Hea;ing
�i�ce 1988 � � � �—
• - ;'r�'OC�.c:i!� '`-�F..��',� i r r=�'�Ir�i � c_,�,ir_':c.s���, �f�;l:�
Sales SE ' �.- . � < <`F 4. :i��.; �,�,':;'�% ' �! '� 1y ; :3=
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4441 Ailen Rd •�Zephyrhills, FL 33541 I,� F: �; �;YiF �..�:;-;�:-, , �-,r;; ��; - �t��, i�:; ;���-�:;���:�
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� ' M�DESCRIPTION OF WORK M � J �ATERIALS&SERVICES � UNIT PRICE AMOUNT
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RECOMMENDATIONS
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Annual M�intenance Recommended by All Equipment Manufacturers. � �
P�essures Lo HI T-Stat i
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r^ • . REFRIGERANT R- LBS. 5 per Ibs. � I
. , :1 ; �, ' ��_� ' �- - i �-
/- '✓ � ; � ; FILTERS x x Changed Monthly I I
7— i ' F LTERS x x Changed Monthly � I
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❑ REGULAR ❑WARRANTY TOTAL SUMMP;RY
Dehumiiiistat Settings: When here"ON", When Away 60°4, T-Stat 80° ❑ MAINTENANCE CONTRACT SERVICE • i
LIMITED WARRANTY: All materials,parts and equipment are warranted by lhe manufacturers' I METHOD OF PAYMENT CALL � i
or suppliers'written warranty only.All labor performed by the above named company is warranted for TOTAL i
30 day�.or as otherxise indicated in writing.The above named company makes no other warranties, ❑CASiH ❑CK# MATERIALS � i
express or implied,and its agents or technicians are not authorized to make any such warranties on • i
behalfofabovenamedcompany. ❑DEBIT ❑CREDIT ❑OTHER MAINTENANCE,. '
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I have authority to order Ihe work outlined a6ove which has been satisfac�orily compleled.I agree Ihat Seller PROG. W / C
retains litle lo equipment/malerials furnished until final paymenl i5 made.If paymen�is nol made as agreed, (;��M� �
seller can remove said equipmenVmaterials al Seller s eYpense.Any damage resulting from said removal shall �
nol be iha responsibiliry of Seller.NET 30 DAVS.A 7 1l2%SERVICE CHARGE WILL BE ADDED MONTHLY TO DATE COMPLETED �-�
AlL UNPAID BALANCES OVER 30 DAYS.NO REFUNDS ,
TECH: - T� i
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CUSTOMERSIGNATURE DATE v�Z�!//G1L �✓IGG TOTAL��►%'�`�b