HomeMy WebLinkAbout15-16579 CITY OF ZEPHYRHILLS
5335-8TH STREET
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(sis)�so-oozo 165 �
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 16579 � Address: 6853 SUNNIDALE 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: VALLEYDALE RO ASSOCIATION
Est. Value: Parcel Number: 03-26-21-0170-00000-1040
Improv. Cost: 3,295.00 ` OWNER INFORMATION
Date Issued: 9/16/2015 Name: GIFFORD JOSEPHINE
Total Fees: 55.00 Address: 6853 SUNNIDALE DR
Amount Paid: 55.00 ZEPHYRHILLS FL 33542-4866
Date Paid: 9/16/2015 Phone: 813-715-0748
Work Desc: A/C CHANGE OUT 3 TON �
CONTRACTOR S ; APPLICATION FEES
BAHR'S PROPANE GAS C,INC. C CHANGEOUT 55.00
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Ins ections�Re uired
DUCTS INSTALLED.---�
DUCTS INSU D � -�
FINAL
REINSPECTION FEES: (c)With respect to Reinspection Ifees 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 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 BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
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CONTRACTOR SIGNATURE � PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD�FROM WEATHER ',
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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
Building Departrnent
F 3 p
Date Racelved Phone�Cont�ct for Permtttin �`3 �0 � _ ����
Owner's Name C�'� B � � '�-�/N I Owner Phone Number ��� P���B�T�
Owner's Addres� (�U �� ``��/V/l�! G�lE � Owner Phone Number � =•
Fee Simple Titlebolder Name Owner Rhone Number
Fee Simple Titleholder Address I
JOB ADDRESS 8�� �LLNJAd��v/��-� �(JI�, LOT# �
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SUBDIVISION ��J'�'1JC'YC�Q�IP.� PARCELID# �3- a� "al ���D 4�1.�00 /D4��
� I (OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED , B NEW CONSTR� ADD/ALT Q SIGN Q � Q DEMOLISH
INSTALL. REPAIR
PROPOSED USE Q SFR [� "COMM � Q OTHER
TYPE OF CONSTRUCTION • Q' BLOCK �``Q FRAME , Q STEEL Q
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DEBCRIPTION OF WORK � �� �(�.:�� �K' , �G �,,,-��� ' /� �OYn Q/�
BUILDIPIG SIZE SQ FOOTAGE� HEIGHT
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QBUILDING $ VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBIiVG $ � '
OMECHANICAL ,$. �2a 95� � „ VALUATION OF MECHANICAL INSTALLATION
:J
QGAS Q ROOFING ..Q SPECIALTY � OTHER
FINISHED FLOOR ELEVATIONS ' FLOOD ZONE AREA QYES NO
BUILDER COMPANY
SIGNATURE REGISTEREO Y/ N FEE CURRE� Y!N
Address ' Lfcense#�
ELECTRICIAN - ` COMP�
SIGNATURE �� ���s7ErtEO Y/ N FEE CURRE� -Y/N
Address � Ucense#
PLUMBER COMP.�
SIGNATURE �REGISTERED Y/ N FEE CURREP Y/N
Address License#
MECHANICI0.L - //,���� � �C.OMP� ���RS �Q fJ � �s����° `%
SIGNATURE �'�-�!J Re�ISTettEO Y/ N FEE CURRE� Y/N
Address�' ���� "�l�E�.� �� �"/i�/�LS r�+ License# �D�1���7�
OTHER . COMPANY
SIGNATURE,� •� REGISTERED Y/ N FEE CURRE� Y/N.
Address ' Ucense#
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RESIDENTIAL Attach(2)PIot:Pians;.(2)sets+of:Building�Plans;•(1)set of-EnergyFortns;R-O-W Permit far new cons6vction,
Minimum;ten(.10).working-days aRer,subrriittal date:".Required onslte,Constiuction P-Ians;Stortnwater Plans w/Silt Fence Installed,
Sanitary Fadlides,&,:1,.dumpste.r,Slte Work,Rermit for subdfVisions/large projects °
COMMERCIAL Attach(3)complete�sefs of Building Plans plus a�Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new consUucUon. --
- - Mlnimum ten(10)worlcing days after submittal date. Requlred onsite,ConsUucUon Plans,Stortnwater Plans w/Silt Fence installed,
Sanitary Facititles&1 dumpster.Stte VVork Pertnit for all new proJects.•All commerciai requlrements must meet compllance
SIGN PERMIT Attacti(2j sets of Engineered�Plans.,.,, � '
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""'PROPERTY SURVEY reguired for all NEW construcdon..l
Directlons: �-
FIII out applicaUon completely.
Owner 8 Contractor sign back of applfcaUon,notarized
if over 52500,a Notice of Commencement i�required. (AIC upgrades over 57500) „
" Agent(for the cenVactor)�or Power of Attomey(for tlie�owner)wauld be someone with notarized letter from owner authorizing same
�VER THE COUNTER PERMITIING; .�,(Front of-Application�Only)i � ' 1
Reroofs if shingles Sewers ' Servioe Upgrades.A/C � Fences(PIoUSurveylFootage)
Driveways-Not over Counter if on public roadways:.needs ROW'-,. '�
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NOTICE OF DEED RE3TRICTIONS: The undersigned;unders�tands:�,th�t:this;�,p�rmifr may be.subJect to,"deed"rest[Ictions" y_
which m�y�be�more.rest�Ictive-=th�n Countyr=regulations:'Thet�"'u'iiderslgned;assumes�responsibility°for'°compliance`witli`any
applicable de�d restrictions. . ,s-,,:;; .,�;.,,� ....�,.�_. - • ' - -
UNLICENSED CONTRACTORS AND COMTRACTOR�RESPONSIBILITIES: =1f the owner has:��hired��a contractor or
contractors to undertake work, they may:be:cequlred,zto<tie�ltcensed In.accordance.with state.and•locae regulattons.: .�If the °
contractor Is not Itcensed as reyulred`:tiy IaVor, tioth the owner and�contractor=may be�cited-fvr�-���misdemeanor violation
under st�te law. If the owner or Intended;=contractor>are.,uncertaln as to what Ilcensing.requirements-�:may�apply.�or�the�-��,� �` - -'`
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tntended work, ttiey are advised to coritact tfie,.Pasco County�ulidingelrispectiori Divislon_-L•icensing Section at 727-847-
8009. Furthermore, If the owner Nas Fif�ed a contraato�o� coritraotors, he ls advfsed to have'th� contractor(s)�sign
portio�s of the"contractor Block°,of.tfils application,forwhich.they,wlll..be.,re.sponsible._.If you�-,as..the owner stgn asFthe` y
contractor, ttiat�may be an indicatlon�tFiat'he Is�noY.properly'licensed"and is not entitled�to permitting p�ivileges In Pasco
County. ; ' ` '
TRANSPORTA710N.IMPACT/UTILITIES�IMPAC'1'�ANb�RESOURCE RECOVERY FEES: �The under�igned understands
that Transportation Impact Fees and:Reco.urse�Recove.ry.Fees may��apply�:to�the constructton of new_bullding�,:;change�of� � �
use in existing buildings; or:expansion�.of�ezlstin�g��buildings, as specffied in Pasco County Ordinance number 89-07 and
90-07, as amended., .,The undersigned also•untlerstands, thaft.�such fees;;:as�may��e:=due,,:wlll:�be identified at the`time�of� -
permitting. It Is further understcod that Transportation Impact Fees artd<Resource:Recovery�Fees_must be pald prior to
receiving a 'certi�cate•of-occupancy" or flnal power release. :I���the proj�ct.does�not Involve�a�cert(ficate of occupancy°or ` �
flnal pow�r release;the.fees must be paid;pcio�.to,permit issuance. F��thermore,�ff:Pasco;County°Il�ater/3ewec�:lmpact -
fees are due, they�:must be•paid pnlor to.permit_:Issuance�in accordance wlth appllcable,Pasco�County�ordinances.
CONSTRUCTION�LIEN"LAW:(Chept�r 713� Florlda$tstute��as amended): If valuation of work is$�,500.00:or more, I
certify that I, �he applicant, have�been provided-with -a-copy of the�"Florida Construcdon� Llen.;L"aw—Homeowner's
Protection Guide" prepared by the Flo�ide Departmenf of Agric.ulture and ConsumerAffairs. if the ap�licant is someone
other than the°owne�", I certifyc that•I�have.,ob�lned�a�-copy,of the above.:described doaur�entand�promise:in,good'failh�to
deliver it to.the�bwne�':prior�to�commencement�'° � ' `� � �
CONTRACTOR'SIOWNER'S AFFIDAVIT: I ce�ti[y,#Fiat:all the,.lnformation imthi�applicatlon is accurate and that�II work
will'be done in compliance with all.appllcable laws regul�ting construction, zoning and:land development. Applicatlon is
hereby made to obtain-:a pe�mit Co :do,;work:,.and,installa�lon as indicafed:.� `I certffy that no work or InsEallatton�iias
commenced prior to issuance of a permif�and that�.all work wlll be pertormed to meet-standards of all laws regulating-
construction, County and City codes, zoning regulatrans� and land development cegulations-in the Jur(sdlct(on: I also
certify that I unde�stand that the regulations of other government agencies may�apply�to the intended work, and that it is
my�esponsiblHty to identffy�what,act(ons 1 must t'ake:to bedn:.complla�ce:,S,uch agencles include but ar�.not Iimited to:
- Department of Envlronmental��Prcitection=Cypress.�Baylieads; Wefland Areas and Erntronmentally Senstttve
Lands�WaterMlastewater Treatment.
- Southwest Florida Wster Management-.District-Wells� Cypress.`�Bay�eads�, Wetland Areas, AlteNng
Watercourses. � ,
- Army Corps of Engtneers-Seawalls,�Docks, Navigatile Waterways.
- Department of Health�'8 ReY�abilitative Ser.vlces/Envtronmental Nealth Unit-Wells, .Wast�water��Treatment,
Septic Tanks. � � `` ,
- US Environmental Protection Agency-Asbestos abatement.
Federal Aviation:Authority_=Runwey8: �
I understand that the.following,restrictions apply to•tfie use of flll:•
- Use of flil is not allowed in;Flood=Zone"V"unless�expressly permitted.
- If the flll material is to be used``In.:Flood--Zone "A", it Is understood that a drainage plan addressing a
"compensating volume" will be submitted at Ome of permitting,which is prepared by a professional engineer
Iicensed by the�tate-of Florida. �
- If ihe flll material is to be used in Flood Zbne 'A" in�connection�with�a permitted buflding using stem wall
construction, I certify th,at fill:wJll:b.e used only.to.fill the area wlthin�the�stem vvaali. - •
- If flll materlal is to be used�in any a�ea, '1-certify that .use. of such flll will not adversely affect ad)acent
p�operties. If,use of fill is found to adversely:�ffect adJaEent�pmperties,.the owner may be cited for violating
the condl#ions of the building�.permit issi�ed�under the'at�ached permit application, for lots less than.one (1)
acre whicFi are elevated�by flll;art englneer�ed dralnage plan is�required. .
If I am the AGENT FOR THE OWNER, I,:promise In good.faith to inform the�owner of��the permitting condi�ons set forth in
this affidavtt�prior to commer�ctng construction: ;I unilerstand that a�separate permft may be requlred for electrical work,
plumbtng, signs, wells,.pools; alr.conditioning, .g�s, or other Install�tlons not,spec�ically InclurJed�in.the application. .A
permit issued shall be construed to be a�licensei to�p�oceed with tNe�work and not as.authottly to,violat���cancel, alter, or
set aside any provisfons of the technical codes;�nor shall issuance�of a.permit.pcevent the Bulldirig Of�icial from thereafter
requiring�coRectlon nf errors in.plans�, construction or vlolatlons of any codes. Every permit Issued shall�become invalid
unless the work authorized.by such permlt:is.commenced•viiithl� six months of permlt Issuance, or If work authorized by
the permit is suspended or.abandoned for a:period of�six(8)montf�s:after the'time�the�work�•ts commenced. An extenslon
may be requested, In writing, from�ttie Building.O�icial for a period�not•to exceed ninety(90) days and will demonstrate
justifiable cause for.the extension�. If work ceasea�for ninety(90)cons.ecutive;days�..th�Job�is considere�aba�doned.
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VVARNING TO OWNER: YOUR..FAILURE�TO.;REC.ORD.A NOTIGE:OF�.COMMEMCEMENT NtAY�RESULT IN YOUR
PAYING TWICE.FOR IMPROVEMEN�S-TO�YOUR:.PROPER'tY. IF�Y011�IHTEI�ID:T��OBTAIN��FIPtANE1NG;'CONSULT
WIT UR D �O. AM�A ORN OR�°:. ECO � 6-� . �C ? E �
FLORID%iJliF�cA�(P=.� a�i. 3j- - - - - _- _ ' - - . . `
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OWNER OR A1�3EP1 CONTRACTO
Subscrlbed and swom to aNirmed)before m ihls ubsalbed and's �io(of afftrtnedr efo me INt� .
by i % -�.�'.
Who Is/are p�rsonelly kn wn to.me or haslhave produced Who is/are onelty kn �to me or haslhave-produced
as-IdentlBcatlon. � � as Identl8ca0on.
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Nofery Public . � . .%�' ^ � � � Notary Public
Commisslon No. , Cotr� taslQ .No _
V �Y.:Ye•, JAC
=zR�� :'__ Commission#FF 150422
Name ot Notary typed,printed or stamped Name of Nolary ; P" er ,
�%'�j'�R f��y°,�• Bond�d Thru iroy Fain Insurence BOOJ&5•7019
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� � � PROPANE GAS ' ' ' '
. � �+►lvD AIC �NC. Servic rder Pro osal Air Conditioning 8 t{eati:
�irce �98� • 81_3-782-5013 � �
Sales, Service & Installations t-,�r.,�r E•. ��>��i:��_.f:•3; ;�E:���.� i.;��:.r.,f.�ra ,: ,; �;F�.�� F-,����:;
r�'- � r i��;�',�_.�•� .r::i ' 9 r_� . v,
4441 All • �. ;�; • r.��-�,:_ , ;:�t. �_��.. ., ?.�; � �:��,
en Rd. Zephyrhills, FL 33541 , .
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NOTES: I;=•-�-r :-�:1'i`•i�• r='f?;Jh1:l'=:1='',� ��Ir =-' "- t3;�i-ti;;
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• DESGRIP'TION`OF WORK QTY. MATERIALS&SERVICES �UNIT PRICE AMOUNT
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RECOMMENDATIONS �'�/l��� T �tl�T �,�C�N�� 7 i� i
Annual Main'teriahce Recommended by All Equipment Manufacturers. � ' '
^ i Pressures Lo HI T-Stat i i
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i REFRIGERANT R- LBS. $per Ibs. I I
iFILTERS` x x Changed Monthly • I I
. FILTERS x x � Changed Monthly � • �
I
�O REGULAR ❑WARRANTY TOTAL St1MMARY ,
' Dehumidisfat Settings: When here"ON°, When Away 60°0, T-Stat 80° 0 MAWTENANCE GONTRACT SERVICE i
LIMITED WARRANTY: All materials,parts and equipment are warranted by lhe manufacturers' � METHOD OF FAYMENT CALL , i
or suppiiers'wriflen warranry only.All labor pedormed by the above named company is warranted for �
30 days or as otherwise indicated in writing.The above named company makes no other warranties, ❑CAS H ❑CK# TOTAL i
i express or implied,and its agents or technicians are not authorized to make any such warranties on MATERIALS i
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behalfofabovenamedcompany. ❑DEBIT ❑CREDIT ❑OTHER MAINTENANCE i
I have authonry to orCer the work ouUined above which has been sa!isfactonly compleleC.I agree Ihat Seller � PROG. W ! C
retains title to equipmenUmeterials lurnished unGl final payment Is matle.II payment is not made as agreed, CLAIM# �
seller can remove said equipmenVmatenals at Seller's expense.Any tlamage resulling Irom said removal shall G'�
not Oe the responsiDiliy of Seller.NET 30 DAYS.A 1 1l2 h SERVICE CHARGE WILL BE ADDED MONTHLY TO I C�(f dN -,�pG'I
ALL UNPAID BALANCES OVER 30 DAYS.NO REFUNDS DATE COMPLETED �,
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