HomeMy WebLinkAbout15-16650 CITY OF ZEPHYRHILLS ��
5335-8TH STREET
(sis)�so-oozo 1 65
BUILDING PERMIT
- PERMIT INFORMATION"' � . LOCATION INFORMATION
Permit N��ber: 16650 Address: 5629 MUSE CT
Per.mit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: SUNSET ESTATES
Est. Value: Parcel Number: 12-26-21-0310-00000-0890
Improv. Cost: 4,170.00 ` OWNER INFORMATION
Date Issued: 10/05/2015 Name: BLACKWELL GERTRUDE M TRUST
Total Fees: 60.00 Address: 5629 MUSE CT
Amount Paid: 60.00 ZEPHYRHILLS FL 33542-5816
Date Paid: 10/05/2015 Phone: 813-788-4309
Work Desc: A/C CHANGE OUT 3 TON
CONTRACTOR S � APPLICATION FEES - �
BAHR'S PROPANE GAS& C, INC. C CHANGE UT 60.00
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Ins ections Re uired
DU TSIN TA ED I
DUCTS INSULA��
I FINAL L O �
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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CONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
�
813-780-0Q20 City of Zephyrfiills Permit Application Fax 813-78U-0021
Bullding Department
Dats R�c�:ved Phon�.Coatast for Permttttn - 1� �� _ �L`��3
Orvner•s Name 1�L �GL� ��i2,7�@ LC.`71� Owner Phooe Namber ���� �o r ���t
Owner's Address �c�r,�� „/��� �IZ� dwrner P'hone Number � �• �
Fee Simple Tltleholder Name �^ � Qwner Phone Number � �
Fee Simple Tltlehalder Addresa
JOB ADDRESS ��40� / ��/�� '-'�`'� LOT# C`�
SUBDIVISION �— � PARCEL ID# fa o� e�j �31� �`G��L� L����
(OBTAINED FRQM PROPERTY TAX NOTICE)
WORK PRt}POSED , e NEW CdNSTR� ADD/AI,T � SiGN Q Q DEMOLISH
INSTALL. REPAIR
PROFOSED USE Q � SFF2 Q 'GOMM � OTHER
TYPE OF CONSTRUCTION • Q BLOCK �'�[� FRAME C� STEEL [�]
DESCRIPTION OF WORK �������/� � � '� � .,� �/lI a �l37n 4 ��.5
BUiLD1NG SiZf � '`.�� $Q FOQTAGE C� HEIGH7 E��
���«��N�"' �� VJ4I.UATION OF TQTAL CQNSTRUCTION
QEi.ECTRICA! $ ��� � � AMP SERVtCE Q RROGRESS ENERGY Q W.R.E.C.
QPLUMBING $ ,
�,�
QMECHANtCAL $ JJ j rT�. D�; VAi.UAT10N QF MECHANICAL IFVSTALIATl01+1
�"
QGAS Q ROOFIt�lG : Q SPECIALTY Q OTHER
FINISHED FLOOR ELEVATIONS �� FLOOD ZONE AREA QYES NO
BUEI.DER COMPANY
SIGNATUR� RHGISTERED Y/ N ' FEE CURRE� Y/N
Addre�s ' L(cense# ( � �
EIECTRIC1Al�t CQMP/WY '
SIGNATURE � REGIS7ERED Y/ N �e cuw�en •Y/N
Addreaa -�� � _Llcense# �� �
PLItMBER COMP.AHY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address � � License# � �
MEGNANtCAL j � COMPANIf ��'S l"fD�i91J�. (�`"� ?°—�+C�"�l�
SIGNATURE ���'�L����/�'�� RHGISTEREd Y/ N �E CuR�ten Y/N
Address ' Lfcense# �l-�%v`T ���`p
OTHER C{>MPANY
SIGNATURE ^ � REGISTERED Y/ N.. �e CuR�n Y/N.
Addres$ ' • Llcense# � ��
,-
RESIDENi1AL.. �Attach{2}.PIot.Plaris;.{2}se#s�af:Biilldliig'Plairs;�{1)set of Energy��artns:�R-O-W Permlt for new construotian,
•Minimum,ten_(:1.4),working:days.aftec.submitteil date..Requlred ansite,ConstFUCtion Rlens;Stormwater'Plans w/Sflt Fence installed,
Sanitary�Faciltfles�&�1,dumpste.r,:SIte:Work�Rermlt for subdtyislonsllarge proJes:ts_ __
GOMMERCIAL Attach{3)complete sets of Suitdirig Ptans pius a�tfe Safety Page;{1}set of Energy Forms.R-O W Permit for new canstruction.
Minfmum ten(1Q)working days'after submittal date. Required ansite,ConsUucdon Pians,Stormwater Plans w/Slit Fence installed,
Sanitary FaciliUes&1 dumpster.Site Wark Permlt for al!neuv projeots:=AIt commeraa!r+equlrements must meat compllance
SIGN FERMIT Attacti'{2)sefs af Englneered�P_lans.,_. �V � . -
"""PROPERTY SURVEY reGutred fo�all NEW constructlon.
Directlons: ' - , , ' ,
Fill out appiicatlan completely. � , � �� r"r . �
Llwner 8�Contractor sign badc of appltcation,;notarfzed � � �
If over 52500,a Notice of Commericeinant ls required�(A!G'y�rades over S75Qq) . --"° �� � _ � ,.,j'Z ,
'" Agent(far tlie cantractor)`or�Power of Attamey(f6r tFie owner)would be someone with notarized letter from awner authorizing same � �� "
DVER THE COUNTER PERMITIING �- (Front of ApPlication:O�ly)...::,w y..f ��.; . _ : . _ _. , . _ _ _ , ,
Reroofs if shingles Sewers Service Upg'rades AJC�, , Fences,(Plot/Survey/Footage) , _, : ��' - ' , , �
� -� �s`' _ � � ,�� i} ,.. - r , .
Clriveways-Not over Counter ifi on pubtic roadweys.�.-needs ROW-'s-`, =� ' , ,' . ° ' � , �
, _.,_ . __ ��-_. ..-.....� ,--: ,'>.`;.....,. -.. __ ., . , .. ,.-__. ,
NOTICE OE DEED RE:3TRICYIONS: �he und�cstgned:undergtands°:tFt�t;tFtt�;.p�xntit:may be.subject t�"deed*res#rlgtlons� ,'
which may be<more�re`sttictive�r�tti�n�.Countjr>�'+egulations:��The�`�'u�dersigned°assumes�responslbiltty�.far�compliance'witli"any ' `
applicable deed restricttans. .,- .t:_ .�,�;.;; :,,FM; -.._. . • � , �
tdNLICENSED CONTRACTORS .aND GK�NTRACTaR�-RESPONSIBiLiTIES: �ff�the awner=has���hiced �a contractar or
contractors to undertake work, they may;be,requlred,bta.be.licensed ln.accordance.with state.and•local_r�gulatlons:��:If the < �
contrac�ar is not 1lcensed as�tequlred;6y law;6oth the owner arid=contsactor=iiiay be�ctted�f�ir:-��.misdemeanar vialation
under state law. If the awner or intended,�:con�ra,ctor_ar,e„uncertaln as ta what Iicensing.requirements.�:may-apply:>far�the- �°: �
�,....., . ; _�.,.
intended work�they are advfsei!to cotitact tkie,-Pasco;County BuitillCi�rlrispectEon Dlvision-=Licensing SectEon at T27-847-
8009. Furthermore, `if the owner'has tiited `a cbrit�aictoT o`r contractors, he is advtsed ta have�the contractor(s),ksign
portia�s of the "contractor Blook" of.tNis.applicatlon far;which..they.wlll...be,r.esponsible. .if..you. as-.the owner"sigri`asi�the
contrac#or, that�may be an Inc3icatian�ttiat`he�is not.prope�y Itc�r�sed arid'Es not entitled to pe�Fnitting prtvlleges In P�sco
County. ' � ' � �
TRAN�PQRTATI�N.�fMPACTIU�1l.ITIES tNIRAC'��A��!RESOURCE RECQVERY FEES;��T�he underslgned understands
that Transportation impact Fees and.RecQUrse R�cove.ry.Fees may:�appiy,to�the�construction of new_buildings,,change5 of= °
use in existing buildings; or•expansi�n-.of.�existing�buildings, as specffied ln Pasc� Caunty Ordinanae number 89-07 and
90-07, as amended.,_,�The undersigned alsa:understa�ds� th�iE�suah fees;�;as=tnay�`be:�due;,.wllt:be identified at#he'fime�;of;-�
permikting, It Is further understood that T�ansportation Impact Fees an.d�Resource.:Recovery'Fees.mu�t be pald prior to
recetving a 'certificate.of occupancy"ar f�nal:powe.r.release. .1�the project:.does riot Involve�,e>cert�ii�fe of occupancy�o� � �
finai power release; the:fees must be paid;prior to permit issuance. Fti�thermore;�if:Pasca Counly�°1Nate�JSewer�:lmpact �
fees are due�they.must:be-pald prio�to.permit=l�suance-In accordance wlth:appticabfe.Pasco':.Countji o�cllnances.
CONSTRUCTtON`L1EN"lAW(Chaq#er T13,Flarxda St�tutes,��r�tendl�dp: if valuation af work is$2,500.00,�or mate� 1
certify that 1, the applican4, have.been provtded with �a copy-of`the�"Florid� Constructlon��Lieh..Lav�Homeowner's
ProtecfEon Gulde" prepared by:ths Florida �ep°aE#r�e�f of Agrlculttire and Consumer�Affalr`s. i#the appt{cant is so�teone
other than the°owner", I certffy.that.l:have.obtained`�a�'copy,of.the above..descritied�docur�ent�and:p,romise:in,good'.faixh�to
deliver it to the"owner."prio��toycommencement:. .' . -' . . .
CONTRACTOR'S/OWNER'S AFFIDAViT: I ce'rti�Y.that::all"th�..information tn thi�appllcatlon is accurate,and that aii work
will'be done in campliance with all.applicable laws �egnlating aonstruction, zontng and:�land�development. Applica#lan Is
hereby made to obtaln .a.permit�.;to,,do.:,warlc:.,and t ins#a1#ation as indtceted:�� 't certify that no work�`or tnstaqation'fias
commenc�d prlar to issuance of a permit'and that':all work will be performed to meet..standards of-ali laws �egulaking-
con�t�uction� County and City codes, zoMng regulat(ans, and land development r.egalstEor�s-tn the jurisdtctian:. .1 also
certify that I understand that the regulattons of other government agencles may�apply�to the intended work, and that it is
my responstbAity to Identify�what.actlons 1 must t�ke:to be,in:.corr�pllance;.,Such agencies include but are.not Ilmited,lo:
- Department of Et`�viranmental�rProte�tion=Cypress�'Bsyhead�, 1lVetland i4re�s'a�rd Environmentatly Sensitive
Lands,Water/Wastewe#er Treatment.
- Southwesi Flor�da Watef Ma�agemer�#� Dis#ric#-Wells, C}lPress.�`Bay.head�,- Wetland Areas� Altering
Watercourses. ,
- Army G�rps of Engineers�Seawails,=Docics,Navlgable Waterways,
- D�partment of Health��� Rei�abllitative,.Ser.vices/Environmental ;Nealth Unit Well.s� Wastev�taterTreatment,
Septic Tanks. .' �, . .` - -
- US Ern�ronmental Protectlon Agency-Asbestos abatement:
Federal AvNat(on�Authority.;Runways:
1 understand that the�folfowing.rest�fctions appty to the use of fllk�
- Use af fill is not allawed tn Fioad.Zone"V"uniess�expressty permitted. .
- If the flli materlal is to be used��in..Flood. Zone. "A"� ft. is understood that a drainage plan addressing a
, "compensating volume"w�ll be submltted at#ime af permittlrag wliich is prepared by a professional engtneer
Ilcensed by the State of Florida.
• !#the �1! materlat'Is to be us.ed 1n Flood �one "A" In;connec�lon�wlth''a�.permitted bu3lrling asing stem wall
� construction, i certifiy that tiil�:wlll:be used only.to.fill#he area wlthfn.the�stem vvall.
- !f fiA materia! Is ta be used !n any area, 1�certify tfiat .uss of-such AN w3A not adversely affect ad�acent
properties, !t use of�it is found to adversety:�ffect adjaeerrt.properties,.the awner may be aited for viola#tng
4he condi#ions of.the bullding�;permit-Issued.<undea�tfie�at�acli�d permit applicatlan, for lots less than.one (1)
acr�whtcti ere eievated�by flll;a�t engineer�acf drai�age plan Is tequlred. .
If I am the AGENT FOR THE OWNER, I;:promise In good faith to Inform th��ownerof�the permitt(ng condi#lons set forth in
thts affidavit`prtor to commencing canat�uction. I undersfand that a�separate permit may be requlred#mr etectrical work,
plumbtng, signs, weils,.poats; air,conditioning,.g�s, vr�other install�itions not.spec�ically inciu�ted�in.the application. .A
permit issued shall be aonshued#o b�-a'Ii�ense to�-p�oceed wlth tF�e work and•not as:autho�tiy to.vinlate,�cancei* alter, or
set aslde any provlsians af the technlcal c�de�;�nor sha11 issuencs•af a.permft.pcevent the Bullding t3i�lcial from thereaftec �
requiring a correction nf enors In•plans�,:consfr"uction or vlolations of any codes. �very permlk i.ssued shail�became�invatid
unless the work authorized_by such permft��ls_cot�tmenEed within si�c.�nortths of permit lssuance, �r 1f�nrork au#hor�zed by
the permif is suspended or.aba�doned foc.a;perlod af�gix(8}monffis:afiter ths tinne#he�work��is commenced. An extenston
___may_be requested,.(n writ(ng,�from #he_Building.Q_fficfalUfor_a_period not•ta_exceed.nlr�ty(9p��days a�d-avviil!�derrionstcate-- - —--- -
justifiable caus�for.�the extenslo�: If wark ceas�s�foc ntne#y(90}cans.ecutive:day.s...t�te jab�s cansldefed aba�tdoned.
WARNING TO �WNfR: YOUR.FAILURE-TQ.,.RE.,C.O�tDYA NOTIGE:Q��C4MM6M�EMEI�T��VtAY�°RESU�T IN�YCtUR
PAYIMG TWiCE:�'t�R:IMPROV�NfEN'�S�TO.YAUR:PROPER�7Y.:�I��YOU�IN'FE�IID:"T�1;�9TAIN��FIN�►�1E�1VG;'C.ONSULT
WIT U D � AN 0 ��:, O � �:- •. _. , ; E, ; _
FI.ORlDA.1{1RA�-(F . . Z.Q3), - Z " . ' . . .
E ,
OYYNER OR A CONTRACTO
Subscribed and�wo {or afllrtned) efa e me this Snbsqibed'�pd' =tc{ot aflirm � etore nte'tht�
by -
� INho Is/are persa ty known M.me or haslhave produced Who.ls/are personally known�.tq�rtte or hasJhave•produced •
as Identlf�8on. s tdentNicatian.
Riotary Publlc Notary Publlc
Commiss No. Commisston_ .
,��"Y'oy�.,, JOEL E.BACON ,�����.
,.��':.r''��, JOEL E.BACON
Name Nofary �i .- une 29,2418 Name of h�ofa ' _t �
^ o�: ExP�f� ;�� ;,; Expirss June 2 ,2018
Bonded Tlvu Troy Fein Instdance 800�308•�O19 t�,a�
����4;� ��iP,a 1kT,, Bnnd�dThmTroyFanlnsurance60o-385a019
vrwwr�a�'�'°"��� n� y�,�.s�
A __ `U�l� � 15 ` !�� �CG �'IC��`� ��es --�.,-�
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� � � � PROPANE CzAS � � � �
� AND AIC ttvc. Service� Order/Proposal Air Conditioning 8�Heatinc II
�S'i�ce �988 813-782�5013 �
L°.�i��l"��i �t'<4)��a;� f��'�[i}_�.'t��l'i�-I�'.i r�C'.^�i C:�3i��
S�.les, Service & Installations �'��`- '�r��'!r= ��'�'`��� �L'�;'�«�:�'i�� 1�i•: �.�;
4441'Allen Rd. • Ze h rhills FL 33541 '���'�'�'' '��`� �`'��'�� ,`�c
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?7,c° -- - - _ _ - ,�.{�i}�s�g�?�':._���,;;t " _ - _'
...fY":"��G�:�2:;• '—,-�.�.�... _ :'i?PBC,;'�:'`�^ ' '�:Ys-�.�- �
• - - ---,r,- _ - _ '" ' - -.;.ti:��s�=.i>,
FILTERS x x Changed Monthly I I
_ FILTERS x x Changed Monthly � �
❑ REGULAR ❑WARRANTY _-�';>`;�4TAtiSUMMARY' ; -
��.DeHtiiniclistaE;�Seftin�s_:When here"-ON";;When Away 60°_;;'-T-Stat 80°Y ❑ MAINTENANCE CONTRACT SERVICE i
LIMITED�WARRANTY: All materials, arts and e ui ment are warranted b �the manufacturers' - CRLL i
P 4 P v iVIETFtOD=aF�PAYMEN'C -
or suppliers'written warranty only.NI labor performed by the above named company is warranted for -�� ""� ` TOTAL i
30 days or as othervvise indicated in writing.The above named company makes no other wartanties, ❑CASH ❑CK# MATERIALS i
express or implied,and its agents or technicians are not authorized to make any such warranties on � �
behalf of above named company. ❑DEBIT ❑CREDIT ❑OTHER MAINTENANCE i
I have auNorily to older the work outlinetl above which has been sa0sfactorily wmpleletl.I�agree ihat Seller PROG. W / C
retains title to equipmeMlmaterials fumished untli finai payment is made.It payment is not made as agreed, CLAIM# I ,
selier can remove seid equipmenUmaterials at Seller's expense.My damage resulting irom said removal shall �
not be Ne responsibliiry ot Seller.NET 30 DAYS.A 1 712%SERVICE CHARGE WILL BE ADDED MONTHLY TO DATE COMPLETED �' � ^ �� ��
ALL UNPAID BAIANCES OVER 30 DAYS.NO REFUNDS
' I
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CUS OME IG RE � DATE ✓� �ozc TOTAL � �v