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HomeMy WebLinkAbout16-17369 CITY OF ZEPHYRHILLS � . 5335-8TH STREET (813)780-0020 17369 BUILDING PERMIT � PERMIT INFORMATION . LOCATION INFORMATION Permit Number: 17369 Address: 5246 17TH ST 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: 11-26-21-0010-17800-0140 Improv. Cost: 4,300.00 OWNER INFORMATION Date Issued: 5/20/2016 � Name: STEWART JULIANA Total Fees: 60.00 Address: 5246 18TH ST Amount Paid: . 60.00 ZEPHYRHILLS, FL. 33542 Date Paid: 5/20/2016 Phone: Work Desc: A/C CHANGE OUT 3 TON CONTRACTOR S � APPLICATION FEES ALL SEASON AIR CONDITIONING & HE A/C CHANGEOUT 60.00 � I In s ections Re uired D CTS INSTAL ED DUCTS INSUL�T FINAL �� 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 performed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. CONTRA OR SIGNATURE PERMIT OFFI R RMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER a�aaa�-aozo City of Zephyrhills Permifi Applicatipn Fax•813-780-0021 ' � , •� Building Departrnent_ Date Rec�tv�d . _ - � Phone Cont�ck:for`Perinifttn``°°��� " - Ownar's Name � rh•� �.1 �w c,v tf.wner Phone Number ' Owner's Address 2 �b ` - � . C� . �{. /`7�~� �7 � l;lvvnsrPhone Number � Fee Simple TlNeholder;Name� `� • � `' � �' �, Qwn�r�Phone;Numbar �� � , . - _ .�r����... ... F _ , . , a _ - ,. .. , ... . '� �- ,. , - �Y � _ Fee Simpl�Tltleholder Addre�s .� - - � - " • - ' - �. ._ J08�1DDRESS � „ LO'�#, �� . , . :, _ _ _��- , - =�. , ... � � - , - � . � . - SUBDiVISICIN F PARCEL ID# '� ' - " . '-_ ' , • , , ` ., ' � .. • �. �(OBTAINED:FROM'PROPERTYTAX`NOTtCE}; WQRK PRt'>P05ED � � NE1N CONSTR �:� � '' �tDD/A[T Q �SiGN ,.�Q " "_; Q:�. DEMOLiSH , � . .., e i� , INS?A@L :;8:-� �:�':REPAIR� - . r .., . = W - . . _. . -,.. . . - . PROPOSED�ifSE. : . . , , Q� 'SFR. � ,GOMM'' � OTH�R - TYPE OF CONSTFtUCTIOW�� -�"' `BCOCK�' ;�CJ.. FRAME � STEEL.;"Q': �,v . DEBCRIPTION OF WORK +� C...�- C':�'1 G� �' C, �.. C� . . � , ; + BUH.DING SIZE ✓ ? ��� ��`SQ FQ07AGE, �� � , :HEIGHT� L..'�__�. , - _ . ��__��a:SLJ. -, . _, QBUILDING � �=�r=�-�_ �..��-=_r- - ; , , • : , • , ` ` ��. �t.._ ..._.. .. � - : , VALUATION OF'`TOTAL CONSTRCICTIOiV ; _ �,� , . _. ' < . �]EI.ECTRICAL $. , 1 AMP SEitVICE `}Q � �PROGRESS ENERGY ,`_[�. VN.R.E.C,. ._ � . �� � - � T, ; .. �PCUMBING $ - . . - - , . '�.��` - `? . , ' -- - - � �c/�� 7;.g �� .. � 5: .:• QMECHANI�A� � $ ' - � VRLUATION,OF M�GHAMEfi.Al.1N8TAltAT10N�, � . , . � '��.:� , � � - ' . . �/.�. QCa�18 . - .. ROO�ING.�;,.,.�< ;, SPECI�4,L7Y^': '. . OTFiER�. : : ��^ •`'`./�' , . ,c� a � a o� � � � �' FINISHED FLOOR ELEVATIONS �� FLOOD ZONE AREA �]Y6S. NO. . ' �"""�.L�/„/ ��"d:.,`-'° - .. �y� '�T' .C'- ' !' BUtk.DER COMPAMf ` . r � _. � . - _ � . _ SICiNATUPt� R6C31STEREd Y/ N�_ � FEE CURRE�;`�,,. I. Y/..N. :- �, , - ` � � _ .._.. 4.. Address .. .�• � , � LiGense# . . . . � t :. : 1 ,. , , N _< ,. , . ,�.� . �,�, . , : �• . .. ELECTRiC1Ai!1,_ ,. ..�, . °�� a.``,CCITi+iPANY° - ` , " _ . SIGNATURE ' �' RHGISTEREQ Y/ N �E Cut�ten;' ' � Y,/�N'��:' . .. , . ,. ,_.:.. : ..l ;.,,.�°�''� ` :..� Addres$ . • .., . . . .�. , `.� „ ,. .::Llcense:#='I:_=:: •:, , -: , , , , . . , .r . , . , . ... �lUMBER � ,� ,�; '., - � . � ,. - '.COMPANYt- '_�::: .:. , :..; ,. ; ' � , SIGNATURE �",.. =R�t�iS�Rep - -. ... �:Y/�N eeE�cuw�n= � X/"N:.: : . �4ddre�s : ..� . � ,. � ,., lJcense.#��• , , . ,� �Ecwar��cu:;_ - ., ` - � ', + � , } -,con+oP�r�r-°: ��;:.. : ._. ' _ = r � s ,i� �� ,.,.,�� , , _ . , � IGMATURE .REG�S7EBED, . Y;��.N , ` .,;',EEE,CURREK� ,Y/N`:�.; : �4ddrass�' _ ���'��. 'j, _"`�',�-'" ..t - - .�. �� . . ��_- :.::,,;_l:ic:ense# f:��/`�i1,....�s„�'5=�:.�,� Q��R . ; � _�.., . - ,. __ e ...r. `��, .� . �V,o-'+p'� .r" s - _ ' � - � • .=,. � ... . -.-.... `. . .. : � - �7'�, .u;�h' ..�..�,: ,ap- _ "'�:Si:;:-; �y SIGPIATURE,, � . � - `` , .'" + � _ ���REGISTEREp Y,./;N;;.•;' �EE�'GURREA'. Y•/�N�� , - � . _ , , �i�}�' . r .. . . _ �`Y. � _ , ,- - , . . „�..}�;�- " _ -iy�'-`'_'�.; '�.:a� _',..n-�.. . � ' v t .}" t` j'�� - � � . ' . �4ddreas ;4'� :�t=;:`�`� - Ll�en§e'#'�I� . � , . , ' _ _ -t k^` _ - _ -•,'t�7" - ;:F:., _ <.n<.�,i'�.`5�'' =i r�•� _ 'vs'4'';�',:< _ . .- .. r. . . . -' R EN Plot:P1"ns.z� ;se":of'B`u11illn`���Plaiis�`�1�'set.`of�Ene= `�Fomis�`R=0=1N=Permtt:#o�nsinr:;croiistruatton' - ESlD T1AL.:;�=�`Rttach:;{2).,_. a .,.��) ts 9`:: �_t:).. r9Y... ,,., r �.: �.,,.;�,.., � ...,,_: -. : .,. ' ��Mlnlmumr,ten'�s1.� workin +d"a' -a{t'e�sufi"`.Iftal{clAte:':R„�ulr".ed oristte;ConsUucUon�Plans;µStomiwater'Plans:wl-Sllt Fenqe Insfalled, - ..u,:� , . ,,,a � Q�b , .9...=.Ys3._ !�! ., �!4 .: . ...: -_ - . ., . _ . � �'Sanita rFadlitt�s;��;1=;dum ter�Slte�,VYork»Pe. �If#4 s�! l �{�;_'��::��:`y";>"=.��-`�_ _..._._� __ - .s:�_ rY .�:.;�i,,.T.�.:.¢�...,,�t.Fsrk,...ru:� ��:x�:�:�-A�!k:. r;'sutitlivi'slciri arg�'p_roecfis; .. ��. .,;: �= ; ..; n. .,:..., . ;_ ,` . COMMERCiAt Attadt(3���:ompleta�sets of'Buitding Pians plus a Ufe Safety Page;(1 j set af Energjr Forms.R•O-W Permit far neW corisiructlon. MiMmum ten(10)working day�'after submittal date. Required onsite,wConstruction Plans,Stormwater Plans w/Slit Fence installed, � Sanitary„FaclliN,es&.1.dumpster..S[tenWork.Permi�rio.r-aN aew�projer.ts:`AI!'commercial.2equifements:must meet compllance _ S1GN:�EttMiT Attacti`(2j sets of fn9��ered Plans:��:;^�~:���>`��... �,:�.. - ° . .` _. . • - -` � , "«""PROPERTY.,SURVEYreguir+�d�:fora�I1�NEW�,cons,tr,ucUon.~ - , ` - � _� . r - � Directions: ;;�-;x,,, _ , • _ ._..__..�.. ,. _._..m_ . ._ _. - . � Flll:out applica8an completely. <3wrner&Contrador stgn back-of applicaHoa,notartred If'over'�2800,a Notice.of..:Commencement Is required._ (AIC upgrac9sa oyer 57500).,._ � ' . � . ..�;��?.,;:,......�w:....._<.:.....� "_�..__.-.._..._..�.,,..�._.�...,....,- .,�.. .,. . �" Agent(inr ttie`contractt�ca`Oc:Power of Attoiney(fo�'#iie owaer)would be someon�with notarized letter from owner authorizing same , : ��;e,,; r1 .. � _ . `OVER'THE"COUNTER.PERMITTING'>-"::=;"{Fiontiof�ApPllctationOnly) .'.� "� -� �� - Reroofs If shingles Sewers Servfce Upgradesi.AlC Rences;,(PIoUSurysy_/Foatage) _. •- .__.._,.._,_._...__� _w,.W,R.:._. . ... ::. ... ME_ .:_'.:.-.i,x��;:-:,:a:�y ; .<.�.��.,,�. ., _ . - - . ��1 k X-•.;: er . ''_,:n,"� ' "' , Driveways-Not aver Caunter If on public roadways::rieeds RQW ��=�' i � '� �-!� 't _ ._ � , .^'--. , . ' j'°� _.i i � -. . . v . - - � . � ..� -.. . � "f`r 'S � • . � , T�CE OF DEED.RE37RICTIONS:�The,undersignect��untlerstand���#.h�t;ttaiat: it:�.may;be;sub e.ct�.to:°aeed";reskic.tions"�"�''�` ,�'�' t � � - ;:.a ,�. a'. r. ; :. 7,��� f4..,�:*.�i+=-r:,"r ��;<�•^.• ��.�. z ` 'r+%"� ch�may be:�more:rest�Ictive:;tFa�Fl�GounEy i�g�ilattons The��n'd,erslgn'ed�a��umeg:re"s,ponsibtlity for�aompliance;with�:any � ' � � �flcable deed'•'re�Nlctions: �:,Y,:;;�:��a�r "� _ • ° ' _ _ _ �-" � :�F�'��`�':. . , - - - -�. ,,;r;r -= - - =` UCENSED��"G:ONT�RAC7>OR3��;AND'CONTRACTOR�''RESPONSI�ILI7`I�S.:��'If=.�Fae�}owner�`lies'�hirecJ�`�TM'i;iintractor or c o �undertake>wo�k :tNe - `a :'be.:r� ui�.d�toa�e;licens:e°d:In�accor..dance.with:state�:antl:.i.oEai-re ul`allons:=�if°�tFie�-���-=a , .. itra t rs`io ,; y:m Y., ,�4- - _ _ t .;: �;,_� m.;��.:�rr. :¢x�:���.v.�..�:t_m.�. _ ,9..,,,._ - �tractor:;ts•�not.ltcensed".as�re'ulr,ed.=.ti .,-1aw';"both��:the:`owner�and�con4i�acto��me "-�tiewcifeii�'for''���misiletneario�vlolatton 4 _ Y .. .�___,_,. . Y ler state law. If tfi��owner or Intende+`d�;cantra:�torr�a%e.,uncertalh e8.to wFiat�licensing:�equlretnents:-ri��yr°appljr�forttie:=�-w�>-Y'�°v�'� , x n:�,,...4 .-�•_._. �� �nded work;iNe �are:advised�to'contacf�tFie P�as"`co:.'�ouiity;:Building'Inspection:�Dtylsio�icensina�Sectlon at 727-847- - Y . � _.. ...�:....._......-....z.t,.._��:...iu ^�.._,�.�.'«'.':a4,Y.:1..- . . .....,. . �. . t-y�+: l. .=t�::.��.,». �9. Furthe�more;=�lf�tlie°fovimer-�Na's��hlr�d'�a`contractor'oT��cont`r'actors;-he�is advised�to Fiave°�:ttte contia,ctor(s)�sign.�t,,,+,`.{;^._•. Ilons of the"contrector Blo,ck°;.of.�this�application;�for:whtch:they wlll.:be,:r,.espons161e.:;;l�:you;,�as#;the`owner�:stgn��as�the� � � � � . . •r , _ , .. . . ... . �._,. ._.�.�..�.�,._. �: . __ ,..v ;. . tractor, tliat`�iia��6e`an�indication th�t.�he-is not`�'pcopeHy�licensed�'antl-Is not''enti8ed"to`permitting prlvileges,�tn Pasco,, , ,,._ ;� , intY• � • ;_.�._. ,... - - . �-_„ .�_�:_�,:�„� _;;.,:,�.--.L. ,.- . - .� .,.. -,. - t'i . , . __,_. .._.___�__...._._.. . ._. ,.._.r ._ . :. �IVSPORTAXION�IMPACTNTILITiES<I�IRAC7:AI��;I�ESOUttC'E�R�COV�RY�FEE3:'�Th�under�ig�ed�understands � _ Transportation Impact Fees�and.Reco.urse Recovery:Fees may�apply�#a tF�e conatruction:of;new;bulldings;;change;of}��°��`�`��'�' In exi'st(ng buildings;�'�r�e�cpai�si�n::of`�zi;sti�i�.,b�iitilii�gs;as�specifled.tn P��co'Couoify Ordinance nuinber 89-07 and . l7. as amende.d.:.�.�h�.undersigned �I�o�urtde�sta�ds; thsit:`such fee.s;:�as:tnay�;�e:«due;;w01���e identlfled at theftime`�of�''`�`��`x°="'� �. ; �: ...•. � , - - . . nitting. It Is furtlier'understood that Tra�sportation.Impacf:Fees and::Resour.'ae'�;Recove�`ji�'Fees:�musti be paid prlor to ` , �Iving:a"cerf�icate�oi-occupancy"-=or:flnal�.power_release.���:lf°�the:pFoJ�ct;;does:not�involve�a;::certiflcate of occupancy�o��-�-���'�`°�'��` I powec.��etease;„the�fees'-;mu�t_�be=paid�pcior to`permit Is�uance. -Fu�tk�ermore;;�if:,:Pascd�County�'Vllater/Sewer�lmpact<<°�,�°� •. �are due,..they must be paid�:p�ior to,permit Issuance��in.accordance,:�wit�;appllcatife.Pasco�:-Countji��ordinances. � ' NSTRUCTIONsL"IEN LAIN"(Chapter 713,FloNda'Statut�s�as amerrded): tf valuation of work is$2�500:OO�.or;more;:l� •,� < .>;���- � ify that ,I,.�he_;�ppltcanf,.,�eve,,.been�provlded->with=-��:cx�py�of::tFie:"Florlda��•ConstrucHonn�:Llen�::Lain�Homeovme�'s , I tectlon Guide prepared.by the�Flo�lda`Department of Agrlculture and Cons�m�er/kffairs. If the applfcant Is sotneone ; . jr than the"owner", I certlfy�th�t:-I_have:.obt�Ine�4'a�copy.of.the;above:des.crlbed:�dbcurt�ent:antl:pronilse��in;good;,:faith�to. � ,. _.�. , ver It to the:"o � ° �� ` ��.,,>N._:.. . . �:5, ... . . __.. -..,::.:-.:;�_;.�= _,: _ :•.�. .�r ..� . . ,. . . wne�-p�io�»to�commenc�merit:`=�- NTRACTOR'S/OWN@R'8 AFFIDAVIT: I.ce'4tfyy�t�afi;:all�,th�-,Informatl�Rzl�rj,thl�appllcatlon.is accurat��and that all work 'be done in compllance wlth.all.appltcabfe`laws��egula8ng constriictlon� zontng and�land.development. Appllcatlor► Is �by made to obtatm:a.permit;to�,do==.wotk�:and:"li�stellatlon as Indlcated:�-:y1.;:cartffy-�tti+at�no"viwo�k'Yor Installatton`�fias �menced p�lor to'Issuance of a permlf"and�thaf:all work wlll be perFormed�to meet::stand�rrds�of:��ll laws regula�ing- struction, County and Cily codes� z.oning regulatlans� and land development°cegulauons�fn`ytfie,ju�lsdlctfon:�� h.al'so� I Ofy that I u�derstand that the regulatlons.of other govemment agencles may�apply;to:the_tntended_work� and that tt is responslbllity to Identiiy•what.acttons I,must take:b tie.sln:_corrlpllancs;,,Such:agencles lnclude��but�are<not Ilmtted;to:. - Depa�tmenf of E�lvironmer�tal�'PFotecti�i'n=Gypress`.-��Baqlieedg;=Wetland tAreas and E�vlronmentaNy Sensltive - Lands,WaterMlastewater Treatment. ' �'` � ������ � ' ' - � � - Southwest FloNda Weter Management�:.:I�tsMct Wells; =Cypress•'T'.BayFi`eadg; -=NVetlai�d Areas, Altering - ` Watercourses. � -�.,. _�_ ...� .. _. . - - Army Corps of Englneet�s=Seawails;�Dock's, Navlgatile Wateruvays. � - Dep�rtment.of„Health;..8,Ref�abilltattve;Senilces/Environmen#al...He�Ith::Unit�Well.s;:INaste.water��Treatment; Septic Tanks: - '" ::'. �: _ '.' �.. '' _ � � ,-- _ - - - - � US Environment�l Protectlon Agency-Asbestos abatement.;,; Federal Avlatton.Autiio�ty„iiuriwsys:�.--.: : f � - , ._ derstand that the_folloviiing;;cestrlctlons'apply'to�t6ie�use offlll: . - - - Use of flll Is not allowed tn:Fload;Zone"V"unless expressly permltted. . _ , T _. -,. ._ . - If the flll_matetlal:�;`:I"s�to..:6e;�usedwln�.:Flood�Zone. "A"� tt:�Is understood-that--a dralnage'�plan addres"stng a "compensating volume" wlll.be subm�ted at#ime'of_permlttJng w61.ch ts prep�red by a professfonal englneer Ilcensed b =.th'e��tate�of;Flotlda;�,-� ��' � . �:�� � Y_., ,.. ., - , If ihe fill,mateclal�:is�>:to:�;be�.used�In �lood Zo�e 'A" ln5 connectton�Wlth:�a��permltted bullding using stem wall conatruction,_I.certify th.at:fill�wall�ti.e used only.to.f111 the:.area:wlthln�the stem:wall:- ._.. �-- - �If flll-mateilal��l's"'wfo��tie'�used'In any-area;�l`�certify that .use. of such""flll'�av111�not adversely affect'ad)acent propertles. If use of f111.1s�found�to advers�l�r,.�fecf°'adJa�nt��properties,.the owner m�y be'ctted for vlolating the cond�to�s:of ttie'ti�iildfng�;p�rmlt f'ssued:,under the"`at�aciied�ecmit;��pplicatlon;-for��lots less�than.�one (1) , acra whfch-are elevafeif�tiy,illt;.��renglneered dralnage plan'ls requtretl. , im the A6ENT.FOR.THE�OWNER;�I�rro`mise'�In_good..falth to�lnform the owner ofithe_pecmltting.;condltlons..set forth In ; I� affidavlt'prlorto commenoing'constructlb� I"undersfand:.thet a�s�,ep�arat�perinit may be requlred for elecMcal work,_ i;� . � , �bing, slgns�_wells,,.pools,..alt..co,ndltloning�..gas,,_or ott�er_Ins#ail atlons�not.spec�lcally Included�in.the appllcatlon. .A . '' '�� �. ��-�.-,s ..�, nit Issued'shalf tie�.conshuetl�to=be��a`Ilcense:to�:proceed wlth the:;work=and�not_;as:.authorlty to,vlolate;�cancel, alte�, or � � ::� �,,! aslde any provistons of'ttie`teofinlcal:�cod�s;�nor shall Issuance�of'a.pe�mlt.prevent the 8ulldlrig Ofitclel from thereafter ilring a correctlon af errors,in;;plans�,:;cor�sfi�uctlon,or vlolatlons�of=anycodes: ��very:p�etrntt Issued°��halF.becume tnvalid �=� , ' ss the.work authoNied�by�sucfi�pe�mlt>�Is.coiiir�ience��virlEhfn�siX.,months=of;permft Issuance, or If work authortzed by �� � � � t...:iw4.a �.f... "" �: :.� �er�lt I's suspended yor.,abandoned-for�a;�erfod.,of:_slx�(�).:montfi�s�.aife�#he�tlme the�work�ls commenced. An extenslon , `; �; be requested, In wGlting;.from the�B�illding;Offtclal for a perloc�notrto:'exaeed���nlnet"y��(90�:days•a�id�wllf�demonstrate ,e �able cause for.�the extenslon: If work ceas,es,for nlnety(90)consecuttve:day.s...th�job�ts�constdered abandoned. ; I, .. � -� - �._ .�.: _ - . -• . . : .. .. _ „- - i tNING TO OVVNER:``YOrUR:FAILWRE`�TtJ.-:`R�E,GORQ'.A;I�OTI.CE::OF-:CbMMENCEIN�EMT:MAY=RESULT�IN YOUR F � ; ; 1NG TWI.CE:FOR.:IMPRO.VEMEN��L:TO�YOUR•:PROPER�TY��I,�;:YO.U�IIV�°iEKID"TQ`;�8�7'AIN�fINApE1NG;'CONSULT � -��ou�=«�a���a�o�'�ar����ro�tN�������t�s��e��w�vvu�r+t���i�����o����;-=---=-- - - -- — -- ; . tIDA JURA'i(F.S.117.03} , . "� . : , � ` ., ER OR AAENT ' � . CGNTRACTOR;_ '�.. xlbed and ewom lo(or afflrteed)before me thls " Subedlbed'and'svuotn=to(o ' rmeslj re.m�fhtB , by :.by —� — , .�.,_ .w;.�:.� . . � s/are personelly known M.me or•haa/have produced Who:ls/are.p.ersonelty,knowri•to m,'e�.or':tiaslheve;prodi�ced. • _ ' .as.ldentlflcatlon� '� � � � ' •- � " °'' as Identlfloatlon. �. _ .. ., ;_; � Notery Publlc _ � Notary Publlc dsslon No: - Com�laslon.No. o(Notary typed,printed or stamped Neme`of Nolery typed,printed or stamped CHEC.K LIST • � •- �� � � ' • . ALL�SEASO�N AIR CONDITIONING p COMPRESSOR � J . / � o S��noN P5� / � & H EATI N G, I N C. ►�p 2 3 6 2 � o�o s � � ,w�s� �J.� 2i 21 W.Main St. • Tampa, FL 33b07 DATE /r 7/� ❑ELECTRICALCONNECTIONS (813)875-0794 •Fax(813)929-9424 •llcense#CAC1876878 ❑CbNTACTS TIGHT&CLEAN � � V ` � DATE O�ERED / ❑OIILEVEL&CONDITION � �1/W.dllseasonacfl.C�m � ❑ CON.p�NSER COIL � NAM� �� DATES�EDULE� Q CLEAN GOIL&CHECK FIN COND. A k ❑ENT 'F LVG 'F ❑ REFRIGERANT o y STFiEEf PHONE ❑LEAK ❑ CHARGE C L✓ 4 ❑FAN AND MOTOR -sw u �m' • SrA ziP WK.PHONE ❑VOLTS AMPS ❑ELECTRICALCQtJNECTIONS G1 �! ? MO L SERIALNUMBER �WABRANiY ❑CONTACTS TIOHT&CLEAN � ❑CONTflACf �FAN PULLEYS(ADJUST BELTj G.' ❑ SERVICE CONTRACT []CHECK.LUB BEARINGS 8 MOTOR , ❑RQRElAL ❑CFM — D SG � ^�� ❑ EVAPORATOR COIL oe ❑ HES. � COMM. LOCATION PRICE � Q CLEAN COIL 8.ChECK FIN, ❑EN7 DB_'FI LVG DB_F X� d REPAIR NUMBEq .__DESCRIPTION __ ,_., _ 11CCEPT nECLINE ❑ENTWB.—'F LVG WB_'F r' Y C � RH1T3617ST1�NJA - , ' ❑ CONDENSATE AREAS - ❑INSPE�B�L�DRAINP� IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIII�IIII � � ` ❑INSPECT&CLEAN DRAIN e I ' ❑ AIR FlLTERS W161639658 ❑CLEANED ❑R��CED • IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII -- � FILTEF SIZE ' ' i ❑ HEATING ASSY.� ; ❑BURNER 8 H�T aCH�GER , I IIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII !_ .--- ❑FUEL SUPPLY&PRESSURE 6 6 2 O 2 13 5 89 13 � ❑PILOTASSEM9LY R F�143 C�A�1:L NA ~��^ � . ' ❑FUIMEADJUSTMENT � � � ❑PAIMARVRELAYBFLUE � �� ,J It �I COMP ' ___ � ❑F�8�MIT SWITCH OPER. I IG�IIII�I�II�II��!I�l If�I!9I���IIIl��lI�II I�fi����i II61I�I G@II I�I I��I C�D E i � ❑BLOWEH ASSEMBLY W(�5:1.6 3 3 G��j ❑RVVALVE . . t�966 �_._._ � ❑S�IP H�T I I I�I I�I�i�R I I I I I��I�i 91I�1 I I 9 I 9�I I�6 I I I��I.I I I I��I I�I�I B I�I I I I d I I !._.._._ � ❑DEFROST CYCLE � p p p y A g Rp p ` � ❑ ELECTRICAL COMP'TS. 1.,In the oase of retrigerant(treon)leak repairs,dur parfs end labor ivarranty Is as stated 26ove wnh the(ollowing I I9�II��I�I��IIIa��gll[��II�II��I II���II�����El�i IA����8�����iG��G������I � ' - �RELAYS ❑CONTACTORS ��fit2ll0ns: � ' ❑OVERLOAD ❑PRE55.SWITGH a.You ete 4UO�gly urged to let the iechnician show you 1he Io�eNon ol lhe leak prior to end atter the repalr.It v����_l 3�7 7�3 7 6 ! i ❑THERMOSTAT thisisnotp'ossibledu9'Ioathcorolfierincomianienllpratian,besurethefec�ii�idanacc�ratelydescnLestheleaK loqtion on his sArvlt@ticket.Our wajrantyis for th�spedfic leak ieptired. ---_- ' ❑O.K. ❑EiEPLACE ' � ti RE�OCAIE b.Untortupal8ly,ma1�y Um@s 1�ePe cefi 6e more than OOe�eak.�q a sYstem.We may only Iqcale one and L7 complele en eNesUve tepalr only lo be called out agd�nla,le!and)jnd another onQ.Qur warranty on Ihe p[evl8us � � leak repalr wtluld not caver the new one.Howevei,ff within 90 days of Ihe►Ifst leak location,w9 w�l provjda a no CERT.a rora� � THAVELTIME cherge diagnastic aqd ieak search.You will�an only pay tor the r6psir ollha leelc.just e5 you wouldheve�one II TECHNiCiAN 07MER ; � we h3d located it on Ne firsf hjp. SIGNA7UFiE CMARG@S TIME ENVIRONMENT CHECK L1ST � •• • • • SUB- ARRIVED TypE SYSTEM CHANGED • TOTAL CHRG. E I HAV�TFIE AUTHORITY.'f0 OR�ER THE ABOVE WORK AND DO SO � TIME CADE a Q OUT(OFI ❑ ❑ ORDER AS OUTLINED A80VE.IT 15 AGREED THAT THE SELLER W ILL DfAG. � DEPpRTED R REFRIG. QTY. � V R�PLACED)7 vES NO RETAIfJ TITL-ETO'ANY EQUIPMENT OR MATERIAL FURNISNED UNTIL CHARGE ; E � � FINAL&COMPLETE.PAYMENT IS MAD�,ANb IF S�T'lLEMENT IS NOT , TIMEEL �O RECOVERED? � � QTY. � P MAMl.ED2. � � . MAbE,ASAGpEED,THESELLERSNA�LHAVETHEpIGNTTOREMOVfi TAX ' � F YES No � M YEs NO SAM�AND TH� SELI.EA WILL gE HELO HAFiMLESS FOR ANY � MILEAGE p � N REFRIGERANT DISPOSAL DAMIAGES RESULTING FROMTH�REMOVALTHEREOF. � ENpING � RECYCLEDI a a QTY., � T O I q� , ` �QUH ERSONNEL � . � START— C' 3O flECIAIMEDT �E pT! RECOMMEND: ' , � ' � ��� /t� � . flETURNED TO � AUtHORIZEo 51GNATURE -� r�rA���Es R THIS SYSTEM9 � � orr. � � — YES NO 'o AHOtiE ORDERED WORK HAS BEEN COMPLETED AND 1 ACKNOWLEDGE RECEIPT OF MY COPY. p OO DISPOSAL X /HR._ , , N OWNER'SINITIALS / /� NON USEABLE � � �TY ACCEPTED oEcuNEo y / X lMI.= T A � DISPOSAL oATE �� , CITY OF ZEPHYRHILLS, FLORIDA 5335 STH STREET CONTR.ACTORS COMPLETION NAME: All Season Air Conditioning 8v Heating Inc DATE: June 1, 2016 ADDRESS 5246 17th St PARCEL I.D. 11-26-21-0010-17800-0140 SUBDIVISION : City of Zephyrhills TYPE OF BUILDING : A/C Change out 3 ton PERMIT'(s) 17369 REMARKS : FINAL DATE: May 26, 2016 BILL BURGESS BUILDING OFFICIAL/ JB �- � ,