HomeMy WebLinkAbout16-17382 CITY OF ZEPHYRHILLS
5335-8TH STREET
• ► (s13)780-0020 �7382
BUILDING PERMIT /
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 17382 Address: 37618 NEUKOM AVE LOT 19
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: MOBILE HOME SUBDIVISION Lot(s): Block: Section:
Square Feet: Subdivision: GRAND HORIZONS
Est. Value: Parcel Number: 34-25-21-0090-00000-0190
Improv. Cost: 7,450.00 OWNER INFORMATION
Date Issued: 5/25/2016 Name: HARDARDT, HELEN G
Total Fees: 115.00 Address: 37618 NEUKOM AVE LOT 19
Amount Paid: 115.00 ZEPHYRHILLS, FL. 33542
,Date Paid: 5/25/2016 Phone: �'-- )7?(�
Work Desc: A/C CHANGE OUT W/ ELECTRIC
CONTRACTOR S APPLICATION FEES
UNIQUE AIR INC A/C CHANGEOUT 75.00
UNIQUE AIR INC ELECTRICAL FEE 40.00
� � ,
Ins ections Re uired
D TSINSTALLED
DUCTSINSULATED
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 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.
CONTRA OR SIGNATURE PERMIT OFFI R
P RMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION �
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 City of Zephyrhills Permit Application Fex-613-780-0027
Building Department
o �
Date Recetved ?��� --�LS
Phone Contactfor Pertnfttin
Owner's Name 1 � VL1 N,� Owner Phone Number � ���� ��
Owner's Address � l v � �V� Owner Phone Number
Fee Simple Titleholder Name Owner Phane Number
Fee S(mple Titleholder Address
JOB ADDRESS J�� l� ' L 3 LOT# �
SUBDNISION C��CI,� 'LI(}Y l�w pppCELIDq ZS � �O d `VO '` �_` �
(OBTAINED FHOld PHOPEp7YTAX NOTIC�
WORK PROPOSED � �NEW CON57R e ADD/ALT Q SIGN Q Q DEMOLISH
�� INSTALL REPAIR
PROPOSED USE Q SFR Q COMM � OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q
DESCRIPTION OF WORK �W�' ��I C �} ��� •5 �'�l.�) U'b� 1/I SCUYI��-�>
BUILDING SIZE S�FOOTAGE I�\� HEIGHT �
QBUILDING $ VALUATIONOFTOTALCONSTRUCTION
ELECTRICAL $ r��,` AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
.> V
QPLUMBING $ �� �f i
��� !i
MECHANICAL $ �"J��� VALUATION OF MECHANICAL INSTALLATION
I
QGAS Q ROOFING Q SPECIALTY Q OTHER �
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO I��
BUILDER •COMPANY•
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
ELECTRICIAN COMPANY ' l,"l�� �Jl_.Y V��--�5
SIGNATURE REGISTERED Y N FEE CURRE� Y/N
Address �S �� ��1. L ����J���nsek C� �Z- �2
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License H
MECHANICAL COMPANY G�r WJ
SIGNATURE � REGISTERED FEE CURRE� Y/N
Address tS l.a � �t3���J LlcenseN l�fl/L � oC
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEECURREA Y/N
�ddress License q
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIItllllllllllllllllll
Attach(2)Plot Pians;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new consWction,
Minimum ten(10)wortdng days after submittal date. Required onsite,Construction Ptans,Stormwater Plans w/SiR Fence installed,
Sanitary Facilities&1 dumpster;Site Work Permit for subdivisionsparge proJects
COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permk for new construction.
M(nimum ten(10)worldng days after submittal date. Required onsite,Construction Plans,Starmwater Plans w/Sift Fence installed,
I Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
"'*PROPERTY SURVEY required for all NEW consW c[ion. I
Directlona:•
FII out application completely.
Owner&Cantractor sign back of applicadon,notarized
If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500)
*' Agent(for the contractor)or Power of Attomey(for ttie owner)would be someone with notarized letter hom owner authorizing same
OVER THE COUNTER PERMITTING (copy of contract requirecn
Reroofs'rfshingles Sewers ServiceUpgrades A/C Fences(PIoUSurvey/Footage)
Drlvaways-Not over Counter'rf on public roadways..needs ROW
- 'NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work,they may be required to be licensed in accordance with state and local regulations. If the ,
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work,they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847- '
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the"contractor Block"of this application for which they will be responsible. If you, as the owner sign as the
contractor,that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buiidings,change of
use in existing buildings, or expansion of existing buildings, as specfied in Pasco County Ordinance number 89-07 and
90-07,as amended. The undersigned also understands,that such fees,as may be due,will be identified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a"certificate of occupancy"or final power release. If the project does not involve a certificate of occupancy or
final power release,the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due,they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes,as amended): If valuation of work is$2,500.00 or more,I
' certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
Protection Guide"prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the"owner",I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the"owner'prior to commencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable laws regulating construction,zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other government agencies may apply to the intended work,and that it is
my responsibility to identiiy what actions I must take to be in compliance. Such agencies include but are not limited to:
- Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,Water/Wastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls,Docks,Navigabie Waterways.
- Department of Heaith & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
- Use of fill is not allowed in Flood Zone"V"unless expressly permitted.
- If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating volume"will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
- If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
construction,I certify that fill will be used only to fill the area within the stem wall.
- If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties,the owner may be cited for violating
the conditions of the building permit issued under the attached permit application,for Iots less than one (1)
acre which are elevated by fill,an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER,I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing consVuction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate,cancel,alter,or
set aside any provisions of the technical codes,nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans,construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance,or if work authorized by
the permit is suspended or abandoned for a period of six(6)months after the time the work is commenced. An extension
may be requested, in writing,from the Building Official for a period not to exceed ninety(90)days and will demonstrate
justifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned.
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.
FLORIDA JURAT(F.S.117.03) ��
I OWNER OR AGENT���2�1�L�OrS(,� CONTRACTOR [c�
Subsaibed and s.wornt��or y before�is Subscribed and sworp�ja�(ar�aifirmed),before.�e this
� by //NH�iS(�,/� by C�U.{i']�_f.� 1�����
Who is/are persona�ly know�e or has ave produced Who is/are personally know�o me or has/have pr uced
as identificatlon. as identfication.
Notary Public Notary Public
Commission No. J L� � LU Commi n No ��
„��,��;�,,. STEPHANIE SMITH
Name oi Notary p ,p ted or stamped Na e o No ,p' t ped �20�` �m �y COMMISSION#FF910782
�Y P STEPHANIE SMITH � �. p(pIRES:AUG 1 S,2019
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r°r''�ti°c+ MYCOMMISSION#FF910782 �; �t�_pa`
i " � � a"'��,�Fl;�`� Bonded through 1 st State Insurance
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IXPIRES:AUG 18,2019 '^�°�^
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, ���;,; U N I C�IJ E 141 R� Installation Con tract
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877-247-7365
INSTALLATION ADDRESS BILLING ADDRESS
Name of Client Helen Hardardt Helen Hardardt
Address 37618 Neukom Ave 37618 Neukom Ave '
City/$tete/Zlp Zephyrhills,FL 33541-7699 Zephyrhills,FL 33541-7699
Phone Number 8137151770 8137151770
E-mail Address
Nry '�. .. �IN1t�STIVIEtd1'� "_.. , , ,:µ° :��
�s:..,__._._..._....__.�.. ��,..____.__�..�.w.�....._.._.___..._�.., _....µ..�_..._�..__��.:' _�___.,
Retail: $10,073
Utility Rebates: �$p�
Manufacturer Rebate: �$p� �. < .Payrrier�t-DetaiJs;`. . .
;:,.��. .
Discounts: ($2,873) -'."�::`;•�:%-;�:'`;� -_, ;'; ,;,: , .; ,-� , -
:Deposii(Creciit Card), u ,<�` �$0
Amount Due: $7,200 rr�, �, , , .
Balance.Due,(Flnancing); � $7,200'
:�., . �
.. ....�.�.::. .._.... ..,...� .._... ...FINANCING::`.�..m�_:. __� .�.. ..�.,..�._`n._Y�
Financing @ 5 Yrs 0%Equal Pmts
Est. First Month Minimum Payment: $121
._.�..._w__�.__.,�.-___,..--,<.._,�.�.__-,__...,..._,_���.�_..M_�:_.�_�,_�_:..,._.,�..��r�. . _.,.� .. . -
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; ':'., "-,.��.� . ' p.05T-1NSTALL REBATES=:.� � � ��=TOTAL;Ct�5T�f.OWNERSHIP,(tC�D)0.N^�._ ..�...__,
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� Utility Rebate: $p Est. 1 Yr Savings: $960
Other Rebate: $p Est. 10 Yr Savings: $9,600
Tax Credit: $0 TCO
($2,400)
Net Investment: $7,200 TCO Monthly . ($20)
Buyer is the owner ofthe property at the Installation Address and is legally authorized to enter into this Agreement. Unique retains title to all equipment,parts and
materials used to improve the property until Buyer's full payment is received by Unique.A service charge of 1.5%per month(18%annual percentage rate)or the maximum
rate permitted by applicable law,whichever is less,will be made on all overdue amounts. Buyer responsible for attorney fees,where allowed,for amounts not paid. Should
any Instant Rebates provided under this Agreement become uncollectible,Buyer will be responsible for payment to Unique of such uncollectible Instant Rebates. Prices are
valid for 10 da s from issuance ofthis A reement.
Customer Signature CA Signature �-('�/ _
� `�� �i� CA Name
Customer Name ���/
Date ��� �— r �(/ Date � 2� _ �1.,/�
051013 License numbers: CMC 041072 � CFC 1426265 � EC 13002942
SO# 876477 Thank You for Choosing Unique Services as your Home Comfort Specialist.