HomeMy WebLinkAbout16-17518 . - � CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 17518
BUILDING PERMIT
PERMIT INFORMATION - LOCATION INFORMATION ,
Permit Number: 17518 Address: 5250 TANGERINE 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: ZEPHYR HEIGHTS
Est. Value: _ Parcel Number: 12-26-21-0040-00400-0180
Improv. Cost: 4,977.00 OWNER INFORMATION
Date Issued: 6/30/2016 Name: M WARD INVESTMENT PROPERTIES
Total Fees: 60.00 Address: 2423 DAKOTA ROCK DR
Amount Paid: 60.00 RUSKIN FL 33570-6387
Date Paid: 6/30/2016 Phone:
Work Desc: A/C CHANGE OUT 3TON HEATPUMP
' CONTRACTOR S APPLICATION FEES
BAYONET PLUMBING HEATING &AC IN A/C CHANGEOUT 60.00
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Ins ections Re uired
DU I STA LED
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 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.
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CONTRACTOR SI A URE PERMIT OFFI R
�- - - PERMIT 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 Fax-813-780-0021
Building Department
Date Received phone Contact for Portnitting LR� $b� _�-b 3(o
�r
Owner's Namo (�.� GtJG Owner Phone Number
OwnersAddress T�Y°C.�l.�� j�[. �Ow�b�mber
Fee Simple Titloholder Namo Owner Phono Number
Fee Simple Titleholder Address I
JOB ADDRESS 50C S� TQ� ��.rLQ� LOT# �
SUBDIVISION �G ' PARCEL ID# �d �p OT V��� ��✓� �
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED � NEW CONSTR 8 ADD/ALT Q SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE ��SFR Q COMM Q OTHER
TYPE OF CONSTRUCTION Q� BLOCK Q FRAME Q STEEL Q
DESCRIPTION OF WORK lJ(�.�. v
BUILDING SIZE SQ FOOTAGE� HEIGHT �
Tr�rr'�' r'r'rr'rr'r'��r'T-r'r'rr'rr'r'r'rrr'�rr'r�r'r'r-r'rrrr
QBUILDING $ VALUATION OFTOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $
�CHANICAL $U/�f..,►J�/ VALUATION OF MECHANICAL INSTALLATION
� � / (
QGAS Q ROOFING Q SPECIALTY Q OTHER
� FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
�.�i-7--i-:-�..�-i.-i-�a-:Ti-^�:--.-6-:-r7 r...r�.--•--.-4i-r.�...ri-.-.i-:�-.-.-..-r .-. �--•--•-i-:-^.�
' BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Addross License#
ELECTRI CIAN COM PANY
� SIGNATURE REGISTERED Y 1 N FEE CURRE� Y/N
' Address License#
PLUMBER COMPANY
I SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
, Addross License#
° C��-!.� bf �f4�
I MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ FEE�URRE� Y/N
�/��p (� � % /
Addross /'rVL,• �,T "�License# � �p
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIItllll
RESIDENTIAL Atlach(2)Plol Plans;(2)sets of Building Pians;(1)set of Energy Fortns;R-O-W Permitfor new construction,
Minimum ten(10)working days after submiltal date. Required onsilo,Construction Plans,Slormwater Plans w/Silt Fence installod,
Sanitary Facilities 8 1 dumpster,Site Work Permit for subdivisions/large projecls
' COMMERCIAL Allach(2)complele sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
� Minimum ten(10)working days aRer submillal date. Required onsite,Construction Plans,Stortnwaler Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster Sile Work Permit for all new projecls.All commercial requiremenls must meet compliance
SIGN PERMIT Atlach(2)sets of Engineered Plans.
""PROPERTY SURVEY required for all NEW construclion.
-i-1-f..4-1-�1-.1-�1..{-1--F�4i-• •.-.�:-r1.b.1-4.i-4��I.��4i-i-�-L-{-i-f.�Ld-' '.-.-:--�-{-i-f.-1�-4-�1-��f--1-1..1-i-L-�{-i�-.
Directlons: i
Fill out application completely. �
Owner&Contractor sign back of application,notarized
If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500)
" Agent(for the conlrector)or Power of Attornay(for lhe owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (copy of conVact required)
Reroofs if shingles Sawers Service Upgrades A!C Fencos(PIoUSurveylFootage)
Driveways-Nol over Countor if on pubiic 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 contrador 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 RE50URCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings,change of
use in existing buildings, or expansion of existing buildings,as specified 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 occupanc�'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 AgricuRure 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 identify 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,WateNWastewater Treatment.
- Southwest Florida Water Management District Wells, Cypress Bayheads, Wetland Areas, Altering
' Watercourses.
, - Army Corps of Engineers-Seawalls,Docks,Navigable Waterways.
- Department of Health & 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 restric6ons 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
'I the conditions of the building permit issued under the attached permit application, for lots 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 construction. 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 Officiai 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 F R IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR L R OR AN ATTORNEY BEFORE RECORDING YOU OTIGE OF COMMENCEMENT.
FLORIDAJURAT .S 11 , � �
OWNER OR N / CONTRACT
ub ' ed nd s o r a u d bef re t is, $ubs rj ed nd sw to(or affi me fore thi �
rt� Y .
" by �S '� — by
o is/are personally known lo me or has/have produ ed o is/are personally known to me or has/have produced I
as identification. ""'�` as identification.
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�� Z �Nolary Public �/1..1.1���. ��_ L�J"-G 1� �" Nolary Public
Co miss an No.�F�� 1 T JJ Co miss on No. �( �I -1 T S`l
��.�t l���ll�E �4.yZl�«-- Uf?�l 1� Qz�(��–
Name of No�'ary typed,prinled or stamped Name of t ta ed
. �� JACQ[JELINE MAZZIp
+�� JACQUELWEMAZZIA � MYCOMApSStON#FF21R153
MY COMMISSION#FF214153 �aRO� ��5:Apn7 12,2019
9+.��� EXFIRES:Apnl l2,2019
� 895o New York Avenue
Hudson,Florida 3466�
� Phone: �2�.868.4636
x.�_ :$� Y =�� Ca Fa�c: �2�.863•7237
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PL��MBING • 'COOLING • HEATING CACo58o62•cFco��s
CITY OF ZEPHYRHILLS
June 22, 2016
To Whom It May Concern:
This letter is to notify you that Jacqueline Mazzia has my permission to
pull permits on my behalf for Bayonet Plumbing Heating and Air. If you
have any questions, please feel free to contact me at the above
number.
� Plumbing License # CFC042998
Mechanical License # CAC058062
�
� -�
Robert Blankenship
Bayonet Plumbing Heating & Air
Who is personally known by me
Sworn and subscribed before me
thiso��^`� day of�, r� _2016
r�•�;;�e�� ANGELA FRANCE
* * MY COMMISSION�Ff 059993
EXPIRES:October 3,2017
N��lF�F`pP��! BondeEThruBudgetNotaryServi�a,.
_ � 8950 New York Avenue -----
� ��tHudson, FL 34667 •
Phone: (727) 868-4636 New Equipment Installation (1�� 14 51 �
� CAC058062 • CFC042998
PLUMBING • COOLING • HEATING v�,W,bayonet-inc.com WO# ���"��Q � Cust# � Job#
Date� Customer Name: ��� ���a�''�
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Address• ��
Salesperson: Rebates/Incentives: City/Zip.
Phone 1: - ne 2:
❑ Work Complete OWork Incomplete ❑ Ready for inspection Email: Bill to:
Items Requiring Attention: , ,
am enance a c arge. � � v�
Airival Time Time Complete �Permit#
Work Performed and Equipment Installed: - ,��
Brand Model S��
L�ir Handler � � ���- '
❑Ca ed Coil
[�eat Pump Z ���
❑AC Condenser
❑Gas Furnace
❑Air Cleaner
❑Electronic
❑Media All Work is COD.Please pay technician. �
❑W Light CCA
❑DEHumidifier Paid by: CASH CHECK# Other
❑Drain Line ❑Copper Lineset❑ Condenser Pad ❑Disconnect ❑Plenums FINANCED Downpymt
❑Duct Work add supplies add retums other A.mount Due •-�
VISA MC DISCOVER AMEX
❑Non-Program Thermostat❑Programmable Thermostat 0 Deluxe T-stat �
Environmental Performance: REFRIGERANT IN USE: Authorization Code Card#
lbs refrigerant recovered lbs refrigerant installed Name On Card Ezp. SSV
I authorized the work outlined on this document and all work has been This system carries a year parts warranty, year labor
performed in an acceptable manner and I acknowledge with my signature belo �'�'anty, and � year compressor wananty as installed. Please call
t3iat work is satisfactory and complete. us immediately at 800-535-4505 if you have any questions.
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