HomeMy WebLinkAbout16-16903 CITY OF ZEPHYRHILLS
� . 5335-8TH STREEf
(813)780-0020 169 3
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION �
Permit Number: 16903 Address: 37610 COREY LEWIS AVE LOT 220
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: 34-25-21-0170-00000-2200
Improv. Cost: 6,840.00 OWNER INFORMATION
Date issued: 1/19/2016 Name: KEHR, JAMES & CAROLYN
Total Fees: 70.00 Address: 37610 COREY LEWIS AVE LOT 220
Amount Paid: 70.00 ZEPHYRHILLS, FL. 33542
Date Paid: 1/19/2016 Phone: (813)782-5218
Work Desc: A/C CHANGE OUT 3.5 PKG UNIT
CONTRACTOR S APPLICATION FEES
WORLD CLASS HEAT & COOLING A/C CHANGEOUT 70.00
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Ins ections Re uired
D T IN TALLED
DUCTS INSULATED
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
Ci Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
CONTRACTOR S ATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
a��-�so-oo2o City of Zephyrhills Permit Application F�-a��-�aaooz�
_ . Building Department
Date Received g -7 a-T T�/ 1 - G��I
Phone Contact for Permittin T eJ
. r� rrrrr�- -- - -- -»-��
Owner's Name E�r /�l� Owner Phone Number (� � ' � pr"Jo���
Owner's Address ��� (�O �..QWl,$ �V�' Owner Phone Number
� Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
J08ADDRESS � IVJI C �Q. ��S � �� ���� LOT# ��V
SUBDIVISION QC�.I�G� D/t/Z�✓�S pARCEL ID# �T �2✓�2� — ���Q � Q�����22�
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEW CONSTR e ADD/ALT 0 SIGN Q Q DEMOLISH
INSTAIL REPAIR
PROPOSED USE Q SFR Q COMM 0 OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q
DESCRIPTIONOFWORK C. �Qra. ou� �'S � I�� LL /-f 8K�
BUILDING SIZE SQ FOOTAGE� HEIGHT �
�BUILDING $ VALUATION OF TOTAL CONSTRUCTION
DELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C.
�PLUMBING $
�MECHANICAL $ �Gi/O.pp VALUATION OF MECHANICAL INSTALLATION
0`-t
�GAS Q ROOFING Q SPECIALTY 0 OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y! N FEE CURRE� Y/N
Address License#
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License it
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
MECHANICAL � \ COMPANY � • �`1A
SIGNATURE �`\ REGISTERED Y/ N FEE CURRE� Y/N
Address \ �" �� � License# ��� D`�P� ,AJ
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
Illllltlllllllllllllltllllltltlllllllllllltllllllllllllllllllllllll
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construclion,
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facililies R 1 dumpster;Site Work Permit for subdivisions/large projects
COMMERCIAL Attach(2)complete 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 afler submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities 8 1 dumpster.Site Woric 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 conslruction.
Directions:
Fill out application compietely.
Owner&Contractor sign back of apptication,notarized
If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500)
" Agent(for lhe contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (copy of contracl required)
Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
Driveways-Not overCounter if on public roadways..needs ROW
' c NOTiCE OF pEED RESTRICTIONS: 'The.undarslgned under�ttands.ith�t.UUs.p�rmlCmay_be:subJect to"deed"resUlctlons"
which may be-more.r.�stfdctive�than GouMy�regalatlons. Ttie under�lg�ed assuriiee'respdrisltillfl`y for comptians�wittf�any
appllcable deed resMctlons. •
UN6.ICENSED GONTRACTORS AND CON'TItACTOR RESPQNS181L1TIE�: �f the owne� has�hired a contractar or
contractors to undertake work,they mey be re,gulred.to be;licensed In accordance.wlth state.and:local regulatlons. If the
� confractor is�ot licensed°as requ�red"tiy law,bottrthe owner and aantractor�may be clted for a•mistlemeanor vtolaHon
' under state iaw. If the owner or tntended•cantracko�ere uncertaln as to what ilcensln re ulreRneMs ma �e
8 Q Y PPh�'��r.the
intanded wark,they are advised to contact�tie P�sco�Couniy 8alttling Irispection Dlirt`ston--Licensing Secflon at�27-847-
�� 8009. Furthertnore, tf#he owrter has hired "a canfractor oF contrectors, he fs advtsed to have the contractar(s),afgn
' pattions oE the"cot�hactor Biock"af this appticadon far_which they wrlll be xeaponsibte. if you,.as.the owrrter"aipn�as the
', CQRtf'dC�Ot,ttiat tnay t�an IndlcaUorr that-he is nof prcpsriy licensed and Is nof en8ded to permftting prirrDeges tn Pasco
i 1'RAPI PQRTATION IMPACTNTILi1'iE$iMRA�1'�ANb RESQUi2CE RECQVERY�fEES:�1'�te undersigned understands
that TrenspartaUon lmpact Feas:and.Recaurse Ret�ve.ry.Fees may:appty,�ta�the construcNon of new buildfngs,change cif °
use In exfsting bulldl�gs,or,expan�lo�.cf•:existl�ig��uitdings,as'spacffied.in Pasco County Ortdirtance number 88-07 and
90-07,as amended. 'ihe undecsigned also�understands,tha�t such tees,:as;ma}r 6e due,,wiib�Be tdenfffted at the tirtie•oF
permitting. It Is fu'ittier understood that Transpartatton impact Fees artd Resource Reanrery'Fees must be paid prtar to
recelvfng a'asr8ftc�te-at-o�upancy'-ar flnat qower-calease. J�Ehe proj�ct.does not imroive.a certfficefe of occupency.or
final power release;the tees mu�t�be patd prtor ta perm(t(ssuance. F��ermore;i�.Pascc County iNater/Sewer�tmpaet
fees are due,they must.be•paid prlor to pemtR-l�syance-in accordance with appitc�bte Pasc�County ardtnanc��.
CONSTRUCTlON LlEN'LAW(Ch�pt�r T13,Eforida Stataf�s;aa am�nded); it vatuatlon af wark is$2,600.OD ar more.I
certify that 1, the appltcant,_have been provlded wfth a ccpy-af Ehe "Ftorida Consttuctbn i.ten taw—Hameawner's
ProtecUon Gutde'}uepared by kFie Florida DepartmenC of Agrtcuttnre and Gonsamer A(fairs. if the appllcant is someons �
other than the'awner",!certHy that!have stbtainad:a:copy;of.the abQve descrlasd doiximent°and promtse in.good faith to
deUver It to.the'awne�'priar to�commencernent:
CONTRACTOR'310YYNER`S AFFIDAYIT: L ceit�fy Hiat all the.InformaUanJn thls appllcatton!s accurate.and that aii waric
will'be done in compliance wHh all.appllcable laws regulatlng consWctiort,z�ning and•lattd development. Appiicattan is
hereby made to obtatn.a.permft to do,wotk-,and Installadan as indlcated� °I certf[jr that no �rork or.ins�ailatlon hes
aommenced prlar to Issuance of'a pemiif and that:all work will be performed to meet standards of all laws regniating�
construction, Counq� and Ctty codes, zoning regulatinns, and land development regulatlans�ln the Ju�lsdictton. 1 aiso
certlfy that i under�tand that the regulatlons of athergovemment agsnctes may�applyta the lntended work,anc�that it is
my responslbllity to Identlfy•what,actton9 I must•take.M be,tn:.corqp!lance: S.uch agencles include buf are.nat ifmited ta:
- Department of Envtronmetitab Protect[brrCypreas:'Baytiead9,YVeUand Areas.and Envlronmentally Sensitfve
Lands,WaterlWestewater Treatment.
- Southweat Flarida Water ManagemenE 'DlstHct-Wells, Cypress: Bayheads, Wetiand Ateas, Altering
Watercaurses.
- Army Corps of Engtneers-Seawalls,Doaks,tJavigable Weterways,
- DepartmeM of Health 8 Rehabl(IteHve Senitces/Emironmentat Flealkh.Unit-Weils,,Wastewrater Treatment,
Septfc�Tanks. , ' _
- US Ernironmentai ProtecUon Agericy-Aabestos abatemenL
Federal Avtation Authority-Runwreys.
i understand that the foilowing resMed`ans apply to the use of fllt:�
- Use of fii!{s rmt aitawed In Fiood Zone M unless expressly permiNed.
- it the fl!1 metariat ts to be used.in:ftood.Zone 'A, it ta understood•that a dralnage pian addresstng a
°compensating votume'wiii be submifted at#ims of permitting whtch is prepared by a profess(onai englneer
Ilcerrsed.by the State af FtoRda.
- }f th�Bf! materiat is to ba used !n Ftcod yane'A irr connection wlth.a permifted bu0ding using stem wall
' cpnstrucUan,t c�fy that flti virlit.he used onty.to�II the ar.ea wifhin:the atem watl.
- - !f fil! mater#ai is ta be used-fn.any are�, i certffy fhat usa of�su�h flti wiil not adversely affect adJacent
properttes. If use af f�i is taanct to advers�eiyr,affect adjaeent��propertie�,.the owner may be cited for.vloTaUng-
the cartditlons of the 6uitding;permiCiss�ed•onder tha affacFied peflnit applic�tion,for tots less than:one(1)
acre whtch ara etevated�by flfl;$�engineered dralnage pfan is required.
If I am the A(iENT FOR THE OWNER,I�romise In gaod fafth to lnform ftre owner of the permtfting candNians set fiorth In
thls aHidavlt�prtor to comme�cfng aonatnai�lon. 1-understsrid that a=separate permlt may be regutred far elecMcal work,
plumbing,stgns,wells, pouls,alr condttlonlna,.gas;�or othec Insl�!!�#tbn�noE•spec�lcslly Ir�dvded•in.the apptEcatEon. .A
permft Issued shall be construed to be a'Ilcense'to pioceed wlth the work and not as:autlwrfly ta.viotater cancel,alter,ar
set aside any provistons of the.techntcal.code�;nor shsll lssuancs•of a permlt.prevent the 8ulldirig t?8`!da!from thareaRer
requlring a corcecNon N errors In plena,coneUuctlon or vlolaUons of at�y s�des. Every permlt Issued shal!becom�invatEd
uNess"the wo�k authoNzed.by such permik�s.commenced within st�c.months of pertnit lssuance,or If wark autharixed by
the permit is suspended or.abandoned for a:periad uf stx(6)montEis�after Rhe time the workds aommere�ed. An extensian
may be requested,ln wrlting,from the Bulldlnp.Qffic[al for a perloil:not to exceed n(nety(90)days and.will demot�strate
justifiable cause for.dhe extenaion. If work ceases,tor ninety(90)consecuUve da�s,�the��ob 1s considered abandoned.
WARNING TO OWNER: YOUR:FAIL.URE Tt1,REC1]RD A,NOTIGE OF.COMMENGEMEl+�T;NRAY RESLILT IN YOUR
PAYING TWIGE.FOR 1MPR01►EMEN7'S TL1.Y4E7t�it�PR(�iPEli'IY JF YOUr1�F�'El�ID±'TO't'lB�AIN<FINAEtE1NG,CONSULT
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FLORIpA JUiilt�(F�S.11T.43} . -, ' . . '
OWNER OR AGENT COMSRACSQ
Subsai6ed an�m Eo(or efiirmed)6efora me thia S eal�eil and'� to(ot'afftrfnedrbetnr�me'tld9 .
Who Istare persenelty lusrnm ka.me cr haalhav�p�lsuxd t�� � e�on t icn me or tar�lhave prodiaced
as Idenflllcatlon. ___.�..Lc�1 c r. ' '.� as�fentl�ation. �
II �,,, (�^, -
NoteryPub!!a �_/~ '� tAS�Cr� Nofaryi'ubitc
Commiasion No. Com �
:�;:'�Y'���:�•'. ion#FF15�422 �
ammiss
' Name af Notary lyped,prlated or stamped Name fa � gg . � �` '
Q+ �
%�'��Ri��'•" BendedTh[utrmf�dnlnsttter.ed��°h-�337Gt9
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P 0.Box 1154 � Tel•(727) 447-5101
Oldsmar,FL 34677 Fax.(727) 442-1278
� �-$E�aT91�IG � COOLif�G, ��6C.
••Z�u� luHce eovssdozt a�.ee�aECv.tQ••
To whom it may concern:
I, Heath Allen Perry, hereby authorize the following names/persons to sign, apply for and
.�
Purchase permits and/or licenses for World Class Heating&Cooling, Inc. This list supersedes all others.
� Sheila Hoffman
Barbara Pursley �
Tom Pursley
Shery A Taylor •
Sincere�4q, �^ � �
' /
------
�.------ i `�.. � ���. �
/ ,��Heath Allen Perry, � � �
CAC1816850.
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Notary Affidavit:
State of Florida �
Pinellas County , ,
Sworn to and subscri,bed before me,this---�"'� day of��.� ,���1�`=�
BY��'�--� �,� �-��1��,S�c�vav� who is personally known to me.
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:yti�"•'�;; REPIEE A9 WILLIr4MS-COX
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