HomeMy WebLinkAbout16-16958 CITY OF ZEPHYRHILLS
5335-8TH STREET
' - � (813)780-0020 16958
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 16958 Address: 37142 CULLENS TRL
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: STEPHENS GLEN PHASE TWO
Est. Value: Parcel Number: 03-26-21-0180-00000-0790
Improv. Cost: 3,945.00 OWNER INFORMATION
Date Issued: 1/22/2016 Name: JOHNSON LARRY& JILL
Total Fees: 55.00 Address: 12837 2345 EAST ST
Amount Paid: 55.00 PRINCETON IL 61356-8510
Date Paid: 1/22/2016 Phone: 815-878-9061
Work Desc: A/C CHANGE OUT 3 TON PKG
CONTRACTOR S APPLICATION FEES
BAHR'S PROPANE GAS &A/C, INC. A/C CHANGEOUT 55.00
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Ins ections Re uired
DUCTS INSTALLED
DUCTS INSU ED
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 OCCUP14NCY BEFORE C.O.
.
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ONTRACT R SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
a�3a8o-oozo City of Zephyrhills Permit Application FaX s�$-�saoo2�
Bullding Department .
., _ -
: •
Date Recelved �7�z - �D/ �1
Phone�Confact forPermttttn / / ��
Owner's Name �./O�/V J�O LI�/d �!�!�/ Owner Phone Number O� �� /��p
Owner's Address �� 7 07 ��Jr.�"'J'�S� � /'�/J�e Owner Phone Number
• _ l�s�v
Fee Slmple Titleholder Name � Owner Phooe tdumber
Fee Simpte Titleholder Addresa ,
JOB ADDRESS J��T p� j�L�le/� �lP. - !G L S �L � �����— LOT# �
, SUBDIVISION o?1�fJE� �.F}/!.($ PARCEL ID# !/�7 o�(pyo�l ��(�� ��D�d d��
- , . (OBTAINED FROM.PROPERTY-TAX NOTICE)
WORK PROPOSED � NEW'CONSTR ADD/AI:T Q� SIGN Q Q DEMOLISH
-:B. INSTALL �REPAIR �
PROPOSED�.USE Q� SFR Q COMM Q OTHER
TYPE OF CONSTRUCTION < Q' "'BLOCK " `Q FRAME Q STEEL `Q
DESCRIPTION OF WORK �, �� (. E'DGLT -3 /U� �A'G� e � Q��
BUILDING SIZE ��`SQ FOOTAGE��, HEIGHT ,
QBUILDING $ VALUATION'OF�TOTAL'CONSTRUCTION
QELECTRICAL $ , - ` AMP SERVICE Q PROGRESS ENERGY [� W.R.E.C.
' QPLUMBING $ ' � ,/
. c,��`b
' QMECHANICAL $ ����' �� VACUATION OF MECHANICAL INSTALLATION
� ��
��S Q ROOFING Q SPECIALTY Q OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA
�YES NO
BUILDER COMPANY'
, SIGNATURE REGISTERED Y/ N FEE CURREP Y/N
Address Llcense.#
ELECTRICIAN 'COMPANY ' - ' -
SIGNATURE �' REGISTERED Y/ N FEE CURRE�" ` Y/N
I Addre�s . �.'Ltcense# ~ , . �
PLUMBER �, . •-COMPANY . - �
SIGNATURE` � :REGIS.TERED. . Y,/�IN�: ,- ;FEE CURREK ' Y�/N
Address � � License# � -
MECHANICAL' ; �������� C.OMP.ANY �ffiES f!'" D�A11�e�vf�c�G
SIGNATURE � � REGISTERED ,_Y./ N . ; FEE CURRE� . Y,/�N
Addres`s'` ,�/ �!!e/IJ �f ' �iY!'GL$. ����I � � � ` License# G��}G'I>�3�/�O ,
OTHER • : . ,�`'COMPANY �
SIGNATURE .. �- - � � � � � RE�is7E�o` Y/ N...:: FeE cu�n Y7 N
Address, ..- - ` ' � - ' � Clcense# . � � .
RESIDENTIAL;;�.: �Attacii;(2)„PIot�Plaris;'(2•)set`s".-of�BulldinglPlans;(1)setof-Ene " >Foim's;R-O-W'Peirril�tfor'newconstrucQon
�9Y
, �: Mi,nimum�ten;(•1.0);uuorking�d"ayg;after.;submiftal-date:`�Requlred onsite,:Consfiuotlon:Plans,Stormwater'Plans w/SIIt Fence installed,
. , ...., .•._. .� �
' � �� SanitaryFacfltUes�,&:;1,,dumpste_r,-Site'Wor1c;P,;.erm(tfcrsu6diVlsionsAarge„projects. �,,..:�: ' � ' -
COMMERCIAL Attech(3)`complete sets of Buildfng Plans plus a Ltfe Safety Page;(1)set of E�ergy Fortns.R-O W Permit for new construction.
Minfmum ten(10)working days after submittal date. Requfred onsite,ConsUucdon Plans,Stormwater Plans w/Sflt Fence installed,
Sanitary Fadlides 8 1 dumpster.Site Work Permit for all new:projects:All commercial requlrements must meet compliance
SIGN PERMIT Attach(2)�sets�of Eng,Ineeredr,Plans:, :._:�- � �. � ° � �
"""PROPERTY SURVEY reyuired.for all NEW_construction..
Dlrectlons: - . . . �
Fill out applicaUon completely.
Owner&Contractor sign back of applfcatlon,notarized
If over;2500,a Notice of Commencement is required. (AIC upgrades over 57500)
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Aqent(for ttie contractor)or'Power of Attortiey(fo�tFie ouvner)would be someone with notarized letter from owner;authorizing same .� -• ; :}i
DVERTHECOUNTER.PERMI7TING- _-_•(Frontof,ApplicaUomOnly).-� � � - , r �.�"� � � •�.�..,�;;;,•;� _;'�� ' ', _ `
Reroofs If shingles Sewers `�Se'rvlce Upgrades.A/C Fences(RlodSurvey/Footage) �� �-� -� - , .
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_ _ .� ._ ._ ..-. � -,�Ci:.• J_.�'...�=!f'i:�:�..� .. �. . : � � ..- ' .,� L . ,:�:,,
Drivewaya-Not over Counter if.'on public roadways{.need's=ROW � - - '" " " �'' ' '`` "`" "J
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NOTICE OF DEED,RE�TRICTIONS: The undersigned,unders�tands�th�tLthi�:p�rmit;.may,:be sub)ect.to."aaea"._.restrlctlohs";._.-_Y:,,�,-�.
which may�;be�more�restftctive-tha�Counly��regulat(ons:-The°'underslgned a§sumes�=�esponsftiiltty for compllarice wltFi�any '
appNcable deed-resMcdtons. , _ , ' • � • . . . •- .�• � �• - �
UNLICENSED��CONTRAC.TORS AND CONTRACTOR RESPONSIBILITIES: ��If the�owner�has°-Nired a"contractar•.or
contractors to undertake work, they may.be.;reqirired_to;;be�licensed in accordance:with state.and�local.regulatlons:.�Ifithe�• �' �-���
contractor ts not Itcensed as�requlred��tiy law;-bottr the owner and:conVaato��may�be��citedr_for�a�misdemeanor violation
under state Iaw. If the owner or intended�,co,ntractor;are.�uncertain as to what Iicenstng;,requirements;`mayr app(yz�for,�tlie'- �s �
Intended work,"they are`advised to contact�tfie�Pasco�County,Bullding._Inspection_Dlvislon--L•tcensing Sectlon at 727=A47-
8009. Furthermore, If the owner�has��Nlred`a conlractor o�contractors, Fie Is advlsed to have �the con.Uactor(s),,slgn_ ; ,_ ; .
portions of the "contractor Block" of thie._application:for.whlch:they.wilt,be=r.esponsible.- ff:7you,.as:the owner`s(gn'as the
_.. _:....�
contractor, that�may be an indication that°he'is'not.prope�ly'Ilcensed�and"'is�not entiNed to pemiitting pri�ileges In Pasco _
County. . ;,..;N� __, .
TRANSPORTATION:IMPACTIUTIWTIES'rMPAC�ANb-RE$OUItCE RECOVERY�FEES: �T�he�unde�stgned understands
that Transportatio� Impact Fees�and.Reco.urse Recove.ry.Fees may;apply.to tf�e:construction_of new_buildings,ichange'°of"��-"'-� ''
use In exisNng buildings, or.lexpansi�r`rrof.�existin�t�buildings, as spec�led.in Pasco County O�dinance number 89-07 and �
„ 90-07� as amended;,..The undersigned aiso;understa�ds, that�such fees�yas�may;b'e�sdne;�will:be idenlffted at the�time°;of.'� � ��.•::``
, permitting. It is furtFie�understcod that Transportatlon Impact Fees an�-Reaource:Recovery�Fees.-must be paid prior to
receEv(ng�a 'certfflcate.of�ocxupancy" or flnaF power;Release: :If�the proJect,,does�not�involve:a�:certfftoafe of occupancy�o��`=�'���' °
' flnal power.release; the-fees mu�t be paid,p�1or to permit issuance. F��thermore;�ff Pasco ti C.ounty`1NaterlSewec-slmpact =_� ., --
, fees are due�.they_must-be;pald.prior#o permit�-lss�ance:�n_accordance wltFf:applfcable,Pasco�-County�ordinances. �
CONSTRUCTION"L"IEN'I.AW(Chepter 713� Florlda 3tatutes�a�s amended): If valuallon of work Is$2,500.00�or more,:lr� �� -���•
certify that I� the.,applicant, have�been proylded -with.�a-copy-of t�e� °Florida� �onsWctton� Llen..Law—Homeowne�'s
_ Protection Guide" prepared by,tFie Flo�ida Departmer�t of A�riculture and Consumer�Affair�. If the applicant is someone; : ,
��-
�other than thQ°ovmer", I certtfy,.that.I�haye.ob,taJnedra�copy.of:#he�above.riescFitied tiocuii'�ent;and.pro�nlse:in;good�.faith to :
, deliver it to the.`.owner"'-prior�.to-commencement:' ` ' ' _ ' - � � r - - . -
� CONTRACTOR'S/OWNER'S AFFIDAVIT: I.certlfy,:tti�at,all:the�lnformation::in thi�appllcation is accurate.and that all work
will'be done in complience with all.appiicable laws regulatlng construction� zoning and::land°development. Applicatlon is
hereby made to obtain .a.permtt:Co ,dv_,wor,'k:,.and�thstallation as indt�efed:�.:.�:1. cei�tffy thaf no work�or Installation fias
commenced prio� to i'ssuance of a permit'"and that.all work will be perto�med�to meet.standards of all laws �egulaking•
construct(on, Counqr and City codes, zoning regulatians, and land development regiilations�in -the jurisdtction.- I;al'so _
certify that I u�derstand that the regulations of other government agencles may�apply�to the.intended work, and that it(s
my responsibility to identify.what,acttons I must.take;M bean:.corrlpllance:.Such agencles.include but are.not Ifmlted to: �
- Department of Environmental-�Protectibn=Cyp'ess.�Bayfiead�; WeHand Areas and Environmentally Sensttive
Lands,WatedWastewater Treatment.
,..,
- Southwest Florida Water Manageriment .I�Istrict Wells,' Cypress. 8ayheads;- Wetland Areas, Altering
Watercourses. - _ • ,
- Army Corps of Englneers�Seawalls,Docks, Navigatile Waterways.
- Department of Health'.8 ReY�abll(tative;Services/Envtronmenfal. Health Unit Well.s� -Wastewater Treatment;
Septic Tanks. - � � ,
- US Environmentai Protectlon Agency-Asbestos abatement... •
- Federal Aviatlon:AuthoM,ty.=Runways�� ,
I understand that.the.following;restrictlons apply to the use of flll:� �
' - Use of flll Is not allowed in�Flood:Zone"V"unless expressly permitted. _
_ - if the flll mateNal=Is to=µb.e used.�ln�:Flood Zone. "A", It is understood that a drainage plan addresstng a
"compeFlsating volume" will be submitted at time of�,permitting which is prepared by a professfonal engineer �
Ilcensed by��tie;�tate of Flo�ida: - "'", " • - , �
- If ihA flll-material��.ts-to�be used In Flood Zone 'A" (m connection�with�a���ermitted building using stem wall,
construction, i certify th.at flll�.v�all=b.e�used only.to.fill the.area within�the�stem�wall. •
- If flll mate�lal is to�be used In any erea,-I �certify that .use. of such flil will not adversely affect adjacent
properties. if use_of fill is found_to adversely:�ffect adJacent��prarperties,.the owrner may be cited for vtolating �
the condl#lons.of.the b�ildtng:permlt•�Issued�-under the`attached permit appltcatlon; for_�.lots�.less�than.one (1)
acre which are elevated�by f111,a�t englneer�ed drainage plan Is required.
If I am the.AGENT FOR�THE•OWNER; I;promise In_good fatth to Inform the owner of��the permitting conditlo�s set forth In
thts affidavtt�pnor to co'mmer�cing constructlon. I understend thet a;aeparate permit may be requlred for elect�ical'work, -_
plumbin , signs� welis, p.00ls; alr condiQonin ��`��`' ���Y
9 g,..gas,..;or-othe� Instatl�tions not�speclflcal�y included-in.the application. .A- .
permit issued shall be construed to be�a�Ncense'to�•proceed with tNe wor'k and�not-as:authoNty to.vtolate�"cancel, alter, or
set aside any provistons of the.teclintcal c+odes; nor shall Issuance•of a.permlt.prevent the Bulldirig Offlctal from thereafter
requlring a,conectton af enors in�plane; gonsfructlon oc violatlons of-any codes. Every=permit issued sliall become�inval(d
unless the work authorized by such permit:�is.co�nmenced•within sfx.m.onths of�permit Issuance� or If work authorized by
the permit is suspended�or.abandoned:for:a:�period;of�six:�)monfFis,:efter.the tirne the�work�is commenced, ,An extension
may be requested, In vu�iting, from.the Buliding,Officlal for a period��not:to exeeed��ninety�(90) days a�d-wllf demonstrate
• justifiable cause for.�the extensior�. If work ceases:for ninety.(90)cons.ecutive day.s,..th�)ob�ts.conside�ed aba�doned:
WARNING TO OWNER: YOUR..FAILWRE.TQ.R�EC.OttD,A,NOTIGE:OF��COMMEMCEMEWT:MIAY RESULT IN=YOUR �
PAYING TWI.CE,-FOR:IMPROVEMEN.�S-TO.;YOUR�::PRI�PER-TY.-�I��.YO.Ua1N�'�EWD`TO'�OBTAIN�FIN�CCP1EtNG;'CONSULT �
WITH YOUR�.�[�9����R,A1�I°�TfORNEX�F013��It��R�1ldf�YOUt�'Rl�TIC�'C!F`COM�1fENC�(6'1�='� - -- — -----
FLORIDA JURA'��(F.S:t17.03) _ �- ,_ , _ ,e . . . �
,OWNER OR AOENT •- " �+- CONTRACTOR_ � �
Subscdbed and swom to afNrtned)betore me thls Subscrlbed and' m�to(ot afflrmed�before me�tFii�. •
by ,by -
Who Is/are personally known to.me ar-haslhave.produced Who.le/are;p.ersoneliy known•to.m.e or haslhave-produced- • .
' ae Identlflcatl4n. " as Identlficatlon.
Notery Public . �� Notary Public
Com I " �v.,-dOEL E.BACON ' Commis/on No.
�r' ,,: ommission � ... :.::. , -
�a; Expires June 29,2018 � :�:N':c '��L E. C
Nam , 9� Neme of Notery lyped,pHntec�or�#FF 137073
��: �=xpires June 29,2018
, • •londed Tlw iroy Fain Insurance 800.385-70f 9
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rvi e Instaitations WOt�K .QRDER#fSE _ � `�GE�lAN 55050 EST
Sales, Se c &
4441 Afien Rd. • ZephyrhiNs, FL 33549 �TE<TIME Tf�t4EN �1 i�si 1� ��:s�
TAKE�4 8Y JM 0,�
' NOTES: ���r-�,...r- �.w�cn5a/ DATE/T I ME I�ROM I SED �d 1/c1�/16 Q10:�J�71
("��� G�'KE 3 C�' 1 � CUSTQMIE�#!Lt]CAT I.�I 16236
FJHO{�tE# � 815-878-9�fs 1 C
5�� �7 OaZ GeZ O Cit cloZ COIVTRCT � � ^ LARRY Jt3HNSQ{d
RCfU7ElS I�N IAf� EST-CURRENT
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JONNSON, LARRY & JILL JOHNSON, LARRY & JILL
3714� CLlLLENS TR. 37142 CULLENS TR
SILVER OAKS
ZEPHYRHILI�S FL 33�42 / ZEPHYRHIL.LS FL33�42
� EST I lt#ATE TO REF'LACE RC
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� ---aj TEhIANT: PRESTOfd & WANDA ARNOLD
�'i�,�"'d`hnp y 0(� �7 (�n�;�. ��'^ 613-395-87�6, 813-713-3156G
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otherwarrantles, ❑GASH ❑CK# TOTAL i
ch wartanties on MATERIALS i
❑DEBfT ❑CREDIT ❑OTHER MAiN7ENANCE �
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iED MONTHLY TO DATE COMPLETED � �
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(813)7$2-5013 �1 (352J 567-7678 TECH: T� �
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�,�iyzf �/�uc TOTAL y$'7Q � �