HomeMy WebLinkAbout16-17001 CITY OF ZEPHYRHILLS
' = 5335-8TH STREET
(sis��so-oo20 1700,��
BUILDING PERMIT �
PERMIT INFORMATION�_ LOCATION INFORMATION
Permit Number: 17001 Address: 37419 LILLY BEA AVE LOT 199
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: 34-25-21-0140-00000-1990
Improv. Cost:. 6,500.00 OWNER INFORMATION
Date Issued: 2/01/2016 Name: HEIM DAVID & MARY
Total Fees: 70.00 Address: 14827 BUTTERNUT ST NW
Amount Paid: 70.00 ANDOVER MN 55304-2727
Date Paid: 2/01/2016 Phone: 612-708-9579
Work Desc: A/C CHANGE OUT 4 TON
CONTRACTOR S APPLICATION FEES
COOL TODAY A/C CHANGEOUT 70.00
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� Ins ections Re uired
D CTS INSTALLED
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 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 properly. 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 pertormed in accordance with
Ci Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
,�',.� . NO OCCUPANCY BEFORE C.O.
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CO OR SIGNATURE 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
� , Bullding Department
Date Received phone Contact for Permitling —
-n-�-�-�-�-�-j- - - - �'7'1'1-1 - -
Owner's Name �l t �� YY> Owner Phone Numbe► (Q/ �3 ' � �
Owner's Address �J7 � ���� �PL "2� Owner Phona Number
Fee Simple Titlaholder Nama Owner Phone Number
Fee Slmple Tltlaholder Address
JOBADDRESS ��y�q �,���y 6P('y, �V�� Z��hy rhl��S �.�is1(� LOT# —1 (
SUBDIVISION �7' '1 F Zf.)t1,S PARCEL ID# c�'7'oZ,�',� -6(�� G�d —( � C7
(OBTAINED FROM PROPERiY TAX NOTICE)
WORK PROPOSED e N TALLS7R e REPAIR � SIGN Q Q DEMOLISH
PROPOSED USE Q SFR Q COMM � OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q
DESCRIPTION OF WORK /?C �. ��r8 1� S f S�''c'% � ,T
BUILDING SIZE SQ FOOTAGE� HEIGHT �
QBUILDING S VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $
�AECHANICAL $�y�Q.L ' VALUATION OF MECHANICAL INSTALLATION
J
QGAS � ROOFING Q SPECIALTY Q OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
ELECTRICIAN COMPANY
31GNATURE REGISTERED Y I N FEE CURRE� Y/N
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Addreas License#
MECHANICAL COMPANY /Yr •` + G I��l e G
SIGNATURE � REGISTERED Y/ N FEE C n Y/N
Address C t , D �0�3� License# C�CO
OTHER COMPANY
SIGNATURE REOISTERED Y/ N FEE CURRE� Y/N
Address Lfcense#
IIIIIIIIIIIItlllltlllllllllllllllllllllllllllllllllllllllllllllllll
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(7)set of Energy Forms;R-O-W Pertnit for new canstruction,
Mfnimum ten(10)warking days aker submfttal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence(nstalled,
Sanitary Facilitfes&1 dumpster;Site Work Permit for subdivisfons/large projects
COMMERCIAL Attach(2)complete sets of Bullding Plans plus a Llfe Satety Page;(1)set of Energy Fortns.R-O-W Permft for new constructfon.
Minimum ten(10)working days after submittal date. Required onsile,Construction Plans,Slortnwater Plans w!Sflt Fence installed,
Sanitary Facllilies&1 dumpster.Sile Wark Permit for all new proJects.All commerclal requirements must meet complience
SIGN PERMIT Attach(2)sets of Engfneered Plans.
""PROPERTY SURVEY requlred for all NEW conslruction.
Directlons:
Ffll out appiication completely.
Owner&Contractor slgn back of applicatfon,notarized
I(ovar 52500,a Notice oT Commancement Is requlred. (AIC upgrades over 57500)
" Agent(for the conlraclor)or Power o(Attomey((or lhe owner)would be someone with nolarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (copy of contract requlred)
Reroofs I(shfngles Sewers Service Upgrades A/C Fences(PIoVSurvey/Footage)
Driveways-Not ovar Counler If on public roadways..needs ROW
�
� NOTICE OP DEED RESSRtCTIONS: The undersEgned understands that this permif may be subject ta"deed"restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility far compliance with any
applicable deed restrictions.
UN{.IGENSED CONTRACTORS AND CONTRACTOR F2ESPONSIBILITIES: If the owner has hired a cantractor or
cantractors to undertake work,they may be required to be licensed in accordance with state and lacal regulations. If the
contractor is not licensed as required by law, bath the owner and contractor may be cited for a misdemeanor vialation
under sfate law. (E the owner or i�tended confractor are unce�tain as to what licensing requiremenfs may apply for the
intended work,they are advised ta contact the Pasco County Building Inspection Division—Licensing Sectian at 727-847-
Sp09. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractar(s) sign
porttons of the"contractar Black"of this applicatian for which they wiil be responsible. !f you,as khe owner sign as the
contractor,that may be an indication tha#he is nat properiy licensed and is not entitied ta permit#ing privileges in Pasco
Counry.
TRANSPQRTATION IMPAGTIU71liTiES 1MPACT AEID RESOURCE REGOVERY 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 specified in Pasco County Ordinance number 89-07 and
90-47,as amended. The undersigned also understands,that such fess,as may be due,wilt be identified at the time of
permitting. It is further understaod that TransporEation tmpact Fees and Resource Recovery Fees must be paid prior to
receiving a"certificate of accupancy"or final power release. If the project does nat involve a certificate of occupancy or
final power release,the fees must be gaid prior to permit issuance. Furthermore,if Pasco Gounty WaterlSewer Impact
fees are due,they must be paid prior to permit issuance in accordance with applicable Pasco County ardinances.
CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes,as amended): If valuatfon of work is$2,500.00 or more,I
certiEy that I, the applicant, have been provided with a copy of the "Florida Gonstruction Lien Law—tiomeowner's
Protection Gulde"prepared by tt�e Florida Department of Agriculture and Consumer Affa3rs. tf the applicant is someone
ather 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.
CONTRACT4R'SlOWNER'S AFFtDAVIT: 1 certify that alE fhe information 3n this application is accurate and that all work
will be dane in campliance with all applicable laws regulating construction,zoning and land development. Appiiaation is
hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installatian has
cammenced prior to issuance of a permit and that ai1 work wilt be performed to meet standards of atl laws regulafing
canstruction, 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 identity what actions 1 musf fake to be in comptia�ce. Such agencies include but are not limited to:
- Department af Enviranmenta) Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,WaterlWastewater Treatment.
- Southwest Florida Water Management District-Welis, Cypress Bayheads, 1Netland Areas, Aitering
Watercourses.
- Army Corps of Engineers-Seawalls,Dacks,Navigabie Waterways.
- Department o! Health R� Rehabilitative SenricesiEnvlronmental Heaith Unit-Wetis, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federa!Aviation Au2hodty-Runways.
t understand tfiat tha fallowing restrictions appiy ta the use of fi(I:
- Use af fill is not allowed in Flaod Zone"V"unless expressly permitted.
, - If the fiU material is to be used in Flood Zone "A", it is undersiood that a drainage pian addressing a
� "compensating volume"wiEl 6e subrnitted at time of permitting which is prepared by a professionai engineer
licensed by the State af Florida.
- lf the FII material is to be used in Flood Zone "A" in connection wiih a permitted building using stem wall
consttvction,i certi(y that fill will be used oniy ta flIi the area wi#hin tha stem wall.
- If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
propertfes. If use of fill is found to adversely affect adJacent properties,the owner mey be cited for violating
the conditions of the building permit 3ssued under tha attached permit application,far(o#s less#han one{1}
acre which are elevated by fill,en 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 affdavit prior to cammencing cons#ruction. 1 understand that a separate permit may be requ(red for etectrica2 work,
plumbing, signs,wells, pools, air conditioning, gas, or other installations not specifically(ncluded in the application. A
permit issued shall be cpnstrued to be a license to proceed with the work and not as authority to violate,cancel,alter,or
set aside any provisio�s of the fechnicat codes,nor shall issuance of a permit prevent the Buitding O�c9ai from#hereafter
requiring a correction of errors in plans,construction or vialations af any codes. Every permit issued shall become fnvalid
unless the work authorized by such permit is commenced within six months of permit issuance,or if work authorized by
ihe perm3t Is suspended or abandoned for a period of six(6)months affer the time the work is commenced. An extension
may be requested,in wri#ing,from the 6uilding 4fficial for a period not ta exceed ninety(90j days and wilt demonstrate
justifiable cause for the extension. If work ceases for nineky(90)consecutive days,the job is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NQTtCE OF COMMENCEMENT MAY RES#JLT IN YOUR
PAYING TWICE FOR IMPROVEMENTS 70 YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITH YdUR LENQER QR AN ATTORNEY BEFORE RECORDING YOUR NQTIGE OF COMMENCEMENT.
Fl.ORIDA JURAT{F.3.S 17.03}
OWNER OR AGENT CONTRACTOR
Subscribed and swom to(or affirmed)before me this Sub cribed an swo o{or aflirm befqr�me ihis
�y 1�r��3�y�A�lY?��-, YI[7�r r?�'5
Who is/are personally known to me or has/have produced Who is/ar personal y known to me or haslhave produced
as identification. as idenlification.
Notary Public �'� - Notary Public
Commissia�No. mission No. �/'" o�c'�i !.�j��
,`�,�c, ��c�L. l��e�5�en
Name of Notety typed,pdnted or stamped Name of�c'taty typed,psiofed or stamped
� ^`l Re�9ina L.Chrees�
' �� NdTARY PUBUG
'� STATE C1F FLORIt�H
. CorrNr�FF221378
M' Expttes 411TI2019
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❑3plit System �j Elaotric Heat KW Panel Type_ �� Full/Thin �'�
�J Package Unit ❑Cased Evap Coii Existing A1Fi E�cisting Gond
❑Wat{Niounted p Furnace:BTU AFUE �� New A(H New Cond
❑ Heat Pump []Vertical p Horfzontal ❑ Double Disoonnect ❑ Single D(sconnect
�Straight Cooi Attic ❑ Under Cei1(ng Etectricai Upgtade: ❑Gust.to Outsource ❑ Provided by CaaiToday
❑Other �t�nt�. � �nn t�L.. O PP� p �{ecQn`nectp L�
System 1 C!U Make Model l_.�(��� O Other��i/llp�f Q (1�I�OnnPL 1�
System 1 A/H Make Modei
System 2 G!U Nlake Madei � , 0,.
System 2 FUM Make Madel
Package I Wall Mounted Make Model ❑N1a#erHeater Type Siza LOCdfIOii
Cassd Evap.Coil M ke Mode! p Power Condldoner ❑ Dehumldtstat
SEER Rating System 1 �� &EER Rating System 2 ❑ Zero Energy ❑ Solar Hot Weter p Solar Poal Heater
p Thermostat�Pytin„a.��Q O Other
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�^Fieconne�t C densete Drain Hook-up ❑ Primary ❑ Secondary �q��work performed In accordance with existing codes
❑ Mounting hardware or stend(Piattorm)for air handler � Inoludes all required permits,liabiliry&Workmen's Camp.Insurance
❑inatai{Naw Auxiiiary Drain Pa� Q New Satety Fiaat SwitCh B ftamovel of existing equipment end debds from tha premises
Refrlgerant: [�P410 ❑ Other
�Pad for outstde unft (�'Hurrioane Tie•Downs Sor outside ur�it
Length oi Run ❑Whtte�ne Cover ❑Siiver Line Cover �Crane Stories(!)Feet
AdditSonat tnstructians p 'L� C�qmpiimentary Precision Tune�Up visit(s}provided
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~ � ❑ 3 Year Werranty by CoolToday on work performed,and
❑Instatl WC iti tion L1gfit Ta Be located �— manufacturer's warcanty on equtpment uniess otherwise stated
�Fitter (�V�� . y�_�Yl�rl-C.� r��'6A,/(•'�F � p S Year Warranty by CooiToday on work performed,and
❑ Replace as needed: [] Supply p Return Plenum "2o�7tf manutacturer's warranty on equfpment uniess othervvise stated
p,�„New(Stamped)(Fllter Back}Grifl X p Property Proteo#ion Guarantee(See Reverse)
❑New Suppty Duct(s) „0 No Lemons Guarantee{Ses Fleverse}
❑ New Return Duct() p Energy and Pertormence Guarantee(See Reverse)
❑Other S��/'� �-3 Year Money 8ack Guarentee{See Reverse)
Q.Rust Free Guarantee(Ufetlme to Orlglnai 8uyer}
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Details of WOrk To Be Perfol'med: �`7 Gpmpressor �� yrs. [r�Labae .� yrs,
�'Parts �_yrs. ❑Other yrs.
❑Other
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M(g.Rebate(s) $ ( � f�s�1C,CQIIIIt NUR1�119� F^�}:a.�y,.',:a,'r:;2' s°�4 rk � M ,.�.Oi ��(F3°
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Co01Tod6 Credlts $t �..� ) _ F�i_..�:Ifl�'^ r`;a��;r�•.,•�3evi�yg�,a a. �k�jty,.;}.._.�,.,, _e,}�,, ���:���5
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subtotat $ b t.e) - , ;;. .._...-- n - - �-- -._ _ ,:a��::.,.:'." �
p6t�st�gm�nt $( �'j U Y )}'��`'� Cv��.?Lday :;I._�✓Z......;...'�: "_/'Y'�
Batence�Bve� g �� . �1�t t7v�n Mi'" ��
9 dollars
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�"COD Terms:Payment due to installers in tuA upon completion of i�stallation. This proposal is valid for 30 days.
I eccep!the proposel and Ihe sqodllcallane and candlflons above.You ere
GoolToday Rep.Signatur� . pate: � � hereby authoslzed to peAorm wotk es sped(led @ ta egteed and Undetatflod
—"—" 6ytheperilasthataqequtpmentwfiichissotdpursvantheretoehelinotbacome
C��g� Nctures or DmM of the reel oslale where Ihey are plocod unlil paymant In loll Is
��1�;j�� rscehred Suyefa right to cance7:Yau,the BtsyeS may cenrst thfs irs�sacttan
Hameowner's Signature: ii (�g�g: � wilhoul panally or ppligaqon enp Ilme pdor lo mldNghl ol lhe lhird huslness
� day aller tha date ef thla Iranseetion by propor notlAcsUon.
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