HomeMy WebLinkAbout16-17111 i
CITY OF ZEPHYRHILLS
5335-8TH STREET
* ' (8i3)78o-oozo 111
BUILDING PERMIT
� PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 17111 Address: 6746 STEPHENS PATH
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: 03-26-21-0160-00000-0310
Improv. Cost: 4,000.00 OWNER INFORMATION
Date Issued: 3/01/2016 Name: TESINI ALLAN J & SUSAN
Total Fees: 55.00 Address: 6806 STEPHENS PATH
Amount Paid: 55.00 ZEPHYRHILLS FL 33542-0654
Date Paid: 3/01/2016 Phone: 786-218-2672
Work Desc: A/C CHANGE OUT 3 TON 15 SEER
- CONTRACTOR S APPLICATION FEES
SACKETT A/C INC A/C.CHANGEOUT . 55.00
.
� � `
� Ins ections Re uired
DUCT IN TA LED
DUCTSINSULAT
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 pertormed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
CONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-78Q-0020 City af Zephyrhills Permit Application Fax 813=780-0021
Building Departmant -
i � . •
Date Recelved Phone-Contact for Permittin �� �.-�r�— "��j J
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Owner's Name G � Ownec Phone Number
Owner's Address ��� �~� ��� Owner Phone Nurnber �G�_"z%�1���.�'�
Fee Simple Titleholder Name �� _� Owner Phone Number � -�. I
' �. ,
( Fee Simple Tltleholder Address
JOB ADpRE58 SO` � �1� � � � LOT# ��
SUBDIVISION ��/��. ��l � PARCEL ID#
(OSTAlNEO FROM PROPERTY TAX NdTICE)
WORK PROPQSED �NEW CONS7R ADD/ALT �' SIGN Q Q DEMOLISH
, e INSTALL 8 REPAIR
PftOPOSEd�USE Q SFR Q CI�MM � OTHER
TYPE 4F CONSTRUCI'ION ', Q BI.00K � Q FRAME � STEEL CJ
2
DESCRIPTION OF WORK � � � � P� � l/�
� , ,,,
BUILDING SIZE ������� � SQ FOOTAGE������i���-� HEIGHT /rG�
QBUILDItVG $ ��°'-`�, .<.__-
�,�"'��"`,,r� VALUATION OF TOTAI.CONSl'RUCTION
.J
QELECTRICAL ($� � AMP SERVICE Q PRQGRESS ENERGY [� W.R.E.C.
�
[�PLUMBtNG � •� �� / �/
�MECHANICAi. $ VALUATtON QF MEChiANICA�.i1VSTALLATIQN
C..-._-.� �� �-
[��as Q RC30FING � s��c�A�•nr �] t3THER �
FINISHED FLQQR ELEVATIONS ��� FI.000 ZONE AREA QYES NQ
BU(LDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N .
Address Cicense# � �
�LECTRiC1AN ,� COMPANY
51GNATURE REGISTERED Y J N FEE CUFiRE� Y/N
Address � License# r �
PLUMBER • COMP�4NY
SIGNATURE REGISTERED Y/ N FEE CUf2RE� Y/N
Address .License# �� ' �
MECHAP11CA1. COMPANY .�� � �G I G � �
SIGNA7URE REGISTERED Y./ N FEE CURRE� Y/N
Address � � �` �Y� �� �'��� License# ��G�d.���''�.�a-�
QTHER COMPANY
SIGNATURE REGI57ERED Y/ N . FEE CURRE� . : Y-/N
Address License# � I
RE3IDEN�IA1: Attaeh(2)Plot Plans;(2}sets�affBu3ldi�g Rlans;'(1)set of Energy�Farm's;Ft-U-W Permit for�new,construction,
Minimum;ten(1,0)�working.days after;subriiittaf daYe. Required onsite,Canstruo8on Plans;Stormwater Plans w/Sllt Fence installed,
Santlary Facffitles.&1;,dumpster Slte Worlc:Perrnitfor""su6afVis3onstiarge proJects ,
COMMERCiAi. Attach(3}aomple#e sets of Buitdirig'Pians pius a�Life Safety Page;(1}set of Energy Forms.R-O-W Permit for new consMucd'on.
- -- - -- Minimum ten(10)working days after submittai date. Required onsite,Constructlan Plana,Stortnwater Plans w/511t Fence inskalled,
Sanitary Fao3liBes&1 dumpster.Site Work PermEt for aii new groJecE"s,Ali commerclal_requlrements must meet compiiance
SIGN PERMIT Attach(2}sets of Engineer,ed P..lans:;, ,Y� �
� """PROPERTY SUR1/EY reguired for all NEW canstructlon.
pirectiona:
FIII out applicadon completely.
Owner&Con#ractar sign badc of applica�on,natarized
If av�r$2500,a Notice of Commencement is requlred. (A/C upgrades over 57500)
" Agent(for the contcacEor)ar Power of Attamey(for the oumer)wauld be someone with notarized tetter from awner autho�izing same
DVER THE COUNTER.PERMI7TING (�ront of Application Only)
Reroofs if shingies Sewers SeMce Upgrades A/C Fences(Plat/Survey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
. , . �
ldOTiC�QE��EL�RE�TF21GTIt}NS. The underslgned u�derstands°�.that#hls.permtt.maybe.subJect ta,"deed"restrlctlot�s"
whlch may be:more rest�ictive,than Caunty:°�egulallons. =1'Oie�undersigned-assume� responsibility for compliance witFi any
applicabls deed restcictions. . -
UNLICENSED CONTRACTOR:� AND CAMTR�►CTOR RESPANSl8iL1TtES: tf fhe owner has hired a cantracfor or
con4raotors ta undertake work, they r�tay be:r.equired.to.be<Itcensed In accardance.with �tate.and•local_regulations. .If the
contractor-ts not_1lcensed as r.equlred'by 1aw� both the owner and cantractor-rriay be cited foe� a misdemeanor violation
under state law. If the owner ar Intended contracto� are:uncerkaln as to what Ilcenstng.r�quire�nents �rnay�apply,�or.�the
intended work, they are advised ta contact�Ehe Pasco Cot�nty Bulliling"InSpectlon D!v!slon—Lfcensing Sectlon at 727-647-
8009. Fu�thermare, ti the awner has hiFed a cont�acfor or coritractors, he is advised to have the contractar(s) slgn
partions of the "contractar Block" of this appllcatlan for which they wlll be cesponsible. .If you�-as.the ov+mer sfgn as the
contractor, that may be an IndEcation that�1ie is no#.properly Ilcensed and Is not entlt#ed to parmlttfng pr€vlleges In Pasco
County. !�
TRAN5PORTATION..IMPACTNTI6ITIES lMPACT ANb�RE�QURCE �ECClYERY��FEES: 1'he undersfgned understands `
that Transpor#ation Impact Fees and.Recourse Recovery.Fees may appiy ta�the;construction of new_bulldings,�change of
use in exis�ing bu(Idings; or��.expansion of��existiri�g`buildings, as specifled in Pasco�County Ordinance number 89-07 and `
90-07, as amended. The undecslgned also understands, that.�such fees;-;as rmay.6e�:due,�:wiH:-�be identifed at the time af ]
permitting. It is furkher understaad that Transpo�#�41on Innpact Fees and Resource RecaVery'Fees must be paid prfor to �
rece�ving a"cer#ifcate-of occupancy" or final�pa�nrer.=release, .1€>the project does �not involve a,aertlficate af accupancy ar
final pawer reiease;,the.fees must be patd prior ta permi# Issuance. Furthermore��1f Pa�co:County�INater/Sewrerrlmpact
f�es are du�, khey�must be-paid prloe to permit•Issuance-in accordance with appllcabis Pasco�County a�dinances, �
CONSTitU�TtORt LlEN`E,AW(Chapter 713, Floctda Statut�s,as amended): !f vatuatian af work is$2,500.00 ar more, 1
certify that I, the applicant, hav�.been provided with a copy of #he "Flarida Constructton� Lien Lawr:Homeowner's
Protectlat� Guide" prepared by the Flo�tda Depa�tmenf of Agrlcutture�and ConsumerA�Fairs. If the applican# Is someone
ather than the°owner", I certify that I h�ve.obtained a copy.of the above.described docu�ent°and.promise in,good faith to
del�ver it to the°ownec"•prior#o�commencement.
CONTRACTOR'StqWNER'S ARFtDAVIT: i cectify that.ati the{nf.ormation in this appiicatlon is accurate and that ali veork
will'be done in compliance with all appi(cable laws regulating construction, zoning and land development. Applicatton (s
hereby made to obtaln .a permit to do wori�.and installation as Ind(cafed..;: '1 certlfjr"that no v�roric ar tnstallatian has
commenced prior ta Issuance of a perm(t and that all work will be pertormed to meet standards of all laws regula#ing�
constructbn, County and C4ty aodes, xoning regulatlans, and land development regulattans�ln the jurfsdlctian. ! aiso
certify that I understand that the regulations af other government agencies may��pply�ta #he Intended work, and that i# is ,
my respansibility to Ident6fy�what.actions I must take to be,in:.corr�pllance: S.uch agencles include but-are,not Iimited to:
- Department af Ertvironmental Protection-Cypress.Bajrheads, W+atland Areas and Environmentatly Sensitive ,
Lands, Water/Was#ewater Treatment. �
- Southwest Ftorida Wafer Management �7is#rlct 1Netls, Cypress. Bayheads; Weftand Areas, Altering
Watercaurses. ,
- A�my Corps of EngineersSeawalls, Docks� Navigable Waterways.
- Department of Health 8 Rehabllitative Serviaes/Environmental Ftealth Unit Il�ell.s, Was#ev�rater�Treatment,
Septic Tanks. ,
- US Environmental Proiectlon Agency-Asbestos abatement,
- Federal Aviatlan Authority-Runways.
I understand that the toltowing�res#rictlons apply to the use of flll.•
- Use of fll is not ailowed in Flood Zone°V"uniess expressly permitted.
- If the fill material. is to be used. in Flaod Zone. "A", It. Is understood that a drainage plan addresstng a
°compensating uolume" will be submltted a#time of permi#ing which is prepared by a professianal engineer
liaensed by the State-of Florida.
- if the fl!1 mat�rla!-_is.ta be used in F1aad Zone °A" in�connection�wri#h a�ermlf�ed buEiding using sfem �rali
canstruction, I certify that fill:wlli=be used only.to.fill the area withln the�stem wail.
- If fill material is to 6e used in any area, I certify that .use of sucti"flll wiil not adversely affect adjacer�f
prapertles. If use of fill is found to advetsely.,�ffect ad)acent propertie5,,the awner may be cited for vialating
the conditions of the�tiuiliding;permit issued•under the attached permit application, for lats less than one (�) .
ac�e wrhich are elevated by�fl11,an englneered drainage plar�Is requlred, . ,
If I am the ACENY F�R THE OWN@R, I;promise In good faith#a inform the owner of-the:permitting conditfar�s set forth In
thls affidavtt�prior to comrnencing construction. I understand that a,separate.permit may be requtred for electrical work,
plumbing, signs, weils, pools; air condttloning,.gas, or�other instaRtations not.spec�ftcally included in.the appiicatioe�. .A �
perPnit Issued shall be construed to be°a'license to p�oceed with the wa�k and not as-authority to,vialate,cancel� alter, or _
set aside any prov�sions of the technEca)cad�s; nor shail issuance�of a permlt.pcevent the�ulldlrig O�'Eclal#rom thereafter �
requfring a correction af errors in pians;eonstn�ctian or violations of any codes. Every peermit(ssued shall become invalid
unless the�nrark authar#zed.by such permlt:ls.commencedwlthin s�C months of�erml# issuancet or If work authorized by
the pe�mit is suspended or.abandoned for a:period of six(8}mnnti�s after the time the�work ds cammenced..An exfension
may be requested, In writing, from the Building.Official for a period.nat to.exceed ninety(90) days a�d will demonstrate i
�ustl��bte cause for.the extensior� If work ceases:for ninefy{90}consecutive daysx..the job�is considered abandoned.`� :
WARNING TO OWN�R; YQUF� FAlLURE TO.=REGQRQ,A..NQ71GE.t?���C?MM�NGEMENT IUTAY�RES�l�.T !N YOt�R �
PAYiNG TWi,CE.F�iR iMPROVEMENTS TO YOUR;PROPER'fY.,:IF�YO.U-tNTEND`T��OBTAIN�F1(dANCIN���CONSUL'�
WITH YC1UR 1�@ND��t:ORAN ATTORI�EY ,BEFORE�RECI?R��ING:YOUR'I�OTICE°OE COMNIENCE�EN'�; '
FI.ORIOA JURA�'{F.S.!.1 TA3} '
DWNER OR ACiENT CONTRACTOR,
3ubscitbed and swom to(or affl�[ned)hefote me tt�is Subscribed and'swom#o{or af�rmed)�br�fore me ttils
bY �Y
Nho Islare personally known to.me or haslhaye produced Who is/are personalry�cnown tu me or haslhave-produced •
as ldentlRcsifon, as idenU�catton.
Y
Notary Public Notary Publ(c
�ommisslon No. - ' Commisslon No.
Vame of Notary typed,prfnted or stamped Name vf Notary typed,p�inted ar�tamped
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Travel SERVICE INVOICE SACI�:ETT A/C 1 j
' IOBTIMEIN: DateofOrdey iNC. -
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IOBTIMEOUT; �� DateSchedule������ (352) 567-2211 OR (813) 779-4161 =
CustomehOrderNo. Phone �N����� Nelper Date 36601 ROBERTS RD. DADE CITY, FL 33525
a,��To��� ��,����f , � OrderTakenBV STATE CLASS "A" CONTRACTOR#CAC058172
Address �d��,,,� �,,,,,. �., � � ooaYWo,� RESIDENTIAL "Fast-de endable- rofessional-service" COMMERCIAL , , ,
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❑concract
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lob Name and C`acation ����'�'4��"'�`� ��'�'Z '
Make Model#(A.H.) Serial#(A.H.)
Work Ordered e. Job Phone / r'� ��rJ ����
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Dealer �, p � ����Date Purchased PARTS SERVICE
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REUSED FREON Customer's Signature
❑ 7ota�amount ❑ Total bllling to PARTS WARRANN MAKE CHECKS PAYABLE TO:SACKETT HEATING&AIR CONDITIONING
due for above be mailed after All parts as recorded are warrented as per manufacture specifications.
work,or completionofwork. �BORGUARANN � � � . � I have the authority to order the above work and do so
This labor charge as recorded here relative to the equipment serviced as outlined above.It is ag�eed that the selle�will retain this
noced,is guaranteed for a period of 90 days.We do not,of course to any equipment or material furnished until final and complete payment is made,and if settlement is not made as
guaranty other parts then those we install.If repairs later become ' agreed,the seller shall have the right to remove same and the seller will be held harmless for any damages resulting
necessary due to other detec[ive parts,they will be charged separately �om the�emoval t e�eof.Ho eowner res onsible for filin wa��a t .
Whfte:Custamer Yellow:Numerical Pink:Alphabetical Gold:Technician
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