HomeMy WebLinkAbout15-16771 � CITY OF ZEPHYRHILLS
, � � 5335-8TH STREET
(sis)�so-oo20 1677
BUILDING PERMIT
� PERMIT INFORMATION - - LOCATION INFORMATION � -
Permit Number: 16771 Address: 6904 FAIRBANKS 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: VALLEYDALE RO ASSOCIATION
� Est. Value: Parcel Number: 03-26-21-0170-00000-0020
Improv. Cost: 3,095.00 �� OWNER�.INFORMATION -
Date Issued: 11/25/2015 Name: FINLEY GERALD & BEVERLEY
Total Fees: 55.00 Address: 6904 FAIRBANKS DR
Amount Paid: 55.00 ZEPHYRHILLS FL 33542-4831
Date Paid: 11/25/2015 Phone: (813)715-2093
Work Desc: A/C CHANGE OUT 2.5 TON (need code to gain access)
CONTRACTOR S - �- ' ' ' APPLICATION FEES °
BA R' PROPANE G S C,INC. C CHAN EOUT 55.00 �
` � -� 1 1 �-`
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� ' - Ins ections Re uired . � • ' - �
D CTS INSTALLED
DUCTSINSULATED
FINAL � 2� L\ -1�-
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.
r �
NTRAC G ATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
�
813-78�-0420 City af Zephyrhills Permit Appiicatian Fax-813-780-0021
� ' Buitding Qepartment -
Date Received phane-Contact for Permlttin 1� �a� - ���J
Owner'�Name � l�- Owner Phone Number ��.3"��5''o�v� ,-
Owner"s Address tG�� � l`-��i"t� Owner Phone Number � ' i �
Fse 5lmpte TitleMolder Name � � � Owner Phane Namber �� �
Fee Simple Tltlehalder Address
JOB ADDRESS (d"�D � LC?T# ��
SU9DIVISION �/�"l/E''/�, � PARCEL ID# (/�' � (,� � 1 � � ��D
(OBTAINHA FROM PROPERN TA%NOnGE)
WBRK PROPOSED , e NEW CONSTR� ADD/ALT � SIGN' Q [� DEMOLISH
tNSi'Atl REPAIR
PRQPOSED USE Q SFR Q COMM Q OTHER
TYPE OF GONSTRUCTIQN Q B�OCK � [� FRAME � STEEL Q
DESCRIPTIONOFWORK � L• ��9' �-GLG� � lOA� �� (,y
BUILDING SIZE �� � SQ FOOTAGE C� MEIGHT �__
QSUILt}ING $ � VAL,UATION OF TOTAL CONSTRUCTION
C]ELECTRICAL ��-- —� AMP SERViCE Q PROGRESS ENERGY [� W.R.E.C.
QPLUMBtNG $ �
QMECHANIGAL $ VALUATION OF MECHAPliCAI.INSTALIATtON
����;�
QGAS Q Rt?OFING Q SPEC1AlTY � OTHSR
FlNISHED FLOOR ELEVATiQNS (��—� FIOOD ZONE AREA �]YES id0
�_
BUiLDER COMPANY
SfGNATURE REGISTERED Y! N �e CUR�n Y/N
Address Cicense# �— �
ELECTRICIAN � COMPANY
SlGMATRJRE RE�ISTERED Y J �3 FEE CURRER Y/N
Addre�s License# �! �
PLIIMBER COMPANY
SIGNATURE REGISTERED Y I N FEE CURRER Y 1 E1
Address License# � �
MECHANtCAl. r� "_� �},�` CQMPANY ��fi�i'��S f3 �����:-���.
3lGNATURE u�.cfrt� /f 1 f�Q.a�r.,p�};,� ���s�erz�a Y 1 N FEE CliRRER Y!N
Address 7��j �ll� � /L�rS License# ��1� �iF`�'%�� ��
OTHER COMPANY
$IGNATURE REGlS7ERED Y 1 N FEE CURREh Y/IV
Address License# � ��
RESfQEMT1AL Attach(2}Plot Rlans;{2)sets�of�Bufiiiir�gPians;{1)set of Eriergy~Fonns;R-0=W Pemiit far new conshuction,
_ Minimum ten-(�1A�:warking days after.submittal date. Requtred onsite,ConstniaHon Plans;Stoimwater Plans wt Sitt fience fnstalfed,
Sanitary Faciltties.&1,,dumpste,r,Site Work�Permit for subdivisionsAarge projects ��
COMMERCIAL Attach{3}coriiplete seis o#Bu3lding Plans plus a Life Safety Page;{i)set af Energy Forms.R-O-W Permit for new canstruction.
Mintmum ten{1Q1 working days'aiter submlttal date. Required onslte,Constructlon Plans,Stormwater Plans w!Silt Fencs insta#led,
Sanitary Facilides&1 dumpster.Site Work Permit for all nevv projects.All commercial requirements must meet compliance
� SIGN PERMIT Attach{2}serts of Englgeered-Pians,; �
' `"•'PROPERTY SURYEY requir+ed fur aA NEW constructicn.
Directlons:
Fill aut applica@on completely.
Owner 8 Contractor sign back of appl(caUon,natarized
if over E2500,a Natice of Commencemant is requlred. (A/C upgrades over$7500) _
'* Agent(for the contractor}or Power of Attomey(for the owner)would be someone with notarized tetter from owner authorizing same .. ;�,,�
.�.•.,,. n ,. , _ _
DVER TtiE CaUFiTER P.ERMIITING :..$(Front_of Appflcatlon Oniy):;J. �,, . ;' �. : `'" ,<`:", '-. ,., ,
Reroofs Ef shingies Sewers Service Upgrad�s.AJC:; �..Fer�aes�.{�to#tSurvaytFootage} " ` ` - � ' - � -
:�i ti , . . �4�,1n. � � . I. �� �._.� � i ,
�! �' � �:� . � :i��f ± •`. �% . . : . - .. a _ r r- .. . s - � ..
Driveways-Not over Caunter if on pubiic roadways..needs'RQV11".;:�,' �
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NOTICE OF DEED RESTRICTIONS: The undersigned-undergtands:-.th�t;this,p�rmit.may`be,subJect to"deed"rest[ictions" .
which may�be;more��r.est�ictive=thaln County.��egr�latlons:�The��underslgned�as'surries:�responsibilltq for�compliance�witFi a`ny
appHcable_deed restrictions. . • -
UNLICENSED CONTRACTORS AND CONTRACTOR�RESPONSIBILITIES: �-If�the owner-has-�hiced�a�contractor or
contractors to undertake work, they may_be:required.rto�be;itcensed In accordance.with state.and•Iocal;regulations� if the
contractor (s not Iicensed as required`tiy law; botti the owner and�aoritracto�{may be�,clted-farta=mtsdemeanor violatton
under state law. If the owner or fntended�contr,actor are:,uncertaln as to what Iicensing.requirements;may�apply„�for:the •
4.„
intended work, they are advised to contact'tlie Fasco County Butlding�Inspection Divlslon-Llcensing�Section at 727-847-
8009. Furthermore, - :�_� � " " Y' ��`"� � � he Is advtsed to have the contractor(s) sign
If the owner has`hired�a contracto� or contractors.
portions of the "contractor Block" of.this appllcation for which they_will be..responsibie....if.you, as..the owner sign�as'tfie ' �
contractor, that may be an indication that he Is not.properly Iicensed and is not entitled to permfttfng privileges In Pasco
County. �
TRANSPORTATION::IMPACTIUTILITIES�rMPAC'1'-ANb-RE$OURCE RECOVERY�FEES:-The undereigned understands
that Transportation Impact Fees and.Reco.urse Recove.ry.Fees may>apply.;to�the construction of_new buildings,.�change of �� � -�
use in existing�bulldings, or;expansion�of��ezlstin;g�buildfngs, as speclfled.in Pasco County Ordinance number 89-07 and
90-07, as amended..,. The undetsigned also�understands, that:such fees,,asttnay��e�.due;,,will:�be identified at the'time°of=
permitting. It Is fuHFier unde�stood that Tra�sportation Impact'Fees an.d�Resource RecoveryJFees..must be pald prior to
receiving a "certificate.of occupancy" or flnal�power..release. :ff�the.proJ�cE.does not Uvolve<a:-.certificafe of occupancy.-or' '
final power release; the�#ees must be paid prior to permit Issuance. Fu�thermore;�If Pasco County�Water/Sewer�,lmpact
fees are due, they.must.be:paid.prior to,permlE-Issuance�in accordance with appllcable Pasco County ordinances.
� CONSTRUCTION LIEN LAW(Chapter 713� Florlda�Statutes�as amended): If valuation of wrork is$2,500.00:or more;-I
certify that I, #he appltcant,, have.been. provided with� a copy of the "Florida Construction� Lien,Law=-Homeowne�'s
Protection Guide" prepared by the Florida Departmenf of Agric.ulture and ConsumerAffairs. if the applicant is someone
other than the"owner", I certify.that I have.obtained>a=copy.of the:above..described docuir�ent°and:promise in,good�faikh.to
deliver It to.the`owner".pdor.�to�commencemenfi:��'� � � � ' � ,
CONTRACTOR'SIOWNER'S AFFIDAVIT: I.certity.:that�aU.the,information.,ln;this.application is accurate and that all work
will�be done in complfance with all.applicable`laws regulating�constniction, zoning and��land development. Application is
hereby�made to obtain .a permit.Co do, work.,and :Installation as indl�efed:;. I certify thaf no work�or Instaliation has
commenced p�lor to Issuance of��a permif and�that':all�work wili be�pertormed to meet standards of.all laws regulating-
construction, County and City codes, zoning regulations, and land development regulatlons-in the�jurisdlction. I al'so
certify that I u�derstand that the �egulations of other government agencies may�apply�to the intended work, and that it is
my responsibility to identify�what.actfons I must take.to be�in..corrlpliance. S.uch agencies Include but�are.not Ilmited to:
- Depanment of E�vironmental�Protection-Cypress.'Bayhead�, WeQand Areas and Env(ronmentally Sensitive
Lands,WatedWastewater Treatment.
- Southwest Florida Water Management�..District Wells, Cypress. `Bayheads; Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls,Docks, iVavigatile Waterways.
- Department of Heaith'& Rehabilitative Services/Environmental Health Unit Wells� Wastev�raater�Treatment,
Septic Tanks. ,
- US Environmental Protection Agency-Asbestos abatement.
- Federal Avlatlon Authority=Runways.
I understand that the following,restrlctlons apply to the use of flll:�
- Use of fill is not allowed in Flood Zone"V"unless expressly permttted.
- If the fill materlal (s to �be used: in:Flood Zone "A", it. Is understood that•a drainage plan addressf�g a
°compensating volume" will be submitted at time of permitting wliich is prepared by a professional engineer
licensed by the State-of Flor(da:
- �f ihe fill materlal.is to be used in Flaod Zone °A° ih�connection�with.a permltted building using stem wrall
� construction, i certify that fill�:wlll=b.e used only.to.fill the area wtthin the stem vuall.
- IF flil material is to be used in any area, I �certify that use. of such fill will not adversely affect adjacent
propertles. If use of fill is found to adversely:�ffect adjacent properties�.the owner may be cited for viotating
the conditions of the building:permit issued�under the.at�ached�permit application, for lots less than one (1)
acre which are elevated�by flll,an engineered drainage plan is required. ,
If I am the AGENT FOR THE OVIINER, I;promise In good faith to inform the owner of-the perm(tting conditions set forth in
this affidavtt�prlor to commencing const�uction. 1 understand that a-separate permlt may be requtred for electrical work,
plumbing, signs, welis, pools; alc condttioning, .gas, or othec install�ttons no��specmcally included�in.the application. .A
permit Issued shal! be construed to be a I(cense to�proceed with the work and not as:authority to..violate,.�cancel, alter, or
set aside any provisions of the technical cod�s;�nor shall tssuance•of a.permlt.prevent the Buildirig O#�icial from thereafter
requiring a correct(on.nf errors in.plans, construction or violations of any codes. Every permit Issued shall become invalid
, unless the work authorized.by such permit:�s-commenced�within sfx months of permit issuance, or if work authorized by
the perm(t is suspended or abandoned for a:period of�six fB)montFis.after the time the�work�is commenced: An extension
may be requested, In writing, from the Building,Offlcial for a period.-not to exceed ninQty(90) days and will demonstrate! ._..__ ___
- justifiabl�cause-for:the extensior�.-ff work-ceases:for-ninety(90)-cons.-eoutive:days;..the jo6�Ps considered ab.a�doned.
WARNING TO OWNER: YOUR.FAILURE-T4.,REC.ORD_A NOTIGE.OF-COMMENCEMEMT�MAY=RESUlT IN YOUR
PAYING TWICE.FOR IMPROVEMENT3 TO YOUR:PROPERTY.-tF YQU��IMTEND'TO OBTAIN•=FIRFANCING.�CONSULT II
WI7 U D O AN ATTO EY- FORE�� ECO � G�� O � O �C °O �` �' E C�E �
. ,. . ,
FLORIDA JURAT(F.S. 17. 3) � • �� ' � .
OWMER OR AOENT ���- �QQ�L CONTRACTO � I
Subscrlbed and swom to ' aflirmed)before me this Subecribed and's m=to(ot aflirtned)�before me ttiis
by
Who is/are personally known M.me or haslhave produced Who.is/are personallyknown�to me or haslhave•praduced •
_as IdenUflcatlpn. as IdendBcaUon.
� Notery Public . Notary.Public
Comm on No:� •�"Y'o�•�, .BACON Comml�s o.
'� '•°' Commission#F ""'�-•. •
:.? ;zo::�.:v���,. JOEL E.BACON
�� = 'res June 29,2018
Name oI Notary �• 08c6E�fNt�$�Fein Insurance 8003e Name of Notary $���@p�2g 2p�g
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Service Or�der/Proposal
PROPANE GAS C. ��_„ Air Conditioning&Heating
AND A/C iNc. ,�3 .� �
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' .. • � DESCR►PTION dF WORK � _ .` QTY. MATERIALS&.SE�iyICES „ UNIT PRICE AMOUNT
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:�.- , �.`::';•.:�:�;;:_,,.:= :�RECOMMENpATIONS' - .. � � i
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Annuaf;Maintenance:Recommended byAll,Equipment Manufacturers. � �
• - • � - - Pressures Lo NI T-Stat i i
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�� �M �•. `� � �`l � REFRIGERANT R= -LBS. $per Ibs. � ; �
V
�2 P FILTERS x x Changed Monthly 1 I
. • � � • FILTERS x x Changed Monthly �,� ' �
s d REGULAR ❑WARRANTY TOTAL SUMMARY �
�DehumidistaCSettings:,:When here"ON"; �When Away80° ,�T-Stat 80° ❑ MAINTENANCE CONTRACT SERVICE • i
LIMITED WARRANTY: All materials,parts and equipment are warranted by the manufacturers' tv1ETHOD OF PAYMENT CALL � i
or suppliers'written warzanty only.All labor performed by the above named company is warranted for • TOTAL i
30 days or as othenvise indicated in writing.The above named company makes no other warranties, ❑CASH ❑CK# MATERIALS i
express or implied,and its agents or technicians are not authorized to make any such warranties on
behalfofabovenamedcompany. 0 DE�I•� ❑CREDIT ❑OTHER MAINTENANCE �
I have authority to order lhe work outlined above which has heen satislactonly completed.I agree lhat Seller �
PROG. W I C �
relains title lo equipmenUmaterials furnished until final paymen�is made.If paymenl is nol matle as agreed, CLAIM# � � �
seller can remove said equipmenVmaterials al Seller's expense.Any tlamage resulling from said removal-shall
not be the responsibiliry of Seller.NET 30 DAYS.A 1 112%SERVICE CHARGE WILL BE ADDED MONTHLY TO �• �
ALL UNPAID BALANCES OVER 30 DAYS.NO REFUNDS DATE COMPLETED
TECH: T� �,I��UQ
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\ CUSTOMERSIGNATURE DATE ✓"1GU//GtL ✓({�u TOTAL �����(J