HomeMy WebLinkAbout16-16875 ; CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 16 5
BUILDING PERMIT
� PERMIT INFORMATION ` ' � LOCATION INFORMATION
Permit Number: 16875 Address: 37818 15TH AVE
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: DOWNS ADDITION
Est. Value: Parcel Number: 10-26-21-0600-00000-0120
Improv. Cost: 9,600.00 OWNER INFORMATION
Date Issued: 1/05/2016 Name: WORRELL JOSEPH
Total Fees: 85.00 Address: 5335 BERNADETTE DR
Amount Paid: 85.00 ZEPHYRHILLS FL 33541-9100
Date Paid: 1/05/2016 Phone: 813-312-7770
Work Desc: A/C CHANGE OUT 2 TON SPLIT SYSTEM
� CONTRACTOR S APPLICATION FEES
COOL TODAY A/C CHANGEOUT 85.00
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DUCTS INSTALLED
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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 property. If you intend to obtain financing,consult with your lender or an attorney
before recording your notice of commencement."
Complete PI 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.
C C OR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
y 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Bullding Department
Date Reeeived Phone Contact to�PermlHin -
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.�^' Cfe.l � ( 3 - ,
Owner'e Neme __XJJ'2 �� Owne►Phone Number I a.'?77
Owner'sAddress cJZ��� �Sfh �2i OwnarPhoneNumber
Fee Slmpla Titleholder Name Owner Phone Number
Fea Slmple Tltlaholder Address
JOB ADDRESS , `Z 5'l� /5 /-}I!2 � h f h�1 ls F� 33 � � LOT# J o"Z
SUBDIVISION PARCEL IDq ��'C�(p•o�� -up�- -���
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEW CONSTR e ADD/ALT Q SIGN Q Q DEMOLISH
INSTALL REPAIR r
PROPOSED USE Q SFR Q COMM � OTHER ' ' _ '�^2 v�
TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q
DESCRIPTION OF WORK � �v o2 �y (� 2�01'��� S��' pp� F
BUILDING SIZE SQ FOOTAGE� HEIGHT �
QBUILDING $ VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W,R.E.C.
QPLUMBING $ ���
MECHANICAL $ , �D VALUATION OF MECHANICAL INSTALLATION 1� ~
QGAS Q 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
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREh Y!N
Address License# I t ,,,�v' y
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MECHANICAL COMPANY � £�/_�,�Il 'ra �
SIGNATURE REGISTEREO Y/ N ' FEE RE� Y I N -^C}F-
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Address �l �( Z GL.$fj'Fit. License# �J"��Jr�v
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREA Y/N
Address License�i
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RESIDENTIAL Altach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns;R-O-W Pertnit for new construction,
Minimum len(10)working days aker submittal date. Required ons(te,Constructian Plans,Stormwater Plans w/Silt Fence fnstalled,
Sanitary Facilitfes&1 dumpster;Site Work Pertnit fo�subdivisfonsllarge projecls
COMMERCIAL AHach(2)complete sets af Building Plans plus a Life Safety Page;(1)set oi Energy Forms,R-O-W Permit for new constructfon.
Minimum len(10)working days aker submitlal date. Requlred onsite,Construction Plans,Starmwater Plans w!Sill Fence installed,
Sanftary Facilftfes 81 dumpster.Site Work Permit for all new proJects.All commarciel requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
""PROPERTY SURVEY requlred for all NEW constructlon.
Dlrectlons:•
FIII out applicatlon completely.
Owner&Contractor sign back of application,notarized
If over 52500,a Notice oT Commencement is required. (AIC upgredes over 57500)
" Agent(for lhe conlraclor)or Pawer of Atlomey(for lhe owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (copy of contract requlred)
Reroofs if shfngles Sewers Service Upgredes A/C Fences(PIoVSurvey/Faotage)
Driveways-Nat over Counter If on public roadways..needs ROW
• NOTICE OF DEED RESTRIC7IONS: The undersigned understands that this permit may be subject to"deed"restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility far compliance with any
applicable deed restrictions.
UNCICENSED CdNTRACTORS AND CON7RACTOR RESPONSIBILITIES: If the owner hes hired a contractor or
contractars to undertake work,they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under s#ate 1aw. If the awner or intended confractor are unce�tain as to what Iicensing requirements may apply for the
intended work,they are advised ta contact the Pasco County Building Inspection Division—Licensing Sectian at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the cantractor(s) sign
portions of#he°contraotor Biock"of this application tor which fhey wil3 be respansible. tf you,as the owner sign as the
contractor,that may be an indication thet he is nat properly licensed and is not entitled to permik#ing privileges in Pasco
County.
TRANSRORTATlON IMPAGTlUTtLiTiE81MPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportatian Impact Fees and Recourse Recovery Fees may appiy to tfie constructian of new buildings,change of
use in existing buildings,or expansion of existing buildings,as specified in Pasco County Ordinance number 89-07 and
' 90-Q7,as amended. The undersigned also understands,thaE such fees,as may be due,wiii be identified af fhe time of
i permitting. It is further understood that Transportation tmpact Fees and Resource Recovery Fees must be paid prior to
' receiving a"certiflcate of accupancy"or flnal power release. If the projeot does not involve a certificate of occupancy or
, Tinal power release,the fees must be paid prior to permit issuance. Furthermore,if Pasco County Waterl5ewer impaot
tees are due,they must be paid prior to permit issuance in accordance with appGcahie Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes,as amended): If valuation af work is$2,500.00 or more,I
certify that I, the applicant, have been provided with a copy of the "Flarida Gonstruction Lien Law—Nameowne�s
Protection Guide"prepared by the Ftorida Department of Agricufture and Cansumer Affairs. If the applicant is someone
other than the"awner",I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the"awner"prior to commencement.
CONTRACTOR'S/OWNER'S AFFEDAVIT: 1 cestity that all the information in this application is accurate and that atl wark
will be done in camplianae with all applicable laws regulating construction,zoning and land development. Application is
hereby made to obtain a permit to do woric and installation es indicated. I certify that no work or insta!lation has
commenced priar to isstaance af a permit and that atl work witl be performed to mee#standards af aCt laws regulating
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 responsit�ility ta identify what actions 1 must take fo be In compliance. Such agencies inclade but are not limited to:
- Department of Environmental Protection-Cypress Bayheads,Wettand Areas and Environmentally Sensitive
Lands,WaterlWastewater Treatment.
- Southwest Ftorida Water Mar�agement District-Wetts, Cypress Bayheads, Wetland Areas, AI#ering
Watercourses.
- Army Corps of Engineers-Seawalls,Docks,Navigable Watervvays.
- Department of Heaith & Rehabltitative ServiceslEnvlronmental Heaith Unit-Wetis, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
1 undarstand that the following restrictions apply to the use of fill:
- Use of fill is not allowed in Flood Zone"V"unless expressly permitted.
I'', - !f the f+ll material is fo be used in Flood Zane "A", it is understoad that a drainage pian addressing a
( "carnpensafing votume"will be submitted at time of permitting which is prepared by a prafessional engineer
licensed by the State af Florida.
- If the fill material is to be used in Flood Zone"A" in connection with a permitted building using stem wall
construotion,i certify that fill will be used only to fill the area within the stem wall.
- If fill material is to be used in any area, I certify that use af such fill will not adversely affect adJacent
properties. (f use of fill is found to adversely affect adjacent properties,the owner may be cited for violating
the condi6ans of the building permit issued under the attached permit application,for tofs less than one{1}
acre which are elevaked 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 af the permitting conditions set forth in
this affidavit prior ta commencing cons#n�ction. 1 understand that a separate permit may be requlred for elecfrical work,
plumbing, signs, wells, pools, air conditianing, gas, or ather installations not specifically(ncluded in the application. A
permit issued shall be construed ta be a license to proceed with the work and not as authority to violate,cancel,alter,or
set aside any provisions of the technica!codes,nor shall issuance oS a permit prevent the Building Official from thereaRer
requlring a correction of errors in plans,constructlon or vlalations of any codes. Every permit issued shail become invalid �
unless the work authorized by such permit is commenced within six months of permit issuance,or if work authorized by
the perrnit is suspended or abandoned for a periad at six(6}months after the time the work is commenced. M extension .
may be requested,in writing,ftom the Building O�cial for a periad not to exceed ninety(90}days and wi�l demanstrate
justifiable cause for the extension. If work ceases for nineky(90)consecutive days,the job is considered abandoned.
WARNING T4 4WNER: YOUR FAiIURE TO RECORD A NOTiCE OF CdMMENCEMENT MAY RESULT tN YOUR
PAYING TWICE FOR IMPROVEMENTS 70 YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITN YOUR LENDER pR AN A'iT�RNEY BEFqRE RECURDING YOUR NQTICE QF COMNiENCEMEN7.
Fl.ORtDA.lURAT{F.S.117.63}
OWNER OR AGENT CONTRACTOR
Subscribed and swom ta(or affrmed)before me this Subseribed and swo to{or fti dj be r me this
by Ja �'G'—
Who is/are personally known to me or has/have produced Who is/ar ersonatly known t me or has/have produced
i
as Identificalion. es(denlification.
Notary Public Notary Public i
Commissian No. �N. I /� �� f 3� a
�10 I✓l r �.. . 4J�A P-SG°'_l� . _ �_
Name flf Notary typsd,pdnted or stamped Name otary typed,printe pad Cg
� NOTARY Pt18L{C
�;� S7ATE OF Fl.ORIGR
µ`-' '� � Gp�Ff7ti378
` � Explres 4117l2019
� I I'llll II'll IIIII IIIII'III'IIIII'llll II'II IIIII IIIII IIII I'II Rept: 1735647 Rec: 10.00
DS: 0;00 IT: 0.00
. 2015202889 i2/2i12oi5 eRecording
Pertnit No. Parcel ID No_ I��6�I"'�,l�Q�-���'�r�
� � NOTICE OF COMMENCEME
State of l �C.t�'T County oi �1'-7,'^�('(1 J
THE UNDERSIGNED hereby gfves notice that improvement will be made to certein real proparty,end In accardence with Chapter 713,Florida Stetutes,
the folbwing infortnatlon Is provided in this Notke of Commen e ent:
1. Dascripdon of Property: Parcel ldentiflcati o._���j p��—�j.,�� `—�'�����I �
Street Address; � �� �
2. General Description of Improvement � � $ S �..�n
5�" r �� Cc�o L _ n ,�
3• Owner Infortnation or Less\ee�i�ormetlon if the essee corrtracted for the im rovemenL•
cJ�1� Y Y����C�►�l F
5' ' me j� Y � � I
Address �
Interesl in Property:
C�ty Sfate
Name ot Fee Slmple Titleholder.
(If differer.t fror.i d.mor!isted ebovo)
Address Clty State
4. Contrador: y f
�0 I 4� l�1"' l� l� �
�_��'4��}-LP��t���
Address City State
Contrectot's Telephone No..
5. Suraty:
Name
` Address City State
Amount of Bond: $ Telephone No.:
8. Lender:
Name
Addiesa C�ty Stete
Lenders Telephone No.:
7. Persons within the Stete of Fbrida designaled by the rnmer upon whom rwUces or other documents may be served as provided by
Section 713.13(1xex7),Florida Sfetutes:
Name
��� C�h' Stale
Tetephone Number of Designeted Peison:
8. In addition to hlmselt,the owner desfgnates of
lo ieceive a copy of the Lienor's Nolice as provided In Seclion 713.13(1)(b),Florida Statutes.
Telephane Number of Percon or Entity Designated by Owner.
9• ExpiraUon dafe of Notice of Commencement(the e�irallon date may not be before the comp�etlon o�consWction and final payment lo the
contractor,but will be one year from the date af recarding unless a different dete is specified):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFfER THE EXPIW►TION OF THE NOTICE OF COMMENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.73, FLORIDA STATUTES, AND CAN
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penafty ot peryury,I declare that I have read lhe foregoing noNce of cwnmencement and thet the facts stated therein are true to the best
of my knowledge and belief.
STATE OF FLORIDA �/
COUNTY OF PASCO /_/��y��
�(
agneture avwner or Lessee,a Owners or Lessee's Authorized
Off fcer/DirectodParfnedManager
SiOnatarys Title/Office
The toregoing instrument was acknowledged before me thia �0 day of�..c C�riN y 2o r5 by_ �b:x:��„l� G;.;nf i P ��
Bg��'��� (type of authority,e.g.,officer,trustee,attomey in fect)far
f party on behalf a instrument was executed).
Personally Known 0 O�F Notary Signatu
Type of IdentificeHon Prodifce�_ Gi�i! 5���N�/ y.2�C'
Name(Print)_ ��,�i[-,� L .✓ r - S���
��
Re�ine L.Drees�n
PAULA S O'NEIL,Ph.D.PASCO CLERK 8 COMPTROLLER NOTARY PUBLIC
12/21/2015 03:38 PM 1 of 1 STATE OF FlORIDA
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CaTY OF / / / / BUILDIN�
ZEPHYRHILLS DEPARTMENT
OF ADDITION OR CORRECTION � ���
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ADDRESS , ATE PERMIT�,
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THIS JOB HAS NOT BEEN COMPLETED. The following additions or corrections shall be made before the job
wi l i be accepted.
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It is unlaxrtul tor any Carpenter,Contractor,Builder,or other persons,to AFTER CORRECTIONS ARE MADE CALL
cover or cause to be covered,any part of the work with flooring;lath,earth 7HO-OO O FOR RE-INSPECTION
or other material,unGl the proper inspector has had ample time to approve �
the installation. �,,� �
OFFICE HOURS 7:30 AM-5 PM MON.-FRI. `\INSP�ECTOR `�9 `�.� ��