HomeMy WebLinkAbout16-16877 CITY OF ZEPHYRHILLS
� 5335-8TH STREET
. � (813)780-0020 16 7
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION �
Permit Number: 16877 Address: 3500 AQUAMARINE WAY
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: EMERALD POINTE RV RESORT
Est. Value: Parcel Number: 24-26-21-0020-00000-0180
Improv. Cost: 3,375.00 OWNER INFORMATION
Date Issued: 1/06/2016 Name: WELLS MICHAEL & HAZEL
Total Fees: 55.00 Address: 5028 DUBLIN RD
Amount Paid: 55.00 KINGSPORT TN 37664-4759
Date Paid: 1/06/2016 Phone: 423-534-5162
Work Desc: A/C CHANGE OUT 2.5 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
D CTSINSTALLED
DUCTSINSULATED
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.
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NTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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813-780-0020 City of Zephyrhills Permit Application Fax-813-780.0p21
Building Department -
Date Reaelved Phone-Contact far Parmlttln � — ��1�
Owner's Nams � e- �f Qwner P1�one Number 7a�"`����1
Owner's Address ��� � /, /f�V ���D Owner Phone Number r • �
Fee Slmple Tikleholder Name �� Owner Phone Number �� ., �1
_,� �
Fee Simple Titleholder Address
JOB ACIDRESS J �� ,i�'/- �G���/��/v'�=' ,�7 /`11�` LOT# �
SUBDIV(SION Gjj"�i � �`G7/�/� PARCEL ID# � .�� ���� 11�G� �`CS � '��
I (OBTAINED FROM PROPERTY 7AX NOTICE) ,
WORK PRdPO3ED � , e NEW CONSTR� ADDJALT � S1GN Q Q DEMOLISH �
INSTALL REPAIR `
PROPOSED USE Q SFR Q Ct�MM � OTHER �
TYPE OF CONSTRUCTION Q BLOCK " Q FRAME � STEEL Q
pE3CRiPTIOtd OF WORK . ��U/I7d C�G- `/}'IVZ�' � '1�.�°�— c�i� D C < ��✓ �G
4
BUtLDING SIZE �i �_SQ FOOTAGE C_�. HEIGHT i;-
�
.... _ �t
QBUI�DthtG r? � VALUA710N`OF�TOTAL CONSTRUCTION �
L
QElECTRICAL �$ . � AMP SERttIGE Q PRtJGRESB ENERGY Q W,R.E,C, 1t,
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[�PLUMBIiVG �� �
QMECHANICAI $ VA�UATtON OF MECFtANICA�.IEVSTA�LATIt�N �
`:,,.�L.�. �..��
QGAS Q ROOFING Q 3PECIAl.TY � OTHER '
FINISHED FLOOR ELEVATIOiVS �`� FL.00D ZONE ARBA QYES NO
BUiLDER COMPAt+tY
SIGNA7URE REGIS7ERED Y/ N FEE CURRE� Y/N '
� Address License# � �
ELECTF2lCIA�1 COMPANY
SIGNATURE «' REGISTERED Y/ N FEE CURRE� Y/N
Address License# r� �
PCUMBER � COMP,.AI+tY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# ` _ �
MECHANICAI. ` � �Q�✓ COMPAI+tY /''�/L � ���j�;�'.�,`��-'�p`��..
SIGNATURE G�� /� REGI$TERED Y./ N FEE CURRE� Y/•N. .
Address ��f /� � ����4"� ��� License# ������!��"'o �
O'CiiER COMPANI'
SIGNATURE " REGISTERED Y/ N . F�E cuRaen Y/N
Address � License# ��T �
RES[DENTIAL: ' Attach{2}Plot Plans;.{2}sets af.Si�l1'tling'Plans;{1)set af Energy°Farms;R-O-W Permlt far new canstruct�on,
Minimum:len;.(1.0)working days after,subrinittal date. Required ons(te,.Constnictibn Plans;Stormwater plans w/Silt Fence installed,
' Sanitary Facllitles,&1:.dumpster S(te°Wot1c•Permit for subdiVisions!large pro�ects �
COMMERCIAI. Attach{3}complete"sets"of 8siildirig Plans plas a Ufe Safetyr Page;(1)sat of Energy Forms.R O-W Permit for new canshuction.
Minimum ten(10)working days after submittal date. Required onsite,CansUucBon Pians,Stormwater Plans w/Silt Fence installed,
Sanitary Facilitles&1 dumpsier.Site Wotk Permit tor a{I nei+v proJeats:All commerciai requtrements must meei compiiance
SIGN PERMIT Attach{2}sets of Engineered;Plans,:.., �
.««»pROPERTY SURVEY reguired for all NEW cpnstrucUan.
Directio�s: , '
, Fill out appl(catlon completely.
C?wner&Contractar slg�back of applicaUan,notarized
' If over S^500,a Notice af Commencement is required, (I4lC upgrades over ST500)
' `" Agent(for the contractor)or'Power of Attoiney(fo��the owner)would be someone with notarized letter from owner autho�izing same
� OVER THH CQUNtER PERMITTiNG- - �(Front of Appiicalion Only)
Reroofs if shingles Sewers Service Upgrades A/G Fences(PIoUSurvey/Footage)
Driveways-Not over Counter if on pubtic roadways..needs ROW
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NOTICE OF DEED RES'�RdCTIONS: The undersigned undergtands:�.th�t,this;p�rmlE�.may be�,subJect to,�deed"_restrictions" _ ;
which may�be�more r.estrictive�th�n County-regulations. �The�undersigned'assumes�'�esponsiblltty`for`complianc�wifh"any �
applicable deed restrictions. � , � • � � _ .. _ ._ _ �
UNLICENSED CONTRACTORS AND CONTRACTOR ttESPONSI8ILITIE�: -•If the owner has hired a 'corotractor or
contractors to undertake work, they may.be.:cequ'(red._to_be�Ilcensed in accordance.with state.and•local regulations. ,:Ifthe�
contractor is nat licen�ed as requlred`=tiy lauv, bofh the owner and-cont�acto��may be-cited-for-a�-misdemeanor vtolation
under state�law. . If�ne owner or intended�contractor-are.uncertaln as to what 1lcensing.require�nents:may�apply��for:�the °�
iMended w�k, theY 9re advtsed to contacf�tFie'Pasco County Building"Inspection Diiilsion—Licensing Section at 727-847-
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8009. F�rthermofe,"(t the ovmer' has�hfred a contracto��ar cont'ractors, he is advised to have the contractor(s),,stgn
portions of the"�onfractor Block of this application for which they will be.responstble. .If..you� as.the owne��'sigri�as the
contractor, lhat nay be an indication thatfie�is-not.properly licensed and is�no4 entitled'to permitting p�ivlleges in Pasco
County• �ON:IMPACTIUTILITIES�IMPACT ANb RESOURCE RECOVERY�FEE3:-The undersigned'understands
TRANSPORT� _
�hat'Cca�sP°tion impact Fees and.Reco.urse Recove.ry.Fees may��apply.,to�th�construction of new buildings,;change�of �
use in exist�buildi�gs, or:;expansibn>of�ezisting�6uildings, as spectfled in Pascv�County Ordinance number 89-07 and
90-07, as �nded._.The undersigned also understands, thait such fees�,,as�may_be�..due„will:�be identified at the�time�of
permilt��9' 's��her understood that Tra�sportatlon Impact Fees and Resource,Recovery'Fees,mu'st be paid prior to
receiving�certificate.of occupancy" or flnal-power.release.�':If the project,,does.not Involve:a-:certiftcate of occupancy�o�
final po�'release;,the�#ees mu�t:be paid prior to permit issuance. Fu�thermore;-if Pasco County�WaterlSewer�lmpact
�e,.they�:must be,paid:prior to permit-lssuance-in accordance wlth applicable.Pasco'County ardlnances,
fees ar CTION'LIER!'U4W(Ch�pt�r 773� Flor�da�Statutes�as atnended): If valuation of work is$2,500.OD:or more, I �.
CON$t I, the,applfcant,_ hade.been provided with. a copy- of the "Elorida Construction� Lien�Law--liomeowner's
certi Guide° prepared by�tfie Florida Departmenf of Agric.ulture and Consumer Affairs. If the applicant is someone � �
p«��the"owner", I certify that I have.obtained'�a copy,of the.above..rJescribed docurt�ent�and.pror�ise:in,good,faith to
othe o the:°.owne�'pcioc•�to�commencement:" ' ' �
�� CTOR'S/OWNER'S AFFIDAVIT: I cert that all the-Information.in 4his appllcation is accurate and that all work
,ffY
W�� ne in comptiance with all applicable laws regulating constructloro, zoning and land devetopment. Appltcation is
h ade to obta(n .a permit to do...work ,and installation as indlcafed. °I certifjr"that no work=�or instailatfon has
ced prior to issuance of�a permit and that.all wvrk will be performed to meet standards of all laws regulating-
� tion, County and City codes, zoning regulations� and land development tegulattons�in the jurisd(ctlon. I ai'so
at I ur�derstand that the regulations of other government agencies may apply�to the intended work, and that it is
onsibflity to identify�what,actions I must take to be�in:.cortlpliance:,Such agencies-include but are.not Ilmited to:
Department of Environmental�Protection=Cypress.Bayfiead�; Wetland Areas and Envtronmentally Sensittve
Lands,WatedWastewater Treatment. ,
Southwest Florida Water Management District-Wells, Cypress.• Bay.heads; Wetland Areas, Altering
Watercourses.
Army-Corps of Engineers-Seawalls, Docks, Navigatile Waterways.
Department of Health 8 Rehabilitative Services/Enyironmenfal Health Unit-Wells, Wastewater,Treatment,
Septic Tanks. � - _ �
� US Envi�onmentai�Protectlon Agency-Asbestos abatement.
Federal Avlation.Authocity-Runways.
erstand that the following:�restrictions apply to the use of flll:�
- Use of fill Is riot allowed in Flood Zon�"V"unless expressly permitted.
- If the fill materlal.�(s to be used.in,�Flood Zone. "A", (t. is understood that�a drainage plan addressing a
; "compensafing volume" will be submltted at time of permitting which is prepared by a professional engineer
/ Iicensed by.the_State of;Florida:
- If the flll material�_is.to :be_used (n Flood Zone "A° in�connecfion�wlth��a permitted building using stem wail
construction, I certify that fitl�:wlll:be used only.to#ill the area wtthin the stem wall. -
- If ffll material is to be used�=ln�any area, I certify that use. of such flil w111 not adversely affect adJacent
/ propertfes. If use of flll is found to adversely:�ffect adJaeent��properties,.the owner may be'cited for vlolating
the conditions of the building:permlt issued�under the attacfied permit appl(cation, for lots less•than.one (1)
acre which are elevated by fllt; an engtneered dralnage plan Is required.
If I am the AGENT FOR THE OY!lNER, I;.promtse in good falth to inform the owner of the permitttng conditlons set forth in
this affidavit prior to commencing constructlon. I undersf�nd th�t a rs.eparate permit may be requtred for electrical work,
plumbing, signs, wells, pools, afr conditioning, .gas, or.other Install�t(ons nol.spec�fically lncluded�in.the application. .A
permit issued shall be constcued to be a`Itcense�.to--p�oceed with ttte work and not as:authority to.violate, cancel, alter, or
set aside any provistons of the technical.codes;�nor shall tssuance�of a.permlt.prevent the Buildirig Official from thereafter
Pequiring_a correction Qf errors in.plans; consfruction or vlolatlons of any codes. Eaery permlt issued shall become invalid
unless the work authorized.by such permit.•Is�commenced•within sfx,months of permtt issuance, or if wrork authorized by
the permlt(s suspended or.abandoned for a:period of�six�f8)montFis.after the time the�work is commenced. An extension
'_ may be requested, (n wrlting, from the Building.Official for a period_-_not to exceed_ninety__(90) davs and will_demonstrate_ __
justifiable cause for.the extension:�lf work ceases:for ninety(90)cons.ecutive�days�..th�Job�is considered aba�doned.
WARNING TO OWNER: YOUR.FAILURE�TO.REC.OltD A.NOTIGE OF-�COMMENCEMEMT MAY�RESUlT IN YOUR
PAYING TWICE.FOR IMPROVEMEPITS TO,YOUR:PROPER7Y.,IF�YO.U�IN��END`T��OBTAIN�FIPtANCIiVG;'CONSULT
WITH YOUR t,END�R.OR AN A'fTORNEY�B�FORE���RECOR�DING:�YOUR'NATI�E�`OF�COMIIIIIENCEIIEIENT�
FLORIDA JURA��(F.S.t17.03) � -
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OWNER OR AOEN CONTRACTO
Subscrlbed and swom (or aiflrmed)before me this Subscrlbed and' to(or afflrme pbefore me ftits
by .by. •.
VVlio Is/are parsonally known to.me or hasthave produced Who Is/are p.ersonally known to me or haslheve�produced •
as IdenUflcatlon. as Identlflcatlon.
Notary Public , Nofary Publlc
Commisslon No:` Comml�sion.No.
Name of Notary typed,printed or stamped Name of Notary typed,printed or atamped
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�: � � � PROPAAIE GAS Service Order/Proposal �
I� .4ND AIC irvc. Air Conditio�ing 8 Heating
. �i�ce �988 813-782-501�" _..
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C7 i.�,<.I..f._F�,a • ..rt4 :[ i=.ri�a; ;. � � �.��� t:_� ��_:
Sales, Service & Installations �,�..i i-E_ ;�;r��!�_" i .=;;,c't:1 �',;. i;�i.cE ; i �`:, �;1��_
4 4 4 1 A l len R d. • Zep hyr hi l ls, F L 33541 ;F°,;<f_;�.� ��.�, ='�f..i�t;�'�L-F 4;;�
T"+��;;�k�..'-f'T;�1�': 1��t=��r_i i�f:;,��E: i"� � ,t
NOTES ,._.._.
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"DESCRIPTION OF�WORK , ' QTY. MATERIALS ERVICES � UNIT PRICE AMOUNT
.............._.--___.._._. _....___.._. '
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� ' ' RECOMMEND/kTIONS ...._ ' i i
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Annual Mainteriar��e Recommended by All Equipment Manufacturers. � �
Pressures Lo HI T-Stat i i
' � i i
� REFRIGERANT R- LBS. $pe�Ibs. I I
A � �- - � , vv,
C ��� � f , FILTERS x x Changed Monthly I I
FILTERS x x Changed Monthly �� �
q ° �� �i'�-�, ., � ❑ REGULAR ❑WARRANTY TOTAL SUMMARY
Dehurimiiiisfat Settings: When here"ON", When Away 60°0, T-Stat 80° ❑ MAINTENANCE CONTRACT SERVICE i
LIMITED WARRANTY: All materials,parts and equipment are warranted by ihe manufacturers' � METHOD OF PAYMENT CALL i
or suppliers'written warranty only.All labor periormed by the above named company is warranted for '
30 days or as othenvise indicated in writing.The above named company makes no other warranties, ❑CASH ❑CK# TOTAL • i
express or implied,and its agents or technicians are not aulhorized to make any such warranties on MATERIALS i
behalfofabovenamedcompany. ❑DEBIT ❑CREDIT ❑OTHER •MAINTENANCE �
I have authority to order Ihe work outlined above which has been satisfactorily completed.I agree thal Seller
PROG. W / C �
retains title lo eqwpmenl/malerials furnishetl until fnal paymenl is made.II payment is not made as agreed, CLAIM# �
seller can remove said equipmenVmalenals at Seller s ex0ense Any damage resulting from said removal shall
not be the respansibility of Seller.NET 30 DAYS.A 7 tl2%SERVICE CHARGE WILL BE ADDED MONTHLY TO �
ALLUNPAIDBALANCESOVER30DAYS.NOREFUNDS DATE COMPLETED
TECH: " TAX �
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CUSTOMFR CIf:NAT1IGF - - '"""""/ �'/' I
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