HomeMy WebLinkAbout16-17725 CITY OF ZEPHYRHILLS � y`
5335-8TH STREET
.: . (813)780-0020 177�5
BUILDING PERMIT �
PERMIT INFORMATION ' LOCATION INFORMATION
Permit Number: 17725 Address: 5324 16TH ST
Perrr�it Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Squa�e Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-17200-0170
Impro�. Cost: 7,469.00 OWNER INFORMATION
Dateilssued: 9/12/2016 Name: JOHNSON, WILLIAM OTIS
Total Fees: 75.00 Address: 5324 16TH ST
Amount Paid: 75.00 ZEPHYRHILLS, FL. 33542
Date Paid: 9/12/2016 Phone: (813)780-6143
Wo'rk Desc: A/C CHANGE OUT 3 TON
CONTRACTOR S APPLICATION FEES
AIRTIME AIR CONDITIONIG AND HTG A/C CHANGEOUT 75.00
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�I Ins ections Re uired
DUCTS INSTALLED
DUCTSINSULATED
FINAL I
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 b i 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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CONTRACTOR 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-813-780-0021
Building DepaAment
` Date Received � � Phone Contact for Permitting ��7 �� — l
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IOwner's Name (��,� s Owner Phone Number 0�7 d'
Owner's Address � �70�� ��� Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Slmple Titleholder Address
JOB ADDRESS � 1� LOT# �
SUBDIVISION PARCEL ID# �I '��� �p�� � ��V� 1 (7�� T�
(OBTAINED FROM PROPERN TAX NOTICE)
WORK PROPOSED • e NEW CONSTR 8 ADD/ALT � SIGN Q Q DEMOLISH
INSTALL REPAIR
� PROPOSED USE Q SFR Q COMM 0 OTHER
TYPE OF CONS7RUCTION Q BLOCK Q FRAME � STEEL Q
DESCRIPTION OF WORK V G LI.� e
BUILDING SIZE SQ FOOTAGE� HEIGHT �
0 BUILDING $ VALUATION OF TOTAL CONSTRUCTION
DELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C.
OPLUMBING $ ' ;) 1
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���MECHANICAL $� �jt� VALUATION OF MECHANICAL INSTALLATION �
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S��
QGAS Q ROOFING Q SPECIALTY Q OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO I
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 CURRE� Y/N
' Address License#
MECHANICAL COMPANY QFr ��1 'I
SIGNATURE REGISTERED N FEE CURRE� Y/N '
Address �� �, ��4 7�V�icense# ����
OTHER COMPANY
SIGNATURE REGISTERED , Y/ N FEE CURREA Y/N
Address License#
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIItllltll
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns;R-O-W Permit for new construcGon,
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed,
Sanitary Facilities 8�1 dumpster;Site Work Permit for subdivisionsllarge projects
COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)sei of Energy Forms.R-O-W Pertnit for new construction.
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence instalied,
Sanitary Facilities 8 1 dumpster Site Work Permit for all new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
""PROPERTY SURVEY required for all NEW construction.
Directions:
Fill out application completely.
Owner&Contractor sign back of applicatlon,notarized �
� If over$2500,a Nottce of Commencement is required. (A/C upgrades over$7500)
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•• Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
, OVER THE COUNTER PERMpTT1NG (copy of contract required)
Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
� Driveways-Not over Counter if on public roadways..needs ROW "
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i�OTICE OF DIEED RESTR(CTIONS: The undersigned understands tfiat.this,permit may be subject to;deed",restnctions",��;
s which may:,be::more,restricfive:than Gounfy regula#ions. The andersigned�a`ssumes responsibifity�#o�`com'pliatice:witfi anq"
appiicable deed restrictians. . ,.. `�•"`•` � "'� '
UhFLICEftiSED�GQhiTR,4CT.ORS AidD CONTRACTOt� RESP.OI�S1BiGET(�S: if tfie•owrier iias-hired�a:contractor,or
' coniractors to undertake wotk,.they.may be;requirgd to be:(icensed in accordance with state and local r.egutafions:- If the�
cantractor is not ifcensed as required�by law, bofh the owner and confracto�.may��tie�citedtifor a misdemeanar violation
� under state law, if the owner or intended.ccsntr,actor are uncertain as to what ticensing requirements::may..appiy for.tfie "` ,
� � intertded-work,they are advised to contactfhe Pasco County Building in'specfion�D'ivisibrr=Licensing Section at 727-847-
8009. Furthermare, if the owner has hired�a contractor ar confracfars, he is advised to have the contractor(s}.,sign �:
partians of the"contractor Bitrck"of this applica6on_far which they.wifl.ba responsibie. -if:yau, a`s flie'oviiner}sign`as tlie
contractor,ttiat may be an indication t#iat he is not praperiy licensed and is ncit enti#tet!to permitting priviteges in Pasca,
County. �: � :,�,��. ,
TRANSPORYA7'ION IMPACTtUTILITtES IMPACT AfdD RESOURCE RECOVERY FEES: The undersigned understands
that Transpottation lmpact Fees and Recaurse Recovery Fees may apply to the construction of new builiiings,charige of � .
use!n existing build3ngs,ar expansion.of exisiing buildings,as specifled in Pasco County Ordinance number 89�7 antl
90-47,as ame�ded. The undersigned aiso understands,thai such fees,as inay.�be due,wiit 6e.icienttfied af the time of•�
permitting. Ik is further understood that Trartsportation Impact Fees and Resource�Recovery.Eees mast be paid prlor to
', receiving a"cerkificate of occupancy"or final�power retease. if the project�do.es not invaive a ceitificate af accnparrcy:ar.'.
, final power relsase,the fees must be paid prior ta permit issuance. Furttiermore, iE,Pasco Gounty WaterlSewer.•i,mpact..
I fees are due,tliey must be pa�d prlor to permit issuance in aacordance writh applicabie Pasco Caunty ordinances. �
CQNSTRUCTlON LIEN LAW�{Chapker 713,Flarlcla Statutes,as a�vtended}: If valuatlon of work is$2,50Q,OO,ar.more,.t,;
certify that t; the applicant, have been provided wikh a capy of the "Florida Consfircfson Lien.Law-Horrieowner's
Protection Guide°prepared by the Florida Department of Rgriculture and Cansurner Affairs. if the applicant is someane.
other than the°owner",!certify khat l.have obtained a copy of the above d'escri6ed"document and promise�in good.faith,to
deliver it to the"owner'prior to commencement
CQNTRACTOR'S/OWNER'S AFFIDAVlT: l.certify that•a!I the information in this application is accuraie and that at!work
will be dona in compliance with ali applIcable laws regulating construction,zoning and�fand development. Apptication.is
nereby made to obtain a permit.to.do work and installatian as indicated. 1 certify that no ivork or.lnstallatton--has
commenced prior to issuance of a permit and that a}!work will be per€armed to meet standards of ati laws regulating
constructian, County and City codes, zoning regulations, and land development regulations in the jur'tsdictiat�: 1 aiso
certify that I understand that the regulations af pther government agencies may apply to the intestded work,and that it is
my responsibiliry to identify what actions I must take to be in compliance. Such agencies include but are noE ftmited.ta:
- Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentalty Sensitive
Lands,WaterMlastewater Treatment.
- Southwest Florida Water Wlanagement District-Welis, Cyptess Bayheads, Wetland Areas, Altering
Watercourses.
i - Army Gorps of EngineersSeawalls,Docks,Navigabte Waterways.
� - Department of Health & Rehabllitatiye Services/Environmental Health Unit-Wells, Wastewater Treatment,-
Septic Tanks. �
�I - US Environmental Protec6on Agency-Asbestos abatement.
- Federal,Aviatian Authority-Runways.
I understand that fhe following resfrictions apply to the use of fill:
- Use of fill is not allowed in Fload Zone"V"unless expressly permitted.
- If.the fill mateFlal is to be used in Fioad Zone "A", it is understoad that a drainage plan addressing a
� "compensating votume"witl be submitted at time of permitting which is prepared by a professional engineer
ticensed by the State of Fiorida.
- tf the fill material is to be used in Ftood Zone"A" in connection with a permitted building using stem wall
construction,t certify that fiit will be used oNy to fill the area within the stem waU.
- If fill material is to be used in any area, t certify that use of such fill will not adversely affect adjacent
properEies. If usa of fiil is found#o adversety effect adjacent properties,the owner may be cited for violating
the condifians of tiae building permit;issued under�the aktached permik application,for lots less than one(1�
acre which are etevated by fiN,an engineered drainage pian is required.
if I am the A�ENT FOR THE OWNER;i promise in good faith to inform the owner of the permitting conditions set forth in
this a�davit prior ta commencing construction. 1 understand tfiat,a separafe permit may be required for electrical work,
pfumbing, signs,weffs, poots, air condi#ianing, gas, or ofher instaltations not specificaliy inctuded in the appiication. A
permit issued shaN be consirued to be a ticense to proceed r+vith the work and nof as autfiority#o violate,cancel,a�ter,or
set aside any provisions of fFse technicat cades,nor shati issuance of a permit prevent fhe Buitding Officiai from thereafter
requiring a correctian of enors in.plans;canstruction or�iolations of any cades. �very permit issued shalt become invatid
unlsss the work authorized by such pertnit is commenced wi#hin six manfhs of permit 3ssuance,or if work aufhorized by
the perrrtit is suspended or abandoned.far a period af.siu{6)months after the time the work'ss'cammenced. An extension
may be requested, in writing,from ttie Buitditig Offtcial for a..period not to'exceed•ninety(90}days and will demonstrate
Justifiable cause for the extensEon. !f work ceases for ninety(SQ}consecutive days,the job is considered abandoned.
WARNING TO QWNEQ2: YbUR FAILURE.TO RECQRD,A.NQ7lCE OE GOMMENGEM�NT MAY RESUGT Ifd YOE1R
PAYING TWICE FOR,lNIPFLQY�NlEN'1'S TO_1FOURs�'ltOPEFt'[Y.:,IF YOU.:IN'�END�TO OBTAIN�FEtdAtdCENG;�ONSUlT
MIITH YOUR L'ENDER QR AN ATPOl�tdEY BEEORE ItECORDiN�YOUR OTIGE O "CO NCEiNENT."
FLORIDA JURAT(F.S.11T.03)
OWNBR OR AGENT CQ(VTRACTdR '�'ti'`+-t_
&ubscrlbed and swom ta{or atflrtned)betore me ihls S 6sc�ik bed�r�d bY�to( afficttsed}b��me���r�c
bY .�FE?. YJ .,^�7
Who is/are personally known to me or has�ave produced ar onal�ly n wn to ma or haslhave pmduced
as ldentl8cation. -S ti�'.�rnC,�,,,_,,_as Identlficadon.
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Natary Public J`�� i Notary Publlc
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CommissIon No. Gom Iss n N -�"' '•�' �.
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Name of Notary typed,prinEed or sNamped Name of Nota • � tl o ecem6er 92�2018
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PERMIT AGENT AUTHORIZATION FORM
ALL INFORMATION IS TO BE TYPED OR LEGIBLY PRINTED
I, Anthony Gonzalez CAC1816958
(ContractoPs Name) NOT COMPANY NAME (Contractor's License No.)
he leb authorize the followin to act as m a ent s in obtainin ermits in Cit of Ze h rhills
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Zir%�; �'�,'�,/�,,s,.,,,-.,,,,,,, , ,m„ ' , . ,j�,.�i/� „ „� i i �%�/i r�%' iiir�,� /�// i a
y;,,� %u%-�� Name of A r ent; ,,,,; ,,,�,,�, � rtver°s,:. , ,r, .� ,::,,,..,,
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ROBERT DEESE D200-762-64-171-0
LUIS PATRACAS - P362-521-760-620-0
� DAIKEL SUAREZ
5623-160-91-211-0 I
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This form supercedes any previously submitted let#er(s) of authorization.
This form must contain only the people you want to pull permits in your name. To make changes to this
form, you must submit a new form. This form will delete and replace any previous authorization form
anc�the information contained thereon.
This authorization will remain in effect until STATE OF ��t�td0.
cancelled in writing by the undersigned 11 I
license holder. COUNTY OF I�i��SbOt�ldO�r�
Sworn to(or�rmed)and subscribed before me this
��� ,day of_S� yYl�'� ,20 �b
' bY C!��trf'�C�/1 �
� (PrintedlTyped ame of Lice e older Making Statement)
L' ense Holder's Signature PU LIC � �
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\\\`„1111i1�" �a Signatur fNotary)
\�����QgP�`�`�'QU�NT�ir�� (NameofNotaryTyp , rinted,�(Stamped��
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_ `�Q�����U\SSIONF�.A/fi9� My Commission expires:
� ��Q-°�������,�•� z Personally Known_�OR Produced Identification
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Hltsbo'taugh_.$1.3.43$.5999
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• Customer name;' .i.�• ' � q$�_
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svee�aea�ot�oh��caao�,: ��,��-�( �t-. . ' o;�y. :�Gi s' • ��'� ra� 3��f..
Prlmary phone:�ft3-�5ro—��.�t3 Other phone: � ' . �n: ,
� � • •• • ❑WYiote House'a,3r.Knight 3te�ill�Rtl6n System � ' '
�W(iole Hei,se UV Stertilzatlon S�stein ' ' ' ' "'' ' ��0 whole•House M.E.R:V.FlltraUor�s$yatem. ' ' 1 ' � ' �� �
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l�Replacement . l�Add-on Air Conil;tioningiHaatlB;oth • .+ .. . ... � ,.. �� • • ' • � .. • ••• - :
�Y Air Hand(er 'maoe���Verticel �Hori�oritai '•�"�" RediaCement ; . 0 Add=on�Air CondHiqning(Haat/8of,li ,
� Heat Pump L7 Ai�Canditio:ler 0.Package Unit�
j� New l�igital Thdmiostet�Non-Propram �'Program � . 3 ���SE.�R :��tlG 67UH.: • • • .
❑ Naw Digitai Programmable Therm.with Hufn3tlity Contrd � Mode1 � ,'m r.� C�aSs fC.
� Relncate from �to. . .• .� •Hurdoahe pari• • � . . . . �
� ' � • • .❑ Relocste trom to I
❑ New'AHU'Stantl:� Met�l� Custarti � .. D New 1 Do'/o copper, dehydrate�re6igerant piping ' , ..
• � Filtration: +CI P.em�nQnt Washable�lter '0 G111te ' `;� �ully insul8te'such`on lirie piping: �� ' � �
, ❑ Nqw saiaty disWnnect•�Witch� , , ., 0 Surge'Protecdon ' . . ,, ,
❑ tVew�re trom breake►panel to ecjulpmeiit ' � • . �' New waterttght'elebtrical wtiip• •• •
GJ VenVh'lue; ' '.D'Complete�new ' p'Usa'ei&ating � 0 ^ .
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❑•�ngtneared duct syetem for � tons . vents� • f :���T � � � • • ,� , �, � �
D F.conomy ❑Mti-Microbiai$ '
� Qbtalning permits(where required) .
• D�fdON-F18F�tGi,ASS:100°/b Ruet R26i&tartt Galvprtized Sheet �/ New A/C oircuit p ction Srand- $•'�-
i7 Metal Ouct System;Energy'�aving IKsulatiori IAcludsd . , �p��syngslze Is:�' �o•• Chenge to;:�J'� �
fl Fiooma requlr{ng pddkl,opAJ'skN,aw: � � ✓ Heaiing and Cooling routina maintenance'4or'-' �__�__,years• ��. '�
❑�►Jew Supply Vent to: . .. , . ✓. Chedc er�tire system tor safaty and eifiqency . ,
I7 New Retum VeM to:, � ,✓ Sfwe covers,mats and drop ctoths to tre used as necessary
❑ � • ✓ Remove existing equipment irom premises ' � •
(�,Nlastic and seal all leaking joints�g_s:�uM.S �/ Cledn up '
,�PDiictSanldzing,.. ,w•�..n4�. ��,..sa_ � . .. . '
• � • � � •�,
24�Hour�Flz.li oiHote!•GuaraAfee: Untike mcst co7npanies,we'are a servica company.We haire a s.taff of,quali.fied service:
technlclans thet are ihere to serye,�+ou in the unlikely event your eystem hae a problem.So our guerentee to yo�is that when we
arrive,we,guarentee that we will have your system up�nd•runntn�wdhin 2�7 hours'of our srrival or we wi11 put y'rou up'in a la�l fiotel'
tor the nlghL � � • � . . ..
E�iCI(1�/Ve."No.Lemons,�'.Gusr,aniee; lf the Cvmpress.or.(the hear.t of yaur,syst�m)in.yo.ur Ai�Conditiorter fa�'ts twice during
the.first flve years of ownarship,we wiN remrnre the unit;rath9'r that the companent,and sliatl install a cornpEetely nebvbne.�ff you'.ve
� ever bo,ught a•"iemorr°before,you trufy a�prectate au.r commftment to your long-term satisfactlan:This guarant�e appttes to our
'.,Premfum peckegsa only.� . •
, "Gi� : We are so confidant in our advance .Q.UV Sterilizabiqrr&M.E.Fi V.fikratlons systerns eblltty to keep
yoursystem•clean rhat'we guarantee.wkh pinper annusl I�your•system'wilf�be mold iree for Ufe or we wiB perform any'
necesssry deanfng tc the e1r handler to remedy the pr ense.Ask about'our me bershtp packages. , ,
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' Totel Invastme� $�,��(-)I Aowgr Corttpany Rebate $ � l� '(-)Servio�Repair Refund S��
AlrTlms Alr Condldoning Rep _ Date of propos2l• a '
Air Ttme AC Wi�l'be tnstallMig e 1''AX CFiED1T•CertHied Corrtfott � i�your home:We recommend thet yai mnsult•wkh youcCPA ta eitsure
� ttint YW will qua('rfy for U�te tex a+etl' ir e AC a nslbAiry lf you do not quality for this tax cred'�t, •
Customer lnldel6� • � Daie��/� � �
Payment to be mada as fallovKs:Balance ompletion
' Air Time'Heakng&Air Condittoh(eg proposes hereby+to lumish and insta�l the equ�pm�nt s,nd materia]s as described on the
back.ah the terms and cond'�tians provided herQin.''fhis�ProAosa!is good for.thlrty(3fD)day.s.from.the date hereof.but may� ,
be axepted At�y tster date a4 the sole isor ion of Air Time Heating 8�Alr Condifronirtp., ,
Gtt&tome�Approva! d'��C+�tti �21�'r"9 GsEe / �. '1-. . �—,�� . �
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