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16-17750
' I CITY OF ZEPHYRHILLS ', 5335-8TH STREET (813)780-0020 17750 � BUILDING PERMIT - PERMIT INFORMATION � ' LOCATION INFORMATION ' Permit Number: 17750 Address: 5626 20TH ST Permit Type: MECHANICAL ZEPHYRHILLS, FL. Class of Work: A/C CHANGEOUT Township: Range: Book: Propos�ed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Esg.Value: Parcel Number: 12-26-21-0020-00400-0110 Improv. Cost: 5,234.04 OWNER INFORMATION � Date Issued: 9/20/2016 Name: OUR SAVIOUR LUTHERN CHURCH Total Fees: 65.00 Address: 5626 20TH ST Amount Paid: 65.00 ZEPHYRHILLS, FL. 33542 Date Paid: 9/20/2016 Phone: (813)782-1369 Wo�k Desc: A/C CHANGE OUT 4 TON SPLIT � CONTRACTOR S � APPLICATION FEES CHRIS'A/C CO. A/C CHANGEOUT 65.00 I � � �� � � � Ins ections Re uired � � � - D CTS 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. NOTICEs 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 impro'I ements to your properly. 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. � I NO OCCUPANCY BEFORE C.O. � , � � � CON OR SIGNATURE PERMIT OFFI R � ' ERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER � � � � ' 8�3-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021 �' � Buflding Departrnent Date Recelved �. c, , , , S . �� / ' � " "� Phone Contact'for:P'ermittin �'�: ' Owner's N I me �� �-�L wner.Phone Number ���'.� �''��b_� Owner's Address �o - 0' • yu,�� ` 'Owiner•Phone Numb�r ' -� Fee Simple Titleholder'Name � : � • Owner.Phone Num6er � Fee 31mple�Titleholder Address- .,. � ` .,, . . , JOB ADDRGSS '^ , . ' G L07# � SUBDIVISIAN ' - .� PARCEL ID# p� - . . :` Oc�� O�� /�O - ' ' ' ' �� , ' .'�(OBTAINED FROM PROP.ERTYTIU(�NOTICE) � , WORK PROP,OSED ' � NEW CONSTR "• ADD/ALT •� - SIGN �Q Q'; '_DEMOLISH - .. ' B y._ INS7;ALL e:. =. �REPAIR . � " � . PROPOSED USE._ , Q::" SFR" [� COMM` `Q ' OTHER" ` � .. TYPE OF CONSTRUCTION:� `Q BL'OCK�', '�Q�� �` FRAME � STEEC. Q' .. , � - � DESCRIPTI N OF WORK Q ,��,�. '. �i9G� , �'4�� I .. ;. , _. _, ` BUILDINGSIZE'-� ' �SQ_FOOTAGE ..� , kHEIGHT,� . � • � . . .. . QBUILDING $ _�'s.;i,r;..;�. ��:�,;,�.c_ :.. . , , • : VALUATION:OF TOTAL COMSTRUCTION ' ,�: . - ,. _ , . QELECTRICAL $ � 'AMP SERVICE �Q' PROGRESS ENERGY [] W.R.E.C. PLI MBING ' I � .` $ � �' . . : �� �� M CHANICAL � $ 'VALUATION.OF.MECHANICAL INSTALLATION •=���� I � 3 � , � Q�►{ : .Q, - ROOFING;�Q SPECIALTY Q. OTHER � J-� FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO l � , ',• �s _ -.,,.; ' �UILDEit - COMPANY� ' ' � ' SIGNATURE REGISTERED Y/ N. , �e cuwzEn' ,: '.Y/.N . � ., , , Address - License#� � , 3� � ELECTRICiAN..:: .,.: , �� ` COMPANY r' , ` ' - - SIGNATURE ' _ '"' REGISTERED Y/ N FEE GURREK ' ':Y/N Address - . , , . ,. • . ' , f ,... .. •L-Icense:#: ' � . .. � � . .. , . ... . . . _ ... ... � PLUMBER � � , , - - - � � � . . . C.OBAPANY�_ `..' �• _ , _,. SIGNATURE ' . � . _ -Rects.7E�D� _ :�,Y./:-�N • -•FEE_Cu�rter.� . .:Y/`N." : ,. _ ,. � ;- _. .. _ ,._ , . . � Addres� - - - - , . ...lJcense#� - _ - - MECHANICAL:;' . . �. ,.� _,COMPANY. _ ��. �. ,_ � , . - - " SIGNATURE ��.` `��[ REGIS7ERED: `N� ,;FEE_CURREP - =YII-N''� � - � F.`., �4ddress`I,� � - /�_ �� ;�� �� r�� ,;Licen,s.e# S .� OTHER I . ` ' _''� ' ` ' ..,.. _. .. . COMPANY; _ . _. - � . . . _ . � , _�. -.�.. ,i?,. a; �, ,. ,. . ... „ ,.,. , :.-_,.�.�:: �; .��:, �:: SIGNATURE. , _. .,_. � _ _ • . �.�;, - .;°.• - ,.;:: �. ,.,,:,. ,,.� , �.,�... ,..,. <-. � ' REGIS7ERE0 Y/ N_<; '. : , . , :s.. . ,,..: - ,. _. , , ... ,. •, _ ,. .,� � .:FE�`CURRE�' �:Y:/;N:". :, �. _ _ :;`; . ... .�i.; .�` � ..i ._{� - , , „ , �d�B�E s;,v.��,,z . , ,.. .. . UC811S9�#�. � -_ - _ �1, i.A':, ., . � . _ . . ` � � '{. `n�u'<. "t "'`4.,`:" " " .7,��['.'1`x..%,�. L :L ). ..}:::V.��.;,� RESIDENTUU:I _,`�Attach.'(2),PIot;Plans;:(�);sets=of�Buildl'ng,Plans;:(1)=sef.of.�Energy�Fomis;�R=O=WyPerrniE:for;new;,canstrucbion,: _ - . -.�-� . . _. _. ,<.. :.. .: :. ;, n.i ,:: Minimum;.ten:,(.10)�worlting;days�after,isubmittal�d"ate:��Requlrsd''onslte;�Consfructlon�Plans;,Sto'rmwate�:FlanswL Stlt Fence lnstalled,� . � �--- � �`Sanitery:FedllUes�B:�tidumpster�SlteFWortc:•Pe[mit`.for.:sutidivi.'slons/large:`pro ` ,;}'`;'."'•�, - � , = ' _ � ' � _ _ .:.--,,-�;< .:._.;..�;. , .., .,_..., �:. �",,�:;, ;•,,.,:,,, . - �...,., �.,,... �;. ..,,: r�• x-.:::. � . .�- ..1...._...::.:,..,..:.. _ . C,OMMERCIAL't Attach(3j`�complete`sets"of Bulltlin"g"Plens plus a Life Safeqr Pege;(1)set of Energy Forms.R-O-W Permit for neW constructlon. Minimum ten(10)working days'after submittal date. Required onsite,Construcdon Plans,Stortnwater Plans w/Silt Fence Installed,. Sanitary FadliUes�1 dumpster.SIte.Work•Fertnit for all.nei�irproject's:i411;commercial.cequlrements_must.meet compllance � �SIGN.PERMIT AttacFi'(2)"§ebof'Eng1ne_'er!sila..P..la[is:�;�;��s�'y.':,�,:�=.•=. �. " . - � � ••••PROP.,ER1_-Y,..SUR1l�Y regulred for�all iVEW.cons.tructlon:.:,.. ^�--_ - _ - � ' . " -_ _ -" - ! . ,,..:. „ ._ ,: , . .�.fy:.'i:.. ,r,� ..r,:.' • "^ ". ___ ... Dl�ectlons: - ..._._ _u Elll.out appflcatlon completely. Owner$Contrector sign back:of applicatlon,notarized If over'E25�00,a Notice,of Commenc�ment la required. (b1fC upgrades over 5T500),;__, F- • _ _ .. I�� � .'s�,�a�:.:_.. ._. ..;. . ..�.:.,_.w, _�. _ , .� . � - AgeM(fur ttie°confr�ctor)�O�:Rower ofAttortiey(fo�the owner)would be�someone with notadzed letter from owner authorizing same 'OVER'THE-CO�JNTER�:PEf�Ml1'fING-=;=�-'""(Front-of-AQplication"Only) ;,.� "__� � ' ' - Reroofs if shing es Sewers Service:Upgredes,A%C Fences(Plot/Survey/Footage) _ -- - ..... ....-r�._. ---_-,:-,_ ... •� �.�.: <:`. = - - . - -, - . , DNvewa -Not over Counter if on';publ�ic roadways.:'n''eeds ROW J ' � � � I � , ... . <_ +� •-4 ' r IOTICE OF DEED:RESTRICTIANS:� The'undecsigned:.untle�tan,ds�;th�t;ihis;:.p�rmit;may,.�..be;sub)e.ct;to:"deed"?rest'fctlons"..;:;;,� � ' � t , - � „..... t : �; � s , .. ; :, rhich may�.tie�more�restciet(ire�•fha�t'Go�unty��reg�laffortis:�;TFie�.und"e.''s1gned'�'a's�umes responsibilfty for''compllance virith any �ppflcatile�deed.rostilctlons. ' _ .,;,,;��:<:; � ' ` - - - _ __ - _ -.:�.,,:...._._�:; "�''.�%� „ . . IIVLICEN,�ED;:GONTRACT?OR���;AND:CONTRA►GTOR�RESPO�ISIglLI7`1�5:-�`-���ff=�ie`�ovimer`has�`fil�ed='��"cor�trac#or or . ,_ �. .. �: - - :� , .. . ontractors to:undertake.wock;#hey_,mey�be;r�qu'Iredr�to:;�e�;Ilcens�d.In�.accordanc�::wiQh state•:and��local:;regulaftons:.��If°�:the•�_� -'� . � ._ .:���_.....:..:. ... .. �.. �ntractor:ls�not•:Ilcensed��as'regulred�6y,law,:both��the owner and`="contrecto��may�be-�cited for���Tmis�lerrreanor�vtolation �nder state law. if the owner or Intendetft�c�ntractor,;;a�e;:uncectaln;as.to-wtiat licensing;requl�ements:;may��`eppljr:}for�::tiie��.��==:=r�:�:- .r.;.,.,x.,.,,.., w. : �tended'work;�they are advised'to:coritact:tfie:�Pasco;.�ounty,Bullding'Insqection;�Dlvlslon-L•'Icensing:Section_at'72T-847- :; . .Rs...,,,,. ..:, . _ . 009. Furthemio�e;'tf�the•owner•�has'`lilred°a�conhacto"r o� contreators; �ie is advised to": ave�.the contracbr(s);.slgn.,_,. , ,<. � �� . { 1:. .y��., ortlons of`the"contrector Block° of;`thi�_,appl�ation.for.which.they__wilL:be�re.sp.onsihle._�If you;��as�-,the:�owner:algn'as'the"� ' � ` . , � _. , �-,--. ._, : ontractor;�that�nay=be�an'indlcation ftiat-he�is=�ot:prope�ly-Ncensed�arid�'t"s�not�entitled'-fo-pe'rmitting prtvileges'in Pasco, ,., �; � . , ,; , :� ;ounty. �;- . _ _ . . -�..._�... -:��-...-- �:;�._�� . .. . '�►NSPORTATION:.IMPACTNTILITI�S�IiWPAC�MA�i��ESOUItCE R�C011ERY�FEES:-Th�und'er�igned��understands »tTransportetfon Impact Fees:and.Reco.urse Recovery.Fees ,m`ay�apply�tat�e;ccnstruction:of new..buildtngs;.�change°of'�=�`�"''-`'�� ° , se In exisNng bulldinge;�:�re�.exparisibrt?;of��izlsN�i�g�b�iiidings;`as speclfled.in Pasco County O�dinance number 89-07 and , 0-07, as amende.d.,:,�h�.undetsigned also:understands� th���suckfees;��as�tnay�`�e:�.due„f�ntllb�be identffied at the:timerof�"- ��=` ���`' ermitting. It is iurtfier'understood�that Tran�poctatlon.Impa`cf Fees and�Resour,ce Reco'v.eryF�Fees mu�f be paid prior to ace�vtng a."certiflcate:ofi occupancy"-orflnal,�povu�r rele�se.-:if�the proJ�ct�:;;does-:not�involve;a{certifl,cate of occupancy:�o��=�="��-`��''� ;� , nal powec�:celease�the:�fees.mustr�be�:paid::prfor.to-.p�rmit Issuance. �F��tk�er;mor,;e;;�If=Pasco,•County^Water/Sewer�lmpact•s> ;. . , jes are due,�lhey_must be;pald:p�lor to;permit•Issyancean,eccordance:wit�.applicatife:Pasco�:Gounty ocdinances. • :OIVSTRUCTION'CIEPI�LAIfI�'(Chapt�r 713,FloNda 3tatutes�ag am�rrd�d): if valuation of work is$2�500:O.Oaor�more;.:la � ; ����.�,r-� eKify that I, the_applicant,__�axe:::.been.:.pr�ovidetl��wtth�-a=�copy of;�the�"Florida���Constructinn.=Lien:�i:aw—Homeowner's ,.�.., . . , �rotection Guida" prep�red by'tMe`Florida,Deperttnent�of Agric.ult�re and Consum�rRtfairs: If the applicant Is sotneone-, . .•_ ,s_ ther than the"owner", I certffy.;:th�t�l;h�ve..obt�[ne��`a"�copy:of.the�above:rfes,cri�ed:�Jticu�ent,:and;pro�iise:in;good>faith�to _. ,- eliver it to�the:'owner"�;pr�or'�toFcommencemer'it:;�� � . • � ' . � � . . .=_ ",. �` '.-'--�-" _ "� ' ' �ONTRd1CTOR'SIOWNER'�A�FIDAVIT: I.certi[y;,�tkiat all_hhe;lnf.ormation::ln�thl.s:applic�tlon is accurat�;�nd that all wo�k rfll�be done in compliance with all.appllcable laws regulating con�truc8on, zontng and�.l�nd-;development. Appltcatlon is . ., ereby made to obtain=;a.permit;,Yo;�,.do.Y:wo#k;�and:°Iristallation as indicate.�a�: ;l:,cettify"that no work-;or Instaliatton fias - ommenced p�lor�to'is`suance of"a pemiif"and�thaf.all-work will be perForm�d�to meet�standards.of�all laws regulating- onstniction, County and City codes, zoning.regulatlans, and land development cegulatlong�in�the:JuFlsdtctfon:��--1�:a1'so ertify th�t I u�derstand that the regulations of other�government agencies may�apply:�:to,the.�intended.work� and that it is � iy responsibility to identify•what.ec0ons I must�take�:to be.tln:.compliance:_.,Such,agencles•�Include�but=are:not Iimited.to: - � ; - Departrtien� of Environmental���Piritecfi�n`=Cypress:''Bayhead�;�`Vlletland fAreas and Environmentafly Sens(tive Lands�Water/Wastewater Treatment. ,- =� - " ' - - �outhwest Florida Water Management-�-::btstrict Wells, •�Cypress.��.BayFiead§;� Wetland � Areas� Altering " Watercourses. _ , - •- - � - ` - Army Corps of Engineers=$eawalls; Docks, Navlgatile Waterways. - D�partment„of Health;.8;_ReF�atillitafi.v..e,..Services/Errvtronmental.-He�alth Unit-Wells; Waste.water�Treatment; �r Septic Tanks:. ' • `. ,- `� :'. . " , . ` - US Environmental Protection Agency-Asbestos atiateme�t.;- � - �.Federal Avlatton:AutMoMty,;Rurn�rays:� --.., -� � _ � � � understand that the._following:resaictlons�apply to�tlie•t��e of flIL•• - Use ofifill is not allowed ih Flood;Zone"V"unless expressly permitted. - if-the_ flll�mateHat_"is��to`;:be�,used:=ln.�Flood.-Zone. °A", tt Is underetood tha�t-a drainage��plan addresstng a "compe�sating;volume"will.be subm(tted at#ime of,permittJng whlch is prepared by a professional englneer � Iicensed by#he::State�of:FloFida: � . � � _ - - If th� flll materlal�:is.,to:be�-used In �lood Zone 'A" (ns connection�wlth:a'��ermitted building usln�g stem wall . conaUuctton,_I ce�tify that fill�:wall-ti�e��used only.to..tlll the�acea.wlthin�;the stem�wall. . - - - If"fllf mate�laF:ts�to'�be���used=1n any°area;`i��certifjr that .use. of such�flll will.not adversely affect�adjacent propertles. If use:of fill_.Is_f.og nd to adverseEy..�ff�ct?ad�aEent��pr�perties,.the owner may be'cited for violaiing _ ......,._ .. .. ; the condltio�."s;of:tfie:ti�iildin��;pecmit issued�under the=,at�acfied_pecmit_•applicatloFl; for��lots,_less�than.one (1) acre which are`elebatetl�by;flll;.a�t engtneersd dralnage plan'ls requlred. I am the A6EN.T...FOR..THE�-OVMNER;`I�rqmise'Irt good faith to�inform the�ownec.of:the,p.ermttting condftlons.set.forth In ��� ds aifidavlt'prior�to-comr'riencin8'constr`uction:"I"understand that.a�separate permit may be requtred for electrical work, � .. � . ..,. ,., _ , _ lumbing, signs, wells,.,:po.ols;.alt.condltioNng,,,,gas,. or,other Instal�allons no1�spec.�flcally included�in.the�applicatlon. .A'" .. _ � ermit issued sfiall tie�con�tiued to'-'be�a'licenseito�pro;eeed with'tt'ieiviroPk�and no,k_as-authoNty-to.;ylolate�.,cancel,�alte�, or ;:; st aside any provistons of the:tecfinical..codes;�nor shall Issuance�of'a.perr�It�:pr.event the Bultdirig Oiflcial from thereafter t.. ..��. aquiring a correctton�,af.eirors-.In�;plans�,conshuction orvlolations-of=any�codes: �Every;permit-:issued�shall�become�invalld �� �' nless the work autFiortzed�:by`sucFi,perm(t:is-co�menced�witfi(n gUc;months:of;permft issuance� or ff work authorized by � �:' F..�.?-.i; " ' ie pemnit is suspended:or..abaradoned�,f,or,:.a::period;of<six(8):montF�s;after tFie-#ime the�work is commen`�ed. An extenslon $ 4 iay be requested, tn wkiting;_.:from`tfie-�Building,.v�iciai �ora pe�ioa.not:to:�exceed�ninety{9o�:aays a�d��ir'�demonstrate �� stifiable cause for�the extensior�.�if�work ceaees,for ninety(90)cons.ecutive:day.s...the)ob�ts.constdered aba�doned.� - . '�� - , . :�_,:. _ - . . IARNING TO�OVYNfR:' YOUR:FAILIJRE'TCI:;;RE.C;ORt�;A,:NOQTICE<OF-COENMEMEEMENT�,:MAY�RESULT IN��YOUR. - AYIfVG TWICE:FOR;IMPROVEMEN:�'S;Tfl`afOUit:;PROPERTY.s`,IF..:YO.tJ,�I��EKID"TQ��7•'JAIN��FINiANEIieIG;�ONSULT ►IT Y U _ , . �. ...,O. AN� �T'O N �•.�8 F�'R ;.-ECO G':;. ,O . Y . ;,-,' - -- --- - - - - ;. � . , ; ,. . _ . � .ORIDA JUFlA�(F.S.,117. },�_ •- ...: . - - -- - . • ~NNER OR JAOENT Gl - - --" CONTRA(�TO '.-� .:• �.�i✓�0.�( ibsalbed and swom M(o'r a(flrmed)b re me thls Sutisaibed'and'swom=to(or aflirtned)-before:me' I$, - b . ., . 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