HomeMy WebLinkAbout16-17776 ' ' CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 17776
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 17776 Address: 4545 BLOSSOM BLVD
Perm�it Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: NOT APPLICABLE • Lot(s): Block: Section:
Square Feet: Subdivision: ORANGE BLOSSOM RANCH
Es�. Value: Parcel Number: 15-26-21-017D-01800-00B0
Impro�r. Cost: 4,120.00 OWNER INFORMATION
Datellssued: 9/27/2016 Name: WALKINSHAW MARILYN
Total Fees: 60.00 Address: 4545 BLOSSOM BLVD
Amo�nt Paid: 60.00 ZEPHYRHILLS FL 33542-5667
Da{te Paid: 9/28/2016 Phone: 813-783-7209
Wo k Desc: A/C CHANGE OUT 2 TON
CONTRACTOR S APPLICATION FEES
BAHR'S PROPANE GAS &A/C, INC. A/C CHANGEOUT 60.00
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Ins ections Re uired
DU TS INSTALLED
DUCTSINSULATED
FINAL �O-�I�� /G,D
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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 property that
may �e 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.
"W rning to owner: Your failure to record a notice of commencement may result in your paying twice for
imp ovements to your properly. If you intend to obtain financing,consult with your lender or an attorney
before recording your notice of commencement."
Com lete 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.
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ONTRAC R IGNATURE PERMIT OFFI R
� PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
. s��- saoa?o City af Zephyrhilis Permit Appiication Fax 813-780-0021
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� Buildfng Department
Date Fteceive , ti �� �r� - .5���
� • Phone Cantact far Perniitting '`
Ov►+n�r's�l�m �'!`y''r ! 5`/`7 l�!!�/"'��< � Owner Phone Number , ���-�����o?U
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Owner"s:Addr ss �J� . � � D7�"j /�/�"� Owrner Phone Idumber
Fee Simple Tctlehotder hlame ` Owner Phane Number
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Fee Stm le T'tteholder Address
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JOB�DfitE �S ��7� jsll�'�L5`7"Y) LJ LOT#
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S��Q�v«�� �������as�o� �� �,�����a# l� � �� �17 a��a� ac���
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED . e' . NEW CONSTR AGD/ALT � SIGN Q Q DEMOUSH
INSTALL - REPAlR
PROP,OSED SE .. Q SFR Q COMM � OTIiER`
TYPE OF CO STRUCTION Q BLOCK • Q FRAME � S,TEEL [�
. �
DESCRIPTtO 'OF WCtRK �,- '�G � A-nJ� �-L`x ce-'T � .G'-r�rr� �N�n17'S � 7'
BWI:D{Nf`$t E ���l� SQ FOOIAGE .liElGHT �, �
�BU LDING � � VAl.UATIOf�=QF"TOTAL CQNSTRUGTlON
QEL CTRICAL . $ �� AMP SERVICE =Q PRQGRESS ENERGY Q W.R.E.C.
QPL MBING ��
QM CHANtCAL $ . VA�UATION OF MECHANICAL INSTALLATION
��c���,..���
QG,S Q ROOFtNG Q SPEGIi4LTY � OTHER
FINISHED F OOR ELEVA710NS FLOOD ZONE AREA QYES NO
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BUILDEF2 � � COMPANY
SIGNATUR _^,�_ ,! REGISTERED Y/'N FEE,CURRE� Y I N
Addres License# �� �� �
ELECTOtIG! COMPANY
� SIGF�ATUR a REGISTERED Y/ N FEE CURRE� Y/N
AdcEres � �9aense# � - '��
PLtilUIBER._;, COMPANY „ ,
SIGNA7UR �REGIS7ERED- �Y�/ N _ �FEE GURRE� YI N
Acidre s � Liaense-# �— - ' �
,..MECH.'AN{C `� ��1 '''� `` COAlIPA1dY /��R fi.S 6`D /��. '�`�'L° ..�-!1i iL
. ,SI(aN�iTUR `` ��� ���'' REGISTERED - Y/ N FEE CURRE� Y/N
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Aildre s:: ��'��� � ��ILL'�"'�„i^ �icense# �tT w�� �� � 1
,a.;3�» .,
OfiNER� w":�: � " CO11flPANY- ' .
`: 'SIGNATU :� � �� � � � � � REGISTERED � Y/'.N FEE CURRE� Y/N
Addre�s,., , � _. _ � . _ � � � License# �—.—i.—l�
�`.RESlDEPlTI �:' Attach.(2)";Plot'�Plans;'�(2)ssets iif8uiltiiiig•'Plans;'(1j�set of Energy For'rris;'�R,C1-W Permit'for`new'construction, -
— d,..-v-r�, - �.= A � .. . , �
��•�a: :��x� �^Mini,mum'�ten�_(�10)wo,rking;iJay.'s�after,submittal;date. "Requir"ed on"site;�Construction Plans,;Stormwater P1ans w/Silt Fence installed,
_ 4y'..�.°.r.,-4�b���,I;x 4y„.i...�.....r - � � � , �
Sanita:ry.,.;Fae%IitiesN&.,1:�dumpster Sife:�Nork Perrn�t#orsubdivisionsllarge.projects.� ' . `` `
:,.,GOMNiERC A[.. Attach''(2j�coriiplete"'sets of'Builcling Plans�pfus a Life 8afety Page;{1)set of Energy FoRns.R-O-W Permit for new coristruction.
Minimum ten(10)working days after submittal date. Required onsite,Canstruction Plans,Stormwater Plans w/Silt Fence:installed,
Sanitary Facilities&1 dumpster.Site,Work Permit fo�a0 new p�ojects.�AN commercial requirements must meet comptiance
';SI,GN'`PER �IT Aftacfi"{2}sets afSErigineetQcf S?tans:�,. f . , "
:� "*""PRaPERTY SURI/EY_requlred for_aU:NEW cc,nsUuction. �
'=D�rec'tRons: .:,:�, . �. , _ ,.
, .Fi4{:ou app{ication campletaly. '
= Oinmer&Gontractor sign back of�application,notarized
If ove $2500,a Notice of Commenaement is reguired. (AJG upgrades over$7500)
,. � •='���„<;.:��,;;,
Agent for the�cantractor)`or Power df-Flttbmey(fo�'ttie�ovuner}wauid be sameane with notarized tetter fram awner autharizing same
,'01fiER'THE CCIUNTER;�PERMITfING ..,. .(capy=of-cantract�requir.ec#)"., , ' "
�Reroofs if"s ingtes S'ewecs Service Upgrades�'i47C � Fences�(1?lotlSurveylFootage)
�._. .._._._.� .;�....._ ,,., ,._ :
Drive ays-Not over Counter if on�public,roadways.;�ieeds I�OW;' '
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NOTIGE OF DEED RESTRICTIQNS: The'undersigned understands.that.this permit may bersubject to_"deed°restrictions°:'-��`
which„ma ,;be�more restricfive:than;.Count .re ulatioits. .Tlie unders� ned-�assuriies��es onsitiil� for^com�`Ilance`wifh.-ariy-`'�
Y Y 9 9� P tY` p
appiicabie deed restrictions. � • �_-- � �°'"�
UNLIGENSED.:;.GONTRACTOR� AND CONTRACTQR RE�PONSIBlL1TtE5: if�tlie�owrier.�lias'fiireii=�°a`��con#�actor'or
coritractors�#o undertake work,-they_may;be.requiced to be�licensed ih accardance with state and'local,,regulations=:���if�:the--'�� �
contractor-is not ticensed as required�by law,,botli�the awner'•and��contracCor�rriay�=be�cited�`for°a�misdemeanQr violation =
undet state law. If the awner ar intencled,.con#rac#or are uncertain as to what licensing requirementsrmay;apply for�;ftie�� ='
intended work, they are advised to con'tac#`thie�Pasco County Building Inspectiori_"Division:-Cicensing Sectian at 727..=847=
� 8005. Furthermore, if the owner has .hired`a cciritractor or canfrac#ars, he is aclvised to_;have #he cantractor(s},.sign. _., �
I partions of the "contractar Block" of this application:,for which they.will.�be responsible:::If-you, as�;the�owner`sign�as�,thie-'" ' ;
, contraetor, that may be an indication that he is nat properly licensed anc!`is nof entitleti fo permitting privileges in Pasco:��
County. ' ' _ _.. , . ._... __. .. . . �. .:_.., ,
� TRANSPORTATION IMPACT!l1TILfTIES IMPACT AND-RESOURCE RECOVERY"FEES:`"The`undersigned understands , ,
� #hat Transpartatian Impact Fees and Recourse Recovery Fees.,may�.appty to the constructian of„new builciings, change,of`-''-` '�
� use in existing buildings, or expansion.of;:existing �uildings, as specified in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands, that such fees, as"rnay:>besdue, will 6�e�identified at::fFie:tiriie.`of``-�H " ,
permitting. tt is further understood that Transportation Impact Fees and Resource'Recovery,Fees must be paid prior#o �
receiving a "certificate of occupancy" or final.pawer release. If the-project does not invalue a cei#ificate of accupancy:or`��� '
fina# power release, the fees-must be paid priar ta permit issuance. Furtfiermore, if,Pasca Coanty WateclS,e,w,er.�lmpaet:;,-r ^
fees are due,,tfiey must be paid prior to permit issuance in accordance with applicable P'asco County ordinances:� � '
CONSTRUCTI�N t�IEN I.A1N{Chapter 71 S;"Florida Statut�s,as amended}: if vaivation of:work is$2,50Q.O.O:,or mor.e,..1-,, .,,
certify that I, the applicant, have been: provided--with a copy_ of the "Flarida �Construction��Liert Law==Homeowner's
Pratection Guide" prepared by the Florida Departrnent of Agriculture and ConsumerAffairs. If the applicant�is someone .
other than the"owner�, I-certify that( have obtained a copy of the-above`described"'document and p.r.omise�in.good�..faitti,;to��.;
deliver it to the�."owner"prior to commencerrtent:� ' � ' � �
� CONTRACT4R'SIC}WNER'S AFFIDAVIT:�I,certify.tha#all#he informa#ion in this applicatian is accura#e and that aS(work
will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is
hereby made #a obtaan a permit..to.;do work and instalfatian as indicated. 1 certiify thaf no work�or.iris#allation=.has
commenced prior to issuance of a permit and that all wark will be performed to meet standards of all laws regulating
construction, County and Gity codes, zoning regulations, and land devetopment regulatians in;,the juristlictian: �t alsa
aertify that t understand that the reguiations of afher gowernment agencies may apply to the interided work, and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies include-but are not limited:.to:
- C?epartment af Environmental Rrotectibn-Cypress 8ayheads, Wetiarid Areas and Env�ronrrteritally Sensitive
Lands,Water/Wastewater Treatment.
- Southwest Florida Water IUlanagement District Wells, Cyp�'ess Bayheads, Wetland Areas, Attering
Watercaurses. , -�
- Army Carps of Engineers-Seawalls, Docks, Navigable Waterways.
- Department of Health & Rehabilita#ive ServiceslEnvirorrrnenta! .Health Unit:Vtlells, 1Nastewater Treatment,
Septic.fianRs: � � - -
- US Environmen#al Protec#ion Agency-Asbestos abatement. -
- Federal Aviatian Authority.-Runways.�, ."
' !understand that=the following�estrictians apply to the use nf fill:
, - Use af fili is not a8owed in Fload Zone"V"untess express(y permitted.
- If the fill material is to be used in 'Flaod Zane "A", it is understood that a drainage plan addressing a
"campensating volume"wi11 be submitted at time•of permitting which is prepared by a prafessional engineer �
licensed by the State of Flarida. -
- If the fi1! material is to be used in Ftood Zone "A" in connection with a permitted building using stem �rall
construction, I certify that.fill wili be used oniy to fill the area within the stem wall.
- If fill material is to .be used in�any area, I certify that use of such fill will not adversely affect adjacent
prope�ties. tt'use of fill is found #o adversely affect adjacent properties, the owner may be cited far violatirig
, #he conditions of�tlie;building permif,_issued under�the attached permit application, for lots less than ane (1)
acre which�are elevated by filE,an engineered drainage plan is requ�red.
If I am the AGENT FOR TWE OWNER;,�I promise in good faith-ta inform the awner af the permitting conditions set forth in
this affidavit prior fo commencing'construction. I:understand that a separate permit may be required fbr electrica! uvork,
piumbing, signs, we(Is, paots,,air conditianing, gas, or. other instat(atians not specifically included in•the application. A -,
permit issued shall be construetl to be a license to:proce�d'with the work and not as au#hority ta violate;.cancel, alter, or , ,
set aside any provisions of�the technical codes, nor shall issuance of a permit preven#the Building Officiat from thereafter !
requiring a correction of errors in,plans;�,construction or vialations of�any codes. Every�permit issued shall become invalid '
unless the work aiathorized by such permit is carnmenced within six months of permiE issuance, or if work autharized by `
the permit is suspended.or abandoned for a period.of siic(6)months after the time the work is�cammenced. An extension - �'
may be requested, in writing,_�from the Building'Official for a;�period nat to exceed•ninety(90) days and will demonstrate
- �" just�iakite cause fo�#Fte e�ension: If virairk ceases for nir►etjr(90}consecutive days,the job is considered abandoned.
WARNtNG TC} QWNER: YOUR FAII.URE TO,REGORD,A.Nt?TICE OF Ct�MMENCEMENT MAY RESULT IN YOUR ' �
PAYING TWtCE.FOR tMPROVEMENTS,TO YOUR,�PROPERTY.. .IF YOU•1NTEND TO.OBTAIN�FINANCING,`CONSULT
WITH YOUR LENDER OR AN A`fT0 NEY BEFORE.RECORDING YOUR(dC?TIC�OF`CQMMENCEMENT:
Fi.QR1DA JURAT . . 47A3)�"' ^ � - .
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OWNER'4R A �YX_� ;�...��CQNTRACTOR
Subscrlbed and swo a{or affinned)before me thls Subscribed and s to(or affirmed)befare me this
by �
Who Is/are person y knouun ko me or has/have produced �� Who ls/are pers ally kno to me or has/have produced
" as 3den�ftcation. as IdenSficaS . �
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Notary Public _ " � '�..-�- Natary Public
Commission No. Com sion a ,� ���., INE BOGES
;,,: ';= Commission#F� 201&
Qecember 12,
Name of NotarY tYP�,P�nted ar stamped Name of No c}r ,;fitit�ao��&Eafi�s�i�a°`�
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� PROPANE C.�AS Serv�tce Clyd r r �-i-`---��
'a AND AlG tMc. +� ./P' oposal Rir Gondition3ng&Heating
�Sia�e�98c� S'[3y782M�"vC!i 3 ���
S 1es, Service & Instaliations ' �Q�� ���'�"��r``'��`�����7'�h.� ,�.�'.�'`�'�° _ r}��`
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L(M D WARRANIY: Nf ma#eriais,parts and equipmem are wartanted by the manufacturers' '^'� , �< .p .,�a��;�;:;;�° CALL' i
or sup liers'written wamanry oniy.Ati labor performed by the above named c4mpany is wartanted for ''`''�,'"�'�t N`�'���='����'�°��=�,��:;i;:=��::=�="�,z.-�.
3o d s or as otherwise ind+cated in writing.fie above named company makes no other wercanties, ❑�ASM ❑CK# TOTAL i
expre s ar implied,and its age�ts or technicians are not authorized to make any such wartanties on MATERIALS i
behai of above named compsny. ❑DEB(T ❑CREDiT 0 OTHER MAINTENANCE �
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i hav auitimlry So arcler the work oullined ubove which ha's been satlsfactnri�y compieted.i agree t4at Seller PROG. W/ G
reWt 6tie to equlpmenVmaterials lumished undl flnat peyment is made.li payme�t is noi made as agreed, �(,}L�M#
sette can 2move satd equlpmeoUmateriais at Seitar's ezpensa.My damage resuiting from said ramoval shall �
not ba the respansibility of Seller.NET 30 DAYS.A 7 1/24o SERYICE GHARGE WILL HE ADOED MONTHLY TO �
ALL NPAiDBAV+NCESOVER300AYS.NOREFUND5 DATE COMPLETED , _��
., , ! ,�- TECH: TAX �
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CU TOMEftSIGNATURE pp7E VJ'E��t�%/biTi tlou TOTAL �I/o�..�'��7C