HomeMy WebLinkAbout16-17784 CITY OF ZEPHYRHILLS ''
.; - :
5335-8TH STREET
(813)780-0020 177$4
BUILDING PERMIT /
PERMIT INFORMATION LOCATION INFORMATION
Permit f�umber: 17784 Address: 5940 9TH ST �
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class a�f Work: A/C CHANGEOUT Township: Range: Book: �
Propos�d Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est� Value: Parcel Number: 11-26-21-0010-00600-0110
Impro� . Cost: 3,770.00 OWNER INFORMATION
Date�ssued: 9/28/2016 Name: QUENNEVILLE, MARC &ANITA
Total Fees: 55.00 Address: 5941 9TH ST
Amou�t Paid: 5'5.00 ZEPHYRHILLS, FL. 33542
Da�;e Paid: 9/28/2016 Phone: (813)782-5136
Wor�C Desc: A/C CHANGE OUT 2 TON
CONTRACTOR S APPLICATION FEES.
BAHR'S PROPANE GAS &A/C, INC. A/C CHANGEOUT 55.00
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Ins ections Re uired
DUCTS INS �ALLED
DUCTS INS�LATED
FINAL
REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the
local go ernment 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.
NOTlCE: In addition to the requirements of this permit, there maybe additional restrictions applicable to this properly that
may be ound 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.
"Warniing to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your properly. If you intend to obtain financing,consult with your lender or an attorney
I before recording your notice of commencement."
Complete 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.
� ~ �-��o
� NTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
- 813-7$0-002o City of Zephyrhills Permit�4pplication Fax-813-780-002't
4� Building Department .
Date Rec�ivec�l, Fhone Cootact for Permftting " �� � ���`` — �v�./ .
Owr�er's Nam /��Nl��RJ!��� �i�� Owner Phane Number l✓"�'—6��� /l�
Owner's.Add ss ���` ��� �, ����-5 � Owner Phone Pdumber �— �
Fee Simple Titleholder Wame . � Ouvner Phone Number �! �
�
Fee Simple T tlehold+�r Address
JOB�DDRE S ���v `�� ��� �-�/�`� f"�- � LOT# ���
S�B��v�s�� . � , �� p�����a# 11 � �l d�f� l.� �oo �tCd
(OBTAIPIED FROM PROPBRTY TAX NOTICE)
WORK PROPd3SED NEW COtvSTR AC}DlALT � SIGN Q Q DEMQLISK
e � WSTALL � REPAIR
" PROP.t3SED �SE Q •SFR Q C{}MM [� OTHER '
TYPE'OF CO STRUGTION Q BLOCK • Q FRAME C� S.TE�L . ,�� ;
� � /� /
DESCRIPTIO�`OF WORK ES. �� C��Yji� G bGL� Id"J1.� t�'lJl1 /�R/�� � � /iN
BUiLDING'SI E � �. SQ FOOTAGE�_,� HEIGHT �__�
Og�Ld'�� �_� VALU/�TtOtV°OF TOTAL CONSTRUCTiON
QEL C.T:RtCA� ,� � AiVIP SEi2VICE ED Pf30GRESS ENEi2GY Q W.R.E.C.
QPL MB1�1G ���
QM CHAI�ICAL $ �s���' ��� VA�UAT101U OF MECHfW1GAL INSTALLATtOiV
�
QG S Q E200FING Q SPEGIAG'fY � OTHEFt �
FINISHED.F OOR ELEVATIONS �+_� FLOOD ZONE AREA QYES NO
BUILDER COMPANY -
SIGWATURE REGIS7ERED Y/ N FEE GURRE� Y/N
Addres ' License# �� �
EtECT121C1. COrilIPANY �
SIGNATURE � REGISTERED Y/ N FEE CURREP Y/N
Addres � Lioense.# �� ` I `
PLUM�ER. COMPANY °
SIGNi�7URE' �REGISTERED Y.�/ N FEE GURRE� Y/N
�4ddres Liaense•#"�� �
�+ nrt�cMiwic � ��.y� � cat�P,ari�r �4 �''S t'!'� fa�l� S��f� ���
SIGNATURE REGIS7ERED ,- Y/.N FEE CURRE� Y/N
•., , , '. �
�;aa�es ��= , �f��/i�l en1 ; ��lLLS `33 SL License# �e� ����O �
.if,•`.'r '• ' " .
OTNER�� ; � � � � CORfIPAt�iiY
;'SIGNATURE 5:� •< --� " �• ' � REGISTEREp Y7 N FEE CURREri Y./N
�4ddres ; <s; � - ' � = ' ' License# �� �
.,f.:� �,.,. ....pt .v[r" '_. "f' : <:;i'} r .t-. .. �.'rc.i � .. `. :.:" .
-:RESIDENTi ::._ Attach;.(2);�'Iat�Ftans;(2):seCs-ofhBuili�3ng=Plans;(1•}set'of°EneFgy Forms;R,Q-W.Pefirilt.for,new:constntctian,
, ._ %;.r,�;.;:..,r;.;, °�Minimum;�ten;,(=1Q)working;days afte�;§u6mittal:date. Required`onsite;'Construction Plans,Stormwater Plans w/;Silt Fence installed,
Sarilta.ry.�FasiliBes>&���;dumpster;Site;Work�Peimit'for`sutidivasions/lacge:.projecEs��� `
4 s F..�4,r_�2^,.a f.`:..rt,*:..�...:..
s, C�MMERGI Attach�(2}�comptete sets ofBuitding Ptans plus a Life Safety Page;(1}set of Energy Forms.R-O-W Permit for new canstructian,
. Minimum ten(10)working days after submittal date. Required ansite,Constructlon Plans,Stormwrater Plans w/Silt Fence�installed,
- Sanitary Facilitles&1 dumps#er.Site 4Work Perm3t foc.atl new projects.Atl commercial requirementsmust meet compliance , _
„,�$IGN�pERM T AttacFi(2f sets of�EngineerQd Rlans:�+ , '
*'""PROPERTY$URVEY rgquired for_aII.NEW cdnstruction. , , ,
bi�ect'ions: ,. _ ���',. .. , __
� FIII'out pplicadon completely. �
�Ouirrter Gontractor sign back of application,natarized
if over 2500;a Notice of.Commenceiment is required. (AIC upgr,ac�es.over$7500)
.,�. �s''--°>"
Agent(orUie�contractor.)�orPower of�Attcimey{for ttie:ovjrner}_wouid be sameone with notarized tetter ftom awner authorizing same
� ,`.OVER.THE- OUNTER.P�RMIf'RING .. .�`:(copy;of�contca'e4required), , "
=Re�oofs if shi gles Sewers�r Serviae Upgi�des A/C= � ;Fences(i?lot/Survey/Footage)
_ ��.�,.. ., . .. r , . . _ .. ..,. �
Drivew ys-Not over Countierif on public�roadways:.needs ROW :
_ �_. _. . ._
' .�_ _�:yx..:..—�cc�-�tiw:...��2x?'�-�:�.��s��-..�;m._�_�,_
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NOTlCE QF'DEED R�STRlCTOf?�lS: The undersigned undecstands;.that.this;pe.cmit may be subject.to"deed"restnctions":'�`�`
which•may:be�mo�e.restrictive:ttian County r.egulations. �The un�ersigraed assa�rr�es'responsibitity;far��co�ipHsnce'iivtth�any�""""
applicable.deed restric#ions. , ,..,,_ ,�r-4�:,.;,�.^�
UNLICIEN$E�>;GONTRACT.ORS AND �GONTRACTpR RESPONSI�ILITIES: If�tlie�owner���has�tiired�aY:cantractor�or
carit�actors to undertake work,�they may be re,quir.ed #o be�licensed in accordance with state-,and:local regulations:�"`Ifi'ther;=<�
contractor is not-licensed:as�:;r.equired E�y law, bofFi"'the awner-.and'confracfor'=-rttay;�tie•citetl�for'a mi`sdemeanor violation "
under state law. If the owner or intended.coritractor are uncertain as to what ticensing requirements�,may��appty fac-�ttie==�="� �;.
intended�work,they are advised to coritac#'tYie Pasco Gountjr Bailcling Inspectiori'Divisiori`,-l�icensing Section at 727�84'7- �.
8009. • Furthermore, �if the owner has hired' a �cont�actor ar con#racto�s, he is advlsed ta;�have the.,can#ractor{s)Msign_,_y �
portions of the "cantractor Black" of this application._for which they.will,.be-cesponsible: �If.you,_asathei'av+rne�'�sign�as�:#he
cantractar, fhat may be an indicafian that he is no# properly�ticensed and`is not entitletl�to permit#ing privileges in,Pasco,..,
County. . . . ..... . -__ .,.. . .. ._�-,,.k _...� 4�;�r�
TRANSPORTATlON-IMPACTlU71l.ITIES 1!VlR�►CT AN�-ftESOUFtCE R�COVERY�FEES: The'und"ersigned understands -
that Transportatian Impact Fees and Recourse Recavery Fees_may°apply`to the construction t�f,new�bullilings, change.�of=��. r.
use in existing buildfigs, or expansion..of�:existing tiuildings, as speci�ed in.Pasco County Ordinance number 89•Q7 anc!
90-07, as amended. The undersigned�also unders#ands,�that such�fees, as inay;b.e�due, will_6'e identified�at'4�t(ie�time�of`=='`" Yw
permitting. It is fti�ther understaod tha#Transpartation impact Fees and Resource��Recovery,.Fees must be paid prior ta
rece�ving a °certi�cate o€.occupane}r"=or final:power release. (f the praject�daes not invoive a�ceitificate of occupancytor.�,��'�
fina! power:release; the fees.must be paid prior to permit issuance. Furttiermore, i�..Pasca County Watec/Sewer�Impac�.�T�-:
fees are due, tliey must be.p�id prior ta permif issuance�n accordance wit�t=applica�le,Pasco.Couiity ordinances.
CONSTRUC'f10N t1EN LAW(Chapter 713;Florida Statutes,a�s anaended): If valuation af work�is$2,50.0.00•,or.mo_r.e,u.l,�,r�
certify tha# i, the applicant, have been. provided,with a copy_ of .the "Florida Gonstruction,:kien..Law=Homeowner's
Protectian Guide" prepared by#he�F(orida Department of Agriculture and Cansumer�Affairs. If the applicant is someone:v
other than the"owne�', t certify that I have obtained a copy of the�above descri6etl'document and promise=in,good:faitli:to,,. .v
delivec..it:to:the�°owner":prior ta commenceritent. � � ' .. .
CONTfZACTOR'SlOWNER'S AFFIDAVl7';�l:certify-.that-al!the informa#ion in this application is accurate and that alt work
will be done in compliance with al! applicable laws regulating canstruction, zon�ng and land-development. Application-is
hereby made to obtain a .permi#,.to:.do virork�and installation as.=indicated. I certify that no�work or.installation��has
cammenced prior to issuance of a permit and that all wark will be performed to meet standards of all laws regulating
construction, Caunty and City codes, zoning regutations, and Iand development reguiations in,the jurisdiction:- I alsa
cerkify that ! understand that Ehe regulatians of other governmen#agencies rriay apply to the intended wark, and that it is
my responsPbility to identify what actPons 1 must take ta be in compl�ance. Such agencies include�but are nat_timited;.to:
- Department of Environmenfal�Protection=Cypress Bayheatls, W�tland i4reas and Envlronmenfalfy Sensltive
Lands,Water/Wastewater Treatment. "
- Southwest Fiorida Water Management District Wells, Cypress Bayheads, Wetland Areas, Altering ,
Watercourses. � .
- Army Carps of Engineers-Seawafls, Docks, Navigable Waterrruays.
- Deparkment of Health & Rehabilitative Services/Enviranmenta! ,Heal#h Unit:Wells, Waster�rater Treatment,-
Septic.TanRs. �
- US Environmental Protection Agency-Asbestos abatement.
- Federal.Aviation Aufhority-Runways. �
I understand that�ttie foilawing re"strictians apply ta the use of fill: '
- Use o#fil!�s nat allawed in Flood Zone°1l"unless expressly permi#ted. •
- !f the.fill materia! is to tie used in Flood Zone "A°, it is understood that a drainage plait addressing a
"compensating volume" will be submitted at time af,permitting which is prepared by a professiana{ engineer "
licensed by the State of Florida.
- tf the fill materiat is ta be used �in Flood Zone °A" irr cannection with a permitted building using stem wall
eanstruction, !certify#hat.fill witl6e used only to fill tfie area within the stem wall.
- I# fill materiaf-is to be used- in�any area, t certi€y #hat use af such fiN will not adverseiy affect adjacent
properties. {f use of fil! is afound ta adversely affect adjacent propecties, the owner may be cited for v�atating.
the canditions-af'the�-building permit'issued under•the attached permit applica#'ton, far lots less than one (1�}
acre which�are elevated by fill,an engineered drainage plan is required. ,
tf I am the AGENT�CiR THE OWNER,=i�:pramise in good faith to infarm the owner of the permitting conditions set farth in
this affidavit priar to commencing constrnction. 1.understand that;a separate permit may be required f.or electrical.,work,.
plumbing, s(gns, uvells, poots,,air conditioning, gas, ar ottier'`instatfations nat specifically.included in the apptication. A , -�
permit issued shal! be construed to be a license to:praceed uvith the wark and�noE as authority#o"violate;�cancel, alter, or
set aside any provisions of"the technical codes, nor shal! issuance of a permit prevent the Building C?�cial from thereafter
requiring a aorrection of ecrors in.plans;�`constructian ar violations of any codes. �very�permit issued shat! become invalid
unless tfie work autharized by such permit is cammenced within six manths•of permit issuance, or if wrork authorized by
the permit is suspended or abandoned�for a period.o#.six(6).months after the time the work is^commenced. An extension
may be requested, in wr9ting, fr'om the,Buildirig'Clfficial for a:perioc3 not ta.exceed-riinety(90) days and witt demonstrate
justifiable cause for the extension. If work ceases for ninety(94)consecutive days,the job is cansideced abandaned.
dNARNtNG TO OWNER: YQUR FAILURE'TCI`RECORD.,A.NOTICE OF COMIVIENCENIENT MAY RESULT IN YOUR ` �
PAYING TWICE.Et3R,tMPROVEMENTS�:TCI�YQ,UR:•PRGI@ERTY.:,IF YOU.:INTEND TO.OBTAIN FINANCING`,`COMSULT
--4!�!'t'-�!-��1►t!#i`�� ��2-t�IR AN-�7"a`t) �L-�-B��FO�2��63��d�RD�N���U�-N{)'FI�E-���'�EbM �EI�daEAlIEM'�:-__.- - --
FLORIDA JURAT{ .S,,1 7.03) � r�" - _ � f
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OWNER'OR AGENT __��\.. CBi�TRACTOR �����..Q.,O��ZC/L
Subscribed and swam to r affirmed)bafore e thls Subscribed and sw to(or affianed�efore me this
by � '
Wha istare personalty knawn to me or has/F�ave produced � Who isJ pers, n iy knawn to me or has/have produced
as identl8catio�; �w� as identi�ca�an.
Notary Public GU2-�6� Nota PubUc
�
Commission No. C m sion .��������+. �
=� �'.� Commission#F�15Q422
Name of Notary typed,printed or stamped Name of Nata . , ,` �t �j��� surance80D385•7979
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., : � �y �1VE CzAS " • • • •
� �G INC. Service Order/Pronosal Air Conditioning&Heating
32M50'I3
„ f =' � � ' . WORK ORDER#fSERVICEMAN 7151� EAU
N���. . �„)�1�.,�.�_: ns _ DATE/TiME TAKEN • � ��9/23f 16 11 :45
3 3 5 4 1 TAKEN HY JM 00 ,�
��'�/� , ' � � DATE/TIME F►ROMISED 09/�3/15 13�:�� �
- ��,-;- -� � . � , CUSTOMER#fLOCATIOIV 17007
� dy ��,, > PHOIVE# 788—�715MARK
' ---r��_ .__���. ; � - PHONE2# 784�-62��
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. ; � CONTAGT TENT: APRIL & ADA
' � -�" - � ROIJTE/SEQ EAU3354C
. ,_'. �.. ; . ..� , MAP —A/H CLOSET
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,I : -- �_;Lb� �, ;�d(�+ 5940 �TH ST •
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� ° � � ZERHYRHILLS FL33�4�
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, . L0�45�72705 ,
LAST MONTH. i�ARK WAIdTS PRICE TO REPLACE -ASAR.
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❑ REGULAR ❑WARRANTY ��`''�"=:;`:;;�'�j,�'/��L��",, �1�.., ; _
^��: '� ,..,���9"''^�"_d d��`<,�3,�`�,'.;�..,
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;Q�afi�td€sf��_��#iqg5wa'When here":07�Afy;When Away§�;T Stat 8f3�;� ❑ MAINTENANCE CONTRACT SERVICE i
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LIMITEDWAR TY:�Nimaterials,partsand�equipmentarewarrantedrbylthemanufacturers� f'�,��'~�5:<%�:7�-r -��� �;�`t4'�r��; ^:.`-:�~:�==!';-:-' CALL
pw,1 ,, :�.._.zF�
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or suppliers'writte warranty only.Ail labor performed by the above named company is warranted for ''°='-��'-� � TOTAL i
30 days or as oth rxnse indicated in writing.The above named company makes no other warran6es, ❑CASH ❑CK# MATERIALS i
e�ress or implie�and its agenes or technicians are not authorized to make any such warrar�ties on
behaH of above n�med company. ❑DEBIT ❑CREDIT ❑OTHER MAINTENANCE �
I have auNority to rder Ihe work outlined above wRchhas been•satlsfaeloriiy mmplated.I agree Nat Seller
PROG. W/ C �
retains title to equi{�tnenUmaterials fumished urrtii final paymant is made.If payment is not made as agread, C��M# �
seiler can remove said equipmenVmater(als et Seilers expense.My damage resulting from said 2moval shall
not be Me responsit�lliry of Sellec NET 30 DAYS.A 1 tl2%SERVICE CHARGE WILL BE ADDED MONTHLY TO DATE COMPLETED I
ALl UNPAID CES OVER 30 DAYS.NO REFUNDS �
TECH: T� �
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� CUSTOMER SIG TURE DATE � ✓1 E�!//NL ✓pic TOTAL I
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