HomeMy WebLinkAbout16-17914 i I
CITY OF ZEPHYRHILLS
" • 5335-8TH STREET I
(813)780-0020 17914 '
BUILDING PERMIT
; ' PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 17914 Address: 37404 CORNWALL DR
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: WEDGEWOOD MANOR
Es�t. Value: Parcel Number: 10-26-21-0120-00000-0470
ImprQ��v. Cost: 2,800.00 OWNER INFORMATION
Date� Issued: 11/15/2016 Name: CASTLE 2015 LLC
To�al Fees: 50.00 Address: 333 WESTCHESTER AVE SOUTH BLDG
Amount Paid: 50.00 WHITE PLAINS NY 10604-2910
D��te Paid: 11/15/2016 Phone: 941-465-0568
Wdrk Desc: A/C CHANGE OUT 3.5TON
CONTRACTOR S APPLICATION FEES
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FIDELITY AIR & REFRIGERATION LLC A/C CHANGEOUT 50.00
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! � Ins ections Re ui d
� DUCTSI STA LED
DUCTSI SULATED
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� REIN�PECTION 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
II first reinspection,whichever is greater,for each such subsequent reinspection.
NOTIG�: In addition to the requirements of this permit, there maybe additional restrictions applicable to this property that
'� may b'e found in the public records of this county, and there may be additional permits required from other governmental
�I entities such as water management, state agencies or federal agencies.
I� "Wa�ning 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
i� before recording your notice of commencement."
Comp ete Plans,Specifications Must Accompany Application. All work shall be pertormed in accordance with
j � City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
I NO OCCUPANCY BEFORE C.O.
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'' TRA R SI ATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
� CALL FOR INSPECTION — 8 HOUR NOTICE REQUIRED
a PROTECT CARD FROM WEATHER
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81�-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
' ' Building Department
DateReceiv,�ed � `b a(��� 3J�a ��9�f _
Phone Contact for Permitting
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Owner's Na�l e C. � Owner Phone Number 1` (pJ���
Owner's Adtlress � � 1.,� Owner Phone Number
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Fee Simple�7itleholder Name Owner Phone Number
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Fee Simple II itleholder Address
JOB ADDR I SS � UI Q.I , LOT# �
SUBDIVISI N � i.�PARCELID# �O'��^ � D •V OQO � O�i !D
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED � NEW CONSTR ADD/ALT 0 SIGN Q 0 DEMOLISH
� B INSTALL e REPAIR
PROPOSEIUSE � SFR Q COMM � OTHER
TYPE OF CI NSTRUCTION Q BLOCK Q FRAME 0 STEEL Q
. 1 � W �
DESCRIPTION OF WORK 1 1 1 W �
BUILDING IZE SQ FOOTAGE� HEIGHT
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OBi ILDING $ VALUATION OF TOTAL CONSTRUCTION
QE! ECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C.
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QP UMBING $ � -i r �
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ECHANICAL $� � � VALUATION OF MECHANICAL INSTALLATION
Q IAS Q ROOFING Q SPECIALTY 0 OTHER
FINISHED I LOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER COMPANY
SIGNATUR REGISTERED Y/ N FEE CURRE� Y/N
Addre s License#
ELECTRIC� COMPANY
SIGNATU� REGISTERED Y/ N FEE CURRE� Y/N
Addr i s License#
PLUMBERI COMPANY
SIGNATUI�E REGISTERED Y/ N FEE CURRE� Y/N
Addr I s License#
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MECHANI�AL /�� COMPANY �C1�1� �lr ��T� l er���� �I.��
SIGNATUI�E � REGISTERED Y/ N FEE CURRE� Y/N
i ryn
Addr Ilss , , � {p�I License# l.R� ' �
OTHER I COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Addr�ss License#
Illllilllll / 11111111111111111111111111111111111111111111111111111111
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, �
I Minimum ten(10)workinp davs after submittal date. Required onsite,Construction Plans.Stormwater Plans w/Silt Fence installed,
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NOTtCE OF C�ElD RESTRfCT1aNS: The undersigned understands that th'ss permit may be subject to"deed'restrictions"
which may be inore restrictive than Caunty regulatians. The undersigned assumes responsibility for comptiance with any
appficable deed restrictions.
UNLICENSED'�GONTRACTOFLS AND CONTRACTOR RESPQNSIBILITIES: If the owner has hired a cont�actor ar
confractars to undertake work,they may be required#o be Itcensed In accordance with state and lncal regulattons. tf fhe
contractor is nok Ilcensed as required by law, both the owner and contracto�may be cited for a misdemeanor violation
under state lay�v. lf the owner or intended contractor are uncertain as to what licensing requlrements may apply for the
'sntended work,,�they are advised to contac#the Pasco County Buitding Inspectlon Division—licensing Sectlon at 727-847-
8009. Furthermore, if the owner has hired a contraotor or contractors, he is advised to have the contractor(s) sign
portions of the"contractor Block"of this applfcation for which they will be responsible. If you,as the owner sfgn as the
contracfor,fha may be an Incficaf'son that he Is not properiy Ilcensed and is nat enti�ed fo permitfing privileges in Pasca
County. !
TRANSPORYATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
fhat Transpostation Impacf Fees and Racourse Recovery Fees may agply ta the consfruction of new bt�ildings,change af
use in existingi buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
90-07,as amended. The undersigned also understands,that such fees,as may be due,will be identrfied at the time of
permltting. It�s further undersfood fhat Traasporfatian Impact Fees and Resoarce Recavery Fees must be paid pnor fo
receiving a'c�rtificate af occupancy"or flnal power retease. ff#he project does not involve a certificate ofi occupancy or
final power release,the fees must be paid prfor to permit issuance. Furthermore, ff Pasco Caunty WatedSewer Impact
fees a�e due,f}�ey must be paid prior ta permit lssuance in accordar�ce wifh applica6Se Pasco County ordinances.
CONS7RUC71QN LtEN LAW(Chapter 713,Flarlda Statutes,as amended): if valuation of work is$2,500.OU or more,t
certify that I, the applicant, have been provlded with a copy of the °Florlda Consdvction Lien Law—Hameowner's
j Protec#lan 6u de"prepared by the Flotlda Department af Ag�iculture and Consumer Affairs. tf the applicant Is someane
ofher tfian the'°owner",i cerfify fhaf t have obt�ined a copy of the above described dacumenf and promise in good faith to
deliver It to the"owner"pHor to commencement.
CONTRACTOI2'SlOWMER'S AP�IDAVtT: !cettlfy that a11 fhe lnionnation in fhls apgticatian is accusate and that a!1 work
wifl be done iri compifiance with all app(icabte laws regutating consfrucfion,zoning and land developrrtent. Application is
hereby madeilto obtaln a permit to do work and installation as indicated. I certify that no work or instailation has
comme�ced �{rior to Issuance of a permit and that a(!wark wiii be performed to meet standards of aii laws�egu(ating
constntcfion,�Couniy and Cify codes, zoning reguta6otts, and land development regutafions in fhe;urisdicfion. 1 alsa
certify that I u derstand that the regula#ions of otfier govemment agencies may apply to the intended work,and that it is
my responslbi ity to identEfy what actions I must take to be In comp4iance. Such agencies Pnciude but are nak limited ta:
- D�epartment of Environmentat Frotection-Cypress Bayheads, Wefland Areas and Environmenfatiy Sensitive
L nds,WateNWastewater Treatment. '
- S� uthwest Ftorida Water Management Dlstrict-Wells, Cypress Bayheads, WeUand Areas, Alter(ng
atercaurses.
- A�rny Corps of Engineers-Seawalis,Docks,Navigable Waterways.
- D�epartment of Heatth & Rehabl!(tative SeMceslEnvironmenta! Nealth Unit-Wells, Wastewater Treatment,
Septic Tanks.
- U�S Environmental ProtecUon Agency-Asbestos abakement.
Federal Aviation Authority-Runways.
t understand�haf fhe fotlawing resfdctEons apply fo#he use a#fitl:�
�se of fill is not allowed in Flood Zane'V"unless expressly permifted.
, - !'the flil materlal is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
°�ompensafing uolume"wttl bs submitted at fime of persnifting which is prepared by a professionel engineer
licensed by the State of Florida.
- !�th�fill rnateria! ts to be used in Flood Zone°A" in connection with a permitted building using stem wall
cansfrucfion,!certify that t111 wlll be used octly ta fitt the area withln the sfern wait.
- I�ftll material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
propertiss. If use of fill is found to adversely affect adjacent properties,the owner may be cited far violating
�e canditions at'the buiiding permit Issued under fhe attached permif agpticatian,for Eots tess than one('i}
`cre which are elevated by flll,an engineered drainage plan is required.
, If I am the AGENT FQR THE OWNER,I promise in gaod faith to inform the owner of the permitting canditions set forth in
this affidavtt�rior ta commencing construction. 1 understand that a saparate perrn3t may be required for electricaf work,
piumbing, signs,wells, pools, air condltioning, gas, or other instatlations not specificaily included in the appticafion. A
permlt issue8 shall be construed to be a license to proceed with the work and not as authority to violate,cancel,alter,or
set aside any provlsions of the fechnical codes,nor shaEt Issuance of a permlt prevent the Bulidirig Ofticlai frorn thereafter
requiring a c�rrection of errors in ptans,construction or violations of any codes. Every permit issued shall become invatid
unless the work authorized by such permit is commenced wilhin six months of permit Issuance,or ff work authorized by
the permif is�suspended or abandoned for a period of s3x{6}months after the tlme the work 9s commenced. An extension
may be req ested, in writing,from the Building Offiiciat for a period no#ta exceed n3naty(90)days an3 wif!demonsfrate
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justifiable ca�se for the extension. if work ceeses for ninety(90)consecutive days,the Job is cnnsidered abandaned.
WARNWG T�O OWNER: YQUR FAtLURE TO REGORD A NOTlCE OF COMMENGEMENT MAY RESt3I.T IN YQUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PP20PERTY. IF YOU IN7END TO OBTAIN FINANCING,CONSULT
WITt[YQllE�LENDER QR AN A'EFORNEY BEF4RE�2ECORDING YOUR NOTICE OF CQMMENCEMEMT.
FLORiDAJURiT(F:5.1S7.03) � �
OVYNER QR AGENT CONTRACTOR �
Suhsalbed an sarom ta(ar ai�rmed)bsfore me thts Sub albed a Ed re r'`
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Who Islare personalry knovm to me or haslhave produced WFy,.�$�are p� an Ily fmown ��r h�Ihave produced
�I asidentlflcadon. �"� ���/V �sidendfica6on.
I� ___� �Notary Public
Notary Pubiic
Commissfon No. Commtssfan No.
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Hame ot Nofa iyped,pdnted ar sffimped �hfame of Notary typed;prl .,
, ,�'�� ,;: ornmission#GG 045343
�'. ,�:oT:Expires November 7,2020
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s�3-7so-oo2o City of Zephyrhills Fire Fax-813-780-0021
Permit Application
Rate Received �—i� Phone Contact for Permit C__� C� ��
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� Qwner's Name Owners Phone Number �� C� C�
IOwner's Address
II Fee Simple Titleholder Name Tideholder Phone Number � �� �
i Fee Simple Titleholder Address
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� Job Address Lot# C�
Sua Division Parce!#
� Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent
� Gomm Exhaust Kitchen liood/Duct Q Hazardous Materiai{Tier II or RQ Facility}ANNUAL
� Controlled Burn � Haod Installation
� Emergency Generator<34 kw Q !.PlNatural Gas-Installation
� Emergency Generator>30 kw � L.P/Natural Gas-ANNUAL Sale
� Fire Profection Maintenance-ANNUAI. � Places of Assembly-ANNtlAL
Q'fr y emi � t er
Sprinkler � � Cl O � Recreational Bum
Fire Alarm � ❑ ❑ ❑ � � Sparklers
Naod Cleaning � 0 ❑ ❑ � � Sprink(er System(nstallations
Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys)
� Fire Alarm Installation � Torch Roofingtfar Kettte
� Fire Pumps � Waste Tire Storage ANNUAL
� Flammable Application-AtVNUAI � , r�— , Valuation af Project
� Fuel Tanks
� {3th@�:
_ ..._.,._._.:.__.._...:�.-------�-,..�-,._.�..m.._.._�..__»_....�--,..._.,,_.......�.__._
�,� -_-,-�---�__._.......�.__.___. _�__..,.�a.�.�......�_r_,.._,_����. ._.,____.�______,,�..._��_.._---___. :_.._______.__....,._._______._.�..---._m_.._ �,.�� ,_._.„_,___.___._.__.,�.._�`a
Contractor Company
Signature Registered Y/N Fee Current Y/N
Address License#
ELECTRICIAN Company
Signature Registered Y/N Fee CuRer�t Y/N
Address License#
PIUMBER Company
Signature Registered Y/N Fee Current Y/N
Address �icense#
MECHANICAL Campany
Signa#ure Registered Y/N Fee Current Y/iV
Address L(cense#
QTHER Company
Signature Registered Y!N Fee Current Yf N
Address � ' ' �\ License#
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Directions: --.�-_.._.__�..�_ �_.._._�__i _.�_. ____._._,.____ _ -__.�_-
Fii(out application completely. �� -
Owner&Gontractar sign baok of application,notarized(Or,copy of signed contract with owner)
If over$2540,a tVotice of Gommencement is required{Mechanicai wark over$5404}
Supply two(2)sets of drawings with appiicable documentation
Allow 10-14 days far review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com)
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Fidelity Air & Refrigeration, LLC
- PO Box 5158 -
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Spring Hill, FL 34611
j CAC1814224
,
352-597-5911 �
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INovember 10, 2016
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I City of Zephyrhills
Building Department
5335 8th Street
Zephyrhills, FL 33542
�To Whom It May Concern:
Javier Morales has permission to act as an agent of Fidelity Air& Refrigeration, LLC, for the
purpose of pulling Mechanical Permits until January 1, 2017.
C�N� �•
Geronimo E. Nunez, Managing Member
, STATE OF FLORIDA COUNTY OF (-�P_P'YI,QYLC�.p
I The foregoing instrument was acknowledged before me this��day of
���vewt.b�er 20�by ('-,e.ron;mb E. l�un ez
Applicants Name
Printed
� ,.a�'yP���,, JEffREY S.HAYYLEY
Notary Signature ��`� �= Notuy Puhllc-State of florlda
_• "My Comm:Expkes Qec 12,Z017
�Personally kno R Produce entification '�%;�p�„���m�n�w�TSYos�
� Type of identification Produced �
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