HomeMy WebLinkAbout16-17985 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 17985
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit f�umber: 17985 Address: 38633 CAMDEN AVE
Perm�it Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Propos�d Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: ALPHA VILLAGE
Es�. Value: Parcel Number: 35-25-21-005A-00000-1170
Improv. Cost: 7,169.00 OWNER INFORMATION
Date Issued: 12/05/2016 Name: PALMER, RICHARD &VALERIE
Total Fees: 75.00 Address: 38633 CAMDEN AVE
Amoi�nt Paid: 75.00 ZEPHYRHILLS, FL. 33540
D �te Paid: 12/06/2016 Phone:
Wo'k Desc: A/C CHANGE OUT 2 COMPONENTS 3 TON
I CONTRACTOR S APPLICATION FEES
BAHR'S�PROPANE GAS &A/C, INC. - A/C CHANGEOUT 75.00
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I Ins ections Re u' ed '
DUCTS IN� TALLED
DUCTSIN ULATED
� FINAL �I
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REINS�ECTION 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.
i NOTICE: In addition to the requirements of this permit, there maybe additional restrictions applicable to this property that
may bie 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.
"Wa ning to owner: Your failure to record a notice of commencement may result in your paying twice for
impravements 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 performed in accordance with
� City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
� NO OCCUPANCY BEFORE C.O.
� �
CONTRA R 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�o-oozo T City of Zephyrhills Permit Application Fax 813-78p-0021
Bultding Department
DateFieceived . ' Phone-Coc�tactfarParnittEin �t � 7r�2 _ JrDIJ�
Owner'�Name� �}�}� �C�°I ' Owner Phone Number �1�" t3 Q"' �.
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Owner's Addr ss ��� 3� C� � � -Owner phone Numbsr �
Fee Simple Tit ehalder Name �� ' � Owner Phone Number � �
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Fea Simple TI I eholder Addre$s ^
JOB ADDRES �/�LP�.:.! � B UG..- G N/LL /'/� 4714 Vi/�Q LOT# ��
SUBDIViSION� - �� � PARCEL ID# ��� �� �� ���� �QD�D ��,�
� (OBTAINED FRQM PR4PERTX TAX NOTICE)
WORK PROP i SED ° NEW:CONSTR ADDlALT Q StGN �Q Q DEMpLISH
e, INSTALL �-�REPAIR .
PRQPOSED� ISE Q SFR Q COMM Q OTHER .
TYPE OF CO�STRUCTION - C.] ' BLOCK ' �C,] FRAME �� STEEL Q
DESCRIPTIO OFWORK F �l� ��C ��A`/V L"DLe-�:• p[ `C� rJ7VF'/U�S � �/�,0
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BUILDING S1ZE �� ' � SQ�FQOTAGE - . . HEIf3HT �� �
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�$��� �N�' � , y '. VALUATION'.OFTQTAL'CONS7'RUCl'ION � �
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QEi. CTRICA! � - � AM3'SE#2VICE Q PFtOGRESS ENERGY Q W.R.E.C.
QPL�MSING _ � -
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QMEI�HANIGAI $ ;�" p���� VRi.UATlOIV OF MECHANICAI tNST1�tilATtON ,
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[�GA� Q RQOfitNG .� SPECIA�TY � OTHER
FINISHED FL OR ELEVATIONS � � FLOOD ZONE AREA QYES NO
BUtE.DER I �
CtlMPANY� .;
SIGNATURE i REGISTERED Y/ N FeE CUtttt�n Y/N .
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Address, �Clcense# '� �
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��.�c��c�a�. coM�,a�air � - �
SIGWATURE, '� REGISTERED Y/ N FEE CURRE�=' ��Y/N'
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Addre�s� - - ' . License�# � �
PCUMSER � COMPANY , _ '
SIGNATURE'I ' _REGI3TERED Y/�N '.FEE CURREk- � Y,/N. �' '
Address �- - • License,# ��, - �
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MECNANIG ' � ' c. ` COMP�tNY � l�1�/�� !'l�pfi�/iJe��qS?�-�U' ��UGG
SIGNATUFlE� '' ��� ���t.Ph... " REGISTEREO Y./ N . FEE CURRE� Y/rN
Addre�` � "7��"�� f��i1) " . - - • � License# ��� ����'��
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OTNER ,' - , ' {;GOMPANY �� `
SIGNATURE, -'. '_, "'� - ' � ' ' �� �` REGISTERED ' Y/ N;._ FEE CURRE� Y/N
Addre�( . ' . ' � � � ,� UCense# i �
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RE$lDEN'it ;Attacti'{2}.;Ptof P,Isiis,�.{2}sets�.ofiBiiil�lrig Plans;{1}'s'et af-'Eiiergy�Faiitts;;R-O�W'Pemilt far new cons#rvction,
- '�j_i•;::Minimum.ten;_(�1.Q)4working;day�,aiter,;submlHal tlete.��Requlr'etl onsite;Constiucdon�Plans;-Stortnwate'r`Plans w%Stlt Fence installed,
- �Sanitary Facflttles-8�::1:;dumpst@r,^Slta Wor1c�P:.errnit for subdiyislohs!large�proJe,cts_,,,:. .:: ' ' " • �
,.-<�.,. , ._ .�.,.,_ _.. .,,
'CORttMERCI i4ttach(3)�cbmplete�seats'Eif-Butliliiig Plaris plas a Life Safe#y�F'age;{'1}set cf Energy Forms.R O-W Permit#o�nerri canstrucUon:
Minimum ten(10)working days�fter submtttal date. Required onsite,Construction Plans,Starmwater Plans w/Silt Fence installed,
Santtary Facilitles�1 dumpster.Site Wark Permit for atl new`projects..All commercla!requlrements must meet compltance
SlGN AERMIT Attach{2)"sets of Eng'irieiered;Plans., ..:,=;== ,.v ., �;... • .
•'••PROPERTY SURVEY reyuired for all NEW constructlon.
Directlon�: � _ .., -� ,
' Fill out a plicadan completely.
Qwner Contraa#ar slgn back of appitca@an,notarized
{f over 2500,a Notice of Coanmencement is required. (A/C upgradea avsr 37500)
" Agent(fpr the�i�nfractor)or P"wer o�'" tk rth�, �vouid be someone w[th notariaed letter from owner authorizing same
���ta�.�.�,a��a���'+_., �.
OVER THE�OtiN lR RERMi�1'tNG-,�:�`,tU�F"ront af-Appatcatiqn�n1yj_ , " .�� " , �`�`''� ,,,,,,�,r„
Reradfs if shi gles ;,Sewers�ss���-Setvfce�Glpgrade�i�.'�Uts', ences(PlodSurvey/Foo 'ge) a!���"f'�'� '''"„�'��'�2 •�y9'•�r�"'J%�
� -� �iJ;_tr}:.tifc;;4Ztlj"'7 itlfiiC:�_4�r�_ t+'.� ��.^, . - 'l ��� {t 7 °IF;i$t;r+"�£ifiSi ' pi��';`�'
� �,°t�^.;� f :9��ii:, � s �,'t;�yJ„a a
Drivew�a -iVot'bverCaunter;�lf`on, ublic�roadwa' t`p�'. 's,Ef ��` +=t Y!t'..'""j;�c� �;";r,` `ft� ° ��r..:'
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i htt��r�ttP.fO�'!G���l��Gl't Ri;:'G5!�T::ST.�i1Q � � (,t•,s,e:�' ,., .. � ,a'����;,•
� �y�et�m.�s''r�sx�;s'y�itn��'�y �a::.`,��;�`.n�',ifiB'�t'paTtte<G:'�k>83-�f=C'F�yqGy��ti� � �
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NOT1C�OF DEED RESTRICTIONS:. T6�e undersigned,under�tands�;th�t:thls;:p�rmlt__.may;be,subJect:tor"deed";resUlctions" ";.;..,r;.,�;
which may�be=tnore��rest�ictive`-th���County�r+agr�lat(ons:=-The.undersignedPassumes.ce�ponsitiillty'for�compliance witfi=any ` � F
appHcable.deed restrictlons. � :.,: - , -=. - : • _. . ,.�. ... : -.,,.,_. .0 � '� _� .'.�;1
UNLICENSED".CONTRACTORS �AND CON�RAC'FOR RESPONSIBILITIES:� --1f�the°�owner-has=`hiced�a`contractar or
contractors'to undertake work, they may;be:ce�qulced:to:be-llcensed In;:accordance.with„state:.and_local.regulations;°��If�the• ��' ��°•��
contractor�Is not Itcensed>as requlred'tiy law,=botti�the owner and=�contractor=riiay be�ctfed�fora�misdemeanor violatton
under state taw. If the owner or intendedtxcontractor;ere,,.uncertaln as to what Iicensing.requireRnents;may-;eppiy-iortiie�� =-°' �%�
,.,;.., ;
Intended work,tHey are advised to�coritact the Pasco`County;Bullding°.Inspection Dfvislon,-l:icensing Section at 727-847-
. __
8009. FurtF�ermore, ff the oininer'fias`Fiired��a �con�acto� or contracfors. he is advi§ed to have the contractor(s),.sign. ;_ ._.
portlons of the_�contractor Block� of.this„appllcation_for,which,they will�be.r.esponsible: If.you�-as�:the owne�=sl'gn`''as�the " "'" �
contractor,'that�may be an indication that�fie`is�not'.properly Ilcensed'and��ls-not'entitled�to permitt(ng pri�lleges in Pasco
County. � � ..�. :>>:.-�..:�� -
TRANSPARTATIONIIMPACTIUTILITIE$�I�Ad1PAC'i��At�b�RE�OURCE RECOVERY�FEES: �The undersigned understands
lhat Transportatlon Impact Fees:and.Reco.urse Recovery.Fees may:apply:ta tf�e,construction:of.new_bulldings�ichange�of'`�'�`��=� "
use in exfsNng bulidings, or��expar�sion�of=+ei�lstin�g�i6uildings, as specffied.in Pasco County Ordinance number 89-07 and
90-07, as amended.,,;The undersigned aisos understands, thait`such fees;-;as.�may:;�e�.due;�wfll:-be identified at the�time��of � �,�'� }``�`
permitting. It is furtFier understbod that Transportation Impact Fees and'`Resour.cer:Recovery�Fees..must be pald prior to
receiving a."cecfi�cate�of-ocxupancy" or�flnal�powerrelease. :If�the.project_doesjnot involve�au.certfficate of occupan'oy�or��=`:�4.�=','
flnal power-release;the�;fees.mu�t;�be pald,pclor to;permit issuance. F��tk�ermore;If:.Pasco.County"iNater/Sewer;lmpact -� . .
. , ,.. . . .
fees are due,.ihey.must.be>paid.p�ior�o,permit�iss,uance�ln.accordance witt�=applfcabfePasco�County ortlinances. �
CONSTRUCTION"LIEN�U4VI1�(Chapter 713� Florlda$tatute��as amended): If�valuatlon of work Is$2,500.00;or:more,_i �., =�..�:F
certify that I, !he appiicant,.-hav.e-.been provided•�with--a- copy�of_the�"F.lorida ��onsfructton� Lten_Law—liomeowner's
Protectfo� Guide" prepared by.the Fio�ida Dep�rtment�of Agric.uiture and Cons,umer:AHalrs. if the appllcant Is someone� ., , ,
other than the'owner", I certify..that I,;have,ob.tatned�a eopy.of..#he,above..des,cribed'document.and.;promis:e;in,good'faith�.to =.�
deliver it to-the:bwner".pi�or�to�commencement:" � � Y -- �
CONTRACTOR'S/OWNER'S AFFIDAVIT: I certtfy:that:all.:thellnf.ormation in�thi� application Is accurat�and that ail work
will'be done in compliance with all.appllcable laws regulating construction, zoning and�land°development. Appltcatton is
hereby made to obtain .a .pecmit��Co�do.:woi`k;;and�instellation as indf�afed:-=�•'f certify that no work=:or (nstallatl'o"n fias
commenced p�lor to issuance of a permlf'and that.all work v�►ill be pe�Formed to meet stand�rd�-�of�ail laws regulating-
construction, County and City codes, zoning regulatians, and tand development cegtalatlons=in the,jurisdlction.��i�also. .
certify that I understand that the regulations of other�government agencies may�apply�to.the intended work, and that it is
my responsibility to identify•what.actlons I must�teke:to besln:.compliance S,uch.agencies-include but=are.not Iimited to: �
- Department of Env(ronmental>�Protection=Cypress:Bayheads�'V1letland Areas and Env(ronmentally Sensittve
Lands,WateNWastewater Treatment. ,
- Southwest Florida Water Management�:�l�lstrict-VHells;' Cypress.~Bayheads;- Wetland Areas,_ Altering
Watercourses. - �- • � '
- Army Corps of Engineers-Seawalls, Docks,Navigatile Waterways.
- Department of_Health;:,8.>Rei�abllitatirre.Services/Environmental:-Health Unit-Well.s, Wastev�rater�Treatment,
Septic Tanks.;: .' � - - -
- US Environmental Protection Agency-Asbestos abatement. , �� .
Federai Av.latlonAul�iority:Runways.�� .
I understand that.the.following:,�estNctions apply to the use of flll:�
- Use of flll is not allowed in Flood:Z,o,ne"V"unless expressly permitted.
- If the �fill`"mateHal=ls to 'b.e usetl�7n :Flood Zone. "A", it. Is under'stood that a dra(nage plan addressing a
°compensafing volume" will be submitted at time of.permitting which (s prepared by a profess(onal engineer "
Iicensed by the�tate of-Flotida: �
- If ihe flll-material�is to .be used In Flood Zone 'A" in>connec�ion�wlth�a�pecmitted buildir�g using stem wall.
' construct(on, I certify that flll:wall�be used only.to.fill the area within�the�stem•wall:
- If flll mate�lal is to be used In any a�ea, I �certify that .usa of such flll will not adversely afFect adJacent
' propertles. If use of flll is found.to adversely.�ffect adJacent�properties,.the owner may be cited for violating
the condl�fons.of the building:permit issued.under tlie' at�aohed_permtt application;.for::lots�.less than one (1)
acre which are elevated�by flll,an,engineered dralnage plan is required. •
If I am the AGENT FOR THE OWNER;.I�promise In good faith to i�form the owner of•the permitting condftlons set forth in
this aifidavlt�prior to commer�cing construction. I understand thata-separate permit may be requtred for electrical work, , ..
plumbing,_signs, wells�..pools;. alr condttioning,-•.gas� or other install�tfons noE.speclflcally,included�tn.the�application. .A .
permit Issued shall be construed to be a�license�b��proceed with'tFie_work and-not-as�authoNty to:violate;�cancel, alter, or
set aside any provistons of the technical codes; nor shall Issuance�of a.permit.prevent the Buildirig Offictal from thereafter
requirin.g a correction af errors in.plans,�constivction_or vlolations of-any codes. Every�permit Issued sliall become invalld
unless the work authorized.by such permit is.commenced•withln stX,m.onths of�permit Issuance, or if work authorized by
the pe�mit is suspended ar.aba�doned-for.a;period�of�six{�)months,:after the;tirne the�work��s cortemenced. An extenslon
may be requested, in writing, from tNe.Bullding;Offictal for a period-not to�exceed'�ninety�(90) days a�id�-wlll`demonstrate
justifiable cause for.�the extenslon: If work ceases.for ninety(90)cons.ecutive days�..th�)ob�ts considered aba�doned. 'I
WARNING TO OWNEIt: YOUR.FAILWRE�TO..R�EC.O.RD A.MOTIGE OF:�COMMEMCEMENT:MFAY;RESULT IN YOUR �
PAYING THIICE.FOR;IMPROVEMEN.TS�Tfl;YOUR-:PROPERT'Y:�-�1�°YO.U�IiV'FEND'T��OBTAIN�FINAI�EING;'CONSULT
WIVH YOUR LEND�R OR AN A'�TORPIE��EF�R��REC0��1[�"�YOlJ�'P�'i`Ii�E`:�F`C��l1�dERlC�lW��.l�l��" ` --- - -- --,
E�
FLORIDA JURA'� . 17.03}_ ' ` ' ;
OWNER OR AOENT �� CONTRACTO ��Q
Subscrlbed and sv�.m (or afflrmed)before me this Subecrlbed end' �to ot'aflirm�p �fore me'ttitk�
b, i„t ..�im2 (� �►'I►s(�-s�Pr .b . me, f')'11s�h�ev�
Who I�rsonaliy knov��o.me or haslhave,produced Who.lsla etsonally�cnovm me or has/have:prnduced • �
as Id°entlflcatl4n. es Identlflcatlon.
Notery Public - Notary Publlc,
Co Isslon NoR Commiselon No.
$YLVIA A.CAMPBELL `�°�� w`�-: Nofary Public�Stffie al Florida
�.���µar.�e�.a•. . : r ' - .
Florida ame ot Notery typed,p • 1fe� u
Name of Notary typed, �� ��r Comm.Expires Jul 19,2017 :s�� P,� Commission#�FF 034230
Cammission#FF 034230 �'�°���N�� , BondeQ.�hrouph Nation�l Notary Assn:
x�'��� ��� ,Bonded.�hrauph National Nofary Assn. .
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Sales, Service & Installations ' '. �FrT��;a;;�rir -,-��;��y f�,,°�:; ;; �:, �y��n��,�
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Q jI�I'C� �"/1ali� ,�lZ�Q� fi/. ❑ REGULAR ❑WARRANTY _ . ;.`CO�fAL•:5t3M,MARY_� -
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LIMITED ARRANTY: NI materials,parts and equipment are wartanted by the manufacturers' " _ , '�;�j�jp���?�,'�;�:;_;'�_;::;'_.r�';
or suppliers�ritten warranry only.NI labor perfortned by ihe above named company is warranted for =�-�� � -'� '��'�� " '`�`' ' ��'� `';�- =-�''�
30 days or a�otherwise indicated in writing.The above named company makes no other warranties, O,CASH ❑CK# TOTAL i
express or i plied,and its agents or technicians are not authorized to make any such warranties on MATERIALS i
behalfofab�venamedcompany. ❑DEBIT ❑CREDIT ❑OTHER MAINTENANCE �
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I have autho�ry lo oNer the work outlined above which has been satisfactodly compie[ed.t agree that Seller •f.� �
refains Utle t equipmenUmaterials fumished until final payment is made.If peyment is not made as agreed, (,`��M# ' yyy
seller can rerrove sald aquipmenUmaterials at Seller's expense.My damage resultlng from said removal shall f � ���'
not be the responsibiliry of Seller.NET 30 DAYS.A 1 1l2%SERVICE CHARGE WILL BE ADDED MONTHLY TO , y 0(J �N GOI
ALL UNPAID BALANCES OVER30 DAYS.NO REFJ,{NDS DATE COMPLETED •
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