HomeMy WebLinkAbout16-17988 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 �79$$
BUILDING PERMIT
, ' PERMIT INFORMATION LOCATION INFORMATION
Permit fVumber: 17988 Address: 3808 LAUREL VALLEY BLVD LOT 50
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
� Class of Work: A/C CHANGEOUT Township: Range: Book:
Propo�ed Use: NOT APPLICABLE Lot(s): Block: Section:
Squ�re Feet: Subdivision: MAJESTIC OAKS
Est. Value: Parcel Number: 24-26-21-0000-00100-0090
Improv. Cost: 3,195.00 OWNER INFORMATION
Datei Issued: 12/06/2016 Name: NHC-FL115 LLC
Tofial Fees: 55.00 Address: 6991 E CAMELBACK RD STE B310
Amo�nt Paid: 55.00 SCOTTSDALE AZ 85251-2493
Date Paid: 12/06/2016 Phone: 813-783-6270
Wo;rk Desc: A/C CHANGEOUT 2.5 TON
CONTRACTOR S APPLICATION FEES
BAHR'S' PROPANE GAS &A/C, INC. A/C CHANGEOUT 55.00
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i Ins ections Re uired
DUCT IN6TALLED
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
I 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 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.
"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
� before recording your notice of commencement."
Compl'ete Plans, Specifications Must Accompany Application. All work shall be pertormed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
� NO OCCUPANCY BEFORE C.O.
. �
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CONT CTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813• eo-ooxo City af Zephyrhills Permit Application Fax 813-780-Q021
Building Department
Date Recelved � . � phons�ConNact for Pe�tritftin —
�Owner's Naml /`K'G+ � �L/J� L L C..', own�r Phone Kumber ���' ��"""��/�
Owner's Add�ess �J��� G-G�IL �'l lC7� `Owner Phbne Number �� .�
Fee Slmple 71tleHoldar'Name � � Owner Phane Number � �
:;,.
Fee Simple T tleholder Address - °
JOB A�DRESS �Q� ��uf'�/ 1/A'L LC. /fJ , LOT# C�
I �Ic9' ��v�t� �f��iS PJ4RCEi.ID# �c�� c�� c�j O�I�
suso�visia ' ,� ,,J , � (�l3/l�0 Dl��?
, � (08TAINED F.R4M PROPERTY TAX NOTICE)
W4RK FROPQSED :,:NEW COPJ57R i ADDlAi.T �-,• SIGN` �Q C] DEMOI:ISN
�e, INSTALI. � REPAIR
PRORt�SED-USE � Q 3�R Q `CQMM C� �OTHER '
TYPE OF CQ STRUCTION - Q� r' BLOCK " [� FRAME � .� 'STEEL Q
DESCRIPTid OF WORK � ��ss � � ���'f"t�'i'� "'C3L�-� �� �d/� �L l Cp7�'� /1!�'R1
�UFLDING SIZE �� �� SQ FOQ1"AGE ` . , HEIGHT�-.
� VAIUATIflN�'tOF TOTAL-CONSTRUCTION �
BUt,�.DING
1 � „-,,, � _
QE��CTRICAI $ ' � AMP SERVIGE Q �PRt)GREBS ENEI2GY Q. W.R.E.C,
OPLt3MBINC3 .�� � _ .
OMECHANtCAL $ . VAl.UATIQN OFaMECHANIGRL tIVSTALLATt{?N
�1�,�.�� .
QGAi Q ROOFIi�iG CJ SPECIAI.Tl �� OTHER
FINISHED FLOOR ELEVATIONS ^ FLOOD'�ONE AREA QYEa� NO
BUII.DER COMPANY� .
SIGNATURE REGISTERED Y/ fV FEE CURRE� Y/N"
Address s � Llcense# � �
E�ECi'RIGIAA6�!! t . CCIMPANY -
SIGNATURE '� REGISTERED Y/ N FEE'CURRE�` 'Y/N
, � . y
Addr�ss � . � , License•# �. ��
PLtlMBEEt " ' . COt49PANY ,
SIGNATURE' ,REGISTERED Y./.N FEE CURREP X/N. �
Addreas . . License.# (� � �
MECHAN1GAt: o . ',a,� `' • C{.1MPAt+IY 1�1R� f' f,� `�" L% ...=,lv G�
SIGNA'fURE� � �I���<��?�rLPJ�„„!" REGI$7ERED Y,/ �V .,' FEE CURREA Y/•N
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Addres`' +e ��.CX` `�'r1ILI� � License# ��-���.! '"x"� �
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07NER - -. ` ' ';GOM�PANY
SIGNATURE� '=• • `� � �� - � � " REGISTERED Y/ N:..- FEE CURRE�•- ' Y/N
Add�� ,- . .. ,. ... ,;w . � - �� . � � L'icense# �� � � -
RES1QEPtTiA',:= -_A#ta�ct�'(2}�Plot%Pians;:(2}sets�.of'Butliling�Plan's;�(.1}setaf<Energy�Foiins;R=Q�W�Perrriltfiornewi;onstrucUon, ��,� , .
� ��•Mintmum�ten�(10);working;days�fter`subr'iilitalilate.:_��Requlretl on'sife,:Constructlon�Plens;�Stoimwater'Ptans wl SIIt�Fence installed,
F Sanitary EacillNes,-&_1�;dumpsteruSite°WoricwPermit for subdiyisions/large,p[ojecfs ;_:. ;: ,_' '� ` '
COMMERCIAt. Attach{3}coiiiplete sets�of B'ulEdliig Plans plas a��.ife Safety Rage;�{1)set af Energy Farms.R C?-W Penntt for newi constructian. �
Minimum ten(10)working days after submlthal date. Required onsite,ConsUuction Plans,Stormwater Plans w/Silt Fence fnstalled,
Sanitary FaciliUes&1 dumpster.Site Wqrk Permit for all neuv:proJecfs:All commerclal requl�ements.must meet complla�ce '
SIGN PERMI� Attach{2}sets of-Eng,i'neer.ed,PJans.; .. •;°.^ , •.. .....
"*'PROPERIY SURVEY r . uirQc!for all_NEW constructlon..
--- _�
Dlieatlon�: ,.., ... , _
FIII out applicatlon completely.
Owaer 8�Contractor.stgn back af appltcatlon,notadzed �
tE avar$ 00,a Notice of Commencament 1a required. {AtC apgrades over 57500)
.,.:.;,,.: ;
'" Agent(f r the aontraictor)or Powe�of74ttomey(fbr tFie owner)�would be someone with notarized letter from owner authorizing same
DVERTHECi�UNTERPERMt'i'CtFtG•.- __.{Fron of•Ap ice�tto �{3 1 }._ . - � �������r��`�'
Reroofsifshi�gles � r , gr , ,,.., ces(PIoUSurvey/Footag � '�±e,%�r' ," �i��Y2 ."'� -'-."'"= �" .'
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n��f?l � Sf S� e?�t 3 t :;:'�.,; +, '`y C r fYt:;.�..1 ''�I 't,.
Drivaws�ya-iUot ove�Cbulnfer�fi q�iypubl��i�aadu�r�y�'s..nee�1s+R�0a11 �T°u.,,o-� ;us.�::�iiic"�3,. - ,t�' �
"�i US.�'� hfw..�1'{Irj; !pilFit9;J't?iX 'a ft���? 3 " r e� :;'; b �r er�' \.
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'Q fl�i�`�f;���•"+ c4 q4�2f;7#:lii�!a "�';;�T2'�.r�:;+ f �
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.:i{;2>�1 y to�?i`+��sflL�S.'f<a�lj:�Slbl� itii�nt7U g ��tr•rs4i+'is,M �,���,�*t;,x;�*'yi;rs-�n<.... :� �:7T.�'�yyc"�
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NOTiCE OF DEED RES'TRICTIONS: The undecsigned under�tands�:.th�t�this;.p�rmit�.may.^be,subJect.to;;"deed",restrlctions"_;_;,`.�:,.,^..
.,, . , ,,;- : ,�� u � n..: ....
which may�tie=more�restFictive-th��-County��i�egulatfons:�=TFie�underslgned`�assumes�responsibiltty-for compilance`with any
appNcable deed restrictlons. ..-::,�..; :,-:;.° . .. �. • ? '° ��' -.' �,�
UNLICENSED=CONTRACTORS AND CON�RACTOR RESPONSIBILITIES:� -�If°the��•ouimer=has}`hired��a`contractor or Y
contractors to undertake work,.they may,b,e:re�qul�ed��to.<be,ltcensed_In.:accordance.viiith state�:and,local_.regulations::�.If�the�� �� �=� --
contractor Is�not iicensed.as�requlred°tiy law� tioth�the owner and=cont�actort-may�be��clted=for�a�_misdemeanor violatton
under state law. If the owner or Intendedt�contractor,are,,.uncertaln as to what Ii�ensing.requirements.;may-:epply�for�-tFie-� �s��` ��`�`
...._:...,��......,. F� , .
Intended work,tHey are ad'vised to`coritact theT Pasao County_Building:lnspection DI`v_,Islon-Licensing�Sectlon at 727-84T-
8009. Furthermore, (f the owner'has�"Filred-�a conVacto� or contractors, he is advlsed to have �the contractor(s),,sign
portlons of the"contractor Block" of.;thiswapp_._ ���� 1 ' �} � �^, ��4
Iication for.which,:they,.will.:be-.r.esponslble:-:If:you;=as:�fhe owner sign�as��the`� ' �"`�
contractor, that tnay be an indication that'he=1s not`.properly licensed��and`�Is�not entitled'fo permitting priiiileges In Pasco ._, a „
County. � � � `'
TRANSPORTATiON.IMPACTIUTILITIES rMPACY ANb RESOURCE RECOVERY FEES:"The undersigned understands
that Transportation Impact Fe�s and.Recourse.Recovery.Fees may:apply�;to�tfie�consbvction of new buildings,;change of''� ��"=' '`�
use in exi'sting buildings,�or�expansi�n�of=sezistin,g�,buildings, as specifled.in Pasco�County Ordinance number 89-07 and
90-07, as amended.,.::The undersigned also:understa�ds, tFiat:`such fees�aas�may:�e�:due;,will;�be identtf(ed at the��time��of��`- -�;`:'� �'�
permitting. It is ftirtFier understood that Tra�sportatlon Impact Fees and-Resoucce.Recovery=Fees.must be paid prior to
receiving a °certfficate.of-ocxupancy" or flnal�power.release.•�:If'the.project;.does.:not Involveaa�certfflcate of occupancyto�'�-!"�~.:'�',.
flnal power release;,the-,fees.mu�t'tie paid;pclor to,permit Issuance. F��thermore;�ff.Pasco�C,ounty'Water/Sewer:impact =� .. .
fees are due,.they_must,be,paid..prlor to permit�-lssuance�:in.accocdance.witF�;appllcatile_Pasco'.County'orclinances. •
CONST'RUCTION"LIEN'LAW'(Cliapter 713,Flor�da Statut����amended): If valuation of work is$2,500.00�or:more�.i� _;. . ,
certify that I,-�he applicant;:-have-been providetl with-�a copy of. the .".Florida�°'Constn,ictton� Lien :Lavu�—Momeowner's
Protectfon Guide" prepared by tHe Flo�ida Departmenf of Agricuiture and Consumer�.Affairs. If the appHcant Is someone� ,, •��
. ,.
other than the'owner", I cert ��`
Ifje.that I have,obtalned�a'copy.of.the:above-.descritied�`�locument-and:promise�in,good:faith.to _ :.,
deliver it to the:'owner":ptior�.to=commencement.�'• ` � . � --- � ; •
COIdTRACTOR'SIOWNER'S AFFIDAVIT: I.ce'tity�:tti;at=all�.the�informatibn,in•thl�appllcation is accurate.and that all work
will�be done in campliance with all.appltcable�laws regulaUng constructlon� zoning and��land°deyelopment. Appticatlon,is
hereby made to obtain..a pecmit.:to._do=woi`k.�and Ihstallation as indi�afed:�>.��:I• ceitffy that no work�or installatton has
commenced prior to issuanc� of�a permit"and that.all work will be perFormed�to meet standards-of all laws regulating-
construction, County and City codes, zoning regulatians, and land development regt�lations`in"tFie.jurisdtction.-� i:al'so. _
certify that I uade�stand that the regulatlons of other government agencies may�apply to the�intended work, and that it is
my responstbility to identify�what,actions I must�take:to be,in�corrlpliancs::S.uch.agencles include�but�-are..not Iimited to: •
- Department of E�vironmental>�Protectiori=Cypress.'BayFiead`�, WeNend Areas and Env(ronmentally Sensittve
Lands,WetedWastewater Treatment.
- Southwest Florida Water Management��.DtsMct-Welis, �Cypress. Bayheads; Wetland` Areas, Altering
Watercourses. - - � � ' '
- Army Corps of Englneers�Seawalls, Docks, IVavigable Waterways.
- Department of Health;:,�: Rehabilitativ.e,Ser.vices/Environmenfal-Health Unit:Well.s� Wastewater�Treatment, �
Septlo T.anks:. _ � � � - - - � � -- .
- US Environmental Protectlon Agency-Asbestos abatement.
Federal Av.lattvn=Aul�iori,ty-:Runways. �
i understand that the..following:restr.ictlons apply'to the use of flll:•
- Use of flll is not allowed in;Flood:Zone"V"unless expressly permitted.
- If the :flll material� is to��be usetl:'`in :Flood Zone. "A", it. is understood that a dratnage plan addressing a
"compensating volume" will be submlited at�ime of permitttng which is prepared by a professlonal engineer
Iicensed by�he State of Flofida: � � -
- If ihe fill materlal�ts to be used In Flood Zone 'A" in�connection�wlth:a��ecmitted building using stem wall, ,
' construction., l certify that flll�:v�111=b.e used only.to.fill the area within�the stem�wall: �
- if flll mate�lal is to be used in any area, I �certify tfiat .use. of such flll wlll not adversely affect adjacent
p�operties. If use of flll Is found�to adversely..�f�ect adJaeent�pr�perties�.the owner may be'cited for viofating
the condl#fons.of the building=.permit issued��under tNa�at�actied_�ermit appltcatfon, for;lots-less than.one (1)
acre whicfi are elevated'tiy flll,��engineered drainag�plan is requlred. •
If I am the AGENT FOR THE OWNER, I�.pr'omise in good.faith to fnform the owner of�the permitting condftlons set forth in
this affidavit`pNor'to commer�oing conatructlon. 1 under�tand thet a�aeparate permlt may be requlred for elect�lcal work, _ . ..
plumbing, signs, wells,.pools;. alr conditioning,-.gas� or otl�e� ins#all�tlons noE.spec�fically included�in.the application. .A .
permit Issued shall be constr.ued to be�a'Ncense'to'p�oceed with the work and not-as:authoNty.to vlolate;'cancel; alter, or .
set aside any"provisions of the.technical.codes;�nor shall issuance�of a.p�rmit.prevent the Bulldirig O#iicial from thereafter
requlring a conection af errors In-plans; consfructlon or violations of-any codes. Every�permlt issued�shall�become inval(d
uniess the work authorized.by such permit.is-commenced�within sUc.;months of�permit Issuance, or If work authorized by
the permit is suspended or abandoned�for a:period.of�six�f8)montf�s:after the time the�work�is commenced. An extension
may be requested, In writing,from tHe Building,Otflclal for a period.�not.to exceed�ninety(90)�-days a�d will`demonstrate
justifiable"cause for.the extension�. If work ceas�es.for ninety(90)cons.ecutive days�..th�job;is considered aba�doned. �
INARNING TO OWNER: YO��.FAILURE.TO,_REC.O.tt�:l�-NQTIG�-:9�.�COMMENCEMEQ�T:14'fAY�RESULT-IN-`YOLiR��"�-�
- -PAYING TINICE;.F.OR:IMPROVEMENT3�-T�.YOUI�.PROPERTY:�:IF°YQtJ�IN�'�END•?TO'�68TAIN��FIN�AI�EING;�C.ONSULT
WIT D �O. AN° O N �. FOR ���� ORfl ��' OU ' ��CE'O ' �°' � E �E '
FLORIDA JURA;.( . : 17.03�. ._ .; ` - --. . -, '� .
OWNER OR A(iENT � CONTRAGTO
Subscrlbed and svuo (or aflirmed)bet me this Subscribed'and' 'to(ot aflirmed'before me ttit�-
by�? i m !5 •by�.T�l� ; = �'h i 5 2.t�QY
Wfio Isla persona y novm _.me or,haslhave produced Who.ls/a ersona, o tu me or haslhave produced •
as IdenUfli�tlon. as IdentlBcaUon.
, . .
� ' � Notary Public . � Notary Publlc
Comm sslon No^� Commlasion•No. _ __ _ •
C��"'�""��. SYLVtA A.CAMPBE,L•l
�PR pt/6��i� p�11111/
Name ot Notary typ c �� � ��@omm.Expires Jul 19,2017 Name of Notery lype ,�ry�ueuc�Statd of Florida
e •r..My Comm.,�xpfre.�Jut 19.2017
"��� ��"•' Commission�M FF 034230 �
�'�; y1 ;: Can�mispiori#�FF 034230
��iiii CP,``
Bonar��7hrough National Notary Assn. t•�`�`,f, �'� 8pri6Ed�hrouQh,National No(aty Assn.
-- -- — 4,— ; - _ .- � -
, �• " � � ! . PROPANE GAS • . s .
Servi�e Order%Prog�o�al
�= ' _ AI1D AIC iNc. Air Cond�tioninp&Heating
�i`�e��988� ,. �'n�1��7����013 � � -
` �_ Sales Service & Installations • ��}�E' c����:r�;�i{��c��+��1f=1�i�=a��� �'�:r���i �� �=��� `
, � I1�t'I"C�/t�:l�fk= i'�1F:F=f�} � 1c`In��`"+/�,� �1��'��►=:7'
44 �1 �Alfen Rd. • Zephyrhills, FL 33541 -�-�-��,�,1�� f�yl ��jF��:��_� �,�,
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� NOTES.''
— � ' Gt_lw"fC1i=9k.�:t�;���/i_GJ[�fl"I"�:�]i`J �.?��.;�.�:�
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,�r�►���� _.r-at.,rae�W ur-�t��:.�=�� rc..��a d:rr����a i....�-�u����._ ,��a�_�.r�Y ��t..�r�
,_:C1�1` �i; ��:_��� f�!t�J`l:�='}�:(C; C?f��:� 7r�Z+a�
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a � f='•:�,Rt'i--t%+�,i1.�4,/E='��;F�Z��t�ral�1 1':?�
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6 IhJ.0�I` l�d ll�!R l" r�1r�1!: C�}�!
� � DESCRIPTION OF WORK , QTY. MATERIALS&SERVICES � . UNIT PRICE ,��AMOUNT
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, RECOMMENDATIONS , i i
Annual Mai tenance Recommended by Ail Equipment Manufacturers. � �
Pressures Lo . HI T•Stat i i
��� 14��' .; �.� i i
� R[FRIGERANT R-�� LBS. $por Ibs. ,,� �
• �_____
r �� � /l� ����� `F _' FILTERS x ' x Changod Monlhly I I
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; FILTERS x r� x Chanped Monthly
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❑ REGULARt: ❑WARRANTY TOTAL SUMMARY
Dehumidis i•Settings: When"here Q", ;When Away�Q°[�,iT Stat$Q° ❑ MAINTENANCE CONTRACT SERVICE �
UMITED WA�RANTY: All materiafs,parts and equipment ere warranted by lhe manufacturers' - METHOD OF PAYMENT- , CALL i
or suppliers'vmi n�+arranty only.Ali labor pedormed by the above named'company is warranled for ' TOTAL i
30 days or as ot enviso indicated In wd6ng.Tho above namod company makes no ofher viarrantles, 0 CASH ❑CK# . MATERIALS �
express or imp!i d,and its agents or techniclans aro not authorized to,make any such warranGes on '"`"��___ ,.�
behalfofabove amedcompany. ., ❑DEBI7 ❑C�EDIT Cl'OTHER � MAINTENANCE �
I havo nu�hwily t'ordor lho wark ouUlnod ntavo whfch hns been nutlslaclon7y,complelod.1 ngroe Utal Solbr PROG� W �Ci
rulains Iitlo!o eqi IpmenVmatedois turnished unlil finnl pnyment la mado.II payment is not mada as ngresd, (�`��M# ' .� ' }�.'� 4�T�� I
ccl�er cnn romova enid oqWpmonUmnlodnls nt Shcorh oxpenso.My dnmogo resultinp trom snld�emoval ahall , �,.
not 6a Iho mspo ibiilty of Sullor.N�T 30 DAYS.A 1 112q StRVICG CHAftGE WILL�E AOOED b70NTHLY TO f �`'� .'' i J I
au uNrnio A CES OVER�96�OAYS.NO REFU s , � DATE COMPL'ETED'— •�� ��1 �"fi
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