HomeMy WebLinkAbout16-17995 CITY OF ZEPHYRHILLS
5335-8TH STREET
. _ „ (813)78o-oozo 17995
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 17995 Address: 37852 MEDICAL ARTS CT
Permi�it Type: MECHANICAL ZEPHYRHILLS, FL.
Class o�f Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Squar'e Feet: Subslivision: CITY OF ZEPHYRHILLS
Est!� Value: Parcel Number: 34-25-21-0080-00000-0030
Improv. Cost: 5,476.85 OWNER INFORMATION
Date Issued: 12/13/2016 Name: R&V HOLDINGS OF PASCO LLC
, Total Fees: 65.00 Address: 37852 MEDICAL ARTS CT UNIT 4
' Amou,nt Paid: 65.00 ZEPHYRHILLS, FL. 33541
Date Paid: 12/13/2016 Phone:
Work Desc: A/C CHANGEOUT 5 TON SPLIT SYST
'! CONTRACTOR S APPLICATION FEES
CHRIS' A/C COMPANY A/C CHANGEOUT 65.00
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Ins ections Re u�red
DUCTS INSTALLED
DUCTS INSULATED
FINAL
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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 be 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.
"Warning 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."
Complete 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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CONTRACTOR I ATURE PERMIT OFFI R
, PERM EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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- 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
duilding Department
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Date Recelved,i ��' �� ��� Phone Contact for Permitting " � _ � G
, Owner's Idame I � 1/ /�d�0� �� , ��� Owrner Phone idumber , O� 7�� (� �
Owner's:Addrei s ?��� ` Owner Phone Number
Fee Simple Titlll holder Name Owner Phone Number
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Fee Simple Titleholder Address
I �JOB ADDRESS / O S � /�� ( LOT#
SUBDIVISION I C��t/`G�/� � PARCEL ID# �a,S- dO � OGOO OO�CJ
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED . NEW CONSTR ADD/ALT 0 SIGN Q Q DEMOLISH
e INSTALL B REPAIR
PROP.OSED USE Q SFR Q COMM [� OTHER ,' ��l� ,
TYPE:OF CONSTRUCTION Q BLOCK - Q FRAME 0 S,TEEL Q , -
- q.
DESCRIPTIOPI OF WORK � A'/ i' � /i. e/� �f0 -
BUILDING'SIZE , SQ FOOTA E�. . HEIGHT .
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QBUI��DING $ VALUATION-OFTOTAL CONSTRUCTION �
� QELEC7'RICAL , $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C.
OPLUI BING $
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MECHANICAL $ q VALUATION OF MECHANICAL INSTALLATION ��
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QGAS Q ROOFING Q SPEGIALTY Q OTHER �
FINISHED.FL i OR ELEVATIONS FLOOD ZONE AREA QYES NO '
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�_BUILDER, -I ,- -- - - ---- -- -- COnAPAfdY - — -- - - - --- - -I
SIGNATURE i REGISTERED Y/ N V FEE CURRE� Y/N ' �
Addressi License#�
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ECECTRICIAN COMPANY �
SIGNATURE ' REGISTERED Y/ N FEE CURRE� Y 1 N
dddress� Cicense.# �
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I� PLUM�ER, ,I COMPANY
SIGNqTURE �Re�isTEREo �Y•/ N FEE GURRE� Y/N
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Address �
,. License#
MECHANICAI. COM PAIdY �` D
��"SIGNATURE� � �. REGISTERED . N FEE CURREfi ' Y N
Address � O License# , Q,S �js �.�� '
°;Ri4i�; - ... .. ' ,
ATHER� ";'��.' COnAPANY
�SIGNATURE�; � ' - RE�ISTERE� � Y/.N FEE CURRE� Y/N '
Ad,dressl• . - I� - - - � -License# '
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- RESIDEJdTIAL;•,� Attach:(2)iPlot'P.lans;':�(2)•sets of�Building�Plans;(4)set of Energy Fomis;�R,O-W P.eRriit;for new..construction, �
. �. ;;;:_t--;�-,Minimum�.tenr(�10.)inrorking:days after.su6mittal•`date.�Required'onsite;Con'stniction Plans,Stormwater Plans w/Silt'Fence.installed, �
- � �� - �' �Sanita.ry,;Facilides;&;1 rdumpster;Site.Work�Permit foe.subdivisions/large:projects � ' -
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-,COPAMERCIAL. Attach'(2)complefe sets of Builiiing�Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
� Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
� 'i Sanitary Facilities�1 dumpster.Site Work Permit foF•all new projects.All commercial requirements must meet compliance
�-SIGN PERMIT Attacfi(2)sets of,Engineer�d Plans:', �i ' - �
- ° """PROPERTY SURVEY required for.aII.NEW constructlon.
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Directions: �� _ �..-. , � �
Fil('out a,pplication completely. �
_ quvner&ConVactor sign back of application,notarized " �
If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) '
" Agent.(for'the contiaotor)orPower�of Attomey(for�tFie`owner)would be someone with notarized letter from owner authorizing same !
'OVER THE COUNTER PERMITTING,, _(copy.of-contraetrequired) � ' ' ' ,
Reraofs if shingles Sewers Servtce Upgrades A/C Fences(Plot/Survey/Footage)
DNveways-Not over Counter if on public roadways..needs ROW
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TIOTICE OF.DEED RESTRICTIQNS: The undersigned under,s,,tands..that-this;permit may b�,subject to°deed:'restr'ic#ions°'";.� .
which:i�na :be;more�restrictiue.than Cotan re utatians: :The`iandersi �ned�assumes�:iesponsitiili °'for�com��liarice"with�an�' "`"
, Y tY 9 9 �Y P Y
applicable deed restrictians. � �-•� ��� �>'�
UNLtGENSED,.CONTRACTORS AND CONTRACTQR RESPQ�I�IBILITIES: 1f�#tie-owner°has° hirecl°a*con#ractor ar
contractors to undertake work,:they may be,required to be.licensed in accordance with state and local,.regulations:-'If�the��� �
contractor- is not.�licensed:as.r�quired by.'law, botti'the awner�and=cont�actor��.may���e�•cited�for���a misdemeanor violation �
under state law. If the awner or intended cantractor are uncer#ain as to what licensing requirements:may�.apply-fior:`the,�-' ,;
intended�work;-they are advised to cantac#'t�ie Pas'co Caunty B'ailding lnspeotion'Division—Licensing Section.at�727=847- ,
8009. Fur#hermore, if the owner has�hared`a con#racfor or cantrac#ars, he is advised to=�have the,confractar{s},,sign ,,A 4
portions of the "contractar Block" of this applicatian_,for which they.will.be.responsible. =Ifyouu, as�`,the�`owne��`sign as�:ttie �
contractor, fhat may be an indicat�on #hat he is'no# properly licensed anc!`is nof en't�tteti`fa permitting'pc�vileges_In,Pasco;_ ,
County. ... _ . -- . .< .. � _ _. .4 __-.. . _
TRANSPORTATION IMPACT/U71LI7'IES-IMPACT ANC1-RESOIlRCE RECOVERY FEES: The unde�signed understands `
that Trans ortatian Im act Fees and Recaurse Recave Fees ma .;a 1 to the eonst�uction of..new builiiin s, ctian e-�of�'��=` �'
P P rY Y PP Y . $ 9
use in existing buildings, ar expansion of,.existing buildings, as specified in Pasca County Ordinance number 89-07 and
9Q-07, as amended. The undersigned also understands, that such-€ees, as inay�be:dus, will�kie`ident�ed at�the.tiriie of�`�-` ';
permitting. �lt is fiurther understaod that'Transportation Impact Fees and Resource�'Recavery Fees must be paid prior to �
receiving a "certificate of occupancy" or final.power release. lf#he projeat does not involve a ceitificate of accupancy�oi:'•���"
finai power release, the fees must be paid prior ta permit issuance. FurtFiermore, if.Pasca County Water/Sewer.-lmpact:�;- ;
fees are due,they must be paid prior to permit issuance�in accordance with applicable Pasco Caunty ordinances.� A ~
CaNSTRUCTION �IEN l.A1N(Chapter 7�t3;�lorida Statutes,as amended}: If valuation of wack is$2,5fl0.00:.or�moce,�}�,,;;.
certify that I, the applicanf, have been pravided with a copy of the "Flarida Cons#ruetion., Lien Law--=Homeowner's�
Protection Gu�de" prepared by the"Fforida Department of Agricul#ure and Gonsumer Affa�rs. If the applicant is someone=.
other than the"owner�, I certify that 1 have obtained a copy of_the above descri6ed'document�and:promise-in good faith'..ta;. ;_.;
deliver it:to the'=owner"�priac.to commencement. � ' ' -
Ci3NTRACTOR'S1t?1NNER'S AFFIDAVtT;;I:certify fhat all the information in this application is accurate and tfiat alt work
will be done in compliance with all applicable laws regulating canstruction, zoning and land development. Application:is
hereby made to abtain a permit to�do wrork and ins#alia#ion as indicated. 1 certif}r that na��uvork or.instal}ation=-has
commenced prior ta issuance af a permit and tha# all wark will be performed to meet standards of all laws regulating'
� construotion, County and Gity codes, zoning regulations, and land developmen# regulatians in the jurisdiction: ! also
certify that I unders#and that#he reguiafions af other government agencies may apply ta the in#erided 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: ��
- Deparftnent of Ernironmental�R'ratection=Cypress Bayheads, Wetland Areas and Environmentally Sensitive. �
Lands,Water/Wastewater Treatment.
- Southwest Flarida Water Management District Wells, Gypress Bayheads, Wetland Areas, Altering
Watercourses. ,
- Army Corps of Engineers-Seawalls, Dacks, Navigable Watennrays. � '�
- Department of Heal#h � Rehabilitative Services/Environmental .Heal#h Unit Vltells,t-Wastewater Treatment;
I Septic.Tanks. : -
- US Environmental Protection Agency-Asbestos abatement. . -
- Federal..Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fiU:
- Use of fili is not aflowed in Flood Zone"V"unless expressly permitted. ,
- If the fill material is� to be used in Flood Zone "A", 'it is understood that a drainage plan addressing a
"cort�pensating volume" will be submitted at time o€permitting which is prepared by a professional eng�rteer "
, licensed by the State of Florida.
- If the filt material is ta be used in Flood Zone "A" in cannectian with a permitted building using stem wall
canstruction, I certify,that fill witl be used only to fill the area within the stem wall.
- If fill material is to :be used in any area, I certify that use of such fi!! will not adversety affect adjacent
properties. Ef use of fill is found ta adversely affect adjacent properties, the owner may be cited for violating
#he conditions of tlie�building permit`issued under the attached permit application,.for lots less than one (1}
acre wiiieh�are elevated by fil1,an engineered drainage plan is cequired. `
If I am the AGENT FOR THE OWNER;�I�promise in good feith ta inform the owner af the permitting canditions set forth in '
this affidavit prior to commencing const�uctitin. 1.understand that a separate permit may be required for electrical,work,
plumbing, signs, welts, poats, air conditioning, gas,.or�ather instaiiations not specifica(ty included in the appiication. A . ,
permit issued shall �e construed to be a license to:proceed`with the work and�not as authority ta�violate,.cancel, alter, or
set aside any provisions of t�ie#echn�cal codes, nar sha[i issuance of a permit pcevent the Building{}f#icial from thereafter . '
requiring a correction of errors in,plans; construction or violations of any codes. Every�permit issued shall become invalid
unless the work authorized by such permit is cammenced within six months of permit issuance, or if work authorized by
the permit is suspended.or abandaned for a period.af�six(6)months after the time the wark is�commenced. An extension "
may be requested, in writing,"fram the Building Official far a.period nat to exceed•ninety (90) days and wiU demanstrate
jus#ifia6le cause for the e�ctens'ron. [f,work ceases for n�ne#y{90}consecutive days,the job is considered abandoned. '
�ItARNING TC? QWNER: YOUR FAIL.URE T'O_RECO.,RD A NC?TICE OF COMNlENCEMENT MAY RESll�:T 1N YOUR
PAY(NG TWiCE FOR tMPROVEMENTS:TO�YOUR.-PROPERT1f..,.IF YOU.:INTEND°�TO OBTAIN FINANCING;CONSULT
WITH YQUR LENDER OR� N ATT_ORNEY B�FOt2F RFCOltDlRIG_YCb!!!2 NCDT E OI�=�OMe11�EFICE�IiEF�'P: � - ����-
Fl.ORIDA;JLlRAT(F.S.9'17.03 �
OWNER'pR AGENT CqNTRACTOR � C
Subscribeci and swam to{ar aff�rmed)before m Is Subscsibed and swam to{a�affirmed}before rne thts � �
by by,. �
Who islare personally known to me or has/have produced � Who islare personally known to me or haslhave produced
. as idenf3ficatian. � r�:. as tden�ficatian. '
Notary Public Notary Public
Co�nmisston Na. Gommission i�o. �
Narr�e of IVotary typed,pr�nted or st�mped Name of tVotary typed,p�inted or stamped
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12232 HWY 301 DADE CITY (3S2)521-4977
DADE IITY, FL 33525 ZEPHYRHILLS{893)7?9=9515
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NAME: ��_ P�sco`�C�'r'dioliagy�, •�' --_ - Da#e: 12113116 SPL1T SYSTEM XX PKG i1NiT -
� SUBDIVISIOIV`. ' � IiEATPUMP 0 STR.COOL X -
ADDRESS: 37852 Medicai Arts Court
cin� � Ze�"hyrhills-� z�p coo�: 33541 caNOENSER: 4A7A4060L1 �i
PHONE: �i 813-788-0439 WORK: 1R NANDLER: GAMrJBOC�O
CELL. �� RENTER: liEATER: BAYEAAC�OLG�
EsrrtuwroR: Jeff B�ro�: AMERICAN STANDARD
SEER RATING: �4 �s�j2�,$�
HORIZON�TA� (NSTANT REBATE : 1,050.00
PF20 3440�ITHERMflSTAT/GOOQ T TAL : �Ja47�.'$�J
AUXILARY PAN TONNAGE: rj PARTS: 1 YR
NANGING;�K1T coMt�R�ssaR: 5 YR �ABOR: 1 YR
IN-LINE FLOAT
DRAIN PAN�LQAT CONDENSEI2: � `
SEAL DUCTWORK TO CODE IR HANDLER: #NIA
Ct3NNECTED l'O EXIS'ttNG DUCTS AND ELECTF2IC ��a�ER: #NIA
ANCHOR CONDENSER BRAND: #N/A
TAX,LRBOR AND FERMIT SEER FtATtNG: � #NIA
AIR HANDLER IN ATTIC INSTANT REBATE : - #N/A
REMOVE EXISTING EC2UtPMENT T TAL : � #N/A .
'j Tor�NA��: #NIA PA�TS: #N/A
�' � con���Esso�: #NIA �aoR: #N/A
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�I CQNDENSER: �
II iR Har��i��R: #N!A
II HEATER: #NIA
(I � et�arto: #N!A �
II SEER RA71NG: � #N/A �
� � INSTANT REBATE . #NIA I
I HAVE THE AUTHORITY TO pRDER THE WORK QUTLINEO ABOVE. I AGREE 7HAT SELLER T TAL : #N/A
i2ETAINS TiT I�TO EQUIPMENTAND MATES2tAl.S UA'TIL FIt4Al.PAYMEIIT SS MADE,IF PAYtu�ENT orvr�A��: #N1A PARTS: #IVIA
IS NOT MADEIAS AGREED,SELLER CAN REMOVE SAID ECIUIPMEN7 AND MA7ERIALS AT COMPRESSOR: #N/A �4�oR: #N/A
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SE�LERS EX II NSE.ANY 4AMAGE RESUITINC,FROM SAID REMOVA�SHALL NOT BE
THE RESPONSIBILITY OF SELLER'. UMITED WARR.4NTY�EQUIPMENT,PAR7S AND
MA'TERtA�HAS WRITTEN MANUFACTt,lREft'S WAF2RANTY ONLY
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GUSTOMER SIGNATURE �aY�. �,�[NSTANT�REBATE;�`��:���;;=4�
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