HomeMy WebLinkAbout17-18043 � CITY OF ZEPHYRHILLS
5335-8TH STREET' ,
� _ (s13)7so-oo20 18043
� BUILDING PERMIT '
PERMIT INFORMATION LOCATION INFORMATION
Permit f�umber: 18043 Adclress: 37633 LORENA AVE LOT 119
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
, Class of Work: A/C CHANGEOUT Township: Range: Book: '
Proposed Use: MOBILE HOME SUBDIVISION Lot(s): Block: Section: '
Squa�e Feet: Subdivision: GRAND HORIZONS ;
Est�. Value: Parcel Number: 34-25-21-0090-00000-1190
Improv. Cost: 3,795.00 OWNER INFORMATION
Date Issued: 1/03/2017 Name: LYDECKER RICHARD & MARY JEAN '
Total Fees: 55.00 Address: 37633 LORENA AVE �
Amo�nt Paid: 55.00 ZEPHYRHILLS, FL 33542 ;
Da�te Paid: 1/03/2017 Phone: 973-714-9663 i
Wor,k Desc: A/C CHANGEOUT 3.5 ON ;
CONTRACTOR S APPLICATION FEES
BAHR'S'PROPANE GAS &A/C, INC. A/C CHANGEOUT 55.00 �
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� Ins ections Re uired '
DUCTSINSTAL ED
DUCTSINSULATED
FINAL I
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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
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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CONTRA R SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
� CALL FOR IN�PECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
• Building Department _
Date RecPived �� ��� _ �O`� �
Phone Contact for Permitting •
Owner's Name e l�/� (�/� �' Owner Phone Number ��— ���` 6�A� �
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Owner's Address 3��� �dl�$/�Q. /'7'U� Owner Phone Number
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Fee Simple Titleholder ldame Owner Phone Number �
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Fee Simple Titleholder Address �
JOB ADDRES � : � � �e LOT# � �
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SUBDIVISION (�/� � /% Z Dl�j PARCEL ID# 3� as �/ �9D ��D� L �� I
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROP SED NSTALLSTR REPAIR � SIGN Q Q DEMOLISH I
� B �
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PROPOSED USIE Q SFR Q COMM 0 OTHER . .
TYPE'.OF CON,5TRUCTION Q BLOCK • Q FRAME 0 STEEL Q
DESCRIPTION OF WORK �C—S /r✓ L� Gf�N e pG[� / C07�7. �Je�f� ..7� � �b7� /�J�
BUICDING SIZ� SQ FOOTAGE� HEIGHT
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�BUI �'DING $ VALUATION'OFTOTALCONSTRUCTION
�ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W:R.E.C.
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OPLU BING $ ;
QMECHANICAL $ � ��� �D VALUATION OF MECHANICAL INSTALLATION �
�GA i Q ROOFING Q SPECIALTY � OTHER �
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
- BUILDER COflAPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# �
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ELECTRI,CI COMPANY i
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address I License# 9 !
PLUMBER.; � COMPANY .
SIGNATURE I - REGISTERED Y�/ N FEE CURRE� � Y/N
Address l - License# � �
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; MECHANICAL, � ' � ��n///III��� , COMPANY ��/QS !'O- gI1I� �����11�G� �
SIGNATURE ��. � REGISTERED Y! N FEE CURRE� Y/N i
Address� '� � � �//eN�/ �� � ` L:icense# l�f���.3��� I
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OTHER� ' COMPANY �
SIGNATURE.� :� - REGISTERED Y/.N FEE CURRE� 1 Y/N '
Address. � License# �
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�RESIDENTIAI�',. Attach(2);Plot Rlans;(2)_s`ets of Building�Plans;(1)'set of Energy Forms;R-O-W Permit for new.construction, �
� � , Minimum.:ten..(,10)working:days aftersubmittal�date. Required onsite,Constniction Plans,Stormwater Plans w/Silt Fence installed, �
Sanita.ry Facilities�&��1.,dumpster;Site:W.ork Permit for:.sutid'ivisions/large projects
�_- COMMERCI Attach'(2)complete sets"of Building Plans plus a Life 8afety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
� ., Minimum ten(10)uvorking days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilit(es&1 dumpster.Site Work Permit fo�all new projects.All commercial requirements must meet compliance
��SIGN�PERMIT Attach�(2)sets of:Engineered Flans.-. ' �
" � '*"*PROPERTY SURVEY required foc aII.NEW.construction. �
� . , .
Directions: II �.- �:.
Fill out application completely. '
Owner&IContractor sign back of application,notarized "' •
` If over$2500,a Notice of Commencement is required. (AIC upgrades over$7500) ' ;
`" Agent(for4h'e-cont���to[.�or,.Po.�we��o,fi4tto n�ev,(f r the owner)would be someone with notarized letter from owner authoriziqg same 4�
�.�3,�..3'x�r�,wids..Y
OVER'THE C�UNTER P�}�`-RMITTIf�G"^4�' x(Co'�ijF.'of contraet�requi[ed)�y �`�°�'.��*�^�"���r�x� �
Reroofs if shingles Sew�'rs'�'t""��Service'•Upgrades A/A�'��<Fengcyes(PIoUSurvey/Footage) ';`�'�'"'' �t`���'y`' �,v�`•"';�•.
�:,rOC ;•�" ���i_ 'ti;j'r.�' :ST::i.i t��i �•qA � ��� �F° q %;Tt�01't �t;n�.;iC 71iCi1lG� � ;ifd'ya ':a�,-:.:,�'•.
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,.._ t; . �''}�i',3 f': ��tjt. '�' ilit,[3�t�#q'�+ 4f•Pi.`.� ih9 '^_, fa�>�F djl i �
Drivewa s-Not ove��CouriteFlf�on publia:roadw8ys..ne�ds��EtO.VN• �� _ � '.t9 r� .f s
�hc:.i'p�E'nv};$i',0'fit�i1?�'J i'S li C',�i�^.�: •':�^ri±.'�1`)�.,�` � .;..-,f+��3'1 � ��i��;.T.E!'.{icj �i,�.��.�E�•iU: ,
*tiYs�B*"�f'��+66t�'x�"i6��'�'���, ;':=�4•,sic'!�,:a�t.lt r.a.4u,;7T L::iir,�i; %:,<i'S:`�' ,
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NtJTlCE OF DEED RESTRICTtONS: The undersigned understa�ds that this;permit may be subject�o"deed�''restri�ions"�.��,
which.rnay�be more rest�ictive.thar�,Caunty.cegulations: The�-undersigned��assumes`responsibili#y'for�comptiance�with any'`
applicable deed restrictions.. � . ..,,. : .�-:.�,:r�
UNLICENSED CONTRACTORS AND' CCJNTRACTOR RESPUNSIBILITlES: !f ttie-owner Itas tiired�a�confractar or ,
contractors to undertak�work, they may be requ,ired to be�licensed in accordance with state anc!.loca! r,egul,ations..�!f,the�-"
canfractor is not iicensed as required �iy law, botii�the owner and:°contractbr-may�=be ci#ed�for=a misdemeanar violation
under s#ate law. If#he awner or intended contractor are uncertain as to what licensing requirements may;app(,.y for the = •
intended war•k, they are advised ta coritact`ttie Fasco County 8uitding Inspection�Division=Cicerising Section-at 727-847-
80Q9. F'urthermore, if the owner has hired�a coritractar ar contractors, he is adv'ised�to�have the contractar(s) sign, :.
partions of the °cantractor Block" of this application for which they will be responsible. If you, as���ttie=ovurier stgn as'tlie3 " -
cantractor, that may be an indication fhaf he�is not properly licensed and is nof entitled to pe�m'itting�privileges in Pasco ,
County. _ � . ' - ' .��'� -. .
i'RANSPORTATIaN IMPACT/UTtLITiES,IMPACT AND RESiJURCE RECOVERY FEES: The undersigned understands �
that Transpa�tation tmpact Fees and Recourse Recovery Fees rr►ay apply to the consfruction of,new buildings, cfiange�of''�" �
use in existing buildings, or expansEon of existing"buildings, as specified in Pasco County Orciinance ntamber 89-07 and ,
90-07, as amended. The undersigned altso understands, #hat such fees, asymay,.,b.e_due, will tie identifed at;.the�#iri�te�of`° �t
permitting. It is further understoad that�Transportation Impact Fees and Resource.�Recovery Fees must be paid prior to
receiving a "certificate of occupancy" or final power release. If the:praject does not involve a certificate of occupancy,��or.�° � ,
final power re(ease, the fees.must be paid prior to permit issuance. �urthermore, if Pasco County Watec/�ewer Impact �
fees are due,they must 6e paid priar ta permit issiaance in accordance with applicable.Pasco County ordinances.
CGINSTRUCTlON lIEN LAW(Chapter 743;"Florida Statutes,as amended}: If valuation of work is$2,500,OO.or more,.l:;q,�
certify that I, the applicant, have been providad with a capy .of .the °Florida Construction Lien �aw=Hameowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant�is some,one >
other than the"owner�, i;certify that l have obtained a capy of the above describe8'document and promise in good faitri fo� _
deliver it to the"owner"prioe�to�commencement: � '
CON7RACTOR'S/OWNER'S AFFfDAVIT: I.certify>that aH the informa#ion in this application is accurate and that alI work
uvil! be done in campliance with af! appl'icable�laws regulating construction, zoning and-land-development. Applicatian is
hereby made to. obtain a permit ta do_work and installation as indicated. I certify that no .wark. ar installation has
commenced prior to issuance of a permit and�that all work will be performed to meet standards of al! laws regulating
construction, County and City cpdes, zoning regulations, and land development regulations in.the jurisdictian. ! also
certify that I understand that the reguia#ions of other gavernment agencies may apply to the interided wark, and that it is
my responsibility to identify what actions t must take to be in compliance. Such agencies include but are not limited to:
- Deparkment of Environmental:Protec#ian-Cypress Bayheads, Wetland Areas and Environmentai(y Sensitive
Lands,WaterlWastew�ter Treatment.
- Southwest Florida Water Management District-WeAs, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawaiis, Docks, Navigable Waterways. "-"
- Department af Health & Rehabilitative Services/Environmental .Health Unit VUells, Wastewater Treatment,
Septic Tanks: ' '
- US Environmenta!Pratection Agency-Asbestos abatement. �
- Federal Aviation Authority-Runways. _
I understand that�#he follawing:re"stric#ions appiy ta the use of fill:
- Use of fill is nof allowed in Flood Zone"V" unless expressly permitted.
- tf the fill materiai is to be used in. Fbod Zone "A", it is understaad that a drainage pian addressing a
"campensating valume" wi!! be submitted a#time of perrnitting which is prepared by a professional engineer "
licensed by the State of Florida.
- If #he fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wal!
construction, I certify that fill will be used only to fill the area within the stem wall.
- if fil( �materiai is to be used in any area, I certify that use af such�fill will nat adversely affect adjacent
properties. If use of fiif is found to adversety affect:adjacent properties, the owner may be cited for vio(ating
#he conditions of the building per►nit issued under the attached permit application, far lots less than one (1)
acre which are elevated by fill,an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform.the owner af the permitting conditions set for#h in
this affidavit prior to commencing construction. t understand that a separate permit may be required�for electrical work, '
plumbing, signs, wells, pools, air conditioning, gas, or other ins#atlations not specifically included in the application. A
permit issued shall�'be construed to be a ticense ta proceed with the wark and nafi as authority fa violate, cancel, alter, or '
set aside any provisions of#he technica!codes, nor shall issuance of a permit prevent the Building �fficiaf from thereafter
requiring a correction of errors in plans, construc#ion or violations of any codes. Every permit issued shalf become invalfd
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorixed by
the permif is suspended or abandaned far a period<of six(6) months.after the time the work is'commenced. An extension
may be reques#ed, in.writing, from the Buildirig Official for a period no# to exceed nine#y(90) days and will demonstrate
justifiable cause for the extension. If work ceases far ninety(90)consecutive days,the jab is considered abandoned.
WARNING�TO OWNER: YOUR FAMLURE TO RECORD A NOTlCE QF GOMMENCEN�ENT MAY RESU�T IN YOUR .
PAYING TWICE FOR IMPROVEMENTS TO YOUR RROPERTY. IF YOU::INTEND TO�OBTAlN FlNANClNG,CONSULT
WtTH YOUR L'" NDER OR AN ATT : NEY BEFORE RECtJRDING YOUR NOTICE OF'C ENCEMENT. __.__
- _FLOR(DA JURAT F.S.I17A3) _ ___ __ _ � _ - . .�-__ - — � -- - - — . -------- ___. _ .�.�
OWNER OR AGEN7 CONTRACTOR ��� � ��_
Subs ribed nd swa or affirmed} e me this S bs�c ribed and m to tor affirtne be re me this
I'�''/ /t1� /�ll5 P" `e�'/ t.`-�tt e�"'
Who is/ar ersonaily known me or haslhave praduaed ` Who is/are rsonally known to e or has/have produced
as(dentification. as identiflca#ion.
�
Notary Public _ Notary Pubfic
mission Na. Commission No. CL
o•`�pn nwa•,
��q�+;,:.,,� SYLYIA A.GAMPSEII ��,,,tp` �-.. Nofary Public-State ot Flarida
Narrre of No 6�;d , Name of Nota � A� �o�� ��on�FF d34230 �
�. . My Com . xpires JuI 19.2017 �`
Z Ff,� Commission�FE 034230 �'a��,�;;:�'' gp�ed'�t�rough Natian2l Notary Asso.
�.?;,o�tst�'a` �p�ed'(hrou�Nattonal Notary Assn. ��►�"'r""�"'r`�'
. �
� � r PROPANE GAS � � � e �
� = AND AIC �Nc. Service Order/Proposal Air Conditioning 8 Heating
��e�98� �::�8�3�782-5013 �J '
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Sales, S.erJr�e=& Installations � - � ������' ���=w�y��ik1=_L�-��:�Tc��r��r4 r�_����� ��F��4` ;
4441 Allen Rd.`• Zephyrhills FL 33541 '`'��'�_ `'���-'`'`� �''-}``�:.'" �`� �''`�`�`'��'' '.�" ' `�� �
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`Annuai:Mai `tenance:Recgmmeridedrby;Ali:;Equipmenb`Manufactvrers:.:.•= , i
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+� � ���. � �� :�c�'� ��. � : - - - _
FILTERS x x Changed Monthly I , I
�•(�(} ���� �+,J���'� �G,��� �9��`i FILTERS x x Changed Monthly � �
�� `f' _ l� � , - " 'TO'fAL;SUMMARY" � �
❑ REGULAR ❑WARRANTY -- _ _ _,_ ,
�;Defiumidi'staf etting's:;VVhen here"ON";�,When Away 6�° ;;T-Stat 80°� ❑ MAINTENANCE CONTRACT � �
���.,�_ .:d....=- s.: ... ;,—:� - SERVICE i !
LIMITED WARRANTY: All materials,parts and equipment are warranted by the manufacturers' �;-_._s_;;;--�;MEl'1-1QD;OF';PAYMENT=_�``=>,<:: CALL i
•::
, : - ,. .
or suppliers'wntten warranty only.All labor performed by the above named company is warranted for '- � - " ' -`" " `' "' TOTAL i
30 days or as otherwise indicated in writing.The above named company makes no other warranGes, ❑CASH ❑CK# MATERIALS i
express or impiied,and its agents or technicians are not authorized to make any such warranties on
behalfofabovenamedcompany. , , • ❑DEBIT ❑CREDIT ❑OTHER MAINTENANCE i
I have authorilylto order the work oWined aDove which has been saGsfactorily wmpieted.I agree Ihat Seller r PROG. W I C
retains title lo equipmenUmalerials fumished until final payment is made.It paymenl is not made as agreed, CLAIM# I •
seller can remove said equipmenUmaterials at Seller's expense.My damage resulting from said removal shall
not be the resp� '" o(Seller.NET 30 DAYS.A 1 tY2°�SERVICE CHAR�,yJILL BE ADDED MONTHLY TO � '
ALLUNPAID I C OV 30DAYS.NOREFUN� ) 1 DATE COMPLETED
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�"� ��%r�2,�c �ozc TOTAL ��`�� �G�
CUSTOMER IGNATURE DATE
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