HomeMy WebLinkAbout17-18426 CITY OF ZEPHYRHILLS
; 5335-8TH STREEf
` (813)780-0020 18426
BUILDING PERMIT ;
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 18426 Address: 39453 TABETHA DR
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: SIXTH AVE
Est. Value: Parcel Number: 12-26-21-002B-00500-0000
Improv. Cost: 5,500.00 OWNER INFORMATION
Date Issued: 4/28/2017 Name: SIXTH AVENUE LLC C/O MHC OPERATI
Total Fees: 65.00 Address: 2 N RIVERSIDE PLZ STE 800
Amount Paid: 65.00 CHICAGO, IL. 60606-2682
' Date Paid: 4/28/2017 Phone:
Work Desc: A/C CHANGE OUT 4 TON 14 SEE PKG UNIT
CONTRACTOR S APPLICATION FEES
AIR RESCUE AIR CONDITIONING INC A/C CHANGEOUT 65.00
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Ins ections Re uire
DUCTS INSTALLED
DUCTSINSULATED
FINAL
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 properly 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.
', "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 performed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
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CONTRACTOR S GNATURE PERMIT OFFI R -
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION '
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED,. "
PROTECT CARD FROM WEATHER
� ' Bullding Department � � '
Date Recelved
Phone Contact f.o�Permitti� �d�3 � 9 - �('�6 5��,no n�►G�+
Owne�'s Name Owner Phone Numb r
Owner's Address S� yZ �^� e�� SY Owner Phone Numb r 7�-Z' ZOq- )�08
Fee Simple Titleholder Name � Owner.Phone Numb r
Fee SI ple TltleholderAddreaa
RESS �1 Y5 TA e'�►ra �R Z-H�NS F(� 33 5�J �.. � LOT# �
SUBDIVI310N �ePE+Q.Y{,�IfS Colo y PARCELID# /2-2fo-2'/-Oo'z8- po�oc� -0000
(OBTAINED FROM P OPI°RTY TAX NOTIGE)
WORK PROPOSED B NE CONSTR 8 ADD/ALT Q� SIGN [] 'Q DEMOLISH
IIVS ALL REPAIR
PROPOSED USE [� SFR Q COMM [� OTHER
TYPE OF CON3TRUCTION Q E�LO K Q FRAME � STEEL Q '
DE8CRIPTION OF WORK �, uAL G�/�nlg�auT� o�' q�� Y T N � 5 P�. ��r
BUILDINti SIZE 8Q FOOTAQE�� HEI(3HT 'I
[�BUILDING ($— � ' _
L__ VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE [�] PROO ESS ENERGY Q W.R,E.C, .
OPLUMBINO $
MECHANICAL $ VALUATION OF MECHANICAL INSTALLATIO `�I v ��
�S�OO� BO
[�GAS �] ROO ING Q SPECIALTY C� OTHER
C7
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA C]YES NO
BUILDER COMPANY
51GMATURE REGISTERED Y/ N FE CURREA Y/N
Address Licens #
°LECTRICIAN COMPANY
DIGNATURE REGISTERED Y/ N � FE CURRE� � Y/N
Address Licens #
'LUMBHR COMPANY
lIGNATURE ' REC3ISTERED Y/ N FE CURRE� Y/N
Address �. Llcens # �
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1ECHANICAL ��,{ � � /k—� � COMPANY Iz I� �G� Sc.l,a 5� � (�,)� Sp
IGNATURE \I -`��` / � � REOISTERED Y/ N ' FE CURRE� Y/N
Addresa I �Z r�ss�,r� /3(�J T�� F� '33�-�» Licens # �GA�. 18133��'�
�THER COMPANY
IGNATURE REOISTERED � Y/ N FE CURRE� Y/N
Address Llcense# �
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ESIDENTIAL Attach(2)Plot Plans;,(2)sets o Building Plans;(1)set of Energy Forms;R-O-W Permit for ew consUuction,
Mlnimum ten(10)working days fter submlttai date. Requlred onsite„Constructlon Plans,S ormwater Plans wl Silt Fence Installed,
Senike.ry�Fac!iffles.&1 dum�stgr Site Wo►�c Permit fvr subdl��lsiens/iarge pro)ects __ _ _—______--- _ ___
OMMERCI�L Attach(3)complete s'ets of Elull ing Plans plus a Life Safety.Page;(1)set of E�tergy Forms. -0-IN Permit for new constructlon. ___ _ _
Minimum ten(10)working days fter submittal date, Requlred onsite,Constructlon Plans,S ormwater Plans wi Sflt�Fenoe insfalled,
Sanitary Facllitfes 8�1 dumpster Site Wark PerrniQ for all new projects.All commerclal requi m�nts must meeY compllance
'GN PERiNIT � Attach(2)sets of Engineereci PI ns.
R�f�PROPERTY SURVEY requi d for all NEW consUucdon.
rectlans:
FIII out applicatlon completely.
Owner 8�Contractor sign back of applicatlon,n tarized
If over 52500,a Notice of Commencemerit i required. (A!C upgrades over 37500)
Agent(for the contractor)or Power of Attomey for the owner)would be someone with notarized letter from ov�mer authorizfng same
/ER THE COUNTER PERMITTING ' (Front.o AppllcaUon Only)�
�roofs If shingles Sewers Service Upgr des_A%C Fences(PIot/Survey/Footage)
Driveways-Not over Counter if on public rofid_ ys,,needs RO.W
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NOTICE OF OEED RESTRICTiON�: ha underslgned understands that this per It ma b�subJeat fo"deed"restr(ctlo �
whlch may be more resfrietive�than �Co nty regulations. The underslgned assum s res oreslblllty for compl4anc�wlth any
appllcable deed restrlctlons. ' '
UNLlCENSER CfJN7'RACTCIRS AN CONTRACTOR RE3PONSIBIUTiES: If the iowner has hired a contraotor ar
contractors ta undertaka work, thay m y be requlred ta be i{censed in accordance wlth;state and local regulaklons. !f the
contractor Is naf 1(censed.as requ(r�d y law, both fhe owner and contractor may be ' it�d for a misdemeana� vlolatbn
under state law. If the owner or Inten ed contracfar are uncertain as ta what iicensin r�quirements may apply for the
infended work, they ars advlsed tn can act tkle Pasca County Bullding Inspectlon D(visi n--Licensing Sect(on at 727-847-
8009, Furthermore, if the owner iia hired a contractpr ar contractars, he is advls d ko have the contractor(s) s(gn
portfons of the "contractor Block" of'th s appllcation for which they will be rasponsibis. tf you, as the owner sign as the
cantractar, khat may be an lndication t at he is not properly (Icensed and Is nat entitle' tu permitfing priviieges in Pasco. =
County. ' � - � r
TRANSPORTATION 1MPACTIUTIUTt S {MPACT AND�RES�URCE REGOVERY FE� S: The undecslgned unders#ands ' �.. �
that'Transportatfon lmpact Fees ancf ecourse Recavery Fees may apply to the canstr ction af�new.buiidings, change of
use fn exfst{ng buildings, or expansia. of exist#ng buildings, as spec(fled In Pasco Co nfy Ordinance number 89-07 and
90-07, as amended. The undersig►�e a}so understands, that such fees, as may be d; e, wiE! be ldentl�ed at the time of
pe�mitting. !t Is fu�ther understood th t TransporEaf(on lmpact Fees and Resaurce Ra overy �ees must be paid prior to
receiving a "ce�tiflaate of occupancy" r flnai power release. (f fhe proJecf does not in olve a certificafe of occupancy or
finai pawer release, the fees must bs paEd prlot� #o permlt Issuanoe. Furthermore, If asco Caunty Water/Sewer lmpact
fees are due, they must be paid prior t permit issuance{n accordance wlth appllaable asco Gounty ordlnances.
C�NSTRUCTION LlEN LAW�Cha�pt r 713, Flortda 5t�tutes, as amendodj: 1f valua ian of work is $2,500.00 or more, 1
certify that I, the appHcatit, have be n provided with a copy of the "F(orlda Con rucfian �Llen Law�Homeowner's
Prc�tection Gu}de" prepared by�the Fia ida E1epa�tment of Agriculture and Cansumer A airs. !f!the app!{cant Is someone
other than the"owner°, I cerfif.y.fhat I h ve obtained a copy of the abvve described doc mant and prom(se in good faifh to
deliver!#to#he"owner" prlor#a�comm ncement.
CONTRACTOR'SiOWNER'S AFFIID IT: ! certlfy that all the Infarmatlan In thls appl! ation is accura#e and thak a!I work
will be done In compiiance with all ap licable iaws regulating canstruction; zon#ng an land de'velopment, Appifcation is
hereby made to obtain a permit ta o wo�k and Insfallat(on as Indlcated. I cerfif that no work or instaNation has
commenced prlor to Issuance af a p rmit and that al! work wil! be per#ormed to me t standards of a(1 laws regulatfng
consfruction, County and City cod�s, zon€ng regulations, and fand development reg !atlons En the )urlsdlctlan. I a!'so
certify that ! tinderstand that the regul tions of ottier government agencies may apply a the intended work, and that it is
my respanslbillty#o identi�y what actlo s i must take to be In compUance. Such agenc( s inc(ude but are not limited to:
- Department of Envlromm �tai Protectlon-G�press Bayheads, UVekland Ar as and Envlronmenta!!y Sensitive
Lands, WaferlWastewater Treafinent.
- Southwest Florlda Wat r Managemen# District-Wells, Cypress Bay e�ds, Wefland Areas, Altering
Watercaurses.
- Army Corps of Engineers- eawails, Docks, IVavlgable Waterways.
- Department of Health & Rehabilitat(ve 8ervices/Envfronmental Neaith nif-We1is, Wasfewater 1"reatment,
Septic Tanks.
- US Envlronrnenta!Protect on Agenay-Asbestas abatement.
- Federal�Aviation Authority Runways.
i unders#and that khe foliowing restrlctl ns apply to the use of flil;�
- Use of fHl is noE allowed In �'lood Zone"V"unless expressly permltted.
- If the fll( mater3ai is ta e used in Flaod,Zone °A", it Is u�tderstoad t at a dralnage plan addressfng a '
"compensafing volume" iil be submitted af flme of permifting which is p p�red �y a professional engineer
llcensed by the State of FI rida.
- if th� flil material is to b used !n Flood Zone "A" !n cannec#!on with a ermitted buIlding using stem wall ,
construction, I certify that li w((I be used oniy to fiil the area within the ste waii.
- !f fi!! material Is to be u ed in any area, I certffy tha# use of such flil wili not adversely affect adjacent
properEles. If use�of fill !s faund to adversely affect adJacent prope�tles, t e owner may be clfed far u(olat(ng
the canditions of the buil €ng permit fss�ed under the attached permlt a plicatlon, for lots Isss than one t1)
acre whlch are elevated b fiii, an engineered drainage pfan is required.
' If I am the AGENT FQR TNE OWNE , ! promise In gaod faifh fo Inform #he awnar of t e permlttin� conditions set forth in
fhis affldavit prfor to commericing co structlon. ! understand that a separate permit ay be required for electrical work,
plumbing, signs, welis, poois,. air co ditioNng, gas, or other instaflatians nat speclfi I!y included !n the applicatian. A
permit lssued shall be construed ta b a Ilcense ta proceed wlth the work�and not as uthorlty ta,violate, cancei, aiter, ar
set aslde any provisians of#he tect�n! a! codes, nor shall issuance of a permlt prevent tho Bulldlrig Off(cial from fhereaffer
' requiring a correction of errors fn pian , constructlan or violat(ons of any eodes. Every permit lssued sha!! become Isivalld �
unless the work aufhor(zed by such ermlt is commenced within six months of permi issuance, or if work authorized by i
the permlk is susgended or abandane fo�a perlod of slx�6j months afker the time the ork (s commenced, An exfenslon ,
may be requasted, in writing, from th Bu(lding,Offlcla!#or a perlod not ta exceed nin ty (90) days and w(II demonstrate
justifiable cause far the exten,s}on, If ork ceases for ninety(9Q}consecutive days, th )oh Is cansidered abandoned.
WARNING TO QWNER: YO.UR �A LURE TO REGORD A NUTICE OF COMMEN E9VIENT MAY RESULT IN YOUR
� - -PAYiFi�'�lN6CL�'C3l� �tll;l�E�PJ.l��IVlE �'S �"C?�lQl1R PRQPERTY. 1F Y!'�U INTEND T OBTAlN-FlNANGlNG, CONSULT
- �'rviS"e#Y+�e;?i"�-L"E�C�f2-C)'�'-AN-A -- ZD �iiE �'� �0�2 `Ft.C !�D! G- - 4:� �- 'O . -E. , F _ E1+3C�M =_- _- == _ -._ - -- -
FLORIQA JURAT(F,S.117,03j '
� OWNER OR A(3ENT CONTR.ACTOR �i�'��'—'------
Subscrlbed and sworn to(or afflFn►ed}before e thls Subscribed and swom fo(ar afflrme befare me#hfs ,
by
' Who is/are personaUy known ta me or haslhav produced Who Islar ersonally kno" -to me o haslhave�produced
, as identlfica8 n. as Identif3catlon.
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Notary Publlc Notary Pub(Ic
, �*�-Y°��. JACQ �CiNE ES
Commission No. Co misst n No, �'-�
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;;;•.,.�t: Expire December 32,2018
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Name oF Notary typed,printed or stamped Name of Notary �°`�"te . '9
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State Lic#CA�18133�5 �� l " ,-�%�.:.;;:;;,4 "�-,�. � _;�����k,, �
Corporate O�ce '� r ,�° F p,. . -�",� � �. ,� �°�
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14��3 �ttassaro Blvd. • Tan7�a, Fl.33619
Proposai Dat:e�l ��'f j ~1 lnstal!t�at? � f 1 ��( �
C��stcam�r N�me �rc'�-,� `'�'�''`^{- _.� �
Address ����� �`��`�� �� -
City �i'��) t �^,���5 State ��"" Zip CQde �����- Emai!
PE�one Number(hom�1 (celi) �'��-" `��t— M �b� _
@ p _ e r...
�f+��If�A�.SEEF2 ��sic t?etux� Pr�r�i�� O�r��rr�ca€� Si�e '�4iarranties
14 SEE� 15 5EER T6 S�ER i8 SEER n �,. P8C'�5 ~ �,�k)�i'
Air Conditioner O ❑ O Ei�4
❑ hleat Pum�> p p Q ❑ 10 Ye�r i a'Y���` ❑
❑ Cot�denserJCoilOniy C� ,�________._. O 3.S
❑�Fiarnace System ' ❑ Ci Cl 1lertical � 3 51(��s' I� ���ar O
Q'Pa�kage Air Conditioner C] ❑ p �.5
❑ Aackage hleat Pump ❑ d ❑ ��rizontal
, � � � Year ❑ 1 Year C�
!.i$etime �Year ❑ 15
Air C3elivery System � Green � Silvef
D 2,000 ❑ 1,600 ❑ 1,400 ❑ 1,20Q CI 1,Q00 p 8Qfl ❑ 604 ❑ Replace Boots ❑ Grilies ❑ Mastic Seal
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� �C.�'`t +`l t'� t t.'�-S"� `t �'� �...��'�..',1� C.�v? '�2. t<i t�C?r^.z'1 I S�, "t"j.t:.r}.�i '-_-^'?I.1 !'��r�,�-c,lti^r�.,�.. ``t..
'"�".. `��"CT- �•.3�M,'�"`t't/�e, �'"( n t�"l�S?� `
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To c�6fain muximum raf�d efficiency frvm any HVACsystem,Pfie equiprrren�and the pir dlstributir�n sysfem must camply with the manufacturer s
specifiratians and requrrements.Air Restue fiirConditiv»ing can only be responsible far camporten[s insrn!!ed byRir Resrue Air Condifionirsg.
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Syst�m Price Customer 5ign��ture '" ^—
TOtr�l Additio115-frarn custamized prrrn_q works/�eet �� Customer(Pt'ittt)_ � `^���`""�� ;) C�
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SUBTOTAL �`6Ci�7 Date �- �t�-l l�.
TECC�IFPL Rebate /�� ARAC R2{�(Printj �"t`�``'"'� �.
Mfc�RebateiARAC Discot�nt �'�� CC# CVV
T'atalF�rice ..������ Check� ����'����'1"3 , ��`"�y�1!"��j;ii�{���i�'�,�i'��1, �l�D
Minu�Do4vn Payrr�ent ��� �r'''��j=.�.,�� C�<"-�K�� Fin�ncing Type Amt Financed
Ba�t�uc upon Srart-Up `"���*� ���`'�� fi��g uwr�the rea!praperty is�Gvhich the rquipment is ta 6e instalted and ti�v�
auihar"tiy tc�ordcr the woFk as outlined a�c�ve.Terrls:E?alanr.2 due upon startup,
ar in accardancc sr.ritt�fina�r.inc�a�rE�ntent.See revers<side far�dditional terms.
f�tt)+EC4�lL„��t("1'O��nC2�:Sf)�.,(}37 �'fltSt5C1�34R7?50}tCIfQCtOT15AIP.,f,7PSK'�IfNpLfljL}flpillQlY21I1L'IJOpCI5p(52NlCFS,�/OU71:{7�CQRCC';fIlI5U0/F2172c'PIChy�l�7V1CI%�Q�YlfftettYl4�lff'tOtf}C
�elterrn�St�rson,f>y tereyrGrn,orbYr»a,i.}�his nctite m��rt inuFicat�thotyou do r,at x�ant rhegoods orservices and ir�;tst be d�:livere�or pas:rn�rkeci betorr midnight of the rt�ird
turirress cir�y�fieryou src�n it�is agreerr�e�tt tfy�tr cc�nccf fh;s ar�reernettt,the selter may rot keep aif ar parr af any cash dawn payrnerrf.
The instaPl techt�ici�n has reviewed tl�is Hc�n7e lmp�ovemer�t A�se�me«t for instaliation oF NV�t:systems by Air RPs�ue Air Condiiinn;ng.
!. ��'�,`l� '�''j''��"�.J� agree tf7at tl��agr�emer� �reflects my unclerst�nclir�c�a€the sco�e of ti�e jc�h and the ec��.aipn���nt
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to k�e instaNecl. Customer 5ignaCur� � ✓'.� �s..._.
���t���hec�fiorm�c�r� $3�C�e���c�r�ur�Q���
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