HomeMy WebLinkAbout17-18109 CITY OF ZEPHYRHILLS
5335-8TH STREET
,- ' (813)780-0020 18109
BUILDING PERMIT '�
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 18109 Address: 4547 BLOSSOM BLVD
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: ORANGE BLOSSOM RANCH
Est. Value: Parcel Number: 15-26-21-017D-01800-OOCO
Improv. Cost: 5,700.00 OWNER INFORMATION i
Date Issued: 1/31/2017 Name: MAXSON BERNARD �
Total Fees: 100.00 Address: 4547 BLOSSOM BLVD '
Amount Paid: 100.00 ZEPHYRHILLS FL 33542-5667 �
Date Paid: 1/31/2017 Phone: 607-423-4377
� Work Desc: A/C CHANGE OUT 2 TON SPLIT SYSTEM W/SUBPANEL CHANGE OUT
CONTRACTOR S . � APPLICATION FEES
COOLQUEST INC A/C CHANGEOUT 45.00
ELECTRIC QUEST LLC ELECTRICAL FEE 55.00
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Ins ections Re uired
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 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.
"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.
�
CONTRACTOR SI PERMIT OFFI R
PERMIT EX RES IN 6 MONTHS WITHOUT APPRAVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
s�s-�eaooao City of Zephyrhills Permit Application Fax-813-780-Do21
Building Depactment
' * Date Received ' •7j l• !�-- phone Contact for Permitting ��7 — �0� ��!�
Owners Name tl. � Owner Phone Number ����t���
Ownets Address � t,,,e.v� �vGi 4wner Phone Flamber �—�
Feo Simple Titleholder Name �— � Owner Phone N�umber �- �
Fee Simple 1'Itleholder Address ' ' ' ' " ' �
30BADDRESS VL.c'��.J v �OT#' ��
SUB�MSION (�Qh`"��t��'M���CEI.ID#l���`a�-,��'����� ' ��0�� ��
{08TAINED FROM PROPERTY TAX NOTtCE}
WORK PROPOSED e NEW CONSTR� ADD/ALT Q SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPdSED USE Q SFR Q COMM � O7I-!ER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q
DESCRtPTION OF WORK �� � L V 51 G S j} � ��J� e t� �� � 5 u' Q�j r B�
BUILDIRtG S12E � � SGl FOOTAGE� HEIGHT ��
QBUILDING �� VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ ��a� AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBIN� ��� �� �, j
�
QMECHANICAL $ O�O VALUATION OF MECHANlCAL INSTALLP;TION� : v
. .� - - - ` ., ��'7
QGAS Q ROOFING Q SPECIALTY � OTHER � (��
- -- ._,. ._. _._ .l _ ,
FINISNED Fl.QOR E�EVATfONS �� FLOOD ZONE ARFA.- F M QYES��'f�'5�10'�•�%: .. .__ �^+_`, ' ,
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C i i �i i i i i i l i 8 11 i i'6 i Q i l i f i i i ay i�6 5 i C 0,•,6 i L�
BUtLDER COMPANY •w;�:���,•,.� �.����.- � �
SIGNATURE � ftEGISTERED Y/ N FEE CURRE�' rv Y/N
Address � � License# � �
ELECTRICIAN COMPANY �� v'V`C� ��^'� -
SIGi�[ATURE REGlSTERED 1 M FEE CURRER ' Y 1 N �"
Address p f� � ' � License t� �G I3 op �4�
PI.UMBER � • � COMPANY � �
SIGNATURE REGISTERED Y/ N FEE CURRE� , Y/N
Address ! � �icense# �— �
MECHANICAL �t�.�,r ,,a�� „' `}-i"a'�r''"'.._�_,.._.._�.GOMPANY a���Gi7 f
SI{�aAIATUk2E t 1 REGISTERED Y N FEE GURREh Y 1 N
Address , � , • License# �1,,.���� 1 J / �
OTHER � � COMPANY � �
SIGNATURE REGISTEREO Y/ N FEE CURREA Y/N
Address license# �� �
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII111111111111111111111111111111
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building PJans;(7)set of Energy Fo¢ns;R-O-W Permit for new constcuction, _
Minimum ten(10)working days after su6mittal date. Requiced onsite,CansWction P2ans,Sto�mwater Plans wl Silt Fence insYalied,
Sanitary Faalities&1 dumpster,Site Work Pertnit for subdivisionsllarge projeds
COMMERCIAI. Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new conshudion.
Minimum ten(10)workSng days after subm3ttai date. Required oosife,Constructioa Pia�s,Stormwater Pia�s w!Silt Fence instailed,
Sanitary FaalKies&�dumpster.Site WorK Persait fot aII new projecfs.A!I commeraat requirements must meeY compiiance
SIGN PERMI7 Attach(2)sets of Engineered Plans.
"`""PROPERTY SURVEY required for atl NEW constmction.
Directions:�
Fill out application completely.
Owner&ConVactor sign back of application,notarized
If aver$2500,a Mo6ce of Commencemeat is required. (AtC npgrades over$7500}
" Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
OVER 7HE COUNTER PERMITf1NG (eopy of contract required)
Reroo(s if shingtes Sewars Sarvice Upgrades FVC Fences(PloUSurveylFoofage}
Driveways-Not over Counter if on public roadways..needs ROW
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Sf�4e of ��'L`C," ' ,
Cauntyof C.O � .��, - � �:�,�.. ,�-�.e
Tho to aing Instrument acknowledged beto m c-. - _. � '
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Po�sonelly known OR produced Iden qon
'ryae idennn�aa �a
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NQTIGE t}F DEED RESTRlCTIONS: The undersigned understands that tktis,permit may be,subject,to".deedfi restric�ons°;„:: �
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vutiich:may.:be mose:resUictive°.than:Cqunty:regulattons:=�'-The:undersignetl';as§urrfes'r�sponsitii!"ity�for:comptiance`with°any
applicable deed�est�ictions. . ����"�:''�`.'''�'
WMLIGEN$ED GONTRACTORS AND GON7RACTOR RESPQNSI816:lTIES: if�ttie owner has Hired-�a:coniractor or
ccrntractors�to undertake work,they may,be required to be'licensed in aecordance wlth state andwiocai regulations.�lf.tlie-�a': �
contractor is�not flaensed�as:reQ�ired tiy law; botH the owra'er:arid co€�fractor rr?ay=tie cite�=for a'.misderrtear[or violation ;
under state law. If the owner or intended coritractor.are uncertain as to what liaensing requRreri�ents;rr:ay��aFply-far.;ifie,"' '
intended work,.the .are advised ta confacf��tie Pasco Caun Buildin 1ris ction`Division=i:�censin Section af 727=847- ' �'' '
Y tY 9 pe _ 9 r �
8009. Furthermore, 'rf the awner has hired a ccyntractor or conf�actors, he�is advised to�have the contractor{s.) signr,.,,, '; ;
portions of the"contractor Black°of this application for which they will be responsible. !f.ybu,as'tlie`oiiviter`stgn as�ttie �``
contractor,that may be an indication thak he is not properly licensed antl is not entitled to permitting pri'vilsges in.P_asco, �;
County. _:,,F:�•F�ri�-• .
TRANSPORTATION IIVIPACT[UTILITIES IMRACT AMD RESOURGE RECOVERY FEEB:�The undersigned undecstands
.�:.,...:r ,. '^3
that l'ransportation Impact Fees and Recourse Recovery Fees mayapply ko-the construction of new buililings,cha"nge�of''�' �,.
' use in existing buildings,orexpansion.of:existing buildings,as spec�ed in Pasco Caunty Qrdinance number89-07 antl "�'.
90-07,as amended. The underslgned a(so underskands,that such fees,as�may be,due,wil!tie:identifted°at=tlie�'tlirie�of-�'���
' permitting. 9t is further understood that Transportation Impact Fees and Resource�Recovery.Fees must be pald p�ior to
� reaeiving a"cefificate of.occupancy'or final power release. If the.project does not 3nvolve a certificate of occupanep�oi=s<• ';
' finat power retease,the fees must be,paid prior to permit issuance.. Furtfiermore, if Pasco.County WaterlSewer=lmpaet��� t
fees are due,they must,be paid prlar to psrmit issuance in accordance with�applicable:Pasco County ordinanoes.
C4NSTRUCTIOhi LIEiN L�Vfi(Chapter T13,F1oNda Statutes,as amended): If valuation of work is$2,500.QO.or more,I.�:.,-
certify that I, the applicant, have been provided with a copy_of the "Florida Construction Lien Law—Homeowrier's � �
Protectian Guide"prepa�ed by the flarida Department af Agriculture and Consumer Affairs. If the applicant�is.someone.,_,
ofher than the°awner",t eertify that I.have obtained a copy of the above described dacument and promise in good;faitfi to�,
deliver_it to the°owner"�prioc fo commencement
COh1TRACTOR'S/OWNER'S AFFIDAVR:. I.certify that aIl the informatian in this application is accurate and that alf work
will be done in compliance with alt applicabte'taws regulating constructlan,zoning and land�develapment. Application is
hereby made fo.obtain a.permit to do,.work and installation as indicated. I certify thaf no work or:instaUation�has
commenced prior to is§uance of a permit and that aII work will be performed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I�alsa
certify that t understand tfiat the reguiations of pther government agencies may apply to the intended work,and that it is
my responsibility to identify what actions t must take to be in compliance. Such agencies includebut are not limited ta ,
- ,Department of Environmental Profectian-Cypress Bayheads,WeUand Areas and Environmentaily Sensitive
i.ands,WatedWastew�ter Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawatis,Docks,Navigabte Waterways.
- Department of Heai#h & RehabitiEafive Services/Environmental Health Unit-Wells, Wastewater Treatment,
Sep#ic:Tanks.
- US Environmental Pratection Agency-Asbestos abatemen#.
- Federai Aviation Autharity-Runways,
!understand that.the foilowing restrictions apply to the use af filh
- Use of fili is not alfovred in Fiood Zone"V"unless expressly permitted.
- tf the fllt materiaF is to be used in Fiood Zone "A", it is understaod that a drainage plan addressing a
"compensating vatume"wiR be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Fiorida.
- tf the fili materiaf is to be used in Ftood Zone"A" in connection with a permifted building using stem wail
construction,1 certi€y that fili wiii be used oniy to fiH the area with'in the s#em well.
- If fill material is io be used in any area, i certify that use of such�fill wiit not adversely a#iect adjacent
properties. If use of fill is found ta adversely affect adJacent properties,fhe owner may be cited for violating
the conditions of.the buitding permit issued under the attached permit application,.for tots tess than one(1}
acre whichare elevated by fiil,an engineered drainage pian is requi�ed.
If I am the AGENT FOR THE QWNER,-I promise in goad faith to inform the owner of-the permitting canditians set forth in
this affsdavit-prior to commencing constructian. !understand that a separate permit may be required for etectrical wark,.
plumbing, signs,wells, pools,air conditioning, gas, ar o#her�ns#ailations not specificalty inciuded in the applicafion. A.
permit issued shaU'be canstrued to'be a license to proceed witFr the work and not as autharity to viofate,cancel,aiter,or
set aside any provisions of the technical codes,nor shall issuance of a permit preveni the Buiiding Officiai from thereafter
requir[ng a correction of errocs in plans,eonsVuctian or violations of any cades. Every permR issued shali become invatid
unless the work authorized by suoh permit is commenced within six months of perrnit issuance,or if wark autharized by
the permit is suspended or abandoned far a period..of-six(6)monfhs after fhe time the work i�commenced. An e�ctension.
may be requested, (n writing,from the Buildirig Official for a periar!not to exceed ninety{94)days and wil!demanstrate
Justifiable cause fbr the extension. If work ceases far ninety(90)consecuiive days,the job is considered abandoned:
iNARNING TO OVNNER: YOUR FAILURE T.O RECORD,A NOTIGE OF COMMENCEMENT MAY RESUC7 1N YOUR
PAYItdG TWICE FOR IIVIFROVE,MENTS'CO Y,.O.UR�FtOPERTY. IF YOII•.IN7'END+TOUB°I'A!N FfNAAt�tIGING,CQNSUL7
WiTH YOUR'LENDER OR Atd A77'ORNEY BEFORE RECf9RDlNG YOUR NOTIC �COMMENCEMENT.
FLORIDA JURAT(F.S.117,63)
��
OWNER OR AGENT COtd7RACTOR .
Subscribed an bswom to(or afflrtned)6atore me this $ub�ri6 and bYo {or• ed Tore m*a th' +��,r/'
y / /-
Who Is/are personatty known to me or hasrhave produced ' Who�rep�rs�oqal*y..kq to e or ha ave produced
as tdentlficaBon. L= I.�iCt��ti `�/•t��3-- as IdentiflcaBon.
!
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Notary Pubtic o ry u Ic
:•'Y,s�. .
Commfssfon No. Com�p ssj n No. '•'"s ' '
(� ;�;. :o<; Expires pecember 12,201$
Name oE Notary typed,ptinted or stamped Name of Notary iype ,pBnt�t3f�hF'sta "
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CONDENSER •'a: � ' • !°�l�� �L�1�l�/T��1-�J��&7 '• ���� �� � �.^.�.-
vo�Ts___�,____� � • 78'17 Rutilio Ci.•New Port Richey,Florida 3�1G53
COFAPRESSORNPA R�,_, cnc�stasas :n��p������i�� p:���� V�o# ����
_._............_._
STR COOL�HEAT PUMP� y� � Pasco:(727)859-0500 E'LOAItiCE f3EP,�tR Herimando:{352)683-2977
GOhtq�AN NPA_RLq� ��"' ��' � t` � S.Pineilas:(?27)585-43�18 V.VhV.O[Y�QifCStcnm FlillSborou�h{813)962-2Cv19 '
NEAp PRESSURE.W � ---�� ��� � ��� � DATEp c,
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SUGTION PRESSURE_
�IEGTRiCALCONtaECTiON_ AODfl�55 � ���� t, � ����� , �
DA7E SCHE�ULE
GONTACTOR�„ CITY `��,; _ °' ATE .,r. � Z[P � f,e��1
CAPACITORS EfiN`COF�iP_ MAKE NlOpEt SERIAL tdUM6Ei2 �t''
CQND CfliL ❑WARRANTY
CON�ITIQN` �SERVIC�
"— AGREEMENT
S.�.E.R,M �,j
AIR HANDLER PhOne ^ '� Y"� � ' f Ce � ❑R�S.�O COMM.
VUCTS •e: • o � e • a- e
F3LQtMER NPA_Ri.A_ J
FLAT � d ! � �C.,�... � « �
t"JNEEL C�tdDITlOtd, � RATE ��i`�'`I �` �+sl�,.. °'�"7
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CpiL CflNDiTIDN___ g� 1
MqLD INSPECTIQN_ �� *� � '�+ � ,�.�.��.��'y"�"" ��� ���'�J r�� g �
F.LOAT 5L"11TCN_ v��:sT�� � d �'' � /��'�c`��° '�L'6.E °� � �'�
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RELAYS �" , `�" '�$iY�,'C` + �°� ''�'��"� � �.•
CdNDITION_
CERT.# TOTAl: �'� �
SIZG WlRE_ THCHNICIAP! � 07k�H
PANEL MAKE_
` S�GM1iA7UPIE �' 'y'"� CtIARGE5 �
_ NAPAE CK,� �^y� s •• r � SUg 70TAL ����
[3REAKER SIZE AH CONDi ��� �
ENTER TEMP I HAVE AUTHORITY TO ORDER THE ABbVE WORK AND DO 50 gEp DISC � `
CREDIT CARO# DL� QRDER AS OUTLfNED ABOVE.IT IS SIGNED THAT THE SELLER
L�hVlNGT'�h4P W�LL REfAiN 717LE TO ANY EQUIPMENT OR MATERIAL�UR-
laT� NISHEd UtdTiL FINAL&CqRrIPLETE PkYMENT I5 P�tARE.ANp tF '�
EXP. ^ ; ' CVU: QEPOSIT g�'�"�'�EIUIENT 15 NdT MAD�!�S RGREED,THE SEI.L�R SHAt,L
SUPER IiEAT_ HAVE THE RIGHT TO REMOVE SAME ANp TNE SELI.[R WILL BE FE'E ` �
BILLING NELD HARMLESS FdR ANY bAMAGES RESULTING FROM Tti[ .,�;
REMOVAITHEFlEOF. TAX
O WORKTOBEPERFORMEDATPRICEQU TED
PAATS WARRANTY: AI!paris are�varranted per manufacturers speci(icaHons.No vrarranty on Freon or�3arts witfi � ` � ' �''" '� ,
qiass.rubber,plasiic or printec!circuit hspards.tiNe are nof responsibie for any damac�ss r�r inccar,v�nierices r.ausad by �...�� ��-�`� -�' � " • � . , �
cEagc�ed drain line Prablems or inadequate duct sizes unless othenlise stated an ihis mvoice.Cootqucst is r,ai tiabie tor At1TMORizE�fG TURE s
clainac�es caused by water leaks,urile.�s othervrise s#ated abbve.
LABOR WAf�RANTY; Any I�bor chargss retative ta equipment service nated is guaranteed tor a period of 30 days. A90VE qRpERED WORK HAS BEEN COMPLETED SA7ISFACTORY ANQ i ACKNOI�dLEdGH AECEIPT
No charc�e�rarranty work wilt b�P�av��ed only duriny normal wr�rkin�hours. F PAY COPY
TERMS: Cash,�heck;tvton�y p���f�r Gredit Card,In ihe even�payment isn't received as agreed,purchaser agrees to � .
pay ail cost ot col�ection inei�d�nc�r�asanablo attomey's foes,Thcre vaill be 1 charge of 530.00 for all returned checks. OATE
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7817 RUTIt�.tO CCIURT
NEW PORT RICHEY, FL 34653
HERNANDO: 352-683-29?7 PASCC}: 727-859-4500
HILLSBOROUGH:813-962-2649 PINELLAS:727-934-3879
License ��id�r; J�hn �. Ph�i�� - EC13�Qfi2�9 E��. 8/31/Z(}1�
Licensed, Banded and lnsured
TO WHOM IT MAY CfJNCERN: 1/31/2017
I,JOHN G PHILIE,AUTHORIZE THESE 1NDIVIDUALS TO BE AUTHORIZED REPRESENTATlVES TO
PER�ORM ANY NECESSARY ACTIONS FOR THE ABOVE LICENSE 1NCLUDING REINSTATEMENTS:
ROBERT CAPAZ FL. D/L C120-773-67-33Q-0
NICHOLAS t3CASt0 F�. DjC 0220-633-79-066-0
KIMBERLY RlTTER FL. D/L R360-513-74-531-0
� THOMAS RAPONE FL. D/L R150-820-$8-426-0
MARK GOODE�I. F�. Djt G340-5A�1-72-391-0
KAZIMIERZ GORCZYMSKI FL. D/L G625-510-85-025-0
JOHN COVELL FL. D/L C140-474-$7-136-0
MARSHAL�COLLEY F�. DjL C400-541-83-Q14-0
RICHARD FURR FL. D/L F600-751-82-390-0
lOSEPH PARIS WV Df L FO?32�42
THANK YOU,
��r�
� '� State ot-!��cfc.c.._
10HN G IE EC13006249 G°��4�
The i g ing instrumem °,�.acknc�wied8ed betor�,me�-�
day of ��
LICENSE HOLDER �11e �, ��- �
� idani{fication_,....
Personaltyluawn PiOd�
'�tl��flca8
Y PUg(� NAl@IB'�{L�i�4Jl,RITTER
��` c* MY COFA�i4S510N�FF 042434
� * EXPIREB:August 4,2017
' `�'a,�eF�4o�.�°`� 6ondzd7hru8udgztNotaryServices
� . •
AIR CONDITIONING, HEATING & APPLIANCES
1/31/2017 LICENSED&INSURED CAC1813939
TO WHOM IT MAY CONCERN:
I,JANE M. HARPER,AUTHORIZE THESE INDIVIDUALS TO BE AUTHORIZED REPRESENTATIVES
TO PERFORM ANY NECESSARY ACTIONS FOR THE ABOVE LICENSE INCLUDING
REINSTATEMENTS:
ROBERT CAPAZ FL. D/L C120-773-67-330-0
NICHOLAS OCASIO FL. D/L 0220-633-79-066-0
KIMBERLY RIITER FL. D/L R360-513-74-631-0
THOMAS RAPONE FL. D/L R150-820-88-426-0
MARK GOODELL FL. D/L G340-541-72-391-0
KAZIMIERZ GORCZYNSKI FL. D/L G625-510-85-025-0
MARSHALL COLLEY FL. D/L C400-541-83-014-0
RICHARD FURR FL. D/L F600-751-82-390-0
JOSEPH PARIS WV D/L F073242
THANK YOU,
. �� ,
� �
JANE M. HARPER ��'���
�c;ounty.of
LICENSE HOLDER �et o(,�ga,�,m�t
r$s
PRESIDENT/OWNER �&---- ---- �ay� �''� ��"
�'�--- �
7817 RUTILLIO COURT ���6Apr�duced�a0on
NEW PORT RICHEY, FL 34653 '
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7817 Rutilio Ct. • New Port Richey, Florida 34653
www.coolquest.com • 727.859.0500 • Fax 727.869.6477