HomeMy WebLinkAbout17-18159 , CITY OF ZEPHYRHILLS
5335-8TH STREE7
(813)780-0020 18159
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 18159 Address: 38620 PIEDMONT AVE
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: ALPHA VILLAGE
Est. Value: Parcel Number: 35-25-21-0050-0000-0850
Improv. Cost: 3,450.00 OWNER INFORMATION
Date Issued: 2/17/2017 Name: HAYNES JAMES & DIANE
Total Fees: 55.00 Address: 38620 PIEDMONT AVE
Amount Paid: 55.00 ZEPHYRHILLS FL 33540-1431
Date Paid: 2/17/2017 Phone: 813-395-8454
Work Desc: A/C CHANGE OUT 2 TON SPLIT SYSTEM
CONTRACTOR S APPLICATION FEES
PATTIE ELEC. & REFRIGERATION A/C CHANGEOUT 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.
,
f� RACTOR SIGNATURE PERMIT OFFI R
✓ PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
� • Pattie Electric & Air Conditioning
39111 Pattie Road
Zephyrhills, FL 33540
813-78�-3319
sales@pattieelectric.com
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�Work Order � . . Date ' .. Summary: � �TTech; � . � . - , ,
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1577-101 2/17/2017 QUOTE GARI A1 03:00 PM
-BiQ�To:� . . :- . ..-�,�_ . . --- _ , . . . E 3Job Nar�e:��:. �.,_.,. _...._____�_.. _.._
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Diane Haynes DianeNHaynes
38620 Piedmont Ave 38620 Piedmont Ave
Zephyrhills, FL 33540 Zephyrhills, FL 33540
813-395-8454 813-395-8454
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Replace 2 ton Rheem split system heat pump unit per quote 53,950.00
Price is Per Stated Quote 1 0
All material is guaranteed to be as specified. All work to be completed in a professional manner according to standard practices. Any alteration or
deviation from above specifications involving extra costs will be executed only upon written orders and will become an extra charge over and above the
estimate. All a�reements contingent upon delays beyond our control. Purchaser agrees to pay all costs of collection,including attorney's fees.
Signature Date
s�saso-oozo City of Zephyrhills Permit Application Fax-813-780-0021
. ,� - �- Building Department
Date Recelved . Phone Contact for Permitting � —
Owner's Name C Owner Phone Number
Owner's Address � 2.(� � 0 C�-'� Owrner Phone Number
Fee Simple Titleholder Name Ouvner Phone Number �
Fee Simple Titleholder Address
JOB ADDRESS �� �O �M Q`n� (' � LOT# �
SUBDIVISION PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED - ,. NEW CONSTR ADD%ALT � SIGN Q � Q DEMOLISH
B INSTALL B °REPAIR
- PROP,,OSED USE Q SFR Q COMfVI Q OTHER .
TYPE'OF CONSTRUCTION Q BLOCK •• Q FRAME. 0 STEEL Q
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DESCRIPTION OF WORK �� Cl. � 1'1 i
BUIL"DING SIZE SQ FOOTAGE� HEIGHT •
,, : ,_.
QBUILDING $ VALUAl'ION'OF TOTAL CONSTRUCTION
QEL.ECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
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QPLUMBING $
[�'�IECHANICAL $ � O VALUATION OF MECHANICAL INSTALLATION
OGAS Q ROOFING Q SPECIALTY 0 OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER CONIPANY
SIGNATURE REGISTERED Y`/ N FEE CURRE� Y/N, .
Address License# �
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ELECTRI,CIAN COM PANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N.
Address License# - °a
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� PCUMBER;._:. . COMPANY�;�' , - • � -
-SIGNATURE " � ' REcisrERe� ; Y/-N: ' .. � FEE CURRE� Y/N
Address ' License#',�
�y.MECHANICAL' �j , , COMP,ANY� , � C �G�
Y 'SIGNATURE''` I ' REGISTERED ,'. Y/. N . ;. FEE.CURRE� , •'/N ' � �� '
Add're`ssY� - ` � L-icense.# ���
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;:OTHER��` '.6.,. ,�, , ,.�.... - _ COMPANY � , - - - II
�`=�SIGNATURE;�i�:' .'= - ' ' ' � ` ' " REGISTERED ' Y/.N. FEE CURREK Y/N�� . _ �
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'�..RESIDENTIAL'a,�; .tittach�(2);Flot"Plans;;(2);sefs;ofYBu'ilding=P.lans;'(,1�)`set'of Energy;Forms;R=O-W;Permit;for new.construction, -
�� r��;f:rx.; - Minfmum:ten;(,1U)working°days;afte�`sutimit'tal•`date..Required'onsite Construct�on Plans;S4ormvirater,.Plans w/SIIfEence'installed;
� � f "Sanita;ry;FaciUties,8�y 1ldumpste.r•;.Sife;1lVork.Permit.f.or.sutidivlsions/la_rge�projects'�`..�, ` =- � • - _ � - _ � - - � •
'=�;COMMERCIAL Attach,(2)xomplete sets of'Building Rlans�plus a�L'ife.Safety.Page;(1)set�of Energy Forms.R-0=W Fermiffor.new.constnicti'on.
-- Minimum;ten.(10),workfng days after,submittafdate. Required onsite,.Construction.Plans;;Sformw,ater Plans vir/Silt Fence,installed, � ,
-,. � _ � ,3anitary'Facilities&1:dumpster:;Slte.Work•P.emiit'fo�%all�new p'rojeots.:All'commercial:requirements�.must�meet compliance.
��•�.:SIGN;PERMIT -Attach'(2)sets of;Engineered�Ptans:�?�,��.�:�..,_�. ��=.- . ` �'- ' � � � - � �
�- � *'""PROPERTY,'SURVEY'tequired.;for:all.,NEW�construction.._ - _ ; -- - -- �; _ . ' .
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;`;`.Di�ections: � , .- . - ;� � • ' .�-� . ..., . . , � , ... .-• . :
.�. . , . .. _ ..
-- �FIII::ouYapplication completely.. _ � , "
- OwneF'&Contra�tor sign.back of�application;,notarized,; ;. �•=,:. -, , �., '� ,
;: If over$2500;a`Notige of Commencement is:require'd:� (AIC'upgrades-ovet.$7500)`;� _.. - -
�"" AgenY(for;th'e;cont�actor)�or Power:of.Attomey(for tFie�o.wrier)would�tie�someone;witli notariied.letter"f["om owner authorizng same
., . , ,._._. ..__. .�,- - . . .
';;`OVER�.THE COUNTER�PERMITTING;� ::;(cqpy;of:confracf�.requ(redj.'°"'��� "' ' _ � " " � - ,'
-°Rero'ofs if`shingles ' ��Sewers .',:.-}:;Seniice�Upgr'ades�.i41C ' Fences(PIot/Survey/Footage)• "
, - � � Drlveways-Not over.Counter if:on.publio,r'oadways:.neecls ROW,.- � � � , � �
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NOTICE OF DEED RESTRIGTIONS: The undersigned understands,that,this-permitmay be subject to".d,eed°,restrictionsn:�,�`�`�-,�
}i.. ;i_:a'_�,_t.:.tta..:^:a�.���,-,.:�..=:-.-t•ty-•>.":a.,�,$n-v.._.,i^"aw�_,,�:.�,;,;�o.�Tl:`-:Ati:` :i.v';,.3'..":.q�;,"
vvhich:may.ber.more,:restrictive�than�'County:regulations:'�:�Tiae�undersigned=assumes-responsibitityfo'r'�,compiiance-with��any_ � .�,
applicabie deed'restc�ctions. `� -.. -., .�: ;;="tik.:``�`:i�':.:�',
UNI:IGENSED. CONTRACTURS AND COIdTRAGTQR RESP:ONSIBILITIES: �If•tiie=owrier�-tias� li'ired:s_a-�contractor or
contractors�ta uridertake work; they,mayj be required to bei.licensed in accordance,with.state andµloeal_,cegula#ion's��,'!f:tli'e�.:�",.:s
contractor is not licensed-as required'by"law, bothi�`the ovimer.and�eontracfor-rriay�be=cited�'-far a.misdemeanorviolatio�n� � ?
under sfate law. If the owner or intended;contrac#or are'uncertain as to what licensing�requirements;,rnay;;apply.,,f.or=;t1%ear�'��=,��
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intended wark,.they are•advised to confaet�tiie'Pasco County Building Inspection�°Division::�Licensing:Section at T27�847= :�.
8049. Fearthermore, if the owner has'�tiirerlya conttactor or confractors, he 'is advised to��?have.the contractor(s.}.,sign rc�,:,;.
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portions of the °contractor Block" of this-application for which they wilt be-�responsible._-!f:you,_as�,tFie:owne�'s'rgr.�:as�ttie�`��`=�:�,;
contractor., that.may-be an indicatian fha# he�is not prope"rly`licensed�and�is not entitled to�p'ermitting prlvileges._in,Pasca,�.LL,,;.r�:,
County. � .:�_ .3.,._�._::,..,�.:��.,
TRANSPGIRTATtON-IMPACT/UTI�ITIES IMPACT AND RESOURCE RECCIVERY FEES:��The unde�signed und�rstands.,;;:,`��
f.;��� ., ���
that Transportation Impact Fees and Recourse Recovery Fe.es may,apply to fhe consfruction.of.new.6uil.clings,.:cFiange�'ofi���`;�.r`,;,,
use �n existing bu�ldings, or�,expansion�of..existing buildings, as specified an Pasco Counfy tJrd9nance number 89=07 and. �;;�';
90-Q7, as amended. The•undersigned al,so understands, that such:-fees,�as'may.;be.due, wiH"'pe�identifiedkat#the=:#im��`af="�`f°;`;�,;
permitting. 'It is furkher�understood that�Transpartation Impact �ees�and Resource`?Re"sovery.Fees must be paid prior to ; :��
rec�iving a °certificate of occupancy" ar final.power release. If the praject does not�involve.a certificate of oceupancy;o�������°:��
final;power rele.as.e;..the:fees.must be paid prior to permit issuance._.Furtfiermore,.=if Pasca County W,_aterlSewer�l;mpact:y,.-�r r
fees are due,.tfiey,must be paid prior ta permit issuance in accardance withrapplicable Fasca Caunty ordinances. � � `
CONSTRUCTIC?N �:lEN-CAitV{Chapter T13;Fbritfa Statutes,as amended): If valuation of work is$2,500.O.O.or mqre,,.i�_�f, i
certi€y that 1, the applicant,. have baen provided with a copy-of the "Fforida Canstr.uction Liett Lau�Homeowner's � ,
Protection Guide" prepafed by the Flarida Department of Agriculture and Consumer.Affairs. !f the applicant�is.someone�,��
other than the°owne�', I-certify that I_have obtained a copy of the.above'descritietl`�document and promise�in,goo,tl`faith:.fo��_� �
deliver,it to.the.'�owner'�,:priar.;fo=cammeneement. - f '
CONTRACT4R'S%CiWNER'S AFPIDAVIT:�_i:certify that all the information in this application is accurate and'that ali�work
will be done in compfiance with a1t applicable�laws regulating r,c�nstruction, zaning and 1and�development. Appticationµis ,
hereby made to obtain a _pecmit to do,swark and installation as�indicated. I certify tha# no work or-instal(ation�Ftas
commenced priar to issuance of a pe�mit and=�that al! work wi!! be per€ormed to..meet standards of aH laws regulating ;
canstruction, County and City codes, zoning regulations, and land development-regulations in'.�the jurisdiGtion. ��!• also
certify that I unders#and that the regulations af other government agencies may apply to the intended work, and that it is ;
my responsibiiity to identify what actions 1 must take to be in compliance. Such agencies ine(ude but are not limited,to:. ''
- .Departmenf of EnvironmenfaC�'Protection-Cjrpress 8ayiieads, Wetland Areas and Environmentaily Sensitive '
� Lands,V1laterMlastewater Treatment. „
- Southwest Florida Water Management Clistrict-We!!s, Cypress �Bayheads, Wetland Areas, Altering t
Watercaurses.
- Army Carps of Engineers-Seawalls, Docks, Navigable Waterways. 5
- Department of Health � Rehabilitative Services/Environmental Health Unit Wells, �Wastewater Treatment, ,
Sept3c:Tanks.
- US Environmen#al Pra#ection Agency-AsbestQs abatement. , •
- Federal Aviatian-Authority-Runways. � .
I understand that�;the following.restrictions apply ta the use of fill:
- Use of f11(is not allowed in F(ood Zone"V" uNess expressly permitted.
- If the fill .material: is to be used in Flood Zone "A", it is unders#ood that a drainage plan addressing a
"compensating volume" wifi! be submitted at#ime of permitting which is prepared by a professianal engineer" �-
liceosed by the State of Florida. '
- If the fill material is ta be used in Flood Zone °A" in connection with a pet�mitted building using stem wail
construction, I certify that fill will be used only to fill the area within the.stem wall. ,
- If fill materiai is to be used in any area, 1 certify that use of such�fill will not adversely a�fect adjacent
praperties. If use of fili is found to adversely affect adjacent properties, the owner may be cited far violating �
the condifions af:the building permit issued under the�aftached permit.application, for to#s less than one (1) Y '
acre which are elevated by fill,an engineered drainage plan is required.
!f I am the AGENT FOR THE OWNER;-I promise in good faith to inform the oHrner of-the permitting conditions set forth Rn
this affidavit prior fo commencing canstruction. 1 understand that a separate permit may be required for electrica! work,
plumbing, signs, wells, pools, air. conditioning, gas, or other installations nat specifically included in the application: A. ,-�
permit issued shal(°be canstrued�#o be a license to proceed with the wark and not as authority to violate; cancel, alter, or �
set aside any provisions af tfie�technicaf cades, nar shatl issuance of a permit prevent the Building t3fficial from ther.eafter
reyuiring�a correction of errors in plans, cansttvction ar violations.of any codes. Every permi#issued st�a11 became inva(id
unless the wrork authorixed by such permit is commenced within six months of permit issuance, ar if work au#horized by '�
the permit is suspended or abandoned for a period..of six(6� months after the time the work is'commenced. An extension. -
may be requested, in writing,.from ttie Building Official for a period not.to exceed ninety(90) days and will demonstrate
justifable cause for the extension. tf wark ceases for ninety(9d)consecutive days,the job is considered abandoned.
I WARNlNG�TO OWNER: YOUR.FAILURE.i'O RECO,RD.A NOTtCE OF CQMMENCEMENT-MAY RESU[:T !N Yt�iUR
PAYING TWICE'FOR IMPRQVEMENTS,:�'O YO.UR:PROPERTY.; !F YQUrINTEND=?Q�OBTAIN�FlNANCING, CQNSULT
- - - --W�'TH YOU�t'!:�(d�E�?-QR-e��!A`TTQRNElf-��FC1R�=R�CORQING YOUR NOTICE�OF�COI6AM NGEMENT.
Fl,ORIDA JURAT(F.S,11.7.03) ' - �
OWNER OR AGENT CONTRACTOR � �
Subscribed and swom to{or affirtned)before me fhis Subscribed and swom to r rmed}before e this � ~
by bu,.--
i Who is/are personally known to me or has/have praduaed Who islare e�s nally. wn to me or has/have produced
as iden�fication. l as identificatlon. .
, �� �7 ° ��
Notary Pub(ic " �G Lit:fC,�t�.A.. Notary Pubtic I
Commisslon No. CommissibFf iVa. �
� _;;�`��� Commission#F�150422 I
Name of tVptary typed,printed or stamqed M1tame of Notary typetl";.p�h'��o,a�,a: N �oY F��i��ren�osooae�-�o�s � i
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