HomeMy WebLinkAbout17-18399 CITY OF ZEPHYRHILLS
� y 5335-8TH STREEf
(813}780-0020 18399
BUILDING RERMIT
PERMIT INFORMATItJN LOCATION INFORMATION
Permit Number: 18399 Adclress: 37520 GILL AVE L.OT 277
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CNANGEOUT Township: Range: Book:
Proposed Use: MOBILE HOME SUBDIVISIt�N Lot�s):277 Block: Section:
Square Feet: Subdivision: GRAND HORIZONS
Est.Vatue: Parcel Number: 34-25-21-0014-02800-2770
Imprav. Cast: 3�'��' � OWNER INFORMATION
Date Issued: 4l2112017 Name; BRC?WNS4R� DAV1D & GA1L MARIE
Total Fees: 55.00 Address: 37520 GILL AVE
Amount Paid: 55.40 ZEPHYRHILLS FL 33541-7794
Date Paid: 4/21J2017 Phane: 407-572-1398
Work Desc: A!C CHANGEOUT 4 TON
CONTRACTOR S ' APPUCATION FEES
BAHR'S PROPANE GAS &A/C, INC. A/C CHANGEOUT 55.00
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Ins ections Re uired
D TS IN�aTA
DUCTS INStJLA�ED.�c�'',
FINAL �S' �^-��
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REINSPECT'ZON FEES: (c)With respect ta Reinspection fees will comply with Flarida Statute 553.80 (2)(c)the
locai government shall impose a fee of four times the amount af the fee imposed for the initiat inspection or
first reinspection,whichever is greater,for each such subsequent reinspection.
NOTICE: In addition to the requirements of this permit, there maybe additianal restrictions applicable to this property that
may be found in the public records of this county, and there may be additianal permits required from other gavernmenfial
entities such as water management, state agencies or federal agencies.
"Warning to owner: Your failure to recard a notice of commencement may result in your paying twice for
impravements ta your property. If you intend to abtain financing,consult with your lender or an attorney
befare recording your notice of commencement."
Complete Plans, Specifications Must Accompany Applicafiion.All work shall be performed in accordance with
G Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NQ OCCUPANCY BEFORE C.O.
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CONTRACT R SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 M4NTHS 1NITHCIUT APPROVED INSPECTION
CALI. FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PRUTECT CARD FROM WEATHER
s�aaso-oozo City of Zephyrhills Permit Application Fax-813-780-0021
�,=,,� • Building Department
Date Received �L� ��� _ �Q`�
Phone Contact for Permitting •
Owner's Name �7�L����Lb ROG��.�f.� Owner Phone Number �b�" �o�'����
Owner's Address J �� !� " U� Owner Phone Number �
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS �/�c�D �l� ��/G, �L/' DI`Y Z4/�7 LOT# �
SUBDIVISION PARCEL ID# �"�` �J ���"'�L��^�� ���v
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEw CONSTR ADD/ALT � SIGN Q Q DEMOLISH
INSTALL REPAIR
PROP..OSED USE Q SFR Q COMM 0 OTHER
TYPE'OF CONSTRUCTION Q BLOCK - Q FRAME � STEEL Q
DESCRIPTION OF WORK � e (/ Z� 2 D-LL� � �D/V J�j4 �1� ` G�'Cfr11 Q/�
BUILDING SIZE SQ FOOTAGE HEIGHT
OBUILDING $ VALUATION'OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $
[�MECHANICAL $ �� � VALUATION OF MECHANICAL INSTALLATION
i
QGAS Q ROOFING Q SPECIALTY 0 OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
ELECTRICIAN COM PANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# � �
PLUMBER, COMPANY
SIGNATURE REGISTERED Y�/ N FEE CURRE� ' Y/N
Address License# �
MECHANICAL �� � COMPANY �f�/2 S� A�/�/r� ��'%�--
SIGNATURE REGISTERED ;�i .Y/ N FEE CURRE� Y/N
Addre§s - `Z'��1 � '` ��/L�` , Licens.e.#. �.!TC--� �'�✓� /�`t
OTHER• � COMPANY .
SIGNATURE�- � � REGISTERED , Y/.N-. FEE CURREk .,.- Y./N
Address � ,.� � License#
RESIDENTIAL Attach"(2)'Plof P.lans;(2)sets of�BuildingPlans;'(1)'set of Energy Forms;R,O-W P.ermit for-new construction,
. Minimum�ten.(.10).inrorking;days after.submittal,date. Required onsite;'Constnictlon Plans,Stormwater Plans w/Silt Fence installed,
. Sanitary Facili6es;&�-1��.dumpster;Site Work Permit for.subdivisions/large projects �� - �
_ .� COMMERCIAL Attaeh'(2)�complete sets of Building 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,
Sanitary Facilities 8 1 dumpster.Site Work Permit fo�all new projects.All commercial requirements must meet compliance
- SIGN PERMIT Attacti(2)sets of;Engineered Plans.•
• "'*PROPERT`f SURVEY required for.aII.NEW.construction:
Directions: �• ._ :•
Fill.out application completely.
- Ovirner&ConVactor sign back of application,notarized
If over$2500,a Notice of�Commencement is requlred. (AIC upgrades over$7500)
" Agent(for th'e�cont�actor)�or�Power'of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER �:,�,�r�.(aop�iPof:cseatStra�f-r€�uil�ed f +����.��e��-lu�����,�.:�
,��Reroofs ifshingles ewers.t�#?;:�?r5ervice 0 rades A/C"''".Fence PI .����`���_� '?��;y.iy'� ,"':"��,,,, ,
pg s( oUSurvey/Footage) ,. . ,��
s.b;rG;i�ID�f::l. .N+:icl' ;�u;i,�r; : �:"�.�..� � ;.: EiT1;u1Z;U Siai: :�uf�tt�3 V:tt;�tf �._•aF�.':
1 �� n;�!" ;7
Driveways-Not ov Gou ter if=on:public roatlways.:nbetls.'ROW�• ,! c I.!�.�:S I�!�~ou��z� cr•:��n:�yr,i _ 9 ''� ;� _
n � �sy�. . �' .�K�4i'�g� f,,:
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't?^.. 'u}:.�t'.'Cu,�.`ir.4'�il�^�Ff,tib."•Jcnij ��':,,,��;"�`�, }c" �iG2l�5'{)��ill:�i�i�i::1.:5ir:�t'.G111?�li:Ci�CEl ���"•:.�eai.N�t•
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NiJTICE OF DIEED RE�TRtCT10NS: The undersigned understands that this permit may be subjec#to"deed" restrictionsn ,'
which:may,-be,moretrestrictiue than County cegr�lations: The.undersigned-assumes��r�`sponsibilit'y'•for`compiiance witF�`any
applicable deed restrictions. ' �-
UNLICENS�D-CONTRACTORS AND CQNTRACTOR RESPONSlBlLlTlES: If the owner has-hireii a contractar or
co'ntractors to undertake work, they may be required to be licensed in accardance with state and local regulations. �lf:the-
contractar is nat licensed as required by law, both the owner and contractor-may-4be cited'for�:a misdemeanor violation �
under state law. If the orrvner or intended confractor are uncertain as to what licensing requirements:rnay apply�for;:ttie.y���
iniended wark, they are advised to coritact�ihe Pasco County Building`tnspectian�Division=Licensing Section a#727=847- �
8QQ9. Furthermare, if the owner has hired a ccintractor or contractors, he��is advised to 'have #he contrac#or(s}, sign ,
portions of the "contractc�r Block" of this application for which they wiH be responsible. !f you, as tFie�owne� sign asy`the � '
contractor, that may be an indication that he is not properly licensed and is not entitled�to permitting privileges in Pasco
Coun#y. _ .. ` ` j
TRANSPORTATION IMPACTLUTiLiTtES 1MPACT AND RESOURCE REGOVERY FEES: The undersigned understands ;
that 7ranspartation tmpact Fees and Recaurse Recovery Fees may,app(y ta the canstruction of new,b,uildings, ciiange�6f � ��
use in existing buildings, Q!' @Xp1f1S10t1 Of @XiSttfl�I}UIIt�IC1gS, as specified in Pasco County Ordinance number 89-Q7 and ;
90-07, as amended. The undersigned_alsa understands, tha#such.fees, as may be dus, wil! be identified at�<tlie time�of��
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to '
receiving a "certificate of occupancy° or final power release. lf the projec#daes not involve a certificate af occupancy�or: �
finai power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer�lmpact� �
fees are due,they must be paid priar to permit issuance in accordance with applicable Pasca County ordinances.
C4NSTRUCTION LIEN LAW(Chapte�743, Ftor�da Stat�ates,as amencfed}: If valuatian of work is$2,500.00.or moce, 1 ..
certify that !, the applicant, have been provided with a copy of the "Florida Gonstruction Lien Law�Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someocne
other than the"awner", I certify that I have obtained a copy of the above described document and promise�in good"'faith to
deliver it to the,"owner"prior to commencement.
CQNTRACTOR'SIOWNER'S AFFIDAVIT: I certify.that all the infarmatian in this applicatian is accurate and that ail"work
will be done in compliance wi#h a!! applicable laws regulating construction, zoning and land development. Application is
hereby made to obtain a permit to do work and insta!lation as indicated. 1 certify that no work or installaticin has
commenced prior to issuance of a permit and that all work will be pertormed to rneet standards of a!I laws regula#ing
construction, Caunty and City codes, zoning regulations, and land development regula#ions in the jurisdiction. I also
certify that 1 understand that the reguiations of other government agencies may apply to the intended work, and that it is
my respansibility to identify what actions I must take to be in campiiance. Such agencies inciude but are nat limited to: `
- Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmeritally Sensitive j
Lands,WaterMlastewater Treatment.
- Southwest Florida Water Management District-We!!s, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps af Engineers-Seawalls, Docks, Navigable Waterways. '
- Department af Heaith & Rehabilitative Services/Environmental Heaith Unit Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestas abatement,
- Federal Aviation Authority-Runways.
I understand that the fo�lowing restric#ions apply to the use of fill:
- Use of fill is not allowed in Flood Zane"V" unless expressly permitted.
- 1f the fill material is ta be used in Ffaad Zone "A", it is understood that a drainage pian addressing a
°compensating uofume" will be submitted at time of permitting which is prepared by a prafessional engineer �
licensed by the State of Florida. �
- If the fill material is to be used in Flaod Zane "A" in connection with a permitted building using stem wall �
construction, I certify that fill will be used only to fill the area within the stem wall.
- If fil( materiat is to be used in any area, 1 certify that use af such-fill will not adversely affect adjacen#
proper#ies, If use af fill is found ta adversely affect adjacent properties, the owner may be ci#ed for viaiating
the conditions af the buiiding permit issued under the attached permit.app(icatian, for'iats less than one (1} ,
acre which are elevated by ftll, an engineered drainage plan is required. •
If I am the AGENT FOR THE OWNER, I pramise in good faith to inform the owner of the permitting canditians set farth in
this affidavit pcior to commencing construction. I understand that a separate permit may be required for electrica! work, �
plumbing, signs, we11s, pools, air conditioning, gas, or ather installations not specifically included in the application. A „
permit issued shatl'be consfrued to be a ticense,to proceed with the work and no# as authority ta vialate, cancel, a(ter, or
set aside any provisions of the technicai codes, nor shalE issuance of a permit prevent#he 8uilding Officiai from thereafter ,
requiring a correction of errars in plans, canst�uction or violations af any codes. Every perrnit issued shail become invalid '
unless the work authorized by such permit is commenced within six manths of permit issuance, or i#work author9zed by
the permit is suspended or abandoned far a period-.of six(6) manths after the time the work is commenced. An extensian �
may be reques#eci, in wri#ing, from the Buildirig Offioial for a period.not to exceed•ninety (90) days and will demonstrate
justifiabte eause for the extension. !f wark ceases far ninety(90}consecutive days,the job is cansidered abandoned.
WARNING TO QWNER: YQUR FAILURE TO RECQRD A NOTICE OF C.OMMENCEMENT MAY RESULT tN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY..!F YOU�INTEND TO QBTAlN FINANClNG, CONSULT
—_ .__-lMiTH YQtIR_�:ENDEFt_012AN AT_1'ORNEY BEEORE RECQRDING YOUR NOTICE OP C4MMENC�MENT.
FLflRtDA JURAT{P.S . 3) � y - �-- --_ -�J ^
C_.�-- t
OWNER OR AGENT 4 f,�� CONTRAC70R � Q��
Sy cribed a d swom to a�rrned)before e tfiis S�y,�scribed and or�i.to(or affirmed}before me this
� 02/-/ 7'` -t'7 L, rs�.t �
o is/ e ersanally known me or has/have produced ' Wha is/are rsonally kno me or has/have produced
as identificatian. as identificatian.
,,,,, �iNotary Public Natary Pubtic
C mission No. Commission No.
+y��+�+a SYIVEA A.CAMPBELI. �~1RY Ali� SYLVIA A.GAMPBEfI.•
�J��,P�pU�� ���� UB���'.
hlame of #�! `�fti � Name of Notary ty �d�a' ot�
•a M Comm. pues Jul 19,2017 �n Expires Ju1.19,2017 �
;� �g y %9 �q,' Gommission�FF 034230
, Commission#�FF 034238 .,,�o���op.'
�'•�t°;U•�~ Bonded Thioupl�N�itan�l Hotary Ass�. ' Bonded Through National Notary Assn.
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;AnnuafiMamtenance Recommended;by;All Egu'ipmentManufacturers.-:_:�' ' E-�-.m.:�`y�:�;��=°��-�:�3r;���<,.�,j:'
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,.,,,::,. , . r Pressures Lo HI TStat "� �� �•:- •.:;.: i
P � �REERIGERANT.R- - _ - LBS. _ ='_$Per ibs. � . -:f ':;. • I
T' �� � Q � '� � - - - - _1� • I
FILTERS x x Changed Monthly I I
FILTERS x x Changed Monthly � �
❑ REGULAR ❑WARRANTY � � ,TOTAE;Sl1MMARY� _
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-DehutDidistat�Settin9s: -When here"ON"t;When Away 60° ;�T-Stat 80° ❑ MAINTENANCE CONTRACT SERVICE ' i ,
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LIMITED�WARRANTY: NI materials,parts and equipment are warranted by the manufacturers' �� _ -`METHOD'OF,PAYMENT �` _-_- CALL i
or suppliers'uVritten warranty only.All labor performed by the above named company is warranted for `" TOTAL I
30 days or as othenvise indicated iri writing.The above named company makes no other wartanGes, ❑CASH ❑CK# MATERIALS i
express or implied,and its agents or technicians are not authorized to make any such wartanties on
behalfofabovenamedcompany. ❑DEBIT ❑CREDIT ❑OTHER MAINTENANCE �
� PROG. W I C �
I have authonty to order�he work ouUined above which has been satisfactorily wmpleted.I agree that Seller
retains htla lo equipmentlmaterials fumished until final paymenl is maEe.If payment is not made as agreed, CLAIM# �
seller can remove said equipmenUmaterials at Seller's expense.My damage resulling trom said removal shall
AILb NPAID BALANCES OVER 30 DAYS.NOYREFUNDS/SERVICE CHARGE WILL BE ADDED MONTHLY TO DATE COMPLETED '
` TECH: T� �
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CUSTOMERSIGNATURE DATE ✓�l�sV/I?L ✓ou TOTAL I