HomeMy WebLinkAbout17-18447 CITY OF ZEPHYRHILLS
� , 5335-8TH STREET
(813)780-0020 18447
BUILDING PERMIT
PERMIT INFORMATION � � LOCATION INFORMATION
Permit Number: 18447 Address: 5900 DOGWOOD ST
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: COLONY HEIGHTS
Est. Value: Parcel Number: 12-26-21-0260-01900-1230
Improv. Cost: 5,926.00 OWNER INFORMATION
Date Issued: 5/05/2017 Name: BLACKBURN THERESA& BLACKBURN B
Total Fees: 65.00 Address: 5900 DOGWOOD ST
, Amount Paid: 65.00 ZEPHYRHIL S, FL. 33542-3862
� Date Paid: 5/05/2017 Phone: � G �-
' Work Desc: A/C CHANGEOUT 3.5 TON
CONTRACTOR S APPLICATION FEES
BAHR'S PROPANE GAS &A/C, INC. A/C CHANGEOUT 65.00
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Ins ections Re uired
DUCTS INSTA LED �
DUCTSINSU ED �
FINAL �- -� �
REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the
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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 pertormed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
� s�����
CONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 I�IONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
� -:8'�3-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
. Building Departrnent
Date Recelved • p p
� P.hone�Contact�for:Permittln C� � �d�- — � �'L�
Owner's Name OQ l Gt� Owner Phone Number o�� ''7� —�L�
Owner's Address aJ-7�v �D- �D� 4� /, Owner Phone Number
Fee Simple Titleholder Name - � Owner Phone Number
,r •
Fee Simpl�Titleholder Address
JOB ADDRESS ✓l DD �B Gu '°.�! LOT# �
SUBDIVISION PARCEL ID# l� a� a� ���o o�9ao ��30
(OBTAINED FROAA PROPERTY,TAX NOTICE)
WORK PROPOSED _NEW CONSTR - ADD/ALT Q SIGN' Q Q DEMOLISH
� B. INSTALL ,. REPi41R
PROPOSED;USE - Q SFR Q COMM Q OTHER
TYPE OF CONSTRUCTION Q BLOCK ' Q FRAME Q STEEL Q
DESCRIPTIOPI OF WORK ��5. �/C (��J�'/v �8�� 3�a Ta� �L,G�'n �1l�YS
�UILDING'SIZE ' SQ�FOOTAGE HEIGHT �
QBUILDING $ VALUATION:OF✓TOl'AL CONSTF2UCTION
QEL'ECTRICAL $ ' AMP SERVICE Q PROGRESS ENERGY Q W:R.E.C.
QRLUMBING $ ' �
QMECHANICAL $ ��2 �a �� VALUATION OF MECHANICAL INSTALLATION
QGAS Q ROOFING Q SPECIALTY Q OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO
BUILDER COMP'14NYr• � ' ' �
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N �
Addres� - , � Cicense#
ELECTRICIAW: : ..COMPANY'� '" , ' , . ,
SIGNATURE � REGISTERED Y/ N FEE GURRE� '' � °tY/'N
Addregs � _. ,,, License.#_,°
PLUMBER ' � COMP.ANY - �
SIGNATURE' � REGISTERED Y.I,.N;' ;_ -•FEE CURREP �. Y�/N. • �
.= ;, . r: _ 5. ; ,'
...... . .
Address „License.# �. � ,
MECHANICAi: ��� � COMPANY. ���"� �S �'6f�A"N�C�/-5 t�e- �1�I�
SIGNATURE � REGISTERED Y,L.N , , -;FEE CURRE� - Y;/:N,• .
Addreas' ;..; 7�7/ �� c�N . ' � License#� � . .��J��
OTHER " � ` � � ,COMPANY - �
SIGNATURE -� - ' ' REGISTERED ` . Y/ N .. FEE CURRE� Y/N
Addre� ° - " ' ' " ticense#�
: _ .-. -• . - : .
RESIDENTIAL;� Attach''(2),;Plo.t%P,lans;(2)'sets:of�Building Plans;`(1)`"set of Energy>Fortns;R-O-W�Permlt for new constructlon,
� � �:;Min(mum,,ten�(10),working;days after_"submiftal date:`:Requlied onsite;.ConstruoUon.-Flens;Stoimwater Plans w/SIIt Fence installed,
" ` Sanlfary�Facilities&:.1:,dumpster Slte Worlc;Permit for,subdivisio�sAaPge:projecfs:-.. _.��_;_ ' � � �
COMMERCIAL Attach(3)�complete"set`s"ofBuiltling Plan's plus a Life Safety Page;(1)set of Energy Fortns.R-O-W Permit for new construction.
Minimum ten(10)workfng days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary FaclliBes&1 dumpster.Site Work Permit for all newrproJects:.All commercial requlrements.must meet compllance
SIGN PERMIT Attacfi`(2)�sets ofEngineared-,Plans.;< --�s�°� . . - ' ' � �
""PROPERTY SURVEY reguired for all,NEW constructlon.. •
Dl�ectlons: � ����' �� � �
Fill out applicaUon completely.
Owner 8 Contractor sign back of appllcatlon,notarized
If over�2500,a Notice of Commencement�is requlred�. (A!C upgrades over 5T500) _
" Agent(for ttie conVactor)' Powe�o�e�t�,q�ey r�t,�j,e owner yypu �ie meone with nota�ized letter m ovu�ey�} ��fne ,,:,,��: :�
�� s v ��s._,.
�Y�,t kq.. J�C";.:...�.``� . ..
OVER THE COUNTER PERMF NG - ' ('�1bnt�f'f�A$►511t�bnz��'�'`q��' � ; ' �i„
RS�`�l�Q. ,y 4.`� >hi7ei�ta�4cd2-3ii��7�t�lt�vt _..�/y�
Reroofs if shingles Sewers� �'SenRce'l)pg�ade�!r1�YCd''�+ s°F� (�' USurvey/Footage) 1 FQ5.�f E;tL 2�3!i�Y:�.r7lfitq��F,3 _•f;_Y : , .: I
''!" 14 rp •�,�;_�:3 "% �� Q����t�"z7 tit-Rt1t8�;tif;a3',n;.`
Drivewaya-Not over Counter if on public roadways.:needs ROW�;,;��•'� .'�8s�d{gtC4?�ar.t�;f����,�:�1T?,sc;r•.:` ��' -
- sc;:^...,��s�:�...u�a`�'''�� ' .'�''�'�`'tiy".-���:�a,,qp,..�:,•"'y
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NOTICE CiF DE�D RE�'TRIGTIONS: The underslgr�ect under�ta�nds�;th�t:thls:p�mtlfmay:be,sub�ect;to,"deed"r+as#ric#lons"_....v .�..,
which may.de�:more:�rest�ictive�tha�'County regulatfons:�Th���underslgned'assuMesx'responsfblltty for�coimpliance with��a�y` " `� �� '
appiicable'deed rest�fctlans. -:.�=ry.:;- ;,.� . .� . • .. F. ._ , ..,_ � � ..
UNLICENSED� CONTRAC�'ORS�.AwD CONTRACTaR .R�SP�NSI�ILiT1ES: -df-the��awner has���hired"a"aintrac#or or
contractors to unde�take work,tkrey may�,be..requl�ed��to.:be-wllcensed In,accordance.anti@h state.and�local„,r,egulatlo.ns:��If the����- ��
contractor is na# licensed:-as'-requlred;liy taw,:bi�th-the owner and�cori#sactor��r»ay be�ctted�for�a tnlsd�meanar vlotation
under state taw. If the owner or intended?`contra�tor�ere�uncertain as to what Ilcensing.requlrements.;`may��apply:ior'tiie � • ���
Entended wcirk,tFiey are advised to cantaci th�_Fasca County,Buiiding�inspection:Dlvlslon--l.Icepsing�Sectlon e�t 727-847-
Soq9. Fur#hermcire, if the awrier'Pias hlred a conhaotor�or contractors, he is advlsed to have the contractor(s),, sign . , . ,
portians of the "contractor Blook" of,this�application,far..whfch,they,wiU�be�tesponsible.- �If you�=as-..#he 6wner�`stgn'as tfie`
con#tac#or, tha#�may tie an indicatl±an thaf`he=1s iiot properiy'llcensec!'�oid"I��nart en#l�ed'to perri�itting ptivileges ln Pasco
. �. , ,
County. � � 5
TRANSP�RTATIQN:IIUfP/s►�TtUTil:iTiES�rMPAC'�A�1b R�l3QURCE RECQYEEtY��EES: The undersfgriediinderstands
that Transportatlon Impact Fees and.Reca.urse Recove.ry.Fees may�,app1y:�to�ti�e;consiructian,.of new,b.uildtngs,rchange-�of"-� �= "'
use in existing buildings, or.�.expansl�n��o��ezlsti�i�:`.buildings� as speatfled.in P�sco Caunty Ordinance number 89-07 and.
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90-07. as amended.,...The undersign�d also,understands� tha�E�such fees,;;as,-may��e•:due;,wil1.�.6e idenfi�ed at fhe•`t3irie;:of-; ..,.-`; �`"A
permitting. It is turtHer understood that Transportation impact Fees and��Resource;Reao�ery�Fees mu�# be pald prlar to
reaetving�a"cert�icate�of occupancy"or-final��powe.r.=celease:..,:lf�the pro��cf::does,no��lrnrolve>a�a�.cetti��ate of accupancy.,o�,;::;, , « -
flnal power release;�the'.fees mus�#"�be pald,prlor to.permft Is��uance. Fu�thermare,•if Pascv:County'INater/Sewer�;impact --•-�
fees are due;.they�must.be,pald:,p�tar,ta.permlt�lssuance'In accordancewitt�.:appllcabte Pascp�.Gounty'ortllnances. �
CONSTRUCTiON CIEN�LAVIi;(Ct��pter T13� Flortda Stat�t���as amenc�ed): if vaturation of work is�2�500.00,or more,.t� : � ��<-
certify that I, #he. applicant;. hav.e-been provided with�-a-capy< nf the�."Florida� Constructlon: Lten�:Lavu=Homeove►ner's
Protectlon Gulde" prepared by tFie Flor�da Qepa��nent af Agrtculture and Consumer:Affalrs. If the sppllca�t Is sa'meane .,.
otherthanthe"owner", Icertify.that,lh�ve�obtained�a'c'opy,of:#he:above..des,cribiadd''acui�ent=and:promise�in,gaod::falih�to .,,,
deliver 1t to:_the"owne�'p�ior:to'�commencement:�'� � � � :-
CONl'RACTOR'S/OWNER'iS AFPICMAVIT. i.cer•kify,;tii;at.ali:.#he�lnf.ormatlon:.in�thl.s appllcation is accurate and that ail work
will'be dane in campliance with all.appltcable�laws regulating constructlan, zoning ancl�land�develapment. AppUcatlon is
hereby made.to. ob#atn .a.petrrti#:;to,.do.woifc.:,��nd�-lnstalla#ion $s Indt�eted.. '1, ce�tifjt ttiat no wark�or tnstal{ation has
commenced p�lor to Issuance of a perrriif"and that.all work will be perto�med�to meet standardsmof all laws regulating�
consiructfon, Counf� and City codes, zoning regulations, and land devetopment regulaEions�In the�urlsdtction.-�i :a1'so
certify that I u�derstand that the regulattans of ofher government agencies may�apply�to the intended work, and that it is
my responslbilily to identify.what.actlans!must kake.:to,be,tln:.con�p!lar�ce:,;,5uch.agencies inciude but�are.not limited to: �
- Departmen# of Er�vironmentai�Protection'-Cypre`ss.`8ayhead�, Wetland 1�reas and Environmentally Sensitive
Lands,WatedWastewater Treatment.
- Southwest FIOI�CIa Water Managemerit::I�istNat:Vltells; �Cypress.'_8ay.heads�; Wetiand Areas� Altering
Watercourses. .. a •
- Army Corps of Engtneers-Seawails;`Docks,Navigabte iNaterways.
- Depaetmen# of;Heaith�,:8.Ret�abilita#iv�..ServicesJEnvitonmentai .Heaith Unit Weti.s� Wasteuu�r�ater�Treatment,
Sepkic.Tanks:..:" ' � � - :
- US Envlronmentai�Protec�on Agertcy-Asbestas abatement.:- ,
Federal Avlatlon:Authorlty=Runways.� ' _ _
�!understand tt�at the.foNowirig.restrictlons appiy`to the use of flll:•
• Use offillis not atlowed 1n.Flood>Zone�V"unless expressiy permttted.
- if the :flif material��(s �to be used_:�In.:Flvad=Zone. "A", (t�is understaod #hat a drainage plan addresstng a
"compensating va�tume"wiil be submttted at#ime of=.permifting w�iich is prepared by a professianai engineer
Iicensed by�he 5tate of'Flo�ida. � � �- � - . _ _, -
- Ef th� f�li-materlal�Is=to be.used In Flood Zone 'A° In�connection�witti�a permltted btaitding ustng stem wa11
constructiqn, I cert(fy.th.at flll:wlll:b.e u�ed only.to.fill the.area within the�stem-�wall: _ • ,
• !t fill materla! Is to be use� In any a�ea, 1 �cettll'y t�tat .use of such�flN w141 not adversely affect adjacent
properties. tf use of fil) is found to adv.ersieFy.:�ffect adjaEeat`�pr�per#tes�.#he owner may be cited for vtolattng
the condi�ons of the bullding;permit is"sued-under tfia attached�ermit applicatlon;�far.lots-:less.than one (1)
acre wh3ch are elevated�by fflt�a�t engineered dralnage ptan is�eguired.
If I am the AGENT FOR THE OIMNER, I�.promise In gaod faith to infarm°#he�owner of-the perm(tting conditlons set farkh in
this affidavlt�pr4ar to commencfng const�actlon. �i u�derstani!that a=s�parate permit may be reqult�ed for eteat�Ecal work, � ,
plumbing, signs, W8$S�,poot8�, 811'.conditianing,.gas� ar,.othec instatt�tions no1.spec�i�lly included�in the apptication. .A
permit Issued sha�ll be canst'tued to be a�Hcense to pmaeed with thie work�nd�not as:authoNty:to,vlolate;.:canciel; al#er. or
set aslde any�provlsians af ttie technlcal.codes;�nor shalt Issuance�of a.petmit.pceven#fhe 8u1ldtrig t3�cial from therea�tec
requiring a,correction af enors in.plans; construction or violatlans of-any codes: Every��p�ermlt lssued sfiall'becbme inval(d
uhless #he work authorized by such permlt:3s-cornmencedw3thin s�t.months af�permlt Essuattce, or If wotk authorizeci by
'the perrtrit is suspended or:abandoned:•for.�.;periad of�sU�fH)monfE►s.efler#he tirne�the�avork�is commen�ed. An extension
may be requested� In writing�:from ttie Bullding,C3iflciel for a� petiod.•not#o-exceed�ninety�(90��days a�d�wiA demonstrate
�usttftabte cause for the extenslon: If work ceas�s.for nlnety,{90}cons.ecu#Ive:days...the�ab�Ps considered aba�doned.
WARNlNG T4 CtMtNER: 11OU1�-�FAILURE�TCI,RE�QttD:d�1.NOTtCE:OF.�CQMMENCEME�+tT.Mie1Y=RESULT IN�YQUR
PAYIIVG TVVICE:�OR..IMPROVEMEMTS,Tfl YOt�R�:PR�PER'IY: �IF°YOU�IIV�'�E�D:TQ:'OBTAiN��FIN�►f��fNNG;�ONSULT
-- 1MIT lJ :O. AN TTO N �� �'C1RE�RE�A.R� f:<YQU ' • �� ' -: °..' E�Y! � � --
FIORIdA JURA�:{F.S; .7.03} � �- � . ' - � _ ' . _
OWN61t OR AOENT ,�/»�-C, "- - �i GgM1'RAGTO �/�.._
Svbscrlbed and swom or atflnne be re me thfs Su�s bed and'swo aw aNtrmed}'betore me#til�
- -!? v"Yl I s r-- S� 7 �
Who Islare nat y knovm me or;haslhave produced Who.lslare p. rsonally kno. , me;or haslhave�produoed � .
as Identl�ca8on, as idanl�3cs�ttan.
i . � �
� � t..__I.L... s .
� ubilc . ry ` Notary Public
aunh, V!A A,.CAMP�ELL, / � �a��N�a &YI.YFA A,CAMPBEI.L�
Go is or� ., �`'w'�r. Co�b�tttsslon. : �'� 4
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� ti, _ ' �c My Comm.,Expdres Jul 1�,2017 � '� •� My Comm.Expires'Jut 19,2ot7
�8tii@ O� �ry r PBotided i�0111��O�iiy�Slfl. Name of Nota � ��n�nu��' $0 de h OUQh h3ti0�2 Nnt2ry Ass�t
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-��� - �t�� � � �
s � ' "' PROPANE GAS r�,����� prder�Proposal - •
d AND AfC rrvc. v ,
��ce�988 ���;.7g�,�,�p�,� � Invoice
. . �,��i��; C�;:1��F��� `�F�V.I'�,r:1�iCtfv "7����:i .��f-1�-;
Sales Service & Installations � �r�?��}-rE���r r�r_�` �r}�F�,E.h� .i�i.�+/k°+E.- 1? 1��a _,i
' ��E'1F',,��� I?� �.i= i�}G�
444� Allen.Rd. � Zephyrhi(I�, FL 33541 r7�;;-r- ; ���,;.1��.� ��rati�i-5�!1���_:r; ���:� ��;�;:,-;.? �;�s.�:�}�.�
NOTES:
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c��1�t i1������la�� ::�� t�..�1�R��1 �)f Ji=):r�it���� 1�
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�.ii�.��'�{�{�� �^��•���_�t� {_{����. � •
. ' < . . DESCf23PT1{,}tV QF-WORK�� . � , ',, QTY. MATERIA�S&SERVIGES. � NIT PRICE AMOUNT
..
.._.____._.__...._. ..___._...---._.__ .. _ ,_ .._.__._._.... .. . _.._..._ _._.... _-- _ --_.._.�.._. _._., ..----._.�_.--.-- _._._..__. .- .- - --•-- _ _. _ ___. .. __..
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' � ' � ' - ti,`? ��(,�(J , �l::�t-(��� t.,��:�1�'�_1�.LG.� � �
- �cl a� v/�� �' a t�' " � � �
, �
y� ,�v £� £ , ' � �G.'G4
. , RECOMMENQATIONS ' �i`'I.r r7�.,(�'� i ��,,,7�!
nual`Maintenance�Recorrimended by All Equipment Manu urers, ' �
. - . � Pressures Lo Fff T-Stat _ E t
i i
- REFRIGERAN . $per Ibs. � I
� f � A
FILTER$ x x Changed Monthly I. I
, r ' FIITERS X x Changed Monthly � �
y
C] REGULAR ❑WARRAN7Y TOTAL SUMMARY ' _
umidistat,Settings: When here"OGI,',`When Away 60°l0,.T-Stat 80° ❑ MAINTENANCE CONTRACT SERVICE i
EOWARRANTY: Atimateriais,partsandequipmentarewarra�tedbythemanufacturers' � METHODQFPAYMENT CALL "' i i
Iiers'written warranty aniy.AII Iabor performed by the above named company is warranted for , , (
or as othenvise indicatetl in writing.The above named company makes no olher warranties, ❑CASH •0 CK# TOTAL i
ar imptied,and its agents or technicians are not authorized lo make any sucti warranGes on MATERIALS i
0 DEBIT CI CREDIT ❑OTHER MAINTENANCE �
f above named company. �
u�horily lo order the wo�k ou�lined above which has heen sal(sfaclorily completed.l agree lhat Seller PROG. W / C
tlg to equipmenUmaterials fumished until final paymeat is mede.11 paymenl is nol made as agreed, CLAIM# I �
n remove said eqssipmenUmatenals at Settefs expense.Any damage resuifing fram"saitl removai shait �
e responsibiliry ot Seller,NET 30 DAYS.A 1 1/2°!o SERVICE CHARGE WILt BE ADDED MONTHLY TO DAY� COMPLETE� -----���—� —
AID BALANCES OVER 30 DAYS.NO REFUNOS "
TECH: T�� ,
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��i2�c ��cc TOTAL �: i=;��I r � t
ER SiGNATURE DAtE
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