HomeMy WebLinkAbout17-18540 �
- - - CITY OF ZEPHYRHILLS
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5335-8TH STREET
(813)780-0020 18 40
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 18540 Address: 5509 12TH ST
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-13800-0030
Improv. Cost: 6,157.00 OWNER INFORMATION
Date Issued: 6/02/2017 Name: GILLIARD ALEXIS
Total Fees: 70.00 Address: 5509 12TH ST
, Amount Paid: 70.00 ZEPHYRHILLS, FL. 33542
Date Paid: 6/02/2017 Phone: 813-377-5089
Work Desc: A/C CHANGE OUT 2.5 TON SPLIT SYSTEM
CONTRACTOR S APPLICATION FEES
RON IERNA'S HTG & COOLING INC A/C CHANGEOUT 70.00
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Ins ections Re uired
DUCTS INSTALLED
' DUCTSINSULATED
FINAL -� ---
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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.
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� C NTRACTOR SIGNATURE PERMIT OFFI R
' PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED ,
��I PROTECT CARD FROM WEATHER I
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Nikole Brown
From: HVAC Proposals <proposals@hvacproposals.com>
Sent: Sunday, May 28, 2017 11:52 AM
To: charlene1010@verizon.net; sherrip@iernaair.com; heatherb@iernaair.com;
nikoleb@iernaair.com; patrickk@iernaair.com
Subject: Proposal Status Changed to Won
The below proposal has been updated with a status of'won'.See details below to process order:
Title 2.5 TON AIR CONDITIONING
Opened Date 05-28-2017 ,
Closed Date 05-28-2017
Install Date 06-02-2017
Customer Alexis Gilliard
5509 12th Street
Zhills,FI,33542
Tel:(813)377 5089
Alexis.gilliard@yahoo.com
Sales Rep Corey Gracey Coreyg@iernaair.com
Units Added Special Parts Common Parts Services Added Upgrades Units Purchased
Added
[] 10 YEAR WARRANTY ON PARTS/COMPRESSOR.,
[]Permit and inspection,
[]Tie into existing duct work,
[]Clean and reuse existing supply and return
plenums, ,
[]New Electrical Whip to Condenser,
[] New hurricane code condenser pad and anchor
kit,
: [] []Flush and tie into existing copper refrigerant line
1166NA030000, ��TH6220D1028 []MISC-100 set, 1 Budget Systems
[] []New liquid line filter drier for refrigerant, []None uoted
, FFMANP030000, ; *1 Parts*1 ��qdd/Remove refrigerant of proper operation, 4
[]CE0412N04 []Tie into existing 220v electrical wiring,
[]Tie into existing 24v electrical wiring,
[]Disposal of equipment,
[]New low voltage wire from air handler to
condenser and t-stat to air handler,
[]New Disconnect Box and Electrical Whip to Air
handler Includes electrical permit,
[]Condensate pump,
[]Turnsfee
Single Stage Scroll Compressor 100%Satisfaction Guarantee! 1 year Labor warranty 1 year preventative Maintenance
Agreement Using turns Financial for$6,000. Have to pay$157.00 upon completion,
To View the HVACopcost.com website-CLICK THIS LINK! HVAC Opcost.com is an independent website. The results of
savings from one system to another may vary and lerna's Heating and Air Conditioning cannot be held accountable for
those same results.The results should be considered as a representation of expectations. �
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1.To view our website-CLICK THIS LINK!
2.To view testimonials about our products and services-CLICK THIS LINK!
TERMS & CONDITIONS OF AGREEMENT
1. Purchaser hereby accepts the equipment and services described above and agrees to pay lerna's Heating and Cooling
Inc the price shown above.
2.All equipment and material are guaranteed by lerna's Heating and Cooling Inc to be as specified.All work will be
completed in a workmanlike manner according to normally accepted practices.
3. Materials and work in addition to that described herein will be furnished only on Purchaser's authorization and will be
paid by Purchaser as an extra charge.
4. Upon failure to pay any sums due hereunder, Purchaser agrees to pay lerna's Heating and Cooling Inc interest at the
rate of one and one half percent(1%%) per month (annual rate of 18%)on all outstanding balances.
5. lerna's Heating and Cooling Inc shall not be liable for any default caused by events beyond its control, including but
not limited to,fire,flood,strikes, accidents, or delays affecting this work or other operations in which it is involved,
directly or indirectly.
6. Purchaser shall permit lerna's Heating and Cooling Inc reasonable access to the property on which equipment is to be
installed.Title to all provided equipment remains with lerna's Heating and Cooling Inc until all amounts due thereon are
paid in full, whether such equipment is affixed to the realty or not, and shall remain personal property and be deemed
sever-able without injury to the freehold. On any payment default by Purchaser, or if in lerna's Heating and Cooling Inc's
judgment, reasonably exercised, its equity appears to be imperiled,then, lerna's Heating and Cooling Inc may without
further notice enter the premises and remove or resell the equipment,and Purchaser shall be liable for any deficiency or �
loss sustained by lerna's Heating and Cooling Inc in connection therewith.
7. Once equipment is connected at Purchaser's property, Purchaser assumes all risk of loss or damage to such
equipment and shall insure same fully to protect all interests of lerna's Heating and Cooling Inc, cost of insurance to be
paid by Purchaser. lerna's Heating and Cooling Inc carries liability insurance and Worker's Compensation Insurance.
8. lerna's Heating and Cooling Inc provides a one-year limited labor warranty. Equipment or system failure due to lack of
proper maintenance service or abuse is expressly excluded. Normal maintenance check-ups and filter replacements are
the responsibility of Purchaser.All other warranties, expressed or implied,are the responsibility of the manufacturer of
the equipment, parts, or materials used in connection with the services. 9.There are no warranties, expressed or
implied,for existing equipment,ductwork, or other materials not installed by lerna's Heating and Cooling Inc.
10.All warranty work will be performed during lerna's Heating and Cooling Inc's normal working hour 7am to 1100 pm 7
days a week, parts subject to supply house availbilty
11. Purchaser is responsible for all costs and reasonable attorney fees incurred by lerna's Heating and Cooling Inc in
connection with any action or proceeding(including arbitration and appeals) arising out of this agreement, including i
collection of any outstanding amounts due,whether or not suit is filed. ''
12. Except as provided herein lerna's Heating and Cooling Inc makes no other representations or warranties,either
express or implied, including, but not limited to, any implied warranties of inerchantability or fitness for a particular
purpose lerna's Heating and Cooling Inc expressly disclaims all other warranties. lerna's Heating and Cooling Inc's
maximum liability hereunder shall consist of refunding all moneys paid to it by Purchaser hereunder subject to removal
and return to lerna's Heating and Cooling Inc of all equipment provided hereunder. Under no circumstances will lerna's
Heating and Cooling Inc be liable to Purchaser or any other person for any damages, including,without limitation, any
indirect, incidental, special, or consequential damages,expenses, cost, profits, lost savings or earnings, lost or corrupted
data,or other liability arising out of or related to this agreement,or the services or equipment provided hereunder.
13.This agreement shall be governed and construed solely according to the internal laws of the State of Florida,without
reference to any conflicts of laws.
14.This agreement is the complete and exclusive statement of the agreement between Purchaser and lerna's Heating
and Cooling Inc and it supersedes all prior oral and written proposals and any prior or subsequent communications
pertaining to the subject matter hereof.
NOTICE OF RIGHT TO CANCEL By signing this document you the customer are aware and agree to all
disclaimers above. You as the customer have the right to cancel any and all service(s)within 3 days of signing this
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, contract. All sales are final. If you choose to cancel the transaction please notify us in writing at the business
address referenced above. lerna's Heating, Cooling & Plumbing reserves the right to file property liens if
payment(s) are not received.
ISignature of Authorized Purchaser:
Date
Payment to be made as follows: Balance on completion lerna's Heating and Cooling Inc proposes hereby to furnish and
install the equipment and materials as described above on the terms and conditions provided herein.This proposal is
good for thirty(30) days from the date hereof, but may be accepted at any later date at the sole discretion of lerna's
Heating and Cooling Inc.
Signature of Authorized � '
, �� /� �
Representative of lerna s Heating and Cooling Inc: x
Date �/ Z�/ '�
Use the link http://hvacbizpro.com/proposals/hardcopv/HVACproposals.com-592991-customer-25-TON-AIR-
CONDITIONING-Mav-28-2017-11-51-35.html to view the proposal online.
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a�saao-oozo City of Zephyrhills Permit Application Fax-813-780-0021
. � Building Department
Date Received Phone Contact for Permitting —
Owner's Name 1'"1�2 ' �:1 '�C � Owner Phone Number g�.�" �7 ��� SO�n
Owner's Address ���� 1 [�� S�' Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS `� sl��'( I Z�" S�"' LOT# �
SUBDIVISION PARCEL ID# �� � Zb-Z( - �O1� — �,�jfl(7t7 `��3O
(OBTAINED FROM PROPERTY TAX NOTICEJ
WORK PROPOSED e NEW CONSTR B ADD/ALT 0 SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM 0 OTHER
TYPE'OF CONSTRUCTION Q BLOCK • Q FRAME 0 STEEL Q
DESCRIPTION OF WORK � ' G�� �� CIn�� �n;� ��' U'e1 SL S Ii I'
BUILDING SIZE � SQ FOOTAGE HEIGHT
QBUILDING $ VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $ �_�� �
QMECHANICAL $ j 1`� VALUATION OF MECHANICAL INSTALLATION
U .7 �`�' G �
QGAS Q ROOFING Q SPECIALTY 0 OTHER /
!
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
, Address License# '
PLUMBER. COMPANY
SIGNATURE -REGISTERED Y�/ N FEE CURRE� Y/N
Address �' License#�
' MECHANICAL � COMPANY I c�`S )-�-e2Tl � �„x����/�
SIGNATURE' REGISTERED Y/ N FEE CURRE� Y/N
ada�egs - 1�l��l3 lA s Lf� ✓� . L-icense,# � � �0 7�o
: •;.,
OTHER� " COMPANY _ � '
SIGNATURE= : REGISTERED Y/N-. FEE CURRE�' , Y/N
Address - ` License#
RESIDENTIAL;�, Attach(2):PIot�P.lans;(2)sefs of Building-Plans;(1)'set`of�Energy;Forms;R-.O-W Permit,for new construction,
�Minimum,ten;(10)working;days after�subrriittal�date. Required'onsite,�Con's'truction Plans,Stormwater.Plans w/Silt Fence installed,
Sanita,,ry..Facilities;&:1�.dumpster;Site Work Perr'tiit for sulidivisions/large:projects _ ,
.'COMMERCIAL Attach(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,Stortnwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster.Site Work Permit fo�all new projects.All commercial requirements must meet compliance � —
� SIGN PERMIT i4ttaoh(2)sets of Engineered Flans.
�• ""PROPERTY SURVEY required for aII.NEW construction.
Directtons: << - �
Fill out applicaGon completely.
Owner&Contractor sign.back of application,notarized
If over$2500;a Notice of Commencement is requlred. (A/C upgrades over$7500)
" Agent(fo�th'e contractor)orPower of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
OVER•THE COUNTER PERNIITTING (copy of contract required)
" Reroofs if shingles Sewers� Service�Upgrades A/C- -�Fences(PIoUSurvey/Footage)
Driveways-Not over Counter if an public roadways..needs R01N
_ _____ �-�:��.�:;�-��.,�..,:�
NC}TICE OF DEED RESTRICTiONS: The undersigned undecstands that this permit.may be_subject to"deed°',restrictians" '
which may,�be mqre-restr:ictive.than Caunty regulations: The�undersigned�assurries responsibility°fot compliance uvitii'any� ''`
applicable deed restrictians. , � � � ��"
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITlES: !f-tfie o+nrrier has hired�a-contractor ar
cantractors�to undertake wark, they may be required to be licensed in accordance with state and laca! regulations. �If�:thef•�
canfractar.is not iicensed as.rEquired �y law, batti the owner and cont�actor m'ay�=be cited-for�a misdemeanor violation
under siate law. If the owner ar intended contractar are uncertain as to what.Iicensing requirements�may:aPply for�.thei •'
intended work, they are advised to coritact'the Pasco Caunfy Buiiding tnspection Division�ticen'sing Section at 727-847- '
8009. Furthermore, if the owner has hired a caritractor or contractors, he�is advised to have the contractor(s} sign.;:
portions of the "cantractor Block" of this application for which they.will be responsible. !f you, as�the owrie�'sign as,:tlie
contractar, that may be an indication that he is not properly licensed and is not entitled�#a'permitting privileges in Pasco '�
County. . � ' h �
TRANSPORTATIt?N IMPACTLUTtLIT1ES tMPACT AND RESOURCE REC�VERY FEES: The�undersigned understands
that Transportation Impact Fees and Recaurse Recavery Fees may appfy ta the canstructian af new,bui(ciings, change�of'�•`�
use in existing buildings, or expansion of.existing buildings, as specified in Pasca County_Ordinance number 89=07 and :
90-07, as amended. The undersigned alsa understands, that such fees, as may,_be dus, wil! be identified at�-.the�tiriie�of
permitting. it is further understood that Transportatian Impact Fees and Resource Reeovery Fees must be paid priar ta
receiving a "certificate of occupancy" or finai power re(ease. If the,project daes not involve a certificate of"occupancy-or.'-
final power release, the fees must be paid prior#o permit issuance. Furthermore, if Pasco County W.,ater/Sewer�lmpact.
fees are due,they must be paid prior ta permi#issuance in accordance with applicable Pasco County ordinances.
C4NSTRUCTIC?N LIEN LAW(Ghapter 773, Flor�da Statutes,as amended}: ff valtaation of work is$2,50Q,QQ or mor.e,,I, :
certify that 1, the applicant, have been provided with a copy �af the "Florida Constructian L:ien Law--Hameowner's�� �
Pratection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant-is someone.
other than the"awner", i certify that t have abtained a copy of#he above descri6ed'document and promise•in goad faith ta .
deliver it ta the."owner"priar to.commencement.
CC?NTRACTOR'StOWNER'S AFFIDAVIT: i certify.that aN the informatian in this application is accurate and that all work
will be clone in compEiance with aA applicable laws regulating construction, zoning and iand�develapment. Applicatian is
hereby made to obtain a permit to do work and insta!lation as indicated. I certi€y that no wark or instaflation�has
commenced prior to issuance of a permit and that all work will be performed to meet standards of a!I laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
cerfify#hat 1 understand that fhe regulations of ather government agencies may appiy to the intended work, and that it is
my responsibility to identify what actions t must take to be in compiiance. Such agencies inctude but are not timited to: n
- Department of Environmental Protection-Cypress Bayheads, Wetiand A�eas and Environmentaily Sensitive
Lands,WaterlWastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalis, Docks, Navigabie Waterways.
- Department of Health & Rehabilitative Services/Environmental Heal#h Unit-Weiis, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbesfios abatement.
- Federal Aviation Autharity-Runways.
I understand that the fo(lowing restrictions apply fo the use of fill:
- Use of fitl is not allowed in Flood Zone"V"unless expressly permifted.
- !f the fill materia! is ta be eised in Ftood Zane °A", it is understaod that a drainage plan addressing a
"compensating volume° will be submitted at time of permitting which is prepared by a professional engineer �
licensed by the State af Florida.
- If the fill material is to be used in Flaod Zane "A° in connection with a permitted building using stem wa!!
construction, I certify that fill wiil be used anly to fill the area within the stem wall.
- If fill materia( is to .be used in any area, I certify that use of such��fill will not adversely affect adjacent
proper#ies. If use of frll is fottnd ta adversely affect adjacent properties, the owner may be cited for vioiating
the conditions of the building permit issued under the attached permit application, for lots less than one (4) ' j
acre which are elevated by fill, an erigineered drainage plan is required.
If I am the AGENT FOR 7HE OWNER, I promise in good faith to infarm the owner af the permitting canditions set forth in °
� this affidavit pcior ta cammencing construction. I understand that a separate permit may be required for electrica! work,.
plumbing, signs, wells, poois, air conditioning, gas, or ather installations not specificaliy included in the applicatian. A
perrr�it issued shail be canstrued to be a ticense ta proceed with the wark and not as authority to viola#e, cancel, aiter, or
set aside any provisions of the technical codes, nor sha11 issuance of a permit prevent the Building Officiai fram thereafter
requiring a carrection of erro'rs in plans, canstruction or violations�of any codes. Every permit issued sha8 become invalid �
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period.of six(6)'rrianths after the time the work is commenced. An extension
may be requested, in writing, from the Buildirig Official for a per.iod.not to exceed•ninety (90) days and will demonstrate
justifiable cause far the extension. If work ceases far ninety(90)consecutive days,the jab is considered a6andoned.
WARNING TO OWNER: YOUR FAILURE TO RECQRD A NO710E.OF CQMMENCEMENT MAY RESUl.T IN YOUR
pAY1NG TWICE FOR IMpROVEMENTS TO YOUR PROPERTY. IF YO,U,INTEND TO OBTAlN FINANC{NG;CONSU�T
WiTH YOUR LENDER OR AN ATTORNEY BEFORE RECORD(NG YOUR NOTIC OF COMMENCEMENT. _
FLQRlDA Jt1RA7(F.S. 117.Q3) ___ -- — _, . _�� �_ -
OWNEit OR AGENT CONTRACTOR ~ �� � J� �
Subscribed an b wom to{or affirmed)before me this Subs�bed and swom to(�r affirme�}before me this
t��
Who is/are personafly known to me ar has/have produced 4 Who is/ar persarrall known to me or has/have produced
as Identification. as identlficatian.
r
Natary PubUc ' � lu� Notary Publtc
Commission No. Co fnissio o.
.. ;
,�I�Y iplh r.._.,
Name of i4otary typetl,pr�nted or stamped Name of Nota t�i� _e������F} . ,viq?2
=;�.Q; Expires Dece�:�-.�::'#2 201�3
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