HomeMy WebLinkAbout17-18562 CITY OF ZEPHYRHILLS �-'`
5335-8TH STREET ,.�'
� _ (813)780-0020 18562
BUILDING PERMIT , /�
PERMIT INFORMATION - LOCATION INFORMATION
Permit Number: 18562 Address: 5932 15TH 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: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-04100-0020
Improv. Cost: 4,200.00 OWNER INFORMATION
Date Issued: 6/12/2017 Name: CHURCHWELL ELIZABETH B LIV TR
Total Fees: 60.00 Address: 5932 15TH ST
Amount Paid: 60.00 ZEPHYRHILLS, FL. 33542
Date Paid: 6/12/2017 Phone: 352-467-2364
Work Desc: DUCT WORK ONLY**********
CONTRACTOR S APPLICATION FEES
CHRIS' A/C COMPANY A/C CHANGEOUT 60.00 �
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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 pertormed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
,
NO OCCUPANCY BEFORE C.O.
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CO TRACTOR I ATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
By order of the Building O�cial: �NaCC'zam./�. �urgess
All �uilding. plurnbing, electrical and mechani�al work
§hall cease at the belovv mentior�eci proper°ty.
Address: ��� o� � ��`_ � ��C-�- I
Date: � � � — � �
Code Enforcernent Officer: � � ��� �
Contact the
Zephyrhills �uilding Depar�trr�ent
5335 - 8th Street
�13-7�0-0020
_ i i i���
813asaoozo City af Zephyrhills Permit Application Fax 813-780-0021
Buitding Qepartmen#
Date Received � �`r-C ' �'' � . Phone�Con#act<far�Perrritttin ��� � ,/ /�7��`
Owner's Name Owner Phone Number ,,�Sa7 - y�7Z '
Owner's Address Owner Phone'Number � �
Fee Simple Tltleholder Name ��" ��� � Owner Phone Number �— �
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Fee Simple Titleholder Address
� JOB ADDRE$$ �— � � LOT# ��,��
, su�oEv�s�o� �- � ��cE�.ro# � / d�. � 4 /d U 0 D
, (OBTAINED FROM PROPERTI!TAX NOTICE)
{ W4RiC PROPQSED � NEVv COt�STR ADDIAc.T � SiGN � � DEMOLlSH
e- IPISTALL 8 REPi41R
PRQPQSED.USE Q SFR. � COMM � -QTHER ��zi/'r�,'{�
TYPE QF CONSTRUCTION' Q" BI.00K " Q FRAME [� STEEI. Q
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DESCRIPTION OF WORK S '`
i BUIt�DlNG SIZE SCi FOOTAGE��. .,HEt HT���_� _
QBUILDING � � VALUATION`OF�TOTAL COiySTRUGTiON
QELECTRICAI. � :�$"� AMP BERVICE Q PROGFtESS ENERGY Q W.R.E.C.
�
QPLUMSING � '
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�MECNANICAI. $ ,/ �,� ,,,�,� VALUATlON OF MECHANICA�1l+iS7AlLATION "'� � �
!"<���L'4' ,C%t,J •
QGAS Q ftQOFtNG .Q SPEC11�t.'tY � OTHER,
FINISHED FLOOR ELEVATI4NS r�� FLOOD�ONE AREA QYES. iV0 ,
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$IGNA7URE REGI3TERED Y/ N FEE CURREA Y/N
Address Gc9nse# � I
EIECTRIC1At[�1 ,.COIYIPANY "-
SIGNATURE "' REGISTERED Y/ N F�`cuRRe��� Y/N
Addre�s � _ License# �� �
PLUMBEi� COMRANY .: `
SIGNATURE` ' , _REGISTERED Y.L�-N.. , EEE,CURREA - Y/N • '
Addre�s �[cense,# � �
MECHANtCAI:' � �- ��� COMPANY - f 1- � C=— , .
SIGNA7URE L.t�' REGISTERED , Y N . FEE CURREA N
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,., �o�.. �j _ `j � � ' ucense# I . �
Addreas� � .
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OTHBR � - � . . . ':COMPANY _ .
SIGNATURE ''�v ' � � � REGI$TERED Y/ N... �FEE CURFtE� Y/N•
,aaat�� , . . . . _ _.. . . , _ . - � �:t�nss#.�- �� , -
RESIDENTIAI:°� :Attacti�(2}nP1ofPlans;:(2}sets:of8iiildliig�Plarts;(1)setaf'EnergyFoiins;R=O=W�Peririiffornewconstruation,
��-- � :Minlmum:ten,�(:10),working;days affer,:submitfai date�_Required onsite,:C6nstrucBon�Rlans;Stortriwater`pians w/Slit Fence installsd,
`�� Sanitary Faciildes_:&;1.dumpster>$Ite Work,Pertnit;for,subdlVisions(large p,rojects.�. .'.:s � '
COMMERCI�U. Attach{3}�cbmplete sets of�Bu3tilirig Plans ptus a k.lfe Safety Page;{1}set a#Energy Forms.R d W Petmit far new oanstnscUan.
Minimum ten(10)wo�Icing days afker submittal date. Requtred onsite,Constructlon Plans,Stortnwater Plans w/Silt Fence instatled,
Sanitary Faailities&1 dumpster.Site Work Perrnit tor all new,proj'ects..All commercial requlrements.must meet compliance �.
SIGN PERNIfT Attadti'{2)"sets of`�isgineered;Plaiis.: - .°� � • � � �
"'"PROPERTY SURVEY,reguired.for,all,NEW arnstruct3an.. -.
Dlrectlon�: .
Ffll out appUcatlon completely.
fJwner&Contrackor sign back of appltcaUan,notarized '�
If avsr�2540,a Watica af Cammencement is requlred. (A/C apgrades aver$7500)
� �n,�•-:;..,,,,
'" Agent(for the i;o�tractor)or Powe�of Attomey(for Uie owner)wauld be someone with notarized IeBer from owner autharizing same
DYERTHE COUNTER.P-ERMI?RIt1G -.-(FronEafiApplicatton On{y)� �
Reroofs If shingles Sewers 5ervice Upgrades A/C Fences(Plot/Survey/Foatage)
Drivewraya-Not aver Counter If on public rosdways..need's ROW
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NO'T10E OF DEED RE�TitICT10t�S: The undersigned undergtands:;th�t;thl��.p�rmit�may.,be.subJect,to,°deed".resttictlons° _ .,..�.
which may tie<more r.esttictive-th�n Counfy=�fegulattons.'�TFie u'nderslgned�assumes'responsibility'�for=compliance:with any� ""�� _f
applicable daed rest�ictions. �.. .- .: ',, = .: "� • _. ., � � '� -:
UNLICENSED�CONTRACTORS�AND CONTRACTOR�RESPONSI�ILSTI�S`. -•If the owner`has-�hired�`a contractor or
contractors to undertake work;they may:be:�re�quired�to..be;ltcensed In_:accordanc�.yirlth,;st��e�.and,loc�l:regulatlons; ,-1f�the� �
contractor is not ltaensed�as��requlced.'tiy law,-both the�owner and�conto�acto��may�be�cited°`fora�intgdeme�nor violatton
under state law. If the owner or intendedlcontractor�are,�.uncertain as to what licensing.requirecnents,�may�appfy��fdr the�� -
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. .__.�_,...., - -., _ . .
intended worlc, tHey are advised to contact the_Pasco�-County;Bulldl�ig::Inspectton,Divlslon�_-t.lcensing Section at 727-8 7-
8009. Fu�ttiermore, If the owiier Fias�filred�a contracfo� or coritractors, he ts advised to have :1he contractor(s),,s(gn .
portb�s of the "contcactor.Block"of this.applicatlonmfor.which.they,_wlll,be=tesp.onsible._. If you,:as.:the owiier'stgn'�as'�the ` ��
contractoP, that-maybe an Indicatlon'thet`iie'Is not"prope�ly-Ilcensed�and-ls"not'entitled to permitting privileges In Pasco _
„��::.' -
County. '
TRARl�PARTATION�IMPACTIUTILITIES°IIIAPAC'��ANb ItESOU1tCE ItECOVERY FEES:� The unde�signed understands
thatTransportation Impact Fees and.Recourse Recovery.Fees may:apply:to�the constructfon of new_.buildings,5change�of�`'��"-°�' `�
_. , _: -
use In existing bulldings, or�expar�sion�of�extsti�i�:�buildings� as speclfled.in Pasco County O�dinance number 89-07 and
90-07, as amended.,,,:The. undersigned also:urtderstands; th�t'�such fees;:as�rnay_:be�,.due;,3will.�.tie identified at the`time=oY= °v= �`�
permitting. It Is furtFier understAod that Tra�sportation Impact-Fees and°Resource_Recodery;Fees�,must be paid prior to
rece4ving a °certiflcate.of occupancy" or flnal��power;release: :pf=the proj�ct�:do�s:not�Involve<a�.certificafe of occupancy��or`�:'�";�,` :`
final powec-release;�.the;fees�mu$t�tie paid:prior to permit issuance. Ft��thermore;1f:Pasco,County`Water/$ewer�;impact� ��-•�� �
fees are due,.they-must.be,_=pald:pNor�o,permit:issuance=�n.accordance wltFi:applic`atile_Pasco'.:County�ortlinances. •
CON�TRUCTION�GEN�I.AW'(Ch�pter 713� Florlda�t�etut����s amen��d): If valuatlon of work is$2,500.00�or more,:.l� �- �:��9�
certify tFiat -I, the applicant,:have�been provided with��a�copy-of the•"Florida� Construction: Lien 'Law=Homeowne�'s
Protection Guide" prepared by�tFie Florida Department�of Agriculture and Consumer.Aifairs. If the applicant is someone-., :_
other than the"owner", I certify,�3h�t I-have.obtained�a'copy;of.the:above:.des.crlbed'tiocui�ent�and'.promise��in,go.od faith to ,��
deliver It to:.thet"owner";=prior't'o��cornmencement.� " - � '� 4 � � •
CONTRACTOR'S/OWNER'S AF�IDAVIT: I.certity::that�all.�th��;information�.l��tht� applicatlon is accurate and that all work
will'be done in compliance with all applicable�laws regulating constructlon, zoning and:�land�development. Appltcatlon is
hereby made to obtain :a:permit�,to.:do.:work::and;instellatlon as indi�ated:� �=1� certffy that no work�:or installation has
commenced prto� to Issuance of�.a permit"and that�:all work will be perFormed to meet standards-of all laws �egulating-
construction, County and City codes� zoning regulatians, and land development tegulations�tn the jurisdiction.r (�also
certify that I understand that the regulattons of other government�gencies may�apply�to the.intended work, and that (t is
my responsibility to identify�what,act(ons I must take,to bedn_.compllance:..:Such agencies�include but�are.not Ilmited to: � �
- Department of Environmentaf�Protection=Cyp�ess�Bayhead�,�Wetland Areas and Environmentally Sensit(ve
Lands,WaterMlastewater Treatment.
- Southwest Florida Water Management�:I�tstr(ct-Wells; Cypress.��Bay.heads; Wetland� Areas, Altering
Watercourses. - -
- Army Corps of Engineers-Seawalls, Docks, iVavigatile VVatervvays.
- Department of,Health::8; ReMabllltatirre..Services/Environmenfal Health Unit Well.s, Wastewater,Treatment, _. _ �
Septic Tanks:__ __' . � � � • � _
- U�EnvCronmental Protection Agency-Asbes2os abatem�nt... - .. :_:;:_,
Federal:Av.latlon:Authority-=Runyvays. -
I understand.that.the.following:�restrictlons apply to the use of flll:�
- Use of flil Is not allowed in:Flood,;Zone"V"unless expressly permitted.
- If the�fill mate�fal-1s fo be used_in.�Flood Zone. "A", if. is understood that a drainage plan addre�sing a
"compensating volume" will be submitted at time of�permitting which (s prepared by a professional engineer � " �
Ilcensed by�he�State of Florida: � ������=� � - ' '
- If ih� flll�materlal,°i"s.to be used in Flood Zone "A° irr connectlon�with�a permitted building using stem waii
' conatruction, l certify:that flll:wall:b.e�used only.to.fiil the area within the stem=wall: �
- If flll materlal ts to be used`in any area; F certify that .use. of such^flll will not adversely affect adjacent
properties. If use of flll is found to adversely:�ifect adJacenE properties,.the owner may be cited for a►iolating ��
the�condFtions of the.building;permit Is�ued�under the'attached_permit�applicatlon� for�lots�less=than.'one (1)
acre wHtch are elevated�tiy fllt; an engineered drainage plan ls required. •
If I am the.AGENT FAR.THE:OWNER; I;promise in.good.faith to tnform-the�owner of�the permitttng condftlons set forth in
thts aifidaVtt�prtor to�commencing constructlon. I under�tan'd th�ta,separate permit may be requtred for electrical work,
plumbing,..signs, wells,.pools;, alr condtttoning, .gas.�.or otMe� install�tions noE.speciflcally Induded�in.th� application. .A
permit Issued shall be'constcued to be�a llcense'to�p�oceed with"tNe'work.and not-as.authoNty�to..violate,.cancel, alter, or
set aside any provisions of the technical codes;�nor shall Issuance�of a.permit.prevent the�ulidirig Oificial from thereafter
requiring a correction o�f eRors:in,plans; constivctlon.or violations of any�codes: Every.-p�ermlt�issued sliall�tiecome•invalid
unless the work aufhorized.by such permit:�s.commenced•withtn sUc;months of�permtt Issua�ce, or tf work authorized by
the permit is suspended�or�:aba�doned�for:a;period of six,(B)�montfis.aRer:the.time tfie�work�is commenced. An extension
may be requested, in writing;,�from tNe:�Building,Otflcial for a perlod:not..to.exceed'�ninety�(90)�days and-wili'demonstrate
justifiable cause for.�the extension•. If work-ceas�s:for ninety(90)cons.ecutive.day.s�..th�job�is constdered aba�doned. ��
WARNING TO OWNER: YOUR.FAILiJRE:T�,R�EC.ORD A;MOTIGE_.OF:°COMMENCEMEMT�:IVIAY RESULT IN'YOUR
PAYING TWICE:FORIMPROVEMENTS,T;O�YOUR<PROPERTY:��I��YO.UaI�I'FEND�T�:�lBTA1N=F1MAN1EING�`CONSULT
11V9T U . D LL �OP i.41d- �O�tPi � ��R��.� OR� �"s� Ol� :' � �;�� s ��. : , E - '' —— -
FLORIDA JURA;•(F.S:1.17.03} - �_ ' ' � �
OWNER OR AOENT CONTRNGTO
Subscrlbed and swom (or aHirtned)befor e fhls Subscribed"and'swom�to(of affinned)�before me tlil
by ,.by - �
Who Islare parsonally known to.me or haslhave.produced 1Nho.ls/are p.ersonallyknown•to nte;oc has/have�p duced •
as Identlflcetl4n. ' as Identlficafion.
Notary Public _ Notary Publlc
Commisslon No: Commisslon.No.
Name ot Notary typed,printed or stamped IVame of Notary lyped,printed or stamped '
_ ; ; ' SERVICE ORdER ''
��;�::�-��,� �� INVOICE
- ;.. � __. . . : � : •f H VAC � .
= �i o � p? ; A N Y � _ 29345
CAC058575 � � EC13007703 � �
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12232 HWY 301 ; DADE CITY (352) 521-4977 �
DADE CITY, FL 33525 ' ZEPHYRHILLS (813) 779-9515
_ , � �fi �j�
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Bili Customer ' AIR CONDITIONING &
BILL TO:
; � � . ELECTRICAL CONTRACTORS
�� SPLIT SYST�M PKG UNIT
NAME: � DATE: MODEL#
ADD�2ES8: ' SERtAL#
CITY: . . � s - ZIP CODE: 33542
FFIONE: Sa ' WORK:; ` MODEL# : , . ;
�
C�LL: RENTERE SERIA!# -
�.,
TECHIVICIAN: Kar�eron I ; DAT�6/p2/17
PROBLEM REPORTED: S�#em nat keepiq�g up BRAND:
, !
� �
- Checked:�rii� Foiittd uriit wo�ki u�rotkiri . -, -
� ,9 Praperly. Found duc#work sepera�ed and crusF�in PARTS 8�LABOR �
attic.A#C;ductwork.in atEic needs replac�,Quoted"customer$42Q0 to:replace a1t ducf Hrort�:,-;. PARTS ONLY
� i ; STAR�UP :
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CHECK# DUE: � � CASH: ' _
f .
CREDIT CARD#: ; � SUCTtON PRESSURE:
CARD TYPE: ; �" � LIQUID PRESSURE: � '
APPROVAL CODE: i � 1'ENiP. DIFFERENCE:
EXPIRATION DATE: i ' � • FILTER: ' , 9�
� � RAINfNG PROPERLI��
I HAVE THE AUTHORITY TO ORbER THE WORK OUTLINED ABOVE WHICH HAS BEEN
, SATISFACTORILY COMPLETED.I AGREE THAT SELLEft RETAINS TITLE TO EQUIPMENT
AND MATERIALS UNTIL FINAL PAYMENT IS MADE.IF�PAYMENT IS NOT MADE AS IMITED WAf�ANTY:Et3U1PCutENT,P}SRTS.AND,NiATERfiAL
AGREED,SELLER CAN REMOVE SAID EQUIPMENT AIVD MATERIALS AT SELLERS IXPENSE IiAS WRITTEN MANUFACTURER'S�WARRANTY ONLY.
ANY DAMAGE RESULTING FROM SAID REMOVAL SHAEL NOT BE THE RESPONSIBILITY ALL LABOR PERFORNFED BY CHRIS'A/C HAS.A ONE YEAR
rJF SELLER. WARRANN.CHRIS'A/C MAKES NO OTHER WARRANTIES
i
` ��� ' � TOTAL: � �5.00 �
.aoo �S��W`�'to--�=-----�----
CUSTO SIGNATURE DATE:
E66iJCE FOR BUSINESS i-$fH1-SBB-6377 � c.,��i,..r_�.��....