HomeMy WebLinkAbout17-18606 �.� �;�, CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 18606
BUILDING PERMIT
` PERMIT INFORMATION - LOCATION INFO.RMATION
Permit Number: 18606 Address: 5214 GALL BLVD
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS ,
Est. Value: Parcel Number: 11-26-21-0010-16600-0250 '
Improv. Cost: 7,450.00 OWNER INFORMATION-
Date Issued: 6/26/2017 Name: VICHRIS INC 'I
Total Fees: 75.00 Address: 5214 GALL BLVD �
Amount Paid: 75.00 ZEPHYRHILLS, FL. 33542 �
Date Paid: 6/26/2017 Phon • (813)782-9556 �
Work Desc: A/C CHANGEOUT 7.5 TON — � Ce., I
CONTRACTOR S APPLICATION FEES
PATTIE ELEC. & REFRIGERATION A/C CHANGEOUT 75.00 I
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Ins ections Re uired
DUCT NSTALLED
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 i
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 il
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 �I
Ci Codes and Ordinances. NO OCCUPANCY BEFORE C.O. i
NO OCCUPANCY BEFORE C.O. I
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T C O SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
n,s-r�u-uuzu City of Zephyrhills Permit Application Fax 813-780-0021 �,
; g� Building Department ' �
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Date Receiv�d ' ..� Phone>Contact for�Permitttn - ,
Owner'a Name n � � Owner Phone Number �
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Owner's Address Owoer Phone Number r
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Fee Simple Tltleholder.Name Owner Phone Number
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Fee Stmpla TIlleholder Address
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JOB ADDRESS �� ��! �G� �(� � LOT# � �� (
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SUBDIVISION PARCEL.ID# � � �
. „ _ (OBTAINED FROM PROPERTY,TAX NOTICE) I p
WORK PROPOSED :NEW CONSTR ADD/ACT � Q SIGN Q Q DEMOLISH � �
�•-B, INSTALL 8� -:-REPAIR - I :
PROPOSED�USE Q SFR• � COMM ° Q OTHER �� `
TYPE OF CONSTRUCTION < Q "BLOCK " Q FRAME . Q STEEL � �i
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DESCRIPTION OF WORK �
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BUILDING SIZE ' �'S6l FOOTAGE ' , ,HEI,GHT��, �� i
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QBUILDING $ VALUATION OFTOTAL-CONSTRUCTION" a :
QELECTRICAL $ " AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. j
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OPLOMBING $ - i �
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MECHANICAL $ 1� VALOATION OF.MECHANICAL INSTALLA7'ION � ;
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QGAS Q ROOFING .0 SPECIALTY Q OTHER i j
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO �' I
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BUILDER COMPANY'
SIGNATURE REGISTERED Y/ N '�E CURRen ' Y/N ',
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Address ' � License# ' '• !
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ELECTRICIAN> , • COMPANY � � '
SIGNATURE � REGISTERED Y/ N FEE CURRE�' ' �"Y/N � !
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Address , - License#. � i ,
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PLUMBER ` COMP..,ANY - . �I '
SIGNATURE' " , _REGIS.TERED, - Y.l�N-. : --FEE CURRE� Y-/N. �
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Addre�s Ucense# 4 . � - �
MECHANICAL' COMPANY, � ' .��� . � �
SI(3NATURE ' ` REGIS7ERED : Y./ N . FEE CURR _ Y./�N =
Address" t � � License# D�� `� !
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OTHER i � ' - ' � '� , -,COI�APANY �'� �, , I
SIGNATURE �'�"' • "- ` - '� � REGISTERED Y/ N:.; FEE CURRE� - Y 7 N.
Addres�, - ^ `, - _ � . � Llcense#�� � �,
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RESIDENIIAL;;�'` ;Attacli"'(2)�PIot;P,.laes;�(2)sets;ofsBu1181ngtPlans;'(1)set of�Energy;Forins;.R=:O=W Per`rriif f6r.new construcUon,
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.^;;;:MlnimumFten;(1A)�urorfcing;dajisaafte','sutimittal'date.�:.Required onsite;:ConstiuoNon��Plans';�Stormwater•'Plans�w/SIIt�Fence installecl,
�� Sanitary`Faclllyesr&f�1;dumpstery.Site�Work�Pennit_#cr-sutidiVislonsAarge;projecfs;;.,^.n";.,:`. � ' �� ` �'-
COMMERCIAL Attach(3)'csomplete'sets"of"Bulidfng Plans'plus a�l:ife S'afety Page;�(1)set of Energy Forms.R-O-W Permit for new construcdon. - -
Minimun 4en(10)working days after submithal date. Required onsite,ConsUuction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilides 81 dumpster.Site Work Permit_for all new:proj�cts:All commercial requirements,must meet compllance �
SIGN PERMIT AttaoFi"(2)sets of�Engfneered�Plans:,, --•�� �� . , � �
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'•••PROPERTY SURVEY reguired_for aII,fVEW construction.,
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�IrecNons: � .. _ . .
Fill out epplicaUon completely. �.
Owner 8 Contractor sign back of appltcaUon,notadzed � � �
If over�2500,a Notice of Commencement is requlred. (A!C upgrades over 5T500)
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qqent(for the contractor):or Powe�of Attomey"(fo�the owner)would be someone with notarized letter from owner authorizing same ,
�VER THE COUNTER{P-ERMITIING-- --� �(Front of-ApplicatlomOnly)� ,
Reroofs if shingles Sewers Service Upgrades A/C Fences(PlodSurvey/Footage)
Drivewaya-Not over Counter if on public roadways:.needs ROW
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Nt1'1'IC�OF DEED RE�TRICTIONS: Tbe u�tderslgn�d Und�r�t�nds�;.th�t}#�ls.�ppcmlti.�m�ygbe:stabjec�;to;:�deed"�,eestrlctRoris°r .. _ �-
�hich m�y=be>mor+��rest�Ictive�tha�r�Coanty"reg�ala�lons:��"�tie"�nder�igr�ed�`�ssumea�re�panslbillty=for c�inpll�nc��with�any
applicable_deed resMctlans. �. m ...� � • .
UNILI�E�lSED COMTRACT��S �AW13 CON�RcAC't`OR �ESi�ON�tB�i�iTGE�S: ifi�•�he ��wner h�s�°6�ire'd���":ezonfractor or
con4ractor�to undertake waric, #Ftiay rnaybe:�r:�quired.jt�::be;,lic�nsed ira.�ccaedance.with state�.and;loca�;:regulaQion�:::itf=the�. ��
con#rac�or is�not 1lcensed as°requlrsd,"6y law� bct�i�'the bw�aet�nd��{;ontr�ct�rxmay°be�clted'fvc�a��rolsilemeanor ufolatlon
under state law, !F the av�nec or lntended;,;contra�tor:�ar�,uncertaln as to wh�f Ilcenaing;re�uirernents imay_:dpp�y���far�the� �
f�tended work� they are ad"vis�d to cantact th�Pasco County�uilding.In;spe�ttan,DCvision--l:Icensing Section et 727-847-
8009. �urthernnore, If the owner fias�'hired a contractor o� corrotraators. he Ts advtsec! to have �#he con#riactq�{sj,;.sigrt,
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�orti�n� of the "coo�tracEor �loct�' of fhls,.appiicatton_:for;which.th�y wllt ber.r.esp.anslbfe.-.,,:if.you;-as-:#he owner"si�gn`�'as tfie" .
cor�tract�r, tt�at�m�°be ara ind�c�tkon that`tie Is not�:properEy licen'sed anii`:!� eiot eritltled to permlttfi�g psivifege�In Pasco .
County.
`Q'�►N�W�RTI�TIAN-1MPi4C41UTILITIES=rMP�►C'�AND-RE��U�tCE RECOVE�2Y•FEE3:� The ur�der�lgn�d�understands
tha�t Yransportatton lmpaat Fees�and.Recoutae.RecoVery.Fees m�y;appty�ta�ti�e:constructlon of new.bullding��achange�of�"= ° °
use in exisEing buildings, orrexpar�si�trrofsexis�in�'��uil�ings, as specifi�d.irr Pasco County Ordinarace numb�r 89-07 and.
9o-O7, �s amettded.wTh�a undecsigned also:understands, that:•such fees;-;assmay:;be°rt�ue;;witl��be Ederif�ted �t fh��dtine;of . . �
permltting. !t I�iurttier understo�d that Tra�s�'o�atlon lmpa�t Fees at�claResource.:Recov.eijr�Fees;tn�ast be pafd p�rloc to
r�ce�v(ng,�.'cerEificate:of occupancy" orflnal�p�wer;Felgase: :If th�.proj�ct:_do�s�,nok invvtv�a��a,.cert�tc�te af occupancy�oi�t.'.�`�. .
flnai power�r�lease;:the-.fees mu�t b�p�ld;p"r:ior to..permit i�suanc�. _F-,��Qh�rmore;�If P�scm,County�1Nater/Sewrec•:Impact � •
fees are due,.they..must be.paid.prior#o.p.err�it�:issu�nce::tn.accordancewitli:��ppliciabtr�:Pasi:o'�.County�ordinances. �
CGN�TRUCTiQi��1:9EN'I.AW(C1i�pter 713� Etartda�tatufi�a,as ami�nd�d): tf vatu��on af work 1��2,500.00.or more�..i �
certify that !r �he: appflcant,-have-beera provtded with�a copy af�the `Flarida� Cons�ttuctfon� Li+�n .I:avu=Homeowr�er's
Protectlon Guide" prepared by tFie Floclda D�partmer�C of�grtc.ultur� at�d Consum�ar.�.�ffalrs. !#the�ppltcant i� s�meone .
other than the"owner", I��rtify:that_.I h�ve^o�tealr�ed=atcopy;af:the��b�ve.�descrlbed�documentand�p.r.�r�i�e�.l�,goad;f�lth�o
d�liv�r it to.the.�"o�ncnec"=p�or'to�comm�ncement�:" ' .
�ONTi�ACT�R'S/OWN�t2•�AFFID�1Vii': i.cert�jr=:that=all..th�.,irrform�tian.i��thi��pplicatton 6s accurate.�nd that alt work
wi#f'be done fn c�mpliance with al! appl#cable taws regul�ttng construc#lon� z�nin�g and�•I�nd�deveimpment. Applicatlon is
hereby made ta obtain.a.perm�t�:to dc��wor'k;�,and .Ihs�ail�tlo� �s tndtG+�ted:==.°I ce�tify that no work�or InsEalia�tion has
commenced p�lor to Issuance �f� permit'�in� that:all work wlll be perf�rmed�#o �n�et standaTds�-of a!! laws �egu{ating�
�conshvctlon, C�unty �nd City codes, zaNng regula9tans, and land development r�guiatl�n��in the�jurlsdictlon: ( �Iso
certi�y that 1 u�derstand thaE th� Peguiations of ot�er government �g�ncle� may�apply�#a the intended work, and that!k is
nny respon�ibiii�+ta identify•w+Frat.�c�ions i must•#�ke:to b��in<.compilar�g�.. S.rach.ag�nctes lnciude bufi�ar�.not Ilmlted to:
- C7epartment o� Envlronmentat��Protectfar�tiCypr'��s.'Bayh�ad�,�tNeHand Area�s and Environmentaily Sensittve
l,ands,WeterMlast�water Treatment.
- Soutnwest Florida lNater Manageme�t .DistMct-4NeUs, Gypress.''Bay�er�ds,� Wetland` Ar�as, A#teri�g
Watercourses. ,
- Army Corps af Engtr�eers-Seaw�fls�Docks,Navigatile Waternr�ys.
- QepaMment of.Heaith;,.8 Retiabilitafive:Servica�/E�vifio�tme�t�i Nealth tlnit Weti.s� Wastev�rafer-i Treat�nent,
aeptRc Tatilcs:. � .
- US Env(ronment�l Protection Agency-Asbes4os a�atemenE.
- FederaO Av.1�Qon.Autho�it�y-Runways.�
I understand fihat the.fallow�ng:restrictians appiy'to the use of flll:
- Use crf flfl is nat altowed in�Ficrod�Zone"V"unless expre��ty p�rmitted.
- If the f�!# matsrl�! is �o be usesl:,!n-�Ftood �one. "A", it �s undecstood that a d�sa�n�ge ptan add�es�ing a
°cornpensattn� volura�e" w1ll b� sub�eltted at�im� of�perrr►ItQlrag wlilah Ds prep�red by � �rofes�ional eng�neer
Ilcens�d by the Stat�of�flarid�: .
- If ih� flp materl�l•is to be us.ed ln Flood �one °A" In�r.�nneetion�wl#h:a ���rmitQed building using sfem w�i!
� construction, i certiiy th.�t fiil:wiil:b.e used oniy.to.tilt the�rea within�the�s#e�n�wa�t. ,
- �f fil! �na#erlal is tv be used ln any are�a, 1 certify tfi�at .use of suah fiil wHi nat adver�ety affeat adjacent
propertles. f#use o#fiN 1s foun�to adverseiy.�ifect adJa��t�propertfe��.the owner may 6�cited for uloiating
!he cond�ions.of!he bulldi�g;pe�mit Is`sued�under the�att��hed:parmlt app�tcatiort;for 4s�t��iess tban.one (1)
acre whtch ere elev�ted�tiy 4111,���ngineered dr�lnage�pla�r is ee�qutred.
Of 1�m the�iGENT.�OR-TWE-OINMER, I;.prorrd�e In.good falth tm inform the�owner of�the permlhing condftlons s�t forth in
this a#fid�vit�prior to c�tmmeracMB construction. 1 understand that a-.�eparate permit may be required for elect�lcai�work,
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plumbing, stgns� WQII8�.p00fS�,81�.G011tlIt10ttlCt�._.9��, ar otlier tns#all�ttoris no�,spec�ltta#1� Included�in.#h��appticx�ti�n. .A
permi�Issued shal! be construed to be`a�Ifd;ense`�to`-proased wltb thi�work and not�as:authority�to,vl�lste,=cancel, after, or
set aside any provistons arf the.4ech�ilcal.c+ode�;�nor shali issuance��f a.permtt.p�event th��u!ldirig Ot�lcla!from thereafter
req�eiring a cor�ection af ercors.ire�•piane;-can�truc.tlon or.vlolatlons of�any code�. �very•�p'ermit-lssued-�hall�bec�me i�valid
unless dhe work�e�thori2ed.by such permtt:is.commenc�d��vfithin si�c monfh� of�permi#isau�nce. or If work autho�ized by
the permlt Is su�p�nded or.ab�r�doned-f,oc:��:perfod of�slx;��)mont��.after the:t1ma th��wrar�k�ts commenced. �n exfension
may be requested� In writlt�g,:.fro�n tlie.�u!!ding.l3(flcla!fbr a perl�d:not-#o�xceed:,�friety�{80j days and�wl�! demonstrate
Justiflable cause for.�the exterrsion�. If work ceas��:far nineqr•(90)c�ns.�c�Qlve�d�ys�..th�job�ts cansidered abandoned.
lNARNING TO CIWNER: YQUR FAIGURE••Tta.,.RECt3EtD;1�.,,M4TIGE:OFr•COMMEN��MENT,NFAY�RESUL4�IM YOUIt
P�YlNt3 TWICE;.,�Q�IMPRQ�dElV1��lTS�TO:;YQ.Ui�:P�flPERTYe=�1��YO.U;I�TEE�iD�TQ=+tfBTAiN�FiN�►W��NG;'CONSUL.T
1A�IT D •l?. A 7T0 N t�E3��.� y O t�:, :tJ ' , � . z .
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FI.ORIDA JURAfi�(F.S:1.17.p3} . —
OWNER Oft AOENT ��t+fl`RAGTO �
9ubscrlb�d and�wom to(ar affirtned)b�fore me thls Subecrlbed and'�waRo'to �mnedj'b�fonei me'ftii��
bY �'Y a� r ,.
Mfho Islase per�onaNy knawn.to.me or•hasA�ave.produced YVho.lslare personal9y ta.me:or heslhavs-piaduced �
ae Id'endAcetlon. �s IdendBc�tion.
Ptotary Pub11c . Notary Rubttc
Commission P.1o: Ccmmtsston.tdo.
Name of Notary typed,p�inted or stamped tVame of Notary typed,printed or�tamped
� ; Pattie Electric & Air Conditioning
39111 Patfie Road �
Zephyrhills, FL 33540 ',
� 813-782-3319 '
sales@pattieelectric.com �,
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{Work Order Date Summary: _ _.._.. ..T$G�= �"� • � �
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1958-102 6/26/2017 SERVICE DAVID N �� .����µ� m��. M�Y rv�rn_���� ,
;Bill To: • ; IJob.Name; . � , . -
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Village Inn , Village Inn
5214 Gall Boulevard 5214 Gall Boulevard '
Zephyrhills, FL 33542 Zephyrhills, FL 33542 �
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813-782-9556 813-782-9556 �
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> 6/26/2017 MON 12:40 PM> �
Install 7.5 ton rooftop unit per quote 57,450.00
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All material is guaranteed to be as specified. All work to be completed in a professional manner according to standard practices. Any alteration or I ,
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 agreements contingent upon delays beyond our control. Purchaser agrees to pay all costs of collection,including attorney's fees. I
Signature Date
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