HomeMy WebLinkAbout17-18641 _ _ ,;
CITY OF ZEPHYRHILLS --'
5335-8TH STREET
(813)780-0020 41
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 18641 Address: 39028 PARK DR
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: ZEPHYR HEIGHTS
Est. Value: Parcel Number: 12-26-21-0030-00200-0100
Improv. Cost: 4,490.00 OWNER INFORMATION �
Date Issued: 7/07/2017 Name: POLING ELLIS & MARGARET
Total Fees: 60.00 Address: 39028 PARK DRIVE
Amount Paid: 60.00 ZEPHYRHILLS, FL. 33542
Date Paid: 7/07/2017 Phone: (813)355-4562
Work Desc: A/C CHANGE OUT 3 TON 14 SEER
' CONTRACTOR S APPLIGATION FEES '
AIR TECH SERVICES OF PASCO INC A/C CHANGEOUT 60.00
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Ins ections e uired
DUCTS INSTALLED
DUCTSINSULATED `
' FINAL �� �' . .--
REINSPECTION FEES: c With res ect t
( ) p o 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 OCCUPAIVCY BEFORE C.O.
6
NTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 City of Zephyrhills Permit Application Fax-873-780-Op21
^ ' Bufiding Deperiment
. ,. . -_�
Date Recelved Phone Conlact tor Permittinc 1
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Owner's Neme C �1\ Owner Phone Number ����^�� �
Ownez"s Address J 1T �rt{�,�(, Ltt���$��v��� Owner Phone Number �, !�
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Fee Slmpla Tllleholder Nama i � Owner Phone Number r_y-�
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i Fee Slmple Titleholder Addrasa �
, JOB AD6RE$S � � .I S � LOT# ��
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SUBDIYISION � � PARCE�l4$ �!X- (C�' - ."'�(`}.!(�j
{08TAIt1ED FROM PROPEI2TY FA%tiOfilCE)
WORI(PROPOSED NEW CONS7R . ADDlAL.7 � SIGN �� Q DEMOLISH
I (NSTALL e REPAIR
PROPO5ED USE Q SFR .: CdMM � QTNER " _ i
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i TYPE OF CONSTRUCTIQN Q BLOCK Q FRAME C] STHEL C]
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dESCA1P'ilOF7OF WORK I � N /�� .7..%` •, .
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QBUILDING �� VALUATION OF TOTAL CONSTRUCTION
QELECTRiCAL �� AMP�SERVIGE Q pROGRESS ENERGY Q W.R.E.C.
QPlUMBiNG �� � {
�MECHANICAI. �6�A�.'}� VALUATION OF AAECNANiC�IiJS7AtLATiON � ���/ �
`�t�' — �33`i � ��'
QGA3 Q ROOFINC, Q SPECIALTY � 07MER �
FINISHE4 Fi.40R Ei�EVATIQtJS �� FLOOII ZO,NE AREA QYES N4 -
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I BUItDER COMPANY . �
SIGNATURE �_ _____--__� REGISTEREp Y/ N FEE CUftFtE� Y!N
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E!@GTRICIAN � � �COMPANY ..�
$tGNATUR� RE�}SIERfd Y I N FEE CURREA Y 1 N
Addreas License# � . , �
PLUMBER � � CQMPANY � �
SIGNA'fURE REGISTEftEO .Y/ N ' � FEE CURRE� Y/N.
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Address Llcense# � .�
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, MEGIIANIGAL ' CqMPANY �jT SF_,t`iPt P�_S L1T �C1�S °(�3�
S{GNATURE � RE�ISjEREO .Y.I N FfE CU1iREh Y/N
Address , _ �3cense# UzC..I 0 1 S�`t�
OTHER CpMPANY � �
SIGNATURE REGISTERED Y J N� 'FEE CURRE� Y/N
Addrass Llcensa# t �
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII111111111111111
RESIQENiIAI Attach{2}piot Pians;(2)sets of Buiiding Pta�s;{1j set of Enet�y�orms;i2-Q-W Permli tor new canstruction,
Minimum ien(!0}working days afier submittsl date. Required onsike,ConstrucHon Plans,"Stormwater Pians w/Sitt Fence inetalted,
Sanilary FacHiUes 8 1 dumpsler,Site Work Permil far subdivi5fonsllarge projects
COMMERCIAL AQach(2}complele sels of Bullding Plans plus a Llfe Sstety Page;{7)sel of Energy Forms.R-O-W Permil for naw consWctlon.
Mlalmum ten(14}working days after submitta4 date. Reyulred onsite,C4nstnrction Plans,Stormwater Pians wJ Sitt Fer�ce installed,
Sanitsry FacitiQes 8 T d'umpster Slte Woric Permll for alI new praJects.Aii commerciai requlrements must meel campiiance
SIGN PERMIT Allach(2)sets o(Engineered Plans.
`"'"PROPERTY SURVEY required tor all NEW construcikan.
�M'.�-5-'r4-0-C-'�:+F:i-�-4-4�f•�i-�i..i=Fi-D-C..`�.F� S-i-i=4i-1-F.ht-I-Mi.�'.+-'+-'�:-'•-'•-'•-•-•-•-•-•--•�-•-
plrectlona;
Fill bul applicaqpn completely
Owner&Ganlractor slgn back o!appiication,notarfzed �
If aver 52546,a Notice af Commericement is requlred. {A/C upgrade's over$7500} �,
"" Agenl(tor Ihe canlrector)or,Power af Allomey(for lhe owner)would be someone wilh naterized leller from awner aulharizing same
OVER THE G4UNTER PERMI7TING {copy of contract required)
Reraofs N shingies Sewets Sarvice Upgrades PJC Fenoes(PIoVSurvey/Footage) -
Driveways-Nol aver Counler if on puhlic roadways..needs ROW �
f � 1
NOTICE OF DEED RESTRICTIONS. The undersigned understands that this permit may be subjeck to"deed"restrickians"
which may be more restriciive than County regulations. The undersigned assumes responsibility for compliance with�ny
agplicable deed_restcictions.
UNLICENSED CONTRACT'ORS AND CONTRACTOR RESPQNSIBILITIES: If the owner has hired a conkractor or
c,�ntractors to undertake wark,they may be required to be licensed in accordance with state and�oca�reguiations. If the
contractor Is not licensed as required tiy law, bath the owner and contractar may bs cited for a misdemeanor violation i
under state law. If the owner ar intended contractor are unpertain as to what licensing requiremen#s may apply for the
intended wark,they are advised to cantact ihe Pasco Counry Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if khe owner has hired a contractor ar contractors, he is advised to have the contractor(s} sign ,
portions of the"contractor Block"of this application for which they will be responsible. If yau, as the owner sign as the
contractar,that tnay be an indication that tre is not properly iicensed and is nat entit{ed#a permi#ting priviieges in Pasco
County. '
TRANSPORTATION iNiPACTIUTiLiTIES IMPACT AND RE50URCE RECQVERY FEES: The undersigned understa�ds
that Transportation lmpact Fees and Recourse Recovery Fees may apply to fhe cansfruction af new bui{dings,changa of ,
use in exisUng buildings, or expansion of existing buildings,as specified in Pasco Gounty Ordinance number 89-07 and
SO-07, as amended. The undersigned also understands,that such fees,as may be due,will be identified at the time of
permikting. It is further understood that Transportation lmpact Fees and Resaurce Recavery Fees must be paid prior to
receiving a"certificate of occupancy"or final power release. If the project does not invalve a certificate of accupancy or
Bnal power release,the fees must be paid prior fo permit issuance. Furthermore, if Pasco County WaterlSewer Impact
fees are due,they must be paid prior to permit issuance in accordance with applicabfe Pasca Counfy ord(nances.
CONSTRUCTION LIEN LAW(Chapter 713,Florida Skatutes,as amended): If valuation oP work is$2,500.00 or more,I
certify fhak t, the applicant, have bean pravided with a copy of the "Florida CansUuction tien Law--Homeowner's
Protection Guide"prepared by the Florida Department of Agriculture and Consurner Affairs. {f the applicant is someone
othe�than tfie"ownet',I certify that I have obtained a copy of the above described document and promise in good faith to
defiver it to the"owner'prior to cammencemenf.
CONTRACTOR'S10WNER'S AFFlDAVIT; I certity that all the information'tn this application is accurate and that a!I work
will be done in compliance with all applicable laws regulating canstruction,zoning and land development. Application is
hereby made to obtaln a permiE to do work and instailation as indicated. 1 certify that no work or Installatian has .
commenced prior to issuance of a permit and that all work will be performed to meek standards pf al! laws regulating
construcfion, Counfy and City codes, zoning regu�ations, and iand development regulations in the jurisdiction. I also
certi(y that I unde�s#and ihat the regulations of other govern.ment agencies may apply to the intended work,and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies include buk are nok limited to:
- Department of Environmenta! Protection-Cyprass Bayheads,1Netiand Areas and Enyiranmentally Sensitive
Lands,WaterlWastewater Treakment.
- Southwest Florida Water Management District-Wells, Cypress Bayhaads, Wetland Areas, Altering
Walercourses.
- Army Corps of Engineers-Seawalls,Docks,Navigable Waterways.
- Department o# Health & Rehebiliketive Servlces/Enviranmental Health Unit-Wells, Wastewater Treatment,
; Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federa)Aviaiion Auihority-Runways.
t�nderstand Ehat ihe fa8owing restric#ions app{y Ea the use of ftil:
- Use of fill Is not allowed in Flood Zone"V"unless expressly permit►ed.
- if the fill material is ta be used in Flood Zone "A", it is understood that a drainage plan addressing a
"cpmpensating volume"wifi be submitted at time of permittir�g which is pcepared 3iy a professiona!engineer
licensed by the State of Florida.
- if the fiil material is ta be used in F{aod Zone°A"in connection with a permitied building using stem wall
construction,!certify that fil!will be used only to fl�l the area witnin the stem wa!!.
- If fill material is to be used in any area, I certify that use of such fill wfll not adversely affect adjacent
praperties. If use of fill Is faurid to adversely affect adjacent properties,the owner may be cited for violating
khe conditions of the building permit issued undes the attached permit appNcation,for lots less than ane{1}
acre wh'ich are elevated by fill,an engineered drainage plan is required.
if i em the AGENT FOI?TtiE C3UVNER,1 promise in gaad faifh to inform the owner of the permitting.eonditions set forth in
this affidavit prior to commencing construckion. !understand that a separate permit may be requ�red for electrica!work,
pfumbing, signs,weiis, paols, air conditioning, gas, or other installations not specifically included in the application. A
permlt issued shalE be canstrued to be a license to proceed with tt�e wark and not as authority to vio{ate,cancal,a{#er,or
set aside any provisions of the technical codes,nor shall issuance of a permit prevent the Building Qfficia!trom thereafter
requiring a correction of errors in pians,consfructian or vioiations of any codes. Every permit issued shali become invalid
unless the work authotized by such permit fs cammenced wiihin six rpanths af permit issuance,ar if work authprized by
the permit is suspended or abandoned for a penod of six(6)manths after the time the work is commenced. An extensian
may be requested,in wriUrig,from the 8uiiding Official for a period not fo exceed ninety(90}days and wiii demonstrate
- justifiable cause for the extension. !f work ceases for ninety(90}conseou#iye days,ttie Joh is considered abandoned.
{NARNit�G Tp 4WNEi2: YOUR fAIi�URE TO RECORD A NOTkGE OF CO NI.�j "�MENT MAY RESULT W YOUft
PAYING 7WICE FOR IMPROVEM�NTS 70 YOUR FROPERTY. !F YOU!NT�D�i�l¢�TAIN FINANGlNG,CONBULT
IT 1(OU LENDE�'AIG�I ORNEY BEFO E RECORDiNG YOUR �TdG O�CO MENCE NT.
FLORIpA'JURAT(P:S.S 0 , .., .-, .... .,_.. _.. .
OWNER OR AGENT__I��def"�' �W••• _, CON7RAG70R . _e
Subscribed and swom lo(ar e irmed)before me this Subscri�e a swom lo irmed)before me this� '
by 1
Who is/are personally known to ma o'r haslfiaVe prod'uced Who is/are p rsonally k� +Nn me or haslhave prod'uced �
as ldenkification. as identificetion.
�
Notary Pu6iic �� � �� N tary Pu6iic
Gommission No. C mm3 io Nb. ��Y���'�
� ;;�� �'k� Commission#FF 150422
Name of Nolary lyped,prinled or stamped Nain af Nolary ty ala �
'�,��tidfl?.�`� 8onds�iThNTroyFainlnsorancu900�385d0i3
I
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SERVICE INVOICE LOCATIONOFWORK YSCA Yes / No
�_ .
CHECK LIST 178 2 7 NAME
❑ COMPRESSOR � �i�T�C� ADDRESS
�S��T�ON PS� � � ,� � � 4 V�b��,� �Yls
❑HEno Psi '� ,r r T ; WORK TO BE DONE-CODE
A �
❑VOLTS IIMPS n 813-779-7508 ` I
❑ELECTRICALCONNECTIONS �� � � GD P.O. BOX 1120•ZEPHYRHILLS,,FL 33539 .r.J��t�.�
❑coriracrsn�rtrac�aN ' ` v
❑OILLEVELBCANOfT10N BiLL� FL State Lic.#CAC1815498 �Date
❑ CONDENSER COIL �ME
❑CIEAN COIL 8 CHECK FlN COND. SERVICE COST ENVIRONMENTAL'CHECK UST
p erir 'F WG °F � , � TECHNICIAN
❑ REFRIGERANT S�E� PHONE WORKPEHFOiiMm OiY. UNRPpICE
❑ FAN A DcMOTOR PGl-�� � —� roRCH us�ce
❑v o�T s A M P S C I T Y STA ZIP �cwMeo
( �''7�� � VACUUM PUMP USACaE
❑ELECTRICALCONNECTIONS '� / �J'"�" Sp
❑coNracTs nc►rr a c�w AKE MODEL SERIAL NUMBER
❑FAN PULLEYS(ADJUST B0.� 0 �`1 � �- ' � � .,,� QTI: MATERIACS
❑CHECK,LUB BEARINGS&MOTOR y� ��t
��� MAKE MODEL SERIAL'NUMBER
❑ EVAPORATOR COIL R}t'IT 3�D�7 1 TA � 17/ .��� REFR�GERAM 0..
❑CLFAN COIL 8 CHECK FlN MAKE MODEL �SERIAL NUMBER
❑ENTDB_°FI WGDB_°F �I�/1�0,.
❑ENT WB_°F WG WB_°F �� Dv .
❑ CONDENSATE AREAS �E . MODEL SERIAL'NUMBER
❑INSPECT d CLEAN DRAIN PAN '
❑INSPECT 8 CLEAN DRAW DESCRIP'T10N OF WORK PERFORMED
❑ AIR FILTERS
❑c�weo ❑R�ucen
FlLTER SIZE � �
❑ HEATING ASSY. �'Y� . �1 �' (.�,� e
❑BURNER&HEAT DCCHANOER �
❑RIELSUPPLYBPRESSURE �S�II /`� . �� ✓
❑PLLAT ASSEMBLY �
❑FLAME A0.IUSTMENi Q` /`, /�, ! �`-�C
❑PRIMARY RELAV 8 RUE a `' D�--' yil I` �' �� ' !U� �-+� I( � �/wt1�1 �-1 r'�^-''
❑FAN fl LIMR SWfTCH OPER
o�,����,a� m�-�� s� �o,� P� , T �- �
❑STAIP HEAT '
❑DEFHOSTCYCLE �
❑ ELECTRICAL COMP?S
❑RELNYS ❑CONTACTORS
❑OVERLOAD �O PRESS.SWfTCH �
❑ THERMOSTAT
❑O.K ❑REPIACE ' TIrtIB Of ARIV81: _
❑RELOCATE '
Time of Departure:
RECOMMENDATIONS I HAVE AUTHORITY TO ORDER WORK AS OUTLINED ABOVE.THIS INVOICE IS SUBJECT TO A FINANCE CHARGE OF 1 1/2%PER MONTFi. TOTAL SUMNIARY
ANNUAL PERCENTAGE RATE OF 18�WHICH IS ALLOWED BY LAW.I AGREE TO PAY ALL COSTS AND REASONABLE ATTORNEY'S FEES
IF THIS INVOICE IS PLACED IN THE'HAND5 OF AN ATTOHNEY FOR COLLECTION.CUSTOMER RECEIVED NOTICE OF CONSUMER TOTAL
MATERIALS
RIGHTS UNDER CONSTRUCTION INDUSTRIES RECOVERY FUND.
TOTAL
LABOR
SERVICE
CUSTOMER'S SIGNATURE CALL CHG.
, TAX
LIMRED WARRANTIf:Ail materials,parts and equipment are warranted by the manufacturers'or suppliers'written warranty only.All
labor peAormed by the above named company is warranted for 30 days or as otherwise iodicated in writing.The above named company
� makes no other warranNes,express or impiied,and Ns agents or technicians are not author¢ed to make any such wananties on behaB of above �
named company. TOTAL 'I�Q