HomeMy WebLinkAbout17-18648 � ' CITY OF ZEPHYRHILLS
�- 5335-8TH STREET
(813)780-0020 18648
BUILDING PERMIT
" PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 18648 Address: 37704 NEUKOM AVE LT 11
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: GRAND HORIZONS
Est. Value: Parcel Number: 34-25-21-0090-00000-0110
Improv. Cost: 4,010.00 OWNER INFORMATION
Date Issued: 7/11/2017 Name: BELLOWS STANLEY A& ELEANOR
Total Fees: 60.00 Address: 37704 NEUKOM AVE
Amount Paid: 60.00 ZEPHYRHILLS, FL. 33541
Date Paid: 7/11/2017 Phone: 813-395-5097
Work Desc: A/C CHANGE OUT 4 TON
CONTRACTOR S APPLICATION FEES
BAHR'S PROPANE GAS &A/C, INC. A/C CHANGEOUT 60.00
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Ins ections Re uired -
D CT N TAL ED
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 Accampany 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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CONTRAC OR SIGNATURE PERMIT OFFI R
, PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
, PROTECT CARD FROM WEATHER
� �8���aa-ooaa City of Zephyrhills Permit Application Fax 813-780-0021
Buitding Department _
Date Recelved - �'`� . – �'�� .
: Phane=Cantact�'for Parmiitt�n =
Owner's Name �/ v�d�a G �C� Owner Phone Number p ,;1"� /� �
Owner's Address �7��� G�' t?�'7 .� Owoer PhoneNumber � ]
Fee Slmple Tltleholder'Name �� � Owner Phbne Number �� tt-1
Fee Simple Tltleholder Addr�ss
JOB AClD�ES$ ����� e!�- Z'�I �=- LOT# C��
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SUBpIVtStON �— � • PARCEL ID# � �7 �1 l✓ � ���' �l1�
' � � . (OBTAINED F.ROM PROPERTY,TAX.NOTICE)
WORK PROPt?SED �.NEW CONSTR ADDlAIT � � SIGN Q• Q pEMO�tSH
- , ;e,. INSTAtL ;_-REPAIR �
PROPOSEDrtlSE � Q SFR. Q ��COMM' � �OTHER °
7YPE OF CON$TRUCTION �]' BI.00K " Q FRAME �� StEEL `Q
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DESCRIPTION OF WORK .t .�L G�1�l�J"tU e�C3I.$� � COn� 15J�,�G✓/�f� . � �T� -
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Btll[.DlNG SIZE �� � SQ FOOTAGE ` � � .HEtGHT�.C_`---_+�
Q$���'�fN�' 1"' � VALUATIOR1:i.'1F`'f01'Ati'CONSTRUCTIOIV -
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[�ELEGTRIGAI y f$ ��� '� AMP SERVIGE Q PRfJGRESS ENEF2GY Q W.R.E.C,
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[�PL•UMBtNt3• �� - , '
r�r VALl7ATlON QF:MECHANtCAL INSTAi.CATiOfV
I QMECHANtCAL $ � ��. '
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QGP.�S Q ROQFfNG _Q SPEGIALTIF �� t}THER
FINISHED FLOOR ELEVATIONS ��� FLOOD ZONE AREA [�YES. Np .
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B�IE.DEit COMPAt+iY� . • ;
StGNATURE REGISTERED Y/ N . � FEE CURRE� ' Y/N
Address ' License#'��, �
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ElEC7RICIJ41d:.,�, , . _ ° ,aC091�1P,�WY . ' , . � ` (
SIGNATURE � REGISTERED Y/ N FEE CURRE�"' � ''Y G N
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Addre� . , . ,- LtceriS@#.�` _
PLUMBER" � � . . `, ,.COMt?ANY ` : .� � ' I
SIGNATURE� 'ry'` _ REGIST,ERED, Y/,N• - �1FEE CURRE�, Y/N. � I
Addre�S LiG@nSe,# ��
M�c�aN�ca�: - `��'; _ ' co�iP�r�ir �}.�f2.`S � ��� �
SIGNATURE� � � " ` y" j REGIS7ERED:,, Y,./.N. . ; FEE*CURREA=. x: X:/�N • . , �
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OTHER �^ '' � � � ~ ` ' ;CQlVqPAWY ..1�;. . . .
SIGNATURE "'-�� ' ` ° . � ' ' 'REGI$TERED; ' " 'Y/ N:.., "'FEE CURRE� �' Y/N
Addres$� -�°r:: 1�. . tz: =,' �- ,}� ' �_' ` � ' L`iceiise# f" ' ` ' 1
RESIDENTIAi:,;;�,Aitacti:{2}.,F36#�Platis;;;(2}`sets;of'Bui'!'dings F?tan's;{'1}se#of=Eiiecgy'�aiins;ft-0�ltViPer_`init far�`new coi�struction, " ` ' �
4 s.�Minimum kenti(�10)�wrcrking;dajrs`aftei�"subm�ttai�date.�,Requi�ed onsite,ConstnicdoirPlai►s;'Stormwater'Plans w!Siit Fence�installed,
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Sanitary Facilfties;&9�;dump.ste_r,rySite:Work;�Penmit`for:sukidiyislonsAarge:proJects;bc..,;;�" ` m° . - . ' '�� :. '
COMMERCtAl. Attach{3)�a�mplete sets`�of Bu[Idlitg Plans plus a C(fe Safety Page;(1}se#of Esiergy Forms.R-O W Petmit foc new construc#tan,
Minimum ten(10)wrorking days after submithal date. Required onsite,CanstrucNon Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities 8 1 dumpster.Site Work Pertnit fur all new:projects:.All comrtier+cial requlrements_must meet c�ompllance �
.�SIGN P�RtY1FT Attach'{2)sets�of'EngirtieeredcP.:.�ans.s>,�;...:�;"°: � .;°.,,�_,•. .. .." s ' '
"•'"PROPERTY SURVEY required for=all IVEW construcUon..._ �
' . Ditections: ,,v., .. . . ,.
, Fill out applicadon compl�tely.
Owner&Contrac#or stgn back of appllcatton,notarized �
if aver�:500,a Notics.of Cammencei»ent ia r�qutred. {A1C upgrades over�b7500) , �
4a .
'" Agent(for the`contraotot)�o"r'Pouvei�of�i4tt�me�r(for tFie pwner)�would be someone with�notarized�let�er��""�i"��au"�'i'b�i�i�5gs��iti��"'��'�`�'�'
< � 4:{,r;:7.r�M`.1�`)'t i ,' . ,� i.F.��s;;a"�' �`+ z'i,i" ,.<
°OVER:THE GOUHTER:PEI2M!'fTlNG._.:-r„�(F!�Es�sa�,App!lt�ttion Oniy)-. _ - °° � ;;t:,,��r=�_�.,;rFt :: �.,
Reroofs if shingles Sewens 5ervic�f Upgrades„NC + Fences(PladSurvey/Footage) ��q�$ r�t �,;; ,- :,� w,
..... -.,.....,........... ......._. .^r'-,� l4 i:>,i"�4t �a.'v.`,.s.�:i�; :'},.. .. t'J�:riSl,.# � : : {t" " - _,-f'V
Orivaways-Not aver Coun#er if an�pubtictroai�ways:.need"s ROW,,, �,4�;.,,,, . '�
c�= ,�x�`i"`'Vi«r"'•��a'�f?"'�:��'•nra�".�{��"x-.w;:;3rw2-v.-'s•;' , ' rQ`�-}�'•':t:" . -:,.z�'�;
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NOTICE OF DEED R@�`�RICTIONS: Th�undersigned,unde�tands��tt�t;this:��emit;may,be.subJect;to_°deed"restric#lo�is"`� ,. _.�
which may..tie<more�r:esttictive-�tha��County���regulatrons:�rTtie`underslgned'assumea�resp�nsibillty,Yfor"compliance°witFi•any'`� �'�. "
applicable d�ed restrictions. .�:W::..:.... . . :. :: . , - -,�, `�,:. . -.. .._
UNLICENSED CONTRACTORS �AND CON�RACTOR R�SPONSIBICITIES: ��If-tfie�ovmer=has=-�Fiired��a-contractvr or
contractors to undertake work, they may:b,e_required_to.�be:;ltcensed In.accordance.with,;state.and:local,�regulations:��if=the�•����-��=r'
contractor:Is not Ilaensed=as�-re�qulred"tiy'law�'6oth`the owner.and��contcacto�--may�be��c(fed°.for�a�-misdemeanoc violatton
under state law. If the owner or Intended;;contractor;ere,,,uncertaln as to what'Iicensing.,,requlremerrts�mayz�epply���for=the`��-�:°��=�����'
:, ....,:., ,,�,-. :; - .
intended"work, they a�e ad'vised to coritact the:Pasco County Bullding"'Inspection Qtvlsion�.-Licensing Section at.727-847-
8009. FurtFiemnore, If the owner'iias`�hired a 'cont�acfor or contractors� he ts advised to have �the contractor(s),_sign,_ _�
portlons of the "contractor Block" of this�application_for�which.they will:b.e-r.esponsible.-.:if you, as�.#he owner'sign"'a§ tlie` �
-. ,...:._.._._ .--,�:
contractor, that may�be an indication that'he'is not properly-Iicensed-antl'I'synot'entitled"to pemiitting priitlleges fn Pasco ,
County. � ; w._=�:. .� --
TRANSPORTATION-IMPI�CT/UTILITIESIMPAC'I�ANb RESAU�tCE RECOVERY�FEES:`The unde�signed�understands
that Transpo�Qation Impact Fees.and.Reco.urse.Recovery.Fees may:-apply.;to�the�constructlon.of new..buildtngs��change'of�='��k�``�;'°�';;
use in existing buildings, or�expansian�of-�ezistin,g abuildings, as specffied.(n Pascv County Ordinance number 89-07 and.
90-07, as amended.�The undersigned also:understands, ttiat'such fees;,as:tnay���e�,due;�wili:�tie identified at the�time"of�� �' •
permitting. It Is iu"rtFier understood that Transportation impact"Fees an�=Resour�:Recodsry�Fees:must be paid prior to
rece�vtng-�a."cerfificate.-of occupancy"�or flnal�-power:,[elease,� :if'the.proJect�:,does�.not.involve:a:certfficate of occupancy or��-�`��������'
final power release;,the.fees=mus�t`be"patd�prior to.permit Issuance. F��thermore;�if:�Pasco;.County;`lNater/Sewec{,Impact� . .�.:•� ,��
fees are due,.they�-must;.be-.paids.p�lor#o.permit��,l§suance=ln_accord"ance�with:gpplfcable Pasco�-Gountji:o'r'dinances. •
CONSTRl1CTION LIEN�LAW(Cliepter 713� FloNda Statutes,as amendad): If e►aluation of work is$2,500.00-or more,:>Ir- � :�:e�
certify tNat I� #he applicant�-have�been provlded-�with=a�copy of:the "Florida� Constructton: Lien :Lau�Homeowner's
Protection Gutde" prepared by-tFie Flo"rida Departme�t�of Agric.ulture and Consumer�-Affairs. if the applicant is someone ,
..,.;
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other than the"owner", I certffy.that I h�ve:obta�ined'a°eopy.of the�above:rfesc�ibed�docu�ent;and;promise�,in,good'•faith�.to _ .. ,�,
deltve�It to'the;`owner"�:prior:to•commencement:��' ` ' " " � � -� • - , ---
CON7RACTOR'S/OWNER'S AFFIDAVIT: I.cer.tity,:tti:at:all the,lnf.ormatitrn..in thi�appllcation is accurate and that all work
will'be done in comptiance with all.applicable'laws regulating constructlon, zoning and��land°development. Appltcation is
hereby made to obtain .a.permit;,Co :do_-work,;.-.;and,installation as IndlCated:=-..'I� certity that no work'or Installatton has�
commenced prio� to Issuance of`a pemilt�and that.all wark will be perFormed�to meet.standards-of all laws regulaxing-
construction, County and City codes, zoning regulations, and land development cegulations�in the jurlsd(ct(on:' (�also _
certify that I understand that the�egulations of other gov�rnment agencies may�apply�to the.intended work, and that it (s
my responsibility to identffy•dvhat,actlons I must•take to be.in:.compliance:�.S,uch.agencles include-but-are.not Iimited to: �- -
- Department of Er�vironmental-�Protection=Cypress. Bayhead�; 1Netlend Areas and Environmentatly Sensitive
Lands,WatedWastewater Treatment. � '
- Southwest Florlda Water Management-.District-Welis; Cypress.� Baybeads; Wetland Areas, Altering
Watercourses. , . ,
- Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
- Department of.Health;;8,.RehablNtative,Servlces/Environmental Heatth Untt-Well.s, Wastewater Treatment,
Septic Tank§:_ � - � � � - - �
- US Environmental Protection Agency-Asbestos abatement. �
Federal�Avlatton.Autho�Ily-Runways.r � �
I understand that the follcwtng:restrictlons apply`fo tFie use of flll:•
- Use of flll is not ailowed in:Flood�Zone"V"unless expressly permitted.
- if the.fill�material�is to b.e used:�'in.�Flood Zone. "A", It. is understood that a drainage plan addressing a
°compensating volume"will be submitted at#ime of�.permitting which is prepared by a professfonal engineer
Iicensed by the State of'Fiofida: � � - � . .
- , If th� flll materlal�is�to be used In Flood Zone "A" (n�connec4ion�wlth:a permitted building using stem waii
constructton, i certify.,that fUl:vdall:b.e used only.to.fill the area within�the�stem waii: '
- If flll mate�lal Is to be used in any area; I �certifyr that .use. of�such flll will not adve�sely affect adjacent
propertles. If use of flll is found�to adversely:�ffect adJac�nt�:propertleg�.the owner may be clted for.viol'ating '�
the condilions of the buildtng�permit Issued=under the:=attached.permit application, for:lots�:less,.than�one (1)
acre wfilch are elevated�by flll; a�r englneer�ed dralnage plan is required.
If i am the�1GENT FAR.THE OWNER, I;:promfae In_good faith to inform the owner of-the permitting conditions set forth in
this aifidavlt�prior to commer�cing construcNon. I unders4and that a-separate permit may be requtred for elecMcal work,
plumbing, signs, welis,:pools; alr conditioning,_..gas,-.or otMe� Install�tlons not,specffically included�in the application. .A �
permit issued shall be constcued to b'e'a'llcense'�to proceed wlth'tNe wiork and not�as:.authoNty:to:vlolate,:cancel. alter, or
set aside any provistons of the tecfinlcal,c�odes;�nor shall tssuance�of a.permit.prevent the Bulldirig Oftictal from thereafter �
requiring a correction�errors in�plans;cons.truction.or irlolaUons of�any codes. Every,•p�ermtt�Issued"shall become invalid
unless the work authorized:by such permit:•Is.commenced�withln sfx.months of�permit Issuance, or if work authorized by
the perm(t is suspended�or;abandoned.:for-a_period of�six;EB)montiis:after the:time the�work�is corrimenced. An extensio�
may be requested�,ln writing,f�om tHe,Building,O�icial for a period-not.to.exceed'-ninety(90)"days and-will'demonstrate
Justifiable cause for:the extens(on�. If work ceas,�s:for ninety.(90)cons.ecutive:day.s...the)ob�is.constdered abandoned. -
WARNING TO OWNER: YOUR.FAILiJRE..�TC1.,.R�EC.ORD;A��,f�OTiGE:OF��COMMEMCEMENT:MAYrRESULT IN`YOUR
PAYING TWICE;FOR IMPROVEMEN�'S;T�.;YOU�:�.PROPER�TY.-�IF�.YO.U�IN�'fEND:TO�CfBTAiN�FINAPIEING;�C.0�18ULT
— =t�9T - -U - - D �G. =AP�� O Pr1 - OfZ�i, E�ai� � �i� :, , .;�. .<� :: °..� . � _ -- -
FLORIDA JURAT=(F.S 7.03) '�" • � ' � - - � _ �
. �' + '`� o
OWNER OR AOEN -' CONTRACTO �
Subscribe and swo ar aflirtped� e�o me� S�' sc e�nd' � � (or afflrm d)' efore me'tFitg
"1 _ rn �_ '/'"�l'l •b �rn �-- /3�r�en
Who Is pe►sonall . o.me or;haslhaye produced Who.ls/are .. ona o •to me:or hes/have produced •
` ae identl8catlon. as Identlflcadon.
Y `�'�-� Notery Public � " '
- N ry Public_
�
Commisslon No: ,.��'�-"�'';.,, SYLVIA A.CAMPBELL Comrnlsslon.No. � SYLViA A.CAMPBELL
;z -" _ ta��� .;DI�r.- 8 e 0 O� a � . -� � � .
_ '� '�� ,irn Erpires Jul 19,2Q17 � `)•.�. My Comm.Expires Jul 19.20�7
Name o(Notary ,E _ _ .or stamped:� ��� h GF 034230 Name ot Nolary typ�ct;. �r at� ss on
�''������,'� - •�a�Notary Aasn. �''�°�����`' Banded Through National Notary Assn.
,..:,G,,.,,�,....,,�„ ,�„...�
�
s ,� � PROPANE GAS Service Order/Propasal
�" AND AIC �Nc.
�Si�rc��988 _ 813-7g2-5o�3 Invoice ��� �
WC7 FZI-; 0�L�C" aa�� .��. . 1 i_.,E���IN�1 ;F3c�7� �-��:.�
'�.�(�-I�J T I h1L. TEa'r i=I`1 l?�7%�7��,�:.7 1�'����� .
Sales, Service & Installations .�.N},�._r.,, �,,,, �:,�a��F,� �,��
4441 Allen Rd. • Zephyrhills, FL 33541 �,r-��i E�; ��x,�r r�r=����Y�r.v;r__u
NOTES• ' L:i_!c;.�.{�irr�E_F2 i�/i._�)C t�T:[C::i�l i_rJ=PfhG•
��i-i�?r�,_;� r:t=f- :���, �J���r
f:�.7t.l�f'�" '��F't.>� FEE�
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_ f�����(x.Ulhl+r{i-'.. Cs�.';i=lc1�S�E_�k'].:.�7�11
r+L_�::it�'�.hlri WGaF<i��l H.i i, ' ' ..
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� - DESCRIPTION-OF WORK' „ QT`(., =' .MATERIALS&SERVICES � � ' . �• '" �,UNIT PRICE;<.��AMOUNI;.,,.
': ------ -�- --Y��----- -
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' � ` `REGOMMENDATIONS - �/�� �.� , i .� ��� �L
:�Annual:Maintenance Recommended by AII�Equipment Manufacturers. pressures Lo HI T-Stat i �
. ..-i:;� ,. i
, � � REFRIGERANT R, _LB§: - $.per'Ibs.,• � �--.c- - �
. � FILTERS x , x Changed Monthly I I
FILTERS x x Changed Monthly I I
� � ❑ REGULAR O WARRANTY , , ; TQTAL_SUMMARY' `..,,,, „
Dehumidisfaf-Settings: When here"ON", �When Away 60°0;,T-Stat 80° ❑ MAINTENANCE CONTRACT SERVICE ' i y
II LIMITED WARRANTY: All materials,parls and equipment are warranted by the manufacturers' ' ' METHOD'OF PAYMENT• .`'' CALL i
or suppliers'written warranty only.All labor performed by t he a bove name d company is warran le d for TOTAL _ i
30 days or as otherwise indicated in writing.The above named company makes no other warranties, ❑CASH O CK# MATERIALS - i
express or implied,and its agents or technicians are not authorized to make any such warranties on
behalf of above named company. ❑DEBIT C?�REDIT ❑OTHER MAINTENANCE �
- ' - PROG. W 1 C �
I have au�horily�o order the work outlined above which has been sa�isfactorily compleled.I agree thal Seller • , -
relains Ulle lo equipmenUmalerials furnished until fnal payment Is made.I(payment isnot made as agreed, CLAIM#• � ,
seller can remove said equipmenUmaterials at Seller's ezpense.Any damage resulling from said removal shall -• �
not be Ihe responsi6ility ot Seller.NET 30 DAYS.A 1 712%SERVICE CHARGE WILL BE ADDED MONTHLY TO ' . �
ALL UNPAID BALANCES OVER 30 DAYS.NO REFUNDS DATE COMPLETED
:� TECH. � T'� �
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,,.. .:�;- >�; .,,, .� �: ,•.,- • 't:(.• /��y�� �!�/ TOTAL \ \ � �
CUSTOMER SIGNATURE • � � � � DATE v'"""'"� `�du �1�J ��'