HomeMy WebLinkAbout17-18721 CITY OF ZEPHYRHILLS
: . 5335-8TH STREET -
(813)780-0020 18721 %
BUILDING PERNIIT �
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 18721 Address: 5316 11TH ST
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
' Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: CHURCH Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0100-17100-0100
' Improv. Cost: 4,280.00 OWNER INFORMATION
Date Issued: 8/04/2017 Name: SAINT JOSEPH CATHOLIC CHURCH
Total Fees: 60.00 Address: 5316 11TH ST
Amount Paid: 60.00 ZEPHYRHILLS, FL. 33542
Date Paid: 8/04/2017 Phone: (813)782-2813
Work Desc: A/C CHANGE OUT 3 TON SPLIT HEAT PUMP/ MUSIC ROOM
CONTRACTOR S APPLICATION FEES
BAHR'S PROPANE GAS &A/C, INC. A/C CHANGEOUT 60.00
� '\
�
Ins ections Re uired
DUCTS INSTALLED
DUCTSINSULAT
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 performed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
�
NTRACTO I NATURE 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 813-780-0021
; �
Building Departrnent .
Date Iteceived � 7�� _ �"��3,,
-�-: P..hone�Contact forPermittin ` �3'
Owner's Name !� � o�/. � Owner Phone Number ��3" ��o� o�-O L J
Owner's Address ���� ��0�00 �/ I�Z=Le!'S Owner Phone Number
Fee Simple Tltleholder.Name � Owner Phone Number ' �
, � _ . ,
Fee Simple Tltleholder Address
JOB ADDRESS S�I� JI� � � � r�j/� S �� ���I�CSIG �/Y] �/ LOT# �
suBoivisioN . e,aRce�io# �l! �lo �l D"�/d J 71�� D��C�
. . (OBTAINED FROM PROPERTY,TAX•NOTICE)
WORKPROPOSED :.'NEW.�CONSTR ADD/ALT Q' SIGN�- Q• " � ° Q� � DEMOLISH
� .B, INSTALL � REPAIR -• - _. ,
PROPOSEDaUS� - Q SFR� Q ' CONiM• - ' Q •OTHER ' � � •
TYPE OF CONSTRUCTION � Q BLOCK ' Q FRAME � �Q STEEL Q � _
�J. � �" �,\
DESCRIPTION OF WORK j ��'All,fj �q� � �L° � /d/� �/�G j�� U 1���/G' �aJ1')`,
. �,C�= , ;�: �. Ca7nn�o�en1 T.S
�UILDING SIZE - ' � `SQ FOOTAGE HEIGHT.�
QBUILDING , $ .�.._._. _. _ ' . � � ..
, VALUATION,:OF=TOTACCONST�RUCTION - �
QELECTRICAL $ ' AMP SERVICE 'Q ` PROGRESS ENERGY Q. W.R.E.C. �
QPLUMBING :$ ' '
�.�. -
QMECHANICAL ' $ i1.j p0,� VALUATION OF,MECHANICAL INSTALLATION
�7 ocd •
Q�S Q ROOFING ,Q SPECIALTY Q OTHER - . �
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES ;NO �
BUILDER COMPANY'� - . . , _ � ,
SIGNATURE REGISTERED Y/ N -FEE CURRE� ' Y/N". "
Address v � License# � �
ELECTRICIAN. - � COMPANY' ' � n ' -
SIGNATURE � REGISTERED Y/ N FEE-CURRE��' ' '•Y/N
E .` . . ... ., ' � ,
Address � - - � _:. License# :
PLUMBER COMPANY . �
SIGNATURE' ` � _ REGI3TERED. Y./-4N.,; „rFEE CURREA ' Y/N.�`_ „_ ,
Address � . � .�License,# , . r . �
MECHANICAL'' � A Lp/L . COMPANY nbl�S.�„OpA%1J���`"R�Gr ..�.
SIGNATURE� ` �� ' � REGI'STERED_;� Y,./ Nt, . ; FEE CURREP s. YJ�N . t
Addres's�� '77�� ���eN:� ;9� �hil. _ , t ... . ..ucense# �i���,T3q'�'�; , -
. . � . . � . .. , , . �� -
OTHER " - ' FCOMPANY � ,
,. ,
., f:�. " a; • -< - ;•r_., � . ,.RED�
SIGNATURE .� - � • � �� ` '�REGISTe ''Y/ N,..:�` `:FEE CURRE� Y'/N
Addre� . . s ,,� , - . .. : � Ucense#� . � � - . ..
r. �r�ry..,:..,.._.. � ,,;� .
RESIDENTIAL'.:-,e :Attach''(2).;Plot�.Plans;�(2)§ets:of Bullding�Plans;'(1)sef of'EnergyFForms;`�R=O-W'Perrn,lt for'new construction,. ' " '_ ' �_ "
�-, ,.;;;;;.Minimumiten,(�1,0);�working;days�after;submiHal`date..Requireii onsite;_Constiuctlon=Plans;�Stormwa4er P1ans wl SilfiFence.installed,
` Senitary Fac(IlUesti&�1;;dumpste_r,;Site�:Work�Pertnit for;subdivisions/large.proje�fs;y ��.-�, "- :..;'.
- - CONIMERCIAL Attach(3)�compl'ete�'sets ofs6'uildtng Plans�plus e'Cife'Safe{y Page;(1)set of Energy Forms.R O-W Permit for naw construcUon. ��
Minimum ten(10)worlcing days after submittal date. Required onsite,ConsUucBon Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilitles&1 dumpster.Site Work Permi�for ail new;projects::All commerGal requlrements,must meet compllance' "� �
SIGN PERMIT Attach"(2)-sets�ofEnginee_r,ed;Plans.;.:s ��=-- � ., � .. - .
""PROPERTY SURVEY required for all_NE�'V construcdon.. . . -
- - -- - z.
DirecNons: � ._-- - � �T' •
FIII out applicatlon completely.
Owner 8 ContracMr sign back of applfcaUon,notarized
If over 52500,a Notice of Commencement t�requlred. (AIC upgrades over a7500) ,
- „,�r_�<;:,
'" Agent(far the contraotor)or`Poviier of Attoiney�(for tFie owner)inrould be someone with notarized letter trom owner authorizing same
DVERTHECOUNTER.PERMI7TING- „•(FrontofApplication•Only) - ' � - ; ,,
Reroofs if shingles Sewers _ ::Service Upgrade's /VC�""""`"'�ences(PlodSurvey/Footage) � ., . ', " �•.,, t;:
. _ _ • ' , };. . . ,. .. . , � � ..
Drivewaya-Not over Counter if on public roadways..needs�ROW " �<; ��,. . _ ,
, , , , . : .-
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MQTICE OF DEEQ RESTRICTItiNS. Ttie underslgned,under�tands-;th�t.#hls.: 8.rmi�*m ,,_,be,sub e.ct..tar"deed",restrt ' "° _.
• c#tons,,.:.,_,.�«.�.�
which may°besmore�r.estt:icttve=th���ounty��regulat�ons. �The underslgned�a�ssumes're`sponsiblltty�for`compllancu'witHYany��}�` ����'�'"��
appliceble deed•-restrictbns. ;.vr :, ... . . ,..,. � '. • � , .. ,._. � .. , , .� . ,.,
UNLICENSED CONTRACTORS �AND CONTRJ�.C70R R@�PONSIBI�6?iES: -1f-tlie��owner=hasµ�hiced"a�"contractar or �
oontraotors#o undertake work, they may:bs:krequ:ire,d:to;be:pcensed�lnsaccardance.with.state.and.�local tiregulati.ans:,�if�the-� n'� }r n'= '
cantractor�ts�-riat��llcer`tseif��as'requlrod`tiy lauv� b0#�1`th8 qVYRB!'8�d'�GOt�#fBC�OP;ni�t be•clted°for•��rnisdemeanor violation
under state law. if the owner or intended-�con�actor ere,:unaectaln as to what Ii+censing;requlrements�mayrapply�ior.=tFie��=._ . 4-��'
, , . ._,_.,.....v-�.,.,.,_.._.._..._ .. n. . .
intended�i�iorkE ttiey afe=aefvlse�f�caritact t!%e.Pasco County-Bu11d1ng�fnspectlon,D�rislon-.-l:Icen.s_!ng Sectton at 727-847-
8009. Fur#liermore, tf the owrier iias�hl�eii a conhacto��o�contractors, he is advised to hsve �the conhac#ar(s),;sign_ .n
,,.,:�,.w..,.��,..,,�,,. ., _
,r..,., : , .s.,.
portions of the °contractar Block'° of this,_appilcation_for�which.they,will:be.r.esp.onsible:- If you,,;as�the bwner's,ign'�'as�tlie"' � '�
contraatvr; that�m�r'be an 1nd�ca�on#ha#�`fie�=ls ito#':�rope��Ilcerised antl"Is�tiot erit�#ed ta petinitting pritiiileges In Pasco
CoU11ky. ' , :,w.a:;;::°r.... ,..,..
TRANSPORTATICIN�IMP/4GT/l�Tit�i'T�ES-l�tIRAC'1'�ANb ltE�C1URCE RECQVEEtY�FEES,-�The understgned"unde�#ands
thatTrerisportation Impact fees and.Reco.urse Recovery.Fees may°.apply:#c�t�e:consUuctton of new„bulidings,?change�of�`� �`'=�'`�`4
use In existing bulldings, or.�expar�si�nrof=�izlsti�i��,bulldings,`as speclfled.in Pasco County Ord(nance number 89-07 and,
90-�T� as amende,d.,t.,The undetsigned aisa:urtderstands, fha�t:�suct�fe.es,-,as��nay:tie�_due;�wttl.�be i�ent�Eed at ti�e�time�of��§- .°:°:,.�1°
� ,.w_
permitting. It Is iurther understood that Tra�sportatlon ImpactTFees ancf°�Ftesour'.ce�,Recoi►eryx�Fees,_mu�t be pa�ld priar to
rece�ving�a"ce�f�tcateraf�accupancy"�or#inal�power.;(elease; :lf�fhe,proJ�ct.:doess:not Involvewa'cert�ic�te of occupat��t°or�;�;}�.':�:�.
final power-release,�:,the;fees•:mu�t�be paid,p��or#o..permit Is'suance. F��thermore,�°if Pasco,.County'°Water/Sewet-;Imp�cF � =���•.-�
feesaredue,.they�must.be;pald.pi4otto_permlt;lss�uanca=ln.ai;cordance.witl�:appltca6fe:Pasco�:County'onllna�ces. •
CONSTRUCTtON`LIEN"t:�CV11(Ciiapter 713� Fiot�kla Statttte�sM as�mend�dj: tf valuation of work Is$2,5q0.80;or more�-1 �-,t�
aertify,tFiat I� the-.applicent;-have:.been providetl��vvith.-a=capy�of the "Flor(da� Constructton�-Lien..Law Homeowner's
Protectbn Guide" prepared by�tlie Flar�da Depa�finent�of Agricut#�re and Consum�r::Afifaics. 1�#he applicant is someone ,r :_., ,
othecthan the°owner", I certifjt�.that,,lri.have:obtained�a�aopy.of..the;abova:des.crlbed�docu�ent;a�d.pr.amise,in,goa��,faith.to . >'a
del�ver it to.the='owrie�`..:or� .. - ' � � �� : . .
pri �#o�coi�imericeritent:'�
CONTRACTOR'S/OWNER'S AFFIDAViT: 1.cer#I�y.�.th;at,.aii:the�;,lnf.ormatlon:.���thl�appltcatlon is accurate�nd that�il�wark
witl'be done in compp�nce wlth all.�pplicable laws regulating constructlon+ zoning and�-land�deyelopment. Appllaatlon is
hereby made to obta€n .�.permit,,to...do.-workz.and;lris#�Ilation as tndtcated:�:>.3'1. certity #hat no work°or Instailation has
cammenced p�lo�to i`ssuance of'a permtE"'and that.all work will be pe�farmed�ta meet standards-af all laws regula�ing�
construc�ian� Coun�r and C��y codes, zoning �egwlatians, and la�d devetopmer�t regtsla�ons�Iri ttie JurisdtctEon.= I:;al'so ,. _
certify that I understand that the regulations of other gavernment agencles may�apply�to the.intended work, and that it is
my responsibllEty t+o ldentliy�what.actions!must teke,to be,lnt.corrlMlance.4.S.uch,a�encfes�ln�lude b�t�are.not Ifmited to:, � �<
- Depa"rtment of Et�vironmental>�Pratec'tion=�yptess.`'�Ba3rheads;j 1IVeHand Areas and Environmentally Sensitive
Lands,Water/Wastewater Treatment. ,y
- Southwest Fiorlda Water Management�`::Distric#-We1Cs;- �Cypress. Bay#�eads;- "Wettand Areas� Atterliig
Watercaurses. - -� - �
� Army Corps of Engfneers=Seawalts��Docks,Navlgable Watervirays.
- Department,of.Heaith:,��;Re�aabilltafiye.�,Services/Environmental�.Health Ui�tt We4.s, Wasteu�rater�Tnaatment,
Se�tic Tanks:.�:. _`: ,_' . ' ,_ . - . ;_
- US Enviranmental Pratectlan Agency-Asbestas abat�ment._ °
Federal�Av,lativn�Authori#y=Runuvays;� � , w _ .
1 unders#and-.that.the.foliowlrig:iryas�rlcttons appiy`ta tfie use of flll: .
- Use af fil�is not a{tawed in!Flood,:Zone"V"unless expressly permitted.
- If the ;fllf material�-Is to� b.e used::�In :Flovd �one "A", �ft Is understood�that a drainage plan 'address(ng a
�compensating volume"will be submitted at�ime of rpermifting wh�ch is prepared by a prafessionat engineer
Ifcensed by lhe State of;Flotida. � - -� ..
- tf fi�e filt matertal..is�to be�used In Fload �one "A� Itt�conneci�on�w1th:a �ertnitted bultding using stem wall :
� conatruction, I certify,.that f[Il.wall:be-used only.to.fill#he area-within�the stem=wralL -
- it' fl!1 material Is=ta be used in any area, i aertlf�r that .use. of T such�tIH wlll not adversely affect adjacent
properties. If use_of fili is fonnc�to adversety:�ffect adJacent=�pr�perties,.the owner may be cited for viofa#ing.,
, _. <. .
the condltions�of the building':perniit t�"sued-under the��atEacfied permit-appllcatian;for lats�.less=than.one (1)
� acre wti}cti"are el�irated�bjr fll�;a�t engtneer�ed dratnag�plan is required. . .
If I am the AGENT FOR�THE OIMNER;,I;promise In good,faith to infarm the�owner of-the perniltting condi#la�s set forth in
thls affidavt!`prior ti�commeracing constructian.•i "uniletsfand that�a�separate permit may be requtred for etectrica# work, . .
�,,...�, .
ptumbing,_,signs, wells,..poots;, alr conditioning,.ge�s,.-oc.otMer installa�tions not.spec.fftcatiy included�tn.the applicatton. .A
permit Issued 5ha11 be construe.d to be`a�It�nse�ta�proceed wlth ttie work and not�as:authodty to.vlolate.�°cancel, alter, ar
set aslde eny provlsians'of t�ie.#echiilcal code�;�nor shall lssuartce3of a.permtt.preven#th�8ulldlrig t�#Flclal from tliereat�er.
requiring a.correctlon af,errors In:plans; constivctian.or violatlans of�any codes.� �very p�ermtt�issued"sfiall'beaume°inval(d
unles� the work aiathorized.by such permit��ls-coEnmenced•writhin si�cvmonths of�permit Issuance, ar iFwork autharizecf by
#he permi#is suspended or,.abar�doned,-for.a;perlod;of�sGc.(8}mnnf�ig.aftec:the;tlrne the�workas commenced. An extensian
may be requested� In writing,:f'rom„tHe.'Bullding.Otticial�far a period-nat.to�exceed�n(nety�(90)�days a�d-wili�demons#rate
�ustl�abie'cause for.�the e�enslon: ff work ceas�.for nlnefy{90}cons.�cutive day.s..the�ab�is considered abacrdoned.
1NARNING TQ OWNfR; YQUR_FAIl.URE..TQ,R�ECORD,A:��QTlC.E.QF;�COMM6�lC�ME[�lT,�AY RE�UE:T 1N:YOUR
PAYING TWICE;FCIR IMPROVEMEN;fiS�.TU,YOUR:::PRC-1PERTY:`��I��YOU{IhITENi��TO��BT�AIN�=FINiAI�E1NG;'CONSUL.T
--= ��"- U ; � U � �il+l�' 1T0 R! •" �E�. -f3R�► �a; ;�V � : ;�. :d �. ,.� � � � � - .�.•`�_— ---
FIOR#DAdtlRAT�{F.S:1. _:. 3} ,� . . : ' . , _ � _ �� �
4WNER OR AQLNT � ~ �'�'Y . ~��''+�' GCMTRACTO `.. �
�bs bed and swam io( aflicmed}b�fore me thts� S scxlbed and` �a ot attirmed�, me'ttii�=
- ,. ..
Who is/a ersanatl knrnm .me.or haslhave.produced Who.fs/�re�8�aonaliy knawn_ me•or basA►ave•produced- •
as Id'en�ftca8on. ° as tdentNication.
/�-`�=--�• Notery Public . � Notary Publlc
C tsslon No.` . � Go lon.No.
,,"p�,µV�P�j�b, SYLVIAA.CAMPBELI ��"'�'P�-., SYLVIAA.CAMPBELL
Name ot IValarY tyP �, a u - a e o or a P18me of lJot�rY 1yP$d,A p °ary c-
_. « = mmission�GG 172934 ;.; Commission#GG i 12939
="� or:` My Comm,Explres Jul 19,2021 's r- oPr My Comm.Expires Jul 79,�021
�'^•.;�oFF;:�`'' gondedthrou9fiNationafNotaryAsso. .,���,n�f;�O�� ' HondedthroughNationalNotaryAssn
� � � � t � PROPANE GAS • �
� AND AlC wc. ervice Order/Proposal
��ce�988 8�3-782•50 i 3 , Invoice �
- WORIi ORDER#/SERVICEMAN 79�c` CJIV
Sales, Se,Nice & Installations . gATE�T:[I�E TAF'Ehl ' Q�7!`►�ii7 �Z�9o�6
4441 Allen-Rd. • Zephyrhills, FL 33541 Tr�i:� �v N,. Ro �►`
NOTES: � DATE/TIME F�ROMISED
CUSTOMER#/LGCATI01�1 1933� /��
F'HOfVE# 81�-78`—L81� 0
�'HONE�'# 81,?,-7A8-1�►36 F
. � F�HOIVE,�# - • 81 J�'"TJ'7�J5.J 1�
CQNTACT MIKE CDZINA
ROUTE/SEG? CJN
ST JOSEF�H CATHOLIC GHURCH " ST JOSERH CATHOLIC CHURCH
5�16 11TH ST 531F 11TH ST �
' •�-4�,U:S_IqC1�F2�.00M=�.�i .
�..��.��� =
ZE�'HYRHILLS FL ���4� EF'HYRHILLS FL�,=,54�: "
RUDD: F 15F�36R�6A, EMC5�7J�hErJ
" • 3T RHEEM HF� A/H :[N�TALL_ 8/1/�7
RE—COND- RHEEM CDo RF'KA—�35JAZ
� SER: ErJ.����4�•��J'�-F1Jy '�'��i::F�i�'�'
UNIT• COh�PLE7ELY OLJT Q� FREON I HAF�REIVDED SAh'#E TIME Ol"HER UNITS WERE DAI�AGED
-e _ _ '"".l:,r..�:. � .. ...
�� `-:��'DESCRIP�'ION<�F oWORK,_='�_: ' ,. ��"- QTY. '-�' MATERIALS S�SERViCES_ _ - : UNIT PRICE=� `AMOUNT;.
_ ".,. _ -
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,fr. � - , RE'COMMENDATIONS - � , ' - i i
- - i i
�AnnLal"Maintenance'Recdmmendetl�tiy Ail�Equ`ment'Man���,'�ers.;: ' '
- , .� :"�,�= Pressures Lo H I T-Stat i i
. ' 'REFRIGEf2ANT R=' � LBS:`�- S per Ibs._ : I, . I
1-� - I
, � . -
. � , FILTERS x x Changed Monthly I I
- ' FILTERS x x , Changed Monthly i� I
C] REGULAR ❑WARRANTY TOTAL SUMMARY „
�-;•,.,..;F, .�.,,: .:._<. '�. • ... -
'�De}iumidisfafSettings:,When here°:ON"„.When Away 6�,-yT-Stat 80°� ❑ MAINTENANCE CONTRACT SERVICE i
LIMITED WARRANTY:�All�materials,parts and equipment are warranted by the manufacturers' ., - '_ METMOD'OF PAY.MENT `, ` - CALL i
or suppliers'written warranty only.All labor performed by the above named company is warranted for � TOTAL i
30 days or as otherwise indicated in writing:The above named company makes no other warranties, O,CASH ❑CK#
E
express or implied,and its agents or technicians are not authorized to make any such warranties on
MAT RIALS i
behalfofabovenamedcom an. ❑DEBIT ❑CREDIT ❑
I
P Y OTHER
MAINTENANCE i
I have authoriry to order�he work outlined abova which has been salisfactorily completed.I agree that Saller PROG. W ! C
relains title to equipmenUmalerials furnished until final payment is made.If payment is nol made as agreed, CLAIM# �
seiler can remove said equipmenUmaterials al Seller's ezpense.My damage resulting from said removal shall
not be Uie responsihiliry of Sellar.NET 30 DAYS.A 1 1/2%SERVICE CHARGE WILL BE ADDED MONTHLY TO �
ALLUNPAIDBAIIWCESOVER30DAVS.NOREFUNDS DATE COMPLETED
, TECH� �p T� i
CUSTOMER3�GNATURE DATE 1G%U//Gt( a�o-c� TOTAL 7 K/J�
�j W