HomeMy WebLinkAbout17-18839 CITY OF ZEPHYRHILLS
4 ' S335-8TF{STREE�
(sls��sa-oozo 18839
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 18839 Address: 3843� COTT�NV1/OOD PL
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/G CNANGEOUT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Eeet: Subdivision: DRIFTWQOD
Est.Value: Parcet Number: 02-26-21-021 B-OOG00-0060
Improv. Cost: 4,999.00 OWNER lNFORMATION
Date Issued: 9JQ712017 Name: MACDONALD JUDITH ANN
Tatal Fees: 60.00 Address: 38435 COTTONWOQD PL
Amount Paid: 60.00 ZEPNYRNILLS FL 33542-6617
Date Paid: 9/07/2Q17 Phone: 817-401-9321
Work Desc: A!G GHANGEflUT 2.5 TON
CONTRACTOR S ' APPLICATION FEES
BAHR'S PROPANE GAS &A/ , lNC. A/C CHANGEOUT 60.00
/� ,
t
Ins ectian e uired �
DU T IN TALLED .�
DUCTS IhISULATED
FINAL �
REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the
tacai government shall impose a fee of four times the amount of the fee imposed far 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 addEtiona! restrictions applicable to this praperty that
may be faund in the public recards of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
"Warning#o awner: Your faiEure to recard a natice of cammencement may resutt in your paying twice for
improvements ta your property. If you intend to obtain financing,consult wi#h yaur lender or an attorney
before recording your notice of commencement."
Complete Plans,Specifications Must Accompany Application.All work shall be pertormed in accordance with
Ci Codes and Ordinances. NO QCCUPANCY BEPORE C.O.
NO OCCUPANCY BEFORE C.O.
.� c._.. •
��;�.�r�--� �
NTRACTOR SIGNATURE PERMIT (7FFI R
PERMIT EXPIRES IN 6 MUNTHS 1NITH8UT APPRt�VED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM {NEATHER
a��-,a+1-�,�,�� City af Zephyrhiils Permit Applicatian Fax-a�s-7saoo��
Building Qepartment
c �
Date Reaeived Phone Contact for Permittln �� ��- - ���
Owner"�Name f j11�"CQ��571p�Z / �/1 Owner Phone Numbor ���" Q ���
Owner's Address O��� d T���V'�Od �� Ov+mer Phane Number � �
Fse Slmple 74tleholcler Mame � � Owner Phone Number �— �
Fee Slmpte Tittehalder Addrsss
JOB ADbRESS �S �� 1..�b ' �7�,�G� J L-• GOT# �,,,�
SUBDIViS10N �f21-N`lL�d�f�Q�}' S PARCEL ID# 4� �� a�' � D�`�J ���`�� ����
(OBTdlNED FROM PROPERTY TAX NOTICE)
WORK PROPQSED , e NEW CONSTR� ADD/ALT � SIGN Q [� DEMOLISH
INSTA�L REPAIR
PRQPOSED.USE Q SFR Q COMM � OTHER
TYPE OF CONSTRUGTiOi+i � BLOCK ' [�J FRAME � STEEL Q
DESCRIPTION OF W4RK ��" � /G� I D7V Q� .(�iD'�1Z 4dJ��-�
BUILDlN�SlZE SQ FOOTaGE Ci_`� HEIGHT [��
QBUILDMG � �� VALUATtON�`OF TOTAL CONSTRUC710N
QELECTRICAL ($ -- ' �� AMP SERVlCE Q PRC?GRESS ENERGY Q W.R.E.C.
(��
OPLUMBING �-� '
[,�MECHANICAL $ �-�� VALUATiON OF MECHAMCAL INSTALlA710N.
QGAS [� ROOFIRfG .Q SPECIALTY Q OTHER
FINISHED FLQOR ELEVATIONS �'} F�OQD ZONE AFtEA QYES NO
�
BUILDER COMPAMY
StGNA7URE REGISTERED Y 1 N FEE CURRE� Y/N
Address Ltcense# � �
ELEC7RtCtl4N � COMPANY
SIGNATURE � }2ECaiSTEREO Y! N �E CURRE� Y/N
Addre�s License# � ��
PLUMBER � GdMPANY
SIGiVA`i'i1RE REC318TEftED Y/ IV FEE CURREP Y/N
Address L(cense# � `�
MECHANICAl. � �1�� � COMPANY t �'D 14 2- � �G'.-=�V�1 �
SIGIV/�'TlIi2E L�`�� J Ciy�l�"` `-C�"'� REGISTERED Y! N FEE GURRER Y/N
Address � � � License# ��������
OTNER ,COMPANY
StGNATURE REGISTERED Y/ N FEE CURREt� Y/{11
Address Ltcense# �i `��
RE3lDENTIA!•. Attach°(2).Plof P.lans;(2)sets cf:8ultili"ng`Pians;(1)sef of-Energy Forms;R-tU-W Permlt far new constructian,
Minimum:ten(1.0).worlcing;days.aRer,.submittal date. Requtred onsite,Construc8on-Plans;Stonnwater Plans w/Sllt Fence instaqed,
Sanftary Facilitles.&:1:,du�pster�Site Work:P..ettnit#or sub8ivislons/iarge projects
COMMERCIAL Attach{3)comptete sets of Buitiling Pians pius a tife Safety Page;(1)set of Energy Farms.R-O-W Permit 1`or new construwtion.
Minimum ten(1 Q)woricing days after submittal date. Required onsite,ConsUuctian Pians,Stormwater Plans w!Sllk Fence insta!led,
Santtary FaciEiBes 8�1 dumpster.Site Work Permit for all new projects:AII camrnercial�equlrements must maet comp!lance
31GN AEFiMIT Rttacii(2}sets of Engineeredrplans.
*'**PROPERI'Y SURIIEY rsquired for atl NEW constructlan. ,
Dtr�attons: -
� Fiii aut apptica�on completety.
Owner&Contractor sign back of appllcaBon,natadzed
if over a2S00,a Notice of Commencement Is required. (AIC upgrades over�7500)
'• Agent(for the contraetor)or Power of Attorr�ey�(for ttte awner}wauld ba someone with notarized le#ter fmm owner authorizing same
DVER THE COUNTER PERMiTTING , (Front of Appiicat(on Only) , � _,�.,,,;_. _
Reroafs if shingles Sewers -Service Upgrades A!C • ferices(PlodSurvey/Footage) � � -� ^ '� ' '
Drlveways-Not over Counter if on public roadways..needa ROW , , - , � , �
,,. ' � ,
�
4_____._ _..._._.. . _:__.�_.v w:_- _._ _._�,:.__.r_.�._-.,..:_.=__.� _�.-.�-- --- -.._..__ �___ . < <-,. e..w.,.__.._,..._�.4........ ...
, • .
NOTICE OF DEED RESTRICTIOIdS: The unde�rsigned und��Qands��th�t-this::.p��nit.may.be,.subJec�to"deed",restrictlons"
which may.be�more.rest"r.tctiv��th��County'��r�gr�latlons:�'fh�underslgned�`e�sumes r'esponsibillty for`compliance�with any
�pplicable deed rest�ictions.
IJNLICEMSED CONTRACTOItS IIa11ND CONT�ICTOF3 RE�POAiS1�CLITI�S: If-t�e owner has htr�d a aroretractar or
contractors to undertake work, they may be.;required��to=be-:Ilcensed In accordance.with state.and•loca9 regulations. �If the
contractoe Is not iicensed as requlred`by law, both the owner and conti�actor;may be-clted for a�misdemeanor violatton
under state law. If the owner or Intendeai-:contractor are,uncertaln as to what Iicensing.requlremenQs may-apply<<�or.the
intended work, they are advised to contact the Pasco County�ullding`Inspection Divislon--Licensing 3ection at 727-84T-
8009. Furthermore, If Yhe owmer has hl�ed a con�ractor or contr�ctors, he is advised to have the contractor(s) sign
portions of the "eontractor Block° of this application for which they will be responslble. If you, as.#ha oHirier�sign as'the
cont�actor, that�may be an indication that�he ts not.properly Iicensed and is not entitied to permitting privileg�s In Pasco
County.
TR�►NSPORTATION.IMPACTIUTIC.ITIE�.IMR'AC7 ANb RES�URCE RECOVERY•FEE�: The unde�signed understands
that Transportation Impact Fees and.Recour�e 6tecove.ry.Fees may�:apply�to�tMe constn�ctlon of new bui9dings� change of
use in existing buildings, or:expansi�n:of��existi�i�g:;6uildings, as speclfl�d.in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned �Iso:understands, that:�such f�es�-,as�may.be�due;�wlll.be Identlfied at the�time°of•
permitting. It Is fur@Fier under�tood that Transportatlon Impact Fees and•Re�ource Recovery Fees must be pald prior to
receiving a "certf�cate of�occupancy" or flnal power:release. :If the proj�ct,..does not invoive:a�certificate �f occupancy. o�
final power release, the fees must be patd pcior to permit issuance. ��ttFrermore;if Pasco County�Water/Sewrer Impact
fees are due,Qhey..must be-pald.prlor to permit-issuance-In accordance wlth�ppiic�bte Pasco�.County ordinances. �
COfdSTRUCTION LIERI LAW(Chapter T13� �larlda�t�tut�s�as amend��); if valuallon of work is�2,500.00�or more, I
certify that I, the applicant, have-been provided w1th. a copy of the "Florida Constructlon� Llen Law—Homeowner's
Protection Gu(de" prapared by the FloPlda Depar�menC of Agrlculture and Consueraer Affairs. If 4he applicant is someone �
other than the"owner", I certffy that I h�ve.obtained�a�copy,of.the:above:.descrlbed docur►�ent=and.p.r.omise in,good faith to
deliver it to the"ownec"prior to•cornmencement:
�ON'PPtACTOR'S/09WNER'S AFFiDAVIT: I.certlfy ttiat�all.the•.Inform�tion In•4his applicatlon is accurate and that all work
will'be done in compl(ance with all applicable laws regulating construction, �oning and land developenent. AppllcaQion is
hereby made to obtain .a permit Co _do_work:.and installatlon as indicafed:�� °I certify that no work=or�Instatlation has
commenced prior Qo Is�uance of a permit and that.all work will be pertormed to meet standards of �II°laws regulating�
construction, County and City codes, zoning regulatians, and land development cegulations�in the jurisdtctlon. I al'so
certify that I understand that the regulations of other governm�nt agencies may�apply�to the intended work, and that it is
my responsibility to identEfy�what.ac�tons I must•t�ke:to be,in:.compllance: S.uch agencle�Include but-are.not Ilmtted to:
- Department of Ehvlronmental�Protectton-Cypress.��ayheads, Wetland Areas and Envlronmentaily Sensitive
Lands, WaterNVastewrater Treatment.
- Southwest Florida U�ater Management� .I�istr(ct-Wells, Cypress.'��ay.h�ads; Wetland Are�s, Altering
Watercourse�.
- Army Corps of Engineers-Seawalls, Docks, Navigable Watervvays.
- Department of Health� � ReY�abilita�ive Setvic�s/EnvironmenC�l Health Unit-Wells� VNastewater Treatment,
Septic Tank�. .
- US Environmental Protectlon Agency-Asbestos ab�fement.
Federal Avlatlon_Aut�orlty-Runways.
I understand that the following.restrictions apply to the use of flIL••
- Use of fill is not�Ilowed in Flood Zone W"unless expressly permitted.
- If the flll materlal is to be used. in.�Flood Zon�. "A", ft. is understood that a drainage plan addresstng a
°compensating volumep w►ill be submitted at 4im� of permift(ng avhich (s prepared by a professional engineer
Iicensed by the State of Florida. � _
- If ihe fill rrr�aterlal ts to be used In Flood Zone "A" (m conn�c�lon�with�a�perm(tted building using stem vua01
constructlon, I certify that flll�:wlll:b.e used oniy.to.fill the area withln the�stem�wall.
- If flll material is to be us�d in any area, I cet�ify that .use of such flll will not adversely affect adjacent
p�operties. If use of flll is found to �dversely.�ffecf ad)aeent�properties, the owner may be clted for violating
the condl#ions of the building:permit Issued under the attached {sermlt application, for.lots less than one (1)
acre whlch are�levated�by fllt, an engineered dr�in�ge plan is required. .
If 9 am the AGENT FOPt TH�OIAPN�R, I,:promise In good fatth to inform the owner of the permitttng conditlons set fo�th in
this affid�vlt�prior to commencing construction. i under�t�nd that�a-separate permit may be requlred for el�ct�ical work,
plumbing, signs, wells, pools;. afr condltioning, .g�s, or other install�tlons not•specFflcally included-in.the application. .A
permit Issued sha91 be construed to be a�Iicense to�proceed writh the wrork and not as.�uthorlty to,violate,cancel, alter, or
set aside any provisions of the technical codes;�nor shall Issuance�of a.permit.prevent the�ulldfrig Officiai from thereafter
requiring a correctlon af errors in plans, construction or violat(ons of any codes. Every piermlt Issued sha01 become invalld
unless the work authortzed.by such permit:�s.commenced•w►Ithfn sUc months of permit I�suance, or if work authorized by
the permtt is suspended or.abandoned�for:a:period of�six(6)mont�s.after the tirt�e the woo�k Is commenced. An extension
may be requested, In writing, from the Building,Officfal for a period.�not to exceed nin�ty�(90) days and will demonstrate
justifiable cause for.the extenslon. If work ceases:for nine�y(90)cons.ecutive:day.s�..the Job�Ps considered;aba�doned.
WARNING TO OWNEIt: YOUR.FAILURE.TQ..REC.ORD A.fYOTIGE�:OF�CONfiHENCEMEMT NFAY RESULT IN YOUR
PAYING TWICE FOR SMPROVEMEN.�S TO YOUR�:PR�PEfL7Y. IF°YO.UaIN�'�END:T����T'AIN��FIRFAI�CING;'CONSU�T
1fU1TH YOUR LEND�R�OR/4N/�TPORNEY���O��sRE��R�CDINE;��YC9UR'�NOTIC�"OF'COAAIWENCE��NT�
FLORIDA JURA�(F.S� 7.03} ' - �" -
� 1
OiNNE1'��Ft A��NT � COPITFIIACTO i a-�-� - - — - - -
Subscrlbed and awom (or atNrmed)be ore me this Subsc►Ibed and' m`to(or a(flrmed)�before me ttif�
- se� r .Q L �s e�-
o Is/a rsonally kno .me or has/have produced Who.ls/are p rsonailykn •to me or he�/hav�•produced •
aa Identlflcatl4n. as tdenB�cation.
` Note Publlc . � � �
�Y Nofary Publfc
Commisslon No:` Co rnlsslon.No.
�"�;,p��•. SYLVIAA.CAMPBELL •' "'"" SYLVIAA.CAMPBELL
�.t��PU.
Name ot No et �, G 112939 Name o(Nolery type p. � u �c- a e o on a
:., •: ommi : . •; Commission N GG 112939
:N,. v� My Comm.Expires Jul 19,2021 -r oY: My Comm.Expires Jul 19,2021
�'9�OFf��� dondedthroughNationalNotaryAssn, �''','FoFF��•'
, Ilonded through National Notary Assn,
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� ..�.�":�-;¢3:?£: 4�i'.'M"r"�at",
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� � � PF20PANE GAS • �
� AND AI� �r[c. Service Order/Pronosal
, ����T9�8 � s��-�8�-so�� Invoice -
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Sales Service & Installatians t,a���;� ���f����fs��Y�c�r�a�� ����7 �a���
4441 Allen�Rd. • Ze h rhills, FL 33541 ���" �- f T�r�« ����tr�tF���a ��r���.n ���� �.�,•� :i�.�+
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��i�IC.:a+! GUST��• 1"�7Ih's4�TE.= F"JFi �EE�J !_��•d]:`Ca 4�F�nf"ici !-(E�lT F'UC'jF'a F?E.CG��1t�I�:idUEL:� �Y f�[L7:(aHPt�R�:
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= r:;��pESCRIP:TiON OF WORK�-' x: ��'�.FQTY.�:�3°"�TVtATER1ACS&=SERVICES`:;:: =:,UNIT PRICE ;`•AMOUNT
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Annua{.Maintenance`Recoriimended_byAi(Equipment,lysf�fac�urers -
�,.�+= - � ;� Pressures Lo HI 7 Stat � i
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REFRIGERAh1TR ` IBS.'-'"`- ` $Perlbs
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.....` _t .:. -t ..-._-. _ .-,.- �`fl:. . ��.�....�......"_
r S, ry �
' FILTERS x x Changed Monlhly I I
FILTERS x x Changed Monthly � �
O REGULAR O WRRRANTI' ° �, _-:.,'�1"t�TAI::SUMMf3RY�;�-.�<_�`;:°:
. .x:". - _- -- - -
;:pehumid'isfat`Settin�s'��tWhen here"ON"°�=.W �" ' "
_ g,.,_ ��,,, hen Away 6�;;:';T-Stat$Q°. ❑ MAINTENANCE CONTRACT �
SERVICE i
�tJMITED^WARRANTYs AII materials,parts and equipment are warranted by the man�(actorers' :,r-:�:`�=,:":;.METH{3D;,O��PAYMENT�.,=,.:�``'»;°�,•-_, CALL t
or suppliers'written warranty only.NI lahor pedormed 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 warzanUes, ❑�ASH ❑CK# MATEEitALS �
express ot fmplied,and its agents or technicians are not authorized ta make any such wamantres an
befia(fofabovenamedcompany. ❑pEBIT 0 CREDIT ❑QTHER MAINTENANCE �
PROG. W/ C �
I have aulharity to order lhe work outlined above whlcRhas been satlsfadorily compieted.I agree that Seller �
reYa7ns titte to equipmenUmaterials WmfsAed unUi frnai payment is made.!t paymont is nat made as agreed, CLAIM# �
settet can removs said equipmenUmateriats ai Seiter's axpense.My damage resutUng fram said iemoval shali ,y .
not be the responsibilily Of Sellec N8T 30 DAYS.A 1 1I2%SERVICE CHARGE WILL BE ADDED MONTHLY TO �� ��'v(,,��� � �+,,,,,
AL�PAIC7 BALANCES OVER 30 QAYS.NO REF�S ' � TECH;COMPLETED �,,,,,,,,,,,T�
I
' �'�� `� } � � �i/_" y '
CU OMEft SIGNATURE� DASE e/� ��o,u TOTAL y�'�'.,9" � r�..�-�
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