HomeMy WebLinkAbout17-18967 CITY OF ZEPHYRHILLS
, ' �� 5335-8TH STREET
(813)780-0020 18967
BUILDING PERMIT
PERMIT INFORMATION � - - LOCATION INFORMATION
Permit Number: 18967 Address: 3903 LAUREL VALLEY BLVD
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: MAJESTIC OAKS
Est. Value: Parcel Number: 24-26-21-0000-00100-0090
Improv. Cost: 3,620.00 � OWNER INFORMATION.
Date Issued: 10/23/2017 Name: NHC-FL115 LLC ATTN: TAX DEPARTME
Total Fees: 55.00 Address: 27777 FRANKLIN RD STE 200
Amount Paid: 55.00 SOUTHFIELD MI 48034-8205
Date Paid: 10/23/2017 Phone: 217-218-8820
Work Desc: A/C CHANGEOUT 2 TON
CONTRACTOR S APPLICATION FEES
BAHR'S PROPANE GAS &A/C, INC. A/C CHANGEOUT 55.00
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Ins ections Re uired
DUCTS INSTALLED
DUCTSINSULAT
FINAL ���
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REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c)the I
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 properly 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.
�
CONTRACTO SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
- ����a�� City of Zephyrhills Permit Application Fax 813-T80-0021
Building Department
T• � '� Z� •
Date Reaeived Phone Contact for Permlttln .� /��a� — �d�
Owner's Name ��' ,[✓ ll�? G L� {}wner Phone Number a'zJ � � p�t'��
... �
Owner's Address c+`���/ �l�+4'!�✓K//1V ��o� Owner Phone Number `�-`�i�
Fee Simple'Tittehatder Nama C� �� Owner Phone Number � �
Fee Simple Tittehotder Address
J4�ADDRESS � J�� �L�G�1ePi,� A-�j�" fJl t.� I.OT# ��
susoivisiaN ���},,fG��c ��4K.5 �a�c��.�a# �� �� �/ �t�CUD C'1���'?G? �D�'i�
{p6TAINEp FRQM PROPER7Y TAX NdTICE)
WORK pROPOSED NEW CONSTR ADQ/ALT [� SIGN C] [� DEMOLISH
, e. INSTAL.L REPAiR
PRQPOSEDrlJSE Q SFR Q COMM [� 07HER
TYPE OF CdNSTRUCTION Q BLOCK ' Q FRAME [� S7EEL [�
nEscR�QnoH oF woR�c �C'So �lG C t7ft� e b�L-� / Go�m �nJ'e�u�� � Tar1 1��r �/�.
BUILDING SIZE � � SQ FOOTAGE HEIGNT [��
QBUILDING � � 1/ALUA'CION`OF'TO'fALCONS7'ROCTIOIU
[�ELECTRICAI. ($ -� AMP SERVICE [� PROGRESS ENERGY Q W.R.E.C.
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[�PLUMBING � � -
�a�MECHaNICAI. $ �/ ��4 a� VALUATtON OP MECHANICAI iNSTALLAi'ION
CP
QGAS Q ROOF4NG Q SPECtALTY � OTHER
F1t31SHED FIOOR E�EVATiONS C� � FLQOD ZONE RREA QYES NO
BUtLDER COMPANY
S1CaNATURE REGISTEREO Y/ RI FEE CURRER Y 1 N
Address � Lloense# I �
ELECTRICIAN COMPANY
SIGNATURE �` REGISTERED Y! N FEE GURREh Y/R)
Address License# � � �
PLUMBER � � COMPANY
SIGNATtIRE REGlS.TERED Y/ N FEE CURREh Y l 4)
Address Lfcanse# � � �
MECFFANtCAt,: , 1 .—., COMPANY r4fJl�S , �tde���� �/1/�,
SIQMATURE a�� ��� ���s7EaED Y i N FEE CURRE[+ Y/N
Address y�'�1 �jl� ��i ��/�/�L5 License# I�.����'��' �
OTHER COMPANY
SIGNATURE REGIS'fEREO Y/ Rf FEE CURREt+ Y t t+!
Address License# � �
E2E31dENT1At: Attach{2}.Plot�Plans:(2)'sets.ofButl�ing'�Plaits;{1)sef of'Eriet+gy°Faims;R-0-W Permit far new cons#ructlor►,
Mtnimum:ten;(1Q)worktng;days-aEter,.submittal date. Required ons4te,ConstnicUomPlans;StarmwaterPlans w!Silt Fence[nstalled,
Sanitary Fao111Ues.&.1;.dumpste.r.Site Work�Permit tar subdivisionsAarge projects
COMMERCIAL Attach(3)aompiete seCs of Buitiiirig Plans plus a Life Safety Page;(1}set af Energy Fomts.R O-W Permit fo�nerN construc�an.
Minimum ten(10)wosicing days aftec submlttaf date. Required onsits,GonstrucNon Plans,Stormwater Plans w!Silt Fence fnstaHed,
Sanitary Facllftles&1 dumpster.Site Work Permi#for all new qrojects.All commercial requlrements must meet complience
'SIGN PERMIT Attach"(2)sets af Engineered:pians.
""•PRQPERTY SURNEY required fot ail NEW constructian.
Directians: `
Fi4f aut applfcaUon campietely.
Owner 8 Contrackar sign back of appitcadon,notarized
if over�2500,a Notice of Commencement Is requlred. (A/C upgrades over$7500)
" Agent(far the cantractor)ar Powier of Attamey�(fnr the owner)would be someone wtth nata�ized letter fmm awner authorizing same
OVER THE COUNTER PERMiTTiNG�.�• (Front of,Appticatlon 4ntyj , `.-'.-'`� ".k"'Y`'�": �- . , , - '`
Retaafs!f shingles Sewers Service Upgrades AtG", �ences{Pto#lSurveylFaotage} - - �
Y � �� " . .
Drivewaya-Nat over Counter If,on public roadways..needs ROW � • - � • .,
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NOTiCE OF DEED RESTRICTIONS: The undersigned understands�th�t-this:p�rml�.may.be,subject to"deed"„res@rictions"
which may be=more:resUlcttve�th�n•County<°r+egulatlons: �The undersigned�assureies°responsiblltQy for`compflance�ritFi�any
applicable deed rest�ictions. , �
UNLICEN�ED CANTREiCTORS AND CON�IZACTOR RESPOWSIB��:lTaf��: If the owner has hired � contractar or
contractors to undertake work, they may be;r,equired•�to-�be,Iicensed In ac�rdance.with state.and•local regulatlons. �If the
contractor ts not itcensed as�requlred-by I�w, both the owner and conQ�actor•�may be clted�for a-misdemeanor vlolatlon
under state law. If the owner or intended�contr�cton ere uncertaln as to what Iicensing.requirements rroay-:apply�:�r the
intended work, they are advised to contact the Pasco County Building lnspectlon Divislon—Llcensing Section at 727-847-
8009. Funhermore, (f the owrner has hl�ed a contractor vr contractors, he Is �dvised�to have the contractor(s), slgn
portions of the "contractor �lockp of thia app0lcation for which they wlll b�responsible.�. If you, as.Qhe owner�fgn�as`Ehe
contractor, that may be an indicatlon that�he is not.properly Ilcensed arod is noQ entitled to permi�ting privileg�s in Pasco
County.
TfZANSPORT�►T10N-:IMPI4CTlUTILITIES-IMPAC'�APIb�lE3�URCE RECOVERY�FEES: The und�rsOgn�d understands
4hat Transportation Impact�ees and.Recourse Recove.ry.Fee� may�-,apply�to�th�construction of new bulldtngs,�change of
use in existing buildings, or exparrsion:�of=�exi"sti�i,g.`:6uildings, as speclfied.in Pasco County Ordinance number 89-07 �nd
90-07, as amended. The undersigned also�understands; thait:�such fees,�,as��tnay_be�due;;will�.>be fdentified at the•tirv�e°of.
perrt�itting. It is fur�Fier understood that Tra�sportatlon Irr�pact Fees ��d=Resourc� Recouery�Fees must be paid pelor to
recefving a "certiflca�te of�occupancy" or f�nal power�.reiease. :If�th�.proj�ct�..does not involve �=certificate of occupancy or -
final power releas�;the fees mu�t be paid pclor to permit Issuance. Fukthermore;�if Pasco County�Water/Sewer:Impact
fees are due, they.must be=pald.,prior to permit-Issuanc�-In accordance with�pplicabfe Pasco�.County ordinances. •
C06dSTRUCTIOtd LIEfd LAW(Ch�pter 713� Eloelda�tmtutea, aa amended): If valuatlon of v+rork is�2,500.00 or more, i
certify Qhat I, �he ,�ppllcant, have-been provlded wtth a copy of the "Florida Construction� Lien Lav�-Homeo�nrner's
Protection Guid�" prepared by the Flo�ida Department�of Agriculture and Consumer Affairs. If the aPpllcant is someone
other than the"owner", I certify thaQ I have.ob.tained�a�copy,of.the:above..�iescribed docurr�ent°and.promise in,good faith to
deliver It to the`owne�'•prior�to•cocnmencement:
COtd4RACTOR'S/OWPIER'�AFFIDAVIT: 1.certtty that all.the�.lnformatimn In�thl� appllcation is accurate.�nd that all work
will'be done in compllance wi#h all applicable laws regul�ting constructlon, zoning and�land�development. Application is
hereby made to obtain .a perm6t .to do work:.,and instali�tlon as Indi�ated:�� I certify that no work°or Installatton has
commenced prior to fssuance of a perrnit and that.all work will be perto�med to meet standards of all laws regulating-
constructlon, County and City cod�s, zoning regulatio.ns, a�d land development regulations-On the jur(sdtction. ( also
certlfy that I uaderstand that the regulat[ons of other gov�rnment �gencies may�apply�to the intended work, and that it ls
my responsfbility to identify.what.act(ons I must•take:to be,in:.corr�pliance: S.uch agencies include but�are.not Iimited to:
- Department of E�vironmental�ProQectlon-Cypress.��ayhead�� WeNand Areas and Environmen4ally Sensitive
Lands,WateNWastewater Treatment.
- Southwest Florida Water Managemer�t. .D6st�tct-Wells, Cypr�ss.� B�yheads; Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seaw�lls, Docks, Navigatile Waterways.
- Department of Health� 8 Rei�abilitative Services/Environmental Health Unit-Wells, Wastewater=Treatrnent,
Septic Tanks.
- US Environmental Protectlon Agency-Asbestos abatement.
- Federal Avlatlon:Authority-Run�n►ays.
I understand that the following;restricfibns apply to th�use of flll:�
- Use of fili is not allowed in Fiood Zone"V"unless expressly permitted.
- If the flll material is to be useii:'In :Flood Zone. "A", tt. is understood that a dra(nage plan addressing a
"compensating volume" will be submitted at#ime of permifting which is prepared by a professfonal engineer
Iicensed by the State of FloNda.
- If ihe fill material ts to be used in Flood �one °A" in>connec�ion�with:a permitted building using stem wall
construction, I ce�tify that fill�:wall-b.e used only.to.fill the area wtthin the�stem•wall.
- If flll material is to be used In any area, I certify that .use. of such flll wlll not adversely �ffect adjacent
properties. If use of fl�l Is found to adversely:�ffect ad)�cent�properties,.the owner may be clted for v(olating
the condi#ions of the building:perm(t issued under tha attached �ermit appl(catlon, for:lots less than one (1)
acre which are elevated�by flil, a�t engineered dr�inage plan Is required. .
If I am the AGEIdT FOR THE OWNER, I,�promi�e in good fatth to inform the owner of•the permitting conditions set forth In
this affidavit�prtor to commencing const�uctlon. I understand thet a;separate permit may be requlred for elecMcal work,
plumbing, sign�, wells, pools;, air conditiontng,.gas, �or other install�t(ons not,spec(flcally Inciuded�tn.the application. .A
permit Issued shall.be constcued to be a�Iicense to-praceed with the vvork and not as.authoNty to,viol�te,.cancel, alter, or
set aside any provistons of the technical cod�s;�nor shall Issuance�of a.permit.pcev�nt the Bulldirig Oti(cial from thereafter
requiring a correction nf enors in.plans, constn�ction or violatlons of any codes. Every permit Issued shall become invalid
unl�ss the work author(zed by such permit.�ls-commenced•wlthtn sfx months of�permit Issuance. or tf work authorized by
the permit is suspended or.abandoned-for a:pertod of�six��(8)montt�s.�fter the tim�the work�is commenced. An extension
may be requested, In writing, f�om the�Building,Officlal for a per(od:not to exceed ninety(90) days a�id will demonstrate
justiflable cause for.the extension�. If work ceases.for ninety(9U)cons.ecutive days...th�job�is.considered abandoned.
WARNING TA 014VNER: YOUR..FAILIJRE•T�..RE.C.ORD �4.NOTIGE.OF.�COMMEMCEME(�T_MAY�RESULT�IId�YOt1R
PAYING TWICE-FOR IMP�tOV�MENT�TO YOIIF��.PR�P�PtT1F. IF°Y6.U{IId��END�°T�09TAIW�FIRFANEING;'C.ONSUL'G'
WITH YDUR LENDER OR API�'�ORNEY;�EFORE�RECe9��IfN��YOUR"NOTICE�`OF'COlYIR�AENP�N�ENT'
FLORIDA JURA��(F.S.1.97.03) � •' - "
OWPIER 06t AOENT � CONTRACTO
���� b� and swom to /�Gd)bef S m��e�C�s� /�b�b/ � ��nP�d,/1'I .S2r ��
. y . �.
o s/ar ersonail _ to.me or ha�lhave produced Who.ls/� person�al_I�� •tu rtle or haslhav�•produced •
as Identlflr,atlpn. as identlftcatlon.
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___ Notary Public _ � Notary Public
Commisslon Pdo: � misslon.No.
,,.ti�;:P�., SYLVIA A.CAMPBE L �� SYLVIA A.CA
s a° ���: Notary Public-State of Florida �� �P"�;'••, tar Public-State of Florida
Name o/Notary �d tir st�t��on N�me of Notery fyped,p : � RipedCommission
N PQs My Comm.Expires Jul 19,2021 ` My Comm.Expires Jul 19,2021
�'?;�oFF;'°e''� BondedihroughNationalNolaryAssn. �'
���oFf��P•'� gpndedlhroughNalionalNotaryAssn
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I� REGULAR ❑WARRANTY = �,`"`"�"T�C'Fi1X;,�.,�`��, 'i�`�.:'.�_-.�,'.'r,:?:7
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r N�,�st,������:r�;lNhen here�When Away��a T-Stat��;� 0 MAINTENANCE CONTRACT MAINTENANCE} r
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GIMITED WARRAAiT1':�NV materials aris a�d ui ment are warranted b the manutacturers' :r�� ="��xY��' ''�'��`�� "+��j''.�j�;;p/�yc �'�,j� ` - - _- PRICE i
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or suppliers'written warranty onty.AI}Iabor performed by the above named campany is warra�ted for ��''.•,._....�..-�.;..:....,.:..._,�,�.,,.e-.-.n.,_.,.a�:>s::,._:"'��,.,-..-.=�,-��_:=
30 days or as othe�wise indicated in writing:The ahove named company makes no other warranGes, ❑CASH 0 CK# TOTAL i
er.press or implied,and its agents or technicfans are not authorized to make any such warzan6es on MATERIALS i
behalfbtabovenamedwmpany. D DEBIT 0 CREDIT 0 OTHER MAINTENANCE �
1 have eWharity W ordar the vrork aWined aCove which has been setlsfactorily completed.I agree thet Sellsr PROG. W/ C
rotains tltle to e uipmenUmalerfals Iumished until final payment Is matle.If peyment Is not made as agreed, (�,�/{�M# I
aetler wn " equiprt�enVmateslats at Setler's expense.Any damage resutting from said remorai shatt �
not De responsibt of Sstter.NE7 30 DAYS.A 7 iC2%SERViCE CNARGE WILL - OdQL�FFNLY T4 DATE COMPLETED
ALL U Alp BALAN S 30 pAYS.NO REFUNDS r,,,
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CUST MERSIGNATUREl / DATE a/�L%1.rnl//G/L ✓osc T07AL �