HomeMy WebLinkAbout17-18994 CITY OF ZEPHYRHILLS
�� 5335-8TH STREET
' (813)780-0020 18994
BUILDING PERMIT
PERMIT INFORMATION � - LOCATION INFORMATION
Permit Number: 18994 Address: 38055 LAWANDA LP
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: WAYWARD WIND
Est. Value: Parcel Number: 14-26-21-0160-00000-0610
Improv. Cost: 7,160.00 OWNER INFORMATION
Date Issued: 10/30/2017 Name: DIEFFENBACH RICHARD & LOIS
Total Fees: 75.00 Address: 38055 LAWANDA LOOP
Amount Paid: 75.00 ZEPHYRHILLS FL 33542
Date Paid: 10/30/2017 Phone: 813-779-3608
Work Desc: A/C CHANGE OUT 4 TON PKG UNIT
CONTRACTOR S APPLICATION FEES
� ACS HOME SERVICES A/C CHANGEOUT 75.00
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Ins ections Re uired
DUCTS INSTALLED
DUCTSINSU TE❑
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.
I 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 pertormed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
ONTRACTOR 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-813-780-0021
Building Department
Date Received �— S( �/ �(
� �� Phone Contact for Permitting C!� v — ���
Owner's Name I�1 C..h�l�L :/�(�� �r,b�Fe.l� Owner Phone Numher ���� �7���310 c8
Owner's Address ���� p���l rT �C�17� Owner Phone Numher
Fee Simple Tltleholder Name d" /`� Owner Phone Number
Fee Simple Tltleholder Address /V`/�
JOB ADDRESS ��/v�S L. (�r{/� � hV^v LOT# �
SUBDIVISION �T (.J�fJL Wr�� PARCEL ID# i -a -a� �DO 0- (/��' V��V
(OBTAINED FROM PROPERTY TAX NOTIC�
WORK PROPOSED � NEW CONSTR e ADD/ALT � SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE � SFR Q COMM � OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q
DESCRIPTION OP WORK An (�U'� �h P � ���/� �j�'J�/4G UNr T
BUILDING SIZE SQ FOOTAGE O(�U p HEIGHT �
QBUILDING $ VALUATIONOFTOTALCONSTRUCTION
QELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C.
OPLUMBING $
�MECHANICAL $�%�� VALUATION OF MECHANICAL INSTALWTION
OGAS 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 License#
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREA Y/N
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREA Y/N
Address License#
MECHANICAL COMPANY �S Q�� �C/UlGQ�
SIGNATURE REGISTERED N FEECURREA N
Address j� � �+��fi��/dZ ,S� License# G�'iL� O J� �S
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIItlllllllllllllllllll
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Pertnit for new consWctian,
Minimum ten(10)working days after submitlal date. Required onsite,Construc8on Plans,Stortnwater Plans w/Silt Fence Installed,
Sanitary Facililies&1 dumpster;Site Work Permit far subdivisionsllarge proJects
COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Pertnit for new canstruction.
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet campliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
""PROPER'fY SURVEY required far all NEW construction.
D�rections.•
FII out applicatfon completely.
Owner&Cantractor sign back of application,notarized
If over 52500,a Notice of Commencement Is required. (A/C upgredes over 57500)
" Agent(for the contractor)or Powar of Attorney(far the owner)would ba someone with notarized letter from owner aulhorizing same
OVER THE COUNTER PERMITTING (copy of conUact required)
Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
Driveways-Not over Caunter if on public roadways..needs ROW
, �NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to°deed"restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work,they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work,they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or 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 you,as the owner sign as the
contractor,that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings,change of
', use in existing buildings,or expansion of existing buildings,as specified in Pasco County Ordinance number 89-07 and
90-07,as amended. The undersigned also understands,that such fees,as may be due,will be identified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a"certificate of occupancy'or final power release. If the project does not involve a certificate of occupancy or
final power release,the fees must be paid prior to permit issuance. Furthermore,if Pasco County WatedSewer Impact
fees are due,they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes,as amended): If valuation of work is$2,500.00 or more,I
certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
Protection Guide"prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the"owner",I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the°owne�'prior to commencement.
CONTRACTOR'SIOWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable laws regulating construction,zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other government 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 but are not limited to:
- Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,Water/Wastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls,Docks,Navigable Waterways.
- Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
- Use of fill is not allowed in Flood Zone"V"unless expressly permitted.
- If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating volume"will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
- If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
construction,I certify that fill will be used only to fill the area within the stem wall.
- if fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties,the owner may be cited for violating
the conditions of the building permit issued under the attached permit application,for lots less than one(1)
acre which are eievated by fill,an engineered drainage plan is required.
if I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate,cancel,alter,or
set aside any provisions of the technical codes,nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans,construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance,or if work authorized by
the permit is suspended or abandoned for a period of six(6)months after the time the work is commenced. An extension
may be requested, in writing,from the Building Official for a period not to exceed ninety(90)days and will demonstrate
justifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned.
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 YO R NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F.S.117.03)
OWNER OR AGENT CONTRACTOR
Subscribed and swom to(or affirmed)before me this Sub crib and sw r�med efore,�18 this
by /�' `-�/�J b _ �)Q� J�'G�av!
Who is/are personally known to me or has/have produced W o is are perso ally known to me or has/have produced
as identificallon. — � as IdentificaGon.
Notary Public �U���ri�� Notary Public
Commission No. om ission No. �� (���
Q�'1 r NLi���
Name of Notary typed,printed or stamped ame of Notary ryped,printed or stamped �4�,ilV OV/�� JENNIFER F.MACCHIELLO
:r° ;`�+=; Notary Public-State of Florida
� • _ Commission#FF 234363
� �%�, �:' My Comm.Expires May 26,2019
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'��������` Bonded through National Notary Assn.
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A � ACS Home Services Invoice 12820562
Headquarters: 1712 E Seward St, Invoice Date 10/25/2017
Fi0lVIE SERVICES Tampa,FL 33604 Completed Date 10/25/2017
813-618�631 Customer PO
\ #CAC1818754
�
Billing Address Job Address
Richard Dieffenbach _ Richard Dieffenbach
38055LawandaLoop 38055LawandaLoop
Zephyrhills,FL 33542 USA Zephyrhills,FL 33542 USA
Description of Work
10-8
Customer: Dieffenbach
Type of call:STU -Craddocks
STU completed. Low r22. Mold covering blower and into ducts.Gave options to repair/remediate or replace.They chose to
re lace with 4 ton
� H�P Byant 14 SEER PKG system.Collected $8960 chk#135.
Install Wednesday, 10.25.17
� T6 tstat
, Hurricane pad
UV
Duct fog
� Cutler Gray box
70a/4awg copper at unit
Dicdee@tampabay.rr.com
Task# Description Quantity Your Price Your Total
414PHP This Install Includes All Of The Following: 1.00 $8,960.00 $8,960.00
� Includes New Thermostat
• Upgrade breakers to proper size for new equipment as needed
• Includes Permit ready install,removal and disposal of old equipment,and all
materials and labor.
• Includes ACS Home Services Maintenance Plan with 2 visits within 1 year.
• 10 Year Parts Warranty
• 1 Year Labor Warranty
Paid On Type Memo Amount I
10/30/2017 Hero ClubMemberAdjustment $1,800.00 I
Member Price $8,960.00 I�
Potential Savings$0.00-$1,792.00
Sub-Total $8,960.00
Tax $0.00
Total Due $8,960.00
Payment $1,800.00
Balance Due $7,160.00
For your peace of mind,should the Customer Satisfaction is our #1 focus!
repair amount exceed 25%of your
system's replacement value,our If you are not completely satisfied for any reason,Please call 813-906-1012 and ask to speak
technician is required to inform you of with the Customer Service Manager.See attached Terms&
options for both repairing and Conditions.
replacing the equipment Your feedback is very important to us.
THANK YOU FOR CHOOSING US FOR YOUR SERVICE NEEDS!
I fi e service and mate a rendered and installed in connection with the described work to have been completed in a satisfactory
manner.I agree that the amount set forth on this contract to be the total and complete price.I understand that a twenty-five dollar($25)
service charge will be added for any returned checks and I could be held liable for up to three(3)times the amount of the check or one
hundred dollars($100),which is more,plus the face value of the check and court costs.A monthly service charge of one and one-half
percent(1.5%)will be added after 30 days,up to one-thousand dollars($1,000),for any unpaid balances.I acknowledge that I have read,
understand,and will receive a legible copy of this contract.
BUYERS RIGHT TO CANCEL-This is a home solicitation sale,and if you do no want the goods or services,you may cancel this agreement
by providing written notice to the seller in person,by telegram,or by mail.This notice must indicate that you do not want the goods or
services and must be delivered or postmarked before midnight of the third business day after you sign this agreement.If you cancel this
agreement,the seller may not keep all or part of any cash down payment.