HomeMy WebLinkAbout17-19091 CITY OF ZEPHYRHILLS ��
� 5335-8TH STREET
' (813)780-0020 1908
BUIL�ING PERMIT �
PERMIT INFORMATION - -� LOCATION INFORMATION �"'
Permit Number: 19089 Address: 3445 BERYL LN �
� Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: RV PARK Lot(s): Block: Section:
Square Feet: Subdivision: EMERALD POINTE RV RESORT
Est. Value: Parcel Number: 24-26-21-0020-00000-0600
Improv. Cost: 5,772.80 OWNER INFORMATION
� Date Issued: 12/01/2017 Name: CONLEY ERNESTINE & DANA
Total Fees: 65.00 Address: 3517 MALACHITE DR
Amount Paid: 65.00 ZEPHYRHILLS FL 33540-7423
Date Paid: 12/01/2017 Phone: 606-232-0789
Work Desc: A/C CHANGE OUT 2.5 TON
CONTRACTOR S � APPLICATION FEES �
CHRIS' A/C COMPANY A/C CHANGEOUT 65.00
�
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I n R �
s ectio s e uired
DUCTS INSTALLED
DUCTSINSULATED�
FINAL
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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 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 pertormed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O. �
,` � ��
CONT R SIGNATURE PERMIT OFFI R
RMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
..��
813-�so-ooao City af Zephyrhills Permit Application Fax 813-780-0021 i
8uiidin¢�Department
Daes Recetved ��7. �� f�" , � phane-Contact for Pernilttin SvZ � ��
Owner's Name � (� " Owner Phone Hurnbsr �� - • �7�`
, � �
Owner's Address 3 yy..� �' �^ � Owner Phane:Number �
Fee Simple Tltleholder,Name � Owner Phone Number �� � -�
Fee Simple Tltleholder Address
JdB ADDREB$ �7 �,Sr " LOT# ��
�I SUBUIVlSION , �y2ck� p���{.: PARCEt».1D# � � O D 0 D D � a 6 O
, , (OBJAINED FROM.PROPERTY,TAX NOTICE)
( WORK PROPt3SEQ _NEw CONSTR� ADDlALT � 31GN Q• Q DEMOLtSH
�•���. INSTALL ��_� �-REPAIR - � �
� RROP{SSED:USE � Q SFR Q �GOMM '- � OTHER � '
TYPE OF CONSTRUGTION - Q` ' BLOCK ' [� FRAME .��] ;STEEL' `�]
DESGRIPTION OF WORK C � ��` / i '��,, U .%/' � �i
BUICDfNG SlZE" �w �'$Q`f08TAGE��: . HEIGHT�..
QBUIGDING , �^� ti/AIUATION:OF`'t'OfiAL�CONSTRUCTION ' � �
QEIECTRIGAE. �� AMP SERVICE Q 'PRO'GRESS ERIERGY Q W:R.E.C.
QPLUMSING. -� �
[�MECHAt+lIGAL $ VALl3ATlQN OF.MEGHANICAt.11�tSTAl�,4TION � o��
/ t .��� ' j���
� • t�
QGAS Q ROOFlNG :Q SPEGIALIY,-C� • QTHER,
FINISHED FLOOR ELEVATIQNS r�� FI.00D ZONE AREA �]YES. :NO
� � - . .,
_vBUlLDER____ ._-___ ; =- - -- - ---- -- __�.- _ .__ �__.---
-- --- --�--- --- - -- - - C�AIlPANY=: _- �n - — -- =
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Addre�s ' License# �— ��
. , .;.
ECECTRICIAN� .: ._COMPANY �
SIGNA7URE � REGISTERED Y/ N FEE'CURRE�`"- ' '=-Y/N �
Actdre�� _ � . ._ : � , ` . License#;(: � , �
PLUMBEE� " � . .,f.COMP=AtdY . , , , ; . � � � � � � '
, SIGNA7URE� � "- � � " _ , ,REGIST.ERED- : Y./�N�. =; <FEE CURREA Y-/N. ' '
� Address ,.Ucense#���: , , . , �
� MECNAN1CAt:' � - COMPMtY. L �
.4,F."
SIGNATUP2E REGISTERED; ,_ N. . , FEE CURREA. /'N .
Address�'' �fc�� (/:� �v�it� . - (J ,. , license# . .:� ,
pr � . .. . .. . r . . .. . ,. . �
OTHER = ` '` _ .z . , _ _ -. �.; . . , _ . , �_ ,
,CONIPANY. �.,
SIGNA7URE �j=: , ��r��r" ��'''` ''� ' " '' ' � `REGISTEREDr ' Y/ N�,. FEE CURRE� Y/N
�C��68$r, . ( ..._ ^,r(fV . Rv'. ' . .t' , , r r .�:�C$�!$8� � � .
' . ,� ..�:,. .. . , _ �iE3 '- '�;fl.��,.yrn. ' t.; . . », . :.. ` . y . , ,. ., . "
RESlDEN3lAL<„<�Attach;('2),P!o#%€?laris;-:(2}"sets`_.of�Bultili'rig�`Plaris;�(1)sef af�Eriergyr'FF'oiins;R=0=1tU�Per`init for new construct�on, -
<<�Minlmum,ken;(10);woricing�days;:after.;submltf`al`dat"e.'�Requi"�red onslte,�Gon"stiucNon Blans;$tortnwater Pians w/Sii4'Fence installed,
x�;`".��•� Sanitary�Faciliyes,&�1f;dumpster,ro5lte�Woric:�;Permit,forsutiidivisions/large:projects.^....'>'�" " - ` � ' :+ . ' ; ,_
COMNlEEtCtAl. Attach{3}`complete sefs'of Bi�l(ii{ifig Plaris plus a l.ife S'afety�Page;{1)set of Energy Eotms.R-O-W Petmit far new c8nstru�on. �
Minfmum ten(10)working days afker submiRtal date. Required onsite,Canstruction Plans,Stormwater Plans w/Siit Fence installed,
Sanitaey FaoiliUes 81 dumpster.Site Wor1c Permit for all netirpnojeofs..All commerGal requhements.must meet compllanca '
�:StGNPERt�tl7 AttacFS"{2)'s`efs'of"Einginee`r,ed:F#aiis:,,-:.:_�,'. �. � ,
`•'"PROPERTY SURVEY reGufred„for ail,IVEW consWctlan.
, 'Direetian�: �.� , • '�
FIU out applicatlon completely. i
Owner&Cantractor sign back of app!{caflqn,notarlaed �
tf over 52500,a Natice of Gommencement la required. {AtC upgrades cver.�7500)
;_..:;;•: �
'" Agent(for tlie-con'tractor)'or Power-of Attomey(for the owner)would�be someone with�notarized letter from owner autho�izing same
i .. -
� DVER"THE COUNTER,P.ERM17"fiNG-'.--- •(Front-af-APPIicaBan�Oniy)-. ._j , ... - , +
Reroofs If shingles Sewers " Service.Upgrades A%C, Fences(PlobSurvey/Foatage)
Driveways-Not aver Counter if on public roadways..need"s•ROW�'� `
,,
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. i. r . ..,. i .,: - ' '.� .`:::`.'_:....;. ...,^,..,�� i .w..t`� .:..f�s�r ': "�.i... . '..u...," ..*r.::���.�.s. '.n ..'.R,�"...A.��aL�.:
NOTICE ttF DEED RESTRICTIONS: The trnder�signed undet�tands°xth�#;1hls< �r:mlf-�rtay.be,,sub eat,to..deed..-,restrlctions ;;.. ;��.�
which may�6'e�mare;restFlctive=tha��Gounty'iregr�latfons:�°7he°undei�slgne.d��assu'rries-respansibility fiar`compiiance�with�any `
appllcable deed�restriotfons. .F:v...: ..._.. �,• .- -- � � . ,_ .. . -,._..._ ._,�. � . :<� . . .:...,�.
UNLICENSED�CONTRACTORS -AND CCINTRACTOR RESPONSI81LiTiES:�:ff-the��oumer�has�°fiire�d �a`"contcac#ar or
conlractors.to undertake work; ttrey,may be:r,�qt'rlred�to3be:�lfaensed In;accardance.wtth state:and=locai;ce�gulatl.on.s.:�=1f'the• �„ -� �--'
contracEo�fs not Iii:enseif as�requir�sd:�tiy 1�r, aot#r�the owner arid`icontractot majr tie�cl#ed�,fot-a'=snlsdameanrir vloie�on
under state law. If the awner or Intendetl�,�contractors ere_�uncertaln as to v�rhat'Itcenstng.requirements�may-•°eppty�`��for:�tlie%°•u�=::•=''`
trttended"work,tliey are advlsei!to.c�intact t1ie,Pasco�Gounty.Building"'Irispectton;Dlvlslon,-l:icenstn�Sectfon at 727-847-
8009. Fur#tiermore, �if the owner'iias"�htreid�a contracfo�'6r contri�ctors� he is advlsed ta have�the contractor(s);.sign . ,,;: ,..
�.,�..r . ,,,�. ,
portions of the_"contracto� Block" of.this�applicatian.for_which._they.�will..be..tesponsible.�=lf.=yau,�as:the owner slgn`�as'the�` ` ' ''"'�
, _ ,..�... .s_ ..
contractor, that may be an indtcat�on that�`Fie Is�rioY:p�ope�y'1lcensed�-and�i's not en#i�ed�to permit�ng pri�lieges In Pasco ;,
County. �� __.� �-w• -.- ,. �.'``°
TRANSPC�FtTAT10M=iMPACTIUTILITIESECNlR14C"�AN�?-RES�QURCE RECOVEEtY-�FEE�:'T�he undersigiied'iitidet�stands
that Transpartatian Impact Fees and.Reco.urse Recovery,F�es may�;apply:�#o�tF�er''construction,;of nevu,butldtngs��changetof��`��`°�''r
use In exi`sting buildings�-or��expansi�i��of}ei�lstin�g;�buildings� as specifled.Ir� Pasco County Ordinanoe number 89=07 and-
So-UT, as amended.�,:Th� undersigned also;un�erstands, ttiat:=such fees,�;as=�tnay�:�e�:due;�w111�6e tdeiitifled at#he�tlme�of==_£-"l' �::
permitting. It Is hir`ther understood that Transp�o�kation Impact"Fees and";Ftesource'Reco�sry�Fees..musi be paid prio�to
receEvtng a:"cerfl�cc�te=of-occupancy"or f�naF�power--release: :I�the proj�ct:;.does<:iio�invoive=a�cert�ic�tie of or.cupancy$ot:��-�;�'if==<�,
flnal power:release;::the;fees�-mu�t be�patid`,pc1""o.'r to,permit Issuarice. �t��k�ermo�e;-�if:Pasco:�County�`lNater/Sewerl:Impact� � :k-:���-
fees a�e due�.they must.be-pald:.prfor#o,.permlt:lssuance:in:acc+ardance wtth.appllcabte Pasco�Gounty>o�3lnances. •
CANSTRUCTiON°CiEN'LAYV�Chepter 713�Ftor�da§tatut���as amended): tf vatuativn af work is$2,500.0O.:,oc;more,-;i�� °�., •-„�..
cert(fy that I, the..applicant;�-have.b.een .provided��with=a=capy of.`�the��"Florida~Constructton� Llen'Laver—Homeowner's
Pratection Guide" prepared by�tFie Flor�da Department of Agrtcult�re and Consum�r.;Aff,alrs. 1f#he appltcant is sa`meane�-:,:, ;. ..:.
� . .. .:.
other than the°owner", I certtfy�that I have.abta.ined�a'�icapy.of.the�abpve.described tiocui�ent°and;p,romise�in,goaa._faith�to - �
del�ver it ta the<`owner."�:p"rior.:to�coiiimericemerit.,�,� ' :: .. - � . _ ..
CONTRACTOR'S/OWNER'S AFFIDAViT: I.c_e,�tt[y;:tii:at�alf�th�;lnf.ormatlon;.in�thl.s appllcation is accurate�nd that all work
will'be done in campliance with ail applicable laws regulating constructlon, zoning and��land�deyelppment. Appllcatlan is
hereby made _to obtaln.a pecm�#;=ta:do�-wo�Yand•tnstailation as indt�afed:�::..<I, cartify.that no work~or tnstallatfion fias-
commenced prior to issuance of'a p+ermif�"and that':all work will be pertormed to meet.sNandards�of all laws �egula�ing-
constructlon� Coun#y and Ctty codes, zoning regulati�ns� and land devetopmet�t r.egalat�ons�in tt�e �u�isdictiort:� 1-.also �
certify that I understand that the regulations of olher government agencies may�apply�#o the.intended work, and that it is
my responsibAity to identlfy.wttat.actlons 1 must•t�ke:ta be,fn:.c�nrrtp!lartce.,Such,agencles�lnclude bt�t��are.rtot limlted ta ,
- Department of E�vironmentat=rProtection-Cypress:`8aytiead�; Vtle�and Areas and Environmentally Sensitive
Lands,WaterlWastewate�Treatment. �
- Southwest Etorida Water Management::-�D�s#rfct Wells; Cypress.r+Bay.heaifs� Weftand' Areas� Alfering
Watercourses. . � �
- Army Corps af EngfneersSeawallsi Dacks,hlavig�tite Waterways,
- DepaMmen# of,Heaith:&��Ret�ebllitative SeniiceslEnvi�anmen#'ai..Neaith Uhit Weil.s, INastewater Treatment,
Septic Tanks.. � � ' - � .
- US Environmentel Protection Agency-Asb�st��ab�temer�t...
Federal Avletlon:Authority-Runways:� �
i understand.that the.fotiov�ing::i�estricttons apply�to the use of f11l:
- Use af flti is not allawed in�Flood;Zone"V"unless expressiy pe�mitted.
- If the flll meterial is to be used:�in �flood�Zone. "A", (t is understood�that a drainage plan address(ng a
°compensating volume"wil! be submitted a##ime ofi:pe�itting which is prepared by a prafessional engineer� -
Iicensed by'�he State of-Florida: ' - � .
- If th� fill-materlal�is�to be�used In Fbod �one `A" 1n�cannection�v�►i#h:a perm�#ed bullding asing sfem wal!
� constructfon, I certity.th.at fill:will.be�used only�to flll the area within:the•stem wall: _
- If fil! material is-to be used tn atiy a�ea; 1'�aenity that .use. of suah fl11 wil! not adversety affeat ad}acen#
' -� properties. if use of flll is found;.to adverseFy.affect adjaEerit��propeNies,.the owner may be ctted far viotating �
the conditions_of the bWllding�:perrriit Issued�under the_�attacfiad�ermit appl(catian, for.lots.less,than.one (1)
acre whrcn are e�evatea�by��t,��engtneer�ed dralnage plan is roqul�erd. .
ff I�m the AGENT FOR THE OWNER, I;pmmise In good faith to Infarm the owner of�#he permitting aonditlons�set forth in
this affidavlt�prtor ta commencing constrnctinn. 1 uridet�taiid that�a;separete,permit may be requtred for efecMcal'wor�k, .
#�.,_�.
pfumbing,_signs, wetls,,,pooSs;, air cundifioning,-.ga:s,,oc.other: installa�tions no�,spec�fcally included•in.the application. .A
permit Issued shall be construed to tife�a�llcense'to=proceed wlth tNe�v�iork end_not�as:authoNty�to._vlalate,�cancel, alter, or
se#aside any"provtsfons ofthe.#ecttt�lcal-c+ades;:nor shatl issuance�af a.�rermit.pcevent the Balldirig t?i�clalfrom thereaftec �
,�,. .,. .
requlring a conection af eRors In.plans;-consfructlan or vlolat(ons of�any codes:� Every�p�ermlt�l.ssued sFiall�become�invalid
unlass ihe wark authorfzed.by such permlt:ls-commenced•v+rlthln si�c.,tnonths of permft Issuance, or if work authorized by
the permit is suspended�or.;abandoned�for:a�;periad,af�s�C�.f�)manfiis�.aRer the time the�work�ls commenced. An extenston
may be requested� In wrlting,,_from.the��ullding.Offlclal for a perlod.�not-to exceed'�nlnety(9p)"days a�d-w�ll demonsUate
just�iabie_c�ause for.the e�tenston: If wor�c ceas�s�for nlnefy.{90}cons.$cutive�day.s...the�ab�is consldered akandaned.
�. _ . , r _.
WARNING TQ OINNER; YOUR.�FAIl.l�tRE:TO.-R�ECQ�2D;A:�i4TICE::QE��COMMEN�EME�T;Nt�AY�RESt1tT IN-'YC►UR
PAYING TWICE;:FOR IMP,RO{VEMENTS�Tfl:YDU1��PRC�►PERTY:'�IF�YO.U�IN'�E�D:TQ�i0BTA1N�FINApE1NG�'C.ONSULT
--lMd� -�- ld - �b A -- �!?� R! - Q►. �� -� � �s,Qi� - � , .,� .., :. . E ' �e - __:::.� .____..__-__—._—.
FI.ORIDA JURA�`:{F.S:1 .0 �'. . - � _ . 4 .. _ . . - . _ . . ._, .
OWN61t OR AOENT . CONTRAGTA K� �/J
Subsctlbed artd svvom M(ot atflrmed}before Is Subsa9bad�tu#'swom to(ot aiflrmed}'betore tne'tM$. . .
b� ,. . ,
Who Is/are personally knrnm M.me or haslhaye produced Who.f ersonal known•tcr.me.or hasdhave:praduced • .
' as IderfUBaaUon, ' ' as tdentt�catton.
. _� �
, Notery Publlc . � Notary Publlc
Commisslon No`: Co lsslo .No.
� Q+:���i%�';•,, JACQU�CINE BOGES
fVame ot Notary typed,Ptlnted or stamped Name af NotarY ' �ti� r� �� F 950�22
=;� Q,: Exp�res ecember T2,2018
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NAME: Tyna Conley � Date: 11/14/17 SPLIT SYSTEM ### PKG UNIT #Pl/A
SUSC}IViSIC3i�: F}EATP13iViF #�# S'FR.004L #PIIA
ADDRESS: 34�5 Be I Ln �:K'>�:"�'>,�.����',��=�t��°� �;��� r��.{;�,�:�.-}:�a_��z���'-._
t'�l `:?�_� ,s, _.��.. _,::ti,:,�31�r���,<�'��:#
cmf: ZephyrFti#Is FI 2i�coD�: 33540 o�o�NSER: ##
PHONE: 606-232-07$9 WORK; G, T�. � IR HAIdDLEf2: #NI/4
CELL: REt+(TEIZ: /' •�/ EER RATiNG: �
ESTIMATOF2: K31T12f011 BRAND: #1�/A
�'��`�`�'w`����-,�� � � � ;��[ � ���, �,r.,.,�.,�,,:,_-�...,-,.._.�,_'r �g�p/
�� r�s:�a"_� ,�,3�' �':� '^�;iII�.V,w� 3* U,�l';t '�?Ww�Nrf,="`':+' T 9'9°S`�8l�
� kaur..�.�.:.,,:.� .r.i:�:.-.:t::t��i<.z
U�TRA MAX Ez 24 VO�T Uv uGH7 ��o �' �`j�r�� INSTANT REBATE: � ����
PRO 60d0 THERMOSTAT ' �� O'TdL L�S�IZ��A3E � ��II�
PAD ONIdAG�: ��J�A PAR3S: #N1A
SEAL dUCTWORK TO CODE OMPRESSOR: #IV/A LABOR: #N/A
REMQVE EX3STIPtCy EQUIPMENT =�.��-�`�ti�''-;���s�:;�v ;._.�; � ,..M :�,,�t�,w���`.�;���.�:�
:��>z�� :.�.' ;� z�. a�st',.k`�'�`.
$Zoo s�r�ioR�iscaur�T CONDENSER: �
CONNECTED TO EXES31�6G DUCTS AND ELECTRIC i��n����: #NiA
ANCHOR CONDENSER SEER RATfNG: �
TAX,tABOR AND PERMIT BRANf�: #NfA
I 10 KVU HEAT n � �RI�A
sHROtla INSTANT REBATE: $ #�IA
NEW M/H DUCT WORK TOT�L LES�REBATE � ��/�
rtiJ i� �` o U ONP�AGE: . #N1A
' COMPRESS : #IV/A LABOR: #
� `""�.=a,� �,s:°.��:- .;�` - m;r-n-�.�'i��*r,�•.rz ,a
'„�a , .:{x`�`,t;i���� -;�:,. ",r :�s,..;:.�,z,�u.�. ,� �7,�,r,..�,'�'�:�.
vic,�'��;�:� a:{w�G.u��,".'3�F°la'i' - ,`.'^°:=^�'f?;'Y'u."'�'�.'�a'�`�:�!..'�Ys�r;'.:Y'S?ira�;¢rr
GQ �NS�R: P�.���aQooK rPOA
1 HANDLER: O
FfRST MAINTENANCE CHECiC FREE � �O , � S ER RATE�IG: 7 4
( wuvo: COMFORTMAKER
� $ �,�22e$Q
,;y{'.z �'}�Sr,7"n,n;S'k:r„Y:-' -�zr y�."py;i'�i:"7,'iST'.:;; :":'i"`T'�`tii:,.L��tr;',,• eFi::,. �.:;;:.`r`'r::�5'iY?.�:..A� .�.g'',
� -'e'�-:Ca-:a%`i:'�:F�'.x:'zY�:,r,,;.�.?*`:i".`1"y:.:.-.'�'fr'<"z::y�=`s� �;,[^;`„��;a.._ ,..t?j"'�:`-�'� - v>2��F.,. `Ts�.�:,:,
, :�r�:��..��:::���.3��:�����:��:���.�.�;�:.��;���_.y�;:..s�,�,��::��" '�..7:�a,�W.F:�; 4;' �� STANT REBATE. $ 750.00
,:��:�<�-�::_ C:�;'>,-� ��.�� @
t HAVE THE AUTHORCTY Tt3 ORDER 7NE WORK Qt)Tl.INEP ABOVE. i A6REE THAT SELLER;:M: TA�L�S� /A W a���g 2a��
RETAINS TITLE Tp EQUIPMENT AND MATERIAIS UNTI�FINAL PAYMENT IS MADE IF PAYMEN7 T MAGE: �`2,51 PARTS: 10 YR
IS NOT MADE AS AGREED.SEElEF2 CAN REMOVE SP.tt3 EQtiIPMENT ANd MATERfALS AT OdYI RESSQR: �O ? U4BaR: "S YR
SELLERS EXPENSE.ANY DAMAGE RESULTING FROM SAID REMOVAL SHALL NOT BE
E RESPOHSiBI�TFY 4F SEllER. LE[diffEC}WARRAN'tY:EQUtPMENT,PARTS R3�[D
�� MATE HAS WFt177EN MANUFACTURER'S WARRANTY ONLY i?'`''�'_��,�y'���'. .;.��%�.'T'-�"'ClL'� n���;'�'N,� t, .Y;���:-•
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i
CITY OF ZEPHYRHILLS
5335-8TH STREET �
, s ($13)780-0020 �•�0�
BUIL�ING RERMIT �
- ' � PERMIT INFORMATION � = L'OCATION INFORMATION
Perrttit Number: 19091 AcOdress: 5607 12TH ST
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Tawnship: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF'ZEPHYRHlLLS
Est.Value: Parcel Number: 11-26-21-0010-10400-0070
Improv. Cast: 3,100.00 OWNER INFORMATII"�N
Date Issued: 12l0�/20�7 Name: HOPKINS BRADLEY CLARK& BARBARA
Total Fees: 55.00 Address: 5607 12TH ST
Amount Paid: 55.40 ZEPHYRHILLS, FL 33542
Date Paid: 12/04I2017 Phone: 585-487-$174
Work Desc: A/C CHANGE OUT 2 TON
CONTRACTOR S ` APPLICATION FEES
AIR TECH SERVICES OF PASCO INC A/C CHANGEOUT 55.00
�
� �
Ins ections Re uired -
DI�S INSTALLED �
DUCTSINSULATEO�
FINAL E- /
REINSPECTION FEES: (c)With respect ta Reinspection fees will comply with Florida Statute 553.80 (2)(c)the
locai government shail impase a fee of four times the amoant of the fee imposed for the[nitia! inspe+ctian or
first reinspection,whichever is greater,far each such subsequent reinspection.
NOTICE: In addition to the requirements of this permit, there maybe additianal restrictions applicable to this property that
may 6e found 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 to awner: Your failure ta record a natice af commencement may result in your paying twice#or
improvements ta your property. If you intend to abtain financing,consult with your lender or an attorney
before recording your notice of commencement>"
Complete Plans,Specifications Must Accompany Application. AII wark shall be pertarmed in accordance with
Ci Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
4 , �� �
CONT TOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MCINTHS WITHUUT APPRt3VED INSPECTIflN
CALL FOR INSPECTxON - 8 HOUR NOTICE REQUIRED
PRtJTECT CARD FROM WEATHER
/ � , ,
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Buildirig Depariment
' Date Recelved
Tm-m Phone Conlact for Permlttin
Owner's Name 2. < Owner Phone Number �85= g�^ �
Owner's Address, 7 � J�-�, `�`S , Owner Phone Number � �i���
Fee Slmple Tllleholder Name Owner Phone Num6er
V �
Fee Simple Tllleholder Address
JOB ADDRESS � �Lo� • 5 �
LOT N
SUBDIVISION PARCEL IDp [ ' - �^�G�
(OBTAINED FROfd PROPERTY TAX NOTICE)
WORK PROPOSED e NEW CONSTa� ADD/ALT �� SIGN Q Q DEMOLISH
INSTALL REPAIR
� PROPOSED USE SFR. Q COMM � OTHER
! TYPE OF CONSTRUCTION � BLOCK „-
Q FRAME � STEEL Q
� DESCRIPTION OF WORK V I��`1 Z�hI� � ��-4. �
I� BUILDING SIZE SQ FOOTAGE�� HEIGHT � .
. . �TT���RT���"tT�ITTrI"1TTT�7T.'1��iT1'7TT1"TTT1"'TI"1:�/�rfT}�
QBUILDING $
VALUATION OF TOTAL CONSTRUCTION
i
� QELEGTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
�
j QPLUMBING $'
` �MECHANICAL $•j IOQ/� ' VALUATION OF MECHANICAL INSTALIATION
� 07
i QGAS Q ROOFING Q SPECI,4LTY � OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
-�1-H-�1-1-4.1-6-�-f��l-4-f-N-'-.�-C-�I-�ai�1-{-1�-1-1-M�1..1-{�{-4-N�1-i-1-.1�-4-4-1-d--{-L�4-1-�{-1-1-f-{�4.��{�I.:S�:���
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� � Y/N
add�agg
License#
ELECTRICIAN 'COMPANI'
SIGNATURE REGISTEREO � Y I N FEE CURRE� Y/N
Address
Lfcense#
PLUMBER COMPANY �
SIGNATURE REGISTERED Y/ N � FEE CURREA �Y I N �
, Address License#
MECHANICAL COMP.ANY !�r ICGFI �e�j/!�L {-'�J�
L�r
SIGNATURE REGISTERED Y/ N FEE CURRE�
Y/N. '
' Address � � �$ � ,3 � License# ��S
I •
i OTHER COMPANY
SIGNATURE
REGISTERED Y/ N KEE CURRE� �'/�.J
i Address -
� IIIIIIIIIIItlIlI11111111111111illllllllllllllll`C111#11111111111111111
i
i RESIDENTIAL Allech(2)Plol Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construclion,
Minimum ten(10)working days afler submitlal date. Requlred onsile,Construction Pians,'Stormwater Plans w!Sill Fence installed,
i Sanitery Facllilles 8 1 dumpsler;Sile Work Permll for subdivislons/large projecls
; COMMERCIAL Allach(2)complete sels of Building Plens plus a Life Safety Page;(1)set o/Energy Forms,R-O-W Permil for new construcllon.
i Mlnimum ten(10)working days aiter submittal date. Requlred onsile,Construclion Plans,Slormwaler Plans w/Sill Fence Installed,
Sanitery Facflllies&1 dumpster Sile Work Permil for ell new proJecls.All commercial requiremenls must meet compliance
SIGN PERMIT Allach(2)sels of Engineered Plans.
'""PROPERTY SURVEY requlred(or all NEW conslructlon.
i �:�C�F.�..{�
Directlone:• •-.-.�-.�1-1�'_`-r.-.-'_".'_^_�..1--1_^�'�.� ^"^:.+-�..�-�-a-�1�-4r1-�-�-�-ti t• u
.-.����a
I Fill out epplicadon,complelety
Owner 8 Conlraclor sign beck of application,nolarized �
If over 5�500,a Notice af Commencement is required. (AIC upgrades over$7500)
"" Agenl(for Iha contraclor)or Power of Allorney(for the owner)would be someone wilh nolarized letler from owner authorizing seme
OVER THE COUNTER PERMI7'TING (copy ot contiacl required) "
Reroofs If shingles Sewers Service Upgrades A/C Fences(PIoUSurveq/Foolege)
Drlveways-Not ovar Counler if o�public roadways..needs ROW ,
M
1 � ,
NOTiCE OF pEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions"
� ' which may be more rest�ictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed reskrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a cantractor or
contractors to unde�take work,they may be required to be Iicensed iri accordance with stafe and loca(regulatians, lf khe
contractor is not Iicensed as required by law, bakh the owner and contractor may be c{ted fo�a misdemeanor vtolation
under state iaw. If the owner or intended contracfor are uncertain as to what licensing requirements may apply for the
intended work,they are advised to cantact ihe Pasco County Building lnspection I�ivision—Licensing Section at 727-847-
8009. Furthermore, if the awner has hired a contractor or contractars, he is advised to have the contractor(s) sign ,
portians of the"contractor B1ock"of this application for which they will be responsible. If you, as the owner sign as the
contrackor,that may be an indication that he is not properly licensed and is not entitied to permitting privilegas in Pasco
County.
TRANSPOF2TATtON lMPACT/UTtLITiEB iMPAGT AhiD RESOURCE RECOVfRY FEES: The undersigned understands
khat?ransportakion lmpack Fees and Recourse Recovery Fees may apply ta the canstruction of new buitdings,change af
use in exisGng buildings, or expansian of existing buildings,as specified in Pasco Caunty.Orclinance number 89-07 and
94-07,as amencled. The underslgned also understands,fhat such fees,as may be due,will be iden6fied at the time of
pe�mitting. It is further unde�stood thak Transportation Impact Fees and Resource Recovery Fees must be paid prior ta
receiving a"certificate of occupancy"or final power reiease. If the project daes not involve a certificate of occupancy or
flnal pawer release,the faes must be paid prior to permit i5suance. Furthermore,if Pasco County Water/Sewer Impact
fees are dua,they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRIlCTION LIEN LAW{Chapter 713',Florida Statutes,as amended): If valuation of woric is$2,500.00 or more,I
certify that !, the applioant, have been provided with a copy oE the "Florida Gonstruction Lien �aw—Homeowner's
Protectlan Guide"prepared by ihe Florida Department of Agriculture and Consumer Affairs� If the applicant#s someone
ather Ehan the"owt�er',I certify thaf I have obtained a copy of fhe above described document and promise in good faith to
deliver it ko khe"owner'prior to commencement.
CONTRACTOR'SIOWNER'S AFFIDAVIT. I certiiy that all the information in this application is aacurate and that all work
witl be done In campiiance wi#h aN appiicable laws regulaking canstructian,zoning and land development. ApplicaUon is
hereby made to obtain a permit to do work and installation as indicated. I certity t#iat no work or fnsta!(ation has
commenced prior to issuanoe of a permif and that a�i work will be performed to meet standards of all laws regulating
constructian, Gounty and City codes, zoning regufatians, and land deve(opmenf regufations in the jurisdiction, i also
certify that I understand that the regulations of other government agencies may apply to the intended work,and khat it is �
my responsibility to iden#ify what actians I must take.to be in compliance. Such agencies inciude but are not limited to:
- Deparkrnent of Environmental Protection-Gypress Bayheads,Wetland Areas and EnvironmenEalfy Sensifive
Lands,Water/Wastewater Treatment.
- Southwest Florida lNater Management District-Wel(s, Cypress Bayheads, Wefland Areas, Aitering
Watercourses.
- Army Corps of Engineers-Seawalls,Docks,Navigable Waterways.
- department of Heal#h $� Rehabilitative ServiceslEnvironmental Health Unit-Weiis, Wastewater Treafinent,
Septic Tanks.
- US Environmental Protection Agency-Asbestas abatement.
- Federal Rviation Authority-Runways:
I understand that the following restriclions apply to the use of fill: ,
- Use of filt is not aflowed in Flood Zone"V"unless expressly permitted.
- It the fill maEerial is to be used iri Flood 2one "A", �t is understood #hat a drainage plan addressing a
"compensating volume"will be submitted at time of permitting which is prepared by a professiona{engineer
licensed by the State af Fiarida.
- If the fill materia{ is to be used in Flood Zone '"A" in connecEion with a pe�m3tted building ttsing s#em wall
eonstruction,I certify thak fill will be used only to fill the area within the stem wali.
- !f fiii materlai Is to be used in any area, { certi#y that use of such fili wi(i nat adversely affect adjacent
propeities. !f use of fill is faund to adverssly affeck adjacent propertles,ihe owner may be cited far vlblaiing
. the conditions af the buitding permit issued under the aktached permit applicatian,for lots less than one{1)
acre wh{ch are elevated by fiH,an engineered drainage plan is required.
If I em the AGENT FOR THE OWNER,l promise fn good faith ta lnfarm the owner of the permiBipg condltions set forth in
this affldaviE prior fo commencing consiruction. i understand that a separate permi#may be required for electrical work,
plum6ing, signs,wells, pools, alr cpnditioning, gas,or other i�stallations nat speci£caily inciuded in the application. A
perrriit_issued shall be construed to be a license to proceed with the work and nat as authority to violate,cancel,alter,or
set aside any provisions af the technical cades,nor shail issuance of a permit prevent the Building Official fram thereafter
requiring a correckion of errors in plans,construotion or violations of any cades. Every permit Issved sha(f becorne invalid
unless the work authorized by such permit is commenced within six months of permit issuance,or if work authorized by
the pefmit is suspended or abandoned for a period of six(6}monihs after the time the work is cdmmenced. An extension
may be requested,in writing,from the Building Officfa!for a period nok to exceed nlnety(94)days and wti!demonstrate
just{fiatale cause for ihe extension. If work ceases for ninety(90)consecutive days,the job is considered ebandoned.
WARNING TO OWNER: R `I URE TO RECORD A NOTICE OF GOM NC MAY RESUL.T lN YQUF{
PAYiNG TWiGE FOR t OV T. TO YOUR PRQPERTY. iF YOU INT D T O N FINANCING,CONSULT
W! H OUR LEND R QRNEY BEFORE REGC?f2Df G Y411i2 'CIG O OM11hENGEMENT.
FLORIDA JURAT(F.S:11 . .. �. . . r^, ,� .
OWNER OR AGENT � CONTRACTOR_ ,,,�_,,,,,___
Subscribed and sworn to( af ine efors me this Subscribsd and swor o{o affrmed}before me lhis
by by
Wbo islare personally known to e or hasthave produced Who istare personally knowr� r 6asJhave produced +
as identificetion. as Identiflcatian.
- Notary Public Nolary Pu611c
Commissian No. Commission No.
Name ot Notary typad,pdnked or stamped Name of Notaty typed,prinfed or stamped
` �� �Lr�F1dl..'� �
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Of�iee: 813-779-750$ • Fax: 813-774-75Q4 • Lic.#CAC1815498
Date• Q � "� ` v��L�
f� `� {.t�t'1�
Customer iVame � � �
Address '� r --- Zip Code��_�
Job locafion i � Subdiv:
Phane#����� "� %1 AI#ernate#
Exisfing Equip.
Mad.# SER.#
Mod.# 5ER.#
���, . Permit#
Type of Unit: MjS SjC � S/S PAC Ton:.:� ? Seer�_
Y 1�.
❑ �Duct Work �ae of Duct Work: Meta) Flex MH flex Duct Baard R-
L�d ❑ �.t�`aLllLr'.�
� ❑ �,e t 5 ' Id: Heater KW: _�` Wire Size Breaker Type
Elec. Pane� Brand: AH Cond. PAC
❑ _�, �
CI �L„i�,e Set:��t,(�1 �=s,#�, Prog. an- ro .
�❑ ,�.asfic Seai� �(�, Airhandler L�catian:�`'-''-� �L�. ,AHU L__,'• H „W ••
U�Mt.� '
� � � LJ'gh�&Recn: Return Air " Duct Size "
'"� � Service Platform: Access/Cioset Doar: Attic HeightjCtoset Size:
Atfic Insulation Depth � =R Value
Speciai Nates• l �' ~�'�
�' � � �IN �- � °� a� � �� �
C�s���1�.1�. L.i
�'� .., „ -.:.n�,: �QQQ�
Bryant$ Rheem$'":�.�~. �`.3'°- �`' Comfortmaker$ � .$
�� �
Factory Rebates:
� Warranty: 10 year Compressor and Parts&1 year an labor _1��—
10 year Compressar��s 2 year n labor
Air Tech Services Appcoval � � date
Customers Approval l J ,��7 date