HomeMy WebLinkAbout18-19209 CITY OF ZEPHYRHILLS
5335-8TN STREEt'
($13}780-0020 192Q9 .
� ` BUI�DING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 19209 Address: 4556 BLQSSOM BLVD .
Permit Type: MECHANICAL ZEPHYRHILLS, FL. ,
Ciass of Work: AiC GHANGEOUT Tawrtship: Range: Book: �
Proposed Use: NOT APPUCABLE Lot(s): Block: Section: ,
Square Feet: Subdivision: ORANGE BLOSSOM RANCH
Est. Value: Parcel Number: 15-26-2.'I-017D-00400-OOBO
Improv. Cost: 3,750.00 OWNER INFORMATION
Date Issued: 1122/2018 Name: HORVATH MC}RENE GRACE TRUST
Total Fees: 60.Op Address: 1474 N CHIPMAN
Amount Paid: 60.Q0 QWOSSC?, M1. 48867-4844
Date Paid: 1/22/2018 Phane: (813 788-0068
Work Desc: CHANGE OUT A/C 2 TON
CCINTRACTOR S APPLICATION FEES
O'DONOVAN'S AJC & HEATING A/C CHANGEOUT 60.00
�
Ins ectians Re uired
D T I TA ED
DUCTSENSU�AT
FINAL
REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Flarida Statute 553.80(2)(c)the -
loca!governmenfi shail impose a fee of four fiimes the amaunt of the fee impased for the initial inspection ar
first reinspection,whichever is greater,for each such subsequent reinspection.
NOTICE: In addition to the reguirements of this permit,there maybe additional restrictians applicable to this property that
may be found in the public recards of this county, and there may be additianai permits required from ather governmentai
entities such as water management, state agencies or federal agencies.
"{Narning ta awner: Your fai[ure to record a notice af commencement may result in yaur paying twice far �
improvements to your property. If yau intend ta obtain financing,consult with your lender or an attorney�
before recording yaur natice of cammencerrtent,"
Complete Plans,Specificatians Must Accompany Application.All wark shall be performed in accordance with
Ci Codes and Ordinances. NO OCCUPANCY BEPORE C.O.
NO OCCUPANCY BEFORE C.O.
./ G�-'' ���'•�' �' ,
NTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MC?NTHS WITHCIUT APPRtJVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PRUTECT CARD FROM WEATHER
' 813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
� • • Building Department
7 i , -
Date Recaived . .Phone Contact tor Perm€tting' - _
' Owner's Name �t� ' 0 i" V�� Owner Phone Number
-7 �- 7�d
� Qwner's Address "l ��lD l� Jr"�� '//nU �(/R /�G l Owner Phone Number � � i
Fee Simple Titlehotder Name � � Owner Phone Number �— �
� Fee Simple Titleholder Address ,
� ` �.� 1D ��t �4t1�E� t1�'YU �.or# ��
# JOB ADDRESS
� ` SLIBDIYESION lGlt c° l.�.i � GdCt CC)/1 PARCEL ID# '
- , (OBTAINED FROM PROPERTY TAX N4TICE) �
WQRK PRQPOSED t , N�W CONSTR ADDIA�T � SIGN Q � Q DEMOLIBH
e INSTALL 8 REPAIR
PROP.OSED USE Q SFR Q COMIVI � QTHER '
TYPE':OF CONS7RUC7'ION Q BLQCK • Q FRAME � STEEL Q
� DESCRIPTION:OF WORK• _ C` �/i � �(/ ! �(�i7�q/���4°/ �(~��-, ��f��(
� BUIIDENG'S1ZE S4 FOOTAGE C� FtE1GHT •C,.i��
��������G �_� VALUATION't7F TOTAL CONSi'Rl7CTION
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QELECTRICAL �sa�� AMP SERVtCE Q t'ROGRESS ENEftGY Q W.R.E.C.
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QPlUMBENG �> � �
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� QMECHANlCA� $ 7 VALUA7'tON QF MECHANICAL INSTAl.LATION j a
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� C]Gas Q R40FING Q SPECIALTY C� UTHER
� FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA QYES N�
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� BUtLDER CONIPANY
�� — 'SIGP7ATO,iR�—�- - -- - _ - REGISTERED_ Y'/ N _ FEE CURRE� Y 7 N
Address License# �� � ~
��E�.EC.T-RtG1At�! .. COMPANI�
._ SIGNATURE r.. ,, REGISTERED Y/ N �FEE CURRE� Y/N
Autdress License# � a y �
P1:UMBEt2.,. . COMPANIf. �
SIGNi4'TU12� � ,REGISTERED Y•/ N F��cuRREn Y/N
� Addrass License# � �
� MECHi4NlCA!_ � � ��?/f�I COMPANY !J/1 fl{/G lj r � f�
, SIGNA7'URE" REGISTERED , Y/ N FEE CURRE� Y/N :
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"SIGNATURE'�, ,:.:;•• REGISTERED Y/ N. FEE CURREK Y/N
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s>'.RESIDENTlAl.�„,;��Attach,(2)sPlof`.Plaiis,'`(2)�sefs�tsf Builifing-Plans:(1j�set bf�Ene�gy`Fii�itis;R=Q=W,F'errnlf.for new,canstiuction,�� ,
�`„r�=.�-�,...-;�Minimum;:ten�1Q. .workin ,da s afte�submittaGdate:''Re w�ed�onsite,"�Gonstriiction Plans;Stbrinwater Plans w/Silt Fence installed,
.. s,.,�.,,::c:.. � �. .)_ 9' Y" • 4 .
. �.,:.. ,.y__.�... .�,.;�.A.-... ...,. .. . ,
( � . -, Sanita,ry;Facllitles,&V1�:dumpst�r�Sife,Worlc.Permit.for:subiiivisions/large;projeets �` _ ��
�Y;'GONIRAERClAC--�Attach�{2}'complete sets'of'Bufldln'g`Plans plus a L(fe Safety Page;(1)set of Energy Forms.R�-lA+Permit for new construction: � - `
� ; Minimum ten(10)working days after submittal date. Required onsite,Constnuction Pians,3tormwater Plans w/Sil#Fence installed, �
-�` Sanitary EaciliUes&1 dumpster.Site Work Permit"fo"r•al!-new piojects.AA cammercial requ�rements must meet comptiance
f�`'`SIGRt PERMlT "Aftach 2 sets-of:,En ineerecl�i?'tans::<�. :•
' I �.>. c �,___.._�._$ ,
� '�"`� ""'*PROPERTY SUR�Y required for aII.NEW conskructfon..
��.Fi. _ . .......n. ..... _ _
I � f:l.iilratCif��R�� :``>;p�... ., ' ' � . ,
�� ''� �'Fill-outapplication completely. �
O.wner�&Contractor sign back af applicatian,nofarized
- ' tf;over$2500,a Notice�.of Cammenaement is required. (A/C upgrades aver$7'S00) . , �
�'`"' Agent(for'fhe�cont�acto�)orPower`of Attomey(for tlis owne�)would tie someone with notarized letter from owner authoriz3ng same
� � �� .,.,,�.
;.,OitER�,7NE COUNTER;PEFtMiTtIN�, .. ,(c:apy.of conUact-required}�•, ' -. :_ _ _ _.
�:�Rerobfs:if sfiingles Sewers Servlce Upgrades A/C Fences(Plot/Survey/Faotage)
! ' Driveways-Nat over Counte�'�fi oii`�pi�Filic't�adwa�is..n�eds ROVV"� �; Y
� - �f JJii-1"�����-=:�;...�_...i, ��i,;�! ��
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; NOTICE OF DEED RESTRBCTION&: The undersigned understands.#hat this;permit may,be�stabject�to"deed,£r,est�ictions�;`;;���
which;ma ,�:be more-restrictive:than°Count ce ulatioias:�^The�undersi'�ner3�assu'rnes'Yr�s`onsibitit'"`fo�com liance with:an
Y Y 9 9• p Y P. Y.. ���
appl��ble deed restrfctions. . .r::.':<-.<:{,;,_-:�:;:,
UNl:iCEN$ED. GONTRAC'T'ORS AND CONTR1�iCTOR RESP.ONSIBILITlES:. !f•tlie�own{er�ktas° taired���a�°cantractor or. ; �
con#ractors ta undertake wark, they may,be r:equir,ed to berlicensed in accordance with s#ate:-and',focaf:cegulations::F=1f.-ti�e"�:"u�
cont�actor is no#.licsnsed�as�required''tiy��law,�lioth"the oinrner"and'confractor,m``ay=be��cited�=for,asxm�isdemeanor violatibn�� .�;i
under state (aw. !f the orrun�r or intended;.contractoc are°uncertain as to what.,ticensing r.equirem.ents=amayr�apply=for�:�tta,e,�-.=',�1
....,,,..,,:. ..,.,,.. ...-: ::...
, intended wark,..they.are-advised ta cont�cf tiie'Pasco County�Builtling Inspection;D,ivision-�Licensing Section af-727=84:7,- _��,
8Q09. Furthermore, if the owner has�hired�a coritractor or cont"ractars, he is advised to�have the. contractor(s}.,sign.,,`�:,
portions of the "contractor Black" of this application.,,for which they wriit be respansibie.,.tf you,=as"tiie=owner'sign_`as��the;`-,.';
oontractoc, that ri�ay �e an indicatian that he is not praperiy licensed�ani{ is not"entitled to�permitting privileges;_in�;Pasco NJ<<,�
County. � . ' ,
TRANSPORTATiON-IMPAGTN'TILITIES�IMPACT AND RESOURCE RECOVERY�FEES:���The`uniiersigned understands,�:�-,�;
that Transportation Impact Fees and Recourse Recovery Fees rriay„�appfy to,the constructian.of..new.buii�ings,.change�ofj:��=; �
use in:exlsting buifdings,�or=;expansion.of°�exi"sting buiidings, as specfied in Pasca County Ordinance numbe�89-07 and. , �
90-07, as amended. The undersigned atso_understands,�that such:.fees, as:may_.b.e:due, wilf tie�_�dentifisd at�tfie=:tirrie�of°��`;
permitting. �tt is further understood tliat Transportation Impact=Fees�and Resource`=Recovery.Fees must be paid'prior,ta '?
receiving a "certificate of occupancy" or•fina!,power release. If the project does not�involve a certificate of accupancy°6�u-:�=�_;t
fna! power release, fhe fees.mus# be.paid prior to pecmit issuance.,..Furtiiermore,.if Pasco,County Water/8ewer.,lmpact.�;4:,.,
. fees are due, they must be paid prior to;permit issuance in�accordance with'applicaale Pasco:County ardina'nces.� � � ,
CONSTRUCTION LIEN•L-aW(Chapter 713,�Flor�da Statutes,as amended): If valuatian of work is$2,500.00.ar;more;ri::�-,;<�{
certi that 1, the a licant, have been. ravided with� a ca � ��� "
fy pp p .py;of the "Fiorida Construe#ian��E:ien Law Homeowner's � f
Protection Guide°'prepared b�r the Fiorida Depar#ment of Agricuiture and Cansumer Affairs, (f the applicantf is.someone,,. _�;
ather than the uowner�,I,certify that Lhave o6tained a copy of the above'`d'e'scri6ed document-and promise�in good`faitli to;_`;�;;�:
deliver.it.to:the:'towne�'.-prior.�ta�commencement.` � ,
CONTRAGTOR'S/OWNER'S AFFIDAVlT:, l..certify.that ai!the information in fhis application is accurate and`tFiat alt'work °
wili be dane in campiiance with alf appl'icable�laws regulating construction, zoning and land�d'evelopment, Application..as
hereby made to abtain a _permit to .do,work=and installation as�indicated. ! cer#ify fhat no wark or.insta!latian-has -
commenced prior to issuance of a perrriit and�that a!! wark wili be performed to meet..standards of ait laws reguiating ,
constructian, County and City codes, zaning regulations, and iand developmenf regulations�iri,.fhe jurisdiction.. �I.also �
certify that i understand that the regulations of other government agencies may apply to the intended work, and that ik is a
�
my responsibiiity ta idenfify what actions I must take to be in compliance. Such agencies�nclude-bu#are not limited.,to: '-,
- y,Department af Envirorimental:Rrotectian-Cypress Baytieads, We#land Rreas and Environmentaliy 5ensitive
Lands,WaterMlastew�ter Treatment. �
F
- Southwest Florid�t Water Management District-WeIIs, Cypress Bayheads, Wetland Areas, Altering
Watercourses. F, �
- Army Corps of Englneers-SeawaHs, Docks, Navigable Waterways.
- Department of Health & Rehabilitative ServicesiEnvironmentai .Meatth Unit Wells, Wastewater Treatment, :
Sep#ic Tanks.
- US Environmental Rrotection�gency/lsbestos abatement, � ;
- Federa!Aviation Authority-Runways. - - - � �
I understand that�the fo!lowing restricfions appiy to the use of fiN: .
- Use of fiti is not aflowed in Flopd Zone"V"untess expressly permitted.
• if #he fiil materia( is to be used in. Flood Zone "A", it is understood that a drainage plan addressing a
"compensating voluPne" will be submitted at time af permitting which is prepared by a professianai engineer "-
licensed by the State of Flvrida.
- if the frl! materiaf is to be used in Flood Zone "A" in cannection wi#h a permitted building using stem wali
construction, I certify that fill witl be used only to�II the area within the stem wall.
- If fill� material is to 6e used in any area, ! certify that use of such��fH wiii not adverseiy a�fec#,adjacent �
properkies. If use of fill is faund to adversely affect adjacent properties, the owner may be cited far violating '
the conditians of:the buitding perrnit issued under the attached per.mit application, for lots less than one (1) '
acre wf7ich.are elevated by fiil,an engineered drainage plan is required.
If I am the AGENT FOR THE OINNER, ! promise in good faith to inform the awner of-the permitting canditions set forth in :
this affidavit prior to commencing ccinstruction. 1 understand that a separate permit may be required for etec#rical work,. �`'
plumbing, signs, wells, pools, air canditioning, gas, or-athe�installations no# specifically included in the application: A � -
permit issued shall�be construed to�be a license to proceed with the work and not as.authority ta violate, cancel, alter, or '
set aside any provisions of the f�chnica!codes, nor shall issuance of a permit prevent the Building Officiat from thereafter
requir�ng a correction of error.s in plans, construction or violations af�any cades. Every perrriit issued siiali become invalid
unless the work authorized by such permit is commenced wifhin six man#hs of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period..of.six(6)'mon'ths after the#ime the work i�commenced. An e�c#ensian ,�;
may be requested, in writing, frorn the Buildirig Afficia! for a perioc! not to exce"ed rifnety{90}iiays and wifl demanstrate , �
justiflable cause for the extension. !f work ceases for ninety(90)consecutive days,the job is considered abandaned.
WARNtNG Tb OWNER: YdUR FAtLURE,TQ RECORD,.A.NOTICE OF CQMMENCEMENT�MAY�RESULT !!d YOUR
PAYING TWiCE FOR IMPROVEIhIfENT$TO YOUR�.RROPERTY,: lF�YOUiINTEND-TO�OB'FAlN<FINANCIN ,CONSULT '
1NITH YOUR iENDER OR AN'AITARN�1f BEFORE:RECORDING YOUR�N �TlCE a'F�G�311�M� +� I� . -- - _
. _FI f1P��a-,:�:��T lYr.$�.i 1-�:�5}� _ , .._. - _ --•- -`�� ' -- f:
OWNER OR AGENT CON7RACT0
Subscribed and swom to(or affirmed)before me thls Su scrib an wam or affirmed)befota me this �
by VU��bY
Who is/are personally known to me or hasJhave produced ' ho'st re ersonally kno.wn#o me or has/t+ave produced
as Idend8q8on. ��%�� I1 as Edentification.
" �t�� �-�'��c,� ���n�.o
Notary' Public Notary Public
Commission No. mission IVci. �
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Name of Notary typed,printed or stamped Name af � nr��+��+^��—^�=^s�----
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WE OFFER TO FURNISH MATERtAL AidD LABOR AND COMPLET�7HE ABOVE IN ACCORRANCEiNITH ABOVE SPEClFiGATiONS FOR7FIE
SUM QF: �
DOLLARS($
PAYMENT TO BE MAl7E AS FOLLOlNS:
AII materiai is guaranteed to be as specified.AII�vork to be complated in a
workmaNike manneraccording to standard practices.Any alteration or deviation
from a6ove speotfications invo{ving extra cosfs tiviil be executed onty upon AUTHORIZED SIGNATURE
written orders and wili become an extra charge over and above the esttmate.
A�I agreements contingent upon strlkes,accidents or delays beyand our OFFER MAY BE WITNDRAWN
control.Owner to carry flre,tomado and other necessary insueance.Our .,,�---- -----1F NOT ACCEPTED WITMN
workers are fuily covered by Worker's CompensaUon insurance. p
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C The above prices,specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the work as speCified.Payment wil(be mdde as outlined abc
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C AU7HOAtZED S(GNA7URE DATE OFAGCEPTAtJC
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