HomeMy WebLinkAbout18-19210 CITY OF ZEPHYRHILLS
5335-8TH STREET '
; - , (813)780-0020 19210
BUILDING PERMIT �
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 19210 Address: 4558 BLOSSOM 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: ORANGE BLOSSOM RANCH
Est. Value: Parcel Number: 15-26-21-017D-00400-OOAO
Improv. Cost: 3,750.00 OWNER INFORMATION
Date Issued: 1/22/2018 Name: HORVATH MORENE GRACE REVOC G N�
Total Fees: 60.00 Address: 1474 N CHIPMAN RD
Amount Paid: 60.00 OWOSSO MI 48867-4804
Date Paid: 1/22/2018 Phone:
Work Desc: CHANGE OUT A/C 2 TON
CONTRACTOR S APPLICATION FEES
O'DONOVAN'S A/C & HEATING A/C CHANGEOUT 60.00
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In s Re uired
D T IN TALLED
DUCTSINSULA ED
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.
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 performed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. �
NO OCCUPANCY BEFORE C.O. �
. � ,
CON CTOR SIGNATURE � PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
.PROTECT CARD FROM WEATHER
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. s�3asaoozo City of Zephyrhills Permit Application Fax 813-780-0021
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Data Receiv�d . -.phone Contact fo�Permitting�� - �
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; Owne�'s Nama �f( ✓V Gt Owner Phone Number , � 3 �7 �- T� i
� Owner's Address � �� � �lDS /"l J./�(/�C��/ �p Owner Phone Number
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t Fee Simple Titleholder Name Owner Phone Number
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� Fee Simple Titleholder Address
� JOB ADDRESS J (�S �'l �v l � �� �C LOT# �
SUBDIVISION D�u/� Il � ,50 G l 0� 0 PARCEL ID# 1 - b � -/✓J 7�-o�-r�✓�- �Q� O
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED � . NEW CONSTR ADD%ALT � SIGN Q Q DEMOUSH
e INSTALL B REPAIR
PROPOSED USE Q SFR Q CONiM Q OTHER :
7YPE"OF CONSTRUCTION Q BLOCK - Q FRAME Q. STEEL Q
°DESCRIPTION OF WORK C ' . (/ r`� ( On�l7��J/j� r� �-�'/1�+-� lJi!!�n y
BUILDING'SIZE �b ( SQ FOOTAGE� HEIGHT •. '
` OBUILDING $ VALUATIOIV'OF TOTAL CONSTRUCTION
DELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
�: �� OPLUMBING $ (� � I
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� QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � � �
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i QGAS Q ROOFING Q SPECIALTY � OTHER ��
z FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES 1D�0
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_ _�, _ BUILDER COMPANY �
SIGNATURE � - — REGISTERED_ Y'/ N FEE CURRE� Y 7 N. :
Address � 'License# 1
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'ELECTRICIAN COM PANY
SIGNATURE REGISTERED Y/ N FEE'CURRE� Y/N
� Address` License# ' �
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; PLUMBER.., , COMPANY-
� SIGNATURE �REGISTERED Y-/ N� FEE CURRE� Y/N
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� Address - License#
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, MECHi4NICAL' ' COMPANY D�/1(>UG/I G O.
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� "�RESIDENTIALy;,�;;'"Attacfi;(2.)::Plot"Plans;�(2);sefs�of Building�Plans;(1�)`set of�Energ'y:Fo'rms;R-O-VU,Permit for.new,construction;-��
� � �p'-,-�,-,:-� •;��:Minimum.tenj.(1Q);_w,orking;days�afte�,sutimittal:date:rReqiiired onsite;'Constniction Plans,�Stormwate,r Plans w/Silt Fence installed,
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; ; _ � -- Sanifary;Faciflties:�&;;1�dumpster;Site;Wor,kReFmit,foi:;subdivisions/large;;projeefs= _�_
" i s_�GOWIWIERCIAL -Attach�1�mplete`s"'�ets ofFuifdingFians pius a°Ci�e Safec�Page;=�1)se�o�er,-ergy�For�i�s:R=3=V1'-Perrritt-fo���ew=constn:ceicrr�--=- " - -_�
� 5, _ Minimum ten(10)working days after submittal date. Required onslte,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary•FaciliBes&�1 dumpster.Site Work Permiffo�all-new projects.All commercial requirements must meet compliance
�`;�SIGR1`.PERRAIT "AttaaFi'°(2j sets;of:;Engineered�,Plans.<<� .
� � ° " "`*PROPERTY SURUEY required for,all:NEW construction.. _
i ;<Dl�ections: ,. .- - .. ,.
� ;��Fill-.out application completely.
� ' O.vimer 8 ContraGtorsign back ofapplication,notarized
I�f over$2500;a.Notice:of Commencement is required. (AIC upgrades over$7500)
� '�"'�' A enY for�the�cont'ractor•or�Fower ofAttome"for"tFi'e owner would be someone with notarized letter from owner authorizin same
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� s�;.OVER�.THE"COUNTER'PERMII�TING., .(copy..of contract-required)•��"� •'�'``" •'` _
' �=:=Re�oofs if sliingles Sewers Service Upgrades A/C Fences(PIot/Survey/Footage)
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; _ :D�iveways-Not over CounteFifron•public�roadways::needs ROVV°•-��~-,�
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NOTICE OF DEED RESTRlCTIONS: The undersigried,�;nder5tands.that<this;permit may,be.:subject,-.to"de.ed"restnction�s..- :
,i _ _ ,�.a`..-uiit,. - - '.:�;a,�_'�;.,'_.s�i.;t`i-.r:�;�;;`.r'�:�=:=i^,'x;ir�,'�=..r�°;:£y�.=�rr�:-^'c';.ti:"_.#;�:;���.`wj;
which.ma ,<<be.more-resfrictive=than`Gourit .fie ulations:T��TheFund'ersi ned�assumes respons�bd4ty��for�complia�ce:udith.-an.y.;,,° x
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applicabie deed restrictions. _ . ..._ , _.. .,,; 4=b�°=��{���'`�µ=��a=�;
' SINLICENSaED, CONTRACTORS AND� CONTRACTCIR RESP.GINSIBILITIES: If•the�ovtriier=�ttas�=:hired�=a;°contractor�°or :
contractors tb undertake�uvork, they,may;be reguired to ber:licensed in accordance with state�and�locaLregul:a#iQns:�zvlf:+tiie�:���`'�
� cantractor is not licensed>as�required�"tiy`iaw; b'otii,�the aiwner��and'�eon4ractor;iiiay==be;cited`for a-misdemeanor violation �
under state�(aw. if the owner or intend.e.c�:cont[actor are;uncertain as #o what.licensing;cequirernerits:�rnay-�apply_for�the�z;='� ,
�y .•:��r� .�.,�.:,: .�. � -- .
intended.wor.k,they=are�advised to confact the Pasco Couniy�Building:lnspectioi�i`D�vislon-�=i:ise'nsing Section,af 727=847 j
8Q09. Furtherrnore, if the owrier=tias°fii`red�'a� coritractor or contractri�s, he is aclvised to�`haveittie contractor(s,)�:,sign,.ry���
- ,_�,���r��:<<:�:��.«.
portions of the "contractar Black"pf fhis application.,#or which they.wiii be respansibie:�.If-.y_ou, as;'tlie;owrte'r`sign.as�;tFie;`� ,;
contraatoc, that may 6e an indication"tiiat he is not properly'licensed and is no# entitled-ta permitting privileges,iniPasco � `�j
County. � _ _. .:� i � - �,...,
TRANSPQRTATION-.lMPACT/UT!!!TlES�IMPACT A[dD RESOURCE RECOVERYFEES:�'TFie undersigned undecstands;.�.:<,j �
= F:.,:r ::.e. .e i
that 7ransporhation Impact Fees and Recaurse Recovery Fe.es.may;appiy,to,fhe constructi_on;of,new,buildings,.ctiangetof;°��;�.�
use in existing buitdings,;br•expansion of..exi"s#ing buildings, as specified in Pasca Gounty Ordinarrce number 89=o7��ar,a�`,��.,�+
90-07, as amended. The�undersigned alsa;understands,�that such;�fees,=as:may::.be.drae, will`;l�e;identified��at�ttie�firaaeA.of<:��'?,�;
permitting. �It is further understaod tha#Transportation lmpact Fees-and Resource�Recovery.Fees must be.paid':prior�to .�;<';
� receiving a "certificate of accupancy" or final.,power r.e(ease. if the.project daes not invoive.a"certificate of occuparicjr:o�-�-Y.�>;:'
finaf,power release, the fees�must be,�.paid prior to permit issuance..y Furttiecmore,.•'rf Pasco a.County WaterlSewer=-lmpa�t:.�=;kr�,; '�
fees a�e due,tfiey must,tie paid prior to permit issuance in accordance with�applicatile.Pasco:County ordinances. � �
GQNS7"RUCTIQN LIEN°LAIN{Ghapter 713,"Flarlda Statutes,as amended): If valua#ion of work is$2;50Q.00.oc,.m.ore,;.f;;�µ���=}
certify that !, the applicant, have been provided with a copy._rof.vthe "Flarida Construcfion.'Lien.-Law=:Homeowner's�
Pratection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. !f the applicant-is;:someone_,,,��;;i
other than the"owner",:!�certify that l,.have o6tained a copy af the above`described document and�pramise;in goo.d.faith�fo'.;�,,,`;
� deliver_�t,to=#he'bwner"�prior.to.cammencement: ' -� ;
CONi'RACTAR'S/OWNER'S AFFIDAViT:;-�i.certify that all�the infiarmation in this app(ication is accurate and`thaf all work
will be done in comptiance vuith all applicable'laws regulating construction, zoning�and land develapment, Application..ls
hereby made to obtain a ,permit_to d;o�.�work-and instalfation-.;as =indicated. 1 Vi certify that na wark or.installatian��has �
comrrienced prior to issuance of a permit and�that all work wiH be performed .to.meet standacds of ail laws regulating '�
constructian, County and City codes, zoning regulations, and Iand development�regulations in;�the jurjsdiction. 1~also �
. certify that 1 understand that the regulatians of other gavernment ag�ncies may apply to the Intended wark, and that it is �.�
my responslbility to identify what actaons 1 must take to be�n compliance. Such�.agencies inctude but are nrat.limited,to: <
- ,Department of Environmental�'Protectian-Cypress BayFieads, Wetland Areas and Environmentally Sensitive ��
� Lands,Wafer/Was#ewater Treatment. �
- Sauthwest Florida Water Management District Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses. �
.,
- Army Carps af Engineers-Seawalls, Docks, Navigabie Waterways.
- Department of Heai#h & Rehabilitative Services/Environmental .Health Unit-Wells, Wastewater T'reatment,
Septic.Tanks. �
- US Environmental Protection Agency-Asbestos a6atement � : �
- Federal Aviation Authority-Runways. '
� t understand that the foliawing restrictioiis appiy to the use of fill: _ �
- - Use of filt is not allowed in Ftopd Zone"V" unless expressly permitted.
- If the fill mat"eria! is ta be used in Elood Zone "A°, it is unders#oad that a drainage plan addressing a �
"compensat9ng volume° wiH be submitted at time of permitting which is prepared by a prafe�sional engineer "�
licensed by the State of Florida. T
- if the fill materiat is to be used in Flood Zone "A" in connection with a permitted building using stem wal!
construction, I certify that fi!!wiA be used only#o fi!!the area within the.stem wall. n '
- If fil! material is to �be used in any area, I certify tha# use of such��fill wili not adversely affect adjacent �
properkies. If use of fiii is faund to adve�se(y affect�adjacent properties,.the owner may be cited for violating ' �
#he conditians ofi the building_permif issued under the attached permit application, for.lots {ess than one (1-)
` acre which.are elevated by fill, an engineered drainage plan is requi�ed. ;�
If!am the AGENT EOR THE OWNER,.I pramise in gaod faith ta infarm the awner of-the permi#ting conditions set forth in �
this affidavit prior fo cvmmencing cans#�uction. 1 understand #hat a separate permit may be required for electrical work,� , '�
piumbing, signs, weils, pools, air conditioning, gas, or�attier installations not specifically included In the applicatibn. A ;; �?
permit issued sha!!°be construed to be a license to proceed with #he work and nat as.authocity to violate, cancel, aiter, or
set aside any provisions of the t'echnical codes, nor shall issuance of a permit prevent the Building Officiat fram thereafter ,
requiring a correction of errars in p{ans, construction or violations of-any�codes. Every perrriit issued shall become invalid
untess the work authorized by such permit is cammenced within six months of permit issuance, or if work authorized by
the permit is suspended.or abandoned for.a period.-af-six(6)months after the time the work i�'cammenced, An e�ctension
may be requested, �n'writing, from the Building Official for a period riot to exceed nine#y(90} days and will demonstrate �
Justifiable cause for the extension. tf wortc ceases for ninety(90}consecutive days, the job is considered abandoned.
VUARNING TO OWNER:, YOUR.FAILURE TO RECQRD.A.NOTlCE OF C,UMMENCE#1dlENT�M�4Y RESUI�T tN YQUR
PAYlNG TWICE FOR�l11!'1lPROVEMENTS,;T4 YOUR:PR4PERT1(:;:lF Yt?U::INT'END�TO��OBTQiN FINANCiNG,C4NSULT �
WITH YC>UR'LENDER Aii iQN AT`T4RNEY.BEF.ORE�•REC.ORDINC�YC)Ui3 ,�TICE:OP�GO��IE�I�IElE+l���T:---� --= ��- -T"
FLORIDA JUFtAT(F.S.11.�.03)_._ -- — - ..--_-_ -.---�:_._ - - , -, , -�
QWNER OR A�ENT CONTRa4CT0
5ubscribed and swom ta{or affirmed)before me thls Subscribed and swom t affi ed)'b ra me this �
bY �,-a��bY :
Who isfare persoaaNy known to me or hasthave praduced � Who is are p rso aily known to e r has/iiave produced
as Identlfication. ,�7�tU�.G-t�+�i�� as identificatton.
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Notary' Pubfic Notary Pubtic
Commission No. Commission IVa. � rJ�,/
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IVame of Natary typed,printed or stamped Name af ta ed -
'�h"�►.';''�. DEBRAEl.AlNERUFFELL
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WE OFFER TQ FURNISM MATlERIAL AND LABOR AND COMPLEYE THE ABOVE!N ACCORDANCE WlTH ABOVE SpECIFIC.4T10NS FOR 7NE
SUM OF: -
DOLLARS($ ).
PAYMENT TO BE MADE AS FOLLOWS:
All materlal Is guarenteed to be as specified,All work to be completed in a
workmanlike manner according to standard praotices.Any alieration or deviatEon
irom above specitications(nvolving exfra oosts w!t[be executed on(y upon AUTHOftiZED StGNATURE
wriRten orders and will become an extra charge over and ebove the estimate.
All agreements'contingent upon strlkes,aocidents or delays beyand our OFFER MAY BE WITHDRAWN
control.Owner to carry tire,tornado and other necessary insurance.Our -- 1F NOT ACCEP7ED WITHIN
workers are futty covered by Warkar's Compensatlon tnsurance. DAYS.
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C The above prices,speoifications and conditions are satisfactory and are hereby accepted.You are authorized to do the work as specified.Payment will be made as autlined above.
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