HomeMy WebLinkAbout18-19300 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 19300
` ° BUILDING PERMIT
�' • PERMIT INFORMATION LOCATION'INFORMATION
Permit Number: 19300 Address: 38515 5TH AVE
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: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-15200-0140
Improv. Cost: 12,000.00 OWNER INFORMATION
Date Issued: 2/13/2018 Name: KOPPELBERGER MYRON & CAROLYN
Total Fees: 100.00 Address: 5709 13TH ST
Amount Paid: 100.00 ZEPHYRHILLS FL 33542-4144
Date Paid: 2/13/2018 Phone:
Work Desc: A/C CHANGE OUT 2 X 5TON UNITS
CONTRACTOR S APPLICATION FEES
KINSEY CENTRAL HEATING &A/C A/C CHANGEOUT 100.00
� n
y �
,�
Ins ections Re uired
DUCTSINSTALLED
DUCTSINSULA��
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
frst 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 properly. 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.
ONTRA OR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROT�CT CARD FROM WEATHER
813-780-0020 City af Zephyrhills Permit Applica#ion Fax-813-78Q-0021
. Buitding Department `�
- :�,,
Date Received Phone Cantact far Pecmittin
�,�
4wn�r's Idame t� L iT Gz`�'� �ra� 7"-Ccs^.�.. Owner Phone Number
Ovrner's Ac�dress -��� S� � �� Owiner Phone Number
Fee Simple;Titleholder Name �� � Ouvner Phone Number
Fee Slmple�Titleholder Address
� LOT# �
JOB ADDREBS
a /
susoivisiQN � � PARC�L tD# I/ �—�+�--.��.— �0/l�'/�5��=— {�/' .
(OBTAINED FROM PROPERTY TAX NOTICE)
` WORK PROPOSED e . NEW CONSTR 8 ADD/A�T' � S1GN Q Q DEM4LISH
} INSTALL REPAIR
PROP,tJSED USE Q SFR Q COtu1M � QTHEF2 _
TYPE`'OF CQNSTRlJC710N Q BLOCK � Q FRi4ME � STEEL Q
� . Z, �`�'m�... -� C.." c�-- �
DESCRIPTION OF WORK
3
BUII:pING'SIZE' � � SQ FOOTAGE�� HEiGHT � �
QB�UtLD1N� �� VALUATION'OF T07AL CONSTRUCTION
. �
QE�kECTF2(CAL $ AMP SERVICE Q PRUGRESS EIVEF2GY Q W.R.E.G I
}
0
P,l.11MBING �> � t,� ��
�MECHANICAL $ VALUA'F10N OF MECtiAN1CAL tNSTALLATION � D
� �`,,2.d a d,
QGAS Q ROOFIRtG Q SPECIA�TY 0 4THER
FINISHED FLOOR ELEVATIONS r�-� FLOOp ZONE AREA QYES NO
� L
, . .
;
BUIL�ER � COMPANY
SIGNATURE REGISTEREp Y'/ N FEE CURRE� Y/N
? -
Addre�� License# � �
. . �` �
� :ELECTRi,CI'AN ,., COMPANY
...SIGNATURE REGISTERED Y/ N �FEE CURRE� Y/N.
� Address License# � �
1
PL'iJIVIBER.�, COINPANY
�SIGNATURE REGISTEREO Y/'N- " FEE CURRE� Y/N
; :�,
, �4ddress - �License# I' .I
, -�.,..r , ,{�
„`,MECFI%1NICAL G%��-.,�--� - CONiPANY t�ir�s � ��.,, �
F� SIGNATURE''' � REGISTERED .' Y/ N - �. .FEE GURRE� ' Y/N
�'? '� - j p
Aildtess'=�' �' " License.# r ( c..� ��
iiir.,:'P ' .... . .. _ . � ,
OTHBRn �=��.�a � _ ' � ' � �GO,Ni,PATdY �
��'SIGNATURE:�. 4� :r - ' ' REGISTERED . Y I.N FEE CURRE�' Y/N
��-'�;,:;�,�':;- . .. � �
Address�.,.•F ,�-�_ . . • . _ License#
..
:`RESiDENT1AL�,r:. .Attach;"2,.Ptof;P,laris;'2:sefsof`Building=Plans;(1�}`set'of�Ene`rgy:Fofrris;l3=Q=1N:P,erriiit foc new.constiuction,~`1
. ,._ t ). � )
��:2�.-�,;,c. �-;Minimum:ten,(,1q);woiking;day�.;afterti§u6miltal ilaCe:°'Reqaired�onsite;Construction Plan's;St`o'rmwafer Plans w/Silt Fence installed,
��. • .. � .__�. ;.`� � . _.-.,- . .. .. �
�3.,r. Sanitary;Facilities;z&n1=�dur►�pste�;;,;Site;Wo[kPecrr[�tfor;sulidivisionsilarge`;pr`ojects: - ' ' . _ . - --
� COMAAERCIAL Attachµ(2)'comp►ete"sets of'Building Plans�pius a Life Safety Page;(1)set of Energy Forms.R-O-W Permit far new construcfion.
" , Minimum ten(10)working tlays after submittal date. Required onsite,Construction Plans,Starmwater Plans w/Siit Fence installed,
Sanitary Facilities&9 dumpster.,Site Waltc Permit.for�all-new�projeots.All commercial cequirements must meet compliance
%';�SIGN°;PERMIT -"AttacFi(2)-sets:.p:f;Engjneered_Rlans:-� � - '
i't:`:,;' "*"*pRQPERTY SURVEY,rgquired for,all.NEW construction.- .
Y:� _ '" _
`�Di�e'`c.k'ions:, r��=�, . :
' `Fill=aut;applicaflon completely. �
- t3wmer&-Contractor sign back of application,notarized
;��` 'If over;$2500,a Notice.of�Commencement is required. (14/C upgrades aver$'f5p0)
�."� .i9geM'{fcir`fi���con#ractor}•orPower of Attomey{for"the owner)woulii tie someane with nota�ized letter from awner authorizing same
`=:O.V'.ER:THE'COUNTER�PERMIITINU .. (copy_of contract-.required) � ��
�Rerobfs if shingles Sewers Service Upgrades A!G Fences(Plot/Survey/Faotage)
� � .,z:. � :... ._ � ,
_ Drivewiays-NotoverCounterifon publicroadways..needs ROW .� . _ , `� ,�, ,�, .-:��. ,� ,.;�.�;; -�.. , • "
`'...,. .-1".i�ti._'S, ,.,4 . �. t _ " . . M1;' , " t� � ' .'' ` , .; y ,
._:., <. ,i � �� i ;e;.,r,; '� r.,...P�t,, , , - j�..:l..� _.. ... ..r.. ..t ..._.,,. ...� � : ... ,.--
___..._ --^c.���esr�:^." "%e^�=�^.'�F".?��i�`
! ?, w�1..�..�,Y;s..
NOTICE OF DEED RESTRlCTIC?NS: The undersigned;understands;that:this;permit may be subject.to"deed�:restr";ictions",;`�
which�tmay;benmor.,e r,estrietive�than:County regulaticrns . The�undersigned-assuriies Trespbns'ibitit�+fof.co`mpi�ance"with ariy`�'
applicable=deed 'restrictions. a<=�=r�,�=°���,T'�,��
UNLICENSED-GON'�RACTL?RS AND' CONTRACTOR RESP{)NSiBiLfTiES: tf•tfie>owiierrv�has�h`irec!'������contractar�or
contractors#o undertake work; they,may�be;r_e,quired;to be�licensed in accordance with state and,:ioeai„ceguiations:-�'if.the:�:at:
contcactor.is.not licensed.as�requi�ed'by faini, botti fhe ovimer.and:contraefo�=rriay�be��cifed��for�<a m�sdemeanor violation� ;<_
under state law. �If the owner or intended.,contractor are uncertain as ta what ticensing requirem.ents*5may��apply=for�ttie:;>";��
...z.,�;..���...:, . ..,.,�b.,,,,
intended wark,.they�are�adVised to confact ttie'1'asco County�Building Inspecfion�Division,=Cicensing Secfion at 727=84:7�
8009. -Fur-therrnore, if the owner has t�i�ed'�a��contractor ar canf"ractors, he� is advised to��;have,the�contraetor(s)ti�ysign.,i,�;,
partians of the contractor Block of this application,far which.they-r�riif.be.resp.onsible: :tf:you, as``the�owne'rsign asw;#he: � ``
cantractor;tF�at may 6e an indication-that he�is not properiy licensed anii�is not'entitled ta perm�tting�pr�vifeges,:in^,tFasco41;yM�.
County. . .. . ... . ' -
TRANSPdRTATtON lMPACTl..UTlLITlES•IMPACT AND RESOURCE RECi3VERY FEES: The undersigned unders#ands, ,.
,�,.w,�;.�:,,
that Transpartation tmpact Fees and Recourse Recavery Fees:may�apply to the construction,of,new.buii.tfings, change;of°'��.�
use in existtng buildings,.-or;expansi�n��.of;ex't,stiiig�buifdings, as specified in Pasca Counfy Ordinance nurnber 89=Q7�.and. ���
r.:. .. �_ .,T..";
90-07, as amended. The��undersignec! also;understands, #hat such;fees, as�may:bs.due, wili�be;identifiedr�at�ttis�;tiiiie>.of���=�,r.
permitting. �ft is furtherunderstood that Transportation Iinpact�Fees and Resource�Recovery Eees must be pafd"pcior to. '�
receiving..a "certificate.of-occupancy" ar=finair;power celease. If the project does not involve:a certificate of occupancy=q��:�E����;
finalYpower release, the.feesh�must bea,paid prior to permit issuance. ;Furttiermore,.if.Pasco�Counfy W;ater/Sewer��lmpact�,�=- .,
fees are due,tiiey;,must,be paid prior�to permit'issuanee�in accordance with�applicable.P'asco�Countyordinances.� � � �
CQNSTRUC71t?N E:IEN�LAVV(Chapter 713;Ftarida Statutes,as amended): tf valuatiar�of wock is$2,5Q0.00 or'mor,e„la;y;�„
ce�Eify that t, the applicant; have .beer=t..pravided with a copy,:of,the "Fiorida Construction�mLien.-Lav�r:Homeowrner's�
Pratection Guide° prepared-by"ttie Florida Depar#ment of Agriculture and Cansumer Affairs. If the appiicant is someone...� ,.
;:;.,�
ather than the`bwner",;I-certif.y#hat.l_have o6tained a copy of the above descriti�etl'�docurnent and pramise�in goad`�faith-to,,._,
deliver it,tathe';o�r�er"r:prior:to-coiiirner�icement: � � . .
�ONTRACTOR'SIOWNER'S�AFFIDAV,IT:��l:certify that all the information in this appl�catian is accurate a�d that alrwork
will be dane in compiiance with all applicable�laws regulating construction, zoning�and land�development. Application_is
hereby made to�obtain;,a;,permit�to .do„work"-and instailatian.as indicated. i ce�tify that no work or-installation�has
commenced prior to issaance of a permit and�that all work will be performed #a meet standards af afl laws regulating
construction, Caunty and City cades, zaning regulations, and tand develapment regula#�ons"in;�the jurisdict�on. ;°�I.atso�
certify that 1 understand that the regulations of other governmenf agencies may apply to the intended work, and that it fs -;
. my responsibility to identify what actions! must take to be in compliance. Such.agencies include but are not.iimited.to:
- ,Departmen# of Environmentai%'Protection-Cypress Bayheads; Wetland Areas and Environmentally Sensitive
Lands,WaterlWastew�ter Treatment.
- Southwest Florida Water Managemenf Dis#rict-Wells, Cypress .Bayheads, We#land Areas, Altering �
Watercaurses. t
- Army Corps af Engineers-Seavvalls, Docks, Navigable 11Vaterways. ; °
- Department of Health & Rehabilitative Services/Environmentaf Nealth Unit Welfs, Wastewater Treatment,
Septic�Tanks. � } ,
- US Enviranmental Pratection Agency-Asbestos abatemenf. .. �
- Federai�Aviation Authority-Runways.
f understand thatY�tiie faltowing restrictions apply to the use of.�Il: .
- Use of fill is not allowed in Ftaod Zone"V"untess expressly permitted. �
- If the fill-materiaF is to be used in Flood Zone "A", it is understaod that a drainage plan addressing a
"campensating volume� will be submitted at time of permitting which is prepared by a professianaf en$gineer
licensed by the State of Florida. �
- tf the fill"materia! is,to be used in Flood Zane "A" in connection with a permitted building using stetn wa(I
canstructian, I certify tha#�fill:will be used only to�fill.the area within#he•stem waA. _
- !f fill �tiiaterial�is�to :be used in any area, ! certify that use of sucn�fill will not adversety affect adjacent
properties. If use of fi!! is found to adversely affect adjacent properties, the awner may be cited for violating
the ccinditians:of�the:building,permif_issued under the attached�permit.application, for.lots fess than o'ne (1) `
acre whicli�aYe elevated by.fill, an engineered drainage p(an is requi�ed. �
If I am the AGENT FOR THE OWNER;-!�•prornise in good faith to ir►form the owner af.the permitting conditians set forth in
this affidauit prior`to commencing"consfniotiori_:�1 understand that a separate permit rrtay be required far electrical�work,.
plumbing, signs, wells,pools,air_conditioning, gas, o�-othe� instaflations not specifically included in the application. A _, .
permit issued shall<�be construedito"6e a license=to.proceed with the work and not as authority to violate, cancel, alter, ar
set aside any provisions of`ttie'technical codes, nor shall issuance of a permit preve�t the Building tJfficial from thereafter
requiring.a carrection.of ecrors.in plans;°�canstruction ar violations of any codes.-=Every permit issued shatl become invalid
untess the wark authorized by such permit is cammenced within six months of permit issuance, or if woric aufhoriied by
the permit is suspended.ar abandoned�for a period.;of six{6) months after the time the work i�"comrnenced. An extensian
may be requested, in writing,•from the Building�Official for a period.no#ta exceed riinety (90)days and will demonstrate
justif+abie cause for the extension. If work ceases for ninety{9Q)consecutive days,the job is cansidered abandanedr -
t
WARNING TO O1P�IN�R:- YC?UR.�AILU.RE TA.REC.O,.RD,p► N0710E OF GOMMENCEMENT MAY RESULT IN YOUR
PAYtNG TWiCE F,OE2,tMPROVEMENTS;TO YOU,R:PROP�RTY.:.IF Y4U�:INTENDzT040BTAfN�FINANClNG,COMSULT
WITH YC?UR'�EN�D�R OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE'OF'COMMENCEMENT. ;
FLOBIDA-JUFL4T(F:S._.1.17:L3j_.._:._.—.—,_-. A ---- _. _� _-� ----�: - - __ . __.� � - ----
QWNEFL OR AGENT � rJ GONTi2ACTOR �'' +�' ��
Sub crib nd swo affirrned} efore me thls Su�te�' d , d b �# (or affirtnec!).before me this a �
bY � Y',
Wha is/are personaAy known to me or has/have produced Who is/are personaliy knawn to me or haslhave produaed � f
as ldentification. as identification.
���;,�,(�.�r� �Notary Public Notary Public
mmission IVa. �� � Com 'ssion No. � ��
� ,�, •l - _� �
lVame of N ' Name of Notary typed,printed,ar stamped
� ,,�;;::':^.':�, D�SRA ELAlN�RLIFFELL �""""'�
;.; ;!Commission#GG 045343 �"��°��'% DEBf�A F+,qE�E RUFPELL
:?�" ��
�<r ';�, '- ,�����4r�&�Jovetr.ber"7,2020 :�;; .«:Cat�}mission#GG 045343
�+'�O��:°''���e�.'�Tt7�'T1�y fiain i�eurence 8G0-385�7019 "'i'y+�.�Q�;•'E�pires November 7,2�120
,•�a•`,:,•, �hru7myFamthauranc;�gpp.g8�,7019
�._._.__�_.�_.__,._..�_..� _ _ . �
�---,--- - _ - .-- --,: -_ , -� - � -- � - .; . . - � = - , -:,
\ __ - .,_-. _ ..,, . �-,
r �
_.._�.. _- .,.-�- _.__._.___._....__,_._..__.__.._._.___ .___.__......�_.._.._.__...,..__.....__._,...-�-.,..__.__ �._._..<.a...�._....._.__._..___..�_._.__._._._._._____
i j .
i�� �
:. � - � Kln�e Cent�al
, � �'
. Heat & Air-Conditioning, Inc.
P.O. Box 2209 '
; � Zephyrhills, Florida 33539-2209 .
(813) 782�2300 CA-0058626 �
i
� PHONE DATEOFORDER
r r
(
� NAME '. DATE PROMISED
! � . .R✓ �J'/L 4 ��"
� AOORESS ' APARTMENT
� , S�! � 5`� ��5�--
i
i aTr
i
,
, MAKE � MODEI �SERIAL NO. �
� ❑ ESTIMATE
1 NATURE OF ❑ CASH
� � SERVICE - ❑ CHARGE
� REQUEST .
f
� QUAN. PART NO. DESCRIPTION PRICE AMOUNT
� �
� -
F
i � � 8� �
� � �
,� � � ����.
�_ � �2 ��� �
t
� �
. � � . �
F
E �
c �
� I
k SERVICE PERFORMED T�A� I
MATERIAL
• � , TECHNICAL
SERVICETIME I
� -
A charge of 1.5%a will be made on all unpaid baiances after 30 days,whiCh is an annual_percentage rate T� � �`
oi 18%applied to past due balances:Customer i5 liable for any charges incurred in collecUng this bill.
- DATE COMPLETED " ON COMPLETON y TOTAL I
���r � _ ' CASH pF�WORK
TECHNICIAN CUSTOMER'&SIGNATURE
� . Y, �
I IIIII�IIIII��III III�I IIIII��III II�II IIII�IIIII IIIII�I�I IIII " Rcpt:1931440 Rec: 10.00
2018024644 . ) DS: 0.00 IT: 0.00 l
02/13/2018 B. M. , Dpty� Clerk �
--- - NOTICE OF•GONIlY�NCEMENT
PRULA S 0'NEIL,Ph D PRSCO CLERK & COMPTROLLER�
. 020R K01����m PG �,� �L�
Permit No_ -
Property Identiftcation No. �< C � o�i � �' ��— v C�l� — L 5^f�l�o ' � � �c�
i _TI�UNllER.SIGNED hereby give informs you that the mmprovement w71 be made to certain real property,and m accordance with -
Section 713.13 of the FIorida Statutes,the fi�Ilowmg information is provided m this NOTICE OF COIVIlV�NCEMEI�IT. � .
1.Description of property(Iegal description) �
a)�StreetAddress: ����� - i - �v�p
2.GeneraI description of improvements: -
. - � � a.� �- c s d� � -
3.Owner Information / jn` � � _ J '� •
a)Name and address: _��ir�-'n�!���'� �i..��'f it-.^v - �1�5'l5�S�'l�-•�� Ze/�-ri y!•c � c 3 3� `�
- b)Name and�ddress of fee�titleholder(if other than owner)
c),Interest in properCy • � -
-.4.Contractor Information _ ,V .Q.� p ` • p /
a)Name and address: -.� ��.c,� ✓�%��/�rt'�k�c,-,� ,��-z� �- - l-c.�.�j[��� ��S�c�
b)Telephone No_: �� - l 'a'� , - � •F�No_( ) " -
5_Surety Information - • � • •
a)Name and addzess: � N��— • •
_ b)Amount of Bond: � • � - '
' c)Telephone No.: • - Fax No.(Opt) • .
i 61.ender � r n � -
- a)Name and address: " �V 0�— - '
' ' • " Phone I�Io. �
- 7.Identity of�srson within the State of Florida designated by owner upon whom notices or other-doc�ents may be served: "
� . a)Natne and address: • - •
b)Telephone No.: Fax�Io_(Opt) .
8_In addition�to hmnsel�owner-designates"the following person to receive a copy ofthe�.,ienor'sNotice as provided'm Section " -
713.13(1)(b),Florida Sta�s: • _
a)Name�d address: • " �
-b)Telephone No_= - ' _Fax-No..(Opt) _ - �
9Expiration date of Notice of Commancement(the expuation date is one'year from the datc of recordmg_imless a di$'eient date is
specified): � -
WARNIl�TG TO OWNL�R ANY PAYMENTS iV1ADE BY THE O'G4TI�TER A�TER THL�EXPIItA�ION-OF T�NOTICE OF'
COMMENCEMENT ARE CONSIDERLD IlVlPROPER PAYNffi�iTS IINDER-C'Fi�ipT�R 7I3,PART��SEGTION 7I3.13,.
FLORIDA STATUTES,�ND CAiv RESUI.T IN YOURPAYIlVG TWICE FOR IlV�ROVENII�IT5�O YOURPROPERTY. -
A NOTICE OF CONIII�IVCLMENT'MQS-T SE�tECORDED AND-POSZ�D ON THE JOB S1TL�BEI�ORE THE FIRST
"INSPECTION. IF YOU INTEND-TO OBTAIN FINANCIIVG,CONSULT YOIIR LENDER OR AN ATTOItNLY BEFORE �
CONIlV�NCING WORK QR RECORDING YOUR NOTICE OF CONIII�NCEMENI'.
I STATE OF FLORIDA -
COUNTY OF PASCO � " -
. . SSBnaihaz of or Ownds orizcd USarlD� r/Pe�cdManagcr '
_ , �.¢�a/u� ��o,��/���i'��-_ _
. PrmcN�� . -
: : �� -
Th_ e fo�go mshvment was ac�owledged before me this� day of��'���0.`�• - Zp�-�,by�'p` �� \� � - .
1F-, ��e.� -e_�' as �� ��'�.�f�_� (type o authority,e.g.officer-,trustee,atto
�� �
m�'
m fact)for . +_-� - ru- 1r`. �� • - . (n�e of party an i�ehalf of whom instrument was execute�:
�.r� c
PersonaIly Rnown�' OR Produced Ide�cafion Notary Signatme " � �
. . . . . , ,. - • � _ TARY PUBL{C ... _
Type ofIdentification P�oduced N�e(print) Y�
. - � E�ires 6l16/2016 �� -
Verification pursuaut to Section"92_�25,Florida.S�.Under penaltites ofperj�y,I decl�e.ttiat I have read the foregomg�d that
' the tacts stated in it az�trne to the best of my l�owledge and beli _ . � �
� ' i
��,�D9 1�..,.
' a ��
�� 4�s
STATE OF f=LORIDA, GOUN'('Y OF PASG� ::�= ��A.�
THIS IS TO CERTIFY THAT THE FOREGUING i5 A � � l,��o,,��t n+;,ryY :; �
TRUE AND COR2ECT COPI'0�=THE DOCUMEN�T � ' $� � y:x.
ON FILE OR UF PUBLIC RECORD IN THI�OFFICE �� �`': �
�s;��.,:- ��
WITNESS MY HAND D OFFICl/�L SCAL iHIS * ��{ ��._ %�'
DAY OF 2 O � _ 6 s 4�,°.' �;�.i�,s:�°' .
AU A S O'NEIL, CLERK&COMPTROLLER �'4� '`"A> '�''��• �.'
-0���.•::�'-� :..
BY� �� �`�C�DEPUTY CLERI� ..� _.