HomeMy WebLinkAbout18-19526 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 19526
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 19526 Address: 4801 AIRPORT RD STE 204
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: ZEPHYR ESTATES
Est. Value: Parcel Number: 13-26-21-0130-00200-2040
Improv. Cost: 4,195.00 OWNER INFORMATION
Date Issued: 4/05/2018 Name: ANDERSEN ALAN R & CATHRYN B
Total Fees: 65.00 Address: 55 COACHLIGHT CIR
Amount Paid: 65.00 FARMINGTON NY 14425-9317
Date Paid: 4/05/2018 Phone:
Work Desc: A/C CHANGE OUT 2 TON
CONTRACTORS APPLICATION FEES
CHRIS'A/C COMPANY A/C CHANGEOUT 65.00
Ins ections Required
DUCTS INSTALLED
DUCTSINSULA,TED
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.
ONTRACTOR SIG ATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
51a-inu-uuzu uty of Gepnyrnins vermIt Application rax a,is-rau-uuc i
Building Department 4
Date Received C —
` `' / .=Phone C:ontact:for•Permitting S' J � - T
Owner's Name C Q.�2, ,may /1�G' Owner Phone Number 3 1 301 .
Owner's Address Owner Phone Number.
Fee SimpleTitleholder Name "" Owner Phone Number
Fee Simpl®=Titleholder Address
1
JOB ADDRESS 7 O I j i" O T LOT#
SUBDIV149m: 6h PAR EL.ID# �J o7 i �<✓ ._6vjo. D D.a Oro
(OBTAINED FROM PROPERTY:TAX NOTICE),..
WORK PR(AP,OSED NEW CONSTR' : ADD/ALT Q SIGN Q' DEMOLISH
ca
R INSTALL 8 :REPAIR
PROPOSED,USE. _ "SFR 0 'Comm FV OTHER:.' (oi¢
di
TYPE`OF.:C,bNSTffUCTION- BLOCK Q. 'FRAME ; STEEL Q.
DESCRIPTION OF WORK �,�/ 7�
-BUILDINGfSIZE. SQ'F00TAGE HEIGHT`:,
.:t
=BfUILDING $ VALUATION'OF TOTAL CONSTRUCTION
�r
ELECTRICAL $ AMP SERVICE PROGRESS ENERGY W.R.E.C.
M. , 0 Q
=PLUMBING . $
AM'rECHANI.CAL $ VALUATION OF MECHANICAL INSTALLATION
]GAS = ROOFING 0. SPECIALTY. [_] OTHER'
FINISHEDIFLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
I
t .
:BUILDER p COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN
Addrq�s -License:#
COMPANY
REGISTERED Y/ N FEE>CURREN .. ' Y/N.
Address License#
--
7."SIGNATUiE.:' 'REGISTERED', Y.4-W .'::. :`FEE GURREP
Address1714
License.#;
COiNP.ANY ;�./(��•• � � �C�
REGISTERED' /NSIGNATURE" C
C
AddressrP. S.
`-:OTHER > :-
SitiN , STR FEE CIRREK Y/NAtZEv G
.:..: i' .. ai•'
RESIDENYI M.. Attach../2, Plot P•.lan ]2 'ets=`of Buildiri'F'la ' •1"a f E F'' rT
. ':YYu. . .l-- t\ )�..,,.-, J•r,1. n et=n n orm R;0=1�V1'P;ertnit�tcrnevir•,coristiucHon,�� '
-,L..t:• :, Minimu rte ;<10,: .orkin da: after utirriittal=date:`°Re ui�ed''on`site�=Consteuction'PI ns`_Storm'`aterPla s'w/Silt. ence'ri Iled '
;'s;•4;': .. .t:",S.v:.:,.,w tu: �ivN n(r.t;�a�! ,,.9..: ,YS,_.. q. i a .W , n F 1 st8 , ..
tary,•�Sani : :Facilities ;1;dum ste'sSif`Work.
,... ... .. &..:,... P G ,4.;P:errnit`•foFsubdivisions/large:projects..;-,'.:-'-'
_,=_COf1AMERCIAL Attach t2);ccmplete;'sets of'Bulidln�g Plan`s plus a Life Safety Page;(1)"set of Energy Forms.R=O-W Permiffor'new construction.
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence,installed,...
Sanitary Facilities&:1 dumpster.Site Work Permit foFall-new projects.All commercial re..quirements.must.meet-compliance~
:iz�S•I,GN':PERBYJIT -AtEacli( )F'sets of EngineerecJ Plaris =;,•.:;'.' ; , .
' "'"PROPERTY-SURVEY regUi[ed)pr.:all,NEW_'constrtiction..
:'Flll:out_application completely.r,
OWner."&'Contractorsign.backofapplication,notarised
-.If:oVer,.'$2500;..a Ndl iee:of Commencement.is required. (AlC upgrades over$7500)
'",:' Agent(fo�fti' contraofo)rorPoweFnf Attorney.(for'thegwner)wouldSe someone with notarized letterfrom owner authorizing same
L;`O1IER I HE COtlN1'ERPE�RPJh'll.�1G,..:..; (coPy:.of�contractarequired)
Retpofs:ifsliingles Sewers`. "Service Upgrades A/C Fences(Plot(Survey/Footage)
Driveways-Not over Counter if on_public`roadways neetls R01N: --
NOTICE OF DEED::RESTRICTIONS:-.The:undersi ned,-understands:•thaLthis� :ermit.-ma >:be�sub'eot to"dealt ;res ictiort`0 ;^
, ..
a .
a; �wi#Fi:an s,�"� :sill oroo. li nce
which:�iY:ia:'`�b'e:�m'oae�resfric#ive:�taan C:ot�i :re��rjfatiat�s.-.1'i'e,,,ilri'nersi"`ried���ass�ri�es>re on � ,.y':_
a lira.e::deed.rests otions:
UNLCCENSE6--=CONrtRACTORS'•ANCI-CONTRACTOR RE6.00 }SOILITIIE �<If Afi 6 ter=has r:hired :a contractor or
<. _... r•a Q .sFJ..
contractors to.undertake.:work`.the .Erna..:°rbe re: lire' 'fo be;lid'ensed:in:.accordance•:with.state,:and dcai�regu, ti ns; .if the_._
... .-.r,y .. Q.4,•..I�. :s y. r, v-x,rj Y:-:.x..
fFi o'`. r id'eoritraato°r=rr2i; e eited�farjza misdixreaiactr:.urofiatio�n . g
contractor! not,[Icensedr as.required.by Paw;;;both a wne a y.,
understate'law. If'the ownetr.or4intended:;contractor--are;uricertaih as.,to..whaLlicensing.regqirerr.Itei: f,53h.
intended_woikr_the:=:are advised"toco�ttactFie'Pasco Couri Brittliig':liisecFio`i i)EvisEot-� icinsmg;Section:elf`72747 1.
y *. ty contractors, y.:.w.._
80.09, Furthermore; If the•owner has:Hired a'conttactor or contractors, he is advised to':have,.the:r.con'traptar(s:)
portion of the-ucontractor-:Block°...of#his;a ficafion-for-•which=the,'::will:be;res .ansibie =if au' as'"tl e`.;owner°si`h qs
contractor,-that may be an indication,#hslt'he isnot.properly'*Iiddnsdd-ar'*d"' not enfitled'to permitting priviteges,in Pascoe :;
County. . : . t-:
,.. r
TRANSPORTATION,"IMPACT/.UTiLITIEs�imPACT AND RESOURCE RECOVERY"FEES: The undersigned underetands::�;..ti
that Transportation Impact Fees-and;Recourse�Recovery-Fe:ev-'i maytpply to<the.construction:.cif:newrbuiiriirigs,:":ci a'i&dfz
use In•existing:birildings,or exponsion�of existIngzi5uildings,.,as specified in Pasco County Ordinance number$9 Q7;and Z y
90-07, as amended: The:undersigned also enders#ands,.:"that suc11,00 s, as.rrtay f edue;;vi/ill'die_:.,identifie&dflthe<.time::ofF
-
, . .
f- _ .
permitting. tt is furtherunderstood tha#Transportation;Impact Feesrarid Resource Ri covery:Feos must be paid;pt'iat;to ., __-�
receivfrtg.a="certificate of accuparacy"ar..finai powier reiease: .lf fhe°,pr`ojec#.does not involve a cttifcate df occup'ancyrorl T :•s
final..power,release.#die fees.txiust:be:pai�}.pngr4o;permit Issuance: Furthermore,;if"Pss io Coui-tyWVaterf.Sewer;tmpact�-=�`?'.
fees`are,'due;;they,Inuit,tie:;paid prior to:permit issuance:in accordance;with�appllcal le Pasbo:Countyordinances.
CONSTRUCTION'LIEN LAVlF(Chapter7l.3;Florida.Statutes,as amended}:-.If,valuation of_wark.is:$2,5.QQ QO:oz:.n ore ai ��_ r
certify that,'I the applicant Have-been _provided with a copy.:of.:the :'"Florida Construcfion`-k ien.'L`au Homeowrier's
Protection Guide" prepared by�the l~lorida Department of Agriculture andConsumer�Affairs.. If.the_applicantis',some'one.,:-"
{;..
other than-the"owner" I c6itify:that:l.have obtained a copy.afthesabove=described document;and`,promise=in:good`
deifver.itto`floe:"auuner"pFior.#o_cotriencement '
CONTRACTOR'STOWNEWS AFFIDAVIT:�1=certify thaFali:the information in this_applicatlon is accurate and'that at all work
will be done in compliance,with:all,appiicalile'laws regula#ing construction,:zoning-and land-=development. Appiication.,is _
hereby:.made to. orbtain;.a::permit`:.to 'da.work•�and°'installation--as'indicated. 1 certify that no work or:instaltafion�Chas
commenced prior to,issuance of a permit an' Ahat all work will be performed to-.meet-standards-of all laws.reguiet ng
construction, County and City codes, zoning regulations, and land development regulations in:.the jurisdiction. ar0°also a
certify that I understand that the regulations of other government agencies may apply to the intended work, and thaOuls
my responsibility to Identify what actions1 must,take�to:be in_comp�iance Such agencies include;biit are not limited
fi _ ..:
Department of EnvironmentaF P`rote6tion=Cypress Bayheads; WetlandAreas=and •Environmentally Sensitive `a
Lands,WaterM/astewater Treatment. #.
Southwest Florida Water Management "District-Wells;: Cypress Bayheads, Wetland .Areas; Altering
Watercourses.
Army Corps of Engineers=Seaw/aiis, Docks--Navigable Waterways.
Department:..of.:Health Re(ia[3liita#ive::ServicesJEnvirbnmeR"I:,.Healthf:Unit-Wells,,,Wastewater:Treatment, 3`
,: Mn
Septic°Tanks:._.. . ... .-.
US Environmental Protection Agency-Asbestos.abatement.
Federal-AViationAuthorty=Runways.".
I understand thatrah`e`:fot16Wng restrictlons apply to the use of fill:
Use of fill is;not alfowo,06 Flood Zone"V"unless expressly permitted,
If the'fill.mat#n9V s to-be used in. 'Flood Zone "A", 'it is understood that a drainage plan addressing i s
"compensafing,volume"will be submitted,at time.of permitting which is prepared by a professional.engineer..:
licensed.:by.the'Stafe'of Florida.
If the fill'material 16-to;'-be. used in Flood Zone "A" in connection with a permitted building using stem gall
construction;I certify#hat>frll wiil[be used onlyto fill the area within thwstem 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:fiii;:is found,to.adversely affect-adjacent properties, the owner may„be cited for violating,
the coridltlorts:ofAhe-66111dlh6 pd6it Issued uncJer the-attached�permi#application,for:lots less than one;(1}
acre whicli"are elevated.by fib;an engineered drainage plan-,is-requited:
If I am-the AGENT FOR.;THE:O1NnIER 'i•promise-in.good faith to inform;the.oWner:of.the•pbrmlttIhg.conditions set forth in
this off+davit:prior`fo commencing construction: .L.understand;that a separate permit may be required for eiectricaLwork,..
plumbing, signs, wells:pools;. air,;condttioriirtg;-;gas;..or otiier;-li ilaflations not specifically included in the application,i
permit issued shail'6e construed=to be a`iicense$to':procee,�uvith the..work and not tit auth'b."y.to-rifolate,..cancel, alter,?or
set aside any provisions of"tile technical codes, nor shall Issuance of,a permit;prevent the Building Official from thereafter
requiring a correction:of,.errors.=in plan$;cddnstruction or violationsof ati t otles: =Every per m'it issued*shal 6"'me invalid
unless the work authorized by such permit is commenced.within.six,.months of permit issuance, or If work authorized
the permit is suspended-or abandoned far:a period of'six(6).rrionths::after the time the work is commenced, An-extension-
may be requestea. in*'--' uritIng. ftpm tfie Buil M bf(lclal for a period:not-to exoeed ninety(g0}"days and will'demonstrate. ,
justifiable cause for.the,extension. ifwork,ceases for ninety(90).consecutive days,:the_job Is considered abandoned.
WARNING TO,*OWNER;''YOUR.I AIL-'OiE TO.:,RECORD;.A=NOTICEiOF:C:QMMENG MENT�,MiAY RESI IrT IN YOUR .
PAYING TW atFQR,IMPRt31fEN�ENTS TO YOItR: !ROPI~t �Y IF XO.0 INkEND TOyOB'FAIN:FIRIi4l PING 'CONSULT
WITH Y011R`L NDER OR y'iV A 1't RNEY BEFt?r E REC,t RDIN Y0F6K.-NOTiCZVF=..00 • MEi�CEIPAI
-FIORiD/'�,lIJP.AT{F:S:4�:93)•-.- '-`-- - ---- --`---- -
OWNER OR AGENT /T� ,9<7 CONTRALTO
Subs� nd'sworn a rmed).before m th Sub �3a nd sworn� or ffirmed)before me this
�7s!J l by / 76G7 / bp_ �STi(ZA �6s11�
Who rslare personally known to me orhasihave,p duced Who Is/are persona0y known to me or has/have produced.
as identification. as Identification.
Notary Public - Notary Public
cc mission No. 3 Commission No.
C(Qt i ,o elf rCt,. act 'eT v it
Name of Notary typed,printed or stamped Name of Notary typed,.printed.cr stamped
Et7
A ELAINE RUFFEL! +DEBRA ELAINE RUFFE!!
ission#GG 045343 =i• ..Commission#GG 045343
s November 7 `-�: o, Expires Novembe ,.2Q24 ¢. r 7 202D
m Troy Fain Insurance 8pp 3gr7019 Bonded Are Troy Fain Insurance 8a385dpiq
HRIS' A/C
COMPAN AIR-CONDITIONING
& ELECTRICAL
I
CAC058575 / EC13007703
Propo;'sal Submitted To' Date: 3/20/2018 Phone: 585-398-301
Alan Anders n �2
4001 Airport D ' e, Unit#204 Job Name: HVAC change out
Zephyrhills, F1 33542 Address:
Furnish and Install 2 ton 14 seer American Standard Straight Cool Split System , 8kw Heater
Digital thermostat, pad, humidistat, connected to existing ducts and electric, tax, labor 4nd
permit included.
In
I
Price $ 4,195.00
Warranty:
Chris'one year limited warranty on materials and labor.
5 Yrs Limited manfacturers warranty on compressor
5 Yrs Limited warranty on equipment only parts.
1 Yrs Limited warranty on labor.
Payment to be made as,follows: Qx Due upon c on D
i I
CHRIS' Authorized,Signature:
I
NOTE:;This proposal may be withdrawn by u if not cepted within 30 a
I have authority to order the work,which shall be performed as outlined a ove. It is agreed the seller will retain title to any equipmer it or material that
may be famished until final payment is made,and if settlement is not made as agreed,the seller shall have the right to remove sami a and the seller will
be held harmless for and damages resulting from the removal thereof.I agree to pay all cost and reasonable attorney's fee if this in oice is placed in
the hands of an attorney for collection.Seller is subject to restocking charge if job canceled
FINANCE!CHARGES:Balance due over 30 days 1 1/2%INTEREST)PER MONTH(18% ANNUAL RATE)will be imposed(where applicable 1.
Customer Acceptance Signature:
Signature: Date: .
Signature: Date:
12232 US HIGHWAY 301i DADE CITY, FL. 33525 PHONE 352-521-4977 FX 352- 21-3393
I ,
estimateform