HomeMy WebLinkAbout18-19663 CITY OF ZEPHYRHILLS
5335 -8TH STREET
.(813)780-0020 19663
BUILDING PERMIT,
PERMIT INFORMATION _ -LOCATION INFORMATION
Permit Number: 19663 Address: 37311 PICKETTS MILL AVE
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): , Block: Section:
Square Feet: Subdivision: SILVER OAKS VILLAGE
Est. Value: Parcel Number: 03-26-21-0200-00000-01513
Improv. Cost: 12,600:00 OWNER INFORMATION
Date Issued: 5/09/2018 Name: HEDGEMOND TYRONE &TAMURA
Total Fees: 150.00 Address: 37311 PICKETTS MILL AVE
Amount Paid: 150.00 ZEPHYRHILLS FL 33542-1815
Date Paid: 5/09/2018 Phone: 813-431-0416
Work Desc: A/C CHANGEOUT 2.5 TON AND 2 ON W /ELECTRIC
CONTRACTORS APPLICATION FEES
EASY AC A/C CHANGEOUT 105.00
EASY A/C ELECTRICAL FEE 45.00
v
DUCTS INSTALLED Ins ections Required
DUCTSINSULATED
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.
C N • TOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received !;-/q
Phone Contact for Permitting
Owner's Name )Yal Het-Aec rkA, Owner` 'P'KOne Number
Owner's AddressE3��d fiCluAts IK i kA ve- Own.er Phone Number
Fee Simple Titleholder Name I Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS c A LOT#jcL4 A
SUBDIVISION PARCELID#1 JT�- 2-�- Z I-C ZOO-00000
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ADD/ALT SIGN DEMOLISH
R INSTALL REPAIR
PROPOSED USE = SFR = COMM OTHER
TYPE OF CONSTRUCTION BLOCK FRAME STEEL
DESCRIPTION OF WORK CV\A"P_ Ten 4C C-,Vq. rA C ��Y1 j
BUILDING SIZE SQ FOOTAGE= HEIGHT Ilq LA+,
=BUILDING 1$ VALUATION OF TOTAL CONSTRUCTION
[p4ELECTRICAL t AMP SERVICE Q PROGRESS ENERGY = W.R.E.kP*c-
=PLUMBING i$
WMECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION
GAS 0 ROOFING = SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
.. . . . . . . .
BUILDER COMPANY
S E REGISTERED Y1 N FEE CURREN Ly-L—Ni
Add License# F_
Iensl VC ELECTRICIAN COMPANY Igg M SIGNATURE REGISTERED FEE CuRsEr, Y I N
Address I CN6Z LLS U_ 6 �ff LOT 7:1 License# I CC]SAQ-7 Ci r65
PLUMBER COMPANY = —7
SIGNATURE REGISTERED Y/ N FEE CURREN L_XIN J
Address —I License# F_
MECHANICAL COMPANY
SIGNATURE REGISTERED I I—Vt N' FEE CURREN LILN J
Address I ILIOZ, US J 46-it L 0 7- Ta ImP& 9�*t 16 License# Fr—14 C_(D5_%9�9-C14
OTHER COMPANY
SIGNATURE F REGISTERED Y1 N I FEE CURREN I YIN
Address License#
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for 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 for subdivisions/large projects
COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
Minimum ten(10)working days after submittal date. Required onsite.Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&I dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans,
*—PROPERTY SURVEY required for all NEW construction.
. . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . .
Directions:
Fill out application completely.
Owner&Contractor sign back of application,notarized
If over$2500,a Notice of Commencement Is required. (AJC upgrades over$7500)
Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (copy of contract required)
Reroofs if shingles Sewers Service Upgrades A/C Fences(PlottSurvey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
III1R1111111111111III11111111111111111111111111111111111111
' 2018078959
Permit No. Parcel ID No " ` �'� `% 1G
NOTICE OF COMMENCEMENT
State of !'40h. County of Q SC o
THE UNDERSIGNED hereby gives notice that Improvement will be made to certain real property,and In accordance with Chapter 713,Florida Statutes,
the following Information is provided in this Notice of Commenc t; ^ �Ob 0
1. Description of Property: Parcel
Identification No. Gtt(t! !
Street Address: 3 1 L AA 1• l\ On N
ID
2. General Description of improvement C16 ov ;2' j yl 13
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01
Of FCi�7 N m to
3. Owner Information or Lessee Information if the Lessee contracted for the improvement:
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v' Vn2Nle CD 0e
r
me S t 11 E} ?�e PhkilchiftS, �, fn co
Address City �] State 3 1-4c �� Interest in Property'. M
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rn —S Name of Fee Simple Titleholder: p m--
m D C1) M (If different from Owner listed above) p -
Z Address 0 'Q
�?
0 Q City State '�
TI
0 � � {-) (4, 11 Contractor: � �r Imo, (}n 0 �
Z D Z O XI �7 Q %Oa Name2. G. 1 .�'r t'c1 I�C. M
M � > -V Xi --I � Address f 2 �j t/^� City Stale
pW n -< Contractor's Telephone No.: i 3"r �i,5' ?ZW 7
C:�:
y r -i --I
Z n t-•j D Surely. Name
-I
PO n —{ c Address City Slate
O0 MM Z Amount of Bond: $ Telephone No.:
> Q -i �j Lender,
Z M m O Name
"t tTl Q ;) -U Address City State
CN p � aQLender's Telephone No.: C)rZ CLn
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Persons within the State of Florida designated by the owner upon whom notices or other documents may be served as provided by ;a O n
r— C!} -TI Rl Uy Section 713.13(1)(a)(7),Florida Statutes: t0 m
\•
� ZD xNo
71
Name CD z
Ah, (Dw r
Address City Stale wy�t9 v
A Telephone Number of Designated Person: F+S
In addition to himself,the owner designates of— on,n
to receive a copy of the Lienoes Notice as provided In Section 713.13(1)(b),Florida Statutes. B
0
m w d FJ Telephone Number of Person or Entity Designated by Owner. .0
'PO
Expiration date of Notice of Commencement(the expiration dale may not be before the completion of construction and final payment to the M
contractor,but will be one year from the date of recording unless a different date Is specified): t F"o
O,� to• r►� WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT t
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CANRESULT IN YOUR
• CEMENT MUST BE
RECORDED AND PO TEID NG ON TWICE E JOB SITE BEFFORE THE Ft ST NSPECT ON RI YOU INTEND TO OBTAIN FINANCING,CONSULT i
WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMM NCEMENT.
o
Under penalty of pery'ury,I declare that I have read the for o com ncament the the �r is staled therein re true to the best
of my knowtedge and belief. m
s
STATE OF FLORIDA
COUNTY OF PASCO
Sign rep
wrier esse ,or Own s or ssee's Authorized
O cert0rtParinertManager
Signja[ttorys Title/Office T
The foregoing Instrument was acknowledged before me this!r day of !/hJ{.&e ,20 rf by
as [ (type of luihority,e.g. officer,triMee,attorney in fact)for
(name ofagity on a m' strument was executed).
Personally Known❑OR Produced Identificati Notary Signatur _
Type of identification Produced Name(print)
� r►� Npta public Slate of Fiotida
Melinda H Oollar
�" My Commission FF 891136
l W Fro Expires 0710812o19
wpdatwbcs/nodcocommencement_pc053048
® Pasco County Building Construction Services
Contractor Licensing
xs
..; . 8731 Citizens Drive, Suite 230
�+ i New Port Richey, FL 34654 1 MA
(727)847-8009
` contractorlicensing@r)ascocountyfl.net
r �
State Certified Contractor Maintenance Form
Please upload or mail this form along with the items listed below.
The following information is required: G�/
1. Copy of the State Certified Contractor's License. State License No. _�
2. A copy of the Workers' Compensation Certificate. Certificate must indicate Pasco County as the
certificate holder. It must indicate the name of the business entity, indicating the license holder is
covered under the Workers' Compensation Policy.
"OR"
A copy of the license holder's Workers' Compensation Exemption Card.
3. The license holder's current home, business address, and phone numbers.
Home Address: Business Name &Address:
I 05-U-3 Ph IGX G I ccll e f . j -a
�\n an G SosScA, L 01 G &A
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Personal Phone: 3 ` "I — I I;o Business Phone: i513-2 S- 92u7
4. Year of Birth of the License Holder: I CN o
5. Email Address: 6 iSpG,4Ch Q QGASc4aL.,UQ,-�
6. Space below is for Authorized Signer(s) to record license, sign for, and obtain permits. This form
supersedes all other letters and forms. 1,� I/
Person: I�1 Gt�/(� bj r,t 0I�I n Person: Ill 1?1 A- 'A W Qst V r 00 K
Person: I CV ) \S 1 Z-2 C Person: G a S-e l/ s► f
Person: ' S ) Person: M��i n�a �(���CAX
Authorized individuals will remain in full force and effect until written documentation i ubmitted, withdrawing
the authorization. The license holder is responsible to keep all information current a correct.
License Holder: &\-6 C1Y0,,kZ License Holder Signature:
(Print Name)
Please Note: Notary section below needs to be completed.
State of Florida
County of Pasco
Sworn to and subscribed before this day l� O
-NotkyPublic State of Florida
(Stamp)
My commission expires O? dg I ti.
b of Fbrida
c�/devsvcsdocuments/1-documentspecialists/bcs/bcsforrns/State Certified ContractorRim
ar Revised 8/19/16
FF 997138
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ACCO"THO.
2017 -2018 �HILLSBOROUGH COUNTY BUSINESS TAX RECEIPT EXPIRES SEPTEMBER 30,2018 99252
OCC,CODE RENEWAL
090.001000 AIR CONDITIONING CONTRACTOR 7 Employees Receipt Fee 18.00
Hazardous Waste Surcharge 40.00
Law Library fee 0.00
CACOSS774
BUSINESS WESTBROOK KEITH ALAN
9402 E HWY 92
TAMPA,FL 33610200'
17
1= 0 1
8
WESTBROOK KEITH ALAN
NAME 3 G AIR CONDITIONING AND HEATING INC
MAILING 9402E HWY 92
ADDRESS TAMPA,FL 33610 Paid 16-0-295674
08/2912017 58.00
BUSINESS TAX -RECEIPT DOUG BELDEN,TAX COLLECTOR
HO HERESYPAM AMMEGETAX TO ENGAGE 8134364200
W GUSWESS.PROFEWKK OR OCCUPATION SPECFF.O HEREON THIS BECOMES A TAX RECEIPT WHEN VALIDATED.
? PiltiTJ.LAS COUNTY CONSTRUCTION
IJCENSING 130ARD
X.
ri:=
- t�Ft"i' .St-HAT"-v ivascncGok
MIRED
1 01>'ST f l'C7'IL - 30,2011
CAC058774
yYest�iir, ICeitTi=Alan '* ls tut oat°Iiceiialaag lines
99t?2:E#iioi-'92-Ste 102
-Tampa,.FL 33610 '
CENTRAL A/C&HEAT 9402 E US HWY 92,Ste 102
Tampa, FL 33610
EASYA/C ', Phone(813)635-0440
'Comfort Made Easy" Fax(813)635-0480
y www.easyac.net
Lic.#CAC058774
A Division of 3G Air Conditioning&Heating, Inc.
May 9, 2018
To whom it may concern in the permits department of the City of Zephyrhills:
This letter is to authorize the following Easy AC personnel to submit and pull permits only for
today May 9, 2018:
Melinda Dollar
If you have any questions please call me direct at 813-635-0440.
Thank you,
Keith Westbrook
Easy AC
Contractor# CAC058774
Keith A.Westbrook
Contractor—CAC058774