HomeMy WebLinkAbout18-19801 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 801
BUILDING PERMIT
'PERMIT INFORMATION.- LOCATION INFORMATION
Permit Number: 19801 Address: 38250 A AVE
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 14-26-21-0010-01300-0010
Improv. Cost: 7,998.00 OWNER INFORMATION
Date Issued: 6/15/2018 Name: SOUTH PASCO HEALTH CARE PROPER 1
Total Fees: 80.00 Address: 485 N KELLER RD STE 250
Amount Paid: 80.00 MAITLAND FL 32751-7535
Date Paid: 6/15/2018 Phone:
Work Desc: A/C CHANGE OUT 4 TON UNIT
CONTRACTORS APPLICATION FEES
TAMPA BAY TRANE A/C CHANGEOUT 80.00
i
a i
D
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.
CONTRACTOR SIGNATURE PERMIT OFFIj1,,rVR
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 Q Q
Date Received Phone Contact for Permitting
I (� /r- L
Owner's Name �� P-ACev f rCR/��• fa<< ProP��ieC LC Owner Phone Number
Owner's Address gf'S-Iv kg 11e/ /� 02 Mw/��if/r r` Owner Phone Number
Fee Simple Titleholder Name F Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS /�Z O •"` A�Q�� LOT#
SUBDIVISION PARCEL ID# I y��6�Z -0010 - 01300-0010
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEW
CONSTR ALL REPAIR SIGN = DEMOLISH
PROPOSED USE = SFR ® COMM = OTHER
TYPE OF CONSTRUCTION ®I-- BLOCK FRAME = STEEL Q
DESCRIPTION OF WORK L I u-6,r L 1 kce ry t,cemed-o ley for kaik d UM/T L
BUILDING SIZE I SQ FOOTAGE HEIGHT
BUILDING $ VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C.
=PLUMBING $ /�i //;
MECHANICAL $7755S`.0n VALUATION OF MECHANICAL INSTALLATION I G V l
=GAS = ROOFING = SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN L Y/N
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN I Y/N Q
Address 1fiMe f 4W 3 License#
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN I Y/N
Address License#
1111111111111111111111111111111111111111111111111111111111111111111
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&1 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.
Directions:
Fill out application completely.
Owner&Contractor sign back of application,notarized
If over$2500,a Notice of Commencement is required. (A/C 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(Plot/Survey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
• NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work,they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work,they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the"contractor Block" of this application for which they will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County,
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings,change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands,that such fees, as may be due,will be'identified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a"certificate of occupancy'or final power release. If the project does not involve a certificate of occupancy or
final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due,they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes,as amended): If valuation of work is$2,500.00 or more,I
certify that 1, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
Protection Guide"prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the"owner",I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the"owner"prior to commencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable laws regulating construction,zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
- Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,Water/Wastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls,Docks,Navigable Waterways.
- Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
- Use of fill is not allowed in Flood Zone"W unless expressly permitted.
- If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating volume"will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
- If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
construction,I certify that fill will be used only to fill the area within the stem 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 fill is found to adversely affect adjacent properties,the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
acre which are elevated by fill,an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER,I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel,alter, or
set aside any provisions of the technical codes,nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans,construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance,or if work authorized by
the permit is suspended or abandoned for a period of six(6)months after the time the work is commenced. An extension
may be requested, in writing,from the Building Official for a period not to exceed ninety(90)days and will demonstrate
justifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned.
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.
FLORIDA JURAT(F.S.117.03)
OWNER OR AGENT CONTRACTOR
Subscribed and sworn to(or affirmed)before me this Su d n born tg{of d efor this
Who is/are personally known to me or has/have produced Who is/are personally known to me or hasihave produced
as identification, as Identification.
Notary Public •� Notary Public
Commission No. Commission No.
Name of Notary typed,printed or stamped Nam a i
1�r Notary Public State of Florida
Andrea M Conley
c My Commission FF 999606
of�d Expires o7H3/2020
902 North Himes Avenue
P.O.Box 18547
Tampa Bay Trane Tampa,Florida,33609
813-877-8251
800-966-8251 Toll Free
TiNNE" 813-877-8252 Service Dispatch
800-966-8252 Toll Free Service Dispatch
813-877-8257 Fax
www.tampabaytrane com
CONTRACTING PROPOSAL
DATE: July 6,2017
TO:Zephyr Haven Health& Rehab Center
ATTN: Neal Frasier
SUMMARY: Remove and replace 4 Ton Packaged Unit C2
INTRODUCTION
Tampa Bay Trane is pleased to provide the following letter of quotation for the turnkey work required for
the project.We would like to take a moment to thank you for allowing us the opportunity to provide this proposal
and,for your confidence in Tampa Bay Trane to provide a solution for the work requested. Below you will find the
scope of work to be performed under this quotation. If you have any questions, please feel free to contact us.
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902 North Himes,Avenue
P O.Box 16547
Tampa Bay Trane Tampa,Florida,33609
813-877-6251
800-966-6251 Toll Free
813-877-8252 Service Dispatch
800-966-6252 Toll Free Service Dispatch
813-877-8257 Fax
www.tampabaWrane.com
4k,
SCOPE OF WORK:
• Remove existing Packaged Unit and dispose of per EPA regulations
• Supply and install(1)Trane 4 Ton straight cool Packaged Unit
• Remove and replace existing disconnect
• Reattach existing duct work
• Startup and check system for proper operation
• Clean job site
ALTERNATES:
• None
INVESTMENT:
1. In accordance with our standard terms, conditions and standard project exclusions, the investment for
the project listed in this proposal is:
$7,998.00 Seven Thousand, Nine Hundred Ninety Eight Dollars.
EXCLUSIONS:
• Any modifications,upgrades, repairs,controls,labor,material,equipment,engineering or service that is
not listed in the scope of work,
902 North Himes Avenue
P.O Box 18547
Tampa Bay Trane Tampa,Florida,33509
813-877-8251
800-966-8251 Toll Free
813-877-8252 Service Dispatch
800-966-8252 Toll Free Service Dispatch
813-877-8257 Fax
www.tampabaytrane.com
CLARIFICATIONS:
• Work will be performed during normal business hours(Monday—Friday,7:00 a.m.-4:30 p.m.), or
(Monday—Thursday,7:00 a.m.-5:30 p.m.for a ten hour shift schedule) unless otherwise noted or agreed
upon by all parties involved in prior to a Purchase Order Release or Signed Sub-Contract Agreement. If
work is agreed upon to perform after normal business hours or during weekend hours after a Purchase
Order Release or Signed Sub Contract Agreement is executed,Tampa Bay Trane reserves the right to
adjust our proposal to include the additional cost for the said project.
• This proposal is valid for(60)days.
• We reserve the right to correct clerical errors.
• We reserve the right to utilize progress invoicing for material, labor and/or work performed on a monthly
basis(30 day increments)unless otherwise agreed upon and accepted by all parties involved with the
listed project.
• New Client or Subcontractor Information.Tampa Bay Trane requires the following current items and
information before any commencement of work begins.These items could include but are not limited to:
Company name, physical address/location, billing address if different from mailing address,AP/AR contact
name and email address, phone/fax number, current W9, Certificate of Insurance, Florida Contractor's
License,a Signed/Approved Sub-Contract,Signed/Approved Purchase Order or Signed/Approved Change
Order and a tax exempt certificate if applicable.
www.tampabaytrane.com/termsandconditions
This Agreement is subject to Customer's acceptance of Tampa Bay Trane Terms and Conditions.A copy of our
Terms and Conditions are available for review by following the web link above.
CUSTOMER ACCEPTANCE TAMPA BAY TRANE ACCEPTANCE
Signature of Authorized Representative
Signature of Authorized Representative
Print Name Tampa Bay System Sales Inc.
dba/Tampa Bay Trane
Company
Title
Title
Date
5/24/18
Date
Purchase Order
Tampa Bay Tran a P.O North!-limes AvenueP.O.Box 18547
Tampa,Florida,33609
�* 813-877-8251
800-966.8251 Toll Free
z. ea�
�,�.._...f" 813 877-8252 Service Dispatch
800-966-8252 Toll Free Service Dispatch
813 877-8257 Fax
:nviv tampabaybane com
Permit Agent Authorization
I, Tim Barnes CAC1818652
(License Holder's Name NOT Company Name) (Contractor's License#)
Permit Agent,Fi,rst and'Last Name,, :D.river's;License Number
Christopher Groves / C — J go
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Todd Watson \n f 325_ 5
5 _H qB o
David Ortiz 1032_ ` U q _ H I A ' 0
David Burness 6 n5 2 _ I ( l_� I _ H f „9 _ O
Kristina Gay tI L j - � '�_ 9 I -1 �2, O
License Holder's Signature: Date: lO f SDI
Email Address: TPA-CoreContracting@trane.com
State of: �
County of.•
Before,me,personally appeared, �� �"" ��S who produced
as.Identification oils personally known tame,and who'did affirm and subscribed before
me this1' `` , day of .\
•'`''" signature of otvry Public
Nome of Notary Typed,printed or stomped
My Commission Expires I \`
Notary Public$fete f t AREJ
6Rn.
Jun 27 2018 03:17PM Tampa Bay Trane 8138778257 page 1
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Jun 27 2018 03:17PM Tampa Bay Trane 8138778257 page 2
STATE Or'FLORIDA COUNTY OF PASCO
THIS IS TO CBRTIF1' THAT i He FOREGOING IS A
TRUE AND CORRECT COPY OF THE DOCUMENT
ON FILE OR OF PUBLIC RECORD!N THIS OFFICE
WITS N,Y HAND AND 00FICIAL SEAL TH IS
PAULA S.O'NEIL, GLER &C MPTROLLER
Sid DEPUTY CLERK