HomeMy WebLinkAbout18-19891 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 19891
BUILDING PERMIT
PERMITINFORMATION 7. LOCATION INFORMATION"=
Permit Number: 19891 Address: 4710 SILVER CIRCLE
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: CHALFONT VILLAS
Est. Value: Parcel Number: 15-26-21-0190-00000-0350
Improv. Cost: 4,549.00 OWNER INFORMATION
Date Issued: 6/29/2018 Name: GAY HAZEL
Total Fees: 65.00 Address: 4710 SILVER CIR
Amount Paid: 65.00 ZEPHYRHILLS, FL. 33541-6506
Date Paid: 6/29/2018 Phone: (813)520-1771
Work Desc: A/C CHANGE OUT 2.5 TON HP
CONTRACTORS APPLICATION FEES.
BAHR'S PROPANE GAS &A/C, INC. A/C CHANGEOUT 65.001
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CIN-- 2-�7
Ins ections Required
DUCTS INSTALLED
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.
I % &-,
Clra- rr ��(�
CONTRACTOR SIGNATURE PERMIT OFFItYR
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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FW+ASHW FLOOR ELEVATIONS FLO0DZON9-AWA ••AYES ,.NO
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SIGNATURE 1I.'iWd3M1rEFtW_' ! F�atttweh
Addmsz Li4�se&.
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COMPANY.
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aatAo. Yaw:
AdWew •License#
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san�teryFQa�uesaia skawakFaerntt+ars saMswnsna�a>� rans►;wow,Pe"lbrnewTraaydbn
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se, y Fecllttlee i4 t dcmpstsr SHe Work Pednk forsu new pro}eae JW mrm:eicte!reitu3renwrtkc must meet
IMNPJ:RW4T Auad+IZ)setsafEralineetadPlatrs,
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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-W21
Building Department �7p �L.
' Data Received Phone Contact for Permitting ( �/3) /O 2 — 60`�
Owners Name /-r #Z a Owner Phone Number O l — .20 1-77
11
Owners Address 7/0 ."Alen Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number.
Fee Simple Titleholder Address
JOB ADDRESS f/0 v '�` �2 LOT#
SUBDMSION CGIA�o r rAk/d r 4 A)PARCEL ID# /s' o?(Q a/ 0190 4994060 0 350
(OBTAINED FROM PROPERTY TAX NOTICE) -
WORK PROPOSED e NEW CONSTR� ADD/ALT = SIGN 0 0 DEMOLISH
INSTALL REPAIR
PROPOSED USE = SFR = COMM = OTHER
TYPE OF CONSTRUCTION = BLOCK 0 FRAME = ST'EEEL- =
DESCRIPTION OF WORK
BUILDING SIZE SQ FOOTAGE HEIGHT
=BUILDING $ VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY Q W.R.E.C.
=PLUMBING $
=MECHANICAL IS VALUATION OF MECHANICAL INSTALLATION
=GAS = ROOFING 0 SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER COMPANY
SIGNATURE REGISTERED I YIN FEE CURREA LXLN
Address'- License#
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREA
Address r License#
MECHANICAL �'w^ COMPANY
SIGNATURE �u!1� REGISTERED Y/ N FEE CURREn Y/N
Address i/q / /leN r !S 3� License#
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
IIIIIIIIIIIIIIIIIIIIIII.IIJlllllltlllllllllllllllllllllltlllllllllll
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 aRersubmittai date. Required onsite,Construction Plans,Storrmwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster,She Work Permit for subdivisions/large projects
COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Fortes.R-O-W Permit for new construction.
Minimum ten(10j working days after submittal data. Required onsite,Construction Plans,Storrmwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster.Site Work Permit for all now projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
PROPERTY SURVEY required for all NEW construction.
Directions:
a
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 authoitzing same
OVER THE COUNTER PERMITTING (copy of'contract required)
Reroofs if shingles Sewers Service Upgrades A/C Fences(PlottSurvey/Footage)'
Driven rays-Not over Counter if on public roadways.s"cls 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, Welland 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"V"unless expressly permitted.
- If the fill material is to be used in Flood Zone W, 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 W 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'm 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.117.0
OWNER OR AGENT CONTRACTOR 9&�
SubscribegLand sworn to(or#ffflrTned)b rare rola this S b ib d d ftom to(or affirmEd)before me this
-4 f
L�!Mf-r by s'
Who is.are sonally known me or has have produced Who I k
as identification. is/are pg2 rally n to me or has have produced
as identification.
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Note Public
NotaryPublic 1�
C 512&ba. AP, Commission No
I — "...
SYLVIA A.CAMPBELL
td�f.,v is-State of Florida
J 43firit6dw Name of Notary typ ad'- L#GG 1]2931
Nam f 1, Commission! Jul 19 20211
.1 CommissibrilIGG112939 p s
Jul9,
21 Be
.,py Comm.Expires Jul 19,2021
My Comm.Expires Jul 19,2021 o
Bonded thiough National Notary Assn.
BondedthrOu VIN811onal
s 's Service t ►rdr Fro osal
,
Iw;
_ 3 - Invoice
- - "L_;��_l(-+rf.... i_rtl';IJs__•i':!;yi "r..r,:{'' 't.jir•.I C.{• :f•�liw} .sit•,.i':
t,..71 1N t •-it:L:.1:r C.., 1.
.. - .. •. •, - - .. ,�f-f t'•.,FV I.1Y );'t�' l� ...J i.: S41�j.
NOTES: lF t:�r- ;F,'. '� tGt�:- '. ._ t,'tc =7:4'•
,
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9 S_:
i•'7 ,.,r =! tt'I1_,l 1 -l;
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f ..., r__ I J 1 r=trl"r HE
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K:n
`A . » M•U
TPRb tA,rflyCi�','�A d T�'•{-:,g^,-
% �. 77, _
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1
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: 71
M
e , �t,�.
[�
d rt?i ntenaietetaorrimeider#..� 'lil' a e. ta cliers:,:
Fressures:.:Lo_ HI`- -: :.�T-Stat
ne
FILTERS-: x x Changed Monthly.. I I
-
1 FILTERS x x Changed Monthly
:=•Y
❑ REGULAR 0 WA
RRA(UTY _ TOTAL SUtttMARY
s}] tarrtttiis#at.Settiri's alNhen here N. .When'Avira > .T'S#'at` MAINT NANC ONT T
=':C], E E"C. RAC
, _' �R
,. . .. ..:-.: : ' - '. -. SE VICE'
LiM1TED:WARRAt�TY:AIi material arts and -of ment are vrarranfed by'the maeuFac#urers'.
>,=;a : CAL L
P cQ-P :c• iltlEliOD,.C31*PAYMMT,
or su�liers',wnften wartan onl:All latio erfom bdtl: "th'e"above'nametl,com an is Warranted fad "'T~'
36 days-or as otherwise indicated;in.wdfhg.The above Hamad company makes no other warranbes 0-CASH. .0,CK# TOTAL'
77
e>ipress qr implied,and its agents qr technidans are not au tharrzed to make any such warranties an _` MATER#ALS. I
behatlove namedcampany 'CREDIT. MAINTENANCE ofab
t
have aothodty to order the arodc oatltnad a6ove;which has Deen sa0sfactarity�mpieted.'!'agree that Seller - PRQG: 'W'1 Ci -
ratams titts.to epuipmentlmatedats rurnlshed until final payment is mado:jf payment is'not me a as'agreed CLAIM#
seller rah remove said eguipment/matedals at Seller's expense.Any,damago,resulting from said iemoval
rat bathe responsibility or Seller:N ET,30 DAYS:Al;1/2%SERVICE:CHARGE;WILL BE ADDED.MONTHLY TO "�'''•- �"'� � �� _ -- . _ I
.ALL UNPAID ND BALANCES OVER 30_DAYS;NO REFUS DATE^GOMPI-EYED -' - -
I
TECH:
%
ok '` tu TOTAL. :7�,90