HomeMy WebLinkAbout18-20269 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 20269
BUILDING PERMIT
PERMIT INFORMATION y LOCATION INFORMATION -
Permit Number: 20269 Address: 4647 LA FORCE ST
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: EDGEWOOD
Est. Value: Parcel Number: 14-26-21-0260-00000-0050
Improv. Cost: 6,201.00 OWNER INFORMATION
Date Issued: 9/21/2018 Name: STRAW LAWRENCE E
Total Fees: 75.00 Address: 4647 LA FORCE ST
Amount Paid: 75.00 ZEPHYRHILLS FL 33542-5611
Date Paid: 9/21/2018 Phone: 813-230-5365
Work Desc: A/C CHANGEOUT 2 TON
CONTRACTORS APPLICATION FEES
ACS HOME SERVICES A/C CHANGEOUT 75.00
Inspections Re u r
DUCTS INSTALLED
eblT
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.
<�--Za &-,
CO TRA OR 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 Q/ / `� /
Date Received // P — C / Phone Contact for Permitting O L �O — 0 G 3 r
Owner's Name 1.- 0r4e-AC.�-- vT-7 'kLJ Own'rPhoneNumber � �6U"J2&
i
Owner's Address 4�. p7 S Owner Phone Number
Fee Simple Titleholder Name /— /rl Owner Phone Number
Fee Simple Titleholder Address A /("/�
JOB ADDRESS z L br 5 W 4,:, S`� �/�� ,yL�OT'�#,\
SUBDIVISION Gt7l ��vo9 PARCEL ID# / 'VOriGV'W`�W w✓�
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR e ADD/ALT = SIGN = = DEMOLISH
INSTALL REPAIR
PROPOSED USE SFR 0 COMM = OTHER
TYPE OF CONSTRUCTION /= BLOCK 0 FRAME Q nSTEEL
Yf
DESCRIPTION OF WORK f` ChA + sC
BUILDING SIZE F SO FOOTAGE HEIGHT Fo�
=BUILDING $ VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C.
=PLUMBING $
PMECHANICAL $�� / VALUATION OF MECHANICAL INSTALLATION
=GAS = ROOFING Q 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 Y/N
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
MECHANICAL COMPANY (2 AJI f
SIGNATURE REGISTERED Y/ N FEE CURREN I Y/N
Address 7� �S AM eW License#
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN I Y/N
Address License#
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII111
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 subdivisionsnarge 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 I, 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,CONS T
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR_NOTJCE OF COMMENCEMENT.
FLORIDA JURAT(F.S.117.03) YdtiS• No�.,a
OWNER OR AGENT CONTRACTOR =� •`s
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Subscribed and swam to(or affirmed)before me this Subscribed an r
rmed)6efoc me this °�o •0�:
by by IeSC2J �-V'1 .,9,oq+•,,�.
Who is/are personally known to me or has/have produced Who ii/are personally known to me or has/have produced
as identification. as identification, o r Z
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Notary Public &� _
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Commission No. d`.) (� �' ?�
FMA-CQ `Q_(lo o y NName of Notary typed,printed or stamped , ed or stamped m w T m n
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AHeadquarters: 8/21/ACS Home Services Invoice 2 1712 E Seward St, Invoice Date 8/21/2018
HOME SERVICES Tampa,FL 33604 Completed Date 8/21/2018
813-618-5631 Customer PO
#EC13008068
#CAC1818754
Billing Address Job Address
Larry Straw Larry Straw
4647 La Force Street 4647 La Force Street
Zephyrhills,FL 33542 USA Zephyrhills,FL 33542 USA
Description of Work
10-8
Customer.Straw
Type of call: No Cool-Craddocks
Diagnosis completed. Low R22 on a used unit from '93 installed here a few years ago. Mold impacting evap and into
blower,then into the ducts. Mold swab results were XX- Purple- Bad. I recommended repair/remediation or replacement.
He chose to replace with a Goodman 2 ton S/C Pkg System. I collected$3201 CC + $3000 chk#285 = $6201 Total.
Install Today,Tuesday,08.21.18.
HW T6 Tstat
Hurricane pad
UV
Larrystraw2004@yahoo.com. Please print and mail invoice and estimate.
Task# Description Quantity Your Price Your Total
214PSC THIS A GOODMAN PACKAGE UNIT.NOT A BRYANT. 1.00 $6,201.00 $6,201.00
This
Install Includes All Of The Following:
• Inspect all accessible duct work and seal any minor leaks.
• Install new Hurricane straps on the condenser per Florida code
• Includes New Thermostat
• Upgrade breakers to proper size for new equipment as needed
• Includes Permit ready install,removal and disposal of old equipment,and all
materials and labor.
• Includes ACS Home Services Maintenance Plan with 2 visits within 1 year.
• 10 Year Parts Warranty
• 1 Year Labor Warranty
• 24 hour fix it or hotel guarantee:We guarantee we will be out to your home
within 24 hours to correct the failure or we will put you in a hotel for the night
• Lowest price guarantee:We guarantee you cannot find a comparable installation
for less or we will pay you$50 over the difference.
• Installation workmanship guarantee:We guarantee all of our craftsmanship to
be the highest standard.
• Exclusive"no lemons"guarantee:If the compressor fails twice within the first
five years,we will remove the unit rather than the component
• No mold guarantee:Units that include the remediation package with UV
sterilization will guarantee to be mold free for the lifetime of the unit
Paid On Type Memo Amount
8/21/2018 Visa $3,201.00
8/21/2018 Check #285 $3,000.00
Member Savings$0.00
Sub-Total $6,201.00
Tax $0.00
Total Due $6,201.00
Payment $6,201.00
Balance Due $0.00
For your peace of mind,should the Customer Satisfaction is our #1 focus!
repair amount exceed 25%of your
system's replacement value,our If you are not completely satisfied for any reason,Please call 813-906-1012 and ask to speak
technician is required to inform you of with the Customer Service Manager.
options for both repairing and Your feedback is very important to us.See attached Terms&
replacing the equipment Conditions.
THANK YOU FOR CHOOSING US FOR YOUR SERVICE NEEDS!
8/21/2018
1 find the service and materials rendered and installed in connection with the described work to have been completed in a satisfactory
manner.I agree that the amount set forth on this contract to be the total and complete price.I understand that a twenty-five dollar($25)
service charge will be added for any returned checks and I could be held liable for up to three(3)times the amount of the check or one
hundred dollars($100),which is more,plus the face value of the check and court costs.A monthly service charge of one and one-half
percent(1.5%)will be added after 30 days,up to one-thousand dollars($1,000),for any unpaid balances.I acknowledge that I have read,
understand,and will receive a legible copy of this contract.
BUYERS RIGHT TO CANCEL-This is a home solicitation sale,and if you do no want the goods or services,you may cancel this agreement
by providing written notice to the seller in person,by telegram,or by mail.This notice must indicate that you do not want the goods or
services and must be delivered or postmarked before midnight of the third business day after you sign this agreement.If you cancel this
agreement,the seller may not keep all or part of any cash down payment.
L '
8/21/2018
1 authorize ACS Home Services Residential HVAC Tampa to charge the agreed amount to my credit card provided herein.I agree that I
will pay for this purchase in accordance with the issuing bank cardholder agreement.
8/21/2018