HomeMy WebLinkAbout18-19970 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 K70
BUILDING PERMIT
PERMIT-INFORMATION - . LOCATION INFORMATION
Permit Number: 19970 Address: 37930 MEDICAL ARTS CT
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: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 34-25-21-0080-00000-0010
Improv. Cost: 7,500.00 OWNER INFORMATION
Date Issued: 7/17/2018 Name: DAIRY QUEEN
Total Fees: 80.00 Address: 37930 MEDICAL ARTS CT
Amount Paid: 80.00 ZEPHYRHILLS, FL. 33542
Date Paid: 7/17/2018 Phone: (813)780-2826
Work Desc: A/C CHANGE OUT 7.5 TON UNIT 03
CONTRACTORS APPLICATION FEES
J M HAYS INC A/C CHANGEOUT 80.00
$ �n
A
1
DUCTS INSTALLED Ins ections Re uired
DUCTS INSULATED
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 renspection,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.
CON OR SIGN PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
JOB PROPOSAL J.nn.�HAYs, Inc. GERq�
Refrigeration & �'
Air Conditioning Services 4`
EF R IG I®AIRE �
State Class "A" Lic. CAC 055504 p , and Coo,i,,,,fe",s
P.O. Box 6889 (813)654-6918
Seffner, FL 33583 Toll Free 1-888-884-HAYS (4297) Date:
Proposal Submitted To: Phone:
P i 3 2_2 vo
Street: Job Name:
City,State&Zip: // Job Locati n:
Contact P son:
0,111,
We Hereby Submit Specifications and Estimates For:
/l/(?
bno d e O F3 "�i- U/ 90
ry JQ F
We Propose Hereby to Furnish Material and Labor - Co lete in Accordance With Above
Specifications, or the Sum Of: _Se vr� , �,s( 1 !0� � (�
i► .gib o rs ($ `Z
Payment to Be Made as Follows: f,
NOTICE:Any changes requested by the customer are not covered by this agreement, and must
be added subsequently, at the cost agreed upon by both parties. Quotes are good for 30 days
from the proposal date.
ACCEPTANCE OF PROPOSAL: The above prices, specifications, and conditions are satisfactory
-and are hereby accepted. You are authorized to do the work as specified. Payment to be made
as outlined.
Date: Signature: . �-�
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received* f�/3 S^7 _ 6 9 Illy/� Phone Contact for Permitting
Owner's Name Al- Q Ue eve Owner Phone Number �'/ �7��
Owner's Address �_3 S Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS -7 I,C N C LOT#
SUBDIVISION F PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED R
NEW CONSTR B ADD/ALT = SIGN 0 = DEMOLISH
INSTALL REPAIR
PROPOSED USE = SFR Q COMM = OTHER
TYPE OF CONSTRUCTION =t BLOCK Q FRAME = STEEL Q /
DESCRIPTION OF WORK 4 ZC �r ,/� a ,�� n �G5 4.4 c/jreN v"`!
BUILDING SIZE SQ FOOTAGE= HEIGHT
=BUILDING $ VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY 0 W.R.E.C.
=PLUMBING $
,��CHANICAL $ ��a O� VALUATION OF MECHANICAL INSTALLATION
��
l=GAS = ROOFING 0 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 I Y/ N FEE CURREN
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN
Address License/#
MECHANICAL ` COMPANY t M r /, ,' S 7-�C'
SIGNATURE / REGISTERED Y N FEE CUR EN Y/N
Address I License# Cn� oSS'S O
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
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/Slit 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