HomeMy WebLinkAbout18-20197 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 20197
BUILDING PERMIT
PERMIT INFORMATION LOCATION-INFORMATION
Permit Number: 20197 Address: 5214 GALL BLVD
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: 11-26-21-0010-16600-0250
Improv. Cost: 22,679.00 OWNER INFORMATION
Date Issued: 8/31/2018 Name: VICHRIS INC
Total Fees: 155.00 Address: 5214 GALL BLVD
Amount Paid: 155.00 ZEPHYRHILLS, FL. 33542
Date Paid: 8/31/2018 Phone: (813)782-9556
Work Desc: A/C CHANGE OUT 20 TON
CONTRACTORS APPLICATION FEES
PATTIE ELEC. & REFRIGERATION A/C CHANGEOUT 155.00
t
DUCTS INSTALLED Ins ections Required
DUCTS INSULATA D
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.
.00 NTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
IIIIII IIIII Illil IIIII Illil IIIII IIIII IIIII illll lllll till till
2018150767
Permit No. 2 O I 0%_1 Parcel ID No 1 1- ?AR- 2.1
•16
NOTICE OF COMMENCEMENT
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State of AbriciiaL County of 2MISM8 NG
0 CD
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property,and in accordance with Chapter 713.Florida Statute., CD
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the following Information Is provided In this Notice of Commencement: (�r1
1. Description of Property. Parcel Identification No. 1 l- '!AN�21 - 00%Q- t 11 to D O-0 Z!St-J N
StraetAddre..:_ 521!4 'fcieLIL Rtvld � 22phy rh i I1 s El-, A96L4 2 �r.
2. General Description of Improvement C—tTf ffikAzA-1- b� 1,0*0 Y% 1y ,S E.4Ar ���,b1�(� s M
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3. Owner Information or Lessee Information If the Lessee contracted for the Improvement 9 B m
NJ Nei .0 m
52.1L4=U,1 ly.4 �Qr,.Irh�► S n
Address City State
Interest In Property: -
Name of Fee Simple Titleholder.
(If different from Owner listed above)
Address 4. Contractorpn�rlrLQ. rG �3 QL*AC sL6 V-N slate
'3411 rmeFA+hf' Vt&. �� -tZen1nNj 1r kkS
Address City State :CDContra toes Telephone No.: BL3"-1 Pl2- 331 r
5. Surety. L71
Name �N o
Address City State N M
Amount of Bond: E Telephone No.: (coo r
6. Lender. ��Fr-
Name ��o
Address City State `t N
Lender'.Telephone No.: B o
7. Persons vAtNn the State or Florida designated by the owner upon whom notices or other documents may be served as provided by do�.
Section 713.13(1)(a)(7),Florida Statutes: M
A
Name ~ ge
�+o
Address City State v
Telephone Number of Designated Person: .A c
r
8. In addition to himself,the owner designates of_ m
to receive a copy of the Usnor's Notice as provided In Section 713.13(1)Cb).Florida Statutes.
Telephone Number of Person or Entity Designated by Owner.
g. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction and final payment to the
contractor,but will be one year from the date of recording unless a different date is specified):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13. FLORIDA STATUTES, AND CAN
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY, A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalty o}pery'ury,I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best
of my knowledge and ballet
STATE OF FLORIDA /
COUNTY OF PASCO A
Signature of Owne ssee�OwWs or essee's Authorized
Ofricer/Di /Partner/Manpger
Signatarys Tdle/ORce '
The foregoing Instrument was acknowledged before me this day of j_,20 Abby
as Qrf-Si GLaX\'r (type of authority,e.g.,officer,trustee,attorney in fact)for-
V i CAnvC S f It V1 C-. (name of party behalf of whom'In_suu/r}/�nt was executed).
Personally Known❑Q$Produced identification Ly' Notary Signature�' L4.
Type of Idendficatlon Produced 6"~ tie t l`tJk Name(Print) M 0.ddi S Omt1 a f 6 h n1 F!G
�♦��N�A
ft"Old"• d roft
of CM111111,111"Nov I,M9
wpdatalbwlnoUeecommenaamentpc053048 wryer
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STATE OF FLORIDA,COUNTY OF PASCO ®
THIS IS TO CERTIFY THAT THE FOREGOING IS A
TRUE AND CORRECT COPY OF THE DOCUMENT
ON FILE OR OF PUBLIC RECORD IN THIS OFFICE �} .
MTNESS MY HAND AND FFIC L SE L THIS , Ixi yod-we ri'usr
P-®� DAY OF
AULA S. IL;C ERK&COMPTROLLER
` 1887
BY DEPUTY CLERK ,91, o
®F FL���®
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received Phone Contact for Permitting
...............17 .......
Owner's Name Owner Phone Number
owner's Address Owner Phone Number
Fee Simple:Titleholder Name Owner Phone Number
Fee Simple!I ItIenolder Address
JOB ADDRESS F &)o1,eV6w-J LOT#
SUBDIVISION PARCEL ID# tl9 r f_W 40 J 7 600✓6 21 50
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTRR ADD/ALT SIGN DEMOLISH
e INSTALL REPAIR
PROPOSED USE 0 SFR Q Comm ,,-OTHER
TYPE OF CONSTRUCTION D.t BLOCK Q FRAME STEEL
77r
DESCRIPTIONOF WORK V_
ractfoo C)V1,C
-BUILDING",SIZE SQ FOOTAGE= HEIGHT
2 amw w44-4 1,111,
=BUILDING VALUATION OF TOTAL CONSTRUCTION*
F---19LECTRIbAL 1$ AMP SERVICE = PROGRESS ENERGY Q W.R.E.C.
PLUMBING
MECHANICAL q VALUATION OF MECHANICAL INSTALLATION
llJ
=GAS Q ROOFING- 0 SPECIALTY OTHER
FINISHED f LOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N • FEE CURREN
LXLN_J'
Address F License#'
ELECTRICIAN COMPANY
.'SIGNATURE REGISTERED FEE C _yL YRREN N L
A ros #
z.
Address License
PLUMBER!' COMPANY
SIGNATURE REGISTERED. I -Y/ N7T FEE CURREN Y�/W
Address, License'
MECHANICAL COMPANY'OMPANY,'
REGISTERED Y/ N_ FEE CUR 'LKLN
SIGNATURE _J
y.
(7 6
Address License# a
OTHER,
COMPANY
SIGNATURE REGISTEREDL_yLLNJ -FEE CURREN
Address License# F
............ .. .
RESIDENTIAL Aitaqh_(2)Plof Plans;(2)sets of building Plans;`('1)set of Energy,Forms;R-O-W Permit`fdr.fiiew.construcfiofi;,
Minimumten:'(ib)•"W'O'rkihgd'ayseift6'r-sU6*'Mlttai'date. Required onsile,Construction-Plans,Stormwat4'P1a'ns*/.S1lt Fence instilled,
Sanitary Facilities&1 clumpster,Site Work Permit for subdivislohs/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(IQ)working days after submittaIr date..lRequired onsite,Construction Plans,,;Stormwater Plans w/Slit F6,rde installed,
Sanitary Facilities&I dumpster.Site Work Permit for all new projects.All commercial
requirements must meet compliance
SIGN PERMIT Attach(2)siets:of Engineered Plans.
****PROPERTY,SURVEY required for all NEW construction.
...........
a I a 6 ff 1 5 a B 1 11 14 i 1"4T-I 1 1
Directions:
Fill'obt application completely.
Owner&Contractor,sign back of application,notarized
If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500)
Agentffor*the contractor),,or Power of Aftomey-(for the owner)would be someone with notarized letter from owner authorizing same
-dVkR4HE.-.COUNTER PERMITTING (copy of contract required)
Rerd6fs if-shingles Sewers Service Upgrades A/C . Fences(Plot(SurVey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
I
NOTICE OF DEED,RESTRICTIONS:. The.undersignied 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,theyma'''be required;to be licensed in accordance with state.and".local:regulatione."•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,'they
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 maybe 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,as4amended): 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", 1 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'SiOWNER'S-AFFIDAVIT:t 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'instailatlon 'as",indl'66i6d. :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 1 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 lbe 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 applyto the use of fill:
Use of fill1s;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. i s
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.NOICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR iMPROVEMENTS'TO:,YO.UR PROPERTY.1-IF YOU iNTEND.'TO OBTAIN FINANCING,CONSULT
WITH YOUR LENDER OR AN ATTORNEY_ BEFORE RECORDINGYOU ICE OF COMMENCEMENT.
FI_ORiDA JURAT,(F.S.117.03)— _ -- - -- ._ --
OWNER OR AGENT !CONTRACTOR'
Subscribed and swoon to(or affirmed)before me this 'Subscribed and sworn (or ffirmed}before me this
by by
Who is/are personally known to me or has/have produced !Who is/are personall own to me or has/have produced
as identification. i as Identification.
Notary Public Notary Public
i
Commission No. Commission No.
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
i
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C,� p-� 7,-e�`rv,►�Yr►y4s
Pattie Electric & Air Conditioning
39111 Pattie Roadm��
Zephyrhills, FL 33540
813-782-3319
sales@pattieelectric.com
Work Order" Date S' nL : Tech:
1958-122 9/6/2018 SERVICE DAVID N
.
;Bill Tom � Job Name:_ . _
Village Inn Village Inn
5214 Gall Boulevard 5214 Gall Boulevard
Zephyrhills, FL 33542 Zephyrhills, FL 33542
813-782-9556 813-782-9556
Item Code Description
> 8/31/2018 FRI 9:16 AM>
Replacement of 20 ton 14 seer Rheem rooftop unit
Price is Per Stated Quote 1.00 22679.00 EA 22679.00
Subtotal
22679.00 $22,679.00
All material is guaranteed to be as specified. All work to be completed in a professional manner according to standard practices. Any alteration or
deviation from above specifications involving extra costs will be executed only upon written orders and will become an extra charge over and above
the estimate. All agreements contingent upon delays beyond our control. Purchaser agrees to pay all costs of collection, including attorney's fees.
Signature Date
Fox c -Q, 10 : 11 - 2Co- ZI — 001 0 - 1toCco0 — O2- 50
V tCH�R.�S INC