HomeMy WebLinkAbout19-20932 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 20932
BUILDING PERMIT
PERMIT INFORMATION . LOCATION INFORMATION
Permit Number: 20932 Address: 6431 HUNTINGTON DR
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: SILVER OAKS
Est. Value: Parcel Number: 03-26-21-0120-00000-0860
Improv. Cost: 6,600.00 OWNER INFORMATION
Date Issued: 3/06/2019 Name: HOLZSCHUHER, CAROLINA
Total Fees: 75.00 Address: 6431 HUNTINGTON DR
Amount Paid: 75.00 ZEPHYRHILLS, FL 33542-0638
Date Paid: 3/06/2019 Phone: 305-798-1226
Work Desc: A/C CHANGE OUT 4 TON
CONTRACTORS APPLICATION FEES
SENICA AIR CONDITIONING INC A/C CHANGEOUT 75.00
l
Ins ections.Re uired
DLI TSINSTALLED
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 SIGNAT R 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
Date Received Phone Contact for Permitting //
Owner's Name /A/ Owner Phone Number' '50 . / b
Owner's Address /O J1 1J& A1 h �Q / Owner Phone Number
-Fee Simple Titleholder Name L Owner Phone Number
Fee Simple Titleholder Addrress
ref
JOB ADDRESS �7�/ 49 / I(J // ,U � T LOT# O
SUBDIVISION / e,e 0" PARCEL 61,F010
(OBTAINED FROM PROPERTY TAX NOTICE) '
WORK PROPOSED NEW CONSTR ADD/ALT SIGN DEMOLISH
e INSTALL B REPAIR
PROPOSED USE SFR Q COMM = OTHER
TYPE OF CONSTRUCTION /= BLOCK 0 FRAME = STEEL
DESCRIPTION OF WORK l UAL C� / ./ ' % rou /
BUILDING SIZE SQ FOOTAGE= HEIGHT
=BUILDING $ VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C.
=PLUMBING $
MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
=GAS = ROOFING 0 SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
—1 1 11 1 1 1 1 1 ".-+—�"�'e--"■ ' °
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN
Address License#
dq
MECHANICAL COMPANY oemlen lid AI / ON/a -Zile,
SIGNATURE .REGISTERED Y/ N FEE CURREN/► Y I N
Address / s Q/ /�� ,G 346/O License# C Py 19
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN
Address License#
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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(3)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,Stormwat_er 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 Ior all'NEW construction.
1. MIMIy■ ■fir m It e m e 9 m..e i..m.mom■ • m 8..m ■ • • ■ ■:■ • ■ ■ ■ • • ■
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 (Front of Application,Only)
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'fmay 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 7'13, 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.
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 A ENT `� - OONTRACTOR� `� 6 - -— —
Subscribed and swo iffi )be m is Subscribed and sworn to(o rets
by by
WF10 is/are personal v known to me or has/have pro uced Who islare personally known to me or has/have produced
as identification. as identification.
/`Notary Public 04;�jx-4440v(�;tary Public
Commis 'on No. O Com ' sion No.
Namd of Notary typed,printed or stamped Name of Notary typed,printed or stamped
PATRICIA ANDERSON PATRICIA ANDERSON
" ;�: �. MY COMMISSION#FF 931900
,, ''• MY COMMISSION k FF 934900 = .
y EXPIRES:January 3,2020 EXPIRES:January 3,2020
Bonded Thru Notary Public Underwriters
o. ,,.•' Bonded Thru Notary Public Underwriters — —
a
SENICA AIR CONDITIONING, INC. HVAC
16640 SHADY HILLS 34 SERVICE ORDER
PRING HILL, FLORIDA 34610
STATE LIC.#CAC1815564 -� --�
1-800-897-2335 - www.senicaair.cb' INVOICE
HERNANDO (352)686-6166
PASCO(727) 856-0058
339889
BILL TO
THIS WORK IS TO BE
❑ C.O.D. ❑CHARGE ❑ NO CHARGE
MAKE MAKE
MODEL MODEL
SERIAL NUMBER SERIAL NUMBER
NAME {
srREET q 11\\ DATEEl yIRONMENTAL CHECK LIST WORK PERFORMED
l t� . 1_.]ti
Cl7y II 1 PROMISED WORK PERFORMED QTY. TYPE/DISPOSI hON CONDENSING UNIT COND'SATE DRAINS
❑ RECOVERED LLVaED CLEANED
P ONE ^ CALL BEFORE ❑ A.M MAIN OAAIN
O P.M. ❑ RECYCLED CLEANED COIL REPAIRED
MAN DRAIN
TECHNICIAN A RIZED BY ❑ RECLAIMED CHECKED CLEANED
CHARGE PANDRAIN
1. REPAIRED REPAIRED
WORK TO BE FORMED ❑ RETURNED LEAK IN COIL PAN DRAIN
❑ DISPOSAL REPAIRED LEAK IN COPPER FURN.OR FAN COIL
❑DISMAMIM K REF. REPLACED BELT
❑CHANGED OUT/REPLACED TOTAL $ CHECKED ADJUSTED BELT
MOTOR
.. ......:.... r._...:........ CHANGED REPLACED
MATERIALs i,:SERVIGE$.::r,-.:` :.`;UFttl pFii f;:: AMOtf1�iT:;'.:. :. �SCI IpT1fl[f:DF:WOR ;P...ERFQf F6Ep:: . ,;, PULLEY
M
REPLACED ADJUSTED
REFRIGERANT R- LBS. ( •/t + - t BELT PULLEY
(L f` ADJUSTED CLEANED
BELT BLOWER
REPLACED REPLAC
CONTACTOR- BEARINGS
ED
RPL START OILED MOTOR
^ •� /-�(�� RELAY
RPL START OILED BEARINGS
` CAPACITOR
REPLACED CLEANED
CAPACITORRUN HEAT EXCH.
CLEANED OR REPLACED
n y /� ADJ. HEAT EXCH.
I To- °J --�t ���fJ. RPAIRED CLEANED OR
WIRING ADJ.PILOT
RE
REPLACED FUSE THE MCOCOUPLE
REPLACED REPAIRED
COMPRESSOR VALVE
REPLACED
tAo�xEVAPORATOR COIL VALVE
10
REPLACED CLEANED
T E7P VALVE BURNERS
r f� ADJUSTED DUCT
REPLACED REPAIRED
CAP.TUBE
CLEARED ADJUSTED
h I• i 1CAPTU AusTED
�Q44 REPAIRED THERMOSTAT
> FILTERS x x
COIL LEAK
REPAIRED
REPLACED
BELTS .,e::..r::.�:.• - ADJUSTED
:S. CLEANED COIL
TOTAL MATERIALS LEVELED COIL
ELECT.HTR. CLG TOWER
HRS. LABOR RATE AMOUNT j U RPLrcEDLINK CLEANED
REPLACED KLIX.
�Q
REPAIRED WIRE PUMP(S)
REPLACED CONT. GREASED
REPAIRED
FILTERS 0 CLEANED ❑REPLACED
MATERIALS ON OTHER
RSI BE TOTAL LABOR LIMITED WARRANTY: All materials, parts
ooNnNUEoor+oTHIAaLDE and equipment are warranted b the
Y TOTAL SUMMARY
TERMS u �� f�S _ // asC manufacturers' or suppliers' written warranty
only.All labor performed by the above named TOTAL
company is warranted for 30 days or as MATERIALS
otherwise indicated in writing.The above named TOTAL
company makes no other warranties, express LABOR
I have authority to order the work outlined above which has been satisfactorily completed.I agree that or implied, and its agents or technicians are 1`•( — I: /,Q
Seller retains till equipment/mate'als furni - until final payment is made.If payment is not made not authorized to make any such warranties
as agreed.S r n r e said pm mat ' Is at Seller's expense.Any damage resulting from on behalf of above named company. TRAVEL
said remo s be t r on IN' of Br.
❑ REGULAR ❑ WARRANTY CHARGE
❑ SERVICE CONTRACT TAX
CUSTOMERSIGNANRDATE— � ^ TOTAL �'�
RE
3�i b b9 c
Sles Rep` In�,�®iC` I�ustll ®aye: 3 M
BUSTING EQUIPMENT
Customer Name: uc �-1u� �. PERMIT TYPE:.- - ( ech) Electric-
Phona1: ��^ �1- L� ` c��-7-� Wire size:
Address Line 1: KW size: .
Address-.Line 2: Breaker size: �;�cti
Pity and Zug c �i ' _ '� Make & Model: fQ��14 j40LIAv
Subdtylsion 1 t. L ei( Tonnage:
NEW EQUIPMENT: (-(tVe' rUcal)—karizomital / Package
.y.
c Lf C ,A'�)o3
BREAKER SIZE r 1
WIRE SIZE
Extras
DESCRIPTION OF EXTRA WORK(QUANTITIES, LENGTH,SIZE, ETC):
4A
I confirm that all items pulled and/or obtained by myself and/or helper are correct for the job per the contract
agreement.
Installer Signature Date
Manager/Supervisor Signature Date
Revised 10.29.13
I
c
Hernando Pasco :Citrus Hillsborough : Pinellas
(352)'086-6166 (727).856-0058: : .(352) 795-9685 (813) 995.050.5 (727) 7.99-1300
Statewide 800 897- 3 5
March 5, 2019:.
City of Zephyrhills
Zephyrhills; FL--
.Pl.ease accept this letter as authorization for Mark Sittig (Drivers License#.S320-547:-
56'-349-0) to act as my agent for Senica Air Conditioning; Inc: -
If.any add itional'information is needed or if there are a.ny.questions;please.contact
my office at 727-856-0058.
. . . Regards:, :: :. ----- -
Mark Nelson
License #CAC1815564 .
State.of Florida
County of Pasco
... . . Sworn to.and subscribed before me.this 5th day of March 2019, - - . - -
b Mark Nelson, who is personally known to me.
ERSON
pATRICIA
4iY CO\,J 1 SSIO D FF 94900 ..... .
` nrizrs
�•,• —'_ EXPIRES•January
'��� l� %'c• a�, Bcnded Thm Notary Pubcc UPde .
Notary Public Print,Name or ea
16640 .544 q&.Road ;SE�;(4 19.
R4,", 576onc'da:34429
- State ,C'ceerr.�e #(�t�G�1�15564