HomeMy WebLinkAbout19-21263 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 . ,/�21263"
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 21263 Address: 5250 MASSACHUSETTS 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: CITY OF ZEPHYRHILLS
Est.Value: Parcel Number: 10-26-0010-09300-0000
Improv. Cost: 4,200.00 . OWNER INFORMATION
Date Issued: 5/17/2019 Name: SHADY REST MHP LLC- BOEHNING
Total Fees: 65.00 Address: P 0 BOX 1931
Amount Paid: 65.00 ZEPHYRHILLS FL 33539-1931
Date Paid: 5/17/2019 Phone: (813)788-7069
Work Desc: A/C CHANGE OUT 2.5 TON PK UNIT
CONTRACTOR(S) � APPLICATION FEES
AIR 0 HEATING & COOLING SYSYTEMS A/C CHANGEOUT 65.00
Ins oectio s 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
Ci!)r Codes and 9rdinances. NO OCCUPANCY BEFORE C.O.
N"CCUPANCY BEFORE C.O.
cbNTRAC",SfdNATURE PERMIT OFFI69R
PEMIT 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 �i—
Owner's Name //Q i A,;' (f O �✓ Owner Phone Number d 13 7,?�-
Owner's Address Owner Phone Number
Owner Phone Number
JOB ADDRESS �� N �% LOT#
SUBDIVISION PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED R NEW CONSTR e ADD/ALT = SIGN = = DEMOLISH
INSTALL REPAIR
PROPOSED USE = SFR Q COMM = OTHER
TYPE OF CONSTRUCTION = BLOCK Q FRAME = STEEL =
DESCRIPTION OF WORK T6 !ir /� l/�J
BUILDING SIZE SQ FOOTAGE= HEIGHT
=BUILDING 1 7$ VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ AMP SERVICE = DUKE ENERGY Q W.R.E.C.
=PLUMBING $
MECHANICAL $ D oo VALUATION OF MECHANICAL INSTALLATION
=GAS = ROOFING = SPECIALTY L� OTHER /Z/
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 I License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN LILN
Address License#
MECHANICAL COMPANY 14/O2 D �Od /
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address .O D J'd License# rs
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN
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/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(PlottSurvey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
iTiCE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions"
ich may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
Acable deed restrictions. `
LICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
itractors to undertake work, they maybe required to be licensed in accordance with state and local regulations. If the
ttractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
ler state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply.for the
nded work, they are advised to contact the Pasco County Building inspection Division—Licensing Section at 727-847-
�9. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
:ions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the
tractor, that may be an indication'that he is not properly licensed and is not entitled to permitting privileges in Pasco
inty.
%NSPORTATION IMPACT/UTiLITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
in existing buildings, or expansion of.existing buildings, as specified in Pasco County Ordinance number 89-07 and
)7, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of
nitting. It is further understood that Transportation impact Fees and Resource Recovery Fees must be paid prior to
giving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
JSTRUCTION LIEN LAW(Chapter 713, Florida Statutes,as amended): If valuation of work is$2,500.00 or more, I
fy that 1, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
ection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
r than the"owner", i certify that I have obtained a copy of the above described document and promise in good faith to
er it to the"owner"prior to commencement.
ITRACTOR'S/OWNER'S AFFIDAVIT: i certify that all the information in this application is accurate and that all work
)e done in compliance with all applicable laws regulating construction, zoning and land development. Application is
by made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
nenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating
truction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
y that I understand that the regulations of other government agencies may apply to the intended work, and that it is
>sponsibiiity 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.
mrstand 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.
i the AGENT FOR THE OWNER, i promise in good faith to inform the owner of the permitting conditions set forth in
fidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
ing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
ide any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
ng a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
rmit is suspended or abandoned for a period of six(6)months after the time the work is commenced. An extension
e requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
ble cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned.
IiNG TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
G TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCI f3,CONSULT
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YO OTIC F COMM EMENT.
4 JURAT(F.S. 117.03)
OR AGENT -- ._-- -- — - CONTRACTOR
ad and sworn to(or affirmed)before me this Subscribed and by m o(�/orAIffi) be(la6e M9 -�.
Y �" 1�
re personally known to me or has/have produced Who is/are personally known to me or has/have produced
as identification. as identification.
Notary Public Notary Public
on No. Commission No.
otary typed,printed or stamped Name of Notary typed,printed or stamped