HomeMy WebLinkAbout19-21376 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 21376
BUILDING PERMIT
PERMIT INFORMATION LOCATION•INFORMATION
Permit Number: 21376 Address: 39139 OLD MILL LN
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section:
Square Feet: Subdivision: SUMMERHILL
Est. Value: Parcel Number: 12-26-21-0100-00000-0340
Improv. Cost: 5,517.00 OWNER INFORMATION
Date Issued: 6/14/2019 Name: HERNANDEZ, JOSE & CARMEN
Total Fees: 70.00 Address: 39139 OLD MILL LN.
Amount Paid: 70.00 ZEPHYRHILLS, FL. 33542
Date Paid: 6/14/2019 Phone: (813)788-9346
Work Desc: A/C CHANGE OUT 2 .5 TON
CONTRACTORS APPLICATION FEES
BAHR'S PROPANE GAS &A/C, INC. A/C CHANGEOUT 70.00
DU T INSTALLED Ins ections Required
DUCTS INSLI
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 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-OD20 City of Zephyrhills Permit Application Fax-813-78D-0021
Building Department
Date Rec*-ed Phone Contact for Pemftrtg I Ze
. . . . . . . . . . 4 - 6013 ,
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Owner's M— Owner Phone Number
o....Add 3 Owner Phone Number
Fee Simple rMebotder Name •
Owner Phone Number
Fee Simple Titleholder Address
V 7 •
;7
JOB ADDRESS 9 F LOT#
SUBDPASION PARCELIO#1 JQ X iP/ &40 PA4040 d
(ORTUNED FRO.PROPERTY TAX NOTICE)
WORK PROPOSED NEW MNM ADDIALT SIGN DEMOLISH
R INSTALL REPAIR
PROPOSED USE SFR CONN OTHER I
TYPE OF coNsTRucrnom M BLOCK FRAME STEEL
M�Od'
DESCRIP11)4N OF WORK I Re$- )9Zd C-44toa 0/7 e--e, .9A 70—Al, .7 777 44A
BUILDING SIZE ISQ FOOTAGE HEIGHT
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
"BUILDING IS VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY W.R.E.C.
=PLUMBING is
MECHANICAL VALUATION OF MECHANICAL INSTALLATION
CvkS Q ROOFING Q SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER COMPANY
SIGNATURE REGISTERED I YIN FEE CURREN LY 1 N
Address i License 9
ELECTRICIAN COMPANY =
SIGNATURE REGISTERED I YIN I FEECUMEN L_XLN J
Address License#F—
PLUMBER COMPANY
SIGNATURE REGISTERED I YIN FEE CURREK I Y/N.
Address I License#I
MECHANICAL COMPANY b41kvh`6P1Me-956
SIGNATURE REGISTERED I YIN FEE CURREI, I Y/N
Address 9441 R717e,--v W Z-A4716-sq License 10,40"o I/S=9=4
OTHER COMPANY
SIGNATURE REGISTERED I Y/ N FEE CURRD L-XL—Ni
Address License J-7 7-1
1111111111111111111111111111111111111111111111111111111111111111111
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)woddng days after subrniw data. Required onsite,Construction Plans,Stormwater Plans wl Sift Fence installed,
Sanitary Facilities&I dumpster.Site Work PmTnd for subdivislonsfiarge 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)woMng days after submittal date. Required onsite,Construction Plans,Stommeater Plans w]Sift Fence installed.
Sanitary Facilities&I d-pster Site Work Permit for all now projects Ail Commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
PROPERTY SURVEY required for all NEW construction.
. . . . . . . . . . . . . . . . . . . . . . assonam . . . . . . . . . . . . . . . .
Fill out application completely.
Owner&Contractor sign back of application,notarized
If over$2500,a Notice of Cominencemenit is required. (AfC upgrades over
Agent(for the contractor)or Power of Attorney(for the owner)vA)wd be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (copy of contract required)
Reroofs;if shingles Sdvem Service upgredas,AfC ' Fences(ploySumeyFootage)
Driveways-Not over Counter if on public roadways-reads 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 contractors) 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"V"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.
i
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. . 7.03) - ` L
OWNER ORAGEN LQ- 4L,L_ CONTRACTOR'
Subs "bid aQ sworn (or affirmed)befo me thi Subscribed �swooraffirmed) efor me this
e- �o islare a ly know o me or hasthave produced ho Wareto me or has/have produced
as Identification. as identification.
- o blic Notary Public
t7,M,Q,. ELL Co mission No.
Ak��
�""Y Pb, Notary Public-State of Florida
SYLVIA DCAMPBELLNa Of of ad prinCbVUff`�A Name of Notary typ dy mMy Comm.Expires Jul 19,2021 * pRdtary Publion a' ' Commissi39liondedthroughNationa *s ors My Comm.E 2021'FOBonded througryAssn.
; �'" -� - �14®PA1�E GAS •
Service Order/Proyosal ,
v`� 8��• s 13-782-5013 Invoice
Sal , Service Installations R ` ' * •r.r._ E ,r' N.
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44 en Rd. Zephyrhills, FL 33541 ; li..�_ ., �_ME ^��al:.=rl ,.: S6ri
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I: . iFt�S.1_- _-_: I__ _.�—/`w ZI_."K FRI i1,.,. ._ ? t`I.._ •1•_1� i.
DESCRIPTION OF WORK. " QTY' MATERIAL$l8�SERVtEES,;`',i; t1NIT,PRICE AMOUNT,`
I I
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L �GI I I
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L( lFX1
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pec n +
REGONI11ilENDATIONS:~''': I I
Annual MaintenandelR commended 6y All EquiR rit`Maniifacture'rs:.`.
Pressures Lo HI T Stat I
;REFRIGERANTR- I,, LBS: '` $perttis. ,
FILTERS x x Changed Monthly I I
FILTERS x x Changed Monthly
❑ REGULAR ❑WARRANTYOTALSIIN�MARY
"Dehumidistaf-Sgongs:;When here`ON"`;)When Away aOO/ -Stat 80°` ❑ MAINTENANCE CONTRACT SERVICE I•
LIMITED WARRANTY: All materials, arts and equipment are warranted b the manufacturers' "' CALL I
PY =METHOD<,Fi:PAYMENT;
or suppliers'written warranty only.All labor performed by the above named company is warranted for ` '
30 days or as otherwise indicated in writing.The above named company makes no other warranties, cry. TOTAL - a
Y 9 P Y 0 CASH ❑CK#M:t:
express or implied,and its agents or technicians are not authorized to make any such warranties on MATERIALS
y:
behalf of above named company. ❑DEBIT ❑CR_EDIT ❑OTHER MAINTENANCE
I have authority to order the work oufiined.above whichhas been satisfactorily completed.I agree that Seller
PROG. W / C r
retains titla to equip enurnaterials fumished until final pa enl is made.If payment is not made as agreed, CLAIM
setter can remove,Sai� uip.....lerials at Seller's expense.Any damage resulting from said removal shall
not be the resporlsibitity of ✓Tier.NET 30 DAYS.A 1 1/2%SERVICE CHARGE WILL BE ADDED MONTHLY TO -I
ALL UNPAID BALANCES OVER 30 DAYS.NO REFUNDS DATE COMPLETED
TECH. TAX d I C
it rl
CUSTOMER SIGNATURE DATE ✓� ✓acc TOTAL '� I
- - •ae}R{at r�
dr:
0
DUCT CERTIFICATION FOR INSTALLATION OF NEW DUCT WORK OR MODIFICATION OF THE EXISTING
DUCT SYSTEM
FLORIDA ENERGEY CONSERVATION CODE(FBC ENERGY,SECTION 403)TO BE LEFT ONSITE AND PICKED
UP BY INSPECTOR
Owner:
Permit#: �
r�l �4Ii �� r PVC
Site Address: � i 3 q I J _
Contractor:
License#:r 0-) I-� �V t '"
Final Inspection Date:
I certifythat I have installed new or modified the existing duct work associated with the HVAC system
g Y
referenced by the permit listed above and found it complies with the requirements FBC Energy Code;..
Section 403.3.Where modified, '
" the existing ducts have been sealed using reinforced mastic orcode-
approved equivalent. Ducts{are located within conditioned space (Section 403.3)System was tested as '
per FBC Energy code,section 403.3.2.1.All new duct work is to comply with FBC Energy 403.2 and FBC
Mechanical chapter 6.
Name of License Holder(print or type) Signature of License Holdee
r •
i '