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Home My WebLink About19-20637 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department Date Received, C�. Phone Contact for Permitting �'o Owner's Name .e /!/ e ' _ Owner Phone Number Owner's Address 7 Owner Phone Number fJ Owner Phone Number r JOB ADDRESS D LOT# SUBDIVISION PARCEL ID# OD DO (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD/ALT = SIGN = = DEMOLISH B INSTALL R REPAIR PROPOSED USE = SFR 0 COMM 1Z OTHER TYPE OF CONSTRUCTION = BLOCK 0 FRAME = STEEL 0 DESCRIPTION OF WORKM BUILDING SIZE SQ FOOTAGE= HEIGHT imil =BUILDING $ VALUATION OF TOTAL CONSTRUCTION =ELECTRICAL $ AMP SERVICE = DUKE ENERGY 0 W.R.E.C. =PLUMBING $ MECHANICAL $ -� VALUATION OF MECHANICAL INSTALLATION =GAS = ROOFING Q SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO BUILDER COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN Address License# ELECTRICIAN COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN Address License# PLUMBER COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN Address License# MECHANICAL COMPANY (� SIGNATURE C REGISTERED / FEE CURREN Y N Address License# c OTHER COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN LILN Address License# F 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(Plot/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW ' NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may bm subject ~ - -- which may be more restrictive than County regulations. The undersigned assumes responsibility -for � . .Ha ma��th applicable ^ ��~ 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 Uomnomd as required by law, both the owner and contractor may be cited for misdemeanor violation under mtatelaw. |f the owner or intended contractor are uncertain aabo what licensing requiremanba-mnayapp|yfmrthe intended work, they are advised tocontact the Pasco County Building Inspection Division—Licensing Section at 73 8OOQ. Furthermore, if the owner has hired a contractor orcontractors, he is advised to have the contractor(s) 'sign portions of the "contractor Block" of this application for which U h they be responsible. If you, as the owner sign as' ' the montroctor, that may beon indication that he |m not properly licensed and is not entitled to permitting privileges in Pasco County. TRANSPORTATION IMPACT/UTIL00ESUMPACT AND RESOURCE RECOVERY FEES: The undersigned understands that Transportation Impact Fees and Recouno' xv Raonvery ��emm��ap�|ytoth� cm.atnu��i�nofn� bui|dinga, changeof use /n existing buildings, expansion of existing bu||dingn, as specified in Pasco County Ordinance nurnber89-D7 and 90-07. as amended. The.undersigned also 'understands, that such fees, as may badue, m/iU 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 o ^cert0ooba of occupancy" or final power release. If the project does not involve o certificate of occupancy or final power release, the fees must be paid prior to permit issuance. Furthermore, ifPoaom'Counb^VVaber/Sovver Impact fees are due,they must be paid prior bo permit issuance in accordance with applicable PogomCo ordinances. CONSTRUCTION LIEN LAW(Chapter 713, FYorida Statutes, as amended): |f valuation of work' $2.5OO.00or more, | certify that |, 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 iosomeone other than the"owner", I certify that I have obtained a copy of the above described document and,promise in good faith to deliver|tto the"cwvner"prior b»commencement. CONTRACTOR'S/OWN ER"S AFFIDAVIT: | certify that all the information in this application ioac' urato and that aUvvorh will ba done )ncomnp/ianco with oUopp|�aLdm |oxmsregulating construction, zoning and land deYa|mpmnent. Application is hereby made to obtain a permit to do work and installation as indicated. | 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 |avv�,rmQu|abng construction, County and City codmo, zoning nagu|mdionm' and land development regulations in the jurisdiction. | 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 ofEnvironmental Protection-Cypress Bayhoado, Wetland Areas and Environmentally Sensitive Lands,Water/Wastewater Treatment. - Southwest Florida VVahor Management Oistrict-VVeUm, Cypress Bayhaado, Wetland Aneao, Altering Watercourses. ' Army Corps mfEngineers-Seawalls, Docks, Naviab|eVVmhenxmym. - Department of Health & Rehabilitative Son/icem/Envinonmenbo| Hea|th Un|t-WmUe, Wastewater Treatment, Septic Tanks. ' - US Environmental PmtectionA0mncv+Ambeatos abatement. - Federal Aviation Authohb+Runxm0s. | understand that the following restrictions apply to the use Vffill: - Use nf fill io 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 m drainage plan addressing a ,.compensating volume" will be submitted at time of permitting which is prepared by professional engineer licensed by the State ofFlorida. - If the fill material is to be used in Flood Zone ^A^ in connection with a permitted building using oh*m vxaU construction, |certify that fill will bm 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 propediem, the owner may be cited for violating the conditions ofthe building permit issued under the attached permit application, for lots less than one (1) acre which are elevated by fill, on engineered drainage plan ierequired. If| arnthe 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. | understand that a separate permit may be required for electrical vvorh, o|umnbing, signs, vveUs, poo|s. air conditioning, 0ea' or other installations not specifically included in the application. A pmrm�1osumd shall be construed to be a license to proceed with the work and not as authority 0mviolate, omncm|, 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 un|moo the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit io suspended mr abandoned for a period of six(6)months after the time the work is commenced. An extension may be requeoted, in writinQ, from the Building Official for a period not tmexceed ninehy (9O) 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 NOTICE OF COMM ENCEMENT 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 OFCOMMENgEMENT. OWNER OR iNT CONTRACTOR Subscribed and sworn to(or affirmed)before meffs Subscribed and swcirn—t6(or affirmed)befp(6 me this Who Is/are personally known womeo,has/have produced Who is/are porsnoa||yknown mmno,hosm produced � ' asonUhcaUnn. ` s|demm8uouon. Notary Public Notary Public Commission No. Commission No. Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped cc� vc 'Mow HVAC .0 CAC058575./`EC13007703 PROPOSAL 12232 HWY 301 DADE CITY (362)621-4977 . "NOW PROVIDING" DADE CITY, FL 33525 ZEPHYRHILLS (813)779-9515 "ELECTRICAL SERVICES" NAME: Jennifer Johnson Date: 01/02/19 SPLIT SYSTEM XX PKG UNIT SUBDIVISION: Zephyr Estates Apt.#113 :/: HEATPUMP 0 1 jSTR;P0OL X ADDRESS: 4801 Airport Rd. INN MUM CITY: Zephyrhills ZIP CODE: 3354 CONDENSER: 4A7A4024L1 PHONE: 507-421-1683 WORK: AIR HANDLER: CELL: RENTER:' J, SEER RATING: W14 HEATER: 5KW j ESTIMATOR: Robert BRAND: AMERICAN STANDARD TOTAL .: 5,139.82 DIGITAL THERMOSTAT/PROGRAMMABLE t INSTANT REBATE : $ 850.00 / HANGING KIT TOTAL LESS REBATE $ 4,289.8 IN-LINE FLOAT A TONNAGE: 2 PARTS: 5 1 YR / DISCONNECT COMPRESSOR: 5-YR LABOR: 1 YR $200 SENIOR DISCOUNT a SEAL DUCTWORK TO CODE C_ DENSER: ## REMOVE EXISTING EQUIPMENT IR:HA LER: #N/A CONNECTED TO EXISTING DUCTS AND ELECTRIC . SEER RATIN . HEA #N/yA ANCHOR CONDENSER BRAND: #N/A I TAX,LABOR AND PERMIT TOTAL : $ #NIA HOM INSTANT REBATE : $ #NIA HORIZONTAL TOTAL.LESS REBATE $ MIA TONNAGE: #N/A PARTS: #N/A COMPRESSOR: #N/A LABOR: #N/A CONDENSER: ## IR HANDLER: #N/A FIRST MAINTENANCE CHECK FREE SEER-RATING: ## HEATER: #NIA BRAND: #N/A TOTAL : $ #N/A INSTANT REBATE : $ #N/A I HAVE THE AUTHORITY TO ORDER THE WORK OUTLINED ABOVE. I AGREE THAT SELLER TOTAL LESS REBATE $ #N/A RETAINS TITLE TO EQUIPMENT AND MATERIALS UNTIL FINAL PAYMENT IS MADE.IFPAYMENT TONNAGE: #NIA PARTS: #N/A IS NOT MADE AS AGREED,SELLER CAN REMOVE SAID EQUIPMENT AND MATERIALS AT COMPRESSOR: #N/A LABOR: #N/A SELLERS EXPENSE.ANY DAMAGE RESULTING FROM SAID REMOVAL SHALL NOT BE THE RESPONSIBILITY OF SELLER. LIMITED WARRANTY:EQUIPMENT,PARTS AND MATERIAL HAS WRITTEN MANUFACTURER'S WARRANTY ONLY. If 9 CUSTOMER SIGNATUR.L4 ATE 1c,,2 5. �4 TEIATE /3 ! 0 13v 0 0 0-0 ...�. . 71 B ` k I 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: y1n(�SG� Permit#: 9 0�o 3-7 Site Address: '401 A1rpoe} Contractor: chr ls' A 1c Corn pony License#: CSC. Final Inspection Date: I certify that I have installed new or modified the existing duct work associated with the HVAC system 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 or code- 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 Holder