HomeMy WebLinkAbout20-22382 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 22382
BUILDING PERMIT '
max.: 'PERMIT-INFORMATION LOCATION INFORMATION ' ` =`
Permit Number: 22382 Address: 38624 5TH AVE
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: 11-26-21-0010-17000-0080
Improv. Cost: 9,600.00 OWNER INFORMATION
Date Issued: 1/28/2020 Name: TILLMAN THOMAS L& MARLENE
Total Fees: 90.00 Address: 38624 5TH AVE
Amount Paid: 90.00 ZEPHYRHILLS, FL. 33542-4335
Date Paid: 1/28/2020 Phone: (813)713-0220
Work Desc: A/C CHANGE OUT 3 TON
CONTRACTORS APPLICATION FEES
AIR TECH SERVICES OF PASCO INC A/C CHANGEOUT 90.00
-DUCTS INSTALLED Ins ections Re uired
DUCTSINSULATED
FINAL
REINSPEC77ON 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 federali 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.
CONTRXCTOR SIGNATURE PERMIT OFFICZR
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
873-7E0-6020 City of Zephyrhitls Permit Application Fax-813a80-0021
Building Department
Data Recstysd. I.Ehofie,Conta6t for Permtttin
' Ownses Name Owner phone Number 3'
Owner's Address' Owner Phone Number
Fee Simple TRlahoidsr Namei� Owner Phone Number i
1 -
Fee Simple Titleholder Address
JOB ADDRESSAuer, S' SY LOT#
SUBDIVISION PARCELID# - O
(OSTAINEO FROM PROPERTY TAX NWICE);
WORK PROPOSED e NEW MNSTR 8 ADD/ALT SIGN 0 0 - !DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR- 0 COMM OTHER
TYPE OF.CONSTRUCTION = BLOCK. 0 FRAME STEEL 0
DESCRIPTION OF WORK v t
'I
BUILDING SIZE 1 Sp FOOTAGE HEIGHT
,
r.
BUILDING $'"
VALUATION OF TOTAL CONSTRUCTION '
=ELECTRICAL $ ''"` AMP SERVICE Q PROGRESS ENERGY 0 W.R.E,C.
=PLUMBING. I$
['VNM£CMANtt AL ��$' *() j VALUATION OF MECHANICAL INSTALLATION
=GAS' = ROOFING 0.1 SPEC,IALTY OTHER
FINISHED FLOOR ELEVATIONS (� 1 FLOOD ZONE AREA =YES NO
L ,
• • • • • • • • • • • • • • • • • • •--. l_l-J_-LLJ__W_
BUILDER COMPANY '
SIGNATURE REGISTERED I YIN -FEE CURFlEA Y/.N'
Address License# t
ELECTRICIAN'. ^-� COMPANY
SIGNATURE REGISTERED Y T N FEE dttRREn" Y J N
Address 77771 UcenSa#
'PLUMBER- COMPANY ~
SIGNATURE REGISTERED I Y/N F'EECURREti' I Y'/N:T
Address License#
MECHANICAL COMPANY FA�,r S 5
ISIGNATURE c REGISTERED Y f N FEEY 1 N
1. t_.'..
Address 5 . License#
OTHER. COMPANY "
SIGNATURE REGIE I Y'/N' 'PEE CLiRREA" Y/N
Address License# -
{.�I
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 ptansiwi Slit Fence installed,
Sanitary Facilities&1 dumpster,Site Work.Permit for subdivislons4arge projects
COMMERCIAL Attach(2)complete sets of Building Plans plus.a Life Safety Page;(1)set of Energy Forms.R-O-W P.ermll for new construction.
Minimum ten(10)working days after submittal Oats. Required onsite,Construction Plans,Stormwater Plans�w/Slit Fence Installed,
Sanitary Facilities&1 dumpster.Site Work Permit for all now projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans: .i
"—PROPERTY SURVEY required for all NEW construction.
Directions-
Fill out application completely..
Owner&Contractor son back of application,notarized.
If over$2500,a Notice of Commencement is required. (AIC upgrados'over$7500)
Agent(for the contractor)or.Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing some
OVER THE COUNTER PERMITTING (copy of contiact required)
Reroofs If shingles, - Sewers Service Upgrades,A/C- Fences(Pipt/Survey/Footage)
Driveways-Not over Counter.lf on public roodways..needs ROW.
i - .i'. .
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
contractor's to undertake work,they may be required to be licensed lh accordance wIth'state and local regulations.. It the
contreictorls not licensed as required by law, both the owner and contractor may be-cited for a misdemeanor violation
under state law: if the owner of intended contractor are uncertain as to what licensing-requirements may apply for the,
Intended I work,they are advised to contact the Pasco qounty.Building Inspection Divlslon—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 Tf the"contractor Block"of this*application for which they Will be responsible. If you,as!the owner signas the
contractor,that may be an Indication that he Is not.properly licensed and Is,not entitled to permitting privileges In Pasco
County.
TRANSPORTATION IMPACTIUTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersignedlInderstands
that Transportation linP act Fees and Recourse Recovery-Fees may apply to the construction of new buildings,change of
Impact
use In existing buildings,or expansion of existing buildings,as specified In Pasco County Ordinance number 99-07 and
90-07 as adiendod. The undersigned*also understands,that such fees,as may be due,will be Identified at thi time of
permliting. It Is further understood that TranSpbrtatlon, Itnpact Fees and Resource Recovery Fees must be paid prior to
receiving a"certificate of.odcupancy".or final power release.. If the project does not Involve aPertificate of occupancy or
Fins!power release,th6 fees must-be'-pald prior to permit issuance. Furthermore,If Pasco County Water/Sewet Impact
fees are due,they must be paid prior to permit Issuance In accordance with applicable Pasco County ordinances;
CONSTRUCTION LIEN LAW(Chapter 7113,.Florlda Statutes,as amended): If valuation of wokis$2,500.00 or more,I'
certify that.1, the 'applicant, have been provided with."a copy of the "Florida Construction Lien.Law—Homeowners
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.obtalfied a,copy of the above described document and promise In good faith to
deliver It to the"owner"prior to commencement.
CONTRACTOITSIOWNEFVS AFFIDAVIT: I certify that all the Information In this application is accurate and that all Work.
will be done in Compliance with,all applica
ble taws regulating construction.zoning
Ing 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 19 compliance. Such agencies Include but are not limited to:
- Department of.Environmental Protectidn-typress Baybeads,Welland Areas and Environmentally Sensitive
Lands,Waterfflastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Weiland- Areas; Altering
Watercourses.
Army Corps of Engineers-Seawalls,Docks,Navigable Waterways;
Department of Health & Rehabilitative Services/Environmental Health Uhit-Wells, Wastewater Treatment
Septic Tanks.
US Environmental Protection Agency-Asbestos abatement.
F eideral Aviation Authority-Runways.
I understand that the f6liowinq restriciloris apply to the use of fill:
Use of fill Is,ndt.E-ifiowed In Flood Zone"V'1uhI6ss expressly permitted.
If the fill material is to be used In Flood Zone "A", It Is understood that a drainage plan addressing.a
g"compensatin 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'X In connection wIth'a permitted building-using-stem.wall
construction,I certify that fill will be used only to fill 60 area within the stain wall.'
If fill material Is to be used In any area,.l certify that use.of such fill Will not adversely affect adjacent
properties. If use of fill is found to adversely affect ad
jacent Iacent properties,the owner may be cited for V16laqn b
the conditions'of the building permit,Issued under the attached permit application,for lots less than one(11),;
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. 1-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,altar,or
set aside any provisions of the technical codegi nor shall Issuance of a pen-nit prevent the Building-Official,from thereafter
requiring a correcljon.of errors In.,plans,construction or violations of any codes. Every permit issued shall become Invalid
unles,s,the work authorized by.such permit Is commenced within six months of permit issuance'or If work authorized by
the permit.Is suspended of 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 qaus6,for the extension. If work ceases for ninety(90)consecutive days,the job Is considered abandoned.
WARNING TO OWNER: YOUR FAILURETO RECORD A NOTICE MAY RESULT IN.YOUR
0
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY pp I DJJ0 OBTAIN FINANCING;CONSULT
OU 0.1
N AT R :E'Y BEF6RE R X( X61 WIT YOUR 1_901ER OR A' Eddlkl)i Y N t OF'COMIMENCEMEkt.
FLORIDA JURAT(P.S:
OWNER OR AGENT, CONTRActaR
tubsChb6d and sworn to(or aMrmdd)before me this Subscribed and 7w n-o N by
affivoed)before me this
y y
Who Istare personally known to me or hdsthaJa produced Who I orsqRI1VTown t has[have pr duced
as Identification. ire as ti cation.
Notary Public Notary Public
Commission No. Commission No. I j
'Rame of Notary type.,printed or stamped 146me of.Notary type A—h"AID0
_Commission 34627
Expires June 18,2023 -
br; B do h troy n Insurance$00-385-7019
From-Air Tench 8137797604 02f2'1/20i20 16:27 #021 P_002
j"viL 10067 PG 1769• , Cj IAlSTR##2Q20Q39 QQ7 oR sK Page 1 of 1
!H �w� � 02121/202D 02:06 PM Rcpt:2137775 Rao:10.00 DS:0.00 IT:0.00
Nikki Alvarez Sowies,Esq.,Pasco curl - C�iel 91611d$mptr0l r Of
P�
this Ih to dF@Fttfy that the foregoing Is a
{rue and dbrrbot Copy of the document
tin flip or�f puoliC record In this office.
t yid Vita s my hand and of'Aciat seat this
Permit No TICS F CO NCEMENT Nikki Alvalt9z-&WI 's,BQ.,G &Comptroller
Pas Cote tt,
Property Identification No&-.. '00 192'f M810 SX €?o"Clefk
THE UNDERSIC INED hereby gives notice that improvements will be made to certain real property and'ua accordance with Section
71313 of the Florida Statutes the following information is provided in the NOTICE OF COMMENCEMENT
1 Description of property(legal&=yhon)
a) Street Address
2 General description ofmiprovements AV C)'O'np- a"
3 Owner Information
a) Name and address Mar tmP ^Y,Iii naa 38,6'L&A SS ma 7,Ce6 s,�ar+ N-1
b) Name and address of be simple titleholder(if other than owner)
c) Interestinproperty Qwnar
4 Contractor Information wak Iry s !
a) Name and address 1 iado-5. :1V1+0 _0 &x 11,20 &sk,,,A i iS j�H 33pq
b) Telephone No $(3•:134-'7 9-49 Fax No (O
5 Surety Information
a) Name and address
b) Amount of Bond
c) Telephone No Fax No (Opt)
6 Lender
a) Name and address
7 Idenu y of person within the State of Florida designated by owner upon whom notices or other doe nis may be served
a) Name and address
b) Telephone No Fax No (Opt)
8 In addition to himself,owner designates the following person to receive a copy of the Lienor a Notice as provtded in Section
713 13(1)(b) Florida Statutes
a) Name and address
b) Telephone No Fax No (Opt)
9 specified) date of Notice of Commencement(the expiration date is one year from the date of recardmg unless a ddfi'rsent date is
WARNING TO OWNER ANY PAYMENTS MADE BY THE OWNER AFTER TBE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1,SECTION 71313,
FLORIDA STATUTES AND CAN RESULT IN YOUR PAYING TWICE FOR IPROYEMENTS 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 YOUR LENVER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOU NOTICE OF CO CEMENT
STATE OF FLORIDA
COUNtY OS' 91goature OF Owner or Owner s Authorized Offr«dDnnectanPa�medNlenager
inntN4
The foregoing instrument was acknowleW
before me thns�day of h,- 2O�by`! r�� �r+vvre,
as e,�ee' (type of suthordy e g oiffm trustee attorney m fact)fox
(name of party on behalf of wh mshtimeat executed)
i
Personally Kum OR Produced Ideatificahoa Notary Signature
Type of ldeagticabon Produced Name(print)
I
YcnfieaUon pumArit to Seenon 92 525 Florida Statutes Under penalties ofpcnury I declare that I have read the foregoing and that the facts stated
in it are true to the best of my knowledge and belief
r*RM3e+oo nretoot
SYpuirBo•iNWsniPmonB�u�Atwvo �
DEM ARLENE HENDLEV
• rfiMY COMMISSION 0OO1045ft5
EXPOM Navombar ca 2M
SERVICE INVOICE LOCATION OF WORK YSCA Yes / No
CHECK LIST 21936 NAME
❑ COMPRESSOR A IrTerh A D SS
❑SUCTION PSI � ` r+
❑HEAD PSI
❑VOLTS AMPS ` 813-779-7508 WORK TO BE DONE-CODE ,
❑ELECTRICAL CONNECTIONS
❑CONTACTS TIGHT6CLEAN CD P.O. BOX 1120 •ZEPHYR ILLS, L 33539 c5
❑OIL LEVEL 6 CONDITION FL State LAC. #CAC1815498 Date v� �
❑ CONDENSER COIL BILLTO
❑CLEAN COIL A CHECK FIN COND. NAME SERVICE COST ENVIRONMENTAL CHECK LIST
❑ENT-°F LVG °F VNTECHNICIAN
❑ REFRIGERANT STREET PHONE WORK PERFORMED CITYY, UNIT PRICE
❑LEAK ❑CHARGE �• D TORCH USAGE
❑ FAN AND MOTOR
VOLTS AMPS CITY STA ZIP RECLAIMED
ELECTRICAL CONNECTIONS ZL S VACUUM PUMP USAGE
❑CONTACTS TIGHT a CLEANMAKE MODEL SERIAL NUMBER
❑FAN PULLEYS(ADJUST BELT) IQTY. MATERIALS
❑CHECK,LUB BEARINGS&MOTOR
p Gee d E MODEL r SERIAL NUMBER
❑ EVAPORATOR COIL REFRIGERANT R.
❑CLEAN COIL&CHECK FIN MAKE MODEL SERIAL NUMBER
❑ENTUB_'FI LVGDB_°F '^ L r
❑ENT'A ENT LVG WB_°F J -
❑ CONDENSATE AREAS MAKE MODEL SERIAL NUMBER ]
❑INSPECT 6 CLEAN DRAIN PAN 61,ne" 0 p
❑INSPECT 6 CLEAN DRAIN DESCRIPTION OF WORK PERFORMED
❑ AIR FILTERS
❑CLEANED ❑REPLACED
FILTER SIZE '
❑ HEATING ASSY.
❑BURNER&HEAT EXCHANGER
❑FUEL SUPPLYB PRESSURE 3 -QQAj Ito S&er- -5L �aCk Lj&.
❑PILOT ASSEMBLYEl FLAME ADJUSTMENT
//� V( 'r 1 �,(/
❑PRIMARY RELAY B FLUE 10 e�W // tf/� r L
❑FAN&LIMIT SWITCH OPER.
❑BLOWER ASSEMBLY
❑RV VALVE Ai6d PrN ][I e--/r 0 61,+
❑STRIP HEAT.
❑DEFROST CYCLE
❑ ELECTRICAL COMP'TS
❑RELAYS -'❑CONTACTORS.
❑OVERLOAD ❑PRESS.SWITCH
❑ THERMOSTAT
❑O.K. ❑REPLACE Time Of Arrival:
❑RELOCATE
Time of Departure:
RECOMMENDATIONS I HAVE AUTHORITY TO ORDER WORK AS OUTLINED ABOVE.THIS INVOICE IS SUBJECT TO A FINANCE CHARGE OF 1 12%PER MONTH. TOTAL SUMMARY
ANNUAL PERCENTAGE RATE OF 18%WHICH IS ALLOWED BY LAW.I AGREE TO PAY ALL COSTS AND REASONABLE ATTORNEYS FEES
IF THIS INVOICE IS PLACED IN THE HANDS OF AN ATTORNEY FOR COLLECTION.CUSTOMER RECEIVED NOTICE OF CONSUMER TOTAL
RIGHTS UNDER CONSTRUCTION INDUSTRIES RECOVERY FUND. MATERIALS
TOTAL
LABOR
SERVICE
CUSTOMER'S SIGNATURE CALL CHG.
TAX
LIMITED WARRANTY:All materials,parts and equipment are warranted by the manufacturers'or suppllers'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,express or implied,and its agents or technicians are not authorized to make any such warranties on behalf of above
named company. TOTAL