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City Of Zephyrhills = PERMIT NUMBER
5335 Eighth Street
Zephyrhills, FL 33542 BGR-000643-2020
Phone: (813)780-0020
Fax: (813)780-0021 1 Issue Date: 08/28/2020
Permit Type: Building General (Residential)
Property Number Street Address
15 26 21 0030 00100 0010
Owner Information Permit Information Contractor Information
Name: KEVIN KILCOLLINS Permit Type:Building General(Residential) Contractor: RON IERNA'S HTG &
Class of Work:HVAC Changeout COOLING INC
Address: 4730 Gordon St Building Valuation:$0.00
ZEPHYRHILLS,FL 33542 Electrical Valuation:$0.00
Phone: (207)551-1239 Mechanical Valuation:$6,221.00
Plumbing Valuation:$0.00
Total Valuation:$6,221.00
Total Fees:$71.10 ^ ,
Amount Paid:$71.10 �/U
Date Paid:8/28/2020 11:33:04AM
Project Description
A/C CHANGE OUT 3.5 TON
Application Fees
Mechanical Permit Fee '$71.10
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 subsequent reinspection.
Notice: In addition to the requirements of this permit,there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permit 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 add fee 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.
IL YIQ Li*-)6111r.
CONTRACTOR SIGNATURE PE IT OFFICE
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
B13-7Bo-ou20 City of Zephyrhills Permit Application Fax-B13-780-0021 ���
Building Department ,/p
'Date Received Phone Contact for Permitting �,v � / !/
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Owner's Name ✓it n /� / ��{J�hS Owner Phone Number +K
Owner s Address �/730 / 1/ 1 Owner Phone Number Qr0�'��.�J'— 20
Fee Simple Titleholder Name I � Ft' Owner Phone Number
Fee Simple Titleholder Address �V`1�14 {,, J G �/ 7
JOB ADDRESS , 730 &m�. �/F'lls ,Ir L �3557�y(��� �/� �7 BLOT#
SUBDIVISION L ills PARCEL ID# 15 7(7 2I-(��. —0010 -D01 D
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEW CONSTR e ADD/ALT = SIGN = = DEMOLISH
INSTALL REPAIR
PROPOSED USE = SFR 0 COMM = OTHER
TYPE OF CONSTRUCTION = BLOCK Q FRAME = STEEL =
DESCRIPTION OF WORK
BUILDING SIZE y SQ FOOTAGE HEIGHT
i;RR4C�.;q.i.C�;Rf.i�.ts.Clti Clf.l�.R�.CCt.t.7.t iCCC�.CC tl�C4�Ci LRCSLt�C R�.0 C�i�.;�
=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
BUILDER COMPANY
SIGNATURE REGISTERED Y/N FEE CURREN Y/N
Address License#
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/N FEE CURREN Y/N
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/N FEE CURREN LZ/N
Address License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/N FEE CURREN Y/N
Address /88N318 A CNN 9-54 91 License#
OTHER COMPANY
SIGNATURE REGISTERED Y/N FEE CURREN Y/N
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 Fortes.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.(AIC 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
813-780-UU2U City of Zephyrhills Permit Application Fax-813-78U-0021
Building Department
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 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 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 1
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 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 NOTICgeOF COMMENCEMENT.
FLORIDA JURAT(F.S.117.03)
OWNER OR AGENT CONTRACTOR
Subscribed and swom to(or affirmed)before me this S scri d a d sworn ffirmed)bef this
by
Who is/are personally known to me or has/have produced ho is/are personally known to me or has/have produced
as identification. as identification.
Notary Public Nory Public
Commission No. Commission No.
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
M
SHERRI L LAYTON
Public-State of Florida
mission f/GG 975326
m.Expires Apr 1,2024
;h National Notary Assn.
I�RH Your Business
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LING & PLUMBING
MAINTAIN • REPLACE
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August 25, 2020
To Whom It May Concern:
Please accept this letter as permission for the below agents to pull permits for lerna's Heating& Cooling..
License#: CAC1813676
Nikole Brown
Richard Lester
Robert.Hicks
Theresa Urdaz
Cindy Caroline
Please remove any names not listed on this letter. This will supersede any previous agents.
Sincerely,
SHERRI L LAY70N
Notary PubliC.State of Florida
Commission N GG 975326
of My Comm.Expires Apr 1,2024
Ro lerna Bonded through National Notary Assn:18843 US Hwy 41 N
Lutz, FL 33549
813-948-6355
813-949-9266- Fax
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Proudly Serving:Hillsborough;Pasco,-Hemando,Pinellas&Polk Counties
Pasco:813 948 6355 1 Tampa:,813-643-0496 1 Lakeland:863 859-00621 Toll-Free:866-323-COOL(2665) WWW. '��na A rk,,Om
1� �y lerna's Heating,Cooling & Plumbing, Inc. Invoice 65205214
18843 US Hwy 41 N Invoice Date 8/24/2020
Lutz, FL 33549 Completed Date 8/24/2020
813-948-6355 Technicians John N.
#CAC1813676/#CFC1429475 JoshuaS.
NEAT NG.CODCI G 8 P SAGI G
Customer PO
Payment Term Due Upon Receipt
Due Date 8/24/2020
Billing Address Job Address
Kevin Kilcollins Kevin Kilcollins
4730 Gordon Street 4730 Gordon Street
Zephyrhills,FL 33542 USA Zephyrhills,FL 33542 USA
Description of Work
Monday 08/24. 5000 on Greensky balance credit card.Square D breakers.
Task# Description Quantity Your Price Your Total
1569 3.5 TON SC PAC UNIT SILVER 1.00 $5,221.00 $5,221.00
PA4ZNA042000
AUXILIARY HEATER
HONEYWELL THERMOSTAT PRO 6000
PACKAGE UNIT 1.00 $0.00 $0.00
• Reconnect to existing ductwork
• Reconnect to existing electrical
• Duct cover(as needed)
• Hurricane slab(as needed)
• Hurricane clips
• Remove and haul away of old equipment
• Clean up all work areas to customer satisfaction
• Permit included
1379 Replace ducts 1.00 $1,000.00 $1,000.00
12"return 3 bags
12"supply 3 bags
10"1 bag
8"2 bags
12x12x10 Y
10x8x8 Y
STDPMAI-FREE Standard PMA 1 Unit-Free with Install 1.00 $0.00 $0.00
Paid On Type Memo Amount
8/24/2020 Credit Card $1,221.00
Sub-Total $6,221.00
Tax $0.00
Total Due $6,221.00
Payment $1,221.00
Balance Due $5,000.00
IERNA Your Trust-IERNA Your Business!
I have the authority to order the above work and do so order as outlined above.It is agreed that the seller will retain title to any
equipment or material furnished until final&complete payment is made.And if settlement is not made as agreed,the seller shall have
the right to remove the same and the seller will be held harmless for any damages resulting from the removal thereof.Payments not
received within 10 days are subject to a service charge of 1.5%on unpaid balance.Returned checks subject to all applicable fees.
CANCELLATIONS:
DEPOSITS ARE NON-REFUNDABLE.All other Cancellations are subject to any permit fees incurred by said county.Applicable fees will
becorpe the financial responsibility of purchaser and/or property owner.
''Customers are responsible for registering their equipment within 90 days for applicable warranties.Please see warranty Terms and
Conditions
Above ordered work has been completed and I acknowledge receipt of my copy.
I authorize lerna's Heating and Cooling to charge the agreed amount to my credit card provided herein.I agree that I will pay for this
purchase in accordance with the issuing bank cardholder agreement.
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8/24/2020