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Q
11111 of] City of Zephyrhills PERMIT NUMBER '
5335 Eighth Street
Zephyrhills, FL 33542 BGR-001`631-2021
Phone: (813)780-0020
Fax: (813)780-0021 Issue Date: 03/05/2021
Permit Type: Building General (Residential)
Property Number Street Address
13 26 21 0130 00200 2050 4801 Airport Road Unit 205
Owner Information Permit Information Contractor Information
Name: JOHN&MARY MATTISON Permit Type:Building General(Residential) Contractor: CHRIS'A/C COMPANY
Class of Work:HVAC Changeout
Address: 1309 S River Dr Building Valuation:$0.00
WABASH,MN 55981-1753 Electrical Valuation:$0.00 4r",
Phone: (651)564-0872 Mechanical Valuation:$4,789.00 Plumbing Valuation:$0.00 ( — v
- Total Valuation:$4,789.00
Total Fees:$63.94
Amount Paid:$63.94
Date Paid:3/5/2021 12:48:06PM
Project Description
A/C CHANGE OUT 2 TON
Application Fees
Mechanical Permit Fee $63.94
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.
aj�a4V4
CONTRA4RES
SIGNATURE PE IT OFFICE
MIT PER EX 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
11 - I Building Department
Date Received
Phone Contact for Permitting —
Owner's Name Owner Phone Number o�
Owner's Address 0p Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS 5�?D c Aws LOT# O�
SUBDIVISION F PARCEL ID# / O?6 off d
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED R NEW CONSTR R
ADD/ALT = SIGN = = DEMOLISH
INSTALL REPAIR
PROPOSED USE = SFR 0 COMM EZ OTHER
TYPE OF CONSTRUCTION = BLOCK Q FRAME = STEEL =
DESCRIPTION OF WORK O y�
BUILDING SIZE SQ FOOTAGE HEIGHT
=BUILDING $ VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C.
=PLUMBING $
E!AECHANICAL VALUATION OF MECHANICAL INSTALLATION$
=GAS = ROOFING Q SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
. . . . . . . . . . . . . . . ... . . ._ . .
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
BUILDER - COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address I License#
ELECTRICIAN COMPANY
SIGNATURE, REGISTERED Y/ N FEE CURREN Y/N
Address I License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License
,#J
MECHANICAL COMPANY G
SIGNATURE REGISTERED "N FEE CURREN Y N
Address 1104 3,5 U License#
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
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)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 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 89-0,7 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 Ipact
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 IIto:
- Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sehsitive
Lands,.Water/Wastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Itering
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 NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F.S.117.03) -
OWNER OR AGENT CONTRACTOR
Subscribed and swom to(or affirmed)before me this Subscribed and swom to(or affirmed)before me i
by by
Who is/are 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
Commission No. Commission No.
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
C SA/C
H R1
COMPANY ! AIR CONDITIONING
& ELECTRICAL
J
CAC058575 / EC13007703
Proposal Submitted To: Date: 3/3/2021 Phone: 651-564-0872
John &Mary Mattison
4801 Airport Road, Unit#205 Job Name: Same
7ephyrhiNs, FL 33542 Address: imimkitt@wabasha.net
Furnish and Install 2 ton First Company Air Handier(Model#24HX5) and 2 ton Trane Stralg#t Cool
14 seer Condenser(Model#4TTR4024) "jrg, , FO U3o;,, ,
Includes: Connecting to existing ducts and electrical, digital thermostat, breakers, permit,anchor,,
condenser to stand, 8 kw heater.
Price$ 4,789.00
Warranty:
Chris'one year.limited warranty on materials and labor.
5 Yrs Limited.manfacturers warranty on compressor _
5 Yrs Limited warranty on equipment only parts.
1 Yrs Limited warranty on labor
Payment to be made as follows: Q Due upon co m. .letion ra.
CHRIS'Authorized Signature: ,
NOTE: This proposal may.be withdrawn by us'f�accepted within 30 s.
I have authority to order the work,which shall be performed as outlined above. It is agreed the seller will retain title to any equipment or material that
may be furnished until final payment is made,and if settlement is not made as agreed,the seller shall have the right to remove same and the seller will
be held harmless for and damages resulting from the removal thereof.I agree to pay all cost and reasonable attorneys fee if this invoice is placed in
the hands of an attorney for collection.Seller is subject to restocking charge if job canceled
FINANCE CHARGES:Balance due over 30 days 11 IWA INTEREST)PER MONTH(IVA ANNUAL RATE)will be Imposed(where.applicable).
Customer Acceptance Signature:
Signature: �? ;�„n, Q z l� r_C U �-.Q Date:
Signature: Date:
12232 US HIGHWAY 301 DADE CITY, FL 33525 PHONE 352-521-4977 chrisaccompany2OOl@yahoo.com
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