HomeMy WebLinkAbout20-1134 oa>toe City of Zephyrhills 'PERMIT 'i@ En,
5335 Eighth Street .;,,
= Zephyrhills, FL 33542 BGR 01134-2020
Phone: (813)780-0020
Fax: (813)780-0021 sue Date: 11/25/2020
Permit Type: Building General (Residential)
Street��Address�
03 26 21 0170 00000 0620 6833 Orlo Drive
+`�' �fit"
Ownerinforma#ion Pelrmit'Informations`C;ontractorinformat�on ;
Name: STEVEN DIVISH Permit Type:Building General(Residential) Contractor: RON IERNA'S HTG &
Class of Work:HVAC Changeout COOLING INC
Address: 6833 Orlo Dr Building Valuation:$0.00
ZEPHYRHILLLS,FL 33542 Electrical Valuation:$0.00
Phone: (808)342-7939 Mechanical Valuation:$6,583.51
Plumbing Valuation:$0.00
Total Valuation:$6,583.51 ✓(®J`�'G
Total Fees:$72.92 1 7/
6
Amount Paid:$72.92
Date Paid:11/25/2020 1:53:19PM
.m '" .a'-- ;✓i+rs.,:� = t�ai- •ts d� a '� �,�,�': r °*.a,�ys,, M"x',r+- ..Pc
)`�m, �
o�ect.Description ,�. t k - 4 _ ��I-r
A/C CHANGE OUT 3 TON PKG UNIT
Mechanical Permit Fee $72.92
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.
CONTRACTOR SIGNATURE PE IT OFFICE
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
- -- City of Zephyrhills Permit Application Fax a13.7e0.0021
Building Department
DWWROCelved G�/�]
t✓ Phone Contact for Permltlln : �J 9. — !f 2 s
4yff , (} G7
} Owners Name /7 Owner Phone Number 3�RP _9.3
Owners Address . 3 1� T' Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address !
JOB ADDRESS J V /-7 L/O�TT# � I
SUBDIVISION PARCEL
(OBTAINED FROM PROPERTY TAX NOTICE) I,
WORK PROPOSED NEW CONSTR ADDIALT [� SIGN [� Q DEMOLISH
e; ST � REPAIR
[PROPOSED USE 7 SFR 0 COMM OTHER Ii
TYPE OF CONSTRUCTION = BLOCK Q FRAME STEEL =
DESCRIPTION OF WORK mill
BUILDING SIZE SQ FOOTAGE HEIGHT
=BUILDING $ VALUATION OF TOTAL CONSTRUCTION
i
i
=ELECTRICAL Is AMP SERVICE = PROGRESS ENERGY 0 W.R.E.C.
PLUMBING �i `
MECHANICAL $ r I VALUATION OF MECHANICAL INSTALLATION
=GAS =] ' ROOFING SPECIALTY = OTHER
FiNISHED•FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
COMPANY
SIGNATURE
4
fitGNATURE ( ReGISTeRSD Y/•N FEHCURREn Y!N
S 'I
Address (� ( ucense#
ELECTRICIAN ( COMPANY ( 4
SIGNATURE ` REGISTERED Y/N FEE CURREA Y!N
Address License# l
I
i
PLUMBER COMPANY I
SIGNATURE REGISTERED Y/N FEE CURREA Y 1 N I
Address I..Icensc S j
SICHANICAL COMPAN i
GNATURE REGISTER Y i N FE URR /
( 111 Ii Address ice s 1
OTHER COMPANY j
SIGNATURE REGISTERED I Y/ N FEE CURM Y 1 N �`�
Address License#t — t
IIIi 61IIiiIIIIIIIIIIIIIIIaII h illII1D111111111111111111111111111011 i
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, j
Minimum ten(10)workng days after submittal date. Required onslte,ConsWction Plans,Stormwater Plans w/Slit Fence installed,
Sanitary Facilities&1 dumpster,Site Work Permit.for subdivisionstierge projects
COMMERCIAL Attach(2)complete sets of Building Plans plus a Ufa Safety Page;(1)set,of Energy Fortes.R-O-W Permit for new construction.
Mlnimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans wl Silt Fence installed,
Sanhary Facilities 8.1 dumpstar.Site Work Permit for all now projects.Ali commercial requirements must meet compliance
SIGN PERMIT Attach(2)sate of Engineered Plans. !
'PROPERTY SURVEY required for all NEW construction.
Dlrecttonsr. • .
Fill out application completely.
Owner$Contractor sign back of application,notarized
If over$2600,a Notice of Commencement Is required. (AiC upgrades over$7600)
Agent(for the contractor)Or Power of Attorney.(for the owner)would be someone with notarized!after from owner authorizing same
OVER THE COUNTER PERMIT ING (copy of contract required)
Remelts N shingles Sewers Service Upgrades AIC Fences(Plot/SurveylFootage)
!
Driveways-Not over Counter If on public roadways-needs ROW j
i
I ,
I
i
i
NOTICE OF DEED.RESTRICTIONS: The undersigned understands that thls: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.
UNLICENSEt) 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 applicailon-for which they'wlil be responsible. If you,as the owner sign as the j
contractor,that may be an.Indication that he is not properly licensed and.is not entitled to permitting privileges in Pasco j
County.
TRANSPORTATION IMPACTIUTILiTIES-IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation:Impact Fees arid'Recourse Recovery Fees may apply to the construction of new buildings,change of I
use in existing buildings,or expansion of existing buildings,as specified in Pasco County Ordinance number 89-07 and
9047,as amended. The,undersigned also understandsi 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 We,they must be paid prior to permit issuance In accordance with,appiicabte Pasco County ordinances.
CONSTRUCTION,LIEN LAW(Chapter 713,.Florida Statutes,,as amended}: If valuation of work is$2,500.00 or more,!
certify, that 1, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's i
Protection,Guide"prepared by the Florida.Department of Agriculture and.;Consumer Affairs. if the applicant is someone 1,
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.
CONTRACTOWSIOWNEit'S-AFFIDAVIT: i car*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 pem7it 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: I
- Department of.Environmental Protection-Cypress Bayheads,Wetland Areas and Environmentally Sensitive
Lands,WateriWastewater 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 ServiceslEnvironmental 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 j
"compensating volume"will be submitted at time of permitting which Is prepared by a professional engineer f
licensed by the State of Florida.
- if,the fill material Iis.to be used in Flood Zone A"in connection with a permitted building using stem wail
construction,i certify.that fill will-be used only to III the area within the stem wall.
If fill material is to be used in any.area,1 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 tots less than one(1)
acre which are elevated by till,an:engirieered 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.affldavit prior to commencing construction. I understand that a aeporate permit may be required for electrical work, .
plumbing;signs,wells, pools,4r conditioning,gas, or other installations not specifically included In the application.,A
permit issued shall be construed to he a license to'-proceed with.the work.and not authority to violate,cancel,after,or
set aside any,provisions of the technical icodes;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
justi iabie cause for the extension. if work-ceases for,ninety(90)consecutive days,the jab is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWtCE FOR IMPROVEMENTS`TO YOUR PROPERTY. IF YOU INTEND TO.OBTAIN FINANCING,CONSULT
WITHYOUKLENIDERORA TTORNEY. O CO DIN YOUR O C F CO ME C ENT i
FLORIDA JURAT-(FXA 17.43)
OWNER ORAr3ENT CONTRACTO
Subscribed-and sworn to for affirmed)-before ma this SyksFti,q �W.tor.arfisrft8dl LTS �r----
by \Lhlti-t �r�C
Who is/are personally knownto me or hasrhave produced Wh i re personally known tome or hasihave produced
as Identification. r as Identification.
i
Notary Public o a ublic
Commission No. Commission No. G
L l
Name of Notary typed,printed or stamped NOW o o `
SHERRI L LAYTON ,
Notary-Public-State of Florida
;y �l Commission#GG 475326
'fag F< My Comm.Expires Apr 1,202A
Bonded through National Notary Assn.
Invoice 67939166
lerna's Heating,Cooling & Plumbing,Inc.
18843 US Hwy 41 N Invoice Date 11/24/2020
Lutz, FL 33549 Completed Date
j 813-948-6355 Technicians Devon N.
#CAC1813676/#CFC1429475 Patrick P.
6 1 G,CO L `�+10 G C
Customer PO
Payment Term Due Upon Receipt
Billing Address Job Address
Chirstine Divish Chirstine Divish
6833 Orlo Drive 6833 Orlo Drive
Zephyrhills,FL 33542 USA Zephyrhills,FL 33542 USA
Description of Work
Warranty information: 10 year parts, 1 year labor.
Install date: 11/24/20
Client to pay with credit card upon completion.
Install customer supplied Thermostat.
Task# Description Quantity Standard Price Your Price Your Total
1564 3 TON HEAT PUMP PAC UNIT 1.00 $6,930.01 $6,583.51 $6,583.51
PH4ZNA036000--TP
AUXILIARY HEATER 5 Kw
Install customer supplied Thermostat
Transfer IAQ
STDPMA1-FREE Standard PMA 1 Unit-Free with-Install 1.00 $0.00 $0.00 $0.00
PACKAGE UNIT 1.00 $0.00 $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
Member Savings $346.50
Sub-Total $6,583.51
Tax $0.00
Total Due $6,583.51
Balance Due $6,583.51
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
become 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.