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Home My WebLink About93-3508 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit N ~ 350SJLf 9-c2/- 9~ . Date BUILDING ELECTRICAL PLUMBING ~~? Sewer Conn Property Owner: t d!u~ ~ ~ ~2 Job Address: 3JY3 '// ("~~.~ fL.. Parcel J.D. # ~- 'd-~ .-;;Zl- 0;;).../13 -- 0 ~ E tJ 0 -- (:) 0/ D Water Conn: Water Meter: T.I.F.'s: Zoning: Energ~ Description of Work -4/ L- c~ (J Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. c.o. Inspecto Valuation or Contract Price .3 c2. r;- t:l. L/O ) Pe,m;t Fee~ Signature ...I Z-~ Company Address City License Registration # h 7 State Certified License# ~-02J- CJ.t/02/J Telephone# BUILDING ELECTRICAL PLUMBING Ftr. Pre SLB Lintel FRM. Insul. CL WL Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compressor Final Driveway REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of Fifteen and 00/100 Dollars ($15.00) shall be made for each trip for each trade: a. Wrong Address b. Condemned work resulting from faulty construction. C. Repairs or corrections not made when inspection called. d. Work not ready for inspection when called. e. Permit not posted on job site. f. Plans not at job site. g. Work not accessible. The payment of inspection fees shall be made before any further permits will be issued to the person owning same. APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT Jack's A/C & Heating ADDRESS 12601 Abbey Drive Dade City FL 33525 Ii 6' OWNER E ~U/,' >1 A. i. e r'<I.H d PHONE~ 904) 521-0420 JOB LOCATION3.s;33.yj r;MMLA.JOOd. PI,. LOT SIZE_____X AREA SQ. FT. SUBDIVISION lJr;{fw~od l'2J-l"k/'J f" LEGAL DESCRIPTION: LOT(S) BLOCK PARCEL I.D.~F (!;>J - .2...~-;zI-C'..z..IB OOEOO 00/0 WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install ____Sign/Temp. ____Sign ____Move _Demolish PROPOSED USE: _Single Family _M/F ____# of Units ._M/H _Commercial _Indust. ____Swim. Pool Other _Restaurant & Health Department Approval BqILDING SIZE: x Square Feet, Height RESIDENTIAL: COMMERCIAL : ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED ____BUILDING $ Valuation of Total Construction _ELECTRICAL ~MlcHANICAL AMP Service Florida Power Corp. _W.R.E.C. $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Frame _Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** Signature CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration # ****************************************** BUILDER ELECTRICIAN Company State Cert. or Regist. # City License Registration # ****************************************** S hma ture PLUMBER Signature Company State Cert. or Regist. # City License Registration # *********************~******************** Signature Company Jack's A/C & Rea tinq State Cert. or Regist. #CAC041220 City License Registration # 69 ****************************************** MECHANICAL OTHER or Regist. # . .tJ;.'i!.t ion iF ~~~H ************ ~*~~******** Company State Cert. City Licen Signature t APPLICAbollJ ~m6VEDBYM"" PE/itJOFFICER . t CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perait aay be subject t~ "deed restrictions" which lay be lore restrictive than City regulations. The undersigned assules responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they lay 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 lay be cited for a aisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813) 788-6611. Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorls) sign portions of the "Contractor Sections. of this application for which they will be responsible. If you, as the owner sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign as contractor that lay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE~ D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - Hoaeowner's Protection Guide. prepared by the Florida Departlent of Agriculture and Consuaer Affairs. If the applicant is sOleone other than the "owner", I certify that I have obtained a copy of the above described doculent and prolise in good faith to deliver it to the "owner. prior to cOllencelent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforlation in this application is accurate and that all work will be done in co.pliance with all applicable laws regulating construction, zoning, and land developlent. Application is hereby lade to obtain a perlit to do work and installation as indicated, I certify that no work or installation has cOllenced prior to issuance of a perlit and that all work will be perforled to leet standards of all laws regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other govern.ental agencies lay apply to the intended work, and that it is IY responsibility to identify what actions I lust take to be in coapliance. Such agencies include but are not li.ited to: , Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive Lands, Water/Wastewater Treat.ent , Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses , ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways , Departaent of Health L Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks , US Environlental Protection AQency - Asbestos abatelent I also certify that, if fill aaterial is to be used in Flood Zon? "A" or "A,etc.", it is understood that a drainage plan addressing a "colpensating volule. will be sublitted which is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A pertit 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 perlit prevent the Building Official frol thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beeole invalid unless the work authorized by such perlit is cOllenced within six lonths of issuance, or if work authorized by the pertit is suspended or abandoned for a period of six lonths after the tile the work is cottenced. One 90 day extension of tile, lay be allowed for the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection lust be logged during each six lonth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COM"ENCEMENT KAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY~IF YOU INT.. END TO O~~.. FIN.ANCING' CONSULT WITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COKKENC .!J7If.9B~JUND~$2~N VALU~ NOT NEED ~~RECORD AND POST A "NOTICE OF COMMENCEMENT", W'VV"L . j[JL,~ 0Lt1J x SIGNATURE: CONTRACTOR SIGNATURE: OWNER OR AGENT STATE OF FLORIDA COUNTY OF ?.v 5 C 0 The foregoing instrument befc.re me this 9 - / ~ was acknowledged , 19..2.Z by STATE OF FLORIDA ~ COUNTY OF . The foregoing invrument before me this -~/ - was acknc.wledged , 19~ by E~/li;>1 A. l~ G/I"'iY)1d who is personally known to me or who has produced /,?>"A7~~-, / ~,.aR as identification and who ~/did not take an oath. ::a,,~'L ~ ~- ~--' ~gnature) .--:-- :JOht'\ y-; {~Ld:.s cA My eomm. Ellp. Jdl8 21. tll7 COW ICe 298157 known to me or who has and who did/did not , ......." (Name Typed, NOTARY PUBLIC (Name Typed, P NOTARY PUBLIC 24 Abbey Drive Dade City. Florida 33525 JJA<cm:I)~ ~Alirr CC:OlDl<tlfinficmll!ldll!l~ tdI ~ IHIuftalllie TO ,f;' W; J1 f.;;,1!. ... .... cI . ,_3'-/ J C_ _~ooe.R- 'PI 7.,^h "1"/1;1/$ /Z 335''/6 {f , , We propose to furnish all labor and e4u1pment<< license and permll when necessary) for complete Inslallatlon. 10 be lested and ready to operate at lotation above. Cert. # Ca C041220 Sales and Service Phone: (904) 521-0420 Service Contracts Available LOC A TION OF J~8 CDY-iff '-c>oocA.. ~ DATE: L.H1...e S-j7-'l3' 788- ~o~/ We have carefully analyzed your equipment and guarantee the e4u1pment to be of suffi\:lent capa\:lly 10 produce deSign conditions a\:cording to Fla. Energy Code High of91 0 outdoors temperature and 780 indoor temperature. Building r.ust be kept reasonably tlghc Windows and doors kept closed except for normal passage of persons and properly Insulated I mintmum 01 1'1 m\:hes thld I. L ~ n X 0'-' #~~/ ~ J'K.f Equipment Includes: I. Air Handler with: 2, Condenser Unit II '7. .0 3. ThennostaleMO.1I ToIalBlU'sJO 4. Supply.Grille & R A -fL;o$' t' H ~ sJ't!':.h1.0il~ D' nJ6"'" nJxd;"'~ -rra>.rl -/A~ al~'c. 6. ;:r;x/~.. #;7/;:,~1i-~fJ~~'1pqlir <u 1:;t1r;.~ .t~dl:~12 ;;1:; ;,~.J_~ "Jr'N ;;%7i ~{1!~;1:$~f;li[~;xr;j~~:* ~;f 14. ~ :~: 51~;~J~ &>/!->;~yr;.fy~~::-~~~C^~~~~jvc-t: :10~~J:c; ~::~:L, C~ek ;i~i~;~1:~ j,;.~~SM -rrJ~~-J:1;~[?~~"-. ~~~m: ~g 21. / y~~~}" bP( L;..I~rir &I.....,ewt 30</5'- 22. 23. 0 tion: Insulalion - 24. U -Grade Senice Yes 0 :-';00 Size 2S ExistinR CeilinR-DamaRe 0 Yes 0 :'110 Duct work will be d!sign~. fabricated and installed in accordance with American Society of Heating & Air Conditioning Engineers Standards of .e::;.. /S~J-f. 9 Supply and return registers and grills will be properly sized and of aluminum. . , LIMITED WARRA:'IITY AN D SER VICE: All equipment. materials and controls furnished by us has a I year warranty. from the date of installation. against defects in workmanship and material. In addition we extend to you the manufacturers 5 yr. protection plan on the compressor. Our one year service responsibility does not include breakdowns of Air Condtioner due to blown fuses. tripped breakers. dirty filters or plugged drain lines. Warranty service will be performed during normal working hours of 8:00 a.m. to 5:00 p.m. Any request for service after 5:00 p.m. or on weekends or holidays will be billed to customers at current billillJ rates of time and one-half. For this service the purchaser a ees to p~y e seller the su of4~ '?(') 'IS- eP Dollars. including tax. Payable as follows: . Price 4uoted not valid after 30 days. his order contains the entire agreement affecting this purchase. :-';0 other agreement. understanding or warranty has been made a part of this contract unless written herein. "If this instrument is referred to an attorney for collection or enforcement. the maker agrees to pay a reasonable attorney's fee. plus court costs. If the maker is delinquent for a period of thirty (30) days. a delinquent fee of 1'.I:Cf per month will be charged. Title to the installed merchandise rema ins vested in the seller until all money due.as the results of the sale has been paid to the seller. Your acceptance below will be our authority to proceed with the installation. Thank you for your business." .Jacks Air Conditioning and Heating A",."" o~ P."h.,,, ~ # ~ ~HJ! ~ ,...Sales resentaU\e IL.S.) Bv VAU'D O:'liLY IF SIG:'IIED BY COMPANY OFFICER