HomeMy WebLinkAbout03-1937
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N~ 1937
(813) 780-0020 ) I
Date 2~ Jlt I\J?-
- .
BUILDING
elECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Property Owner: {AJ I LL-l f'M (~ / 5~bVl:A j)1ViIVIrlttJ
Job Address: ~L8'f ib ~ ~~ I
Parcel I. D. "
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
DescriDtion of Work
Energy Code: Radon Gas:
Z 1\1&vJ It /(. s 'f~ T~s.. ^ \u A\ 'l< r r .-UoIlIC
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.
DATE
Inspector _
~
Permit Fee ;;.J
S;gnaMe ~ _ _ ~~
Company
Address
Telephone#
Valuation or ~.., ~U
Contract Price ';/ ')
City license Registration #
State Certified license#
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
]J7J~ ~1)'\1%Z
TO- v~~o
MECHANICAL
Ftr.
Pre SLB
lintel
FRM.
Insul. CL
WL
ELECTRICAL
Breakers
Ducts Insl.
Compressor
Final
Driveway
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of twenty-five and 00/100 Dollars ($25.00) 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.
FLA. 1977 lI\WS
FS 713.13
SEMINOLE FORM 408
NOTICE OF COl\tlMENCEMENT
~:a:~:f o:lorida f- ~ } IPR~PARE IN DUPLICATE' ~~~~~ll~I~!~1I111111I111111I111111111I11111I111111I1
The undersigned hereby informs all concerned that improvements will be made to certain real property, and in accordance
with section 713.13 of the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT.
Description of property '" .17.r~r..,. ../Ct. Tlt.......~ -"'("'.~r:;:-T... ';:a~t/#...../ /-:-.;?~.~;?I.-:-.Qo.l.9.-:.I9 .Joe
7 . 7-'~'I!t ~C ~ Ol{10
. , , . . . . . . . . . . . . . , . . . . . . . ~ ~,.J:!.V.7 . . . .1(, . .~) . : .~. . . . . . . . 31;;1.? Y:?:-:-: . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
... ...... ..... ... ... ........... ..... .................. ... ..... ..... .-......................... .............. .....................
-1/. /1/... ;f Rcpt: 664279 Rec: 6 00
Generaldes~ionofimprovements ....,4.?...,..~~,<=?~~.._",. ~~~l~i~~ IT: 0:00
Owner.. ,~~~. .:J::kI(fJ~~q.0,...,...,. '......,.,....".,..............., . ,.............,........ . .D~~Y. .Cl~"~.
,.. .7:Y3.Y,.., . I?? t~,... ~1. .'.... "?~~".(~).EC.... .~!~~rb........................
Address
Owner's interest in site of the improvement. . . . , . . , . . . , . . . . . . . . . . . . , . . , , . , . . . . . . . . . . . . . .
Fee Simple Title holder (if ether than owner) i~91~~~lf'lAIs:~':;O fOUNT!, C\ERK
OR BK 5279 PG 1101
Name ....... .,....................................,.,................, .......... .. ........ ....... ..........
R
Address......... ........:...............,...,..~..................~.... ... f..... . .... ."...: ....................... ..... .. .....
Contracto'...... vL"" ~kC.. jk~~c~... U9...... (J-a:tlU'L~.,...........
Address....... ~5.cJ.-1..... .4/:...... )(I.'1??/ !i.tf.15lf.4.. .~~.-. .'.... T~? F(.... ?-!.o/(t(....
Surety (if any) ..............................,...........,.....,......
Address ...............................................,...,....,...........
Any person making a loan for the construction of the improvements:
.. .... . . . .Amount of bond $ ...
Name ..............
Address .................................,........................,........................................,
Person within the State of Florida designated by owner upon whom notices or other documents may be served:
Name ....... ....
Address ................ ..,........................,..,..........."...................................... . . . . . . . . .
In addition to himself. owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.13 (1) (h), Florida Statutes. (Fill in at Owner's option).
Name
Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
THIS SPACE FOR RECORDER'S USE ONLY
(-
... .~~:)~'.
,.'1...---__________
Owner
Sworn to and subscribed before me this . .
1 q f '-'~ 'it (':> .~ (k~. . . ')" . .. .
........................dayv
.M.t~HtS.?10'J ~~ '~~~.~2Q~ .
~
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7.1/)"",
19..F:..:::. ..
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING nIllPARTM~NT 5335 8th STRIllET ZIllPHYRHILLS, FL 33540
Pho~eI813-780-Q020 FaxI813-780-0021
IJA'rBJ RIllCBlIVIllD __, ___ __,~
PhANS RBlVIEW FIBI .
OWNER' a lIA"EJ!I{~!".._~~~-Z>L/~v::_._. _._ PHONE CONl'A<,"._._-::: __
,J08 SI'l'El AD1}RElSSL_2..'!'.3/-_LLt..~~ -~~'-f_L._________________~_________._________.__
IJB1(]1\L DBJSC!RT P'I'IUll: LOT (S)
BLOCK
SUBDIVISION
-_..~.~-------.. _.. ._-~'....._- ._, -_._~~---
PARCEl, II.l #
WORK PROPSElIJ I [.J NEW c'ONS'I'RI1CTlON
-.----_._-------'-------_.__.~._._-~--_._-._-_._-------'_.._-_...__._-+---~._._._-,
(OBTAIN PROM PRoPER'ry 'I'AX NO'l'ICEl)
- - .----.__~____4 -----+-...._. ...~_~... ~ ......_ _.~..__.,_____ .__0
rJ ADD I'I' ION
o AUrElRA'rION
[J RElPAIR
[J IN8'rAIJI,
r.::J s rem
[J MOVE
[J DElMUl,ISII
PROPOSED USE: I [Jsm, Fl\MII,y DWEJU,H1Gl
[]~1lJW'I" FAMIl,Y
Cl# UF UNl'l'S
CJSN1MMINl1 POUL
[] 1108!I,El llot1HJ
IJ OTHER
[] COf1MBlRl'JAI,
[J INDUSTRIAlJ
L~J RE1STAURANT & HElAI,TIl DElPAR'll1EJNT APPROVAL,
J>EJBCRIPTION OF NORK
B!1IL.flINt~ SIZEJ
N___~____.______.__...______..___~._,__ .._.___.__._..~_.___.._.____.__.________.____.. ____.___.._ ...~__.__
--_.~_._---._----
SQUARE FOOTAGE
I/EllI1H'r ._._____._ __________
RES IDIllNTIAl. I A'!"I'l\ClI (:2) PL,o'!' PIJAI1S & (:2) SElTS OF BUHDINl3 PLANS & (1.) BEl'!, ElNElRnV FORMS,
COHMBlRCIAL,I A'I"liACH (3) SE'I'S OF BUtLDING PLANS & (1) SET ElNElR(~Y FORtIlS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONS'I'RUCTION.
~ERMITS REQUESTED
lJ BlnLIJINf3
1:.1 ElLBlC'I'RlCAI,
$__.
VALUATION OF TOTAL CONSTRUC'I'IOH
-.---.-----------
AMP gElRVICEI
o
FI,ORIDA POWElR
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[] PWt18ING
~HANIC!A.rJ
[J (ms
rJ ROOFING
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$_.-~/.3 ~O_~_ VAIJUATION OF tIlElCHA.NCIAr. HlS'I'AI,I,A'I'TON
-Yj
LJ SPEJCIAUry [I O'I'HEJR
TYPEl OF' COH8TRtJ(!'l'IDH I [J BLOCK
[J FRAJIIEJ
[J STElEL
[J OTHEJR
FINISHEJJ Fl.UCJR ElIJElVATIONS
IS PROLrEC'I' IN FLOO/) ZONE ARElAO YElS [) l~o
BUI LDBlR CDt1P A N Y____ .._____...___.__________.. _'_____h__ .. ___....______._.__
STATE CEJRT OR RElrns'I' # __________________._..
81r31~A.TUREl __.__________.______________________.______ CITY PROCEl8SUTG L_ -__.__._h_._____. __.__ ____.__.._._
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8 J (mATURE: _m_
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C011 PAN Y ._h_____...hH __, __ ___ ______ .______ ___..._______._.._
STATE: e'ERT OR R@CHS'l' #
CITY PROCE881Nl~ #
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.LIAVUIJlJlV ,LlWij:!ld ,if 0 SNOIJ,HJNO~)
JUliOR HERIAloEz
Heating & Cooling Contractor
Contract for Business
This a special pricing quote prepared for:
William C. Green
Sandra Dallman
5434 16th street
Zephyrhills, FL 33542
Junior Hernandez Heating and Cooling agrees to supply and install (2) 2.5 TON 12 SEER
Gibson Heat pump Systems. The location ofthe air handler shall be horizontal in the attic
area provided. There shall be a new secondary metal pan for the air handlers along with
safety condensate overflow devices. The condensing units will be installed in the same
location as the old and shall sit on existing pads.
Main refrigeration copper runs will be fe-used, all existing air ducts will be re-used, main
drain lines shall be re-used, all electrical lines and connections shall be re-used * with
exceptions to breakers (only if needed). New digital heatpump thermostats will be
included.
The warranties are as follows:
10 year Parts
10 year Compressor
] 0 year Labor
The 1 st year labor warranty shall be provided by Junior Hernandez Heating and Cooling,
the additional Labor Warranty shall be provided by Nordyne Watch Dog Program.
Junior Hernandez Heating and Cooling agrees to perform all work described above for a
compensation sum of $ 5350.00 due upon completion
Junior Hernandez Heating and Cooling agrees to install said equipment on a timely basis
and conform to all existing codes and implement all new building code requirements.
A Florida Power 12 SEER Heat pump rebate form shall be filled out for each system that
is changed out.
Free Estimates
4521 W. Knollwood St. . Tampa, Fl33614 · Zephyrhills Office: (813) 782-8428 . Fax: (813) 884-1648
24 Hr. Emergency: (813) 299-0423
lic. No. CAC058251
Junior Hernandez Heating and Cooling is a State of Florida certified HV AC in previty to
lien contractor LiC# CAC058251
I have thoroughly read and understand all terms and conditions of this contract between
Junior Hernandez Heating and Cooling (a State of Florida HV AC contractor); Sandra
Dallman and William C. Green referred to as (owners).
Furthermore we the (owners) state to have the authority to make such decisions for said
property located at 5434 16th. Street Zephyrhills, Florida 33542.
And do so authorize the above entitled contractor to start work immediately.
Sandra Dallman (owner) a--.
William C. Green (owner) tj; ~ C'. ~~/
JuniOrHernandez(contractoG~
-y 4r~ -Ii> ~.aw / I ~~
J;:; h
-,
~~;~~%~~~T~~~k)~ L)
On thi~ \ 0.1' . l\~ " - ,,-..
.3, .'1-' nf I ( I, ,., "" "\ I! ........
th'" fi' - .---' J - '- ^.I:.! h ..- J' )
v.oregomf!~~"M"o,l ~_'_ '_ , -
" . \ i '-F:', 'l" '!!1ent was acknowledged before
\,,2"\ . '-LJ .-.......-
~;' ~~-;tkn,:c:,::
- -__._.....l:....i..--.::... .
OFFiCiAL '':::'''.' _
I'..,." J1i"./'I-"~
N 'Viu:lRYN D - ."'; ;>:_i-l.r:--
O'rARYPUBu 'HERRIMAN /
Co c sr A.TE 0'-' 1
M'Y........~MISsION No r-.-: F.....OR.IDA
~. '!-VlY1M'-,....,. ........ . '. . L<' J:n lS3[l .
-...."'.. ,-
STATE OFFLORIOA
DEPARTMENT OF INSURANCE
OfVtSIONOFWORKERS' COMPENSATION
CERTFlCA TE . OF EXEMPTION.FROMfLORtDA WOAK.ERS'COMPENSATfQN lAW
1.2-06-2002
CONSTRUCTION INDUSTRY EXEMPT!ON
This certifies that theiodlviduallisted belo.w has elected to be exempt from
Florida Workers' COIl1PCJn$8tion law ,
EFFECTIVE
PERSON
12/07/.2002
EXPJRA TION DATE 12} 06 / 2004
HEP.Klib.~EZ
JUN.!OR R
S~N
072~.64 -::\42S
FEW
BUSINESS
59321293J
HEP.NANDEZ JtJlUOR HEATlNG it COOL um
-4521 W KNOLLWOOD ST
'I'A.."1PA F'L:5 3 614
NOTE: Pursuant to Chapter 440, 1(H1},{g), 2.LS . a so~prollrietor. pattner, or an
offfettr -of. '" CVJ.V4KilIlluil '.1lIrhu .Cluct~ eAUlJ~tiun (nn.. tI~nul ide. Wo.L'OO. .t;..'
COmpen$tltion Law. mav not recovel" benetitt or. eompenution under Chapter 44 () ,
NEASE cm our HtE
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CUT HERE
· Carry bottom portion 01'1 the Job, ~ upper portion for your records.
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