The URL can be used to link to this page

Home My WebLink About03-2359 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 2359 Permit Number: 2359 Permit Type: MECHANICAL Class of Work: A/C CHANGEOUT Proposed Use: NOT APPLICABLE Square Feet: Est. Value: Improv. Cost: 2,845.00 Date Issued: 9/15/2003 Total Fees: 45.00 Amount Paid: 45.00 Date Paid: 9/15/2003 Work Desc: 'A/C CHANGE-OUT Address: 6141 20TH ST ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 02-26-21-0190-00000-0150 Name: GRADOWSKI, DEBBIE Address: 6141 20TH ST ZEPHYRHILLS, FL. 33542 Phone: - I I . 1_ REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of Thirty-Five Dollars ($35.00) 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 ,~'Warnlng to 'Owner: Your-failureto 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 and Fee Must Accompany Application.------~-- ____uu_____ ,_~lIuv.'()rk s~~!lbe_~erfor~ed in ~cordance ~ith City Codes and Ordinanc..e~___. '_~__ NO OCCUPANCY BEFORE C.O. ---_._~---,.._..._---_._-_.._._._~---_._-._---_._--_.----- "----..--.--""-- ~;f~~ ~MITOFFI CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER OWNER'S NAME 2)J2. U? ~ JOB SITE ADDRESS (; / CITY OF ZEPHYRHILLS PERMIT APPLICATION BUILDING DBPARTMENT 5335 8th STRBBT ZBPHYRRILLS, PL 33540 Phone: 813-780-0020 PBX: 813-780-0021 ~ r- /17 DATE RBCEIVBD _-/~~ . PLANS REVIEW PBB LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL ID # /J:< - ,2 t -;21- IJ/9tJ - t1~/)~/) - tJ/5tJ WORK PROPSED: [JNEW CONSTRUCTION (OBTAIN FROM PROPERTY TAX NOTICE) [J ADDITION [JALTERATION [J REPAIR [J INSTALL [JSIGN [J MOVE [J DEMOLISH PROPOSED USE: [JSGL FAMILY DWELLING [JMULTI-FAM1LY [J# OF UNITS [JMOBILE HOME [J OTHER [J COMMERCIAL [J INDUSTRIAL [J SWIMMING POOL o RESTAURANT & HEALTH DEPARTMENT APPROVAL DESCRIPTION OF WORK 1k BUILDING SIZE C#;(~ t: "C// SQUARE FOOTAGE 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. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REQUESTED [J BUILDING $ VALUATION OF TOTAL CONSTRUCTION [J ELECTRICAL AMP SERVICE [J FLORIDA POWER [J W.R.E.C. [J PLUMBING [J MECHANICAL $ TYPE OF CONSTRUCTION: [J BLOCK [J FRAME [J STEEL [J OTHER {? VALUATION OF MECHANCIAL INSTALLATION [JGAS [J ROOFING [J SPECIALTY [J OTHER FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREA[J YES [J NO BUILDBR COMPANY STATE CERT OR REG 1ST # CITY PROCESSING # SIGNATURE ****************************************************************** ELBCTRICIAN COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ****************************************************************** PLUMBBR COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ******************************************** ********** , L:7( COMPANY n;., STATE CERT OR REGIST # CITY PROCESSING # * ************************************************************** OTHBR COMPANY STATE CERT OR REGIST # SIGNATURE CITY PROCESSING # ***************************************************************** CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this permit may be subject to ~deed restrictions" which may be more restrictive than City regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions. B. 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 City of Zephyrhills Building Department, 813-788-6611. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the "Contractor Sections" of this application for which they will be responsible. If you, as the owner signs 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 may be an indication that he is not properly licensed and is not entitled to permitting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTUION 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 - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other that the "owner", I cerify 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. E. 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, City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other governmental 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 Regulation-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 *U.S. Environmental Protection Agency-Asbestos abatement I also certify that, if fill material is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addressing a "compensating volume" will be submitted which is prepared by a professional engineer registered in the State of Florida prior to permit issuance. 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 code. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of issuance, or if work authorized by the permit is suspended or abandoned for a period of six months after the time the work is commenced. One 90 day extension of time may be allowed for the permit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection must be logged during each six month period, or the project will be 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'. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". ^ SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged Before me this _____ day of 1L- by \ (Qa~~ ~f person ackno~ledged) Dwho is personally known to me, or ~... i" '. STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _day of by acknowledged 19 o who has produced (type of identification) and whoD did Ddid not take an oath. (name of person acknowledged) [1ho is personally known to me, or o who has produced (type of identification) and who Ddid Oiid not take an oath Signature of person taking acknowledgement Signature of person taking acknowledgment Name typed, printed or stamped Name typed, printed or stamped " '. n ': J/'l l' l'; I):.> iv,' ; i,'I" "')( It ~"'..I.. _. - ~.\ -, --, t li Cor - d If) ~. ,', .\' ()/_:~~/) O()U(jU HVAC qO~$ERVICE ORDER ;~;;INVOICE J-. ~~ '~and CoofingPmdut't; BAHR'S PROPANE GAS & Air. INC. ~~&I~ 44,U pJien Road Zephymilis. FL 33fJil (8U) 182-5013 BILL TO ; L '-.,..; ""-1;'; . 'J J I .i , i.----".. '\J(_~_. ,- ;, NAME (7 r- J.CJ ,',<,jj t' " 0AiE ,_/:~,"-~ -)-3 . -~.- " ..; STREET/" ~ ~_' I df": i ( ... , .' .r PRbMISED CITY > Pf/',' TECHNICIAN ./J'/:~; .~-' : CAll BEFORE A.M. - P.M. AUTHORIZED BY WOR~ T'18~ PFRFORMrD 1"': f ,L-! '~l !!' . I t ,~ ;' . ,1.'._ /;'.; - i : '""'~ .:nrc'liCA I I I : ! fr'~: OTY, MATERIALS & SERVICES UNIT PRICE REFRIGERANT R. LBS. Tc Ii) iV'/t' &1 I.. . l ;.. _~_ _;," S ' )1 ^ (,<..J /"i l/.X ." , ;-/~ , ,,~ /" -"'1 /!(i .r , r<(--~' c ,. _'r ,,";' i-." )-/. ,'I ;'.)(7 F o-t,:1/ ,~; " . ,/ ) ~,.... ! / I /". i C' c ';"71)! :[;;- I' , --?- FILTERS x > FILTERS BELTS HRS, 'i AMOUNT I I I I I I I I I LABOR RATE I I I I I I I MATERIALS & LABOR MAY BE CONTINUED ON OTHER SIDE TOTAL LABOR TERMS 1 have authority to order the work outfined above which has been satisfactorily completed. I agree that Seller retains title 10 equipment/materials furnished until final payment is made. If payment is not made as agreed. seller can remove said equipment/materials at Seller's expense. Any damage resulting from sakt removal shaU not be the responsibility of Seller. ~:T _).~ --.) ~ :;.-'~ . ~'-' r: I !....r /c.i.f_ - f: THIS WORK IS TO BE C.O.D. MAKE MODEL SERIAL NUMBER ENVIRONMENTAL CHECK LIST WORK PERFORMED --- RECOVERED OTY. TYPE/DISPOSITION RECYCLED _ _ RECLAIMED ...-- RETURNED ~-- DISPOSAL. "-'. DISMANTLED CHANGED OUT/REPLACED TOTAL S DESCRIPTION OF WORK PERFORMED .--i '~,.-- r..,----.--- '--'-'~-1 I I I I f ~'~'?- t-j L. .,: f1 I f b i i l_~ ,- .- -. ..j,-- RECOMMENDATIONS LIMITED WARRANTY: All materials, parts and equipment are warranted by the manufacturers' or suppliers' written warranty only, All labor performed by the above named company is warranted for 30 days or as otherwise indicated in writing. The above named company makes no other warranties. express or implied, and its agents or technicians are not authorized to make any such warranties on' behalf of above named company. .. REGULAR '~ SERVICE CONTRACT ,~ WARRANTY .., 1; CHARGE MAKE MODEL SERIAL NUMBER - ~-",.._-- NO CHARGE CONDENSING UNIT WORK PERFORMED COND'SATE DRAINS LEVELED GLEANED carl CHECKED CHARGE REPAIRED LE~,K IN COIL REPAIRED LEA..K IN COPPER #REF \ I I i i i I i ! I CHECKED ~AOTOR CHANGED MarOR REPLACED BELT ADJUSTED BElT REPLACED CONTACTOR REPL START REi.AY REF>!.. START CAPACITOR REPLACED RUN CAPACITOR ClE-ANED OR AOJ. CONTACTOA REPAIRED WIRING REPLACED FUSE REPLACED COMPRESSOR EIJAPORATOR COIL REPLACED EXP. VALVE ADJUSTED EXP. VALVE REPLACED CAP. TUBE CLEARED CAP. TUBE REPAIRED COIL LEAK REPAIRED COPPER CONN CLEANED COil AMOUNT I I I I /f~i~*t I I I.. I I I I I I r /1/1 I I I i I I , I I "" I i f : ~t)r,,:"j t (~,,____..J., ~ - r I I I f'--1~7 I "I I j , ,..j /!/.~~,r,.: "..... : ." .) C - \ I I .......--:----_______---------J I I I I I ... L r I I I TOTAL MATERIALS' 2., 1iJ'- LEVELED COIL ELECT. lrn~ REPLACED UNK REPLACED KUX REPAIRED WIRE REPLACED CONT ~ILTEns I TOTAL MATERIALS TOTAL LABOR TRAVEL CHARGE CLEANED MAIN DRAIN REPAIRED MAIN DRAIN CLEANED PAN DRAIN REPAIRED PAN DRAIN FURn OR FAN COil REPLACED BELT ADJUSTED BELT REPLACED PULLEY ADJUSTED PULLEY CLEANED BLOWER REPLACED BEARINGS OILED MOTOR OILED BEARINGS CLEANED HEAT EXCH. REPLACED HEAT EXCH. CLEANED OR ADJ. PilOT REPLACED THERMOCOUPLE REPAIRED _ VALVE REPLACED VALVE CLEANED BURNERS DUCT REPAIRED ADJUSTED THERI'.10STAT REPLACED ADJUSTED CLG TO\^JER CLEANED I PUi.1P~S\ GREASED REPAIRED CLEANED __. REPLACED TOTAL SUMMARY I I : I I /. I. , 1..-. TAX J" ~/ 1 .. 1 28$"...>/OQ ,~'