HomeMy WebLinkAbout04-2665
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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
'----'
2665
Permit NUmber: 2665
i Permit Type: MECHANICAL
Class of Work: AlC CHANGEOUT
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost: 4,288.00
, Date Issued: 1/21/2004
Total Fees: 55.00
Amount Paid: 55.00
Date Paid: 1/21/2004
Wor' Oesc: 3.5 TON CHANGE OUT
Address: 38511 7TH AVE
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Name: MARY RIDEOUT
Address: 38511 7TH AVE
ZEPHYRHILLS, FL. 33542
Phone:
I
i ----~~----------'------" .-.. .-... '.,' "".-,-- -----.-.......- ,-.--...- --.-- -.-.-.---. ' , '~-----..-...-' -., ..-
I REINSPEcnON FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
i charge of Thirty-Five Dollars ($35.00) shall be made for each trip for each trade:
,
i
i (a) Wrong address (b) Condemned work resulting from faulty construction (c) Repairs or corrections not made when
I 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
"Warnin9 to owner:Yourfailure-torecorcfi:l notice of commencement may result in-you-rpaying twice for
improvements to your property. If you intend to obtain financing, consult with your lender or an attorney
_1!t!!o~.!E!~()I'~iI'I~ty~ur not!ce of commence'!l~~t. II
Complete Plans, Specifications and Fee Must Accompany Application.
J\11,^,or~ shall be performed in~C:~C?!~~l1ce with City Codes and Ordinanc~~_
NO OCCUPANCY BEFORE C.O.
'&-e-
~d~__~~
CONTRACTOR SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
DATE RECEIVED
PLANS REVl:EW FBB
OWNER'S NAME \(.. \J e CJ'^-...-+- ~ \7,-\
, '
JOB ADDRESS 38S' (I 'Ie ;:J v-<...
I.t +- 1 ~
PARCEL ID # I J -;;J&, -;;2/ - 0010
--"7
L.. e
P h "11<- h. \, '\ I f'
1/9
PHONE 8/ ~ - 780 -7~-&8
3 .5 SLt J
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
J jC>) 00 - 0 I JC)(OBTAIN FROM
- - _______ __ PROPERTY TAX NOTICE)
WORK PROPSED: DNEW CONSTRUCTION
o ADDITION
DALTERATION
o REPAIR
o INSTALL
Os I GN
PROPOSED USE:~SGL FAMILY DWELLING
o COMMERCIAL
o MOVE
o DEMOLI SH
lLC pi fJc..u~+
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
D MOBILE HOME
D OTHER
DESCRIPTION OF WORK
D RESTAURANT
Y ~ ~ C' ~ ~( 0 '^-/t- .3.. ~ -\u- .___
SQUARE FOOTAGE / 7 0 ()
& HEALTH DEPARTMENT APPROVAL
~.Q.L f1,Vm,) 'S; p W LJ J~r(,)
I ~LJ pI 1 ,/ ,.cy.
HEIGHT
BUILDING SIZE
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
o BUILDING
$
VALUATION;OF TOTAL CONSTRUCTION
D ELECTRICAL
AMP SERVICE
o FLORIDA POWER · D W.R.E.C.
o PLUMBING
18 MECHANICAL
Od
$ ~I ;),88 ~
VALUATION OF MEC&ANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES
D NO
BUILDER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
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ELECTRICIAN
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
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PLUMBER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
** * * * * * * * * *,* * * * * * * * ** * ** * * * * * ** * * *** ** ** *-:-*-1< * * * * * *":* *!:*****,* * *:..** *
MECHANICAL COMPANY: ::-::> e Ie, U I c...e... {' /\f P f u~, - , 1-
~Lc7< ~~ STATE CERT OR REGIST II ('"eu~~
SIGNATUR . ~IT~ PROCESSING #
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OTHER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
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'. _l_ \j .1. J ...' V L ,._ J..d ,J_ L!_ L J \L .t' L .IJ} \ V .t L
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 reqllired by law, both the owner and contractor may be cited for a misdemeanor
violation under state law. If the owner or intended contractqr 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 Envi~onmentally 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 '::ertify that, if fill matetial 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 l
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".
IJbitOR~~ <
~ ~. V<t~~-
SIGNATURE: CONTRACTOR
~
STATE OF F~ORIDA STATE OF FLORIDA D
COUNTY OF ~5Lb COUNTY OF --L8SLb
The foregoing inst~m~nt was acknowledged The foregoing instr~ent wa~ acknowledged
Before me this ~ day of 1'DtllU A'r ' ltlJr-..2()oy Before me this ::-:;~ay of.]..Q,ul)..J"r-t, ' H ~O 'I
by .<:;J..Ar-OAJ L. 1~~A-iJ by ~ ~ btrD,J L.__I_M4J ,,"" ,
(name of person acknowledged) (name of person acknOWledg~d)
Dwho is personally known to me, or [1ho is personally known to me, or
g(hO has produced.(1 'hLtt: tf2,("f"-7"JZ-'-/L-{.g3-{) ~ho has produced F/... oW! Jl7.\J-792-11o~("f3-0
/' (type of identification) -./ (type of identification)
nd whoDdid Gfdid not take an oath. a d who ~did ~id not take an oath
i
taking acknowledgement
acknowledgment
Name
t~g~Q, printed or stamped
~~\~..r~ Joan V. Nowicki
NL'~\*~ MY COMMISSION # 00068394 EXPIRES
~'~';'''l October 30, 2005
"/f.iff. ,f-.."f." BONDED THl!U TROYFAlN INSURANCE, INC
....~..,.~~e typeJ/kln'P~d or stamped
t:"f\'T;!'\;-.." MY COMMISSION # 00068394 EXPIRES
~",:.~.~j October 30, 2005
"i:;;;i\-~~ BONDED THRU TROY FAIN INSURANCE, INC.
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ID
VI
ACORDru I CERTIFICATE OF INSURANCE I ISSUE DATE
12/23/2003
PRODUCER This certificate is issued as a matter of information only and confers no rights
MCGRIFF, SEIBElS & WilLIAMS OF TEXAS, INC. upon the Certificate Holder. This Certificate does not amend, extend or alter the
coverage afforded by the policies below,
5949 Sherry Lane
Suite 1300 COMPANIES AFFORDING COVERAGE
Dallas, TX 75225-6532
(469) 232-2100 Company ACE Insurance Co of Texas
A
INSURED Company ACE American Insurance Co
Service Experts LLC B
11747 87th Street North Company
largo, Fl 33773 C
Company
D
Company
E
This is to certify that the policies of insurance described herein have been issued to the Insured named herein for the policy periOd indicated. Notwithstanding
any requirement, term or condition of contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by
the policies described herein is subject to all the terms, conditions and exclusions of such policies, Limits shown may have been reduced by paid claims,
CO TYPE OF INSURANCE POLICY NUMBER EFFECTIVE LIMITS OF LIABILITY
LT EXPIRATION
A GENERAL LIABILITY CGOG19904623 12/31/2003 EACH OCCURRENCE $ 1,000,000
00 Commercial General Liability 12/31/2004 FIRE DAMAGE $ 1,000,000
o Claims Made 00 Occurrence MEDICAL EXPENSE excluded
o Owners' and Contractors' Protection PERS, AND ADVERTISING INJURY $ 1,000,000
0
0 GENERAL AGGREGATE $ 3,000,000
General! Aggregate Limit applies per: PRODUCTS AND COMP, OPER. AGG, see below
00 Policy 0 Project o Location
B AUTOMOBILE LIABILITY SCAH08004651 12/31/2003 COMBINED SINGLE LIMIT $ 2,000,000
00 Any Automobile 12131/2004 BODILY INJURY (Per person)
o All Owned Automobiles BODILY INJURY (Per accident)
o Scheduled Automobiles PROPERTY DAMAGE (Per accident)
00 Hired Automobiles
00 Non-owned Automobiles COMPREHENSIVE $1000 deductible
0 COLLISION $1000 deductible
B WORK~RS' COMPENSATION RSCC43528361 (All 12/31/2003 WC Statutory Limit I x I Other I I
AND EMPLOYERS' LIABILITY States/Stop Gap Included) 12/31/2004 EL EACH ACCIDENT $ 1,000,000
EL DISEASE (Each emplovee) $ 1,000,000
EL DISEASE (Policy Limit) $ 1,000,000
EXCESS LIABILITY EACH OCCURRENCE
o Occurrence 0 Claims Made AGGREGATE
A PRODlIICTS/COMPLETED OPS. CGOG19905330 12/31/2003 Aggregate Limit $ 6,000,000
12/31/2004 Occurrence $ 2,000,000
CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, THE INSURER WILL ENDEAVOR TO MAIL 30
DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.
BUT A FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE ISSUER, COMPANY, ITS AGENTS OR
REPRESENTATIVES,
Authorized Representative ~1/~
CITY OF ZEPHYRHILLS
5335 8TH ST.
ZEPHYRHILLS, FL 34248
Certificate ID # RAO-06BA
ROBERT HUGUES ENTERPRISES INC.
7510 NEBRASKA AVENUE
NEW PORT RICHEY, FL 34653
(727)847-5806 FAX (727)847-5211
EC - 0001040
OCTOBER 4, 2002
TO WHOM IT MAY CONCERN AT CITY OF 7.F.PHY'RHTT.T.~
BUILDING DEPARTMENT
I, ROBERT HUGUES , HEREBY AUTHORIZE THE FOLLOWING NAMED PERSON OR
PERSONS TO APPLY FOR, SIGN AND PURCHASE PERMITS AND/OR LICENSES ROBERT
HUGUeS ENTERPRISES INC.
THIS LIST IS TO REPLACE ALL OTHER PREVIOUSLY ISSUED WHICH ARE NOW TO BE
CONSIDERED NULL AND VOID.
AUTHORIZED SIGNERS: ROBERT HUGUES
DONNA M. LEONARD
MARYANN MARTINENKO
LORRIANE ENGLE
MARK MADISON
CHUCK LEGGETTE
SHARON HALL
JEFF HAWLEY
JOE VADDER
RUDIE NEWMAN
WILLIAM MOREJON
WESLEY RAKES
RICHARD LEE KING
M. SUE ULATOWSKI
LISA WILLIAMSON
RYAN MC CABE
CATHY GALLAGHER
MARK MILES
JOAN OLSEN
~ ROBERT VAUGHN
CONTRA~
SWORN AND SUBSCRIBED BEFORE ME THIS 4TH DAY OF OCTOBER_ 2002
~fpUBlI~T.(~iF~
....~~ Sharon L Hickman
f.fi}:-% MY COMMISSION # CC824651 EXPIRES
~~. .: i AprilS, 2003
~. ;;r.i....- BONOI:D THI1U TROY FAIN INSURANCE. IN<:
RONALD WE ISENSEE
DIANNE MIRIMONTI
JERRY LEE PECKHAM
RA YMOND KARLESKIND
WILLIAM "ROCKY" RHOADS
JEANNNIE LEWIS
SHARON HICKMAN
JOANNA EHNIS
BRITNI WILLIS
EC - 0001040
LICENSE NUMBER
= Service™
.. Experts
"YOUR fST CALL"
Heating, Cooling and Indoor Air Quality
City of Zephyrhills Building Department
19 September 2002
I, Dennis L. Creviston, holding state certification number CAC057008, hereby authorize
the following named persons to apply for, sign and purchase permits, complete jobs and
represent me due to code violation for work performed under the name Service Experts,
LLC.
This list is to replace all others previously issued, which are now to be considered null
and void.
Authorized Signers:
Jeannie Lewis
M. Sue Ulatowski
Robert Vaughn
Sharon Hickman
Jeffrey Hawley
Joanna Ehnis
Britni Willis
SSN
264-89-7857
378-46-6807
419-06-9876
225-60-6927
593-54-3891
589-60-7387
589-22-2156
FL DR. LIe.
L200-790-65-945-0
U432-557 -4 7 -910-0
V250-767-69-187-0
H255-792-46-683-0
H400-437-71-466-0
E520-432-79-789-0
W420-072-83-741-0
~..w.L '7-t4--0;1./
Dennis L. Creviston Date
Contractor License CAC057008
STATE OF FLORIDA
COUNTY OF ()~e.,
The foregoing mstrum t was a~knowledged. be~ore me thist?<1h-
2002, by /)eJ1l'1i5 L .&vI.:shYJ who IS eIther
V-- Personally Known OR Produced Identification;
Type of Identification Produced:
~4 t2 '11~
~ of NotlID' Public
1'-1-. I(()~
Printed Name of Notary Public
My commission expires:
~ ~ Ozella A Rohrer
!'J .; My Commission 00091347
'\'1;..1 Expires February 11, 2006
day Of~,
Service Experts, LLC . 11747 87th Street North. Largo, FL 33773
Pinellas (727) 397-0500 . Fax (727) 392-0800 . 1-800-570-KOOL (5665)