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Home My WebLink About04-2740 r~ . CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 2740 Permit Number: Permit Type: Class of Work: Proposed Use: Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: 2740 MECHANICAL AlC CHANGEOUT NOT APPLICABLE Address: 38719 8TH AVE ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 4,000.00 2/12/2004 50.00 50.00 2/12/2004 CHANGE OUT Name: TED TROY ANa Address: 38719 8TH AVE ZEPHYRHILLS, FL. 33542 Phone: I I I I --.~------._-~ - , - I ______~___ 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 -"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 and Fee Must Accompany Application.----------- ----- ----- __ __A~"",ork shall be performed in accordance with City Codes and Ordinances__ ________ NO OCCUPANCY BEFORE C.O. -- --;-/3-7) - - -- --- -- --------------~-- ------ - -- ~@i~ - ~ CONTRACf SIGNATURE PERMIT OFFI CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER CITY OF ZEPHYRHILLS PERMIT APPLICATION BUILDING DEPARTMENT 5335 8D St, Zephyrhills, FL 33542 813-780-0020 FAX: 813-780-0021 DATE RECEIVED c:l-// PHONE CONTACT FOR PERMITTING OWNER'S NAME ;;- / ;7;;Y.YA rt/(.? JOB ADDRESS J'? /' / 9' ? !:...4 /f V ~ PHONE 9/3,.7 F /- ?.2J-t.? 2 -t" ~~)' rA/2t..J ~ /t. '7 /...5-~ ~ ". LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL ID # (ORTAIN FROM PROPERTY TAX NOTICE) WORK PROPSED: []NEW CONSTRUCTION [] SIGN PROPOSED USE: ~SGL FAMILY DWELLING [] COMMERCIAL [] ADDITION [] MOVE []ALTERATION [] DEMOLISH [] REPAIR [] INSTALL []MULTI-FAMILY [] INDUSTRIAL ~# OF UNITS [] SWIMMING POOL [] MOBILE HOME [] OTHER BUILDING SIZE CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL . ;re/~HC-e A1/e- E4V)/~~4/;-r SQUARE FOOTAGE /' ~- II? t? HEIGHT DESCRIPTION OF WORK 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. IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REQUESTED [] BUILDING [] ELECTRICAL $ VALUATION OF TOTAL CONSTRUCTION AMP SERVICE [] FLORIDA POWER [] W,R.E.C. [] PLUMBING ~ MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION []GAS [] ROOFING [] SPECIALTY [] OTHER TYPE OF CONSTRUCTION:;r BLOCK FINISHED FLOOR ELEVATIONS [] FRAME [] STEEL [] OTHER IS PROJECT IN FLOOD ZONE AREA[] YES [] NO PQ~~~~J'$ECTION BUILDER COMPANY SIGNATURE STATE CERT OR REGIST # ****************************************************************** ELECTRICIAN COMPANY SIGNATURE STATE CERT OR REGIST # ****************************************************************** PLtJHBiR COMPANY SIGNATURE STATE CERT OR REGIST # MECHANICAL SIGNATURE/iij ~ ****************************************************************** COMPANY C()41'4~rL/4 L S,)'J,,k-ey STATE CERT OR REGIST # ***************************************************************** OTHER COMPANY SIGNATURE STATE CERT OR REGIST # 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, 813-780-0020. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign po~tions 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 indica~ion 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. Appli~ation 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 fora 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 acknowledged , 2<1..- STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _____day of by STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _____ day of by acknowledged ,20_ (name of person acknowledged) Owho is personally known to me, or (name of person acknowledged) C1ho is personally known to me, or Owho has produced (type and whoO did 0 did not of identification) take an oath. Owho has produced (type of identification) and who Odid DHd not take an oath Signature of person taking acknowledgement Signature of person taking acknowledgment Name typed, printed or stamped Name typed, printed or stamped '~!!'!1! 2.10.04 TO Whom It May concern, Please be advised that this letter Is authorizing Arleigh Halterman to register Hubert Lee Beasley and Commercial Systems of Tampa, Inc. with the City of St. Zephyrhllls, Florida. If you need further Information, please call us at 813.626.4677. Thank You, f>tat. of Aoricia Gounfo( of Hdltborougb f>~om to and ftUkA'ibtd beforf nit lbi. loKt da'f of ~ to OL\- bot ~ ~. ~bo 16 perHna\ll ~hn to nit or ~bo produtMl 16 IdNrtific.ation. . '~.. K. SMml r~ MY COMMISSION t DO 2al461 i j-\ EXPIRES: Auaust 1~.... Ilclnlllld ThnINalIIV 'Nit M1 Gommi66ton ""pir..: 9810 Highway 92 East · Tampa, Florida 33610 · (813) 626-4677 . Fax: (81 :3) 626-5646 2.10.04 TO Whom It May Concern, "tem, of Tampa, 'nc. Please be advised that this letter Is authorizing the following people to be able to apply for mechanical permits for Commercial Systems of Tampa, Inc. LIcense No. CAC 056303: Hubert Lee Beasley Mike campbell Michael Shane Smith Darrel Peterson Rick Lurvey Arlelgh Halterman DL# B240-332-57-055-o DL# C514-545-44-345-o DL# 5530-557-71-391-1 DL# P362-176-66-252-0 DL# L610-732-68-058-0 DL# H436-001-45-345-0 If you need further Information, please call us at 813.626.4677. Thank You, ubert L Beasle President f>tat. of Ronda c.ountf of tI",.borough ~'Mom to and 6ub""'ib.d "-fort 1M thi6 ldh da'f of ~ 1.0 ~ bot l-tu..be-+- .ltt. 'ft~lp.L. 'Mho i. "l'$On"'l ~O'Mn to 1M or 'Mho produud a6 iJtntiftGation. - M1 c.omml66ion ."'pir.6: K. SMmf . MY COMMISSION , DO 2al461 EXPIRES: Auaust 10. 'S11 ....,llIftlNllllyN*.......... ...~ 9810 Highway 92 East · Tampa, Florida 33610 · (813) 626-4 77 . Fax: (81:3) 626-5646 02/10/2004 TIc 11: 30 FAX S13 932 628i ADCOCK-ADCOCK IaJ 001 ACIJREt CERTIFICATE OF LIABILITY INSURANCE I DATi (IIIlIIlOm'YY} 02/10/2004 PIttJDUCe~ (813)933-6691 FAX (813)932-6287 THIS CERTIFICATE IS Issueo AS A MATTER OF INFORMATION Adcock & Adcock Insurance Ag$ncy OHL Y AND CONFERS NO RIGHTS UPON THE CI!RTIFICATE HOLDER. THIS CERTIFlCAT~~ tgr AMEND. ~p OR 3IS W. Fletcher Ave. AL TEfl THE COV!RAGI! AFF THE POLIC S ELOW. Tampa, FL 33612-)414 INSURERS AFFORDING COVERAGE NAIe # INSURED INSVReR A: Southern-Owners Insurance Co. 10190 Commercia' Systems of Tampa, Inc. INSURER II: Auto-Owners Insurance Co. 1898. 9810 U.S. Highway 92 East INSUReR c, Associated Industries Taql&, Fl 33610 INSURliR 0: INSURER E: ES THE POliCIES OF INSURANC! LISTED BELOW HAVE BEEN ISSU!O TO THE INSUREO NAMEO ABOVE FOR HiE POLlCY PERIOD INDICATED. NOTWITHSTANOIN' ANY REQUIREMENT, TeAM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 8E ISSUED OR MAY PERTAIN. TM! INSURANCE AFfORDeD BY THE POLlCliS OESCRIB~D H~REIN IS SUBJeCT TO ALL THE r~MS. EXCLUSIONS ANO CONDmoNS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUceD BY PAID ClAlMS. rr -~-'" "'"~- ...,..,""""", pouev EXPlRA110H UMIT$ ~&RAL LlABIU'I'V 2058631203 04/07/2003 04/07/2004 IOACH oeeuMI!HOe $ 1.000.000 I ~D'AL GalERAl. LIABILITY DAMAG~ TO RENnD $ 100.000 I-::-:- CLAIMS MAOE m oecUF\ MEO EXP (Any one _n) $ 10.000 A ~ Contractual liab. PeRSOt.IAl... AD\! INJURY $ 1.000.000 ~ GIHfRAL AGGREGATE $ 2,000,000 GEiN'L AGGREGATE LIMIT APPI,.IES PtiR' PROOUCT$ . eololPiOP AGG S 2 000,000 ~. POLICY n:8,: n LOC ~UTOM0811." LlABLITY 4227072900 06/01/2003 06/01/2004 COMIlINED SINGLE LIMIT lEa aCCIdent) S ..! ANV AUTO 500 ooe - ALL OWNEO AUTOS DODIl. Y INJURY (P<< p815on) S SCHEI:lIJLED AUTOS 8 X Ht~ED AUTOS BOOlL Y INJURY ~ $ ~ NOJ'l..oWNI!O AUTOS (per_Idem) t-- F'AOPIiiRTY OAI.IAGIi $ (Per accldentl RARAGe! LIABIUTY AUTO ONt Y , eAACClOeHT $ ANY AUTO OTHe~ THM! eAACe S "'UTO ONly, AGe> $ EXC~LIADILI1'Y 4227072901 04/07/2003 04/07/2004 EACli OCCUAAiNCe $ 1.000,O(H !loecu/\ 0 CLAIMS MADE AGGRkGATE $ 1. 000.001 B $ ~ DEDUC'1181E S X RiTENl10N S 5 I 004l s WORKERS coroIIeNSATION AND 200333287& 06/01/2003 06/01/2004 X I we STATl)- I (~ I!.MI'I..OYER$' LWIIU'I'Y E.L. EACH ACCIDENT 1,000 00 C l>NY PRQPRllITORJPA1UNERlEXECUTIVE $ OI'FICl!I\IMEIw1BeR EXCLUOEOt e.L OISEA.$.. . lOA EMPLOYEe s 1. 000, 001 ~~M~~v\s~NS belOw E.\.. CIWMe -/'OLlCY LIMIT ~ 1.000 001 CI'I'MP OI!SCIlIl"T1OH OF OPEltAT1OICS I LClCA'TIOHa fVE14ICLEBIEXCLUSION$ ADDEO 1IY INOORSliMiHT ISP~ PROVISIONS to ........., I A""'-' $HOUUlIWV Of' THI AeOVE DEBCRl8IiP /'OLlCIR BE CAHCa1.l.llD IUORE THE IiXPlIU.TION DATE THEltSOl'. THE ISSUING INSUREIt WILL ENDSAYOR TO MAl. ...19- OAYS WRITTEN NOTICe TO T11l! cu:nrICATI tIOLDliR NAMED TO THE lEFT. BUT fAlI.URE TO MAIL SUCH NOTICIi SJoIAU. tMrOSE NO oeUGATION OR LIADtUTY OF AHV KIND UI'OH THE INSURER. IT$ AGI!NTlJ 011 fCEPRIil$&NTATMlS. AUTHOIIZICI_AIiSEN1'ATlVE James Randa", III C.I.C. Zephyrhills Building Department ;335 Height Street Zephyrhills, FL 33542 ACORD 25 (2001108) @ACORDCORPORAnON1M 02/10/2004 TIT 11.: 30 FAX 813 932 628i ADCOCK-ADCOCK ~002 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed_ A statement on this certificate does not confer rlghts to the certificate holder in lieu of such endorsement(s}. If SUBROGATION IS WAIVED, subject to the terms and conditions of the polley, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certiftoate holder In lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the rtVet'Se side of this form does not constitute a contract between the issuing insurer(s), authori~ representative or producer, and the certificate holder, nor d088 it affirmatively or negatively amend. extend or alter the coverage efforded by the policies listed thereon. ACORD 2S (2001108) 9810 Hwy. 92 E. Tampa, FL 33610 PROPOSAL mmerdal y~!!~~ Office: (813) 626-4677 Fax: (813) 626-5646 .5A4 PHONE JOB NAME Z- JOB LOCATION CITY. STATE. ZIP CODE FURNISHED BY COMMERCIAL SYSTEMS OF TAMPA EQUIPMENT SPECIFICATIONS: MANUFACTURER ~ TRANE 0 OTHER MD# /W Eo st., h..1FtfAIR HANDLER OTY.---L- MD# MD# ,j, 7T tf a) [) y ~/APsI!ONDENSER OTY.~ MD# MD#61'.Y...v7t/~/t)tJ~A'HEAT STRIP OTY.-'- MD# MD# MD# THERMOSTAT OTY.____ AIR HANDLER OTY.____ MD# MD# PACKAGE UNIT OTY.____ PACKAGE UNIT OTY.____ PACKAGE UNIT OTY.____ PACKAGE UNIT OTY.____ MISC. OTY.____ MISC. OTY.____ MD# CONDENSER WARRANTY: .r"PARTS & LABOR L YEARS EXHAUST FANS: MFG. EXHAUST FANS: MFG. OTY.____ MD# /ECOMPRESSOR /OYEARS MD# MD# MJUTDOOR COIL ~EARS R-6 FIBERGLASS DUCT BOARD R-6 FOIL BACK FIBERGLASS FLEX DUCT R-6 SUPPLY DUCT BOXES ADJUSTABLE SUPPLY GRILLS QTY. RETURN AIR GRILLS QTY._ X AIR HANDLER SUSPENDED AIR HANDLER SUPPORT STAND REFRIGERANT PIPING (COPPER) REFRIGERANT PIPE INSULATION OTY. OTY._ PRIMARY DRAIN (PVC) SECONDARY DRAIN (PVC) AUXILIARY DRAIN & FLOAT SWITCH PIPE COVER SHEETMETAL DUCT ELECTRICAL SERVICE FIRE DAMPER 2x2 LAY-IN DIFFUSERS QTY._ 2x2 STEP-DOWN GRILLS QTY._ RANGE VENTING DRYER VENTING EXHAUST DUCT REMOVE REMOVE MISC. MISC. OPTIONS OPTIONS WE PROPOSE HEREBY TO FURNISH MATERIAL AND LABOR - COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS, FOR THE SUM OF: $ ~t:>OO, f/)v PAYMENT TO BE MADE AS FOLLOWS: All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications involving extra costs, will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Our workers are fully covered by Workmen's Compensation Insurance. Price includes one year guarantee against defects in workmanship and material at no charge during normal working hours. If other than normal working hours, overtime rates will be charged. This guarantee does not include items such as blown fuses and dirty filters. NOTE: This proposal may be withdrawn by us if not accepted within :J j) days. COMM?RC~ SYp.~E OFT~~~, Bd~<</~~ C~ ''\----- Signature "\.. .~ ~ .. ~"- ~ c;.. \ '" c \ r~ j ,', ~---\. \ ~ Signature Acceptance of Proposal - The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Acceptor agrees to pay all Court costs, attorney fees or other expenses incurred in the collection of the above payments upon default by Acceptor. Date of Acceptance: ~": ./ /....::-\ 1_-..:..) 0:::::.... o.~