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HomeMy WebLinkAbout04-3158 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 3158 Permit Number: 3158 Permit Type: MECHANICAL Class of Work: A/C CHANGEOUT Proposed Use: COMMERCIAL Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: 2,650.00 6/14/2004 45.00 45.00 6/14/2004 WALL HUNG A/C Address: 4241 SKY DIVE LN ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: Name: CITY OF ZEPHYRHILLS Address: 4241 SKY DIVE LN ZEPHYRHILLS, FL. 33542 ___~ Phone: I Ii! - REINSPEcnONFEES:When extra InSpediOntripsar:enecessarv dUe to anyone of the followingreasons, 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: YourtaiTure torecord 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 andFeeMust Accompany Appllcation-:--~----------- - - - - - - ____~II~or~_~h..ClII_.l>_~_perfo!"med in accordance with City Co~s and..Qrdinance~__ ____________ NO OCCUPANCY BEFORE C.O. ---.---..----------------------- --._---_._.~.__._._._--~._._---._---_.._-.__.__. ---------_..__..-.------._--~_._---- ~ -- -------- RACTOR SIGNATU 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 PHONE CONTACT FOR PERMITTING OWNER'S NAME S J( V IJ...zVC: C/-~ JOB ADDRESS '7? 7'/ S K I.j /J /. V L L "'i..v G LEGAL DESCRIPTION: LOT(S) BLOCK PHONE 7/ S'- -S 08-6' Z;,f1.J r k /1.5 ,.c/, SUBDIVISION PARCEL ID # WORK PROPSED: [JNEW CONSTRUCTION [J SIGN [J ADDITION [J MOVE (OBTAIN FROM PROPF.RTY TAX NOTTCF.1 PROPOSED USE: [JSGL FAMILY DWELLING [J COMMERCIAL [J ALTERAT ION [J DEMOLISH [J REPAIR [J INSTALL [JMULTI-FAMILY [J INDUSTRIAL [J# OF UNITS [J SWIMMING POOL [J MOBILE HOME [J OTHER DESCRIPTION OF WORK J( e J!.. CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL BUILDING SIZE U}"q / / /I (./;1/' Q / /1/c. , SQUARE FOOTAGE HEIGHT 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. [J BUILDING PERMITS REQUESTED $ VALUATION OF TOTAL CONSTRUCTION [J ELECTRICAL AMP SERVICE [J FLORIDA POWER [J W.R.E.C. [J PLUMBING ~HANICAL $ 2S-00 ,00 [JGAS [J ROOFING [J SPECIALTY VALUATION OF MECHANCIAL INSTALLATION [J OTHER TYPE OF CONSTRUCTION: [J BLOCK [J FRAME [J STEEL [J OTHER FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREA[J YES [J NO cO~QWO;aJ.$EqTIOl'i( ""'",. ,- -,- "" --.', '-','- ".:'- "..,,'-, BUILDER COMPANY SIGNATURE STATE CERT OR REGIST # ELECTRICIAN ****************************************************************** COMPANY. SIGNATURE STATE CERT OR REGIST # PLUHBER ****************************************************************** COMPANY SIGNATURE STATE CERT OR REGIST # MECHANICAL L/~~_ ***.q:*********************************************************** ****************************************************************** COMPANY ,tJAII/?~ /~"';<?/./;v L C:;"f..r-e ~ .z~c. STATE CERT OR REGIST # CA~" 7"J'9 7' cP SIGNATURE OTHER COMPANY SIGNATURE STATE CERT OR REGIST # NOTICE OF DEED RESTRICTIONS undersigned understands that this permit may be subject to "deed restrictions" which .dY 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 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 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 $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE: CONTRACTOR SIGNATURE: OWNER OR AGENT acknowledged , 2U-- STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _____day of by STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _____ day of by acknowledged , 20_ (name of person acknowledged) Owho is personally known to me, or (name of person acknowledged) C1ho is personally known to me, or o who has produced (type and whoO did 0 did not of identification) take an oath. o who has produced (type of identification) and who Odid OEd not take an oath Signature of person taking acknowledgment Signature of person taking acknowledgement Name typed, printed or stamped Name typed, printed or stamped I ~ ~~_, (5:S (j~~ 'nrfF~'INiW&.'n . t~,-~ 1 _. ~_ HVAC !fk:ttrgElI j 1)(11[1: J'dUl'1 --.... ~- SI:.RVICE ORDER BA"I~l"!:i; F IH)fi \I\!~ IiI~S & lVC INe, INVOICE ~ii'II'e I, ~,E!r!j'l & !!i,I:" Hc'tiOflS 44.1. II lie 1 R>a, ~~pl 1r'1i 5, FL 3..' 541 (:-:1:) : 'B~'.!.H ! BILL TO /I l... .,AI. \, ~L.. A-I\QI -fl4. ' . . Lilf\,'Lt .. f 1);...1" ~ I ~~ . 'lll~) ~ 5C~ (..Q ~~lye( cO ~. :~-' ,~J,. ~t ~t ~V')R,S TC EE NAM QTY. REFRIGERhNT R- LI33 ~cI (~~-pttS(f'OA./ / I I /3AJ Lei ".,,11 ,t~ P"CL.. .---- ----.. --.$' To,.-,.!' /0 .A(.~./ f.'? <i_>,.1,.e ~ IrE,It{ 7 FILTERS > FILTERS BELTS TOTAL MATERIALS HRS. LABOR RATE MATERIALS & LABOR MAY BE CO"lTI"l:.JED ON OTH",R SIDE TOTAL LABOR TERMS n 1.'5 A ic?,. t) -.--- I; I 'r.,-"' :;.0.0. " '<E ,.-:' '-.lJti,CA ,) JOEL ld11.l72-Aco (;' Yli < ___ ;: F<:Ai... NUI~B,::::R \~ CJ~~ 9f()(' 7 ---1---- LJ - -- 1---- EN" :nNMENl ~ _ CHECK LIST _~~~ 'ERFORI ;;p~.=~ ~ == -~= ~,~~~:' -:~==j!., ~----- eLM.IED F · =,~ ~:~:>m,~lOTAL , UYFEIDISPOSITION DESCRIP nON OF It'ORK PERFORMED q !<6l0E> - t-t.5 UF ~p &)U,Jlf..J. ~l1JL I I I '2..54; :,00 I I I I I I I I I RECOMMENDATIONS -- AMOUI IT -- -- 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 Dther warranties, express or implied, and its agents or technicians are not authorized to make any such warranties on behalf of above named company. -- I have authority to order the work :JutlillE'd above which has been satisfactorily completed I agreE Irat Seller retains title to equiprnenVma1erials furnished until final payment is made. If payment is not r lade as agreed, seller can remove said equipment/materials at Seller's expense Any damage resulting rrom said removal shall not be the reSpo'lsitility of Seller CUSTOMER SIGNATURE DATE REGULAR - SERVICE CONTRACT WARRANTY fJU~ It<JA/ll/v/'J ~ CHARGE CONDENSING UNIT LEVE:LED CLEANED COIL CHECKED CHARGE REPAIRED LEA~ IN COIL REP/l,iRED LEAK IN COPPER * REF CHECKED MOTOR CHANGED MOTOR REPLACED BELT ADJUSTED BELT REPLACED CONTACTOR REPL START RELAv REPL START CAPACITOR REPLACED RUN CAPACITOR CLEANED OR ADJ_ CONTACTOR REPAI=lED WIRING REPLACED FUSE REPL,O..CED COMPRESSOR EVAPORATOR COIL REPLACED EXP VALVE ADJUSTED EXP VALVE REPLACED CAP TUBE CLEARED CAP TUBE REPAIPED COiL LEAK REPAIRED COPPER CONN CLEANED COIL LEVELED COIL ELECT HTR. REPLACED UNK REPLACED KLlX REPAIRED WIRE REPLACED CONT FILTERS I TOTAL MATERIALS TOTAL LABOR TRAVEL CHARGE TAX TOTAL U,v,' f NO CHARGE MAKE MODEL SERIAL NUMBER ./ WORK PERFORMED COND'SATE DRAINS 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 THERMOSTAT REPLACED ADJUSTED CLG TOWER CLEANED PUMP(S) GREASED REPAIRED CLEANED REPLACED 5 I ':~:..5-1 ~ ~ ---.,---. - ---C---t--..---. cjJlf.?_-_'J"~~I_____~ul___ __ STREET ~ ;; ~ {Lel.l V' ~:I_1-.~lClL : t:Q l tJ c >c1TY2 ~- rt=jJif..2.-lM ~---~=~ PH rJ.. 5 <;I' C^, Bf fORE i' \ I:,;...... ()U Fr/ TECHNIC/AN - - - - - - ~- - +-Alj rl- OF~ZE 0 BY ~- --- --- - - - - - J-,--- __ 1ED r .' ma.j~~ , :-{~C(l u.j?:~__ _ L. ( n..Q t ~ I nCl ~~Jdu ncQ./ -y- MAT :RIA~~ ,~~;RVj(;E ~:~- UNIT PRICE AMO Jr iT ___u_ ----------- I I I I I I TOTAL SUMMARY : : I I I I ISO: 00 2 c;SQ: 00