HomeMy WebLinkAbout04-3235
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
3235
Permit Number: 3235
Permit Type: MECHANICAL
Class of Work: AlC CHANGEOUT
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost: 8,000.00
Date Issued: 7/20/2004
Total Fees: 105.00
Amount Paid: 105.00
Date Paid: 7/20/2004
Work Desc: 2 TON AlC SYSTEM CHANGE-OUT
Address: 5444 4TH
ZEPHYRHILLS, FL.
TownShip: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 11-26-21-0010-06300-0110
Name: CHURCH OF CHRIST
Address: 5444 4TH ST.
ZEPHYRHILLS, FL. 33542
Phone:
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 yment of inspection fees shall be made before an further permits will be issued to the person owning same
nWarning 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. n
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall rformecl in accordance with City Codes and Ordinances
o OCCUPANCY BEFORE C.O.
~-.
CTOR SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECE IVED
7-;:;0-01
PHONE CONTACT FOR PERMITTINq~)5l..7"" 6'"37 ~-'
OWNER'S NAME tltfL/?tJ.# &+ (JJlJ?J;~1
JOB ADDRESS,t:f~f1 ~/ZlJ/ .57-:
PHONE
LEGAL DESCRIPTION: LOT(S)
BLOCK
PARCEL ID # //-d(P-;:}/ -t)C)//J -t)(P300-o/ /0
.
SUBDIVISION
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: ONEW CONSTRUCTION
Os I GN
PROPOSED USE: OSGL FAMILY DWELLING
o COMMERCIAL
o ADDITION
o ALTERATION
o REPAIR
o INSTALL
o MOVE
o DEMOLISH
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SW IMMING POOL
o MOB ILE HOME
o OTHER
CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK /l Ie:. <5 f(STW? 6fr;U"~, -t2/T
BUILDING SIZE 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.
o BUILDING
o ELECTRICAL
$-=fJN......'~
PERMITS REQUESTED
VALUATION OF TOTAL CONS TRUCTI 0\1.___,
s
J~~..
,~.
AMP SERVICE
o FLORIDA POWER
o W.R.E.C.
o PLUMBING
~MECHANICAL
1/)0
$ BODO -
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: D BLOCK
D FRAME
o STEEL
D OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES D NO
CONTRAC*1'OR,"SECTION
BUILDER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
SIGNATUR
************************
****************************************
COMPANylVJ/p.WAJ~~ ~de12)t?S:
STATE CERT OR REGIST # ~~J?/~~~
**************************************************************
PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
*************************************~
COMPANY ~J/,t:f24'L///I~L/17IL ~~70RS
STATE CERT OR REGIST # &rt4Jd9aB2.
*************************************************************
OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to udeed restrictionsU 0hich
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 uContractor SectionsU 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 uFlorida's Construction
lien Law - Homeowner's Protection Guideu prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "ownerU, 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 conunencement.
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 conunenced 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.u, it is
understood that a draiIlage plan addressing a ucompensating volumeu 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 conunenced 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 ATTORNE FORE RECORDING YOUR TICE OF COMMENCEMENT. BS UNDER
$2, IN VALUE DO NOT NEED T CORD AND POST A " OTICE OF COMMENCEMEN U
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by
acknowledged
, 20_
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)
Diho is personally known to me, or
Owho has produced
(type
and whoO did Odid not
of identification)
take an oath.
Owho has produced
(type of identification)
and who Odid [}did not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
ParcellD# II 2621 0010063000110
Tax"Folio #
/1111/1/111111/11111111111111111/111/11111111111111111II/III
2004135047
STATE OF FLORIDA
COUNTY OF PASCO
NOTICE OF COMMENCEMENT
Rcpt : 800458 Rec: 10.00
OS: 0. 00 IT: 0. 00
07/20/04 ~_____ Dpty Clerk
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in
accordance with Chapter 713.13, Florida Statutes, the following information is provided in this Notice of
Commencement
I. Description of property: (legal description of property, and street address if available)
5444 FOURTH STREET, ZEPHYRHILLS, FL 33540 JEO PITTMAN, PASCO COUNTY CLERK
Pasco County ParcellD# II 26 21 00 I 0 06300 0 II 0 07/20/04 09: 44am 1 pr: Oaf 159
OR IK 594a ~
2. General Description of improvement: INSTALLATION OF AIR CONDITIONING EQUIPMENT
3. Owner information:
CHURCH OF CHRIST
5444 FOURTH STREET, ZEPHYRHILLS, FL 33540
4. Contractor:
R.. a. Name and Address: ENVIRONMENTAL CONTRACTORS
10221 HWY 301, DADE CITY, FL 33525
b. Phone number: (352) 567-5515
5. Surety:
a. Name and address: N/A
b. Phone number:
6. Lender:
a. Name and address: N/A
b. Phone number:
c. Fax number: (optional, if service by fax is acceptable)
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be
served as provided in Section 713.13( I )7., Florida Statutes:
a. Name and address:
b. Phone number:
c. Fax number: (optional, if service by fax is acceptable)
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as
provided in Section 713.13( I )(b), Florida Statutes:
a. Name and address:
b. Phone number:
c. Fax number: (optional, if service by fax is acceptable)
9. Expiration date of Notice of Commencement (the expiration date is one year from the date of recording
unless a different date is specified)
Sworn and subscribed before me by ROBERT C. EHRMAN, who is personally known to me or produced a
as identific ion, and who did not take an oath this 20th T:;~
Signature of Notary ~'.
Printed name of Notary ~ Am'(Y)fr\ '\
/
/
l
Commission expires
Seal:
~ H...,. AmmonI
! . My CommIIIlon 00113178
~.::I Expirel May 01, 2001