HomeMy WebLinkAbout05-4420
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
4420
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:
4420
MECHANICAL
AlC CHANGEOUT
NOT APPLICABLE
Address: 6023 16TH T
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
8,019.00
6/10/2005
75.00
75.00
6/10/2005
CHANGE OUT
Name: ROY NABOZNY
Address: 6023 16TH 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 payment of inspection fees shall be made before any 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 be performed in accordance with City Codes and Ordinances
NO OCCUPANCY BEFORE C.O.
~~~
RE PERMIT OFFI
OR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICAT~UN
BUILDING DEPARTMENT 5335 8TH st, Zephyrhills, FL 33542
813-780-0020 FAX:813-780-0021
DATE RECE IVED
PHONE CONTACT FOR PERMITTING 71.1- )"f'f - 4-.J." J....
OWNER'S NAME /(0 Y
JOB ADDRESS ~ 0 P{J
NIl!102NY
/& 7?i Sf
PHONE Y/S- 7ff1.-- I~ ~ ~
LEGAL DESCRIPTION: LOT(S) BLOCK
PARCEL 10 # 0 J- 20 - ;1- 6'10-- VOCno ~ 0" ;20
SUBDIVISION
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: DNEW CONSTRUCTION
o ADDITION
DALTERATION
o REPAIR
~STALL
DSIGN
PROPOSED USE:~. FAMILY DWELLING
o COMMERCIAL
o MOVE
o DEMOLISH
DMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
DESCRIPTION OF WORK
c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL
E:CI>l.IAL CW~NGC Du-r O~ clJ1l>N to/(/~E/l/fER ol,,J rvfl/ ti'll
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.
PERMITS REQUESTED
o BUILDING
$
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
o PLUMBING
~CHANICAL
AMP SERVICE
o Progress Energy 0
W.R.E.C.
Ill.)
$ y()/1-
VALUATION OF MECHANCIAL 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 0 NO
BUILDER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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ELECTRICIAN
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
MECHANICAL, COMPANY lie S of 7it/l--J PA 11,4 Y
SIGNATURE ~ fJvv~~ STATE CERT OR REGIST . CAe.. /fJYf(,5"'
*****************************************************************
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 contracto~ 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 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.
Appli~ation 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 issuahce 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 proc~e~ with the work a?d not as
authority to violate, cancel, alter, or set aside any prov~s~ons of the techn~cal,c?des,
nor shall issuance of a permit prevent the Building Official from thereafter requ~r~ng a
correction of errors in plans, construction, or violations of any c~de: Every perml~ ,
issued shall become invalid unless the work authorized by such perm~t ~s conunenced w~th~n
six months of issuance, or if work authorized by the permit is suspended or a?andoned,for 'a
period of six months after the time the work is conunenced. One 90 d~y extens~on of tlme
may be allowed for the permit with fee charge of $15,00. The extenslon shall b~ requeste~
in writing to the Building Official. An approved inspection must be logged dur~ng each SlX
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".
SIG~WN~ S~~ON~
acknowledged
, 2~
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)
Dwho is personally known to me, or
(name of person acknowledged)
C1ho is personally known to me, or
Dwho has produced
(type of identification)
and whoD did Odid not take an oath.
Owho has produced
(type of identification)
and who Odid [Jdid not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
NOTICE OF COJ\.IMENCEMENT
Petmit No,
Parce1I. D. No. 6 J. - ~f;;;- 4t - 0 I fa -()E)(')6b - 00 J.. 0
1/1111111111 1111/ 1111111/11111111111111111111111111111111111
2005114405
Rcpt: 891591 Rec: 10.00
os: 0,00 IT: 0.00
06/08/05 Dpty Clerk
PASCO COUNTY CLERK
~i~0~~1~MAMi : 0~m 1 1of8515
OR BK 641~ PG
State of Florida
County of PinelIas
THE UNDERSIGNED hereby give notice that the improvement will be made to
certain real property in accordance with Chapter 7 13, Florida Statutes, the following
infonnation is provided in this notice of commencement.
~ J1S 14;,Pr;' ~
3, Owner information: tJ/l V C" 7!-1 2 J )
a.)Namealldaddress~QL oJ NIIB~ZIf/~ (dJJ.J Jh rr; E:jJHY/?IIILC.~ Fe... JfSroL
".. b,) Interest in property
. .. " c,) Name of address of fee simple titleholder (if other than owner)
:t.,~:', ,f;
'4~Contractor(nameandaddress) dTEl/c--JtI 111/..1 1n/(l.rolV 70
5. Surety
a,) Name and address
b.) Amount of bond
6. Lender (name and address)
7. Person within the State of Florida designated by owner upon who notices or other documents may be served as provided by Section 713.13
(1) (a) (7), Florida Statutes.
a.) Name and address
8. In addition to him or herself, owner designates of
to receive a copy of the Lienor's Notice as provided in Section 713,13 (1) (b), Florida Statutes.
~. Expiration date of Notice of Commencement (the expiration date is one year from the date of
recording unless a different date is specified),
STATE OF FLORIDA
;OUNTY OF PINELLAS
~.l0 _
Sign ne ~
'C7 ~ ....-.-
'he following instmment was acknowledged before me this ~ day of :] l/ ~{ E
who is personally known to me or who has produced
,20 of, bY~Y f' 10?6'4)/VY
~ identification.
Notary signature (1vL~.lt'\O.... ~ v). 0 ~O
Name (print) 6 S\-C'l-on ~() -'
Stamp:
fier recording, return to:
ame
ddress
lty IState
;..-: ';' :/,,'.>':. ,': ,;. :' ':~~, ~ '-'<"'C:"'-, ,<<,:::'" :'J
"' '/'','''is;>4'':r.~:.~;:":{!ii;~MJr''!,
I........... II .............
: .;,\\\""1"",- SHAu..:11...,e.!.!...............1
: '" ~~l PV.e.'" '~LOVALLO.
: u'rn"'tolV" Commlulon , 000180259 f
: ~.P'~ ExpIre, 112612007 :
: ~111~rJ,\\ Bonded through :
: (lIOO-432..c254) Florida N :
................... otary Assn. I 'nc. .
:'i::,j~i;:'''</~:::_':'i'>;('''l):~..f..:~j,,'Wi';.iti;:~~:,:'*.,~1,Jf~'*,il:f.';,:';j'~"~~.'~MMS!i'tl\'r:..~lfJU.W_It~_~,......~~~~l~1IIiIil8:~;~~'l@~~!i;
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STATE OF FLORIDA
COUNTY OF PASCO
THIS IS TO CERTIFY THAT THE FOREGOING IS A
TRUE AND CORRECT COpy OF TH~DO T ON FILE
OR UBLlC RECORD IN THIS OFFI NESS MY
HAND A OFFICIAL SEAL THIS DAY OF
2
C JED C" C T COURT
BY 0 Y CLERK
PROPOSAL
N~ 6 9 0 7
~--<<>
.-.- .....
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. !!!!!~
HILLSBOROUGH
PASCO
PINELLAS
FAX
813-623-2665
727-937 -4277
727-588-4200
727 -581-3058
Of Tampa Bay
License # CAC1813365
[!aon's
We hereby propose: To furnish, install and service under warranty (stated below), products or related equipment for
your home in accordance with the conditions and specifications set forth in this proposal.
NEW EQUIPMENT CONTROLS AND EQUIPMENT /r, E
o Room Unit 0 Brand 0 Digital 0 Thermidistat 0 Humidistat
o Air Conditioning Tons I Model ~ progra~CnIe Digital thermostat 0 Easy Read thermostat
Jif. Heat Pump 2,)' C~\.J--. Tons I Model 3/1 'inK 0 Install new Amp. electric service and panel $
~ir Handler 7, :5 CJ:m;\lY1' Tons I Model 'i:a.l..J A-N 0 Newall copper, insulated, electric circuit(s) with disconnect switch
o Furnace Tons I Model box(es) at Condensing unit 6u Air handler
o Evaporator Coil Tons I Model Circuit Breakers - Condenser type
o Heat Recovery Unit R22_R410A Airhandler type
AHeatStriP '~rw' ~ . ~RRANTIES
g:BTUh Cooling SEER Rating \..., 0 HSPF j, J ".
~ -+LL- All work and equipment IS warranteed against defects for 1 full
Indoor Unit Stand Insulated yes a no a year from the date of installation. Replacement of defective parts and
o Sheet Metal 0 Wood labor costs are provided with no charge to customer.
o Other ~ompressor: /iJ..-year(s), parts:~year(s).
~ ~rnace Heat Exchanger: _year(s)
PIPING ~ondenserCoil:~year(s)
,lZ\ Condensate drain hookup 0 Primary 0 Secondary )ZJ 24 hour emergency service. NO OVERTIME CHARGES
o Galvanized line cover 0 Liquid line 0 Extended warranties: 0 5 year - parts & labor
o Suction line with armaflex insulation 0 10 Year. parts & labor
o Lifetime Limited Warranty on all new ductwork installed.
o Condensate pump
o Safety Overflow Float Switch
Ceiling Saver Kit
AIR DISTRIBUTION
o Modifications of supply plenum_ 0 return plenum _
o New supply diffuser(s)_O Ceiling_O Sidewall_
~mper controlled rust resistant anodized aluminum.
rz( New return air filter grille(s)_O Ceiling_O Sidewall_
o New transfer grille(s) 0 door grille(s)
Rust resistant anodized aluminum.
o R - 6 Flex & Fiberglass duct system designed for best airflow in
all manual J load calculations. $
o New insulated return box
o Inspect and seal leaks in duct system
o Fire stat located in return air
o Smoke detector
o High ef~ir clearr
o Other: If to.
(..Q(tld;;,.l 4rr $({Jv.r
~ dt ~ tJmJ P~f
1.1"145
.'\Jd fL.+wr,rt cJ..1flJ/J)
~ISCELLANEOUS
AAII work done in accordance with mechanical codes
:;.,a- All required permits
.fi ,gertified start-up by technician
Ji1 Bemoval of the existing equipment from the premises
)2:(Weather resistant vibration proof isolation pads
o Crane_set back_height_set up location_
o Reinforced pads - blocks_concrete DVC
0.,28 gauge galvanized steel weatherproof duct cover
..er All work to be performed in a neat and professional manner by
journeymen class technicians; sweeping, dusting, and vacuuming will
be accomplished at the conclusion of each day's work and all debris
~ved from the premises / /
.,..Jc::J Equipment location OD_ ID~ pkg._
o Duct cleaning and sanitizing _ Supplies_ Returns_
Power company rebates 12 SEER he9"Pump systems only
Florida Power 0 $100 0 $150 )a $250 0 $350
F. P. Heat Recovery 0 $100 TECO 0 $100 0 $250
Electronic Collection of Returned Checks. WE GLADLY ACCEPT YOUR CHECK AS
PAYMENT. HOWEVER, PLEASE BE ADVISED THAT ANY RETURNED CHECK MAY BE
COLLECTED ELECTRONICALLY FROM THE CHECK WRITER'S ACCOUNT IF THE
CHECK IS RETURNED FOR INSUFFICIENT OR UNCOLLECTED FUN OS ('NSF
FUNDS'). IF THIS CHECK IS COLLECTED FOR NSF FUNDS, AN APPROPRIATE FEE
WILL BE COLLECTED ELECTRONICALLY FROM THE WRITER'S ACCOUNT BASED
UPON THE FEE ALLOWABLE BY LAW
olq
/. ~
'f\1"Ic"lO
Less Deposit:
Balance Due:
l SJ,'1 V-
---
L.{~(];'
We hereby propose to furnish complete as above specified for the sum of: $
METHOD OF PAYMENT:
Credit Card #
Financing:
Cash
Exp._/_
I ~.<.::t;::
/'J.A.! "J
Check #
(deposit required) 1, I
fJJ!t(l j O~m'"
ork as oullln above. I agree to pay all costs and It is agreed and understood by the parties that all equipment and parts which are
is placed in the hands of an attorney sold pursuant to agreement above shall become fixture or part of the real estate
where they are placed. Said parts and equipment shall remain personal proper.
ty and the title hereto shall remain with the seller until payment in full is received.
Buyer hereby agrees that all parts and equipment may be repossessed in the
event ot nonpayment.
Date (., - ) -oC; Home owner Is responsible lor upgrading existing electrical to code,
(deposit required)
ARS/RESCUE ROOTER IS AN EEO/AA COMPANY, COMPLiES WITH FED-
By signing, I understand that by January 1,2010, manufacturers can no longer ERAL AND STATE EEO LAWS AND ABIDES BY EXECUTIVE ORDER 11246
use refrigerant R22 in air conditioners and heat pumps. SECTION 503 & 38USC42.12
"The Company that Honesty and Integrity Built". 100% Satisfaction Guarantee