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Home My WebLink About05-5175 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 5175 Permit Number: 5175 Permit Type: MECHANICAL Class of Work: AlC CHANGEOUT Proposed Use: MOBILE HOME SUBDIVISION Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: Address: 38645 GRAN LN ZEPHYRHILLS, FL. Township: Range: Book: Lot{s): Block: Section: Subdivision: VILLAGE GROVE Parcel Number: 2,500.00 11/22/2005 45.00 45.00 11/22/2005 AlC CHANGE OUT PACKAGE UNIT MCCUISTI ,AUL 38645 GRANGER LN ZEPHYRHILLS, FL. 33542 Phone: REINSPEcnON 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. All work shall be performed in accordance with City Codes and Ordinances NO OCCUPANCY BEFORE C.O. ~' ~11J4 ~ e~~ CONTRACTOR SIG TURE 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 RECEIVED ;!-:2:;- ~ PHONE CONTACT FOR PERMITTING 5 d I - Lf 911 OWNER'S NAME Ptw.l Metw's+,'on 3 6lOtf 5 PHONE (g /3) 3 ) 0 -111l) JOB ADDRESS ~ Un ~ BLOCK LEGAL DESCRIPTION: LOT(S) SUBDIVISION PARCEL 10 # o ~ - ~fo -J. i-DO lC- ()OOOO -0 3q() WORK PROPSED: DNEW CONSTRUCTION o ADDITION (OBTAIN FROM PROPERTY TAX NOTICE) ~TERATION 0 REPAIR 0 INSTALL o SIGN PROPOSED USE: ~L 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 Cl-tamcf wt ~ wti-1 SQUARE FOOTAGE BUILDING SIZE 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 PLUMBING ~ECHANICAL $ d500. 00 VALUATION OF MECHANCIAL INSTALLATIO W.R.E.C. ~-'\ :;$,i{{ o ELECTRICAL AMP SERVICE o Progress Energy 0 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 # ********************************************************~,********* ELECTRICIAN COMPANY SIGNATURE STATE CERT OR REGIST # ****************************************************************** PLUMBER COMPANY SIGNATURE STATE CERT OR REGIST # SIGNATURE **********************************~~~;~~~**~~~i**2\iiC;*~;;~vI ~H~mHmmS*~~~:*~E*:~ *~:*::~*~T*:*H~~*~~ 5 g 57[; MECHANICAL 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 corrunencement. 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 corrunenced 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 corrunenced 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 corrunenced. 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". :X;l~ ~ SIGNATURE: OWNER OR A T ~ SIGNATURE: CONTRACTOR ~wJ STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged Before me this _ day of , 2CL- by (name of person acknowledged) Dwho is personally known to me, or STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _day of by acknowledged , 20 (name of person acknowledged) C1ho is personally known to me, or of identification) take an oath. Dwho has produced (type of identification) and who Ddid [}jid not take an oath o who has produced (type and wrioO did 0 did not Signature of person taking acknowledgement Signature of person taking acknowledgment Name typed, printed or stamped Name typed, printed or stamped J s ~ 0 -- 8 J 10 - h I - 01 +-0 ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDNYYY) TM 11/21/2005 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Bauer & Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 12210 US Highway 301 AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. DADE CITY FL 33525 I 93520 567-3702 - - -- ~ IN_~_~ERS AFFORDING COV~RAG~______ NAIC # ____ ------- ._-~--.~------..~--~~-- INSURED CHRIS' AlC COMPANY INS_U".ER_A_ZU~.r~'i___ ,___, __n __ ______ _ __.__ _'__ _ P.O. BOX 1781 ""'''' BRIOGEFIELD t ZEPHYRHILLS, FL 33539 , I IN~RER C__ 1_INSlillE:B_D~_--=--==---=_-==~=-~~~=-=::-=_=-=-~==~-- , INSURER E. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TfiE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OT'iER 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS iiliS-R -DO' --------"------------T-...-;~L1CY NUMBER POLicy EFFECTIVE POLICY EXPIRATION LIMITS A GENERAL LIABILITY Kt,-" CO, ,~MERCIAL GENE,?", L ~IABILlTY _ _, I CLAIMS MADE I_~J OCCUR ~-~,~ AG~R~~A;E L1M;T~~~;~P: POLICY I PRO. LOC AUTOMOBILE LIABILITY ."j ANY AUTO ALL OWNED AUTOS L~-' SCHEDULED AUTOS I ' I 1 HIRED AUTOS I'-l NON.OWNED AUTOS -, SCP0041955742 ! 03/07/05 03/07/06 EACH OCCURRENCE $ 500,000 DAMAGE TO RENTED ~NA-'- :ED EXP=::~ i: 10,000-' - ~SON~L & AD~-INJURY -1 ,$ 500,000 ,.=--_ GENERAL AGGR,EGATE $ 1,000,000 PRODUC~_: COMPIOP AGG $ 1,000,000 ! I', COMBINED SINGLE LIMIT I' $ (Ea accident) ~---I------- ~ODIL Y INJURY _I' : $_ (Per person) Up~~~LC~I~~~Vt"_____~____ _, I i I PROPERTY DAMAGE $ I (Per aCCident) GARAGE LIABILITY ,_=~ ANY AUTO ~l!TO Q.NL Y . EA ACCIDENT $ EA ACC $ OTHER THAN AUTO ONLY B ~! E, X, C, ESSIUMBRELLA,LIABILlTY _l OCCUR [J CLAIMS MADE -- i ,. DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTlVE OFFICERIMEMBER EXCLUDED? If yes, deSCribe under , SPECIAL PROVISIONS below 1 OTHER I I AGG $ EACH OC(:t,)RREN~ _~____, I AGGREGATE i $ f---====~-~ $ ~== I ________ I~________ 1 [509700 11/14/2005 $ i ",,/') X WC STATU. OTH. le~O_~oV 1-;;" EAC:~I~ENT~__j ~-100,~00== --0'-0 :_UJJJSEA~UA EMPLOYEE4.!..1 OO,~OO ,__ EL DISEASE. POLICY LIMIT' $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS AIR CONDITIONING REPAIR AND INSTALLATION CERTIFICATE HOLDER CANCELLATION CITY OF ZEPHYRHILLS BLDG DEPT 5335 8TH ST SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR ZEPHYRHILLS, FL 33540 ACORD 25 (2001/08)