HomeMy WebLinkAbout06-5625
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
5625
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:
5625
MECHANICAL
AlC CHANGEOUT
NOT APPLICABLE
Address: 611819TH ST
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 02-26-21-0190-00000-0180
2,795.00
3/29/2006
45.00
45.00
3/29/2006
REPLACE AlC UNIT
Name: LUDWIG, DAVID
Address: 6118 19TH ST
ZEPHYRHILLS, FL. 33542
Phone:
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REINSPECTION FEES: Reinspection fees will comply with Florida statute 553.80 (2)( c) when extra inspection
trips are necessary due to anyone of the following reasons: a) wrong address b) condemned work resulting
from faulty construction c) repairs or corrections not made when inspections 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.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
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."
NO OCCUPANCY BEFORE C.O.
~$ ~~
CONTRKCTOR SIGNATURe - PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
TEMPST&~1
Heating and Cooling Products
iAFi'n's PROPANE GAS & AlC INC.
" .' Sales, Service & Installations
4441 Allen Rd. . Zephyrhills, FL 33541
(813) 782-5013
OTES:
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FILTERS
FILTERS
BELTS
TOTAL MATERIALS
rERIAlS & LABOR: MAY BE
'JTlNUED ON OTHER SlOE
TOTAL LABOR
ERMS
,ave authority to order the work outlined above which has been satisfactorily completed. I agree that Seller
:ains title to equipment/materials furnished until flnal payment is made. If payment is not made as agreed,
Uer can remove said equipment/materials at Seller's expense. Any damage resulting from said removal shall
t be the responsibility of Seller. NET 30 DAYS. A 1 1/2% SERVICE CHARGE WILL BEADOED MONTHLYTQ
l UNPAID BALANCES OVER 30 DAYS. NO REFUNDS
JSTOMER SIGNATURE
DATE
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TOTAL
HVAC SERVICE ORDER / INVOICE
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CHECKED CHARGE
REPAIRED
LEAK IN COIL
REPAIRED
LEAK IN COPPER
CHANGE'r
MOTOR
REPLN~
CONTAC
REPL. S I
RELAY
REPL. S.
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REPAIRE
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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 other warranties. express
or implied, and its agents or technicians are not
authorized ti make any such warranties on behalf of
above named com an .
o REGULAR 0 WARRANTY
o SERVICE CONTRACT
~tank OJIou
CONDENSING UNIT
LEVELED
CLEANED COIL
COND'SATE DRAINS
CLEANED
MAIN DRAIN
REPAIRED
MAIN DRAIN
CLEANED
PAN DRAIN
EVAPORATOR COIL
REPLACED
EXP. VALVE
ENVIRONMENTAL CHECK LIST.
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SERVICE
CALL
TAX
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2 7'1..5100
813-780-0020
City of Zephyrhills Permit Application
Building Department
Fax-813-780-0021
Date Received
I 'e;:
Owner Phone Number
Owner Phone Number I
Owner Phone Number I
Owner's Name
Owner's Address
Fee Simple Titleholder Nam~
..sT
JOB ADDRESS
Fee Simple Titleholder Address I
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I
WORK PROPOSED
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NEW CONSTR
INSTALL
SFR
BLOCK
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I LOT# I
PARCELlD#lo2 -cJ.1o -;) 1- () ,go '-c:t:::I::i:;O - OflrQ
(OBTAINED FROM PROPERTY TAX NOTICE)
rn SIGN 0 MOVE D
SUBDIVISION
PROPOSED USE
TYPE OF CONSTRUCTION
ADD/AL T
REPAIR
COMM
FRAME
DEMOLISH
D
D
OTHER
STEEL
I
o
OTHER I
,.1/(_ {/ V I ',-
/
SQ FOOTAGE I
HEIGHT I
DESCRIPTION OF WORK
BUILDING SIZE I I
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BUILDING
1$
1$
1$
1$ 2-7'1-.5- ,
c=J GAS D
FINISHED FLOOR ELEVATIONS I
D
D
D
D
VALUATION OF TOTAL CONSTRUCTION
ELECTRICAL
AMP SERVICE
D
PROGRESS ENERGY
o
W,R.E.C,
PLUMBING
MECHANICAL
0'0
VALUATION OF MECHANICAL INSTALLATION
ROOFING
D
I
SPECIAL TV D OTHER
FLOOD ZONE AREA DYES
DNO
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BUILDER
SIGNATURE
COMPANY
REGISTERED
Y/N FEE CURRENT
License #
Y/N FEE CURRENT
LIcense #
Y/N FEE CURRENT
License #
Y/N
Address
ELECTRICIAN
SIGNATURE
COMPANY
REGISTERED
Y/N
Address
PLUMBER
SIGNATURE
COMPANY
REGISTERED
Y/N
Address
MECHANICAL
SIGNATURE
Address
License #
OTHER
SIGNATURE
COMPANY
REGISTERED
Y/N
FEE CURRENT
Y/N
Address
RESIDENTIAL
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License #
COMMERCIAL
Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster
Attach (3) sets of Building Plans; (1) set of Energy Forms.
Minimum ten (10) working days after submittal date, Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster
All commercial requirements must meet compliance.
Attach (2) sets of Engineered Plans.
....PROPERTY SURVEY required for all NEW construction,
SIGN PERMIT
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Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement Is required. (A1C upgrades over $5000)
Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs Sewers Service Upgrades A1C Driveways Fences (Plot/Survey/Footage)
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
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 Pasco County Building Inspection Division-Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the .contractor Block" of this application for which they will be responsible. If you; as the owner sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a .certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I
certify that I, the applicant, have been provided with a copy of the .Florida Construction Lien Law-Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the .owner", I certify 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.
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
commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other government 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 Protection-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.
US Environmental Protection Agency-Asbestos abatement.
Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
Use offill is not allowed in Flood Zone .V" unless expressly permitted.
If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating volume" will be submitted at time of permitting which is prepared by a profeSSional engineer
licensed by the State of Florida.
If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
construction, I certify that fill will be used only to fill the area within the stem wall.
If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
. acre which are elevated by fill, an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. 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 codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension
may be requested, in writing, from the Building Officia~ for a period not t~ exceed nin~ty ,90.) da~s and will demonstrate
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the Job IS 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.
FLORIDA JURAT (F.S. 117.03)
OWNER OR AGENT
Subscribed and sworn to (or affirmed) before me this
by
Who is/are personally known to me or haslhave produced
as identification.
CONTRACTOR
Subscribed and sworn to (or affirmed) before me this
by
Who Is/are personally known to me or haslhave produced
as Identification.
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed. printed or stamped
Name of Notary typed, printed or stamped