HomeMy WebLinkAbout09-9077 CITY OF ZEPHYRHILLS
5335 - 8T1-1 STREET
(813)780 -0020 9077
BUILDING PERMIT
Permit Number: 9077 Address: 39525 9TH AVE
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: SUNSET ESTATES
Est. Value: Parcel Number: 12- 26 -21- 0300 - 00000 -0230
Improv. Cost: 2,800.00
Date Issued: 4/28/2009 Name: AMISON, MARK
Total Fees: 45.00 Address: 39525 9TH AVE
Amount Paid: 45.00 ZEPHYRHILLS, FL. 33542
Date Paid: 4/28/2009 Phone: (813)355 -7698
Work Desc: REPLACE 2.5 TON A/C UNIT W/ AIR HANDLER
31a � #`� ? * « " it «7 r ?. 3
AIRTECH SERVICES INC NC CHANGEOUT 45.00
fop p f
rA s
D INSTALLED
DUCTS INSULATED , 1
FINAL t '
REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection
trips are necessary due to any one 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
improvemen • • � property. If you intend to obtain financing, consult with your lender or an attorney
before - •• • ing ' u otice of commencement."
6 6g, fir 4 4 41,
CONTRA TOR SIGNATURE PERMIT OFFI ATR
P IT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780 -0020 City of Zephyrhills Permit Application Fax -813 -780 -0021
Building Department
Date Received - Z � - O Phone Contact for Permitting --
Owner's Name VY1 Alt I' 14 in SO n) Owner Phone Number ' /3 355 (.i
Owner's Address 3 ` S as q r1 /4 i e. Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS 39 sas 9 r t LOT #
SUBDIVISION PARCEL ID# (2 -24 - Z(" 63d ' 00000 _0230
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED q. NEW CONSTR ADD /ALT n SIGN n MOVE I I DEMOLISH
INSTALL REPAIR
PROPOSED USE Fri SFR I I COMM 1 I OTHER
TYPE OF CONSTRUCTION I 1 BLOCK I 1 FRAME I I STEEL I] OTHER I
DESCRIPTION OF WORK kip t eQ tacteiyyj /4' e U/V I1 /,zMcN d/0 4 aNdeiusgi •
BUILDING SIZE SQ FOOTAGE HEIGHT
I I BUILDING $ VALUATION OF TOTAL CONSTRUCTION
I I ELECTRICAL $ AMP SERVICE I I PROGRESS ENERGY I 1 W.R.E.C.
I I PLUMBING $
MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
I I GAS I (J 1� (( � JYY R��OO O OFING 1 SPECIALTY I I OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES I—I NO
BUILDER COMPANY
SIGNATURE REGISTERED I Y/ N j FEE CURRENT I Y/ N I
Address 1 License #
ELECTRICIAN COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I
Address 1 License # 1
PLUMBER COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1
Address License #
MECHANICAL COMPANY i T Gh Sej2 V l' c cs .ZP-'G
SIGNATURE ��`� /2 REGISTERED I Y/ N 1 FEE CURRENT I Y/ N I
Address -P d 130)C, ( / o 2 'n hi (k T� 3 License# l'/- els ys0
OTHER ! COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1
Address 1 License #
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -O -W Permit for new construction,
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects
COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R -O -W Permit for new construction.
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
* ** *PROPERTY SURVEY required for all NEW construction.
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required. (A/C 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 NC Fences (Plot/Survey /Footage)
Driveways - Not over Counter if on public roadways..needs ROW
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 of fill 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 Official for a period not to exceed ninety (90) days 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 0 OBTAIN FINANCING, RE CONSUL IN
PAY TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INT
WITH YOUR LENDER OR A ,.2.TTORNEY BEFORE RECORDING YOU' ' OTIC , COMMENCEMENT.
FLORIDA JURAT (F.S. 117.
OWNER OR AGENT • CONTRACTOR
Subscribed and sworn to (or ld) before me this Subscribed and sworn to or affirmed) before me this
by by
y Who Is /are personally kn• to me or has /have produced
Who is/are personally known to me
i has denti mav i on. produced as identification.
as identification.
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed, printed or stamped
Name of Notary typed, printed or stamped
APR -28 -2009 TUE 02:21 PM AIR TECH FAX NO. 813 779 7504 P. 01
AIR TECH SERVICES, INC.
CAC 1815498
P.O. Box 1120
Zephyrhxlls, Fl. 33593
Phone: 813 -779 -7508
Fax: 813 -779 -7504
AX CO`NEILS EE?
Date: o pages:
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APR -28 -2009 TUE 02:21 PM AIR TECH FAX NO, 813 779 7504 P. 02
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ACORDTM CERTIFICATE OF LIABILITY INSURANCE { { DA's "">
PRODUCER j 04/28/09 A COMMUNITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
39336 STH AVENUE ONLY AND CONFERS NO RIGHT 'WORM CERTIFICATE
ZE HYtHILLS, FL 33542 HOLDER. THIS CERTIFICATE DOES NOT AMEND,ILETEND OR
Phone: (813)779 -9902 ALIRR THE COVStu +vE ^gtrpasD>rpsy THE pptlq BELOW.
Fax: (813) 779 -71A3 INSURERS AFFORDING COVERAGE
INSURED
AIR TECH SERVICES INC intsURLRA: American Vehicle Insurance Company
PO )30X 1220
INSURER R:
ZEPHYREILLS EL 33539 INS
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COVERAGE
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THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH
RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES.
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
y :M roucvuncrIvE -- roLIC9,EZrIRATION
TYRE OF INSURANCE I POLICY " NERRR" 1 DATL(MM/DD/VY7 DAT1i(119.AM/YYI :EMITS
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ACHOCCURptCE" s 1, 000.,000
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AGGREGATE s" 2, 000 000
'L AGGREGATE LOOT ArrLIES ODUCTS - CObIPi!)P
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DILSCRIPTION OF OPERATIONS/ OCAT , NRAICLESMICCLUSIONS ADDED BY ZNDORSENSINT/SPECIAL PROVISIONS ..
AIR CONDITIONERS - INSTALLATION, SERVICE, REPAIR
. CERTIFJCATE HOLDER 1 ' ADDEFlo(AL INSVRm,INSURrD LETTER: CANCELLATION
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iNtHIATCeN DATE T1 TRx ffiS1JAr6 nr4URCR wit RNALAVQiI TOi1IAII: _11
DAYS NOME TO TRY CRIM RCATL MOLDIER NAMED TO THE =Ft /MT
PAILDRit TO DOSO SRAM moss NO OHUGATTON OR uoa ny OF ANY KIND
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CITY OF ZEPHYRHILL$
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5335 8TH ST
2 EPxYRHILLS, FL 33542 AvTHORIVEDFEVRESEMTATIVL
Faxes! to: 813 -780 -0021
.
ACORU 26 -S (7l97)
ACORD CORPORATION IfSS
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