HomeMy WebLinkAbout09-9098 CITY OF ZEPHYRHILLS
5335 - 8T1-1 STREET
(813)780 -0020 9098
BUILDING PERMIT
N ......, r a "t , € ` :.. ' .., 'Aviv ' a ., "
Permit Number: 9098 Address: 5931 FOREST LANE
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: NC CHANGEOUT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: FOREST VILLAS
Est. Value: Parcel Number:
Improv. Cost: 3,639.00
Date Issued: 5/19/2009 Name: WETHERELL, ELLIE
Total Fees: 50.00 Address: 5931 FOREST LANE
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 5/06/2009 Phone:
Work Desc: A/C CHANGE OUT ( $
,... T..s �w. "'d E".� &$ °° 8 4'TOY 4 a. .:yN f ir �.��::. ' % �. '•:... r:... �, L50.0� �� Ii .. ..,. �. ... �2n i` - - _ . `�'' . . .. $'C a�.
CORNERSTONE A/C & HEATING INC A/C CHANGEOUT
DUCTS INSTALLED
DUCTS INSULATED
FINAL
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
improvements to your property. If you intend to obtain financing, consult with your lender or an attorney
before recording your notice of commencement."
A A Z r
grever - T F OR SIGNATURE
PERMIT OFFI �R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
May 06 2009 5:21PM HP LASERJET FAX p.1
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813- 780 -0020 City of Zephyrhills Permit Application Fax -813- 780 -0021
Building Department
Date Received 0
D --
DD Phone Contact for Permittin •
Owner's Name , (C.. / // Owner Phone Number X13 - 713 7/100
Owner's Address 5q3 ( / -est Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address �] //�
JOB ADDRESS 51,3 I _S G / / LOT #
SUBDIVISION PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ADD /ALT 1 I SIGN n MOVE I 1 DEMOLISH
INSTALL REPAIR
PROPOSED USE 1 1 SFR 1 1 COMM 1 1 OTHER 1
TYPE OF CONSTRUCTION I I BLOCK / I I FRAME n STEEL I I OTHER I
DESCRIPTION OF WORK /a C 1 , V 161 . Q oil
BUILDING SIZE /000 S' SQ FOOTAGE HEIGHT
1 1 BUILDING $ VALUATION OF TOTAL CONSTRUCTION
1 ELECTRICAL $ AMP SERVICE 1 1 PROGRESS ENERGY n
I 1 PLUMBING $ 9
MECHANICAL $ ✓ 6 �1 9 VALUATION OF MECHANICAL INSTALLATION
I I GAS I 1 ROOFING 1 1 SPECIALTY n OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 'YES 1 INO
BUILDER COMPANY
SIGNATURE REGISTERED I Y/ N ] FEE CURRENT I Y/ N I
Address License #
ELECTRICIAN COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I
Address License #
PLUMBER COMPANY
SIGNATURE REGISTERED I Y/ N j FEE CURRENT I Y/ N I
Address License #
MECHANICAL COMPANY
uiefstzyv ✓�
SIGNATURE l/ REGISTERED Y / N I FEE CURRENT / I Y / N I
Address 11:1) La/ 6 (t&S / l /u e'` License # , CI C 1 el ,S5
OTHER COMPANY
SIGNATURE REGISTERED I Y/ N ] FEE CURRENT I Y/ N I
Address 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) 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 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
atio
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply
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 construction FEES: he f new b gne un dersta of
that Transportation Impact Fees and Recourse Recovery Fees may apply to the
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 clone 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
the e found con diti If use of fill is ditions of the build ingp erm t issued under adjacent
attached permit properties, on, for lots less thanvone violating
the coning
acre which are elevated by fill, an engineered drainage plan is required. condit rth in
If I am the AGENT FOR THE OWNER, �u tion!s I lunde�stan faith
d that a permit may be for c l
this affidavit prior to commencing const
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application.
permit a a ny p i io be construed co i codes, nor shall issuance of a permit prevent the Building Official from thereafter
set aside any provisions of the technic
requiring a correction of errors in plans, construction r enced six of permit pss uince,uordif shall
invalid
unless the work authorized by such permit
p r eques is es ted, spend
in d or writing, from abandoned
the or
Building Official for a period not time
to the
n ninety work
days and will demonstrate
may be rted, in g, from te B g
ob is considered abandoned.
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the j
WARNING G TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO N O BTAIN F Y RESULT
G IN YOU
PAYING TW FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU I
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 117.03)
OWNER OR AGENT CONTRACTOR
Subscribed and sworn to (or affirmed) before me this
Subscribed and sworn to (or affirmed) before me this by
by Who is/are rsonally known to me or has /have produced
Who is/are personally known to me or has /have 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