HomeMy WebLinkAbout09-9255 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780 -0020 9255
BUILDING PERMIT
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Permit Number: 9255 Address: 5124 16TH ST
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: NC CHANGEOUT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11- 26 -21- 0010 - 20300 -0170
Improv. Cost: 3,100.00 A -: `'�° ka::
Date Issued: 6/16/2009 Name: PANZER, FRANCIS & EVELYN
Total Fees: 50.00 Address: 5124 16TH ST
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 6/16/2009 Phone: (813)629 -4041
Work Desc: 2 TON HEAT PUMP CHANGE OUT
CHRIS' A/C CO. A/C CHANGEOUT �� 50.00
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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 . ur notice of commencement."
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CONT ' CTOR SIGNATURE PERMIT OFFI'R
PERMIT 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 fq rf 5
Date Receil<ed 41 Phone Contact for Permitting �a t -- 4-97 7
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Owner's Name Owner Phone Number r ,
Owner's Address Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address L 1 C
JOB ADDRESS 5 1,2 '[ ` � vt LOT #
SUBDIVISION PARCEL ID# II —a6 _a 1— COI 0-0300-401
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ADD /ALT 1 1 SIGN I 1 MOVE I 1 DEMOLISH
INSTALL REPAIR
PROPOSED USE SFR I I COMM 1 1 OTHER I
TYPE OF CONSTRUCTION II I BLOCK I I FRAME I 1 STEEL 1 I OTHER I
DESCRIPTION OF WORN c2 - n 4 ,L Pc< wte
BUILDING SIZE SQ FOOTAGE HEIGHT
1 BUILDING $ VALUATION OF TOTAL CONSTRUCTION
I 1 ELECTRICAL $ AMP SERVICE 1 1 PROGRESS ENERGY 1 J W.R.E.C.
I I PLUMBING $
MECHANICAL $ 3 i o o . op VALUATION OF MECHANICAL INSTALLATION
GAS I I ROOFING 1 I SPECIALTY I I OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 'YES 1 (NO
BUILDER COMPANY
SIGNATURE REGISTERED I Y/ N I 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 I FEE CURRENT I Y / N I
Address 1 License #
MECHANICAL 01,11 S /"t
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SIGNATURE REGISTERED I Y/ N I FEE CURRENT Y/ N 1
Address License # CA 5 -
OTHER COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I YIN I
Address 1 License # F
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.
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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. (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 A/C 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 x
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
job is considered abandoned.
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the j
WARNING TWICE FOR IMPROVEMENTS YOUR FAILURE TS TO YOUR NOTICE OF COMMENCEMENT
YOU INTEND TO OBTAIN FI Y NANCING CONSULT
PAYING TWIC
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 117.03 / \3'iVYL. .�J-'
OWNER OR AGENT -.0.1 1 _ .1L4 i A O
Subsprib�ind swom to (or affirmed) before me this
Subscribed and sworn to (or affirmed) before me this C., ll b
tV o16 by wn to me or has /have produced Who is /are personally known to me or has /have produced
Who Is /are perso�31LK lcoo as identification.
as identification.
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'' Name of Notary typed, printed or stamped
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Name of Notary typed, printed or stamped
CH R 1 S' AIC SERVICE ORDER
HVAC INVOICE
HIGH EFFICIENT HEATING & COOLING
C O M P A N Y _
3676
CACO58575
12232 HWY 301 DADE CITY (352) 521 -4977
DADE CITY, FL 33525 ZEPHYRHILLS (813) 779 -9515
BILL TO:
SPLIT SYSTEM' X I IPKG UNIT '
NAME: PANZER DATE: 5-26 -09 MODEL ,# 2 TON
ADDRESS: 5124 16TH ST SERIAL #
CITY: ZEPHYRHILLS ZIP CODE:
PHONE: 813 - 629 -4041 WORK: MODEL #
CELL: RENTER: SERIAL #
TECHNICIAN: TONY DATE: 5-26-09
PROBLEM REPORTED: NO COOL BRAND: RHEEMBARD
UNIT LOW ON FREON CHARGED UP COOLING LEAK CHECKED UNIT ACCMLATOR IS L ' ARTS & LABOR
NEEDS TO BE REPLACED ArM,,
/ /. PARTS ONLY
START UP :
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REPLACE NIT DUE TO AGE
UNIT 3100.00 2 TON WP 5 KW
TS 1 LABOR
CHECK # : I•'.
DUE• � CASH: �rz�� ���� ��� �����' � Y t4, � ?g �� e
CREDIT CARD #: SUCTION PRESSURE: 80
CARD TYPE: LIQUID PRESSURE:
APPROVAL CODE: TEMP. DIFFERENCE:
EXPIRATION DATE: FILTER: OK
: DRAINING PROPERLY:
I HAVE THE AUTHORITY TO ORDER THE WORK OUTLINED ABOVE WHICH HAS BEEN 3 3
SATISFACTORILY COMPLETED. I AGREE THAT SELLER RETAINS TITLE TO EQUIPMENT
AND MATERIALS UNTIL FINAL PAYMENT IS MADE. IF PAYMENT IS NOT MADE AS LIMITED WARRANTY: EQUIPMENT, PARTS AND MATERIAL
AGREED, SELLER CAN REMOVE SAID EQUIPMENT AND MATERIALS AT SELLERS EXPENSE HAS WRITTEN MANUFACTURER'S WARRANTY ONLY.
ANY DAMAGE RESULTING FROM SAID REMOVAL SHALL NOT BE THE RESPONSIBILITY ALL LABOR PERFORMED BY CHRIS' A/C HAS A ONE YEAR
OF SELLER. WARRANTY. CHRIS' A/C MAKES NO OTHER WARRANTIES
155.00
pew TOTAL: $
CUSTOMER SIGNATURE
DATE: