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HomeMy WebLinkAbout10-10004 CITY OF ZEPHYRHILLS 5335 - 8T1-1 STREET (813)780 -0020 10004 BUILDING PERMIT 01' r '4444 ": >' IS"7 i * 3 e ,=4 Permit Number: 10004 Address: 6135 9TH 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: TYSON Est. Value: Parcel Number: 02- 26 -21- 016 - 000 - 2000 -10 Improv. Cost: 2,850.00 , Date Issued: 1/19/2010 Name: HALL, DANNY & JOAN Total Fees: 45.00 Address: 2119 STOUT RD Amount Paid: 45.00 WELLSVILLE NY 14895 Date Paid: 1/19/2010 Phone: (813)779 -2773 Work Desc: A/C CHANGE OUT 3 .5 TON t t ° AIR H - VI IN AN • 45.00 j fr 7x.. °.Y 'e•...;,.••'':... 1. ... ..e . {',.9 "s'.ffi ::'': :." 4 s 9 ....+�' a.,: ,.:°;: env .,. `` 'E...x` _� , Ay DU IN ALL D DUCTS INSULATED FINAL 3.-/ 0 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 ' our property. If you intend to obtain financing, consult with your lender or an attorney before reco • ing • notice of commencement." • .t e CTOR SIGNATURE PERMIT OFFI R • E • MIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 1 F ` _._ _________.______._.____._• �- -_- try o . 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(� 1 -41 w m 0 z v) ., co Cr • S 9 " -, lZ X 1 o a l'' o atw� wZ .' `�� ^c F• 8 i U Q W Z Z Z N Z W - ` L ..:+ U U❑ ° Q _ Nxw °UQ 0 >: " o w l w ° a1 w o Q U U U H 3 U y r w w< >w Z > a ® 0 000 OO O O �. ❑ ❑ ❑ ❑ ❑❑ 1-‹ EW 1- �,,,., 0ta O ° F Q F ° h1 813-7130-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department Date Received Phone Contact for Permitting - . Owner's Name .- 04 4 0 4 L L Owner Phone Number 6/ p t,3 9 2" 9 Owner's Address I' I i 3 I T H S T I Owner Phone Number I Fee Simple Titleholder Name' 1 Owner Phone Number I I Fee Simple Titleholder Addrress.} I 3 ''77 JOB ADDRESS I l,7 \ 9 r# 3 r 2 iewyRH 1 I L 1. ,S 1 LO T# I q / SUBDIVISION I 1 PARCEL ID #106 -L 1 0160 - '0 6 at0 0/00 I (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED W NEW CONSTR I ADD /ALT n SIGN (— MOVE ED DEMOLISH INSTALL REPAIR PROPOSED USE I SFR I COMM n OTHER I I TYPE OF CONSTRUCTION = BLOCK f] FRAME Q STEEL (1 OTHER I I DESCRIPTION OF WORK kFe Lila fh >: cy-T 0 r R0- 3 1 t t 1"41 BUILDING SIZE I I SO FOOTAGE I I HEIGHT I BUILDING $ 1 VALUATION OF TOTAL CONSTRUCTION El ELECTRICAL $ 1 AMP SERVICE I PROGRESS ENERGY I-1 W.R.E.C. Q PLUMBING $ (l MECHANICAL I$ /t C.Q U o , ` 1 VALUATION OF MECHANICAL INSTALLATION I GAS = t7 ROOFING n SPECIALTY I:=1 OTHER FINISHED FLOOR ELEVATIONS I 1 FLOOD ZONE AREA I" =NO BUILDER COMPANY I SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y1 N I Address ( 1 License # ( ELECTRICIAN COMPANY 1 SIGNATURE REGISTERED I Y / N 1 FEE CURRENT I Y/ N I Address I 1 License # I PLUMBER COMPANY 1 SIGNATURE REGISTERED 1 Y/ N I FEE CURRENT 1 Y/ N I Address I J License # I MECHANICAL l COMPANY I / 11) TEcH Se vw, ce3 1 NC. SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N I Address Al , f : • license # C�C18 OTHER COMPANY I SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address I 1 License # I 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 H over $2500, a Notice of Commencement Is required (NC 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 (PIot/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 MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IN - : • OBTAIN FINANCING, CONSULT WITH YOUR LENDER ! :.al ±• ORNEY BEFORE RECORDING Y• - ' NO _,•1 COMMENCEMENT. FLORIDA JURAT (F.S. .03) / OWNER OR A T CONTRA di Subscribed and o o affirmed) before me this Subscribed and sw• n to (or affirmed) before me this b b Who is /are personalty k o o me or has /have produced Who Is /are pers. • . -' nown to me or has /have produced as identification. as identification. 10 I Notary Public ' Notary Public JACQUELINE BUS.• Commission q !AC Comm si ti JA r rio 621 EL,-, rnrnis mber12 201u { ELIN R FC �.7f1t4 ; "F pO1lR Name of Not aBtit tinted trr'stai4i'pe Name of p or stae010 lllly t /try r41 nlno4 a._. du:�. 2164019 813- 780 -0020 C y O` ZG'? Ir 'S °" t \ , ^ 7) " E' _ r Eui din Dt:p _,ltii iit Date Received . Phone: Contact for Permitting -- - Lyiittiitt31±titltItttt - ttttlti - TT Owner's Name _ _ _____� Owner Phone Number Owner's Address L , Owner Phone Number Fee Simple Titleholder Namel _ _ _ Owner Phone Number Fee Simple Titleholder Address I -- _ -- JOB ADDRESS - — LOT# SUBDIVISION PARCEL ID #1 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED I I NEW CONSTR I I ADD /ALT I I SIGN MOVE I I DEMOLISH INSTALL REPAIR PROPOSED USE I I SFR I I COMM 1 j OTHER I I TYPE OF CONSTRUCTION I I BLOCK I I FRAME I I STEEL I I OTHER I I DESCRIPTION OF WC)RK BUILDING SIZE SQ FOOTAGE HEIGHT I BUILDING $ VALUATION OF TOTAL CONSTRUCTION I I ELECTRICAL $ AMP SERVICE 1 I PROGRESS ENERGY I I W.R.E.C. I I PLUMBING $ I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION I I GAS I I ROOFING 1 1 SPECIALTY I I OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IYES I INO BUILDER COMPANY SIGNATURE REGISTERED I Y/ N 1 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 I N I Address License # T 1 MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT 1 Y / N I Address License # OTHER COMPANY SIGNATURE REGISTERED 1 Y/ N I FEE CURRENT I Y/ N I Address License # I 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 A/C Fences (Plot/SurveylFootage) Driveways -Not over Counter if on public roadways..needs ROW Sent by: A Community Insurance of CFL (813)779 7183 1/19/2010 10:28:49 AM Page 1 of 1 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (IIM/DD/YYYY) 1 /19 / 1 /19/2010 PRODUCER Phone# (813) 779 8802 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION A Community Insurance of Central FL, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Y HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 38336 5th Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Zephyrhills, FL 33541 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: AMERICAN VEHICLE AIR TECH SERVICES, INC INSURER B: P.O. BOX 1120 INSURER C: Zephyrhills, FL 33549 INSURER D: INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 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 DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ALKYL POLICY EFFECTIVE POUCY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE (MM /DD /YY) DATE IMM/DD/YYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurence) $ 100,000 A CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5,000 11182009A_647783 11/18/09 11/18/10 PERSONAL& ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 — 7 POLICY PRO— JFCT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON•OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE UABILITY AUTO ONLY- EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WC STATU- OTH- WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS' LABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER /MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ If yes, describe under SPECIAL PROVISIONS bebw E.L. DISEASE • POLICY LIMIT _ $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Air conditioning CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE THE EXPIRATION Zephyrhills Building Department GATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN 5335 8th Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL Zephyrhills, FL. 33542 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR ATTN: Jackie REPRESENTATIVES. fax 813 780 0021 AUTHORIZED REPRESENTATIVE Tatyana Midili ACORD 25 (2001/08) © ACORD CORPORATION 1988