HomeMy WebLinkAbout10-10432 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780 -0020 { 10432
BUILDING PERMIT
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Permit Number: 10432 Address: 5315 5TH ST
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: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11- 26 -21- 0010 - 12400 -0070
Improv. Cost: 4,842.00 :
Date Issued: 5/06/2010 Name: DE NORA & BOYETTE, TIM
Total Fees: 55.00 Address: 5315 5TH ST
Amount Paid: 55.00 ZEPHYRHILLS, FL. 33542
Date Paid: 5/06/2010 Phone: (813)782 -4493
Work Desc: A/C CHANGE OUT 2.5 TON
Fi
?1,i2 IN HAN • 55.00
DU IN - ALL D
DUCTS INSULATED
FINAL 'S " ( ((,%
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."
6 e.e..— 44/.•
CONOR 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
Date Received Phone Contact for Permitting -
Owner's Name -4 /orA 'f'.S'C0kho Owner Phone Number ei..?" / 8 y 93
Owner's Address S3/5 Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
5-nt. �-./ /.�/ �/
JOB ADDRESS V J • jr. LOT #
SUBDIVISION PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ADD /ALT I 1 SIGN I I MOVE n DEMOLISH
INSTALL le REPAIR
PROPOSED USE rill SFR I I COMM I OTHER I
TYPE OF CONSTRUCTION I 1 BLOCK I I FRAME I STEEL I OTHER I ,
DESCRIPTION OF WORK 2 -r / I ) #Orf4o7 1 A , / , r p��� /,'n��I l`y /1/4 / (00d.
BUILDING SIZE SQ FOOTAGE I HEIGHT
I I BUILDING $ VALUATION OF TOTAL CONSTRUCTION
I ELECTRICAL $ AMP SERVICE 1 I PROGRESS ENERGY I I W.R.E.C.
I I PLUMBING $
,I:1 MECHANICAL $ #(/ v p Op VALUATION OF MECHANICAL INSTALLATION
I I GAS I I ROOFING F SPECIALTY I I OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES [INO
BUILDER COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I
Address License # I
ELECTRICIAN COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N
Address 1 License #
PLUMBER COMPANY
SIGNATURE REGISTERED I Y/ N ] FEE CURRENT I yin' I
Address 1 License #
MECHANICAL COMPANY
SIGNATURE .• '7 '/,Lt.,/ ^' REGISTERED I Y/ N I FEE CURRENT I Y/ N I ■
Address I�7 /7) /L / /►,�,�r C /npA R. Y.y4/O -gy0 License# I!ff E /G P 6 /J I
OTHER COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I YIN I
Address 1 License # 1
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/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 INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 117.03) '`
► '" , CONTRACTOR r
OWNER OR AGENT .�L ■ I ° _ J
and sworn too fflrmed e m = Sub and swim' to r e for e thi
Subscribed 47- 6- a In fja /I /r - ) if rP1 i r3h /� 'L
,5= �- Q by 11` . .„,k — HP r`1'1' °�!"• ��1Jh .._J _5' -6 -/0 by -�
Who is /are,ppersonally known to me or has/have produced Who is /ale personally known to me or has/have produced
0 C�rr 3-e as identification. 1-It.' as identification.
AP
a i ,,, _ OA. - Notary Public •, r,`_,.-- p Notary Public
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Co ssion • Commissio I • Commissio O. �, , /J �A�CQU��pLINEr��1 •
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Name of Notary typed, printed or stamped Name of Notary typ'' q,' ed tiPb 'M
1
• HEATING & AIR CONDITIONING SALES AND SERVICE
MINE TM AIR CONDITIONING — HEATING —AIR PURIFICATION `
mi l
9718 LINDA PLACE, TAMPA, FL 33610
,"� / (813) 621 -0742 DATE: L./.7 ,
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; . / { r �C,✓�" %�''�J t,� •5/ l LOCATION OF JOB 1 7,. `�
We have carefully analyzed your equipment and guarantee the equipment to be of sufficient capacity so produce design conditions
according to Florida Energy Code High of 91" outdoor temperature. Building must be kept reasonably tight, windows and doors kept
closed except for normal passage of persons and properly insulated (minimum of 6 inches thick).
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Up -Grade Service Yes ❑ No I"Size Amps
27 . Existing Ceiling- Damage Yes ❑ No 5/
Duct work will Jag designed, fa icatyd and installed i accprdance with American Society of Heating & Air Conditioning Engineers
Standards of ` OD r '' /rC'►n ; c' tf / Supply and return registers and grills will be
properly sized and of aluminum.
LIMITED WARRANTY
AND SERVICE: All equipment, materials and controls furnished by us has a 1 year ❑ 2 year ❑ warranty, from the date of
installation, against defects in workmanship and material. In addition, we extend to you, the manufacturer's 5 year ❑ 10 year
protection plan on the compressor. Our one year service responsibility does not include breakdowns of Air Conditioner due to blown
fuses, tripped breakers, dirty filters or plugged drain lines. Warranty service ill be performed during normal working hours of 8:00 am.
to 5:00 pm. or on weekends or holidays will be billed to customer at current billing rates of time and one -half.
For this ser )ce the purchaser ag�ees to pa t e seller the sum of - 7 d'7 . Q Dollars, including tax. Payable as
follows: 0 t t..1/•-).0 • 1 < 'D' +1 /� /r i' 5 '1 . Price quoted not valid after 30 days.
This order contains the entire agreement affecting this purchase. No other agreement, understanding or warranty has been made a
part of this contract unless written herein.
"If this instrument is referred to an attorney for collection or enforcement, the maker agrees to pay a reasonable attorney's fee,
plus court costs. If the maker is delinquent for a period of thirty (30) days, a delinquent fee of 1 112% per month will be charged. Title
to the installed merchandise remains vested in the seller until all money due, as the result of the sale has been paid to the seller. Your
acceptance below will be our authority to proceed with the installation. Thank you for your business."
Accepted Date
By . it /C . / ,ttle'.r
Purchaser \ r"" State Lic# CA 1814813
0 •-,. I a Sr (..)
Address: 5 11/ - SEER: 1 •
ri / 2,1 --: P • _ a COP : I
Phone: Date: ,5- Qa/.0 ESPF: i
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R/P: .. RNVZIIImresMIIIIIIIIIIIIIIIIIIIIIS i
ta: ,or . - irialmeinging1111111111111111linnum -
Elect litr:Rfiri,M1M1111111111
Tstatt: Air 4 .0 i
NAMIIIIIIIIIIMIIIIIIIII
Tstat Wire: AO
11111 1111111111111101111111111111
Refri-erant: . tiell11111111n1
Ref. Pi." z t : • 11111111111
A Slab: MIIIINIIIIIIIIIIIIIIIIIHIIIIIIIINIIIN
Line Cover: IIIIIIIIIIIIIIIIIIHIIIIIIIIIIIIIIIIIIIII
PVC Insulation: MIIIII111111111111111111
Metal ' **' a: tallIllillIllUIIIIIIIIIII
Pan 4 Stand: 2gaIIIIIIIIIIIIIIIIIIIINMIIIIIIIB
Return Grills: 111111111.111111111111111111111111111111mm
-1 Grills;
Float Switch:
Millimmuum
Fib e .lass: MallialifillIMMINIUMMIIIIIM
Mastic:
IIIIIIIIIIIMIIIIIIIIIIIIIII
Flex Duct: UFIIIIMIIIIIMIIIIMNIIINIRIMIIIIIIIIIIII
Metal Collars:
Mill.IIIIIIIInjllIllIlIlIl
Electrical: 00 1111111111111111
•
Duct T - / St r- -es: PAINNIIIII
Iliac: 0 11111111111
mommasmen. .
Total Materials; 0,WQ i
Sales Tax
sv.v..,01111111111 1
Permits:
Labor:
SYMMIIIIII 1
Labor:
Labor:
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7 °kez31C°11,: _______
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Total Labor 4 Mkt: crya.„ i
Price After Mar . 95
Warren ; 50
Electrician: i 1
Commisions: / allEMB111111111111111111
Sellin. Price; ' '' 0
# •
OLD DOMINION INSURED
t INSURANCE COMPANY
4601 Touchton Road East, Ste. 3300
P.O. Box 16100, Jacksonville, FL 32245 -6100
Telephone: 1- 904 -642 -3000 / 1 -800- 226 -0875
CONTRACTORS POLICY DECLARATIONS
Named Insured and Mailing Address
SHERREL HEATING AND AIR
CONDITIONING INC Policy Number: MPG75889
9718 LINDA PLACE Account Number: CACG75889
TAMPA, FL 33610
Agent: BUHL INSURANCE AGENCY INC Producer Code: 090065003
AGENT PHONE : 813 876 0057
POLICYHOLDER INFORMATION
Named Insureds Business: AIR COND SYSTEMS OR EQUIP- NO LPG
Entity: CORPORATION
Policy Term: 12
Effective: 12/27/09 (12:01 A.M. Standard Time at the address
Expiration: 12/27/10 of the Named Insured stated above)
In return for the payment of the premium and subject to all the terms of this policy, we agree with you to provide
the insurance as stated in this policy. See the attached schedules for Description of Premises, Property Coverage,
Optional Coverages, Forms and Endorsements applying to this policy and Mortgagee Schedule if applicable.
BUSINESSOWNERS LIABILITY COVERAGE
Liability & Medical Expenses - each occurrence LIMITS OF INSURANCE
Personal and Advertising Injury Limit $ 3 0 0, 0 0 0
Products - Completed Operations A $ 300,000
Aggregate Limit $ 600,000
General Aggregate Limit
$ 600,000
Fire Legal Liability - any one fire or explosion $ 500,000
Medical Expense Limit - per person
$ 10,000
Business Liability and Medical Expense: Except for Fire Legal Liability, each paid claim for the above cover-
ages reduces the amount of insurance we provide during the applicable annual period. Please refer to
section D.4. of the Businessowners Liability Coverage Form.
•
For policies subject to premium audit: Annual Audit Applies.
Commercial Inland Marine Coverage Part INCLUDED
FL EMPAT FUND: 4.00
FL FIRE MARSHALL: $ .76
Estimated Annual Premium: S 857
FL RECOUPMENT: 30.59
TOTAL PREMIUM AND CHARGES S 892.35
Countersigned: 0
64-5470 (7/07) 11/02/09 RENEW JC
STATE OF FLORIDA
• DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
CONSTRUCTION INDUSTRY '"
CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA ,
WORKERS' COMPENSATION LAW 11 '4
EFFECTIVE: 12 EXPIRATION DATE: 12/23/2011
PERSON: SHERRELL R MINSHEW
FEIN: 010847864
BUSINESS NAME AND ADDRESS:
SHERRELL'S HEATING & AIR CONDITIONING SERVICES INC
9718 LINDA PLACE
TAMPA, FL 33610
•
SCOPE OF BUSINESS OR TRADE:
1- HEATING & AIR CONDITIONING
STATE OF FLORIDA AC# 3815 98.8
DEPARTMENT OF BUSINESS AND
PROFESSIONAL REGULATION "` I'
CAC1814813 06/13/08 070`515349 '.
CERTIFIED AIR COND CONTR
MINSHEW, SERRELL RENE
SHERRELL S ::HEATING & AIR CONDITI
IS CERTIFIED under the provisions; .pf Ch -489 P
Expiration date: AUG 31, 2010 L08 0 61 3 0 05 11.
CERTIFICATE OF COMPETENCY
HILLSBOROUGH COUNTY, FLORIDA
Type:CERTIFIED AIR CONDITIONING CONTRACTOR
NO PERMIT UNTIL STATE REGISTERED, IF APPLICABLE
CAC1814813 10/31/2010
• Certificate No. Expiration Date
Issued To:
MINSHEW SHERRELL RENE
DBA:SHERRELL'S HEATING & A/C SERVICES INC
Workers'Comp: EXEMPT 01/12/2010
Issuing Officer
2009 - 2010 HILLSBOROUGH COUNTY BUSINESS TAX RECEIPT EXPIRES 9 -2010 FOLIO NO.
FACILITIES OR MACHIN S - • • S SEATS 3 S _ 9 . 0 0 0 1 RENEWAL 165679.0000
OCC. CODE BUSINESS TYPE H. WASTE TAX
SU
090.001 AIR CO + 2 4 O 9241 CO ; 40.00 18.00
BUSINESS 9718 LINDA PL
LOCATION TAMPA 33610
NAME MINSHEW SHERRELL RENE
MAILING SHERRELLS HEATING & AIR CONDITION
ADDRESS 9718 LINDA PL
TAMPA FL 33610
BUSINESS TAX RECEIPT DOUG BELDEN, TAX COLLECTOR PAID - 1360 - 85
HAS HEREBY PAID A PRIVILEGE TAX TO ENGAGE 813- 635 -5200 07/08/2009 58.00
IN BUSINESS, PROFESSION, OR OCCUPATION SPECIFIED HEREON. THIS BECOMES A TAX RECEIPT WHEN VALIDATED.