HomeMy WebLinkAbout11-11500 , CITY OF ZEPHYRHILLS
� 5335 - 8TH STREET
(sis)�so-oo20 11500
BUILDING PERMIT
Permit Number: 11500 Address: 5724 18TH 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: Parcei Number: 11-26-21-0010-07900-0160
Improv. Cost: 2,800.00
Date Issued: 2/10/2011 Name: DAVIS, STEPHANIE & JOHN
Total Fees: 50.00 Address: 5724 18TH ST
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 2/10/2011 Phone: (813)788-7907
Work Desc: A/C CHANGE OUT 2 TON
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DUCTSINSULATED
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 � plans not at job site g) work not acc:essible.
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: failure to record a notice of commencement may result in your paying twice for
improvements to y r p rly. if you intend to obtain financing, consult with your lender or an attorney
before reco y ur no f commencement."
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CO T CT, R IGNAT RE PERMIT OFFI R
PERMIT EXP ES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL OR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 City of Zephyrhills Nermit Application / 1 rax
Building Department , � J `u� lJ
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Date Received Phone Contact for Permittin —
Owner's Name � s Owner Phone Number �� ` 0 7
Owner's Address ��� / � Owner Phone Number
Fee Simple Titleholder Name � Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS
� '� �" LOT # ��
SUBDIVISION � . PARCEL ID#
(08TAINED PROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEW CONSTR � ADD/ALT �] SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM � OTHER
TYPE OF CONSTRUCTION Q BLOCK Q �RAME � STEEL Q
DESCRIPTION OF WORK � ` � �
BUILDING SIZE SQ FOOTAGE � � C� HEIGHT
QBUILDING $ VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $
QMECHANICAL $ ���,� VALUATION OF MECHANICAL INSTALLATION
QGAS Q ROOFING Q SPECIALTY � OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER COMPANY
SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/ N
Address ' License #
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
Address License # �— �
PLUMBER � COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N �
Address License #
MECHANICAL COMPANY � �.�..
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
Address License # ��,/ n' , 1 1
OTHER � COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
Address License # �—
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fonns; R-O-W Permit fo� new construction,.
Minimum ten (10) working days after submittal date. Required onsite, Constructlon Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Faalities & 1 dumpster; Site Wor1c Permit for subdivisions/large proJects
Dade City (352) 588-9210 A'1 B C��� � 15873 Lake lola Rd .
Dade City, FL 33523
Tampa (813) 221-5850 Heat & Air, LLC 3 2 4�
P8SC0 (727) $44 -9906 Lic. # CAC1814313
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CUSTOMER �;� ,� ,!�s'� -� J� �•D. MAKE MODEL SERIAL
REQUEST �j � ��
WORKPERFORMED
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Make all Checks Payable to A-1 B Cool Heat 3 Alr, LLC � �''' • PRICE
CHECKLIST ' � ' • • • ❑ R22 ❑ R410A
COMPRESSOR I adcnowledge that repairs have been performed in
❑ SUCL_�_PSIG a manner satlsfactory to me• �n the event payment
0 oisc._r_PSic �S not made as agreed, purchaser agree to pay all
o vo�rs �st of collecUon including a reasonable amount as
O AMPS_/_RATED attome s fees. Interest at the rate ot 1896 per
O 10 O 30 Y
p EIECTRICAL CONNECTIONS annum will be added to all delinquent balances.
o conirnncroR PoiN'►s There will be a$20.00 charge for all retumed
O FAN A. / RATED ChBCkS.
0 SUPERHEAT
O SUB COOLING X
CONDENSER COIL A�TM��D SICaNATURE
a c��w 1 certlfy that 1 have perfortned services indicate and
O FIN CONDITION insta f1S �IStBd.
0 AMBIENT 'F �
REFRIGERANT � TECHNICUW S1c3NATURE
O LEAK
0 o.K. � � PRiCE
FAN AND MOTOR P � $ �
O AMPS / RATED 0 m� �� �^� ae per
O CON7RACTOR POIN7S PARTS
O BLOVYERASSM. CLEAN Q ugpR GU/1R/►NTY SERVICE
0 LUBRICATION The kbor cha►ys n reeoMed here relatHe
O TOTAL S.P. O to }►�e puipment �ervioe as noted, 4 TECHNICAL
gu�ranteed for e period ai 30 daya. 'Nc SERVICE
ELECTRICAL HEAT STRIPS �erDe' M'+�^H ��� Pro� o"b' SHOP
OINSPECTCONNECTIONS ❑ ���OR^�����• LABOR
O AMPS_!_RATED
EvnPORnroR coi� � NO WARRANTY
o c�� ❑ ON DRAIN LINES.
❑ AIR IN 'F
vAIROUT 'F � A'1 B COOL
CONDENSATEAREA � HEAT 8 AIR, LLC ���
O INSPECTED PAN IS NOT
❑ IN3PECTED DRAIN
O FLOAT SWITCH � LIABLE PAID BY :
AIR FILTER RECOMMENDED � c�� �oecuN�o FOR DAMAGES ❑ CHECK #
o c�enNeo CAUSED BY o visn nruc o a,n�ex o �isCv
OTMPE CED SERVICE WATER LEAKS ❑ FINANCE � CASH
t�_�,,�, �STATE OF FLORIDA �
-- --- Q " DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
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-��� CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395
',,�� � 1940 NORTH MONROE STREET
TALLAHASSEE FL 32399-0783
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FINLAY, RUSSELL K
A-1 B COOL HEAT & AIR LLC
15873 LAKE IOLA ROAD �
DADE CITY FL 33523
STATE OF FI,ORIDA AC# 4 9 8 5 0`
Congratulations! With this license you become one of the nearly one miilion D$�A�TMEI�iT ,OF �USINES9 A2Q�
Floridians licensed by the Department of Business and Professional Regulation •�` �, �pROFB�SIONAL R8,C7UTiATTON
Our professionals and businesses range from architects to yacht brokers, from -�-
boxers to barbeque restaurants, and they keep Florida's economy strong '�AC18�+�313 06 f 0�/10 09046508
Every day we work to improve the way we do business in order to serve you better -
For information about our services, please log onto www.myfloridalicense.com. CEI�TIFZgD AIR COND CQNTR
There you can find more information about our divisions and the regulations that F�NLAY' ;� RIISSS�I. K
impact you, subscribe to department newsletters and leam more about the Ar l E'�' CO��'. I�AT & AIR LLC'
DepartmenYs initiatives ,
Our mission at the Department is. License Efficiently, Regulate Fairly We
constantly strive to serve you better so that you can serve your customers IS CERTZFIED unaer tne pro..�Bione of, Ch.489
Thank you for doing business in Florida, and congratulations on your new license! �pirat�ob aate� AUG', 31. 2012 L10U60Q00655
DETACH HERE
Ac# 4 9 8 5 0 9 5 �� ST,#�T� 4F FLORID/� ,
D�PAR"!'1!��,Q ST�UCT�C7�T��1s�TD�TR�RL'I'CEI���IHG��CR��LATION'
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Plamed be�],ow, IS.''�ERTIF�ED _ ",
Under �he p.rov�:sions of'Chap�er 489 F3. ' '
Expiration date: AUG 31, 2012
P'TNLAY, �2T.�SSE,"'LL K „ • ' � .
A=1 ; B �t30L, �H�,"`�T & ',AXR �LC
158;73 LAR�. ��3�A RD „ �
DADE CITY FL 33523
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• e-Bode Systems - Policy Send Form Preview Page 1 of 2
- A�ORD CERTIFICATE OF LIABILITY INSURANCE �oziio�ii'
PRODUCER
JOV ITA INSURANCE AGENCY THIS CERTIFICATE IS iSSUED AS A MATTER OF INFORMATtON
P O BOX 18 9 ONLY AND CONFERS NO RIGHT UPON THE CERTIFICATE HOLDER.
THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
SAN ANTONIO, FL 3357 6 COVERAGE AFFORDED BY THE POLICIES BELOW.
Phone: (352)588-3671 INSURERSAFFORDINGCOVERAGE
Fax:(352)588-2885
INSURED
A-1 B COOL HEAT AND AIR LLC INSURERA: NOr'th Pointe Insurance Company
15873 LAKE IOLA RD INSURERB:
INSURER C:
DADE CITY, FL 33525 INSURERD:
INSURER E:
COVERAGE
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 WFiICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE iNSURANCE AFFORDED BY THE POLICiES.
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCEO BY PAID CLAIMS
INSR POLICY EFFECTIVE POLICY EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER DATE (MMlDD/YY) DATE (MM/DD/YY) LIMITS
ENERALLIABILITY CHOCCURENCE S 1, OOO� 000
X COMMEF2CIAL GENERAL IRE DAMAGE(My mie
ire) S 100, 000
ineiulv
LAIMS MADE Q OCCUR ED EXP(My one person) f 5, O O O
A 8090009322 04/21/2010 04/21/2011 INJUROY�ANDADV s 1, 000, 000
ENERAL AGGREGATE s Z, O O O, O O O
EN'L AGGREGATE LIMIT APPLIES RODUCTS - COMPlOP
ER. GG S 2,000,000
X ppLICY ❑ PROJECT Q LOC
UTOMOBILE LIABILITY OMBINED SINGLE LI,IdFT =
ANY AUTO ea accideM
ALL OWNED AUTOS ODILY INJURY s
SCHEDULED AUTOS Per person)
HIRED AUTOS ODILY INJURY
NON-0WNED AUTOS Per accident) s
ROPERTY DAMAGE s
Per accident)
ARAGE LIA&LITY UTO ONLY - EA s
CCIDENT
ANY AUTO THER THAN EA AC S
UTO ONLY AG ;
XCESS LIABILITY CH OCCURANCE S
CCUR ❑CLAIMS MADE GGREGATE S
S
EDUCTIBLE S
ETENTION E
ORKERS COMPENSATION AND STATUTORY
MPLOYERS LIABILITY
IMITS ❑OTHER
L. EACH ACCIDENT i
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MPLOYEE i
.L.DISEASE - POLICY
iMIT j
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DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Works on heat and air units
CERTIFICATE HOLDER ADDI710NAL INSURED:INSURED LETTER: CANCELLATION
HOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TME
PIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAYOR TO MAIL 10
AYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THf LEFT. BUT
AILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND
PON TNf INSURER ITS AGENTS OR REPRESENTATIVES.
UTHORIZED REPRESENTATNE
CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
5335 8TH STREET
ZEPHYRHILLS, FL 33542
http://amelia.e-bode.com/innovare/GL/SendFormPreviewAndSend.cfm 2/10/2011
e-Bode Systems - Policy Send Form Preview Page 2 of 2
Faxecl to:
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ACORD 26S (7/97) ACORD CORPORATION 1988
http://amelia.e-bode.com/innovare/GL/SendFormPreviewAndSend.cfm 2/10/2011
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ACD �,� C�ERTIFICATE OF LIABILITY INSURANCE i DATE(MM/DD/YWY)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
JOVITA INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTENp OR
POB 189 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
San Antonio, FL 33576
352 588-3671 INSURERS AFFORDING COVERAGE NAIC#
INSURED A B COOL HEAT AND AIR, LLC . INSURER A. PROGRESSIVE EXPRESS INSURANCE COt�ANY
INSURER B: SOUTHERN INSURANCE COMPANY
15873 � I��l � INSURER C:
DADE CITY, FL 33525 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. i
�� '� POLICY NUMBER POLICY EFFECTNE POLICY EXPIRATION LIMITS I
�rn Nsftn P F N RAN E DATE MM/DD/YY DATE MM/DDIYY
CiENERAL LIABILITY EACH OCCURRENCE $
COMMERCIAL GENERAL LIABILIN PREMISES Ea occurence $
I CLAIMSMADE �I OCCUR MED EXP (Any one person) $
PERSONAL & ADV INJURY $ �
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PE PRODUCTS - COMP/OP AGG $
POLICY PR � LOC
JECT
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $
ANYAUTO (Ea accident)
ALL OWNED AUTOS
BODILY INJURY
X SCHEDULEDAUTOS (Perperson) $ ZOO � OOO
A HIREDAUTOS O4531017-1 01�28�11 O7�ZS��.1 gODILYINJURY
NON-OWNEDAUTOS (Peraccident) $ 3 �� i 0 ��
PROPERTY DAMAGE �jO OOO
(PeraccideM) $ i
GARAGELIABILITY AUTOONLY-EAACCIDENT $
ANYAUTO OTHERTHAN �ACC $
AUTOONLY AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
I OCCUR CI CLAIMSMADE AGGREGATE $
$
DEDUCTIBLE $
RETENTION $ $
WORKERSCOMPENSATIONAND A - T -
EMPLOYERS' LIABILITY � X TORYLIMITS ER
ANV PROPRIETOR/PARTNEWEXECUTIVE SIC0012235-01 O6"Z3�1O 06-13-11 E.L.EACHACCIDENT $ 5OO OOO
B OFFICERIMEMBER EXCLUDED9 E.L. DISEASE - EA EMPLOYE $ SOO OOO
If BS, dBS<xibe under O 0 O
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S ECIAL PROVISIONS below E L DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS! LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
Works on heat and air units
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO
CITY OF ZEPHYRHILLS DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIQQ_ DAYS WRITfEN
SUILD ING DEPARTMENT NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHAL
5335 8TH STREET IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS O
ZEPHYRHZLLS, FL. 33542 REPRESENTATIVES. -
. -AUTHORIZED REPRESENTATIVE ��� `
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ACORD25(2007/08) ." � \ �OACORD C TION 1988
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