HomeMy WebLinkAbout11-11897 CITY OF ZEPHYRHILLS
, , 5335 - 8TH STREET
(si3)�so-oozo 11897
BUILDING PERMIT
Permit Number: 11897 Address: 38034 MEDICAL CENTER AVE
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: OFFICE PROFESSIONAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 35-25-21-0070-00000-0030
Improv. Cost: 4,400.00
Date Issued: 5/20/2011 Name: MARCH, PAUL
Total Fees: 60.00 Address: 38034 MEDICAL CENTER AVE
Amount Paid: 60.00 ZEPHYRHILLS, FL. 33542
Date Paid: 5/20/2011 Phone: (813)783-8134
Work Desc: A/C CHANGE OUT 4TON
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DUCTSINSULATED
FINAL �- 3��
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 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 properly. If you intend to obtain financing, consult with your lender or an attorney
before recording your notice of commencement."
CONTRACTOR SI ATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
_ s�s-�eo-oo2o City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
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Date Received Phone Contact for Permittin ��� 5�� -- �
Owner's Name � Owner Phone Number ✓ '"� � 3
Owner's Address Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS � �5 � 3 C/,Z: � LOT # �
SUBDIVISION PARCEL ID# �� v�,�' � � '-' � O / D � �d �Q� """ �.7(J
(08TAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED B NEW CONSTR B ADD/ALT SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q
DESCRIPTION OF WORK Q � Ci �' '-' � TUY�
BUILDING SIZE SQ FOOTAGE HEIGHT
QBUILDING $ VALUATION OF TOTAL CONSTRUCTION
DELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $ // `� ^
� U� �
�MECHANICAL $' L � O Q 61 VALUATION OF MECHANICAL INSTALLATION
. �1 (J
�GAS 0 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 !S '�LG ��
SIGNATURE REGISTERED Y/ N FEE CURRE� / N
Address � ,3 a V J �� t'� �Ci License # ��C' Q J� a� I�
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREA Y/ N
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) worfcing days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities 8 1 dumpster; Site Wor1c 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 wmmercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
""'*PROPERTY SURVEY required for all NEW construcGon.
Dfrections:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required. (A/C upgrades over 57500)
'" Agent (for the contracto�) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs if shingles 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" r�„strictic�ns"
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 unde�take 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 contracto� 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 certi�cate 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 p�ior 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 responsibiliry 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 pe�mit 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, poots, 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) �/'
OWNER OR AGENT NTRACTOR
Subscribed and swom to (or affi before me this Subscribed and swom to (or afflrmed) before me this
by bY
Who is/are personally known to m or has/have produced Who is/are personally known to me or has/have produced
s Identlflcatlon. as identification.
� �
ry Public
T � �-- Notary Public
Commission No. Commi � o ' "
�*t Commisslon # EE 040520
Name of Notary typed, printed or stamped Name of N . P aop3ee.roia
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CACO58575
DATE: � / M /
TO:
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NAME: � � ' � %�� � � '� � � ° r �PHONE #: " " ' ` —� , — .%,.
ADDRESS: " ` ' ' ` � �� ' r '
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CITY: � s `� STATE/ZIP: � '
FURNISH AND IN;3TALL THE FOLLOWING EQUIPMENT AND MATERIAL.
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STYLE AND SIZE A]�U BREAKER STYLE AND SIZE COND. BREAKER
YEAR COMPRESSOR PART WAR.RANTY :� YEAR LABOR WARRANTY ON EQUIPMENT ONLY
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YEAR EQUIPMENT ONLY PARTS WARRANTY
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PRICE $`' ; � Price good for 30 days
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PAYMENT: UPON COMPLETION 50% ROUGH IN 50% UPON FINAL DRAWS
SELLER RETAINS TITLE TO EQUIPMENT/MATERIALS UNTIL PAYMENT IS MADE. IF A PAYMENT IS NOT MADE AS AGREED, SELLER CAN
REMOVE SAID EQUIPMENT/MATERIAL AT SELLER'S EXPENSE. ANY DAMAGE RESULTING FROM SAID REMOVAL SHALL NOT BE THE
RESPONSIBILITY OF SE:I�LER. BUYER WILL BE SUBJECT TO RESTOCKING CHARGE IF JOB IS CANCELED
AGREED
CHRIS' � � DATE '� �� { � � _�
BUYER DATE
12232 US HWY 301 DADE CITY, FL. 33525 PH. 352-521-4977
813-779-9515