HomeMy WebLinkAbout12-12989 CITY OF ZEPHYRHILLS `_
' S335-8TH STREET
(sis)�so-oo20 �2989
BUILDING PERMIT
Permit Number: 12989 Address: 4773 SILVER CIRCLE
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: CHALFONT VILLAS
Est. Value: Parcel Number: 15-26-21-0190-00000-0040
Improv. Cost: 6,600.00
Date Issued: 4/17/2012 Name: ROBERTS, RICHARD & JOAN
Total Fees: 70.00 Address: 4773 SILVER CIRCLE
Amount Paid: 70.00 ZEPHYRHILLS FL 33541
Date Paid: 4/17/2012 Phone: (813)780-2836
Work Desc: A/C CHANGE OUT 2 TON HEAT PUMP
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DUCTSINS TED
FINAL ��/Z-- _
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) worlc not ready for
inspection when called e) permit not posted on job site� pians 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.
"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."
Complete Plan pecifications Must Accompany Application.All work shall be pertormed in accordance with
Ci Codes and Ordinances. NO OCCUPANCY BEFO C.O.
O�
CONT CT R SIGNATURE PERMIT OFFI R
E IT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 City of Zephyrhilis Permit Application Fax-813-780-0021
Building Department
Date Received Phone Contact for Permittin
Owner's Name ���n �0 21'� Owner Phone Number 1 3^��C7"oZ$�a
Owner's Address —t �� �v�✓ �\n-�-�e Owner Phone Number �
Fee Simple Titleholder Name �— Owner Phone Number �—
Fee Simple Titleholder Address
JOB ADDRESS �' LOT# �
SUBDIVISION � PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONS7R 8 ADD/ALT � SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE SFR Q COMM � OTHER
TYPE OF CONSTRUCTION BLOCK Q FRAME � STEEL Q
DESCRIPTION OF WORK o? ' �a"n I�l.��' �u�n � S G 1��.n P a J'�' � /ri,S c (c�v c.`�
BUILDING SIZE SQ FOOTAGE� HEIGHT
OBUILDING $ VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $
QMECHANICAL $ Q� 6O VALUATION OF MECHANICAL INSTALLATION �� �(2Gj
� ?/ C/ I
OGAS Q ROOFING Q SPECIALTY 0 OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Addreas License# �—
ELECTRiCIAN � COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# �
PLUMBER COMPANY
SIGNATURE REGISTERED Y 1 N FEE CURRE� Y/N
Address License#
MECHANICAL COMPANY �^ SM��LTY0�1 �C •
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# �
OTHER COMPANY
SIGNATURE REGISTERED Y I N FEE CURRE� Y/N
Address License# �
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Buflding 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 Faciflties&1 dumpster;Site Woric Permit for subdivisionsAarge 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 consVuction.
Directions:
Fill out application completely.
Owner&Contractor sign back of application,notarized
If over E2500,a Notice of Commencement is required. (A/C upgrades over 57500)
" Agent(for the conUactor)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 llpgrades A/C Fences(PIoUSurvey/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 specffied in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned aiso 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 °ce�tificate 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 8� 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�II:
- 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 "An 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 a�ea, 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 R�LE DERIOR AN ATTORNEY EFORE RECORDING YOUR NOT CE OF COMMENCEMENT.' CONSULT
WITH YOU
FLORIDA JURAT(F.S. 117.03) J -
OWNER OR AGENT CONTRACTOR�
S bscribed and s (or afff ed fore me this
Subscribed and swom to(or alflrmed)before me thls ,ya� !y
by T
Who islare personally known to me or haslhave produced Who Islare personall�r known to me or haslhave produced
as identlfica8on. r�-�'��-- as idenHficatlon•
�� .
Notary Public '' �- � Notary Public
`�' JACQUELINE B S
Commission No. Com [�,.�
=� -�'�a.€ Expi►'es December 12,2014
� �'�OF
Name of Notary typed,printed or stamped Name of I�t .
Pasco County Parcel: 15-26-21-0190-00000-0040 001 Page 1 of 1
Data Current as of: Weekly Archive - Saturday, April 14, 2012
Parcel ID 15-26-21-0190-00000-0040 (Card: 001 of 001)
�Classification 01 - Single Family
Mailing Address Property Value
ROBERTS RICHARD&]OAN Ag Land $0
4773 SILVER CIR Land $13,108
ZEPHYRHILLS FL 33541-6516 Building $52,821
Physical Address Extra Features $371
4773 SILVER CIR
ZEPHYRHILLS FL 33541-6516 7ust Value �66,300
Assessed (Save Our Homes) $66,300
Leaal DeSCriDtion (First 4 Lines) Homestead 196.031 - $25,000
See Plat for this Subdivision,p' Non-School Additionai Homestead Exemption - $16,300
CHALFONT VILLAS PLAT II
PB 31 PGS 69-70 Non-School Taxable Value �25,000
LOT 4 School District Taxable Value �41,300
OR 4709 PG 1071 1A►arning: A significant taxable value increase may occur when sold.
Click h re for details and info. regarding the posting of exemptions.
Land Detail (Card: 001 of 001)
Line Use Description Zoning Units Type Price Condition Value
�1 0100 SFR OPUD 3,000.00 � $4.33 1.00 $12,990
�2 0100 SFR OPUD 256.01 � $0.46 1.00 $118
Additional Land Information
Acres 0.08 Tax Area 30ZH FEMA Code �R�sidential Code HC ALLP1
Buildinq Information - Use 07 - Single Family Villas (Card: 001 of 001)
Year Built 1995 Stories 1.0
Exterior Wall 1 Concrete Block Stucco Exterior Wall 2 None
Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle
Interior Wall i Drywall Interior Wall 2 None
Flooring i Cork or Vinyl Tile Flooring 2 Carpet
Fuel Electric Heat Forced Air- Ducted
A/C Central Baths 2.0
Line Description Sq. Feet Repl. Cost New
1 � 1,036 $56,410
2 F�,R 240 $5,227
3 Q 108 $1,470
Extra Features (Card: 001 of 001)
Line Description Year Units � Value
1 DWC 1995 230 $371
Sales History
Previous Owner BROWN ROY JOHN
Year Month Book/Page Type Amount
2001 � 08 4709/ 1071 WD $72,000
http://appraiser.pascogov.com/search/parcel.aspx?sec=15&twn=26&rng=21&sbb=0190&b... 4/17/2012
Bruce Jones Air Conditioning
;--� 5509 Ike Smith Rd. -
; � Plant City, FL. 33565
� -..- � Ph. # (813) 986-0264
8��� � Fax #: {813) 986-8020
I �- ' : ,:,
�----' ' www.brucejonesair.com `�°�° �
CAC056720
Date:3-26-12
Joan Roberfs
4773 Silver Circle
Zephryhills , FI
Ph:813-780-2836
We hereby propose to furnish labor and material in accordance with the
foliowing terms and specifications:
1 )Provide and instali one American Standard platinum ZM 2 ton 18 seer
heat pump system with variable speed air handler with 5kw electric heat
model #'s 4A6Z0024A100 8� AAAAM8AOB30V21
2)Provide and install new hanging hardware , secondary pan and float
switch
3}Relocate air handler and install fiberglass hard duct supply pienum ( this
wili atlow us to shorfen existing fiex drops in bedrooms and kitchen area for
better air flow j
4)Provide and install new supply duct with distribution box for living area
5}Provide and install ground pad and tie downs
6)Provide and instaii American Standard digita! programmable touch
screen thermostat model # ACONT900AC43
7)Provide mechanical permit
� Warranty =12 years on compressor 10 years on all other parfs
10 years on labor
Cost for this project = $6600.00
American Standard rebate = $ 1000.00
Totai after rebates =$ 5600.00
You may signify your acceptance of this proposal by signing in the space
provided below and returning by fax or address listed above.
Proposai acce ' by v Date: � � �t,�
THANK YOU FOR CONSIDERING OUR COMPANY IN YOUR PROJECT!
2011-2012 HILLSBOROUGH COUNTY BUSINESS TAX RECEIPT EXPIRES 9-30-2Q12 FOLIONO
STAMPS FACILITIES OR MACHINES ROOMS SEATS EMPLOYEES
0 0 0 2 RENEWAL 44849 0000
OCC CODE BUSINESS TYPE H wnsrE Tnx
SURCHARGE
090.001 CONTRACT R-A/ HEAT 40 00 18 00
._., �,�� �
� � � y. ��
eusiNESS 5509 IKE SMITH RD
LOCATION PLANT CITY 33565
NAME JONES BRUCE RAYBON/CRAFTSMAN GROUP INC
MAILING 5509 IKE SMITH RD
ADDRESS p�p,NT CITY FL 33565-0000
B U S I N ES S TAX R E C E I PT Df1UG BEL.QEN,TAX COLLEC70R PAID-4291 -85
HAS HEREBV PAID A PRIVILEGE TAX TO ENGAGE 813-53�-52U0 O7/�Z/ZO��I '��rjH OO
IN BUSINESS,PROFESSION,OR OGCUPATION SPEGFIED HEREON TH�B BECOMES A TAX RECEIPT WHEN VAUDATED
�C�:
From:Eileen Corsini FaxID:Morrow Insurance Page 1 of 1 Date:4/11l2012 0520 PM Page 1 of 1
�r1 CRAFT-1 OP ID' EN
'`���.__°R° CERTIFICATE QF LIABILITY INSURANCE �ATE�MMIDWYYW)
04111112
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMA710N ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMA7IVELY OR NEGA7IVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S�, AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CER7IFICA7E HOLDER.
IMPORTANT: If the ceRificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGA710N IS WAIVED, subject to
the terms and conditlons of the policy,certaln policies may requlre an endorsement. A statement on this certiflcate does not confer rights to the
certificate holder in lieu of such endorsement(sj.
PRODUCER 813-963-1669 °�E: MORROW INSURANCE GROUP
MORROW INSURANCE GROUP �C No E :$13-963-1669
�ENORAC.oLNEY/A196o64 813�61�743 P"°"E aC No:813-961-3743
18936 NORTH DALE MABRY HIGHWAY E-MAIL
TAMPA, F�33548 nooRess:EILEEN MORROWINSURANCE.NET
Lenora C.Olney INSURER(S)AFFORDING COVERAGE ruic�
INSURERA FCCIINAT'L TRUST INS.COMPANY 33472
INSURED CRAFTSMAN GROUP INC. iNSUaeRs
5509 IKE SMITH ROAD
PLANT CITY,FL 33565 INSURER C
INSURER D
INSURER E
INSURER F.
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABONE FOR THE POLICY PERIOD
INDICATED. NOTWffHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WffH 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,
EXCLUS�ONSAND CONDITIONS OF SUCH POLICIES.LIMffS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS.
INSR
�7R lYPE OF INSURANCE POLICY NUMBER MMILD�D1`/YYY MMNDIYYYY LIMfTS
GENERALLIABILITY EACHOCCURRENCE $ ��OOO,OO
/Ol X COMMERCIAL GENERAL LIABILITY GL 0000835 70 08�09j1� �8/O9J�Z pREM SES Ea ocwrrence $ �0�,0�
CLAIMSMADE �OGCUR MED EJW(Any one person) $ S,OO
X CONTRACTUAL LIAB. PERSONAL&ADV INJURY $ 1,000,00
GENERAL AGGREGATE $ Z�OOO,OO
GEN'L AGGREGATE UMIT APPLIES PER PRODUCTS-COMPlOP AGG $ Y,OOO�OO
POLICY X PR� LOC $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
Ea aaident $ ��0,��
A X ANY AUTO CA 0001920 10 �$/�9)�� Q$fQ9J�Z BODILY INJURY(Pe�person) $
ALLOWNED SCHEDU�ED
AUTOS AUTOS BODILY INJURY(Per acadenq $
X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE
AUTOS Peracaden[ $
$
UMBRELLA LIAB OCGUR EACH OCCURRENCE $
E%CESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION$ $
WOPo(ERS COMPENSATION WC STATU- OTH-
AFD EMPLOYER3'LIABILITY Y�N TORY IMITS ER
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICER/MEMBER EXCLUDED� ❑ N/A E L EACH ACCIDENT $
(Mandatory in NHj E L DISEASE-EA EMPLOYEE $
If yes,describa untler
DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERA770NS 1 LOCATIONS 1 VEHCLES (Akach ACORD 101,Additional Remarks Schedule,if more space is require�
CERTIFICATE HOLDER CANCELLATION
CITYZEP
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
CITY OF ZEPHYRHILLS TME EXPIRATION DATE THEREOF, N0710E WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISION3.
BUILDING DEPT
CONTRACTOR LICENSING BOARD qu{�.pRIZEpREpRESENTATNE
5335 8TH ST.
ZEPHYRHILLS, FL 33540 � �� � fn /,,,,, ,�
(�ti•"°�
O 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010/05) The ACORD name and logo are registered marks ofACORD
DATE(MM/DDIYYW)
ACOR�� CERTIFICATE OF LIABILITY INSURANCE
THI�RTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT• If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER Alliance Insurance Solutions, LLC ID� TLR coNrncr N,aME: Aimee Gra
c/o TLR of Bonita ��1C PHONE NC No Ext: 727-$2�-7676 x 222 FAXlNC No): 727-525-3862
1700 Dr MLK Jr S�treet N Suite B E-MAIL ADDRESS:
St. Petersburg, FL 33704 — —
_INSURER5�AFPORDINGCOVERAGE _._ ____ _ NAICff
_ _ �NSUrteaA. UNZ Insurance Company
INSURED INSURER B As n Re-London-Best Ratin "A"
TLR Of BO�tta, Inc dba EnterpriseHR INSURER C Catlin S ndicate-Llo ds-Best Ratin "A" _. __ _—_.
Encore Busmess Solutions, Inc
and its Subsidiaries INSURER D sr�t s ndicate-Llo ds-Best Rating��A� __ __ —_
1700 Dr MLK Jr Street N , Ste B i►,suReR e __ —_ — -
St Petersburg FL 33704 INSURER F.
COVERAGES CERTIFICATE NUMBER: 12827702 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW NAVE 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 DESCRlBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS _ __ _
— POLICY EFF POLICY EXP LIMITS
�LTR TYPE OF INSURANCE POLICY NUMBER MAAlOD/YYYY MMIDDlYYYY
GENERAL LIABILITY EACH OCCURRENGE _ S _ _. _
� i DAM AGE TO RENTED
COMMERCIAL GENERAL LIABILITY I PREMISES(Ea occurrence) $_ ___
� �CLAIMSMADE ��OCCUR I, MED EXP(Any one person) $ __ _
-- PERSONAL 8 ADV INJURY $ _ _
��--- -- � I � GENERAL AGGREGATE $ _
�""— -� "— � I PRODUCTS-COMPlOP AGG $
GEN'L AGGREGATE LIMIT APPLIES PER. I F-
POLICY PR6 � �'i L� $
E�a aButler�itSINGLE LIMIT $
AUTOMOBILE LIABILITY -- -------
ANY AUTO BODILY INJURY(Per person) $
F------ ---
AUT0.S ED �_ AUT0.SULED , I �,BODILY INJURY(Per aceitlent) $ __ _
PROPE YTR DAMAGE
� �NON-OWNED peraccWerrt ____ $ . --
HIRED AUTOS L_ AUTOS
� - - - --- -- -$—
UMBRELLALIAB EACH OCCURRENCE $ _
OCCUR ��---t---
� EXCESS LIAB �_L CLAIMS-MADE AGGREGATE _ $ — _
—t
, J DED _,REfENTION$� I I � — - '� —
i —�$
p'�' �$
A WORKERS COMPENSATION WCPE0000000107 6J1/201 1 6l112012 TORY LAMITS ER I
AND EMPLOYERS'UA8ILITY Y!N ' EL EACH AGCIDENT '$ 'I OOOOOO
ANY PROPRIETOR/PARTNERlEXECUTIVE❑ N�A — �-
OFFICER/MEMBER EXCLUDED� E L DISEASE-EA EMPLOYEE $ 1 OOOOOO
(Mandatory ln NH) I —
If yes,describe under E L DISEASE-POLICY LIMIT $ 10���0�
DESCRIPTION OF OPERATIONS below
B Workers Compensation This is for informational purposes
C Excess Coverage � and nothing shall create any right
under such reinsurance.
D
DESCRIPTON OF OPERATIONS/LOCA710NS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required)
Coverage provided for all leased employees but not subcontractors of•Craftsman Group,Inc.dba Bruce Jones A!C
Client Effective Oate 11l29/2007
CERTIFICATE HOLDER CANCELLATION
4836 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Clty of Zephyrhills Building Dept THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
5335 8th St, ACCORDANCE WITH THE POLICY PROVISIONS.
Zephyrhiils FL 33542
AUTHORIZED REPRESENTATIVE �r'r�l��
J ,L�"` 0 �
Glen J Distefano
O 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010l05) The ACORD name and logo are registered marks of ACORD
CEFT NO 12877702 CLTENT CObE TLR Aimee Gray P 727 520 7575 4/11/2012 12 17 55 PM Page 1 of 1
. � STATE OF FLORIDA
_ = _ - DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
F -
CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395
��.�*�"� TALLAHASSEEMONROE STRFLT32399-0783
JONES, BRUCE RAYBON
CRAFTSMAN GROUP INC
5509 IKE SMITH RD
PLANT CITY FL 33565
-- -- ---- = sr���—�mA �- -�'`��7-��{
Congratulations! With this license you become one of the nearly one million �gg�g�_�}g $IISi�S� �ii�73
Floridians licensed by the Department of Business and Professional Regulation. pRQF�SSIQi�,�,, RSGiT�.ATrON
Our professionals and businesses range from architects to yacht brokers,from � •_
boxers to barbeque restaurants, and they keep Florida's economy strong. _ "'ys
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constantly strive to serve you better so that you can serve your customers. Is CSa�xFI� uader tha provisfaas o� c�.489
Thank you for doing business in Florida, and congratulations on your new license! �raEion date: ALT�+'r 31, 2#ti2 L1005Z70U333
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DETACH HERE
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Duct Seal Affidavit
Company�fVCe ..�o,ngS M���2 License# C►�CDS[a7�4
Address y773 S;�UG�✓ Ci�e Permit# t a9 g9
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I �fUt_P J Or12S ,affiant,hereby affirm that I am the duly licensed contractor of record for the above
referenced permit,that all of the forgoing information is true and accurate,and that the duct sealing at the above
referenced address has been completed in accordance with all applicable codes and standards.
Contractors Name(printed) �rUGe �c��12 S Date �7''�$ "�.2
Signature �w--
Pro ect Summarv Job:
� ���t��+���f�� � 'J Date: 4/18/2012
��� � Entire House By: Bruce Jones
Bruce Jones Air Conditionig
5509 Ike Smith Road,Plant Crty,FL 33565 Phone�813986-0264 Fax 813-986-8020 Email:brucesa�r@wildblue.net Web:www.brucepnesair com License:CAC056720
� • ' • •
For� Joan Roberts
4773 Silver Circle,Zephyrhills, FL
Phone. 813-780-2836
Notes.
� - • • •
Weather Tampa, FL, US
Winter Design Conditions Summer Design Conditions
Outside db 41 °F Outside db 91 °F
Inside db 70 °F Inside db 75 °F
Design TD 29 °F Design TD 16 °F
Daily range L
Relative humidity 50 %
Moisture difference 56 grllb
Heating Summary Sensible Cooling Equipment Load Sizing
Structure 14018 Btuh Structure 1011 Q Btuh
Ducts 3177 Btuh Ducts 4919 Btuh
Central vent(0 cfm) 0 Btuh Central vent(0 cfm) 0 Btuh
Humidification 0 Btuh Blower 0 Btuh
Piping 0 Btuh
Equipment load 17195 Btuh Use manufacturer's data
Rate/swing multiplier 1 OOY
Infiltration Equipment sensible load 15029 Btuh
Method Simplified Latent Cooling Equipment Load Sizing
Construction quality Average
Fireplaces 0 Structure 1967 Btuh
Ducts 971 Btuh
Heating Cooling Central vent(0 cfm) 0 Btuh
Prea(ftz) 750 750 Equipment latent load 2938 Btuh
Vblume(fN) 6750 6750
Ai r changes/hour 0 61 0.32 Equipment total load 17966 Btuh
Equiv AVF(cfm) 69 36 Req.total capacity at 0 70 SHR 1 8 ton
Heating Equipment Summary Cooling Equipment Summary
Make American Standard Make American Standard
Trade Trade
Model 4A6Z0024A1 Cond 4A6Z0024A1
AHRI ref no 4385831 Coil AM8AOB30V21
AHRI ref no 4385831
Efficiency 0 HSPF Effciency 19 SEER
Heating input Sensible cooling 0 Btuh
Heating output 0 Btuh @ 47°F Latent cooling 0 Btuh
Temperature rise 0 °F Total cooling 0 Btuh
Actual air flow 610 cfm Actual air flow 610 cfm
Air flow factor 0 035 cfm/Btuh Air flow factor 0 041 cfm/Btuh
Static pressure 0 in H20 Static pressure 0 in H20
Space thermostat Load sensible heat ratio 0 84
Calculations approved by ACCA to meet all requirements of Manual J 8th Ed.
��,� M���, 2012-Apr-18 01 28.22
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�. �;������. R'ight JOO MObile RepOr't Da e: 4118/2012
Ent�re House By: Bruce Jones
Bruce Jones Air Conditionig
5509 Ike Smrth Road,Plant Crty,FL 33565 Phone:813-986-0264 Fau:813-9868020 Email:brucesair�wildblue.net Web:www brucejonesair.com L�cense.CAC056720
� � ' • �
For Joan Roberts
4773 Silver Circle,Zephyrhills, FL
Phone. 813-780-2836
� - • • • •
Location: Indoor: Heating Cooling
Tampa, FL, US Indoor temperature(°F) 70 75
Elevation: 10 ft Design TD(°� 29 16
Latitude 28°N Relative humidity{%) 30 50
OutdOOr: Heating Cooling Moisture difference(grAb) 2.8 55 8
Drybul b(°F) 41 91 Infiltration:
Dailyrange(°� - 15 ( L ) Method Simplified
Vlktbulb(°F) - 78 Constructionquality Average
Wind speed(mph) 15 0 7 5 Fireplaces 0
s
Component Btuhlft2 Btuh %of load
Walls 4 5 3883 22.6 �
Glazi ng 26 5 2646 15 4 ��5.
Doors 115 241 14
Ceilings 1 4 1080 6 3
Floors 5 3 3949 23 0 Iridtr�m
Infiltration 2.2 2219 12.9
Ducts 3177 18 5 a�rg
Piping 0 d
Humidification 0 0 �� �
Ventilation 0 0
Adjustments 0
Total 17195 100.0
• • •
Com onent BtuhNt� Btuh %of load
Walls 2.6 2219 14 8
Glazing 31 1 3112 20 7 �� �"����'
Doors 119 251 17 �
Ceilings 2.7 1988 132
Floors 0 0 0
Infiltration 0 7 649 4 3 c3aar�_
Ducts 4919 32.7
Ventilation 0 0 p�
Internal gains 1890 12.6
Blower 0 0 Qher
Adjustments p ��� �rf�
Total 15029 100.0
Latent Cooling Load=2938 Btuh
Overall U-value=0161 Btuh/f�-°F
Data entries checked.
� ��.i ��,�,,�` 2012-Apr-18 01 28 22
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��C\WINDOWSITEMPIwstmp10dd5daeb-adbf-4030-bc343cd43249c1b1_rup Calc=MJ8 Front Door faces N
. This combination qualifies for a Federal Energy
1 Efficiency Tax Credit when placed in service
between Feb 17,2009 and Dec 31, 2011.
Certificate of Product Ratin s
AHRI Certified Reference Number: 4738366 Date: 4/16/2012
Product: Split System: Heat Pump with Remote Outdoor Unit-Air-Source
Outdoor Unit Model Number: 4A6Z0024A1
Indoor Unit Model Number: *AM8AOB30V21
Manufacturer: AMERICAN STANDARD, INC.
Trade/Brand name: HERITAGE 20
Manufacturer responsible for the rating of this system combination is AMERICAN STANDARD, INC.
Rated as follows in accordance with AHRI Standard 210/240-2008 for Unitary Air-Conditioning and Air-Source
Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent,third
party testing:
Cooling Capacity(Btuh)� 23800
EER Rating (Cooling): 14.00
SEER Rating (Cooling): 19.00
Heating Capacity(Btuh)@ 47 F: 20800
Region IV HSPF Rating (Heating): 9.50
Heating Capacity(Btuh)@ 17 F: 12300
'Ratings followed by an asterisk(")indicate a voluntary rerate of previously published data,unless accompanied with a WAS,which indicates an involuntary rerate.
DISCLAIMER
AHRI does not endorse the product�s)listed on tfiis CeA'rficate and makes no represerMations,warranties or guarentees as to,and assumes no responsibilily for,
the producqs)listed on this Certificate.AHRI expressly disclaims all liability for damages of any kind aNsing out of the use or performance of fhe producqs►,or the
unauthorized alteretion of data listed on this Certificate.Certified retings are valid only for models and configurations listed in the directory at www.ahridirectory.org.
TERMS AND CONDITIONS
This Certficatc and'rts contents are proprietary products of AHRI.This Certifkate shall oniy be used for individual,personal and confidential reference purposes.
The contents of this Certificate may not,in whole or In parf,be reproduced;copied;disseminated;entered into a computer database;or othervvise utilized,in any
fortn or manner or by any means,except for the user's individual,personal and conFidential reference.
CERTIFICATE VERIFICATtON � ��'
The information for the model cited on this certificate can be verified at www.ahridirectory.org,
click on"VeriTy Certificate"link and enter the AHRI Certified Reference Number and the date on � ■■`' Air-Conditioning,Heating,
which the certificate was issued,which is listed above,and the Certificate No.,wnicn is iisted beiow, and Refrigeration Institute
02012 Air-Conditioning, Heating,and Refrigeration Institute CERTIFICATE NO.: 129790831153403954