HomeMy WebLinkAbout12-12995 ` CITY OF ZEPHYRHILLS
5335-8TH STREET
(si3)�so-oozo 12995
BUILDING PERMIT
Permit Number: 12995 Address: 38605 LANSING AVE 2
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: MOBILE HOME PARK Lot(s): Block: Section:
Square Feet: Subdivision: SLEEPY HOLLOW MHSUB DIV
Est. Value: Parcel Number: 02-26-21-0260-00000-1210
Improv. Cost: 4,275.00
Date Issued: 4/18/2012 Name: LATHROP, CLINT
Total Fees: 60.00 Address: 38605 LANSING AVE
Amount Paid: 60.00 ZEPHYRHILLS, FL. 33542
Date Paid: 4/18/2012 Phone: (860)334-8244
Work Desc: A/C CHANGE OUT 2.5 TON 13 SEER PACKAGE UNIT
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DUCTS INSU T D
FINAL� '
REINSPECTION FEES: Reinspection fees will comply with Fiorida Statute 553.80(2)(c)when e�ctra 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 calied e) permit not posted on job site fl 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.
"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 Plans,Specifications Must Accompany Application.All work shall be performed in accordance with
Ci Codes and Ordinances. NO OCCUPANCY BEFO C.O.
r �.
C T CTOR SIGN URE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
s�.s-�ao-aCzo City of Zephyrhilis Permit Application Fax-813-780-0021
Building Department
Date Received Phone Contact for Permittin —
Owner's Name �5� �41. '��Q Owner Phone Number � "'J?j - �ay s�-
Owner's Address p t(/ �J�1� t-rv Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS ���pO�� l„Q 1►� j t\ �Q.. � � IS � LOT# � �
SUBDIVISION � lOt1.j PARCEL ID# �� ' •d`—I "(� O--l �
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEW CONSTR B ADD/ALT � SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE � SFR Q COMM 0 OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q
DESCRIPTION OF WORK p� �
BUILDING SIZE SQ FOOTAGE HEIGHT
QBUILDING $ VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.0
QPLUMBING $ _ ��
f� ��
�MECHANICAL � VALUATION OF MECHANICAL INSTALLATION '�� �
� , �
QGAS Q ROOFING Q SPECIALTY 0 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 �( � C�.I�O ���
SIGNATURE REGISTERED Y! N FEE CURRE� /N
Address "I�d� License# �g��jlp`1 \p�
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 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 8�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:
Fiil out application completely.
Owner&Contractor sign back of applicaGon,notarized
If over 52500,a Notice of Commencement is required. (A!C upgrades over a7500)
"' 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 if shingles Sewers Service Upgrades 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 yau, 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 expa�sion of existing buildings, as specified in Pasco �otmty 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 Transpo�tation 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'SIOWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work
will be done in compliance with all applicabie 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-Welis, 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 Flvod Zone "A" in connection with a permitted building using stem wall
construction, i certify that fill will be used oniy to fill the area within the stem wali.
- If fill material is to be used in any area, I certify that use of such fill wiil 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 1 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, sig�ls, welis, pools,�air conditioning, gas, or other installations not specifically included in the appiication. 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
the ob is considered abandoned.
just�able cause for the extension. tf work ceases for ninery(s:�)consecutive days, j
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR�OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENTG, CONSULT
WITH YOUR LEN�ER
FLORIDA JURAT(F.S.117.03)
OWNER OR A(3ENT CONTRACTOR
Subscribed swom (or efo �
Subscribed bu� fl�^ ) e� e this by
Wh s/are personally knovm ro as identlficatl nroduced
Who is/ar ersonally known to a as identlfication.
� -• Notary Public
Notary Public
Commission No.
Commission No.
�� S `�fl� 1� �
nt rq5,stam� Name of Notary type , �.,, Not ry Pubiic State of Fiorida
Name of Notary typed, �� .,,` otary puWic State , r-londa
a° � Joseph L Masae
�� ; Joseph L Mass� �,� . My Commiasion DD9a2937
P� My Commiasion�D942 �a��p� Expires 11129l2013
''+�aFAOa Expiros 11/29/2013
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. R ,8 L E MANUFACTURER SPECIFIGTIONS
LI IT �PERATOR �BOR GUARANTY
� I STRIP H�AT B`Y THE UBOR CHARGE AS ftECOftDED HERE ftEUTNE *CANCELLATIONS* �
707NE E�UIPMENT SERVICED AS NOTED.IS GUARArv- I
❑DEFROST YCLE TEED FOR A PER100 OF 30 DAVS
.i I ALL CANCELLATIONS ARE SUBJECT TO ANY PERMIT
�,� ECTRICAL CSAAPONENTS dRTYfCLOGGEDAIR FILTENS,TRI�PEDBREAKERS FEES iNCURRED BY SA1D COUNTY.APPLICABLE FEES I
�J ,�}REI.AVS �C7 C�,Q�TACTOR AND CLOGGED DRAIN LINE$ARE NOT WA0.RANTY
. ��RLOAD ❑PRESS SWITCH �saues. WILL BECOME THE FINANCIAL RESPONSIBILITY OF
' PURCHASER AND/OR PROPERTY OWNER. I
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-'6OK ❑REP�ACE TMAN TN09E WE 9UPPlY IF XE►NftS LATER BEGOME
_ ❑RELOCATE NECFl9ARV DUE TO OTMEROEF@CTNE PARTA TXEV TECHNICIAN ' � TCCH i{2
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REFRI(,T,.� �� � ����a __ j ORDER AS OUTLINED ABOVE IT IS AGREED THAT THE SELLER W1LL I EP �� � .\,,.
OTY REPIACEDI _. �, �
I RETAIN 71TLE TO ANY EQUIPMENT OR MATERIAL FURNISHED UNTIL �� � t�
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R RECOVEREO� � prv I MADE AS AGREEO 7HE SE�LER SHALL HAVE THE RIGHT TO REMOVE F
REFRIGERANT OiSPOSAL SAME AND THE SELLER Vv1LL BE HELD HARMLESS FOR ANV DAMAGES �TR P�r �
t ' �' RESl1LTING FROIA THE REMOVAL THEREOF PAVM4NTS NOT RiC61VED
- RECVCLED� - OTV WITHIN 10 DAVS ARE SUBJER TO A SERVICE CNARGE OF 1.SN.ON HAft E � - a�---
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