HomeMy WebLinkAbout12-13331 '� CITY OF ZEPHYRHILLS �-
5335-8TH STREET '
�si3��so-oozo 13331
BUILDING PERMIT
PER�AIT I�[�t'�t�AATIC�N L.£�AT�C#N �►RiI�C'fl4N
Permit Number: 13331 Address: 5903 YORKSHIRE DR
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: WEDGEWOOD MANOR
Est. Value: Parcel Number: 10-26-21-0120-00000-0400 i
; Improv. Cost: 5,695.00
� Date Issued: 8/13/2012 Name: LEECH, ROBERT 8� SHIRLEY
' Total Fees: 65.00 Address: 5903 YORKSHIRE DR
Amount Paid: 65.00 ZEPHYRHILLS, FL. 33542
Date Paid: 8/13/2012 Phone: (813)780-1394
Work Desc: A/C CHANGE OUT 3 TON SPLIT SYSTEM (2 COMPONENTS) �
Ct�i'T�A►C7 S APP��lk`t��
BA A , A/ U 5
I I
�
\ `� �/
°���, a�
', '_ % �
,
1r�a
DU IN AL
DUCTS INSU TE
�I FINAL -
REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80(2)(c)when eutra 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 properly 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 commenaement 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�mmencement."
Complete Plans, Specifications Must Accompany Application. All work shall be pertormed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFO C.O.
'� CONT CT R SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
r.--
.
� � � PR4PANE GAS � HeaHngBAirConditloning
� AND AlC iNC. �ce Order/Proposal �rn�r�a`
� LASTS AND LAST.S ANO LASTS:
i��G 1988 ' �
RI?f�R# '^F:F�I!1rE=MAN �,�1��.� 1�1AR
5100 OFF New A/C Unit Installation ��C -F�'���=r� `=��/k��/j �� 1 ��:�.�s
�.t'r i.% p. .
��j.
(limit one per person per househotd) ���� �'f�r��I�F T>
. rR# 'L.C7CR"fI�7N =�4�,��,
www.bahrs ro ane asandac.com • 813-782�-5013 � �'� �'��� r�i�' - � .���''
P P 9 ��t? , h�t A R�.a x,_,!'F)C i.
�
■�����������/�� �������, s�����������
�
c (_�:_��f'f'{; �:if�����(
.J
����?, Yi'j�F;SHIfzE L��
7 uJED.r_,.E_WOOn I�If�NC)R
Z(=PH'fRH.C�_.L� I=I--:�.?�4�='
, :?T TEMF� H1='
NFi:X�,60k'�_r.1.lL_�i�;;�4nt3
TCFi�36FaKA�:!L �Z�1 c 1�.5��?�
LE
QTY MATERIALS & SERVICES UN4T PRfCE AMOUNT
- - - - -------�---
- --. _------ - - ---
- ___._-, - - -t �
� 3 0.� A ,�.�. � 7 �o
o f � C . �V N � D �� � i �
� ,
/ �2 v.�, � ' �
�sz / 0 3� � . � �
io �4 � �
.
F.� << .� � �
� ,
� I� 3% � � i1A,O �
G �f/L /n , '
� ,
�vL� t £ � • � �'/ n/ y �
� i i
i i
R�C`AN#14l�NpAT10NS ' I
. � �
+�131IUe11 Mc7%Il�I7 — i i
���t�e�ed.#;�+�4/t Equrpmen[Manufacturers. Pressures Lo HI T-Stat � i
� ,
REFRIGERANT R- �gg. � I
I �
FILTERS . Changed Monthly �
I
FI�TERS . � Changed Monthly � I
� REGULAR J WARRANTY TOTAL SUMMARY
Dehuttt�{jgtA#5e�tEngs; When here" y�, T-Stat�5� ❑ MAINTENANCE CONTRACT
�,;, When Awa
LIMITED WARRANTY: All materials,parts and equipment are warranted by the manufacturers' SE RV ICE �
orsuppliers'writtenwarrantyonly.Alllaborperformedbytheabovenamedcompanyiswarrantedfor METHOD OF PAYMENT CALL i
30 days or as othenvise indicated in writing.The above named company makes no other warranties, ❑CAS H J CK# TOTAL � �
express or implied,and its agents or technicians are not authorized to make any such war�ties on MATERIALS �
behalf of above named company.
-.� �._l DEBIT J CREDIT ;]OTHER MAINTENANCE i
I have authority to ortler the work outhned above which has been satisfactorJy completed I agree ihat Seller
relams ti�le to equipmenVma�erials furnished unttl final payment is made.If payment is not made as agreed PROG W ; (', I
selier can remove saitl equipment/materials at Seller's ezpense Any damage resulhng from saitl removal shau C�IM#
not be�he respansibility o(Seller.NET 30 DAYS A 1 7/2%SERVICE CHARGE WILL BE AODED MONTHLI TO /
ALL UNPAID BAIANCES OVER 30 DAYS NO REFUNDS DATE COMPLETED
_ ! ov/Gi✓—�f� � OU
� I
"� Q�, `i'�+a �v y,. �.. � �,�.� TECH --�—_AX
/C ..../ i
CUSTOMER SIGNATURE 1// / J I
DATE �/fJ{1'jjf(' 1��r� TOTAL 3� .r-'op
u,.�-�nu-uuzu City of Zephyrhills Permit Application Fax-813-780-0021
• • Building Department
Date Received
Phone Contact for Permittin _
Owner's Name G� j�� ���� Owner Phone Number g l —�80-`�9
Owner'sAddress �-l�' ORK��T�I�� ��. OwnerPhoneNumber
Fee Simple Titleholder Name � Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS ��D D S rr� �IQ, � ��j�` C � �� ��' ' LOT# �
SUBDIVISION , PARCEL ID# I� "2GP'Z� ' ��`LQ` �.�,- /�,�d
(OBTAINED F�pROPERTY T�71cE1 DEMOLISH
WORK PROPOSED B NEW CONSTR ADD/ALT C] SIGN
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM � OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q
DESCRIPTION OF WORK r 1�/°7��� "j- �E? ��}�� 3 �p� Cj ��'� �C �- �� z CtM CJ�UP
BUILDING SIZE SQ FOOTAGE� HEIGHT
QBUILDING $
VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $
�/.3 3�/.
�MECHANICAL $ ����'� VALUATION OF MECHANICAL INSTALLATION
QGAS Q ROOFING Q SPECIALTY � OTHER I ��
FINISHED FLOOR ELEVATIONS l �
FLOOD ZONE AREA [�YES 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 p,��� !�'^,�y COMPANY �/Q� /UC�c$�'j��C��
SIGNATURE L��v//t� ���(�!�� REGISTERED Y/ N FEE CURRE� Y/N
Address License# C13��,��8
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,ConstrucNon Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities 8 1 dumpste�;Site Work Permit for subdivisions/large projects
COMMERCIAL Attach(3)complete sets of Building Ptans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
Minimum ten(10)working days aRer 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.
Fill out application completely.
Owner 8 Contractor sign back of application,notarized
If over 52500,a Notice of Commencement is required. (A/C upgrades over;7500)
*'' Agent(for the contractor)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(PlotlSunrey/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 owne� 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 wilt 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 IMPACTIUTILITIES 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 identi�ed 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 c�rtificate 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 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 instatlation 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 fitl:
- 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
prope�ties. 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 U INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING O R NOTICE OF MMENCEMENT.
FLORIDA JURAT(F.S. 117.03)
OWNER OR AGENT CONTRACTOR y �.(.Q-��!'t'���-
Subscribed and sworn to(or affirmed)before me this Subscribed and s to(or affi ed) efore me this
by �-(3-(Z--
Who islare personally known to me or has/have produced Who is/are pers known to me or haslhave produced
as ldentlficatlon. as identification.
�
Notary Public � i � Notary Public
Commission No. Com i sion ��� ��
r�,Ym:r�= JACQLIELINE BOGES
Name of Notary typed,printed or stamped Name of Notary l�li��q}nb2r'�Q,2Q14
e�a nx,�t�oy F�xu�,�,ca eoa�esaota