HomeMy WebLinkAbout13-14446 CITY OF ZEPHYRHILLS
� � 5335-8TH STREET
(si3)�so-oozo 446
BUILDING PERMIT
Permit Number: 14446 Address: 6126 16TH 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: Parcel Number: 02-26-21-0180-00000-0740
Improv. Cost: 3,400.00
Date Issued: 8/13/2013 Name: KRICK, LISA
Total Fees: 55.00 Address: 6126 16TH ST
Amount Paid: 55.00 ZEPHYRHILLS, FL. 33542
Date Paid: 8/13/2013 Phone: 407-221-3472
Work Desc: A/C CHANGE OUT 2TON SPLIT SYSTEM PULL DOWN FROM ATTIC
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DUCTSINSULATED
FINAL �Z 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) work not ready for
inspection vu�hen 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.
"Warning to ovivner: 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 cifi ti ns ust Acxompany Application.All work shall be performed in acwrdance with
i Codes and Ordinances. NO OCCUPANCY BEFO C.O.
CON C O SIGN URE PERMIT OFFI R
P�R IT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
e�saeo-oo2o City of Zephyrhills Permit Application Faz-813-780-0021
Building Department
Date Received Phone Contact for Permfttin --
Owner's Name �'"��� �r 1 L �� Owner Phone Number '7�� ZZ � J� �7
Owner's Address � � � ( � s Owner Phone Number �
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS w f�'(� ( � �t LOT# �
SUBDIVI510N �— PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CoN57R ADD/ALT Q SIGN Q Q DEMOLISH
INSTALI B RE�AIR
PROPOSED USE Q SFR Q COMM Q OTHER
TYPE OF CONSTRUCTIDN Q BLOCK Q FRAME 0 STEEL Q
DESCRIPTION OF WORK
BUILDING SIZE SQ FOOTAGE� HEIGHT
OBUILDING S VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL a AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBING a _' `
(�(.���J
QMECHANICAL $ ��ov Q U VALUATION OF MECHANICAL INSTALLATION � � � �
�GAS Q ROOFING Q SPECIALTY Q OTHER ��J L' -
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 CURREP Y!N
Address License#
MECHANiCAL COMPANY � � �Ud / ' �-� St
SIGNATURE REGISTERED / N FEE CURRE� /N
Address S�� �P �Li4 G" License# ��°1`- ��� �� 3
OTHER COMPANY
SIGNATURE REGISTERED Y/ 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 aRer submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary FaGlities&1 dumpster;Site Work Permit for subdivisfons/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 aiter submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities 8 1 dumpster.Site Work Permlt for all new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
""'PF�OPERTY SURVEY requfred for all NEW consVuctlon.
DirecNons:
Fill out application completely.
Owner 8 Co�tractor Sign back of application,notarized
If over 52500,a Noti�ce of Commencement is requlred. (AJC upgrades over 57500)
" Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PffRMITTING (Front of Applicatlon 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"restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSfBILITIES: 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 unce�tain 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 cont�actor or contractors, he is advised to have the contractor(s) sign
portions of the "contractor Block° of this application for which they will be responsibie. 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 Transpo�tation 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 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(Chapte�713, Fiorida 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—Homeowne�'s
Protection Guide" prepared by the Florida Depa�tment of Agriculture and Consumer Affairs. If the applicant is someone
other than the"owner", 1 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'SlOWNER'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, WaterNVastewater 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
prope�ties. If use of�II is found to adversely affect adjacent properties, the owne� 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 ptan 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 const�uction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not spec�cally 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 technicat 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
justi�able 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 COMMENC MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEN O A1 ANCING, CONSULT
WITH YO R LENDER OR A►N ATT'ORNEY EFO E RECORDING YOUR NO C O EM NT.
FLORtDA JURAT(F.S. 117.03) j��
OWNER OR AGENT CONTRACTOR
Subsc�lbed and swom to(or afflrmed)before me this Subscribed and swo (o fflrm me this
by by
Who isfare personally known to me or haslhave produced Who Islare personally known to me or haslh d�nUfica on.
as Identlflcadon.
Notary Public � � � Notary Public
Commission No. Com slon
�",., JACf�1ELIN��t��S
.,,;,��,.;
Name of Notary typed,prfnted or stamped Name of Nota ,`' � � r 1�,��14
* `,�.:,
,t IorkkB Tlw�ltoy aMu I�eur�ika 0�3e&to10
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� ���d�c�ty (352) 588-9210 A-1 B COOI 15873 Lake lola Rd.
Tampa (813) 221-5850 Dade City, FL 33523
Heat & Air LLC
Pasco (727) 844-9906 ' � 2 4 �
Lic.#CAC1814373
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NAME ���J CODE 0� � � � TIME iN TiME oUT �RESIDENTIAL AGE OF
EQUIPMENT
ADDRESS APT.NO.
0 COMMERCIAL
CITY ZIP PHONE O.D.MAKE MODEL SERIAL
CUSTOMER �� r e�' � I.D.MAKE MODEL SERIAL
REQUEST �
WORK PERFORMED
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Make all Checks Payabfe to A-1 B Cool Heat&Air, LLC �' •' '• ' � ' ' � PRICE
CHECKLIST • •• • • • ❑ R22 ❑ R410A
CoMPRESSOR I acknowledge that repairs have been performed in ,�,+� �� ^
o sucT.i PSIG a manner satisfactory to me.In the event payment Cl(1 � 6.
❑DISC.�/_PSIG ig not made as agreed,purchaser agree to pay all
o vo�rs c�st of collection includin a reasonable amount as
❑AMPS / RATED 9
❑�o -- 0 3o attomey's fees. Interest at the rate of 18% per �
❑EIECTRICAL CONNECTIONS annum will be added to all delinquent balances.
❑CONTRACTOR POINTS There w' a $20.0 c rge for all retumed
OFANA._/_RATED CF1@C °
O SUPERHEAT ,
❑SUB COOLING � �
CONDENSER COIL AUTHO IZED SIGNATUR
o c�enN I certify that pe Rned services indicate and
O PIN CONDITION installed pa is
0 AMB�ENT •F �
REFRIGERANT 7ECHNIGAN SIGNArURE
❑LEAK � . . . �
0 o.K. PRICE
• • •-.
FAN AND MOTOR PARTS WARRANTY
O AMPS 1_RATEO � Ail parts as recorded are wartanted as per
❑CONTRACTOR POINTS manufacturer specifications. PARTS
❑BLOWERASSM.CLEAN � LABOR GUARANTY SERVICE
O LUBRICATION
❑TOTAL S.P The labor charge as recorded here relative
� to the equipment service as noted, ia TECHNICAL
ELECTRICAL HEAT STRIPS guaranteed tw a period ot 30 days.•No SERVICE
charge'warraMy work will be provided onty SHOP
O INSPECT CONNECTIONS ❑ during normalwoAcing hours. �qgOR
�AMPS_!_RATED
� NO WARRANTY
EVAPORATOR COIL .
o°A�NN •F � ON DRAIN LINES.
❑AIR OUT 'F � A'1 B COOL ��" r—�""'
CONDENSATEAREA � HEAT �AIR, LLC � Y�,
❑INSPECTED PAN IS NOT �
O INSPECTED DRAIN
❑FLOATSWITCH � LIABLE PAID BY:
OWNER'S INITIALS
AIR FILTER RECOMMENDED ACCEPTED DECLINED FOR DAMAGES O CHECK#
❑CLEANED CAUSED BY ❑VISA M/C ❑AMEX O DISCV
OTMPE CED SERVICE WATER LEAKS. ❑FINANCE O CASH
� FLORIDA ENERGY CONSERVATION CODE
Mandatory Duct Inspection Certification for HVAC change-out
For use when part of the duct andlor HVAC system has been replaced(Section 101 4 7 I 1 &FS 553 912)
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Owner� - Contractor name: / c� �i
, � ----- -� - - --- _
� Street acldress � � _ ^�_ Jurisdiction: __ `
� C�:y � _ ___..._ . __ PermitNo.•
�.�!�_._.___,______�_ = Final iospection date: ^�
1 c�rt,fy that ! have inspected the duct work associated with the HVAC unit referenced'uy the permit listed
abc�ve �und it complies with the requirements of Section 101.4.7.1.1 as indicated below:
� Where needed,the existing ducts have been sealed using reinforced mastic or code-approved
eqi��dalent.
D x�ucts are located within conditioned space. (Section 101.4.7.1.1 exception 1)
The joints or seams are already sealed with fabric and mastic(Section 101.4.7.1.1 exception 2)
5ysten� was tested ee I w) repairs were made as necessary—(Section 101.4.7.1.1 exception 3)
Signature• �� � Date: ` _.____ _i
-__ _ ' �_�___�� _
PrRnted Name. �-��-�`'Z� �
�
�;��ntractar l,icense#: .____�����f ��3 � -�
.___--------------------------------------------------------------------------------------------------------------_..----------=
1 certified I have tested the replaced air distribution system(s)referenced by the permit(isted above at a
pressure differcntia! of 25 Pascals(0,10 in. w.c.). -
S i gr�aw re� ______ � � � Date: _
Printed Name. � �_
t arm revismn date:March 18,2011
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Resuits are intended for use with Rheern heating and caoling systems
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