HomeMy WebLinkAbout13-14826 � CITY OF ZEPHYRHILLS
5335-8TH STREET
(si3��so-oo20 1 6
BUILDING PERMIT
Permit Number: 14826 Address: 7730 KAY MARIE AVE LOT 232
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: MOBILE HOME SUBDIVISION Lot(s):232 Block: Section:
Square Feet: Subdivision: GRAND HORIZONS
Est. Value: Parcel Number: 34-25-21-0010-02800-0232
Improv. Cost: 7,350.00
Date Issued: 12/31/2013 Name: MCDONALD, GLENN & ONA
Total Fees: 75.00 Address: 7730 KAY MARIE AVE LOT 232
Amount Paid: 75.00 ZEPHYRHILLS, FL. 33542
Date Paid: 12/31/2013 Phone: (813)788-6220
Work Desc: A/C CHANGE OUT 3.5 TON 13 SEER PACKAGE UNIT
-�
h
,
DUCTSINSU T
FINAL �
REINSPECiION FEES: Reinspection fees will comply with Florida Statute 553.80(2)(c)when extra ins
trips are neaessary due to any one of the following reasons: a)wrong address b)condemned work resup It�ing
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 rnunty, 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 properly. If you intend to obtain financing,oonsult with your lender or an attorney
Com lete Plans S �f�����n9 your notice of wmmencement."
p , pecifications Must Accompany Application. All work shall be perfarmed in accordance with
Ci Codes and Ordinances. NO OCCUPANCY BEFO C.O.
C NTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
; 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
� Building Department
Date Received 7a� 232 �'f�
Trn-r� Phone Contactfor Pertnitting __
- rrr
Owner's Name Owner Phone Number a 3� —�2
Owners Address /7 Owner Phone Number
Fee Simple Titleholder Name
Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS 1 ��
LOT#
SUBDIVISION PARCEL ID# �.1 . �j�- � —� l
J
(OBTAINED F�PROPERTY TA�710E)DEMOLISH
WORK PROPOSED B NEw CON57R� ADD/ALT � SIGN
INSTALL REPAIR
PROPOSED USE � SFR Q COMM � OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q
DESCRIP710N OF WORK ��� � �
BUILDING SIZE SQ FOOTAGE ,L-• HEIGHT
�BUILDING $
VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE � PROGRESS ENERGY
Q W.R.E.C.
�PLUMBING $
�MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
!
�GAS 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 CURREA �'/nJ
Address
License#
PLUMBER
SIGNATURE COMPANY
REGISTERED Y/ N FEE CURRE� Y/N
Add ress �
License#
MECHANICAL COMPANY ��
SIGNATURE n� ,
ISTERED Y/ N FEE CURRE� Y/N
Address �0 e._P ,. �
�� J� License#
OTHER
SIGNATURE COMPANY
REGISTERED Y/ N FEE CURRE� Y/N
Address
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 II 1 IS 1#1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
RESIDENTIAL Attach(2)plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Pertnit 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 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 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&Contractor sign back of application,notarized
If over$2500,a Notice of Commencement is required. (A/C upgredes over E7500)
" Agent(for the contractor)or Power of Atromey(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"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 contrador 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 specified in Pasco Couniy 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 WatedSewer 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 certity 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 indirzted. I certify that no work or installation has
commenced prior to issuance of a permit and that all work will be pertormed 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 fill:
- Use of fill is not atlowed in Flood Zone"V"unless expressly permitted.
- If the fiIl 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 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 MqY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IN ND TO OBTAIN FINANCING,CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU ICE F COMMENCEMENT.
FLORIDA JUR,4T(F.S.117.03)
OWNER OR AGENT
Subsaibed and swom to(or affirmed)before me this CONTRACTO
by Subsaibed an r re me is
Who is/are personally known to me or has/have produced -bY �
Who is/are personally kno t me or has/have p duced
as identification.
as identfiption.
Notary public ���� 7__' �, �
Commission Na. No�ary Public
Commission No._ � �j�3�03
Name of Notary typed,printed or stamped -----
Name of Notary typed,printetl or stamped
�1;���� LINDSEY BASSETi'
* * MY COMMISSION;f FF 063303
rr � EXPIRES:Octob@r 15,2017
'rF ff F��`O Bonded Thru Budget Notary Servicea
; s:o o � S e
�� � abee AC & Heat - n �_ � f
H�, �� � Inc. 2�#�i�
1�e , �i TOLL FREE:855-833-2665 ccoo��
� MAIN OFFICE NORTH OFFICE
7924 Rutillio Ct. 6896 W.Grover Cleveland Bivd.
"G�tt DOl" New Port Richey, FL 34653 Homosassa, FL 34446
NAME_ C_..-7(PI✓1Y1 I 1111c, � �Ov�'� ��
PHONE�l3- ��-_ (DZ Zc� DATE I Z- i -(�_
ADDRESS 7 7.3v K S V I'�G,r.�¢ �.t .,�
CITY Z-Z'�1'1 � y���,�S ,Q MECHANIC =�5��
COUNTY /4 ZIp S LI I CUSTOMER NO.
JOB LOCATION �,r
PHONE �
EQUIPMENTMFG. � SERVICETYPE!yea,..� �
STYLE LytSL E� MODELNO.�- UNITS/N �—
NATURE OF WORKTO BE DONE �~''� S COMP S/N
�� C
COST SOURCE � J08 COMPLETE? YES NO
QUAN. DESCRiPT10N
I, i PRICE ITEM COST HOURS CHARGE
�°" 5� Pf�-t � K�,J -1-- �
� 7
� ���c�,..�i
'� � -�-s�-�,�
i'E 4 Yf f� ' � �M � 'V+crV � �i
We Value This Opportunity to Serve You! EXECUTIVESAVINGS C
SEE BqCK OF THIS TICKET FOR SPECIAL INFORMATION,AND PROBLEM SOLVING. AGREEMENTDISCOUNT
All electrical parts are non-refuncfable. Su6 TOTA�
Customer request replacement rather than repairs for de ` �
Customer Si nature Pendabili't)I and/O�E+ffiCj@n�y, TOTAL BILLING
MAKE CHECKS PAYABLE TO SEABEE AMOUNT COLLERED �
BALANCE DUE
CUSTOMER SURVEY
1. Was the representative clean in a � P�EASE INITIAL PARTS WARRANTY
ppearance.
z. Was the representative helpful in answering all your questions? A�� Parts as recorded are warranted as per
3. Was the service performed in a professional manner? �Yes _No manufacturer specfications.
4. Did the representative fully explain the services performed or any additional ��Yes _No
services to be performed in a professional and non-pressuring manner? LABOR GUARANTEE
5. Was the work area left neat and clean? 'i.Yes _No
�Yes _No The labor charge as recorded here relative
6. Would you recommend to your friends,relatives and neighbors? to the equipment serviced as noted, is
7. Overall,how would you rate the value you received from Seabee AC&Heat,Inc.�Yes _No guaranteed for a period of 30 days.
Excellent� Good Fair Poor Customer agrees by signing that Seabee qC
��S &Heat,Inc.will not be held responsible for
$30 CHARGE FOR RETURNED CHECK ' any mold or mildew damage.
Warranry on thermosiats is only one year.Warranry as outlined is facto warran Customer d�SO agrees Yflat IY IS thelf
8:00 am to 5.90 pm.Warranty service at other tirries will inwr addi[ionar cost Thi�can not be modified un��5��bN�o al service houn Mon.thru Fri.
responsibiliry to check and maintain their
upon receipt A finance charge of 7'/�%per month will be chergty on all balances over 30 days,plus any atto 9 y ��e office.All accounts due
iryofthisagreementisfecevaluewi[hattom �eYfeesand/orcourtcostsincurred.Totalliabil- drain lines on a regular basis.Seabee qC&
eyfees notto exceed 7 pg6,p��pyymenu mus[be made to Seabee AC&Heat,Inc No warraM�,on drain Iines. ���nc.will not be held responsible for any
I have authority to orcler the work,which has bean saasfactoriy performed,as ouNined above.It is agrety that the seller will reain title to any equipment or 9
material that may be fumished until final paymenc is made,and if settlement is not made as agreed,the seller shall have the right to rertwve same and the dama e resulting from a water leak.
seller wi11 be held harmless forany damages resulting from the removal thereof. Customer understands that after January
Youarenotobligatedtopaya�ymor�y����rousignehiswMractaedretumittotheseller. 1, 2010, manufacturers can no longer use
BUYERS RIGHTTO CANCEL refrigerant R-22.
This is a home solicitation sale,and if you do not wynY the goods or services,you may cancel this agreement b Customer agrees that they are responsible for
Seller in person,by telegrem or by mail.This notice must indicate that you do not want the goocls and services,andvmust be delivered or posr upgrading existing electrical to code.
marked before midnight of the third business day after you sign this agreement tf you cancel this agreement,the seller may not keep all or part of
any cash down payment.Receipt ofthe foregoing Buyers Rightto Cancel is hereby acknowledged on the date listed atthe top ofthis agreement.
Customer's Signature 1� �� i
Date f Z'��-j �
..,�1:'a�c� y.� �c t� aF��ioztuatit�y .ta �iue y�c:,
CAC 1815493
�'ea�' �e
� i"� �� � Seabee AC & He
at, INC.
� _ "� ��� � 7924 Rutillio Court New Port Riche FL 34653
Y,
� . . 1 � Phone: 1 (855) 833-2665 (COOL) Fax: (727) 835-0111
��� �
�,�
�� ,�
�a� I�o `
AUTHORIZATION FORM
Date: /� "�'_C_�_m��r .j � �!�1 �
,
Name of License Holder: Rock A Masse
County Certificate # or State License #: CAC 1815493
The following person(s) are authorized to sign for permits for the above referenced
license holder. All person(s) authorized to sign must produce a valid Driver's License
with photo or Government issues photo ID card with this application. This Authorization
is for Permit Applications only.
NAME(S):PLEASE PRINT SI(' ATURES RELATIONSHIP
Zachary Harris ___ Employee
Authorization forms are good for 12 months of dated form.
(Unless o erwise specified if less than 12 months �
X _ �ii� l �
Signature of License ld r or Authorized Agent
STATE OF - � ��
COUNTY OF � ��
I HEREBY CERTIFY that the foregoing instrument was acknowledged before me this
5}
�-day of `� r , 2p�by .�vC k � c �
� �1 ��C\.�
who is ersonally known to m or who has produced
� as
identifi at'on.
' I
i`
�
Si�n ur of N �� a�t}��a�blic �
. ^ JOHN J.AqqON
* h�Y COMMISSION!i DD 977675
N,9T ap EXPIRES:April 4,20f 4
�
Print, Type, or Stamp Name of Notary m�s
. � . . �% 5�. P��
.
� � � / .
,
�ertificate of Produc� Ra�in s
AHRI Certified Reference Number: 5053552 Date: 12/18/2013
Product: Single-Package Air-Conditioner,Air-Cooled
Model Number: PAJ342000K'"*OA2
Manufacturer: COMFORTMAKER
Trade/Brand name: R410A AC SPP
Series name:
Manufacturer responsible for the rating of this system combination is COMFORTMAKER
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): 40500
EER Rating (Cooling): 11.50
SEER Rating {Cooling): 13.50
IEER Rating (Cooling):
'Ratings followetl by an asterisk(')indicate a voluntary re2te of previous�y published data,unless accompanied with a WAS,which indiptes an involuntary rerate.
DISCLAIMER
AHRI does not endorse the product(s)listed on this Ce�cate and makes no represerrtatioru,wamaMies or guardrrtees as to,and assumes no responsibility for,
the product(s)listed on this Certificate.AHRI expressly disclaims all liablity for damages of any kind arising out of the use or performance ofthe product�s),or the
unauthorized atteradon of data listed on this CeRificate.Ce�ed ratings are valid only for models and configurations listed in the directory at www.ahridirectory.orc�.
TERMS AND CONDITIONS
This Certificate and its cwrte�are proprieWry products ofAHRI.This Certificate shall only be used for individual,personal and confdendal reference purposes.
The corRerrts of this Certificate may not,in whole or in part,be reproduced;wpied;disseminated;erttered irrto a computer database;or otherwise udlized,in any
form or manner or by any means,except for the user's individual,personal and confider�al reference.
CERTIFICATE VERIFICATION � ��,
The irrformation forthe model cited on this ceRiFicate can be verified at www.ahridirecfory.org,
click on"Verify Ce�cate"link and errter the AHRI Certified Reference Number and the date on � ■■., Air-Cond€tioning,!�{f?d1fi3�,
which the certificate was issued,which is listed above,and the Certificate No.,which is listed below. Ci�1d R8fP1�2�a�IOCt IP1S�11U#G
02013 Air-Conditioning, Heating,and Refrigeration Institute CERTIFICATE NO.: 130318716121902360