HomeMy WebLinkAbout14-15672 � CITY OF ZE HYRHILLS
� 5335-8T STREET
(sis)�s�-oozo 1 5 2
BUILDIN PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 15672 Address: 6149 19TH ST
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 02-26-21-0190-00000-0320
Improv. Cost: 11,189.00 OWNER INFORMATION
Date Issued: 1/16/2015 Name: ZURAWSKI SCOTT T & DIANNE JEAN
Total Fees: 95.00 Address: 6149 19TH ST
Amount Paid: 95.00 ZEPHYRHILLS, FL. 33542
Date Paid: 1/16/2015 Phone: (269)268-3585
Work Desc: A/C CHANGE OUT 2 TON
CONTRACTOR S APPLICATION FEES
AMERICAN RESIDENTIAL S R ICES OF C CHANGEOUT 95.00
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Ins ection Re uired
DUCTSINSTALLED
DUCTSINSULATED
FINAL 'L - �. '-�
REINSPECTION FEES: Reinspection fees will comply ith Florida Statute 553.80 (2)(c) when extra inspection
trips are necessary due to any one of the following re sons: a)wrong address b) condemned work resulting
from faulty construction c) repairs or corrections no made when inspections called d) work not ready for
inspection when called e) permit not posted on jo site f) plans not at job site g)work not accessible.
NOTICE: In addition to the requirements of this permit, ther may be additional restrictions applicable to this property that
may be found in the public records of this county, and ther may be additional permits required from other governmental
entities such as water manageme t, state agencies or federal agencies.
"Warning to owner: Your failure to record a notice f commencement may result in your paying twice for
improvements to your property. If you intend to ob in financing,consult with your lender or an attorney
before recording your otice of commencement."
Complete Plans,Specifications Must Accompany Appl cation.All work shall be pertormed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFO C.O.
CONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS ITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - HOUR NOTICE REQUIRED
PROTECT CAft FROM WEATHER
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813-780-0p20 City of Zephyrhills ermit Application Fax-8'13-780-0021
� Building D partment
Gate Received phone Contact tor P ICUng
dwner's Name I A1��� ����-i�V3�K\ Owner Phone Number 2��� � 2����J�b 5
4wne�s Address t��`t"I �`"t� � 4wner Phone Nnmber �� �
� Fee Simple Tltleholder Name Owner Phone N�mber �- �
Fee Simple Titleholder Address
.IOB ADDRESS �t"�'� �_t� � LOT# �
susflmsio� ZEP�k�� 6��'ZG Pnacei�o� t�Z-2t�-21 -d l�tC)-ooaao-032.�
(dBTAiNED FROM PROPERTY TAX NO'iiCE)
WORK PROPOSED NEW CONSTR ADD/ALT 51GN Q 0 DEMOLISH
IMSTALL REPAIR
PROPBSEA US£ Q SFR Q COMM OTHER
TYPE OF CpNSTRUCTION Q BLOCK Q FRAME STEEL Q
DESCRIPTION OF WORK 1�1�AC. -Ci�an i l!� ��.('i Z'}�P� l��-Lr ,��} �y�N��2 � Ct>: ��NLL a��Lf1gp03
BUICDiN6 SiZE �� SQ FOOTAGE HEIGHT C�
QBUILDING �� VALUATlON OF T TAL CONSTRUCTION
QELECTRICAL �� AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. �
QPLUMBlNG �� �1��+�
QMECHAN{CAt. $j! J���`�p VALUATtON OF ECFtANICA�INSTAILATiON 1�_
d[ I :�r
OGAS Q ROOFING Q SPECIALTY OTHER
FINISHED FI.00ft E�EVAT10t9S r�� FLOOD ZON ARFA QYES Nd
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BUILDER � CQMP Y -�
SIGNATURE REGis� o Y/ N FEE CURRE� Y/N
Address License# ��
ELECTRICtAN � � COMP Y �
St�NATURE R���sTE o Y J N �e cutv�n Y 1 N
Address License# �` �
PLUMBER � � COMP Y �
SIGNATURE REGISTE � Y/ N FEE CURRE� Y/N
Address License#�` `�
MEGHANtCAL � `�� CQtNP Y �!C J �
SIGNANRE k REGISTER D Y J Rl FEE CUftREh Y I N
Address ���d �• SC;l.�2-PC.�"��, �� r�• License# C�n��.� 2t� n�9�t
OTHER � � CpMP Y �
SIGNATURE REGISTE o V! N FEE CURRE� Y/N
Address License# �i �
IIIIIIIIIIIIIIIIIII � IIIIIIIIIIIIIMIIIIIIIIIIIIItllllllllllltlllllll
RESiDEM71At. Attach{2)Piot Pians;(2)seis of Buiiding Pians;(3)set of En rgy Forms;R-O-W Permit for new construction,
Minimum ten(44)worfcing days after submiftal date. Require onsite,Construction Plens,Stortnwater Plans w/Silt fience installed,
Sanitery Facilitles&1 dumpster,Sita Work Permit for subdivi ions/large proJects
COMMERCIAL Attach(3)complete sets of Building Plans plus a Li(e Safety age;(1)set of Energy Focros,R-O-W Permit for new eqnstruction,
Minimum fen(i0}work3ng days after submitket date. Require onsite,Gonstruction Plans,Stormwater Ptans wt Sitt Fence installed,
Sanitary Facilities 81 dumpster.Site Work Permit for ait new projects.Afl commercia�requirements must meet compiiance
SIGN PERMIT Attach(2)sets af Engineered Plans.
"'"PROPERTY SURVEY required for a!I NEW constnrction.
Directions:
Fill out applicafion completely.
Qwner&ConVactor sign back of appiicalPon,notarized
!f over 52506,a Noftce of Cammensement!s requlred. {AtC upgradss er b7500)
`• Agent(for the contractor)ar Pawer of Attamey(for the owner)would be so eone with notarized letter from owner authorizing same
OVER THE COUNTER pERMiTTiNG (Frant of Application O�ly}
Reroafs ff shingtes Sewers Service Upgrades AtC Fences(PbU urveyJFaotage}
Driveways-Not over Counter if on pubiic roadways..needs ROW
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NOTiCE dF DEEO RESTRtCTIf3NS: The undersigned unde stands that this permit may be subject to"deed"restrictions"
' � which may be more restrictive than County regulations. The ndersigned assumes respansibility for compliance with any
appiicable deed resUictions.
UNLtCENSED COHTRACTORS AND COHTRACTOFF RE PdNSIBiLITiES: ff the owner has hired a contractor ar
contractors to undertake work,they may be required to be fic nsed in eccordance with state and local regulations. If the
contrac2or is not licensed as required by law, both the own r and contractor may be oifed for a misdemeanar vialation
under state taw. If the owner or intended cantractor are un ertain 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. Furthermare, if the owner has hired a eontractor o contractors, he is advised to have the contractor(s} sign
partions af tYre"confractor Block"of this application for whic they wilt be responsible. If you,as the awner sign as tfie
contractor,that may be an indication that he is not prope�ly I censed and is not entiUed to permitting privileges in Pasco
County.
TRANSPORTATION IMPACTIUTILETlES IMPACT AND RE URCE RECOVERY FEES: The undersigned undersfands
that Transportation Impact Fees and Recourse f2ecovery Fe s may apply to the construction of new buildings,change of
use in existing buildings,or expansion of existing buildings, s specified in Pasco County Ordinance number 89-07 and
90-07,as amended. The undersigned aisa understands,th such fees,as may he due,will be ident�ed a#the time af
permitting. It is further understaod that Transpartation Impa t Fees and Resource Recavery Fees must be paid prior to
receiving a"certificate of occupancy"ar final pawer release. If the project does not involve a cerk�cate af occupancy or
final power reEease,the fees.must he paid prior to permit is uance. Farthermore, if Pasca Gounty WaterlSewer tmpact
fees are due,they must be paid prior to permit issuance in ac ordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713,Florida Statute ,as amended): If valuatian of work is$2,500.00 or more,I
certiiy thaf I, the applicant, have been provided with a py of fhe "Flarida Construotian �ien Caw—FfomeawnePs
Protection Guide"prepared by the Florida Department of Ag"culture and Consumer Affairs. If the applicant is someone
other than the"owne�',I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to fhe"owner"pr'tor to cammencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that ail th informatian in this application is accurate and that all work
will be done in campliance with all applicable laws regulatin construction,zoning and land development. Application is
hereby made to obtain a permit to do work and instalfati n as indicated. l certify that no work or insfaliation has
commenced prior to issuance of a permit and that afl work will be performed to rneet standards of all laws reguiating
construction, County and City codes, zoning regulations, a d lend development regulations in the jurisdiction. I also
certify that t understand that the regulations of other goveen ent agencies may apply to the intended work,and thaf it is
my responsibility to identify wha#actions 1 must take to be in c mpliance. Such agencies inciude bu#are nof timited to:
- Department of Environmentel Protection-Cypres Bayheads, Wetland Areas and Environmentally Sensitive
Lands,Watee/Wastewater Treatment.
- Southwest Florida Water MartagemenE Dist ct-WeIIs, Cypress Bayheads, Wettand Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawa!!s,Docks,Navig b!e Waterways.
- Depertment af Health & 32ehabititative Service Environmental Health Un3t-Wells, Wastewafer Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos a atemeni.
- Federal Aviafion Authorify-Runways.
I understand that the following restrictions apply ta the use of ill:
- Use of fill is not allowed in Flood Zone"V°unless xpressly permitted.
- If the fill material is to ba used irt Ftood Zon "A", it is understood that a drainage plan addressing a
"compensating volume"wiil 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° "in cannectran wifh a perrr:itted buiiding using stem watl
construction,I certify that fiii will be used only to fi�the area within the stem wall.
- If fill material is to be used in any area, I ce ify that use of such fill will not adversely affect adjacent
properties. tf use af fil!is found to adversely aff ct adjacent properties,the awner may be cifed far vialating
the conditions of the building permit issued und r the atfached permit application,far lots tess than one (1)
acre which are elevated by fill,an engineered dra nage plan is required.
!f 1 am the A6EN7 F4ft THE OWNEft,i promise in gaod fait to infarm the owner ef the permitting conditians set forth in
this affidavit prior to.commencing construction. 1 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 ith the wotk and not as authority to violate,cancel,alfer,or
' set aside any provisians of the teehnical cades,nor shall issu nce of a permit prevent the Building Officia(from thereafter
� requiring a corcection of eROrs in plans,canstruction or violati ns of any codes. Every permit issued shall become invalid
' unless the work authorized by sueh permit is commenced wi hin six months of permit issuance,or if wark autharized by
the permit is suspended ar abandoned Eor a period af six(fi} onths after fhe fime the work is comrnenced. An e�ttension
may be requested, in writing,fram the Building Clfficial for a period not#a exceed ninety(90)days and will demanstrate
� justtfiable cause for the e�etension. !f work ceases for ninety( 0)consecutive days,the job is considered abandoned.
� WARNING TO OWNER: YOUR FAILURE Tp RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
� PAYING TWICE FOR IMPROVEMENTS TO YQUR PRdpE TY. IF YOU INTEND TO 4BTAlN FINANCING,CQNSULT
II WITH YOUR LENDER O}2 AM ATTdRNEY BEFORE RECO DING YOUR NOTICE OF CdMMENCEMENT.
FLORIDA JURAT(F.S.'117 )--�
OWNERORAGENT \S"' �� � CON RACTOR
Su6scribed and swom to{or affimted}6efore me fhis Sabs ribed and swom to(ar affirmed)before me this
by by
Who is/aro personally known ta me or has/have produced Who i/are personally known ta me or has/have produced
as ident�cation. as identifccaUon.
....... .......... ......_
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Rcpt:1654339 Rec: 1@.00
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� �'.���� � � � �'����� �� � � •�. �01/16/2015 L. K. , Dpty Clerk
Stete of Flor(da � � rH�sa�aisr�avr-nFOr�c�KOFTNeCauRrt�ariflc�r�oa
Couoty of - -
�iiE tA�fOERSiG�tED 1tie�eby g'nres nafice that ir�prov+emenf�wiH b�made to . ` reaf Propsr[Y. and in acoord�ce wnfi Sec6i�r� 7f3.i3 of if�
Fiorida St�u[e"s.the foliowing infomnatia�is provided'm lhis AtOTICE OF ENCEMENT.
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�-�{.cr•� (�u,w.. FV�-k Uv� o �Oa S l��G s Z, � �j o"z�
�.�v�t�ei{n�arn�tion or L�se�infc�rr�atia�if t�e L�e�ca�acf�d f+�r ir��ver�en�:
aj Name attd adsfs�:ss: Q t�t-�N E Zu Ct S K- Cn t 4 �9.�-5-� . ?� fZ tft2..f..S � '3 3 S'�t Z
b}.Name�d�dress of fe�sitnpie fiiieholder('rf diffe�ent than Chrmer hsfed v�)
c�Intetes#in P�P��� �� '
4.�ont►�ae�ar ittF�rrriaaar� s` S� la�� �.-rz 7�2, �S'�S
�}htatr��f addr�ss; � "� t� N . Sc. rJ r• � t � C'�s ��-.�i�.�r � f�'�-t.. 3371�
b)Telephane No.: "�2 a-?� `-cR�1 —4 R 1'� Fax No.:(op6onal) -
SSurety{i�applicable,a copp af fhe pay�►ent bond is attachedj .
a}Name ar►d address: -PAULR S 0'NEIL,Ph D PA5C0 CLERK & COMPTROLLER �
�����y0���,: 3 02I1612015 01;26 m 1 af 1
cj l�mounf af Bor�d; � ,, OR BK C���� PG G�"S� —
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a)�f�me and address:
b}T'eiephone t�o.: �
7.Rerscrt�s u�rif�it�tfse Sfat�of Fforida d�signat�d�S��r�er upon�ham no6 s or other documents maY be�sen�ed as prorric�d by S�ecfion
713.13�1a{a�7.,florida St�atutes:
a)Name and address: -
b}7elephon��t�.: F��40.:{optionat}
�.a�ar�d'�to F�irrisetf or f�rs�if��d�sigr�ates af �
to receir��a oo��of the Lier►Qr's 1iEof�ce as prouidetf it�Section 7'E 3.�3{1}{i�} Fi�rid�Sfatuf�s.�
b)Pf�ane f�umber of Person ar enGty design�ted by 0►�n�r.
�.E�ir2€Eic�€t€af�a€s�otic�o€cotntt���c�ent(#�e eaip9rafifart da�e rr�ay nof befcxe t(�cam�►te�on of cQnstruc#ion and f�nat paymer►f�o the
cantractar,but will be t imm the date of recordin .untess a dirff�rent is ' e�S: �p
i�1�t�i�t�FO QVi�itER:�Y PI�Yf�fEt�TS C�6A►QE�Y THE QW(StER AFtE� E EXP1Rk�IC}i�E}F T�E[�C��E f�F Cfli��CII�Et�T'1�E -
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• � 1 ��e'��'t o �' . � TRUE P,ND GORR�CT COPY OF TH��dOCUMENT
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BY / �Y CLERK