HomeMy WebLinkAbout14-15694 � .� . , : CITY OF ZE HYRHILLS
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° (sis)�s�-0020 15 94
BUILDIN PERMIT
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����` ; _ _P.ERMIT��INFORMATIQN "LOCATION INFORMATION � �' '�'�`�=�"`°��":���
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Permit Number: 15694 Address: 4534 EAGLE RANCH DR LOT 21
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: EAGLE RANCH
Est. Value: 130,000.00 Parcel Number: 14-26-21-0170-00000-0210
Improv. Cost: 5,849.00 - _ ��.OWNER:�INFO:�RMATIO.N'°`���`����"��`���x�.G:���:
Date Issued: 9/29/2014 Name: KENNON ALLEN
Total Fees: 65.00 Address: 4534 EAGLE RANCH DR
Amount Paid: 65.00 ZEPHYRHILLS, FL. 33542
Date Paid: 9/29/2014 Phone: (813)479-5402
Work Desc: A/C CHANGE OUT 2 TON
CONTRACTOR S APPLICATION FEES =
AIRTIME AIR CONDITIONIG A D HTG A/C CHANGEOUT 65.00
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�° ° ' ` Ins ection "Re uired ' �fi� k`'g �;
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�DUCTS INSTALLEDy
DUCTSINSULATED
FINAL l'G�3l - 1 y
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 r 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 fl 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 properly 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 App ication. All work shall be pertormed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFO C.O.
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CONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS ITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CAR FROM WEATHER
813-780-0020 City of Zephyrhills P�rmit Application Fax-813-780-0021
. , � Building Department
• Date Received Phone ContactforPerthitting V � �l.J � – I L /
Owner's Name �`�� �� Owner Phane Number �7 —1� l� �7�i
Owner's Address ��� � �e Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Slmple Titleholde►Address
JOB ADDRESS ��� 1 e ' LOT# �
SUBDIVISION � , � � PARCEL IDtF � l �4�b–��'V��d�\JIJ�-+IJIJ° ll'��<Y
�OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED B NEW CoNSTR B ADDIALT SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME I STEEL Q
DESCRIPTION OF WORK � � CJ � �
BUILDING SIZE SQ FOOTAGE �O V" HEIGHT �
�BUILDING $ VALUATION OF T TAL CONSTRUCTION
DELECTRICAL $ AMP SERVICE , Q PROGRESS ENERGY Q W.R.E.C.
�PLUMBING $ ��
[�MECHANICAL $ c ,q fcA VALUATION OF ECHANICAL INSTALLATION � `��
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�GAS Q ROOFING Q SPECIALTY � OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZON AREA QYES NO
BUILDER COMP Y
SIGNATURE REGISTE ED Y! N FEE CURRE� Y/N
Address License#
ELECTRICIAN COMP NY
SIGNATURE REGISTE ED Y/ N FEE CURREA Y/N
Address License#
PLUMBER COMP Y
SIGNATURE REGISTE ED Y/ N FEE CURRE� Y/N
Address License#
MECHANICAL COMP Y ��m l�l I� l�l�1�OY1�
SIGNATURE REGIST RED / N FEE CURRE� Y 1 N
Address � � ✓� ������� UZ".- f! ' ''3����License# ��I7C.��
OTHER COMP NY
SIGNATURE REGiST RED Y/ N FEE CURREI. Y/N
Address License#
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII11111111111111
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of E ergy Forms;R-O-W Permit for new construction,
Minimum ten(10)working days after submittal date. Requi ed onsite,Construction Plans,Stormwater Plans wl Silt Fence installed,
Sanitary Facilities&1 dumpster;Site Work Pemtit for subd visions/large projects
COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safet Page;(1)set of Energy Forms.R-O-W Permit for new construction.
Minimum ten(10)working days after submittal date. Requi ed onsite,Construction Plans,Stormwater Plans w/Silt Fence instailed,
Sanitary Facilities&1 dumpster Site Work Permit for all n w projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
""PROPERI'Y SURVEY required for all NEW constructio .
Directions:
Fiil out application completely.
Owner 8 Contractor sign back of application,notarized
If over$2500,a Notice of Commencement is required. (AIC upgrad s over$7500)
'" Agent(for the contracfor)or Power of Attomey(for the owner)would be s meone with notarized letter irom owner authorizing same
OVER THE COUNTER PERMITl1NG (Front of Application Only)
Reroofs if shingles Sewers Service Upgrades A/C Fences(PI t/Survey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
• . � NOTICE OF DEED RESTRICTIONS: The undersigned under tands that this permit may be subject to"deed"restrictions"
. which may be more restrictive than County regulations. The u dersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RES ONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work,they may be required to be lic nsed 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 unc rtain as to what licensing requirements may apply for the
intended work,they are advised to contact the Pasco County uilding 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 li ensed and is not entiUed to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RES URCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fee 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 also understands,tha such fees,as may be due, will be identified at the time of
permitting. It is further understood that Transportation Impa 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 iss ance. Furthermore, if Pasco County Water/Sewer Impact
fees are due,they must be paid prior to permit issuance in ac ordance with applicable Pasco County ordinances.
COMSTRUCTION LIEN LAW(Chapter 713,Florida Statute ,as amended): If valuation of work is$2,500.00 or more,I
certify that I, the applicant, have been provided with a c py of the "Florida Construction Lien Law—Homeowner's
Protection Guide"prepared by the Florida Department of Ag iculture 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 th information in this application is accurate and that all work
will be done in compliance with all applicable laws regulatin construction,zoning and land development. Application is
hereby made to obtain a permit to do work and installati n 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, a d land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other govern ent agencies may apply to the intended work,and that it is
my responsibility to identify what actions I must take to be in ompliance. Such agencies include but are not limited to:
- Department of Environmental Protection-Cypres Bayheads, Wetland Areas and Environmentally Sensitive
Lands,Water/Wastewater Treatment.
- Southwest Florida Water Management Dist ict-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls,Docks,Navi able Waterways.
- Department of Health & Rehabilitative Service /Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos batement.
- 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"unles expressly permitted.
- If the fill material is to be used in Flood Zon "A°, it is understood that a drainage plan addressing a
"compensating volume"will be submitted at tim 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 ill 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. If use of fill is found to adversely a ect adjacent properties,the owner may be cited for violating
the conditions of the building permit issued un er the attached permit application,for lots less than one(1)
acre which are elevated by fill,an engineered dr inage plan is required.
If I am the AGENT FOR THE OWNER,I promise in good fa h to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understan that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or oth r 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 iss ance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans,construction or viol tions of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced ithin 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 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.
�\���`\,�QUINT/� ���/WARNING TO OWNER: YOUR FAILURE TO RECORD NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
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�����0• �...�A/�!4 /.��qYING TWICE FOR IMPROVEMENTS TO YOUR PROP RTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
`�Q-��5$\ON�{•p�.�� H YOUR LEND OR AN RNEY BEFORE REC RDING YOU NOTI E OF OMMENCEMENT.
=Q�O�l1`��10,2o�B 9�.�:�d�IDA JURAT(F.S.1 7. )
=m�}� •� � �R OR AGENT � CO TRACTOR `��1\�{�IIIIII//���
i :� �,``� � ip�{ n bsw to r affirm d) ore me this O c�r e sworn or med)befor e this ` \`���P�pRA D Q�ii����
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��( ; �F �• �1�}f�s a ersonal kno me or has/have produced Wh is/ar rsort me or h s/have produced `� �•�MMISS�p•./yJ'��
� '� � • � as' ntification. as identification. � G N ;q �
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Notary Public L�J Notary Py�• �
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mission No. �� � mission No. / � � i��Y �� ;QQ`
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Name of Notary ty�`pnnted or stamped 1 � � Na e of Notary typed,printed or stamped //��j���/I$�i;i+�1`�O�`\
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PERMIT AGENT AUT ORIZATION FORM
ALL INFORMATION IS TO BE T PED OR LEGIBLY PRINTED
I Anthon Gonzalez � CAC1816958
(Contractor's Name) NOT COMPANY NA E (Contractor's License No.)
hereb authorize the followin to act as m a en (s) in obtainin permits in Ci of Ze h rhills
Name of A `ent � � ` DriveYs License No.
Berneice Vibbert V163-073-79-718-1
Robert Deese
D200=762-64-171-0
� Scott Richardson
R263-785-77-229-0
Radford Richardson
R263-736-90-326-0
Joseph Abel Martinez
M635-010-90-103-0
Joshua Bello
B400-430-91-168-0
Addison Hatcher ' H326-006-93-021-0
This form supercedes any previously submitted letter(s) of authorization.
This form must contain only the people you want to pull permits in your name. To make changes to this
form, you must submit a new form. This form will del te and replace any previous authorization form
and the information contained thereon.
STATE OF \
This authorization will remain in effect until � Ivr��G
cancelled in writing by the undersigned 1 1 t,�
license holder.
COUNTY OF �`l`1S �/OC�(��
Sworn to(or�rmed)and subscribed before me this
I l ,day of o �O'UC� r ,20 �L
b le
(PrintedlTyped ame of Licen e Hal er Making S atement)
ense Holder's Signature Y P LIC
`\������������+����/�� ( �gnature otary)
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` ���0��t 10/�/��.*?/�� (Name ofNotary Typed, Printed,or Stamped)
` ��QO� A��.�ynt % My Commission expires:
- �yt� w�y�.: Personally Known x OR Produced Identification
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