HomeMy WebLinkAbout14-15715 CITY OF ZE HYRHILLS
5335-8 STREET
(s��)�s -0020 1 5 5
. �
BUILQIN PERMIT
�t";`�� PERMIT 1NFORNIATION L.t'�CATIQN INFORMATION
Permit�Number: 15715 Address: 5613 19TH ST
Pe�cnit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CNANGEOUT Township: Range. Book:
Proposed Use: NOT APPLICABLE Lot(s); Black: Section:
Square Feet: Subdivision: CITY QF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-p010-11200-0010
improv. Cost: 3,40QA0 t?WNER INFaRMATtON
Date Issued: 10/10I2014 Name: LANE-WORLEY BRENDA
Total Fees: 55.00 � Address: 9703 GLENPOINTE DR
Amount Paid: 55.00 RIVERVIEW FL 33569-5638
Date Paid: 10/10/2014 Phone: 813-475-2522
Work Desc: A/C GNANGE OUT 2.5 TON
CONTRACTOR S APPLICATION FEES
QllALiTY AIR C4 FORT i GHAN EO T 55.44
' Ins ection Re uired
DU TSINSTALLED
DUC7SINSULATED
� FlNAL IO '���- I�-
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R�INSPECTION FEES: Reinspection fees will camply ith Florida Statute 553.80 (2)(c)when e�c#ra inspection
trips are necessary due to any one of the foHawing r sans: a)wrong address b}condemneci work resulting
from faulty construction c) repairs or corrections n made when inspections called d)work not ready for
inspection when called e) permit not posfied an jo site f} plans nat at job site g�wark nat accessible.
IU�TICE: In addition to the requirements af this permit, ther may be additianaE restrictions applicable ta this praperty 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 ta owner: Your failure to record a notice f cammencement may resuit in your paying twice for
improvements to your property. If you intend to ab in financing, consult with your lender or an attorney
before recarding your otice of cammencement."
Cample#e Plans,Specifications Must Accompany App ication.All wark shall be pertormed in accordance with
Ci Codes and drdinances NO{}CCUPANCY BEFO C.O.
���-y�`"
' CON CTO RE PERMIT QFFI R
PE IT XPIRES IN fa MONTHS ITHOUT APPROVED INSPECTION
CALL FOR INSPECTI4N - 8 HOUR NOTICE REQUIRED
PROTECT CAR FROM WEATHER
813-780-0020 City of Zephyr ills Permit Application Fax-813-760-0021
Build g Department
Date Received Phone ConQacQ or Permitting --
Owner's f�ame }�-C �1 (�� L p � �, Ovuner Phone Idumber � � �/J � °252�
Oevner's Address �b �� / / S� Owner Phone fduenber
�ee Sioviple Titleholder F1ame Own�r Phone M�amber
Fee 5imple Titieholder Address
�o��►����SS � 9 s� ��- ��� Is. �oT# 0
SUBDINI5101d PARC L 9D# t� ' Z y - 2 f �' �b�D�- �l Z D n— QQ f �
. (OBTAIRIED FROAA PROPERTY TdX NOTICE)
HNORb(Pi20POSED B lVEW CONSTR 8 ADD/A T 0 SIGIV Q Q DEMOLISH
INSTALL REPAI
�6tOPOSED U5E Q SFR Q COM 0 OTHEl2
T1fPE OF CONSTItUCTIORI Q BLOCK Q FRAM j 0 STEEL 0
D�SCRIPTIOId OF HNORK l/1 aJ'� � 6iL/ �X�s �,�1 � P�m �3 i� �'vY!v�Fil'!�e/' �1��/
�U1�.�9R9G SIZE Sf�FOOyE�GE � � �BEIGHT p �
QBUILDING $ VALUATIO OF TOTAL CONSTRUCTION
DELECTRICAL $ AMP SER ICE 0 PROGRESS ENERGY Q W.R.E.C.
OPLUMBING $ J
�MECHANICAL $ ���� �U VALUATIO OF MECHANICAL INSTALLATION `��� S
�
QGAS Q ROOFING Q SPEC ALTY 0 OTHER
FINISHED FLOOR ELEVATIOMS FLOO ZONE AREA QYES fV0
BUILDER C fUIPAtdY
SIGfdATURE R GISTERED Y/ M FEE CURRE� Y/N
�ddress License#
�LEC7'RICIAtd C Rf1PAfdV
�IGfde4TURE R GISTERED Y/ N FEE CURRE� Y/N
Address License#
PLUAflIBER RAPAfdV
SIGWs�TURE R GISTERED Y/ N FEE CURRE� Y/IV
Address License#
AII�CHARIICAL ' OAAP�AfdY 1hGL/�T� �/� U� b�' �I�
SE�xRI�TU�E R GISTERED Y/ fV FEE CURRE� Y/fV
alddress �7�� ad/o�Q �G � �13�G�v License# G�CO s2 Z�
oTH�� �1�., 9J� 9� OflAPAMY
SIGRIATURE GISTERED Y/ RI FEE CURRE� Y/M
B►ddress License#
R�SIDE�TIea►L Attach(2)Plot Plans;(2)sets of Building Plans;(1)s t 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,
I Sanitary Facflities 8 1 dumpster;Site VVork Permit fo subdiv(sionsllarge projects
CORARAEP2CIAL 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 wl Silt Fence installed,
Sanitary Facilities&1 dumpster.Site Work Permit fo all new projects.All commercial requirements must meet compliance
SIGR1 PERMIT Attach(2)sets of Engineered Plans.
°•°"PROPERTY SURVEY required for all NEW cons uctlon.
Direc@ions:
Fill out applicat(on completely.
Owner 8 Contractor sign back oi application,notar(zed
I�oeer$2500,a(dotice of Commencement Is required. (�/C u grades over�7500)
°° Agent(for the contractor)or Power of Attomey..(for the owner)woul be someone with notarized letter from owner authorizing same
OdER THE COUfdTER PERMI7TI(dG (Front,of.i4pplicatjon Only)
Reroofs if shingles � Sewers �,�,Service Upg�ades NC Fen s(PIoUSurvey/Footage)
Drivevuays-Not over Counterif on•publiaroadwajis.;n�ecfs ROW
PlOTICE Of� ���D R��T�9CYIOP��: The undersigned understands that this permit may be subject to"deed" restrictions"
which may be more restrictive than County regulaYions. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
11R9L9CfERIS�D COP17R��YO�t� ��� �ORI���'��� ����OR9�If�ILl�lf��: If the owner has hired a contractor or
contractors to undertake vvork, they may be required Yo 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 infended contractor are uncertain as fo 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 wilt be responsible. If you, as the ov�rner sign as the
contractor, that may be an indication that he is noF properly licensed and is not enfitled to permitting privileges in Pasco
� County.
'��ft9���R7�Y10�1 96lfl���YIIJY�L9YVf�� Vflf����Y�R91� V���O��Cf� ��C��IEf��f F���: The undersigned understand�
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 identified at the tirr�e of
permitting. It is further understood fhat Transportafion 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 lnfater/Sevver Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable F'asco County ordinances.
GON�Yf�UC710W LO�R9 L�ll3V(ChapQ�r 7�3, I�lo�m����ai4����, �� ��o��r�re�): 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—Homeowe�er's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer f�ffairs. 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 t,o
deliver it to the"owner" prior to commencement.
�Oi�Y��.�70�'S/0�39Y�1��'� �►f��9��1�9IV: i certiiy that all the information in this application is accurate and fhat all vvork
will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is
hereby made to obtain a permit fo do work and installation as indicated. I certify thaf no work or installation has
commenced prior to issuance of a permif 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 oth�r government agencies may apply to the intended vvork, and that it is
my responsibility to idenfify 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, ln/aterNVastewater Treatment.
- Southwest Florida Water Nianagement District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- prmy Corps of Engineers-Seawalls, Docks, iVavigable Waferways.
- Department of Health � Rehabilitative Services/Environmental Health Unit-V1lells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authority-Runvuays.
I understand fhat the following restrictions apply to fhe use of fill:�
- Use of fill is not allowed in Flood Zone"V"unless expr�ssly 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 uvhich 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 rn�all
construction, I certify that fll wrill 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 properfies, the owner may be ciQed for violating
the conditions of the building permit issued under fhe atfached permit application, for lots less than one (1)
acre wrhich are elevated by fill, an engineered drainage plan is required.
If I am the s�GI�RJY �OR V�IE O!�l9NBE@�, 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 yvork,
plumbing, signs, vvells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permi4 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
fhe permit is suspended or abandoned fior a period of six(6) months after the $ime the work is commenced. f1n 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 vvork ceases for ninety(90)consecutive days, the job is considered abandoned.
�i!lA�PIIR�G �O �liilR9�R: 1(OU� ��ILI➢�f� �O R�CO�fD � I�O�I'Y�� �� �O�fifiifilf��IC�CPifl�Pl� flH�+Y ��SIILT oFl YOUR
��YIFdCy 7�4dICE FOR d�lfif���l/�fl�IEi��� �'O lfOl9� �@�O�E�t"rY. �fF YOIJ IR9Y�Pl��O O�YI�IIPI �IP��hVC9f�f�, CO�ISUL�
9flfl�H YOU� L.��f�IE�Y OU3�i�s�Y��li�k�9�1(�����I� ��C�P��E{�� Y011� R�OIf'6Cf� Of� COd�ii�d�R9 Hfi���'.
FLORIDA JURAT(F.S 117.03)
�
OIRIPIER OR 6�GEW7 CORIi'62ACTOR
Subscribed and sworn to(or affirmed)before me this Subscribed sworn to or affirm d efore this
by by
Who is/are personally known to me or has/have produced Who is/are personatly known to me or has ave roduced
as Identlfication. s ide 'fication.
Notary Public ,�,��„ otary Public
,Q1,..&,,, .
Commisslon IVo. Commissio o � := Commission#FF 137073
•a: �
�%'fj�id t�°,�` Bonded Tlw Troy Fain Insurarica 800�995-7019
Name of PJotary typed,printed or stamped IVame of otary typed,printed or stamped
, .. . ' . ..� . , , ., ,, .... :.... .. . _ ,- . . . .. . .- ; .- , , :. � . _.. , . ,`en,,`X.
' , - _ Lic#CAC042746 � �
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' 17.710 Haddock Drive �^ � - �
� � 6pringhill, FL 34610 � " �_ ° � �� � . �
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813-917-9625 (Pasco/Hills) • 352-544-0603 (Hernando)~��'+`� y,} � ,
; 352-345-8180 (Fax). = � , " � � '
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PROPOSAL SUf�MIT(EU TO ' _�J/ `
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We hereby pro{�ose Co furnish material�nd labor, complete.in a cordance with abov�specifcations, fo�the '
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sum of , _ , — , � -�dollars(S� )
�vith p�+yment to be made as�foll�v��s. �. ' �
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� � ` You ma Is e charged 1.5° �' onfh on any outstanding balances past the due date.
ftll rTiateriai is guara:�teed to Ge as specitied.�II�ti�ork is to be completed in 4vork.rr:�nlike pR afeeof$39.00wilh igedforanycheckreturnedforanyreason. �
m�nner according to sta��dard pra.uces. Any alterat�on ar eieviation From specifications Ihavetheauthorityt �rtheworkoutlinedabovewhichhas6eensatisfacrorilycompleted. q
, involving extra cosCS.�,Sriil be,executed upon svritten ord�rs,and,.viii neceme a i extra cnarge �agree that Seller remains title to equipment/materials fumished until final payment is made. �
over;and abo��e the esCimate- All a�reements contin�geiiC unon str;kes..acci _n�s er�eiays If payment is not made as agreed,seller can remove said equipmendmaterials atsellers expense.�
beyoi'�d our control:C�wner[o carry fire,.tomado and other necessar y insuranc�.Our,�vorkers Any damage resulting from'said removal shall not be the responsibiliry ofseller..
- � die fully co��erecl by UVorker's C�mpensaCiori Insurance. ' , If any legal action is required sellers legal fees will be paid for in full by the customer. ��
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'� , I1CC�(�C�1iC2 Of PIO�OSa!=The a�Ul�e prices,spedhcations ar.c1 conditior s � ��• `�
• �} are satisfactory 3nii are I�erehy acceE:cec1.Yr�u are autherized c�do the wcrk s SignatuYe
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�? ' specitied.Pa}�ner�t wiI!t�e made as eutlinecl aGO�`e. � � Note:This o osa/ma be withdrawn b us if not.acce ted within do s.
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