HomeMy WebLinkAbout14-15773�___
CITY OF ZE HYRHILLS
� 5335-8TH STREET
(sisps -0020 15 3
BUILDIN PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 15773 Address: 39576 MEADOWOOD LOOP
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: MEADOWOOD ESTATES
Est. Value: Parcel Number:
Improv. Cost: 3,990.00 OWNER INFORMATION
Date Issued: 11/10/2014 Name: CHRISTENSEN KEITH A & PAULA BALD
Total Fees: 55.00 Address: 39576 MEADOWOOD LOOP
Amount Paid: 55.00 ZEPHYRHILLS FL 33542-6713
Date Paid: 11/10/2014 Phone: 813-778-3798
Work Desc: A/C CHANGE OUT 3.5 TON
CONTRACTOR S APPLICATION FEES
BAHR'S PROPANE GAS& C,INC. C C AN EOUT 55.00
�
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Ins ection Re uired .
DU TSINSTALLED
DUCTSINSU ED
FINAL � �
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� 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 properly. 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.Al) work shall be pertormed in accordance with
City Codes and Ordinances NO OCCUPANCY BEFO C.O.
� �
CONTRACTO SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS ITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CAR FROM WEATHER
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813-780-0020 City of Zephyrhills ermit Application Fax-813-780-0021
'" Building D partment
Date Received Phone Contact for P rmitting �� O� ° ����
Owner's Name /�� � ��T���� Owner Phone Number g/.�— ��" ��
Owner's Address Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS ���/ � � D LOT# �
) n �1 �
SUBDIVISION • PARCEL ID �r�� �/�lJ/ O'����/D ���8
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED B NEW CONSTR�DD/ALT Q SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM � OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q
DESCRIPTION OF WORK �G���� �- �P- /�C�e � o J"/f?��" 07�Z�LT/!�/��
BUILDING SIZE SQ FOOTAGE HEIGHT
QBUILDING $ VALUATION OF OTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
OPLUMBING $ �/�
� J
v
OMECHANICAL $ r��� A'D� VALUATION OF ECHANICAL INSTALLATION � 1S
J �d
QGAS Q ROOFING Q SPECIALTY Q OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZO E AREA QYES NO
BUILDER COMP NY
SIGNATURE REGISTE ED Y/ N FEE CURREt� Y/N
Address License#
ELECTRICIAN COMP NY
SIGNATURE REGIS ED Y/ N FEE CURRE� Y/N
Address License#
PLUMBER COMP NY
SIGPIATURE REGIST ED Y/ N FEE CURRE� Y/N
Address License#
MECHANICAL ���qy/� ^ COMP NY �H��S ��A�/IA�C�S � C�L°'
SIGNATURE C�C"'���` REGIST RED Y/ N FEE CURRE� Y/N
Address � ! �—°� ���l S License# �/�����T�
OTHER COMP NY
SIGNATURE REGIST RED Y/ N FEE CURRE� Y/N
Address License#
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of E ergy Forms;R-O-W Permit fo�new construction,
I _ Minimum ten(10)working days after submittal date. Requi ed onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facllitfes 81 dumpster;Site Work Permit for subdi isionsAarge projects
' COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safe 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 installed,
Sanitary Facilities 8�1 dumpster.Site Work Permit for all n projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
""PROPERTY SURVEY required for all NEW constructlo .
Directlons:
Fill out application completely.
Owner&Contractor sign back of application,notarized
If over 32500,a Notice of Commencement(s required. ,(A/C upgrade over 57500)
"" Agent(for the contractor)or Power of Attomey�(fo�;tfie awne�f:wauld'be s meone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING �' :'<(F�ont of.Application;O,n�y), '_ i
Reroofs if shingles Sewers � Ser`vice Upgratles �AlC "'=.,:FenCes(PI t/Survey/Footage)
Driveways-Not over Counter if on public roadways..needs�ROiN"�"'`;
: P .
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NOTIC�OF DEED RESTRICTIONS: The undersigned understands that this permi#may be subject#o"deed° restrictions"
which may be mare restric#ive than Caunty regulations. The undersigned assumss respons9bility for compliance witti'`any
applicable deed resfricfions.
UNLICENSED CONTRACTORS AND CON'TRACTOR RESPONSIBILITIES: If`the ,owner has hired a contractor or
cantrac#ors to under#ake work, they may be required to be licensed in accordance with sEate and iacal regulafions. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violatfon
under stafe law. If fhe owner or intended contractor are trncertain 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. Fu�thermore, if the owner has hired a contractor w contractors, he is advised to have the contractor(s) sign
portions af the "contracfor Block" of this apptication for which they wili be responsibie. ff you, as fhe awner sign as the
contractar, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
CouMy. ,
TRANSPORTATION IMPACT/U7ILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
#hat Transpo�tation Irttpact Fees and Recourse Recovery,Fees may appiy to the construction of new buildings, change of
' use in existing buildings, or expansion of exis#ing 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. 1t is further understood fhat Transportation Impact Fees and Resource Recavery Fees must be paid prior to
receiving a "certificate of occupancy" ar final power release. If the praject daes not invalve a certificate of occupancy ar
fnai pawer release, the fees must be paid priar fo permit Issuance. Furthermore, if Pasca County WaterlSewer Impact
fees are due, they must be paid prior to permit issuance ln accordance with applicable Pasco Caunty ardinances.
CONSTRUGTl�N LIEN.LAW(Chapter 743, FlorEda Statutes,as amended}: !f valuatian of work is$2,500.40 or more, !
certify tha# 1, the apptican#, have been pravided with a copy of the "Florida Construcfion Lien Law—Homeawner's
Protection Gulde" prepared by the Florida Department of Agriculture and Consumer Affairs. If the�applicant is someone
other than the"owner", 1 cerfif}r thaf 1 have obtained a capy of the abave described documenf and promise in good faith to
deliver ik to the"owner" priar to commencement.
CQNTRACTOR'S1�WNER'S AFFIDAVIT: 1 certify that ail the Information in this appl9cation is accurate and that all v►rork
will be done in compliance with all applicable laws regulating construction, zoning and land devefopment. Application is
hereby made ta obtain a permit to do work and insta!latiQn as indicated. I certify that na work or installation has
commenced prior ta issuance of a permit and that all wotk wili be performed to meet sfandards of ali laws regulating
construction, Caunty and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
cer#ify tha# 1 understand that#he regulations o#other government agencies may apply fo the intended work, and that if is
my respansibility 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, Wetiand Areas and Environrrxen#aily Sensitive
Lands, Water/Wastewater Treatment.
- SouthwesE Flarida Water Management District-Wells, Cyp�ess Bayheads, We#land Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
- Depa�tment of Health � Rehabll�tative ServiceslEnvironmen#a1 Health Unit-We!!s; Wastewater Treatment,
Septic 1'anks. - .
- l!S Environtnental Ptotectian Agency-Asbestos abatement.
- Federal Aviatian Authority-Runways.
I understand that the following restrictions apply to the use af fill:�
- Use of fiil is not atlowec3 in Flood Zone"V"unless expressly permitted.
- If ihe fill material is to be used in Flood Zane °A", it is understoad that a drainage plan addressing a
°compensating voiume° will be submitted at#Ime of permitting which is prepared by a professianai engineer
licensed by the State of Florida.
- If the �1! trtaterial is to be used r`n Flood Zone "A" in cannection with a permitted building using stem wal!
construction, i certify fhat fill will be used only to fi8 the area within the stem wait.
- If fill ma#eria! is to be used in any area, I certify that use of such fill wili not adversely affect adjacent
properties. if use of fili is found to advetsety affect adjacent properties, the owner may be cited for violating
the condi#ibns of the building permit issued under the attached permit application, for lats less than one (1)
acre which are elevated by filt, an engfineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faifh to inform the awner of the permitting conditions set forth in
this affidavit prior to commencing constfvctian. I understand that a separate permit may:be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or ofher insfallatirrns not specifically included in the applicatian. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate,�cancel, aiter, ar
' sEt aside any pravisions of the technica# cades, nar shall issuance of a permit prevent the Suilding Official from thereafter
requiring a correction of errars in plans, construction or vialations of any codes. Every'p'ermit issued shall become invalid
uniess the work aufhorized by such permit is commenced within siic rnonths of permtt issuance, or if work authorized by
the permi#is suspended or abandoned for a period af six(6) mvnfhs affer 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
just�able cause for the extension. If work ceases for ninety(80)consecutive days,the job is considered abandoned.
WARNtNG TC► OWNER: YOUR FAtLURE TO RECORD A NC)TICE OF CQMMENCEMENT MAY RESULT 1N YOUR
PAYING TWICE FOR IMPROV�MENTS TO YOUR PROF'ERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSUL.T
--iNITH Y�tUR�4:�ND�R QR-tAN-A'�'i�R��Y�l��ORE RECQRDING YC?4!R-lNOTl�CE-�E-COM tdClEMEN'�. -
FLORtDA JURAT(F.S. 11�.03) �` _
, �
OWNEtt OFi AGENT CONTRAGTOR".—_ .._
Subscrfbed and swom to(or affirmed)before me th(s Subscribed and s fa(or affirme }before me this
by
Who islare personally knawn to me or haslhave prodnced Who Istare personatEy kno to me or has/have produced
as idenUficaBon. as ldentificafion.
Notary F'ublic Notary Public
� � �,•,• s•,•, JOEL E.BACON
Commisslon No. Commissi . .'�'•-
� ; �a: Expires June 29,2018
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Name of Notary typed,printed or stamped Name of -
C i' \ ��2/'12 ,'�
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� � ' PROPANE GAS Se ice Order Pro osal � � � �
� AND AIC �tvc. Air Conditioning 8 Heating
�7�e �988 813-782-5013
Sales, Service & Irrstallations worF� o�n����;�:_;�rV7:GEh1F�h��� �y�7��� �����i•�a
4441 Allen Rd. • Ze h rhills, FL 33541 n��TC�;�T�I h1E Tr��;E� �.���;.::�;i 4 �. i. ; �.�
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F r�?� TU�=S r�o�r•a z r•�G i'•.�':�:t i��� .
- .DESCRIPT.ION OF WORK . QTY. MATERIA6S&SERVICES UNIT PRICE AMOUNT
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RECOMMENDATIONS i
- .�. , �.5'�'
Annual Maintenance Recommended 6y AlI Equipment Manufacturers. ' '
Pr sures Lo HI T-Stat i i
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RE RIGERANT R- ' LBS. � $per Ibs, ,� �
FIL ERS x x Changed Monthly i i
FIL ERS x x Changed Monthly � �
❑ R GULAR ❑WARRANTY TOTAL SU(41MARY
Dehumidistat Settings: When here"ON", When Away 6�,_ T-Stat 8Q° ❑ AINTENANCE CONTRACT SERVICE i
LIMITED WARRANTY: All materials,parts and equipment are warranted by the manufacturers' METHOD,OE PAYMENT CALL i
�r suppliers'written warranty only.All labor performed by the above named company is warranted for TOTAL i
30 days or as othenvise indicated in writing.The above named company makes no other warranties, ❑CAS ❑CK# MATERIALS i,
:xpress or implied,and its agents or technicians are riot authorized to make any such warranties on
�ehalfofabovenamedcompany. ❑DEBI ❑CREDIT ❑OTHER MAINTENANCE �
I�ave aulhoriry lo order the work ouUined aDOVe which has been Satis(aCtorily compleled.I agree lhat Seller
PROG. W ! C �
retains title to equipment/materials furnishetl until final paymenl is made.I(payment is not made as agreed, CLAIM�$ �
seller can remove saitl equipmenVmaterials al Sellers expense.Any damaga resulting from said removal shall
nol be Ihe responsi0iliry o(Seller.NET 30 DAYS.A 1 1!2%SERVICE CHARGE WILI BE ADDED MONTHLY TO I
ALL UNPAID BALANCES OVER 30 DAYS.NO REFUNDS-� DATE C MPLETED
TECH T� �
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�USTOMERSIGNATURE DATE Q-L(i — TOTAL < �9Q iOO
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