HomeMy WebLinkAbout15-15908 CI OF �EPHYRHILLS
5335-8TH STREET
(si3)�so-oozo 1590
` � B ILDING PERMIT
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PERMIT INFORMATION � ' LOCATION INFORMATION
Permit Number: 15908 ! ; Address: 39421 SOUTH AVE
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: CITY OF ZEPHYRHILLS
Est. Value: ! � Parcel Number: 12-26-21-0000-04900-0000
� Improv. Cost: 5,150.00 � OWNER INFORMATION
Date Issued: 1/12/2015 � Name: CITY OF ZEPHYRHILLS
Total Fees: 170.00 ; ; Address: 39421 SOUTH AVE
Amount Paid: V,r��' '��- � � � ; ZEPHYRHILLS, FL. 33542
Date Paid: �C'�� � � Phone:
Work Desc: 2 - 5TON A/C CHANGE OU -GI�VEN BY SHAWN- CITY HAS UNITS-FEE WAIVED
CONTRACTOR S � , APPLICATION FEES
KINSEY CENTRAL EATIN & C MECHA ICAL F E ! I 40.00 C CHANGE T 65.00
BUILDING FEE ' I 65.00
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' Ins ections Re uired
DUCTS INSTALLED i
DUCTSINSULATED �
FINAL '2 - � -�- � '
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REINSPECTION FEES: Reinspection fees will omply with Florida Statute 553.80 (2)(c) when extra inspection
trips are necessary due to any one of the foll wing reasons: a)wrong address b) condemned work resulting
from faulty construction c) repairs or corre ions not made when inspections called d) work not ready for
inspection when called e) permit not pos ed on job site� plans not at job site g) work not accessible.
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NOTICE: In addition to the requirements of this pe mit,�thel e may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water m nageme�nt, state agencies or federal agencies.
"Warning to owner: Your failure to record notice�of commencement may result in your paying twice for
improvements to your property. If you inte d to obtain financing,consult with your lender or an attorney
before recordi g your notice of commencement."
Complete Plans,Specifications Must Accomp ny Application. All work shall be performed in accordance with
City Codes and Ord nances. NO OCCUPANCY BEFO C.O.
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ONT OR SIGNATURE i � PERMIT OFFI R
PERMIT EXPIRES IN 6 M NTHSj WITHOUT APPROVED INSPECTION
CALL FOR INSPE ION -,�8 HOUR NOTICE REQUIRED
PROTE CARD FROM WEATHER
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�� Kins Cent�al
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� H�at �Air-Conditioning, lnc.
P.O. Box 2209
' Zephyrhills, Florida 33539-2209 �
' �813� 782-2300 �q_co5�s26
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❑ ESTIMATE
P1AiLRE OF C� CASH
� SERVICE
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ptJAN. PARTNO. D.ESCRIPTION PWCE AMOUNT —
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a�a-�so-oozo City of Zep yrhi,lls Permit Application Fax-813-780-0021
uilding Department
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Date Received � � � — �5�- �S� i i __
Phone Con ct for Permitting
Owner's Name � 1t� r �� �!� rn- Q� Owner Phone Number
Owner's Address � `F �— ��v9 I
Owner Phone Number
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Fee Simple Titleholder Name � Owner Phone Number
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Fee Simple Titleholder Address i I
, �JOB ADDRESS , i LOT#
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SUBDIVISION P CEL�ID# I
I � (OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED B NEW CONSTR e AD /ALTI � SIGN Q � DEMOLISH
INSTALL RE AIR 'I I
PROPOSED USE Q SFR Q CO M � 0 OTHER
TYPE OF CONSTRUCTION Q BLOCK Q F ME I� STEEL Q
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DESCRIPTION OF WORK °�e- �I ��' j G � � (�
BUILDING SIZE SQ FOOTAGE I HEIGHT �
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�BUILDING $ VALUAT ON OF TOTAL CONSTRUCTION
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i DELECTRICAL $ AMP SE VICE I 0 PROGRESS ENERGY Q W.R.E.C.
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�PLUMBING $ ' � �
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OMECHANICAL $ d,� VALUAT ON OF MECHANICAL INSTALLATION �
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�GAS 0 ROOFING Q SP CIALTY I� OTHER
FINISHED FLOOR ELEVATIONS FL OD ZONEIAREA �YES NO
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I BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
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Address � License#
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ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
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Address � � License#
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PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address ; License#
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MECHANICAL COMPANY [�v g�,�
SIGNATURE vv REGISI ERED Y/ FEE CURRE� Y/N
Address i I License# � ��
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OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
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Address � License#
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1) et of Enerl'gy Forms;R-O-W Permit for new construction,
Minimum ten(10)working days after submittal date. Requiredjonsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster;Site Work Permit f r sub'divisions/large projects
COMiNERCIAL Attach(3)complete sets of Building Plans plus a Lif 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 f r all new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans. I ��
""PROPERTY SURVEY required for all NEW con truction. �
Directions: '
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Fill out application completely. I '
Owner&Contractor sign back of application,notarized �
If over$2500,a Notice of Commencement is required. (A!C u grades over$7500)
" Agent(for the contractor)or Power of Attorney(for the owner)wou d be somelone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only) ' �'
Reroofs if shingles Sewers Service Upgrades A/C Fen es(PIoUSurvey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW � ,
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NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"�estricti�ns"
which may be more restrictive than County regulations. "fhe undersigned assumes responsibility for compliance with any
applicabie deed restrictions.
UNLICENSED CONTRACTORS IAND 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 contractor 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.
T'RANSPORTATION IMP�►CTIUTILITIES BII�PACT AND RESOURCE FtECOVERY 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 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. 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 Water/Sewer Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
COfVSTRUCTIOfV LIEN LAVII(Chapter 7�3, 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 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'S/01�INER'S AFFIDAVIY: 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 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, 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 foflowing restrictions apply to the use of fill:�
- Use of fill is not allowed in Flood Zone"V"unless expressly 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 which is prepared by a professional engineer
licensed by the State of Florida.
- If the fill materia) 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�►GENT 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 Officia!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.
WIARNING TO OWNER: YOUR FAILURE TO RECORD �► NOTICE OF COMMENCEMENT Ih�AY RESULT IN YOUFt
PAYING TWICE FOR IMPROVEMENTS YO YOUR P120PERTY. IF YOU INTEND TO OBTAIN FINANCING� CONSULT
WITFI YOUR LENDER OFi�►FI�A I�Ti�F�PICY BEFOr`Zc n�a�r'3'aIPIE91'�'�9E2-ldOTlCE-�E-�'�!�!!!!�J�!MGEAA�I�1t------_ - -
FLORIDA JURAT(F.S. 117.03
OWNER OR AGENT CONTRACT
Subscrlbed and swom Q(q affirmed)bef ine this Subscribed and s r o(or affir ed)before me this
by ��
Who is/are personally e�C� me or has/have produced Who Is/are personally known to me or has/have produced
as IdentlficaUon. as identification.
Notary Public Notary Public
Commisslon No. Commission No.
. Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
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