HomeMy WebLinkAbout16-17156 �,.
CITY OF ZEPHYRHILLS
5335-8TH STREET
'� �' �- � (813)780-0020 156
� � BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 17156 Address: 6834 GALL BLVD BLD A 104
Permit Type: COMMERCIAL ZEPHYRHILLS, FL.
Class of Work: NEW CONST/COMM Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 02-26-21-0010-02400-0010
Improv. Cost: 106,653.30 OWNER INFORMATION
Date Issued: 4/22/2016 Name: SYNC II LLC
Total Fees: 10,830.38 Address: 18608 AVENUE MONAC
Amount Paid: 4,894.43 LUTZ FL 33558-5316
Date Paid: 4/22/2016 Phone: 813-780-8774
Work Desc: BUILD OUT WELLNESS CENTER 1,334 SQ FT-paid 25% tif
CONTRACTOR S . APPLICATION FEES
GTB BUILDERS LLC BUILDING FEE 519.18
ROBERT S CHRISTLIEB ENTERPRISE I SEWER CONNECTION COMMERCIAL 577.56
WHITE A/C INC �.�'j� �LECTRICAL FEE 214.43
SAMPLE PLUMBING INC WATER CONNECTION COMMERCIAL 513.06
���, PLUMBING FEE 76.35
, TRAFFIC IMPACT FEE 99% 7,835.47
MECHANICAL FEE 53.45
T MPA ° 79.15
�� �� ATE 881.69
�� FIRE PLAN REVIEW FEES . 4
I �Gl
/ln
�Sd�c:�C�S�l� � -�-�r6 �2b�� � �'�Gr"� /���. �el'
�L 5 5 , �C:: ns ections e uired �
FO TER 2ND R U PLUMB MI C INSULAT N CEILING
FOOTER BOND DUCTS INSULATED SE MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE-SLAB SHEATHING MISC. MISC.
CONSTRUCTION POLE FRAME MISC. MISC.
REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c)the
local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or
first reinspection,whichever is greater,for each such sutisequent reinspection.
NOTICE: In addition to the requirements of this permit, there maybe 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 management, state agencies or federal agencies.
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your property. If you intend to obtain financing,consult with your lender or an attorney
before recording your notice of,commencement."
Complete Plans,Specifications Must Accompany Application.All work shall be pertormed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
� �
RAC OR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
8��-�so-oo2o City af Zephyrhills Permit Applic '��— Fax-813asaoo2�
Bui1d'sng Department �
Date Fteceived phone�Contact for ParmitEin � �z 1 0 ��
owner's Hame �', Z��� owner ne Humber �51� � —'Z 3��
Owner's Address � � �U� � C' LJ Z)� ��- Owner Phone Number
Fee Simple Titleholder Name � � Owner Phone Number C� �
Fee Simple Titleholder Address
JOB AGQRESB CJ ��" (��LL t–U f� � � LOT# ��
SUBDIVISION �__ � PARCEL ID# V
(QBTAINE'Q FROM PROPERTY TAX NQT{CE}
WORK PROPOSED NEW CONSTR ADD/ALT Q S1GN Q Q DEMOLISH
e INSTALL REPAIR
PROPOSED USE , � SFR � � COMM Q OTHER
TYPE OF CONSTRUC'PION . Q BLOCK [�J FRAME C] STEEL Q
q
DESCRIPTION OF WORK T�rry✓r �u«-� Du'� �lL 1:tlL�ZL,/UG�-� �.L�-r/r�r �
BUILDING SIZE ���� � SQ FOOTAGE 4 Z� HEIGHT �_____�
�BUII.DthtG $ � � --„'��:" .. =`-
���p � VALUATION OF TOTAL CONSTRUCTION
�ELECTRICAI. $ � a �v � AMP SERVICE Q PRQGRESS ENERGY Q W.R.E.C. ��
�PLUM8ING � °_� � � 1 N��' �.�i� �°�G
�`���
�tViECHANIGA� $ j Q �� � ` VALt3ATIdN OF MEGFtA1+E1CAl(NSTALlATION ��V��
OGAS Q Rt�OFING Q SPECIA�TI �� OTHER � ��c.!/"
FINISHED FLOOR ELEVATIQNS FLOOD ZONE AREA QYES NO �
�, BUILQER r - COMPANY C9I I.� ��-�{f�,.j�j�/L� �..C
' SIGPIATURE REGI$TERED / N FEE CURRE� Y/N
Address �-i��if L� �2.CSt�L �r �4- 1'L Gcense# G�� 11� `l�-1? I �
��EC1"RIClAN COMPANY �-��i'L-�S GL'fi��-tS1�L.,1�13 �"j✓l1 � .
SIGNATURE � P REGISTERED Y/ N FEE CURREA Y/N
Address �S' 10 �, LUGu S J ` �'A'1PA ucense# .-,"�oo�� l�!(o �
�UMBER � f COMP,ANY
SIG AT�t` (� f A �� � REGISTERED Y/ N FEE CURRE� Y/N
z��l;�
�'�'�� ; License#
MECHAEtICA1. /f��� � Je��t ��ii� COMRIINY � V�/����� /c''
SIGNATURE REGISTERED Y/ N h'�E cuRtten Y/N
� Address� ��} 1`r ti � �3 �License# ��� ���7 cJ '�~� �
OTHER COMPANY
SIGNATURE REGISTERED Y/ N . FEE CURRE� Y/N.
sddress License# �— �� ,
RESlDENTIAL Aftach{2)P!o#�P1ans;(2}sets af:BtiiEding`P1a�s;{1}sefof Energy Forms;R O-W Permit for new canstructian,
Minimum ten.(10),working?days after,subr►iittal date. Requlred onsite,Construction Plans,Stormwater'Plans w/Sllt Fence installed,
SaNtary Eacili8es,&1;dumpster°Site'Work�Permit for s►ibdivislons!large pro�ects
COMMERC(A� Attach{3)t�mplete sets af Buildirig Plans ptas a"l.lfe Safety Page;(1)set of Energy Famts.R-O-W Permit for new construc�tion.
Minimum ten(10)wrarking days after submittal date. Required onslte,Constructlan Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facititles&1 dumpster.Site Work Permit for aU new projea#s.Rit commerciai requlrements must meet campliance
SIGN PERMET Atiach"{2)sets of Englneered Ptans. .
"`"PROPERTY SURVEY required for all NEW canstrucUon.
Dlrecflans: �
`� ' ��',
FIII out appflca8on completely. '�. ' ,
Owner&Contraotor sign back of appifcaflon,riota�iied;;�� _ '`..'Y'. - _..._._ _._. �: �'4
If aver E2508,a Notice af Commencement is required. ,(A/C opgr'ades over�7500) . ;'" ., � -'
`" Agent(for the c:ontractor)or Power of Attorrmey(for,the owner),wauld be so�ieone with natarized letter from ownet authoHzing same .
CiVER TNE COUFITER PERMi1TING: (Front of i4pplica#ion Only) • ' � " , - � ,
�I Reroofs if shingles Sewers �' Service Upgradas A/C., _ Fences(PIoUSurvey/Footage) � � - . � ,
Drivewrays-Not over Counter if on pubiic roadways..needs ROW
NOTICE OF DEED RESTRICTIONS: The.unders(gned undergtands�.th8tthis,p�ermit:may be:subjectto"deed"restric$lons" � ,:.
which may be=more'.rest�icttve=th�n County'�regulations. �TNe undersigned`assurries:responsibility for�compllance witfi�any
appllcable deed restrictions. • . . • - ,
UNLICENSED CONTRACTORS �AND CONTRACTOR RESPONSIBILITIES: If the owrner has hired a contractor or
contractors to undertake work, tfiey may be r�qulred::to be�Iicensed In accordance.with state.and�local regulations. If the�
contractor fs not ifcensed as`reyulred_tiy law, both�the owner and conUaator-may be-cited for a-misdemeanor violation
under state law. If the owner or fntended contractor�are:uncertaln as to what Itcensing.requirements.may apply.��foc,:the-
intended work, they are advised to contact�the.Pasco County Buildtng�inspection Divlslo'n—Llcensing Section at 727-847-
8009. Furthermore, if the owner has hi�ed a contractor o�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 owrier'sign�as tiie �
contractor, that may be an indication that�he Is noY.properly licensed and�is not entitled to permittfng privileges In Pasco
County. - ,
TRANSPORTATION IMPACTIUTILITIE$-IMPAC'1'�AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and.Recourse Recove.ry.Fees may�:apply;:to�the construction of new buildings�.:change of
use in existing buildings, or..expansion of�,existin,g`:buildings, as specffied.in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also:�understands, tha�E.�such fees,:.as rmay_be:due„wlll�be identifled at the�:time�of
permitting. It is furtfie�understood that T�ansportatlon Impact Fees and°Resource Recovery Fees,must be pald prior to
rece4ving a "certificate of•occupancy" or flnal�.power:release. :I�the project�does.not Involve a.certificafe of occupancy..o�-
final power release, the-fees.must�be paid prior to permit Issuance. F�tthermore;if:Pasco County Water/Sewer•Impact . '�
fees are due, they_.must be-paid,prior to permit-Issuance-in accordance wltF�applicable Pascv�County o�dinances.
CONSTRUCTIO(d LIEN�LAW(Ctiapter 713. Florlda Statutes�as amended): If valuat(on of work is$2,500.00�or more, I
certify that I, the applicant,,have-been provided with a copy of�the "Florida� Construction� Llen Law=Homeowner's
Protectfo� Guide" prepared by the Florida Department�of Agric.ulture and Consumer Affairs. If the appllcant is someone .
other than the�owner", I certify that I h�ve.obtalned a copy of.the above..descrlbed docu�ent°and.promise(n.good faith to ,
deliver it to:the'owner"r prior.-toscommencement:
. CONTRACTOR'S/OWNER'3 AFFIDAVIT: I certify that all the Information In this application is accurate and that all work
will'be done in complfance with all applicable�laws regulating construction� zoning and land development. Application is
hereby made to obtain .a .permit.Co do,work.,and Installation as indiCafed:• °I certify that no work .or instaliation has
commenced prior to Issuance of a permit and that ali work will be pertormed to meet standards of all laws regulating�
c8nstructiqn, County and City codes, zoning regulatiQns, and land development regulattons�in the jurisdtctlon. I al'so
certify �iaE l ��derst�nd•tf�at tre regulatlons of other government agencies may�apply�to the intended work, and that it is
my responsf�il'tyr tar'Odenti6y�what,actions I must take to be,in:.corr�pliance. Such agenoles include but are:not Ilmited to:
- DepartmQnt'-of Er�vironmental Protection-Cypre"ss.'Bayheads; Wetland Areas and Envtronmentally Sensitive
� Lands;V�late'rMl,astewater Treatment.
- Southwest Flo�'ida Water Management: l�istrict-Wells, Cypress. Bey_heads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls, Docks� Navigable Waterways.
- Department of Health & ReMabilitative Serv(ceslEnvironmental Health Unit Wells, WasteHtater�Treatment, '
Septic Tanks. ,
- dJS Environmental Protectlon Agency-Asbestos abatement.
- Federal Aviatton Authority-Runways.
I understand that the following:restrictions apply to the use of flll:•
- Use of flll is not allowed in Flood Zone"V"unless expressiy permltted.
- If .the�flll materfal is to be used, in :Flood Zone "A", It: is understood that�a drainage plan addressing a
°compensating volume" will be submitted at tlme of permifting.which is prepared by a professional engineer
Iicensed by the State of Florida.
- If the flll material is to be used in Flood Zone °A" (ns connection with.a pecmitted buflding using stern wall
construction, I certify that fill�:wall:b.e used only.to.fill the area withln the stem wall. -
- If flll matertal is to be used ln any area, I certify tfiat .use of,such flll will not adve�sely affect adjacent
properties. If use of flll is found to adversely.��ffect adJacent propertles,.the¢wner may be'cited for violafing.
the condltions of the building:permit issued�under the.�attached permit appiicatior�, for.lots less than.one (1)
acre which are elevated�by flll,an engtneered drainage plan is required. ,
if I am the AGENT FOR THE OWNER, I;promtse In good faith to inform the-owner of•the permitting conditions set forth in
this affidavit�prior to commencing construction. I undersfand that a separate permlt may be requlred for electrical worK,
plumbing, signs, wells, pools, air conditioning,.gas,`or othec ins4allatlons not.spec�fically included-in the application. .A ._.
permit Issued shail be consfrued to be a'license to-proceed with the work and not as:authority to.violate,cancel, alter, or
set aside any provistons of the technical codes;�nor shall Issuance•of a.permit.prevent th�Bulldirig Official from thereafter
requlring a correctlo� af errors in:plans, construction or violat(ons of�r�y codes. Every.p�ermit 15sued sh�ll become invalid
unless the wo�k authorized.by such permit:ts-commenced•within sUc months of permit lssuance, or if work authorized by
the permtt is suspended or.abandoned#or a�:period of�stx(8)months:aRer the tirne the work�s commenced. An extension
may be requested, in wrtting, from the Building,Offlcial for a perlod not to exceed nlnety�(90) days a�d will demonsuate
justifiabie cause for the extension. If work ceases.for ninety(90)cons.ecutive.day.s...the Job�is constdered abandoned.
WARNING TO OWNER: YOUl�.FAILURE�TO.REC.ORD.A PIOTICE OF�COMMEMCEMEMT�MAY�RESULT IN�YOUR
PAYING TWICE,FOR:IMPROVEMENTS TO-YOUf�:PR�OPERTY. .IF°YO.0 IId�EMD�'T��OBTAIN��FIN�ANCING'��CONSULT
---- �lIITH-- -i�U -L- D �. A�e4�!"TO �! -� �R���R Cf� �D �' OU ' � �C ' ; •'� � E C ENY�-- -- -- --- -
FLORIDA JURA'�(F.S.1.17. � �-
OWNER OR A(3ENT � CONTRACTO "
Subscribed and swom ta(o aNirmed)befor me this Subscribed and'swo to( t affirmed)�before rtie tfii§
by �by
VYho is/are personally knovm to.me or has/have produced �Who Is/are nally known to me or has/have produced- •
ae Identlflcatlon. � as idendflcatlon.
Note ublic . Notary Public
�"�Y''��F'•, mission#FF 137073 'i��'�qyB`;: Comm FF 137073
Commi n � • : �am � Commis =.; ission#
,� xpi a�s�o,e :,: o: s-�o,e
s'� d �;` BondadihNTroYFmnlnsun� �% oe� Bonded7YwTra�pFdnlnsurence80a39
���PF���`'�
Name of Nota , or s amped Name of Nota ,p nted or stamped
a��:��arzo City of ZePhyrhills Pernilt Appllca6on F��s»-T$aooz�
� 8ulidmg DepsrrRmeni
. � , bdr Rsalwd PiroM CentaCt iot F�nitktin �'G — 1 i�C9�
Owtia�a liatno �. �`��Y";� Owr�sr,f'lsesss Number ��� %�"a��Z 3 3/ -
Qwnur.'aAddreas -� �/� �U� '�.�. Z=.�� 1��_ �tAmirPAonekuisrWr 1 �
F.p Slmph 7ithhold�r ll�m� ��"_` 1 Ownsr Photis Harn6w C'�
F�r Simpia TiUahoWor J�lrosa
�oe iwaR�ss $'3� Gfl4� l:,V� � - � . iara ��
SUBD1YISfUN ��� PARt�t.IDit '
t�TANfffi FROU PR�ES2tY TAk NOSSCEl.
VYORK PR04�OSED N[wt cotiStA ' ADOlALT [�] StGN (� [�f OEMDiJSH
e INS`TAI.L � fiEPA1R
FROP.OSEO USE [� SFR � COMlA � 01'MER
NPE OF GONS7RUCTtON Q BLOClC � Q FtiAME � STEEI Q
DESCRlFn10NOF.WORK T� T I3U(C.D l?GLj� t-O� %tlY�[J�/��S GL��I�'C.
BUILOING SIZE ��._� SQ FOOTA4E } ZIP HEICtST �_�
G
�BUILplNC3 [S_. � ypa.{iATiDN OF TOTAS.CUNSTRt3CTtON
I l �,�ao.0
�ELEC7ftICAL S' AMP SEitVlCE [� PROGRESS EFtERGY [� W.it.E.C.
� - ��.�.a��. GT�
�PLUMBlNG 3 � Q' � �Q� 'L� �s�
�L���
�JMECNlRNfCA!_ ; ! O DC9 C.� VALUATtON OF MECHANICAI.{NSTAi.Ul710N ��V Q'S'
�e,�s (� acso�irs� [,� SPECtALTY[� pTHER � J�j.�
F�NiSfiED f400R ELEVAI'IONS Fl;OpO ZbNE Af2EA QYES NO
su��.o�c . � co�ee�►ta�r ls"Tl� j�c.ttc;i�,ts'2�j„L C �
'SIGNATURE itEotslEEtED t N cEE�x ' Y I N
�der.:e �.-10`6� :LJ � 2t5i�L l�'ii{. k 'NL uranses G�?�1 SZ>4Y7!. 1
EI:ECTRNGuiai � Co1APANr �.'06�aG-T�S CLfi;GtS'TZr�LfS fSiU J,�
&tGNA7URE NEc�Srgtm Y 1.N �cz�uta. Y'!N
,a�su i5- .7f) N'. 1-c�G u'�3 T1�1/�,4 G�er�e� �''O oC>Q 1 7�,�
�r�ee�t � ..�� co�tPawr �v�l���� � -
SfONAT�lRE `Q�_���e " RBGfS7Et�0 Y�l.N ��'r. YIN
..��z,f, 1 f�.� ;�- .
ndda,nw ' L}'>-�,t.�-• 11 uos„�� - -
'�r, i':�'� - "
� J� ,.. ! -.,
t�ECHANiCAt. G'I�`�Ii�� CONPANY fTi.�t°$ N -
StGNJCfURE iaEctsr6�n YJ N F�Ca�n Y/N : -
��,�x po �s ]/ �i,-��� r��a�:�r l��7���1
OTFIER (I� 'COMPAHY �
. Si4?u�TURE ( � FEas-TEit-�s Y f N' tFE CURrt�r. Y!N
u3dr�as LloonseY,� �
REStO€1dtl�t. Atisch(2)P3at PEins;(2j a�af B�9ng Piat�;{1)'eat o}Ene�py Fmn�R-0�w Perinit 6or rreiww cansWcflon, �
t�t+dmum f�(to?+uoAdng days iRnr auhmivat aaw: Requtrea oriatie,Cans.trueBon Plam,sm+mwater Ptana wr s�t P�uce atsmn�dd.
Sani�ry Fac�lies!41 dumpm;W,Ske WaAi Patmtt tat atibdl�spa pto�e�cts
COMMiERClAL Atlach'(3S oompiatp eets o1 Bu�1d'mg Ptant p3us a lNe Safey Page;(1)eet d Hnergy f-orm'a:R-aW.Pe�mti!ar naw saaqst�ssan.
t�dm�un teas{t8j working days afler eubm�tml dsta Retyidred on�te:C�orts4�ieDoti PRuis,SEo�mw�ter Plavis w/$ail Ferwe kale8�d,
Sasdiuy Fata�tlas b t t4ut�psler.Site Work Petrtifit br eq.isaw pro}er,Ls.A11 mmmedot iequlromi�ts must rrinet rnml�9anou
8tGM PERERIT Attach(I}eai�M Ers9��a�red Piam.
""pROPERTY SURVEY rei�uired Wr 8tl NEW cai�uctlon.
Dkoclloni: - . _
Flfl out eppLcallon completely.
Owner 8 ColltrOcbr clgn badt oi!�ppYC9tbr1,rqSarixed `
i1 river 32SD0,a Nntla M Commonc�mmt b r�qulrad (AIC�¢pqrad+s awt STSOQJ.
•• Agmt((or'the oWttrsx�l M Prn+esr od Attoniey{fof ltUie owrterj aould D9'aomeaaie wlth rwtetlzed btt�bartt ow�iat m+tfnHtiiig sume t
OYER 7HE COUNIER PERAi1T71HG (Front o1/1pQtks�Bon�nly)
Remafs'NQfimpiea Sewam Sr�v�eU{igradss'MC 'Fetices(RbVSurveyiFootuge�
�4
odmrays-Not over can,ser N cs,a��aewen..nsnas aow
: �Print Form
CI1Y OF ZEPHYRHILLS
UTILITIES WORK ORDER
WATER ACCOUNT NO.: DATE: Apr 22,2016
OWNER/RENTER/BUSINESS:SYNC II LLC CONTACT PERSON: GTB BUILDERS
MAILING ADDRESS: 6834 GALL BLVD BLD A 104 PHONE NUMBER: 813-927-4868
ZEPHYRHILLS FL 33542 EMAIL ADDRESS:
SERVICE ADDRESS: 6834 GALL BLVD BLD A 104
, SHUT OFF SERVICE ❑X ❑X WATER
TURN ON SERVICE ❑ ❑ SEWER
INSTALL MEfER X❑ ❑ GARBAGE
READ MEfER ❑ ❑X IN CITY
CHECK MEfER ❑ ❑ OUT CITY
OTHER ❑
DESCRIBE OTHER: 1'Water Meter
NUMBER OF UNITS
DEPOSIT AMOUNT
AMOUNT LAST BILL
DATE
MISC. CHARGE
METER: FULL 1'
IIRRIGATION
WORK COMPLETED BY&DATE ORDER TAKEN BY: Jackie Boges
COMPLEfED '
ORDER GIVEN BY:
,
Revised 9/2010
L
� , I IIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII Idll
2016071901
� I� ��(p OZ -2lo—Zl-oa�o-t7Z'�Ov -Ub�U
Pertnit No. Parcel ID No
NOTICE OF COMMENCEMENT
State of E Lol���/� County of �T[S�U
THE UNDERSIGNED hereby gives notice that impravement will be made ta certain real property,and in accordance with Chapter 713,Florida Statutes,
the failowing infartnation is provided in this Notice of Commencement:
1. Description of Property� Parcel Identification No. OZ—2(�— Z r— OOf 0 �OZ y� —d0�0
SVeetAddress: �03Y �Ru- �L✓� (�� �jV°7
2. General Description of Improvement ����lCJ/2 ��iV��� Ri u��C���
3. Owner Information or Lessee infortnation if the Lessee contracted for the improvement:
EDcvh� [..��vA�>
��Ol Do"ta� CAtaLTy�J A�2. 'rfiv�tP�F FL
Address Ciry State
Interest in Property: ��/��A/�
Name of Fee Simple Titleholder:
(If different from Owner listed above)
Address q���NCn� �v��� S City State
contractor• 6
Z���mef3lZl5�'?�L /4l/�i. �/�4P�' �L. �����
Address t��j City Slate
ContractorsTelephoneNa. k�� �9Z7�' 7fJG�
, 5. Surety:
Name
Address Ciry State
Amount of Bond: $ Telephone No.•
6. Lender•
Name
Address City State
Lenders Telephone No.
7 Persons within the State of Florida designated by the owner upon whom notices or other documents may be served as provided by
Section 713.13(1)(a)(7),Florida Statutes:
Name
Address City State
Telephone Number of Designated Person:
8. In addition to himself,the owner designates of_
to receive a copy of the Lienors Notice as provided in Section 713.13(1)(b),Florida Statutes.
Telephone Number of Person or Entity Designated by Owner•
9. E�iraUon date of Notice of Commencement(the e�iration date may not be before the completion of construction and final payment to the
conVactor,but will be one year from the date of recording unless a ditferent date is specified):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR LENDER OR AN ATTORIVEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT
Under penalty of perjury,I declare that I have read the foregoing notice of commence that the fads stated therein are true to the best
of my knowledge and belief.
STATE OF FLORIDA
COUNTY OF PASCO
Signature o ee,or Owners or Lessee's Authorized
OfficedDirectoNPartned anager _ �`
,�rzes�d�',/;_
Signatory's Title/Office
Theforegoing insWmentwas acknowledged before methis � day of •-�^ L ,20�iqby�Z.�L� ��./���
i —
as �����'2 (type of authority,e.g.,officer,ttustee,attomey in fad)for
WL�x-'�D,i4 t�J L�(.�.Il�� (name party on e 60 0 ''mentwa executed).
Persanally Known�R Produced Identification❑ Nolary Signature
Type of IdentficaUon Produced Name(Print) � ef.' �
Rcpt:1769600 Rec: 10.00
DS: 0.00 I T: 0.00 ��yP�"��c TERRY BALESTRACCI
05/09/2016 J. R. , Dpty Clerk �f MYCOIvIMISSION#FF2194b6
��o�°� E}�IRES:Apn7 12,2019
PRULR 5 0'NEIL,Ph D FqSCO CLERK & COM R
050R9BK01C�36�m PG L�2�
. � . .
Cost Plus Percentage Contract
Gulf To Bay Builders , Inc
2108 W. Bristoi Ave
Tampa, Florida 33606
Telephone:(813)253-3555 Fax: (813}253�552
License#GCG1509471 Date:04/11/2016
CLIENT INFORMATION:
Name: Dr. Edward Leonard Project Number. ZHWELLNESS
Address: 6834 Gall Boulevard
Zephyrhilis, Florida 33542 Project Name: Florida Wellness&Rehab
Project Address: 6834 Gall Boulevard
Telephone: Zephyrhifls, Florida 33542
i. PARTIES
This corrtrad dated the 11 day of April,2016, is between Dr. EdwaM Leona�d/Fiorida Wellness&Rehab Center,
Ciient, and Gulf To Bay Builders,lnc, Contractor. In consideration of the mutual promises contained here9n, Contractor -
agrees to pertorm the following work:
Design Build Tena�Build out at 6834 Gall Boulevard,Zephyhilis, Florida 33542
11. SCOPE OF WORK
Contractor will supply all the labor, materials, subcontractors and equipment to complete the work described below:
1. Complete Design Build/Tenant Build out For Weflness&Rehab Center as per plans APPROVED by
Zephyrhills Butiding Department for the address of 6834 GaB Boulevard,Zephyfiills Florida 33542
The work does not include:
Description
OWNER TO SUPPLYANYANDALL FFEAS NEEDED
111. CONTRACT DOCUMENTS �
The Contract Documents consist of the following:
1. Drawing's Supplied and done by Russell Feriita
An estimate is attached solely for the purpose of describing the categories of work.The pricing on the estimate shall
have no bearing on the cost of work. COST PIUS 20%
N. CONTRACTOR'S DUTIES
Corrtractor aocepts the relationship of trust and corifidence established between his company and Client He
covenants with Client to fumish his skill and good judgment in furthering the interest of Client He agrees to fumish
supervision and handle business adminisVation efficiently, and use his best efforts to fumish at all times an adequate
r
supply of workers and materials,and to pe�foRn the work in the most expedifious and economical manner. , I
V. SCHEDULE AND TIMING
The work to be performed under this contract shall cammence on Q4/13/2016. Contractor shali use his best efforts to
complete said improvements on or before 05/13/2016.
VI. COSTS TO BE REIMBURSED
Contractor shall, every two weeks during the course of work, deliver to Client a statement showing a summary of the
costs incurred by his company in the execution of this contract fnr the preceding iwo-week period. Client shall re�iew
the statement and remit such amount within three business days of reoeipt. Client agrees to reimburse Contractor for
all the costs outlined below. Such reimbursemer�t shall be in addition to Contractor's fee as stated in paragraph VII,
following.
1. Labor Costs:The hourly rate far workers employed by Cor�traetor(in-house labor)to pertorm the constn�ction
wark is established by the Rate Schedule below. Factored into the rate per haur are gross wages plus all
applicable payroll taxes, medical insurar�ce, retirement benefits, bonuses, etc.
'� COST PLUS 20%
2. Material and Equipment Costs: Client will pay the costs af all materials and equipment used in construction,
plus costs associated with materials delivery, pick up,or+dering and handiing.Any unused,excess materials
shall be retumed to the supplier for a credit.This credit will be issued to Client with the next bilting by
Contractor.
3. Subcontractor Costs: Client will pay Contractor for the costs of all Subcorrtra�tors used on the project.
4. Other Projeet-Related Costs: Client will pay Contractor for other project-relat�i costs such as utilities fees,
supplies consumed during the course of constru�tion(i.e., saw blades, carpenter's pencils, chalk, etc), and
costs for temporary items such as fencing and sanitaation.
VII. CONTRACTOR'S FEE
In consideration of the pertormance of the contract, Client agrees to pay Corrtractor, as compensation for his services,
a Contractor's fee as follows:ALL COST PLUS 209�0
All costs incurred over total length of the project plus 0 percent of those costs for overhead and profit.
"All costs°shaN mean costs necessarily and reasonably incurred in the performance of the worfc and adually paid by
Contractor, including all costs incurred due to changes and extras not listed on the attached estimate.
VIII. CHANGE ORDERS
During the course of the project, Client may request Corrtractor to perform additional woric_All change orders must be
in writing and signed by Contractor and Client(or ClienYs qgent).
, IX. SITE CONDITIONS
Client acknowtedges that this contract is based on Contractor's observation of conditions of the workplace and
structure. Hidden conditions, which could not have been ascertained in advance, and which are not in keeping with
what would have reasonably been expected,will be a�additional charge to the extent that those hidden conditions
cause extra expense. Hidden condi6ons would include such things as buried rock,water damage, mold, te�rnite
damage, pre-existing code violations and other concealed oonditions. If a hidden condition is discovered, Contraator
will notify Ctient and attempt to reach an agreement for a change order to this corrtract that addresses the condition. i
X. DEPOSIT REQUIRED �
Client agrees to pay a�20,000.00 deposit upon obtaining permits or start of a job,whichever occurs first.The deposit
will be applied to the first invoice Each Additionat invoice will be due with in 5 days after it is received by owner from
Contractor
XI. PERMITS
Contractor shall procure the necessary permits for the work of improvement. Client shall pay the govemmental fees
and Contractor's charges for said permits.OWNER PAY'S ALL PERMIT FEES AND CONTRACTOR'S TIME FOR
THE PERMITTING PROCESS
�� .
XII. SUBCONTRACTS AND OTHER AGREEMENTS
All portions of the woric that Contractor's employees cannot perform directly shall be pertormed under subcontracts.
; Unless Client has agreed in advance, all subcontracts shall be on a faed-price basis. Contractor shall secure Clierrt's
consent before entering into any subcontracts.
XIII.ACCOUNTING RECORDS
Contra�tor shall keep full and detaited accounts as necessary for properfinancial management under this agreement.
Clier�t shall be afforded access to all Contractor's recorcis, books, carrespondence, instrudions, drawings, receipts,
vouchers, memoranda and similar data relating to this.contract, and Contractor shafl preserve all sudi recvrds for a
period of three years after the final payment.
� XIV. INSURANCE
The Contractor agrees to maintain workers'compensation and liability insurance throughout the course of the worlc.
Contractor hereby agrees to hold Client harmless and to indemnify Client against any and all claims which may arise
during the course of the work as a consequence of the negligent acts or deliberate omissions of Contractor, its agents,
or employees.
XV. SIGNATURES
I have read and ag o � terms and conditions of this contract. ; `
:,
Client Name: Florida ness 8 Rehab Center �� Contra a e: Guff To Bay Builders, Inc
Client Name: Dr. Edward Leonard Contractor Name : Ken Mourtos
i
Signature Signature
04/13/2016 04/13/201
Date Date �1 l� t`4
��(S �� � �' ,
o .
0
1'10/11 UH
� ' �.��=�►-�
. __�-
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: G � � � (3 lS l LD��S �- �- �
Date Received: Z - 3 ' / 6 �
site: 68 3 �J (�A�l. /3 Lvd . II
Permit Type: l EN(�N T �U l�.0 b U T�
Approved w/no comments:� Approved w/the below comments: ❑ Denied w/the below comments: ❑
This comment sheet shall be kept with the permit and/or plans.
� r .����1(
Kalvin S " itze - ans Examiner Date Contractor and/or Homeowner
(Required when comments are present)
. . ��PHI'R6�lLL� Fl�� �E�A��f1��1��
• 6907 Dairy Road, Zephyrhills, FL 33542
�IF2E SERVlCE USER FEES
Occup�ncy No.:
, Plan No.: Contractor:
, Business Name: Billing Address:
Business Address:
Business Phone No.: Billing Phone No.:
Business Fax No.: Billing Fax No.:
', Contact: Contact:
PLAN REVIEW FEES INSPECTION FEES PERMIT FEE FALSE ALARM FEE
Site Plan N/C Annual N/C Sprinkler $50 1st Alarm N/C
Multi-Family/Commercial .06 sf 1st Re-inspection N/C Standpipes $50 2nd Alarm N/C
(Minimum Charge$25.00 2nd Re-inspection $100 Fire Pump $50 3rd Alarm N/C
� Plan Revisions DBL 3rd Re-inspection $250 Hoods $50 4th Alarm $100
4th Re-Inspection $500 Fire Alarm $50 5th Alarm $150
SPRIMKLER SYSTENiS (Business closed until LP Gas $50 6th Alarm $200
0-25 Heads $50 violations corrected) Natural Gas $50 NON COMPLIANCE $150
26 plus Heads $100 SPRINKLER SYSTEAAS Fuel Tanks- Pe�wnk $50
STMIDPIPE SYSTEM Hydro Undergrounds $45 Sparklers $100
� Per Riser $50 Hydrostatic Test $65 per system Fire Works $500
FIRE PUAAP Acceptance Test $45 persystem Camp Fire $25
❑ Per Pump $100 Hydrant Flow $75 Controlled Bum $100
FIRE ALARAA SYSTEM Hood/Duct $50
0-25 Devices $50 FIRE ALARM SYSTEM Place of Assembly $50 Mnual
26 plus Devices $100 System Acceptance $50 Fire Protection $25
SUPPRESSION SYSTEMS Recall Acceptance $50 Flammable Application $50 nnnua�
Wet $50 OTHER Waste Tire Storage $50 Mnual
Dry $50 Fire WaWSmoke Wall $15 perwall Generator<KW $100
CO2 $50 LP Gas $25 per tank Generator>30 KW 150
Other $50 Natural Gas $25 persystem Bio-Hazard Waste $100 Mnual
KITCHEN EXHAUST Fumigation Tenting $50
� Hood/Ducts $50 Tent 10'x10'or greater $15 Per tent Torch PoUApplied $50
OTHER Fire Pump $45 Haz.Materials $100 Mnual
aLP Installatlon per tank $50 Fire Suppression $30
Fuel Tank Installation $50 System Acceptance
(Per Tank) $50 E�aust Hood/Duct $30
�Natural Gas InstallaUon $50 Re-inSpeCtion DBL
(Per System) (other than annual)
� Spray Booth $50 � Inspection scheduled DBL B
and cancelled less than
24 hours
8 Construction Insp. N!C
Emergency Vehicle Ai $50 FALSE ALARAA
PLANS TOTAL� INSPECTION TOTAL� PERMIT TOTAL� TOTAL�
GRAND TOTAL
Comments:
Date:
Inspector:__1�. /
nm G
. 6�34 gall blvd ste 104 Wellness Center-Buildout GTB Builders-
� 1,326 sq ft
o umn
SQ. FEET PRICE ,
MAIN OR LIVING: 1,334 $ 79.95 cost @ 132.45-what showed paid 52.50(difference)
OTHER AREA UNDER ROOF: - $ 88.00
OTHER: - $ -
VALUATION $ 106,653.30
FEE SHEET $ 509.00
ADDRESS
DRIVEWAY
BUILDING: $ 519.18
ELECTRICAL: $ � 214.43
PLUMBING: $ 76.35
MECHANICAL: $ 53.45
SUB-TOTAL $ 863.41
TOTAL $ 863.47
SEWER: $ 577.56
WATER: $ 513.06
IRRIGATION: $ -
TOTAL: $ 7,090.62
WATER METER: $ 881.69 � � ��'��
IRRIGATION METER $ - na
FIRE DEPARTMENT FEES
PLANS TOTAL: $ 80.04
INSPECTION TOTAL:
PERMIT TOTAL
TOTAL: $ 80.04
PUBLIC SAFETY IMPACT FEES
POLICE n/a
FIRE n/a
5% $ -
TOTAL: $ -
SUB-TOTAL $ 2,915.76
PARK IMPACT FEES n/a
SIF'S: na
100.0% $ -
1.0% $ - ,T
TOTAL: $ ' �� O � I/ ��I U ''t¢".� �� �m c I
T 1 F'S: $ 7,974.62 `r� �� / � (,�►`��"^''"� "U
99% $ 7,835.47 j��. ��
1% $ 79.15 � �� � �-�- ��� �
�' S, q 35� R � r.e��� �� �
TOTAL: $ 10,830.38 �-"�`e-'�" c� `
� � .���` � p�-��`-�``
1
, .City of Zephyrhills � -
" � ' � " Water and Sewer Impact Fee Calculation
iand Use Type: • .
Office � -
No. of Square Feet 1334
Impact Fees I
Within City Limits Outside City Limits �
Water Distribution System $ 513.06 $ 641.32
Wastewater Collection System $ �c��,+,, 1,031.24 $ 1,289.05
Wastewater Treatment Plant Capacity $ � 577.56 $ 721.95
TOTAL $ 2,121.86 $ 2,652.33
o umn
SQ. FEET PRICE
MAIN OR LIVING: 1,334 $ 79.95 r'3�,z //.S� - f Z��
OTHER AREA UNDER ROOF: - $ 88.00
OTHER: - $ -
VALUATION $ 106,653.30
FEE SHEET $ 506.00
ADDRESS
DRIVEWAY
BUILDING: $ 516.12
ELECTRICAL: $ 113.85
PLUMBING: $ 75.90
MECHANICAL: $ 60.00
SUB-TOTAL $ 765.87
TOTAL $ 765.87
SEWER: $ 577.56
WATER: $ 513.06
IRRIGATION: $ -
TOTAL: $ 1,090.62
WATER METER: $ 881.69 i � mtt,`K.�.
IRRIGATION METER $ -
FIRE DEPARTMENT FEES
PLANS TOTAL: $ 80.04
INSPECTION TOTAL:
PERMIT TOTAL
TOTAL: $ 80.04
PUBLIC SAFETY IMPACT FEES
POLICE
FIRE
5% $ -
TOTAL: $ -
SUB-TOTAL $ 2,818.22
PARK IMPACT FEES
SIF'S:
100.0% $ -
1.0% $ -
TOTAL: $ -
T I F'S: $ 7,914.62 $5933 Per 1000Sq Ft
99% $ 7,835.47
1% $ 79.15
TOTAL: $ 10,732.84
\
DiBi-6834 Gall Blvd -Unit A Shell
SQ. FEET PRICE
MAIN OR LIVING: 6,795 $ 52.50
1/2 of required $105.00 Merchantile
OTHER AREA UNDER ROOF: - $ -
OTHER: - $ -
VALUATION $ 356,737.50
FEE SHEET $ 1,251.00
ADDRESS $ 30.00
DRIVEWAY $ 30.00
BUILDING: $ 1,336.02 '
ELECTRICAL: $ 281.48
PLUMBING: $ 187.65
MECHANICAL: $ 131.36
SUB-TOTAL $ 1,936.50
RADON: $ 67.95
� TOTAL $ 2,004.45
SEWER: $ - Applicable at Build Out
WATER: $ - Applicable at Build Out
IRRIGATION: $ -
TOTAL: $ -
WATER METER: $ 860.00 1@ 220.00/each and 2@ 320.00/each
IRRIGATION METER $ � -
FIRE DEPARTMENT FEES �ii
PLANS TOTAL: $ 271.80 � �
INSPECTION TOTAL:
PERMIT TOTAL � �V� �
TOTAL: $ 271.80 � �� � i
�
PUBLIC SAFETY IMPACT FEES 1 p � G Cc
POLICE $ 619.56 �
l /
FIRE $ 665.17 `d \ ��ra�
5% $ 64.24 �
TOTAL: $ 1,348.97 Based on 3801 Sq Ft ` �
�
S U B-TOTAL $ 4,485.22
PARK IMPACT FEES $ - Not Applicable
SIF'S: $ - Not Applicable
100.0% $ -
1.0% $ -
TOTAL: $ -
' T I F'S : $ - Applicable at Build Out
I 99% $ -
1% $ -
TOTAL: $ 4,485.22
� '
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�� �' FLQF1tpA BU/LD/NG CODE,ENERGYCONSEf?VATIDN �
I �NAPTER C4—COMtNERC1A1.ENERGY£FFICIE[�tGY _.��_ --- � �
�-i
Form C402-2q14 AITERATiONS,RENCIVATED BUlLDING and BUILDING SYST�MS �
__._....____.____ 4�33m�te Zone: � 2A � i
ProjeotName: FLORIDA WEI.LNESS MED GRP OFFICES � occupancytype: HEALTHGARE CUNIC � ''
Addrr�ss: 6$34 GA�L BLVD Atteration L}� Renovated Buitding❑ Bui�dingSystem❑ �
city,zipcoaer ZEPHRYHILLS, FLORIDA 33542 ��� � eurrdlny�ermitrvo.: r,$' '
&uilder: {T �u_„J �i`'"�,� �l'� ___._T`___._.. _... Pemr;tfing t)tfice: � � r� �
awner. ` �i�'7.�r�� t ,�Q
� � I�
I � BU1LDiNG ENVELOFE INFORMATION{Wfiere cManged}
_`� -�_!�M Requiremeni Eftic'sency �
Envelape Campanent Descr'spflon �_� _._.______. � �
Loaation �� Unit Required fnstalled
1�001 type�� N/A @XlStltl� 4L - Tabl�r G402.1.2 ar ;<_U•factor or � �V �'�-- �
Ta�la C402,2 �>_R-vaJue �
Aoalreflectanoe/�rnittance ��� '��� '����� >Sol�zrreflPr,tance, �
N/A existin r�vre cao�.2,�.r j—
flow slope rooJs) 9 �>_7herma�emirtance
_... ..._._ __..__..
INatt type,above grade ; NtA existing � �
Wal1,belowgrzrde ' N/A existing .�� ---- `7aGlo C402.L2 nr Ttbi�C�t02.2 �u-r�t�rQr or �
__A-vaJus
Ftoorryp� N/A existing�� ; i �
�..._ __. , t --._.___�
<114z�ctor � �
Verficalferiestratiaras Njj-� �XISti�C�
; � <SNGC • �
•-' 7'able G402.3
� ._ ---_.____._�__ _ <U-(actcr ( M
�st�trynrs N/A __.___. � �
�s s�r�c
BU{LDItVG SYSTEMS INFO�tMAT10N[tor HVAC,service hat waier ar paai heaYing,ifghting systems,and replasemen#tenestraiion tCi01.A.7)] �
~ ��� � y Requirement Effictenc � �
System Type(describe system) � ,__._ Y � I
Locatlon Un�Y Reqaired Insta!!ed '
t �
Air-cond+tionirigsy:srorn �'�';NE1N 5-TON RTU TablesC403.2.3{'1-3,�-r�. to•tr) SEFl�arEER,leF� 13.0 13.0 �
� _ �� �
_:__..__.____ �_ ___.
xeatrngsysrem 9-KW RTU STRIP HEA�#�sc�as.z.s�z-s� �ts�FoFcc�par-uF�;ar�� nla nla
__._. ... __..._..__:_..._.. _ . __�v�___._.,._ _�_._._ __.,_._.-- I
Ventilatinn/aithxndtiitguysfem NEW RTU BLOWE 37�ahIeSC403.2,t0.1(1-2} Fanpower(c(mj: �
R 2.04 �.a ,
_.,______ ____. ,��...____
Duct.s � ioc�tion�Bl tilg SpaGB �Tab(s C�C3.2.7 t F3-vakie ____.....�_�,,....w._..._ �.2 �.a �
�..___.._..��
�Pipfng � Fiuid desrgr operating teinp; �� Table G403,28 inches �
�or water � 15-ga11on Electric Tank ravr�caca.� �F�t,cci� N/A N/A i p
tlghting �� � 3,�p< p „(p�+ �{���y}� �,/ �T�j nte C:4Ga5.2{7 ar 2) ��{Lighilr,g�ower density � �,? �.3 g
`i��1�/"l�<rCIIYlI� �1� IVI r —___f.�_....-._ ' M
FenestrafEons:Enter tnformatiqn in 6Utl.DiNG ENVELflPE 1N�'QRMA7lQN hax above. �
Othew __..._� } �_.___�_....�.._.__a_._ �
f
__�..�... . _...__.�_.....�"__`___�...._..'__.�_ �
COMPLlANCE%S 8Y AAtSi/ASIiRAFJ1ESNA 90.i "—." --___�.._----._�___ ._ �
(Submit attemafe form ar apperrd documer!ts as rtr eded)
1 here y certily thnt thQ plans and specifiaations caveied by the ca�cutation are in comp/iance with the Fteview of pl'arts anU specifrcations cover6 by Niis � '
Florida Suiidrng Cnde.�'nerg Conservadan. cafcufatrotr fndicates comptiance�vith the Florida Bui(ding �
PHEf'ARED BY.^ �r�e��,L y�/�t�� Goda,�narc�y Gonservt+iron.Batare cons rcfio»is
�/ f�-- �
�DAFF_.'���_. /j_�___ c�rnpteted,this buifding wrl! , ec . pr comptiance
/heroGy ce�/y that thrs buitd/ng Is A�compliance witn the FJarida Buitdinc7 Gade.�'nerr�y CanservatrQn: rn accordance wrth Section, 3 .
�OWNER/AGElJTi�_____._ BLIfCl1lA+�OF 1 / L _,,_„__ � �
DATE.� Dr�TF_:.__._� ._�
.___.�._...___._p.�_....^�_ ___. ______._.. _ g
`�.�,:
FLdRiDA BU1LDtNG CODE—BNERGY GOi�tSERVA7iON,5tfi�p17fON(2074) GC.1
Air System Sizing Summary for MEDICAL OFFICES
��ro;ect Name:F�ORIDA WEL�NESS W1ED GRP 0112012016
" Prepare�+b�c:SL 01:59AM
Air System information
Air System Name...... ......._ ..MEDICAL OFFICES Number of zones__........ ..__..........__... _...... ...... .....1
Equipment C3ass .- --- -.... ...... ......... UNDEF Flaor Area --------..... ---- .-------.--._ .-------.....-----.---......_i3&8.0 ft2
Air System Type ... ...... ...... _.. SZCAV Lacation ......Tampa,Florida
�- �--- •..... ... .... ...... .
Sizing Calculation Information
Zone and Space Sizing Method:
Zone CF(vi_........... Sum of space airfiow rates Calcuiation tvlonths....... ...... ... ...... ................Jan to Dec
Space CFM ......... .......Individual peak space loads Sizing Data .... ........_.._........_.._..Calculated
� �--�- - •
Central Cooling Coil Sizing Data
7otai coil load..--- --.....- ----._. ...... .._-------..... _4.3 Tans �oad occurs at.__ ........ ...... .............-._._-------- Sep 1540
Total coil load............ ....... ...-- .......-�--�-.... ... 51.3 MBH QA DB I WB--- ......------. ...... ........ ......- --. 93.0/79.0 °F
Sensible coil load---. .....-.--_-- ._....__. ................. ..33.8 M8H Entering DB/WB..-------- .----------...--•----------..... ...73.0/64.6 °F
Caii CFM at Sep 1500----------- -------- ----------------....----1819 �FM �eavTng D81 WB---------......------....--------.......----- 55.8 J 55.'f °F
Ma7c block CFM ......... ...... ..................... ...�--.........1819 CFM Coil ADP....----�---....-------. .....- -----.... ._. ..-----....-�-�---...... ..53.9 °F
Sum of peak zone CFM_...... .-.--_---- --•------------------1819 CFM Bypass Factor---......-------.....----- -...--_----------.....- .-.----...... 0.100
Sensible heaT ratia- --------------_. - ... _------........ Q.86Q Resulting RH---_......----..... --�-- .......- --...-- -----.....-- - -83 °lo
ft2/Ton ...................... ....� - ...... ......- �----_...._..319.9 Design supply temp.--- ....--- -�--� --- ..._-� --��---. .....56.0 °F
BTU/(hr-ftz)--......- ---�--.. .._............. ,_.. - .....- --37.5 Zone T-stat Check----- -....._ ----._-- - _..._. ........ 1 of 1 OK
Water f(aw{q?i 0.0°F rise ......... ....................... 10.2? gpm Mau zone temperature deviafion.....-------_....._- -_.....--_--0.0 °F
Centrat Meating CoEI$izing Data
Max coil load... .... ....... ........... - -�--...,... ._14.q MBH Load occurs at_.......------...-.-.--..__......---�-�------.... ...[1es Htg
Coil CFM at Des Htg.... ...... ............ ... -_---.---....... 1819 CFM 8TU!{hr-ftz)-_--------...--_------- --..... _---_....---14.3
. .------ -�--
Svla�c coil GFM.....-------_...----. .....- .---._---------...,... 1819 CFEvI Ent.DB 1 L.vg D8,....---.----..------------- ------.----...---- 67.2 t 74.4 °F
Water flaw @ 20.0°F drop .... ........ ........................1.40 gprn
Supply Fan Sixing Data
Actual max CFM ------...._,--------. --... ....... ............i819 CFM Fan motor BFtP ...-.-------.._ _------.. ..-----------------.......__Q2? BHP
Standard CFtui .. .......... ..��--�-•�-- - - ._. .............1819 CFM Fan motar kW.........--- ......----.........- ----......._. ...... ...0.20 kW
Actual max CFM/ft2... ..................... ...... ........ ..1.33 CFM/ftz Fan static... ----......-----.....--.-.•--..---.......... 0.50 in wg
, �-�-�.....................
Outdoor Ventilation Air Data
Design airflow CFM ................... -. --- ----...._---950 CFM GFMtperson-------.....---------....-•-------......-----------.----------....._15.Q0 CFMtpersan
CFMlft2.. .--------...---�........... .............. .........�- ..... ...0.11 CFMJft2
Haurly Analysis Pragram v4.50 Page 1 of 1
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FLOH/AA BUlLDl1�G CODE,EIVERGY CONSERVfITiDlV
CtiAPTER CQ--GOMMERCiAL ENERCaY EFFtC3ENCY �
Form C402-2014 ALTERATIONS,RENOVATED BU�LbING and BUILDINC�SYST�MS ��� �
—_.__._... _.___.._ -������maieZone: ZJ� �
�rafectN�me: FLORIDA WELLNESS MED GRP OFFICES � ���uP���vtvpE� HEALTHGARE CLINIC �
,�ddr�ss: 6834 GALC. BLVD���� � Atteration C�j FtQnovated Buiid�ng❑ 8uiidingSyst�m L! t
City,ztp coda: ZEpHRYHILLS, FLORIDA 33542 �~ � � euitdiny Perrnittvo.. • �
8vilder. s TM'� � t'ormlttrr,g Office: �
Ownet: ._..._ ..---..__.__.�_�...�_
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� � BU1Lt11NG ENVELflP�INFORMATION(Where changed} �
_.._ _,_,...____...�.�._..�equirement EfficEsncy �
Envelape ComponenE Desorip#Ion --.._�. _._._.._._.�__. _ �
�Loaatic�n i Unii f Required Installed
r�oof tyFP N!A @XlStIR� �—._,. TaDle G402,1.2 ar t S II'fBC�Df OF _...-__ �.«..� '
?'a6te C4tT2,2 {>_R-valus g
RoafretleotancefEmittance �� �� �=Salc�rrefiect�nce,
(lo�v slope rools) N/A existing !r�b�o caoz.a.i.y > 777orma!erniUttnce �
wfl��rypB,�vovo yrAae NiA existing ; �
Wafi.delo�vgr<�de I N!A existing "��__....__..._;ravte caoz.r.x nr r��lm caoz.2 >R_!�iu�`or -- �
Flaortypa N/A existing � �e
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Vertiaat for7estratioas NlA BXIStItI� --------
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Skytigf�ts N/A c___...._..._ �
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BUIIDiNG SYS7EMS 3NFt?RiViAT10N(for tiVAC,service hot wafer ar pool heaY3ng,lighiing systems,and reptacement fe»es#raYEon{G t01.4.7)j �
�� ^� Requirement Eificienc �
5ystem Type{describe syatem) ._, Y �
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F.oaa#ton Unif Requ"sred Instaltec! �
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Air-canditioning system N EW 5-TON RTU �7abies G403.2.3(1-3.&�ti, �o-r r� SEER or FFR,re�a 13.0 13.0 �
--.._._.^�_........_..._____ - — ---_
Near�rr�sy�rern � g-KW RTU STRIP HEA��i"�c�o�.z.s��-sr Nsr�FQrcc�paFu��ore� n/a nla
_ . _ __________._.__ _._.. __— i
Ventilatinnlair handlrng system N EW RTU B LOW ER��bre�c�,Qs.�.�o.r�s-aJ ��n po�uer(ctm} My� � 2.04�.� 1.0- �
v�,�rs� co��t,onCei ing space'����-��recaos.�:r� F3-vatue __..__,.«_.____..___.__ �.2 6.� �
Piping _y Ffurd desigr operating t�mp: � Table G�03.2.8 �nches E �
xot warer �^���5-gallan�3ectric Tank r��;e cao4,2 F��„cap N/A N/A � �
Llghting ~�� S,�f���sA(�.p�C7I�t�EX/�TM+ble G405.5.2{7 ar 2J ---���Ligh,ing pewer densrry � �.'T �.3 t �
Fenestrations:Enter tnformation in BUtLDiNG ENVELpPE iN�ORMATiON box rabave. �
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COMPtlANC1ElS BYANSUAShlRAE/IES/VA 90:i --�.-._.+__�_—_.,__ v_ �
�Sut�mit atfsmate form or append dncumenis as rrseded) �
i
1 here4y cerlily fhat tha plans and sper,iticAtions cavered by tlie calculation are in complrance:vlth d�a Revrew o;plans an0 specifrcations covered by Nris �
F(onda euilding Code er y nservadpn. y�� catculatro�indreaies comp(ianca vrith the FloriUa Building
PREPAR D BY��������_�_�1L j.-¢.@��► �t/�'t+�� = Gode,Fneray Conservafron.&efore cons#ructioaa fs �
DRTE;.�y�{ cwnpJeted,this building wili t�e" p ted r mpliar>ce �
1 h�reby ceni/y Al tI715 G?UIICIIng!w^I/1 COI71pU�nCB Wlti1 Ifl@ FID!'id�BLt!(G�lnt�CpC/A,E716f(7y CQl73f31Wc�ttlJR: 177 8CCt1lLI2t1CQ kYflll SBC.�IO 8.F
dW(Y�Ft�AGEIUT:.�_,_____.�.._._.__._.v._______. 8!l1LL71NG ��Fl�!AL �
DATE: __.,____� . _.__._.,..�..____�..f?ATF':___.��!!y.� �
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FLORIDA BUILDING CODE--ENERGY COhtSERVATION,5th�DIT1pN(2014) C-C.1
Air System Sizing Summary for MEDICAL OFFICES
y , �rojsct Name:F�QRIDA WELLNESS MED GRP Q112012016
Prepare�b}::SL • 01:59AM
Air System Infarmation
Air System Name ... ... ...... MEDICAL QFFICES Number of zones ._...__... ... ..._ .. _._..1
---- • --...... 2
Equipment C1ass.. ... .-............. -- - _....UNDEF Flaor Area ......-- --- 1368A Tt
-.. ..... .. ..... -• - -
Air System Type..... ............. ... ...... ....... SZCAV Location.. ._.... .. .. ......Tampa,Florida
Sizing Calculation Information
Zane and Space Sizing Methad:
Zone CFM.... ........ ......Sum of space airflow rates Caiculaiian Months .---.-.-. .-_...... .__---.. ....-- -_.Jan ta Dec
Space CFM................ ...Individual peak space loads Sizing Data....... --..... _........ .---. .-- ---Calculated
Central Cooling Coil Sizing Data
Totai coif load... -•---------.... ............. .......... Q.3 Tons l.oad accurs at... ... _. --- -- _ ----. Sep 1500
Tota(coil load................... ............ ......... .....51.3 MBH OA DB/WB ...93.0/79.Q °F
...... -- ...... .. �-� --
Sensible coil load..... ..... ..... ... ... ....... ._.. .....33.8 MBH Entering DB/WB .___...... .....73.0/64.6 °F
--. ... ..
Coil CFM at Sep 15Q0..--------- ------ --------------.. _-_1818 CFM �eaving DS I W B ,----._..._-- ------.----------....----...55.8155.i °F
Max biock CFM...................�--........... -- ----..........1819 CFM Coil ADP... - ...... -- ....-- -.......... .........- ---....... .._53.9 °F
Sum of peak zone CFM ........ ... ............. .........1819 CFM Bypass Factor_.,.. ..._.._.._. ......0.100
.... ..------ - -----�-
Sensible heat ratio------•------- --.....----.---_.... ........... 0.660 Resulting RH_.__......----- -..... ---•-.--- -----..-- ------•- --------63 °lo
ft2/Ton..... ---- -...... ......... .............. ... ..-�------. ..319.9 Design suppiy temp._..- -•--�---- . ....-•---� - ......- -56.0 °F
..--.
BTU/(hr-ftz) - ........---.....-� ............ ...... ......._37.5 Zone T-stat Check -- --....---�--.......- ----.... -�-�-- .1 of 1 OK
Water fiow @ 10.4�F rise -_- -_-. ---..._.-- --.-_... ---i Q.27 gpm Max zane temperature deviafion ...... ....... ... ._.....-_-_ 0.0 °F
Central Heating CaiE Sizing Data
Max coil load... .... ....--. .......... ........... _..... 14.0 MBH Load occurs at .......--. .......-- .--......------.---....--.-----..Des Htg
Coil CFM at Des Htg............ ......... ...... ---.....---1819 CFM BTU!(hr-ft� ._..---- -..... i 0.3
z
--- ....._- --�--•� -- _.. -
Max coil CFM •-----............. ........................ . ...........1819 CFM Ent.D81 Lvg DB..------ --• - ---- ....._.- - ....-��----67.2174.4 °F
Water flow @ 20.0°F drop .........._. .... ............... 1.40 gpm
Supply Fan Sizing Data
Actual max CFM ......-----........................-- -....... i819 GFM Fa�motor BHP ...--- --._.._----- ------- ---.... ... ..... 4.27 BHP
Standard CFM.... ............ .... .........�--. ....,._...----_...---18i 9 CFM Fan motor kW........-------- .... ....-- -----. ............. 0.20 kW
Actual max CFM/ftz ........ ......_. ..........._._. ...._.1.33 CFM/ft2 Fan static .....___........._..._......... ...._0.50 in wg
- - - -----------�--....
Outdoor Ventilation Air Data
Design airflaw GFM.......-----------...._. ... ............._-----.150 CFM CFMJperson-------......-------....._------ ......--.----_.....-----......._i5.00 CFMJpersan
CFM/ftz...- ...... .............. �--.....-- ..........- - --...... - 0.1 i CFM/fi2
Haurly Analysis Program v4.50 Page 1 of 1
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- : :: P�4SC0 C�UNTY, ��ORI�A
.,,,:
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� � Permit No. ���_
Date Permitted �►-��_ ��
Builder Name/Owner Name V�� �����°'S �-�-� Control#
County Parcel No. _(j2 Z(�-21-D��D�-bZ��p�OU/U SubDiv:
Address/Location ��� �i9-1� ,8��� �4- %D�
Classification/Type of Use �l/���heSS �(�.e,-
TRANSPORTATION IMPACT FEE Rate: Sq Ft Unit: %, 3 3�
Exempt � Yes � No How Determined
� Impact Fee Amount $ 7, 9��Z•�Z Zone No. T,c�;
SCHOOL IMPACT FEE
Account (056) Single-Family Detached House Amount $ ��
(057) Mobile Home
(058) Other Residential
123) Collection Fee
Exempt Yes [] No How Determined
PARKS AND RECREATION FEE
Land Account Land Credit Land Total
Recreation Account Recreation Credit Recreation Total
Zone TOTAL AMOUNT $ C�
Exempt � Yes � No How Determined
LIBRARY FEE
Land Account Land Credit Land Total
Facility Account Facility Credit Facility Total
Exempt � Yes � No How Determined _ Total Amount �
RESOURCE FEE ERU
TOTAL AMOUNT
Prepared By ;�j Checked By
NO CERTIFICATE OF OCCUPAf�CY WILL BE ISSUED OR FIPIAL (RISPECTION
PERFORMED UNTI�THE 70TAL AMOUNTS LISTED HAVE
BEEN PAID AND
RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY
Acknowledgement below does not Imply acceptance of concurrence, but sfmply recelpt of a copy of this form,placing
the building permit owner on notice of this assessment and the conditions of payment for same.
DATE RECEIVED BY
RECEIPT NO. DATE gY
Page 1 of 1
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• ���H�'RC�,r I IIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII
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� �'' �.q_;_ - 9 Transaction#: 3387230 Print Date:
�� < �e ' Receipt#: 3139578 5/19/2016 11:44:42 AM
• a Cashier Date: 5/19/201611:44:42 AM
.
y�`�qs o N�F`�°Q (CLKRD23)
(727)464-4876
Customer Tnfonnation Transaction Information Payment Summary
DateReceived: OS/19/2016
Source Code: St. Pete
Branch
()KENNETH MOURTOS Q Code: St. Pete
� 2108 W BRISTOL AVE Branch Total Fees $13.00
TAMPA, FL 33606 Return Code: Over the Total Payments $13.00
Counter
Trans Type: Recording
Agent Ref
Num:
1 Payments
�� Tendered: $20.00 Refund: $7.00 �$13.00
� CASH
1 Recorded Items
� BK/PG: 19198/632 CFN.•2016151950
R � (NOT CONII NUZ'ICE OF � Date:S/19/201611:44:40 AM
COMM�NC�M�NT From: To:
Recording @ 1 st=$10, Addt'1=$8.50 ea. 1 $10.00
Indexing @ 1 st 4 Names Free, Addt'1=$1 ea. 3 $0.00
COPIES (1) Copy 1 $1.00
Certify 1 - $2.00
0 Search Items
0 Miscellaneous Items '
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, May 9, 2016 12:36 PM
Receipt # 176960Q Drawer EGR001W
KENNETH MOURTOS
Op�zator: J. Radriguez
Amount 13.00
i Instrument # 2016-071901 Type 0117
Book # 9364 Page # 2025 Time 12:36 PM
Recordi.ng Fee 10.00
DC-COPIES/RECORDE 1.00
DC-CERTIFICATION 2.00
Reference: KEN 813-927-4868
I Cash 20.00
Amt Refunded: 7.00
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