HomeMy WebLinkAbout16-17909 � � i
CITY OF ZEPHYRHILLS
' � 5335-8TH STREET
(si3)�so-oozo 17909
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
� PERMIT INFORMATION LOCATION INFORMATION
Permit#:17909 Issued: 11/10/2016 Address: 37816 PRAIRIE ROSE LP LT 62
Permit Type: GENERAL BUILDING PERMIT ZEPHYRHILLS, FL.
� Class o�Work: 105-NEW CONST/MULTI 5+ UNIT Township: Range:
Propos d Use: NOT APPLICABLE Lot(s): Block: Section:
Sq. Fee : Est.Value: - Book: Page:
Cost: 170,922.29 Total Fees: 9,230.10 Subdivision: WALNUT GROVE TOWNHOMES
Amoun Paid: 9,230.10 Date Paid: 11/10/2016 Parcel Number: 15-26-21-0210-00000-0620
CONTRACTOR.INFORMATION OWNER INFORMATION
Name: �AILEY CONTRACTING LLC Name: BUTTERFIELD MOBILE HOME SVC INC
Addr: 209 GALL BLVD Address: 38930 BUTTERFIELD LN
�EPHYRHILLS, FL 33542 ZEPHYRHILLS, FL 33542
Phone: (813)377-7395 Lic: Phone:
Wo k Desc: CONSTRUCT NEW TOWNHOME 1,669 SQ FT
� APPLICATION FEES
BUILDING EE 795.02 EL TRI AL FEE 214.43 PLUMBING FEE 105.15
MECHANI �AL FEE 73.61 SEWER CONNECTION RESIDEN" 2,010.00 WATER CONNECTION RESIDENI 641.00
WATER M�TER RES 3/4" 473.78 FIRE PLAN REVIEW FEES 114.20 POLICE IMPACT FEE 254.00
FIRE IMP �CT FEE 273.00 PUBLIC SAFETY 5% 26.35 PARK FEES TOWNHOMES 769.56
TRAFFIC I PACT FEE 99% 3,445.20 TRAFFIC IMPACT FEE 1% 34.80
� �
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�Q� C� ��vc'v � C
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' � ' Ins ections Re uired
FOOTER 2ND ROUGH PL B MIS INSULATION CEILING
FOOTER OND DUCTS INSUCATED SEWER MISC.
ROUGH E ECTRIC LINTEL MISC MISC.
1ST ROU H PLUMB PRE-METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE-SLA� SHEATHING MISC. MISC.
CONSTR CTION POLE FRAME MISC. MISC.
REINS ECTION,FEES: (c)With respect to Reinspection fees will comply with.Florida Statute 553.80(2)(c)the
local overnment shall impose a fee of four times the amount of the fee imposed for the initial inspection or
fi t reinspection,whichever is greater,for each such subsequent reinspection.REINSPECTlON FEES:
NOTIC : In addition to the requirements of this permit, there may be additional restrictions applicable to this properly that
may b 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.
"Wa ning to owner: Your failure to record a notice of commencement may result in your paying twice for
impr vements 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 and Must Accompany Application.All work shall be performed in accordance
' with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
�
� ONTRACTOR IGNATURE �� PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
i .
� ' Townhome-37816 Priarie Rose Lp 1669 sq ft- Bailey Construction
middle section
o umn
SQ. FEET PRICE
MAIN OR LIVING: 1,669 $ 102.41
OTHER AREA UNDER ROOF: - $ 88.00
OTHER: - $ -
VALUATION $ 170,922.29
FEE SHEET $ 701.00
ADDRESS $ 40.00
DRIVEWAY $ 40.00
BUILDING: $ 795.02
ELECTRICAL: $ 214.43
PLUMBING: $ 105.15
MECHANICAL: $ 73.61
� SUB-TOTAL $ 1,188.21
TOTAL $ 1,188.27
SEWER: $ 2,010.00
WATER: $. . 641.00
IRRIGATION: $ -
`' TOTAL: $ 2,651.00
WATER METER: $ 473.78
IRRIGATION METER $ -
FIRE DEPARTMENT FEES
PLANS TOTAL: $ 114.20
INSPECTION TOTAL:
PERMIT TOTAL
TOTAL: $ 114.20
PUBLIC SAFETY IMPACT FEES
POLICE $ 254.00
FIRE $ 273.00
5% $ 26.35
TOTAL: $ 553.35
SUB-TOTAL $ 4,980.54
PARK IMPACT FEES $ 769.56
SIF'S: N/A
100.0% $ -
1.0% $ -
TOTAL:
T I F'S: $ 3,480.00
99% $ 3,445.20
1% $ 34.80
TOTAL: $ 9,230.10
� 1669 sq ft ��A�"��,� ��
/"�
� o umn
SQ. FEET PRICE
MAIN OR LIVING: 1,669 $ 102.41
OTHER AREA UNDER ROOF. - $ 88.00
OTHER: - $ -
VALUATION $ 170,922.29
FEE SHEET $ 698.00
ADDRESS $ 40.00
DRIVEWAY $ 40.00
BUILDING: $ 791.96
ELECTRICAL: $ 157.05
PLUMBING: $ 104.70
MECHANICAL: $ 73.29
SUB-TOTAL $ 1,127.00
TOTAL $ 1,127.00
SEWER: $ 2,010.00
WATER: $ 641.00
IRRIGATION: $ -
TOTAL: $ 2,657.00
WATER METER: $ 473.78
IRRIGATION METER $ -
FIRE DEPARTMENT FEES
PLANS TOTAL: $ 114.20
INSPECTION TOTAL:
PERMIT TOTAL
TOTAL: $ 114.20
PUBLIC SAFETY IMPACT FEES
POLICE $ 254.00
FIRE $ 273.00
5% $ 26.35
TOTAL: $ 553.35
SUB-TOTAL $ 4,919.33
', PARK IMPACT FEES $ 769.56
SIF'S:
100.0% $ -
1.0% $ -
TOTAL: $ -
, T I F'S: $ 3,480.00
99% $ 3,445.20
1% $ 34.80
TOTAL: $ 9,168.89
i
Jacqueline Boges �
From: FATHOM<support@gwfathom.zendesk.com>
Sent: Thursday, November 10, 2016 1:47 PM
To: Jacqueline Boges
Subject [Request received]water/sewer and water meter installation
##- Ple se type your reply above this line -##
Hello Ja queline Boges,
We are orking to resolve your request promptly and will keep you updated. One of our Support Analyst will keep you ,
update on the progress of your request.
Best Re ards,
FATHOM Support Team
TO AD ADDITIONAL COMMENTS, reply to this email or click the link below:
htt s: wfathom.zendesk.com hc re uests 100484
�.� � Jacqueline Boges
��--- -' Nov 10, 1 1 .46 AM MST
New townhome customer need service for water, sewer and a water meter
This e ail is a service from FATHOM.
1
Jacqueline Boges
From: TQ Randolph (FATHOM)<support@gwfathom.zendesk.com>
Sent: Wednesday, November 16, 2016 1:16 PM
To: Jacqueline Boges
Subject: [FATHOM] Re:water/sewer and water meter installation
Follow�p Flag: Follow up
Flag St�tus: Flagged
##- PI ase type your reply above this line -##
Your re uest (#100484) has been solved. TO REOPEN THIS REQUEST, reply to this email or click the link below:
htt s: wfathom.zendesk.com hc re uests 100484
�, ��y � TQ Randolph (FATHOM)
-- --` Nov 16, 1 1 1 5 AM MST
COMPLETE. 899779 - 2457399
Best Regards,
TQ� FATHOM Support
� FATHOM ZenDesk Support (FATHOM)
--- --' Nov 1 6, 1 0:50 AM MST
GIS has been updated to reflect the account.
Thank you.
-Bill
� - ; Jacqueline Boges ,
-- � fVov 10, 1 1 .4G AM MST
New townhome customer need service for water, sewer and a water meter
This e ail is a service from FATHOM.
1
15- I6-21-0210-00000-0620 � Pasco County Property Appraiser G Page 1 of 1
. . ��U I
�
Mike Wells Pasco County Property Appraiser�
Data Current as Of: Weekly Archive - Saturday, November 5, 2016
Parcel ID 15-26-21-0210-00000-0620 (Card: 001 of 001)
Classification 00 -Vacant Residential
Mailing Address Property Value
BUITERFIELD MOBILE HOME Ag Land $0
SERVICE INC Land $4,212
38930 BUTTERFIELD LN
ZEPHYRHILLS FL 33542-1677 Building $0
Physical Address Extra Features $0
37816 PRAIRIE ROSE LOOP
ZEPHYRHILLS FL 33542-2203
Legal Description (First 4 Lines) �ust Value $4,212
See Plat for this Subdivision Assessed (Non-School Amendment 1) $4,212
WALNUT GROVE TOWNHOUSES •
PB 69 PG 054 Taxable Value $4,212
LOT 62
OR 6544 PG 1916
Jurisdiction
Citv of Zephvrhills
Land Detail (Card: 001 of 001)___ __
___�__.._—___,._ _.___`___.__,__ ��_.._
Line �_ Use __ Descr�ption Zoning Units Type__�_ Price Condition Value
1 � 0100 SFR � MPUD� 2,700.00 � SF j $1.56 -� 1.00 � � $4,212 v
Additional Land Information
-----__....-----._.. �___.�..-_----___. .__._�._._______._,__._____--- -—-- ----- - I -
� �
Acres ' 0 06 � Tax Area ! 30ZH �ode X �Residential Code WGTHLPI
� �
Building Information - Use 00 - Unimproved (Card: 001 of 001)
Unimproved Parcel 00 - Unimproved
Extra Features (Card: 001 of 001)
-- —-- — - �— ---
---- — ------�-----
Line I Description_ _J`__�__Year T Units ! Value
----__--_---- �--- ---�
No Extra Features �� ��---�W_..___....._.._—�-__�
Sales Historv
Previous Owner: N/A
—___.___._.�—_..� _.�-----.----_..____,_._.___._.,�----- ---- ..___.—_—�.__.__
Month Year Book Pa e � T e � DOR Code ��Condition Amount
-------�------ -.�...__9_____ I T___ YP__ __�__.— __---�----------
08/2005 i_ 6544 / 1916 �_Warranty Deed i Vacant ( $600,000
---.�:___..—__
--- ----__._______.-- ,.--- --'�—------
11/1981 � 1157 / 1702 ! �y Vacant I �130,000
----- ----I_-----._�__._.______��----_.�--__, —
01/1973 � � � 0707/ 0675 � i ( Vacant j $0 �
h Ip://appraiser.pascogov.com/search/parcel.aspx?parce1=2126150210000000620 11/9/2016
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; ��t4.��� !�►���"���g �t�����.dl� .
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" � Permit No. �lD
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Date Permitte�d���
, Bu Ider Name/Owner Name �r� ����� Control#
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Go nty Parcel No. � �- Z�-- �.-J..� Zl�3--L?dC�.Y?'L���4 SubDiv: �als'1 C.!'T ,�'
Ad resslLocation ,'�7 ��� �G2�i'i�.. /L��- �.� � ��� �"
CI ssificatiantType of Use �� ����-
T �AN�PORTATI4N lMPACT FEE Rate: Sq Ft Unit: 1; j�i L_..�
� Ex mpt ❑ Yes ❑ No How Determined
IIm act Fse Amount $ .�i ���• Zone No. TAZ:
St�HOOL INlPAGT FEE
Account (056) Single-Family Detached House Rmount $ �
I (057} Mot�iie Nome
' (058} Other Residential
123} CoNection Fee
E empt � Yes [] No How Determined
I P RKS AND RECREATION FEE
La�nd Account Land Credit Land Tata(
R creation Accaunt Recreatian Credit Recreation Tota!
Z ne TOTAl.AMt�UNT $ ��, ��o
E empt [] Yes ❑ No How Determined
LI RARY FEE
L nd Account land Credit Land Totaf
� F cility Acca�ant Facifity Credit Facillty Tota!
�
�I E empt ❑ Yes (� Na How Determined Tatai Amaunt ����"'�
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', R�SOURCEEEE ERU
'� T4TAL AMqUNT
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P epared By ` Checked By
Af0 CERTIFtC�4TC OF OCCUPANCY lMILL BE ISSUED C1R FINAL 1NSPIECTIt3N
PERFORM�D UNTIE.THE TOTAL 1�MOUMTS LIS7ED HA!!E
BEEN PAiD AMb
RECEIPTED FUR BY Pd ClE1�TRAL PEIRMITTiNG OFFICE OF PASCO COUNTY
A knowiedgemant befow daes nat impiy acceptance�of concurrence,but slmpty recelpt af a copy o#this form,pfactng
the building perm(t owner on notice of thls assessment and thq canditions of payment fo�same.
ATE RECEIVED BY
ECEiPT NU. DATE BY
.. - -- --- �
. �
F �405-2014
FLORID�► ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION
Flo�ida Department of Business and Professional Regulation - Residential PerFormance Method
Project N me: R1016412 Unit 8-1 and 8-6 Builder Name.' Butterfield �i
Street: 4408 Court St Permit Office: City of Zephyrhills Q �y
City,Stat ,Zip: Zephyrhills,FL,33542 Permit�Number: J �rJ 03 t' %�]!0 /
Owner: � Typical-End Units 8-1 and 8-6 Jurisdiction: 611600
Design L cation: FL,Tampa County:: Pasco(Florida Climate Zone 2)
1. New co struction or existing New(From Plans) 9. Wall Types(1085.3 sqft.) Insulation Area i
2. Single f mily or multiple family Single-family a.ConGrete Block-Ext Insul,Exterior R=5.0 898.67 ft� I
b.Frame-Wood,Adjacent R=13.0 186.67 ft
3. Numbe of units,if multiple family 1 c.N/A R {�2
4. Numbe of Bedrooms 3 d.N/A R= ft�
10.Ceiling Types (1435.0 sqft.) Insulation Area
5. Is this worst case? No a.Under Attic(Vented) R=30.0 1435.00 ft2
6. Conditi ned floor area above grade(ft� 1435 b.N/A R= ft2
Conditioned floor area below grade(ft� 0 c.N/A R= ft2
11.Ducts R ftZ
7. Windol (137.0 sqft.) Description Area ' a.Sup:Attic,Ret:Attic,AH:ah 6 175
a. U-F ctor: Dbl,U=0.30 137.00 ft�
SH C: SHGC=0.25
b. U-F ctor: N/A {�z 12.Cooling systems kBtu/hr Efficiency
SH� C: a.Central Unit 27.8 SEER:14.00
c. U-F ctor: N/A ftz
SH C: 13.Heating systems kBtu/hr Efficiency
d. U- actor: N/A ft2 , a.Electric Strip Heat 27.3 COP:1.00
SH C:
Area Ieighted Average Overhang Depth: 1.672 ft.
Area Weighted Average SHGC: 0.250 14 Hot water systems
a.Electric Cap:40 gallons
8. Floor ypes (1435.0 sqft.) Insulation Area EF:0.970
a.Sla -On-Grade Edge Insulation R=0.0 1435.00 ftz b. Conservation features �
b.N/ ' R= ft2 None
c.N/ R= ftZ 15.Credits CF,Pstat
Glass/I IoorArea: 0.095 Total Proposed Modified Loads: 44.53 pASS
Total Baseline Loads: 46.69
I hereb certify that the plans and specifications covered by Review of the plans and ��'C���'`���.
this cal ulation are in compliance with the Florida Energy specifications covered by this =$ �, .
.�' �'%. +;�.� -�
Code. ��/�� calculation indicates compliance g -,�� ,��!�'
wit h t he F lori da Energy Co de. �» �r��,, '� k�;:'r,.��"„f
�t' � �
PREP RED BY: Before construction is completed c�: '
DATE 10-25-16 this building will be inspected for � i���'' T ;. �
compliance with Section 553.908 � �;
I here y certify that this building,as designed, is in compliance Florida Statutes. ,�,� . �,�,
with th Florida Energy Code. �',t3''�''�' .
OWN R/AGENT:_ BUILDING OFFIC AL:
DAT : DATE: �
- Co pliance requires certification by the air handler unit manufacturer that the air handler enc sure qualifies as
ce fied factory�ealed in accordance with R403.2.2.1.
-Co pliance requires an Air Barrier and Insulation Inspection Checklist in accordance with R402.4.1.1 and an envelope leakage
test r port in accordance with R402.4.1.2.
10/ 5/2016 2:01 PM EnergyGauge�USA-FlaRes2014 Section R405.4.1 Compliant Software Page 1 of 5
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Date Permitted
B ilder Name/0wner Name ��r� (.� ��C�� Controt#
C�unty Parcei No. � 2�O�- �/-.jj 2-I�7�,-j,��j[;�?'f]�.Z4 SubDiv: �aj�`'1�1` �'"
�,r� Ci��r}�
A�dressiLocation ,''��] ��� �`YGtr t��`�' l?�e �,� � 7��� �
� �
Classification/Type of Use G�� ���-.
TRAIVSPORTATIORI I(WPACT FEE Rate: Sq Ft Unit: ��
Exem t Yes No How Determined
p ❑ ❑
� Ir�ipact Fee Amount $ ..�� ��p• Zone No. TAZ:
S HOOL IMPACT�EE
A count (Q56} Single-Famify Detached House Amount $ �
(057} Mabiie Home
(058) Other Residentia!
123) Cailection Fee
E empt [� Yes [] No How Determined
P' RKS AND RECREATION FEE
L nd Account l.and Credit l.and Tatai
ecreation Account Recreatian Credit Recreation Totai
Z ne TOTAl.RMOUNT $ 7�, ��
E� empt [� Yes [� No How Determined
L�BRARY FEE
L nd AccounE Land Credit L.and Total
F�acility Account Facifity Credit Facility Totai
xempt ❑ Yes [� Na How Determined Total Amount �i�
ESOURGE �EE / _ ERU
QTAL AMOUNT �� �.�J� � ��'''�
' �(f l
�repared By 'I� Checked By
NQ CERTIPICATE t?� 4CCUPA,NCY!N{LL �E 15SUED OR F1P1AL INSPECTit3N
PEFiFORMED UNTi�.THE TOTAL AMOUNTS LISTED HAl/E
BE�1� PAIC! AId[�
RECEIPTED Ft�R BY A CENTRA�. PE62MiTT1NC t'3FF'iCE�.t� PA5C0 COUNTY
cknowledgement below does not imply acceptance of concur�ence,but simply receipt of a copy of this farm,placing
the building permit owner on natice of this assessment and thQ canditions af payment for same.
l� � I �. �. �.�����.C�
�ATE RE EIVED BY
RECEfPT NO. DATE �- �.7 BY ���.` ` !
,
� � CITY OF ZEPHYRHILLS
5335-8TH STREET
��, ($ss)�so-oozo 17
. � BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
� PERMIT INFORMATION LOCATION.INFORMATION
Permit#:17907 �� Issued: 11/10/2016 Address: 37820 PRAIRIE ROSE LP LT 64
Permit Type: GENERAL BUILDING PERMIT ZEPHYRHILLS, FL.
Class of Work: 105-NEW CONST/MULTI 5+ UNIT Township: Range: �
Proposed Use: ' NOT APPLICABLE Lot(s): Block: Section: '
Sq. Feet: I Est. Value: Book: Page: ;
Cost: 170,922.29 Total Fees: 9,230.10 Subdivision: WALNUT GROVE TOWNHOMES!
Amount Paid: 9,230.10 Date Paid: 11/10/2016 Parcel Number: 15-26-21-0210-00000-0640
CONTRACTOR INF�ORMATION � OWNER INFORMATION
Name: BAILEY CONTRACTING LLC Name: BUTTERFIELD MOBILE HOME SVC INC
Addr: 4209 GALL BL�VD Address: 38930 BUTTERFIELD LN '
ZEPHYRHILLS, FL 33542 ZEPHYRHILLS, FL 33542
Phone: (813)377-7395�; Lic: Phone:
Work Desc: CON;STRUCT NEW TOWNHOME 1,669 SQ FT
� I� . �' i � APPLICATION FEES
BUILDING FEE 795.02 E TRI AL FEE 214.43 PLUMBING FEE 105.15
MECHANICAL FEE 73.61 SEWER CONNECTION RESIDEN" 2,010.00 WATER CONNECTION RESIDENI 641.00
WATER METER RES 3/4" 473.78 FIRE PLAN REVIEW FEES 114.20 POLICE IMPACT FEE 254.00
FIRE IMPACT FEE 273.00 PUBLIC SAFETY 5% 26.35 PARK FEES TOWNHOMES 769.56
TRAFFIC IMPACT FEE 99% ' � 3,445.20 TRAFFIC IMPACT FEE 1°/a 34.80
� � � L
, � � ,
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$��c✓� �
S4wrc� ,
� ;< 'I.� Ins ections Re uired ` �
FOOTER I 2ND RO GH PLUMB MIS N ULATION CEILI G
FOOTER BOND I� DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC I� LINTEL MISC MISC.
1ST ROUGH PLUMB I PRE-METER INSULATION WALL MISC:
DUCTS INSTACLED I WATER MISC DRIVEWAY
PRE-SLAB I� SHEATHING MISC. MISC.
CONSTRUCTION POLE I� FRAME MISC. MISC. �
REINSPECTION FEES,: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the
local government sh�all 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 subsequent reinspection.REINSPECTION FEES:
NOTICE: In addition to the requirements of this permit, there 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 management, state agencies or federal agencies.
"Warning to owne�: 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 and Must Accompany Application.All work shall be performed in accordance
�� with Ci Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
� NO OCCUPANCY BEFORE C.O.
I �
� '
C NTRACTOR SIGNATURE PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
�
� i
: �
Jacqueline Boges � ''
From: Timothy Corson (FATHOM)<support@gwfathom.zendesk.com> I
Sent: Monday, November 21, 2016 9:59 AM � '�
To: Jacqueline Boges �
, Subject: [FATHOM] Re: new townhome
�
;
�
##- Please type your reply above �his line -## ;
Your request (#100525), has been solved. TO REOPEN THIS REQUEST, reply to this email or click the link below:
https://gwfathom.zendesk.com/hc/requests/100525
... 3
� �� �
�-- ----�
� ��J ' Timothy Corson (FATHOM)
��, � I
�--��� Nov 21, 7 99 AM MS ;
Hello,
This has been setup. Their customer/account# 899779-2457439 and SO#533088 has been
created to have meter installed.
Thank you,
' Best Regarlds, . �
Timothy � FATHOM Support
�'; � FATHOM ZenDesk Support (FATHOM) �
. ;
-._ 1
--- --' Nov 17, 11 :36 AM �ST
GIS has been updated to reflect the account.
Thank yo .
-Bill
�---- - ,
�� � )acqueline Boges �
�
-' ;
--�--_ Nov 10, 12�55 PM P� ST
customer need water service, sewer service and a water meter
This email is a service from FAT 10M.
1
. ,
Jacqueline Boges � �
From: FATHOM <support@gwfathom.zendesk.com> I�
Sent: Thursday, November 10, 2016 2:56 PM
To: Jacqueline Boges
Subject: (Request received] new townhome
##- Please type your reply above this line -## '
Hello Jacqueline Boges,
We are working to resolve your request promptly and will keep you updated. One of our Support Analyst will keep you
updated on the progress of your request.
Best Regards,
FATHOM Support Team�
TO ADD ADDITIONAL COMMENTS, reply to this email or click the link below:
https://gwfathom.zendesk.com/hc/reauests/100525
r-----�
� �:M- � Jacqueline Boges
I---- --! Nov 10, 12I 55 PM �� ST
customer I eed water service, sewer service and a water meter
i
This email is a service from FATFIOM.
�
1
;
' ' Townhome-37820 Priarie Rose Lp 1669 sq ft-Bailey Construction
middle section �
�
p o umn , ,
I. SQ. FEET PRICE � '
� MAIN OR LIVING: 1,669 $ 102.41
� �
bTHER AREA UNDER ROOF: - $ gg,pp
� �
I� OTHER: _ $ _ � '
��
�'
� VALUATION $ 170,922.29
�
I' FEE SHEET $ 701.00
�
I' ADDRESS $ 40.00
�
� DRIVEWAY $ 40.00 �
I
�' BUILDING: $ 795.02
�� ELECTRICAL: $ 214.43
�' PLUMBING: $ 105.15
�' MECHANICAL: $ 73.61
� SU B-TOTAL $ 1,188.21
I; '
�' TOTAL $ 1,188.21
I,
I' SEWER: $ 2,010.00
I WATER: $ 641.00
�� IRRIGATION: $ - �
�' TOTAL: $ 2,651.00
�' ,
I , WATER METER: $ 473.78
�, IRRIGATION METER $ -
� i
�' FIRE DEPARTMENT FEES
�� PLANS TOTAL: $ 114.20
I' INSPECTION TOTAL:
�' PERMIT TOTAL
� ' TOTAL: $ 114.20
I
I� PUBLIC SAFETY IMPACT FEES
� POLICE $ 254.00
�� FIRE $ 273.00 �
� 5% $ 26.35
�� TOTAL: $ 553.35 '
I� �
, �� �SUB-TOTAL $ 4,980.54 �
�� .
�; PARK IMPACT FEES $ 769.56 �
I �
I� SIF'S: N/A
� 100.0% $ -
� 1.0% $ -
�' TOTAL:
I;
�� T I F'S: $ 3,480.00
� 99% $ 3,445.20
� 1% $ 34.80
I'
�' TOTAL: $ 9,230.10
� '
� '
� 1669 sq ft
� o umn
I' SQ. FEET PRICE
�� MAIN OR LIVING: 1,669 $ 102.41 i
� �
OTHER AREA UNDER ROOF• - $ 88.00 �
� ;
I, OTHER: - $ - i i
� �
�� �
� VALUATION $ 170,922.29
� I
�' FEE SHEET $ 698.00 �
� � ��
I� ADDRESS $ 40.00
�'
� DRIVEWAY $ 40.00 �
I;
�� BUILDING: $ 791.96
�' ELECTRICAL: $ 157.05
� PLUMBING: $ 104.70
� MECHANICAL: $ 73.29
� SUB-TOTAL $ 1,127.00
�
� � TOTAL $ 1,127.00
I�
�, SEWER: $ 2,010.00 ,
I WATER: $ 641.00
� IRRIGATION: $ -
� TOTAL: $ 2,657.00
�
I� WATER METER: $ 473.78 �
;IRRIGATION METER $ -
� ' �
�FIRE DEPARTMENT FEES
� PLANS TOTAL: $ 114.20
INSPECTION TOTAL:
� PERMIT TOTAL
� TOTAL: $ 174.20 ,
I� ' i
PUBLIC SAFETY IMPACT FEES
� POLICE $ 254.00 �
�� ' FIRE $ 273.00 ;
� � 5% $ 26.35
� TOTAL: $ 553.35 �
I
�; SUB-TOTAL $ 4,919.33 , -
�
PARK IMPACT FEES $ 769.56 �
i
I� ' �
� SIF'S: '
�' 100.0% $ - '
� 1.0% $ - �
�; TOTAL: $ -
I �
�' T I F'S: $ 3,480.00
� 99% $ 3,445.20 �
� 1% $ 34.80 �
� ' '
� TOTAL: $ 9,168.89 �
�
15-26-21-0210-00000-0640 � Pasco County Property Appraiser Page 1 of 1
. . ��7 �0�
Mike Wells Pasco County Property Appraiser
Data Current as Of: Weekly Archive - Saturday, November 5, 2016 �
ParcelID 15-26-21-0210-00000-0640 (Card: 001 of001)
Classification 00 -Vacant Residential
Mailing Address Property Value
BUTTERFIELD MOBILE HOME Ag Land $0
SERVICE INC Land $4,212
38930 BUTTERFIELD LN
ZEPHYRHILLS FL 33542-1677 Building $0 .
Physical Address Extra Features $0
37820 PRAIRIE ROSE LOOP
ZEPHYRHILLS FL 33542-2203
Leaal Description (First 4 Lines)
7ust Value $4,212
See Piat for tliis Subdivision , ASSeSSed (Non-School Amendment 1) $4,212
I �
WALNUT GROVE TOWNHOUSES
PB 69 PG 054 Taxable Value $4,212
LOT 64
OR 6544 PG 1916
7urisdiction
Citv of Zeohvrhills
I_�M _ _ Land Detail (Card: 001 of 001) __�_
� Line Use Description Zoning Units Type � Pr�ce Condition Value i
1 0100 � SFR � MPUD� 2,700.00 SF � $1.56 1.00 i $4,212
___ _____�_ �____._� Additional Land Information �_ ____�__�
� Acres� 0.06 �Tax Area ( 30ZH � Co� X Residential Codei WGTHLPI
Building Information - Use 00 - Unimproved (Card: 001 of 001)
Unimproved Parcel 00 - Unimproved �
Extra Features(Card: 001 of 001)
Line _�� �Description � Year _ _ � Units __`�� Value `
No Extra Features '
' Sales Historv
Previous Owner: � N/A
__ Month/Year �Y Book/Page� �� Type , �DOR Code� Condition Amount
08/2005 � 6544 / 1916 Warranty Deed � Vacant��f����$�600,�0�00
- ----- - - 1
1157 1702 �� � �� �
11/1981 � � , Vac n �
_ _i _ , a t I $130,000
01/1973 � ` 0707/ 0675 � � �� Vacant $0
� ;
�
� �
http://appraiser.pascogov.com/search/parcel.aspx?parce1=2126150210000000640 11/9/2016
i
� �'r t
; : � � .:. ;, i�A��� ���N`fY, FL��ID�
:, ; . 1
, - �
" " Permit�lo, 1��� �
Date Permitted + / 1- .- !
Builder Name/Ow i e�-fUame y�-!e-y�� t�7"�'��=Y-�/� _ Cantroi# ,
____ J �,�f _f
o t Parcel No� f 2� -���''��2`� 5ubDiv: �G't.7"� r'�'Il�..
C un y c�.�-- �..�� G�
AddresslLocation ��?'��, r Y zC�.- ✓C4 St' ,� ��� �'�
ClassificationlType of Use' ! Q�G�? l�ld}�1�
TRANSPORTATIDN IMP�CT FEE Rate: Sq Ft Unit: �i ���r '
Exempt [] Yes [] No How Determined
` lmpact Fee Amourtt $�c�10 Zone No. TAZ:
SCHOOL IMPACT FEE
Account (056} Singie-Family Detached Hause Amount $ ��
(057) Mobile Hame
(058} Other�Resfdentiai
' 123}� Collection Fee
Exempt (� Yes [] No How Determ(ned
(�
PARKS AND REGREATtt7N FEE
Land Account {'� Land Credit Land Tata!
Recreation Acco Int Recreation Credit Recreation Tota!
Zone I T4TAL AMOUNT $ 7G� 'f�`<-5�,�
Exempt [� Yel � No How Determined �
LlBRARY �EE
Land Account Land Credit Land Total ,
Facility Account , Faciiity Credif Facility Total
Exempt [] Yes [� Na Haw Determined Total AmounE �
(.
RESOURGE F�E; ERU
TOTAL AMOUNTi
I
Prepared By ; � ____ � Checked By
1
NO CERTI�tCATE'OF OCGUPANCY M11LL BE 1SSUED (JR FINAL INSPECTIQN ,
RERFt3R61JIED UN'�Ik.THE 70TAL AMOUNTS �I51"ED HA1/E
� BEEN PAID AND
RECElPTELI FOR BY A CENTRAC. PEFtM1TTiNG OFFICE OF P�4SCC1 COUNlTY �
Acknowledgertaent befow daes nnt impiy acceptance of concurrence,but slmpiy recelpt of a copy of this form,p{acCng
the building permit owner on notice of this assessment and the,conditians of payment for same.
DATE RECEIV�D BY �
RECEIPT NO. DATE BY
�, _ -
� # '.I
i : ' �.. � ����^�7 l�h�����! ���ed�'��
:+ �
' ' � Permit No. � �
Date Permitted / -- r i
�./�- _ �-�� _ �
Builder Name/Owner Name ____� � Contral#
County Parcel No'. �c,�-.�- �.l-(�2��"���'`��� �ubDiv: �Gc7^ t'Ji�'..
AddressiL�catian� ��7�.�b �ar r��P.- ,�d Se- � �-�� "�
ClassificatianlType of Use 1 11'Gf��2 l�IL''Y�'I� �
7RANSPORTATI�tJN lMPAGT FEE Rate. Sq Ft Unit: �i ���
Exem t Y Is �to How Determined
p ❑ ❑
� impact Fee Amo�nt $ ,�r`�c�(} Zone No. TAZ:
��
SCHODL tMPA►GT FEE �-�- �
Account {056) Singie-Famiiy Detached House Amount $
(057) Mobile Home
(058� C7ther Residentiai
' 123� Colfection Fee
Exempt [� Yes � Na How Determined
j
PARKS AND RECREATI4aR! FEE
Land Account � �Land Credit Land Totai
Recreation Account Rscreation Gredit Recreation Totai
Zone � TOTAL AMOUNT $ 7C��`��
Exempt ❑ Ye,s [] No How Determined
,�
LIBRARY FEE I
Land Accaunt Land Credit Land Total
Facility Account I Facifity Credit Faciiity Totai
Exempt 0 Y�s (� No How Determir�ed Tatai Amount �
RESOURGE FEE /�� ERU
TOTAL AMOUNT �' l,P�_1� �(�+
� ' ��
Prepared By � t � Checked By
!
NO CERTIFiCATE OF OCCUPANCY'4�lILL�� ISSUED OR FIPJAL lNSPEGT{ON
PERFORMED UNTI�.THE 70TAL AMOUNTS USTED HAVE '
BEEM PAID AND ,
RECEIPTED FOR �Y A CEIdTRAl. P�RMITTING OF�{CE C1F PASCO CtIUIt�iTY �
Acknowledgement�efow does not impiy acceptance of concurrence,but slmply recelpt of a capy of this form,placing
the build'ing perm(t owner an notice of this assessment and th�conditions of payment for same.
I h
I �-- �`2 �l � �Ec�'�Q B�P.���
�
DATE
' RECEIPT NO. ' DATE BY �� ,
�_-- �
i
� CITY OF ZEPHYRHILLS
, 5335-8TH STREET
' ' �si3)�so-oo20 17908
- BUILDING PERMIT SIRIGLE FAMILY RESIDENTIAL
PERMIT INFORM'ATION LOCATION INFORMATION
Permit#:17908 ! Issued: 11/10/2016 Address: 37818 PRAIRIE ROSE LP LT 63
Permit Type: GENERAL BUILDING PERMIT ZEPHYRHILLS, FL.
Class of Work: 105!NEW CONST/MULTI 5+ UNIT Township: Range:
Proposed Use: NO i APPLICABLE Lot(s): Block: Section:
Sq. Feet: � Est. Value: Book: Page:
Cost: 170,922.29 Total Fees: 9,230.10 Subdivision: WALNUT GROVE TOWNHOMES
Amount Paid: 9,230.10 Date Paid: 11/10/2016 Parcel Number: 15-26-21-0210-00000-0630
CONTRACTiOR INF�ORMATION OWNER INFORMATION
Name: BAILEY CONTRACTING LLC Name: BUTTERFIELD MOBILE HOME SVC INC
Addr: 4209 GALL BLVD Address: 38930 BUTTERFIELD LN
ZEPHYRHILLS, FL 33542 ZEPHYRHILLS, FL 33542
Phone: (813)377-7395 Lic: Phone:
Work Desc: CONSTRUCT NEW TOWNHOME 1,669 SQ FT
� APPLICATION FEES
BUILDING FEE � 795.02 ELECTRICAL FEE 214.43 PLUMB NG FEE 105.15
MECHANICAL FEE I 73.61 SEWER CONNECTION RESIDEN" 2,010.00 WATER CONNECTION RESIDENI 641.00
WATER METER RES 3/4" 473.78 FIRE PLAN REVIEW FEES 114.20 POLICE IMPACT FEE 254.00
FIRE IMPACT FEE 273.00 PUBLIC SAFETY 5% 26.35 PARK FEES TOWNHOMES 769.56
TRAFFIC IMPACT FEE 99% 3,445.20 TRAFFIC IMPACT FEE 1% 34.80
I
�
I \ �
' E/ ' �-(�- � �
�����
�
I' � Ins ections Re uired
FO TER I 2ND ROUGH PLUMB MI INSULATION CEILING
FOOTER BOND I� DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC i LINTEL MISC MISC.
1ST ROUGH PLUMB I PRE-METER INSULATION WALL MISC.
DUCTS INSTALLED � WATER MISC DRIVEWAY
PRE-SLAB I SHEATHING MISC MISC.
CONSTRUCTION POLE I 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 subsequent reinspection.REINSPECTION FEES:
NOTICE: In addition to�the requirements of this permit, there may be additional restrictions applicable to this properly that
may be found in the p I blic 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 and Must Accompany Application. All work shall be performed in accordance
� with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. '
I NO OCCUPANCY BEFORE C.O. �
��-� � � _
CONTRACTOR IGNATURE PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
i
PROTECT CARD FROM WEATHER
I
I
, , . Townhome-37818 Priarie Rose Lp 1669 sq ft-Bailey Construction
middle section
� o umn
I SQ. FEET PRICE
� MAIN OR LIVING: 1,669 $ 102.41
�
;OTHER AREA UNDER ROOF: - $ 88.00
� �
I OTHER: - $ - ,
I� �
�
�� VALUATION $ 170,922.29 '
�
I FEE SHEET $ 701.00
�
I' ADDRESS $ 40.00
�
� DRIVEWAY $ 40.00
I
� BUILDING: $ 795.02
�, ELECTRICAL: $ 214.43
� � PLUMBING: $ 105.15
�; MECHANICAL: $ 73.61
�� SUB-TOTAL $ 1,188.21
�,
� TOTAL $ 1,188.27
I
I SEWER: $ 2,010.00
I� ' WATER: $ 641.00
� IRRIGATION: $ -
�; TOTAL: $ 2,651.00
�
I � WATER METER: $ 473.78
� IRRIGATION METER $ -
I,
�, FIRE DEPARTMENT FEES
�' PLANS TOTAL: $ 114.20
I' INSPECTION TOTAL:
� PERMIT TOTAL
�' � TOTAL: $ 114.20
�� ,
I� PUBLIC SAFETY IMPACT FEES
� POLICE $ 254.00
� FIRE $ 273.00
� 5% $ 26.35
� TOTAL: $ 553.35
I
�, 'SUB-TOTAL $ 4,980.54 '
� ;
� PARK IMPACT FEES $ 769.56 �
I
I SIF'S: N/A
� � 100.0% $ -
�' 1.0% $ -
I� � TOTAL:
I;
� T I F'S: $ 3,480.00
� 99% $ 3,445.20
�i 1% $ 34.80
I ,
�� TOTAL: $ 9,230.10 � � �
� ' 1669 sq ft
� o umn
I � SQ. FEET PRICE
�' MAIN OR LIVING: 1,669 $ 102.41
I ' '
OTHER AREA UNDER ROOF: - $ 88.00
� �
I OTHER: - $ - �
�� i
� i
� VALUATION $ 170,922.29
�
I� FEE SHEET $ 698.00 �
�
I ADDRESS $ 40.00
� ,
�' DRIVEWAY $ 40.00 '
I
� BUILDING: $ 791.96 ,
�� ELECTRICAL: $ 157.05
� PLUMBING: $ 104.70
�, MECHANICAL: $ 73.29
� SUB-TOTAL $ 1,127.00
�
� TOTAL $ 1,127.00
I'
I SEWER: $ 2,010.00
I � WATER: $ 641.00
� IRRIGATION: $ -
�; i TOTAL: $ 2,651.00 ,
��
�i WATER METER: $ 473.78
�IRRIGATION METER $ -
�, '
��FIRE DEPARTMENT FEES
� PLANS TOTAL: $ 114.20
IN,SPECTION TOTAL:
- �' PERMIT TOTAL � �
�' TOTAL: $ 114.20
I' '
PUBLIC SAFETY IMPACT FEES
� POLICE $ 254.00 �
� FIRE $ 273.00 �
�; ' 5% $ 26.35 '
� � TOTAL: $ 553.35
I '
�; SUB-TOTAL $ 4,919.33
�
�
�PARK IMPACT FEES $ 769.56 i
I �
I� SIF'S: �
I
� 100.0% $ -
�� � 1.0% $ - �
�� TOTAL: $ -
I ' �
� T I F'S: $ 3,480.00 �
�, 99% $ 3,445.20
� 1% $ 34.80
I�
� TOTAL: $ 9,168.89 �
, , r' � I
•'�
; ; .. � ���4�'� b9�°����g ������8`"!a
. �
��, �
'" � Permit Na 1 7�� � �
,
Date Permitted '
, Builder Name/Owner Name ��� � ��L� � l Contrai# �,
County Parcel No. ��2Yf-�f D l�-��� � SubDiv: ��1�� ���'�'-.�
AddresslLocation � �L�l� J`7'���'`��° r�"sQ- �" �"I���P`�
ClassificationCl'ype of Us� ��%�i'�� /�l��°-
I �
TRAN�PORTATl4N tMPACT FEE Rate: Sq Ft Unit: �1 ��� �
Exempt [] Ye�s [� No How Determined ;
� impact Fee Amo�nt $ �� 7�D� Zone No. TAZ:
�
SCH�OL IMPACT FEE ��
Account (056� Single-�amily Detachad Nouse Amount $ ,
� (057} Mobiie Nome '
(058j Uther Residentiai '
� 123) Coilection Fee ,
Exempt [] Yes ❑ No How Determined
1�
PARKS AND RECREATICbN FEE �
Land Accaunt � Land Credit Land Total
Recreatian Acca i nt Recreation Credit Recreation Total �
�I
Zane T�TAl. AMt?UNT $ ��i� �..3`�� '
, Exempt ❑ Ye�s ❑ No How Determined
� I
' LiBRARY FEE
�, Land Account (, �and Credit Land Tota!
��
Facility Account Facility Credit Facility Total
� Exempt �] Yek!s �] No How Determined Total Amount �°°-�
I
RESQURGE FEE ERU
TOTAL AMOUN i
, �
Prepared By � ' ���" Checked By
I T---- ,
I�
R10 CERTiFiCATIE OF OCCUPANCY V4�t�.L�E ISSUED OR EIhIAL tNSPECTION
PER�OR6�lii�D UNTtl.THE TOTAL AMOUPd7S LlSTED HAVE
�EEN PAID AND
RECEIPTIED FOR BY A CENTRAL. PERMIT'TlNG t�FFiC�OF PA5C0 COUNTY ,
Acknowledgement below does not impiy acceptance of cancurrence,but slmply recslpt of a copy o{thls form,placfng
the buildilg permit owner on natice of this assessment and th�conditions of payment for same.
I �
� . '
DATE RECEiVED BY
RECEIPT NO. DATE BY
� _ -- _ . _.—
15-26-21-0210-00000-0630 � Pasco County Property Appraiser Page 1 of 1
. . -�t���
Mike Wells Pasco County Property Appraiser
Data Current as Of: Weekly Archive- Saturday, November 5, 2016 �
Parcel ID 15-26-21-0210-00000-0630 (Card: 001 of 001) '
Classification 00 -Vacant Residential
Mailing Address Property Value
BUTTERFIELD MOBILE HOME Ag Land $0 I
SER�ICE INC Land $4 212 �
38930 BUTTERFIEL:D LN ' '
ZEPHYRHILLS FL 33542-1677 Building $0 �
Physical Address Extra Features $0
37818 PRAI�RIE ROSE LOOP
ZEPHYRHILLS FL 33542-2203 �
� Just Value $4,212
Leaal Description (First 4 Lines) ,
See Plat for t�his Subdivision ASSeSSed (Non-School Amendment 1) $4,212
I
WALNUT GROVE TOWNHOUSES
PB 69 PG 054 Taxable Value $4,212
LOT 63 ,
OR 6544 PG 1916
7urisdiction� '
Citv of Zephvrhills �
i
�v_ Land Detail (Card: 001 of 001) _
Line Use Description Zoning Un�ts Type__i Price Condition Value
1 � 0100 SFR � MPUD 2,700.00 SF j $1.56 � 1.00 $4,212
_______��._y._ ��._ Additional Land Information_, __Y_�� ;
Acres '0.06 Tax Area 30ZH C de X Residential Code�WGTHLPI
--- �� -�--- � �
Building Information - Use 00 - Unimproved (Card: 001 of 001)
Unimproved Parcel 00 - Unimproved
_ _ I Extra Features (Card: 001 of 001)
__Line �,1_ Description i_ Year � � Units Value
I, No Extra Features �i
Sales Historv
Previous Owner: N/A
Month/Year, Book/Page _ Type i DOR Code , Condition ( Amount
08/2005 6544 / 1916 Warranty Deed i �Vacant $600,000
' 11/1981 � 1157 / 1702 �� � � Vacant _��$_�130�,0.._00 ,
� O1/1973 � 0707/ 0675 ( � � ; Vacant I $0
�
�
i
i
�
�
I
http://appraiser.pascogov.com/search/parcel.aspx?parce1=2126150210000000630 11/9/2016 '
i
Jacqueline Boges
From: TQ Randolph (FATHOM)<support@gwfathom.zendesk.com>
Sent: Wednesday, November 16, 2016 1:15 PM
To: Jacqueline Boges
Subject: [FATHOM] Re: new townhome
##- Please type your Ieply abo���� this line -## � '
�
Your request (#100516) has been solved. TO REOPEN THIS REQUEST, reply to this email or click the link below:
https://gwfathom.zendesk.com/hc/requests/100516 �
I �
.i ...
r " ' TQ Randolph (FATHOM) �
f .�-' ;
L-4��--' fVov 1 6, i 14 AM P i5T �
�
COMPLETE. 899779 - 2457409
Best Regards,
TQ� FATHOM Support
' � _: � FATHOM ZenDesk Support (FATHOM) �
�--- ' Nov 16, 1 � •56 AM !15T �
GIS has been updated to reflect the account.
Thank you.
-Bill
! ! Jacquelinle Boges ,
----' Nov 10, 12:48 PM P ��T �
customer need water service, sewer service and a water meter ,
This email is a service from FATI iOM.
1
�
Jacqueline Boges
From: FATHOM <support@gwfathom.zendesk.com> ,
Sent: Thursday, November 10, 2016 2:48 PM '
To: Jacqueline Boges i li
Subject: [Request received] new townhome
##- Please type your reply abov�.� this line -##
Hello Jacqueline Boges, �
We are working to resolve your request promptly and will keep you updated. One of our Support Analyst will keep you
updated on the progress of your request. �
Best Regards,
FATHOM Support Team
I
TO ADD ADDITIONAL COMMENTS, reply to this email or click the link below: ' I
https://gwfathom.zendesk.com/hc/requests/100516 I
r----- -,
; Jacquelinle Boges
� ,
—�T,J Nov 10, 12 48 PM f� �T �
� i
customer need water service, sewer service and a water meter
This email is a service from FATI'OM.
i
i
I
�
i
1
i
� � �
��t
f"'t9� �'i
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� F :. ;= P�S�C� �C�l�f�`T1(, F��►F�1��►
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Permit No. �7�
.
Date Permitte����
Builder Name/Owner Name 1��t'r i+� ���7'� l�''�' Contro)#
County Parcel No, l������ � lD'L��� �� Subdiv: �c������`���''`2-� ,
� �L��� J"r �f � 7�
Address/Location Ccr�`•� t��.'S'�- G- �-T` ��
Classificafion/Type of Use �%ir''�cl�'1 /�4`y'►'1'�-
TRANS6'QRTATION IMPACT F�E Rate: sq Ft unit: li ��� �
1
Exempt [] Yes ❑ No How Determined
' impact Fee Amaunt $ �j T�Qr Zone No. TAZ:
�
SCHOOl. IMPACT FEE y �/ .
Accaunt (056� Single-Family Detached House Amount $ ���� '
(057) Mabile Home
(058} �ther Residential
123.) Collection Fee
Exempt (� Yes � No How Determined �
� '
PARKS AND RECREATI�}id FEE
Land Account �� Land Credit Land Totai �
Recreation Accalunt Recreation Credit Recreatian Totai
Zone I TOTAL AMOUNT $ �� �S�
Exempt (� Yes [] No How Determined
LiBRARY F�E � �
Land Account I Land Gredit Land Total
Faciiity Account Facility Gredit Facility Total
Exempt � Y�s [] No How Determined Total Amount ��
i
RESOURCE FEE ( � ERU �
TOTAL AMOUNT � tQ�
� f 1 ��� :
�
Prepared By ; ' � Checked By
I
NO CERTIFlCATE OF OCGUPANCY�lI1�.L �E ISSUED OR �fNAL INSPECTlt3N
�'PER�ORMED UNTIL 7HE TOTAL AMOUNTS LiSTED HANE
BEEM PAID AND
RECElPTED FC1Ff BY A CI�MTRAL �ERMITTING 4FFtCE Gl� PASCO COUNTY
��
Acknowledgament below dpes not impty acceptance of cancurcence,but simpfy receipt af a copy of this form,placing
the building permit owner on natice of this assassment and fhe.conditions of payment for same.
� 1����1�c� ����� _
DATE RE�
I ED BY
RECElPT NO. DATE BY _ ��!'��
� �
, _-
I — ,
813-780-0020 City of Zephyrhills Perrnit Application Fax-813-780-00��
Building Department �
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Date Received '
Phone Contact for Permitting �• � ���-Z-S�v �
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Owner's Name ;�-��l � _�v •sS� �c-� Owner Phone Plumber .3, �7.3• 5���
Owner's Address l � ZS�, I�/dil e/L �- � a� � Owrner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOBADDRESS � ' r 7��0'��i Z-" 7�� �f `-377-3��7�� � LOT# �
SUBDIVISION W��nf I� �'� PARCEL ID#
I (OBTAINED FROM PROPERTY TAX NOTICE) �
WORK PROPOSED Bj .. NEw CONSTR B ADD/AlT 0 SIGN � Q DEMOLISH
I INSTALL REPi41R
PROP.OSED USE �.��Q COMM 0 OTHER
TYPE:'OF CONSTRUCTION i BLOCK �• Q FRAME STEEL Q
.. ' .r �A� �
DESCRIPTION OF WORK ����
BUILDING SIZE SQ FOOTAGE� HEIGHT •
�BUILDING $ I �� ���, VALUATION'OF TOTAL CONSTRUCTION
�
QEL.ECTRICAL $ AMP SERVICE PROGRESS ENERGY Q W.R.E.C.
�
QPLUMBING $ '�i,
OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATIOfV
I
D;GAS Q ROOFING Q SPECIALTY 0 OTHER
FINISHED FLOOR ELEVATIONS 'I FLOOD ZONE AREA �YES NO
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BUILDER � COMPANY
SIGNATURE - �( �� � C.-%����"`� �t'REGISTERED Y/ N FEE CURRE� Y/N
Addross I License#
ELEC,TRICIAN COMPANY � ltv-x�r�� J ��-- .,�?G .
SIGNATURE I REGISTERED Y/ N FEE CURRE� Y/N
Address 3�.�/��y � — 2� .- i ( .FJ• � License# U � Z
P.LUII�BEId. y�� _ COMPANY� � a" ' � �, � i� ' C i �-'�`'��
SIGNATURE - �'�-`-'�+ Z� REGISTERED -/ N FEE CURRE� Y/N
Address � � 'b I � � _ � Z License# ��rZ/ � ��.�Q�i
_ MiECHANICAL' y�� I� COMPANY ��1�.S S L L
SIGNi4TURE' i� REGISTERED Y/ N F .CU RRE� Y/N
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aaa�ass r YYY/�/ i c�ov /Z� 2`���S �3� l License# CAC� Y-�!`' �j' �
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OTHER'� "-`` � i COIIAPkNY
SIGNATURE�.` .• . I ' REGISTERED Y/ N FEE CURREK Y/N
t;, .�:• ;, .,, _
Address,:- =I' . ' ' ' License#
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;'�;RESIDENTIAL;�:� Attacli.;(2)-:Plof P.la�ns;"(2)�"sets'of Building°Plans;(1�)'set of Energy,Fortns;R;O-W Permit.for new,construction,
- � �_- Minimum,ten;(;10):working`rdays afte�su6mittal;iiate."Required'bnsite;Constriiction Plans,Stormwater Plans w/Silt Fence installed,
,. `,::;:.;'s-t�,z _, ..- , ,
_ Sanitary:FaciliNes;&;a1�dumpster;Sife:Wor,k Permitfor..subdivisionsAarge.projects� ` '
=_�:COMMERCIAL Attach(2)�complete sets of'Buildirig 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 w/Silt Fence installed,
Sanitary Facilities�&1 dumpster.Site Work Permit"fo�all-new projects.All commercial requirements must meet compliance
�;:SIGN'PERAAIT Attacli(2jsetsof;EngineeredPlans•�
- """PROPERTY SURVEY required for aII.NEW construction. , �
- r --• -
�:-Uirections: �- � �, �
Fill-out application completely.
Owner 8 Contraotor sign back of application,notarized
If over$2500;a Notice of Commencement is required. (A/C upgrades over$7500)
"'"' i4gent(for�#fie�contFactor)orPower`of Attomey(for the owner)would be someone with notarized letter from owner authorizing same "
�;,:OVER.THE COUPITER_RERIVIITTING. (copy of contract required) `
=Reroofs if sliingles Sewers �Service Upgrades A/C Fences(Plot/Sun.�ey/Footage)
Driveways-Not over Counter if on public roacJways..needs ROW
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NOTICE OF DEED•RESTRlCTIONS: The undersigned understands:that.this;permit may,be subject to".deed".resf�ictioris;,-.,;�:�::
which;.may:�e:mor.e:cestricfive;#han�County:reguiat'sons:���The`�iandecsigned�•assurries�°fesponsib�'tify°far-campliance iiii�th any�"w` �
applicable.deed restrictions. • .. . �-°:-�"�':`',,`'"�"`5�' .'
UNLICENSED- CONTRACTORS AND CONTRACTOR-1�E�.P..ONSIB1LITtES: If•fiie-owiiee„has��Fai�etl�-�a��con#ractor or
contractors�to undertake work,rt#hey,mayJ.be r:equired to be�licensed.i�n accor.dance with state;and�local_.regulations:.',=1f�'tfie��;,�:<:a
contrac#or.is not licensed-as requiced by law, both the owr�er:and'cQnfractor:may;be��cited��for�:a'tnisdemeanor vio{_ation• ,�;;;
under sfate (aw. If the awner or intended.contractor are uncertain as #a what iicensing requirements�arnayNapply�.for�tlie;<r;`��;�
•.�9A:'�f't'"'k
intended work, they-are advised to contact the Pasco CountyBuilding Inspection"Diyisian-Licensing Section afi727=847=
8009: Fuctherrnore, if the owner has tiired�a �coii#ractor or cont"racfo�s, he is advised to�have the contracto.r,{s.);�:s�gn,;,,v�.�r
u n .,t�.. :...:�..��:;i: �;,^.',«:.cC•>' :
portions of the contractor Block of this applicatian..for which they-will be resP.onsible: .If yau, as tfieYowner'sign:as�tlie"'' ��:;;
contractac, that may be an'indication ttiat he is nat properly licensed anc! is nof erititled to permitting piiyileges,in;Pasco_._;,,.;�,
Caunty. . :� . .. . ��:: _, w.�;
' TRANSPORTATION IMRACT/,UTILITIES IMPACT AND RESDURCE RECOVERY FEES:-�The undersigned understands �
�...: ,
that Transportation Impact Fees and Recourse Recovery Fees may:apply to#he canstrucfran.af new:builctings, cFiange.�of}==`����:;�j
use in existing buildings, orexp,'ansian.of:existing buildings, as specified in Pasca County Ordinance number 89=Q7 ani� ';:;
9Q-Q7, as amended. The�undet�signec! also understands, that such:fees, as�may,:b.e,due, will't�e=ident�ed�at�tlie�:tiiite�ofi��u`�' ;
permitting. �It is further understood that Transportation impact Fees=and Re§ource�Recovery Fees must be paid pcior to '
receiving a "certificate of dccupancy.° or fna!power release. !f the.praject does not involve a'certificate of occupariey�.cirr<�t� '%, .
� finai power rele.ase, the tees-�mus# be paid prior to perrnit issuance. .Furtfiermore, if Pasco�County W,_,ater/Sewerr.impact:.:�-,::� :
fees are due, tliey must.be paid prior ta permit issuance in accordance with=applicable Pasco.County ordinances. '
CQNSTRUCTlOM�LIEN-�AW{Ghapter 793, Flar�da�ta�tutes,as amended}: If valuat3an of wock is$2,.5,OQ.00�or moce,�.l;.;,,�
. .,..Y., :
certify that I, the applicant, have been- provided with a copy_of the "Florida Constr.uetion Lien .Law Homeownec's �
Protection Guide° prepared�by the Flarida Departmen#of Agricuiture and Consumer AfFairs. If the appGcant�is.someone_, ,
other than the"owner", I certify#hat I have obtained a copy of#he abave d'esc�i6etl document and promise•in goad:faitli�tq',�`,,.
deliver�it.to the"owner��p�ior:fo commeneement. � �
CONTRI�►CTCJR'S/t3WNER'S AFFIDAVIT:, �I-.certify that all the inforrnation in this apptication is accurate a,nd"thaf ai!-wark
will be done in compliance with all applicable'laws regulating construction, zoning�and land�development. Application.is
hereby made to obtain,a..,petmit_to do work' and installation as indicated. 1 certify that no-work ar-instalfation=has .
commenced prior to issuance of a permit and�that all work will be pertormed to.meet-.standards af all laws regulating
const�uction, County and City codes, zoning cegulations, and land deve{opment regulations iit the jurisdic#ian. !:also
, certify that i undersfand that the regulatians of other government agencies may apply ta the intended work, and that it is "
my responsibility to identify what actians I must take to be in compliance. Such agencies include,but are not limited.to:
- ,,Depactment o# Enviranmental.Protection-Gypress Baytaeads, Wefland Areas and Ertv�ronmen#atly Sensitive '
Lands,WaterMlastewater Trea#ment. �
- Southwest Florida Water Management District Wells, Cypress Bayheads, Wetland Areas, Attering
Watercourses. ��
- Army Corps af Engineers-Seawalls, Docks, Navigable Waterways.
- Department of Health 8� Rehabititative ServicesJEnvironmentaf .Hea(th .Unit-Wells, 1N.astewater T'reatment,
5ep#ic�Tanks. '
- US Enuironmental Protection Agency-Asbestos abatement. � .
- Federal Aviation Authority-Runways.
I understand that�.the foHowing restrict(ons apply to the use af fill:
- Use of fill is not altawed in Flood Zone"V"untess expressly permitted.
� - If the �II-material is to be used in. Flood Zone °A", it is understaod that a drainage plan addressing a
"compensating rrolume" wi11 be submitted at time:of permitting which.is prepared by a professianal engin�er
licensed by the State of Flarida. �
- !f the fill material is to be used in Flood Zone "A" in connec#ion with a permitted building using stem wall
construction, I certify that fil�will be used only to fill the area within the stem wall. �
- If fill material is,to be used in any area, I certify tha# use of such�-fill will not adversely affec# adjacent
, praperkies. If use af fiiE is found to adversely affect adjacent properties, the owner may be ci#ed for vio(ating
the conditions of.the building permit issued under the attached permit.application, for lats less than one (1)
acre which are elevated by filt,an.engineered drainage plan is requi�ed.
If I am#he AGENT FOR THE OWNER,-I•promise in goad faith to inform the owner of-the permitting canditions set forth in
this affidavit prior to commencing consVuction, I understand that a separate permit may be required far electrical work,. . �
plumbing, signs, wells, pools, air conditioning, gas, or other insfaltations not specifically_inciuded in the application. A ,
permit issued shall':be construed to'be a license to.proceed with the work and not as�authoriry.to vialate, cancel, alter, or
set aside any provisions of the technical codes, nor shall Issuance of a permit prevent the BuiSd'mg C}fficial from thereafter
requiring a correction of errors in plans,�construction or violations of any codes. Every permit issued sfiall become invalid
unless the work author�zed by such permit is commenced within six monfhs af permit issuance, or if work autharized by
#he permit is suspended ar abandoned for a period-.of six(6)months after the time the work i��commenced. An e�ctension
may be requested, in writing, from the Building Officia! for a period not to exceed ninety (90) days and will demonstrate
justifiable cause for the extension. If wark ceases far ninety�90)consecutive days,the jab is considered abandoned.
WARNlNG TQ OWNER; YOUR FAl1.URE. .T.Q RECORD..A NOTICE OF CQMM�CEMENT�MAY RESULT IN YOldR
PAYING TWICE FQR IMPROVEMENT$.TO YOUR:PROPERTY.:IF.YOU:INTEND TO�OBTAIN�'FINANCING, CONSULT
WITH YOUR'IENDER OR AN ATTORNEY BEFORE REGORDlNG YC?UR NOTI�E'OF�CQMMENCEMENT.
FI.ORtdA JURAT{FS.11 ZQ3). ,,,....— ' -` ' �
OWMER OR AGENT �,ti-�'�-�����..�'� , � GONTRACTOR„�(�� �. '��"—�__..._.
Subscribed and swam to(or a#�m�ed)before me 1 8ubscribed and swom to(or af�rmed}Befare ie this
by
Who is/are personally known to me or has/have produced ` Who is! personally kn ta me or hasfhave produced
as Iden�fication. y�. as idenUfication.
Notary public Notary Publlc
Comm�sstan No. C Is ' n '�Y rs�••. JACQU�LCNE GES �
_:; ;k� Comm ssion#FF 150422
- :ex Ex lres�ec�mbsr 12 �018
Rlame of Natary typed,printed or stamped iVame of iVa r , '��pri�t+�N�i�pe�i�fla soo•a�saos�
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� 111111111111111iIIlllllllllllllllllilll(1llllllll[Illlflllll :
� Zeisis97ze
Rcpt:18071f7 Rec: 10.00
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- 10/il/2016 K. p. K. J ppty C�grk �,
PAULA 5 0'NEI�.,Ph D.ppSGO CLERK & G4MPTROLLEF
10l12/201� ,�1n�am pG ��V �i
NOTICE OF COMMENCEMENT OR BK ��.�,
Pecmit No. �
3Prapr�y�aemifilc�ion xo. "l�-�.�b�.�.l -� �?,I cs _cs,�..v�t�— �?� ;
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THE UNAERSIGNED hereby give iafarms you thet the�rovement will he made to certain reat P��3S eud'm eccardaaae with i
3�ction?l3.23 ofthe Ftortda Statutes,ihe foltowing�omSatlms is prav3dsd 4a tts£s NOTtCE O�COMh�.+NCEhSE2�IT. �
1.Description of�oPeriy(Le al dercr Boe) -•. .-• —• �Ci C?(?�Gr *' C��l�,j �
a}StreetAxtdRsa: o�� ra �f a'� ;
2.Oeneial descriplticm of improvemeass: uv.�Gs -e» �
;
� �.�WIlG7 jAf0IiB8XttlA - rr'^� fy. .
a)Neme'emd addcess•' � V.r4s��.,�.� . I
b)Neme�ain�i addross of fee simple titledolder("if othei owner) l ,
o}7atacs�t ia'P�P�Y .t•! � •c�t _ 1,
4.GonhactbrIafo�rmatiufi ' ,�f', �(�
a,x�a�a aaa�:,.�'��1�`-z .-�.-��.Pc-��'R . �Z� F � /�� /���_ 2..1
b)Tciephone Na.: —G F�o.{QFL)
S.Surety infoimstion .
e)Nacne emd'eddress:
h A�o�spt of Bond: . '
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c)Teleph'ona No.: ' Fa�t Na.(Opt.) ,
6.I.ender �
a)PIame i d addr�.ss� '
� • Pfiane No. ' ,
7.Identiry of pecson within the Stete af Florida�le,eignated by owner upop rvhom aptices oF a�thv doaaments mey be aerved:
a)Neme azid addrass•
b}Tetephane No.: ` Faac No.(Opt.) ;
8.Ia addiHon to him9elf�owne�r desigoatas;fte fallowirig pttson W rccciya a copy bfthe x.icnox's Nottca as provided"m Section
713.13(1}(bj,Florida Smtrues: • ,
a}Nama end eddsess:
b)Telephonallo.: '�� " ' .FaxNo.(Opt) �
9.E+atpitaHon dete of Notic�ofCoinmencemppt(We exgisarioa date is one y'tar frbap the date of recording esa a diffefmst dato�S
speci$a3}. I
,
WARNI2YGr'L'U O.i R: ANY PA'liNtEN'I"a"I41ADR$X'THE Q'P4!NSR AFTER T$E�IRA�'IOAF 027'THE ATOTICE OF`
COMMENCEM�:NT ARE CANSID�ItED IMFRBPER PAYMEl�13'S[7KDER C��Ai''T'ER 913,PAIiT i,SECtTON T13.33�
F1:ORIDA ST'ATU1�S;A1V'D CAN RPSIJI.T W YOUR.PA7Ci1'�C TVVXCE FOR IIVIPROVBMEN'I'S 1b YOCJ�t�EtOPEIt'I`Y. .
A 1KQTiCE Q�+C01112VlE1V�MENT 21NST H�RECt7ItD&D.AND POSTRD 4IV THE JQB SIT�BEFO�t&T'HE I+'I�tST �
IlYSPECTION IF YOU INTEND TO OBTAAi�t RINA1�1'CIIiIG,CONStILT YOTJ�t LElYDBR 4R.AN A.TTORNEY BFsFORE '
COMMENCllYG W4)RIC OI�RECORDING YOUR NOTICE OF COMl4IENCEMENI: . �
STA'I'B OF FiAItIDA
CO11N7V OF PASCO C1.��''°"�-"�ys � �
- Slgnrmue of Owrier or Ovma'�Au�Offi-iaer/D)rktor�-��tim/r/MaQage
t�t�rY�'� L3w/��.Fi� 1
Friat Name I
'Ib� oagoksg ios�umettt was ac�lsmowledgal befarc me th3s,�,�day of W.f V�/� . ,20�by (�/�����.
��L_�t 1� as {type oYasrthority,e.pY officer. e�.attozuaY
in fact)for ' �{f I o r�- (neme ofparty on behalf of wh m fastnmmeat euted).
s �,.L �
Persaanally Known U��,,OR Fhraduced Identificatiott= Notsry Sigoafurz� � .
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Typc of Idratificatiaa Pi vducai t�ame(priat) �� .
Yeztficallon pursnsat to�Section 42.525,Fiorida St�utes.Under peaehies of parje�r}',I deciare that I hav�r�ad the foregsring&ad ti�at
the facts stated in it azc true to the best of my imow3edge aad belie£
� � stgnenue otntmas7 ruaon sigatng Abcro' �
FORMSRi �
pa�ny '
•;3:�•v'�•. HEATHEA D.MA7}iIS'-
''�� �'% MY GOMMISSIOtt Y FF 454687
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=v:�,:,; EXPIRES:September 2,20i7
'%Y�f iyd:•` Banded Thru Notary Pudic Underwtiters
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STATE aF FLQRIDA,COUNTY OF F�ASCO �.`� ° ' o �'o�
THIS 1S TG C�RTIFY THAT THE FOREGOING IS A G� , �
TRUE ANU CORRECT COPY OF THE DOCUMENT " � - �
c 1j a.. , O �
ON FILE OR OF PUBLIC RECORD IN THIS OFFICE � • �7 Go�14�-n��
WITNESS MY HAND AND FFICIAL SEAL THIS � . �
� 2 � �, ���y. o�}
DAYOF � �., ��� �
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P LA S O'NEIL,CLER COMPTROLL R ��8 j
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gY ��� DEPUTY CLERK
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� City of Zephyrhills ,
� BUILDING PLAN REVIEW COMMENTS �
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Contractor/Homeowner: �� � � �C
Date Received: �(j� ��i--/
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Site: `�J ���7"�J�70��, �37�/�, 3��z� 3��-S�� 3���
P ermit Typ e: /�°t��v��[r��
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Approved w/no commerits:0 Approved w/the below comments: D�Denied w/the below comments: ❑
U�t +� � ���� � � �� ��
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This comment sheet shall be kept with the permit and/or plans. ' '
� - Ga.�7r i G�
Gene Brown—Fire Safety Officer Date Contractor and/or Homeowner
(Required when comments are present)
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� Single Family Dwelling
Plan Review Comments
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1. F.F.E. shalil be a minimum of 8" above the road elevation and an engineered site plan.
2. Lots shall be graded to comply with R401.3 of the F.B.C.
3. Compaction test required if 24" or more of fill dirt is brought in at any one place.
4. Tie in survley required before pouring concrete.
5. Drivewaysl require a R.O.W. use permit. A114 sides of driveway thru the sidewalk shall have
expansion�material.
6. All setbacks shall be met.
7. All property markers shall be uncovered and marked at time of first inspection.
8. All A.D.A.�requirements shall be met.
9. No electric,plumbing,mechanical, or framing shall be covered without an inspection and
approval first. �
10. All Garage�s shall coinply with section R302.6 of the F.B.C. (Fire Separation).
1 l. Appliances�� shall not be installed in a location where subject to mechanical damage unless
protected by approved barriers. M303.4 of the F.B.0 �
12. Water heaters shall comply with section P607.3 of the F.B.C.
13. Foundatiori supports forA/C units shall be raised at least 3" above finished grade. M1308.1
14. Return air '�i�n all bedrooms. F.B.C. M1620.4
15. Smoke detectors are to be installed in accordance with R313.1 of the F.B.C.
16. All glazinglrequirements are to be in accordance with R308.4 of the F.B.C.
17. All means of egress are to be in accordance with R311 of the F.B.C.
18. "Green gypsum board" shall not be used as a backer in showers or tubs. R702.4.2 F.B.C.
19. Combination-type AFCI breakers are required at all locations requiring an AFCI type breaker.
20. Carbon monoxide alarms will be required in new construction that uses fossil-burning heating '
or appliances or an attached garage. They shall be installed in accordance with the F.B.C.
21. All plumbirig, mechanical, and electrical shall be separate from unit to unit. This includes all
underground plumbing and electric.
22. A112008 N�:E.C. Codes will be enforced. '
23. Tamper-Resistant Receptacles in accordance with 406.11 of the 2008 N.E.0 �,
22. In accordance with tlie Land Development Code, lots shall be sodded before final at least 10
feet around the structure.
F.F.E.-Finished Floor Elevation ,
F.B.C- Flori�da Building Code 5�'Edition
R.O.W.-Right of Way
A.D.A.-Am�ericans with Disabilities Act N.E.C.-National Electric Code(2008)
��PHYRFiILLS FlRE DLPART�VIEf�T �
6907 Dairy Road, Zephyrhilis, FL 33542
�IRE SERVICE U�ER FEES
Occupancy Alo.:
Plan No.: I Contractor.
Business Name: � ' Billing Address:
Business Address: I
Business Phone No.: I' Billing Phone No.:
Business Fax No.: I Biliing Fax No.:
, Contact: I Contact:
P REVIEW FEES INSPECTIOtd FEES PERMIT FEE FALSE ALARM FEE
e Plan N/C Annual N/C Sprinkler $50 1st Alarm N/C
Mufti-FamilylCommercial .O6 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
SPRINKLER SYSTEMS� (Business closed until LP Gas $50 6ih Alarm $200
0-25 Heads $50 violations corrected) . Natural Gas $50 NON COMPLIANCE $150
26 plus Heads $100 SPRINKLER SYSTEMS Fuel Tanks- Perc�nk $50
STANDPIPE SYSTEM Hydro Undergrounds $45 Sparklers $100
�Per Riser $50 Hydrostatic Test $65 per system Fire Works $500 i
FIRE PURAP ' Acceptance Test $45 persystem Camp Fire $25 i
�Per Pump $100 Hydrant Flow $75 Controlled Bum $100
�IRE ALARNi SYSTE(�A Hood/Duct $50
0-25 Devices $50 FIRE ALARM SYSTEAA Place of Assembly $50 Mnual
26 plus Devices $100 System Acceptance $50 Fire Protection $25
SUPPRESSiOId SYSTEflAS 8 Recall Acceptance $50 Flammable Applicauon $50 annua� ,
Wet $50 OTHER Waste Tire Storage $50 Mnual '
Dry $50 Fire WalUSmoke Wall $'15 per wan Generator<KW $100
CO2 $50 LP Gas $25 pertank Generator>30 KW 150
' Other $50 Natural Gas $25 persystem Bio-Hazard Waste $100 a,nuai
KITCHEtd EXHAUST Fumigation Tenting $50 �
�Hood/Ducts $50 Tent 10'x10'or greater $15 per lent Torch PoUApp�ied $50 ,
OTHER Fire Pump $45 Haz.Maferials $100 annuai
8 LP InstallaUon per tank $50 Fire Suppression $30
Fuel Tank Installation $50 System Acceptance
(Per Tank) $50 Exhaust Hood/Duct $30
�Natural Gas InstallaUon $50 e Re-inspection DBL
(Per System) (other than annual)
�Spray Booth $50 �Inspection scheduled DBL B
and cancelled less than
24 hours
Construction Insp. N/C
Emergency Vehicle A� $50 FALSE ALARM !
PLANSTOTAL Z�, IIdSPECTIONTOTAL� PERRAITTOTAL� TOTAL�
GRAND TOTAL p�
Comments: .
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Date: � �
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Inspector:
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_._ .__ ___„ � � �ny ar�epnym�iis rerm�t Appiication Fax-s�aaso-oa2�
Bufiding bepartmeni
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iDate Reselved phone Contact for Permltttn
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Chnme�'s Mame fJ��o�-��, ' l-�f � Owner Phane Mumber 7�=5���
Dwner's Address �.�'.3Z>� � .ai �v�-e�9 l�ry ,.�i�c�r'�' �j.� Owner Phone Number � ���
Fee Simpte'iitteholder Neme �� t Owner Pfione Numbar ry �
�ee Simple Ti#lehoider Address ��
aQe A�DResS � � �,3 !S' � 3��'�;� �.�?�lz4�-,3� Ept# ��_�
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5U8DNISION ���ivw��r11,.�-v -�- � PARCEL It?# �:��,%� �`G�"�a q—�d �
I (OBTAINED FROM PROPERTY tAX NOTICE)
WORK PROPOSED ; NEW CON5TR 8 ADD/AL7 � SIGN � Q DEMOLISH
I INSTALL REPAIR
PRi�ROSED llSE �I ' SFR Q COMM � OTNER
TYPE t�F CONSTitUCT10N � BL.00K Q FRAME C� STEEL Q
QESCRIPtI(!M OF WORIC � �-% t��
BUILDING SIZE �� � SQ FOOTAGE�_�� F!ElGH`I' ��r_��
[�BU1LDiNG $� �.� �� VALUATION OF TOTAL COMSTRUCTION
QEIECTRtCA� $I' � � AMP SERVICE Q PROGRESS ENERGY CJ W.R.E.C.
i QPLUMBINf3 $I
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QMECHANtCAl. $!. ; � VAI.UATtt1N OF MECHANICAI INSTALLATION
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� [�]GAS Ci� J E200FING �J SPECIALTY �„� OTHER
=1NISHED FIOQR ELEVA7lOt�[S I �� FLOOD 20M1tE AFtEA [�YES NO
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3tltLDER -�-� ��
'stCsNATUttE , c �y�.�l c,�� �'C'— R OM5'fERr D Y/ N FEE WRR � Y!N
'I Address
I Ucense# ��`���
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`eLECTRlCIAN .�,�„�,r.�..�:'"'� COMPANY r)i��C� �/'�t 1�+�-�i ft �``t�6��-.
�IGNATUFCE � „ REGIS'tERED Y I N FEE CURREt� Y I IV
Address ( License# �d�2- ��
��uMe�a `�,�""' �`J{ �f(��.�..� Ct�MPAP1"Y �t,�l�;3 L, , W; 1 l�tt w'
IIGNA"RlFtE l�`-� ��¢."" � Y
REGtSTERED Y/ N FEE CURREh Y I I�I
Address �� ucense# C,�c 1 y z .�"6���- �
AECHANICAI. '� I /��"�"'�-- COMPANY lJ�l��r S �Qep /�ir/rt �AS e-� L,,,
i1GNA7URE .""""' I REGlSTEREQ Y i N_ PEE CUR n Y J N
Address �. License# G�GD �..�J� %�� �
)THER Ct?MPANIf
i1CNATURE I REGIS'T'ERED Y
/ N FEE CURREA Y!N
Address ( l.icense# 1 . ���
tESIDENTIAL Attach(2�.PIot Plans;(2)sets of Bullding F?lans;(!)set of Energy Forrrss;R-O-W Permft for new cons#ructEan,
Mlntmum ten(10);working days aiter submlttal date. Requlred onsite,Construcdon Plans,Stormwater Plans w/S!ft Fence installed,
Sanitary Fadlitiss&1 dumpster,Site Wark Permit for�subdlvlstonsAarge projects
:OMMERCIAI. Attach(3)camplete seCs of BuCiding Plans plus a l.Ife Safety Page;{1}set of Energy Forms.R-O-W f'ermtt tor new conshuation.
Minlmum ten(10)worktng days after submittal date. Requlred onslte,Conshuc0an Plans.Stormwater Plans w/Stlt Fence Installed,
Santfary Fadlities&i dumpster.Site Wark Permit for alt new projects.Ati commerciai requtrements must meet compllance
cIGN PERMIT Attact�(2)sats of�Engineered�Plans.
•'••PROPERTY SURVEY requlred for all NEW construcUan.
►irectlons;
Fill out applicatlon completely. �
Owner&Contractor sign back of appNcatton,notarized
If over S2SOC,a Mottce of Commenaement is requlred. {,AlG upgrades over�7500}
' Agent{for the+co�tractor�ar Pav�er of Attarriey{for the awner)woutd be someone with natarized letter from o��mer authorizing same
�, .
lVER 7HE GOUN`CER PERMI7TlNG {Front of Appiica8an Only)
;eroofs if shingles Sewers �j,Servfce Upgrades A/C Fences{PIot/Survey/Footage�
Driveways-Not aver Counter#I�n pubiic roadways..needs ROW
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NQTICE OE QEED RESTRICTlONS: The undersigned understands that this permit may be subJect to°deed°restrictions°
�rhtch may"be.mare.restrictive than.Gaunty r.egulatlans, The unders(gned assumesrespon�iblllty:for compllance wlth any
appiicabte deed rest�ictfons.
UNLICENSED CONTRAC7'ORS AND Ct3NTRACTOR RESPUNS181LfTiES: if the owner has hired a can#ractor or
cont�actors to unde�kake warkw they may be requtred to be licensed tn accordance with state and tocai regutations, tf the
contractar is nat ftcensed as requtred by law, bath the awner and eontractor may be cited�for a mfsdemeanor vtolatton
under stata law. if the awner or intended contractor are uncertafin as ta what liaensing requiremertts may apply for the
intended work;they are advised to contac#tiie Pasca County Building tnspectfon Divislon—k.icensing Sectlan at?27-847-
8009. Furthermore, tf the owner has hired a confracfor or contractors, he is advised to have the contractor(s) sign
portEons of the "contractor Biack" of thls application for which they w(II be respons(ble. If you. as the awner sign,as the
contractar, that may be an Indtcatfon that he is not proper�y Iicensed and is not-entitled to permitting prtvileges.in Pasco
County.
TRANSPORTATION IMPACTlUTiLiTiES IMPACT AND I�ESOURCE RECt3VERY FEES: The undersigned understands
that T�ansportation Impact Fees and Recourse Recovery Fees may.apply to-the consfruction of new buildings, change of
use in existing buildings, or expansion af exlsting bulldings, as specifled in Pasco County Ordinance number 89-U7 and
90-OT, as amended. "Che undersigned aiso understands, that such fees� as may�be due, wtH be [dentified at the time of
permitting. It is further undersfood that Transportation Impact fees and.Resource Recovery Fees must be paid prior to
recelving a "asrtiflcate of occupancy" or flnal power.r.elease. If tfie project daes nof irnolve a certificate af occupancy or
finai pawer celease, the fees must be pald prEor ta permit Issuance. Furthermore, if Pasco County_Wate�lSewer Impact
fees are due,they must be paid prior to permlt fssuance 1n accordance witti applicable Pasca County ordinances.
CONSTRUCTION LIEN LAVY(Cfiapfer 715� Fiorida Statutes, as amended): If valuation af work is$2;500.00 or cnore, !
cerkify that !, the appllcant, have .been provided with a copy of fiie "Florida Construction Lien Law—Hameowner's
Protectlan Guide° prepared by the Florlda Department of Agriculture and Consumer Affairs. (f the appllcant Is someone
other than#he"qwner", I cert�jr that i have abtained a copy of the above-describe�document and promfse in good#aith to
deliver it#o the°owner�prior to commencement. �
CNNTRAGTQR'SlOWNEl�'S AFFIDAV!'t': 1 cer#ify that all the information In this application is accurate and that ail work
wi{i'be done in comptiance with ai! applicable laws regulating construction, zoning and land development, Application is
hereby made ta obtain a permit ta da. wor:k and instaffation as lndicatad. ! aerklfy that no work ar instailation has
commenc�d prior to issuance of a permit and that ali work wiii be performed to meeE standards af afl laws regulating
construction, Couniy and Cify cades, zoning regulations, and iand devetopment regulations-in the jurisdicfion. ( a{sa
° certify that 1 understand that the regulations of ottier governm�nt agencies may apply to#he intended work, and that i#is
, -my responsibility#o id�ntify what actions i must take to be!n compllance. Such agencles include but are not Iimlted to;
- Department of Environmen#al Protection-Cypress Bayheads, Wetland Areas and Envlronmentafly Sensikive
Lands,Water/Wastewater Treatment.
� - Southwest Flarida Water Management Distriot-Wells,. Cypress Bayheads, �Wefiand Areas, Aitering
VVatercourses.
- Army Corps of Engineers-Seawaiis, Docks, Navigabie Waterways.
- Department of Health 8 RehabilitaEive ServiceslEnvironmentai Health Unit-WeUs, Wastewater Treatment,
Septic Tanks. .
- US Environmentai Protection Agency-Asbestos abatement.
- Federal Aviation Authority=Runways.
!understand that the foAow►ing restrictlons apply to the use of flll:�
- Use o€fill Is not al{owed in Flood�Zone"V"unless expressly permitted. - -
- if the fifl materiat is to be used in Flood Zane "A", tt fs understaod that a drainage plan addressing a
"compensating volume" will be submitted at time of permitting whEah is prepared by a professional engfieer
licensed by the State of Florida.
- If the fiH ma#erial is to be used in Flood Zone "A" in connection with a permifted buiiding using stem wal!
' construction, i certify that fiii wiA be used only to t111 the area withtn the stern wall.
- lf fiil mater.ial is to be used in any area, i certify that use of,such fill wi!! not adversely affect adjaaent
properties. If use of�Il�ts found to adversely affect adjacent propert9es, the owner may be clted for viotating
the aonditions of the bullding permit issued under the atfached permit application, .far iots.less than one (1)
acre which are elevated by f�ti, an enginee�ed draPnage plan!s required.
!f I am the AGENT Ft3R THE OWNER, {promise,in good.#aith to lnfarm the awner of the permitting conditfons set forth in
this affidavlt prior t'ti�comim+encing constr.uction. i`,underst�ind that a.separate permit may be required far electrical work,
piumbing, signs, weHs, poots, air conditioning, gas, ar other instaltations not specfficatly inc#uded"in the application. A
permit issued shalt,be construed to be a license to proceed wlth the work and ncit as.authority to.viotate, cancei, aiter, or
set aside any provisions�af�tFie techt�ical codes, nar shail fssuance of a permlt prevent the Bulldirig Official from fhereafter
requ�rEng a correction of e�rors In plans, construotion or vialatians af any codes. Every pemtit fssued shall becorne invalid
uniess the wark authar�Zed by such permit is commenced withln-six months,of permit issuance, or if wark authorized by
the permit is suspended or abandoned for-a perlod of s4x(6�months afke�the time the work is commenced. An extensian �
may be requested, in wri#ing, from the Buiiding Official for a period not!o excesd ninety (90) days and will demonstrate
)ust�iable cause fo�the extensiany If wotk ceasas for ninety(90)cansecuEive.days,the�)ob is consEdered abandoned.
WARNING TO OWNER: YOUR.�AILURE TU RECORD'� NOTICE OF�COMMENCEMENT MAY R�SULT iN YOUR
PAYING TWICE FUR tMPRC1VEMENTS TO YCtUR PROPERTY. IE YOU INTEND TO OBTAIN°FINANCING�CONSULT
W!T !?UR LE DER O �1 ATTOR EY B . - CORD G�Y U i:l .IG �la . G E EM
FLORlDA JURAT(F.S.117.03) „� �
QWPlEtZ OEt AGEN7' �—K�'' .`.;�' � CONTR�4CT0 ��
Subscribed and swom to{or a rmed}before me ~ Subscrlbed and suvom to ot af�rmed), , me:this
b
Wha ls/are pecs4na41y known to me or haslhave produced Who is/are pe onaliy kna to me or hasthave produced �
as IdentlBcatlon, as 1dsn8Rcatton.
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Notary Pudlic Nok�ery Public
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Commisslan No. Commissio
,��",a. ? r E BOGES
N�me of Notary tYPgd�Pdnked or stamped Name af Nota t�. '''t�9t�Rt'r�1�IDP�F
-�. • = 2d18
- Ex�ites December 12,
�. , +N'r .a`,' ,;�,�,n fiy Tmy Faln Insurence 8003&5 7ti59
,l_ '�,`a,';,;;,
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Jacqueline Boges. �
From: FATHOM <support@gwfathom.zendesk.com> �
Sent: � Wednesday, November 16, 2016 8:04 PM
To: Jacqueline Boges
Subject: Request#100532: How would you rate the support you received?
##- Please type your reply abo��c this line -##
Hello )acqueline Bogesl,
We'd love to hear what you think of our customer service. Please take a moment to answer one simple question by
' clicking either link bel i�w:
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How would you rate the saapport you received?
Good. I'm satisfied
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Here's a reminder of what your ticket was about: ,
��_ _ _, �1 � ;
�._ � TQ Randolph (FATHOM) ;
.._` � i
�u�i Nov i 5, 5 I�06 PM M T �
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THE ACCOUNT HAS BEEN CREATED. CUST/ACCT 899779 - 245741 9
;
Best Regalyds, ;
TQ� FATHOM Support ,
�_.��
j : FATHOM ZenDesk Support (FATHOM) ,
� �r` i
�-----� Nov 1 5, 4 �30 PM M T
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GIS has been updated to reflect the account.
Thank you. �
-Bill
�, ...
� �-� � Jacqueline Boges
( -= :
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Jacqueline Boges i �
�
From: FATHOM<support@gwfathom.zendesk.com> �
Sent: Thu�sday, November 10, 2016 3:02 PM ;
To: , Jacqueline Boges �
Subject: ' [Reguest received] new Townhome
� �
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�
##- Please type your �eply above this line -## �
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Hello Jacqueline Boges;
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We are working to resolve your�request promptly and will keep you updated. One of our Support Analyst will keep you
updated on the progress of your request. � ;
Best Regards, '
FATHOM Support Team ,
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TO ADD ADDITIONAL COMMENTS, reply to this email or click the link below:
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�--�____�-� �
;�, �� Jacqueli I`e Boges j
' ' Nov 10, 1 �02 PM M'_T
, �
customer�need water service, sewer service and a water meter �
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This email is a service from FATHOM. �
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