HomeMy WebLinkAbout19-21551 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 21551
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
PERMIT INFORMATION LOCATION INFORMATION
Permit#:21551 Issued: 8/15/2019 Address: 39410 KENNEDY AVE
Permit Type: NEW SINGLE FAMILY DWELLING ZEPHYRHILLS, FL.
Class of Work: 101-NEW CONST/SFR Township: Range:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Sq. Feet: Est. Value: Book: Page:
Cost: 255,940.80 Total Fees: 18,388.97 Subdivision: CITY OF ZEPHYRHILLS
Amount Paid: 18,388.97 Date Paid: 8/15/2019 Parcel Number: 12-26-21-0000-00400-0000
CONTRACTOR INFORMATION OWNER INFORMATION
Name: HOMEOWNER Name: GARCIA, MARIA& GARCIA, MARIO
Addr: Address: 36338 CHRISTIAN RD
DADE CITY, FL 33523-1286
Phone: Lic: Phone: 352-346-6716
Work Desc: CONSTRUCT SINGLE FAMILY 2,272 SQ FT
APPLICATION FEES
PLUMBING FEE 198.00 SEWER CONNECTION RE IDEW 2,090.00 ELECTRICAL FEE 297.00
WATER CONNECTION RESIDENT 1,010.00 MECHANICAL FEE 138.60 SCHOOL IMPACT FEE-sfr/1% 77.28
SCHOOL IMPACT FEE-sfr/100% 7,728.00 TRAFFIC IMPACT FEE 1% 36.32 TRAFFIC IMPACT FEE 99% 3,595.68
BUILDING FEE 1,421.40 POLICE IMPACT FEE 254.00 FIRE IMPACT FEE 273.00
PUBLIC SAFETY 5% 26.35 PARK FEES SF 769.56 WATER METER RES 3/4" 473.78
. � Its,u
Inspections Required
FOOTER 2ND ROUGH PLUMB MISC INSULATION CEILING
FOOTER BOND DUCTS INSULATED SEWER 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 Rennspection 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 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,S ecifications 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.
i
Cb NTRACTO IGNATURE PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
Envelope Leakage Test Report (Blower Door Test)
Residential Prescriptive, Performance or ERI Method Compliance
2017 Florida Building Code, Energy Conservation, 6th Edition
Jurisdiction: 611600 Permit#:
Job Information;
Builder: A2&T16bmsfFmct16n Community: Lot: NA
Address: Kennedy Avenue
City: Zephyrhills State: FL Zip:
Me LeakageJ''est Results Passing,results rnust meet either the Peiformance,-Prescdpti,ve,or ERI Method."'
OPRESCRIPTIVE METHOD-The building or dwelling unit.shall be tested and verified as having an air=leakage rate of not exceeding l air.
, changes per hour at a pressure of 0.2 inch w.g.(50 Pascals)in Climate Zones 1 and 2.
® PERFORMANCE or ERI METHOD-The building or dwelling unit shall be tested and`verified as having an air leakage rate of-not exceeding
the;selected ACH(50)value,as shoe n&on Form R405-2017(Performance)"or R406-2017(ER!),section labeled as infiltration,'sub-section.ACH50.
ACH(50).specified on Form R405 2017-Energy Caic(Performande)or R406-2017(ERI):1 5.000
/J L� x 60 = 20106 = �� Method for calculating building volume:
CFM(50) uilding Volume ACH(50) O Retrieved from architectural plans
PASS • Code software calculated
When ACH(50)is less than 3, Mechanical Ventilation installation O Field measured and calculated
must be verified by building department.
R402.4.1.2 Testing. Testing shall be conducted in accordance with ANSI/RESNET/ICC 380 and reported at a pressure of 0.2 inch w.g.(50 Pascals)
Testing shall be conducted by either individuals as defined in Section 553.993(5)or(7),Florida Statues.or individuals licensed as set forth in Section
489.105(3)(f),(g),or(i)or an approved third party.A written report of the results of the test shall be signed by the party conducting the test and
provided to thecode official. Testing shall be performed at any time after creation of all penetrations of the building thermal envelope.
During testing:
1. Exterior windows and doors,fireplace and stove doors shall be closed,but not sealed,beyond the intended weatherstripping or other infiltration
control measures.
2.Dampers including exhaust,intake,makeup air,back draft and flue dampers shall be closed,but not sealed beyond intended infiltration control
measures.
3.Interior doors,if installed at the time of the test,shall be open.
4.Exterior doors for continuous ventilation systems and heat recovery ventilators shall be closed and sealed.
5.Heating and cooling systems,if installed at the time of the test shall be turned off.
6.Supply and return registers,if installed at the time of the test shall be fully open.
Testing,Company (�C
Company Name: -v o .
I hereby verify that the above Air Leakage results are in accord nce with the 2017 6th Edition Florida Buil ing Code
Energy Conservation re ui i4g the compliance method selected above.
Signature of Teste Date of Test: Z 2-
Z�
Printed Name of Tester: � . /L A/_
License/Certification#: � % �� Issuing Authority: EST,
51112019 8:51:58 AM EnergyGauge®USA 6.0.02(Rev. 1)-FlaRes2017 FBC 6th Edition(2017)Compliant Software Page 1 of 1
PASCO COUNTY, PLORID'
P r11 No.
c &
ate Permitted
-
Builder 5r -
Builder Name/Owner Name ntrol#' //f���
County Pa(49i No. ��' —2r XW-ea.'( �� SubDiv: C..Iavfz-'I"ly
Address/Location
k Classificatlonrrype of Use le Z14
I Z7
i TRANSPORTATION IMPACT FE . Rate, Sq.Ft Unit:
i Exempt ❑Yes ❑ No How Dete ad
4
1 Impact Fee Amount $.S/ Zone No. TAZ:
,
( SCHOOL IMPACT FEE
t i Account (056) Single-Family Det ched House Amount $ :&5.2S
i (057) Mobile Home
(058) Other Residential
123) Collection Fe
Exempt HYes []No ow Determined
PARKS AND RECREATION FEE
Land Account Land Credit Land Total
Recreation Account Recreation Credit Recreation Totally
Zone TOTAL AMOUNT $
Exempt ❑Yes ❑ No How oetermined
LIBRARY FEE
Land Account Land Credit Land Total
Facility Accou t Facility Credit Facility Total
Exempt Yes ❑ No Haw Determined Total Arr►ouna�n `
RESOU40EFEE ERU
TOTAL MOUNT
Pre ared By Checked By
NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL 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 simply receipt of a copy of this form,placing
the building permit owner on nolice of this assessment and the conditions of payment for same.
DATE RECEIVED BY
RECEIPT NO. DATE BY
DISCLOSURE STATEMENT FOR OWNER
CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
have read and fully understand and
agree to the provisions of this instrument.
The undersigned states and affirms that he or she is desirous of constructing,
renovating, adding to or reroofing his or her own domicile, that he or she
actually occupies, or will occupy by - - - said domicile, and same is not for
rent, lease or sale. That he or she shall comply with the following conditions:
1. That the owner and he or she alone shall act as the builder for all phases of
construction.
2. That the owner will comply with all provisions of the City of Zephyrhills
ordinances and codes pertinent. to the building.
3. That in the event various phases of construction are subcontracted, he will
engage only properly licensed subcontractors and will personally supervise
such work.
4. That in the event the Building Inspector shall require corrections to be made,
the owner will assume full responsibility to insure they are made, and upon
completion will call for a reinspection before proceeding with the building.
5. That the owner shall assume full responsibility for the construction and will
not expect supervision of his work from the City of Zephyrhills Building
Department.
6. That prior to final inspection any additional fees, including reinspection
fees, must be paid in full. A written request from this office shall
constitute an official notice to pay additional fees.
7. That the owner shall comply with all City, State and Federal laws in regard to
social security, workman's compensation, lien laws, etc. , where applicable.
8. That the owner shall comply with all the safety codes issued by the Florida
Industrial Commission.
9. State law requires construction to be done by licensed contractors. You have
applied for a permit under an exemption to that law. The exemption allows
you, as the owner of your property, to act as your own contractor with certain
restrictions even though you do not have a license. You must provide direct
onsite supervision of the construction yourself. You may build or improve a
one-family or two-family residence or a farm outbuilding. You may also build
or improve a commercial building, provided your costs do not exceed $75,000.
The building or residence must be for your own use or occupancy. It may not
be built or substantially improved for sale or lease. if you sell or lease a
building you have built or substantially improved yourself within I year after
the construction is complete, the law will presume that you built or
substantially improved if for sale or lease, which is a violation of this
exemption. You may not hire an unlicensed person to act as your contractor or
to supervise people working on your building. It is your responsibility to
make sure that people employed by you have licenses required by state law and
by county or municipal licensing ordinances. You may not delegate the
responsibility for supervising work to a licensed contractor who is not
licensed to perform the work being done. Any person working on your building
who is not licensed must work under your direct supervision and must be
employed by you, which means that you must deduct F.I.C.A. and withholding tax
and provide workers' compensation for that employee, all as prescribed by law,.
Your construction must comply wit all applicable laws, ordinances, building-
codes, and zoning reguX, ions.
OWNER'S SIGNATUPX, DATE
'ADDRESS
PHONE
WITNESS PERMIT #
O
r
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: ' 0 (2,r- C 11 fib
Date Received:
Site: 3 9 o ffym
Permit Type: W ��J ) vh A �! Q
Approved w/no comments:❑ Approved w/the below comments: Denied w/the below comments: ❑
This comment sheet shall be ke e permit and/or plans.
JUL 2 1019
Kalvin S rtzer—Plans Examiner Date tonffaquired
tor Homeowner(R when comments are present)
Jacqueline Boges
From: Jacqueline Boges
Sent: Thursday,July 25,2019 10:02 AM
To: 'garciapele@yahoo.com'
Subject: 39410 kenndey ave single family
Attachments: 39410 kennedy ave 2,272 sq ft.xls
Hello Ms. Garcia,
It was a pleasure speaking with you this morning. I have attached our fee sheet for the cost of the permit due new
single family home located at 39410 Kennedy ave.
We require all fees paid at time of pick up that is including impact fees.The only allowance is that you may pay all permit
fee and impact fee but leave balance of 75%due from Transportation impact fee and only pay 25%of this fee at time of
pick up
So this is what is due entire amount$18,388.97
Or
$6,182.13+$769.56+$7805.28+$908 (25%of the$3632)=$15,664.97----- leaving balance due$2,724.
Any additional questions you may contact and ask for Jackie.
Thank you
�{�
Jackie Boges
813-780-0020 ext 3513
"A rule I have had for years is:to treat the Lord Jesus Christ as a personal friend. His is not a creed,a mere doctrine, but it is He
Himself we have."Dwight L. Moody
Florida has a very broad public records law. Electronic communications regarding most City
of Zephyrhills business are public records and available upon request. Your e-mail
communications may therefore be subject to public disclosure. If you received this message in
error, please do not read, forward, copy, etc. and delete immediately.
1
12-26-21-0000-00400-00,00 1 Pasco County Property Appraiser Page I of I
Parcel ID 12-26-21-0000-00400-0000 (Card: 1 of 1)
Classification 00000-Vacant
Mailing Address Property Value
GARCIA MARIA& Ag Land $0
GARCIA MARIO Land $9,850
36338 CHRISTIAN RD Building $0
DADE CITY, FL 33523-1286 Extra Features $0
Physical Address
39410 KENNEDY AVENUE, Just Value $9,850
ZEPHYRHILLS, FL 33542 Assessed (Non-School Amendment 1) $9,850
Legal Description (First 200 Non-School Taxable Value $9,850
characters)COM SE COR OF NE 1/4 OF SW 1/4 School District Taxable Value $9,850
TH NODEG 06' 07"W 300 FT ALG
EAST LINE OF NE1/4 OF SW1/4 TH
W 375 FT FOR POB TH W 75 FT
NOODEG 06' 07"W 120 FT TH EAST
75 FT TH SOODEG 06'07E 120 FT TO
POB AKA LOT 48 UN[...
Jurisdiction
CITY OF ZEPHYRHILLS
Land Detail (Card: 1 of
Line Use Code n jV
__,ZonIng'Units __Jyj�_ jPrice ondition; alue
1 0110V LP3-1 SFR Rural 10OR2 1 8,000.00 1 SF 1, $1.21 1.00 $9,680
2 0110V LP3-3 I SFR Rural i 00112 1 1,000.00 1 SF $0.17
Additional Land Information
Acres Tax Area FEMA Code Res Code T Com Code t Condo Code
0.21 20ZH X ZHLP i ZHLP ZHLP
Building Information (Card: I of 1)
Unimproved Parcel
------ Extra Features (Card: 1 of 1)
Line Code ;Description Year 'units
No Extra Features
Sales History
Previous Owner: CONTRERAS ALICIA
Month/Year"t
r j _Book/Page - Type iDOR Cade Condition Amount
02/2005 6244 / 1014 _j__qt#t Claim Deed Vacant 1 $8,000
08/2002 5027 / 0812 Quit Claim Deed 1 1 Vacant $0
08/2002 5034 / 0785 J Quit Claim Deed Vacant $0
-------------
08/2002 j 5034 / 0788 Warranty Deed Vacant j $7,000
08/2002 5034 / 0787 Quit Claim Deed Vacant $0
http://search.pascopa.com/parcel.aspx?parcel=2126120000004000000 7/24/2019
PLOT PLAN SITE ADDRESS:
SECTION 12, TOWNSHIP 26 SOUTH, RANGE 21 EAST 39410 KENNEDY AVENUE
KENNEDY AVENUE PASCO COUNTY, FLORIDA
50'R/W PER LINCOLN HEIGHTS SUBDIVISION
PLAT BOOK 13. PAGE 113 -
20'ASPHALT PAVEMENT
SEr MASHE �M
MTAMLT TREE LEGEND LEGEND
OEVA710N a-I
(NAV.a OF 1p BC BLACK CHERRY TREE FD FOUND
p ,f„ C CAMPHOR TREE IR IRON ROD
SOUTHERLY R/w UNE CB CHINA BERRY TREE IP IRON PIPE OF KENNEDY AVERAIE % 4L2 .1
CL CHERRY LAUREL TREE CM CONCRETE MONUMENT
+OR�gy 0 OAK TREE N&D NAIL&DISK
w R/w S OF d wATEN uENE DU DIAMETER MAG MAGNETICFD 3'XO'a - DBH DIA AT BREAST Y TREE P PLAT
fro m/ __JLT e �' 14'CB 14'CHINA BERRY TREE M MEASURED
N6959'30'E(P�M) ' I C CALCULATED -
FD 1/,p D DESCRIBED
50.44'(PkM) aB' MVEor�+ i c/w no It1/ _R/W RIGHT-OF-WAY
FD s R avc d I K 4 TYPICAL TREE DETAIL R POINT OF INTERSECTION
PAD
+� te. '0 EASTERLY BOUNDARY LIE LB LICENSED BUSINESS
97E ANODIAIM: IB(�7MttB rfo3 �o Ym i i
E MAO Me0.l8/7ee3 �'�o° SIEPS (ems��iEAP BEARINGS) LID IDENTICONCFICATION
f1EVA11a1 e4.01 1&OD'
ETE
(NAV.0.tF fBID) C/S CONC SLAB
PROPOSED PRORCH
PROPagn o. 21ar �� CONC WALK
SEWER UNE C PAD PROPOSED ELECTRIC LINE A AIR CONDITIONER
..® t TO ETOSTNO TRANSFORMER DID- PLF PLASTIC FENCE
a 09 A AT REAR OF PROPERTY =� ch CLF CHAIN LINK FENCE
PROPOSED ONE EOP EDGE OF PAVEMENT
SCE MASOlv�r NRY
3 CLF a N.A.V.D. NORTH AMERICAN
VERTICAL DATUM
NUN.FAS E1r61M17 i ,e'eo Za z IA7 EXISTING ELEVATION
lOT Is t i w +� '3 LOT 47 NOTE TREE SIZE IS SHOWN IN F.F. FINISHED FLOOR
uNtplN HDaiTS SUBiNw51W gn LIKEN Hearts SIIBDIVmON � DIAMETER INCHES MEASURED '�^^- DRAINAGE FLOW ARROW
PLAT BOOK 13.PAGE 113 q I PLAT BOOK 13,PAGE 113
PARCEL/12-26-21 ! AT BREAST HEIGHT(DBH).
0000-0040D-0000 I t.Y
on3*0 _ zaar reve',D
ee I
W QF R i 1.5'
1&ar Omc eb
LEGAL DESCRIPTION:
I rrm � COMMENCING AT THE SOUTHEAST CORNER OF THE NORTHEAST 1/4 OF THE SOUTHWEST 1/4
OF SECTION 12.TOWNSHIP 26 SOUTH,RANGE 21 EAST,PASCO COUNTY.FLORIDA. THENCE
'mc Im G I x s'aF RUN NORTH 00TI6'07-WEST,300 FEET ALONG THE EAST LINE OF SAID NORTHEAST 1/4 OF
FO e/e'IR 5 I V GF � THE SOUTHWEST 1/4; THENCE RUN WEST,375 FEET TO THE POINT OF BEGINNING; THENCE
LB m� 0.Y L� TRANSI—PAD WEST(.)S8959'30'W(C) 1, No OR ser CONTINUE WEST,75 FEET; THENCE NORTH 00'WO7'WEST.120.0 FEET; THENCE RUN EAST.
_ t°"ts+m ' -- I` 75 FEET.. THENCE RUN SOUTH DGWO7'EAST.120.0 FEET TO THE POINT OF BEGINNING.
I'aF � L4 a --- -
1.FY
m �% Ix PORE OF BEGIN
AM
FO«'aF B'PLF I FO R Ie LT73e5 AT F.I.R.M. CERTIFICATION:
a N,I011,223'EAST THE PROPERTY SURVEYED HEREON IS SITUATED IN ZONE-AE'(EL-62.6')AS DELINEATED ON
LOT 29 Ln'r I V PLF LOT 31 1 FLOOD INSURANCE RATE MAP PANEL NO.12101CO456F,DATED SEPTEMBER 26,2014.
�+1 UNCGN HFIGH75 suBOwswN UNCOIN EEK*M SLMDIVBON LINOUN HEIGHTS MBDI Snx a
PLAT BOOK 13.PAGE 113 PUT BOOK 13,PAGE 113 PLAT BOO 13,PAG:113 p
o � SURVEYOR'S NOTES:
S o I '� 1.NO UNDERGROUND INSTALLATIONS OR IMPROVEMENTS HAVE BEEN LOCATED,EXCEPT AS SHOWN.
a "I 2.NO INSTRUMENTS OF RECORD REFLECTING EASEMENTS,RIGHTS-OF-WAY,AND/OR OWNERSHIP
WERE FURNISHED THIS SURVEYOR.EXCEPT AS SHOWN. THIS SURVEY WAS PREPARED WITHOUT
v _ THE BENEFIT OF A TITLE REPORT OR OWNERSHIP AND ENCUMBRANCE REPORT.
3.SURVEY FIELD WORK WAS COMPLETED ON MAY 28,2019.
m 4.ADDITIONS OR DELETIONS TO SURVEY MAPS OR REPORTS BY OTHER THAN THE SIGNING PARTY
o � S OR PARTIES IS PROHIBITED WITHOUT WRITTEN CONSENT OF THE SIGNING PARTY OR PARTIES
.2 &LEGAL DESCRIPTION SHOWN HEREON WAS OBTAINED FROM DEED RECORDED IN O.R.BOOK 6244,
y o PAGE 1014,OF THE PUBLIC RECORDS OF PASCO COUNTY,FLORIDA.
pS Q 6.BEARINGS SHOWN HEREON ARE BASED ON THE DEED BEARING OF SOUTH 0098'O7'EAST
FOR THE EASTERLY BOUNDARY LINE OF SUBJECT PARCEL AS SHOWN HEREON.
Z 7.ELEVATIONS SHOWN HEREON ARE IN FEET AND REFER TO N.A.V.D.OF 196B.
1 &BENCHMARK: NATIONAL GEODETIC SURVEY BENCHMARK'K 736'BEING A FLANGED STEEL ROO
WITHOUT A SUEIM 2.4 FEET FROM A CARSOIITE WITNESS POST AND LOCATED 0.2 MILES EAST
OF THE JUNCTION OF AIRPORT ROAD AND B AVENUE.184.3 FEET NORTH OF THE APPROXIMATE
�OF NE 1/4 OF
COMMENCEMENT CENTERLINE OF B AVENUE ELEVATION o SM37 FEET(N.A.V.D.OF 1988).
d SW 1/No M�ER FO ORRSSET Cer6Rd b;
11- 12 PUMPAN - Aa rter
o-m-u 1 IxxWc .Rp®4WFa A,m um umo0"DePAT a Ad rtw A2M2 CONSTRUCTION.INC
UNE TABLE Dab I 0."y of nut
•. IL. THIS PLOT PLAN NOT VALID UNLESS IMPRINTED VMH AN E]B�SIIt1F10R'S SAL
LINE LENGTH BEARING
4 ate * SURVEYWIS m IFICATe Thr Q1m.1Emt D r m of the W.C. SHERRILL AND COMPANY, LLC
d GRAPHIC SCALE �A�� w��thd If. " b
5' EAST trysvRVEnnc•MAPPING•CWA1LTNc
a m a a etw w,ad forth
th Chwh S 1M.of ciohe kd&Board
.tmdud.at pmlb
L2 7& 6959'30'E p.meet-.,se i. NMI FI M.St W 1B•PEaldo Board of pp
a on th P.O.BOX 2W•a)65A ELORIDA 33sse
L D&M 12Q00' S00'OB'07'E tIDCDar � Panuud b SMtan 4720Z�FlvMaI Stab 5tatuta Th.wd appwE+p on thY P.el}31:r4270•MEB4IE WWYAVL.97EARRLC�1
d=.Snt R mFh4lafl
61 75' WEST wr>�. r� Stoa of Flatda,caBRmt.of Authodm8on LB/7as3
(1R MT) e. �+ James Kirk---
E mot-20 ft DATE
9/25/19 Project No.: 19-08-138 Data 5-28-19
i JAMES H.KIRK JR. ,P.S.M.No. 8103 Section 12 Townships_Range 21 E
a
MAP OF .SURVEY SITE ADDRESS:
SECTION 12, TOWNSHIP 26 SOUTH, RANGE 21 EAST 39410 KENNEDY AVENUE,
KENNEDY AVENUE PASCO COUNTY, FLORIDA
SW R/W PER LINCOLN HEIGHTS SUBDIVISION
PLAT BOOK 13, PAGE 113
20'ASPHALT PAVEMENT
SET StT�Am. TREE LEGEND LEGEND
uAoqm
(N.Ava OF, .d BC BLACK CHERRY TREE FD FOUND
SDITn ERLr R/W LIE y pf p K C CAMPHOR TREE IR IRON ROD
CB CHINA BERRY TREE IP IRON PIPE
OF KENND)Y AVIIAIE I Q,y LEP Q�I I iq CL CHERRY LAUREL TREE CM CONCRETE MONUMENT
O OAK TREE N&D NAIL&DISC
to DIA 0 AMEIFA MAC MAGNETIC
FD 3 A.�-- _ 4� d ---_- DBH CIA AT BREAST HEIGHT P PLAT
NO LD1 L2 14'CB 14'CHINA BERRY TREE CM MEASURED
MEASURED
N8959'30'E(PkM) 1 aY
D/W DESCRIBED
30.44'(PhM) No ID/ PI POINT OF INTERSECTION
two.m... -aep� +d .� SITYPICAL TREE DETAIL LB LICENSED BU394M
/ ID IDENTIFICATION
(NAVI0.OF 10" EASTERLY BOUNDARY UNE CONS CONCRETE
OF SUBECT PARCEL C/S CONS SLAB
XBASIS OF BEARINGS) C/P CONC PORCH
C//W CONC WALK
1em AIR COND17IONER
lop •� DID- PLFC PLASTIC FENCE
s OF CHAIN LINK FENCE
=:H rich EOP EDGE OF PAVEMENT
�t0 5'CLF o 4 N.A.V.D. NORTH AMERICAN
VERTICAL DATUM
1e+o 2a X B67 ENSDNG ELEVATION
LOT 411 =+ nva + '� Lm 47 NOTE: TREE SIZE IS SHOWN IN
UNCON H13CM SUBDIVISION �} ,N} LNCO N HBMOTM WWVWON � DIAMETER INCHES MEASURE
PLAT BOO(13.PAGE 113 p y,4 PLAT BOOK 13,PACE 113
AT BREAST HEIGHT(DBH).
1.Y
tn3'0 PARCEL./12-26-21- T'aV'ab
0000-004OD-OODO
B'Qf 1.9
44
60, LEGAL DESCRIPTION:
COMMENCING AT THE SOUTHEAST CORNER OF THE NORTHEAST 1/4 OF THE SOUTHWEST 1/4
%s're'ro OF SECTION 12,TOWNSHIP 26 SOUTH,RANGE 21 EAST,PASOO COUNTY.FLORIDA. THENCE
'rod av 5'OF RUN NORTH OOTTB'OY HEST,300 FEET ALONG THE EAST LINE OF SAID NORTHEAST 1/4 OF
FD B/m N a 5 CIF THE SOUTHWEST 1/4; THENCE RUN WEST,375 FEET TO THE POINT OF BEGINNING THENCE
to m�E 1aYam TRANSFORMER PAD �, WEST(D)S8959'30'W(C) t9 OR SETCONTINUE WEST,75 FEET; THENCE NORTH OOTNH'07'WEST,120.0 FEET; THENCE RUN EAST.
F- 75 FEET; THENCE RUN SOUTH OOM'07'EAST,120.0 FEET TO THE POINT OF BEGINNING.
m1 B'11 L4 10 I f POINT a�3aOHo
'n x B PLF I, RD'%'CVT.HG IDA ALSO
e aF FD B/B'R LB f7TB5 AT F.I.R.M. CERIIFlCATION:
nay xoRnL aa5 EASE THE PROPERTY SURVEYED HEREON IS SITUATED IN ZONE'AE'(EL-82.6')AS DELINEATED ON
LOT 20 Lor 30 I 6'PLF LOT 31 FLOOD INSURANCE RATE MAP PANEL NO.12101CO456F,DATED S PTEABER 26,2014.
[] LINCOLN HEIGHTS SUBDIVISION LNCOLN H UGHTS SUBDIVISIONUNCOLN HEIGHTSSU®IVISION
F. PLAT BOOK 13.PAGE 113 PLAT BOOM 13,PAGE 113 PLAT BOOK 13 PACE 113 f.9
wz CL
I �' SURVEYOR'S NOTES:
3 Jj 1.NO UNDQidtOUND INSTALLATIONS OR IMPROVEMENTS HAVE BEEN LOCATED,EXCEPT AS SHOWN.
I 2.NO INSTRUMENTS OF RECORD REFLECTING EASEMENTS,RIGHTS-OF-WAY,AND/OR OWNERSHIP
WERE FURNISHED THIS SURVEYOR•EXCEPT AS SHOWN. THIS SURVEY WAS PREPARE WITHOUT
$ THE BENEFIT OF A TIME REPORT OR OWNERSHIP AND ENCUMBRANCE REPORT.
c 3.SURVEY FIELD WORK WAS COMPLETED ON MAY 28.2019.
4.ADDITIONS OR DELETIONS TO SURVEY MAPS OR REPORTS BY OTHER THAN THE SIGNING PARTY
OR PARTIES IS PROHIBITED WITHOUT WRITTEN CONSENT OF THE SIGNING PARTY OR PARTIES
5.LEGAL DESCRIPTION SHOWN HLAEON WAS OBTAINED FROM DEED RECORDED IN O.R.BOOK 6244.
o PACE 1014.OF THE PUBLIC RECORDS OF PASCO COUNTY.FLORIDA.
6.BEARINGS SHOWN HEREON ARE BASE ON THE DEED BEARING OF SOUTH OOT18'07'EAST
FOR THE EASTERLY BOUNDARY LINE OF SUBJECT PARCEL AS SHOWN HEREON.
�+ = 7.ELEVATIONS SHOWN HEREON ARE IN FEET AND REFER TO N.A.V.D.OF 1981L
B.BENCHMARK: NATIONAL GEODETIC SURVEY BENCHMARK'K 738'BEING A FIANCEE STEEL ROO
WITHOUT A SLEEVE,2.4 FRET FROM A CARSDNITE WITNESS POST AND LOCATED 0.2 MILES EAST
OF THE JUNCTION OF AIRPORT ROAD AND B AVENUE,184.3 FEET NORTH OF THE APPROXIMATE
POF�ENm NT CENTEIRUNE OF B AVENUE ELEVATION-SM37 FEET(N.A.V.D.OF 1988).
BE CORNERSV 1/4 DF SEOnON 12;r21 c.,m.d to:
J NO CORNEA FD 01t SET
b-tu naAdwF,fP0a1A/Ne AIfO Tws Iau1Ia1 tlAtlq' as A(a AK A2M2 CONSTRUCTION.ING
aft
LINE TABLE OTM
WS SURVEY NOT VALID UNIUSS MiwOnID YHVH AN B®Os4D SURVEYOR'S SEAL b
viisd
LINE LENGTH BEARING
GRAPHIC SCALE FALST t1O AVM C MF1P M Th6 o.+mn Umt a ony of th.vaPMrty droMd W.C. SHERRILL AND COMPANY. LLC
hw" wa Dab udr mV wgrVIiotl and that the a tnw
n w o rd a=td, a fl~and n.wtd ar..Ran°m�.a r:aeDa.rr SURVEYING•MAPPING•CO NSUL NG
5. 8959' wvw)•rt trMh h O.�tr tfJ-17 br tho FMft Bond oT Lmd 51bw� P.0.BOX�3.ODEaA,FLORIDA 33558
&M 2 00' 7'E D�bZF--gab5--- 1ha— qonhY P.ef3-31r42TO•NEBSIIEWESF dowmw.t authorRtdbb�b Stab o1 FWd"CrUOwb of Aulhwlmtion LB/7863
t�_20 R James Kirk m"^� ^
5' «a KMh' 8/5/19 Project No.: 19-05-147 1 Data 5-28-19
i JAMES FL qRK.JR. ,psY.N. 8103 3eotlon 12 Townehlp 26.S Range 2
a.
INSTR#20191 45809 OR BK 9963 PG 1868 Page 1 of 1
08/28/2019 10:31 AM Rept:2085370 Rec:10.00 DS:0.00 IT:0.00
Nikki Alvarez-Sowles,Esq.,Pasco County Clerk&Comptroller
NOTICE OF COMMENCEMENT
Permit No. 2-1Ssl 1
Property Identification No. 19 DUUU
THE UNDERSIGNED hereby give informs you that the improvement will be made to certain real property,and in accordance with
Section 713.13 of the Florida Statutes,the following information is provided in this NOTICE OF COMMENCEMENT. f
I.Description of property(t ql d crlprfon:)
a)Street Address:� A_
2.0eneral description of improvemen
t"as1 c�Lr t
3.Owner Information ;
a)Name and address: ,(�r/e � jr �T2o/ Uetali Ci�2/.4
b)Name and address of flee simple titleholder(if other than owner) Y
c)Interest is property W
.4.Contractor Information
a)Name and address: rluh.h .6 � SG33 t��(�.i f1j47 C0 w tU—i- Co W V
b)Telephone No.: --- Z-',c/G��.el t. Fax No.(Got) C7 � 0 = J >-
S.Surety Information - Z 0 0 1'
a)Name and address: O 0= Q N Er- c-
b)Amount of Bond: CD Q LI-I LU
c)Telephone No.: Fax No.(Opt) W z
6 I ender O 'M Q O
a)Name and address: u- ~ 0 —
' Phone No. L i 0 0 U C3
7.Identityof on within the Slate of Florida designated = O O
pars gna by owner upon whom notices or other documents may served: = >- U 0 Y
a)Name and address: O IL �
b)Telephone No.: Fax No.(Opt.) U Z U LLI
d.In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in Section -'
713.13(i)(b),Florida Statutes: ~ J Q 0
m U-
e)Name and address. LL W ZD Z 0
b)Telephone No.: Fax No.(Opt)
9.Expiration_date of Notice of Commencement(the expiration date is one year from the date of recording unless a diffeteat date is O- W O O
specified): U- U U (Y n
LL 0-Q-0
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF U ~ Q
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I,SECTION 713.13, Uj U _.I �Q
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 )_ 0
INSPECTION.IF YOU INTEND TO OBTAIN FINANCING,CONSULT YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF MMEryjMENT.
STATE OF t+1,0 �yy f y,
0
KIMBERLY E.H01�'ELL s or ofHarr�ireetar/PnvrrTd,esger
( p ail'C0NjAjssj0N1;G02j6479 ,y
Name EXP1Rf5:lvlap 10.2022 (f ti�',•.
v'i.. this�0 � a _ 3 c o
e or ego usnvm was acknowledged before me day of 0�by e
�1Y1.4/Zr'A (1/A2u'aasf (type ofauthority,e.g.offi—.trustee,attomey r r
In(act)for 1 (n a of pm,-tyonbelhalVofwho hatrument was execuuted).
Personally Known_OR Produced Identification ✓ Notary Signa 4h l-
Type of ldeatifieation Produced" ��a .Name(print)
Verification pursuant to Section 92.525,Florida Statutes.Under penalties of perjury,I declare that I have read the foregoing and that
the facts stated in it are true io the best of my knowledge and belief
Signatue ofN,mnl Parson Slping Above
FoRms"00A,M
813-780-0020 City of Zephyrhi Ils Permit Application Fax-813-780-0021
Building Department
Date Received. Phone Contact for Permitting
—Irrr= .......I........rl-M...........
" * Ra,�L 9
Owner's Name M%6*0 I � Owner Phone Number
Owner's Address IT633k CAn hegllr,9 Owner Phone Number
Owner Phone Number
JOB ADDRESS LOT#
SUBDIVISION PARCEL I D# .2_,J6 a I-0,000—(DO VC)V 0000
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED �NEW CONSTR ADD/ALT SIGN DEMOLISH
INSTALL R REPAIR
PROPOSED USE Q SFR Q COMM OTHER
TYPE OF CONSTRUCTION F7--L—
BLOCK Q FRAME STEEL
7.
DESCRIPTION OF WORK L
SQ FOO?AGE HEIGHT BUILDING SIZErr
9
.. ......... .
=BUILDING
1' -70 OW VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL C.. 1C
AMP SERVICE DUKE ENERGY W.R.E.C.
=PLUMBING 1$ V,
=MECHANICAL $ L VALUATION OF MECHANICAL INSTALLATION
=GAS Q ROOFING Q SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER COMPANY
SIGNATURE AR /j- 11�_ r-XX66f REGISTERED Y/ N FEE CURREN LI±N J
Address License#
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN
Address License#
4
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN
Address License# F_
MECHANICAL c COMPANY
SIGNATURE REGISTERED Y/ N_J FEE CURREN
Address I License# F_
OTHER COMPANY
SIGNATURE REGISTERED Y/ N_J FEE CURREN L_YLN J
Address License#
HHHHi
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(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 for subdivisions/large projects
COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&I dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans,
****PROPERTY SURVEY required for all NEW construction.
Directions:
Fill out application completely.
Owner&Contractor sign back of application,notarized
If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500)
Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (copy of contract required)
Reroofs if shingles Se-Wers Service Upgrades A/C Fences(PlottSurvey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject-to"deed"restrictions"
which may be more restrictive than County regulations. The undersigned assumes'responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work, they are advised to contact the Pasco County Building Inspection Division—Licensing Section.at 727-84z-- -
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I
certify that I, the applicant, have been provided with,a copy of the "Florida Construction Lien Law—Homeowner's
Protection Guide" prepared by the Florida Department of:Agriculture and-Consumer Affairs. If the applicant is someone
other than the "owner", I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the"owner"prior to commencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and-that all work
will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
- Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,Water/Wastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
- Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
- Use of fill is not allowed in Flood Zone W"unless expressly permitted.
- If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating volume" will be submitted at time of permitting which is that
by a professional engineer
licensed by the State of Florida.
- If the fill material is to be used in Flood Zone "A" in connection with a permitted building using, stem wall
construction, I certify that fill will be used only to fill the area within the stem wall.
- If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
acre which are elevated by fill, an engineered drainage plan is required. '
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six(6) months after the time the work is commenced. An extension
may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety(90)consecutive days, the job is considered abandoned.
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 YOURLENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F.S.117.03)
OWNER OR AGENT CONTRACTOR
Subscribed and sworn to(or affirmed)before me this Subscribed and sworn to(or affirmed)before me this
by by
Who is/are personally known to me or has/have produced Who is/are personally known to me or has/have produced
as identification. as identification.
Notary Public Notary Public
Commission No. Commission No.
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
o °
•
Single Family Dwelling
Plan Review Comments
1. F.F.E.. shall 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 survey required before pouring concrete..
5: Driveways require a R.O.W. use permit: All 4 sides of drivewaythru 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,in or framing shall be covered without an inspection and
approval first.-
10: All Garages shall comply with section R302-6 of the F.3.C. (Fire Separation).
11. 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. Foundation supports for A/C units shall be raised at least 3" above finished grade. M1308:1
14:Return air in all bedrooms: F.B.-C. M1620.4
1.5. Smoke detectors are to be- installed in accordance with.R313.1 of the F.B.C.
16. All glazing requirements 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 riot be used as a backer in showers or tubs. R702.4.2 F.B.C.
10: 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 plumbing, mechanical, and electrical shall be separate from unit to unit. This includes all
underground plumbing and electric.
22. All 2016 N.R.C. Codes will be enforced.
23. Tamper-Resistant Receptacles in accordance with 406.11 of the,2016 N.E.0
24. In accordance with the Land Development Code,lots shall be sodded before final at least 10
feet around the structure.
25. R403.5.3Hot water pipe insulation
insulation-for hot water pipe with a minimum thermal resistance (R-value) of R-3 shall be applied to the
following:
Piping.3/: inch (19.1 mm) and larger in nominal diameter.
Piping serving more than one dwelling unit:
Piping located outside the conditioned space.
Piping from the water heater to a'distribution manifold:.
Piping located under a floor slab:
Buried in piping.-
Supply and return piping in recirculation systems other than demand recirculation systems.
25. Blower door'test shall be provided before C.O;
26.A cony of the energy.Bach shall be with'permit at all times
27. Copy.of final insulation report shall be provided with permit before rnaL
28 No fence, pool or screen-enclosure .is issued with:this permit
F.F.E.-Finished Floor Elevation
F.B.C-Florida Building Code 6 h Edition
R.O.W.-Right of Way
A.D.A.-Americans with Disabilities Act N.E.C.-National Electric Code (2016)
12-26-21-0000-00400-OOQO I Pasco County Property Appraiser Page 1 of I
Parcel ID 12-26-21-0000-00400-0000 (Card: 1 of 1)
Classification 00000-Vacant
Mailing Address Property Value
GARCIA MARIA & Ag Land $0
GARCIA MARIO Land $9,850
36338 CHRISTIAN RD Building $0
DADE CITY, FL 33523-1286 Extra Features $0
Physical Address Just Value $9,850
39410 KENNEDY AVENUE,ZEPHYRHILLS, FL 33542 Assessed (Non-School Amendment 1) $9,850
Legal Description (First 200 Non-School Taxable Value $9,850
characters)COM SE COR OF NE 1/4 OF SW 1/4 School District Taxable Value $9,850
TH NODEG 06' 07"W 300 FT ALG
EAST LINE OF NE1/4 OF SW1/4 TH
W 375 FT FOR POB TH W 75 FT
NOODEG 06' 07"W 120 FT TH EAST
75 FT TH SOODEG 06'07E 120 FT TO
POB AKA LOT 48 UN[...
Jurisdiction
CITY OF ZEPHYRHILLS
Land Detail (Card: 1 of
Line;Use Code IDescription ZoninglUnits ype Price ConclitionValue
1 0110V LP3-1 SFR Rural 1 00R2 8,000.00 SF $1.21 1.00 1 $9,680
2 i 0110V LP3-3 SFR Rural 00R2 j 1,000.00 j SF I $0.17 1.00 $170
Additional Land Information
Acres., I Tax Area I FEMA Code Res Code Com Code Condo Code
0.21 30ZH I X ZHLP i ZHLP ZHLP
Building Information (Card: 1 of 1)
Unimproved Parcel
Extra Features (Card: I of 1)
Line (Code IDescription `rpar (Units jValue
No Extra Features
Sales History
Previous Owner: CONTRERAS ALICIA
Month/Year IBook/Page jType D R Code Condition Amount
Quit Claim Deed Vacant 1 $8,000
02t2OO5 6244 / 1014 Vaca
4
08/2002 5027 / 0812 Quit Claim Deed Vacant 1 $0
08/2002 5034 / 0785 Quit Claim Deed 1 Vacant $0
08/2002- i 56 10788 J Warranty Deed j Vacant $7,000
08/2002 5034 / 0787 Quit Claim Deed Vacant $o
http://search.pascopa.com/parcel.aspx?parcel=2126120000004000000 7/24/2019
DISCLOSURE STATEMENT FOR OWNER
CITY OF ZZPHYRKILLS BUILDING DEPARTMENT
1, 'have read and fully understand and
agree to the provisions of this instrument.
The undersigned states and affirms that he or she is desirous of constructing,
renovating, adding to or reroofing his or her own domicile, that he or she
actually
ctually occupies, or will occupy by _ said domicile, and same is not for
rent, lease or sale. That he or she shall comply with the following -conditions:
1. That the owner and he or she alone shall act as the builder for all phases of
construction.
2. That the owner will comply with all provisions of the City of Zephyrhills
ordinances and codes pertinent to the building.
3. That in the event various phases of construction are subcontracted, he will
engage only properly licensed subcontractors and will personally supervise
such work.
4. That in the event the Building Inspector shall require corrections to be made,
the owner will assume full responsibility to insure they are made, and upon
completion will call for a reinspection before proceeding with the building.
5. That the owner shall assume full responsibility for the construction and will
not expect supervision of his work from the City of Zephyrhills Building
Department.
6. That prior to final inspection any additional fees, including reinspection
fees, must be paid in full. A written request from this office shall
constitute an official notice to pay additional fees.
7. That the owner shall comply with all City, State and Federal laws in regard to
social security, workman's compensation, lien laws, etc. , where applicable.
8. That the owner shall comply with all the safety codes issued by the Florida
Industrial Commission.
9. State law requires construction to be done by licensed contractors. You have
applied for a permit under an exemption to that law. The exemption allows
you, as the owner of your property, to act as your own contractor with certain
restrictions even though you do not have a license. You must provide direct
onsite supervision Of the construction yourself. You may build or improve a
one-family or two-family residence or a farm outbuilding. You may also build
or improve a commercial building, provided your costs do not exceed $75,000.
The building or residence must be for your own use or occupancy. It may not
be built or substantially improved for sale or lease. If you sell or lease a
building you have built or substantially improved yourself within I year after
the construction is complete, the law will presume that you built or
substantially improved if for sale or lease, which is a violation of this
exemption. You may not hire an unlicensed person to act as your contractor or
to supervise people working on your building. it is your responsibility to
make sure that people employed by you have licenses required by state law and
by county or municipal licensing ordinances. You may not delegate the
responsibility for supervising work to a licensed contractor who is not
licensed to perform the work being done. Any person working on your building
who is not licensed must work under your direct supervision and must be
employed by you, which means that you must deduct F.I.C.A. and withholding tax
and provide workers' compensation for that employee, all as prescribed by law.
Your construction must comply with all applicable laws, ordinances, building
codes, and zoning regulations.
OWNER'S S GNATURE DATE
ADDRESS 3353
PHONE
WITNESS PERMIT #
Jacqueline Boges
From: City of Zephyrhills Support <support@zephyrhillsfl.zendesk.com>
Sent: Tuesday,August 20, 2019 9:16 AM
To: Jacqueline Boges
Subject: [Request received] by 21551 39410 kennedy ave
EXTERNAL EMAIL
##- 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 Analysts 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:
httr)s://zel?hyrhillsfl.zendesk.com/hc/requests/287929
.........................................................................................................................................................................................................................................................................................................................................................................
Jacqueline Boges
--- Aug 20, 6:16 AM MST
services for 39410 kennedy ave by#21 551
This email is a service from City of Zephyrhills Support .
1
CITY OF " NOTICE / / BUILDING
ZEPHYRHILLS DEPARTMENT
OF ADDITION OR CORRECTION
D • NOT REMOVE
ADDRESS DATE PERMIT f
AM /7-6 Z
THIS JOB HAS NOT BEEN COMPLETED. The following additions or corrections shall be made before,the job
will be accepted.
a��)L7_ C---LA&1�
It is unlawful for any Carpenter,Contractor,Builder,or other persons,to AFTER CORRECTIONS ARE MADE CALL
cover or cause to be covered,any part of the work with flooring,lath,earth 780-0020 FOR RE-INSPECTION
or other material,until the proper inspector has had ample time to approve
the installation.
OFFICE HOURS 7:30AM-4:30 PM MON.-FRI. INSPECTOR v
CITY OF " NOTICE BUILDING
ZEPHYRHILLS DEPARTMENT
OF ADDITION OR CORRECTION
D • NOT REMOVE
ADDRE DATE PERMIT#
THIS JOB HAS NOT BEEN COMPLETE . The following additions or corrections shall be made before the job
will be accepted.
r
6SVIOW
It is unlawful for any Carpenter,Contractor,Builder,or other persons,to AFTER CORRECTIONS ARE MADE CALL
cover or cause to be covered,any part of the work with flooring,lath,earth 7g0-0020 FaRSPECTION
or other material,until the proper inspector has had ample time to approve
the Installation.
OFFICE HOURS 7:30AM-4:30 PM MON.-FRI. INSPECTOR
39410 Kennedy Ave. Mario Garcia-2,272 Sqft
o umn ts
SQ. FEET, PRICE
MAIN OR LIVING: 2,272 $ 112.65
OTHER AREA UNDER ROOF: - $ 88.00
OTHER: - $ -
VALUATION $ 255,940.80
FEE SHEET $ 1,320.00
ADDRESS $ 30.00
DRIVEWAYI $ 45.00
BUILDING: $ 1,421.40 J �G�j�,Olw%
ELECTRICAL: $ 297.00
PLUMBING: $ 198.00 P
MECHANICAL: $ 138.60 g
SUB-TOTAL $ 2,055.00
TOTAL $ 2,055.00 r
SEWER: $ ` "21990_00
WATER: $
IRRIGATION: $ -
TOTAL: $ 3,100.00
WATER METER: $ 473.78
IRRIGATION METER $ -
FIRE DEPARTMENT FEES
PLANS TOTAL:
INSPECTION TOTAL:
PERMIT TOTAL
TOTAL: $ -
PUBLIC SAFETY IMPACT FEES
POLICE $ E �. 254.00
FIRE $ r L---273-00 -
5% $ f __ Z085111"-
TOTAL: $ 4 553.35
SUB-TOTAL $ tlV2.13 ,
PARK IMPACT FEES $ -769.56'
SIF'S: $ —7..7.28:00
100.0% $ U"7;72800
TOTAL: $ 7,805.28
T I F'S: $ 3,632.00 - "
.� �
99% $ �--359568?
1% $ 06.32
1
TOTAL: $ 18,388.97
Bldg# 1 273879 12-26-21-0000-00400-0000
2020 PASCO COUNTY CO Print Date 10/22/2019 By rrinuno 39410 KENNEDYAVE Sec # 1 of 1 Card# 1 of 1
COM SE COR OF NE 1/4 OF SW 1/4 TH Current Owner Pro a Location Value Summary
NODEG 06'07'W 300 FTALG EAST LINE OF GARCIA MARIA& Tax Area 30ZH Land Value 9,850
NE1/4 OF SW1/4 TH W 375 FT FOR POB TH RES Nbad ZHLP Building Value 0
W 75 FT NOODEG 06'07"W 120 FT TH EAST 36338 CHRISTIAN RD COMM Nbad ZHLP Miscellaneous Value 0
75 FT TH SOODEG 06'07E 120 FT TO POB : Sinkhole Code Market Value 9,850
AKA LOT 48 UNREC LINCOLN HTS OR 6244 DADE CITY FL 33523-1286 Value By . C
Construction Detail Market Adjusted 9,850
Element Code Description Previous Value 9,850
Homestead Eli 0 County Assessed Value 9,850
Status 0 Active School Assessed Value 9,850
Model 00- Vacant County Exempt Amount 0
School Exempt Amount 0
Bldg Use 00
#Res Units 0 County Taxable Value 9,850
School Taxable Value 9,850
Stories 1.0 1 Story
Quality 0 N/A
Quality Overrid 0 Appraiser JP
Constr Class 0 N/A Appraiser Date 05-29-2019
Exterior Wall 1 00 None No Sketch Property Use 00000 Vacant
Exterior Walll 100
Exterior Wall 2 00 None This card is for Public Use
Exterior Wa112 0
Roof Structure 00 None -:Building Valuation
Roof Cover 00 None
Effective Area 0
Interior Wall 1 00 None ? �/ ��
Interior Walll 100 J Base Rate
Net Other
Interior Wall 2 00 None I .
Building RCN
0
Interior Wa112 0 %Good 100.00
Floor Cover 1 00 None /( (Y\
ol
Floor Covert % 100 Functional Obs
Bulldin Sub Areas . Economic Obsol
Floor Cover 2 00 None Code Description Livina Area I Gross Area Eff% Eff Area RCN RCNLD %Observed Condition
Floor Covert% 0
Heat Fuel 00 None Building RCNLD 0
Heating&Air 00 None Exemptions
AC Type 00 None Code Description Amount
Bathrooms .0 No.Baths
Exemption Cod
Impr Category
Size Adjust
TOTALS 10 10 0 10 10
Miscellaneous Features
Code Ln# Description Su Units Unit Price Year %Cond Cd %Good Apr Value
Total 0.00
Sales Information
Book/Pa a Sale Date Qual/Un ual Vac/Imp Sale Price Instrument
6244 1014 02-01-2005 U V 8,000 QC
5034 0788 08-01-2002 Q V 7,000 WD
5034 0787 08-01-2002 U V 0 QC
5034 0785 08-01-2002 U V 0 QC
5027 0812 08-01-2002 U V 0 QC
2020 PASCO COUNTY CO Print Date 10/22/2019 By mnuno 39410 KENNEDY AVE Bldg# 1 273879 12-26-21-0000-00400-0000
Sec # 1 of 1 Card# 1 of 1
Land Lines
B Use Sub Use Unit Depth and Notes Special S Adj Adj Unit Land
# Code Nbad Description Front Depth Units Price Factor Factor Condition Ad' Pricing Factor Price Value .
1 0110V LP3-1 SFR Rural 8,000.00 SF 1:21 1.000 1.00 0 1.000 1.21 9,680
1 0110V LP3-3 SFR Rural 1,000.00 SF 0.17 1.000 1.00 0 -1.000 0.17 170
Total Acres 0.21 JV/Mkt 9,850 Total Ad'JV/Mkt 9,850
Classified Acres 01 Classified JV/Mkt 0 Classified Ad'JV/Mkt 1 0
Costl Marketa ua von Buildik ermi
Base Rate 0.00 Permit ID Issue Date T e Description Amount Insp Date %Comp Date Comp Comments
Bldg Replace Cost 0
Net Other Adjustment
Replace Cost 0
Actual Year Built 0
Effective Year Built 0
Remodel Rating
Year Remodel
Eff Yr Bit Depr
Functional Obsol%
Economic Obsol%
Observed Condition
Observed Condition%
Percent Good 100.00
Deprec Value 0
Dep%Ovr
Dep Ovr Comment
Misc Imp Ovr
Misc Imp Ovr Comment
Cost to Cure Ovr
Cost to Cure Ovr Comment
RKET
TAX AREA CODE - 30ZH
COUNTY OF PASCO 12/30/86 J 0 T SEC TWP RGE SUED BLK/PAR LOT/C.O.
12 26 21 0000 00400 0000
PRISED BY CELK ON 14/84 9541
COST MMRET CONSTRUCTION DETAI COST-MARKET VALUE OE►RKIAFION VALU@ SVMMAn
,765
WWI CODE eaatlRrp11 Dim N,AtlA IIIL CWrIAew m.n rAar _nm VMQA"D MUM VUA
'". Au 1 0 --- _ rAluAmrlx
E SIN L-Ew AMIL`YIRRESIDENTIAL FR►_G SONS-TRUGTION Tmµ��pr 6143
soa snxluv GABLE OR HIP SCA[E'd/-157 �'""`Y�"� roruwov,ueawsr
Now com rowwDVAUR.ApalMT.
nr•wus 102 WALL BOARD OR W00
a a +-----------------+
r^-aool.o 109 PINE OR SOFT WOODS ISAS I WOWANIOAC"VALM
2100 1 1 tow AGOWNUVAW1<uo
1l 04 ri/1 103 GAS I I ron1AGMUI tl1VA FA-1
WATM0Rm 02 CONVECTION I 1 ronECTSST" lvAmc 13,095
AW CCW+IrN Ill NONE I I rorA1 CCW4AAWf VAUO:IAML
DETAIL FOR SPECIAL MODELS I I INCOME VALUATION
03 I I
STORIES 01 11.0 STORIES I I METHOD:
I I
I I oeoseArxuancaAl ___---__--_
II vACAMACOMUW --- ---------—
ADD moNu DEMIL I I 'Rxcmc'u""O"'
BATH 1.0 I I ru1DD"urllolma
r.111m ewt
I I NErANAu1.NODNe --- -----------
ANA WAS I ICI 11"As 11AAaMWr I I
nN Aei &W Ao� colrraw I I
r
a
FO �16 02 3 �431 I i
I I A
I I s
I I
I I r
I I INCOME VALUE
I I I ar.A:cao AT" v aora"o
I I aoa rAoe n wr------------------
�� sAlurece
I I 1
IFOP I s
1 I
I I s
+-----------------+ rrores
Isuu 1
MIT
o.a ANNuu 1uldno nAn111 t
ICf qV l 1
b alaD110N 1a.n uNU IAKt 0,[aiW RATE cd VAWE • a
• • r
• • A
• • a
r
■
v
TOTAL OS XF VALUE w
NIAm, [AND 1041 rCNuu "II" low oOn 0010 : "ORSUDOO1kl ADMr. rmn AOMIEO UxD VAIN
' Com ascm= la.NO 4ND Owta 1 L7 "NICE
OM SR A , 3,330
s
I
low wmrAm E
COUNTY OF PASCO 12/30/86 K 0 7 SEC TWPARGEDSUBD3BLK/PAR LOT/C.O.
APPRAISED Y JSWB ON 1 15/86 12 26 21 0000 00500 OOF00 9542
COST MAILNEt COFSTRUCTION WALLCOSTMARRET VALUE WRECIATION VALUE suMMAR1•
numm? cool . camuSu ONO1rM vA A02A amcasTMw mAn NaM f[OND. MMCAW ALUM VAVA
SAL WAU 1 D v=AmNgv MARK
s STOR S OFF C SFR — SFR CONSTRUCT ON TOTAIC1RORWYAW1� 6161
Eswl mwm P SCALE 1/202 1OrAL1MOVAUANAA W
ww oonE 03 SPH LT OR COMPOS �'-A1uovAm+oaa/.
sd•.rAU 1 LAST RED
a04 LYWOOD PANEL
.rlomo I ASP ALT T LE a1COW ANICAM SAM
a 0 roruAoeaanwrAUArAm
NLnfuU AS toGuemClAuuvAUR1AEa1
mTnonN 02 CONVECTION - mruoDnavasrruwnAo
ASS cam tm 01 NONE 1ouAcmT. vAOmr"m 140.954
3. If the School Board receives any new revenue for school capital
construction for new capacity that was not assumed in the 2017
Study, including, but not limited to, revenue from a school capital
outlay surtax, general obligation bond, or increase in the maximum
school capital outlay millage ("New Revenue Source"), then school
impact fees shall be adjusted within 90 days of the effective date of
the New Revenue Source, by resolution of the Board of County
Commissioners, to reflect an appropriate revenue credit, as
determined by the School Board's impact fee consultant, for the
portion of the New Revenue Source allocated to new school capacity
projects.
4. The school impact fee shall be determined at the time a completed
application for a Building Permit or Mobile Home Tie-Down Permit for
new residential construction is submitted.
5. Exemptions: An exemption must be claimed by the applicant or it
shall be waived. Payment of the school impact fee shall not apply to
the following situations if the applicant clearly demonstrates with
competent substantial evidence to the County Administrator or
designee, or city official where applicable, one (1) of the following:
a. Other uses. No school impact fee shall be imposed on a non-
residential structure, which cannot result in an increase in the
demand for school facilities.
b. Alterations or expansions. No school impact fee shall be
imposed for alterations or expansions of a dwelling unit that
existed prior to the effective date of the 2017 school impact fee
increase (January 1, 2018). However, where an alteration or
expansion will create an additional dwelling unit; e.g., a single-
family detached house altered to create two (2) or more
apartments, a school impact fee equivalent to the difference
between the school impact fee amount for the existing use and
the new use shall be due for each additional dwelling unit
pursuant to the school impact fee schedule in place at the time
of the change in circumstances.
C. Accessory buildings. No school impact fee shall be imposed
for construction of accessory buildings or structures that
cannot create additional dwelling units.
d. Repla ec ment of dwelling:unitl No school impact fee shall be
imposed for the replacement of a dwelling unit, in whole or in
part, as long as the own_er_can_demonstr`ate th-g fhe. am e
existed as oT_F_e rmb ua_ry_27._, 2001� or that the appropriate school
impact fee has been paid. However, where a replacement will
create a greater student demand generator, as defined in the
Page 1302.3-4 Land Development Code
wpdata/ldawndcl302.3schoolimpactfees January 1, 2012
CITY OF " NOTICE / / BUILDING
ZEPHYRHILLS DEPARTMENT
OF ADDITION OR CORRECTION
D • NOT REM-OVE
AD RE55 DATE PERMIT
l 2_-titr 2c<zp� s l
THIS JOB HAS NOT BEEN COMPLETED. The following additions or corrections shall be made before the job
'•. will be accepted.
e
It is unlawful for any Carpenter,Contractor,Builder;or other persons,to AFTER CORRECTIONS ARE MADE CALL
cover or cause to be covered,any part of the work with flooring,lath,earth
or other material,until the proper inspector has.had ample time to approve 780-O,02Q.-FOR RE-INSPECTION
the installation.
OFFICE;0 YQ §7:30AM-4:30 PM MON.-FRL INSPECTOR. za. ;.
g4ro
:PERmr r APP.ucATION
F�Rt19E1A6A"Y PEFBN� i�iPPL AT10K
C®iN5`TR1 �81 'Vt� fMZN V- B1I��=i�IGHT G.IF-WA'�If
All information n=be-flltecHn completely'
:City-0f.40hyrh111s
5335:e Street,:ZephyNiis,"F,L 33542 t '
7-elephone.813.7.80:6000 Fax 813.780.0005. E
S�'72'•Uf.r'd 'Iic�O` - �•_ " '�?rQC9eSSE��~;:rai•c — .'�TYn�__p
�:.'f .ssrK.;.�.•.:5:.• '_ ..2 :,�-� 1���= -�. _ �,� _a-,}j .;t<. ;:c,•
t=_i,--_r<' ,,,ram - ..i1�Ti;-9_•a F-"=i.':-�.-5 t.t _ __ 'i". ,i:: `f,'
,'�st. `.i':"• =. �-- ,� !`)i'.:- ,.
,wP ctD3Bnfldt fI1: ibne Y; zy„.• :. ;' .,=: '~
10R03ECT'J4?B`SITE: -PROPERTWOWN
Address:': CU v Name: e. cLu curt,!
.Unit#: Address: . Co•?S' . c' Unit. _
Parcel.IdentiFication'Nurnber: Ci State-Zi ..cto(p- )—�
Phone:
;CONTRACTOR:
77
Company:,
Name:
Cohtractor's License#: E-M611:
'Phone:. 'Cell: Fax'
ARCiiITECT/ENGINEER.-.
'Name: Firm Name:
Address: City: Stater DO:
State License#: Phone: Cell: Fail: '
i
lies+ rit�tion of ProjecC
j TYPE OF DRIVEWAY '' jLU LENGTH OF DRiVEVJAY Q �- CULVERTSWE-EDED
/ RESIDEM'IAL DRIVEWAY WIDTH IMF DRIVEWAY r 2' ( )REINFORCED.CONCRETE
COMMERCIAL DRIVEWAY - W FKCAVATEO111 ( )CORR.UGATM MATERIAL ..
,,,PUBLIC ACCESS DRIVEWAY DEPTH: .- LINEAR FEET ( )BOX CULVERT
COt1 MUMON MATERIAL _CURB CUT RE ( )OTHER(EMI ATN)
---ASPHALT YES NO ,
.CONCRETE (` � hriVeWayt .
IiEADNPALi[ REOUxREDT YES /. NO fq o t O t` �, I
N=i=TO APPLICANT:_If actual work exceeds scope of this description,,additional permits or draivaings
will be required.
UTILITY LOCATIONS REQUIRED: CALL BEFORE YOU DIG.-1.800.432.47,70
Page 1 of 3
PERMIT APPLICATION
UTILITIES LOCATE CONFIRMATION NUMBER:
PROVIDE SKETCH IN THIS AREA,IF ADDITIONAL_SPACE IS REQUIRED,_ATTACK TO THIS
APPLICATIOTi. ;:: : 2
_ "/ 0 hf %: %Y
' .. � r ' .
� 01 o M o
oi ,
T rN7 ��.
/ .
,r �� u4asS.
i AFFIDAVIT: Applicatipn is hereby made to obtain a permit to do work and installations as indicated. I certify that all foregoing
Information is acd6rate„and that all work will comply,with:all applicable codes. I understand these codes shall take precedence over.all,
approved construction documents,.and issuance of this permit is verification that I will notify the property owner-of Florda Llen Law
req.,F.S.713.
The Issuance of this'permit does not ensure.compliance with deed.restrictlons'and I.understand that additlonal deed -
restrictions may apply tb this property
All wokkAhall comply vgith the cunent Florida.Building,Code,Public Works Design Manual and FDOT Design
Standards(if applicable). (Public.Works Design Manual online link:www.cl.iephyrhflls•fl.us/public_works.asp)
APPLICATION IS.VOID UNLESS SIGNED WITH PROPER IDENTIFICATION AND wrmESSED BY.A PERMTf
TECHNICIAN OR'NOTARY PUBLIC.
NOTE: The City of.Zephyrhilis Is not responsible for maintenance or repairs of driveways.-®thieways shall not biter/
interfere with existing stormwater treatment and/or conveyance:
PROPERTY OWNERS: By sign,ng tills application: I certify that I have read and understand the ownerybullder disdosure
statement. (please initial)
Applicant Print.Name Applicant Signature Date
Permit Technician Signature (or)Notary Signature Date
-Applicant is( .)personalty.known to me or produced . as identification.
(type of Identification)'
Pagel of 3
i
PERMIT APPLICATION
OFFICE USE ONLY
-;2.,a. ..�4Y.h., •.1.� :.+..F�'� e.'fi`. _ .y_ _ '. f t Y `-G',t..'..`c:.y—,r . - -
Cotkrete=(min.6'j Y: N
Asphalt Base.(min.6 ) Y .. N
Asphalt(min. 1%0) Y. N.
Length(min:.191
Width.(10'min-20'max) Y: N:
E)isting.sidewalk. Y N
New sidewalk .: . Y.
ADA compliant Y: N
Expansion material required.: .. Y N i7
Contiguous paridng pad. :. . Y N
Triangular flare 3'W x 71 Y N
Visibility triangle o.k.7 N
Side setback(3'min.R.O.W.) Y . "N
Plan Review Fee:
A41dt Titgal ti[esi ci"t�i�oxta W-;s:.4e p � oDeetior. n :bi Tv .
1
ale.:
Permit application approved :.. . Date:. ( L
Page 3 pf 3
00 KYNENE0
THE EVOLUTION OF INSULATION
INSULATION CERTIFICATE
This form must be filled out and posted to comply with building code requirements.
Meets IRC requirements: 2006 IRC-N1101.2,N1101.4,N1101.8
2009 IRC-N1101.2,N 1101.4,N 1101.8
2012 IRC-N1101.3,N1101.7,N1101.12
The following spray polyurethane foam product(s) has/have been installed.
❑ LD-C-50 ❑LD-R-50 ❑ MD-C-200 ❑ MD-R-200 ❑ MD-R-210 ❑Other
Please consult International Building Code(IBC),Chapter 26-Plastic and International Residential
Code(IRC)2006 IRC R314,2009 IRC R316,2012 IRC R316-Foam Plastics for specific requirements.The
aforementioned Icynene spray polyurethane foam insulation system(s) has/have been installed in
accordance with manufacturer's processing guidelines to provide a thermal resistance of:
Area Insulated Aged R-Value Thickness*
Attic Area R- 20 at inches
Sloped Ceilings R- at inches
Walls(location): R- at inches
Walls(location): R- at inches
Floors(over an unheated crawl space) R- at inches
Crawl Space Perimeter R- at inches
Basement Walls R- at inches
Other(location): R- at inches
*Nominal thicknesses are representative of field,spray-applied foam material.
Jobsite Address F 39410 Kennedy Ave Ze h rhills FI,33542
Date of Insulation Installation 11/25/2020
Building Contractor
Insulation Contractor F&G SPRAYFOAM INSULATION LLC
Insulation Contractor Phone F 8 33 363 32 97
Installed By
INSULATION CERTIFICATE • ®O NOT REMOVE
Please post near electrical panel.