HomeMy WebLinkAbout91-1787
STATE OF FLORIDA ..
City of Zephyrhills
PASCO COUNTY
Permit N~
17878
BUILDING DEPARTMENT
~-d ;7,~() 1-813-788-6611
T of Permit 7:l-SO ?d..~~() L./ Date 9- / b - ~ I
\~ ;~ ~,_rD ,~~c~ J.d7cf< cID
BUILDING EL-ECTRI~A~) PLUMBIN.G) ~CHA~ A/eiL,-: t;t~. " ,?-5CJ - OCJ
- - -- // ~-' /~/' j'Jz,' I bS". OV
properIYownerSName:!2l~>~ ~Lr~~1- (fl~ybi)
Job Address: h / (j ~ _ _~ _ ---'- ~ _U-
Legal Description: SUb.DiV'~/1 tJHL Lot
Zoning CI: d - .;l {, -d-/ - i - 6 ~
DescriplionofWork ffi.b<Y 2~' .If. .~ '. .
Blk.
Energy Code Readout:""'p-;;' ,
j Mtt> /fi-rl(f
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost: 6 ~ /-..!>-.:s-: t:JO
OCCUPATIONAL LICENSE #;l..:J... W ,~.A?,
Fee: ?/J-su :; ~.:l,~,g-,
SIGNATURE ~_ c? ~
COMPANY
ADDRESS
TELEPHONE #
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
p
Tp.Serv. 1J,f-
Rough In I J ,,$l1 /. --f I Breakers
Meter Can Ducts InSI.II.,tI,f/~
Canst. Pole Compressor
Pool Final
Pre-Meter I - ~ - Q"
Final
Driveway
/1..-l.~-1 J ~
.
Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of ten (SIO.OO)
dollars shall be made for each trip.
(a) Wrong Address
(b) Condemned work resulting from faulty construction
(c) Repairs or corrections not made when inspection called for
(d) Work not ready for inspection when called.
The payment of reinspection fees shall be made before any further permits will be issued to the person owning same.
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Westgate Office
37031 County Route 54
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FORM 900.B.91
FLORIDA ENERGY EFFICIENCY CODE
FOR BUILDING CONSTRUCTION
Section 9 - Residential Point System Method
Department of Community Affairs
Climate .Z~s
CENTRA~ 6
OWNER:
et C~
ZONE: 4[9--5060
~~
PROJECT NAME
AND ADDRESS:
NEW CONSTRUCTION
ADDITION
MUlTIFAMilY ATTACHED
~
D
IF MUlTIFAMilY, NUMBER OF CONDITIONED
UNITS ClJIERED BY [IJJ FLOOR AREA
THIS SUBMITTAL: PREDOMINANT
EAVE OVERHANG
CHECK IF THIS SUBMITTAL LENGTH
REPRESENTS A WORST CASE PORCH lJIERHANG rn n:J '
CONDITION: D lENGTH . Ld FT.,
~
DIJ.~ Fl
GLASS AREA AND TYPE
CLEAR TINT.FllM.SOlAR SCREEN
SINGLE- OJ]] SQ, SINGLE- OJ]]' SQ,
P~NE FT. PANE " FT.
DOUBLE- SQ DOUBLE. OJ]] SQ.
PANE FT. PANE FT.
SINGLE-FAMilY DETACHED
NET WALL AREA AND INSULATION
EXTERIOR MASONRY R = EXTERIOR FRAME R = EXTERIOR STEEL R = R =
CIlIililiJ so. m .8J ITIIIJSO' m ITIIIJ so. m m
FT. FT. FT.
ADJACENT MASONRY R= AO.W:ENTFRAME ADJACENT STEEL R= R.. I
ITIIIJ so m.D so. rnrnso. m so. m
FT. FT. ' FT. FT. I
I
CEILING AREA AND INSULAnON
R ... SGl ASSEMBLY
~ ITIIIJ~'
DUCTS
IN
UNCONDITIONED
SPACE R =
~.!a
I~:TIONED
SPACE R.
m.D
COOLING SYSTEM
1;Zl CENTRAL
o ROOM
o PACKAGE TERMINAl
AIR CONDITIONER
o NONE
SEEPJCER. rn.S]
HEAnNG SYSTEM
o ELECmlC smlP
o NATURAl GAS
o ROOM UNIT OR
PACKAGE TERMINAl.. 0
tEAT PUMP NONE
~~I [2l~
SLAB PERIMETER
c.J2IiliJFT.
R.OOR TYPE AND ,"SULAnON
R = RAISED WD 0 CON 0
~ . ITIIIJSO.
UU FT.
HEAT
PUMP
o OTHER
FUELS
KYAC CREDITS
o CEILING FANS
o CROSS VENTILATION '
o WHOlE HOUSE FAN
I
o ATTIC RADIANT
BARRIER
o MUlTlZONE
flI ElECmlC
o NATURAl GAs
o OTHER FuElS
o NONE '
EF...EDQ
INFIlTRATION [QJill[QE] ~ DlliJ.rn
PRACTICE USED X 100 =
D #1 ~#2 D #3 TOTAL AS-BUILTPOINTS TOT At BASE POINTS CALCULATED E.P.!.
CALCULATED ENERGY PERFORMANCE INDEX MUST NOT EXCEED 100 POINTS.
I hereby certify that the plans and speclflcallons covered by the ClIIcuI8tion ara in c:omplIance wtth the
Florida Energy Code. V)", \,
PREPARED BY: "'~ \J~ DATE: 9 -5 -g I
I her~rttIY thaI th\Sro.~kfi!'ll1s In IlOlnI!.fianca wtth the Florida Energy Code.
OWNE~~:, ~-tJt~ ~0-~ : DATE:...:l-S -9 I DATE: '
SN:' 1594
DOUGHTY - LOT 2, SILVER OAKS
FLORIDA ENERGY EFFICIENCY CODE
FOR BUILDING CONSTRUCTION
Section 9 Compliance Program - Residential Point System Method
Version 1.0 January, 1991
Department Of Community Affairs
Printout generated by EPI91 and submitted in lieu of Form 900-A-91
THIS COMPLIANCE FORM IS VALID IF SUBMITTED AFTER JANUARY 1, 1991
--------------------------------------------------------------------------------
)ROJECT NAME: SINGLE FAMILY RESIDENCE
PERMITTING OFFICE:
------------------------------
~ND ADDRESS: LOT 2, SILVER OAKS
ZEPHYRHILLS, FLORIDA
--------------------------------
CLIMATE ZONE:
4
5
6
------------------------------
WILDER:
)WNER:
MR. DOUGHTY
GENERAL HOME DEVELOPMENT CORP.
PERMIT NO.:
------------------------------
JURISDICTION NO.::
------------------------------
~---------------------------------------------------------------~---------------
;TRUCTURE TYPE:
Single-Family
'REDOMINANT EVE OVERHANG Length:
'ORCH OVERHANG Length:
IINDOWS
DouDle Clear
All Vertical Glass
All Skylight Glass
IALLS
Ext NormWtBlock Int
Adj Wood Frame
IOORS
Ext Insulated
Adj Wood
EILINGS
FLAT Under Attic
PITCHED Under Attic
PITCHED Under Attic
LOORS
Slab-on-Grade
UCTS
Unconditioned Space
OOLING
Central A/C
EATING
Heat Pump
OT WATER
Electric
:OMPONENT:
NFILTRATION
Conditioned Floor
AS BUILT POINTS
28,607.24
DIMENSION:
VALUE: RATING: VALUE: OFFICIAL CHECKLIST
1.83
7.33
Total Area
Total Area
Total Area
286.90
286.90
.00
Area:
Area:
1152.90 R-Val:
186.40 R-Val:
7.20
11.00
Area:
Area:
21.60
21.60
Area:
Area:
Area:
848.00 R-Val:
1042.50 R-Val:
168_00 R-Val:
40.00
40.00
23.00
Perimeter:
208.70 R-Val:
.00
Length ALL
R-Val:
4.20
SEER:
8.95
COP:
2.84
EF:
.90
Bedrooms:
3.00
Area:
1748_00 Pract:
2.00
/
BASE POINTS
100
*
:::
EPI
34,813.43
82.17
GLASS TO FLOOR AREA RATIO ::: .1641
n Accordance with Sec. 553.907 F.S.,
Hereby certify that the plans and
:pecifications covered by this calcu-
ation are in compliance with the
lorida Energy Code.
IWNER~:
lATE:
~-~
Review of the plans and specifications
covered by this calculation indicates
compliance with the Florida Energy
Code. Before construction is completed
this building will be inspected for
compliance in accordance with Section
553.908 F.S. ~
BUILOINYFFICIAL' 4 - , " · '-4A..~
DATE: ,--~-r(
** PRESCRIPTIVE MEASURES (Must be met or exeeded by all residences) **
:============================================~=================~:===============
~OMPONENTS
SECTION
REQUIREMENTS
:================~==============================================================
JINDOWS
:XTERIOR &
~DJ ACENT DOORS
904.1
904.1
:XTERIOR JOINTS 904.1
< CRACKS
JATER HEATERS
904.2
Maximum of 0.34 CFM per linear foot of operable sash
crack.
Maximum of 0.5 CFM per sq. ft. of door area. Includes
sliding glass doors, solid core, wood panel,
insulated, or glass doors only.
To be caulked, gasketed, weather stripped or other-
wise sealed.
Must bear label indicating compliance w/ASHRAE stand-
ard 90 or comply with efficiency and standby loss re-
quirements_ Switch or clearly marked circuit breaker
(electric), or cut-off (gas) must be provided. An
external or built in heat trap must be provided_
~---------------------------------------------------------------~---------------
;WIMMING POOLS
< SPAS
904.3
Spas and heated pools must have covers (except solar
heated). Non-commercial pools must have a pump timer.
Gas spa & pool heaters must have minimum thermal
efficiency of 78
~---------------------------------------------------------------~---------------
lOT WATER
)IPES
904.4
Insulation is required only for recirculating systems
In such cases, piping heat loss shall be limited to
17.5 BTU/H/Linear Ft. of pipe.
~---------------------------------------------------------------~---------------
;HOWER HEADS
904.5
Water flow must be restricted to no more than 3 gal-
lons per minute at 80 PSIG.
v_______________________________________________________________v_______________
lVAC DUCT
:ONSTRUCTION
903.2
904.6
Constructed in accordance with industry standards &
local mechanical codes. Ducts in unconditioned space
must be insulated to minimum R-4.2 & Joints must be
sealed.
~-------------------------------------------------------------------------------
IVAC CONTROLS
904.7
Separate readily accessible manual or automatic
thermostat for each system.
~-------------------------------------------------------------------------------
NSULATION
904.9
Ceilings minimum R-19. Common Walls - Frame R-11 or
CBS R-3. Frame Common Ceilings & Floors R-11.
** INFILTRATION REDUCTION PRACTICE COMPLIANCE CHECKLIST **
~_______________________________________________________________v_______________
~_______________________________________________________________A_______________
:OMPONENTS
REQUIREMENTS
~---------------------------------------------------------------~---------------
~---------------------------------------------------------------~---------------
)RACTICE #2
Comply with Practice #1 and the following.
:xterior walls & Floors
Top plate penetrations sealed. Infiltration barrier
installed. Sole plate/floor joint caulked or sealed.
:xterior Walls &
:eilings
Penetrations, joints and cracks on interior surface
caulked, sealed, and gasketed.
)uctWor k
Ductwork in unconditioned space must be sealed.
: i replaces
Equipped with outside combustion air, doors, and flue
dampers.
:xhaust Fans
Equipped with dampers. Combustion devices see 903.2
( f ) .
:ombustion Appliances
Provided with outside combustion air.
~******************************************************************************
SUMMER CALCULATIONS
~******************************************************************************
=== BASE ===: === AS-BUILT ===
--------------------------------------------------------------------------------
-------------------------------------------------------------------------------
~LASS----------------
)RIEN AREA x BSPM =
I
I
POINTS :
TYPE
SC
ORIEN
AREA
x SPM
x SOF
= POINTS
--------------------------------------------------------------------------------
N 54.10 47.8 2586.0 DBL CLR N 23.7 47.8 .87 980.6
DBL CLR N 23.7 47.8 .87 980.6
DBL CLR N 6.7 47.8 .69 221.0
E 36.10 102.0 3682.2 DBL CLR E 8.7 102.0 .84 747.4
DBL CLR E 8.7 102.0 .84 747_4
DBL CLR E 5.3 102.0 .94 510.9
DBL CLR E 13.4 102.0 _94 1284.8
S 134.00 90.9 12180.6 DBL CLR S 53.4 90.9 .39 1893.1
DBL CLR S 23.7 90_9 .39 840.2
DBL CLR S 23.7 90.9 .76 1634.9
DBL CLR S 16.6 90.9 .76 1145.1
DBL CLR S 16.6 90.9 .76 1145.1
W 62.70 102.0 6395.4 DBL CLR W 5.3 102.0 _79 425.9
DBL CLR W 8_7 102.0 .95 846.7
DBL CLR W 8.7 102.0 .94 829.7
DBL CLR W 40.0 102.0 .88 3594.9
.------------------------------------------------------------------------------
15 x CONDo FLOOR / TOTAL GLASS = ADJ. x
AREA AREA FACTOR
GLASS =
POINTS
ADJ GLASS
POINTS
GLASS
POINTS
.-------------------------------------------------------------------------------
15
1,748.00
286.90
.914
24,844.18
22,705.28 :
17,828.18
.---------------------------------------------------------------.---------------
.-------------------------------------------------------------------------------
ION GLASS------------ :
AREA x BSPM = POINTS: TYPE
R-VALUE
AREA x SPM = POINTS
-----~-----~--------------~-----~---------------------------------------------
ALLS----------------
xt 1152.9 1.0
dj 186.4 .7
1152.9
130.5
Ext NormWtBlock In
Adj Wood Frame
7.2
11.0
1152.9
186.4
.78
.70
899.3
130.5
OORS----------------
xt 21.6 4.8
dj 21.6 1.6
103.7
34.6
Ext Insulated
Adj Wood
21.6 4.80
21.6 2.40
40.0 848.0 .40
40.0 1042.5 .40
23.0 168.0 .85
103.7
51.8
EILINGS-------------
A 1748.0 .6
1048.8
Under Attic
Under Attic
Under Attic
339.2
417.0
142.8
LOORS---------------
lb 208.7 -31.8 -6636.7
Slab-an-Grade
.0
208.7 -31.90 -6657.5
NFILTRATION---------
1748.0 10.9 19053.2
Practice #2
1748.0 10.90 19053.2
==============================================================================
OTAL SUMMER POINTS :
37,592.24 :
32,308.11
~--------------------------------------------------------------'---------------
~-----------------------------------------------------------------------------
::nAL x
JM PTS
SYSTEM =
MULT
COOLING : TOTAL
POINTS : COMPON
x CAP x DUCT x SYSTEM x CREDIT = COOLING
RATIO MULT MULT MULT POINTS
-~--~----------------------------------~-----------------------,---------------
37,592.24
.42
15,788.74 : 32,308.11 1.00 1.140
.378
1.000 13,934.49
-----------------~-~-----~--~-----~-----~--------~------------_._------------~-
------------------------------------------------------------------------------
:******************************************************************************
WINTER CALCULATIONS
:******************************************************************************
=== BASE ===: === AS-BUILT ===
~-------------------------------------------------------------------------------
.------------------------------------------------------------------------------
iLASS----------------
lRIEN AREA x BWPM =
I
I
POINTS :
TYPE
SC
ORIEN
AREA
x WPM
x WOF
= POINTS
--------------------------------------------------------------------------------
N 54.10 5.6 303.0 DBL CLR N 23.7 5.6 1 .11 147.8
DBL CLR N 23.7 5.6 1 .11 147.8
DBL CLR N 6.7 5.6 1.28 48.0
E 36.10 -5.6 -202.2 DBL CLR E 8.7 -5.6 .64 -31.3
DBL CLR E 8.7 -5_6 .64 -31.3
DBL CLR E 5.3 -5.6 .87 -25.8
DBL CLR E 13.4 -5.6 .86 -64.5
S 134.00 -14.0 -1876.0 DBL CLR S 53.4 -14.0 .13 -97.2
DBL CLR S 23.7 -14.0 .13 -43.1
DBL CLR S 23.7 -14.0 .86 -285.3
DBL CLR S 16.6 -14.0 .86 -199.9
DBL CLR S 16.6 -14.0 .86 -199.9
W 62.70 -5.6 -351.1 DBL CLR W 5.3 -5.6 .52 -15.4
DBL CLR W 8.7 -5.6 .89 -43.4
DBL CLR W 8.7 -5.6 .85 -41.4
DBL CLR W 40.0 -5.6 .73 -163.8
------------------------------------------------------------------------------
15 x CONDo FLOOR / TOTAL GLASS = ADJ. x
AREA AREA FACTOR
GLASS =
POINTS
ADJ GLASS
POINTS
GLASS
POINTS
15
286.90
------------------------------------------------------------------------------
-898.69
1,748.00
.914
-2,126.32
-1,943.26 :
------------------------------------------------------------------------------
-------------------------------------------------------------------------------
ON GLASS------------ :
AREA x BWPM = POINTS: TYPE
R-VALUE
AREA x WPM = POINTS
------------------------------------------------------------------------------
ALLS----------------
xt 1152.9 1.1
dj 186.4 1.8
1268.2
335.5
OORS----------------
xt 21.6 5.1
dj 21.6 4.0
110.2
86.4
EILINGS-------------
A 1748.0 .6
1048.8
LOORS---------------
lb 208.7 -1.9
-396_5
NFILTRATION---------
1748.0 4.1
7166.8
==============================================================================
OTAL WINTER POINTS
I
I
7,676.08 :
Ext NormWtBlock In 7.2 1152.9 2.26 2605.6
Adj Wood Frame 11.0 186.4 1.80 335.5
Ext Insulated 21.6 5.10 110.2
Adj Wood 21.6 5.90 127.4
Under Attic 40.0 848.0 .40 339.2
Under Attic 40.0 1042.5 .40 417.0
Under Attic 23.0 168.0 .85 142.8
Slab-an-Grade _0 208.7 2.50 521.8
Practice #2 1748.0 4.10 7166.8
------------------------------------------------------------------------------
------------------------------------------------------------------------------
10,867.53
OTAL x
IN PTS
SYSTEM = HEATING : TOTAL
MULT POINTS: COMPON
x CAP x DUCT x SYSTEM x CREDIT = HEATING
RATIO MULT MULT MULT POINTS
7,676.08 1.10
------------------------------------------------------------------------------
4,323.76
8,443.69 : 10,867.53 1.00 1.140
.349
1.000
==============================================================================
c******************************************************************************
WATER HEATING
c******************************************************************************
=== BASE === === AS-BUILT ===
N_______________________________________________________________~_______________
-------------------------------------------------------------------------------
~UM OF
~EDRMS
x
MULT
==
TOTAL
TANK VOLUME
EF
TANK
RATIO
x MULT x CREDIT
MULT
== TOTAL
3
~---------------------------------------------------------------~---------------
10,349,00
3527.0
10,581.00
40
.90
1.000 3449.7
1.00
~---------------------------------------------------------------y---------------
~----------------------------------~--~-------------------------~---------------
:******************************************************************************
SUMMARY
:******************************************************************************
===== BASE ====== ===== AS-BUILT ====
-------------------------------------------------------------------------------
._------------------------------------------------_.~~--------------------------
:OOLING
'OINTS
+
HEATING
POINTS
HOT WATER
+ POINTS =
TOTAL
POINTS
: COOLING
: POINTS
+
HEATING
POINTS
TOTAL
POINTS
HOT WATER
+ POINTS -
15788.7
.------------------------------------------------------------------------------
10349.0 28,607.24
8443.7
10581.0 34,813.43
13934.5
4323.8
.---------------------------------------------------------------.---------------
.------------------------------------------------------------------------------
*****************
* EPI == 82_17 *
*****************
__ __ ___'._...._-.-__~:.r.._...__"'::_:___~:~ :-::-:-~~ -."'"
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER
General Home Development CorP.
817 ILS qg RWac;c; ~mlth} Dade City, FL
Robert Doughty
33525pHONE
(904)567-6581
APPLICANT
ADDRESS
2
BLOCK
11~.45xI98.2xI81.41xI90.25
LOT SIZE X AREA SQ. FT.
SUBDIVISION Silver Oaks
"
JOB LOCATION Lot 2,
Silver Oaks
LEGAL DESCRIPTION: LOT(S)
PARCEL 1. D . i~ .:J - ;L" - .J.-I - J J.. - 0 - ~
WORK PROPOSED:.!-New Construction ____Addition ____Alteration ____Repair ____Install
____sign/Temp.
PROPOSED USE: ~Single Family
____Sign
_Hove
_Demolish
____M/F
____~~ of Units
, .____M I H
____commercial
____Indust.
-LSwim. Pool
Other
____Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
**COPY OF CONTRACT REQUIRED.
pERM1TS REOUESTED
-LBUILDING
2-ELECTRICAL
~MECHANICAL
X .
____PLUMBING
$
Valuation of Total Construction
AMP Service
X Florida power Corp.
_W.R.E.C.
$
Valuation of Mechanical Installation
GAS
ROOFING
SPECIALTY
..; .
TYPE OF CONSTRUCTION: ~Block
____Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
CONTRACTOR SECTION
BlJ11JlER ~0IIe. Dey~"t Corp, Company Key;" 1. Roberts -
_ ~ >>. State Cert. or Regist, 11 CG<:OO~q",
Signa ture Ci ty License Regis tra t ion ii ;2 ;;L
******************************************
ELECTRICIAN MCAr-ti\-\ (:JQ.<...t"(""C Company 11 "r.h.... E/e,f-r,-c.
State Cert. or Regist.4i ER.(JO IIHD
Sio-nature ~ 7cL~: L City License Registration ii /5: ~
******~***********************************
Signature
Company --Z;;4.YO/7JC::- T t1:~6 p? b / <::~~
State Cert. or Regist. 4,! L rcck/ ~ 7&;]>
City License Registration 0 9/
******************************************
MECHANICAL ;:t;.
Signature ~
-'
Company ~ U T H &.--/2- '"'\..
~ ~ State cert~r R;g~~ 41
~ City License Registration #
******************************************
<::::.-.c.\ VL. ~ D~ "\
/2... "Vt CV) I SD Z- ?.
/~
Signature
Company
State Cert. or Regist. 0
City License Registration 0
OTHER
APPLICATION APPROVED BY
*H * * * * * * * * * * ~ -I: * * * * * * * * * '.~ ** of, *~, 1, * * *,1' * * * * *,
"'hU'~ f J7A~, . ..
PERMIT OFFICER.
-il.... II" ~CIf....~
CONDITIONS OF P~RMIT AFFIDAVIT
A. NOTIC~ OF D~ED RESTRICTIONS
The ,undersigned understands that this perlit lay bl subject to "deed restrictions" which may be 50re restr,ictive than City
regulations. The undersigned assules responsibility";for.,colpliance with any applicable deed restrictions.
. ~,.' . ,
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor Dr contractors to undertake work, they lay be required to be licensed in accordance with
stlte Ind locll regulltions. If the contractor is not licensed as required by law, both the owner and contractor ~ay be
cited for a eisde.eanor violation under state law. If the owner Dr intended contractor are uncertain as to what licensing
requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
788-66il.
Furtherlore, if the owner has hired a contractor Dr contractors, he it advi5~~ to have the contractorls) sign portions of the
'Contractor Sections. of this application for which they will be respClnsible:.' IT you, -as-the c.wner .sign a5 t~e (C.ntractor,
you are indicating that you, rather than the contractor, are responsible for the work. If the contractc.r wishes you to sign
as contractor that lay be an indication that he is not properly licensed and is not entitled to permitting privileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D.
CONSTRUCTION LIEN LAW
(CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
1 certify that I, the applicant, have been provided Mith a copy of "Florida's Construction Lien Law - HOleowner's Protection
Guide" prepared by the Florida Departlent of Agriculture and Con suter Affairs. If the applicant is sOle{.ne other than the
'owner" , I certify that I have obtained a, copy of the above described docutent and promise in good faith to deliver it to the
"owner" prior to cOllencelent. I
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
1 certify that all the information in this application is accurate and that all work will be done in cOlpliance with all
applicable law5 regulating construction, zoning, and land develop.ent. .
Application is hereby lade to obtain a perlit to'do work and install~tion as indicated. I certify that no work Dr
installation has comtenced prior to issuance of a perlit and that all work will be performed to leet standards of all laMS
regulating construction, City cod~s, zoning regulatiGns, and land development r~gulations in the jurisdiction. I also
certify that I understand that the regulations of other governmental agencies fiay apply'to the intended work, and that it is
,y responsibility to identify what actions 1 lust take to be in COMpliance. Such agencies include bl,t il e Dot li_ited to:
. ~. #'
I Department of Environmental ReQulation - Cypress Bayheads, Wetland ~reas and Environmentally Sensitive Lands,
Water/Wastewater Treatlent
I Southwest Florida Water ManaQelent District - Wells; Cypress Bayheads, Wetland ~reas, Altering Watercourses
I ~rlv Ct1rps ,of EnQineers - Seawalls, Docks, Navigable Ilaterways
I Departlent of Health ~ Rehabilitative Services. Environmental Health Unit - IIells, Wastewater Treat~en~. Septic Tanks
I US Environaental Protection AQency - Asbestos abatement
1 also cedify that, if fill material is to be used in Hood Zone "A" or "A,etc.', it is understr1t1d thil a drainage plan
addressing a 'colpensating volule" will be sublitted which is prepared by a professional engineer reqist2red in the State of
Florida prior to perlit issuance.
A pertit issued shall be construed to be a license to proceed with the work and not as authority to viol~te, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official frol thereafter
requiring a correction of errors in plans; construction, or violations of any code. Every permit issll~d ;hall becole invalid
unless the work authorized by such permit is co.menced Mithin six months of issuance, Dr if work authol lzed by the perlit is
suspended or abandoned fr.l' a period e.f six months after the ti.'le the llork is ctlKlmenced. One 9(\ day e~\;;iisioll of tilt', aay be
allowed for the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection aust be logged during each six tonth period, or the project will be considered dbdlldooed-
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. JOBS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE_~_~~------- SIGNATURE_ ~C-O-NT-R-- -A.-CT--O~R--- ~
OWNER OR AGENT .z~
DATE___________,~-~,{SU----------------
~g~~~~C~~R~~____~~~~
DA TE______________9Jnqj-----------.-------
~~~~~V O~S A~~NT __fj~g.--~~-
MY COMMISSION EXPI-lWrARY PUBLIC. STATE OF Fl.ORIDA.
Hilts ~QJ'rtl'J1JSSJOrll. .i:UU~M"R-: ~;-t994.
BONDED THRU NOTARY PUBLIC UNDERWR.lTERS.
MY COMMISSION EXP8~~~~~~~~
MY COMMISSION EXPIRES- F'1:O"RI1n.
.ONDCD THftU NOTAlty flU."'" MAR. 26. 1994.
C UNDIlIIWFtITl!It..
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OWNER
DEPARTMENT
JOB LOCATION
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PARCEL I.D. #
SHOW ALL EXISTING & PROPOSED STRUCTURES GIVING DIMENSIONS & SETBACKS.
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FRONT PROPERTY LINE
(NOTE EXAMPLES 1 & 2 ) STREET
1. SETBACKS FOR Rl, R2 ZONING
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10'
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FRONT PROPERTY LINE
NOTICE
OF
RESOURCE RECOVERY ASSESSMENT FORM
() DATE
APPLICANT I OWNER ;( _ thLr! 1-./ ~...t>A 7 ---i!
COUNTY PARCEL # -3 - &-6- ~/ - /;;J- - 0 .~ .~
LOCATION 6/ lJ 2" ~"'/0L. (I d~ ~O
USE/CODE DESCRIPTION ~ ~~-?-/ :~/h r;y
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PERMIT II
RESIDENTIAL
NON-RESIDENTIAL
Ii UNITS
GROSS SQ. FT. (GSF)
/
RATE/ERU=$SO.OO X 0.96*/YEAR OR $0.1315/DAY ERU ASSIGN #
ASSESSMENT = (# UNITS)X($0.131S)X(NO OF DAYS) ASSESSMENT=(GSF)X(ERU)X(0.131S)X(NO DAYS)
100
TOTAL FEE
$
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TOTAL FEE = $
PREPARED BY
- -
* DISCOUNTED FOR PREPAYMENT
--------------------------------------------------------------------.-----------------
The above assessment has been established pursuant to the Pasco County Ordinance
No. 89-07 and Resolution No. 89-197 as commended.
THE ASSESSMENT WILL BE CALCULATED AT THE TIME OF ISSUANCE OF THE C/O. NO CERTIFICATE
OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED UNTIL THE ASSESSMENT HAS BEEN PAID.
APPLICANT HEREBY ACKNOWLEDGES RECEIPT OF THIS NOTICE AND THE REQUIREMENT OF ASSESSMENT
FEE PAYMENT PRIOR TO C/O OR FINp~ RELEASE.
DATE
RECEIVED BY
---------------------------------------------------------------------.-----------------
FOR OFFICE USE ONLY
RECEIPT II
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