HomeMy WebLinkAbout92-2121
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N~ 21218
(813) 788-6611 Date ;2 -/1-7::J.....
. sts.--s-zJ 6t.7--S- S"0"': OU Jo.-tTD
C ~~ GLECTR~ C;:;-<O GCHA~ Sewer Conn ~ 2 7~ t77J.
~ ;# /J Water Conn: 3.50. trV
pmpertYowne;Jr~ . ____, _~gl-4.J~;e:Mete' /6.5.-; tTD
Job Address: 6 b __'-_ ~ T,IFs: -
Parcell.D. # J -,;)6 -- .;L/ - /:J- - 0 - b 7 IRR/t?IIr: METFll. j)11 165-'~
Zoning: 7Y 1-:2.1- 'l:L
Description of Work
NO OCCUPANCY BEFORE C,Q.
~
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
City License Registration # -5'3 7
State Certified License# C-8GA d-./ 0 ~/
Permit Fee '7 /.5-' c2~- rJ...1, ';)1'
Signature c::f?~ ~
Company
Address
Telephone#
Valuation or
Contract Price 7 / ~'. cJC)
BUILDING
'JI
/0;>
MECHANICAL
Tp. Servo A.-: SLB Z-13-9Z ~
Rough In ~- \9 ,q J- ~.1""" Tub Set 3~l~.q1-
MMerCan Wa~r
Const, Pole Z...-J" ''iLl'"'' Sewer 2-/~ ._':y2- R.I
Pool ~ Final ~
Pre-Meter ,,/' . /7 Jj7:. ~C'
Final
Breakers
Ducts Insl. ~.-2c-Jf2 fi~
Compressor
Final
Ftr.
Pre SLB .
~~n~~,71i~1t ~,y
Insul. CL tJ.
WL '3 -tc.qL ~
Driveway It-z-q t- !b a.e
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15,00) shall be made for each trip for each trade:
a. Wrong Address
b, Condemned work resulting from faulty construction,
C. Repairs or corrections not made when inspection called,
d, Work not ready for inspection when called,
e, Permit not posted on job site,
f, Plans not at job site,
g, Work not accessible,
Vri 9'-62/- 9~, Jt.J-
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
.APPLICATION FOR PER~IT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT ~~ Ua\ C\")~~ ~ r\\~VY"'\~<s,
I
ADDRESS~. C). ~~X ~;>~lfl ~f(l?l[\~A1.'O 0 I~ ~~Io020 PHONE
o ·
OWNER W'\a.."'\ \'Yl t2.~. J a \'Y) "U..e...\ SO-MLJ\.. ')
\" 6
JOB LOCATION "S', \" tol O~\<$ - 1-'OJCtnoo.. ~".
LEGAL DESCRIPTION: LOT(S) to ~ BLOCK
~ 00-"'0 ;J- / &; j /r;
LOT SIZE~X 9o.J.JAREA SQ,FT,
C'. 0
SUBDIVISION':::::>~ , ve. r ,q Ks
PARCEL 1. D. #
WORK PROPOSED:~New Construction ____Addition ____Alteration ____Repair ____Install
_Sign/Temp.
PROPOSED USE: ~Single Family
_Sign
_Move
_Demolish
_M/F
_IF of Units
._M/H
____Commercial
_Indust.
____Swim. Pool
Other
BUILDING SIZE: to 0
_Restaurant & Health Department Approval
,,/ ~t(j/
r2~"1"i Square Feet,
x 5''' ,
/01
J
Height
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FOR~S.**
ATTACH (3) SETS OF BUILDING PLANS & 0) SET ENERGY FORMS,*'"
**COPY OF CONTRACT REQUIRED.
PERMITS REOUESTED
LBUILDING $ -<(~ I 7BJ../ 00 Valuation of Total Construction
~ELECTRICAL \S 0 AMP Service Florida Power Corp. _W.R.E.C.
~MECHANICAL $ ~ J 00. 00 Valuation of Mechanical Installation
~PLl~BING ~ _ __GAS ROOFING SPECIALTY
TYPE OF CONSTRUCTION: ~Block _Frame ____Steel Other
I 1_ I'
FINISHED FLOOR ELEVATIONS: /5.. 'C/pT.
******************************************
BUILDER J.. 0 112 C!!! #19
Si~~~
CONTRACTOR SE9~~
m"r22iA..C'0 Company I (}{)acJ.,tncM.J-!-iorne5
~ ~ State Cert. or Regist. # c....f&2-~ 2jD;;;J-/
~ ~'o<City License Registration jf ...397
********* ******************************
ELECTRICIAN Denise.. m, Vs a~ fe~A[O Company {l,11 f 1<=(1 +~,. c.
~ - /;? ~ State Cert. or Regist. 'I ete :!.ogo~.s'"
Sig ~ --Y;7- 7' /~~-co-- City License Registration # c2 ~
,~ ******q *********************************
Company
"------
Company \\t"\~~\-\lA.",'. Y\ d
State Cert. or Regist. IF ;€jtfC)t)/.-f"6,</(',
Ci ty License Regis tration:.! J D '7
****************************;"":;: * ,',* * **,,**,' * --,-~
Signature
OTHER
------
----
_ Com:e?_ill' ---- ..'
--~~or Regist. IF
Ci ty License "Regi-s--tx_a,tion ~F
Signature
----
PERMIT OFFIC~
APPLICATION APPROVED BY
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICT!ONS .
The undersigned understands that this per.it.ay be subject to "deed restrictions' which .ay be .ore restrictive than City
regulations. The undersigned assu.es responsibility for co.pliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they .ay 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 .ay be
cited for a .isde.eanor violation under state law. If the owner Dr intended contractor are uncertain as to what licensing
require.ents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Depart.ent, !B131
788-6611.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor!s) sign portions of the
"Contractor Sections" of this application for which they will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, ra~her than the contractor, are responsible for the work. 1f the contractor wishes you to sign
as contractor that .ay be an in~ication that he is not properly licensed and is not entitled to per.itting privileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE~
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - Ho.eowner's Protection
Suide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is so.eone 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 cOllencelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work will be done in co.pliance with all
applicable laws regulatiDg construction, zoning, and land develop.ent.
Application is hereby .ade to obtain a per.it to do work and installation as indicated. I certify that no work or
installation has co.tenced prior to issuance of a per.it and that all work will be perfor.ed to .eet standards of all laws
regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other govern.ental agencies .ay apply to the intended Mork, and that it is
'Y responsibility to identify what actions I lust take to be in cotpliance. Such agencies include but are not li.ited to:
I Departlent of Environ.ental ReQulation - Cypress Bayheads, ~etIand Areas and Environ.entaIly Sensitive Lands,
Water/Wastewater Treatlent
I Southwest Florida Water "anaQe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
I Depart.ent of Health ~ Rehabilitative Services. Environ.ental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
I US Environ.ental Protection AQeney - Asbestos abatelent
I also certify that, if fill .aterial is to be used in Flood Zone "A" Dr "A,etc.", it 'is understood that a drainage plan
addressing a .colpensating volule. will be sub.itted which is prepared by a professional engineer registered in the State of
Florida prior to pertit issuance.
A perlit 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 per.it prevent the Building Official frot thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every per.it issued shall beco.e invalid
unless the work authorized by such per.it is cOI.enced within six tonths of issuance, or if work authorized by the perlit is
suspended Dr abandoned for a period of six .onths after the ti.e the work is cOI.enced. One 90 day extension of tile, .ay be
alloNed for the perlit with fee charge of SI5.00. The extension shall be requested in writing to the Building Official. An
approved inspection .~st be logged during each six lonth period, or the project Nill be considered abandoned.
WARNING~TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO"MENCE"ENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
PROPERTY: IF YOU INTEND TO OBTAIN F. AMCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCE" NT. JOBS UNDER S2,500 I ALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
), ~a~"
STATE OF FLORI~~ ~ ~
COUNTY OF LV ~
The fDregoing instrument was a
befDr e this {l- \0 ,19
{Signature)
~ Q~,\ M
(Name Typed, P.
NOTARY PUBLIC
MARY MAZZUCa
Notary Public,Stale of Florida
My Commission Expires SEP 07 1992
SIGNATURE: CONTRACTOR
MABY MAZZUCO
Notary Publi':,Stat~) of Florida
My Commission Expires SEP 0'7 1992
~
ROYAL COACBMBH BOMBS
SAMUEL SAYER
6621 FOXHDOR DR.
SILVER OAKS
1,712 Sq. Ft. Living x $ 35
962 Sq. Ft. Other x $ 11
VALUATION: $ 71,000.00
Building: $ 563.50
Plumbing: 55.00
Elec. 66.75
Mech. 30.00
S1JB"J.'O!'AL : $ 715.25
BUILDIRG PLAIIS RBVEIW CREDIT: 80.00
PERMIT "l"O"I'AL: $ 635.25
CONHBC"l'IOH FEES:
Sewer $ 1,278.00
Water 350.00
Meter 165.00
"l"O"I'AL : $ 1,793.00
RADOR GAS: $ 26.74
Sq. Ft. 2,674
TRAIISPORrATION FEES: $ N/A
x 99%
x 01%
$ N/A
$ N/A
GRAND "l'O"l"AL
: $ 2,454.99
\ FORM'900-B-91
FLORID.A ENERGY EFFICIENCY CODE
. FOR BUILDING CONSTRUCTION
Section 9 - Residential Point System Method
Department of Community Affairs
Climate Z.9(1es
CENTRAO' 5 6
PROJECT NAME
AND ADDRESS:
BUILDER:
PERMITTING
OFFICE:
PERMIT
NO.:
S
4~ 50 60
~
NEW CONSTRUCTION tA IF MULTIFAMILY, NUMBER OF CONDITIONED ~sa GLASS AREA AND TYPE
UNITS COVERED BY [[IJ FLOOR AREA FT.
0 THIS SUBMITTAL CLEAR TINT.FILM,SOLAR SCREEN
ADDITION PREDOMINANT rn [QI
EAVE OVERHANG 2. FT SINGLE- ITW SO, SINGLE- [IITI sa
MULTIFAMILY ATTACHED 0 CHECK IF THIS SUBMITTAL LENGTH .' PANE F'- PANE FT
REPRESENTS A WO~ASE PORCH OVERHANG [M.~ FT DOUBLE- [IITI SO DOUBLE- [IITI sa
SINGLE-FAMILY DETACHEDKl CONDITION LENGTH PANE FT PANE FT
NET WALL AREA AND INSULATION
EXTERIOR MASONRY R = EXTERIOR FRAME R = EXTERIOR STEEL R = EXTERIOR LOG R =
~so. WJ.O [[IJJ] SO, m [[IJJ] so, m [DJJJ~' m
FT. FT. FT.
ADJACENT MASONRY R = ADJACENT FRAME R = ADJACENT STEEL R = ADJACENT LOG R =
[[IJJ] so. m.o ~~' [ill] [[IJJ] so. m [[IJJ] so m
FT, FT. FT.
CEILING AREA AND INSULATION FLOOR TYPE AND INSULATION
UNDER ATTIC R= SGL ASSEMBLY R = SLAB PERIMETER R = RAISED. WD 0 CON 0 R =
~sa, ~ [[IJJ]sa, m []]MFT rn [DJJJsa m
FT. FT. FT.
DUCTS
IN
UNCONDITIONED
SPACE R =
D&l~
IN CONDITIONED
SPACE R =
m.D
COOLING SYSTEM
i1 CENTRAL
o ROOM
o PACKAGE TERMINAL
AIR CONDITIONER
o NONE
@ER= ~.0
HEATING SYSTEM
o ELECTRIC STRIP ~ HEAT
o NATURAL GAS PUMP
o ROOM UNIT OR 0 OTHER
PACKAGE TERMINAL FUELS
HEAT PUMP 0 NONE
~~~~ [2: ~
HVAC CREDITS
o CEILING FANS
o CROSS VENTILATION
o WHOLE HOUSE FAN
o ATTIC RADIANT
BARRIER
o MULTIZONE
HOT WATER SYSTEM
~ ELECTRIC
o NATURAL (,AS
o OTHER FUELS
o NONE
HOT WATER CREDITS
SOLAR: 0 m
S.F = .
HEAT RECOVERY (CHECK) D
DEDiCATED ,..
HE:~P~MP: 0 . m
NUMBER OF r 1-:;]
BEDROOMS - KL...
EF = . ~~
INFIL TRA TlON ~ ~ CIZIZJ. [2J
PRACTICE USED X 100 --
o #1 00 #2 0 #3 TOTAL AS-BUILT POINTS TOTAL BASE POINTS CALCULATED E.P.I.
CALCULATED ENERGY PERFORMANCE INDEX MUST NOT EXCEED 100 POINTS.
red by the calculation are in compliance with the
DATE /~ A"- fz"
lorida Energy Code, a
ATE: I-~- /';2
Review of plans and specifications covered by tllis calculation indicates compliance with
the Florida Energy Code, Before constructio ' completed. this building , be inspected
for compliance in accordanc ,Sectio ,908, F,S, .
DATE:
Lof u'7 ~:r
';J~ m~o (l. ~. ~ u.-.b .
~~ \\teJ'" OA~~
hi \4n ~~
~5b.~
cJ-/~1 !3
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/- c;L>1-r~
...~~~'.'.'.'."'."~'CO--
~~V~ /-d-1-9,,~ I
e~~~
;;;';L ~ vo - 9' Z---
THIS SURVEY NOT VAllO
UNLESS EMFJOSSEO \\llTH A SEA
THIS STAMP IS REO
__.___..___ -1___ _._n.;..'_________
A SURVf V Of'
tOT 61 SILVER o.t.K,S PHASt ONe AS RECOfWf'O IN PLAT 100
PU8Ll C ~f('mws Of PASCO COlMY. r LORlOA LESS AltO EXC
PORTION THEREOf LYING NORTH Of EXISTING FENCl'; AS PE
RliCORVtO IN O.~. fll1S PG 0"4 Of SAlP PUBLIC
8l: ING , UR1Hf:R Vf.SCRIBtO AS FOLL~:
('OIMf:N('f AT Till: St1J CcJRNtR OF SAID LOT 61 FOR A I'M'" (
FEB-11-92 TUE
e.~37 R~YAL COACHMAN HOMES
~ ,-'
N, BNDY. SILVER OAKS - PHASE ONE _./
t os per pIal thereof) ,
borb WIre fence'.'
N8SC53'31"e: 76.27'
FIR ~3555 :J;.
1+
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- ..---.------.---.-.--..
~ARY SURVEV tJllV.
.fGAL VfSCRIPT10N WRITTEN
~ THIS OFfJCf (lOT .
URNl SHfO 8V CliENT I
JfARINGS BASfO ~ S '9 -19' .fO"t
"-*_......LI.'_dol.c r..$ _~.JJ .J:rikJAtN~V
P . a 1
~c. 3
'TWp.
112(~ I l S :rw
66
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.
HOMES
INC
February il, 1992
City of ephyrhills
Building Depa.rtIrent
To wham it nay concern:
This letter is to serve as authorixation for Ron Barr to pick up the penni t
for Lot 67 Silver Oaks for Royal Coachman Hones Inc.
," /7 ( .///"
/--'-;x/t:-uZZ; 6/\., 7' /rci~~ ~
L---// J ,/ 7
Loretta R. Mauuco
CBa21021
Sworn to and subscribed before me this 11th day of February I 1992
, NOTARY PUBLIC;: C C. 000
P.O. Box 5254 . Spring Hill, Florida 34606 . (813 862-2051 . 1-800-752-7 16
Iab\reports\feb92\9S91OS1 - 1
WILLIAMS & ASSOCIATES
EXCELLENCE IN ENGINEERING
12290 U.S. Highway 19 North, Clearwater, Florida 34624
Clearwater: (813) 535-9802 Toll Free: (800) 277-9802
Brooksville: (904) 799-8266 Tampa: (813) 228-7020
Jacksonville: (904) 765-6099 Toll Free: (800) 277-6099
DENSITY TESTS
CLffiNT: Royal Coachman Homes
JOB NUMBER: 9591051
PROJECT: VARIOUS BUILDING PADS FOR
ROYAL COACHMAN HOMES
PERFORMED BY: F. Mullins
JOB SPECIFICATIONS: 90% ASTM D-1557
DATE PERFORMED: 02/18/92
Test
No,
Location
Dry Unit
Weight
PCF
% Proctor
Moisture No.
Result
%
ELEV
Foxmoor Drive, Lot 67
Permit No. Not Provided
BUILDING PAD - bottom of footing
27 approx, 30' north and 20' east of the
southwest comer
0,0'
105.8
4,1
1
100
+ Retests of failing densities will be performed at the client's request. Retests may have been performed
prior to your receipt of this report. If there is a question, please contact our office.
DISTRIBUTION:
(3) Royal Coachman Homes
(1) City of Zephyr Hills
/
. ,II , ,/",
\ 'LA"
" ~ i: J Sr.'...
..,..\ " ........ q~.,.....
....- ... ....", "\ \ F J C ,.,.. 'J,;;, -:.
........"'''.4,....'..
. ..
PROcrOR NUMBER
1
SOIL DESCRIPTION
tan fine sand
3/28/81 IIrolcnpt
.-.... ',.. ' --....- _ ,...
,., .
.~;"''':'.:::.:,~ Wlllkrns & Associates, Inc.
;~....a'_ Gzok:-:cr'ncol Ecgreers
-'
Repcr ~NO 95 q iPS I __
PO>JA __ of ____
- -
A'tOJECT P:OY rn () ?!l..JLfJ______L=_~__n__.____ DATE 7 -' , '. -' '-7- ,-
,-
--------.--
CLIEKT r?:. 6 it? L C ot1c 1/rn'J,/j lIDV"') ,; ) TECHNICIAN )-::/) ....,
-.-- -, .. -~._--- .-p--",---,,---' - --
--.-........-.-.-...----..--.-- -- -- ---'"7"-"---=_c==cr=~
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-- - - '- --'= -:-:.--:- --=- =::-_~_u ~=
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i I _L!~!!LQf SA~1!,.IAB HQ~ _JAfTm____.____.___ --..---
~-'- ------,- ----- .-.- ---.--- ---.--- --- -- - ---.
\5 1 \1["HT Of mo USEO (LINE I . L1IlE 2 I __oK!::..L
Wo.I .-----..---.---.--.---- ----- --- ..-...._------ _... ..----.---- -....-+- - ----
~ ~-,-~!!eHT Of SAND TO fiLL CONE WIIH PLATE I J-~ r
~ tL/.i~ ---------- --- -'--------- '------- ------
5, IEICHT Of SAIIO TO FILL MOLE (UlIE 3 . 1I11E 4.1
- - E~OO"T~ J==C~
... S IEK:ltT Of SOIL FROII KOlE 0.7 r ~~
li ~
i .4 -,- -.__.,._____.._ _._.n___..,_._.,.___ .. ___ _.. _ _ ,,___
1, lET DElSITY ((lIll~IX~O ,LBS SAil{) CAl J II q, I
~ "tual __ ____h_,_ _____, ~_
& WATER COIIHHT "4 '.Ptedy C J ,I
-- -- - ~=~--------= ~~-~=-J .~O=~~=
9 DRY DENSITY (LINE 7 LINE 8 I 10) /Os.r
c ---- -..-----------.----.----. --
... -- ___._ ___4
c! J!...~OCl'~_ "Y~_,F loS~
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~ -_... ---- -
.... NEETS SPfClfl~f1f!l~~!~tJllf..EH~._________ Le~
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_'-EltHl Of COli!~~U m ~_~J_!RAllS ----..-----..-..-- ------ "_..___._ ._._.n_.. . ,-- ..._._._---< __ ,.,_u____..__u..
'" .-......-----. -..-.--.....---.
.... WE~T Of ~Tl.P.lf.Il . DIIY SOIL. CRANS
-
....
0- --_._--_._._~...._--- --~_. 1------- ------- -----._-- ----- --------.-
ft _.m~T (fi 'lATER. mlls_________..
.---.--- r-------, ------- ---.---.--
- IEICNT Of COfHAlllER , CUllS
..... .-- --_.- -- 1---- --- ~-_.- --- -----
... ----
iI WE leHT Of OIlY SOIL> CRANS
-, . ="'=='-~--==!-=" ., =T-;o~~---=~::='~ ------- ,- ~~
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'ATER COIITEIT . ,.
.-
TEST TITLE IJ LOt:: 1Jt1C> () r5-'2 II- 1'1/1'
10 , , IIllS HIRE (lY UNIT PROCTOfl PROCTOR
lOCATIOIl T~ICIIlESS El ElIATKJI CONTENT "4 .!LYCF NO "4
"'- 30 , ynov-'? -Ole
I - /') JO C ~ l.J C ortn6'\. 0- 0 if - / /0)'6 I (j,G
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DATUM {Jo rto ..') o r:~ FIJOf/1 c...-
10, -_._-.---- -.. __
PROCTOR DATA ClASSlflcmOI ~k' ~,,~
---------.--. _!1Ll F 1l00~T1aC~__
714-"1 Pj JDS<:(' H.7
---------. ..-
--.------- ----- -----
.
WAL - s001. 78
fIeld denSItIes, sand cone
worksheet
2tR..~j~~
NOTICE
OF
RESOURCE RECOVERY ASSESSMENT FORM
PERMIT II c2 / rl /
DATE 1;1- c:<I- r .-2
13
APPLICANT/OWNER ~AuAAPj7 ..f!.,rA
COUNTY PARCEL {I J- {)..~ -- ;;L/ - / .;L - 0- 6 7
LOCATION t 6;;(/ ....5~~~ .{O~
USE/CODE DESCRIPTION~v~~~
RESIDENTIAL
NON-RESIDENTIAL
ii UNITS
J
GROSS SQ. FT. (GSF)
RATE/ERU=$SO.OO X 0.96*/YEAR OR $0.131S/DAY ERU ASSIGN #
ASSESSMENT = (# UNITS)X($0.131S)X(NO OF DAYS) ASSESSMENT=(GSF)X(ERD)X(0.131S)X(NO DAYS)
100
TOTAL FEE = $
33~yO
TOTAL FEE = $
PREPARED BY ~SL ~ r 1.. 0 n ~
* DISCOUNTED OR PAYMENT
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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.
RECEIVED BY
DATE
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FOR OFFICE USE ONLY
RECEIPT il J 3 f .;:;>. S 1
DATE
2J-~) -9~
BY e ~Q~.l L,r. "CL,