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Home My WebLink About92-2486 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 -0 I, 15~ J ~ BUILDING - ()..o ELECTRICAL 61-0 PLUMBING Permit N<! 2486,6 7" / j-'lJ- Date .:20 MECHANICAL Sewer Conn - Water Conn: PmpertyOwne, W/~AJ$~~ ~,,(,.ita-$k.wate:Me,., -_ Job Address: ,..g 9 '5" ~ - a . T.I.F-~:DD /~ 69tJ "7-IO-<}~ , . Parcell.D. # /t)-:a~ - .2./- bO- {;1 - ::J.... ~} 1rS Zon;ng' '7<- 4 Ene'gyCode,. AadonGa" . q~ Qat NO OCCUPANCY BEFORE C.O. FINAL I - l.- DATE C.O. ~-/{)- DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. Valuation or t 4UJ Contract Price ~ D.:J.., VOO' -- City License Registration # 2. 5'5" ;1 J..M . S te Certifie.d Lice se# (! 13 ~ 0 ;g, .54(/ or Permit Fee Signature Company Address Telephone# Ftr. Pre SLB Lintel FRM. Insul. CL WL SLB Tub Set Water Sewer Tp. Servo Rough In Meter Can =h; Const. Pole 7- Z I-qz . f) Pool ~ J~I Pre-Meter I /1--12- ~.P- Final Driveway Q,,'l<:i: ME C H A N I CA #..s::}.--- Breakers Ducts Insl. Compressor Final W. tf~,.:r ~ · 1').- 1-7-12.- /0. It, 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 inade for each trip for each trade: ?e::26 ()S"/3 .26 bD t3 ,273/ 1'1 ..2. /3Y? JS "J..l r'll'1 The payment of inspection fees shall be made before any further permits will be issued to the person owning same. a. b. c. d. e. f. g. Wrong Address Condemned work resulting from faulty construction. Repairs or corrections not made when inspection called. Work not ready for inspection when called. Permit not posted on job site. Plans not at job site. Work not accessible. <6.20-- q1- ~t l~ P"'ft.....r loLv-c.> q-Io -(jl- J."i2 ~ ~ IO-dj/~l- /)/~mdln /1-/1--92 )I~7io-p /&;08 K3'ilI ~X/ J1t1l .APPL'ICAftft. .. l"mtHIT CITJ' OF jUr,nu-..nJ-S BUJ:J.D1JIC DEPMI1I1:101I.1 DIIIIER '8 IIMII University Park Convalescent Center ~ 813~977-2622 IF. , ....8 ADD-'" .11731 Northr)5th Street, TAmp,a, Fl. 33612 .Joa ADDIUfSS 37815 15th Ave. WestJ. Zephvrhills, Fl. LEG\L DBSCIIPI'I.: tm(S) PAlCIL 1.D.' 1IOItK PROI'08IDI----.JIev C088tmcticm. -MdiUon ----..UteratiOll' ...:.--l.epair ~IVISIOI Tn-ull -lii8D --.JIove ---J)eMlish 'PRftPD.4lg ".1 staate haUy ;. Hip _' of Units --,,'8 _CGMereial T-'-t. _SViJl. Pool other --t.eunl1lt a 8ea1th ~t Appmval. BUIUJDG SIZII :x . Square Feet. Ueipt .1tBSIDmttIALl AftACJI (2) PIm PUlIS It (2) SEIS OF ItJ1IJ)DIC PIAlIS , (1) SEt IlIIRCY POItIIS. *. COItIIIRCIAL I ATI'ACII (3) SBI'S OF BUIJ.D1* PIMS I: (1) SEI EIIERCY fOIttS... ..00f'f OF mftIAcr IIQUDIID. ftMl'I'B ..mttB'l1m ~UI1.D'IIO "20~.917.60 ValuatioD. of Total Omst.~tion Rf."RcrlI1CAL AIIP 8erviee Plod.... PoYer Corp. W.R.E.C. ~CA1. ~DG .. YalaatiGll of ~ica1 IDstallatioa GAS JDJI1lIG SPItcIALft . nPE 0' COID.dWGnOllI __..JIlodt ~ _St.et!!l otlu!r PDISBED FLOOR EUNATIOIJS :~ Ft. IS PIID.JECr U noon ZOIlE AREAt , . .......................................... "DS RO '1J"-I.DDl_...QllrAJl'f Classic Homes & Development, State cert. or Regist.. f CB CO 3 6 5 4 9 Sipat:ure City Lic:~e ReRis'tratioa . :.:-= . ~' A"'__A7:~7JZlf~-, .--7: . State cei-t.. or Reg18t..., . / llkf. . cit;y Li_ IIetllst..U... t ,C; fL- ....................................... . PUllBER ~ ~ IDIlUY ~UIE~ Qlu.t-<b, p~ //1 A 1. ; E S Sbll:e Cert. or Reai5t. f CFCO'3 . c:;, S~ Sipat:u.r:e ~ f v~ city l.icenae ReAistratioa . **..............*............."'*~..:~......... '- _c.u. ..----:-- --,~ fj{~ - /D!f / State cert. or Re~st. fa SiRDAlture LJ. ~ City License Registrat.ion , S"s ~ ~...................**... . ... ..***... ...... ::1nre^^J,-z /()~a; ~. .. ~~O~ii:''':=~':'':= , ~ ~~A~~........A...........A.~.. . I . APPLlCAUu. hfllCu.. BY PERIItt OP'FXCBR. JDP"'RAeMIl SEf;J'IoiI Inc. - = . CONbITIONS OF PERMIT A~FIOAVIT A.~rJCE OF DEED ~~STRICTIONS _ Thl underll.1Id Unf.,...ndl thlt this ,erlit .., bf lubJlct to -d"d r,strlctlon,. which IIY b. 'Or. testrictive thin City tltaSlll'nl, T~. uftd,r.l,ned ..Iu.el responsibility for cD.ptl,nt' with Iny .ppll,.ble dlld reltrl~tlDnl. . B. UNLICEN$EQ ~DNTRACTORS AND CONTRACTOR RESPONSIBILITIES If th. 'Wfter.bl' hlr,' I contr.ct.r or contrlctor. to und.rt.ke work, they IIY b. r!qulr.d to b, lic,nsl' In Iccer',ne, .Ith stlte Ind IICII Tfgul.tlons. If thl refttrltt,r is, not licensed as requir!d by I'M, both thl ownlr Ind contr.ctor .ay be clt.d 'Dr. tlsd.IIIDor .iDlatlon Ind.r Itlt. 1'1. If the oln.r or Intend.d cont~.ctor Ir. unclrtain ., to 'hat JicfRllnv rfqulr..rntl .ay apply f.r th. Intended IOrk. th.y arl Idvlsed to contact the City Df 2.phyrhlll, Building Depart,ent, (813) 788-6611 . . Furth.r.orl. If th, otntr hi' hlre~ . contrlctor Dr contrlctor., h. II advised to hlv, the contr.ctor(s) sign portion. of the "Contrlctor B.ctions" of 'hiS .ppllcltitn for which th.y .ill .t rI5pon!ibl.. . If YDV, II th. owntr lion al the cDntractDr, you Ir. Iftdie.t1nt th.t you, rlther than lhl con'tactor, are rl'ptnsible fDr tht .ori, If the cDntrlctor IIsbes yov tD s19n II contrlctor th.t la, be In ladlcallon that h. I. not properly licens.d and 1s not t~titlld to ptralttln, prlvt!egls In lh, Clt, If Z.,h,rhllll. C. TRaNSPORTATION IMPACT .~~~S AND UTILITY CONNECtION FEES o. CONSTRUCTION LIEN LA~ (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I cfrtlfy 'hi' J, th. I,pliclnt, hlv. b..n proyid.d 11th. copy Df 'Floridl's Conltruction LI'n Law. HOI.oMnfr'. Prottctlon BUid'- pr.p.r.d ., 'h, flDrida Departllnt"f Agrlcultur@ and Conlu..r Affairs. If thl .ppliclnt II ""Ont oth.r th,n th. .Dwnlr', . clrtlf, 'hat I hi" I',ained . cop, of the Ibo,. delcrlbed dotu..nt .nd prolll. In 100' filth to dill,., I' to t~. "ownet' pri,r t. C"lencllent. , E. CONTRACTOa'~(QW~ER'S AFFIDAVIT r clrtlf, th.t 111 thl Inferlltleft in this ."Ile.tlon II Itclratl Ind thlt III wa'~ _111 b. don. In to'pllant. with III IppltClb.. I... ,..ul.tlnt construction, zoning. and land dlvllop..nt. · ApplJcltltft II h!,.by lad, to obt.ln I p.r.it to do IOrt .nd installatlen .. indlcat.d. I certify thlt no .ork or instlllltiDn hll cOI.enced prior to ilsuanee of I per'll and thlt It 1 MDrt will bl p.rfarlld to leel st.ftdatds 0' ell llw, rl9vlaling construction, tit, tOd's. loning "Qullllonl, Ind Ilnd dlYltlpl!nt r!gulations In 'h. jurisdictIon. I 1150 e!rtify th.t I und,rstand thlt th, rlgulltionl Df Dlh.r govern..ntat Iglnei.. Ily Ipply to th, int.nd,d IDrk, Ind th,t it is IY r'lponslbility to id.ntlf, wha' 'ctlonl t lUll tlk, to b, in cD.plilnce. Such agenci.s lncJud. but .r, nDt ti.it,d tOI , OeDar...ft' Df ~"YirDn~nl.l RIDulatlon - Cypress alyhllds, Vetland Artal and Envlran..nt.1Iy 9,nllllve llnds, U.I't/N.steMat,r Trlat~ent · SDvtb~llt Fllrl'. Vatlt ftl~t.tft'JPllttlct - N,lll, Cvpress B.yheldl, V.ttand Ar.al, Alt.rin, lal.rtaut... t Ar.' CDrDs of EftGln'lr. - S....lls. JOtta, MI.1o.ble N.terwlYs . · ~'Dlttl'nt of Hlllth , Rlh.billeltlv, IIfVicll. Envlron'lnt.1 Health Unit - Weill, Wllte"lt.r Trllt..nt, Stptic Tlnks · US Eny'r'"lental ProtlC'iDn ADentY - A,b"'DI .b".I.nt t IIII t.rtlfy thlt, If fill 1.'.rl.1 II ,. b. u..d In Flood lon' 'A' or 'A,.tc.", It II undlrltaod thlt I drllnl,1 pl.n addr'!I!n, . Ico.p,nlll1ng VOlUllI will ., lub.ltlld which II p"plr.d by . profesliDnll Intlnllr r'9ilterld In thl 911tl Df Florid. prior t. ,.r.'t 1.luane.. A plr.lt 1.luld Ihlll be eonstru.d to b. I llc.n., to prDclld lith th. Hork and not II lulhDrlty to viol.tt, tlnc,1 'It.r, or ,.t I'id. .ny prDvlllonl of Ih' t.chnlcal codls. ner shill il.ulncl of a p.rllt prevent the Bulld1", Of lie I. I f,o. thlt.aftft requiring. rorrlCtl.n of ,rrOfS In pl.ns, construetioft, or .iolltiDns of Iny cod,. EVlry p.rlit il.uld shill hICOI. in,alid unit's thl IDrk luthDrllld by ,uch perlit 11 cDllfncld lithin six .onths of lssuance, or if lork autbori!'d by the ptr.lt is SUlptndtd Dr Ih.ndDned for I "riDd of Iii .onthl .ft.r th' tile thl ~Drk i. cOII.ne,d. One 90 day tlt.nslon of tl.., "y bt IIIDI'd fDr thl p.r.lt " f.. chlr,1 0' $15.00. The eltensl.n shill bf reqvested in Iritlng to the Building Officill, An ,pprDv.d inlp'ctl ~.l b. 10 d during lath .1. .onlh ptrio', or 'hi proJ.tt will b, consld,r.d .blndDn.d. . N~RNJNS TO OU I YOUR F~ILUAE f RECORD A NOlIC' OF CDftftENCERENT RAy RESULT IN YOUR PAYING TWICE FOR I"PROYE~NTS TO YOUR PROPERTY. Y INTEND TO DB FINANCING, CONSUlT VITH YOUR LENDER OR AN AT E R~CORDIN8 YOUR NOTICE OF CDMMENtEIIE . O' VALUE DO NOT NEU TO RECORD AM& PO · J "IiNT". DrAU Of!' FLORIDA D COUNTY OF 'V ~ L Th. 10r"901n9 l~~ wa. ac~.n owledged bltfore Ill. thh , 1?~ by ~x~~~ who 1. p.raonal1y known to m~ or who ha. produced ~ .. ld.ntlfic.tlo~ and who did/did not tak~f)1 ~ (Slgnatur.) STATE OF F~ ' tOWIlY O~ ~ The 10regoin9 instrumtpt bcfc4re Iftlt th i. "Yl wa. ac lenow ll!dged , 19~ by who 15 person,l V fenow" tt;'~ or who h.. produc:ed as identification and wh~ .~d/dld not take oath. - ~ ~. ~::;N: 4115. PICL.I FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION Section 9 Compliance Program - Residential Point System Method Version 1.0 January, 1992 Department Of Community Affairs Printout generated by EPI92 and submitted in lieu of Form 900-A-91 THIS COMPLIANCE FORM IS VALID IF SUBMITTED AFTER JANUARY 1, 1992 ........-.------.....------.-...----...----.---.-----.----........---.-.---...------..------..-..-..-..-------------------------------- PERMITTING OFFICE: Z FT' f-I Y rn.1 I Ll_ ~3 ~..; I:.:: ";:' ~ ~ ~;::~;. -- ~~; ~~ .~.-- - -@--;-- - ~ - - - -- -.- '<CJ,TF:cr N('~lvlE:: ~::;E::F~F:N Ir Y WE~::;'r ~D ADDRESS: 37815 15TH AVE ZEPHYRHILlS, FL 33541 .i I LDE:F~: 1:3013 lAF~K I N UNIV. PK. CONVElESCENT INC. Ji';[R :: PE:I:~[1 I'r NO.: 24861:3 JURISDICTION NO.: --~.!!_.~-~._Q_._- ....__._._-_..._-----------_._-~_.._--------_.__.__._.-..--.--.-----.--...----....-----..---.-.----------------------------- DIMEN~:;ION:: VALUE: RATING: VALUE: OFFICIAL CHECKLIST :)['lPONF:N'r: iRuc'rUF~[ TYPE: i'lult i'-'Fami ly : ,,:E:DOl"l I NANT EVE: ."I:<C\...I OVE:f~HANG I r\1DOW~::; :;1. nqlc~ Clc~ar ('Ill Vey.t ical (Ill ~::;kyl iqht (lL.L.~::; Ext E:xt I::/t i:xt C! U f~ ~::; :It- of uni ts OVE:r~I"'IANU L..enS;lt h:: L.enqt h :: 1 WORST CASE REP. ;::' .. 00 ..00 G.l.aGS (....1 .:4.. i3.~)t) Wood Wood Wood Wood F'y' ame Frame F,' ame r::y'ame Ixt InE;u.l.at(-ld I::.xt I nsu 1 at ed I::xt I nsu 1 at ed i J 1.... I NG~::; ::I...I,-,\'r Und~::.:y' At t :1 c Cl U r~ ~::; ~; J ab.....on.....Ciy. a.de .:c>r~:; Unconditioned Space !() I.... I N G :';f:~nt " a lAIC Multizone: Credit firING ~::;t Y' i p 1"'leat Multizone: Credit !.lr WATER Natuy'al Gas >11' I L. TF~A'r I ON Conditioned Floor (~~:; 13U I L'r PU I Nr~::; 1 H/ . :>1:::; .. 4.4 Total Total Total ()r ea AY'C':i:1 Ar (:~a '1 E);? .. 00 <) !::i ;'? .. 00 ..00 Ay'ea: Area: Ay'ea: AY' ea : 1 HOE; .. 00 r~'-'Va 1 :: :3:::'0.. 00 F~-"'Va 1 : :::;;::>0 .. 00 r~"'-Va 1 :: 1 ;::~40 .. 00 1:~""'Va.l: 11.00 11 .00 11 .00 11 .00 Ay'c.)a :: AY' ea : An3a: 4:::'..00 ;:':~ 1 . 0 0 :::'1..00 An~a : 30 .. 00 F~'-"Va].:: 30..00 PeY' i mClt c~,' :: 560 .. 00 F~'-"Va 1 :: ..00 L..enqt h A 1... L_ F~-"Va 1 : 6.00 ~::;[[F~ : 10.00 ~::;'rl==< I P : 1 .00 EF':: .66 E3edY'oom~3 : ::32..00 A'( ea : ')600.. 00 p, act :: 1 I E3(1~:;1: PU I Nr~::; [PI -x 100 ;':': :;~ f:., ,:::' '? <) .. 4 H 82.74 GL.ASS TO FL.OOR AREA RATIU . 0<)9;:~ , Hereby certify that the plans and pecifications covered by this ca.l.cu- : J.t :ion a,'f~ in compl ii:~lce w:i.th thc~ : 'orida Energy Code.. : ~ I I )::; '-'\ r F D F3 Y .. . I i":" ~=~-~.;fJ7i:J~.C====-~====:: i I '1 I 1 I I I 1 I I I Review of the plans and specifications covered by this calculation indicates compliance with the Florida EneY'qy Code. l3efore constY'uction is completed this building will be inspected for compliance in accordance with Section !::i5~:l .. ')OEl F.. S . h(-"~n:~by .\?~)rt i fy that t his bu i1 d:i nt.j :i. B ",j;';(:~mp.l"idnce W~ith t~'he F::loY'ida E~ney'gy :'ll (<,I Mil :'I'JT : 0CJ-.. ! :: .... .-:../a......z.. .. qz.- ..... -. uom..._. .... . 8lJIU1ING OFFICIAL~~___ [) ('II .............~O..:::-:.~.:::::......:~.......... ..... .........._............... ..... ..... ~**x~*x~x*x* XAXXX~' AXXX*X** ,\ '.;<.-}( .}{....:.: '. <><'\:K){ :A. X -j( ,< -)(- ':i>, x -)( -)( )( -x :", 'f; 'X :xc .K -x x .\: x)( 'X .1( :~)( X -x .K ;/ SUMMER CALCULATIONS xxxxxxxxxxxx**xx**x-x-xxxx***xxxxxx**xxxxxxxxxxxxxxxxxxx***********************x === BASE === === AS-BUILT === ..................-..-.........--...--..-..-...........--.-.--.............-..---------.................-..----......-.-..--.................-..-.....-.-.--......------.--------------.---.---------------- :..._...___.....________.____._.._.______...___.._._______.__.._._._.._._..._......._______..............__..__..___.._.._______M________________________._ ~LASS---------------- ORIEN AREA x BSPM = I I POINTS : ~::;C Ol~ I EN AREA x SPM X ~:;OF:- = PO I NT::; 1'1 "760,,00 47.El 3632B.0 ......------.-.------------.-.--------------.--.-----------.-----.-.-.------------------------------ TYPE ;..~ ~:) 1.'12,,00 '10,,'1 1./452.8 ~::; [~ 1... CL..I:~ N 40 ,,0 51 .0 .88 1792 .'1 SCL.. CL..r~ N 40 ,,0 51 .0 .BEl 1 79:~ .9 ~::;CL.. . CI._I~ N 40 ,,0 51 .0 .88 1792 .'1 ("'('1 CL.r~ N 40 .0 51 .0 .B8 1792 .'1 .::> :. .u ~:;CL. CL.R N 40 .0 51 .0 .88 17'1;2 . 'i S(~L CI_I~ N 40 .0 51 .0 .BB 179:;~ .'1 ~;Gl... cl._r~ N 40 .0 51 .0 .88 1"792 .9 ~::; C~ I... C 1... r~ N 40 ,,0 51 .0 .88 179:-2 .'1 ~::;CI.... CL_r~ I'J 40 .0 51 .0 .88 1792 .9 SCL.. CL.I~ N 40 .0 51 .0 . f.3B 1792 .9 ~:;bl.... CL..I:~ N 40 ,,0 51 .0 .88 1792 .9 ~::;UL. CL..r~ N 40 .() 51 .0 .88 1792 .9 ~::;CiL cl....r~ N 40 ,,0 51 .0 .BEl 1792 .9 ~::;GI.... CL..r~ N 40 ,,0 51 .() .B8 1792 .9 ~::; C~ 1... cl...r~ N 40 .0 51 .0 .88 1792 .9 ~::;CLu CLr< ~~ 40 ,,0 51 .0 .BB 1792 .9 ~::; (~L.. CI...I~ N 40 ,,0 51 .0 .88 1792 .9 ~::;C~ I.. CL..I:~ N 40 ,,0 51 .0 .B8 1792 .9 ~:; C~ 1... C 1... r~ N 40 ,,0 ~.i 1 .0 .BB 1792 .9 ~:; b 1... CLr~ C~ 12 ,,0 100 '-' .'19 952 .6 ....J . .:::' ~:;Gl... CI....I:~ c 1 ,.., .0 100 '~.. .79 952 .6 ...:) .L . "- ~::;UL.. Cl...r~ ~::; ] r:.> .0 100 .. :~~ .79 952 .6 . L.. ~:;CL. CL.F~ ~:; 1 ;? ..0 100 It :'2 .79 952 .6 ~::; r~ 1... CI._F~ ~::; 1 r:.> .0 100 .. :2 .79 952 .I:.> . "- ~::;CL. CL.I:~ ~::; 1? ,,0 100 ,-) ."79 952 .6 .. ..;:- ~::;CL. CI....I~ ~::; 1"" .0 100 ") . 7'1 952 .6 L ..,:... SC:lI... CLr~ ('" 1 "', ..0 100.:2 .79 952 .6 .:> .L ~::; C~ 1.... CL.I:~ ~::; 1 ;~ ..0 100 " .79 952 .6 N.t::' c'C'1 C 1... F~ ~::; 1 r:.> ..0 100 .. :::':~ .79 952 .6 ..:) :A __ L. ~:;tJL. CI....I~ ~::; 1 ':.> .0 100 "") .79 952 .6 ,(;., . ..... ~::;CL.. CL.F~ ~::; 1 ;::~ ..0 100 ..:2 .79 952 . c., ~::;CL. CL.I:~ ~::; 1 r:.> ..0 100 .. :~'? ./9 952 .6 . ^_. ~::;GL. CL..r~ (..~ 1 "., ,,0 100 ..:2 . 79 9~)2 .6 ~::) .:::. ~::; C~ 1... 'CL..F~ ~::; 12 ..0 100 ", .79 952 .6 ...,c;:. ~::;CL.. cl...r~ ~::; ] r:., .0 100 ." .79 'It:: r, .6 . L.. ...,c:: ;:)",::, ..........--..--...-...-------------..-.-.-------------...----.-----..--------------.---------------------------- "15 x COND" FL.OOR / TOTAl... GLASS = ADJ" x AREA AREA FACTOR (~I.... (.j ~::;~::; PD I NT'~::; ADJ GLAS~) POINTS GL.ASS POINTS " 1 ::; 9.600.00 95:? .00 ..........-........--.....--...---..-..-...--...---.................-..-.---------.--...---.-..-.-..----..----.--------------------------------- 1 .51:3 5J./UO.UO B1.349..11 : 49.306.(33 ...:::::::=:=====:====:::======::::::::::::::::==:=:=::=======:::==::::::::::::::::=:========:===:=================================== NON Gl...ASS~----------- : AREA x BSPM = POINTS: TYPE F~'--VAL.UE AREA x SPM = POINTS .......-...-.-..---...---.------..-..........-.......--..._._-._..._-------_......._.._~--_.__._-----------_.._--------------------------- ~ALl...S---------------- xt 36UB.0 1.,,0 368B.0 JOORS---------------- xt B4,,0 4,,8 403,,2 CEILINGS------------- UA 30.0 ,,6 18.0 LDORS--------------- ; 1 b 5f.)0 .. 0 -31 .. 8 .....17808.0 lNFILTRATION--------- 9600..0 10,,9 104640.0 Ext Wood F'j'"ame Ext Wood Fy'amc E:xt Wood F'y'a.me E:xt Wood F'y'ame II ,,0 1liOB.0 1 .90 34::35 .2 11 .0 ::l20 .0 1 .90 6CH3 .0 11 ,,0 320.0 1 .'10 60B.O 1 1 ..0 1240.0 1.90 2356.0 42.0 4,,80 201 .6 :~ 1 .0 4.80 100.8 21 .0 4.00 10O.B I::.xt Innulatf::~d I:::.xt InE;ula.ted Ext Innulatc-:':d Urldur At tic 30.0- .60 -18.0 30.(1- ~::;]. a.b..h.on....(;~Y. a.de .0 560.0 -31.90 -17864.0 Pro act i cc.~ :U: 1. '1600.0 13.80 132480.0 ::::::=::==:============::::=======:::::=========::::::::=::::==:==::::===:=::::=:================================ OTAL SUMMER POINTS : 1./;;;:' .;?9Cl ..:-31 : .......... ..... ..... ..... ..... ..... ..... ..... ..... ..-. -... -.. ..... -... ..... ..... ..... ..... .-....... ..... ..... .-.. ..-..- ..... ..... ._........_.___.._............._._w_.___..__..._...._................_..._.____.__........... 1? 1 ,351 . ;~3 ............. ..................................... ............... .. .............................................-..................-...... ...--...---.--...-.--.-..-.-...----..-------------..------- .....-...-..-----...------.------..-----------..------ Jl (11... x ~::;Y~::;T.E:M ;UM P'TS MULT ............. .~.... ............ ... f ?;.? .2'10 ..31 ..37 COOLING : TOTAl... x CAP x DUCT x SYSTEM x CREDIT = COOLING POINTS : COMPON RATIO MUl...T MUl...T MULT POINTS 63./4"7,,42 :1."71. .351 .23 1...00 1. ,,100 .340 .900 57,676.82 :::::=::::====:====:========:==:=========:==:=:=::==::=:::::::==:=:::::===:::::======:========================== ',:--: AA AAAfiXXXXXXXXXXXXXXXXXX*XX GJ.I. ;\:11::1< C(~\ICIJi..(lr J UN~; YXx*xx***xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxXXxxx*XXXXXxxxxxx****** === BASE : === AS-BUILT === ~i.,..A~~;~;-M__-----'-'------_'-'M---- ..__.___.__......_____.M.................._......._........_......_._._....___.._....._...._..........................................-. ............_...__......___.._._..........__....._._.........._......................._._..._M.____...._..........._....-....___.............. .................................._.......M_.._...__........___...______....._._______.________.. .........._..........._.__....M.._._..___._______________.._..._____________ RIEN AREA x BWPM = I I POINT~; : IJ 760,,00 5" 6 ij.>:56 ,,0 ;..) 19:?"OO --,14 ,,0 --;?6HH .. 0 TYPE: ~:;c UF~ I E:N Af<EA' x WPM x WOF :::: POINTS ~::; (~I... CLI< N 40 ,,0 9 ,,6 1 .07 41 :? .. :'? ~:;(:jL. CL.I< N 40 ,,0 9 .6 1 ..07 41 :;:~ ,,,) .....:.. c'C'1 CL.I~ N 40 ..0 '1 ..6 1 .07 41 :2 .2 ~:> :;1 .... SCiL. CL.I< N 40 .0 9 .6 1 .07 412 . ~~~ ~=';CL. CI.._I< I'-J 40 ..0 9 ..c:, 1 .07 412 .. ;:~ ~::;CI.... CL.I< N 40 ..0 9 .6 1 .07 412 ';> ..J.... ~::;CL. CI....R N 40 ,,0 9 .6 1 .07 41:2 ,.:) . ,- ~::;Cl.. C 1... 1< 1\1 40 ,,0 9 ..6 1 .07 41 :? .. :':':~ ~::;Cjl... CI....R N 40 .0 9 . () 1 .07 41 ;;;~ .. :~ ~:; (:~ 1... C 1.... 1< N 40 .0 ;;:; .6 1 .07 412 r, .L ~::; (';1 I.. CI...I< N 40 ..0 9 .6 1 .07 412 ") . J.:_ ~::;hL. CI...I< N 40 ..0 9 .6 1 .07 412 .. ~':':~ ~:;Cl... C I... 1< I'-J 40 "C) 9 .6 1 .07 41 :.:~ ,.... .."... ~:;bl.. CLI< N 40 ,,0 9 .6 1 .07 41 ::~ ., :':':~ ~=';bl... CI....I< N 40 .0 9 .6 1 .07 412 r, . .c::' ~:;CI... C I... 1< N 40 ..0 9 .6 1 ..07 412 . :.~~ ~:;CL.. CI..F:< N 40 ..0 9 .6 1 .07 412 .2 C'C'I CL..I:< N 40 .0 9 .6 1 .07 412 ", ~::) :;i _.. . ...;:. ~::;hl.... C 1... 1< N 40 ..0 9 . () 1 .07 412 ") ...:.. ~:)CI... C 1... 1< ~::; 12 .0 -10 .9 .H5 -1 1 1 r) . Lou SCL C 1..1< ~::) 12 .0 "-10 .9 .H5 -1 1 1 . :~ SGL CLR ~::; 1 :;~ .0 -10 .9 .85 -1 1 1 ..., . ,,::. ~=';CiL.. CLf< ~:; 1 ''', ..0 -,,10 .9 .H5 -1 1 1 .2 .L ~':;CjL_ C L..I< ~::; 1 ,-.> .0 ,-,,10 .9 .85 -11 1 .2 ..:.. ~::;CI... CI..I< ~~; 12 ..0 "'-10 .9 ..H5 -1 1 1 .. ;:~ ~~;CL. CL.F~ ~::; 1 ;? .0 .....10 .9 ..B5 --1 1 1 ") tf,(:.. ~::;UI.._ CL.F~ ~~; 1 '''.' .0 .....10 .9 .05 -1 1 1 ", ..:.. . "- :::;CiL. CL.I:< ,-, 1 r:.> .0 -10 .9 .05 -1 1 1 . ~~ ~:) k.. ~::;CL. C I.... F< ~::; 1 ~':~ .0 '--10 .9 ..B5 -1 1 1 r.l . ~- ~~;CI._ CL.I< ("~ 1 :? .0 .....10 . '? .H5 -1 1 1 . ::':~ ~:) ::;hl CI.F< c 12 ,,0 '--1 D ('" .05 -1 1 1 ,,,} ...J . j . ~- ~::;hL C::I...I~ C~ 1 :? ,,0 "'-10 ("I . 13,<5 -1 1 1 .. ::'~ ~..) .. 7 :::;UL. CL.H ~::; 12 ..D '--10 ("'1 . t35 -1 1 1 . ::~ .. 7 ~::;C:~L. CLF< C~ ] r:.> ..0 -10 .. <1' .H5 -1 1 1 ,,,) ~..I .. ,c,_ . ...:- ~::;Ci I... C 1.... 1:< ~::; 12 .0 --10 .7' .H5 -1 1 1 . :~ 15 x COND.. FLOOR / TOTAL CLASS = ADJ.. AREA AREA FACTOR v ^ Cj L. A ~:; ~::; PDINfS 1 i::; 9,60D"OO '15;?..00 ............---------...-----.--..................-...-..-..-...-...-..---...--.---...-.-..-...-........---..-.-..-......-...-.-.---..--.-----..------------------.---.- .........____..__M_.._._____.._.._.._......._......._._..___.._.____.._..._.._.._......._......___......___._.__._...__._________________________________ ADJ ULAS~) PO I NT~; CiLN:;S POINTS 2,371.76 : 6 ,052 . 16 1 ,,513 1,5613.00 ;ON GLASS-~---------- : AREA x BWPM = POINTS: TYPE ~LLS-~-------------- xt 3688.0 1..1 4Cl56..B 'I U 1< ~::; .----.---,--- --- -.--- _m..._ _m -.- \t 84..0 5..1 42B.4 ILINGS------------- ,<:'; :::~ () .. () .. f) 10.0 ~LOORS--------------- 'lb 560..0 -1.9 -1064.0 lNFILTRATION--------- 9600,,0 4..1 39360..0 I I : Ext : I'::xt : Ext .: L. x t; I I i I I I I I I I Wuud Wuud Wood Wuud F"r ame F',ame F"( am(::~ 1~:Y'ame I~-'-VAL.UE AREA x WPM = POINTS Ext Insulated E::xt In~3uli:">,t(.:)c:J Ext Insu.l.ated Uncle, Attic ;::; 1 i:">.b.....on.....CjY. adc~ Py'act ice ~fl 11 ..0 1 nm3 .0 2.00 3616.0 II .0 :='l20 .0 ;"2.00 640.0 11 .0 320.0 2.00 640.0 11 .0 1240.0 2.00 2480.0 42.0 5.10 214.2 :? 1 ..0 5.10 107.1 21 .0 5.10 107.1 30,,0 30.0 .60 18.0 .0 560.0 2.50 1400.0 9600.0 6..20 59520.0 ::::::::::=:==:===:==:=:===:==:::::=~::====:====;::::=::::::::=::::::::::====:=:::===:::=::================================= .UTAL WINTER POINTS : 45,170,,96 : 74,794.56 :::::::~:====:::::::;======:=::=:~==:::=====:====;:::::::::=:.............................-..-.-:=::..:::::::::::::;:::::==::=:::::::::=====:======================== 1)1 AI.. x ~::;YSl'FI'1 I f-1 p'r~::; [vlUL.l' ..... ..... ..... ._ _... .... .". .... ..._ ..m .._ ..._ .... <j.::i ,170 ,,'16 1..10 HEATING : TOTAL x CAP x DUCT x SYSTEM x CREDIT = HFATINC PUINTS : COMPON RATJU MULT MULT MULT POINTS ...........-..-..--.....-.--".----.-.--...--.-.-.......--"'"......-........----...,... ...............--.-..-...--.-.--..-....---.-..-....-........-.-............-...-----.... 49,6HH..06 : 74,7'14..56 1,,00 1.100 .900 74,046.62 1 .000 ........................-.--..............-------.----------------------- ............-................-..-..-.......-------.-------.--------------.--- XYXX*X****X******XXXXXXX***XX**X**XXXXXXXXXXXXXXX****************************** === BASE : === AS-BUILT === .........................M..""......._...M......._..........___...________.__..______ .......................--.....................---.--..-.---..-----------.---- l'.j U [v1 U F d F: U r~ rv1 ~::i x rvlUL.r rurr;L. r r^1NI< IvIUI.Ulv'IF IF 'r (1 Nf< r~A'r I U x MUL.T x CF<F:D I T MUL.T :::: TOTAL. 3~0:' 3527.0 112,864.00: HO .6(:) 1.000 1735.0 1.00 55.520.00 .....---...-...----..-------.--.-.--...,......-.--.--.--..........-------...-..--...............----..............................-,..-.-.------.---.----------------------------.-- ..............__.....____.._.._______._......._._..___.._.__...____~___.___.__.____..__....._..._..........___.._______..._________M_________________________._ ***************X******************XX*XXXXXXX*X********************************* ~::;UI1M{iF~Y ~x***************x*************xx*xxx*xxxxxx*x*x****x************************** === BASE === : === AS-BUIL.T === ....._........__._...._._...._____._______._._.....M...........____...._.._________.....__..._........_......._._........_..._.._._..._.___..__.._.__.___________________________._._._M ............._.......__..M_._____..._._____.___._....._...___._._..___________.___... .....-...-....-.....--.--..-.----.-.....--.--.--.-..-.---------------------------------- CUUL. I NG I)U I N'l~::; +. HEATING PU I NT'~::; I...IUT WATE:r~ + PU I NT~:; ..... 'lU'lAL.. : CUUL.. I NCi PU I ~~'l~::; : PO I NT~::; + I...IEAT I NG PO I NT'S HUT WATER + POINTS -. TOTAL.. PO I NT~) .......-...-..----.--.-...---.-..--.--.-.--...--------------..-...-..-.-..........-...-...------............-....-........-.--....--.-.--.-----------------------------_.- (,]74/..4 49688..1 112864..0 226,299.48 ~::)/6/6 ..H 74046.6 55520.0 187,243.44 ...-....-................-..-.....-.-.----.---.--.-........-.......-.-..........-.-.........-..---...-.............-...-...-.....................--..........-.....-.......-...-...-...-.-..-..-...-...-.......---..--..-----------------.-...-...-.... ...-....-.......-.....--..-..-.........----....................-..---....-....-.-.---.---...-...........-...-.-..........-.........-..--....-.-...--...---......--....-..-..-.---.--.-.-.---------..---------------... *XXXX*XX*X*XX**** * EPI = 82.74 * ********x**xxx*** " . ,,,--...., -\ (pC . \.....; /r' ~' ....~. - ~ I ZEPIt fRHILLS FIRE DEPT Zephyrhills Florida 33540 FIRE CODE INSPECTION Business Name S' ~,e iEIV llj UE-$-I- Classification Il (! L F Address '318 r S- I ~ #t/ ~ Owner/Manager ("n (L L~/::.L f\ / Business Phone 18:z. -e4oe Emergency Contact Phone Occupancy Load TYPE OF INSPECTION CONDUCTED o QUARTERLY ~INAL 0 ANNUAL 0 BI-ANNUAL ORE-INSPECTION 0 OTHER o APPROVED flf NOT APPROVED o COMMERCIAL CHECK Listed below are items which must be complied with before this occupancy can be approved by the Fire Department. o CODE VIOLATIONS This inspection report specifies code violation(s) which if not corrected could cause a fire, contribute to the spread of fire, or prevent safe egress during a fire. Your immediate attention to the correction of these violations shall be required, as failure to do so is a violation of the city of Zephyrhills Fire Prevention Code. Se.c..?~~ AILrcJ+$ A./~.b e&1t-lL-6~~A./ ot "-b -r;-c.(~ lA-p :J::.-.S(Je-L--I-c.rA./. ') P u e-L /Se,.;e ~ C; (! 0'___. E. /tV' (JI.u 8cr14- 'Z.d 1t/t.-5 ~ up ~E:- -K~E:- ~(Z ""'- CJ.\A-f2- -t t ReL~ Zc) fV'S I .fa ~ LL; (J Smok. s) -:rIA --P EJ'L S 0....9 J ell E:.-s' M-E- J t4oi:~b. ~ ~ ~ p~tlvU~ S't ~ ~cO~Sf s r ~"'-- <-L~l:-c L- l/-etL- p ~ fS; e:t'l t\ ~A-- ~ <; u {l. q, 'S 0. S. "'-'D L.e A t.5 . Q;) f.? ~ oL~ <i ~ f2<=t- ( t+-z... ~S-., G:J ;;:~,e.4~ L (~. C7IV ;4",..;a tV ~L tfr-.. ~ t-L I?-. ~ ~~ ~ fA....) f!<.SE-,L ~ s) ~s.l!E- +:~~'1 \ ~--\- '"---rc=> l ~ f' ~ (b {~L d-~~------tZ _ Inspect. Date ;.z - 7 - 7 2- Inspect. TIlTIe / ~';9 L- ~ d Jr ~ * 5S I Re-lnspect.Date k7,{L (!~ InspectGme~ OwnotIManager Signature ~ f,/ ...;./ Tille 1f,",>J'.f1?7 ",7. & This building has been CheJ'ed by t e Zephyrhills Rre Dept. under the codes & regulations of the NFPA minimum standards, the State Fire Marshall's Uniform Rre Safety rules and other focaffire safety codes. -r ZEPHYRHILLS FIRE DEP ARTMEN'T Zephyrhills, Florida 33540 38410 6th Avenue (813) 782-8184 FINAL BUILDING INSPECTION Fire Chief Nilliam T. Fenton Assistant Chief- Robert Hartwig OCCUPANCY, C;6R.E~ ILJE~ ADDRESS: 3 78/ S- / I)v€. DATE: /2-/ '7- 9'z- OWNER/MANAGER: :r-~ ~l:> BUSINESS PHONE: 7&:Z - c94a:::;:> This huilding has heen inspected by the Zephyrhills Fire Department under the codes and regulations of the NFPA ~inimum Standards and other local fire safety codes. ~ROVED NOT APPROVED CO~f~fENTS:~<.L\.tJ ~S B€.E-tL-- /Jpp~c/4"b IS,! Z~:o ~~ (!~CO. ;f)'~ ~ciJ~~ A-iAe.~ ~\.1~~ ""'-~~ (S,E ~0+gf2-lE-l, I \e, ~ E=As+ r:;.TV'\O~/../tiL. WE~ 5:'m~k/ fJt.4.LL. C9 {' , -, N'cJE-.";;;"~ ~(L~~ ~L (fvl ~1(..v: 1\ !!:> B(",,-~ +J~ <tf,..~ yJ",~ ~ "'~ l~ u~"''''- c/J. /-i;D. INSPEcr~~ DATE: /2-'7 ~ fL TIME: 1S7~ .IJ~..s 1J,k.' 5yJ____ fft~J k C~9 fZy ~",^p{E;,;r ()51/! 06/17/86 als ::::D. ~_f~ - ZEPHYRHILLS FIRE DEPT .\'-. \ ;;;;"~.' . i~.," " ..... L... Zephyrhills Florida 33540 FIRE CODE INSPECTION Business Name S€ eErvJ~ 06S~ Address 378 IS- I ~ Ht/E Classification if C!.. L (', Owner/Manager Business Phone Emergency Contact Phone_ Occupancy Load TYPE OF INSPECTION CONDUCTED o QUARTERLY ORE-INSPECTION I ~ APPROVED o FINAL ~OTHER o NOT APPROVED o ANNUAL ~pRrl'\..iK~ --r-fES~ OBI-ANNUAL o COMMERCIAL CHECK Listed below are items which must be complied with before this occupancy can be approved by the Fire Department. o CODE VIOLATIONS This inspection report specifies code violation(s) which if not corrected could cause a fire, contribute to the spread of fire, or prevent safe egress during a fire. Your immediate attention to the correction of these violations shall be required, as failure to do so is a violation of the city of Zephyrhills Fire Prevention Code. C;; : I ~ \/'"'" "- \. \. --.. l' 1./ / /1 e ,r~~'-e ~ f ~<:,'-';- f..L../~"_e I'J \,.:.. ~ <\" t!="J.::> I-$" '- J ~ P tt-c "- ~L~ rL La>. T~S( ~ iT- '~e.-C ~rra ;2oe-;ps/ --hL- 2 ).j/Z-$ ;U; {~s WIE-tl2.-E:_ '--"" +~ ~ (V\> , -H-E-.A-):, S 4Ju.______~ c;;L 2A- S ~ L~ LO"'''/ vJE-<<-C- /?~>-~ ~~ . JJ~'), \'~ LU~E-/L )~~c-,L 2~ ~~K5> c.~L..r-'~E';b. 1~E-JC-'b LOA S<4-"c'D~~ J ~ rJ f c~ee-~C/vv--- .' -;-, e E-.~. ~ C^- ~ ~ S '.0-,,-,. ~J'C,: c.~~ :> c:; ~yd-f~ d-rJ g d-s: c :b ? ;;-J I~ I~~ (\ ~~ - ,- I 1 ( I Ju. '-\~~ '- -...Q... - ';:,~ L ~."-../ u:......- c~ C. o'~\..I:., ~ ' Inspect. Date I ~ ~ <::; , '72- Inspect. "me '~3,D<, Fi~t.I9J s:;s- / Re-Inspect. Date Inspectors Name',:~ ~-' Z ~ ~~,' ---- , ... .......... Owner/Manager Signature Ii J..rJ- ........1 U'...J ~ '" ......~ Title ~ fT 1 n ~ j (. E' 'PD {' r:. t-, C~ r This building has been checked by the Zephyrhills Fire Dept. under the codes & regulations of the NFPA minimum standards, the State Fire Marshall's Uniform Fire Safety rules and other local fire safety codes. _~. _ "",.~7""I!"f!".~,'-. "'"' T . - r -.."" EF'H'.'I."F.',LJ I LL ",.-, iF.:Ci,'1 CU=i~=;~=; j C r!;]I'lE~=; TH.-'t,ll C, ,,-,':;' '1'"" '71:' TI-I ,- I "( 11,- _ rl -,_ ""-1...:.._' :?,_l I .~_.....___ '_' _ T -4[12 F'. [11 OJ ~~,~ I ~'" [.) CtASSK HO~:~r.I~,,~VHOPMfNr PO eox '47.4 DAOf aT't'.'l 33m t90t) 561-$1.43 . /'..,./ ' ? 'i/./ ~? //?~ ""~$T INION m ':' ,;;'~':"..' "'Al':")N,l,l ~.U-lr. Ct FlOll!()", OA()f ':m'. 1'\0lll0.l. m'M ~~ 004390 CHECK NUMBER DAlE /:< -;?.j ~72 -If. AMOUNT , /'o..~ ~ , 1 1 J I 1 f ~ f OF bLJAIlU ~F COUNTY COMMISSIONERS. . PA~CO COUNTY, FLORIOA ~ S; roo.. ~ '1011- ':0 t; 3 ~o 5 '? q :'1: UIOOO 500 2ABn' '.llJ\rj I-Ull: f :;1 reI jj: f' 1()I(lr~~: I.J~J 1 VCT(:::: I TY r'{~I;::, 'Ui I','. r r:rrl 1.1\" :'iLrf.rn: :~!7C::L:'.:i l'::;Tll (~\.' !. ! ':':1: /: Illl US '. f:. t I r (;; ,\ L r' I: r: Ij J ,'rr:;l).J C:.IJI..lIJ ry, F'L.CW: J )J{\ I Ii !, LI(l r [~ 1. ',:,':,' 2:: I'~',:: "(')1:;[.: I. '.!F j ! :::':':I'j: '.If r J !:[ ~ Lr r: F I:.: r': .t I"! ' J '.111 P r: : (l~) J. :~', .:~' 7 ':: .~", Ii)" r J IT' !I(l!'( I_.lt{ I-!Jf~ ~ I:L"::::UIJI::r. rCT:: '.J 11:1.1< ~t II:.:' 11 (l1:.:I:I'j! I 1. " Tn r (\L ()I'II..IUI'l T = t:::I:,!t'II"1'JY 0C:1'::'-I1.f'1 r :F11 n:n n1::-:u -. ::::(:,',:Ul)().. ""_ 1.1). (.l (\i1CiI)/rl 1. '.,' , (. /1 ItJ'~.'-:lr.'!r'r IllrJ,rr~.r\I'11 r:('dn L'F.:/I..r:: '1 W K l.! t~ ~ ~I rJ PI: C[: 1 \.'[Lr IN f? / M"! ./ / . ./'. -/J2-;:fr - ... ,,:i./;i.IZi/.u_ '- ..----- ".....---- .../ .".- ..- -'~ '-.- .~,-,._.'"'-,...' ...._~- JHI~ J.5 ":33 1?: 02 T[I C I T( [IF ZEFHr'f-(-l I LL~, =-r' . ~ 1'1 I::l. A~=;'=; I C HC)f'lE:::; T -4C12 F'. C12 / ./' PASCO COUNT)'", FLORIDA " Permit #I .;2. 1../ /6 i3 . Date-Lr). - /' Y - 7:2 _~ ,-- ~., ' 7 J) .'. .....{",.. '.';; .' I ,.1 ~ - ,,'1 ' > .... ./~ . NamelOwner2l.;... #fA'" . ;' '" __ ~ L4<'fl~ (pdt", "~. ?.6AP"~ )'./~ County Parcel H /0 - ;it .;)/ - /<<1 Cl ~ () - J, 3. '( -.L. S 7 . ~ 7I?'j- /LL a.- Location ....5 . ) -.' . 't'....... /' - ') Classification I Type ofUse~1:k1:l.lK<J 1'I~L";(.,,.i. ...----....---- a, L. L. ;:: lRANSPORTA110N IMPACT FEE CALCULATION Rate $ Zoneft The above impact fee has been es~br, ed pUTS\U\nt to the PMcO County r '. . . ' t:l Impac.t Ordinance as adoptl.',d by the Board of County Commis~mt is payable PRIOR to theissnance or a Certificate o~ty to utilize the permitted structure. ( PrenftTeO bv.___--..--..n ~_...--- --- Sq. Ft./ Unit.s~ --- Impact Fee Amount $ RESOURCE RECOVERY ASSESSMENT RESIDENTIAL NONRESIDENTIAL # Units Gross Sq, Ft. (asp) / C7 / (:).. D ERU Assign II ' / () Rate I ERU = 50.00:lt 0.96.... I Year or $0.13 1 5 I Day Assessment = (# Units) JI; ($0.1315) x (# Days) Asse.ssment = LG.S.El x (ERtJ) It (0.13 15) x (# Days) 100 TOTAL FEE $ - itJ~) <~~ TOTAL FEE $~_..____ /().~f~ "'Discounted for Prepayment Toe above asses~tncnt ha.~ been establishr,d pursuant to the Pasco County Ordinance No. 89-07 and R('~oll1tion No, 89-197. as commended. TIlE ASSESSMENT WILL BE CALCULATED AT THE TIME OF ISSUANCE OF THE CERTTFICA TE OF OCCUPANCY. NO CRRTJFlCATR OF OCCUPANCY OR FINAL POWER RELEASE WILL HE ISSUED UNTIL THE AMOllNTS LISTED HA VR BEEN PAID AND RECEIPTfW FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY. Acknowledgement below docs not imply acceptance of concurrence,l)ut simply receipt of a copy of this fonn, placing the building permit owner on notice of this l'Isscssment aJld the conditions of payment for same, Date Received By ------ -....--... --...................--- --.........----.. ..........---....... ...-..----....- ---- --------------....... ........---.... --.. -- -........-...-..........- ......... .....----.--- ..-- .................. ........... .-- .... .-... ............... ------- OFFICE USE ONL Y TRANSPOR T A TION REC. # RESOURCE RECOVERY REC. It '1 f Ir!1-.L<;;-- r>,/ / j ~1 IS? Canary Tnms I Finance DATE DATE-L.---ra~~ BY BY ,J I Ll-...~.0 n-~~;/' On,.n . --~ Bldg"'/lmp--. -- White Applicant Canary RR I Finance Pink Office ~ ,,!~J"'~' _ T .,'.____Lt:P~ Department of Building Regulation January 18/ 1993 To~ Mr. Bob Larkin Classic Horne & Development by Larkin Re: Serenity West ACLF 37815 - 15th Avenue Zephyrhills, Florida Dear Mr. Larkin: o On December 11/ 1992/ our agency finaled construction on the First Phase of renovations - Permit #2486, Pending completion and approval of Second Phase renovations - Permit lf2925 - enclosure of screen room to common area ~ by all governing agencies involved, our department will issue Certificate of Occupancy. -- Sincerely, CITY OF ZEPHYRHILLS . !J.JL-l~ William A. Burgess Building Inspector WAB/bs "Building Safety Is No Accident" . STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTHA TION February 3, 1993 Jeffery Ward Administrator serenity West 37815 15th Avenue Zephyrhills, Florida 33541 Dear Mr. Ward: A follow-up survey visits and desk review for Licensure of your Adult Congregate Living Facility (ACLF) was completed on January 20, 22, & 27, by Diane Cruz, Janet Mills, and Robert Scharnweber, all representing this office. The resident census on the date of the visit was none. The enclosed provider copy of the annotated Classification of Deficiencies for ACLF Licensure Requirements (HRS Form 553 D) indicates the status of corrective action observed on the date of this visit for those deficiencies identified during the survey of 12/17/92. A follow-up visit will be conducted to ensure correction for any deficiencies found not corrected at the time of this visit. The enclosed HRS Form 553 D may be used as a summa~y of this follow-up survey and review to replace any previously provided summary of the annual survey. This document is required to be prominently posted in the facility so as to be accessible to all residents and to the general public, in accordance with Chapter 400.435(3), Florida statutes. Documents relating to state Licensure requirements will be made available for public disclosure as required by Florida Law. A recommendation for a provisional license has been submit.ted to our Central Office in Tallahassee for a capacity of 43. This license when approved will be forwarded to you under separate cover. A recommendation a standard license cannot be made until aft.er the deficiencies listed have been corrected and a follow-up visit conducted. 877 EXECUTIVE CENTER DRIVE WEST, ST. PETERSBURG, FLORIDA 33702 (813) 570-5181 FAX (813) 570-5164- LAWTON CHILES. GOVEaNOR Serenity West Page Two (2) You were verbally advised and this letter re-confirms that both immediate and continuing efforts are considered mandatory to correct the deficiencies listed in the attached report. Please direct all' correspondence, requests for additional information or questions to Ms. Cruz. Sincerely, .:. cy.> .... i/. .(' (.. (. ".' r 1.._ tl.l. t \.. I Carol E. King Area Supervisor DCC/th Enclosure: BRS Form 553 D (Annotated) Copy to: 5DA/5DLTCOC C. Karesh/Public Library