HomeMy WebLinkAbout92-2508
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BUILDING PERMIT
Property Owner.
Job Address:
Parcell.D. #
Water Conn:
2508,,8.
Date 7- c:l-1-9:2
Sewer Conn l ~ 151-
.~~ -
&c--
Water Meter: --7
T,I.F.'s:
r:o
/a~
:J 7'
C~CTRI~~
CITY OF ZEPHYRHILLS
{813}.188-6611 ~
5~IS.O ~D
~ GCHANI~
Permit
N~
Zoning:
Description of Work
Ih~3
City License Registration # ~:2
State Certified License# (?(;.et..)!)56~
Permit Fee
Signature
Company
Address
Telephone#
SIC 11,551117 jJ/J IP
/ /-'i:?~9~ ~~
FINAL J. .-
C.O. -'- -
NO OCCUPANCY BEFORE C.O.
Complete Plans, Spec)fications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances.
Valuation or ~ ~ -
Contract Price ~ ~ t:f{. 000 '
,
~lf::I;;t
ELECTRICA# /5. UMBIN~ MECHANIC~/7
Tp. Serv. SLB 7) '-4- -'12 <. {; Breakers
Rough In 10- IS ,,(n-e~ Tub Set It? ~I ?-9'2-t:,r- Ducts Ins!. 10-15- q W~
Meter Can Water Compressor
FRM. Const. Pole Sewer ,&~~q-l1::). ~ Final
Insul. CL Pool Final
WL \0- ,6 -~2..~ Pre-Meter 11-Zt:J-tjL.&l.r
, Final
Driveway 11- Jz....qZ 8Ul
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.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
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ORIDA ENERGY EFFICIENCY CODE
FOR r::!)TI...DINC (::Oi\!STRUCTIOi\i
~) (~C t. L () Ii (?) C: 0 rnp 1 i. .:~ f: C 0:;" ';' () 9 r' (;l. n-) F? '(:' ~::~;i dc' 'j"'l t~ i d,.1 F) 0 i n t /,~:3 tE0 flj >'18 t_ f"', (.) (j
I.) ()}'- 10':', ] (, Janual/, :199
r) e I:':) art rn E;: r1 t () f C () rn m u n '/ {~f f ai r ~:3:
Printout generated b/ EPI92
rH I <3, COMPI.., T M,!eE ORr'i :U; ',it);
clnd submitted in liei'
r f) ~:~ F L) rJ ~.'i 1: 'r
PlF'TL:.'
of form 900-A-91
(,;NW\RY 1, I <::;2
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m::NEr~AL, 110M!,: D:::IJf:! O::>ME:t\!T CORP,
PERMIT tKl
ll,.Jf\lLFi
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d ~~:e
f,~ ('I :
2.JC
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(~:,i r'i~~ 1 e C: 1 ec:i '(
{>,]] VeY'tied:' Glas~3
All Skyl ght Glass
T',_Jt.Ei] {;F(;:d
T () t (3} Pl '( (-~~ d
Total (iyea
273.40
2-73 I~,()
,00
J(,d... L "
l'~,_ >< t.
r\iOY' mlrJ tFs 1 ()c L;
i;Jood ::'yam<0
Tnt
(\ ': eEl. :
(~(jj
(-IYE,-a;
9':,3.00 R--\/aJ'
100.00 R-,I.)a 1. .
5 00
1:1 00
:: () C) F:::
F:)(t T ni'O:U aLeej
.F~TL i\~C
r:L,;T (.)ndey tiLt
Pll'C:~-iEO L.Jrlder Attic
(~r Cd "
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-:0.00
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(,'I"ea.
t,'; Ad.
(} f3 () .. 0 C:: I~\ \/ pj I
:~ <-> () <)
200, 00 i~~'.Ja 1 '
J. ''; uo
'L.OORS
a f) .... 0 II G '( a d EO'
::> e rim e t er
L 60 .':,0 F? ',j a 1 :
,00
jUf'. '":-' ~..
,,) 'J': () nc! i. t, i () nec1 ~)FJace
L. Ilg h AL. L_
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() , (>0
Ck Ti\le
C,c' tr a J (~/C
I f::' (~ Tl r.,j (:~
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10T l,JAH::P
~::: 1 ectr c'
SE::E:P:
10 00
i'iC,PF;
- () ()
[:,'F" :
90
[:led}" OOITi::,
,00
. !\~ F.' 'I L.. '1" F~ A -;" T () t'.!
Conditioned Floor
{~1 '( (} (.1, ~
1238.00 Place,:
-,
,,:..
(:1 Hl) r PO I NT:::,
/
HA,::,[: r:'OTNT
)[
'1. O()
EPT
22 .~:3f.)2 a24
23,J7<=:.78
9E:; ,67
Ci. {j3<::, TO F'I OOf~ AF~E{~ P{HTO
,,2208
i~': (~Y' C; ('~ (} "(
;::Jec::L f 5 (:,,3 t i. () n:':::
~'.;:3. 't, () n a. Y' f') (1
, , ! 1..,A E: n~':;r' 9)/
) !.~'~: r:" {~ F~ E ;"j !] \( -
)':i T
;~- ;:- : 1 ;3 t t..l"'.: E; r) 1 a n~) a r\ cj
(~oveY'eC by this calC:
() rn p l, r.;, "" (~:; lAi i I'"': ('i (>
C()d('< ,
\, _~~~~~_mm"
, s.o::~:S:::~'~~"_m"'_____..___"___. __.____
hereby certify that this building is
! 'I C'. () rn r> 1 .i 'J n c. (S. LI,1 i 'toe 1"1 the F 1 0 Y' i d a E n (:; Y' 9 'y'
oej(
"
lWNr-r:;/p""'I' ~J~~
) AT ~~ r: :__~~~~~~_~~==_-=~~S~9d~~~~~-~:'==~~~:~~::=:==
F<evleil-J of:he plans and so:pec.Lficatiolis
covered by this calculation indicates
(ornpliance l-Jith the r:J.o"(ida [:,(:1"97
Code. Be'fol"p C()flstrLl t,50}"1 is C:)(D letcd
t h .1 ~:::; ;:) u ,J. C1 i rl 9 I/J .1 t.) e ' '1'1 ~,~; 1:) (':; C, t,.. E-~~ d CJ .'(
campI) ance 1)1 accc,',-di1fIC e 1,\li t h ~3cctj ()CI
5',3.90f) r.
BUILDING 0 FICIAL.
;) (~~ T
,ei' PF<[~3,(" P I PT I IjE ivil:;{~:)1 )1-<[: ':, ('11.1 :": t L)t; fnet u r u >< aedeci by
,~- ~- -,- ~~- --
-- - ~._, .-- ,-.-
()~1 P O~~[ NT ::)
,\1 T r'-iDD ~~
-)<T[~F~ J ()f:~ .&
'~: :).] ('1([ i'~' r DO 0 F~:c)
" '~~.' .~ - ~ .-,'~ -".' "~,, -.- .~~
. ~. ~,_ ,,'/ ~ 'w. ._,_ _.,'._ _^~_
:'F,CTTON
~_ ._. '~'.~ _,,~ ,_. ',"Y eo'.
"".-.y _.,~ ",,~...... .,,- ~
904
90/} .:1
_XTERIOR JOINTS 904.1
;; CFMC I<:~;
\i {~-!' F?
~:-;_.
r-':.,'
(,\ ~;-
:;W I MI'1 I Ne; ::'()fJL ::;,
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lOT vJAn~R
) T P E ~)
3HDWE::r-=< Hl:::AD::.
:'v':~C DLiCr
~ONSTI~UCTION
IV{.',C CCJr1TPOL"
l\.! ~:) !~..1 L _ ~~) vI' ~r ()~)
>'04 ")
')Ot+ .3
C;JO/t '< 4
90/1 :;)
":;,03 _
904.6
904./
904.9
l.i. r' (:;~) i. (01 e n C f>. ~_~;) Ac * .
,~" -,~. ~~ __ _ -__ __A' _-, ~ ~'.' ~,." ._.~ _v, ~~." ~'~ ~.~ '~_' ~.' '.._ oW' _.. _~. ~_ _.0' ..y~' ~~ .__
._---_._-~---,-- _._-_..__._--,~._._._----
..,_ _~ .,_. .~_ _~. - '..~' ~._ '_ ._. '.'.,n
w~~" "... _,'_ ,,~-. _~ ~". "" __ _._ _"
F:E:: OU I F:[i'1E~ ~,! T<:.
-- w____._ ,_. '~_ .~ __,_" __ '.w ~., ~_ ,__ -,~',ow _.__ bV' ..... ,.... ,._ __ v_~ ~..~ ~__ ~~ ~_ w.~ .,__,."
"',., . ". 'w ,n. _ ,_... W~ '....-.. .~_, "" _M .~_ ~A. _'., ,'~, ~~_ ,'_. _.,v ,_, _, ~~, ~_ _, ~_~ _~. _~, _"" _
Maximum of o. 4 CFM per llllear Fout of operable sash
c,:rdch
MaximiJnl o'f 0.5 CFM rJer sq~ ~ of dool BY'Gd. Incll,ldes
0: i cJ 5.::'0 9 1. as;;,': door S, ",;0.1 i d COY' e, wood pa ne.1 ,
insulated, or glass doors only.
T ('
C.. d U 1 !.{, () d. ~;l E:l. ~':~ k t? t, C~ c]) w e ,~j t, h e'( :::~ t '( .i ::)~) c d () rot hey
",.1 I, :,,,
(~} ,;3 ~':? c; ~
!V1U t~, b e (~ r 1 d, L) e 1 L rl (J 1. ca';, ng c ()rnrJ 1 i d, fie e ~~ / (~:)r'1F-?(1 t. ('~ "1 c]
a'((j ()() ()'r c()rn~)ly IAJi,t..h (~~~.(": iE",,'r!c/ .a"flcl ~~t.-al'l(Jby lC:):3:~_; y'p
C:i U 1. y- e 111 E-.; 'i--i ~;~; ) ""I .1. :-"1 0 Y' ~,~ rj -'(' .L Y dl c:; r- ;<; (:; (1 (.:.L. -r c. i..J i t rj Y' e a k e I-
e J(3ct'f'ic), ell cut crf (gac3) mU~'jt provided, An
e >< t,"Y' (](3 1 OY bui J t ; 'f'1 heat t. r ap 'lIU~3 t~ t.c pi' uv i ded '
d, Y'ICj hc~ ate d F) 0 () 1. f; fnLl S t ;---1 a \/ e c: c)\/ e r ~~) (~e :::( C,; e f.)t, ::;;:;01. a Y'
i)u(::tt(C~d). [\jan"coITlmer'.: iai pool:::; must hi3\J,2' a purnp t Ifn(~','
(sa ~?:: 2;Pa. (\' rJ()().l t e '( ~~,) n u :::_; L n D..../ ~,'} rn 1 n 1 fflLl 1'1'1 L h (-~ r' rnEl
nff i<':L erlcy of 70
InSl.Jlat5c)fl l~~ Y'equir'ed ()nJ,y fa
Y'I ~~:lj(~h caS8~3, I~ipillg heAt ~OS8
/" -~~; r~~ "r ,/ :'--1 / :.,_, i n e.3 'f 't. () f p .i f:-l e ~
recirculating systems
shall be limi E~d ~o
l;,J,] te' j" f 1 ()I;.J rnu ~:~:
( c~ ~.:: t r i (, t, f? (! t C flO rn ()( t h a r: ~3 9 d, 1.....
.Lori:::; ~)e'( fn,i~nu.te Eit.. f30 PSIG..
Constl ucted ~n accordance ~ith industry standards &
local mechanical codes, Ducts in unconditioned space
,iL; ) n~'>u 1 a t c~d too ill 1 n 1 rnum R" -4 .2' & j 0 i ntc3 :Tlust be
~~3 C' tl ,1" C(
ar~jte )Neadil,y decessit]
n'!,;3 Y-'l i..j (~: J () I Ej l) t () en ,':i '~-
t i\eY'rll():ce;taL f,;))'
. ,
e~ ,:3 c~ 1"1 ~3 )" :.=::'; tern ,_
C e i 1 i n 9 "';: rn i n i In u nl F~" 1 9" Corn in 0 n W a j ,; ceo "m Ii) f~: ' .~. 0 Y
C B '::' p,) F '( a rn e C 0 iYl m 0 n C C;' i 1 i n 9 s; ?< F 1 00 ',' co: p" 1 1 "
~
NFIL1RATrON REDUCTION ?RACfrCE COMPLIANCE
V'J...
t- .-T'
( OMPOI\!E!\1T",
-~.' ~ ~.- ~..~ ~ ~.~ -~ .~ ....." ~.- ~-
.~. --_._--------~-- _._~--,- _..._~
""RAC TT CErt2
:C X t () 1":' 0 ( !;J re; L :::: ?, fc' 1 U 0 1- ;3
;;" >( t.: ~:,.:~ ~-- C.'I " ....\1 d.I. J 23 ,~-
('} LLIi'J
)u,c :-"~~()Y" i<,
,. 1 '(" (~ ;~J d f3 ::~
.-.: >< haLLS L F a l'i~3
:ombl.Jstio Appliances
Ht:C f(, L. :~; T
'~-.- -. ~ ~. __ ,_..' ,~ ..... 'd_ _ '~'.' .w_ '."" ....'< ..~.' '..".
~. ~w. _. _. .__ _~ ._ ~, w_ .~ ~__ ,",_ ._., __ A_
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_. ._. .y,- -" - . -_. ~. ._. ...
F~[()U I REMEI',IT:)
._.' ." --- -..
~y. .~- ~-'. .~'"
onlpl Y Hitr'l Practice #1 and thE; foJ IOiAI5 ng.
~op plate peTlet.f"at.ions sea ed, Infi .ti~atiorl barr-ier
1.n;7:~t-,allt~~(J \)olc-? ~)l{~J.t.e/flo()'IU jU}'I":t C:~iU kc)(J ()--:' ~:3ea_,.L
r~);erl(?t ':',a,t~5.()n2; j join-t~::; i::;ncJ c::rack~~3 on irli:,_e'( Lor- ::3lJ,'(-fL:lC;::~
caulked, sealed. and gasketed.
uc tHO!' k
. j" j
.:.. nun con C .I t 1 0 nee spa c e
rnLl~3t :_)E} :3(:)f.-'{1.f~cl"
i ppod v.i i t I, OIJ ts i de combust ion a i ,', door::3, .:J. nd f LJi
oampc;':-~::: ,
Equipped with dampers. Combustion devices see 903.2
( f ) .
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~~** *~ r*********~ t**********~*t**********~*t
~;;UMr1FF; [(\1. e\1 P,TTON
.~ -. [3 ?~ ~j C :~::
'j.:: : ,/;,'*t:- :* >k >i:"'. ::-f,.: ;:t-: ::.t:: * :::{( >~: ::.~, ('. .* )j.~' >f: ~'1:- :* .* ,:1< :.1<" ;cK ,~f:: -:l'-f. :1<. :.i< ;l: :,i< >V- ,(' :~.:: ::+: :'-~<. ~:~ >i( '{::
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:~ I .'. ()i ~~, ~. :0
)RIEN AREA x BSPM
() (~) t~ ()
/1,/ .. i3
(,-
c..
1 ,J_ 2:, :~3 0
"1 n >c ()
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90,9
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V'.J
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102~O
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TYPE.'
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;. 6 . I')
"j. :7 7 O"4! C; L_ C L", F<
~~:) (~ :. C 1.._ r,<
11 ;')0
2436.1
31i6<3,0
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Cl~R
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CL.F,;
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15 x COND, FLOOR, TOTAL GLASS
AREA AREA
..1..'::)
) ,-1:.](3,- OC
1 0 i'i Ci L, (\ ~3 ':;,
~lR[I;
:27 40
~679
v
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w. -... ~"^ .~~ ~-,.~ - -- ~-- ,_~ __ ,_, __ _~, ~'_ ~_ ~~ _ _. _ _" _ ~_ _ __ __ ,_, _' ~ _. __ ,,_ __ ...^ _, .._ __ _~" _. ___ _ .~~ _. ~, _. _,_, ~..~ __ __ _. ....A N_.. ,_. .___ ~._ _~._
,0
953 ,()
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103,7
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TYPE
ExL NormWtBlock In
(':dj Wood r'ramc
[>< t I r'j~~)u '1 (D. (:(.1
d r (ittic
lJncJor ('it~t.r
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r"ractice #2
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25,492.46 1.00 1.100
j-"1l..J 1
16~6
166
11':;" (;.
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13.4
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1::1.4
7.0
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30 0
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109.2
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3,32 ~ 0
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168.5
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SF'i'1 ,~ r)OI!~TS
CRED IT
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953~O
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1..99 -,2
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,00
,70
4.::,0
,60
1 < 10
"'~~':31 " 9 0
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APPLICATION FOR PERI-lIT
CITY OF ZEPHYRlfILLS
BUILDING DEPARTMENT
APPLICANT General Home Development Corporation
ADDRESS
817 U.S. 98 Bypass South narlp r.ity. FI ~~"?,, PHONE (904)567-65Rl
General Home Development Corporation
OWNER
JOB LOCATION Lot 7 & 8 Tract "0" Brentwoorl
Tract "0"
LEGAL DESCRIPTION: LOT(S) 7 & R nJ~~
LOT SIZE see~lot PWm:A SQ.FT.
SUBDlvIsIoN-5ilver Oaks PB 29 PGS 86-89
PARCEL I.D.4F
WORK PROPOSED:--*-New Construction ____Addition ____Alteration ____Repair ____Install
____Sign/Temp.
____Sign
_Nove
____Demolish
PROPOSED USE: --1-Single Family
____M/F
2-~F of Uni ts
,____N / H
____Commercial
____Indus t .
____Swim. Pool
Other
____Restaurant & Health Department Approval
B~ILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORI-IS.**
**COPY OF CONTRACT REQUIRED.
PERMITS REOUESTED
____BUILDING
$
Valuation of Total Construction
____ELECTRICAL
____NE:.CHANI CAL
NiP Service
Florida Power Corp.
_W.R.E.C.
$
Valuation of Mechanical Installation
____PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ____Block ____Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
CONTRACTOR SECTION
BUILDER KP~i ~ts Company Genera 1 Home Deve 1 opment
. State Cert. or Regist. #CG005695
Signature ~~~, 5iJ~ City License Registration iF -2~,
, -- - ...................................*..*.*.
Corporation
ELECTRICIAN
~ 11 ~j-
Company Martin Electric
State Cert. or Regist. #
SiQnature Robert H. Martin Jr. City License Registration
******************************************
ef('oolfll<J
# / >~g
.
PLlJMRER James Martin Company Bayonet Plumbing
~ ~~ State Cert. or Regist. ,/ <VCo'-/:>-"Tf{J
Signatu ~" City License Registration 4F 9/
*********************~********************
MECHANICAL Thomas Lachance
Signature ~ ~<----~
Company Southern Comfort Enterprises,
State Cert. or Regist. #
City License Registration ~
******************************************
Inc.
/}
OTHER
Company
State Cert. or Regist. #
City License Registration #
Signature
******************************************
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMiT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIQN~
The undersigned understands that this perlit lay be subject to "deed restrictions" which lay be lore restrictive than City
regulations. The undersigned assules responsibility for cOlpliance with any applicable deed restrictions.
B. UNLI ENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner ,as hired a contractor or contractors to undertake Mork, they lay be required to be licensed in accordance with
state and Ioc'l regulations. If the contractor is not licensed as required by laM, both the owner and contractor lay be
cited for a sdeleanor violation under state IaN. If the owner or intended contractor are uncertain as to what licensing
requirelent5~y apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, 18131
788-6611.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorlsJ 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, rather than the contractor, are responsible for the work. If the contractor wishes you to sign
as contractor that lay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
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 LaM - HOleowner's Protection
Guide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the
"owner", I certify that I have obtained a copy of the above described doculent and prolise 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 Hill be done in cOlpliance Mith all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has cOllenced prior to issuance of a perlit and that all work will be perforled to leet 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 governlental agencies lay apply to the intended worK, and that it is
IY responsibility to identify what actions I lust taKe to be in cOlpliance. Such agencies include but are not lilited to:
I Depart.ent of Environ.ental Reoulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treatlent
I Southwest Florida Water "anaoelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of Enoineers - Seawalls, Docks, Navigable Waterways
I Departlent of Health ~ Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
I US Environlental Protection Aoency - Asbestos abatelent
I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
addressing a "colpensating volule" Nill be sublitted which is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A perlit issued shall be construed to be a license to proceed Nith the work and not as authority to violate, cancel alter, Dr
set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frol thereafter
requiring a correction of errors in plans, construction, Dr violations of any cDde. Every perlit issued shall becole invalid
unless the work authorized by such perlit is cOllenced Nithin six lonths of issuance, or if worK authorized by the per.it is
suspended or abandoned for a period of six lonths after the tile the work is cOllenced. One 90 day extension of tile, lay 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 lust be logged during each six lonth period, or the project will be 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 YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCE"ENT. JOBS UNDER $2,500 IN VALUE DO HOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
)(~ r1~ 1-0 ~ /f ~
SIGNA RE: OIlNER OR AGENT SIG ATURE: CONTRACTOR
whcl is
produced
as identification and who did~
~~a;h,-<-~
(Si ture)
J a. Vl....\ Ie ~ I Q..<-K-w -e. tf (~tb- A-A-{,O{p P 1
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
o me clr who has
STATE OF FLORIDA ~
COUNTY Of, , .' . ~
. The foregoing instrument
befDI-e me thisS~IC
~ sci''-~ ~~ b,e ~;-~--_.
WhD i DE sona known ~o m~ or who has
produced -
as identificatiDn and who did~
take an oath.
~~~ \0<..9. ~
(Slg ture)
..\ n.-.-......t- K_ B. \li...c-K W-e. / ( ~ t:/.. 4.1I90f&J J.?--1
(Name Typed, Printed Dr Stamped)
NOTARY PUBLIC
:ota-rv ~U~"c; S~flT or nO-rfcfl
y Commlss.on Expires Sept, 2.: 199Z
~Ias acl~ncl~ll edged
, 19~ by
STATE,OF FLORID~
COUNTY OF
was acknowledged
, 19 If ~ by
befcq-e me
Nof8tyPu6lTc, S'fafiJ or notflJl
My Commluion Expires Sept, 2, 199~
~,'-'-- -----....- _.~
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E N T t:.: H L_ F' E n t'1 J r 'T I N U
F';:I:,:;C'~l CO'JNT\, FLOF I D?~
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NOTICE
OF
RESOURCE RECOVERY ASSESSMENT FORM
". .-~
___ ~,; ,:1
PERMIT II ::~)/-) i.~; ({ L'5
DATE
APPLICANT/OWNER
?'
.,- ,
AI-'l
i '/;'
, \.. ,....-/
COUNTY PARCEL II
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LOCATION
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USE/CODE DESCRIPTION
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RESIDENTIAL
NON-RESIDENTIAL
/i UNITS
/
GROSS SQ. FT. (GSF)
RATE/ERU=$SO.OO X O.96*/YEAR OR $0.131S/DAY ERU ASSIGN /I
ASSESSMENT = (/I UNITS)X($0.1315)X(NO OF DAYS) ASSESSMENT=(GSF)X(ERU)X(0.131S)X(NO DAYS)
100
TOTAL FEE = $
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/CI. 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 FIN~~ RELEASE.
DATE
RECEIVED BY
--------------------------------------------------------------------------------------
FOR OFFICE USE ONLY
RECEIPT /1 '
DATE
BY
.'