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Home My WebLink About92-2705 BUILDING PERMIT ? /6, 7..!j- CITY OF ZEPHYRHILLS (813) 788-6611 307~7J 0UMBI9 f#F'~ r . ~ 6 7-5-.56 I ~I~ING~~ ~TRI0 PmpertyOwne' t~q f~~ y~~J Job Address: 7..3 ~ - /..,;'V" Parcell.D. # .3 Y -c:2..!;;- - .2 I - 3 -~ ~ -? ~ANI~ Zoning: Energy Code: Radon Gas: "71<"",,~ I:, Y Description of Work f~A~~ (:.;t~ K~ Permit N? 2705 (j Date /0 - / 'T - ?;;L Sewer Conn I ~ .3Yc2,dJ....s- Water Conn: 3./0'. ~- , Water Meter: T,I.F.'s: II y, .3 ?}.' 67 01l~TIE A~5J11/'PI1JjJ ~-::J~-93 NO OCCUPANCY BEFORE C.O. FINAL Complete Plans, Specifications and Fee Must Accompany Application, C.O. All work shall be performed in accordance with City Codes and Ordinances. Valuation or Contract Price ~. f- f-b,. /rlJ7.;). cTD Permit F Signature Company Address Telephone# City License Registration # State Certified License# 35--9 , DATE Ftr. Pre SLB Lintel FRM. . Insul. CL WL Tp. serv.~ ' SLB Rough In '1j~3-2c.f:ltrUb Set Meter Can Water Const. Pole Sewer Pool Final Pre-Meter .~-1111 ~ Final j//jf2+rrA-I/:,-.Af l Lf-/6-9~ g[ ~ J/" "'," /J_.~ IlJ t ~~ ~ ( Driveway ~.(.-: hpt\l-- ,a<..r"frc<J (;,."),, L. LI-1j;t3 .:-f~/b.,Ci ~ &-t' Breakers Ducts Insl. 4f /.,6 ,'y ~ ~,-- Compressor Final ~t:2hc~ I I'/~-rt. i.f -/""43 &-c<... 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. ~ffiWtlU.. w~s-r {.~ d- . NoiLdfoo4LL Fc.:>cl'tt~ 10- /'1--7 'L ~e, mWlwlfU-(,..)lL)fo.::rl-4-<-, d- INtd/c;~<, (,cWr"'t..\ f~\1 /O--/h -'12- (;)~i>~ 'O-d.O-q~ ~.~ 'c-aO-q~ ~. J, ~~'\"I.II'1>Wc,.- I~~~ WALL /O-U-qL flux ~ &f 6:.u~ fitt.~H ~ ~ of ~tfLL. fi~ sf ~f/. ~ Otd f(4A ~Wt~ tJ~~~ SeMc.e ~L f te. lLi>c,- ~ 8/4 ob~ \)-S-q~ G\.ll. ~ 6 ll-- 4--l\:J.. ts ~ "fI~ \.J&l7~) ot"~ 11-4--~~ B~ .2>~ ')3 ~ ~ \\ -~- 9 d... 5~ ~w~~~oJt l\-lo-q:t GO~ ~ftlr ~ ?L~ ~ fJ~ 1/,1-QL M!8B. fi"'t.4P GU.L. U fl &-u~;fIJ~ \,Alt)f <.J~ 11-'1-9 L -$.~ ~-~~,~~J-J~~q~ ~lJ.L ~sH.Vozrl:~~ IJ- J;J-'1.:t &I,... ~~~~ JJ- J3-QZ ~~ . "1l.t.~ :S~~WctLL H-'7~qL el LL ~~W~~ 11-I1-q1- eIL}- ~V3~ }J-/1-f2--- Bill ~ ~~~~ J:;~I ~-~ ~ 1}jf:- ~ tj. 11/lq-t;L #J'jj W~~f> IJI2fI./'r 1/-2-342- ~ ?~~ u)~'t 5f,A' V 11- 2'f -f{2.- U (SI5: 6~ ~~ f;~tJ, /o~3o ~~'Z. J3~g J- @~ fI.,.u.. ~ ftJG- I\Jal.fI-\ SU~ i.. tll<-~ ~ L.lNnL} L.fLLL. S~UL ~untl.U~u.... 3 Cell,s LJt-ll.. C:;~C..L. ~~~ ~ - t1-c,,* cuo,u- l1fL. ~t"'- "Tl-..>clL LlF4- 5LA-B ~ SL.1B ,rf ~1C- ~n~~ f~~ ~~~ f\lJ~~~ ~~~~'/~' llvL-t. b~~ l\\t.. rr~ 5ov.u-.J.~4-~, Notf{~ ~K M,ALF rl1Mfl2::r fY\~2'Z~lJoli t ~4Wdl ~O ... . / LI~f'R.L- '\ ~~~vJt\LL. L.Dt\'i)I~cr ~ T\~~l ~ ,,- ~~'T SL.-.16 ~~~i . ~}~~ . Wflu- "lv.-.~ (~ f~ ~ NO(tt~ ~\.Ih ~ 50 f,(J, t ~ ~H (~.Jv.".- (~J~~~~ . ~.frft'L fr~w G of ~~ CJRt..t,p'l ~1IlL. ~1~c. ~orL) !V\t.N:s &R~ ~...,b~v ~ ~ 11- 2'1 ~?2- M-/t5.e 1/... Z c.{Jf 2- C,e 1(-~-9'L 8'. ~ J 186~11.- 3: IJ--- 12... /-q L- E;Li- /2-- ~ .<:f""2.. ~ I BB. Il- '1- CiL ~.J3- 12-~ ') -C;'L- idS, ld....l4-q;} tslU- ~2...t~-~1--- rs~L J,d. -' llJ,. '\ Z- \) ~ Jl- 8~()-t)L 6J.J 4$o-t- It -2,1 -f,- '?~ /2- -ZI-Q2 ;[~, /Z-r 12-q1.. ~, (2- -z ~ - 'll- c.~ ~-dq ,q~ B~ /". lv--c,? ~JI3, l - 2-'1 -q 3 B Lif t ,.. 2-C) - q 3 E ~ 2. . 3 ,. 9~ ~ /bC z. - j ~9 3 $'~ '2~ '-q~ ~ d -Ot - t\ ~ \3cU '2.. - r 0 r- 9'3 pilL ~ -/6-13 b.u- z - 1'1-7:5 ~ / ~e~ 3,.3".tj3 ,6k w '-I2--1.3 &-B- FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION FORM 500.A.91 SECTION 5 . BUILDING DESIGN BY COMPONENT PERFORMANCE APPROAOH Non.Resldentlal Buildings ADMINISTERED BY THE DEPARTMENT OF COMMUNITY AFFAIRS Residential Buildings oyer 3 stones ALL CLIMATE ZONES ZONE:_,.1..._ BUILDING CLASSIFICATION S: BUILDING PERMIT NO,: ,2} () S PERMITTING OFFICE' JURISDICTION NO.! TYPE Conclele (CBS) WOOIJ lt~m~ Melal Irame Insulallon R.value BUILDING INFORMATION ROOF/CEILING FLOORS TYPE U AREA TYPE U GLASS TYPE U AREA Single, wall 1, Double. wall Single, rool Double, rool Und" ellic Single Assembly Olhe': Insulelion A.value SYSTEMS INFORMATION AIR CONDITIONER HEATING SYSTEM HOT WATER TYPE EFFICIENCY TONS TYPE EFFICIENCY BTU/H TYPE Un1lary & Heal Pump Central & Heal Pump EleClllC rd <65,000 Blu'" _ SEER < 65.000 Blu 1 n .-:__ HSPF - Aeslslance ,65,000 elu'" ~.EER __,PLV ~ 2: 65,000 Blu I n ...__ COP - Oe<licaleO Heal Pump 0 Wale' cooled ____ COP - Gas Waler Coo1ec -- EER --.-- IPLV - Evapo'ailvely cOOled __ COP 0 Nalulal e....aoo1il'...ely COOleo _EER --- EleClllc reS,Slance _...1..- COP ,~ LPG 0 P1AC -- EER - Gas/Oil (Circle one) $ HeA1'" ReLJP-H/\ Oil 0 Cr'hUer~ COP IPLV < 225,000/300,000 Bluln _..AFUE _ HAU 0 - - - 2: 225.000/300,000 Btuln E Olner: Osne' I _..,__OH' -- -, LIGHTING IOto ")(,,?- Lighling Budgel (from Taole 5-(3), ~,.,. TOlal Lignling Wallage + Total Condilloneo Floor A'ea ,4:,tU.Ol- = WailS I SQ, tt: ~.3 PRESCRIPTIVE MEASURES (Must be met or exceeded by all buildings.) COMPONENTS SECTION REOUIREMENTS I CHECK \t".llndOws 50V MaXimum 01,37 c;1m pel hnear 1001 01 operable sash c'a~~_._,_._ , " Doo's 502,4 Maximum 01 1.25 elm pe' squa'e 1001 01 doo' a'ea, , ., -.... JOihlslC'acils 502.4 To be caulked, gasketed, wealherslripped or olherwise sealee Renoal 503,3 Supply ai' restriCled to set coldlhot deck temperature \('. moelload 01 worst case zone, Resislance reheat prohibited, , Venlilallon 503,4 Supplied wilh readily accessible switch lor shut.oH and/o' volume reduction when ventilalion is nOI required. 1/ HVAC EN,c'ency 503.4 Minimum eHiciencies.Healing: Tables 5.4. 5.5 & 5.6, ~~,?hng _ Tables 5.7A, 5.7~, 5.8 & 5.9. '" Tlanspon Enelgy 503,5 Minimum 01 8.0, V Balancino 503.6 Provide means lor balancino HVAC air system & wale' d,stllllUilon system, tI HV AC ConlrolS 503,7 Separale readilv accessible manual or automalic thermos tal 101 each svslem, V HV AC OUCIS 503.8 Ai' duCls, finings, mechanical eQulpmenl and plenum cnambe'S shall be mechanically anached, sealed. 503.9 insulated and inslalled In accordance wlln Ihe crilella ot !\I.lcttons 503,8, 503,9 and 503,10, J. 503,10 - Piping Insulation 503,11 In accordance with Table 5.10, " Waler Healers 504,2 Aulomallc electric Slorage water healers S120 gallons and gas & oil.fired storage water healers S 75,000 Btulh shall meet perlormance minimums in Table 5." Larger sized water heaters shall J meel minimums in Table 11.1 01 Standard AS.9 atter 111192, SWimming Pools 504,2 Spas ~ heated pools muSI have covers, Non.commerclal pOOls musl have pump timer. }..J I A. & Spas Gas spa & pool healers must have minimum lhermal elficiency 01 78%, Hot Wate' Pipe 5044 Piping heat loss is Iimiled \017,5 Blulh linear 1001 of pipe lor recllculating systems (see Table 5.12), J Insulation Wale' Fixtures 504,5 Water flow restriCled to maximum 01 3 gpm at 80 psig: 10ilelS ma.<.mum 3.5 gallon flush. J Public lavalory IiXlure maximum flow of ,5 gpm or ,5 gallon il nas sOIl,closing valve, Lignilng 505,1 Lighting power budgets are lisled in Table 5.13, Minimum Ballast ElIicacy Factors are listed in Table 5.14, J Uo wall AllowaOle O. :?,q.. Uo wall Nolual Ii. A,.'7 II comp/'flr<;Uf'()8! !r... D'O>'tSOns 01 S, 502,1"enI811'" coTIlined Uo values 101 the enllle e"",,1oOe Uo 'ool/cellong AllowaOle 0"0 Uo rool/ ceiling Nolual 0.0" In Ihls seCh.'" J ~ Uo 1100' Allowaole - Uo flool Nolual - Uo el1\1li(x'" AII........OIe 0 f Uo e"""IOO8 Aclual ' f), I A OTTV wall Allowable "Ill r ,.." OTTV wellllClual -1>0 ' <L'&;: OnY 1001/ ceilong AllowaOle - OTTV rool/ ceiiing Notual - Compliance wilh Section 5 was demonstrated by a Prescriptive Measures methodology: O 508,0 (a) Dela.:hed commercial buildings 0 508.0 (b) Skyboxes or sports stadium buildings less Ihan Dr) s re leti!. thai are used only seasonally, OWNER/AGENT I hereby con1ty I wim 11'\8 F lanCla PREPARED BY I hereDy can1ty Ih 1 " S-51 li' o w ~ o w I o :c () <t U'JO Za: 00. -a. ~<t ..JUJ ::> () c :3z~ <t <t 2 () ~ .. >- a: l5 " 0 () a: u. go UJ a: :!2 Z UJ '; w a. CD a: .... .9 o ffi · u. Z 8 .... 0 ~ UJ a. i W :!: ;g ~Rw ~ \oJ >- a: >- ~ oco~ ~z~ S2 -g LOU)LL ZW 00 -" t;z w- U'Jg ::J co o z !:: :::; a: w 0.. ~ ~~.~ ~ ~ ~ - " " " " " " ~ iii -J II II II II II ,.;2 ~ l{~99~~ ~ xxxxx ; H ~~~~~ CJ xxxxx i H ~~~~ ~ = ~ ~~ _NMoq'l/) & & & & & ~ .~ ~~~~~t2<( II II II ~ ..r e q-' x x x ... Cl~ III :I E- E " ~ ~ Q x x x Cl:'1 u- III . t: III :l e tnc( ci - O8.&8.i~~ g ~ ~~~t2 <( .!! III ;g ~~~.~ ~ ~ ..J ~. I ~ II (1'1111 II I H ~~~~ CJ 'x x x x x Z ~ H~~~~ ~ ... 01 , c:( 8 I/) ::E a: f! N iij ;g II II II ~~ ~ ~i 1 x x x CD:'~ u- III . t: III :l ! (l)c( .-: ------ iii liri~ ;2 -] ""- "-'- ~- . en 8 () x x x x x x 8 ~ --..............-- x x x x x x ~ n~ ~ c~ ..2 "C. ~~ Il~ -z ~~ ~ ~ ~ iij ;g II II II ... Cl ~ CI :I - - C III j ~ - x X x ~ Cl:' d I H~ M ~ ~ .( oj ~ ~ iii iii .2 .2 r- r- ~ II III :l iij >. ~ ~ oq' - CD C - .~ nl_ - CD t2<( ~(O ~iii + ::l ~ ti 0+<( i Q J cO a:i CD iij iij.~ ;2 ;g~ J: ~i lri r-- <) - CD o c =!. ;~~;~nl nl 8 ~ ;~~iii 8 ~ ~ ;~8.iij~ iij ~ ;; ~ ~~~~~i i Q ~ ~~~;2 ~ a ~ ~~~;2:r ;2..f 5-52 ~~ "- III E . ~ (fJ x . ~ ~ .... ~ i; t2 ;: CD .~ '0 o (,) iij ;g x -I- .... - S2 ~I . ~ ::::l en N .;, Q) is ~ E e u. II II ~ ::::l' 1 .< ~ ~ ~ N .;, III is ~ E ~ e u. II ~ & II ~ ~ co g: iii :l ~ 1 :J to - ~ g ~ ~ ... to r:r~ = ~u.. ~ ...! o - o a: I =. e-= ~ Sill :::1>- U)::;) + <( :' , ,... N II II II ~ ............ ...... ill ;2 II r-: C\I oj .~ ill ;2 II .- M Cll .E '0 8 N M II XXXX ~l III ~ g iij ;2 x z Cl en Cl:' w u- Q III a Cl ~! z U)< :J o o (,.) xxxx x X X + CO N + ~= <<I a 't:<<I ~~ ... Q) E E :J en - (") III ~ a:i C\I cO C\I X Q) :J , .- C\I M '<l' 0"8 88. ~~~~~a... a: ~ ~~~~~~ :c E Q ... C\I. M .21 =8, iij~ ~~~~~;2cr ... CO 0 N q: ~ III ::: '0 F '0 CI) ~ 4.: ~ :::::: III c;t ~ ~ --~ \ A ] X ~~ -~. ! Ie ] x it) M I~ '0 _::l ~ ~;t~ :J III iij oS > c- ::> - '0 ,.f +~~xrG ,... ~ ! III .- - ~ 0 c- eea ,,0 ~ ~ +::l i~-i .iij - ~ } q: x l~~ ::> _::l ~! II e;;- M III ~ + (") N III .S 9 -.;: -g Ol III ~ III Q) .D '0 c >- co E .... 0Zl ~i - w <( tJl ~ Ol ~ . ~ ~ ~i ~~~1 ro '0 CI) III :J ~ iiii 73 - q: .. q: q: 4: ~ . (; () ... '0 '0 ::> .:J ::> ::> d N ~ ll'i N ..j ll'i N C\I C\I C\I C\I .0 M M .0 Cll Q) Cl Q) LL iij iij .E :0 a: .S :0 ;2 ;2 ro ~ 0 ro ~ 0 Q) Q) 0 :x: E 9 :z;: E a: iij II e LL iij II 0 .. J ~ u. I ~ u. II II II II II II II 0 ~ 0 ::) .. CI .. CI ::) .. III M Z III ::J CI ::J III ::J M - - - - Z -- cD Cl C <<I C CQ C " ~~ ~~ Cl ~~ ~ en en w w c X X X X X X X .. C Cl ~ Cl z N .J. Z ~ Cl:' Cl:' ~ G:' ~- .0 - + u- <<I a " a 't: .r ~ <<I S! 't:1lI J: ::J ! :::I ! J: :::I CD U)oI( U)oI( 0Zl ... U).( ~ N cD ai ... CO; ~ CO; ... N N M ... 0 CD - ... ..Q 1: .s:::. 0 :J Cl q: .. ~(\J('I')~< .-NM'<l' g~ CI ....C\lM II II - !. =8. ii1~ iij 88.'~~8.8.~ !~ !!A!~1 ~ ~ ,!!!;2ct ;2 0 '0 ::> ti:~ F-F-~~,2 ::> 5-53 N .0 CD :0 ~ E e u. . .. + ON H~"""i w - ~~ vj o tJl x ;:).2~ % ~ 61~ 52:> ~ fa ~ + ~ ~~-- F=:' z- cD -~ ~ t-::~ - ~ g ~ :1:< .( Q) X t~J c~ w :> ~! II -., WALL R.VALUES BUilDING COMPONENT DESCRIPTION WAll WALL WALL WALL WALL TYPE 1 TYPE 2 TYPE 3 TYPE 4 TYPE 5 Exterior air film , O. /7 o. J 7 0.17 0,1'1 0.11 Stucco - - - - - Block \ 2 II L'" U /. 21 I, Z \ - - - I~ ~ II t:. MrJ - - 1,()4 /. /') A- - Firring strip Insulation UJ 1/ 13A1'1' - - - Iq.OC Wall bo9rd }?" G )P. 0.45 - ~ .4-6' 0,45 Solid Other SPA-NDllR - - - '.04 Otner Au~. 5PAO;; o ,'i1 - t:>.97 - -- Olner Inlerior air lilm ()./"f). O.~~ ().tnA Q. (0 A o.~~ R TOTAL .3 .kE) 2. (!) ltJ 2. b3 f. t;J..9 2. \.34- u = l/R O.?q o.4C'f O.3~ 0,53 0.047 AREA 4.?JV') If).'11f) 840 '2.41i10 l~lD~ . Weignt (Ib/ sQ fl.) IF FRAME: Size _ x _ Inches O.C. _ ROOF/CEILING R.VALUES BUILDING COMPONENT DESCRIPTION ROOF ROOF ROOF ROOF ROOF TYPE 1 TYPE 2 TYPE 3 TYPE 4 TYPE 5 Room air film o.9Q Wall board - Truss Insulation I~.t"ll"l Other 01her 01ner Other Outside air lilm O.2.~ R TOTAL Icr,24 U = l/R O.O~? AREA (sQ, 11.) 4(0 2f) 1 U + Te IF FRAME: Size _ x _ Inches O.C, _ 5-54 APPLICA"o."ION Fo(.,h~ PEl'il!fiT CITY OF ZE:1IYRiI.ILLS BUTILDlliG DEPAR1'KENT OWNER · S =RFS:;~;; It;; ~7J$..v~~ J PHONE OWNER · S JOB ADDRESS LEGAL DESCRIPTION: LOT(5) PARCEL LD.' 31 -d..S--~ I ...s - ~ BLOCK SUlBDIVISION IroRK PROPOSED: ~ev Construction _Addition _Alteration _Re93ir _Install _Sign _Move _Deao1ish PROPOSED USE: Sing1e F~i1y Veo-ercia1 _KIF _, of Units _HID _Indust. _Swia. Poo1 Other _Rest:aurant &: Hea1t:h Depart:aent Approva1 BUILDING SIZE: x Square Feet, Height RESIDENTIAL : COHKERCIAL : ATTACH (2) PLot PLAliS &: (2) SEIS OF BlITLDIXG PI..lWS &: (1) SET RNERGY FORMS. ** ATTACH (3) SEIS OF BlJIIJ)ING PLAliS &: (1) SET El!mR.GY FORHS.** **COPV OF CONTRACT RIl'Qm:RED. / _BUILDING V ELECTRICAL /KECHAIf[CAL ~UHBIlIG PERl!IITS REQUESTED $ Va1uatiou of Tot:a1 Construction AKP Service F10rida Power Corp. W.R.E.C. s Va1uatiou of Hecbanical Installation GAS IIDOFING . SPECIALTI' TYPE OF CONSTRUCTION: _B1ock _FrMle _Stee1 Other FHiISBED FLOOR ELEVATIONS: FI' . IS PRO..JECT IN FLOOD ZONE AREA? YES NO ************************************* COIIJ'I'RACI'OR S~ON MY ~ St:ate Cert:. or Regist:. , City License Registration ****************************************** COlIPA1MY St:ate Cert. or Regist. , City License Registration t ****************************************** PLDlBER Signature COlIPABY St:ate Cert:. or Regist:. ## ~~L> Lic~e R~gi~~ra~ion t **********t*********~~******************** KECllANICAL Signature a>>tPABY St:ate Cert. or Regist. I City License Registration I ****************************************** OTHER Signature CO!tPAIin' State ~rt. or Regist. ## City License Registration I *********************~~******************* . APPLICATION APPROVED BY PRRKIT OFFICER. CONDITIONS OF PEQMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlitlilY be subject to 'det:d restric:tie,jis" which lay be lore re!;trictive than City regulations. The undersigned assules responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRA~TOR RESPONSIBILITIES If the owner has hired a contractor Dr contractors to undertake w0,"k, they lay be required to be licensed in accordance with state and local regulations. If the"iontractor is not licensed as required by law, both the owner and cDntractor lay b!! cited for a lisd!!leanor violation under state IaN. If the owner Dr intended contractor are uncertain as to what licensing requirellents lilY apply for the intended work, they are advised to contact the City of Zephyrhills Building Deparhent, (8131 7BB-bbl1. Furthertore, 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, 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 FEE~ D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, have b!!en provided with a copy of "Florida's Construction Lien Lall - Hoaeowner's Protection Guide" prepared by the Florida Departaent of Agriculture and Consuaer Affairs. If the applicant is sOleone other than the "owner", I certify that I have obtained a copy of the above described doculent and promise in good faith to deliver it to the "owner" prior to cotaencelent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforaation in this application is accurate and that all work Nill be done in coapliance with all applicable laws regulating construction, zoning, and land developaent. Application is hereby aade to obtain a perait to do 1I0rk and installation as indicated. I certify that no lIorK e,r installation has coatenced prior to issuance of a perait and that all work will be perfor.ed to teet standards of all lalls 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 aay apply, to the intended work, and that it is IY responsibility to identify what actions I aust take to be in rOlpliance. Such agenties include but are not lilited to: f Departlent of Environlental ReQulation - Cypress Bayheads, Wetl~nd Areas and Environmentally Sensitive Lands, Water/Wastewater Treatlent I f Southwest Florida Water KanaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways t Depart_ent of Health L Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic TanKS f US Environaental Protection AQenry - Asbestos abatetent I also certify that, if fill aaterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addressing a "colpensating volule" will be subaitted whic~ is prepared by a professional engineer registered 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 violate, rancel alt!!r, or set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frol th!!reafter requiring a correction of errors in plans, construction, or violations of any codp. Every pertit issued shall becole invalid unless the work authorized by such pertit is cOllenced within six lonths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six lonths after the tile the work is cOlienced. One 90 day extension of tile, lay be allowed for the perait with fee charge of $15.00" The extension shall be requested in,Hriting to the Building Official. An approved inspection lUSt be logged during each six .~nth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT KAY 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 UF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE: CONTRACTOR SIGNATURE: OWNER OR AGENT STATE OF FLORIDA COUNTY OF The foregoing instrument befol-e me this STATE OF FLORIDA COUNTY OF T~e ~Dregnin~ instrument JiefcH e me th is was ar.kf'r.,,~ledap.d , 19_ 0y I~Jas a~kn,::~':ledgcd 19_ by who is personally known to me or who has produced as identification and who did/did not take an oath. who 1S personally known to me Dr who has prDduced ~s identification and who did/did not take an oath. (Signature) (Signature) .. (Name Typed, Printed or Stamped) !:l~lTARY PUBLIC - (Name Typed, Printed or Stamped) NOTARY PUBLIC ?- APPLICATIOOO }"'Oltt i"j'~mrrT CI'IY OF ZE:P;BiTP.lHU S BmLDIOOG DEP/,R"f1Nr~~,T OWNER' S MAKE PlIONlE OWKER · S ADDRESS JOB ADDRESS LEGAL DESCRIPTION: Wf(S) BLOCK SUBDIVISION PARCEL I. D." IOORK PROPOSED:_Nev Construction _Addition _Alteration _Repair _Install _Sign _I!fove _DeJIOlish PROPOSED USE: Sing].e Faaily _KIF _, of Units _K/H _~rcia1 _Indust. _Swia. Pool Other _ResUurant & Bea1t:h ~t Approva1 BUILDING SIZE: x ~re Feet, Height RESIDENTIAL: cottKERCIAL : ATTACH (2) PLOI' PLOS & (2) SEI'S OF BUTI.DING PLANS & (1) SET ENERGY FORMS. U ATTACH (3) SEI'S OF BUIIJ)llJIG PLOS & (1) SET ENERGY FORKS. ** **COPY OF CONTRACT RE(lill'RED. PElMITS RF.oUESTED _BUILDING $ Va1uation of Tota1 Construct.ion _ELECTRICAL AMP Service __Florida Power Corp. W.R.E.C. _HECHARICAL $ Va1uation of Mechanical Installation _PLUMBING GAS ROOFDiG SPECIALTY TYPE OF CONSTRUCTION: _Block _FraIIe _Steel Other FlIISBED FLOOR ELEVATIONS: FI' . IS PRO.JECT IN FLOOD ZONE AREA? YES NO *****....***....*.....,.......'dl-*....................*............**........******....***:t<'* COI8lTKACIOR SECTION Signature CO!tPMW State Cert. or Regist. #f City License Registration #f ***........**....................*....****............****....*********....***....** BUILDER ELECTRICIAH lU SiJroature ..r ~ COHPANY Moraan & Burt Electric Co.. ~ State CerL. or Regist. #f Frnnnn1?n " City License Registration I 244 *....*.............*........................***............................................................********** Inc. PL1JlKBER CDKPAINJY 5t:at:e CerL or Regist:. :J# Signature G:it::y l.:iceu::,~ R('.gist..:;:,\!:-E-m , *....*................*............*.........w....................*~....*****....************ HECllAHICAL COIiPM!IY State Cert. or Reg:ist. I Signature City License Registration I ******....**....***....~~*....*................*****........********....*** OTHER CO'!IPM',"Y State Cert. or Regist. :J# Signature City License Registration I ............****....*........****....***............*....*******....********** APPLICAnON APPROVED BY PERKIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The.undersi~ned understands that this perlit lay be subject to 'deed restrictions' which lay be aore restrictive than City regulations. The undersigned assules responsibility for compliance with any applicable deed restrictions. B. UNL I CENSED CONTRACTORS P,~p CQNTR{~c:._LOR .r..:.s:_?J:::(]l~IS.I..r;~lb..I T I Ef.; 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 lay be cited for a lisde.eanor violation under state law. If the owner or 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) 788-6611. 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, rather than the contractor, are responsible for the work. If the contractor wishes you to sign as contractor that aay 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 Law - 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 docueent and promise in good faith to deliver it to the "owner" prior to cOI.encelent. 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 compliance with all applicable la~s regulating construction, zoning, and land developlent. Application is hereby tade to obtain a pertit to do Hork and installation as indicated. I certify that no ~ork or installation has cOllenced prior to issuance of a pertit and that all work will be performed 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 governmental agencies may 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 liaited to: I Departtent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment I Southwest Florida Water KanaQement District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways t Department of Health ~ Rehabilitative Services, Environmental Health Unit - Wells, Wastewater Treat.ent, Septic Tanks t US Environ.ental Protection AQency - Asbestos abatement 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 "coapensating volute" will be subtitted 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 with the work and not as authority to violate, cancel alter, or set aside any provisions of the technical rodes, nor shall issuance of a pertit prevent the Building Official frol thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perait issued shall becote invalid unless the work authorized by such pertit is cOI.enced within six tonths of issuance, or if work authorized by the perait is suspended or abandoned for a period of six lonths after the tile the work is COtuenced. One 90 day e~tension of tile, lay be allowed for the per.it with fee charge of $15.00. The extension shall be requested in writing to the Building Official, An approved inspection must be logged during each six month 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 COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE: CONfRACTOR SIGNATURE: OWNER OR AGENT was acknc,wledged , 19_ by STATE OF FLORIDA COUNTY OF The foregoing instrument was ~cknDwledged befcq-e me this , 19_ by STATE OF FLORIDA COUNTY OF The foregoing instrument before me this who is personally known to me or who has produced as identification and who did/did not take an oath. who is personally known to me or who has produced as identification and who did/did not take an oath. (Signature) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped> NOTARY PUBLIC APPLICATION FOR PERMIT CTIY OF ZEPBYRIilLLS B1ITLDIBG DEPARlKENT OWER'S NAKE ~A.J' ~ ,,,f~ c+- #1" ~.. OWNER'S ADDRESS JOB ADDRESS LEGAL DESCR.IYITOlli: LOI'(S) BLOCK SUBDIVISIOJri PARCEL I. D.' liORK PROPOSED:_Nev Construction _Addition _A1teration _Repair _Install I _Sign _Hove _Deaolish PROPOSED USE: Single Fallily _KIF _' of Units _K/H _~rcial _Indust. _Swia. Pool Other _Resrnurant &: Hea1t:h Depart:.ent Approval BUILDING SIZE: x Square Feet. Height RESIDENTIAL: COHKERCIAL : ATTACH (2) PLOI' PLJUiIS &: (2) SEIS OF BlJILDIJriG PLANlS &: (1) SET ENERGY FORKS. ** ATTACH (3) SEI'S OF BUILDlliIG PLJUiIS &: (1) SET ENERGY FORKS. ~~ ~*COPY OF COWfRACT REQm::RED. PEmnTS REQUESTED _BUILDING $ Valuation of Total ConstrtJCtion _ELECTRICAL AMP Service Florida Power Corp. W.R.E.C. _KECHMITCAL s Valuation of Mechanical Installation _PLUMBING GAS ROOFllfG SPECIALTY TYPE OF CONSTRUCTION: _Block _FraIIe _Steel Other FINISHED FLOOR :ELEVATIONS: FT. IS PRO.JECT IN FLOOD ZONE AREA? YES NO *~~**~*~~*****************~~***********i** COllilTRAClUR SECTION CDl!fPMiY State Cert. or Regist. , City License Registration , ****************************************** BUILDER Signature ELECTRICIAN COIIPANY State Cert:. or Regist:. #i= City License Registration I ****************************************** Siamature C01IPANY State Cert. or Regist. , City License Registration I **************************************~*** PUllKBER Signature :7 OO!tPANY (.1+/-1 mt?cj ~'C~ State Cert. or Regist. I City License Registration' /2,v ***************************************~** ,...,---, J--'V c-- KECIIANI CDl!fPANY State Cert:. or Regist:. :f# City License Registration , *****************~****~**~**~************* Signature APPLICATION APPROVED BY PE'RKIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject t~ 'deed restrictions' which may be lore restrictive than City regulations: The undersigned assules responsibility for cOlpliance with any applicable deed rEstrictions. - B. UNL I CENSED CONTRACTORS A.I':JO CONTRACTOR F:ESF~m'IS I B I LIT I E!:i If the owner has hired a contractor or contractors to undertake work, they may be reQui'red to be licensed in accordance with state and local regulations. If the contractor is Jot licensed as required by law, both the owner and contractor lay be cited for a lisdeleanor violation under state law. If the owner or 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 Depart.ent, (813) 788-ilb 11. Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorlsl 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 per.itting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE!:i 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 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 docu_ent and promise in good faith to deliver it to the .owner' prior to co.aence.ent. 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 cOlpliance with all applicable laws regulating construction, zoning, and land developlent. Application is hereby lade, to obtain a pertit 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 perfor~ed to ~eet standards of all laws regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. ! also certify that I understand that the regulations of other governmental agencies may 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: f Departlent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment I Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways f Departaent of Health ~ Rehabilitative Services, Environ.ental Health Unit - Wells, Wastewater Treatlent, Septic Tanks f US Environmental Protection AQency - Asbestos abateaent I also certify that, if fill material is to be used in Flood Zone .A' or .A,etc.", it is understood that a drainage plan addressing a 'colpensating volume' Mill be sublitted which is prepared by a professional engineer registered in the State of Florida prior to per_it issuance. A pertit issued shall be construed to be a license to proceed Kith 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 frol thereafter requiring a correction of errors in plans, construction, or violations of any code. Every periit issued shall bee ole invalid unless the work authorized by such pertit is cOlmenced within six lonths of issuance, or if work authorized by the permit is suspended or abandoned for a period of six lonths after the tite the work is comaenced. One 90 day extension of tiMe, lay be allowed for the pertit 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 tonth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAVING 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: CONTRACTOR SIGNATURE: OWNER OR AGENT was acknowledged , 1S'_ oy STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged befclj-e me this , 19_ by STATE OF FLORIDA COUNTY OF The foregoing instrument before me this who is personally known to me or who has produced as identification and who did/did not take an oath. who is personally known to me or who has pl-oduced as identificatiop and who did/did not take an oath. (SignatLll-e) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC APFLICATION! FOR i'EmtIT CITY OF ZEPHYP.HILLS BillWUiG DEPAKIHE'NT OWNER · S NAME PDO~E OWNER · S ADDRESS JOB ADDRESS LEGAL DESCRIPTION: LOI'(S) BL.OCK SUBDIVISION! PARCEL 1. D.I WORK PROPOSED:_llew Construction ~ition _Mt.eration _Repair _Inst.all _Sign _Move _ne.olish PROPOSED USE: Single F3IIIily _KIF _, of Unit.s _"-IH _~ercial _Indust. _Sri.-. Pool Other _Restaurant. &- Health Depar~t. Approval BUILDING SIZE: x Square Feet. Height RESIDENTIAL: COHKERCIAL : ATTACH (2) PLOT l'I...MiS &- (2) SEIS OF BUILDIN!G PUNlS &- (I) SET ENERGY FORM.'>. ** ATTACH (3) SEIS OF BUILDllilG l'I...MiS &- (1) SET ENERGY FORMS. ** **COPI' OF CONTRACT REQUIRED. PEmlITS REQUESTED _BUIIJ>ING $ Valuation of Total Construction _ELECTRICAL AMP Service _Florida Power Corp. W.R.E.C. _HECHMUCAL $ Valuation of Hechanica~ Inst.allation _PLUMBING GAS ROOFlliG SPECIALTY TYPE OF CONSTRUCTION: _Block _Fra.e _St.eel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ***********************~*~**************** COnRACI'OR SECT'IOI!i BUILDER CD!'IPANY State Cert.. or Regist.. , Signat.ure City License Regist.rat.ion , ********..*..""*""**.***,,,,,*,******************** ELECTRICIAN COIfPANY_ Stat.e Cert.. or Regist.. , Si2B3t.ure City License Regist.rat.ion I .*.******....*******.**.****.********** PLUKBER CO'IIPANY /I Jv€ Ttlll,j3' s7' ~~I U ~ L ;;1 J3; /1/ b St:at.~ Gel t:. or Regist.. 1# ~OO~<I)20 78'" Signat.ure C (', _r" Cit::y License l{egist.rat..io~ I /<;() ***...*.**...*...**.*~******.************* MECHANICAL COIfPANY Stat.e Cert.. or Regist.. , Signature City License Regist.rat.ion , .*..-I:***-I:-I:**-I:-I:-I:-I:.*-I:***~.*.*.-I:.*-I:********** 01'1IER cmtPARY St.at.e Cert.. or Regist. , Signature City License Regist.rat.ion j **-1:***-1:-1:*-1:-1:-1:-1:-1:-1:-1:-1:-1:*-1:*-1:..****-1:************* APPLICATION APPROVED BY PERMIT OFFICER. CONDIT7~NS O~ PC~~IT AFFIDAVIT A. NOTICE OF DEED RESTR ICT::.O!\iEi. The ~ndersig~ed understands that this permit .~v bp subject to "deed restrictions" which lay be more restrictive than City regulations. The undersigned assules respon5ib~lity for compliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undert~ke -;ork;~ey may-be~Q-uired ~b;.~icensed in accordance with state and local regulations. If the contractor i,. not licensed as required by law, both the owner and contractor lay be cited for a lisdeleanor violation under state iaw" If the owner or intended contractor are uncertain as to what licensing requirelents lay apply for the intended "ork, they are advised to contact the City of Zephyrhills Building Departlent, (8131 788-6611. Furtherlore, if the owner has hired a contractor or contractors, he is advised t'o have the contractor(sl 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. I 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 Guide. prepared by the Florida Department 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 document and promise in good faith to deliver it to the .owner' prior to co..ence.ent. E. CONTRACTOR'S/qWNER'S AFFIDAVII I certify that all the information in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and laDd develop.ent. Application is hereby made to ~btain a perlit to do work and installation as indicated. I certify that no work Dr installation has commenced prior to issuance 0' a permit and that all work will be perforled to seet standards of all la~s regulating construction, City codes, zoning r2Q~lations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulation~ of other governmental agencies lay apply' to the intended Mork, and that it is IY responsibility to identify what actions I lust take to he ill cOlpliance. Such agencies include but are not lilited to: f Depart.ent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treat.ent f Southwest Florida Water ManaQement District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f Army Corps of EnQineers - Seawalls, DOCKS, Navigable Waterways I Department of Health ~ Rehabilitative Services, Environ.ental Health Unit - Wells, Wastewater Treatlent, Septic Tanks f US Environ.ental Protection AQency - Asbestos abate.ent I also certify that, if fill .aterial is to be used in Flood Zone 'A' or "A,etc,", it,is understood that a drainage plan addressing a 'colpensating volule' will be submitted which is prepared by a professional engineer r~gistered in the State of Florida prior to perait issuance. A perlit issued shall be construed to be a license to proceed with the Mork and not as authority to violate, cancel alter, or set aside any provisions of the technical code~l nor s~:all issuance of a pertit prevent the Building Ufficial frot thereafter requiring a correction of errors in plans, constructior; or violations of any code. Every perlit issued shall becole invalid unless the work authorized by such perlit is co.tenced within ~ix lonths of issuance, or if work authorized by the permit is suspended or abandoned for a period of six months after th~ t:!e the work is comeenced. One 90 day extension of ti~e, 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 THICE 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". SI6NATURE: CONTRACTOR SI6NATURE: OWNER OR AGENT ~J .~~ STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged '.J',=fcq-e il1e;h"s 1'7'_ by STATE OF FLORIDA COUNTY OF The foregoing i~strument was before me t~i5 19 ackrv:'!.l edged who is personally known to me or who has produced as identification and who did/did not take an oath. who is personally known to me or who has produced as identification and who did/did not take an oath. (S i gna tLll-e) (Signature) (Name Typed, Printed Dr Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC ..,(, \,-, ,("J /- , \.. ~- \" O\., ~ " , , ,,1 ; " 'I VAl,..,\J.An'ON~ I cg~(oIDC C , ~. ..~,,.........,, , .-.,ir..-------,-- ,~'-,~ . _ ,J{L-rAIl,..:7 ~? _~._ 4'" .22 b t~ . tl l~ f \,.1'\1T \)_. .____!!.~2 ~>L____J 13-J~2..~;1' fi, __0-)frtf- t\l"~l~~ . .jj_.L_,._3, S2S~'1' f~ ~RrX~~~ . ~', a- _____._________ t ~~ T ~~-r.~'1 . ~ 5~ 4-. X 4!-1, ~'2>J 6,. H. 11otl(~f~ . CV,\lroefor ,"- CtlSiCb 0'" Io~'o 0 f . ?J. ( 72,313 t~LJ-+ ~rl'lL ~~r-.I4, . c..D~~~("t.:\ Q.~__ff42 Sf-:v1_~.~ U ,3~ z., .;~:>' . W.6rE.Jt 3) I Ulo . 2~S' 1/ Z '" /Y) e.. Ie: r2- To_flt'- r(fr\)~~_~~.s tf5, 5 tp4 ~. F~, \:?~l (..~~~ ~pLu_~_B-, 1\J_& 'J,Lf(r~-'(.h L- .: iME'c.t\r)_~IU'lL · S-..)iSjQJ:~L- ~~U\\ ~-C1\'L- ,- fD in 7~' r J =>;0) 3 07 .6'1: 7/lu.75 357,Ot' 'DJ 05~,75 I ")4) of') ,,5..2.'- .. (p,1.D7b.7S / - ---_.---,.------_..~._------_.. --- _____,~.L__ . <:;1.10 C .~.. i.:J7.. _ I ~ l,<3't> ..5" 0 / T--. ....,....... \..t$'- -r -,. - , tf,~. ~'-I Coat; deJ;;( ~- _.._---_.,--~-------- ~ _l~~J~\Z..:(r\"oN Ifv' f"L-l' --_._-~-- -A~sA i ~rr'1 . . -r-; 1-( r- - / ',./ r:;::>'=: ...__ '.__ (! F ,.::;.=:> w4f ;.;-:::. I - ~~ 5t&,c./ tYf;sF X Z./~c;, 34 ~...N1 T7,c II //'h 335..57/ Fe:. c. Co.. ' ~------'---_.~_._-_._----- ----~-- , / / ~-I--Z?' 02... / / / / Lf s..3 " ._._.n__.) .", , >o-71lLb.:34.} 7Slo"~--- . , , l/ €:.. C ';..:\ .... \ 'f, <\, ...' lil{ r, r \...> I I .., ,. r' f ( fo c>\\ '5 "fo ..!l,) TABLE A - WORKSHEET CITY OF ZEPHYRHILLS CONNECTION FEES RESOLUTION #312 WATER $1.75/GALLON SEWER $6.39/GALLON RESIDENTIAL (Each Lot or Unit) Residence $ 350.00 $1,278.00 Travel Trailer Park 131. 25 479.25 COMMERCIAL (PER FIXTURE) , Sinks 87.50 319.50 Water Closet 131.25 479.25 Urinal 87.50 319.50 Lavatory 43.75 159.75 Tub/Shower 87.50 319.50 Washing Machines-Commercial Size 350.00 1.278.00 Washing Machines-Domestic Size 87.50 319.50 FOOD SERVICE - Dishwasher 700.00 2.556.00 Sinks (3 Compartment) 175.00 639.00 Car Wash (Per Stall) 1 000.00 6,390.00 FIXTURE G.P.D. # WATER SEWER TOTAL PER FIXTURE Sinks 50 \ , _.u_~Lhl. 50 3\ 5/4.5'0 t-f, 4 77, (> 0 Water Closets 75 1 en '6. 0"1 S /). C I /;.,. '-I 2.73,50 ,:'), :):;;.... . Urinals 50 2 1'/5['1"1 ~3q. ;)u 1:,)'-1.00 Lavatories 25 & "'5 C f 117.7'5.00 I loZS, Of) .~ 0."-' TubS/Showers 50 Washing Machine 200 Washing Machine 50 Dishwasher 400 Sinks-3 Comprt 100 q 7 00. DD 2..,55b. DO :?, ,~(" . OC " , Car Wash-p/st. 1,000 I 3.' Ob,k~ \\ '3 '-12... t~ I Lf, "It-! B.So T 2.." WATER METER <54c. (, (> GRAND '.'OTAL I." z. '6 'B. '!5 L") I . ZEPHYRHILLS FIRE DEPT ~'\ '" -~ Zephyrhills Florida" 33540 FIRE CODE INSPECTION' . . Business Name K~<;A A/ /(,q1212! Classification I11E~c~;(.,J L--=- Address 73~ GI4LL 6(~ Own~~J" eChA-lt.~ Le..-fSR-'-'-N Business Phone 7 Go - ) 0 4 Cv Emergency Contact Phone '7 Be - 6 toCc 6 Occupancy Load &~ -r /4v j(. L, Qu (21Z- ) lJ::-.' ~ <:" ~ ~'ON '> ) TYPE OF INSPECTION CONDUCTED -' o QUARTERLY ~FINAL 0 ANNUAL 0 BI-ANNUAL ORE-INSPECTION 0 OTHER //pfRotJEb {,U,J-( (1;/l-'J:bJrcY\.-S }&.' APPROVED 0 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. OK B 'I z~ +;~ ~'Y~L C.c:J, ,-de J:c~;.L:/\."-~ .I--f-~~ '; UJ\(L o / ( D. ----0 +-A. J~ E Q <.?"""-~LE-<\. Eb. ~ 'f ~./4S~ f.../tf:- S be-'- f ((\ ~ 'f 2. c.o . 1),.:10 ~~A--~E A-t3ov,E"- c~C)G:. (l. c; - RE--#'Y1o,/f: s--L,fL4-yF _ 2) r;".....s-l-A--lL S(~~S ~tv ~~,'L E~\-k -- DocJl'l.s -k, R€"",cq,v v..'\-.~c.~,,:1 'b.....er.:5 ~u-S{r"-~C;S ~-'-;2S. - Lr---,.j(s .z....c.c-<~...s ME- )c"VL &"-" +h t.r~uo-c. s!-dff) "'3) -hcL Oo,~<.. t!.?IV RA~~'b. ~cC 1- -1..'?;> f:(d~'12.. 4) 7A-~~ f>~51cc. gf+:- ~C( <; ~<'"'-\:-C~L ).-\c..A\:' S Drc;c....ss ~ ~ J:..+ "..f 'F;~ t:J1J ~A, ?(~{L r4ll.eA &) P,sc.....SS Lcc~(.e-....... ~ p~C( ~ (~ S' c>~k e....... 7) :E:.r.-s-f.A-L( b~I!e.c-~t'ly ~n....- 1X.A.t-___. rA,..,~L ~"'-~ R.e.~L Pet"'-€-L e) ~~~ fb IN S€C~~tJ,/ ~ . ~ l11,vl:- 1Y\.Il.Lt:?1L B t:=~r-!- 5:: L/ (..v' Lc al~ ~tL /iI l<~ cllL- 2. ~c-- r&{"/;; Inspect. Date S- -;z..{ - 17- Inspect. Time /otJO I..r S-s- / Re-Inspect. Date 0Wrre~7Si!P18lur '< .... TIUe ~~ Tb~cbuilding;)l8s ~n~l.t~:~ttte.ZephYlfiil1s Ire Depl under thecod~~regu~ .of J.e NFPAminimum standards; the State Fu'eMarShal'sUniform Fire Safety rules andotherl6c8f;;fjrB'SilfetycOt;fes. ........ .. PASCO COUNTY, FLORIDA ... .;.'" Permit # Date Name/Owner County Parcel # Location Classification / Type of Use lRANSPORTATION IMPACT FEE CALCULATION Rate $ Zone # Sq. Ft. / Unit Prepared by Impact Fee Amount $ The above impact fee has been established pursuant to the Pasco County Transportation Impact Ordinance as adopted by the Board of County Commissioners. This amount is payable PRIOR to the issuance of a Certificate of Occupancy or authority to utilize the permitted structure. RESOURCE RECOVERY ASSESSMENT RESIDENTIAL NONRESIDENTIAL # Units Gross Sq. FL (GSF) Rate / ERU = 50.00 x 0.96* / Year or$0.1315/Day ERU Assign # Assessment = (# Units) x ($0.1315) x (# Days) Assessment = !Q.SfJ. x (ERU) x (0.1315) x (# Days) 100 TOTAL FEE $ TOTAL FEE $ *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 CERTIFICATE OF OCCUPANCY. NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED UNTIL THE AMOUNTS LISTED HAVE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY. Acknowledgement below does not imply acceptance of concurrence, but simply receipt of a copy of this form, placing the building permit owner on notice of this assessment and the conditions of payment for same. Date Received By OFFICE USE ONLY ------------------------~-------------------_..._------------------------------------------------------------------------------------------------------------------ lRANSPORTATION REC. # RESOURCE RECOVERY REC. # DATE DATE BY BY White Applicant Canary Trans / Finance Canary RR / Finance Pink Office Green Bldg / Insp