HomeMy WebLinkAbout92-2733
BUILDING PERMIT
Permit
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CITY OF ZEPHYRHILLS
(813) 788-6611
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Sewer Conn t 2. 7~ ~ ,
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Water Conn: ..E.fJ.--rJ
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Water Meter: ~
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Job Address:
Parcell.D. #
FINAL
Zoning:
Description of Work
NO OCCUPANCY BEFORE C.O.
Complete Plans. Specifications and Fee Must Accompany Application, C.O.
All work shall be performed in accordance with City Codes and Ordinances,
DATE
Inspector
Valuation or
Contract Price
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Permit Fee
Signature ~", I I ,
Company
Address
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BUILDING
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Lintel t:lil
FRM. i2-f(PfJ..- -
Insul. CL
Wl ~A l'l"q;i ;5' iU
City Licen.a Regi.ttation # t/ ~.
State Certified License#, ;.f
h)J~'1f~ J;l~0-~::"~
ElECTRICAL~6 PlUMBING# .5"7
Tp.Serv. SLB j/-/o.~l.- ~iiI
Rough In J.j / II}. If) t5iflI Tub Set /2:, ~ l' .
Meter Can !1J~?-) ~ Water
Const. Pole Sewer
Pool Final
Pre-Meter 2. "'1-7?J f;IJ/-M.
Final
Telephone#
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M HANICAl# 7/
Breakers ~
Ducts Insl.~f;'92 U.
Compressor
Final
Driveway
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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.
FORM 900-B-91
FLORIDA ENERGY EFFICIENCY CODE
FOR BUILDING CONSTRUCTION
Section 9 - Residential Point System Method
Department of Community Affairs
Climate Z.Mes
CENTRA~5 6
NEW CONSTRUCTION
ADDITION 0
MULTIFAMILY ATTACHED 0
SINGLE. FAMILY DETACHED 0
IF MULTIFAMILY, NUMBER OF
UNITS COJERED BY OIJ
THIS SUBMITTAL:
CHECK IF THIS SUBMITTAL
REPRESENTS A WOR~!,,GAy
CONDITION Ud""'"
CONDITIONED ~o sa
FLOOR AREA ~ Fl
PREDOMINANT
EAVE OVERHANG
LENGTH
PORCH OJERHANG
LENGTH
PERMI
NO.:
PROJECT NAME
AND ADDRESS:
m.D Fl
m.D Fl
GLASS AREA AND TYPE
CLEAR TlNT,FILM,SOLAR S
SINGLE. [ill] sa SINGLE.
PANE Fl PANE Fl
DOUBLE. [ill] sa, DOUBLE- [ill] sa
PANE Fl PANE FT
NET WALL AREA AND INSULATION
~TERIOR MASONRY R = EXTERIOR FRAME R = EXTERIOR STEEL R = EXTERIOR LOG R =
DIIDSQ. m.o ~~ [ill] DIIDso, m DIIDso, m
FT FT FT,
ADJACENT MASONRY R = ADJACENT FRAME R = ADJACENT STEEL R = ADJACENT LOG R=
DIID~.' m.D DIIDso, m DIIDSQ, m DIIDso, m
FT FT FT,
CEILING AREA AND INSULATION FLOOR TYPE AND INSULATION
UNDER ATTIC R = SGL ASSEMBLY R = SLAB PERIMETER R= RAISED WD 0 CON 0 R=
~sa, ~ [[[[[]sa, ITJ ~Fl roo [[[[[]sa, ITJ
Fl Fl FT.
DUCTS COOLING SYSTEM HEATING SYSTEM HVAC CREDITS HOT WATER SYSTEM HOT WATER CREDITS
IN ~ENTRAL o ELECTRIC STRIP ~AT o CEILING FANS ~CTRIC SOLAR: O.ITJ
UNCONDITIONED S,F. =
SfilR= o ROOM o NATURAL GAS PUMP o CROSS VENTILATION o NATURAL GAS HEAT RECOVERY ICHECK) 0
[.g] o PACKAGE TERMINAL o ROOM UNIT OR o OTHER o WHOLE HOUSE FAN o OTHER FUELS
FUELS DEDICATED 0
IN CONDITIONED AIR CONDITIONER PACKAGE TERMINAL o NONE o ATTIC RADIANT o NONE HEAT PUMP: .ITJ
SPACE R = o NONE HEAT PUMP BARRIER E,F. =
m.D SEER/EER = ern.lQ] COP I HSPF I ~.@9 o MULTIZONE EF = . ITJ NUMBER OF rn
AFUE = BEDROOMS =
INFIL TRA liON
PRACTICE ~D
o #1 lJV#2 0 #3
~ ~ x100= .[Q]
TOTAL A5-8UILT POINTS TOTAL BASE POINTS CALCULATED E.P.I,
CALCULATED ENERGY PERFORMANCE INDEX MUST NOT EXCEED 100 POINTS.
1 hBreby carMy that the plans and s98J;lficallons covered by the calculation are in compliance With the
Florldd Enttrgy COdel t
PREPAREDBy:t:. / ;7'". '- ~ DATE/:'
I hereby certify that this building is in coOjpiiance with the Florida Energy Code,
OWNER AGENT: / ( . r .' / ";" ,. ' DATE: ~
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P.O. BOX 596. ZEPHYRHILLS. FLORIDA 34283-0596. (813) 782-9080
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.\PPLICATIOJif FOIl PERKI.T
ern OF :zE1I'II'fRHILL
BmUH.J!IG DEPA.'lt'DIEMT
OWNER' S RAKE
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LEGAL DESCRIPTION: LOT(S)
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BLOCK______SUBDIVISION
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WORK PROPOSED:~lrev Construction _Addition _Alteration -----Repair _Install
_Sign
_Move
____Deaolish
PROPOSED USE:
i~1:Dgle Faaily
,_KIF
_' of Units
_K/H
_~rcial
_Indost.
_S,"--. Pool
Other
~Kestaurant &: Health ~t Approval
BUILDING SIZE:
x
Square Feet.
/,\','.
Height
RESIDENTIAL :
COHKERCIAL :
AtTACH (2) PLOt' PLANS &: (2) SEI'S OF B1ITLDDfG PI..A.5S &: (1) SET RNERGY FORKS. **
A1TACH (3) SEI'S OF BmLDB!G PL.~JifS &: OJ SET ENERGY FORKS. 'H,
"''''COPT UF CONl"RAGI' REQm:RED.
PERI!tITS t:FQ!liRSTED
_BUILDING
$
Valuation ._,I Total Construction
_ELEC'l'RICAL
AKP Service
_, .Flurida Power Corp.
W.K.E.C.
_tlECllAHICAL
$
Val.f'I3tin, , o:f "..ecbanical Installation
_PLUKBING GAS
F~FiJiG
SPECIALTY
TYPE OF CONSTRUCTION: _Block
_FraIIe _Steel
Other
FII!IISHED FLOOR ELEVATIONS:
IT .
IS 'PIID,"ffiGI' DI FLOOD ZONE AREA?
YES NO
.....................*""'......* ' ,"'.........!'c....v...oJ:-......i!'*....................................................
cmII'I'RACIOK SEGI'ION
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CUfPArry !
St:ate Cert. or Kegist. '+---L-,
Signature ; Cit.y Lioeense Registration ,
n=rRICIAR ..........._.=:.~LvL(jL.
:~:~~. , St:ate Cert. or Kegist.' tt7 tf/ /::l /{/ I
S-=-- e " City l,icense Registration # .;{ CJ ~
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St:a. ; :':~<::..:.;,:. or Regist. ,
City License Registration I
BUTTDER
PLOftBER
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Signature
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Signature
WllPA'ilY liz AI ~ _ C .o..f/ffJ
St:ate Cert. or Ke - t.' # Oa ~-YI'2...
City l~icense Registration I 7 I
................~........*............................................~*...*...................~..........................
KEaJAlfICAL
COItPLRY
Stat~ CeT~. or Regist. ,
City ~;~:....,.:efiSe Registration ,
......................~....................-il->l:....................* .<it..........................................................
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Signature
APPLICATION' APPROVED BY
PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this per~it lay be subject to 'deed restrictions' which .ay be .ore restrictive than City
regulations. The undersigned assu.es responsibility for co.pliance with any applicable deed restrictions. ..
B. UNLICENSED CONTRACTOI~S AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they aay be required to be licensed in accordance with
state and local regulations. If the~tG~ractor is not ,licensed as required by law, both the owner and rontractor .ay be
cited for a .isde.eanor violation under state l~w. If the owner or 1ntended contractor are uncertain as to what licensing
require.ents .ay apply for the intended w~rk, they are advised to contact the City of Zephyrhills Building Depart.ent, (8131
788-6611.
Further.ore, if the owner has hired a contractor or contractors, he is advised to 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 .ay be an indication tiiat he is not properly licensed and is not entitled to per.itting privileges in-the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE~
D. CONSTRUCTION LIEN LAt{ (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applirant, have been provided with a copy of 'Florida's Construction lien law - Ho.eowner'~ Protection
Guide' prepared by the Florida Depart.ent of Agriculture and Consu.er Affairs. If the applicant is so.eone 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'lence.ent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infor.ation in this application is accurate and that all work will be done in co.pliance with all
applicable laws regulating construction, zoning, and land develop.ent.
Application is hereby .ade to obtain a per.it to do work and i~stallation 'as indicated. I certify that no work or
installation has co..enced prior to issurtnce of a per.it and that all work will be perfor.ed to .eet standards of all laws
regulating construction, City codes, zoni~g regulations, and land develop.ent regulations in the jurisdiction. I also
certify that I understand that the regulations of other go/ern.ental agencies lay apply to the intended work, and that it is
'Y responsibility to identify what actio!;; I lust take to be in cOlpliance. Such agencies include but are not li.it\?d to:
I Departtent of Environ.ental ReQulation - Cypress Bayheads, Hetland Areas and Environ.entally Sensitive lands,
Wdt2r/Wastewater Treat.ent
I Southwest Florida Water KanaQelent Dis;,-i(t - We~ls: Cypress Bayheaos, Wetland Areas, Altpring Watercourses
I Ar.y Corps of EnQineers - Seawalls, Docks, Navigable Waters~vs
f Departlent of Health ~ Rehabilitative Services. Environ.ent~J Health Unit - Wells, Wastewat\?r Treat.ent, Septic Tanks
I US Environ.ental Protection AQency - A~bestos at~tetent
I also certify that, if fill laterla! is '0 t2 tised in F:~o~ .~ll~ .~. ~r '~,~t[.', i~'is uoderstLad thi" a drainage ~lan
addressing a 'colpensating volu.e' will be sublitted which is prepared by a professional engineer registered in the State of
Fl3rida prior to per.it issuance.
A pertit 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 code~, nor shall i~~uance of a pertit prevent the Building Official frot thereafter
requiring a correction of errors in plans, construction, or vi~lations of any code. Every per.it issued shall beeo.e invalid
unless the work authorized by such per.it is co.tenced "l~hin six ~onths of issuance, or if work authorized by the per.it is
suspended or abandoned for a period of six .onths after th~ ti.e the work is co..enced. One 90 day extension of tile, .ay be
allowed for the per.it with fee charge of $15.00. The exten5~~n shall be requested in writing to the Building Official. An
approved inspection lust be logged during each six .onth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORU A NOTICE OF COKMENCEKENT AAY RESULT IN YOUR PAYING TWICE FOR IKPROVEMENTS TO YOUR
PROPERTY. IF YOU INTEND iO OBTAIN FINANCING, CONSULT WITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT. JOBS UNDER $2,500 IN VALU;: DO NOT NEED TO RECORD AND POST A 'NOTICE OF COMMENCEMENT'.
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SIGNATURE: OWNER'OR AGENT
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SIGNATURE: CONTRACTOR
STATE OF FLORIDA U
COUNTY OF r ~_
':h~ forege,ing i,nstr.L~ent vIas acknc.vlledged
::..efcl\-e me this ~9~ ~, 19U- by
fA;. /l-, Iv e fA W74/1I1'V
who i 5 pel-]J'~-I~ l~ l_y krff1:n to me or who has
produced ~ ~ ,ro ~
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E.-o IZ; B€'-1- 1/ In - 1< u.. S..J' -e (, '-
(Ndme Typed, Printed or Stamped)
NOTARY PUBLIC
~TATE OF FLORIDA ~ ~
COUNTY OF ____~
The fc.regc,ing instrUII)~,'t", ,!,ps acknowledged
before me t:'lis g2.~Q'3'1'}..1_~ by
W.4, /lieu. h'VJNtV
who is pers,nally me or wh9 ~
produced 'E.
as identification ho did/d~d nDt
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Lc:o~;'"RE+1I }yr, 1?Vf.SSeLL
(Name Typed, Pr i nted CIj- Stamped)
NOTARY PUBLIC
Notary Public, 81210 of Florida at Large
My Commission E:<,~';es Aug, 28. 1994
~,i Cc ul(')\J ~~
Notary Publ~c\ S(;~te of Ficrid~ L~ Lz:rg.:J
My Commiss!c<1 E:,";es Aug. 28.1994
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PASCO COUNfV: F~~R~~A
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OFFICE: DADE CITY
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PASCO COUNTY, FLORIDA
Pennit #I
Date
Name/Owner
County Parcel #I
,./'
Location
Classification / Type of Use
TRANSPORTATION IMPACT FEE CALCULATION
Rate $
Zone #I
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
#I Units
Gross Sq. FL (GSF)
Rate / ERU = 50.00 x 0.96* / Year
or$0.1315/Day
ERU Assign #I
Assessment = (#I Units) x ($0.1315)
x (#I Days)
Assessment =
!Q.Sflx (ERU) x (0.1315) x (#I 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.
TIIE ASSESSMENT Wll..L BE CALCULATED AT TIIE TIME OF ISSUANCE OF TIIE 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 fonn, placing the building permit
owner on notice of this assessment and the conditions of payment for same.
Date
Received By
OFFICE USE ONLY
-------------------------------------------...-....--------------------...--------------------------------------------------------------------------------------------
TRANSPORTATION REC. #I
RESOURCE RECOVERY REC. #I
DATE
DATE
BY
BY
White
Applicant
Canary
Trans I Finance
Canary
RR I Finance
Pink
Office
Green
Bldg I Insp