HomeMy WebLinkAbout94-3773
BUILDING PERMIT
Permit N ~
CITY OF ZEPHYRHILLS
,D (813) 788-6611 ~
~ ~ ~:~ C;;~
::~:::,~,:n~7;;f)#;J!::t1f;$ CJl1~
Parcell.D, # ~1- j/;)--eJ/ - OOOD -t!)O~oo -000 U
Zoning:
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.
Valuation or d b ~ . ~
Contract Price ~ . DD D
,
Permit Fee.
Signature
Company
Address
City License Registration # It
State Certif License# {!"'~:J //}'j;(3
Date
_37736
/-/0 -c;~
-
Sewer Conn &> ~9
Water Conn: /75-
Water Meter: 7JD. /:2-1, -9;$
T.I.F.'s: ~ 1/ IJI. 4~
'~-r
BUILDING
ELECTRICAL
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL b:1I,qL} ~
Tp. Serv.
Rough In 02/08/94 BOB
Meter Can
Const. Pole
Pool .
Pre-Meter ~-I/<N Et-IJ
Final J./-U-i1<{ ~
SLB
TubS.. ~
E:~~~n--- --,--/
Driveway
ht.J~ -~ .Z.b4o.f'B'u.-
MECHANICA
Breakers
Ducts Ins!. 02/01/94 IDB
Compre.~~r
Final ~-l1> '4t..f ~
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.001 shall be made for each trip for each trade:
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.
7/ t1 ~ -;26 -7'<-(
fJ-d r... Jb -- 9 'f
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
r- ,
\I...I..~..;.........I
VdlUdllUII.1 tb 3/ 1J07J. 0'0--,
Permit Fees:
_._-_.._--~ .----.
Building j 7.3 ~~ 7)___
Plumbing / .2 . 0J~D
Electrical 0-~' 00
.J~e~~an}cal J tJ__.ffJ2___
Subtotal J- 70 ,-50
---.-----.-.- ------------....-
Credit
-~----_._--- -------_._-
Total d-- 7 tJ, S7J
Connection Fees:
-..----....---.-----.- -----,--...__.... .---
__.,__ ___~ewer & 0.L:fl_
Water ) 76: (}()
Meter /.:l-t '-7...1 '" .l
/
Total ~ I 'f tJ7)
[-R-~o~~~-~~s {J -6- ~l__,_j!-_(_=-_~
.____~q. Feet ~ s 7 0
~ '-ItJl. yL:,
[=~_----T:I-:-';:;I~% t 3~-Z..~j
Ii: LJ t.;, tJ I
"'/;1-~ a~ ~
~r/3
-'13u"\ Id Ouf
lJ o_~ 5'; 'f f'!>-; ~l
/Sq. Ft. Livingl
~ij9'O f
[iq. Ft~th;rT--fO--~]
,
Il'V\S'i)iL(V- .f-tl'L-n ~U~ 0-
i~.1-'l?/'
"-1.._..:....._.1- /3- D--; 0--- --j
VdIUdLIUII.! co , ~
[sq. Ft. Livin~ ~L/;qo
~. Ft. Ot~!iI1fJ5:- K 1?O--~]
. i5" lC- Si31.. L) 5')- f-t- ~tt.KI,Jtr
Permit Fees:
------..-.---.. -.-" ._----~ .-
Building '115. 5'"0
Plumbing 37.5'0
Electrical 5t..{,50
--..--- ---~-_._--
__fY1_~~~~nL~~! ___3D ,_~:____
u__ S_~~~~~~~ __~Ll. 5~___
Credit - ~O, 'C -",
:_-:~=~~---T~tal - 5S-7~5b-----l
VO ,\6
v/h. 0 ~ 0 l~c0
\(:] 0 ~
. \{)~
[ i/!oL'&I~____~,;_ . ,\0 ~ .// \ ~\
... _ T.!. F.~!; l'!'-' _ .<1; 5"7. ~ sl _ "\ \ ,,{
/ % 'It/. _ \ ~ {l
\ \
lT~t~~r~;'~-l
--------1-----f
Connection Fees:
"-'---'-~'-' -------,------.----.-
0:>
__.____ ___~e~_~r_~3:t___~__.__
Water L 00
--?J-7T-~---
.11 Meter b~. 0 D
D
Total q:JJ. ~____
\c
~;;J-)
1\
e
~o __.___.______
Radon Gas
_~q. Feet
/5:7D
"-----
5-70
-
U101 T l3
mE.ulCi\L- AtU"~ 8Lb&
TAnLE A - WORKSHEET
CTTY OF ZEPHYRHILLS CON!'mCTTON rET~S
RESOLUTION 1;312 \<lATER $1. 75/GALLON SEWER ~6.39/GALLON
. RESIDENTIAL (Each Lot or tJn it)
Residence $ 350.00 $1,278.00
Travel Trailer Park 131.25 If 7 9 . 2 5
COMMERCIAL (PER FIXTURE )
Sinks 87.50 319.50
Water Closet 131.25 I. 79 . 2 5
Urinal 87.50 319.50
Lavatory 1.3.75 159.75
Tub/Shower 87.50 319.50
.. .- - _.
Hashing Machines-Commercial Size 350.00 1.278.00
.
Washing Machines-Domestic Size 87.50 3J9.50
FOOD SERVICE - Dish\vasher 700.00 2.556.00
Sinks (3 Compartment) . 175.00 639.00
Car h'ash (Per Stall ) 1,000.00 6.390.00
FIXTURE G.P.D. if WATER SEh'ER TOTAL PER FIXTURE
Sinks 50
Water Closets 75 I J31. 2-5 1-/7Q. 2-:;- - folD, 50
Urinals 50
Lavatories 25 J t./3, I~ /5Q. '7S- 2-03,50
Tubs/Showers 50
Washing !'-lachine 200
Washing !'-Iachine 50
Dishwasher. 1100
Sinks-3 Comprt 100
Car Hash-p/st. 1,000 -
/75: 00 1031. DO "SlY-" 0 0- - -
3f1
"
h'ATEF: ~lETER
/~?, 00
17'1~ u D
GRAND TOTAL
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT ~o\.J..YrJ\J \ E.\.\J ~ Ca', c..o...~ \\\'-\s 'Qo.f\-N t. f i h', ~
ADDRESS '\~ ~ G..\.\ ~ \vcl*~ 2- ~.\ \ \ ~ PHONE C ~\'~) ~ g'~ -gY10
OWNER ~ ~ v0~\ t.-\.0 Po. {' -\- ~
JOB LOCATION
\ ~+. LOT SIZE
x
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
:3 ~ - ~ 5 - ~l -COCo -60.3oo-0COlJ
BLOCK
SUBDIVISION
PARCEL I.D.~~
WORK PROPOSED:~New Construction
_Sign/Temp.
----Addition _Alteration ~epair _Install
_Sign
_Move
_Demolish
PROPOSED USE: _Single Family
_M/F
_t~ of Uni ts
.~/H
~commercial
_Indust.
_Swim. Pool
Other
~Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Feet.
Height
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
**COPY OF CONTRACT REQUlRED.
PERMITS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
_W.R.E.C.
~ECHANICAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
Sitmature
~ JJ.
CONTRACTOR SECTION (\ ~ C\-
Company ~o..~~ t! to. ~ ~~.
State Cert. or Regis. # ~ Ci \aqj.~
City License Registration #
................................~~...
Company f1AA 7_~~
Vt. . L State Cert. or Regist. 4~ 6- (2fJlJ IIII/J
,-~ City License Registration #
*******~*********************************
Signatu
RT.RCTRTCIAN
PLUMBER /'} Company ~~ 0 ~Cf \;\
e ~ ~ State Cert. or gist. 1/
Signature (. City Llcense Reglstratlon
, - .......... .............................
MECHANICAL Company ~Ati~~ /d(J~;(A./<i. 'f..sAS fl..~
-4 AI. / '. State Cert. or Regist. l L,tIC 0 V...? 9 ~,
Signature / p ~ City License Registration 4~
******************************************
Company
State Cert. or Regist. #
City License Registration #
Signature
******************************************
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFiOAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit lay be subject to "deed restrictions" which lay be iore restrictive than City
regulations. The undersigned assules responsibility for co.pliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they aay 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 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 Departlent, CB13}
7B8-6611.
Furtherlore, if the owner has hired a contractor Dr contractors, he is advised to have the contractorCs} 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 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 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 will be done in cOlpliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a perlit to do MOrk 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 Iilited to:
f Departlent of Environlental Requlation - Cypress Bayheads, YetIand Areas and Environlentally Sensitive Lands,
Water/Wastewater Treatlent
f Southwest Florida Water "anaqelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of Enqineers - Seawalls, Docks, Navigable Waterways
f Departlent of Health L Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treat_ent, Septic Tanks
f US Environlental Protection AGency - 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" will be sublitted which is prepared by a professional engineer registered in the State of
Florida prior to perlit issuanre.
A per.it issued shall be construed to be a lirense 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 per.it prevent the Building Official frol thereafter
requiring a rorrection of errors in plans, construction, Dr violations of any code. Every per_it issued shall becole invalid
unless the work authorized by such perlit is cOllenced within six lonths of issuance, or if NorK authorized by the per.it is
suspended or abandoned for a period of six .onths after the tile the Nork is cOllenced. One 90 day extension of tile, lay be
allowed for the perlit with fee charge of SI5.00. 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 Nill be considered abandoned.
WARNIN6 TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO"KENCE"ENT HAY RESULT IN YOUR PAYIN6 TWICE FOR IHPROVEHENTS TO YOUR
PROPERTY. IF YOU 'INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
CO""ENCEKENT. JOBS UNDER S , N VALUE DO NOT NEED TO RECORD AN POST A -NOTICE OF CO"HENCE NT".
SIGNATURE: CONTRACTOR
STATE OF FLORIDA ~
COUNTY OF Q,. C; e. u
The foregoing i~trument
before me th i s ~'t!!.. \
was acknowledged
, 19...:tl by
STATE OF FLORIDA ~
COUNTY OF r YS t..Q
The foregoing in~ument
befc.re me th i s ~'C:.~ \
was ac~nowledged
, 19~ by
c...t~~-r
know to me or who has who is ersonally to me has
~ produc
as identification and who d~did not \ as identification and who di .f id no
take ~~ :s 3 ~ Q ":-;;-- ~take an ~~ :s ~ ~t's
(Signatur~.' d ..~ .~ '\. (SlgnatUl-eh.1...\ ~ . 4-.
~ ...)e:..~~ \\ ~-r6 ~ ()<<t:...~ ..J' 10
(Name Typed, PrO ted or Stamped) (Name Typed, Prl ed or Stamped)
NOTARY PUBLIC NOTARY PUBLIC
"'~-;;'\fj;;.:.< BmY JEAN TIPTON
.~,' -.'1f'
f*; . :;~ MY COMMISSION' CC 233647
~'. .'61 EXPIRES: Oclllber 8. 1996
";:~p. "f:I'<f,.'- IIondId llIni NDlIIY PlIbIIc lblIlwIftIII
BETIY JEAN TIPTON
MY COMMISSION' CO 233547
EXPIRES: October 8. 1996
IIondId TIlru NollIIy PllIlIIc I.hlIrMIlIII
FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTR~CTION
FORM 500 A-93 CHAPTER 5 . BUILDING DESIGN BY COMPONENT PERFORMANCE APPROACH
Non.Resldenllel Buildings ADMINISTERED BY THE DEPARTMENT OF COMMUNITY AFFAIRS
R.sldenllel Buildings over 3 stories ALL CLIMATE ZONES
~ NE:
BUILDING CLASSIFICATION S .
BUILDING PERMIT NO.:
PERMITTING OFFICE:
JURISDICTION NO.:
11"....-:. ,-.~--.-~,._-_.,-~--
'-
"
........
BUILDING INFORMATION
WAL ...s ROOF/CEILING FLOORS 000 RR GLASS
TYPE U AREA TYPE U AREA TYPE U AREA . TYPE U AREA TYPE i AREA
Concrete (CBS) .13 all 9" Under attic 31 cro/ /) Sla~~rade 0 I(.O/b Wood Single, wall J l, J. "
Wood frame Single Assembly Raised Wood Metal Double, wall
Metal frame Other: Raised concrete Insulated .'" 4J-~.K Single, roof
Insulation R-value Insulation R-value =10 Insulation R-value Other Double, roof
SYSTEMS INFORMATION
AIR CONDITIONER HEATING SYSTEM
TYPE EFFIr.IENCY TON!=: TYPE - EFFICIENCY BTU/H
Unitary & Heat Pump ~SEER ~ Central & Heat Pump
<65.000 Btulh < 65.000 Btu 1 h -=r.. HSPF U.f#J
~5,OOO Btulh EER IPLV 2: 65,000 Btu 1 h COP
- - - Water cooled _COP
-
Water Cooled _EER - IPLV - Evaporallvely cooled _COP
-
Evaporatively Cooled - EER - Electric resistance _COP -
PTAC - EER - GaslOtI (circle one)
Chillers COP - IPLV - < 225.000/300,000 Btu/h _AFUE -
- > 225.000/300,000 Btu/h Et
Other:
UGHTlNG Total Lighting Wattage (p 0,1 ~'-' = F, , Lighting Budget: ~
Total Conditioned Floor Area = LJo ,.1) Wattslsq.ft. (from Table 5-13)
COMPONENTS
Windows
Doors
Joints/Cracks
Reheat
Ventilation
HV AC Efficiency
Transport Energy
Balancina
HV AC Controls
HV AC Ducts
Piping Insulation
Water Heaters
Swimming Pools
&Spas
Hot Water Pipe
Insulation
Water Fixtures
Lighting
HOT .AYIOR
TYPE
Electric
Resistance ~
Dedicated Heat Pump 0
Gas
Natural 0
LPG 0
Oil 0
HRU 0
Other:
DUCTS R-value: ~
..'n PRESCRIPTIVE MEASURES (Must be met or exceeded by all buildings.)
SECTION REQUIREMENTS
502.4
502.4
502.4
503,3
503.4
503.4
503.5
503.6
503.7
503.8
503.9
503.10
503.11
504,2
504.2
504.4
504.5
505.1
Uo wall Allowable " ... V
Uo rooll ceiling Allowable - / n
Uo floor Allowable
0TlV wail Allowable
0TlV rooll cellina Allowable
'0'
CHECK
~
')
Maximum of .37 elm per linear foot of operable sash crack.
Maximum of 1.25 cfm per square foot of door area.
To be caulked, gasketed, weatherstrlpped or otherwise sealed.
Supply air restricted to set coldlhot deck temperature to meet load of worst case zone. Resistance reheat prohibited.
Supplied with readily accessibie switch for shut-off and/or volume reduction when ventilation is not required.
Minimum efficiencies-Heating: Tables 5-4, 5-5 & 5-6. Cooling: Tables 5-7A, 5-7B, 5-8 & 5-9:
Minimum of 8.0.
Provide means for balancina HV AC air system & water distribution SYstem.
Seoarate readilv accessible manual or automatic thermostat for each svstem.
Air ducts, fittings, mechanical equipment and plenum chambers shall be mechanically attached, sealed,
Insulated and installed In accordance with the criteria of sections 503.8,503.9 and 503.10.
.,.
')C
x
..,..
In accordance with Table 5-10.
Automatic electric atorage water heaters ~ 120 gallons and ga & oil-fired slDrag8 water heatera ~ 75,000 BtuIh shaH
meet performance minimums in Table 5-11. Electric> 120 gallons: atandbr loll < :JlJ+27Nyo Ga > 75,000, 011 >
105,000: E. .78, Standby loss 1.30 + 114NT. Ga. OR> 155,000: E..78.llandbr 10111.30 +95IVT.
Spas & heated pools must have covers. Non-commerclal pools must have pump timer.
Gas spa & pool heaters must have minimum thermal efficiency of 78%.
Piping heat loss is limited to 17.5 Btuth linear foot of pipe for recirculating systems (sea Table 5-12).
}.
PI
"-
}-
I'
Water flow restricted to maximum of 3 gpm at 80 psig; toilets maximum 3.5 gallon flush.
Public lavatory fixture maximum flow of .5 gpm or .5 gallon If has self-ciosing valve.
Lighting power budgets are listed In Table 5-13. Minimum Ballast Efficacy Factors are listed in Table 5-14.
Uo wall Actual
Uo roof I ceiling Actual
Uo floor Actual
~7
.D"':J
If COf11)Iying under the provisions of S. 502.2 enter the ccrnblned Uo vaJueslor the entire 8I'N8lope
In this aection.'.. .
Uo envelope Allowable Uo envelope Actual
0TlV wall Actual I v I u
0TlV rooll cellina Actual
<l.rJ . -i-.
Compliance with Chapter 5was demonstrated by a Prescriptive Measures methodology:
D 508.0 (a) Detached commercial buildings D 508.0 (b) Skyboxes or sports stadium buildings D ~.O(C)Traffi.c safety
less than 100 square feet. that are used only seasonally. control towers
I hereby certify that and covered by the cala.l1atIon are In compliance Review of plans and specifications covered by thla ceIculallon Indlcatee oompIance wtth the
wtth the Florida E L a cJ Florida Energy Code, Before pleted, thla building wfbe Inapected lor
PREPARED BY: DIfrE: lO- T'" /, compliance In accordance F,S.
I hereby certify thaI Energy Code. BUILDING OFFICIAL:
OWNER/AGENT: ATE: L -ttJ-7f DATE:
:?P':'.l~~"
...--
.r-
\ WALL R.VAWES
BUILDING COMPO~ENT DESCRIPTION WALL WALL WALL WALL WALL i';
, TYPE 1 TYPE 2 TYPE 3 TYPE 4 TYPE 5
Ext.mOr air film .~ .:' , t1~
.'
, , ..
Stucco , ;1..6
Block (. ( ( ../ : :
Stud , , ..
,
Flrring strip . .'
Insulation s: 0
Wall board :, ,'15 ,
Solid } :. . , ,
. .
Other
Other ,,':>
Other flt ",,;."..' " "
Interior a.lr film ,to! .....~, ".
. ::,: ;>'
R TOTAL 7,& i
. / :J ',j} , i'
U = l/R
;l195 ~ I,..
AREA ,
, "
Weight (Ib/sq. ft.) Ifo
IF FRAME: Size _ x _ Inches O.C. _
ROOF/CEILING R.VAWES :: , iIi,
BUILDING COMPONENT DESCRIPTION ROOF ROOF ROOF I. ROOF :., t~;) , ROOF.:
TYPE 1 TYPE 2 TYPE 3 TYPE 4 TYPE 5
Room air film ,9/ ",'i.
Wall board ~Y5 ..:'..'7','
Truss
Insulallon 30.D D
Other ,6/
Other '..
:
Other
Other
Outside air film i :J....6>
R TOTAL '7. )L
U = l/R , 0 51
AREA (sq. 1t.1 rl-O/6
U + TC
IF FRAME: Size _ x _ Inches O.C, _
, ;
. ..~i
,:...' r'"! .:...
i ~,
'r.," '1- "<j
,-" .;. I ri?~
,',_ '~.,f
''''! ,
:-'-. .~-: F .'<.le :';-
::) r- (" ["~ T r.::, wr
1-. r',
,.; ;1-...ofT:::rr:J
",~' ".. I'
r" ,
..~ ...,~, "'1'
PASCO COUNTY, FLORIDA
Permit No. 0773
Date Permitted / - / tJ - '1 y
,
Builder Name/Owner Name 2r::;'yL1/'''~~~A J )JJ~j t2.:1;...'?~
County Parcel No. J ~ - ~...... - ;v,_,= IJ () 0 tJ - {) CJ.3 tJ CJ - 0 00 0
Location d'7tr/o /'1!Lf. U_u~____SUbd
Claesification/Type of Use C~;'.I (lJu1.~) _ ___ B
'----,
TRANSPORTATION IMPACT FEE CALCULATION
EXE~i\Vf LJ
Rate $
Sq. Ft./Unit
Impact Fee Amount $
The above impact fee has been establis pursuant to the Pasco County Transportation Impact Ordinance as adopted
by the Board of County Commis' ers. This amount is payable PRIOR to the issuance of a Certificate of Occupancy
or authority to utilize the itted structure.
EXEMPT 0
RESOURCE
RESIDENTIAL
No. Units
NONRESIDENTIAL
Gross Sq, Ft. (GSF) /.5-7 (J
ERU Assign No. I ( S
Rate/ERU - 50.00 x 0.96*/Year
or $0.1315/Day
Assessment - (No. Units) x ($0.1315)
x (No. Days)
Assessment -
(GSF) x (ERU) X (0.1315) x (No. Days)
100
TOTAL FEE $
TOT AL FEE $
707 ~~I
*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
TRANSPORTATION REC. NO.
RESOURCE RECOVERY REC. NO.
DATE
::I/(JS77 DATE
.
BBYY ^
~-,2t, .9Y ~
,
White
Applicant
Canary
Trans/Finance
Canary
RR/Finance
Pink
Office
Green
Bldgllnsp
feecal:ce
-".",;
P 02
~~
'V
~ --_......~-----~~-----_....._.._----_._----_.-.............
.... --------..--~----------..~.~~~.;~--;:- Zo.hn A.I.A. t 813 681 2a32 PdH
May 2. 1994
Bu1ldln. Department
City of Zephyrh11le
6335 - 8th S~reet
Zephyrhllls. PL 33~40
Attention Mr. Roy Burneide
DlUU' Ro Y ~
R~: TOWNVIEW MEDICAL ARTS. PHASE XII
The use ot Flrex Hodel '0242 smoke alarm with provision tor the
hearin~-lmpaired is an ~coeptable alternate to the Life-Lite
Model H-I. as specified.
Slnc$rely. ~
~a#ldhn
DlrZ/mz