HomeMy WebLinkAbout94-3893
BUILDING PERMIT
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Parcell.D. # -,-.:16:;;-3 -3 tJ -..3-.s
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Description of Work ~..6I J 'At j...l{ \~ -1' ~:-t b
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BUILDING
CITY OF ZEPHYRHILLS
(813) 788.6611
Permit N ~
_ 3893 E
Date ...5 -0>-r '-/
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SO. oV
MECHANICAL
s'::S: t1tJ
PLUMBING
Sewer Conn ~ rl '/ cf . uo.
Water Conn: 3..s-z;. cro
ELECTRICAL
....
FINAL
C.O.
- b ~q .;-
DATE
6 -tL -9~-
DATE
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances.
Pre-meter-Florida IUwer (Renitta) Nancy 04/28/95-09:30 A.M.
Inspector
Permit Fee
Signature
Company
Address
Telephone#
Valuation or
Contract Price S:t ~ d I trz)
City License Registration # d) tj 3
State Certified License#
~e~fY1
BUILDING
~LL
iu....
Lintel '() ~ 1tL--
FRM. 2- ~"7';- Bl LL.-
Insul. CL
WL 2....~41' OLLl---'
fl ~L. (, - 2.-b ~y 5 ~b-
Driveway
I) . td\
~'iVO \-~.q5 ~UIL
Yv--
~ :If tjAA-tl'J
ELECTRICAL/6r~
(~ R 81yt~
PLUMBING / t) 7
SLB ~.-2J..j.-qL/ iliLL.-
Tub Set tt-b-Cj ~ ~ c.L
Water p
Sewer 2-23..15 iL)-
Final b. '2--6. 7-5" ,;r It-
~j( tl~
MECHANICAL '77
Breakers
Ducts Insl. 2-~-CjS- ~
Compressor
Final C--U~~-:)~
Tp. Servo
Rough In 'b- "-7:) /Z-h
Meter Can 3 -.$ _. Y'l
Const. Pole
Pool
Pre-Meter J(..."'2~ -9')" 6J~
Final ""~-7~ ~
fOoleJI- . .' b
OeM!> lo-b.'('-I Btl-
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:
Va, ~-3-7(1
,J b-.)~-7'-5-
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.
9. 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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. . ~epi1; :iI1(;~~fC:;';mU~Aff;;;':FLORlDi~Er'~ERGYEFB~iENC;{ CODE FOR BUILD~ONS;;ucm~~"~-l
FORM Gc':,~,-a3 Residential Whole Building Performance Method A CENTRAL 4 5 6
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PROJECT NAME:
AND ADD HESS:
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BUILDER: ('US~6LL )'v\. 'm<-C)~~___
PERMITTING CLIMATE r/l 11 [-1
QFFICE: 2. e--FINf211 \ uS lONE: 4 CJ 5 l-.-J 6 _
PERMIT NO'~J.-TI JURISDICTION NO.: rz1LITJil~]~~
OVVNER: 'f2 US
1. New CCH1S;fUCn'n or cdr.HHon
2_ ~~pr~~ fc:mf~~! d~t~~':~l~~d c,r F)~u~t~f2~nBy t:tt~chcd
8. ~f ;:.'~;J;,;.t :\)~ <J~~ ~~-j~'ij: c,::r~\,/(.;':-:~ ~'"'-J thi,~; Gu~~'n~~:.,St-cn
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b. .Tint, f-ikn Ijr ~;()~ar scrGon
9.. Flcer tJ;~P'; '::~ii1d i;"~ZU~G1tfon:
Q. 81;:\0 on gL:de (llvalue -: pc;l :rneter)
b. Wood, r;;l:sod (R-value + sq, ft.)
c. Ccncrcte, rab,;cl (Rvf';:ue)
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a. Exted:<r: 1. (;0;lcI8te block (Insula1ion P."J8I11e)
2, VJ~)oJ frame (insuiation R-value)
3, Steel frame (Insulation R-value)
4. Leg (Insulation R-v2.1ua)
b. i!}.dj,"~cenl: 1, Concrete block (Insulation R-value)
2, Wood frame (Insulation R-value)
3. Stefl frar:-m (Insulation R-value)
4. Loe (InsL:!nlicn R-value)
11. C€Wi1g type, ;-....&'3 anJ !nsu!t'J!ion:
<;;. UndG; attic (Insulation R-value)
b. S:n~)1o 2ssemb!y (!n::~uiation R-va!de)
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1..>0 Ducts Or':~;ul~,:(k>n + LOc2;tion)
b. ,\i. !i2:1dif3r( ~n:~L.;ul;on + Location)
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(Types: c,;nlral-3p::l. C0rllral.sing:e pkfJ., rol)m ur:it. PTAC.. nOllo)
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OWNERAGEN,v_ rvr.}S1,.(rc.-- DATE:_
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I BASE BA.SE GLASS SINGLE.PANE DOUBLE-PANE fSiifMERl f~s.BuiCT--
GLASS x SUMMER = SUMMER }: SUMMER POINT MUL T. OR SUMMER POINT MUL T. x OVERHANG = GL~SS
AREA PT. MULT. POINTS AREA TIN'f2 CLE.AR Tl1fr- FACTOR (6A-1) SUi,1. PTS
N 82.2 \ N 2 G 51.5 47.8 -- 43~5------;-G-'-1
NE 82.2 NE 76.6 71.7 63.4
E 82.2 E 107.1 _---1Q?L._ 87.3
~E 82.2 SE 110.3 1~ 89.4
S 82.2 S --5 100. _ _.Jl~ __ 90 9_ ____I~~L__ _:..d_J_
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'FOR GLASS WITH KNOWN SHADING COEFFICIENT, SEE SECTION 1.1 OF Af'Pl:NDIX C. TiNT MULl iPLlERS Mi\ ': BE
USED FOR GLASS WITH SOLAR SCREENS. FILM, OR TINT.
-2.
SUMMErl POINT ;li~UL TIPLIERS (SPM)
GA.1 SUI,;(;iEi1 OV/EJiH,\NG FACTORS SO
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fi: ~ Ef!J 1.00
irll SEJSW 1.00
w ~ 1m
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CLIMATE lONES '4 5 5
FOR SINGLE AND DOUBLE PANE GLASS.
,12-.17 .18-.26 .27-.35 .36-.46 .47-.57 .58..70 .71-.83 .84-1.18 1.19.1.72 1.73-2.73 274+
.94 .91 .87 ,83 .79 .75 .72. I.. '6~.' . .,62 =~~--=----~o
.94 .91 .85 .79 .72 .68 .~~_ __:L _~ --.::1.9 .36
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vro f;:;1QQ!.!2LQyerh~Plg lcnqth, nt') raft of glass $hall be momli\3il r.,ft be!'::.\'. tie r.'1.0~'L_.....___...~____.._______ ____....
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APPLICAn... - IIY:~' s4JA.<'" r PIlIIIIIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
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 co.pliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the OMner has hired a contractor or contractors to undertake Mork, they lay be required to be licensed in accordance Mith
state and local regulations. If the contractor is not licensed as required by law, both the OMner and contractor lay be
cited for a lisdelea~or violation under state laM. If the owner or intended contractor are uncertain as to what licensing
requirelents lay apply for the intended Mork, they are advised to contact the City of Zephyrhills Building Departlent, 1813}
788-6611.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor Is} 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 Mork. 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 Mork 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 Mork will be perforled to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developaent 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 Departlent of EnviroRlental ReQulation - Cypress Bayheads, Metland Areas and Environlentally Sensitive Lands,
Mater/Wastewater Treatlent
I Southwest Florida Water "anaqelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
I ArlY Corps of EnQineers - Seawalls, Docks, Navigable WaterMays
I Departlent of Health L Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
I US EnviroRlental 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 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 codes, nor shall issuance of a perlit prevent the Building Official frol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becole invalid
unless the work authorized by such perlit 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 Mork 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 COKKENCEKENT "AY RESULT IN YOUR PAYING TWICE FOR I"PROVE"ENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
CIJItIlENCE"ENT. JOBS UNDER '2,500 IN VALUE DO NOT NEED TO RECORD AND POST A 'NOTICE OF COMENCE"ENT..
Q'M bLl 1'V\ S2, ~
SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR
was acknowledged
, 19 _ by
STATE OF FLORID~
COUNTY OF t-'" A $'( Cl
The foregoing i~stru~ent~as acknowledged
befc,re me this t'l!'b .n.. ~ , 19~ by
o
l'-us.-s -e ((
who is ~rsonally known to me Dr who has
produced
as identifi ation and who did/did not
take an 0
rt'15\OwrU
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.
(Signature)
4- j11(~
atur:C.[W If /11C& //IIWl
(Name Typed, Printed or Stamped)
NOTARY PUBLIC .......
.'~~"" OFFICIAL SEAL
( !fil \ SUSAN A. Mc:COLLUM
\ I My Commission Explrn
I April 16, 1997
"~""(lp~'" Comm. No. CC 268679
........
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
VALUATION:
SQ. FT. LIVING:
COST/FT:
RUSSELL BROWN
4710 SILVER CIRCLE
$53,860.00
1,399
$35.00
SQ. FT. OTHER:
445
COST/FT:
$11.00
VALUATION
DRIVEWAY
$53,860.00
$20.00
ADDRESS
$20.00
FEE SHEET
$281.00
SQ. FT. UNDER ROOF
RADON GAS
1,844
$18.44
TRAFFIC IMPACT FEES
99%
1 %
$1,585.00
$1,569.15
$15.85
PERMIT FEES
BUILDING:
PLUMBING :'
ELECTRICAL:
MECHANICAL:
SUB-TOTAL:
CREDIT:
TOTAL:
CONNECTION FEES
SEWER:
WATER:
METER:
TOTAL:
461.50
55.00
64.25
30.00
$610.75
50.00
$560.75
1,278.00
350.00
165.00
$1,793.00
GRAND TOTAL: $3,957.19
PASCO COUNTY; FLORIDA
Permit #
Date
Name/Owner
Comly Parcel #
Location
ClassiIlCation / Type of Use
lRANSPORTATION IMPACf 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. Ft (GSF)
Rate / ERU = 50.00 x 0.96'" / Year
or$0.1315/Day
ERU Assign #
Assessment = (# Units) x ($0.1315)
x (# Days)
Assessment =
!Q.Sfl 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
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