HomeMy WebLinkAbout94-3897
BUILDING PERMIT
Permit N ~
~.,~
~
CITY OF ZEPHYRHILLS
(813) 788-6611
25-
~~
dO
~t!ANI~
---
_ 389715'
~-3J -CJ-fL
,
-"
110
c;ILD~
Date
Sewer Conn
~DD-
Zoning:
Water Conn:
~f)n -
Property Owner:
Job Address:
Parcel LD, #
-
Water Meter: 16>.s
T F. t'2u,> /,).$:,.
,I. ,5: +-~
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,
DATE
f',-f1 9+ a. ·
Permit Fee
Signature
Company
Address
Telephone#
Valuation or
Contract Price
...---
tif2
BUILDING
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Insl.
Compressor
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
SLB
Tub Set
Water
Sewer
Final
.
w/l-~~~
, .
3-'3-91
t-i.J-YO - 1>1
Driveway
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.
APPLICATION FOR PERMIT
CITY OF ZEPBYRHILLS
BUILDING DEPARTMENT
OWNER'S NAME B~~ aJk~ .-'
OWNER'S ADDRESS 3 tf" () b.3 /-.fw'; II 0/1 ,L..~
JOB ADDRESS 0/1 /JJ E
LEGAL DESCRIPTION: LOT(S) to BLOCK SUBDIVISION ~~W.lfR L) W/ #..[)
PARCEL I.D.' / ( - ~ -,+.! - 0/10 - t?OOCJO -4~
WORK PROPOSED:~ew Construction ____Addition Alteration ____Repair ____Install
PHONE f 7 If - / (, ,;z. ?'
____Sign
Move
Demolish
PROPOSED USE: &ingle Family
____M/F ____' of Units
2SM/H
Commercial
Indust. ____Swim. Pool
Other
____Restaurant & Health Department Approval
BUILDING SIZE: ~;- x~, RfI};I/ lid
Square Feet,
/~ t:J r
,
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 CON'l'RACT REQUIRED.
PERMITS REQUESTED
~BUILDING
~ ELECTRICAL
)( MECHANICAL
~PLUHBING
$ 3 J=; (J-irV . 0-0 Valuation of Total Construction
/
/~ AMP Service ~ Florida Power Corp.
_W.R.E.C.
$
Valuation of Mechanical Installation
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION : ____Block ____ Frame Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
BUILDER
CON'l'RACTOR SECTION
~ ~ COlPAIIY 81 r h.v
?ff97.:{1State Cert. or Regist.' // /'7
~'111'../' ~~ . Ci ty License Registration' 4~-:['7
. ***** *********************************** "
tPotJSL(
Signature
ELECTRICIAN~ COMPAIIY EIl'rm'C('l 'SYSkms &n1.
, State Cert. or Regist.' S;;Z 7,3'
Signature ~ Ci ty License Registration # h I
* ***** **********************************
PLUMBER
~ COlPAIIY 'G" vi <1.0'" ,,,",,,,, h \
. State Cert. or Regist. .
~ ~y License Registration .
' ~..............................
to r\, -h-c. c. tv rs
4<1f/b
7'6
Signature
~ ~ COlPAIIY t:,...Villo"'.......n 1".1 C"w\.rc..d"""
. State Cert. or Regist.' 3s&JZ- ..
~ ~ C. Y License Registration # I-fLf
, ~ ~..~......................
MECHANICAL
Signature
OTHER
COMPANY
State Cert. or Regist. ,
City License Registration #
******************************************
Signature
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
!be undersigned understands that tbis petlit JaY be subject to -deed restrictions- which JaY be lOre restrictive than City
regulations. !be undersigned asSUles responsibility for COIpliance witb any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If tbe owner has hired a contractor or contractors to undertake work, tbey JaY be required to be licensed in accordance witb
state and local regulations. If tbe contractor is not licensed as required by law, botb tbe owner and contractor laY be
cited for a lisdeJeanor violation under state law. If tbe owner or intended contractor are uncertain as to what licensing
requireaents laY apply for tbe intended work, they are advised to contact tbe City of Zephyrhills Building Departaent, (813)
788-6611.
FurtbeIlOre, if tbe owner has hired a contractor or contractors, he is advised to have tbe contractor(s) sign portions of tbe
-Contractor Sections- of tbis application for which tbey will be responsible. If JOU, as tbe owner sign as tbe contractor,
you are indicating that you, ratber tban the. contractor, are responsible for tbe work. If tbe contractor wishes you to sign
as contractor that laY be an indication tbat he is not properly licensed and is not entitled to pertitting privileges in tbe
City of Zephyrbills.
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 witb a copy of -Florida's Construction Lien Law - RcIIeoImer's Protection
Guide- prepared by tbe Florida Departlent of Agriculture and Consuaer Affairs. If tbe applicant is SCIISOIle otber than the
-owner-, I certify tbat I have obtained a copy of tbe above described docuIent and pralise in good faitb to deliver it to tbe
-owner- prior to COIIenceaent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
. I certify that all tbe inforaation in tbis application is accurate and that all work will be done in COIpliance witb all
applicable laws regulating construction, loning, and land developlent.
Application is hereby tade to obtain a petlit to do work and installation as indicated. I certify that no work or
installation has CCJII8Ilced prior to issuance of a perlit and that all worl will be perfoIJed to Jeet standards of all laws
regulating construction, City codes, loning regulations, and land develDplent regulations in the jurisdiction. I also
certify tbat I understand tbat tbe regulations of otber govemaental agenCies laY apply to the intended worl, and tbat it is
If responsibility to identify what actions I lUst tue to be in COIpliance. Such agencies include but are not lilited to:
I Departlent of Environaental Regulation - Cypress Baybeads, Wetland Areas and InvirolllM!1ltally Sensitive Lands,
Water IWastewater 'J'real:lent
I SoutJlwest Florida Water Manageaent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
I Atly Corps of Engineers - Seawalls, Docks, lavigable Waterways
I Departlent of Healtb i Rebabilitative Services, InvirODleDtal Healtb Unit - Wells, Wastewater 'J'reatlent, Septic 'J'anks
t US InvirODleDtal Protection Agency - Asbestos abatuent
I also certify that, if fill taterial is to be used in Flood Zone -A- or -A,etc.-, it is understood tbat a drainage plan
addressing a -COIpeJlSating volute- will be sub8itted which is prepared by a professional engineer registered in the State of
Florida prior to petlit issuance.
A petlit issued shall be construed to be a license to proceed witb tbe worl and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a petlit prevent the Building Official frot tbereafter
requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall becoIe invalid
unless the worl authoriled by such petlit is COII8Dced witbin sillODths of issuance, or if work authoriled by the petlit is
suspended or abandoned for a period of sil IODths after tbe tile tbe work is COIIenced. One 90 day atension of tile, JaY be
allowed for tbe perlit witb fee charge of $15.00. 'J'be extension shall be requested in writing to the Building Official. An
approved inspection lUst be logged during each sillODtb period, or tbe project will be considered abandoned.
wmllG TO lMER: YOUR FAILURE TO RECORD A IfO'I'ICE OF aJlMDCBIIIM'I' MAY RESUL'J' II YOUR PAnIC "'ICE FOR IMPROVEMmS TO YOUR
PROPERTY. IF YOU IflBIiD TO OB'l'AIII FIIUCI.G, COJISUL! WI'J'H YOOR LDDIR OR II A'I"I'ORRIY BEFORE RECORDIIIG YOUR JIO'I'ICE OF
COMMEllCEMEIft'. JOBS UlmER $2,500 III VALUE DO IfO'I' IfUD TO RECORD AID POS! A "IfO'I'ICE OF C(JtMEJICEMEII'I'-.
. j 1I;4(~1f
SIGMA*, OR AGBII'f
-dlLit ~7
S'J'A'J'E OF FLORIDA ~
coum OF
The foregoing ~s~~en~ was a~~owledged
before me this'~, 19~ by
JeVY~ l4 . M(XLte~ I :$~,
who is pe~Pl' ~ ... or who has
produced J \l@v;.r . .f...rr't.d?
as identifica ion and wbo did/ "d not
tat oath.
S'lAII OF fUIIG
coum OF ~
The foregoing ins.tfufenJ:# ~~, ac~qwledged
before me this ~9~ by
'^^-
~ m . GUll
(Name Typed, Printed or
NOTARY PUBLIC
(Si
I
~~'""
.. ,.
o _
z n
JEAINE M. aUAlUAIII
Notary Public, State of florida
My comm. expires Mar. 21,1181
Comm. No. CC2100ll
~.."
.. ,.
o _
Z II)
JEANNE M. aUABUMI
Notary Public. SbiIll of FIorNI
My c:omm. uplrea....11.1_
COlmn. No. CCZ700II
OWNER
CITY OF ZEPHYRHILLS MOBILE HOME PLOT PLAN APPLICATION
f/o...r 0 IrI I'1()Qfe,
JOB LOCATION 39,()(...,:S Lall)O-hdc.. t.P, 2Qoh~rA/J/s/ J7"
I /
1'I"'2t- 1.' - olbO- ()OOOO ~ obb--O
PARCEL I. D. #
-2 .3 ~- Y /
.
SHOW ALL EXISTING & PROPOSED STRUCTURES GIVING DIMENSIONS & SETBACKS.
S3
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~
.3&
IJ/-
~7
';6,1 3b
REO /J 11/
c-
I
If?
(NOTE EXAMPLES 1 & 2)
STREET
FRONT PROPERTY LINE
53
1. SETBACKS FOR M1/M2 ZONING(INTERIOR)
10'
7.5' MH 7.5'
20'
FRONT PROPERTY LINE
2. SETBACKS FOR M1/M2 ZONING
ABUTTING PUBLIC RIGHT-OF-WAY
10'
7.5' MH 10'
20'
FRONT PROPERTY LINE
gxo
T
U
B
L
I
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R
o
W
1
EHTRE-MARK
~~fr(J."Ufi'I(!'('f.
10121 IIwy, 301. \lade Cily. 1:1. 3Yi)j
(IJ01) 561-1:"1') Fa;.; (1)0,1) 5(,1-1tl,')lJ
(j,:PII<r'rf flr'nl Est.1r" flln~('r
--~-_..~_.._--_._----.__.._--
-...January 25
,19~
r.pntre - Mark Corp.
Irom R p r n ice 0 a ~ A . 0 .
sum 01 :Iw.D- tho usa n d
I
Realtor
, acknowledges receipl
, hereinalter called BUYElf, oll/1.e
($.2.QlliL. 0 0
) DOllARS
Cash or check as doposll on account 01 offer 10 purchase the p1opEl1ty 01
-----Le.CUL...l._W i Iso n
------+-_._~_._-----~----._--~-_.__._----,-------------'--~
horell1alll:r callod Soller, said property blJing known PS:
Lot 65 Wayward Wind Subdivision FL.
Plat book 28 Page 61 Pasco County
upon Iho terms and condllions as follows: 9 0 0 0 0 0
1. Full purchase Pnce $3 0 0 0 . 0 0 , payable $ .
Realtor In escrow pending closing oftransaclioo, balance payable in the following mll1V1Af:
i1 CI\$h, 01 which the above deposit shaU apply as part and shall be held by said
Cash at closing
2, TERMITE INSPECTION: At N / A _ 8Xp9I\~e 1I1a""r Irom a licellSlld !("rmile iospoctOf Slating lhefe are no visible signs of active lermlte inleslalJon
shall be IUIfl.shed prior 10 closing. In the evenl inlesLation is Ildicaled, property shall be treated al!he expense 01 , " cost oItrealmenl exceeds
1% 01 purchase plice, I at his option may cancet this contract without peoaIty. by giving wnlteo notice, and ~ shall be considered nuM & void,
(Non.appIabte lor vllC.8nt IlwI)
3. TITLE EVIDENCE: Soller shall purchase and deliver 10 Buyer tille io$urance policy OIl !he real p1ope1ly awored hereuoder in !he amount of the lull purchase price al time 01 closing.
In 1110 evenl Ule ~lIe shall be p10ven 10 be unmerchantable, the SeUer shall have a period 0145 days alter notilicalion lhefeol within which 10 cure defects in tille. and Ihis sale shall be
do~ed wilhin 10 days aher notice 01 such curing to Ihe Buyer or his allorney. Upon SeUer'llail..... to COllect oomerchantabiity, witIln Ihe time Iimi~ !he earnest money deposit shall be
relurne<! 10 the Buyer upon demand, and II righll end IiIbiIitieI ~ hertlllder u between Buyer and SeIer Iha1l8rminala
4. CLOSING DATE AND OCCUPANCY: Subject to !he aforesaid ClIdv. period, .. 88le IhalI be cIo6ed on or before Fe b r u a r y 25, 1 9 ~ ~ ll(kllliorlal time
needed 10 meel mortgage requitemenl$, wilh Cla:l4lII/lCY ~ it c 1 0 c: i n g . (See 110)
Sellor represents thallhere ate nol paI1ies in occupancy other Ihan Seller, buC W Property 1e1nl8nded to be reoted or occupied beyond closing, !he lact and terms theroof shall be
Slaled herein, and the lenanl(s) shaJJ be disctosed. Seller agrees 10 detiv. occupancy 01 property II time 01 cIoIi1g lIlIess otherwise lpeCi/ied above, n occupancy is 10 be deI/vElfed pOOr
to closing, Buyer assumes an risk 01 maintenance lhereol torn laid dale, and WI be deemed 10 haVIICC8J*ld Ihe Prtfer1y, real and 1*1008I. i1 its existing condition as 01 time 01 takivJ
occupancy unless olhelWise noted in writing,
5 METHOD OF CONVEYANCE: Seliei' agrees 10 convey Ii1le 10 the aloresaid p1ope1ty 10 !he Buyer by W (l r r i'l n :t.y. Deedl free and clear of all 8OCU/Jlb(ilOO\S or rrns except
covenants and reslricllOns 01 record, provided however. IhaI none ollhe loregoing llhd ~ WIt use 01 the property lor Ihe pulJlOSe of Res 1 d e n t 1 ,a 1 s e
6. EXPENSES: The required documenla1y stamps &hall be placed onlh8 deed by SeIer, The Buyer IhaI property execute any requied noles andmort9ages, pay intangible taxes, and
pldce Ihe required stamps lheleon,
All dd/ustrnenls ollaxes, insurance premiums, inlares~ assessments and rents or olhef ~Gmt on said property are 10 be made on a prorala basis as 01 C 1 0 sj n 9 0 q Ittti
arnounl 01 taxes and assessments lor the curreol year cannot be asceI1ained, rlle& lor Ihe previout yew shaI be used i1 pror~ laxe& and as&essmenls due allowance being madtllor
homestead and olher exemplions,
7. TIME FOR ACCEPTANCE' EFFECTIVE DATE: "this ollElf is nol execuled by bolh parties hereto on or before , !he aloresaid deposit shall be, al U18 option 01
Buyer, relumed to him and Ihis oHer shallhereal1ef be IllII P void. The date 01 ~ (Ellecliv. clala) IhaI be Ihe dllle when Ihe last one 01 the Seller and Buyer has signed !his o"er,
B. SURVEY: The . B u y e r al his expense and willlin!he line allowed lor U18 delivery 01 evidence 01 title and examination !hereof, shaJI have Ihe p10perty surveyed. II U16
survey, cer1lhed by a regislered Florida surveyor, &hoWl an encroadvneol 01 !he property or thaI inprovements located on !he property in lad enaoach on lands of others, or inteOOed
Improvements would encroach on !he land 01 olherI or VOates any 0I1he contIad coveoants, lhe wne 8haI be ~ealed 88 . tille delect.
9. RISK OF LOSS: IIlhe Implovements ate damaged by nre or other casualty before !he closing hereunder and can be reslOfed 10 substantially U16 same condition as now wilhin a peliod
0160 days Ihereahcr. Ihe Seller shall so restore !he improvemeols and the dosing daI8 hereinabove..t &haI be IXIeoded aooordingly, but if such restoration cannoI be compleled within
1I1dt lime tillS conlracl shall be declated cancelled,
10 FINANCING: ThiS Conlracl (is). (is not) contingent UpOfl hi Buyer oblainjng_Nl1\_,~ financing 01
a locallonlllllg InSllluhon al an inleresl ral. ~ exceeding wilOO
.-'...---- 01 dl9 purchasll pnca from
working days from the dale SellElf signs cootIact
11. ASSIGNABIUTY: Buyer
may assign,
X may nol assign ttlis Conlracl
12 OTHER PROVISIONS: The words "Reallor', "Buyer', and 'Seller' harei1 employed shall include their heirs, adminislralor, executors and successors, and said words, and any plOI1OUns
relative thereto, shall include the masculine, feminine and neuter gender, and Ile 8inguIar and p1wal runber, wherllYtr Ile conI8xt so lIOOlils or requi~es,
No agreemenls, unless incorporated in this contract. shaI be bi1dilg upon Ile Rea/lor, Buyer or Seller.
In connecllon with any Iiligation arising out 0I1tU Conlract, Ile prevailing party shall be entitled to recover II costs 1ncIrred, Induding reasonable alDney's lees,
13, TYPEWRITTEN OR HANDWRITTEN PROVISIONS: Typewrill8n or handwrill8n provislons inserted herei1 or allllched hereto as Addenda 8haI control d printed provisions in conflict
therewith,
14. BROKERAGE FEE: The Seller agrees to pay said Realtor f)I / n. % 01 gross purchase price or $ allle lime 01 cklsing or 01 delaun in'performance,1I1le BuY9f
lails 10 perlorm Ihis contracl within the time herei1 specified, lime being 0I1le essence 01.. agreemenl, Ile deposit made by the Buy. shaI be disposed olin Ile IoIIowIng manner: To lie
Realtor an amount equal to his earned commission, bulln no IYlR 10 exceed one-haII (Y21 01 the deposil. whIc:h shaI cI8dIIIge lie Seler'allbfaalion 10 hin fa that service. Remainder to the
Sener to be credited by him against his damages lIOCrII8d by I8ISOll of lie breach 01 cxnract. II !he .nactIon ahaI no! be closed bec:auae'Of lie Seller's refusal to perbm, then lie Seller
shan pay said commission to the Realtor on demand. FaiIIn << refusal of wile << IMband 01 SeIer or Buyer to execute deed or mortgage reqWed hereunder or falin, refusal << Inability 01
either to perform any act necessary to !he cIoslng of purchase and aaIe under lie terms 01 ttQ ClllWact shaI be deemed delauIl on the part of !he Buyer or Seller, This propel1y is ofI9fed
wlthotll respect to race or color 01 the applicant. IlIle Seller or Buyer fails to perform, lie defaUting party shel be responsible to !he ReaJtor lor all expenses paid or inamld by Reallor in
connection herewith, including bu! nollimited to charges lor title Insurance, SUlYey and aedit reports and said defaulling party shaI pey said ReaIIor therefore on demand,
15, SPECIAL CLAUSES:
NOTE: Time is ollhe essence in alllransaclions pursuant to this Contract & Sale,
A1llnlormalion furnished regarding property for sale, renlal or financing is from sources deemed, in our sole opinion,to be refiable, No representation is made as to the accuracy !hereof and it is
subrnlned sublecllo errors, omissions, change 01 price, fenlal or other condillons, prior b> salel lease or financing or withdrawal without notice.
TillS IS INTENDED TO BE LEGALLY BINDING CONTRACT
IF NOr FULLY UNDERSTOOD, SEEK DIE ADVICE Of AN ATTORNEY PRIOR TO SIGNING
ROOUR
WITNESSES AS TO SIGNA' URES OF BUYE~
h-IL~. '
J
b'OFFER HEREBY CONFIRMED:
)(.. 'i6....e /? </__ L~. . (J-cl kA ~ ':
BUYER
(SEAL)
(SEAL)
BUYER
WITNESSES AS TO SIGNATURES OF SELLER:
~,,:"EPTED AND "'r'" ~
'---: . ')
"= /'>,(~52)2Q:.- ,:-
SEllER
day 01
,19_
~
(SEAL)
SEllER
(SEAL)
Buyer's' addIess
Seller's address
-..,-.,~~- -.-, - - .-- - - -.-'--,- ----r'---,.-,-' - -'-.,- '-"-..--.- ,- ---;c-,
C E N 1 R ALP E R M I
PASCO COUNTY, FLORIDA
r r ( N G DATE: 03/30/94
PAC,E :; 1 OF .1
:i ~::,:::;UE OFF ICE: L1
RECEIPT NUMBR= 00208000
OFFICE: DADE CITY
C:ONH<ACTOR *t:
NAME; BERNICE OAKES
ADDR: 38063 LAWANDA LOOP
C' /:::;T: ZH I L.L:::::
FOR: RESOURCE 3897B
CHEC~::: *F CA::::;H
114
rOTAl. Al"IOUNT:
COMPNY ACCOUNT CENTER
8450 - 363000 - ,
.'37 . ::;:: 1
AMOUNT DESCRIPTION/PERMT DATA DRIeR
37.81 ****** SOLID WASTE FEE 60
(~cc:~'.~'r'
REG!:: I I,JED BY
,I. . . <' )
"'~ ~----:---r- -- 'M_ --.t.L-~L 'to:!:. ~_ ~.o.-_,._~. ._. t~ _... __ ,._ ~~-__,:..~ _ ~ _.. ~_ ..... _ ,._.._
~..:,<'''',,,,,,",~c':';,.~,.,
~-:~<....;..;-h-.-_:-
~+';'~-::::~ ~ ,'_'~.>;"'~~ ,,:~~.,,__,,_,.,...:..;.--:~~-,.,,;;-~-. ""1'!-,,".,:, ,,'.,' "''':("''~~''r .
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....'
PASCO COUNTY, FLORIDA
Permit #
Date
Name/Owner
COWlly Parcel #
Location
ClassiilCation 1 Type of Use
lRANSPORTATION IMPACT FEE CALCULATION
Rate $
Zone #
Sq. Ft. 1 Unit
Prepared by
Impact Fee Amount $
The above impact fee has been established pursuant to the Pasco COWlty Transportation Impact Ordinance as adopted by the Board of
COWlty 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
I
..
Gross Sq. Ft (GSF)
Rate 1 ERU =
50.00 x 0.96* / Year
or $0.13151 Day
ERU Assign #
Assessment =
(# Units) x ($0.1315)
x (# Days)
Assessment =
ID.Sfl x (ERU) x (0.1315) x (# Days)
100
TOTAL FEE $
"
i
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
lRANSPORTATIONREC. #
RESOURCE RECOVERY REC. #
DATE
DATE
BY
BY
White
Applicant
Canary
Trans 1 Finance
Canary
RR 1 Finance
Pink
Office
Green
Bldg /Insp