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Home My WebLink About94-4344 . . ~BUILDING PERMIT ,,~y CaTV OF ZEPHYRHILLS Permit N.C? .4344:$ ~ iY ~ (813) 188-6611 , ~ Date 9 -.;Z 9 - 9Y g~~IN~) ~ ~~-J ~~ Sewe.Cooo ~ II Water Conn: ~;JJ a Property Owner: Water Meter: Job Address: Parcell.D. # Zoning: ~gy Code: De",;pt;on ~:: ~~ r~ NO OCCUPANCY BEFORE C.O. T,I.F.'s: Radon Gas: ,; . ~:n~urz Complete Plans, Specifications and Fee Must Acco All work shall be performed in accordarr:-e with Clt FINAL C.O. -4 ~ '1l, DATE DATE Valuation or Contract Price Inspector '~ mit Fee. . . ;9na,",e, . ~ Company Address . Telephpne' V;:?- ,-:; g'tJ' y (}./l;v~ ~ 1f~R~ IM+)A ( . PLUMBIN. J MECHANICAL SLB /2-1- f'-l EhLL TubSet f-2..?-?5' gl[t...- Water Sewer 'I--II-QS tdlL- Final City License Registratio State Ce";/;ed Ucense' _~ CO"~~/) Wt<.>JtLLl) BUILDING ELECTRICAL ::~ S~B- ~~:::lf.t~tt ~:~~' L-l~. ~sg~ InSUI.~~ ~~.~.;- ~ Driveway Tp. Servo Rough In /-'2-7-&/) i&:h Meter Can Const. Pole Pool Pre-Meter Final \?~~\\w\S-qlt€W~ &b Breakers Ducts Insl./-2-7-95 Compressor Final ~Io ~~\j\ ~. ~ Dl \1\\ IAJ~ ~ \r Y \V ~ 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. FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION FORM 600B-93 Residential Component Prescriptive Method B CENTRAL 4 5 6 Department of Community Affairs OWNER: ZONE: 4~6D JURISDICTION NO.: ~ GENERAL DIRECTIONS 1, New construction including additions which incorporates any of the following features cannot comply using this method: raised wood floors without continuous stem walls, steel stud walls, single assembly roof/ceiling construction, or skylights or other non-vertical roof glass, 2, Choose one of the component paci{ages "A" through "P' from Table 6B-1 by which you inlend to comply with the Code, Circle the column of the package you have chosen, 3, Fill in all the applicable spaces of the "To Be Installed" column on Table 6B-1 with the information requested, All "To Be Installed" values must be equal to or more efficient than the required levels, 4, Complete page 1 based on the "To Be Installed" column information, 5, Read "Minimum Requirements for All Packages", Table 6B-2 and check each box to indicate your intent to comply with all applicable items, 6, Read, sign and date the "Prepared By" certification statement at the bottom of page 1, The owner or owner's agent must also sign and date the form, Please Print CK 1. Compliance package chosen (A-F) 2. New construction or addition 3. Single family detached or Multifamily attached 4. If Multifamily-No. of units covered by this submission 5. If Multifamily, is this a worst case (yes / no) 6. Conditioned floor area (sq, ft.) 7. Predominant eave overhang (ft,) 8. Porch overhang length (ft.) 9. Glass area and type: a. Clear glass b. Tint, film or solar screen 10. Percentage of glass to floor area 11. Floor type and insulation: a. Slab on grade (R-value) b. Wood, raised (R-value) c. Wood, common (R-value) d. Concrete, raised (R-value) e. Concrete, common (R-value) 12. Wall type and insulation: a. Exterior: 1. Masonry (Insulation R-value) " ! 2. Wood frame (Insulation R-value) b. Adjacent: 1, Masonry (Insulation R-value) 2. Wood frame (Insulation R-value) 13. Ceiling type and insulation: a. Under attic (Insulation R-value) b, Single assembly (Insulation R-value) 14. Cooling system (Types: central, room unit, package terminal A.C" none) 15. Heating system: (Types: heat pDmp, elec, strip, nat. gas, L.P, gas, room or PTAC, none) 16. Hot water system: (Types: elec" nat. gas, L.P, gas, solar, heat rec" ded, heat pump, other, none) I hereby certify that the plans and specifications covered by the calculation are in compliance with the Florida Energy Code. PREPARED BY: I hereby certify that t DATE: e orida Energy Code, DATE:f::-.2 ~ 9';/ -1- BUILDING DATE: 1. 2. 3. 4. 5. 6. 7. 8. A J.:d.., -r-( ,..) }~) -, ~ " l.~ rAtr11 J'''''''''o ~_ ill r' NA, AJ4 1-1 ~:..> -/ r"\ ' 'f::;A Single Pane t- 0 sq. ft. sq, ft. I -3 % 9a. 9b. 10. Double Pane sq. ft. sq. ft. 11a. 11b, 11c. 11d. 11e, R= 0 R= R= R= R= sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. 12a-1 R= sq. ft. 12a-2 R= I , 4~? sq. ft. 12b-1 R= sq. ft. 12b-2 R= sq, ft. " , ;t. 13a. R= {)Ie sq. ft. 13b, R= sq, ft. 14. (t'. /). 'TIA l Type: ._t:.'.I~ ",. ..'.."" SEERlEER: . 'dr' I' Type: /-ieAi-- r t.(PI1/' HSPF/COP/AFUE: J.'R, "':? Type: iA...II? EF: J1f,.},t1 15. 16. TABLE 6B-1 MINIMUM REQUIREMENTS COMPONENTS PACKAGES FOR NEW CONSTRUCTION A B C D E F Max,"I00f glass to Floor Area 15% 15% 20% 20% 25% 25% Cf) Type Single Clear (SC) Single Tint (ST) Single Tint (ST) Cf) Single Tint (ST) Double Tint (DT) Double Tint (DT) :) C) Overhang 2' 2' 2' 2' 2' 2' Masonry EXTERIOR AND ADJACENT MASONRY WALLS R-5 Cf) COMMON MASONRY WALLS R-3 EACH SIDE. ...J ...J <( ~ Wood EXTERIOR, ADJACENT, AND COMMON WOOD FRAME Frame WALLS R-11 CEILINGS CEILINGS UNDER ATTIC R-30, FRAME COMMON CEILINGS R-11, (NO SINGLE ASSEMBLY CEILINGS ALLOWED) Cf) Slab-On-Grade R-O II: 0 Raised Wood R-11 (ONLY STEM WALL CONSTRUCTION ALLOWED) 0 ...J Raised Concrete R-5 LL. DUCTS R-6 R-6 COND, R-6 R-6 R-6 SPACE COOLING (SEER) 11.1 10,0* 10,0* 10,5 10,0* 10,9 ~ Elect. (HSPF) STRIP 6,8* 6,8* 7,3 6,8* 7,6 w Gas/Oil (AFUE) MINIMUM OF ,73 (Direct heating) or ,78 (Central) I II: Electric EF ,90 EF ,90 EF ,90 EF ,90 NOT ALLOWED EF ,90 w~ Resistance** (SEE BELOW) I-w <(I- Gas & Oil ** MINIMUM EF OF ,54 NA rURAL GAS ONLY ~Cf) (SEE BELOW) 1->- OCf) I Other Any of the following are allowed: dedicated heat pump, heat recovery unit or solar system, Climate Zones 4 5 6 TO BE INSTALLED I ":.or,. % DC: D DT: D '1 FEET EXT: R= - ADJ: R= - COM: R= - EXT: R= J I ADJ: R= COM: R- '-I. :l UNDER ATTIC: R = ~ COMMOM: R= R- 0 R= - R- - R= ~ COND, 0 SEER = ....:1 00 COP= :::::-.or HSPF=~ AFUE = AJt:i EF = NA:- EF- III -A DHP: t5 EF= - - HRU: SOLAR: 0 EF= - - Single package un~s minimum SEER=9,7, HSPF = 6,6, Minimum efficiencies for gas and electric hot water systems apply to to 40 gallon water heaters, Refer to Table 6-11 for minimum Code efficiencies for oil water heaters and other sizes, DESCRIPTION OF BUILDING COMPONENTS LISTED Pen:ent of Glass to Floor Area: This percentage is calculated by dividing the total of all glass areas by the total cond~ioned floor area, Overhang: The overhang is the distance the roof or soffit projects out horizontally from the face of the glass, All glass areas shall be under an overhang of at least the prescribed length with the following exceptions: 1) glass on the gabled ends of a house and 2) the glass in the lower stories of a multi-story house, Wall, Ceiling and Floor Insulation Values: The R-values indicated represent the minimum acceptable insulation level added to the structural components of the wall, ceiling or floor, The R-value of the structural building materials shall not be included in this calculation, 'Common" components are those separating conditioned tenancies in a multifamily building, "Adjacenf components separate conditioned space from unconditioned but enclosed space, "Exterior" components separate conditioned space from unconditioned and unenclosed space, Floor: Slab-on-grade floors without edge insulation are acceptable, Raised wood floors shall have continuous stem walls with insulation placed on the stem wall or under the floor, Ducts: "CONDO indicates that the ducts must be installed within the conditioned space; that is, the ductwork shall be located on the conditioned side of the insulation, Ducts in conditioned space are acceptable for any prescriptive package, Space Cooling System: Cooling systems shall have a Seasonal Energy Efficiency Ratio (SEER) for central units or Energy Efficiency Ratio (EER) for room units or PT AC's equal to or greater than the prescribed value, Electric Space Heating Option: Heat pump systems shall be rated with a Heating Seasonal Performance Factor (HSPF) equal to or greater than the prescribed HSPF, Heat pump systems may contain electric strip backups meeting the criteria of section 608,1,ABC,3,2,2, No electric resistance space heat is allowed for these packages, Electric Resistance Hot Water Option: For packages designated "Not Allowed", an electric resistance hot water system may be installed only in conjunction with one of the "Other Hot Water System Options", See below, Other Hot Water System Options: Any dedicated heat pump, heat recovery unit, or solar hot water system with an EF of 1,5 or higher may be installed, Solar systems must be designed to provide at least 40% of the total hot water, Electric resistance systems having an EF of ,88 or greater, or natural gas systems with EF ,54 or greater may be used in conjunction with these systems, TABLE 6B-21 MINIMUM REQUIREMENTS FOR ALL PACKAGES COMPONENTS SECTION REQUIREMENTS CHECK Exterior Joints & Cracks 606,1 To be caulked, gasketed, weather-stripped or otherwise sealed, 0/ Interior Joints & Cracks 606,1 All openings in interior surfaces of ceilings and exterior walls must be sealed, .,/ Sole & Top Plates 606,1 Sole plates and penetrations through top plates of exterior walls must be sealed, v" Infiltration Barrier 606,1 Infiltration barrier must be installed in exterior walls & raised wood floors, ,I' Fireplaces 606,1 Fireplaces must have flue dampers, glass doors and outside combustion air intakes, - Exhaust Fans 606,1 Exhaust fans vented to unconditioned space shall have dampers, except for combustion devices with integral exhaust ductwork, - Water Heaters 612,1 Comply with efficiency requirements in Table 6-12, Switch or clearly marked circuit breaker (electric) or cutoff (gas) must be provided, External or built-in heat trap required, - Swimming 612,1 Spas & heated pools must have covers (except solar heated), Non-commercial pools must have a Pools & Spas pump timer. Gas spa & pool heaters must have minimum thermal efficiency of 78%, - Hot Water Pipes 612,1 Insulation is required for hot water circulating systems, (including heat recovery units) and the first f 8' of piping from the water heater (or until piping enters an insulated wall or slab), Shower Heads 612,1 Water flow must be restricted to no more than 3 gallons per minute at 80 PSIG, / HV AC Duct 610,1 All ducts, fittings, mechanical equipment and plenum chambers shall be mechanically attached, Construction, sealed, insulated and installed in accordance with the criteria of Section 610,1, Ducts in attics must be .; Insulation & Installation insulated to a minimum of R-6, Air handlers shall not be installed in attics unless in mechanical closets, HV AC Controls 607,1 Separate readily accessible manual or automatic thermostat for each system, - -2- -~I , ~'O{,.JJ {---- 8, ~A-J\j 122 / o~' t" :i :~,:" > '( 1: Q ,91' -9_ ..S,LLIJJJG r :.. ~- ',:. 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II! : (t- ~qc!-..~ii, __-_-_-_-~Ii .~ T /l\ __:! ; lj . rl , \, ':: :, ~ i ~ ___-x.:/ ~1-~*- 7' \ r ,:.: ! "'li ,'\. \ I, /\ if i~ ;JJ(~~ k_ ---x--- 0..; ___ __ ---=c::-.-=__. -J,~ .~--:::i?~,:::-:~:;:-n /' t" ;L~ t f/ ,~c_~,~u~~== ----:;--.-.::.:,- , Ik "- ~ uj , I ~- I 1 ~ V f.//I/, ' ../' V ; /," /\ - 2. 0 - 7 /' /(P /' / (,,::> {}..o,", (2 ye re ?a j s ~~ joY 2X 8>1)( ["'ua/sF;/ A 1/ ,L...~. ley JOY j7e~/( /s-?J(;z71 Y b::~ c > -:- .;;---, 1/' P , Ifeb/ar!..e ~~!I ~ 0- I 'sk '-- -x--- ~ - WI I i , -4// ::=.. / /01/ S e..a/e. E: Fx " (' ..- Y' '-// '-;." .(/ -,! j _/ ~; -------- ---:/ l ~ o . v \ij ~ ).. ~ u,~ .J ;;' ~ ~ l V'\ .- 30 .." . -,- , , , , , . I I ' .. .. , -- - . . , I ; ,." J . / , N. B9" 49' 4(0' If. , IOI.(j,4 -1' \ ~ ~ ~., 'I 15" I~,"/~ (,,/~ f ~ ~ \: 101 ~ .<.G" ~J) ~ ,,~ '13 . ~ ~K~, PT t ~ l:! '- I{ ~ J P"''';f J' ~ ~l\j -~ . ~'--->/W~'., ~. :<{i,. 0' .('~__,,~ ~ - - - =-~. _/)'4 L.; Lllycr " ~ - - - ~" f~Y-9' . ,"-- ~ \) r 0" . \:) \) . V) )C:, . " ,..' .' 32. 3' . 6(;;,-' / , i, 1:~ \:to --?>- ~~-- .y . LOi 92 , ! . ! ' I \'\- /~ u:~ 0_ I I i! . 1 ...H .....""...'r,'4II:N~.t.~,', " ' , . "\ ...; , " f , I ,. -, ..:: ",.., ..., --...... -- J '""'-. _ DISCLOSURE STATEKENT FOR. OWNER CITY OF ZEPIIYRIIILLS BUILDIliG DEPARTMENT I, ")Oi77 (J /"irc2 h T, ~y, to the provisions of this instrument." have read and fully understand and agree The undersigned states and affirms renovating, adding to or reroofing occupy, or will occupy by sale. That he or she shall comply that he or she is desirous of constructing, his or her own domicile, that he or she actually said domicile, and same is not for rent, lease or with the following conditions: 1. That the owner and he or she alone shall act as the builder for a.ll phases of construction. 2. That the owner will comply with all provisions of the City of Zephyrhills ordinances and codes pertinent to the building. 3. That in the event various phases of construction are subcontracted, he will engage only properly licensed subcontractors and will personally supervise such work. 4. That in the event the Building Inspector shall require corrections to be made, the owner will assume full responsibility to insure they are made, and upon completion will call for a reinspection before proceeding with the building. S. That the owner shall assume full responsibility for the construction and will not expect supervision of his work from the City of Zephyrhi.lls Building Department. 6. That prior to final inspection any additional fees, including relnspection fees, must be paid in full. A written request from this office shall constitute an official notice to pay additional fees. 7, That the owner shall comply with all City, State and Federal laws in regard to social security, workman's compensation, lien laws, etc., where applicable. 8. That the owner shall comply with all the safety codes issued by the Florida Industrial Commission. 9. State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one-family or two-family residence or a farm outbuilding. You may also build or improve a commercial building at a cost of $25,000 or less. The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease more than one building you have built yourself within 1 year after the construction is complete, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your contractor. Your construction must be done according to building codes and zoning regulations. It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. DATE: u?~~~/fd~~ f1!,/ PH:t/"?F';?- 3[?,cJY ( WITNESS: WITNESS: PERMIT t~ APPLICATION FOR PERKIT CITY OF ZEPBYRBILLS BUILDING DEPARTMENT OWNER I S NAHB John C. Brant Sr PHONE 813-788-3804 OWNER I S ADDRESS 5628 McCoy Ct Zepyrhills,Fl. 33540 JOB ADDRESS 5628 McCoy Ct Zephyrhills,Fl. 33540 LEGAL DESCRIP'l'ION: LOT(S) 92 BLOCK SUBDIVISION Sunset Estates #2 PARCEL 1.D.' 12-26-21-0310-00000-0920 (OBTAIN FROK PROPERTY TAX NOTICE) WORK PROPOSED:-Rew Construction ~ition --...Alteration ___epair _Install _Sign ~ve .1QLDeaolish PROPOSED USE: -!!,Single F_ily --1f/F _' of Units _K/H _ec-ercial _Indust. _Swia. Pool _Other ___estaurant & Health Departaent Approval DESCRIPTION OF WORK: Move Deck, Extend 2 rooms and make Master Bedroom w/Bath & Move Kitchen BUILDING SIZE: /.h X ,.11 ,........,,-:5.:F2 Square Feet, /~ I' Height RESIDENTIAL: COtIHERCIAL : A'lTACB (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. A'lTACB (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED -BUILDING $ Ii;mo 0? _ELECl'RICAL Valuation of Total Construction AMP Service ~ Florida Power Corp. 00 $ ~ CCl? ~ , W.R.E.C. ----.JIECBARICAL -LPLUH8~NG Valuation of Mechanical Installation GAS V ROOFING ~r_e _Steel SPECIALTY TYPE OF CONSTRUCTION: ~lock Other PIliISBBD FLOOR ELEVAnONS: Fl. IS PROJEct IN FLOOD ZONE AREA? -L YES NO ****************************************** Signature CONTRActOR SECTION COMPANY ~ State Cert. or Regist. . City License Registration . ****************************************** Bun.DER IU.RCTRICIAR COMPANY C/WVLf2./\.- State Cert. or Regist. . City License Registration . ****************************************** PIDIBER d i Q>>IPAIIY ('jlR It; l5-1k~ p'dyUm.p:(I/( ~ . State Cert. or ReRiat.' _ Fc6 f!;"~ SillDature " ,C- 2~ e~ty UC<!DSe kgistration . ,S":2 . ****************************************** J SilmAture MECHANICAL 7 SillDature ~ ~ jJ City Liceoae ReRistrsUon . ****************************************** OTIIRR COMPANY State Cert. or Regist. , Signature City License Registration , *.**************************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS . Tbe undersigned understands that this pellit lay be subject to 'deed restrictions" wbieb lay be IDre restrictive than City regulations. !be undersigned assUles responsibility for COIpliance with any applicable deed restrictions. B. UNLICENSEP CONTRACTORS AND CONTRACTOR RESPONSIB~~ITIES If the owner bas bired a contractor or contractors to undertake work, they lay 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 lisdeteanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing requiretents tay apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departtent, (813) 788-6611. FurtberlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the "Contractor Sections' of this application for wbieb 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 wisbes you to sign as contractor that tay be an indication that be is not properly licensed and is not entitled to peuitting privileges in the City of Zepbyrbills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, bave been provided with a copy of 'Florida's Construction Lien Law - Hoteowner's Protection Guide" prepared by the Florida Departtent of Agriculture and COOSUHr Affairs. If the applicant is SOHone other than the 'owner", I certify that I bave obtained a copy of the above described docUleDt and prOtise in good faith to deliver it to the "owner' prior to COlleDcetent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforaation in this application is accurate and that all work will be done in cotpliance with all applicable laws regulating construction, loning, and land developlent. Application is hereby lade to obtain a pellit to do work and installation as indicated. I certify that no work or installation bas cOllenced prior to issuance of a pellit and that all work will be perfoited to teet standards of all laws regulating construction, City codes, loning regulations, and land developteDt regulations in the jurisdiction. I also certif! that I understand that the regulations of other goveruental agencies tay apply to the intended work, and that it is IY responsibility to identify wbat actions I lust take to be in COIpliance. Sucb agencies include but are not liaited to: t Departlent of Bnvirollll!l1tal Regulation - Cypress Baybeads, Wetland Areas and BnviroDlentally Sensitive Lands, Water/Wastewater !reatlent t Southwest Florida Water Managetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses t AllY Corps of Engineers - Seawalls, Docks, Navigable Watenays t Departlent of Health rr Rebabilitative Services, EnvirODlental Health Unit - Wells, Wastewater !reattent, Septic ranks t US BnvirODlental Protection Agency - Asbestos abatetent 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 'cOtpensating volUte' will be subtitted wbieb is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A perlit issued sball 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 sball issuance of a pellit prevent the Building Official frOt thereafter requiring a correction of errors in plans, construction, or violations of any code. Every persit issued sball beCOle invalid unless tbe work authoriled by sueb pellit is COII8IlCed within slllODtba of issuance, or if work authoriled by the pellit is suspended or abandoned for a period of slllOntba after the tHe the work is c_enced. One 90 day eltension of tile, tay be allowed for the pellit with fee ebarge of $15.00. Tbe eltension sball be requested in writing to the Building Official. An approved inspection lUst be logged during eaeb sil IDnth period, or the project will be considered abandoned. WAIUUNG TO OtUfBR: YOUR FAILURE TO RECORD A NOTICE OF COIlMBNCBMm MAY RESULT IN YOUR PAYING nICB FOR IMPROVEMmS TO YOUR PROPBRTY. IF YOU IIIfBHD TO OBTAIN FIIWICIHG, COHSULT WITH YOUR LEIIDBR OR 111 AffORIEY BEFORE RECORDIHG YOUR HO'rICE OF COIlMBNCEHBNt'. JOBS UNDER $2,500 IN VALUE 00 NOT NBED TO RECORD lIID POST A 'NOTICB OF CCiuIBIICBMBIIT". SIGNAtURE: OIOIBR OR AGm SIGNA!URE: COIlfRACfOR STATE OF FWRIDA coum OF The foregoing instrument was acknowledged before me this 1 19____ by STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged befQre me this ' . ; 19 by 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 (Nam~ Typed, Printed or Stamped) NOTARY PUBLIC JOHN BRANT ADDITION 5628 McCOY CT. VALUATION: $11,220.00 PERMIT FEES BUILDING: 112.50 PLUMBING: 20.00 SQ. FT. LIVING: 352 ELECTRICAL: 29.50 MECHANICAL: 20.00 SUB-TOTAL: $182.00 COST/FT: $25.00 CREDIT: 20.00 TOTAL: $162.00 SQ. FT. OTHER: 220 CONNECTION FEES COST/FT: $11.00 SEWER: 0.00 WATER: 0.00 METER: 0.00 VALUATION $11,220.00 TOTAL: $0.00 DRIVEWAY $0.00 ADDRESS $0.00 FEE SHEET $75.00 SQ. FT. UNDER ROOF 352 RADON GAS $3.52 TRAFFIC IMPACT FEES $0.00 99% $0.00 GRAND TOTAL: $165.52 1 % $0.00