HomeMy WebLinkAbout94-4486
~~(t- BUIL~I!~9HY~L~RM!! ~ ~4486i5
,1 J:3- __ (813)7..!8-6611 Di) Date 1/-~3-9f
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~ ~I~ cPW"1~ G:HAN'::> S,wee CO"
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/~ :;l'1g .
Water Conn: .aa-O -
Water Meter: /- f.E6 ~5 =
1- :;:~, /'-5
T.I.F.'s: / ~ R-O. t?'V 11l
/ .:3-10-7'.5
Job Address:
Parcell.D. #
Zoning:
Description of Work
FINAL
.5 - /J-f - ((.5
NO OCCUPANCY BEFORE C.O.
DATE
C.O. ..3 -/~ - X- <-
DATE
Complete Plans. Specifications and Fee Must Accompany Application.
All work shall be performed in accordarce with City Codes and Ordinances.
@6>11.h~
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Valuation or JJ... ~ "U
Contract Price VJ::Y '"'~ ~ 13 f? ()'
City License Registration #
State Certified License#
~
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rA Ftr. 11-.~;;J-9'11{13 Tp. Servo SLB
;- Pre SLB Rough In I-\-ASf':kL Tub Setl..4~Q'S ~~
~.. FLRinMte.' ~"'t,~{b "1ete,Can II-t13-'i4~ Wate,
~ . _ ____ Const. Pole Sewer ';)-~'1- Cf4. ~~
v~ Insul. CL Pool Final" ~ LJ - '75 _--:lL
~ WL 1--5".-'1<( $~ Pre-Meter J...JIa -CiS f5cJr
b~Sl-AB il- --2fl-C,1./ BiLL Final
Driveway ~--
~ ~~'" l~-t>~~q4 ~tU' 9-~ ~~12.--/4t(L( B'tlG
(~\. ~~a-(>~,.tl4()LeJ' 'frn4 ~ /)"'lb-t['f Bll.4v
REINSPECTION FEES: When extra insp~triPs are necessary due to anyone of the following reasons, a
:ha,ge;:~~:;d::: 00/100 Dolla,s ($15,001 shall be made 10' each tr: I:' e: tr:~~ /-A
b, Condemned work resulting from faulty construction. .Iz/ ~ ~-
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.
0~~
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final :3 -13 --tI Y{';~
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
Elton & Ruth Boberg
5500 10th street
VALUATION: $31 ,380.00
SQ. FT. LIVING: 1 ,040
COST/FT: $25.00
SQ. FT. OTHER: 538
COST/FT: $10.00
VALUATION $31,380.00
DRIVEWAY $20.00
ADDRESS $20.00
FEE SHEET $175.00
SQ. FT. UNDER ROOF 1,578
RADON GAS $15.78
TRAFFIC IMPACT FEES
99%
1 %
$1,480.00
$1,465.20
$14.80
PERMIT FEES
BUILDING:
PLUMBING:
ELECTRICAL:
MECHANICAL:
SUB-TOTAL:
CREDIT:
TOTAL:
CONNECTION FEES
SEWER:
WATER:
METER:
TOTAL:
302.50
55.00
59.00
25.00
$441.50
45.00
$396.50
1,278.00
350.00
165.00
$1,793.00
GRAND TOTAL: $3,685.28
CITY OF ZEPHYRBILLS BUILDING DEPARTMEN"l
OWNER EL..7ol'l L. -I' R()TkI $; 80i3E.e Go
JOB LOCATION 5S~n / ~ "fA STk!.EE'7) z..~.PNYR./.I UJ.'sII=LA. 33~#o
PARCEL I.D. # /1-.;2~ - ~/ - ~/:)/O - //'00 -t:)/.4~
SHOW ALL EXISTIRG &: PROPOSED STRUCl"URES GIVING DDlENSIOIfS &: SETBACKS.
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ALLEYWAY ACCESS FOR
GARAGE OR CARPORT -
15 FOOT SETBACK
REQUIRED.
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UTILITY BUILDINGS
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1. SETBACKS FOR R1f R2 ZONING
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2. SETBACKS FOR R3 ZONING
60'
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FROIft" PROPERTY LIRE
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FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION
FORM 600B-93 Residential Component Prescriptive Method B CENTRAL 4 5 6
Department of Community Affairs
OWNER:
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 packages "A" through "F" from Table 6B-1 by which you intend 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)
1.
2,
3.
4,
5,
6.
7,
8.
A).u<- '
/ \ .. (.r r
-'; /t- (P '1-.
/0 f.(C)
.,
~--
'i(p '( if
Single Pane
sq. ft.
sq. ft.
Ii %
Double Pane
sq. ft.
/11.. I sq. ft.
9a.
9b,
10.
11a.
11b.
11c.
11d.
11e.
R=
R= If
R=
R=
R=
sq. ft.
/ Of{ l> sq. ft.
sq. ft.
sq. ft.
sq. ft.
12a-1 R= sq. ft.
12a-2 R= II sq. ft.
12b-1 R= sq. ft.
12b-2 R= 1/ jet0 sq. ft.
,
13a. R= J() _/ C' l/ C, sq. ft.
13b. R= sq. ft.
Type: ( I/' 1'-''7' &1 Ii /
SEERlEER: ---L!2 ", C
Type: IjfF/I fVtt/
HSPF/COP/AFUE: '7,- c 0
Type: L /p c-f
EF:
14,
15, Heating system:
(Types: heat pump, elec. strip, nat. gas, L.P. gas, room or PTAC, none)
16. Hot water system:
(Types: ele<;., nat. gas, L.P. gas, solar, heat rec., ded. heat pump, other, none)
15,
16,
-1-
TABLE 6B-1
MINIMUM REQUIREMENTS
COMPONENTS PACKAGES FOR NEW CONSTRUCTION
A B C 0 E F
Max.%of glass to Floor Area 15% 15% 20% 20% 25% 25%
en Type Single Clear (SC) Single Tint (ST)
en Single Tint (ST) Single Tint (ST) Double Tint (DT) Double Tint (DT)
:5
<.!:l Overhang 2' 2' 2' 2' 2' 2'
Masonry EXTERIOR AND ADJACENT MASONRY WALLS R-5
en COMMON MASONRY WALLS R-3 EACH SIDE.
...J
...J
c(
~ 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)
en Slab-On-Grade R-O
II:
0 Raised Wood R-11 (ONLY STEM WALL CONSTRUCTION ALLOWED)
0
...J Raised Concrete R-5
u.
DUCTS R-6 R-6 CONDo R-6 R-6 R-6
SPACE COOLING (SEER) 11.1 10.0* 10.0* 10.5 10.0* 10.9
I- Elect lHSPF) STRIP 6.8* 6.8* 7.3 6.8* 7.6
c(
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)
!;(w Gas & Oil ** MINIMUM EF OF .54 NATURAL GAS ONLY
~~
1->- (SEE BELOW)
Oen
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
/4 %
DC: l')!:l DT: 0
2- FEET
EXT: R=
ADJ: R=
COM: R-
EXT: R= II
ADJ: R= /1
COM: R-
UNDER ATTIC: R = '30
COMMOM: R=
R-
R- i'!
R=
R= ff:, CONDo 0
SEER - f () ( f>L
COP= _ or HSPF= 'l-.tltJ
AFUE -
EF- I 9/
~ ,
EF-
DHP: B EF= -
HRU:
SOLAR: 0 EF= -
Single package units 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
Percent of Glass to Floor Area: This percentage is calculated by dividing the total of all glass areas by the total conditioned floor area.
Overhang: The overhang is the distance the roof 01 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 muni-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 PTAC'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. )(
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. \!
Infiltration Barrier 606.1 Infiltration barrier must be installed in exterior walls & raised wood floors. )(
Fireplaces 606.1 Fireplaces must have flue dampers, glass doors and outside combustion air intakes. 'f
Exhaust Fans 606.1 Exhaust fans vented to unconditioned space shall have dampers, except for combustion AJIl
devices with integral exhaust ductwork.
Water Heaters 612.1 Comply with efficiency requirements in Table 6-12. Switch or clearly marked circuit breaker (electric) X'
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 ,td
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 K
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. k
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 X
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. X
-2-
if R ftl-'o/!3~/ .Ib' 9 f
_'S - ELTaN t,.J /?U T# E. ~t:.~ P8OIII\ IfN-/t,lRd,~
OWER'S ADDUSS 55 et>o /~/7f; S7L:EE-r". ZE'/IIY.e.///LL S ~LP, ~~51/6
) ,
JOB ADDRESS 6'Si!>D /LJ~ S'7L~h~7 ZE~I/YK!U//J S. ..cLA. 3.3St/6
, .
LEGAL DESCRIPTION: LOT(S) /':3 -f /4 B~SUBDIVISION
PARCEL I. D. # / / - ~ (., - :l / - tJO/ () - /1 fftXJ- O/.$tJ (OBTAIN FROM PIlOPERTY TAX NOTICE)
APPLICATION FOR PERHIT
CITY OF ZEP11YR11ILI3
BUILDING DEPARTKERT
WORK PROPOSED:~ew Construction --^ddition ----.Alteration --..,;Repair _Insta11
_Sign
-----Kove
--Peaolish
PROPOSED USE: ~SiDg1e F_11y
---1t/F _' of Units ---1t/H
_ec-ercial
_Indust. _Swia. Pool _Other
---..Restaurant &: Health Departllent Approval
DESCRIPTIOIi OF WORK: .5in&..J~ FAMIL"I k{,1'~'u.. A'1"7AaNPj) &~U!.AC.~./ /6Jt!.~H
,
BUILDING SIZE: ~ ~ X tb.:l. /6'1 J' Square Feet. /.; I Height
RESIDEIITIAL: ATrACII (2) PLOT PLAliS &: (2) SETS OF BUILDING PLARS &: (1) SET ElERGY FORMS.
COHHERCIAL: ATlACII (3) SETS OF BUILDING PLARS &: (1) SET EliERGY FOBHS.
PROPERTY SURVEY REQUIRED FOR ALL NEW COIiSTRUCTION.
-BUILDING
RJ,RCTRICAL
-lIECIIAlIICAL
.-PLUKBDiG
PERKI.TS REQUESTED
$ .30 60CJ,OD
,
Valuation of Total Construction
/.tF () AKP Service
i>( Florida Power Corp.
W.R.E.C.
$ ...~_t:) 00, 0 0
GAS
Valuation of Hechanica1 Installation
ROOFING
SPECIALTY
TYPE OF OONSTRUCTION: ~loclt ~Fraae _Steel Other
FIllISBBD .FI.OOR ELEVAnOIiS: ~ ~ Fl. IS PROJECt IIi FLOOD ZOIiE AREA! ~
YES NO
RIJJU)ER
Signature
RJ.RCTRICIAR
SilmAture
PLUKBER
Signature
IlECllARICAL
Signature
OTRRR
Signature
..........................................
CONTRACTOR SECTION'
OOKPANY. ~
f!J/~ J~ State Cert. or Regist. #
V~ iI- City License Registration .
~..... .................................
COMPANY /J'--C.dn~
IP /.JIC- ~ J /::7~ State Cert. or Regist. .
[/(.-( hl 7 ~ City License Registration.'
........ *...............................
COMPANY ~~
I!' / ~ J //?$f.". State Cert. or Regist. #
'C/t-tn ;;. ~ City License Registration .
........ ...............................
7- COMPANY ~/?u't
~ State Cert. or Regist. .
~ J ' City License Registration .
....... ..........................*......
" COMPABY " d7A/n..R(
~ ./ & State Cort. or Ilegist. .
, City License Registration .
...... .................................
APPLICATION APPROVED BY
PERHIT OFnCa.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
!be undersigned understands that tbis penit lilY be subject to Ideed restrictionsl ,bich lilY be lOre restrictive than City
regulations. !be undersigned assUIeB responsibility for cmpliance ,itb any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the QlIIIler bas hired a contractor or contractors to undertake wort, tbey lilY be required to be licensed In accordance ,itb
state and local regulations. If tbe contractor Is not licensed as required by law, botb the OIlIer and contractor lilY be
cited for a liscll!ll!illOr violation under state law. If tbe 0IIleI or intended contractor are uncertain as to what licBD8!ng
regulreIeDts lilY apply for tbe intended wort, tbey are advised to contact tbe City of Zepbyrbills Building Departlent, (813)
788-6611.
Furtbenore, if tbe owner bas hired a contractor or contractors, be is advised to have tbe contractor(s) sign portions of tbe
IContractor Sectionsl of tbis application for wbich tbey will be responsible. If JOU, as tbe OIIler sign as the contractor,
you are indicating that JOU, rather tban the contractor, are responsible for tbe IOrt. If tbe contractor wishes fOIl to sign
as contractor that lilY be an Indication that he is not properly licBD8ed and is not entitled to perlitting privileges in tbe
City of Zepbyrhllls.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, tbe applicant, have been provided witb a copy of IPlorida's Construction Lien Law - lkIIeoImer's Protection
Guidel prepared by tbe Plorlda Departlent of Agriculture and ConsUller Affairs. If the applicant i8 SOl8Olle other than the
lOIIlerl, I certify tbat I have obtained a copy of tbe above described dOCUElt and prolise in good faitb to deliver it to tbe
IQlIIIlerl prior to co.enCelellt.
E. CONTRACTOR'S/OWER'S AFFIDAVIT
I certify that all the infoIliltion in tbis application is accurate and tbat all work ,ill be clone in COIpliance ,itb all
applicable laws regulating construction, loning, and land developleDt.
Application is hereby Iilde to obtain a penit to do work and installation as indicated. I certify that no wort or
installation has CDlenced prior to iBluance of a perlit and that all wort will be perfol'led to _t standards of all laws
regulating construction, City codes, zoning regulations, and land developJleDt regulations in tbe jurisdiction. I also
certify tbat I understand tbat the regulations of other goverDleDW agencies lilY apply to the Intended IIOIt, and that It is
IY responsibility to identify what actions I lUSt tate to be in COIplianee. Such agencies include but are not lilited to:
t DepartJent of InvirOlllelltal Regulation - Cypress Baybeada, Wetland Areas and Envirollll!llWly Sensitive Lands,
Water/Wastewater '1reatlent
t Southwest Florida lIater HanageleDt District - Wells, Cypress Baybeada, Wetland Areas, Altering Watercourses
t A[IJ Corps of Engineers - Seawalls, Docks, lIavigable Watmays
t Departlent of Bealtb i Rehabilitative Senices, InvirOllleDtal Bealtb Unit - Wells, Wastewater '1reatlent, Septic 'fanb
t US InvirOllleDtal ProtectibD Agency - Asbestos abateJent
I also certify that, if fill Iilterial is to be used In Flood Zone IAI or IA,etc.l, it is understood tbat a drainage plan
addressing a lCOIp8II8ating voluel will be saltted which is prepared by a professional engineer registered In the State of
Florida prior to peIlit issuance.
A pmit issued shall be construed to be a license to proceed witb the wort and not as authority to violate, cancel alter, or
set aside any provisions of tbe technical codes, nor shall issuance of a peIJit prevent the Building Official fIOl thereafter
requiring a correction of errors In plans,. construction, or violations of any code. Ivery peIJit issued aball becDe Invalid
unless tbe wort authoriled by such penit is ~ced witbin sil IOIltbs of iBluanee, or if work autboriled by the perlit is
suspended or abandoned for a periOd of 8il IODtbs after tbe u.e the IIOIt is co.enced. ODe 90 day 81tension of tile, lilY be
allowed for tbe penit witb fee charge of $15.00. fhe 81tension shall be requested in .riting to the Building Official. An
approved inspection lUSt be logged during each sillODtb period, or the project .ill be considered abandoDed.
IfARlfIIG 'fO OIIIIER: YOOR FAILURI '10 RECORD A IIO'fICE OF aJlllBllCIIID1' MAY RlSOL'I III YOOR PIYIHG DICE FOR IIIPROVIIIIII'fS 'fO YOOR
PROPERlY. IF YOU IJIDIID 'fO 0B'l1lJl PIWCIIIG, COJISUL'I WI'll YOOR LIIIDIR OR 1II1'f'fOR11Y BBFORB RICORDIIIG YOOR DICE OF
aJtIIENCIIID1'. JOBS UllDD '2,500 IN VALUE DO IIO'f tIDD '10 RICORD IIID POSI A wlIO'fICE OF aJlMlllCIIID1'I.
SIGNA'IURI: (MIIR OR IGIIft'
SIGIII'fURI: COII'fIIIC'fOR
S'IA'II OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before me this , 19____ by
StAD OF FLORIDA
coum OF
The foregoing instrument was aCknowledged
before me this , 19_ by
who is personally know.n to me or who has
produced
as identification and who didldid not
take an oath.
who is personally know.n to me or who has
produced
as identification and who did/did not
take an oath.
(Signature)
(Name Typed, Printed or Sta.ped)
NOTARY PUBLIC
(Signature)
(Name ~ed, Printed or Stamped)
NOTARY PUBLIC
cm,.jn;:Ac.:TOF< #:
NAME: RUTH ROBERG
ADDR: 5500 10TH 8T
C/ST: ZEPHYRHILLS FL
C E N T R ALp E R M I 1" TIN G DATE: 12/30/94
PASCO COUNTY, FLORIDA PAGE: 1 OF 1
I ::;:::;;:UE C)FF ICE:: D
RECEIPT NUMBR: 00234680
OFFICE: DADE CITY
F' () 1:;: ~~
C:HE:CI< # C:A::;;j.-t
RESOURCE FEE ON PERMIT 44868
CITY OF ZEPHYRHILLS
{~) C 1::: "~ T
1:[ iJ.
TOTAL {.:iMCIUNT:
COMPNY ACCOUNT CENTER
8450 - 363000 _ ~
.14
AMOUNT DESCRIPTION/PERMT DATA DRICR
.14 ****** SOLID WASTE FEE 60
'E-'-E'.I\IE"'I'. I'" ~
(~C~.. ~J jY ______ _
< . .. -
PASCO COUNTY, FL,ORIDA
Iff9'6~
Date Pe,mitted ~ :z:3-r-jl
Builde, Name/Owne, Name ~~ ~ ~~ 8. ~ _ ,
County Paccel No, 11- .,2-, -;L ~-~Ol; - / {POD. - OI!:IO (
~~O- /()~ ~A~~
cq.L_5;dl!~;.e
TRANSPORTATION IMPACT FEE CALCULATION
Permit No.
Location
Subd.
Classification/Type of Use
Rate $
EXEMPT
o
//
./
E RECOVERY ASSESSMENT
Zone No.
Sq. Ft./Unit
Impact Fee Amount $
The above impact fee h een established pursuant to the Pasco Count
by the Board of Co y Commissioners. This amount is payable PR
. lze the permitted structure.
ransportation Impact Ordinance as adopted
to the issuance of a Certificate of Occupancy
EXEMPT 0
RESIDENTIAL
No. Units
/
NONRESIDENTIAL
Rate/ERU - 50.00 x 0.96*/Year
or $0.1315/Day
Gross Sq. Ft. (GSF)
ERU Assign No.
Assessment - (No. Units) x ($0.1315)
x (No. Days)
Assessment -
(GSF) x (ERU) X (0.1315) x (No. 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
HA VE 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. Q3{~, X- ()
DATE I J ~~~
DATE1~ 3J1C;r B~:' ".. ~..
White
Applicant
Canary
Trans/Finance
Canary
RR/Finance
Pink
Office
Green
Bldgllnsp
feeca/:ce