HomeMy WebLinkAbout95-4865
BUILDING PERMIT
Permit ~
CITY OF ZEPHYRHILLS
(813) 788-6611
J~s, tfO
//1 '1,,-
ls;1V. ~->
ELECTRICAL
-5-~~ tJ7J
PLUMBING
.3 ()" tJL)
MECHANICAL
BUILDING
'2
:::::;e~s:n3 ~f~C-;Af>t Jf:::i~~~j
Parcel 1.0. # :J--:26 ~I - OJ! 0 - CJ CJ cJ c9 0- D /0 V
Zoning: Energy 9de: Ra<!on Gas: / :<(~
Description of Work ~/--'--J '-fi ~ '?.A..-:x- (&.,/1. It ~)
NO OCCUPANCY BEFORE C.O.
Date
4865 ;g
]1- / 7 -7~-
Sewer Conn ~~ 7 y. 07)
Water Conn: 3-..!.'o. ch.:J
-
Water Meter:
T.I.F.'s: f/6t. ZJ.J....
p-;.zr~~-
C.O.
FINAL
Permit Fee ~:.5C;. bl-'s-
Signature ~ ~
Company
Address
Telephone#
Complete Plans, Specifications and Fee Must Accompany Application.
6.11 work shall be performed in accordance with City Codes and Ordinances.
Pre-IOOter FPC (Betty) Nancy 07/26/95 10:24 A.M.
Valuatior. or
Contract F'ice
~~:<, 'If 6 < O-Ul
/
DATE
Inspector
City License Registration # 02 .:2..
State Certified License#
xZ'~ .~A.J..b1)
/1i;d>uT
PLUMBING 9'/
>>;.4~~
ELECTRICAL t~ 71
BUILDING
_~/~Z?i/v~t ~J7
MECHANICAL J / D
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.00) shall be made for each trip for each trade:
.~. If. -7J7/:"/7 - ?3-
iJ"'./,.v...e. 4:
~~
pJ !1-:2J--y-g:-
Tp. Servo ~ SLB 4..:z"\-<f5 ~Q~
9"$& Rough In ~-IJ?) J~f ~ Tub Set F 3o.95'~
\L-L.. Meter Can 'f-1'l-9..s- Water
FRM. ' 1- ll~ Const. Pole Sewer rb/08/95 BITL
Insul. CL~ ~ Pool Final '7- 7.7t.; j' tSiL~
~ WL - _ .qc:; __LlL- Pre-Meter'!' u.;;~lr [1'0
il~AL '7 ',):7'i)" tS;l.-L- Final I 2 7lJ'j- Yx.h
Driveway . <Sltt> 4.Gt-~J)o])
..5H~1lt,A(,. t;;-17.Q)' !SiLL- ..
a.
b.
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.
c.
d.
e.
f.
g.
Breakers i
Ducts Insl. GJ -I-<() '~ pg
Compressor
22 .,.. /2...f
Final' , .7 -',) ;>" .)
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
'""" . r \ , i ....J.'_ I ("~ ~
_ X' \-\'-1""': ,,'..J:'::)C .- ... . ~"- .
FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION
FORM 600A-93 . Residential Component Prescriptive Method A CENTRAL
PRO~ECT NAME: ATTACHED PATIO HOME :BUILDER: GENERAL HOME DEVELOPMENT CORP.
AND ADDF~: . J. COTTONWOOD PLA: PERMITT~ING J : CLIMATE ~
,j'~lf'( Cc-ll.:')t.t.ft""'ZEPHYRHILLS, FL 335: OFFICE: : ZONE: 4: _: 5: _: 6:_:
mmER: \s~,"ero..\ -t~I't"-eh.\f\:.l'''1.~(Y,e,,--r : PERMIT O. '/R~"'" tE : JURISDICTION NO. 6/1 b vi)
- 0v r-f, CK
1. New construction or addition 1. New Construction
2. Single family detached or Multifamily attached 2. Multi-F~mily
3. If Multifamily-No. of units 3. 4
4. If Multifamily, is this a worst case (yes/no) 4. No
5. Conditioned floor area (sq.ft.) 5. 1195.00
S. Predominant eave overhang (ft.) 6. 2.30
7. Porch overhang length (ft.) 7. 0.00
3. Glass area and type: Single Pane
B. Clear Glass 8a.239.4sqft
b. Tint, film or solar screen 8b. O.Osqft
~. Floor type and insulation:
a. Slab on grade (R-value, perimeter)
LO.Net Wall type area and insulation:
a. Exterior: 1. Concrete (Insulation R-value) 10a--1 R= 4.20, 285.50sqft_
a. Exterior: 2. Wood frame (Insulation R-value) 10a-2 R=11.00, 40.30sqft____
.1.Ceiling type area and insulation:
a. Under attic (Insulation R-value)
a. Under attic (Insulation R-value)
2.Air distribution systems
a. Ducts (Insulation + Location)
3.Cooling system
Department of Community Affairs
SN: 60,96
Double Pane
O.OOsqft
O.OOsqft
9a.R= 0.00 ,
60.80 ft
11a.R=22.00, 98.00sqft_
11a .R=30 .00 , 1200.00sqft__
4.Heating System:
12a. R= 6.00, uncond
13. Type: Central A/C
EER: 10 .00
14. Type: Heat Pump
HSPF: 7.00
15. Type: Electric
EF: 0.90
5.Hot water system:
6.Hot Water Credits: (HR-Heat Recovery,
DHP-Dedicated Heat Pump)
7.Infiltration practice: 1, 2 or 3
8.HVAC Credits (CF-Ceiling Fan, CV-Cross vent,
HF-Whole house fan, RB-Attic radiant
barrier, MZ-Multizone)
9.EPI (must not exceed 100 points)
a. Total As_Built points
b. Total Base points
16.
17.
18.
2
19.
19a.
19b.
83.39
19255.47
23089.58
-------------------------------------------------------------------------------
------------------------------------------------------------------------------
Hereby certify that the plans and
~ecifications covered by this calcu-
~tion are in compliance with the
lorida Energy Code.
,
Review of the plans and specifications
covered by this calculation indicates
compliance with the Florida Energy
Code. Before construction is completed
this building will be inspected for
compliance in accordance with Section
553.908 F.S.
<EPARED BY:
~TE :
" ~ . \-D~
. . 1~ '. \. A A-
~-,-9')
hereby certify that this building is
) compliance with the Florida Energy
>de.
INER/AGENT:
ITE:
l'~
" . ",
';' 1+-J...
. ~- rr -'45
BUILDING OFFI~L'4r~...11-
DATE: _3.. -;:1.. ?-
*~ INFILTRATION REDUCTION PRACTICE COt1PlIANCE CHECKLIST **
==================~====;========================================================
:OMPQNENTS
SECTION
REQUIREMENTS FOR EACH PRACTICE
CHECK
================================================================================
)RACTICE 1:t1
606.1
COMPLY WITH All INFILTRATION PRESCRIPTIVES.
--------------------------------------------------------------------------------
~ i ndows
606.1
Maximum of 0.34 CFM per linear foot of operable sash
crack (includes sliding glass doors).
-------------------------------------------------------------------------------
~xter ior &
~djacent Doors
606.1
Maximum of 0.5 CFM per sq. ft. of door area: solid
core, wood panel,insulated or glass doors only.
~---------------------------------------------------------------~---------------
~xter ior Joi nts
;., Cracks
606.1
To be caulked, gasketed, weather-stripped or other-
wise sealed.
-------------------------------------------------------------------------------
)RACTICE #2
606.1
COMPLY WITH PRACTICE #1 AND THE FOllOWING:
-------------------------------------------------------------------------------
:xter ior Walls
, Floors
606.1
Top plate penetrations sealed. Infiltration barrier
installed. Sole plate/floor joint caulked or sealed.
-------------------------------------------------------------------------------
:xterior Walls
, Ceilings
606.1
Penetrations, joints and cracks on interior surface
caulked, sealed or gasketed.
-------------------------------------------------------------------------------
luctWor k
606.1
Ductwork in unconditioned space must be sealed.
-------------------------------------------------------------------------------
. i replaces
606.1
Equipped with outside combustion air, doors and flue
dampers.
.------------------------------------------------------------------------------
xhaust Fans
606.1
Equipped with dampers. Combustion devices see
606.1.A.2.
--------------------------------------------------------------------------------
ombustion
Ippl ia nces
606.1
Be in unconditioned space (except direct vent), draw
air from unconditioned space, exhaust to outside.
Cooking appliances shall be dampered and use
intermittent ignition.
----------------~--------------------------------~-----------------------------
ater Heaters
* OTHER PRESCRIPTIVE MEASURES (must be met or exceeded by all residences.) **
------------------------------------------------~~-----------------------------
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.
wimming Pools
Spas
-------------------------------------------------------------------------------
612.1
Spas and heated pools must have covers (except solar
heated). Non-commercial pools must have a pump timer.
Gas spa & pool heaters must have a minimum thermal
efficiency of 78 percent.
hower Heads
------------------------------------------------------------------------------
612.1
Water flow must be restricted to no more than 3 gal-
lons per minute at 80 PSIG.
--~---------------------------------------------------------------------------
VAC Duct
onstruction
nsu.lation &
nstallation
610.1
All ducts, fittings, mechanical equipment and plenum
chambers shall be mechanically attached, sealed, ins-
ulated and installed i~ accordance with the criteria
of Section 610.1.ABC.2 & 610.1.ABC.3. Du.ct in attics
must be insulated to a minimum of R-6. Air handlers
shall not be installed in attics unless in mechanical
closet.
------------------------------------------------------------------------------
>lAC Controls
607.1
------------------------------------------------------------------------------
Separate readily accessible manual or automatic
thermostat for each system.
nsulation
604.1
602.1
Ceilings minimum R-19. Common Walls - Frame R-11 or
CBS R-3 both sides. Common ceiling & floors R-11.
r****************************************************************************~*
SUMMER CALCULATIONS
r***~**************************************************************************
=== BASE === === AS-BUILT ===
===============================================================~:===============
3LASS---------------- I
I
)RIEN AREA x BSPM = POINTS I TYPE SC ORIEN AREA x SPI'1 x SOF = POINTS
I
-
-----------------------------------------------------------------------------------
E 45.30 82.2 3723.7 SGL CLR E 23.7 109.2 .77 1981. 0
SGL CLR E 21.6 109.2 .74 1736.9
W 74.40 82.2 6115.7 SGL CLR W 3.0 109.2 .68 222.2
SGL CLR W 12.0 109.2 .77 1003.1
SGL CLR W 12.0 109.2 .77 1003.1
SGL CLR W 23.7 109.2 .77 1981.0
SGL CLR W 23.7 109.2 .95 2458.6
-------------------------------------------------------------------------------
,15 x CONDo FLOOR / TOTAL GLASS = ADJ. x GLASS =
AREA AREA FACTOR POINTS
ADJ GLASS
POINTS
GLASS
POINTS
----------------------------------------------------------------.---------------
15
1,195.00
119.70
1.497
9,839.34
14,734.35 :
10,385.84
._----------~------------------------------------------------------------------
-------------------------------------------------------------------------------
ION GLASS------------ :
AREA x BSPM = POINTS: TYPE
R-VALUE
AREA x SPM = POINTS
.------------------------------------------------------------------------------
IALLS----------------
xt 325.8 1.0 325.8
Ext NormWtBlock In 4.2
Ext Wood Frame 11.0
285.5
40.3
1.16
1.90
331.2
76.6
'OORS- ----------- ----
xt 43.2 4.8 207.4
Ext Insulated
Ext Insulated
21.6 4.80
21.6 4.80
30.0 460.0 .60
30.0 740.0 .60
22.0 98.0 .90
103.7
103.7
EILINGS-------------
A 1195.0. .6 717.0
Under Attic
Under Attic
Under Attic
276.0
444.0
88.2
LOORS---------------
lb 60.8 -31.8 -1933.4
Slab-on-Grade
.0
60.8 -31.90 -1939.5
NFILTRATION---------
1195.0 10.9 13025.5
Practice #2
1195.0 10.90 13025.5
===============================================================:===============
OTAL SUMMER POINTS :
27,076.57 :
22,895.13
===============================================================================
OTAL x SYSTEM = COOLING : TOTAL
UM PTS MULT POINTS: COMPON
x CAP x DUCT x SYSTEM x CREDIT = COOLING
RATIO MULT MULT MULT POINTS
------------------------------------------------------------------------------
27,076.57
.37
10,018.33 : 22,895.13 1.00 1.100
.340
1.000
8,562.78
===============================================================:~==============
*~***************~**********************************************************+**
WINTER CALCULATIONS
********~**********************************************************************
. === BASE ===: === AS-BUILT ===
ORIEN
--------------------------------------------------------------------------------
-------------------------------------------------------------------------------
GLASS----------------
ORIEN AREA x BWPM =
1
I
POINTS :
TYPE
SC
AREA
x t.JPM
x WOF
--------------------------------------------------------------------------------
= POINTS
E 45.30 -3.4 -154.0 SGL CLR E 23.7 -2.2 -.28 14.7
SGL CLR E 21.6 -2.2 -.45 21.2
W 74.40 -3.4 -253.0 SGL CLR t.J 3.0 -2.2 -.80 5.3
SGL CLR W 12.0 -2.2 -.28 7.4
SGL CLR W 12.0 -2.2 -.28 7.4
SGL CLR W 23.7 -2.2 -.28 14.7
SGL CLR W 23.7 -2.2 .71 -37.0
.15 x CONDo FLOOR / TOTAL GLASS = ADJ. x
AREA AREA FACTOR
=
-------------------------------------------------------------------------------
GLASS
POINTS
ADJ GLASS
POINTS
GLASS
POINTS
.15
-406.98
-609.45 :
--------------------------------------------------------------------------------
33.67
1,195.00
119.70
1.497
===============================================================:================
~ON GLASS------------ :
AREA x BWPM = POINTS :
TYPE
R-VALUE
AREA x WPM = POINTS
---------------------------------------------------------------------------------
NALLS----------------
~xt 325.8 1.1 358.4
Ext NormWtBlock In
Ext Wood Frame
4.2
11.0
285.5
40.3
3.26
2.00
)OORS----------------
:xt 43.2 5.1 220.3
Ext Insulated
Ext Insulated
21.6 5.10
21.6 5.10
30.0 460.0 .60
30.0 740.0 .60
22.0 98.0 .90
.0 60.8 2.50
:EILINGS-------------
JA 1195.0" .6 717.0
Under Attic
Under Attic
I Under Attic
~LOORS---------------
)lb 60.8 -1.9 -115.5
Slab-an-Grade
:NFILTRATION---------
1195.0 4.1 4899.5
Practice #2
1195.0
4.10
::::::====:::::=:::=======:===:==:=:::=========::===::==========:===============
4899.5
.OTAL WINTER POINTS
I
I
5,470.23 :
930.7
80.6
110.2
110.2
276.0
444.0
88.2
152.0
.OT AL x
IIN PTS
HEATING : TOTAL
POINTS : CDt1PON
::==============:=====================================:======::::========:=====:
7,125.02
x CAP x DUCT x SYSTEM x CREDIT = HEATING
RATIO MULT MULT MULT POINTS
SYSTEM =
MULT
5,470.23 1.10
1.000
.------------------------------------------------------------------------------
3,793.36
6,017.25 :
7,125.02 1.00 1.100
.484
.==============================================================::==========:====
*****~***********~**********************************************************~**
. WATER HEATING
*******************************************************************************
=== BASE ===: === AS-BUILT ===
---------------------------------------------------------------------------------
--------------------------------------------------------------------------------
NUM OF
BEDRMS
x
MULT
=
TOTAL
TANK VOLUr'1E
EF
TANK
RATIO
x MULT x CREDIT
i"1UL T
= TOTAL
---------------------------------------------------------------------------------
2
3527.0
7,054.00
40
.90
1.000 3449.7
1.00
6,899.33
-------------------------------------------------------------------------------
--------------------------------------------------------------------------------
*******************************************************************************
SUMt1ARY
*******************************************************************************
=== BASE === : === AS-BUILT ===
-------------------------------------------------------------------------------
-------------------------------------------------------------------------------
::OOLING
::JOINTS +
HEATING
POINTS
HOT WATER
+ POINTS =
TOTAL
POINTS
COOLING
POINTS +
HEATING
POINTS
HOT WATER
+ POINTS =
TOTAL
POINTS
--------------------------------------------.-----------------------------------
10018.3
6017.3
7054.0 23,089.58
8562.8
3793.4
6899.3
19,255.47
-------------------------------------------------------------------------------
--------------------------------------------------------------------------------
*****************
* EPI = 83.39 *
*****************
ENERGY GUIDE
For detailed inform~tion
of the EPI rating number
or for any ITEM listed,
ask your Builder for
DCA Form 600A-93
or Form 600B-93
EPI= 83.4
o 10 20 30 40 50 60 70 80 90 100
:---------------------------------x-------:
The maximum allowable EPI is 100. The lower the EPI the more efficient the home
RESIDENTIAL ENERGY PERFORMANCE RATING SHEET
ITEt-1
HOME VALUE
Low Efficiency
High Efficiency
~INDOWS.................... .Single Clear
SINGL CLR DBL TINT
:X--------------------:
INSULATION. . . . . . . . . . . . . . . . . .
. Ce i 1 i ng
R-Value.........29.4
R-10 R-30
:-------------------X-:
R-O
R-7
Wall
R-Value......... 5.0
:--------------x------:
R-O
R--19
Floor
R-Value......... 0.0
:x--------------------:
~IR CONDITIONER.............
SEER/EER . . . . . . . . . . . . . . . . .. 10.3
10.0 SEER 17.0
:X--------------------:
9.7
EER
16.0
iEATING SySTEM..............
Electric ~OP/HSPF..... ... 7.0
6.8 HSPF 12.0
:X--------------------:
0.78 AFUE 0.90
, ,
,---------------------1
Gas AFUE............ 0.00
lATER HEATER................
Electric EF.............. 0.90
0.88
0.96
:----x----------------:
0.54
0.90
Gas
EF . . . . . . . . . . . . .. 0 .00
---------------------
Solar
0.40
0.80
EF............. .
---------------------
ITHER FEATURES..............
~ " .. " " .. " .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..
certify that these energy saving features required for the Florida
nergy Code have been installed in this house.
(.~. , Builder
ddl-ess: ~c-\ PIQtC' Signature:
it y ~z i p Z 9~'1 r~; US, f ~ ?., ~)5'-t\J
lorIda Energy Co~e for BUIldIng Construction
lorida Department of Community Affairs
,~~
Date: 3- '1-95
- 1993
FL-EPL CARD93
1:'NJ Lo-\-%\O&
General Home Development
"Acclaim"
38444 Cottonwood Place
VALUATION:
$42,496.00
SQ. FT. LIVING:
1,195
COST/FT:
$35.00
SQ. FT. OTHER:
61
COST/FT:
$11.00
VALUATION
$42,496.00
DRIVEWAY
$20.00
ADDRESS
$20.00
FEE SHEET
$230.00
SQ. FT. UNDER ROOF
1,256
RADON GAS
$12.56
TRAFFIC IMPACT FEES
99%
1 %
$466.02
$461 .36
$4.66
PERMIT FEES
BUILDING:
PLUMBING:
ELECTRICAL:
MECHANICAL:
SUB-TOTAL:
CREDIT:
TOTAL:
CONNECTION FEES
SEWER:
WATER:
METER:
TOTAL:
385.00
55.00
60.25
30.00
$530.25
95.00
$435.25
1,278.00
350.00
0.00
$1,628.00
GRAND TOTAL: $2,541.83
APPLICATIOlNl FOR PRRHIT
CIIY OF' ZEPIlYRIIIU.S
llUTILDIEG DEPARlKENT
. OWNER'S NAME General Home Development Corp.
OWNER'S ADDRESS 13924 Seventh St. Dade City, FL 33525
dc9-1/YY' ~~
JOB ADDRESS Lot 108 Driftwood Subdivision Phase III
PlIOlN1~' (904)567-6581
LEGAL DESCRIPTION: LOT(S)
108
B~SunDIVISIOlNl Driftwood Phrl~~ TII
PARCEL LD.# 2-26-21-021-00000- 0108
h~RK PROPOSED:--X-lNlew Construction ----Addition
_Alteration _Repair
I .
_Install
_Sign
_Hove
_Deaolish
PROPOSED USE: X Single Faaily
_H/F
_, of Units .
_M/B
_Commercial
_Indust.
_Swa. Pool '
Other
_Restaurant & Heal.th DepartDent Approval.
BUILDING SIZE:
x
"Acclaim" 1232
Square Feet.
Height
RESIDENTIAL:
COHKRRCIAL :
AT'fACII (2) PLOT PI..MIlS & (2) SEIS OF BUILDING PLANS & (I) SF:I' .ENERGY FORMS. **
ATrACII (3) SEI'SOF BUllDlBG PlANS & (1) SF:I' .ENERGY FORtlS.**
**COPY OF CONTkAcr RRQlDIR1ID.
PElMITS REQUESTED
-LBUILDING
$ 37.400.00
Val.uation of Total Constrt,Jction
-LELECTRICAL
-1..JfEClJAHICAL
AHP Service
Florida Power Corp.
W.R.E.C.
$
Val.uation of Mechanical. Installation
---L.PLUMBING GAS ROOFING
, .
S'pECIALTY
TYPE OF CONSTRUCTION: -Lnlock. _Pralle _Steel
Other
FINISHED FLOOR ELEVATIOlNlS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
******************************************
YES NO
CDNTRACTOR SECTION
BUILDER K~i n T. Roberts COMPANY r,~n~"';:Il Hom~ Deve 1 opm~nt Corp
~n_ I ^ _ State Cert. or Regist. I CGC005695
Signature ~"~.J:I City License Registration I 22
***************x**************************
U COIHPANY Mrlrtin El~r.trir. . :
State Cert. or Regist. , FR001144Q
City License Registration I ?71
*********CZ*******************************
c:t>>IPANY Bayonet P1lJmbin~
State Cert. or Regist~ I FC042998
City License Registration I 91
******************************************
HECUANI~<,C~ rter COMPANY Southern Comfort Enterprises
, State Cert. or Regist.' I RM0015022
Signature.. . City License Registration # '110
*********************x********************
01'1IER Rick
Gavin /'. C021P.t'\RY Gavin Roofing
~/ ./ \ State Cert. or Regist. j RC0046241
N, A~ (~ City License Registration .,
******************************************
Signature
APPLICATION APPROVED BY
PERHIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT,
A. NOTICE OF DEED REST~ICTION$
The undersigned understands that this per.it .ay be subject to "deed restrictions" which lay be lore restrictive than City
regulations. The undersigned assu.es re5ponsibility for co.plianc~ Hith any applicable deed restrictions.
B. UNLICENSED CONTRACTC~RS AND CONTRACTOF\ RESPONSIBILITIES
If the owner has hired a contractor or c~ntractors to undertake Nork, they may be required to be licensed in accordance Nith
state and local regulations. If the "contrlictor is not licensed as required by law. both the ONner and contractor liY be
cited for a lisdeleanor violation under state law. If tne ONner or intended contractor are uncertain as to "hat licensing
requirelents lay apply for the intended :Iork, they are advised to contact the City of Zephyrhills Building Departlent, (813)
788-6611.
Furtherlore. if the owner has hired a contractor or contractors, he is advised to have the contractorls) sign portions of the
'Contractor Sections' of this application for which they "ill 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 aay be an indication that he is not pr~perly 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 document and promise in good faith to deliver it to the
"owner" prior to coalenceaent.
E" CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all Hork Mill be done in COlpliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a perlit to do Nork and installation as indicated. I certify that no Nork or
installation has coalenced prior to issuance of a perlit and that all work will be perforaed to aeet 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 governmental agencies lay apply to the intended Nork, 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 Environaental ReQulation - Cypress Bayheads, Wetland Areas and Environaentally Sensitive Lands,
Water/Wastewater Treatment
I Southwest Florida Water ManaQeaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t ArlY Corps of EnQineers - Seawalls, Docls, Navigable Waterways
I Departaent of Health ~ Rehabilitative Services. Environaental Health Unit - Wells, Wastewater Treatlent. Septic Tanks
t US Environaental Protection AQency - Asbestos abatement
I also certify that. if fill aaterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
addressing a "compensating volule' Kill be subaitted "which is prepared by a professional engineer registered in the State of
Florida prior t~ 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 aperlit prevent the Building Official frol thereafter
requiring a correction of errors in plan~, construction, or violations of any code. Every perait issued shall becOle invalid
unless the work authorized by such perAit is cOlmenced Kithin'six months of issuance, or if work authorized by the pertit is
suspended or abandoned for a period of 5 I X Bonths after thetiae the Mork is COlflenced. . One 90 day extension of tile, aay be
alloHed for the perlit with fee charge of 115.00. The extension shall be requested in writing to the Building Official. An
approved inspection lUSt be logged durin] each six sonth period, or the project Nill be considered abandoned.
WARHING TO OWNER: YOUR FAILURE TO RECORIl A NOTICE OF COMMENCEMENT KAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINAlJi:IIlS, CONSULT \11TH YOUR LENDER OR AN ATTORHEY BEFORE RECORDING YOUR NOTICE OF
COKKENCEIIENT. JOBS UNDER $2,500 IN VALU:: DO NOT NEED TO RECORD AHD POST A "NOTICE OF C0I1MEIlCEMENT'.
~ '
.... J.1- 0h-L~
S ATURE: CONTRACTOR
~o.......x R~~
SIG RE: OWNER OR AGENT
. \
STATE OF FLORIDA ~
COUNTY OF I fi..U..D'
The foregoing instrument was ac~~owledged
before me this Wlnl\A"--k lC) , 11)~ by
~ ~p,l'" B ~K LV e... \ \
who ~ r , a 11 y kno\'1n to me~r who has
produced
as identification and who di~ ~
tal{e a'l::?'.ath;_ ..... /?
~ Zl oJ2.tJ .ATl..~
(Signatt.t5e)
l"Y/-r9Q. " ~. A { 1rftL-.
,(Name Typed, Printed Co1- Stamped)
NOTARY PUBLIC
.
r~
The foregc.ing instl-ument "las aclmo"lledged
befctl-e me this 'M1LU..k \S" , 19.Ys:- by
STATE OF FLORIDA
COUNTY OF
~n.n~ fi S lar ~w~t~
'\'lhocCl S ersclna y lmown to /II. or who has
produced
as identification and who didlafd no1C>
take an Da41~ 9.' at2(J /.)..,...~'
(Signatu're) B::rt-Mat.. A.. dr {Sd'L-
(Name Typed, Printed Dr Stamped)
NOTARY 'PUBLI'C
BARBARA A. ALLISON
Nota ry Public, State of Florida
My Comm. Exp. 03.24.111
, Comm. No. CC a5Be40
BARBARA A. ALLISON
Not,ry Public, State of Florida
My Comm. Exp. 03.26.118
Comm. No. CC 3581140
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PASCO COUNTY It FLORIDA
Permit No.
Date Permitted
/
Builder Name/Owner Name
County Parcel No.
Location
"
,
Subd.
Classification/Type of Use
TRANSPORTATION IMPACT FEE CALCULATION
EXEMPT D
Rate $
Zone No.
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
EXEMPT D
RESIDENTIAL
NONRESIDENTIAL
No. Units
/
Gross Sq. Ft. (GSF)
Rate/ERU - 50.00 x 0.96*/Year
or $0. 1315/Day
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 CALCULA TED 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
DATE
BY
BY
White
Applicant
Canary
Trans/Finance
Canary
RR/Finance
Pink
Office
Green
Bldgllnsp
feecal:ce
~------~-----~--_.__.~----
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!I\
C E N T R ALP E R M I T TIN G
PASCO COUNTY. FLORIDA
DATE: 07/27/95
PACiE~ 1 OF 1
I:::;:3UE OFFICE: D
RECEIPf NUMBR: 00254742
OFFICE: DADE CITY
CONTRACTOR #: 003495
NAME: KEVIN T ROBERTS
ADDR: 612 SEVENTH STREET
C /:,:;T ~ DADE C J Tl
F'L :::~::35255\)~54
FOh:~
C:HECI< # 1274
RESOURCE PERMIT 4865 CITY OF Z/HILLS
CONTRACTOR: 003495
l:~C:CN r
11/),
rOTA!.. Pd10UNT~
COMPNY ACCOUNT CENTER
B4~50 ,., 36::':000.. .-,
21..~Sl
AMOUNT DESCRIPTION/PERMT DATA DRieR
21.51 ****** SOLID WASTE FEE ~)
/
_ "'~: . ..' "!!,,.'Y
--'
"'-
F,ECE I "lED BY
~.._._-_.._.~'~~----,_._--_._----_.._---------------