HomeMy WebLinkAbout95-5270
(pO 1i2.fL.
./ ~
!jh1' -
BUILDING
BUILDING PERMIT; '-52708
Permit
Zoning:
CITY OF ZEPHYRHILLS
~~--- (813) 788-6611 gJ2- Date 9 - :2.. 9 -,~~
hO' 7' -~~~ &V.
ELECTRICAL pfUMBING MECHANICAL Sewer Conn ~ bl~~
~ 9 - l'ater Conn: ,--;'00
~J~= _ ~r~LWate'Met.' -
- /. - / ' T.I.F.'S:S37:JJ4,1'c/ /.2-.2.7-7S
,;2 -':2 ~ - ~ 1- I)::J../O - DO 01':)0 - D07'D
0# c;lu
Property Owner:
Job Address:
Parcel 1.0. #
Description of Work
--
:>
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
I
P . F ~~O'5:
ermlt ee -
S;gnaMe . 80 ".' (li)
Company
Address
Telephone#
Valuation or 0... H ~) ~
Contract Price '-If/ S' /; ,.3 X 0 #
City license Registration # r57& 7
State Certified license# C r:; ~ 00.52 fS-
ElECTRICAI1'" PlUMBIN~
Tp. Servo SlB :/fD.../o-9SISJI..L
Rough In /;-/Il-f-> PtJ6 Tub Set I/-J~...qS8JL.'-
Meter Can q -,;lC; ~ <i,&;- Water
Const. Pole Sewer 1- Z 2. - eJ,_j- &.1 ~
Pool Final 1_- J,J -)'::) _tW
WL n '5 Pre-Meter '-~~'i(.> ~
Final /2.-],1 J 6'l>b
Driveway v1'i,/J.{-.tpS"#lL f~~ \Q).3.-q~ 80-&.
.sh~}hl~ JI-7q." fJiL.A...-
hNftL- IL~2.t-~. j- gtil..
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:
I) /"1 /7 I;Q --..2!? -7S-
a. Wrong Address ~ C^- ;a tf'
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.
BUilDING
Breakers
Ducts Insl. 11-1 trr;r &8
Compressor b ~
Final /2 -2I q) r ~:
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
Department of Community Affairs
FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION
Residential Component Prescriptive Method A CENTRAL
SINGLE FAMILY RESIDE:BUILDER: GENERAL HOME DEVELOPMENT SORP.
:PERMITTING :CLIMATE~'
ZEPHYRHILLS, FL 335: OFFICE :(],11'lzo:;,N'tIlJI.lS : ZONE: 4: ~ 5: _: 6:_:
BURT : PERMIT NO .d~7ol3 : JURISDICTION NO .~II4:>t)U
CK
FORM 600A-93
PROJECT NAME:
AND ADDRESS:
OWNER:
1. New construction or addition
2. Single family detached or Multifamily attached
3. If Multifamily-No. of units
4. If Multifamily, is this a worst case (yes/no)
5. Conditioned floor area (sq.ft.)
6. Predominant eave overhang (ft.)
7. Porch overhang length (ft.)
8. Glass area and type:
a. Clear Glass
b. Tint, film or solar screen
9. Floor type and insulation:
a. Slab on grade (R-value, perimeter)
10.Net Wall type area and insulation:
a. Exterior: 1. Concrete (Insulation R-value)
a. Adjacent: 2. Wood frame (Insulation R-value)
11.Ceiling type area and insulation:
a. Under attic (Insulation R-value)
12.Air distribution systems
a. Ducts (Insulation + Location)
13.Cooling system
14.Heating System:
15.Hot water system:
16.Hot Water Credits: (HR-Heat Recovery,
DHP-Dedicated Heat Pump)
17.Infiltration practice: 1, 2 or 3
18.HVAC Credits (CF-Ceiling Fan, CV-Cross vent,
HF-Whole house fan, RB-Attic radiant
barrier, MZ-Multizone)
19.EPI (must not exceed 100 points)
a. Total As_Built points
b. Total Base points
SN: 6096
New Construction
Single-Family
o
1.
2.
3.
4.
5. 1340.00
6 . 2 .33
7 . 9 .66
Single Pane
8a.133.0sqft
8b. O.Osqft.
Double Pane
O.OOsqft.
O.OOsqft.
9a.R= 0.00 , 159.00 ft
10a-l R= 4.20, 889.40sqft____
10a-2 R=11.00, 280.40sqft____
lla.R=30.00 , 1466.00sqft____
12a. R= 6.00, uncond
13. Type: Central A/C
SEER: 10.00
14. Type: Heat Pump
HSPF: 7.00
15. Type: Electric
EF: 0.90
16.
17.
18.
2
19.
19a.
19b.
77.94
19586.39
25129.32
-------------------------------------------------------------------------------
-------------------------------------------------------------------------------
I Hereby certifv that the plans and
specifications covered by this calcu-
lation are in compliance with the
Florida Energy Code.
PREPARED BY: ~ ""'--~~'-~~
DATE: . ~-\~..s'\5
Review of the plans and specifications
covered by this calculation indicates
compliance with the Florida Energy
Code. Before const.ruction is complet.ed
this building will be inspected for
compliance in accordance with Section
553.908 F.S.
I hereby certify that this building is
in compliance with the Flo~ida Energy
Code.
OWNER~~i:
DATE:
~~ '-\...I-^--L-,^-,,-_
""''\- \.:l -"15
BUILDING
DATE:
o[p~,--4f.d~, II
COMPoNENTS
** INFILTRAT~ON ~EDUCTION PRACTICE COMPLIANCE CHECKLIST **
CHECK
==~============================================================================
SECTION
REQUIREMENTS FOR EACH PRACTICE
===============================================================================
PRACTICE #1
Windows
Exterior &
Adjacent Doors
Exterior Joints
& Cracks.
PRACTICE #2
Exterior Walls
& Floors
Exterior Walls
& Ceilings
DuctWork
Fireplaces
Exhaust Fans
Combustion
Appliances
606.1
606.1
606.1
606.1
606.1
606.1
606.1
606.1
606.1
606.1
606.1
COMPLY WITH ALL INFILTRATION PRESCRIPTIVES.
Maximum of 0.34 CFM per linear foot of operable sash
crack (includes sliding glass doors).
Maximum of 0.5 CFM per sq. ft. of door area: solid
core, wood panel,insulated or glass doors only.
To be caulked, gasketed, weather-stripped or other-
wise sealed.
COMPLY WITH PRACTICE #1 AND THE FOLLOWING:
Top plate penetrations sealed. Infiltration barrier
installed. Sole plate/floor joint caulked or sealed.
Penetrations, joints and cracks on interior surface
caulked, sealed or gasketed.
Ductwork in unconditioned space must be sealed.
Equipped with outside combustion air, doors and flue
dampers.
Equipped with dampers. Combustion devices see
606.1.A.2.
Be in unconditioned space (except direct vent), draw
air from unconditioned space, exhaust to outside.
Cooking appliances shall be dampered and use
intermittent ignition.
--------------------------------------------------------------.-----------------
Water 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.
-------------------------------------------------------------_._----------------
Swimming 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.
Shower Heads
-------------------------~------------------------------------,~----------------
612.1 Water flow must be restricted to no more than 3 gal-
, lons per minute at 80 PSIG.
--------------------------------------------------------------.-----------------
HVAC Duct
Construction
Insulation &
Installation
610.1
All ducts, fittings, mechanical equipment and plenum
chambers shall be mechanically attached, sealed, ins-
ulated and installed in accordance with the criteria
of Section 610.1.ABC.2 & 610.1.ABC.3. Duct in attics
must be insulated to a minimum of R-6. Air handlers
shall not be installed in attics unless in mechanical
closet.
HVAC Controls
-------------------------~------------------------------------.-----------------
607.1
Separate readily accessible manual or automatic
thermostat for each system.
Insulation
--------------------------------------------------------------------------------
or
604.1
602.1
Ceilings minimum R-19. Common Walls - Frame R
CBS R-3 both sides. Common ceiling & ~loo,s ~ :
OV'::::'..1.
L.-O~ t'(;-J UUL.fl :::i.1.Ue:::i. L.-OIlHllOn ce~.J..~Tl9 6c T.J..OOTS K-~.J...
-------------------------------------------------------------------------7---~-
*******************************************************************************
SUMMER CALCULATIONS
*******************************************************************************
=== BASE ===: === AS-BUILT ===
===============================================================================
GLASS----------------
ORIEN AREA x BSPM =
I
I
POINTS :
TYPE
SC
ORIEN
AREA
x SPM
x SOF
= POINTS
N 59.80 82.2 4915.6 SGL CLR N 19.1 51.0 .79 769.5
SGL CLR N 19.1 51.0 .79 769.5
SGL CLR N 21.6 51.0 .81 890.3
E 24.60 82.2 2022.1 SGL CLR E 21.6 109.2 .37 872.7
SGL CLR E 3.0 109.2 .26 85.2
S 43.60 82.2 3583.9 SGL CLR S 15.1 100.2 .62 931.2
SGL CLR S 15.1 100.2 .62 931.2
SGL CLR S 13.4 100.2 .57 765.3
W 5.00 82.2 411.0 SGL CLR W 5.0 109.2 .94 516.0
.15 x CONDo FLOOR / TOTAL GLASS = ADJ. x
AREA AREA FACTOR
GLASS =
POINTS
ADJ GLASS
POINTS
GLASS
POINTS
-------------------------------------------------------------------------------
.15
1,340.00
133.00
1.511
10,932.60
16,522.20 :
6,530.96
-------------------------------------------------------------------------------
-------------------------------------------------------------------------------
NON GLASS------------ :
AREA x BSPM = POINTS :
TYPE
R-VALUE
AREA x SPM = POINTS
-------------------------------------------------------------------------------
WALLS----------------
Ext 889.4 1.0
Ad j 280 .4 .7
889.4
196.3
Ext NOrmWtBlock In
Adj Wood Frame
4.2
11.0
889.4
280.4
1.16
.70
1031.7
196.3
DOORS----------------
Ext 21.6 4.8
Adj 19.0 1.6
103.7
30.4
Ext Insulated
Adj Wood
21.6 4.80 103.7
19.0 2.40 45.6
30.0 706.0 .60 423.6
30.0 664.0 .60 398.4
30.0 96.0 .60 57.6
.0 159.0 -31.90 -5072.1
1340.0 10.90 14606.0
CEILINGS-------------
UA 1340.0 .6
804.0
Under Attic
Under Attic
Under Attic
FLOORS---------------
SIb 159.0 -31.8 -5056.2
Slab-an-Grade
INFILTRATION---------
1340.0 10.9 14606.0: Practice #2
===============================================================================
TOTAL SUMMER POINTS :
28,095.76 :
18,321.72
===============================================================================
TOTAL x
SUM PTS
SYSTEM =
MULT
COOLING : TOTAL
POINTS : COMPON
x CAP x DUCT x SYSTEM x CREDIT = COOLING
RATIO MULT MULT MULT POINTS
--~--~-------------------------------------------------------------------------
28,095.76
.37
10,395.43 : 18,321.72 1.00 1.100
.340
1.000
6,852.33
=======================================================:===:=::====:===:==::==:=
*******************************************************************************
WINTER CALCULATIONS
*******************************************************************************
=== BASE === === AS-BUILT ===
-------------------------------------------------------------------------------
-------------------------------------------------------------------------------
GLASS---------------- I
t
ORIEN AREA x BWPM = POINTS , TYPE SC ORIEN AREA x WPM x WOF = POINTS
I -------------------------------------------------------------------------------
N 59.80 -3.4 -203.3 SGL CLR N 19.1 9.6 1.13 207.2
SGL CLR N 19.1 9.6 1.13 207.2
SGL CLR N 21.6 9.6 1.12 231.5
E 24.60 -3.4 -83.6 SGL CLR E 21.6 -2.2 -3.59 170.8
SGL CLR E 3.0 -2.2 -5.04 33.3
S 43.60 -3.4 -148.2 SGL CLR S 15.1 -10.9 .61 -100.8
SGL CLR S 15.1 -10.9 .61 -100.8
SGL CLR S 13.4 -10.9 .54 -78.9
W 5.00 -3.4 -17.0 SGL CLR W 5.0 -2.2 .69 -7.6
-------------------------------------------------~-----------------~------------
.15 x CONDo FLOOR / TOTAL GLASS = ADJ. x
AREA AREA FACTOR
GLASS =
POINTS
ADJ GLASS
POINTS
GLASS
POINTS
-------------------------------------------------------------------------------
.15
1,340.00
133.00
1.511
-452.20
-683.40 :
561.78
-------------------------------------------------------------------------------
-------------------------------------------------------------------------------
NON GLASS------------ :
AREA x BWPM = POINTS :
TYPE
R-VALUE
AREA x WPM = POINTS
-------------------------------------------------------------------------------
WALLS----------------
Ext 889.4 1.1
Adj 280.4 1.8
978.3
504.7
Ext NormWtBlock In
Adj Wood Frame
4.2
11.0
889.4
280.4
3.26
1.80
2899.4
504.7
DOORS----------------
Ext 21.6 5.1
Adj 19.0 4.0
110.2
76.0
Ext Insulated
Adj Wood
21.6 5.10 110.2
19.0 5.90 112.1
30.0 706.0 .60 423.6
30.0 664.0 .60 398.4
30.0 96.0 .60 57.6
.0 159.0 2.50 397.5
1340.0 4.10 5494.0
CEILINGS-------------
UA 1340.0 .6
804.0
Under Attic
Under Attic
Under Attic
FLOORS---------------
SIb 159.0 -1.9
-302.1
Slab-an-Grade
INFILTRATION---------
1340.0 4.1
5494.0
Practice #2
=============================================================:==================
TOTAL WINTER POINTS
I
I
6,981.72 :
10,959.30
=============================================================:==================
TOTAL x
WIN PTS
SYSTEM =
MULT
HEATING : TOTAL
POINTS : COMPON
x CAP x DUCT x SYSTEM x CREDIT = HEATING
RATIO MULT MULT MULT POINTS
-------------------------------------------------------------------------------
6,981.72 1.10
7,679.89 : 10,959.30 1.00 1.100
.484
1.000
5,834.73
=============================================================:==================
*******************************************************************************
WATER HEATING
*******************************************************************************
=== BASE ===: === AS-BUILT ===
~------------------------------------------------------------------------------
-------------------------------------------------------------------------------
NUM OF
BEDRMS
x
MULT
=
TOTAL
TANK VOLUME
EF
TANK
RATIO
x MULT x CREDIT
MULT
= TOTAL
-------------------------------------------------------------------------------
2
3527.0
7,054.00
40
.90
1.000
3449.7
1.00
6,899.33
-------------------------------------------------------------------------------
-------------------------------------.------------------------------------------
*******************************************************************************
SUMMARY
*******************************************************************************
=== BASE === : === AS-BUILT ===
---~---------------------------------------------------------------------------
-------------------------------------------------------------------------------
COOLING
POINTS
+
HEATING
POINTS
HOT WATER
+ POINTS =
TOTAL
POINTS
COOLING
POINTS +
HEATING
POINTS
HOT WATER
+ POINTS =
TOTAL
POINTS
-------------------------------------------------------------------------------
10395.4
7679.9
7054.0
25,129.32
6852.3
5834.7
6899.3
19,586.39
----------------------~--------------------------------------------------------
-------------------------------------------------------------------------------
*****************
* EPI = 77.94 *
*****************
'{N
,. I
\ ~- \0
151
I
I
i
I
I
I
! G--oro~e
i r---
,
'1:J r , '{ of
....
/V\
rv
_L_
"i4.0
,
l\
3,:)'-0"
. -:Y~rd,'<
. '
~)<\.J.,q'd \::' '.!-:
o
LEGAL DESCRIPTION:
Lot 7, Driftwood Subdivision
Phase IV, Pasco County,
Florida.
I"
5:.a
/\
?
~
General Home
Development Corporation
September 29, 1995
City of Zephyrhills Building Department
5335 8th Street
Zephyrhills, FL 33540
RE: Contractor ID # 22 State # CGC005695
Permit for Burt Lot 7 Driftwood Phase IV A
To Whom It May Concern:
Please allow this letter to act as our written request
to change the Plumbing Subcontractor from Bayonet Plumbing,
Zephyrhills ID # 91,to Rusty's Plumbing, on the above referenced
Permit application.
If you have any questions, please don't hesitate to give
us a call.
S;;:Z~' r- ~ ~-~
o~ ~
Kevin T. Roberts
GENERAL HOME DEVELOPMENT CORP.
KTR/jkb
Sworn to and subscribed before me this ~ day of
September, 19 22-
~~~
ary
.-'
-K- Personally known to me
Identification
Notary Public, State of florlda
IANET DlACKWE.LL
MV Co",m, Exp, 9.18-96
Co","" No. CC 228545
Main Office: 13924 7th Street Dade City, FL 33525
Phone: (904) 567-6581
Fax: (904) 567-6742
eu'Lb'N&
Et-i2L17l. \L..-
itu~
1l\~.L).\tWll(\L-
SvB1.O "R\- L-
Ci{ Ji.j) l T
701A-L-
.slUv~
WAT~~
M~
lbTn L
1-101-0 .s"
- -...-~~-_..__.";
GrlU
0(P~'5 pLS1itdho
,;:.
Vf\L.UrrntyJ :: :)~,31>D:~ '
--.
.t.J 0 "7. "JC
I .;tS
r:)O-
5Z,~Q
3 't) ;" tJ
- t.oOlC~
LCNJU~cN f'~&
JIZ.J~ [,0
3'30.<.:>0
,..s/t".
I 102_ cl. CU
~ t. !},
~A-~W ~
JJ 2..0 ~ 1--0
7~6Poa.rm1tyJ tmH1LT rru--S
. Clef/X: s: S3;, 7~
I ~& "::;- 5, ~1
53Q. i 3
." ....-...... -. ""'t" ~~ -' ., ':"" .....
:......
-- 35/,0 ;( 1,3'-10 . 6),rr: ~.~v'IN6-
/~O{) )(. to 8D ~. F~ oTI.tlUL
.. .-.. ....... .. -~ .... --, ..... ....
. ~ . ... . .... .. .-.,. - -.. -..........-........ ~. .
t __
h .. .. .. ,. '" ._.._....._...... _....., .
... "'~ <.-... ." ..... ".....-. ........- - ,..
I'
, e_._..._ ...... . _. .............._..........
.. '. o. .. .. _0. _, ....... . _...._. .. ._.........___._, .
. ....-..-............-........ "--- -. .
. ... -. .... .. ---... ..-................-....,....,.
.., .. ".- -, ..,. ..-...........u........_. '.. ...
.. ......... .-. ....- -.-. -."''''-'' ... ,
.., ............ ".. .---.-. ...
APPLICATIOlNl FOR PERHIT
CI'IY OF ZEPlIYRllTLLS
nUfU..DIEG DRPARU1Em"
. .
(i7(2f IJJfl60';
, / 9//~
OWNER'S ADDRESS
John and Mi 1 dred Burt PllONE. (517)753-6486
525 Morley Dr., Saqinaw, MI 48601
.. OWNER' S NAME
JOB ADDRESS Lot 7 Driftwood Subdivision Phase IV, Pasco County, Florida
6(,15 'P/5â„¢HIO
LEGAL DESCRIPTION: LOT(S) 7 B~SunDIVISIOlNl Driftwood PhflC;P TV
PARCEL I.D.I
?-?fi-?1-0?10-00000- 0070
h'URK PROPOSED:-Lrmew Construction ---..Addition _Alteration
_Repair
I
_Install
_Sign
_Hove
_Deaolish
PROPOSED USE: X Single Fanily
_H/F
_' of Units .
---1:f/H
_CoamIercial
_Indust.
_Swia. Pool .
Other
_Restaurant & lIealt:h: Depa;:-t:lIIen.t Approval
.
BUILDING SIZE:
x
?O?O
Square Feet,
Height
RESIDENTIAL :
COMMERCIAL :
AlTACH (2) PLOT PUUlS &: (2) SEIS OF BUILDING PLADiS &: (1) SET ENERGY FORMS. **
ATrACU (3) SETS OFBUllDlBG PLANS &: (1) SET ENERGY FORtIS. **
uCOFY OF CONI'kA(''T RRQIITRED.
PERHITS REOUE.ciTRD
...L-.-BUILDING
$
48,000.00
Valuation of Total ConstIVction
...L-.-ELEGTRICAL
AHP Service
Florjda Power Corp.
W.R.E.C.
..LJIEClIANICAL
$
Valuation of Mechanical Installation
LYLUHBING GAS ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: -X-Block. _Frase _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN PIOo.n ZONE AREA?
YES NO
******************************************
CONTRACTOR SECTION
BUILDER Kevin T. Roberts COHPANYr,A~A~al ~omp Opvplopmpnt r.orp~
:-'\ . State Cert. or Regist. 4# CGC005695
Signaturee~ J<v8Q.d.~ City License Registration , 22 B-(;; 7
***************x***~********~*************
./
rian DUPtl.is/~7 COIHPANY Martin Electric
^. '... ~W. S"~"".~ Cpr.... ()- l1ap...,.t -II' C'Dnn1~
-...c::..,-_ ..... .... ... _.._~__ .. 't'1"~~" .
.. - ...,~ City License Registration ~ '1
******.***2*******************************
v'/
Signature
cmt.PANY
te Cert. or Regist~ Ie
City License Registration I ~
******************************************
/'
MECHANICAL z:.Od ey S. Carter COHPANYSouthern Comfort Enterprises
'.-~ d State Cert. or Regist..' ri in C)t:J 1S""(j /_L-
Signature .. J~ City License Registration I. 110 S$
***********~****************.*************
v
Signature
OTHER Rick Gavin
~/~
COnP~~ Gavin Roofinq
State Cert. or Regist. jRC0046~41
Ci~ License Registration ,
*************.*******.~**************.****
APPLICATION APPROVED BY
PEmfiT OFFICER.
. CDI'I]) 1 T I OJ\j~> OF F'ER!'i 1 T (')FF I D{'')'v IT,
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this p;I~.it-Alay bE! -;'ubjl!d to "deed restrictions" which flay be iIlore restrictive than Ci ty
regulations. The undersigned assuae5 re.ponsibility for cOMpliance Kith anv applicable deed restrirtio~5.
B. UNLICENSED CONTRACTC~S AND CONTRACTOR RESPONSI8ILITIE~
If the owner has hired a contractor or r~ntractors to undertak~ Nork, they may be required to be licen~ed in accordance with
state and local regulations. If the "contractor is not I icensed as required b'{ Jaw, both the owner and contractor aay ilE:
cited for a lisde.eanor violation under state l?w. If the owner or intended contractor are uncertain as to what licensing
requirelents lay apply for the intended :lork1 they are ~~vised to contact the City of Zephyrhills Building Departlent, (813)
788-6611.
Furtherlore, if the owner has hired a contractor or contr~ctDrs, he is advised te have the ~ontractor(s) sign portions of the
"Contractor Sections" of this application for which they will be responsible. If you, as the owner sign 3S the contractor,
you are indicating that you, rather than the contractor, are responsible for the work. If the contract~r wishes you to sign
. as contractor that Day 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 Kith a copy of "Florida's Construction Lien Law - He.ee"ner's Protection
6uide" prepared by the Florida Departlent of Agriculture and Consu.er Affairs. If the applicant is !iOleone other than the
"owner", I certify that I have obtained a copy of the aboye described document and promise in good faith to deliver it to the
'owner" prior to cOllencelent.
E. CONTRACTOR'S/OWNER'e AFFIDAVIT
I certify that all the inforlation in this applicaticn is accurate ~nd that all work will be done in cOlpliance with all
applicable laws regulating constructivn, zoning, and land develop.ent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work Dr
installation has co..enced prior to issuance of a perlit and that all work will be perforled to leet standards of all laws
regulating construction, City codes, zoning regulatior.s, and land d~veIQPle~t regulations in the jurisdiction. I also
certify that I understand that th~ regulations of vther governmental agencies lay ap~ly to the intended work, and that it is
.y responsibility to identify what actions I lust take to be in cr~pliance. Su~h agencies include but ~re not li.ited to:
f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entaIly Sensitive Lands,
Water/Wastewater Treataent
f Southwest Florida Water ManaQeaent District ,- Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of EnQineers - Seawalls, Do~~s, Navigable Waterways
f Departlent of Health ~ Rehabilitative Services, Environlental Health Unit - Wells. Wastewater Treatlent, Septic Tanks
f US Environ.ental Protection AQency - Asbestos abatelent
I also certify that, if fill .aterial is to be used in Flood Zone "A" or "A,etc,", it is understood that a drainage plan
addressing a "coDpensating volume" Hill be submitted which is prepared by a professional engineer registered in the state of
Florida prior ~o 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, ncr shall issuance of aperlit prevent the Building Official frol thereafter
requiring a correction of errors in plan~, construction, or violations of any code. Every periit issued shall becole invalid
unless the Nork authorized by such permit is cOlee need within six lonths of issuance, Dr if work authorized by the per.it is
suspended or abandoned for a period of SIX lonths after the tile the Hork is cOlIJenced,' One 90 :lay extension of tile, lay be
allowed for the per.it with fee charge of 115.0C. The extension shall be requested in writing to the Building Official, An
approved inspection lust be logged durin) each si~ lIonth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTIr.E OF CO~MENCEHENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FIHAII,;JIl6, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COllIIENCEl\ENT. JOBS UNDER $2,500 IN VALUI: DO NOT HEED TO RECORD AND POST f:l "NOTICE OF C0l1t1EIKEtlENT".
~ K. AOt1.vl,~c
51 URE: O~NER OR AGFN.T
. ,
,
STATE OF FLORIDA ~
COUNTY OF LetS C-o' _
The foregc.ing i~st.Trument Iolas acknowledged
befcl\-e me this .d.!::f..r-l.~. di , 19-1..,L by
...)t'l v.... 1- a 16..LKuJ~ J I
~ho is personally known to me or who has
produced
as identification and who did/did not
take an o_a~~ .r:l. ~
(SignatUl-e f
STATE OF FlORIDA~
COUIITY OF y () S c.o
The foregOingJ;t'nstrument was acknowledged
before me th i I J.... t:l\. , il} ~ by
,
~) a,Y\f'T G IG-Lk \u L. L L
who is personally known to m~ or who has
produced ~
as identification and Iolhc, did/did not
take;?~ JL ~~
(Signature)
BARBARA A. ALLISON
Notary Public, State 0' Florida
My Comm. Exp. 03.26.98
Comm. No. CC 358940
(N~me Typ~d, Printed or Stamped)
NOTARY_PUBLI
BARBARA A. ALLISON
Notary PUblic, State of Florfda
My Comm. Exp. 03.26.98
Comm. No. CC 358~40
. (Name Typed, Printed 01- Stamped)
NOTARY PUBLIC
. 3~qjf
PASCO COUNTY, FLORIDA
Permit No.
S~7013
9-b<9-9r
Date Permitted
Builder Name/Owner Name~""LJ ,~ flJ4h'~~
County Parcel No. ~ -;Lb -,;)./ - t!J,;u tJ -.. t) 0 [) CJ U.. 0 l) 7' 0
Location "6 if.s ---~~ Subd.
Classification/Type of Use c-;? W ~ t1 .. ...._____
TRANSPORTATION IMPACT FEE CALCULATION
EXEl\fFf
Rate $
Z011\..; ,
Sq. Ft./U nit
Impact Fee Amount $
The above impact fee een established pursuant to the Pas ounty Transportation Impact Ordinance as adopted
by the Board of nty Commissioners. This amount is payable PR 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 $
.~7
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.
t ~- J- I -15 0YltkM L --=h/l A.4Y
Date Received ~
--------------------------------------------------------------------------------------------------------------------.-------------------------------
OFFICE USE ONLY
TRANSPORTATION REC. NO. DATE BY
RESOURCE RECOVERY REC. N~0 Cj& 0 q DATE I~- BY
7-
White
Applicant
Canary
Trans/Finance
Canary
RR/Finance
Pink
Office
Green
Bldg/lnsp
feecal:ce