HomeMy WebLinkAbout95-5440
BUILDING PERMIT-
CITY OF ZEPHYRHILLS Permit N!
(813) 788-6611
1~544013
dJ<s~ tJ7J
Date / cJ- -5::,- - 7~-
BUILDING
6CJ. --Su
ELECTRICAL
J~-: lJV
PLUMBING
J-f:>"'- tJ7)
MECHANICAL
Sewer Conn / ~ 7g': tlV
Water Conn: 3.Sl:} ,cJV -
./.6$. 01J~1~11.
Water Meter: / -6~-" trl)
T.I.F.'s:
",operty Owne' 1;(J1: ::f-/-Z ..
Job Address: 3 ~. /> ~
Parcell.D. # -3 ,;L6 -::v-- 0/;;2 () - z;C)C)o 0 - O~/ 0
Zoning:
Description of Work
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
DAT
~d
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Oonst.pole FPC (Mimi) Nancy 12/07/95 11:07 A.M.
. .
~....'11P~ lJt ~ n t?t. ij-I'l-9-b II; o~/t-H
Inspector
City License Registration #
State Certified License#
~'/R'
Permit Fee ~r;25,--.5-V
Signature ~
,
Company
Address
Valuation or
Contract Price
-$1";(, 7/ be cT"D
,
Telephone#
A/ff & ~
~~ ;L9/
BUILDING
ELECTRICAL
~J11
PLUMBING
~~ r2tJ~
MECHANICAL
Ftr. /Z-15-'1y$,LL- Tp.Serv.
PreSLB /2 ...13- f~.Jijl-'-ROU9h In 2,,,. Q-Cj~!}!r-
Lintel 1:;J,,;J'rQ,s- ~ Meter Can 102$-7-.5
FRM. 2-9-Z.~~_' Const. Pole 12 -~5 6i~
Insul. CL z- J. - _----'4J:iI/i-Pool
WL .Pre-Meter ~'\,\.,b 20 &
A \ vb, H 1I.n. \ Final
Driveway ~Fl>I~Ii~B,V\,b /?..t3,..'f)' bp [)
~ 1-\&..QIo &.a
SLB I z.-7J -~)" J5tl "-
Tub Set 2-S:16B~
Water
Sewer ~.\ qb - ~~g
Final
Breakers
Ducts Insl. 2' -~~71~~
Compressor
Final
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 _
'/ / -#- /71,._. j _ -?1- Ii /02......5---- p~
a. Wrong Address /Vt:.~- ~A'..P't...JI" ~.(Jzt:.
b. Condemned work resulting from faulty construction.
1. .' - ....L..
c. Repairs or corrections not made when inspection called. ,.-l. " ~- r~'
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.
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PHONE 79'S - 7'fJ l-
0IlRER' S ADDllESS 37 21 <0 &..!M:: '1 ~J. J;l.:.k c.ry I ,e./.... 35 ~ 2S'
JOB ADDRESS 57 / n ~;J.,.f'~ ':);b.z- 2-e,..I...A III, /t.. ns-rl
fi . -r . .
LEGAL DESCRIPTION: LOT~ 5:'/ B~~ :::r'SUBDIVISION t/lrl#~ Lid.J
PARCEL I.D.' 03 - Zb - Z/ - () 12 ~ - 000 va - O~BTAIN FROH PROPERTY TAX NOTICE)
WORK PROPOSED:~ew Construction _Addition --...Alteration _Repair _Install
APPLICATION FOR PERKIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER'S NAME
EJb~
B~cetUl~
_Sign
---1Iove
_Deaolish
PROPOSED USE: ~ingle Faaily
_~ercial
---1I/F _' of Units _H/H
_Indust. _Swia. Pool _Other
_Restaurant Ii Health Departaent Approval
5.1-j/- P~./1 t;}j.,- M.~ .
1>' ~' [l' (7' fl~
BUILDING SIZE: 1. X . 1'1'11- Square Feet. 0 Het8ht
~ID~~A'lTACB (2) .:..o.r PlANS . (2,t;;ETS OF BUILDIRG PLAIIIS . (l)~ET EIIEIlGY FORKS.
tHannv : ATTACH (3) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS. ~.O. /Jfu,. ~
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
DESCRIPTION OF WORK:
~BUILDING
~CTRICAL
-XMECBAlfICAL
~UHB~NG .
~ /' PERKITS REOUESTED
$ 5X /)() &.) Valuation of Total Construction
Zoo AMP Service X Florida Power Corp.
$:( 1.200--
W.R.E.C.
Valuation of Mechanical Installation
GAS
TYPE OF CONSTRUCTION: XBIOCk _Fraae _Steel
,
FIRISBED FLOOR ELEVATIONS: Y:J FT .
..>( ROOFING
SPECIALTY
Other
YES
X
NO
IS PROJECT IN FLOOD ZONE AREA?
..........................................
CONTRACTOR SECTION
~ COIIPARY-B:1 I (1..... ("..IrJ.~'1. ....
~ State Cert. or Regist.' CfL l>S;-&-' &J I
Signature City License Registration . Z. ~~
~ ..........................................
BUIlllER
:::~ a?~.~
~I... tl'~f~
State Cert. or Regist. # tt 0002.1
City License Registration # ~
..........................................
~~
COMPANY
PLUMBER COMPANY I ~t ~""'r ~
~n t~' \. '~. State Cert. or Regist.' c...F-C 0 2
Signature .t--i..o.. ~~ City License Registration # .,
........... ..............................
MECHANICAL ~ COMPANY 50 ""1'\..'1') tJ, jc...6"'~',J A-~~/'4'~-
~ ~ State Cert. or Regist. #
Signature J( "'- ~~ ~ City License Registration . :1-(9 (L:)
...... ................................
()
~
Signatur
COMPANY h - J /I.~ In.:.. ~
State Cert. or Regist.' lLc- oole>/'Il-r
City License Registration f ~ ~
....................................
OTRRR
PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
'l'be undersigned understands that this perait 6Y be subject to .deed restrictions" wbieb 6y be lOre restrictive than City
regulations. 'he undersigned assOles responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas bired a contractor or contractors to undertake wort, they 6Y 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 6Y be
cited for a lisdl!lH!anor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requirl!lents 6Y apply for the intended work, they are advised to contact the City of Zephyrhills Building Departtent, (813)
788-6611.
FurtbeIlOre, if the owner has hired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the
'Contractor Sections" of this application for..hieb 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 lay be an indication that he is not properly licensed and is not entitled to peraitting privileges in the
City of Zephyrbills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of .Florida's Construction Lien Law - HoIeoIner's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsuteI Affairs. If the applicant is sOleone other than the
"owner", I certify that I have obtained a copy of the above described dOCUleDt and prOlise in good faith to deliver it to the
"owner" prior to cOllellceaent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infortation in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, zoning, and land developlellt.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has cOlleDced prior to issuance of a perait and that all work will be perf oIled to teet standards of all laws
regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also
certify that I understand that the regulations of other goveIDlental agencies laY apply to the intended work, and that it is
IY responsibility to identify wbat actions I lust take to be in colpliance. Sucb agencies include but are not lilited to:
t Departtent of Bnvironaental Regulation - Cypress Bayheads, Wetland Areas and BnviroDlentally Sensitive Lands,
Water/Wastewater 'l'reatlent
t Southwest Florida Water Managetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
t Aray Corps of Engineers - Seawalls, Docks, Navigable Waterways
t Departlent of Health & Rebabilitative Services, EnvirODlental Health Unit - Wells, Wastewater 'l'reatlent, Septic 'l'ants
t US EnviIODlental Protection Agency - Asbestos abateaent
I also certify that, if fill laterial is to be used in Flood ZOne HA. or "A, etc. ., it is understood that a drainage plan
addressing a UcQlPeDsating volOle' will be sublitted whieb is prepared by a professional engineer registered in the State of
Florida prior to perait 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 tbe technical codes, nor shall issuance of a perait prevent the Building Official frOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Bvery petlit issued shall beCOle invalid
unless the Ifork authorized by sucb perait is cOllenced within six IOnths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six IOnths after the tile the wort is cOlleDced. One 90 day extension of tile, laY be
allowed for the perait with fee ebarge of $15.00. 'l'be extension sball be requested in writing to the Building Official. An
approved inspection lUst be logged during eacb six IOnth period, or the project will be considered abandoned.
WWIHG '1'0 OWNER: YOUR FAILIJRB '1'0 RECORD A NOtICE OF COIlMDCBMm' MAY RESUL' IH YOUR PAYING 'l'WlCE FOR IMPROVEMHIIl'S '1'0 YOUR
PROPERTY. IF YOU IJi'I'END '1'0 OB'I'Alli FlliAICING, CONSUL'I' WITH YOUR LBNDER OR AI 1I'J"1'ORJ1EY BEFORE RECORDIIIG YOUR "OtlCE OF
ClBIICmIIr. JO UIDIIl $2,500 IN VIUIIl 00 lOr IiIIiIl ~ 110 PI1I1/~d'~'i/,<-... K.4.-
S .JI8IfAfDRE: CO RACfOR
S'I'A'I'B OF FLORIDA ~
COUN'I'Y OF M
The foregoing inst~ent was ~~~Owledged
before me this Nm, 19 by
W/II,4n1 .~~
who is personal y known to me or who has
produced
as entification
ta an oath.
STATE OF FLORIDA _ /)
COUJi'I'Y OF rtlSC1J
The foregoing instrument was ac~edged
before me this ~j /'lot!, 19 by
U)ll!/Am fJtJ6'
who is personally known to me or who has
produced
as identi
take an
-S..igb ture)
~~ IYi r)\ . ro i ello.-
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
. "~:~~'~;:;;" DANA M. GIELLA
f:."'b>~:\ MY COMMISSION * CC301855 EXPIRES
~.ic~~Q'j July. 14, 1997 NO
"<~'o,",;'~~ BOMDEJH-"TROV fAIN INSURANCE,I .
'!f!.~H
".'?-.':A~'f;J,"'" DANA M. G1ELLA
t*'f"Q,~;'" MY COMMISSION * CC301855 EXPIRES
~~.~{{j July 14, 1997
~"~,~I.:r..W-' SONllEO THRU TROY FAIN INSURANCE, INC.
LEGAL OESCRIPnON.
Lot(s) 51 . Block
recorded In Plat Book ~.
MAP OF BOUNDARY SURVEY
of the Plot of ~/U/CJt. ~ p~ CtJJ!.
P0ge~ 4fs,.41 I of tho Public Records of ' . PA~c.o
, os
. Couflty, Florida.
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LEGEND
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RONALD H PAC,
PARrY-CH.rrWTil-t7--------- DArt
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Ct1ECl(f:O: ~ ~
MURRAY &: ASSOCIATES. INC.
LAND SURV['I1NG
PI-S. '''660
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M \49C2-8 N. Florida AYlI. II
+. Tompo, Fl JJ"J ~+"
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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 1 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 pump, 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)
OWNER AGENT:
J}"" ') . 7\
,
/1-lZ--9
DATE:
-1-
1.
2. ,1/, Vi )
3. ';u~ .IV (D (C
4.
5.
6. I 0 7 ~
7. (il-..
8. II ; 6 ,.,
Single Pane
9a. sq. ft.
9b. ~tt.. sq. ft.
10. 1--7~ S%
Double Pane
sq. ft.
sq. ft.
11a. R= t!:>
11b. R=
11 c, R=
11d. R=
l1e. R=
tC>7 ~sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
12a-1 R= )-
12a-2 R=
b &io sq. ft.
sq. ft.
12b-1 R= sq. ft.
12b-2 R= 11 ILl c..( sq. ft.
,
13a. R= ?>D /0,10 sq. ft.
13b. R= sq. ft.
14. Type: CeN,fV6 !
SEERlEER: Ic.dD
15. Type: He III I VpYl-jl'
HSPF/COP/AFUE: IJ l ()
16. Type: ~ (e... (- f
EF: ,'1 (
Review of plans and specifications covered by this calculation indicates compliance with
the Florida Energy Code. Before construction is completed, this building e inspected
for compliance in accordance wi tion 55~1 F.S. c
C!..
DATE:
s-
,.
lABLE 68-1
MINIMUM REQUIREMENTS
COMPONENTS PACKAGES FOR NEW CONSTRUCTION
A B C D E F
Max. %01 glass to Floor Area 15% 15% 20% 20% 25% 25%
en Type
en Single Clear (SC) Single Tint (ST) Single Tint (ST) Single Tint (ST) Double Tint (DT) Double Tint (DT)
:s
C!J 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
<
3= 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
a:
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. (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
a: Electric EF .90 EF .90 EF .90 EF .90 NOT ALLOWED EF .90
w:::;E Resistance ** (SEE BELOW)
I-w
<I- Gas & Oil ** MINIMUM EF OF .54 NA rURAL GAS ONLY
3= en (SEE BELOW)
1->-
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
F7. c. %
DC: D..:;r DT: 0
FEET
EXT: R= C
ADJ: R=
COM: R-
EXT: R=
ADJ: R= II
COM: R-
UNDER ATTIC: R = ~O
COMMOM: R=
R=
R-
R=
R= j, COND. 0
SEER - It:> i 0(;1
COP= _or HSPF= Ji!L
AFUE -
EF = CI rf
EF =
DHP: Ej 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 or sofftt 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 mu~i-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: "COND" 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 untts 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 musthave flue dampers, glass doors and outside combustion air intakes. tI't-
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 M1
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 1\
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. t
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RECEIPT NUMBP: 00281012
~~DDR: 371,17 F:'OXRUI'~ 1'"L
C~FFIC~I~~ [~A[lE C:ITY
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PASCO COUNTY, FLORIDA
Permit No.
--.5 '- y '1l~
13
Date Permitted /:J ~,~--- 9 ~ -
Builder NamelOwner Name /J- 4 J7/) /-j;;-
'lJ3-U /cJ-f ~
County Parcel No. 3 -.;;2 b - ~/ - tJ I~ 0.. 0 CJ l) cJ D - 0--5/ U
Location...3 7/1 jr d d;l-""A.{.J /f/1?/'.{ ~ .5L..
Classification/Type 'Of Use ~~rtArJ
Subd.
TRANSPORTATION IMPACT FEE CALCULATION
EXEMPT 0
Rate $
Zone No.
Sq. FLlU
Prcpdll.::d By
Impact Fee Amount $
The above impact fee has been e s ed pursuant to the Pas ounty Transportation Impact Ordinance as adopted
by the Board of County Co lssioners. This amount is payable PRI the issuance of a Certificate of Occupancy
permitted structure. ~,
EXEMPT 0
RESIDENTIAL
NONRESIDENTIAL
No. Units
I
Gross Sq. Ft. (GSF)
RatelERU - 50.00 x O,96*/Year
or $0.1315/Day
ERU Assign No.
Assessment - (No. Units) x ($0.1315)
x (No. Days)
'3:J- 9;3
Assessment --
(GSF) x (ERU) X (0, B 15) 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
HAVE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY.
Acknowledgement below does not imply acceptance of concurrence. but ~;J1nply receipt of a copy of this form, placing
the building permit owner on notice of this assessment awl the conditions of payment for same.
Date
Received By
---------------------------------------------------------------------------------------------------------------------------------------------------
OFFICE USE ONLY
TRANSPORTATION REC. NO. /2 ~ 0 / ~
RESOURCE RECOVERY REC. NO. (
DATE
DATE
, ~~ 9t BY P ji
Ii- - ' By/lDtuL~/1,1
(,j
White
Applicant
Canary
T rans/Fi nance
Canary
RR/Finance
Pink
Office
Green
Bldg/lnsp
feecal:ce