HomeMy WebLinkAbout95-5469
BUILDING PERMIT-
CITY OF ZEPHYRHILLS Permit II!
(813) 788-6611
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Oonst.pole FPC (Jewel) Nancy 12/19/95 02:28 P.M.
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Permit Fee (V ol- , -..:)
Valuation or '-< ' /J - r/
Contract Price 0 "'-j t C7J, ell) Signature ~W /.L-7 ~ ~ .'
Company
Address
Tp. Servo SLB /2.-2.c;...QS &8
Rough In .3 - 1~ 9 G, (!jtrlr Tub Set s- l-J- t;~ 1:Jb-!-
Meter Can /:J ~/Y.-f'~ Water
Const. Pole 12.'Itt'i'i- 8-::0 sewer~l, ~il L
Pool Final
.Pre-Meter "-1'.../2....' ~~
Final
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1(6/..3:> /)
7;l,cJ.s
ELECTRICAL
to. cJ7;J
PLUMBING
BUILDING
P<operty Owne, ~~:1 ~
Job Address: 6P ~ ~ (3 / . ~
Parcell.D. # () - ;2/'- d-./ -() ;;30 -- u CJ 8 CJ 0 ~ ;7
Zoning:
Description of Work
NO OCCUPANCY BEFORE C.O.
City License Registration #
State Certified License#
A;~:J2~__
BUILDING
8~ jJd-if?1
ELECTRICAL
Ftr. /2 -Jq-.:/) b>6
Pre SLB I" 34" bot>
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WL
Driveway ~
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Date Id..'" J 'i - 9 ~--
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MECHANICAL
Sewer Conn 1.;2. ~ r. o-v
Water Conn: 3..!:>'/:), (JV
Water Meter: / ~~: r.Ji>
T.I.F.'s:
<~- iJ e )')j -a-T C.() "
s!~r
FINAL 4
A Tf...
C.O. ~/- :l-S'- -- ,7 h
DATE
Inspector
g~~
Telephone#
tJ~ ~7~/h"-
PLUMBING
6J.u ~ /)
MECHANICAL
Breakers ~
Ducts Insl. S-JlJjJt,:,
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 ($15.001 shall be made for each trip for each trade:
a. Wrong Address ~4 ~7~-ul.jJ /.;J~/Y~-
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
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APPLICATION Foa PERMIT
CITY OF ZEPBYRBILLS
BUILDING DEPARTMENT
OWNER'S NAKE )(ctJ ~ E7 H M,
OWNER'S ADDRESS 3~ D j 0
JOB ADDRESS &, 8' ~ 0". K
Gv~(;eJS
IJj TIfAIIE.
C~ESI
PHONE
712--5778
II PT t-J
i!:-~fflyI..H, L.Ls. FL.
JJ Pt- r
LEGAL DESCRIPTION: LOT(S) BLOCK
PARCEL I.D.'2. -..2'- 2..1 - 0210 - ~ tJo" 0 - -,
WORK PROPOSED: j New Construction _Addition
SUBDIVISION
(OBTAIN FROM PROPERTY TAX NOTICE)
_Alteration _Repair _Install
PROPOSED USE:
_Sign
l.SiJJ&l; F..ily
_Move
_DeJlolish
_M/F
_' of Units
_K/H
_eo..ercial
_Indust.
_Swia. Pool _Other
Restaurant & Health Deparblent Approval
DESCRIPTION OF WORK:~ h... \AJ ~\N~ ~Ltf-DVJ\"4.lIJC-
(;..) I c::5'^e1.
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL :
COKKERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS.
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTED
$
Valuation of Total Construction
ELEC'fRICAL
tHECHANICAL
_PLUKB~NG .
AMP Service
Florida Power Corp.
W.R.E.C.
$
Valuation of Mechanical Installation
,GAS
I Block
ROOFING
SPECIALTY
TYPE OF CORSTRUCTION:
_Fraae _Steel
Other
~'
NO
Fl.NISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZORE AREA?
YES
******************************************
BUILDER
~/
COMPANY {JvJ . .
/ V~~;) State Cert. or Regist. .
~~ r - ~~ City License Registration .
* ***************************************
CONTRACTOR SECTION
Signature'
PLUKBER
~ ~ COIIPANY "--~"'-'-,, I2.Ll~',.
State Cert. or Regist. # cx;t: At \..o~
e ~ Q) City License Registration' G i
**************************************** .
COMPANY {, 'h JI VI e5
tt( State Cert. or egist.
, City License Registration .
* ***************************************
v
Signature
Signature
. , COMPANY tA tll!- '5 fll!.f.J fJ~;vz. il I9/L
~.fi ~ State Cert. or Regist. 't en,,> ;;2:' "/8
City License Registration' /~
. ******************************************
v
KECHAlUCAL
OTHER COMPANY
State Cert. or Regist. ,
Signature City License Registration f
******************************************
APPLICATION APPROVED BY PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A.' NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perJit lay be subject to "deed restrictions" whieb lay be lOre restrictive than City
regulations. Tbe undersigned assllles 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 work, they lay be required to be licensed in accordance with
state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor laY be
cited for a lisdl!leanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requirelents lay apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
788-6611.
FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
"Contractor Sections" of this application for wbieb they will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wisbes you to sign
as contractor that laY be an indication that be is not properly licensed and is not entitled to peraitting privileges in the
City of Zepbyrbills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law - HDIeOIDer's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsUleI' Affairs. If the applicant is SOIeone otber than the
"owner", I certify that I bave obtained a copy of the above described docuaent and prOlise in good faith to deliver it to the
"owner" prior to cOllenceaent.
E. CONTRACTOR'SjOWNER'S AFFIDAVIT
I certify that all the inforJation in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, loning, and land developaent.
Application is bereby lade to obtain a perJit to do work and installation as indicated. I certify that no work or
installation bas cOllenced prior to issuance of a perJit and that all work will be perf oIled to leet standards of all laws
regulating construction, City codes, loning regulations, and land developaent regulations in the jurisdiction. I also
certify that I understand that the regulations of other governaental agencies lay apply to the intended IOrk, and that it is
Iy responsibility to identify wbat actions I lust take to be in cOlpliance. Sueb agencies include but are not lilited to:
t Departlent of Environaental Regulation - Cypress Baybeads, Wetland Areas and EnviroDleDtally Sensitive Lands,
Water/Wastewater Treatlent
t Southwest Florida Water Hanageaent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
t Departlent of Health & Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater Treatlent, Septic Tanks
t US EnvirODlental Protection Agency - Asbestos abateaent
I also certify that, if fill laterial is to be used in Flood Zone "A" or DA,etc.", it is understood that a drainage plan
addressing a "co,pensating VOIUleR will be sublitted wbich is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A perlit issued sball be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
set aside any provisions of tbe technical codes, nor shall issuance of a perJit prevent the Building Official frol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perJit issued shall beCOle invalid
unless the work authorized by such perlit is cOll8nced within sil IOnths of issuance, or if work authoriled by the perJit is
suspended or abandoned for a period of sil IODtbs after the tile the work is cOlleDCed. One 90 day extension of tile, laY be
allowed for the perlit with fee charge of $15.00. Tbe extension sball be requested in writing to the Building Official. An
approved inspection lUst be logged during each sillODth period, or the project will be considered abandoned.
WARMING TO OWNER: YOUR FAILURE TO RECORD A NO'l'ICE OF COHMEICEIlDT MAY RESULT IN YOUR PAYING TWICE FOR IHPROVEJIENl'S TO YOUR
PROPERTY. IF YOU INTEID TO OB'lAIN FIIAlCING, COISOLT WITH YOUR LEIDER OR AI AnoRl1BY BEFORE RECORDIIG YOUR IOTICE OF
COHHENCEHEHr. JOBS UffDER $2,500 IN VALUE 00 NOT HEED TO RECORD AJID POST A "NO'l'ICE OF COMHEICEMEIT".
~---M~r~_._~~,
SIGNATURE: OIOOlR OR AGENT
~~ O--Zr u'" dJ....
SIGIATURE: CONTRACTOR
STATE OF FLORIDA
coum OF "A So CD
The foregoing instrument was acknowledged
before me this De-c s- , 19~ by
~(\e;1f f't\.. buf-6f' Ss S~
w 0 is personally known to me or who has
produced fL f){2-\-~S U~~t':""
as identification and who did/did not
~~ an oath. ~
QAaLr...~ ~
(Signature) G;."
CLe~-a\l f'^. ~ J.:S~
(Name Typed, Printed or Stam d)
NOTARY PUBLIC
.11.." NII,_ CLEREEN M BRUNTY 730
11 M commission CC383
y 15 1_
* Expire. Jun, .
* Bontlod by ANB
.~ ,.':1' 800-862-6878
STATE OF J.
COUNTY OF A S' ("0
The foregoing i~trument was acknowledged
before me this \.-Je<:-r , 19..11::- by
lLt,~ (\ en{ ~ ~ u ~~ (-.J \ S I-
who is personally known to me or who has
produced FL De.-t VE~S "C-\""l1 \C
as identification and who did/did not
tak~ ""th. ?k~
C Q~~
(Signature) R-
~~~J l'V'- '->~^-Yfff
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
~'A'
.tc II *
. ~Q",""
CLEREEN M BRUNTY
My Commie.ion CC383730
Expires Jun. 15. 1998
Bonded by ANa
800-852-5878
DISCLOSUllE STATEIIEIIT FOR. OWNER
CITY OF ZEP8YRIIILLS BUlLDDlG DEPARTMENT
I,
to the provisions of this instrument."
-d~ 7~/~ .~
have read and fully understand and agree
The undersigned states and affirms that he or she is desirous of constructing,
renovating, adding to or reroofing his or her own domicile, that he or she actually
occupy, or will occupy by said domicile, and same is not for rent, lease or
sale. That he or she shall comply with the following conditions:
1. That the owner and he or she alone shall act as the builder for all phases
of construction.
2. That the owner will comply with all provisions of the City of Zephyrhills
ordinances and codes pertinent to the building.
3. That in the event various phases of construction are subcontracted, he will
engage only properly licensed subcontractors and will personally supervise
such work.
4. That in the event the Building Inspector shall require co~rections to be
made, the owner will assume full responsibility to insure they are made, and
upon completion will call for a reinspection before proceeding with the
building.
5. That the owner shall assume full responsibility for the construction and
will not expect supervision of his work from the City of Zephyrhills
Building Department.
6. That prior to final inspection any additional fees, including reinspection
fees, must be paid in full. A written request from this office shall
constitute an official notice to pay additional fees.
7. That the owner shall comply with all City, State and Federal laws in regard
to social security, workman's compensation, lien laws, etc., where
applicable.
8. That the owner shall comply with all the safety codes issued by the Florida
Industrial Commission.
9. State law requires construction to be done by licensed contractors. You
have applied for a permit under an exemption to that law. The exemption
allows you, as the owner of your property, to act as your own contractor
even though you do not have a license. You must supervise the construction
yourself. You may build or improve a one-family or two-family residence or
a farm outbuilding. You may also build or improve a commercial building at
a cost of $25,000 or less. The building must be for your own use and
occupancy. It may not be built for sale or lease. If you sell or lease
more than one building you have built yourself within 1 year after the
construction is complete, the law will presume that you built it for sale or
lease, which is a violation of this exemption. You may not hire an
unlicensed person as your contractor. Your construction must be done
according to building codes and zoning regulations. It is your
responsibility to make sure that people employed by you have licenses
required by state law and by county or municipal licensing ordinances.
DATE: / )-/ S'/7-0
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OWNER: //.~---/~ ~/ t~~ '8--e... .
ADDRESS: '38:?iO /~/'~AJ/2 If?; y.
PH: 7[?,2 -S-'l7 'if
CI"l"Y OF ZEPHYRHILLS BUILDING DEPAR'l'MENT
OWNER K'ffIJlIJf(f.( lYl. l?JuKGE55 5~
JOB LOCATION h '39'3-- OAK CRti5" 'vIA-7
PARCEL I.D. # .2. - 2(,-21 ,- Cl-Z-30 ~ O(>c}(,'jO - 7
SHOW ALL EXISTING & PROPOSED STRUCTURES GIVING DIMENSIONS & SETBACKS.
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STREET
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1. 0;:1. ..<:' f(::: 1l " (1I.) 'I
1 :~:;'7 2" 1 o 1':; q ft. ....'.n_..
1 BE!. BOsq + t ..........._...._
lla.R=30"OO ~ 1838.00sq-ft____
1. :'';;: a. F<:::::
t.,::;. 'fYPE? ~
6.00, uncor',d
C~i':'nt.I,..i:.'11 P,/C
EE:T<: 9. 70
Hi:?a t F'urnp
H~,PF: 6.60
EIE,:,ctl''':ic
O.HU
14..
Typ ~=?:
1 ~5 n
T",/p€-? ~
EF~
1 .'
..C)II
17.
lB..
:;~
CF [;'.,1
I. Cf.
19;:<. "
1 '-ib .
74.42
;~ {J ~:=.:; :~~ ~:5. ~;.~ E.1
~~~~::~:~:;f~8. ~:i:~;
..~ .~- ..... "'4 .... ..... ..... _.. '_.4......'. .... .~_ ..... ..,. ~_ u4 'M" '.0_.' . N_, ,._ .,,~ "'M '__'M' M'" .... M'" "... "'M .__ ...., .~~ ..~. ..._ .'H .__ .'_ ..,~ ._..
I I IF!!" E~I:1 \,' c.l:.0r"":if 'y' l: hEll.: t Iif:'? P L:'11't ~." i:'.n d
sppcifications covered by this calcu-
1 ic~ t:i. on "-':\.1'" \:~ :i. n c Offlp 1 :i. ii:ln c ~:? I/'I:i. t 1'1 t h E'~
F J. cW'i dEl F:nE'''- C 'v' CCH::!P n
~;:;~~~""'I/:;;;j;S>< ....... .:_,~::
I IH'?I'''E'.by CE'.'....t:,:i.+'y.. t:h;::d: th:i.~:. bu:i.lcl:i.nq is
:i.n CDflIpJ.ii:':'nce \,...itl', t.hE' F'lut.'iclc:~ ErH~'t'-'qy
C;C:odE~ "
:~~li~,,'.~(~1;2'l~~'!!~:E':
...-........... .......... - ....,......- ................"'........................................._......""H...H......H.........O<...H.. ................"'.._. ....._............
Review of thE' plans and specifications
cuvered by this calculation indicates
compliance w:ith the Florida Energy
Code. Before construction is completed
th:i~:, buildinq v,i11 bE? in~.;pected few
compliance in accorclance with Section
!j~5:~::1t .~;1()f3 f~'" E\u
/7~! ~.
qlll'L () }'I\I':; -'If:'f:' I '.: I ''''~, /,
". ..... .... L l. ,l f'l.. .
? -~ .... .,.. . -- --. ...- ,_. ..,.. ,-- -.., ,_.. ,_.. ....
n{~ T E: ..,.. ,L2~../..??.,,::.., , ., _... .._, _,~_... ,_.. _,. ..... ..,_ _, _.. _.. om. ..., ,_ ..... _, .,_ ,.... ....,_..
~**~**~~K~*.****~***K***.*~~******~*************************************~******
r; 1..11"11"1 E:r;: L:,:::)LJ::::ULPIT I ON~::;
~:::c.~: ::: r: () b F
~****~*~*K*****~~*******KK*~*K~****~***K*********~**~**************************
:::::::::::;:: (~IB'''''BU I L'r :::::::::::::
"-' ...- ..... "M' ~_.__. ___"_' '___..' ,". '.'M ..~. ._, ..... "00' ___ .._. .__ ..... ..." M'" ..... ..0.. ..... ~M. ..... ,__ __. _... ._.. ..... ._.. ..... ..... ..... ..... ._.. _....._ ..... __.__ M_.._ ..... __. .__ _... 'M', ..... _._.. __ __ ..... ._.._ ......... __ ._. ..... _. ..... __._ _ _.. _ ..... ..... _....._. ..... ..._ ____ .....
..... ..... ...- N_" ..... ..... ..._ ..~. .__ '"N' ,'... ,........ MM ..... ..... ..'N ..... ..... ..... ..... ','.. "'M ..... Oh_ ..... .._.. ..... ..... _... ..... "N' .M_ ..... ..... ..... ,_.. ..... ..... ._.. 'u" ..... ._.. ..... 0__ ..'" __ .__ ..... ..". ..._ ..... .__ __ _H' ..... _... ._.. __ .__ _H' _.. .__ .~_ .~~ ~_ ._.. ._..._ __ .,.~ .~.. ~._ _~. .__ _...._ ..._ .._
UI.. ()E\U ,.
ORIEN AREA n BSPM = POIN1S
N 1 ...... ()() r......... {/ L~ /;> /[
_m . ,"\..' " ,,-::. .
I,,::; 42 '",!,,';;) :::J~? "'j ":'-1:::' -.:,. 1 "
. . .'... ...>...J..':, " -.
t:; ....; 1. :.:;0 E~:';'? ....; 1 '7~:.;() 9
.t~:' " " .t'.:' .
I.~J \~J I. n 1 ~J:'~:'~ r':. ~:iOBO U
. " J:.. "
1'-"
.. \:)
n COND. FL.OCII:;~ ./
(.mF:PI
TOTAL GL.ASS = ADJ.
('~IRE() F(.'leTOR
..',
GL.f-'"18~3
POINTB
GUiSS
POINTS
j 1""
.. :')
J ~ o:::;u. 00
150.07
'~_._"""__"~"_"'_""'_~'_'''_-_...__...__..,,-.,----.._-.._..._--_.-_.~..~..~_._--_.__.~-~-.._..._._-----~...----...-.-------.---.------..-.-..----.--.--------.-..-.-----..----.-.--.---.-
'--...- ..... ..... '-" ..-.. _.n ...- ..... ..... ..... ...._ _... _H' ..... .._. ._.. ..... ..... ..... .~.. ..... ..._ ..... ..... ..._ ..... '_._ ..... ..._ ..... ... _'" ._.. ..... .._ ..... 'N" n", ,_. _.. .._. ..... ..... ..... ..... ... ..._ ..... ..... ~_. ~.~ .~_ .__ ,_._ ....._ ..._ __ ._, ..,_ .._ .__ ~_ .~_ ..... ~._. ._.. __ __..._ .... ..... ..... ..... ~... .._. .~.._._
TYPE
N
BPN ~:: PO I NT:;
NUI\I bL(~ISU"
PIHE(.~1
H~JPI"l :::: PO I N rs
.. ........ .... ...- ..... ...~ .-.. .-... ..-. -........ ..... .... '.'-' ..... ..... ... ......... ..'M "M'" . ....... ..__ ..... ._. ..,.. .... ......._ .........._ ... _.., ......._ ....._ ,,,._ ~_ ..._ _._ .._.._ _'''_'''_' _ .._ .__ _... __ .......... .._..._.._ ._.. ._. _. ._._ __.._
~\JPJL.I....E~' . h............ ....-.
[>~ t J :,:::,?::;::. :I. 1 . 0
{'lei j 1. HEt. U , /
1 :,:l:?:;:'" 1.
1.:~;:>' ,,?
DCJClF<E-;.---........,' ....
F:;( t ~?~::,i" 0
(:)i:Jj l'/"H
4.H
1" 6
:1,20.0
~'t? fJ If ~5
CE 1: L I NCiH.....". ..,..
U(i 1 E(:~;U. 0
I
" C~
1.1.0:::;'.B
F'LO(Jf~~3..,....
81b
l'::?7'" :::~
<:q. H '6:"?74.:1.
J I\JF J Lff;;(iT 101\1...._. ",.,............
1838.0 :1.0.9 20034.2
'lYPE
BC [mIEN AREA x SPN x SOF ::::: POINTS
... ~..,.... ......... .~.. ... ..... ..... ,.-. .... ..,- -....... ... ...- ..-. .... ..-. ..... .... .-. -... ..... ..... ......... .... ..... ._~ ..... .._ ..._.._. "... ..... ..... 'h"..._ .._ _. ...._ ~... ......._ .._ ._...._ ._..
DHL..l I N'f
OIJ\.. TINT
DB!.. TINT
DB!...f I NT'
DOL. "1" J N'l
DBI.., 'f I N'r
UGL.. [:I,_F;:
DBL T II'JT
1'-.1 .1. /"", 0 4'" !~.:.; lEi 407 (l
.I.: . , .::' . . .
F' :1.0 ....j B7 :::'~'-? :~;L~ ~."i :I.
.. ."::. .. ... . .
F" -:1"'''\ F< B7 .,:. E<9 2 ~:.i :~: l E!
''':'..::. . . . .
,-, 4 c; lEI B 57 ",.-" :I. 0
~:) .. .. . .t.:..il::. .
C" :l. 4 7B.. B 8r, 1051:l C?
~:~ \7:'\ II . . J.:. .
L..J :t. t1" 4 B? . ,,:'\ . B9 :t ~'~6~:; n 9
~'J :I r". :l.O';? r'\ ~:j4 74 1 t:l
....:. , .3'" . .
H .-:,....-j 8 E:7 89 ,-','::"';1' 1 8
''':'.f':' . . -' . ...::."J...) .
. ...... ..... ..... ..... -... ..... .~- ..... ....- ..... ..... ..... ..... ~... ..... ...~ -... ..... ~... --. ..-. -... .._, ..... -..... -...- ...- -- _.. -. .......... -...---- --. ..-. -... -.-..-...... ---..-.-.
(-H),} GU,'"1G~3
POINTS
..._ .~. h_.. _........ ..... ..._ ..... ..._........ ..... ..". ..... ..._. .__ ......_ .._,..._ ..._ ..._ ..... ..... .._ .._. ..... __ ..... .__ __ __ ._.. .._. ..._..... ~_. ._...._ _ .__ ..... ._. .._. ..._ ......._ _...
.1 . c{(?/
1. 1 ? :;;; LVi . ~:;: ~:,)
:;:~:? ':I 6f.'..\:'~ II ~5.l}.
C.t , 1. ():3 II ~?;~
p-_.V{-)L..UE
{-)F~:E(:1
E.>~t !\IDl'ml.'Jt~BICiCk Ir',
{-'leI j 1..'..Iuod Fir. <':"ii€',!
~:.;" ()
.1. :::;72. 1
18B.B
1 . 00
.70
1 S72. 1
:1.:1..0
1 :~):? ~:~
E::,: t. (AJoDcI
(.k1 i 1!.,Iooc1
25. ()
7.20
2.4,0
180.0
42.. "7
17.8
l.JnclF:I" (H: t. i c
::;:0. (I
1 El3:E3. 0
.60
ll(l~.:~. B
E~ 1 i::\I:::o .....on ..'..Ur. Eldp
.0
197.5 -51.90 -6293.9
F'r' cle: tic E~ #2
l 8~58 . 0
lO. 90 2(>O:~A. 2
TOTAL SUMNEP POINTS
59?17H.14 ~
:.~:: :::::::::: ::: ::::::::: ::::: ::::: ::::: :=: :::: :::::,::::: ::::. :::::::.::.: ::::::: ::: :::-.::::: ::.~::-.: :::::::: :::: ::: ~.::::: ::-.:: ::: ::::::: :::::::: ::-.:: ::: ::: ::::: =:::::::::-.:: ==:= ::: ::::::::::::::.-:: :.-:: == =:::;;:::::::::::::::::::::::::: :::: =.::::: ~'::: =:::::::;:::::::::: =::::: ==::::::::::: =:: ::.::
're)'}" {iL... '.1
SUt'l P'T~3
BYblEI"1
nUL. 'T
=:=::.==::==:=:=::::~=:=~::::=:==~::.=:::::=:::::::::=::::=::::::=====::::==::.~====:==:==:====:==================:::========~====:
~~ ~~i , t'..\'7:3. ~.::~ ~~::
COUL I I'..IU : T(:Jr(~IL
FO I NTE; \ CONPON
x CAP x DUCT x SYSTEN x CREDIT = COOLING
RATIO MUL.T MULT MUL.T POINTS
:y:; 'j 1 7Li. 1 il
n "~' /
1."t~49~::i.';?1
......'..M._....'_._.W..__......____._.._,~_.__......._.._.___.._,.___._..__.___._._.__..._.._.____.__..____.._~.__..__,_.._______________..____________._
B, :~H 5.86
25,673.33 1.00 1.070
. :3;5;.=:
..1360
=:=:=:::::;::::::;=::==::====:::::~==:~~:::==~~:==:::::::::::====:::::==::========:==========================::=============
*******~******~Y~**~~~*~*****K**~**********~**~***************************~****
WIN1ER CALCULATIONS
::::: ::::,;: .H P, bE
*~***M*******~******~**~*********~**********~**********************************
:::::::: ::::: (1 B -,-[< tJ I L.. T ::: :::: :::
--.-.-..--------.......--.....-.--.----...-----..--...----.....--------.-----.-.--.-.--.-.------...-.-----.------..----.---.---.---..-------.----..-
...--.--......-..--.-..-----.--...--...--.-----.--.--........--.---.-.--..----.----.-.-..---.-.--.---.-----.---.---.------.----------------.----------------.---.-.
CIL.. r'18f:~-
ORrEN AREA x BWPM = PUINTS
t\1
F
:I '::::" 00
.. :::;. 4
.':::" 4
.w 40" Ll
--- 1 .Lk:~. 1
it :',? rl r? /:.')
r'\
.;:~
:'?1" :::::0
"-::::" 4
"h'7:'~::" l~
v.J
t::~lnE~l
'-:,~:., 4
'-'210" :2
'fVPE
SC ORIEN AREA x WPM x WOF = POINTS
OBI.... 'r I Nr
OBL., '1' I !.,j'r
Df.JL 'r n.rl
(JElL TINT
DBI..., T I N'l
DElI.... '"I" I trr
HF~L, eLF::
nUL TINT'
I",j
r-
F
'"
.::)
f;
\J.J
l'J
{~j
:I. :"2 . 0 (, . 1 1 . 1 7 H6 . Cf
1 .. ) T'") 6 -,- E12 ::~;o :I.
c . ..~. .- . . .
'-:r:"j B -T f.:, 714- -'B7. -,.
.P.....::. . -.~:- . . ..:.'
14- " 9 "-.:1. 1. . 0 . 6~; -_.:~;.~, . ~~~
1 IS. 4 ....,1 1 . I :> . 9 1 -- 16:::; . 1
1 6 4 '~ f:) 74 -.'-4::':: ....,
. M'~ .~:- . . . .'
1 ::'~ '7 " ::~ -...1 BEl 1:::" r") l"_-
. ,/. . . ""J..c:' . d
:~:;~~ fl w", 6 74 ''''B7 :2;
. .-....:'" . .
" 1~::; "
CUNI). FUJUr:::
(.) F;: E {\
.--.---......--..--....--.--...-...-...-.-....--......---....--......----...---.-.---.-..---.......--------.-.-------.------------------
/ TOTAL GLASS = ADJ"
(iPEn F{1CTUn
J ~";
1 '.1 U::~;(:l. 00
1 ::q:l. 0 '?
--.--...---.......----..--.....-..----....---.---...---.-.----....--...-.--....--.--.-.-..-----.----..-.---..----.__._-_._-------_.._---_._---._-----.~----_._-------.----------.--.--
.---......--...--.-.-..-..--.....-.~..--.-.-----...--._.~_..M_._...~__....__M..__.__.._._._.__.__._..___.___.-----....------..-------------.--________.___._____w_..___________.________.._.___
NUI\! bL.{,',bb .,.,_.._,.." ",. ....",.."."..,
AREA x BWPM = PUINTS I
}{
Gt...f~bb
PDIN'rE:
f~DJ GL.IC\SB
POINTS
GLASS
POINTS
:l.. iY?'l
,.,.Ah':1 . 44
.... ...... ..,.. ...M _._ ..... .... "". MM' "'N ..". ..... ..,. ..... _... ..... .._ .__ .__ "M ._. _._ .__ _.. ._.. ..._._ _....._ "'M .... .... .._ ._.. _H' __ .._. ..._ .... ....._.._ ._.
",247. 1.7
1:::,).; t, Wc.otl
nd j (.1joocl
Undpl'- rH,t;,ic:
E~]' E:{ t:) -... Ln'f ..... (3Ir' f::'{ cl E!
PI'" 0:\ c:: t. j, C f,,~ *~ ~Z
'I f)f (,:,L );
(J,J 11\) FT~3
SYE;TEI'I
!"1UL.T
f IEPd 11,.1(3 :n::rl(il....
F'Cn t.rrt:; : CO!'1PClt,.j
x CAP x DUCT x SYSTEM x CREDIT = HEATING
RATIO MULT MULT MULT POINTS
'!VFE
-:; , :T? 4. 20
1 v 1. 0
.~.. ..... ..... .... ..... ..... .......... _"n .." .h" ..... .... ..... ._... .. '..d ..... ..... ..,_ ..... _... ..... .....
.-.-__._........__M._..._....._.___._.__._.__.____._.___________..__.______..._.___
"7 ~ 4~m. 42
M'.' fj ~~~~? . :::;; E~
R,....'V{:.)LUE
(-)REfi ):
WPI'1 ::: PO I NTS
hlP,L.!.. S' '. ...'m.... ..... ....m '..,
""h ..... ..... ...- ....... . "'M' ..... ..... ..... ..... _... ..._ .... ..._ _.... .... "'~ ..._ .__.._ h',,' .__ _..M ..... .... ..... .__ ..... __ ..... _." ..... .M_ ._. "M' .". ,,_. ..... '.._ ..... .__ .... _". .._ .__ ..... ..... __ '._ 'M'. .... .__ ..._ "'_ __ ._. .... _... .... _... .... ..... ._.. __ __. .._._ __. ._. __.._ .... ._.. _.. ... ___.
f::, ); t :I ::::~ '7 :~'? :l. :I. 1 1 ~:.:.~ () ~:.i ~'1' E:>: I:. Nol'"' mv.Jt D 1 Dck In ~:.:.~ (> 1:::;;72. :l. r'\ '.y'() ~::;97{"1 1
. . . '-) . .r:" . .
nd ..i :tUB E~ :I. U ..:r...;......; U (ki j !!Jood Fl'- "Hnf~ 1 1 i.) 1 (:IB B :l 00 :::'::::'9. 0
. . '..:"~:' 7 . . .. .
DUUf;~~:; .,., ..... .,..". ..--- ..--- '"-''' .,.., "".-.- -., ,_..
Ext 25.0 5.1
Adj 17,,8 4.0
l ~::'7 . ~:~.c
71,:',::
CE:r L. I I'H:3:3'
1...1 PI :1. O::,H. 0
II Ii::-
1 :I. 0:::: . H
FLUOF:~;---_.,' ."....-
HI!.!
:I. (/./ . :~~;
..,..1. ':1
-... :~:; '7 it " (:.?
I NF I L.rF::r:~d I Uhl .-...,---...-.--.---
:I f.:r::;B . 0
.il,. J
~7 ~5 :~:. ~:i. t3
=::::==::::==::==:~;=~::=?=:==:=============:======:===========:===:===~=======~:===:==============
'fUTAL.. WINTER PUINTH
("1' IJ ~!:;'7 L~ ft ~,?() :
"'''r_'' 0 7. 60 190. (I
..::......f.
J 7 B r:.. 90 105.0
. ....1 f!II
:;;:0. (> 1 EL>f,3 . 0 . 60 1. 102. 8
0 177. ":r r',i 50 49~:.. :~)
. .I:.. .
lB3fl. 0 4. JO -"":'t:::"7~;' B
I .....f._.......f.
::::=~::=::=:=:==::::~=::==::====::=:~===:::=~=::::=:===:===:::=:===:~==::::======:==:====:====:==:=====:======:==:========:
13,4ClEl.6~j
10,311.62 : 13,498.63 1.00 1,,070
. ~~:l!5
1 . 000
:~=~~==:=====::==::=::~=:=:=:::==::====:==::=:::=:=::==:====:==:==:=:==========~=:::==::==============================
****~~*********~***.~*****~****~********~********************************~*****
!,'JfYIEP HE:f.YI I 1\~Ci
*************~*************~***************************************************
",,::,,:;::::: B(ir;E: ::::::::::::"
:::::::,,=:: PI~:;""'BUJ.LT ::::::::::=:
-___.__.___..___.____"_._....._.___..w.....__...._.__._....__....._....__.______.._.______.._.___.___.._..___....______..___.___._.._.________.________.________
.--....--.--..--.--.....,...--.-..-..---.--------.----.-----..--.-.--------..------.----.-.-----....-.---.-.----------_.__.__._--~---_._------_._--_.__._--
NLWI UFo
BEDI~I"1b
..'\
IvlUL'T
Tu'rtlL
'I"t,I\II< './UL.tJlvIE
EF'
-frw,w: ::-: NUL r ::-:
1::{Yf I 0
CF~:ED I T
11UL.. 'I
::::: 'fOTAL
.. ,. ..... "u. ..... "'W ...... .. ..... ..... M',. ..... .... ..._ _... ..... w'.. .... .... .... .... M'" ..... ..... ~... .~.. ~.,. .._ ..... _.. ..... ~... .~~ 'n. ~... ..... ....... . ..... _... ..... _... "... .....
::~: ~:.~.:.~ :~.~ "J'" 'I ()
:1.0 ~ ~'.:in:l. _,00
40
" (3::3
:1.,,000
:2:~ ~.;:2 .}'. OJ ()
:1...00
:I. (> ~ ~~;iJ :I. . 00
--......,......__..~_._--_..........~._--_._-_........~_..-"._------_._..._....,--~...__._-_.~-~_.~...-.-.-..-_._.._._--_.._._...-..._._-----_.~_._-_._-.._---_._.._---_._-----.---
-.............---........-.....-.......-.........-..-....-.--..............---......-..........-.._.._.. _........_.._......._....._....__.4_......_...~.....___.._.......___.._...._._.._.....__...._____._...._._____~__.._.__".._________~__
~******~***********************************************************************
BUI-'11'!rinV
*****~*****************************.****~**************************************
,,": ::::: :::0: :u (~I U E
::::::::0:::: p,S---.BU I LT :::::::::::::::
.._-~.._-_.-._-_._-_.._.__._.._..._._.._.._-....__.~......__..-._~_._..__._.....-.._..._-_._-_.-_.._-_._._--._.._---..-.--....----...---.--.--..---.---..-.--------------..--.-------..---.------
.-....-.--.--....---..-..-.......--.............-.----..--..-.__..__....__......._.-..._.._.._.__.._._--~._._..._..._-_..-.--...-..........--..-.----......-....---...----.---------.--..-----...-----.----....--.--.-.-------
CC)UL I NC)
PO T 1\lrE;
+-
1.1 E: (~I'r I 1\1 C;
PU I I\j rr3
1.1 D "I" ~'JtITFn
+ F'O 11'-H\:3 ,--
T[I'r{~IL.
F'Ci 11\ITEl
COOLING
PO INn..:;
+.
1--IEr~ T' I NG
PO I I\IT\::';
HUT WPd'EF:
+ Pc) I NTS -,-
-rUT(.)L.
POINTS
.......-..-,........p..--......~---..-.----~.--.p.....--.-............_._M__...__.___.._....____..__._.___M...__..----.----------.-.----__..______._.~M__.._.__
:t l~I.I.9:::;.. 9
10::::;:I.:!... 6
1.0~:::;B1... 0
=::: ~:i , ::::; f3 :::1ll ~.:; ::~;
E.r:::; 1. ~_:; . 9
7if:'m. if
1 O~:IB 1. .. 0
:21.:) , :3::;.~:;" 2~3
-...--.--.-.---..--..........----.--.--...................---.--.--....--..-.--.--.....---------.--------..----..-.-----.-.------..--.--..-----.-....---....-.--.-----..--..-.-.--..---
--........-.-.-.....-...-..............--.....-..--... .................-..-...-............--.--. ---.--.......-.....-.-----...----.--.--....-...-..--.---...---.....-----.-.--.-.--.-------.----.---..-.....----..-
*****************
* EPI = 74.42 *
*****************
ENEPLiY' [iUIDE
For' dt,~t<:;.,i 1 E,~d i nf Dr'm,:,~t, i Dr)
u.f -[,hE': E:F'I rl::'\tinq nUiilbE"'"
Dr f UI".. <:HY/ IfEI'.'1 l:i :::t,i::~d j
ask your Builder for
!JCt! FCli'- iTi ()OO(.,~....7::;:.
or FCH"!fc <:':~00J3".(:r;::
EPI::::: 74. I.~
(> 10 20 30 40 50 60 70 80 90 100
: .".~ ._~ M'" "'M .,.... ....8 ,"._. ._. .__ _'R '_'. __. .... ".".. .__ ..... X MO" _._ 'w_ _w.. M.w'_ __...._ __ ..... 'M'_ t
The maximum allowable EPI is 100.rhe lower the EPI the more efficient the home
RESIDENTIAL ENERGY PERFORMANCE RATING SHEET
lrFf-!
IIOIIF ',/P,L.UE
L.O~"I E-f'fic:ipncy
Hiql", Efficiency
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BuilclEi't",
Address~_______________________Signature:_______________________Date:__________
City/l:ip..______________________
Florida Energy Code for Building Construction - 1993
Florida Department of Community Affairs
FL -,EPL C?~r;:D9:::::
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C E N T R ALP E R M I T TIN G
PASCO COUNTY, FLORIDA
DATE: 04/22/':;'6
PACiE: 1 OF 1
I S~=;UE OFF I CE: D
RECEIPT NUMBR: 00280929
OFFICE: DADE CITY
CCJNTRACTOR #:
NAME: KENNETH BURGESS
ADDR= 6845 OAK CREST WAY
C/ST: CITY OF Z/HILLS
FOR:
C;HECI< t-t 4098
ACCNT
1.14
TOTAL AMOUNT:
COMPNY ACCOUNT CENTER
B450 - 363000 - 2
35.9:3
AMOUNT DESCRIPTION/PERMT DATA DR/CR
35.93 ****** SOLID WASTE FEE 60
RECEIVED BY
,( /
~ / / //
j:c::__{l-'L.!.L__Ii.(/.:.!3~~S~_____
/ /'
/ ...//
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~:..:::..=:__v- ...,....
,
,
._-~/
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f'::I","f'"
-,.....-. "I'''~'':'''''r".,.~--~'.2;'<f,'>>f~iJt:~'"'f.;;''~~~'''~
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" , ,
PASCO COUNTY, FLORIDA
Permit No.
Date Permitted
Builder NamelOwner Name
~
County Parcel No.
;;
Location
Subd.
Classification/Type of Use
(
~ "
4
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
J
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 $
,h
,
~j
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.
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
r
.__""n_________,_~______._.___~________ '__"__,___ ,____