HomeMy WebLinkAbout96-5878
BUltDING PERMITNo
CITY OF ZEPHYRHILLS Permit.
(813) 788-6611
~ 587~ IJ
Date
S-629-9&
/.6-S7.~''G)
I
BUILDING
/.).I...LS-
ELECTRICAL
~o. ,-""v
PLUMBING
lit}, P"V
MECHANICAL
Sewer Conn I 5'--P }7, .5 D
,/
Water Conn: '1c3}>, ~"t)
Water Meter: :l )lJ~ (rZJ~~~
T,I.F.'s: /1, ~;2tJ. 0 r
P<opertyOwne" _OJ., ~ (]; fl.. A<<4d~-J
Job Address: -..5 L"C? ~ /!I:l:d
Parcel I. D. # / /- c9. 6 -:L 1- CJ 0/ D - / -;L / 0 0 -- O,;L .s ---- U
Zoning: Energy Code: Radon Gas: t:, 9, f ~
Description of Work (J4~ ~ /Q 4.AL ~
r
.fj ~"f ,t .., ,l
'J .
FINAL
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Permit Fee ~ R- ;I..f; ?~-
Signature _ - .f7;;i'-?r
compant
Address
Telephone#
(3
Valuation or
Contract Price ,.1:1..10) J I/&--. tI1J
City License Registration # J 7 t-....s
State Certified License#
ZJ JlI1~'
v
~E-/4ALrJ /7R;f-'
{I~L> //?~
'(fJ-JUL /?~3
ELECTRICAL
'7-30 -fl.{; 2J
Tp. Servo SLB
Pre SLB Rough In Tub Set i- .~uAt. &rD
M. Lintel 1 . Ii l(. '!J (t,L-- Meter Can :) -;)..7 -7'....6 Wseawteerr~~s... 9h~
FRM. 1...,3D ".r~, &8 Const. Pole ~..-6'961;;1J 0_dS::9.h.~
Insul. CLPool Final
WL ,Pre-Meter a~ 20-9h /bB /~ () CJ-.6~ J>'-J!J -?b
~~~,;7,.SJ'i~&iFinal ,), rJh .
Driveway e~~"",/ ~.q~ S. Lt- '1-2-11, 6"t-L-/'-3-1~G'~L
~ll~l1~-~ ~\v\ ~c\\wu . ~j)~e~<iullr<; If d uJ p,-L-L 7,'" If:-- f~ 6, Lv
2. i-\t4 ?ll.~'V'), ~~~I~~$'-ttV(5& ~ ~ b-d'1-qh &8
REINSPECTION FEES: When extra inspection trips are necessary due 1lb a"v one of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.001 shall be made for each trip for each trade:
',I. -# /# . . , 7. II, , ffS,cJ..7-Y--6
Wrong Address A/(.~ ~~ ~ J. .g--....;lf-9.-b
Condemned work resulting from faulty construction. (\' ft . () I. ' . (5& g .
Repairs or corrections not made when inspection called. ~W <JX-"- "l r Ll.-I-tt V
Wor~ not ready for in~pec~ion when called. ~.~ fl &., .p~.J...-.::t:- - b-~_ i- -lc -1 /p t3tJf$
Permit not posted on Job site. .........~ \ VV' \J.oVt ~
Plansnotatjobs~te. ei-...:_' -\,J^IJ ~_ I 0,- S:LL
Work not accessible. ~ """"-, c5 I", - .., V'
PLUMBING
MECHANICAL
--------.
Breakers
Ducts Insl.
Compressor
Finat
a.
b.
c.
d,
e.
f,
g,
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
BUILDER:
ADDRESS: 5350 GaD Blvd,
OWNER: Auto Zone Inc,
SQ. FT. PRICE
LMNG OR MAIN AREA:~ 2, 788 ~ $ 42.00 f
OTHER AREA UNDER ROOF:~ 4,202 , $ 28.00 ~
OTHER AREA:' 24,529 I $ 0.85 ~
SQUARE FEET UNDER ROOF:I 8,980 ~
VALUATION:I $ 228,348,00 1
ADDRESS:I $ 20.00 ~
DRIVEWAY:1 $ - r
FEES: 1 $ 1,155.00 1
BLDG, PLUMB. ELEC. MECH.
PERMIT FEES: 1 $ 1,557,50 I $ 40.00 I $ 121.25 ~ $110.00
3/4" 1" 1-1/2" 2"
WATER METER SIZE:t $ 185,00 I $ X 245.00 I $ 810.00 I $ 840.00 I
SEWER WATER METER
CONNECTION FEES:I $ 1,597.50 ~ $ 437.50 ~ $ ~~~~
RADON GAs:1 $
PERMIT FEES: J $
CONNECTION FEES:~ $
WATER METER:~ $
TRANSPORTATION IMPACT FEES:
99%
1%
89.90 ~
1,828.751
2,035.00 I
~I
$ 11,820.09
$ 11,701.89
$ 118,20
CREDlT:1 $ 195.00 ~
,,-
SUB-TOTAL! $ 11,888.741 / S~-.S-StJ'. 7~
II
IRRIGATION METER~ $ .J.~6:-d)ll
TOTAL I $ 1&,163.7'41 J~ ~()3. 7Y
_ I 9J-,
13- 9 '1 g. 'l '-/
)
CITY OF ZEPHYRHILLS CONNECTION FEES TABLE A - WORKSHEET
ORD. #395IRESOLUTIONS 3121372 WATER $1.75 GAL. SEWER $8.3IIGAL
RESIDENTIAL (Each Lot or Unit)
Residence $ 350.00 $ 1,278.00
Travel Trailer Park $ 131.25 $ 479.25
COMERCIAL (Per fixtire)
Sinks $ 87.50 $ 319.50
Water Closet $ 131,25 $ 479.25
Urinal $ 87.50 $ 319,50
Lavatory $ 43.75 $ 159.75
Tub/Shower $ 87.50 $ 319.50
Washing Machine-Commercial Size $ 350.00 $ 1.278.00
Washing Machine-Domestic Size $ 87.50 $ 319.50
Dishwasher-Limited Use $ 87.50 $ 319.50
Food Service-Dishwasher $ 700.00 $ 3.556,00
Sinks (3-ComDartmentl $ 175,00 $ 639,00
Car Wash (Per Stall) $ 1 000.00 $ 6,390.00
SINKS ~O 1 $ 87.50 $ 319,50 $ 407.00
WATER CLOSETS 75 2 $262.50 $ 958.50 $ 1 221.00
URINALS ~O $ - $ - $ -
LAVATORIES 25 2 $ 87.50 $ 319.50 $ 407.00
TUB/SHOWERS ~O $ - $ - $ -
WASH. MACH. COMM. 200 $ - $ - $ -
WASH. MACH DOM, ~60 $ - $ - $ -
DISHWASHER COMM. 400 $ - $ - $ -
DISHWASHER LIMITED USE 60 $ - $ - $ -
SINKS-3 COMPARTMENT 100 $ - $ - $ -
CAR WASH PER/STALL 1000 $ - $ - $ -
SUB-TOTAL $437,50 $ 1,597.50 $ 2,035.00
1" WATER METER $ 245.00
GRAND TOTAL $ 2,280.00
FIXTURE
G.P.D.
#
WATER SEWER TOTAL PER FIXTURE
4/18/96
05/21/1996 14:05
77 [1 Ed:, 2 5 tt ::11:1
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05/21/1996 14:42
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MAY-22-1996 10:42, FROM A CATAPANO PLUMBING TO
'ruiT-':::~-~b Nr.1J lU'qu nut L""- I II.JVVlaolVoJV
ftAY-22-96 ME~ 88:25 ~" YATES ELEC~JC INC. ela gG? 7484
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TOTAL P.01
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-.. ..,.. , ..,- MAY-21-'96 TUE'10:41 ID:
011I.' S IWIII
011I1&' S .ADDll1IIm
JOB ADDlas
TEL NO:
t:l119 P02
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LIGAL DBSOIUPI'I.DB: toT(8) lLOOIt SUBDIV1S:ION ..
PARCIJ. I.D.' (;-:010 - tu 00 ~ o'l.SO CDBTAIII ... ftOP"''I'Y 7ft BDTI.cal
IiIJRK PROJI08IOI~ew Ooutrucllon. ----AdditlOD ----1\lteratlon ....lr Tn_taU
---1Jlan
PROIOSID USE: -8lDale '_ily
V 1C.e77tt<-
A-Cuililiircial
--......JIove
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---1:f./r _' of Unite ---lI/H
_I.oduat. -8W:la. Pool _Other
____taultllnt . Health DePll'tlleDt Approval
D8SCRIPnOll Of' WORK. #t'W baitJ/~ 1- StYe 9f~lures ~, ~-Ia,l auk f-,rb 'S-tvr~
BUlLDI1IC SUB: ~. squue Feet.t~l'3S- Retsht ('1 ~G-/
ItISIDIIft'IAt: AtTACB (2) l'Im PLUS Ie (2) sns OF BUlLDUfG PLAlS a (1) 81'1 IIfII.CY PONfS.
COfItIBRCIAL: ATTACH (3) SITS OP 8UlLDI.IG PLANS I: (1) 81'1' B..IRQ! POBtIS.
PaOPEllTY SIIKYBI RlQ1JlR&D FOR ALL Ii. OOIIS'lRUOTlON.
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PERMns RIOUISI'RQ
Valuatloa of Total eon.tl:UCtioD
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AIIP senice
Florida Power Corp.
--.:......&.1.0.
Valuation of lle~hfQtClll ID8ta1J.atloo
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nn OP ODBS'f.lucnOl: X -1.Gck
PDtaIIBD I'WUIl ....YAI'IOlI8=~.
ROOfING S'ICIALTY
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IS PBOJECI' I. FLOoD ZORI .ADA,...;L ~ lo;.k.. C
1118 10
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City Lieen.. "ep_tntioa . ) , _
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State Cet;t. or Reaiat... liCe
""'- City Lic~ lteal8t.ration . ~
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Sipatu.re
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State Ceet. or Real.I:.' C~C~61-43{g ~
City LleelUle ...iel:ntlcm, _ _ J 9 ? a-
..........................................
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COIIf'ANY ~~Y ,,<Jt>trB~ ~::e-
State Gen.. dr b818t. . / ____'
City License -..i.tlt.tIOD . ff<j ') ~:: "-
..........................................
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" CONDITIONS OF PERMIT AFFIDAVIT
A.NOTICE OF DEED RESTRICTIONS
Tbe undersigned understands that this perait JaY be subject to "deed restrictions. lfbieb lay be lOre restrictive than City
regulations. fbe undersigned assUJes responsibility for cOlpliance 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 lisdeteanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requiretents lay apply for the intended work, they are advised to contact tbe City of Zepbyrbills Building Departlent, (813)
788-6611.
FurtberlOre, if the owner bas bired a contractor or contractors, he is advised to have 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 wort. If the contractor wishes 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 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, have been provided with a copy of .Florida's Construction Lien Law _ HOIeOWDer's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsWler Affairs. If the applicant is SOftOIle other than the
"owner", I certify that I bave obtained a copy of the above described docOlent and prolise in good faith to deliver it to the
"owner" prior to COlleDcetent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforaation in this application is accurate and that all wort will be done in cOlpliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a perait to do wort and installation as indicated. I certify that no wort or
installation has cOllenced prior to issuance of a perait and that all wort will be perforted to teet standards of all laws
regulating construction, City codes, zoning regulations, and land developaent regulations in the jurisdiction. I also
certify that I understand that the regulations of other gOVerntental agencies Jay apply to the intended wort, and that it is
IY responsibility to identify wbat actions I lUst tate to be in cOlpliance. Sucb agencies include but are not luited to:
t Departtent of Environaental Regulation - Cypress Bayheads, Wetland Areas and Environaentally Sensitive Lands,
Water/Wastewater freattent
t Soutbwest Florida Water Hanagetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
t Departtent of Health' Rebabilitative Services, Environaental Health Unit - lIells, Wastewater Treatlent, Septic fants
t US Environaental Protection Agency - Asbestos abatetent
I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
addressing a .cQlpensating vol Ole" will be subtitted wbieb 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 tbe work and not as authority to violate, cancel alter, or
set aside any proviSions of the technical codes, nor shall issuance of a pertit prevent the Building Official fral thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perait issued shall beCOle invalid
unless tbe wort authorized by such perait is COllellced within sillOnths of issuance, or if wort authorized by the perait is
suspended or abandoned for a period of six IOnths after the tite the work is COllenced. One 90 day extension of tile, lay be
allowed for the perait with fee cbarge of $15.00. Tbe extension sball be requested in writing to the Building Official. An
approved inspection lUSt be logged during eaeb sillOnth period, or the project will be considered abandoned.
WARNING TO amR: YOUR FAILURE TO RECORD A NOTICE OF COMMBHCEHEHI MAY RESULT IN Y PAYING TWICE FOR IMPROVEMmS TO YOUR
PROPERTY. IF YOU IHmD TO OBTAIN FINANCING, CONSULT WITH YOUR LEHDEII OR AX Ana BEFORE RECORDING YOUR NOTICE OF
COMHENCEMEHl.1 JOBS UNDER $2,500 IN VALUE DO NOT HEED TO RECORD AND POST A "HOTI OF COMMBHC HI'.
SIGIIAJW~~......s ~~tc. uP.
T ~-<;S=
STATE OF Ft _~ ~
coum OF _~ -Lgv
The foregOing instrument was acknowledged
before, ..e thiB')prrJ ~;l' 193fL by
L{JL()~JV(f- f. 1--: __ N~
who is personally known to me o.r~J ~ bas'
pee dlMl.d
C.hlAlI
. /did not
----.m ( ,~L;J rntllv
~L"" l
STATE OF ~
COfJHTY OF 6 c.v;' /t Yle. ++
The foregOing inst~ent was aCknowledged
before me this 5 Z-Z- , 19~ by
PCt.VI DC.. We^-. +~
who is personally known tD me or who has
produced 0" v'i. r '') L. ce
as identification who d' /did not
take an 0 tho \.,
My CommIssion Expires March 25, 1997
.~
( Signatur~J
H{(IY e ,', A, eser
(Name Typed, Printed or Stamped)
NOTARY PUBLIC ,,_..... ~
NaiIIry PublIc, FuIan _..,. ..-.ow-
My Commllelon ExpnI AwguIt 8. 1_
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
Whole Building Performance Method for Commercial Buildings
Form 400A-94
ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION
Florida Department of Community Affairs
FLA/COM-94 Version 2.1A
PERMITTING OFFICE:
_Zephyrhills
CLIMATE ZONE: 4
PERMIT NO:
JURISDICTION NO: 611600
PROJECT NAME 65W AUTOZONE
ADDRESS: 5350 GALL BLVD
ZEPHYRHILLS FL 33541
OWNER: AUTOZONE INC.
AGENT:
BUILDING TYPE: Mercantile (Retail)
CONSTRUCTION CONDITION: New construction
DESIGN COMPLETION: _Finished Building
CONDITIONED FLOOR AREA: 6470
MAX. TONNAGE OF EQUIPMENT PER SYSTEM:
NUMBER OF ZONES: 1
5
COMPLIANCE CALCULATION:
METHOD A DESIGN CRITERIA RESULT
----------------- ------ -------- ------
A. WHOLE BUILDING 57.37 100.00 PASSES
PRESCRIPTIVE REQUIREMENTS:
LIGHTING
EXTERI~R LIGHTING 4525.00 4590.00 PASSES
LIGHTING CONTROL REQUIREMENTS PASSES
HVAC EQUIPMENT
COOLING EQUIPMENT
1. SEER 10.50 9.70 PASSES
HEATING EQUIPMENT
1. HSPF 7.00 6.60 PASSES
AIR DISTRIBUTION SYSTEM INSULATION LEVEL
1. Conditioned Space 0.00 0.00 N/A
WATER HEATING EQUIPMENT
1. EF 0.92 0.92 PASSES
PIPING INSULATION REQUIREMENTS
1. Non-Circulating 1. 00 1. 00 PASSES
COMPLIANCE CERTIFICATION:
I hereby certify that the plans and
specifications covered by this calcu-
lation are in compliance with the
Florida Ener$ffif;'e y Code.
PREPARED BY:~
DATE: ,2, .
I hereby certify that this building is
in compliance with the Florida Energy
Efficiency COd~e,
OWNER/AGENT: ---=-=-=
DATE: . 'Z. '2..
Review of the plans and specifica-
tions covered by this calculation
indicates compliance with the
Florida Energy Efficiency Code.
Before construction is completed,
this building will be inspected
for compliance in accordance with
Section 553.908, Florida Statutes.
BUILDING OFFICIAL:
DATE:
I ,hereby certify(*) that the system design is in compliance with the Florida
Energy Efficiency Code.
SYSTEM DESIGNER
a.etWl<~ {J. c:::'Ac-LOJ.r-f
REGISTRATION/STATE
AIL eof4( 5~ .FL-
ARCHITECT :
MECHANICAL:
PLUMBING
ELECTRICAL:
LIGHTING
(*) Signature
by registered
be used where
is required where Florida law requires design to be performed
design professionals. Typed names and registration numbers may
all relevant information is contained on signed/sealed plans.
==============================================================:==============
:
401.------GLAZING--ZONE
Elevation Type
BUILDING INFORMATION COMPLIANCE
CHECK
1------------------------------------------------v-
U SC VLT Shading Area (Sqft)
Southwest
Southwest
Southwest
Commercial
Commercial
Commercial
402.------WALLS--ZONE
Elevation Type
Southwest
Northwest
Northeast
Southeast
L & Hvywt.
L & Hvywt.
L & Hvywt.
L & Hvywt.
403.------DOORS--ZONE
Elevation Type
Northwest
Northwest
Northeast
Southwest
North
1-3/4 Steel
1-3/4 Steel
1-3/4 Steel
No doors
No doors
404.------ROOFS--ZONE
Type
1.31 .59 .65 Continuous Ove 326
1.31 .59 .65 Continuous Ove 138
1.31 .59 .65 Continuous Ove 828
Total Glass Area in Zone 1 = 1292
Total Glass Area = 1292
1------------------------------------------------
U Added R Gross (Sqft)
Concrete Block: 8" Li 0.149 13 1516
Concrete Block: 8" Li 0.149 13 1118
Concrete Block: 8" Li 0.149 13 1390
Concrete Block: 8" Li 0.149 13 1118
Total Wall Area in Zone 1 = 5142
Total Gross Wall Area = 5142
1------------------------------------------------
U Area (Sqft)
Door-Polystyrene core (18 g
Door-Paper Honeycomb core
Door-Paper Honeycomb core
0.35 48
0.56 21
0.56 21
0.00 51
0.00 0
Total Door Area in Zone 1 = 141
Total Door Area = 141
1------------------------------------------------
Color U Added R Area (Sqft)
Steel Sheet with 1" Insulation
405.------FLOORS-ZONE
Type
Light 0.213 19 0
Total Roof Area in Zone 1 = 0
Total Roof Area = 0
1------------------------------------------------
R Area (Sqft)
Slab on Grade/Uninsulated 0 0
Total Floor Area in Zone 1 = 0
Total Floor Area = 0
406.------INFILTRATION----------------------------------------,----------
I CHECK
Infiltration Criteria in 406.1.ABC.1 have been met.
407.------COOLING SySTEMS-------------------------------------.----------
Type No Efficiency IPLV Tons
1. Single Package 4 10.5 5.00
408.------HEATING SySTEMS-----------------------------------------------
Type No Efficiency BTU/hr
1. Single Package 4 7.0 51000
409.------VENTILATION---------------------------------------------------
I CHECK
Ventilation Criteria in 409.1.ABC.1 have been met.
410.-----AIR DISTRIBUTION SySTEM----------------------------------------
ABU Type Duct Location R-value
1. Split / PTHP Air-to-air Heat Conditioned Space 0
411.-----PUMPS AND PIPING-ZONE 1---------------------------------------
Type R-value/in Diameter Thickness
1. Non-Circulating 3.6.5 1
412.-----WATER HEATING SYSTEMS-ZONE 1----------------------------------
Type Efficiency StandbyLoss InputRate Gallons
1. <=12 kW .92 0 5 10
413.-----ELECTRICAL POWER DISTRIBUTION----------------------------------
CHECK
Metering criteria in 413.1.ABC.1 have been met.
Transformer criteria in 413.1.ABC.2 have been met.
414.-----MOTORS--------------------------------------------------- -----
Motor efficiencies in 414.1.ABC.1 have been met.
415.-----LIGHTING SYSTEMS-ZONE 1---------------------------------------
Space Type No Control Type 1 No Control Type 2 No Watts Area(Sqft)
Type C(Mas
Toilet and
Material H
Parking Ar
1
2
1
1
On/Off
On/Off
On/Off
Programmable T
10 On/Off
2
2
2
Total Watts
Total Area
2 13775
150
1720
5000
for Zone 1
for Zone 1
Total Watts
Total Area
5272
108
1090
o
20645
6470
20645
6470
CHECK
Lighting criteria in 415.1.ABC have been met.
16. HVAC load sizing has been performed. (407.1.ABC.1)
17. Duct sizing and design have been performed. (410.1.ABC.1.2)
18. Testing and balancing will be performed. (410.1.ABC.4)
19. Operation/maintenance manual will be provided to owner. (102.1)
~~~
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60 Madison Avenue Memphis,TN 38103-2107 * (901)495-8756 * FAX (901) 495-8424
August 22, 1996
City of Zephyrhills
Building Department
5335 Eighth Street
Zephyrhills, FL 33540
Dear Sir:
We apologize for the confusion related to the free-standing sign foundation installation at
our new store in Zephyrhills.
AutoZone accepts the foundation as installed by the contractor, W. H. Bass. This
installation conforms to the design as submitted and approved under the permit.
Should you have any questions, please call me at (901) 495-8752.
Very truly yours,
AUTOZONE, INC.
~~~ xl&5#-
Constance Hickey Scott, P .E.
g'2t..,(;.
C!3NTRACTOH #=
NAME: W. H. BA::..:;S
r-lDDR: 5::':50 GAL.L BLVD.
C/$TI Z...HIIU:;
C E N T R ALP E R M I T TIN G DATE: 08/28/96
PASCO COUNTY. FLORIDA PAGE~ 1 OF 1
ISSUE OFFICE: D
RECEIPT NUMBR= 00294146
OFFICE: DADE CITY
FORI
CHECk: # CASH
RESC.
ACCNT
114
TOTAL AMOUNT:
COMPNY ACCOUNT CENTER
B450 - 363000 - 2
17.75
AMOUNT DESCRIPTION/PERMT DATA DRICR
17.75 ****** SOLID WASTE FEE 60
/
I :
RECE I VED BY __~::...~:ty.:..~._f.~~___._____._______,______
.~--- ~-_._-_...... ~ .~_.._.- --~ --.- -._- ----
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114
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PASCO COUNTY, FLORIDA
, -- ,) /-7 ) 1-',
Permit No, ~~I ,:<.....-I
,
Date Permitted _~~2 'l - 1 (~
Builder Name/Owner Name
-"~I
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'-'-.,-,.,.~,; I,,':<_~
County Parcel No.
,/ ./ ....
'~/ I -
" It,
,-' :'1/ ' />
,~-, ^:~)
Location
"",' ..r-'~
/)
Subd,
Classification/Type of Use
TRANSPORTATION IMPACT FEE CALCULATION
EXEMPT D
""~ '
~_./
.' "
Rate $
Zone No,
Sy, Ft./Unit
Impact Fee AmquHt"'$'
The above impact tee 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)
(,'J 170
Rate/ERU - 52.00/Year
or $0. I 42/Day
ERU Assign No.
Assessment - (No, Units) x ($0,142)
x (No, Days)
TOTAL FEE $ /7 1 (/
Assessment -
(GSF) x (ERU) x (0.142) x (No. Days)
100
TOTAL FEE $
The above assessment has been established pursuant to the Pasco County Ordinance No, 89-07 and Resolution No. 89-197,
as commended,
THE ASSESSMENT WILL BE CALCULATED AT THE TIME OF ISSUANCE OF THE CERTIFICATE OF
OCCUPANCY,
NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED UNTIL THE AMOUNTS LISTED
HA VE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY.
Acknowledgement below does not imply acceptance of concurrence, but simply receipt of a copy of this form, placing
the building permit owner on notice of this assessment and the conditions of payment for same.
Date
"
Received By
-----.---------------------------------------------------------------------------------------------------------------------------------------------
'1
OFFICE USE ONLY
TRANSPORTATION REC. NO.
RESOURCE RECOVERY REC. NO.
,'< ,c" /' '~~'i". ..
.
DATE
DATE
BY
BY
White
Applicant
Canary
Trans/Finance
Canary
RR/Finance
Pink
Office
Green
Bldgllnsp
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PC93113094/A