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Home My WebLink About97-6700 - . o--iJ rpRp- t () , B'UILDING PERMIT BUILDING !l~. crv ELECTRICAL CITY OF ZEPHYRHILLS (813) 788-6611 ~~rc.!J ZJ PLUMBING Permit N! - 67001l 'I gs<~U Date ~-- / - <7 > do. ov MECHANICAL Sewer Conn /.;;l /' g-. t:7z? , Water Conn: . =? <,'-z:> < (Ii:) ..1 (~. II'V~ ./~<O-V Property Owner: Job Address: b~ I Parcel I. D. # .;;J.. -:;),6 -~ -- o;;...:r 0 ... D CJ CJ G) - 0 c:> ~ 0 Zon;n9' .n"2 . . ~n Gav. .P.:l. :~- Desc"p~OnOfWo~,~ . _(]-t1. ~- . 1. ~""-\J ~-'L.$--:J - '7" ~ Y': t7'1 )1111 / - <; - /Oc'0.6 )1 i4( NO OCCUPANCY BEF T,LF.'s: FINAL Complete Plans, Specifications and Fee Must Accompany Application, All work shall be performed in accordance with City Codes and Ordinances. c.o. <::-.. Inspector II? Permit Fee .) ~~" . ~ro Signature lD.-) 'lz~ Company Address Telephone# Valuation or / '/ ,., Contract Price fn /., / <7 / c t:/7) City License Registration # State Certified License# -=~::;~1ff AJiAAi" BUILDING ELECTRICAL Ftr. S- /7/9'7 8dL Tp. Servo io Pre SLB$-23. '1'1 f5/LL Rough In 1/1" (1 tf(/l Lintel 10 I J:, /9 7 gfJiS Meter Can FRM. 8/L{(~7 H.(I- Const. Pole S/;;/97l9l Insul. CL Pool WL VLf h 7 /3; (C Pre-Meter t/Jl/c,~ r,,~ I I .1/ Final Driveway <=) /1' 1'7 (J. IL ~I:>o+t.r rsOf\J s-/ ~ /97 !?oK 5~€Ic'J).,.~, ,,') -1/7/17 I):f( , Jf..u~.d /..s -Y'b PLUMBING SLB 5//5/97 to>J Tub Set f 7/nf<i I 60lJ Water Sewer "/'1 /~ 7 B:O Final J~~~ '-S3 MECHANICAL Breakers Ducts Insl. tln /<; 7 t:..iJ , 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 ($15.00) shall be made for each trip for each trade: , /; . M~ ~ JI, -, ...$ --/-Y! a. Wrong Address ~V b. Condemned work resulting from faulty construction. Q c. Repairs or corrections not made when inspection called. ~. - 1} /) _ /1"- Ii d. Work not ready for inspection when called. ~ 0'. 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. M,A.F~-'-' r r< E ~_FC~'TF~' .i. "'f C: :\J!'_~i r~~ 'il-.r l () t h :~; 'TF?E l::-r p;")\ f, ,~-, ->, '-t,_1 ' [i l\ __ 1 T"~.', FL. ;:;,:~::!~::(~:-o!~ "7 .-_~. '_i ~, ~, ~'_ 1 .~.3:3, ~ C' I 'l'-'.~ !JF' '-', , ,\ '....'1. 1";-';:r .........: l;. -', ':.~ '~; J,:"'" F: ~ : " ''';~' , "'l t-: ~ ~._'! .'-. ..,....-:-., '''4 r--.,... , ! :"\'-,.", , .1 "_.J ,-,. , . . r-'! '1 l':t: :' '~;. c- 7:::'.:: "w!- (' '\." i -r >~ 1\ \/ ;'.~ CJ f'-~ .:~.: E: ~~ :\1 : F'EFi-: r T t"K:'''BER 6712 ~:JE GEE~'~ART CC!f~S1+RUCT10N~ ;["0 CjA~~CREST SUB[)IVlSION LOT ---:~ '-'~"'T~ 'f~~ i ,'~ .-..~ 'n I r'~F ;=lr:-.' >1 01-1 r INE \)/ r L L BE [.:iJ I \;C; ""T'r..-fE E L E c~'rR ! (:- BE REPLAC!N~~ ROGERS E~ECTR!,~. ('J"r\J~) LOT e F!ER:V! I T r'.J;_;MBE~' 6700 ARE PASCO 18735. STATE ~ERon13449. ZEPHYR~!ILLS CiTY NUMBER CiL;R C~[i !Jf\JT'! !\ ["Jr.:. :~;TA TE f\J ...iMB E R,~:, WE \i.i r L L [-;-':Af\lt,' Eq~:' 1[1, j'< L>l.. :F' 0~ p. O~~ .'.:::.: \)J!J ;<,:~ r-.; /\ f\) [) --::J ~3 ....", < l""\ J- :~, .i'. C, C ,.1 q :~;" f.' :"\ -~_? >-: E~ ~r tn1 '~:: :\""v "111. .t.ti"~ *~* ~,~.,~ ~I' ~ F Of f~O" .~ > '~" ~! : () :,'--1 SHIRlEY A TUCKER My ComrnI.alon CC4~23 ExpIr"Aug.30,1888 LiJ S' ; [) /. ~~ "i~:; ~.~; ~\.1 i'4. L~_" .- :< ~,1 r~; VJr~ r'IE r f'\Fr\l~' i F [C',A -r 1 C);\] Department of Community Affairs FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION FORM 600A-93 'Residential comronent Prescriptive Method A PROJECT NAME: Model1748 BUILDER:~ebha t , AND ADDRESS: PERMITTING I CLIMATE ../ IA OFFICE: ZONE: 41~1 5~ 6/_/ OWNER: Gebhart PERMIT NO., 7 tJ 0 JURISDICTION NO. 6/1 b6 0 CK New Construction ~ Single-Family ____ o 0 ?- ~ --,,;:;;- 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. Porcq overhang length (ft.) 8. Glass area and type: a. Clear Glass b. Tint, film or solar screen 9. Floor type and insulption: 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 CENTRAL 1. 2. 3. 4. 5. 1748.00 6. 1. 00 7. 5.40 Single Pane 8a.177.0sqft 8b. O. Osqft Double Pane O.OOsqft ........-- O.OOsqft ~ 9a.R= 0.00 , 194.00 ft ~ 10a-1 R= 5.00, 1155.00sqft / 10a-2 R=11.00, 164.00sqft ~/ 11a.R=30.00 , 1748.00sqft ~" 12a. R= 6.00, uncond 13. Type: Central A/C EER: 10.00 14. Type: Heat Pump HSPF: 7.00 15. Type: Electric EF: 0.90 L,..-/ y:r- [,./ {./ ~ J;7'- --z;r- 0- 16. 17. 18. 1 .,/' ~' 19. 19a. 19b. L// ~ -V- 92.83 31543.71 33978.68 ------------------------------------------------------------------------------- -----------------------------------------------------------------~------------- Review of the p~ans and specifications covered by this calculation indicates compliance with' the Florida Energy Code. Before construction is completed this building will be inspected for compliance in accordance with Section 553.908 F.S. I Hereby certify that the plans and specifications covered by this calcu- lation are in co 'ance with the Florida Energy PREPARED BY: DATE: I hereby certify that this building is in compliance with the Florida Energy Code. OWNER/AGENT: DATE: COMPONENTS ** INFILTRATION REDUCTION PRACTICE COMPLIANCE CHECKLIST ** ~=======================================================~====================== SECTION REQUIREMENTS FOR EACH PRACTICE CHECK =============================================================================== PRACTICE #1 606.1 COMPLY WITH ALL INFILTRATION PRESCRIPTIVES. ------------------------------------------------------------------------------- Windows 606.1 Exterior & Adjacent Doors --------------------------------------------------------~---------------------- Maximum of 0.34 CFM per linear foot of operable sash crack (includes sliding glass doors). 606.1 Maximum of 0.5 CFM per sq. ft. of door area: solid core, wood panel,insulated or glass doors only. Exterior Joints' & Cracks ------------------------------------------------------------------------------- To be caulked, gasketed, weather-strippeq or other- wise sealed. 606.1 ------------------------------------------------------------------------------- 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 ------------------------------------------------------------------------------- Water flow must be restricted to no more than 3 gal- lons per minute at 80 PSIG. ------------------------------------------------------------------------------- HVAC Duct Construction Insulation & Installation 612.1 610.1 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 604.1 602.1 ------------------------------------------------------------------------------- Ceilings minimum R-19. Common Walls - Frame R-11 or CBS R-3 both sides. Common ceiling & floors R-11. SUMMER CALCULATIONS . ******************************************************************************* ******************************************************************************* --- BASE --- --- AS-BUILT --- =============================================================================== GLASS-----------_____ I ORIEN AREA x BSPM = POINTS TYPE SC ORIEN AREA x SPM x SOF = POINTS ------------------------------------------------------------------------------- N 6.00 82.2 493.2 SGL CLR N 6.0 51.0 .72 220.3 E 74.00 82.2 6082.8 SGL CLR E 15.0 109.2 .58 950.0 SGL CLR E 15.0 109.2 .58 950.0 SGL CLR E 12.0 109.2 .58 760.0 SGL CLR E 6.0 109.2 .58 380.0 SGL CLR E 6.0 109.2 .58 380.0 SGL CLR E 20.0 109.2 .58 1266.7 SE 6.00 82.2 493.2 SGL CLR SE 6.0 112.9 .49 331. 9 S 4.00 82.2 328.8 SGL CLR S 4.0 . 100.2 .45 180.4 W 81. 00 82.2 6658.2 SGL CLR W 36.0 109.2 1.00 3931.2 SGL CLR W 3.0 , 109.2 .26 85.2 SGl. CLR W 3.0 109.2 .26 85.2 SGL CLR W 3.0 109.2 .26 85.2 SGL cut W 36.0 109.2 .58 2280.1 NW 6.00 82.2 493.2 SGL CLR NW 6.0 77.2 .63 291.8 ------------------------------------------------------------------------------- .15 x CONDo FLOOR I TOTAL GLASS = ADJ. x GLASS = AREA AREA FACTOR POINTS ADJ GLASS POINTS GLASS POINTS ------------------------------------------------------------------------------- .15 1,748.00 177.00 1. 481 14,549.40 21,552.84 I 12,178.11 NON GLASS----------__ I AREA x BSPM = POINTS TYPE =============================================================================== ------------------------------------------------------------------------------- R-VALUE AREA x SPM = POINTS WALLS---------_______ Ext 1155.0 1.0 1'155.0 Ext NormWtBlock In 5.0 1155.0 1.00 1155.0 Adj 164.0 .7 114.8 Adj Wood Frame 11.0 164.0 .70 114.8 DOORS--------________ Ext 44.0 4.8 211.2 Ext Insulated 20.0 4.80 96.0 Ext Insulated 12.0 4.80 57.6 Ext Insulated 12.0 4.80 57.6 Adj 20.0 1.6 32.0 Adj Wood 20.0 2.40 48.0 CEILINGS-----~------- UA 1748.0 .6 1048.8 Under Attic 30.0 1748.0 .60 1048.8 FLOORS--------~______ SIb 194.0 -31. 8 -6169.2 Slab-on-Grade .0 194.0 -31. 90 -6188.6 INFILTRATION-----____ 1748.0 10.9 19053.2 Practice #1 1748.0 13.80 24122.4 TOTAL SUMMER POINTS I 36,998.64 =============================================================================== TOTAL x SUM PTS =============================================================================== SYSTEM = MULT 32,689.71 ------------------------------------------------------------------------------- COOLING I TOTAL POINTS COMPON x CAP x DUCT x SYSTEM x CREDIT = COOLING RATIO MULT MULT MULT POINTS 36,998.64 .37 13,689.50 I 32,689.71 1.00 1.100 .340 1.000 12,225.95 =============================================================================== ******************************************************************************* WINTER CALCULATIONS ******************************************************************************* --- BASE --- --- AS-BUILT --- =============================================================================== GLASS------------____ I ORIEN AREA x BWPM = POINTS TYPE SC ORIEN AREA x WPM x WaF = POINTS ------------------------------------------------------------------------------- N 6.00 -3.4 -20.4 SGL CLR N 6.0 9.6 1.18 68.0 E 74.00 -3.4 -251. 6 SGL CLR E 15.0 -2.2 -1.48 48.8 SGL CLR E 15.0 -2.2 -1.48 48.8 SGL CLR E 12.0 -2.2 -1.48 39.1 SGL CLR E 6.0 -2.2 -1. 48 19.5 SGL CLR E 6.0 -2.2 -1.48 19.5 SGL CLR E 20.0 -2.2 -1. 48 65.1 SE 6.00 -3.4 -20.4 SGL CLR SE 6.0 -10.3 .22 -13.6 S 4.00 -3.4 -13.6 SGL CLR S 4.0 -10.9 .13 -5.7 W 81.00 -3.4 -275.4 SGL CLR W 36.0 -2.2 1.00 -79.2 SGL CLR W 3.0 -2.2 -5.04 33.3 SGL CLR W 3.0 -2.2 -5.04 33.3 SGL CLR W 3.0 -2.2 -5.04 33.3 SGL CLR W 36.0 -2.2 -1. 48 117.2 NW 6.00 -3.4 -20.4 SGL CLR NW 6.0 7.4 1.35 59.9 ------------------------------------------------------------------------------- .15 x CONDo FLOOR I TOTAL GLASS = ADJ. x GLASS = AREA AREA FACTOR POINTS ADJ GLASS POINTS GLASS POINTS --------------~~-----------------------------------------~--------------------- .15 1,748.00 177.00 1.481 -601. 80 -891.48 I 487.40 NON GLASS----------__ I AREA x BWPM = POINTS TYPE =============================================================================== ------------------------------------------------------------------------------- R-VALUE AREA x WPM = POINTS WALLS--~------------- Ext 1155.0 1.1 1270.5 Ext NormWtBlock In 5.0 1155.0 2.90 3349.5 Adj 164.0 1.8 295.2 Adj Wood Frame 11.0 164.0 1.80 295.2 DOORS----------______ Ext 44.0 5.1 224.4 Ext Insulated 20.0 5.10 102.0 Ext Insulated 12.0 5.10 61.2 Ext Insulated 12.0 5.10 61.2 Adj 20.0 4.0 80.0 Adj Wood 20.0 5.90 118.0 CEILINGS-------___~-- UA 1748.0 .6 1048.8 Under Attic 30.0 1748.0 .60 1048.8 FLOORS---------______ SIb 194.0 -1.9 -368.6 Slab-on-Grade .0 194.0 2.50 485.0 INFILTRATION--~~----- 1748.0 4.1 7166.8 P:J:'actice #1 1748.0 6.20 10837.6 TOTAL WINTER POINTS I 8,825.62 =============================================================================== TOTAL x WIN PTS ' =============================================================================== 16,845.90 SYSTEM = MULT HEATING I TOTAL POINTS COMPON x CAP x DUCT x SYSTEM x CREDIT = HEATING RATIO MULT MULT MUL~ POINTS ------------------------------------------------------------------------------- 8,825.62 1.10 9,708.18 I 16,845.90 1.00 1.100 .484 1. 000 8,968.76 =============================================================================== WATER HEATING ******************************************************************************* ******************************************************************************* === BASE === === AS-BUILT === NUM OF BEDRMS =============================================================================== x MULT = TOTAL I TANK VOLUME EF TANK RATIO x MULT x CREDIT MULT = TOTAL ------------------------------------------------------------~------~----------- 3 " 3527.0 10,581.00 I 40 .90 1. 000 3449.7 1.00 10,349.00 =============================================================================== SUMMARY ******************************************************************************* ******************************************************************************* , === BASE === === AS-BUILT =~= COOLING POINTS =============================================================================== + HEATING POINTS HOT WATER + POINTS = TOTAL I COOLING POINTS POINTS + HEATING POINTS HOT WATER + POINTS = TOTAL POINTS ------------------------------------------------------------------------------- 13689.5 9708.2 10581.0 33,978.68 I 12226.0 8968.8 10349.0 31,543.71 =============================================================================== ***************** * EPI = 92.83 * ***************** For detailed information of the ~PI rating number or for any ITEM listed, ask your Builder for DCA Form 600A-93 or Form 600B-93 ENERGY GUIDE EPI= 92.8 o 10 20 30 40 50 60 70 80 90 100 I-------------------------------------x---I The maximum allowable EPI is 100. The lower the EPI the more efficient the home RESIDENTIAL ENERGY PERFORMANCE RATING SHEET ITEM HOME VALUE Low Efficiency High Efficiency WINDOWS.....................Single Clear SINGL CLR DBL TINT Ix-------------------_I INSULATION. . . . ,. ,. . . . . . . . . . . . . Wall R-Value......... 5.7 R-10 R-30 I--------------------xl R-O R-7 I----------------x----I R-O R-19 Ix------------------__I Ceiling R-Value......... 30.0 Floor R-Value......... 0.0 AIR CONDITIONER............. SEER/EER.................. 10.3 10.0 SEER 17.0 Ix-----------------___I 9.7 EER 16.0 HEATING SySTEM.............. Electric COP/HSPF........ 7.0 6.8 HSPF 12.0 Ix-----------------___I 0.78 AFUE 0.90 1---------------------1 Gas AFUE..~......... 0.00 WATER HEATER................ Electric EF.............. 0.90 0.88 0.96 I----x---------------_I 0.54 0.90 1---------------------1 0.40 0.80 1---------------------1 Gas EF~~............ 0.00 Solar EF.............. OTHER FEATURES.............. . . . . . . . .' . . . . . . . . . . . . . . . . . . . . I certify that these energy saving features required for the Florida Energy Code have been installed in this house. Builder Signature: Date: Address: City/zip Florida Energy Code for Building Construction _ 1993 Florida Department of Community Affairs FL-EPL CARD93 BUILDER: Gebhart ConsInJctlon ADDRESS: 6851 08kcrest Way OWNER: SQ. FT. PRICE LMNG OR MAIN AREA:J 1,748 I $ 35.00 I OTHER AREA UNDER ROOF:~ 547 ~ $ 11.00 , OTHER:t 0 I $ 11.00 ~ SQUARE FEET UNDER RooF:1 2.295 ~ VALUATION:J $ 67,197.00 , ADDRESS:t $ 20.00 , DRIVEWAy:t $ 20.00 I FEES:1 $ 337.00 , BLDG. PLUMB. ELEC. MECH. PERMIT FEES:t $ 485,50 I $ 62.50 t $ 72.00 f $30.00 I 314. 1. 'Z' WATER METER SIZE:' $ X 180.00 I $ 250.00 , $ 650.00 I $ 875.00 f SEWER WATER METER CONNECTION FEES:t $ 1,278.00 t $ 350.00 , $ 180.00 ~ RADON GAS:' $ PERMIT FEES:t $ CONNECTION FEES:1 $ WATER METER:t $ 22.95 , 650.00 , 1,628.00 I 180.00 , TRANSPORTATION IMPACT FEES: 99% 1% $ 1,480.00 $ 1.465.20 $ 14.80 CREDlT:t $ 60.00 , SUB-TOTAL' $ 3,960.95 f IRRIGATION METER I $ 180.00 I TOTAL' $ 4,140.95 r Gebbart Construction, /nc. at Oak Crest &tates /p~g;~aJ,yf'(!~ March 28, 1997 This is to advise the Zephyrhills Building Department that The Oak Crest Estates Architectural Review Committee has reviewed the building plans submitted by Gebhart Construction Inc. for the model home to be constructed on lot 8, Oak Crest Estates phase I. Respectfully Submitted, ~;tP'~ G.L. St e g, 38719 Evelyn Ln. . ZephyrhiIls, FL 33540 Phone: (813) 782-1743 . St. Lie. #RB0021583 flA. 1977 LAW. FI 713.13 NOTICE OF COMMENCEMENT 11111111111I11111 11111 1111I11111 1111I11111 11111111 97037341 SEMINOLE FORM 408 State of Florida } County of \ The undersigned hereby informs all concerned that improvements will be made to certain real property, and In accordance with section 713.13 of the Florida Statutes, the following informetion Is stated in this NOTICE OF COMMENCEMENT. '.......ARK IN DUPL'CATK. . . Lot 8, Oak Crest Estates Phase One Oescllptlon of property .,.....,..,...................,......,....,...,..........,..."..........,..,......,.""......,.,.,."., , . , , . ,02 -:-.2.6:-: 2,:t..-: 0, 2.~ P:-. O.Q Q 9,Q::Q9.~ P . . . . . . . . . . . . . . . , . . , . . , . , , : . , , . . . . Rcpt: 144127 Rec: 05: 0.00 IT: 04/04/97 6.00 0.00 DptV Clerk "0 .0....0..................0.0 "0 ........................0.0 .0..0.0.0.0. .0. ..0. .........0.... ......"...... ........ ........ ...... General description of improvements......,..... N~~. .<;~~.~.~~~S.~ ~.C;>.I?-,,:-...~ ~.~,~.~~. ,~~~~.~!, .:.E7~ ~,~.E7~C:=.~".... R',' Owner.., .Gebhart. .CQns.t.r:\i.C.t.i.9.Q.......,..,.".,.,..,..."...,..". ~~~}~~; l~A;CO 1 ~~Np CLERK.. . 14353 ~lst St. OR BK 3722P PG B69 Address . .Da de. C ~ t,y,,. . .F.1, . 3.3523. . . . . , . . , , . . , . . . . . . . . . . , , . . . , . , , , , . , . , , , , , . , . . . . . . , . . . . . . , . . . , .{. . , , . . . . , , . . . . . , , . . , , , . Owner's interest in site of the improve",ent . , . . . . . . . , , , . . , . . . , . . . . . , . , , . , , . . , . . , . . . . . . , . , . . . . , . . , . . . , . . . . . . , , . . . . . . , . . , , . . . , . . . , Fee Simple Title holder (If other than owner) Name ,.....,......,.,....,...,......,......,...,...,....."..,.,..".,..,',....,..,..,........,....,.,.....,..,.......",..".. Address ...,.,",.....,...,....,...,',..,.,.,...,.,..,.,."...,...,......,.....,....................,.,...,.......,...."".,.., Contractor, .<;;.~?~.<:i.~~. .<;.'?~~.~:r:~C::.~.~~I!.. ~~,<?~...,...,..",..,.,.."."............,."..,..",...,......,......,.,.,., Address.,. '~':~~'~'ctf.j.;. '~}" 3.3.523.....'.'...'.'.'.' .\,.. ':""',..,..,..,...,..,.......,..."....,.,.,.....,.......,.. Surety (if any) . Was.tarn.. Surety..,."...,..,.."...,.",......",...,.,...".....",.."..,..,.....,..,.,...,."..".... ,I Address .,....,...................,........,...".,..,.."...,..,.,.,..,....,...,..,....,....., Amount of bond $ . 5 00,0... OQ, . Any person making a loan for the construction of the improvements: Name ......,.,...,..'.,........",.........".,..,.,....,.,,.,.."..,',..,.,....,.....,.,......,...".",......,........."...,. Address ..".....................,',."........,..,""",..,..,..,....,............,.......,..."..,.".".""...,...,....,." Person within the State of Florida designated by owner upon whom notices or other documents may be served: Name ..."...,...,...,.......",....,....,.."...".,...,....,"',..,......,...,.....,....",.,.,.,."...,....,.........,.,.,.. Address .,..................,',..,..,...,......,..,.,.",...,..,..,.,.".,.,..".............,..",...".".".".."......,..,. In addition to himself. owner designates the following person to receive a copy of the lienor's Notice as provided in Section .713.13 (1) (h). Florida Statutes. (Fill in at Owner's option). Name ........................................ .....-...-...................................................................................... 3T,t~TE C~ n..C"':";;DA ~i\~ ~ CDLif'rr'/ OF F}\'?:~O .. TH:S is TO W>i ;/;'7 TFt fiJ~tG0WG ~ ~ ~ ~;,'~~f~;.:;:,~;;:;' 'y,";~]:.~~~;,:~;,F~~; -~ ~,,_____~, ;.).+':1.-. :~2Y)~':'" D,e Department of Community Affairs FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION FORM 600A-93 Residential com/onent Prescriptive Method A PROJECT NAME: Model ":7 BUILDER: p~lt..;;.tJt, , AND ADDRESS: 6 go --5...../ (). ~ PERMITTING CLIMATE . / ~ C OFFICE: ZONE: 41~, ~ 61_1 OWNER: G EeH ~tt..~ ~ o..v$"t. Qo.:14v<.... PERMIT NO.6 '/00 13 JURISDICTtON NO.6 /1 b ~ 0 CK ~ t/ t<J/ ~ Double Pane../ O.OOsqft v O.OOsqft -0 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) II.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 ~ater 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 10a-l R= 5.00, 1163.00sqft /' 10a-2 R=II.00, 148.00sqft ~ lla.R=30.00 , 1748.00sqft ~ V ~ -V -,;r- --;;:::r -;;:r- -V ~ ,/ 1- 1. 2. 3. 4. 5. 1748.00 6. 1. 00 7. 5.40 Single Pane 8a.177.0sqft 8b. O.Osqft New Construction Single-Family o 9a.R= 0.00 , 194.00 ft 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. 1 SN: 6096 CENTRAL / z/' ~. ------------------------------------------------------------------------------- , 19. 19a. 19b. 92.86 31532.13 33955.49 ------------------------------------------------------------------------------- I Hereby certify that the plans and specifications covered by this calcu- lation are in compliance with the Florida Energy C e. ~/~ Review of the plans and specifications covered by this calculation indicates compliance with the Florida Energy Code. Before construction is completed this building will be inspected for compliance in accordance with Section 553.908 F.S. PREPARED BY: DATE: I hereby certify that this building is in compliance with the Florida Energy Code. OWNER/A~ENT: ~~~ DATE: ,1/~/<? 7 tV ~~ii~INJ;2f%7AL: ~~- COMPONENTS ** INFILTRATION REDUCTION PRACTICE COMPLIANCE CHECKLIST ** =============================================================================== SECTION REQUIREMENTS FOR EACH PRACTICE CHECK ==================~============================================================ PRACTICE #1 606.1 COMPLY WITH ALL INFILTRATION PRESCRIPTIVES. ------------------------------------------------------------------------------- Windows 606.1 Exterior & Adjacent Doors ------------------------------------------------------------------------------- Maximum of 0.34 CFM per linear foot of operable sash crack (includes sliding glass doors). 606.1 Maximum of 0.5 CFM per sq. ft. of door area: solid core, wood panel, insulated or glass doors only. Exterior Joints & Cracks ------------------------------------------------------------------------------- To be caulked, gasketed, weather-stripped or other- wise sealed. 606.1 ------------------------------------------------------------------------------- Water Heaters ** OTHER PRESCRIPTIVE ~ASURES (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 ------------------------------------------------------------------------------- Water flow must be restricted to no more than 3 gal- lons per minute at 80 PSIG. ------------------------------------------------------------------------------- HVAC Duct Construction Insulation & Installation 612.1 610.1 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 ------------------------------------------------------------------------------- Separate readily accessible manual or automatic thermostat for each system. 607.1 Insulation ------------------------------------------------------------------------------- 604.1. 602.1 ------------------------------------------------------------------------------- Ceilings minimum R-19. Common Walls - Frame R-11 or CBS R-3 both sides. Common ceiling & floors R-11. ****************~~~~***~******************************************************* SUMMER CALCULATIONS ******************************************************************************* --- BASE --- I --- AS-BUILT --- =============================================================================== g~~i~--~;;~-~-;~;~-:- POINTS I TYPE SC ORIEN AREA x SPM x SOF = POINTS N E 6.00 74.00 493.2 6082.8 ------------------------------------------------------------------------------- 82.2 82.2 SE S W 6.00 4.00 81.00 82.2 82.2 82.2 493.2 328.8 6658.2 NW 6.00 493.2 ------------------------------------------------------------------------------- 82.2 SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR N E E E E E E SE S W W W W W NW 6.0 15.0 15.0 12.0 6.0 6.0 20.0 6.0 4.0 36.0 3.0 3.0 3.0 36.0 6.0 .15 x CONDo FLOOR / TOTAL GLASS = ADJ. x GLASS = , AREA AREA FACTOR POINTS 51.0 109.2 109.2 109.2 109.2 109.2 109.2 112.9 100.2 109.2 109.2 109.2 109.2 109.2 77.2 ADJ GLASS POINTS .72 .58 .58 .58 .58 .58 .58 .49 .45 1.00 .26 .26 .26 .58 .63 220.0 946.8 946.8 757.4 378.7 378.7 1262.4 330.4 179.6 3931.2 85.2 85.2 85.2 2272.3 291.1 GLASS POINTS .15 177.00 ------------------------------------------------------------------------------- 12,150.93 1,748.00 1. 481 14,549.40 21,552.84 I ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- NON GLASS------------. I AREA x BSPM = POINTS TYPE R-VALUE AREA x SPM = POINTS ------------------------------------------------------------------------------- WALLS---------------- Ext 1163.0 1.0 1163.0 Ext NormWtBlock In 5.0 1163.0 1.00 1163.0 Adj 148.0 .7 103.6 Adj Wood Frame 11.0 148.0 .70 103.6 DOORS---------------- Ext 44.0 4.8 211.2 Ext Insulated 20.0 4.80 96.0 Ext Insulated 12.0 4.80 57.6 Ext Insulated 12.0 4.80 57.6 Adj 20.0 1.6 32.0 Adj Wood 20.0 2.40 48.0 CEILINGS------------- UA 1748.0 .6 1048.8 Under Attic 30.0 1748.0 .60 1048.8 FLOORS--------------- SIb 194.0 -31.8 -6169.2 Slab-on-Grade .0 194.0 -31. 90 -6188.6 INFILTRATION--------- 1748.0 10.9 19053.2 Practice #1 1748.0 13.80 24122.4 TOTAL SUMMER POINTS . I 36,995.44 =============================================================================== TOTAL x SUM PTS SYSTEM = MULT ===========================================~=================================== 32,659.33 COOLING I TOTAL POINTS COMPON x CAP x DUCT x SYSTEM x CREDIT = COOLING RATIO MULT MULT MULT POINTS 36,995.44 ------------------------------------------------------------------------------- .37 ,13,688.31 I 32,659.33 1.00 1.100 .340 1.000 12,214.59 =============================================================================== ******************w************************************************************ WINTER CALCULATIONS ******************************************************************************* --- BASE --- I --- AS-BUILT --- =======================================================~======================= ~~~i~--~;;~-~-~;;;-:- POINTS I TYPE SC ORIEN AREA x WPM x WOF = POINTS N E 6.00 74.00 -20.4 -251. 6 ------------------------------------------------------------------------------- -3.4 -3.4 SE S W 6.00 4.00 81.00 -3.~ -3.4 -3.4 -20.4 -13.6 -275.4 NW 6.00 -3.4 -20.4 ------------------------------------------------------------------------------- SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR SGL CLR N E E E E E E SE S W W W W W NW 6.0 15.0 15.0 12.0 6.0 6.0 20.0 6.0 4.0 36.0 3.0 3.0 3.0 36.0 6.0 .15 x CONDo FLOOR I TOTAL GLASS = ADJ. x GLASS = AREA AREA FACTOR POINTS 9.6 -2.2 -2.2 -2.2 -2.2 -2.2 -2.2 -10.3 -10.9 -2.2 -2.2 -2.2 -2.2 -2.2 7.4 ADJ GLASS POINTS 1.18 -1.50 -1.50 -1.50 -1.50 '"'1.50 -1.50 .21 .12 1.00 -5.04 -5.04 -5.04 -1.50 1.35 68.0 49.4 49.4 39.6 19.8 19.8 65.9 -13.2 -5.3 -79.2 33.3 33.3 33.3 118.7 60.0 GLASS POINTS .15 177.00 ------------------------------------------------------------------------------- 492.60 1,748.00 1.481 -601. 80 -891.48 I =============================================================================== NON GLASS------------ I AREA x BWPM = POINTS TYPE R-VALUE AREA x WPM = POINTS ------------------------------------------------------------------------------- WALLS---------------- Ext 1163.0 1.1 1279.3 Ext NormWtBIQck In 5.0 1163.0 2.90 3372.7 Adj 148.0 1.8 266.4 Adj Wood Frame 11.0 148.0 1.80 266.4 DOORS---------------- Ext 44.0 5.1 224.4 Ext Insulated 20.0 5.10 102.0 Ext Insulated 12.0 5.10 61.2 Ext Insulated 12.0 5.10 61.2 Adj 20.0 4.0 80.0 Adj Wood 20.0 5.90 118.0 CEILINGS------------- UA 1748.0 .6 1048.8 Under Attic 30.0 1748.0 .60 1048.8 FLOORS--------------- SIb 194.0 -1.9 -368.6 Slab-on-Grade .0 194.0 2.50 485.0 INFILTRATION--------- 1748.0 4.1 7166.8 Practice #1 1748.0 6.20 10837.6 =============================================================================== TOTAL WINTER POINTS I 8,805.62 16,845.50 TOTAL x WIN PTS SYSTEM = MULT =============================================================================== HEATING I TOTAL POINTS COMPON x CAP x DUCT x SYSTEM x CREDIT = HEATING RATIO MULT MULT MULT POINTS 8,805.62 1.10 ------------------------------------------------------------------------------- 8,968.54 9,686.18 I 16,845.50 1.00 1.100 .484 1. 000 =============================================================~================= *****************.~****i******************************************************* WATER HEATING ******************************************************************************* === BASE === === AS-BUILT === =============================================================================== NUM OF BEDRMS x MULT = TOTAL I TANK VOLUME EF TANK RATIO x MULT x CREDIT MULT = TOTAL ------------------------------------------------------------------------------- 3 3527.0 10,581.00 I 40 .90 1.000 3449.7 1.00 10,349.00 =================================================~============================= ******************************************************************************* SUMMARY ******************************************************************************* === BASE === === AS-BUILT === COOLING POINTS =============================================================================== + HEATING POINTS HOT WATER + POINTS = TOTAL I COOLING POINTS POINTS + HEATING POINTS HOT WATER + POINTS = TOTAL POINTS ------------------~------------------------------------------------~----------- 13688.3 9686.2 10581.0 33,955.49 I 12214.6 8968.5 10349.0 31,532.13 =============================================================================== ***************** * EPI = 92.86 * ***************** For detailed information of the EPI rating number or for any ITEM listed, ask your Builder for DCA Form 600A-93 or Form 600B-93 ENERGY GUIDE EPI= 92.9 , 0 10 20 30 40 50 60 70 80 90 100 I-------------------------------------x---I The maximum allowable EPI is 100. The lower the EPI the more efficient the home RESIDENTIAL ENERGY PERFORMANCE RATING SHEET ITEM HOME VALUE Low Efficiency High Efficiency WINDOWS.....................Single Clear SINGL CLR DBL TINT Ix--------------------I INSULATION. . . . . . . . . . . . . . . . . . Ceiling R-Value......... 30.0 R-10 R-30 I--------------------xl R-O R-7 I----------------x----I R-O R-19 Ix--------------------I Wall R-Value......... 5.7 Floor R-Value......... 0.0 AIR CONDITIONER............. SEER/EER.................. 10.0 10.0 SEER 17.0 Ix--------------------I 9.7 EER 16.0 HEATING SySTEM.............. Electric COP/HSPF........ 7.0 6.8 HSPF 12.0 Ix--------------------I 0.78 AFUE 0.90 1---------------------1 Gas AFUE............ 0.00 WATER HEATER................ Electric EF.............. 0.90 0.88 0.96 I----x----------------I 0.54 0.90 1---------------------1 0.40 0.80 1---------------------1 Gas EF.............. 0.00 Solar EF.............. OTHER FEATURES.............. . . . . . . . . . . . . . . . . . . . . . . . . . . . . I certify that these energy saving features required for the Florida Energy Code have b~en installed in this house. Builder Signature: Date: Address: City/Zip Florida Energy Code for Building Construction - 1993 Florida Department of Community Affairs FL-EPL CARD93 APPLICATION FOR PERKlT CITY OF ZEPIIYRBILLS BUILDING DEPARTHENT f ' ?K;O'trU OWNER'S IWtE ~E~~<<t Gf'l <)~e.:,h'c-JL/~. PHONE 6~ - b 702-- OWNER'S ADDRas-Lt '6 S~ ~ \ " t S~. 17ct j) c.. C;\t-L, ~\. \ JOB ADDRESS (,r.. ~ I eh K (.J2e <; -\ (~) Drf 1 ? f(( h\j~ Vi.d \ LEGAL DESCRIPTION: LOT(S) ~ BLOCK SUBDIVISION CC) PARCEL IoD.' 0 - t?\ .- C,~otl ~c:c<.<.C , '-0080 WORK PROPOSED: V'New Construction ---..Addition --Alteration --.Jtepair _Insta11 _Sign --1Iove -1)eaolish / PROPOSED USE: _Single Faaily ----.Jt/F _' of Units ----.Jt/H _ec-ercial _Iodust. _Swia. Pool _Other Restaurant Ii: Health Departaent Approval DESCRIPTIOB OF WORK: (1'\0 i) (,,\ ~ (:, (1\ e- BUILDING SIZE: 5(/ X 5;)',1, ~~C)'S Square Feet, 9.lllf II Height RESIDEIITIAL: ATTACH (2) PLOT PLABS Ii: (2) SETS OF BUILDING PLANS Ii: (1) SET BRBRGY FORHS. COMKERCIAL: ATTACH (3) SETS OF BUILDING PLANS Ii: (1) SET ENERGY FORHS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REQUESTED LaUlLDING t/ RI.I~cnuCAL -LJmCIIANICAL -LPLUKBING $ &~ 9~;/O, ('; () , Valuation of Total Construction ?\o~ AIIP Service V' Florida Power Corp. W.R.E.C. $ <^'1' \i () Valuation of tlecbanica1 Insta1lation GAS V ROOFING SPECIALTY TYPE OF mBSTllucnoB: -block _Fraae _Steel Other FIBISBED FLOOR. ELEVAnOBS: Fl. IS PROJECl IB FLOOD ZONE AREA? /' .......................................... YES NO COBTRACfOR SECTION' rl ,", n ,- BUTT.DER ~ t\~ Ire COtIPANY C~~~'HCUt+ "-6N~(I.,t~~ ,~c:. / (~ .ovcr-' ' State Cert. or Regist.' f-...~ ~j(~ V Signature ')..j ~ City License Registration' 1/7 / ~~,......~......~.~...:....:......:~.~ " \' 3~ P ~HPANY -r&r(rf' IlL~i' /'YIkrh},j ~/~ / " , State Cert. or Regist.' El"l..,ptT { l. l..ll V SilmJlture City License Registration' <? Ii f ' .......................................... PL_ ~ COHPAIIY (; P lAm loll'! ~ State Cert. or haist. f Signature ' City License Registration . ......... . ............................ IIBCllANICAL ~',\.. , COMPANY S' a:..FT r\E,<.....\,.. C C }-L- -f-' C'" \' E ~\ / J. .A V . "/ State Cert. or Regist.' ,:z fv\.80 J ~ G d-;,.)- Siaoature J . 1L.-1Z,_~ City Licease _iB~atiOD f S"' '~o"" ~~!.....~ .......................................... OTIIRR.. ~ COHPAIIY ~f<3~.ct Q"',,-{fU.C+.'''''' S-i<.<:', - ~;;;1 , " State Cert. or Regist.' Rf!, C' ()~ , c:- R'-3 Signature ' ~ '- - \ City License Registration' } /1 ' '.......... ............................... APPLICAnON APPROVED BY PBRHIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIOJ(S fbe undersigned understancls that tbis perIIit tay be subject to "deed restrictions I Ibich tay be lOre restrictive than eltJ regulations. !be undersigned as&1IIeB responsibility for cmpliance litb any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND eONTRACTOR RESPONSIBILITIES If the OIIJIer bas bired a contractor or contractors to undertake IIOrt, they tay be required to be llcensed In accorc1ance 11th state and local regulations. ~f the contractor Is not licensed as required by law, both the 0IIIIeI and contractor tay be cited for a Ilsclell!anor violation 'under 'state lal. If the O101er or Intended contractor are uncertain as to .bat licensing requirl!ll!llu tay apply for the intended IIOrt, they are advised tq contact t;beCity of Zepbyrbills Building Departlent, (813) 788-6611. FurtherlOre, if the OIIJIer bas bired a contractor or contractors, be Is advised to bave the contractor(s) sign portions of the "Contractor Secti_" of this applicatioo for wbich they ,ill be responsible. If JOU, as the 0IIIleI sign as the contractor, you are indicating that you, rather than the contractor, are responsible for tbe IIOrt. If the cootractor .ilbes you to sign as contractor that tay be an indication that be is not properly licensed and Is not entitled to penitUng privileges in tbe 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 ,itb a copy of "'lorida's Construction Lien Law - lkIIeoImer's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsUIeI Affairs. If the applicant is sueone other than the "OIDer", I certify that I bave obtained a copy of the above described doc1ment and pIOlise in good faith to deliver it to the "owner" prior to COII8DCl!ll!llt. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the infoIliltion in this application is accurate and that all IIOrt will be clone in co.pliance 11th all applicable laws regulating construction, zoning, and land developHDt. Application Is hereby tade to obtain a peIlit ~ clo IIOrt and installation as indicated. I certify that no IOrt or installation baa ~ced prior to issuance of a perlit and that all IIOrt will be perf ODed to .et atanc1arcla of all lau regulating construction, City codes, zoning regulations, and land developllent regulations in the jurisdiction. I also certify tbat I understand tbat the regulations of other goveruental agencies tay apply to the intendecJ 1IOI1, and that it is IY responsibility to identify wbat actions I lUst take to be in cotpliance. Such agencies include but are not lilited to: t Departlent of EnvirOJllelltal Regulation - Cypress Baybeads, Wetland Areas and Envirolllelltally Sensitive Lands, Water ,Wastewater !reatlent t Southwest Florida Water Hanagetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses t AIIY COIPS of Engineers - SeawallS, Docks, Kavigable WateI1lays t Departlent of Healtb , Rehabilitative Senices, EnvirODl8Dtal Health Unit - Wells, Wastewater !reatleDt, Septic tanks * US EnviIODl8l1tal Protection Agency - Asbestos abatell!llt 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 "COIp8Il8ating volute" ,ill be saiUed wbieb is prepared by a professional engineer registered in the State of Florida prior to peIlit issuance. A pertit issued &ball be construed to be a license to proceed with the IOrt and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor sball issuance of a peIlit prevent the Building Official frOl thereafter requiring a correctioo of errors in plans, construction, or violations of any code. Ivery penit issued shall becaIe invalid unless the wort authoriled by such peIlit is COBeJlced lIithin sblOllths of issuance, or if IIOrt authoriled by the perlit is suspended or abancloned for a period of IiI IODtbs after the u.e the 1IOIk is COIIeDced. One 90 day eatension of tile, tay be allowed for the peIlit with fee charge of $15.00. fbe eatension sball be requested in writing to the Building Official. An approved inspection lUSt be logged during each sillODth period, or tbe profect will be considered abandoned. WARNING fO OOIR: YOOR FAILURE ro RECORD A KOfICE OF aJlHDCEIIm MAY BESULf III YOUR PAYIIIG !VICE PUR DIPROVIIIIIIS ro YOUR PROPmY. IF YOU IID10} ro OBIIIJI ,FIIWICIIIG, COIfSUL! WIrS YOUR LBIIDBR OR AI IftORIIY BIFORE RICORDIIG fOOl JOIICI 0' C(JIMEIlCEHBII1'. JOBS OlDER '2,500 III VALUE DO 1101 IlEED 'f0 RECORD AND POSf A 'IIOfICB OF CCllllEllCBIIDI". ~,V01A ~\?~r SIGJfA!URE: OIIDR OR AGBIII ~'1IHm ~hhaA"t SIGIA : ~ COMIJIACIOR STATI OF FLORIDA coum OF The foregoing inst~ent was acknowledged before me this , 19____ by STAn: OF FLORIDA coum OF The foregoing instrument was acknowledged before me this , 19_ by who is personally known to me or who has produced as identification and who did/did not take an oath. who is personally known to me or who has produced as identification and who did/did not take an oct.th. (Signature) (Na.e Typed, Printed or Stamped) NOTARY PUBLIC (Signature) (Name 'J,'yped, Printed or Stamped) NOTARY 'PUBLIC