HomeMy WebLinkAbout98-7617
BUILDING PE,RMIT
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BUILDING
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ELECTRICAL
CITY OF ZEPHYRHILLS
(813) 788~6611
Permit
7617$
Date _ ,3-~-'tV
~~
M~L
Sewer Conn
.'
Water Conn:
Property Owner:
T.I.F.'
Zon;ng' ~ En.'gy Cod., Radon Ga" ~
O..enodon of W:;'A/. . < ~i") ':.qI~$-~ a ----- ~ --:
<f-
FINAL
DATE
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
City license Registration #
State Certified license#
c27-r
Pe,m;t Fe"$1- ~
Signature . '- ~
,
Company
Address
Telephone#
Valuation or
Contract Price
.Ui
ItJ, S~O'
. .
~- rJw&
BUILDING
/J/()}) ctJJv
ELECTRICAL..:2 :2tJ......
PLU
Ftr.
Pre SLB
lintel 'J
FRM. 4-1 3 ~ CP51 I3ILL
Insul. CL-tj J I d 19i-iot
WL II 1 I 0
Tp. Servo I 1
Rough In 4/1'-1 If, KIS
Meter Can
Con st. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
Driveway
S~u.:,~ y(q{o,i go~
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.801 shall be made for each trip for each trade:
..l.~--'tJ"V
a. Wrong Address
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.
11111111111111111111111111111111111111111111111111
98046118
NO'l'ICE OF COMMENCEMENT'
Rcpt: 232558 Rec: 6.00
DS: 0.00 IT: 0.00
04/22/98 'n~. 'n_nn_n Dptv Clerif
JED PITTMAN, PASCO COUNTY CLERK
04/22/98 10:40a. 1 of 1
OR BK 3919 PG 53&
C'ClUnty 0 j
PASCO
state of FLORIDA
'l'!lR UNDERSIGN~D hereby give:l notice t_hat illlprc'i'lf\cnt will }.. l::: Jt' L() c.c:rL!:
r,-,),l property, and in accorl~nce ,with ,Chaptf~'! 713,. Fl()!.n_l.~. .:-::._ilLutcs, ti.
fullo,,^'ing inforr-:1ation is pro'.'.lded 1n th1s Not.u'c! of COm!l\C'llC"I!Il'It\ :
1.
Descr iplion of Property:
Parcel No. ~S-=__~- cl\~_n~~S~- ~\:)()\:)~
- \ \0\0 C::J
7322 .2:EEHIGH CT.
(Legal description of the property and str~eet address J.T LlvilTIable)
2.
General Description of Irnprl"'ement
ADDITION
3 .
O\vncr Information: Name
MYRNA STEMEN
City
ZEPHYRHl.2:.2:S
~;t:<il~e FI
l~ddress
7322 .2:EEHIGH CT.
Interest in Property:
OWNER
Name of Fee Simple Titlc)lder:
(If other th~n owner'
Address
City
~~ l '" L '..'
R1.
Contractor: Name
R YM AN....nCON.S TRll.CT.lG~JNC..__.___.
.;"....~._....,"
Address 37325 S.R. 54_WE.B.T..__ City _.z_EPJiYRH..ILL_~__.__
, ~ :..: '
F'L
-3~~''; J
5.
Surety: NuIne
Address
City
~:) L;1 t. \:~
Amount of Bond: $
G. Lender: Name
Address
City
:_; t. it t c
'7.
Persons wi thin the S L\ i.e of Florida
notices or other documents may be
713.13(1)(a)(7), Floridil Statutes:
de~; ignated
served as
by (Jo..mer
provided
upon whc..:
by Sectio!1
Name
Addres :;
City
;.l (-: Le
B. In addi Lion to himself, t..'ner designate~~
of
Lienor's Notice as prov]de'~
,
~n
to receive a COp'l of thc.
Sectionn J . 1 J ( 1 ) (b) f F'lor ida nStatutes.
(). . F.xp1.rlli 1'Jn d~te of Notle!'- of Commencement l the explrilt i,,:! cLlte ]:, 11'(;i1:
fr')m the date of record: ng unless a differ1cnt date is ~T'(.::'citied.)
Si\jnature of Owner: _lJ.u~ ~f'\.O~
Sworn to and subscribed before me this \~
19 % .
PRINT NAMF. frJ}j8...ll A 67 FAi EN
day of ~~; ),,~
Notury Publ ic .
~,~~\~},~~
My Commission Expires:
~ooc: '9l JeQwaoea S8J!cbg ~"""'fo
9iHtO.l.;);) lIO!U,wwu-J An. JII...
J8UU8)I H 8ueuuy ,~...
.>>.;:.;,..... AnneUe H Kenner
4 ~ *My r.nmml".unn r.r.7DS1~
.4<; . 00"
-"'" ....~ Expires December 111, 2 .
RYMAN CONSTRUCTION
7322 LEHIGH CT.
SQ. FEET PRICE
MAIN OR LIVING AREA 264 $ 40.00
OTHER AREA UNDER ROOF $ 15.00
OTHER - $ 0.85
VALUATION $ 10,560.00
FEE SHEET $ 75.00
ADDRESS $ -
DRIVEWAY $ -
BUILDING: $ 112.50
ELECTRICAL: $ 22.80
PLUMBING: $ -
MECHANICAL: $ -
RADON: $ 2.64
CREDIT:
TOTAL $ 137.94
I
SEWER'I $
WATER: $
TOTAL: $
- I
314"
WATER METERI $
- ~
I
T'F~H
- I
TOTAL: $
137.94
CITY OP ZEPHYRHILLS BUILDING DE?l\l\T~\ENT
OWNE R - '(Y) ~ f:fIJ It- - S'-\-cm~l\.)
JOB LOCATION ~~~d- ~ech5~ ~- -~'ny.eh~{"
PARCEL I.D, # ~
SHOW ALL EXISTING & PROPOSED STRUCTURES GIVING DI~!CNSIONS & SETBACKS.
'I'
1::0
~l
. . 'l~'
dl e~ s--\.- i ~~ ~fV'\
~. +0 be ~"c.Ec>
';for
~~s ~.~
;)0'
UTILITY BUILDINGS
KUST SHOW SIZE &
FOUNDATION INFOR-
KATION,
3B
FRONT PROPERTx LINE
<?O
~
I
(NOTE EXAMPLES 1 & 2)
l. SETBACKS FOR Rl1 R2 ZONING
60'-
10'
P E
R X
0 I
, 10' P S 10'
0 T 1 0'
S I I
E N
0 G
I
20' _L
FRONT PROPERTY LINE
--.--
STREET
2. SETBACKS FOR R,3 ZONING
60'_
r-:
I
10'
10'
l
EXISTING I
1-. PROPOSED 1
l _.-J
10'
120'SGL f}\H
JO'DUPLEX
fRONT PROPERTY LINE
/00
T
1 0'
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t:
Wm. A. "Bill" Burgess
Director of Building,
Licensing, & Zoning
City of Zephyrhills
Building Department
5335 Eighlh Slreel
Zephyrhills. Florida 33540
(813) 788-6611
INSPECTION REQUEST
PERMIT # : ~=+lo l q
TYPE OF
INSPECTION: ~oo~~ I S(~ Co
I
. DA TE REQUESTED: S ~ ~ lD - ~ 0
\.~ ~~
SIGNATURE~:~ _ ~ --
FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION
FORM 600C-93 Residential Limited Applications Prescriptive Method C CENTRAL 4 5 6
Small Additions and Renovations Department of Community Affairs
'~ompliance with Method C of Chapter 6 of the Florida Energy Efficiency Code may be demonstrated by the use of Form 6OOC-93 for additions of 600 square feel or less, site- installed components
of manufactured homes, and renovations to single and multifamily residences. Alternative methods are provided for additions by use of Form 6OOB-9:1 or 600A-93.
PROJECT NAME: (l\ e,l\JA- BUILDER:
AND ADDRESS: /6
j OWNER: c~
';MALL ADDITIONS TO EXISTING RESIDENCES (600 Square feet or less of conditioned area). Prescriptive requirements in Tables 6C-1, 6C-2 and 6C-3 apply only to the
components of the addition. not to the eXISling building. Space heating, cooling, and water heating equipment efficiency levels must be met only when equipment is installed
,.pecifically to serve the addition or !s being installed in conjunction with the addition construction. Components separating unconditioned spaces from conditioned spaces must
"eet the prescribed minimum insulation levels. RENOVATIONS (Residential buildings undergoing renovations costing more than 30% of the assessed value of the building).
I >rescriptive requirements in Tables 6C-1 and 6C-2 apply only to the components and equipment being renovated or replaced. MANUFACTURED HOMES AND BUILDINGS. Only srte-
,'stalled components and features are covered by this form. Please Print CK
1. Renovation, Addition or Manufactured Home
2. Single family detached or Multifamily attached
3. If Multifamily-No. of units covered by this submission
4. Conditioned floor area (sq. ft.)
'5. Predominant eave overhang (ft.)
;i. Porch overhang length (ft.)
7. Glass area and type:
a. Clear glass
b. Tint, film or solar screen
8. Percentage of glass to floor area
9. Floor type and insulation:
a. Slab on grade (R-value)
b. Wood, raised (R-value)
c. Wood, common (R-value)
d. Concrete, raised (R-value)
e. Concrete, common (R-value)
10. Wall type and insulation:
a. Exterior:
1. Masonry (Insulation R-value)
2. Wood frame (Insulation R-value)
b. Adjacent:
-I. Masonry (Insulation R-value)
2. Wood frame (Insulation R-value)
c. Marriage Walls of Multiple Units* (Yes/No)
11. Ceiling type and insulation:
a. Under attic (Insulation R-value)
b. Single assembly (Insulation R-value)
12. Cooling system* - ~~)
(Types: central, room unit, package terminal A.C., none)
13. Heating system*:
(Types: heat pump, elec. strip, natural gas, L.P. gas, room or PTAC, none)
14. Air Distribution System*:
a. Backflow damper or single package systems* (Yes/No)
b. Ducts on marriage walls adequately sealed* (Yes/No)
15. Hot water system:
(Types: elec., natural gas, other, none)
. Pertains to manufactured homes with site installed components.
I hereby certif t at I
compliance w' t
PREPARED BY:
I hereby certify th
OWNER AGENT:
d specifications covered by the calculation are in
Code.
DATE: S-l \ -'18>
mpliance with the Florida Energy Code.
DATE: 3 -l \. -<1, <is'
-1-
1. ;\.(:) 0 j ~-h ~
2. Sl-<\):.::}....~.l~
3.
4. 'Z..(o'f
5. ,
6.
~g1; Pa~ Double Pane
7a. sq. ft. sq. ft.
7b. 45 sq. ft. sq. ft.
8. \.Z?O %
9a. R= sq. ft.
9b. R= sq. ft,
9c. R= sq. ft.
9d. R= sq. ft.
ge. R= sq. ft.
10a-1 R= 5" - sq. ft. --
10a-2 R= - sq. ft.
1 Ob-1 R= - sq. ft.
10b-2 R= - sq. ft.
10c
11a. R= \C\ - sq. ft.
11b. R= - sq. ft.
12. Type:~c.Q
SEERlEER:
13. Type:
HSPF/COP/AFUE:
14a.
14b.
15. Type:
EF:
this calculation indicates compliance
. is completed, this building will be
'on 553.908, F.S.
DATE:
r";lirr'Jle Zones 4 5 6
MINIMUM INSULATION
COMPONENT INSULATION INSTALLED
Concrete R.5
en Frame, 2' x 4' R.11
....J Frame, 2' x 6' R-19
....J
~ Common, Frame R-11
~
Common, Masonry R-3 a,,-5'
~ Under Attic R-30
z Single Assembly; enclosed ~ ~
:J
W Single Assembly; Opened R-10
0 Common, Frame R-11
en Slab-on-grade No Minimum S[~
a: Raised Wood R-11
0
0 Raised Concrete R-5
....J Common, Frame
~ R-11
f-
0 In unconditioned space R-6
::>
0 In conditioned space No minimum
TABLE 6C.1 : PRESCRIPTIVE REQUIREMENTS FOR SMAll AODf1l0NS (600 Sq. Fl and Less), RENOVATIONS TO EXISTING BUILDINGS AND SITE-INSTALLED COMPONENTS OF MANUFACTURED HOMES.
MINIMUM INSTALLED
EFRCIENCY EFRCIENCY
SEER 10.0 SE
SEER 9.7 ER
EER 8.5* EER
EQUIPMENT
Cl
Z
::;
o
o
u
- Split
Ie Pkg.
Room unit or PT
Cl
Z
~
UJ
:r:
UJ
u
<l:
0-
(f)
AFUE
AFUE
ex::
I- UJ
01-
:r:<l:
:s:
Elect' Resistance
G ; Natural or L.P.
F elOi!
EF
EF
EF
.88
.54
.54
TABLE 6C-2: PRESCRIPTIVE REQUIREMENTS FOR GLASS AREAS IN ADDITIONS ONLY
. See Table 6.3. 6,7
Maximum percentage glass to floor area allowed is selected by type, overhang length, and shading coefficient. Maximum%- Installed % -
GLASS TYPE, OVERHANG, AND SHADING COEFFICIENT REQUIRED FOR GLASS PERCENTAGE ALLOWED
UP TO 20% UP TO 30% UP TO 40% UP TO 50%
Single Double Single Double Single Double Single Double
OH-SC OH-SC OH - SC OH - SC OH-SC OH - SC OH-SC OH-SC
1'- 1.0 0'- .90 2'- 1.0 1'- .90 3'- 1.0 2'- .90 4'- 1.0 3'- .90
0'- .86 1'- .86 0'- .70 2'- .86 1'- .70 3'- .86 2'- .70
0'- .65 1'- .65 0'- .50 2', .65 1', .50
0'- .45 1'- .45 0'- .40
0', .35
Shading coefficients (SC) may be obtained from the manufacturer. Single clear SC = 1.0, double clear SC = .90, and single tint SC = .86.
TABLE 6C-3 I MINIMUM REQUIREMENTS FOR ALL PACKAGES
COMPONENTS SECTION REQUIREMENTS CHECK
Exterior Joints & Cracks 606.1 To be caulked, gasketed, weather-stripped or otherwise sealed. t,./"'"
Interior Joints & Cracks 606,1 All openings in interior surfaces of ceilings and exterior walls must be sealed. ..---
Sole & Top Plates 606.1 :SOle plates and penetrations through top plates of exterior walls must be sealed. ../""
Infiltration Barrier 606.1 Infiltration barrier must be installed in exterior walls & raised wood floors. ---
Fireplaces 606.1 Fireplaces must have flue dampers, glass doors and outside combustion air intakes.
Exhaust Fans 606.1 Exhaust fans vented to unconditioned space shall have dampers, except for combustion
devices with integral exhaust ductwork.
Combustion 606.1 Combustion space and water heating systems must be provided with outside combustion air,
Heating except for direct vent appliances.
Water Heaters 612.1 Comply with efficiency requirements in Table 6-11. Switch or clearly marked circuit breaker (electric)
or cutoff (gas) must be provided. External or built-in heat trap required.
Swimming 612.1 Spas & heated pools must have covers (except solar heated). Non-commercial pools must have a
Pools & Spas pump timer. Gas spa & pool heaters must have minimum thermal efficiency of 78%_
Hot Water Pipes 612.1 Insulation is required for hot water circulating systems, (including heat recovery units) and the first
8' of piping from the water heater (or until piping enters an insulated wall or slab).
Shower Heads 612.1 Water flow must be restricted to no more than 3 gallons per minute at 80 PSIG.
HVAC Duct 610.1 All ducts, fittings, mechanical equipment and plenum chambers shall be mechanically attached,
Construction, sealed, insulated and installed in accordance with the criteria of Section 610.1. Ducts in attics must be
Insulation & Installation insulated to a minimum of R-6. Air handlers shall not be installed in attics unless In mechanical closets.
HV AC Controls 607.1 Separate readily accessible manual or automatic thermostat for each system.
GENERAL DIRECTIONS:
1. On Table 6C-1 indicate the R-value of the insulation being added to each component and the efficiency levels of the equipment being installed. All R-values and efficiencies installed must meet or exceed the minimum values
listed. Gomponents and equipment neither being added nor renovated may be left blank.
2. ADDmONS ONLY. Determine the percentage 01 new glass to conditioned floor area in the addition as follows. Total the areas of all glass windows, sliding glass doors and glass door panels. Double the area of all non.
vertical roof glass and add rt to the previous total. When glass in existing exterior walls is being removed or enclosed by the addition, an amount equal to the total area of this glass may be subtracted from the total glass area
Divide the adjusted glass area total by the conditioned floor area of the addition. Multiply by 100 to get the percent. Find the largest glass percentage under which your calculated percentage falls on Table 6C-2. Prescriptives
are given by the type of glass (Single or Double pane) and the overhang (OH) paired with a shading coefficient (SC). For a given glass type and overhang, the minimum shading coefficient allowed is specified. Actual glass
windows and doors previously in the exterior walls of the house and being reinstalled in the addition, do not have to comply with the overhang and shading coefficient requirements on Table 6C.2. All new glass in the addition
must meet the requirement for one of the options in the glass percentage category you indicated. The overhang (OH) distance is measured perpendicularly from the lace of the glass to a point directly under the outermost edge
of the overhang.
3. RENOVATIONS ONLY. Replacement glass needs to meet the following requirements. Any giass type and shading coefficient may be used for glass areas which are under at least a two foot overhang and whose lowest
edge does not extend further than 8 feet from the overhang. Glass areas being renovated that do not meet this criteria must be either single-pane tinted, double-pane clear or double-pane tinted.
4. Complete the information requested on the top half 01 page 1.
5. Read "Minimum Requirements for Small Additions and Renovations., Table 6C-3, and check all applicable items.
6. Read, sign and dale the "Owner/Agenr certification Slalemenl on page 1.
-2-
~ltY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER'S NAME f'r\l1etJA- 'S.kme.i\..J
I
OWNER'S ADDRESS t:t-3~Q. ~\tU ~Y\
JOB ADDRESS SA-fY\b
cA:: - ~~h.~ _
'..-'
';\'h
./~t;:..
LEGAL D&~CRIPTION: LOT(S)
BLOCK
SUBDIVISION,,>:<
, . ':~'~~~ll"/:-.
, (OBTAIN FROM PROPERTY TAX NOTiCE)
~~eration ----aepair ~~
- ,ill
o~'..' .,
PARCEL 1. D. #
WORK PROPOSED:____New Construction ~ddition
____Sign
-Hove
_Demolish
PROPOSED USE: ~Single Family
_M/F
_* of Units
_M/H
;
...,"n
~ ; ~ .
'~.;ll;~'f'
":2!1':
~'~"
-Restaurant & Health Department Approval ';~i~;~.
DESCRIPTION OF WORK: ~ v=<9 €t""""'" ~) "'-~ e,lodc ~:.J
BUILDING SIZE: -X--. Square Feet. Height :l~
,\jA '.
RESIDENTIAL: ATTACH (2) FLOT l'LANs . (2) SETS OF BUILDING PLANS, (1) SET ENERGY FO~~t
COHIIERCIAL: ATTACH (3) SETS OF BUILDING PLANS. (1) SET ENERGY FOEllS. .?$).
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION ';:i;S{,.
:.'''fl
~L
.,.:,.'l.
~.(~P
_eo.tercial
_Indust.
_Swim. Pool
_Other
_BUILDING
$
oe-
\3,500 ~
PERMTTS REOUESTEl!
Valuation of Total Construction
GAS
~lock
:fJ
. ~W.R.E.C';~,l
@l~',
VM::::N:f HechanicM =::iool
.~..p" .
Florida Power Corp.
_ELEc:"RICAL
~
TYPE OF CONSTRUCTION:
AMP Service
$
_Fralle
_Steel
Other
COMPANY c.--.
~ State Cert. r Regist. #eBQ..-03..st~
c-- City License Registration # ~1 Lf
******************************************
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOoD ZONE AREA?
-
******************************************
YES NO
BUlLD~
Signature~
CONTRACTOR SECTION
ELECTRICIAN
. COMPANY-IY\~ &-~~~~~<<-
g <5 5A / /~ - . State Cert. or Eegist. #
. , I/v7 (9~ ~ 'r..J City License Registration t r:l. ;t 'J.-
******************************************
~'JO:,".
Signature
/O/A
",
COMPANY
State Cert. or Regist. #
City License Registration ~
******************************************
"'l,
L~~: .
SiRnature
FLUMB~
MECHANICAI.t
Signature
IU ~r-
I
COMPANY
State Cert. or Regist. #
City License Registration *
******************************************
APPLICATION APPROVED BY
PERMIT OFFICER.
-:i. CONDITIONS OF PERMIT AFFIDAVIT
'"f.:ij\. NOTICE OF DEED RESTRICTIONS
jj)p.e undersigned .understands tbat this per_It .ay be subject to "deed restrictions" ,bicb oay be .ore restrictive tban City
,~;regulations. fhe undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
'J;'''
.fl' UNLICEN.SEO CONTRACTORS AND CONTRACTOR RESPONSIBILITIE~ .
-..If tbs ....r bas blred a cootractor or contractors to undertake ,ort, they _ay be reqUired to be licensed In accordance with
~tate and local rsgulati.... If the contractor is not licensed as required by la" both the owner and contractor lay be
;~Ilted for a _ied......r violation under state la,. If the OHOer or Intended contractor are uncertain as to wbat licensing
~Ir....ts ..y apply for tbs intended ..rt, they are advised to contact the City of Zepbyrbllls Building Depar"'ent, [BI3)
~'.c'~788-661l
"0~\; .
".~r\.'"
.;J! '.' theanre, if tbs owner bas bired a contractor or contractnrs, be is advised to bave the contractor(s) sign portions of the
. Contractor Sections' of this application for wbich they will be responsible. If you, " the owner sign as the contractor,
<,.~gU are Indicating tbst yoo, rather tbsn the contractor, are responsible for tbe HOd. If tbe contractor Hisbes you to sign
.~ contractor !bat "y be an Indicatinn that be Is nnt properly licensed and is not entitled to Perlitting priVileges in lbe
!;~iCity of Zephyrhills.
.~. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
: l~i,:
. ~~!,~;'>'
;lg. CONSTRUCTION LIEN LAW (CRAPTER 713, FLORIDA STATUTES, AS AMENDED)
,~; certify tbst I, tbs applicant, bave bean provided wi th a copy nf 'Florida's Construction Lien Law _ H..eowner' s Protection
'+~de" p{epared by the Florida Department of Agriculture and ConsUler Affairs. If the applicant is sOleone other than the
.{~owner", I certify that I have obtained a copy of the above described docUJent and prOlise in good faith to deliver it to the
'::~ownerll prior to couenceaent. ,
'j;,.:
:,~. CONTRACTOR I S/OWNER I S AFFIDAVIT
.~t~certify that all the infor.ation in this application is accurate and that all work will be done in compliance with all
\'applicable laws regulating construction, zoning, and land develop.ent.
::;;.t~r
;~pplication is hereby lade to obtain a perl it to do work and installation as indicated. I certify that no work or
"lDStallation bas cOllenced prior to issuance of a perlit and that all work will be perfofled to leet standards of all laws
,~,tlng cnnatructlnn, City codee, .oning regulatinns, and land develop.ent regolations in the jurisdiction. I also
,tlitlfY that I unierstand that the regolations 01 other governaental agencies .ay apply tn tbe intended wort, and that it is
;~"espnnslbflity to Identify wbat acti... I luet tate tn be in colpllance. Sucb agencies include but are not ii_ited to:
":~ZDepartlent of Environmental Regulation - Cypress Bayheads, Wetland Areas and Envirolllentally Sensitive Lands,
'f:/ Water/Wastewater 'freatJent
~:~~Southwest Florida Water HanageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
.,~~ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
'~JDe artJent of Health & Rehabilitative Services Environmental Health Unit - Wells, Wastewater Treatment, Septic Tanks
~/US Bnvironmental Protection Agenc~ - Asbestos abateJent
iii!bn certifY tbst, if fill ..teria1 is to be used in Plond Zone 'A" or "A, etc. ", it is understuni tbat a drainage plan
Oiaressing a 'c",,",ating vnlUle' will be suloitted .bicb ie prepared by a professional engineer registered in lbe State nf
~~Qrida prior to perlit issuance.
Acp".lt Issued shall be construed tn be a license to proceed with the ,orl and not as authO'ity to vinlate, cancel alter, or
. S@laside any p,ovislons nf the technical codee, nnr ,ball issuance nf a peroit prevent the Building Official frno thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perait issued shall beCOle invalid
ugt... the wort autho,ized by such pe"'~t is cn..eneed within six .nnthe nf issuance, or if wnrt authnri.ed hy the pe,.it ie
s~pendedor abandoned for a period of six IOntbs after the tile tbe work is cOlllenced. One 90 day extension of tile, lay be
allowed for the perait with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
appJoved inspection lust be logged during each six IOntb period, or the project will be considered abandoned.
KARNING fO OWNER: YOUR FAILURE TO RECORD A NOfICE OF COKHENCKHENT MAY RESULT IN YOUR PAYING TWICE FOR IHPROVKHENTS TO YOUR
~jQ~RRrY. IF YOU INrRHD TO OBTAIN FlHANCING, CONSULT WIfH YOUR LENDER OR AN ArTORNEY BEFORE RECORDING YOUR NOTICE OF
.cmtHENCBKENf. JOBS UNDER $2,500 IN VALUE DO NOT NEED to RECORD AND POST A "NOTICE OF COMMENCEMENT 1/ .
:. '.~~1;~1 .
:fe. ~ _ ~
..~~~',,:,
SrATE OF FLORIDA
coliNrr OF ~(~ ~ ~ J1:-.r
TlliFforegoing instrument was acknowledged
~~fore me this ~,,~ \~ , 19 ~ by
~._;'~~.'."
STATE OF FLORIDA ~
COUNTY OF \\.,,\.y fl)
The foregOing instrument was ac~owledged
before me this ~\.~\\ B.... , 19~ by
w~9is\ p"~:sonalIYlnoWil}to me or who has
'. pr9(1uced-..________
as~'i'dentification and who dicf/4!~ no"t-)
.....y... ~ ~----
t. aIte" an oath.' i
..._",\.~;' , "', \
.:\. ~~l:" \W'):\\'\"\~'
(S~gnature)
; ~tt:~:l '. .
who is( personally lWoWn--to me or who has
produced .'-
, as identific
take an oath.
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
~
(N.Clint! Typed, Print~d oX:'''~~~e~~J Kenner
NOTARY PUBLIC :tfk~MY Commission CC703125
'.'. . -'" ;",..", Expires December 16, 2001
"";"~"'1- Annelle H Kenner
< ;if *~Y Commission CC103125
'. " ":~rl(€S D8Cember 16, 2001