HomeMy WebLinkAbout00-9431
BUILDING PERMIT
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\.:ECTRICAL
CITY OF ZEPHYRHILLS
(813) 788-6611
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09431
Date ~ -.a 7-0 D
Sewer Conn ~ 9/1 ~
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BUILDING
Permit
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Descriotion of Work
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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.
FINAL
470..000
Permit Fe
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~gnatur..!p
Company
Address
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ELECTRICALo1~J;! PLUMBINGlf,1tJ MECHANICAL S~
Valuation or
Contract Price
-
City License Registration # /4 I
State Certified License# C!B en L/s..:;g..r
w'?"' ~.
BUILDING
Ftr.
Pre SlB
Lintel
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Insul. Cl
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Driveway
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
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Tub Set -/b-fo/Y 2~
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
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REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($ 25.001 shall be made for eech trip fO~ each tra~ ~ ~
a, Wrong Address .:::r--- .?5 ~ 17 ..R-5,~~ f)L ~!:L
b. Condemned work resulting from faulty construction. 1~ \ {/ "
c. Repairs or corrections not made when inspection called, pp
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. i /
The payment of inspection fees shall be made before any further permits will be issue~ the person owning
same.
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NAME- ""Erotas$~oJ.l Aircraft Main:tenuce,
CITY,'OF: ZEPH'YRHIU:S~; FLORIDA,
. 5335, Sth;Streef '
CER;JIFICATE; O'FOCCU:PANCY
AD'DRESS 39-514, A.v"-ad.oJil Avei1ue
PARCEL I.D.# 13-26-2141000.-0,0100-005.2
SUBDIVISION:
TYPE, OF I3UIj;;DING 3teel. BWUd:itlg
C01ttRACTOlt-M;1ze Constnu:t.iori ?ermi.'b: 1094-31
TO i4PnOVEllS:ITE Y.!.AN..
a;i,pa'ture.
WHITE:' Cantractoror Owner
YELLow:, Bldg;.Dept~
PINK:tJtllltlesDepL '. '.'
GaLDENF.lOD~GeJ1el'8l"Servlces:,.
;(".. . 1,-, I
~J'-t:. f<"\ ,,--' Ie
T.ananE<~3 Sipature
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Professional Aircraft Maintenance, Inc.
Zephyrhills Airport
39514 Aviation Ave.
Zephyrhills, Florida 33540
Tel- (813) 788-0836
Fax - (813) 783-8095
PROFESSIONAL AIRCRAFT MAINTENANCE, INC.
July 28, 2000
Phase one - Hanger, Bathroom, one Office with separation.
Will penn it second Phase (residence) at later date.
Sincerely,
~~
Cecil L. Beck
Professional Aircraft Maintenance, Inc.
Zephyrhills Airport
39514 Aviation Ave.
Zephyrhills, Florida 33540
Tel- (813) 788-0836
Fax - (813) 783-8095
PROFESSIONAL AIRCRAFT MAINTENANCE, INC.
July 28, 2000
The occupancy of Hangar only, delete residency at this time, residency to be repennited at later date.
Sincerely,
~~
Cecil L. Beck
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
DATE RECEIVED ~'-.3D - DU
PLANS REVIEW FEE
OWNER'S NAME
3"1.5/'1 (Z;~
(J/J;L .
fir
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID # /eS-;;2t,-;;/-O~06- t:)O/-'f)ttJ-Ot/~.!2., (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: ~NEW CONSTRUCTION
o ADDITION
o ALTERATION
,
o REPAIR
o INSTALL
o SIGN
o MOVE
o DEMOLISH
PROPOSED USE: DSGL FAMILY DWELLING
o COMMERCIAL
DMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
BUILDING SIZE
DEPARTMENT APPROVAL
.,
DESCRIPTION OF WORK
SQUARE
E I~IJQO
HEIGHT
RESIDENTIAL:
COMMERCIAL:
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
or BUILDING
62J ELECTRICAL
i2r PLUMBING
o MECHANI CAL
$ jq/J,OO().{:)O
;~ 00
VALUATION OF
TOTAL CONSTRUCTION. . ::J;.
Od FWRIDA POWER 0 ;iit~{})
AMP SERVICE
$
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
u;r STEEL
@LL-. ({S(c.K .
o OTHER t fdLq 9'3 ~O <6 :3 (p
'ONE AREAq YES
o NO
FINISHED FLOOR ELEVATIONS
IS PROJECT
BUILDER
SIGNATURE
COMPANY ,
STATE CERT OR REGIST
CITY PROCESSING #
**************************************************
SIGNATURE
COMPANY 131J51- /11:5to ?:t.l!iZ-f/2tC"-
STATE CERT OR REGIST # ~/2~o/LfS91
CITY PROCESSING # ?f3f- {)~V/
******************************************************************
PLUMBER ~
SIGNATURE \..tv-::. j
\;J ~c,-v~
COMPANY PEP",.' ~ L. ~: ~ \' tr--~
STATE CERT OR REGI ST # '( F - O:~r U (0
CITY PROCESSING # I 9 2. 07)~ 1,./.....
SIGNATURE
* * * * * * * * * * *.* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ~ * * * * * * * * * * *
COMPANY Ci
;i --- STATE CERT OR REGIST #
CITY PROCESSING #
MECHANICAL
****************************************************
OTHER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to ~deed restrictions" which
may be more restrictive than City regulations. The undersigned assumes responsibility fo~
compliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they may 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 may be cited for a misdemeanor
violation under state law. If the owner or intended contractor are uncertain as to what
licensing requirements may apply for the intended work, they are advised to contact the
City of Zephyrhills Building Department, 813-788-6611.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the ~Contractor Sections" of this application for which they
will be responsible. If you, as the owner signs as the contractor, you are indicating that
you, rather than the contractor, are responsible for the work. If the contractor wishes
you to sign as contractor that may be an indication that he is not properly licensed and is
not entitled to permitting privileges in the City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTUION 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 - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "owner", I cerify that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the ~owner" prior to commencement.
E. CONTRACTOR' S/OWNER' S AFFIDAVIT
I certify that all the information in this application is accurate and that all work will
be done in compliance with all applicable laws regulating construction, zoning, and land
development.
Application is hereby made to obtain a permit to do work and installation as indicated. I
certify that no work or installation has commenced prior to issuance of a permit and that
all work will be performed to meet standards of all laws regulating construction, City
codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other governmental agencies may apply to
the intended work, and that it is my responsibility to identify what actions I must take to
be in compliance. Such agencies include but are not limited to: *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment
*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone ~A" or ~A,etc.", it is
understood that a drainage plan addressing a ~compensating volume" will be submitted which
is prepared by a professional engineer registered in the State of Florida prior to permit
issuance.
A permit issued shall 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 the technical codes,
nor shall issuance of a permit prevent the Building Official from thereafter requiring a
correction of errors in plans, construction, or violations of any code. Every permit
issued shall become invalid unless the work authorized by such permit is commenced within
six months of issuance, or if work authorized by the permit is suspended or abandoned for a
period of six months after the time the work is commenced. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be requested
in writing to the Building Official. An approved inspection must be logged during each six
month period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A ~NOTICE OF COMMENCEMENT".
L/
SIGNATURE: OWNER OR AGENT
~~tJ"LroJ
SIGNATURE: CONTRACTOR
acknowledged
, 19_
STATE OF FLORIDA
COUNTY OF
The foregoing instrument w~noWledged
Before mhthis ~da~ i1~ . , ~ 00
by Ft?-IL. . E(
_ ~hame of person acknowledged)
~o is personally known to me, or
(9 tL.:1 e iJ
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by
(name of person acknowledged)
Dwho is personally known to me, or
o who has produced
(type
and whoD did 0 did not
of identification)
take an oath.
Signature of person taking acknowledgement
Name:,,,, "_
:~~~}~.~~ ~~~~:g
Name typed, printed or stamped
........
LEGAL DESCRIPTION:
SHEET ~
WORK ORDER
NUMBER 12525
PARCEL "B"
Commence at the Northwest corner .of. Section 13, Township 26
South, Range 21 East, Pasco County, Florida; thence
N.89054'37"E. along the North line of said Section 13 a
distance of 1,339.57 feet; thence S.00007'19"E. a distance of
1,068.93 feet; thence N.89054'37"E. parallel to the North
line of said Section 13 a distance of 421.29 feet; thence
S.00018'49"E. a distance of 120.00 feet; thence N.89041'11"E.
a distance of 628.85 feet; thence N.00018'49"W. a distance of
139.87 feet to the Northerly edge of a taxiway for a POINT OF
BEGINNING; thence continue N.00018'49''W. a distance of 235.13
feet; thence N.48022'10"E., a distance of 374.81 feet to" the
Westerly edge of a taxiway; thence along said Westerly edge
the following course; S.41037'50"E. a distance of 401.50 feet
to the beginning of a curve concave to the Southwest having a
Radius of 173.00 feet, Chord Bearing of S.21009'58"W., 120.97
feet; thence along the arc a distance of 123.58 feet to the
beginning of a curve concave to the Northwest having a Radius
of 64.00 feet, Chord Bearing of S.44017'57"W., 90.51 Feet
thence along the arc a distance of 100.53 feet; thence
S.89017'57"W. a distance of 526.10 feet to the point of
beginning. ...........
TOGETHER WITH an easement for ingress and egress over and
across the following described lands:
CommenCing at the aforementioned Point of'beginning; thence
-N.00018'49"W. a distance of 235.13 feet; thence N.48022'10"E.
a distance of 35.69 feet for a POINT OF BEGINNING OF
EASEMENT; thence N.43029'51"W. a distance of 195.52 feet;
thence S.45059'44"W. a distance of 27.45 feet to the Westerly
line of Parcel "A"; thence N.41004'11"W along said
Westerly line a distance of 18.00 feet; thence N.45059'44"E.
a distance- of 44.68 feet; thence S:43029'51"E. a distance of
214.26 feet to the Southerly line of said Parcel "A"; thence
S.48022'10"W. along said line a distance of 18.00 feet to the
point of beginning. '
Said parcel containing 2.04 acres more or less.
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CECIL BECK
AVIATION AVE.
SQ. FEET PRICE
HANGER 10,000 $ 29.00
OFFICE 2,000 $ 40.00
OTHER
VALUATION $ 370,000.00
FEE SHEET $ 1,283.00
ADDRESS $ 20.00
DRIVEWAY $ -
BUILDING: $ 1,944.50
CREDIT: $ -
BUILDING LESS CREDIT: $ 1,944.50
ELECTRICAL: $ 49.32
PLUMBING: $ 80.00
MECHANICAL: $ 40,00
RADON: $ 120.00
TOTAL $ 2,233.82
SEWER: $ 1,917.00
WATER: $ 525.00
TOTAL: $ 2,442.00
i/
3/4" WATER METER:l $
180,00 f i/.'
TI F'S: $ 4,788.00
99% $ 4,740.12
1% $ 47,88
tV
TOTAL: $ 9,643.82 ~.. _
.~ 2.~,~.e.
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::::::::-----
CITY OF ZEPHYRHILLS CONNECTION FEES TABLE A - WORKSHEET
ORD. #3951RESOLUTIONS 312/372 WATER $1.75 GAL. SEWER $6.39/GAL
RESIDENTIAL (Each Lot or Unit)
Residence $ 350,00 $ 1,278.00
Travel Trailer Park $ 131,25 $ 479.25
COMMERCIAL (Per fixture)
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
WashinQ 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 $ 2,556.00
Sinks (3-Compartment) $ 175,00 $ 639.00
Car Wash (Per Stall) $ 1,000.00 $ 6,390,00
SINKS 50 $ - $ - $ -
WATER CLOSETS 75 2 $ 262,50 $ 958.50 $ 1,221.00
URINALS 50 $ - $ - $ -
LAVATORIES 25 2 $ 87.50 $ 319,50 $ 407,00
TUB/SHOWERS 50 2 $ 175,00 $ 639,00 $ 814,00
WASH. MACH. COMM. 560 $ - $ - $ -
WASH, MACH DOM, 200 $ - $ - $ -
DISHWASHER COMM. 400 $ - $ - $ -
DISHWASHER LIMITED USE 60 $ - $ - $ -
SINKS-3 COMPARTMENT 100 $ - $ - $ -
CAR WASH PER/STALL 1000 $ - $ - $ -
IRRIGATION METER
SUB-TOTAL $ 525,00 $ 1,917,00 $ 2,442,00
WATER METER
IRRIGATION METER
IRRIGATION CONNECTION FEE
GRAND TOTAL $ 2,442.00
FIXTURE
G.P.D.
#
WATER
SEWER TOTAL PER FIXTURE
4/12/00
/'
. ~IW\
r.- r -. \~ ':'" ,~ 'J
.......,\~._\......J I ~....--l",
1\ \/;' ""1(0,,J ..~ V .
SQ. FEET PRICE
MAIN OR LIVING AREA 10 000 tbz.CJ; o~
q ,yNl...'1jr J.....
OTHER ARE~_UNDER ROOF 1/7 _,
2-1oC)() . LfOI 'CU
CJ'U -r J...Jl-
OTHER
VJ\W 370 DoD
BUILDING:
ELECTRICAL: ~10,:3~
PLUMBING: ~O ._lY~>
MECHANICAL: 'Is~ u~
I l\t)\:) 0 "7) ff RADON: 1'20 L t>"V
CREDIT: /J lit
'~L ~~ CLu~q
2- - ~.<;
2__ S f ~
SEWER:
WATER:
TOTAL:
~ T.I.F'.S 1-/ 7j'6, vC
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FLA. 11177 LAWS
-FS 713,13
NOTICE OF COMMENCEMENT
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 information is stated in this NOTICE OF COMMENCEMENT.
II . (I
Description of property. . .~~. ~il?ah:./;~.... ..... "" . . ..,. ... .. .,.. . . . . , , ., . , ... . . . . . . . . . ..,. .. . , . .,., . ,..,... . ." , '., .
IHI.PAII. IN DUpt.,ICATII.
... ....... ... ............ ...... .... .... ..... ............... .... ........ ....... ...................., .0........0.......0.....'.....
....0 .... ..... .............. ..... ................. ....... ...... .......0.... ........... .....0.... '0' ......0 ......... ....... .......
. General description of improvements . .~. ~~.z? . .~,. . Er'. .(~~-P? . . (1~;tY~~. /r4..:0fM:, , , . . , . , . , . .
R 0_.,.. tk~!0.. .~': ..1t:~.... 0.'0... .~~?Y.I!!4~rr:r iHf40'&o.W~'..............
Address ..J?'I.ff!.... .~~~.. .df~........ ~~dt.#f M:. .~~~,..,.,.,..,.".........."...,....,...,'"
Owner's interest in site of the improvement. . . . . , . . . . . . . . . . . . . . . . . . . . . . , . . . . . , . . . . . . , . . . , . . . , , . . , . , . , . . . , , , . . . . . . . . . . . . . , . , , . . . ,
Fee Simple Title holder (if other than owner)
Name ,....,.,.."..,.,......,..,......,...,.,.....................,',......,..".....,...,....,.",....,."...,.,,.",."""..
Address ...,...,..,..,...,.....".,......,..."............,....,......"....",.."..",.,.,.."....,.,...,."..",.,....."....
Contractor ./J21l6~-.,. .{j~~. ~?.... .--:-:... ..~JM, ,A:v.~~.",.... ,.....,...""",..,."."""
Address... /J.p.." ~o/.. .Q7$."..". .~.b.7:Q,;. .taJ4:~,,., ,~....,' .3.'1~.$9....".,."""."."
Surety (if anyl ',..,.,',....."..,.,.,.............,....,............,..,..."."",...,..,..."..,.,...."...,..""".,.""".
Address,..,....,.,...,...."..,........,.......,..................,.."...,."..,."...,.... ,Amount of bond $ .".""..,.."
Any person making a loan for the construction of the improvements:
Name ".S#A,..?'7i:v.-'5L. ~.~~........................,...,.,.."...,",..,",.,..."...".,..,',..,""',.,.."..,'"
Address . .4'1~fj.".. f~" .~~~........ .~!Yr.4.!k(~~"". .335,'7(/......,.".,..,...,.."
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 Notrce as provided in Section
713.13 (11 (hI, Florida Statutes. (Fill in at Owner's option).
Name..,......"..,. ~"".,'. ,. ...,."..__..,....,...,.,.,..."..,.,."'........,....,.
Address ..."...,",.."....,......"."."...,.,....,..............,."..."..,."""".""".,...,.,..,...,.".,.."..,.,...
THIS SPACE FOR RECORDER'S USE ONLY
1111111111111111I111111111I11111 111111111I1111111I11 11111111
2000039031
~.~~,.~.".,..,""""',..".".,.
CEC IL L. BECK Owner
Personally appeared before me Cecil L. Beck
Sworn to and subscribed before me this. . ,30,t;b, , . . , , . , , , , , . , , , , ' , , , , .
Rept.: 402327
DS: 0.00
03/30/00
. Ree: 10,50
IT: 0.00
Dpty Clerk
. . , , , . , . , , , . . , . , , , . , . . , , , . , ' , . ,D.,,2.0,QO
s License #B200-112-3o-088-0
JED PITTMANft PASCO COUNTY CLERK
03/30/00 11'1: 43am 1 of 2
OR BK 4338 PG 547
...A'Io.. CONNIE AMAH
I ,. ~. .... fA F10rtdII
ill c.. _ Sept f7, 2IXIO
c... cc...
___,~=~~J"~~
OR BI<
4338
2
PG 548
of 2
............
SHEET .f.
WORK ORDER
NUMBER 12525
LEGAL DESCRIPTION:
PARCEL "B"
Commence at the Northwest corner of Section 13, Township 26
South, Range 21 East, Pasco County, Florida; thence
N.89054'37"E. along the North line'''' of said Section 13 a
distance of 1,339.57 feet; thence S.00007'19''E. a distance of
1,068.93 feet; thence N.89054'37"E. parallel to the North
line of said Section 13 a distance of 421.29 feet; thence
S.00018'49''E. a distance of 120.00 feet; thence N.89041'11"E.
a distance of 628.85 feet; thence N.00018'49''W. a distance of
139.87 feet to the Northerly edge of a taxiway for a POINT OF
BEGINNING; thence continue N.00018'49''W. a distance of 235.13
feet; thence N.48022'10"E., a distance of 374.81 feet to'the
Westerly edge of a taxiway; thence along said Westerly edge
the following course; S.41037'50"E."'a distance of 401.50 feet
to the beginning of a curve concave to the Southwest having a
Radius of 173.00 feet, Chord Bearing of S.21009'58"W., 120.97
feet; thence along the arc a distance of 123.58 feet to the
beginning of a curve concave to the Northwest having a Radius
of 64.00 feet, Chord Bearing of S.44017'57"W., 90.51 Feet
thence along the arc a distance of 100.53 feet; thence
S.89017'57"W. a distance of 526.10 feet to the point of
beginning.
TOGETHER WITH an easement for ingress and egress over and
across the following described l~nds:
Commencing at the aforementioned Point of beginning; thence
-N.00018'49''W. a distance of 235.13 feet; thence N.48022'10"E.
a distance of 35.69 feet for a POINT OF BEGINNING OF
EASEMENT; thence N.43029'51"W. a distance of 195.52 feet;
thence S.45059'44"W. a distance of 27.45 feet to the Westerly
line of Parcel "A"; thence N.41c04'11"W along said
Westerly line a distance of 18.00 feet; thence N.45059'44"E.
a distance of 44.68 feet; thence S.43029'51"E. a distance of
214.26 feet to the Southerly line of said Parcel "A"; thence
S.48022'10"W. along said line a distance of 18.00 feet to the
point of beginning.
Said parcel containing .~ acres more or less.
.:..;', " .~.:-
~.~~~. ;~1":;;;; .,. "".~.
! -F.,
PASCO COUNTYlt FLORIDA
\
I
~ermit No.
I
,?ate Permitted _
Builder Name/Owner Name
County Parcel No,
--
Address/Location
I
Subd,
Classificationffype of Use
How Determined
TRANSPORTATION IMPACT FEE CALCULATION
EXEMPT 0
Why?
Rate $
Zone No.
Sq, FtlUnit
Prepared By
Impact Fee Amount $
Checked By
The above impact fee has been established pursuant to the Pasco County Transportation Impact Ordinance as adopted by the
Board of Pasco County Commissioners. This amount is payable PRIOR to the issuance of a Certificate of Occupancy or
utilization of the permitted structure.
RESOURCE RECOVERY ASSESSMENT
EXEMPT 0
RESIDENTIAL
NONRESIDENTIAL
No. Units
Gross Sq. Ft. (GSF)
RJte ERl:
52.00/YeJr
or SO.I.+2IDay
ERU Assign No, . .::..4....
L-M ''-('i, f';t~~.
Assessment -
(GSF) x (ERU) x (01.+21 x (No, Days)
IO()
Assessment - (]\;o. Units) x ($01.+21
x (No. Days)
TOTAL FEE $
fOTAl FEE $
NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED VNTIL THE AMOUNTS LISTED
HA VE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY.
Acknowiedgement below docs not imply acceptance of concurrence. hut Simply recclpt of a copy of this form, placing
the huildmg permit owner on notice of this assessment and the conditions of payment for same.
Date
Received By
OFfiCE L'SE ONLY
TRANSPORTATION REC NO.
RESOURCE RECOVERY REC NO.
.~ ....> ,. . \ I ,,)
DATE
DATE
BY
. ,~
BY
;:#!,.
'/1
\~...-/
White
Applicant
Canary
Trans/Finance
Canary
RR/Flnance
Pink
Office
Green
Bldg/lnsp
feecalce
PC93113094/D
ZEPHYI<.HILLS FIRE DEP ARTl\'~NT
38410 SIXTH AVE
PH. 813-782- 8184 ZEPHYRHILLS, FL. 33540 FAX 813-788-9700
Business Name ~/1FES.s./I'J:UA t
,
/l)A ;'llT1!!AJ.cMk: is Owner/Mgr 0 AVI..L
e~c
Address 3951']1 At) JA ~ t:,J Occupancy Load Date Posted
Bus. Phone"-m- "Og 3~ Emergency Phone Contact Person
,
Alarm Company
-
Type of Inspection Conducted
Phone #
Other
Quarterly _ Final V-- Commercial Check _
APPROVED ~T APPROVED_
Annual
Reinspect _
""
OK ,)lOT OK
~ Exit Signs
z= Emergency Lights
Heat Detectors
/'_ Sprinkler System
_ _Exits
Window Size
Control Valves
_ Water Supply
Duct Detectors
_ Exposures
OK YOT OK
~ _ Fire Extinguishers
Smoke Detectors
_ Alarm Systems
_ Hood System
_ Storage
Pressure Test
_ Fire Dampers
Fire Walls
Address posted
_ Hydrants
OK NOT OK
_ _ HV AC Shutdown
_ _ Smoke Doors
_ _ Elevators
_ _ Electrical
_ _ Tamper Switch
_ _ Inspectors Test
_ _ Smoke Separation
_ _ Extension Cords
_ _ Tenant Separation
Smoke Evac.
Code violations specified in this report, if not corrected could cause or contribute to the spread of fire, or
prevent safe egress during a fire. Your immediate attention to the correction of these violations shall be
required, failure to comply is a violation of the City of Zephyrhills Fire Prevention Code.
Comments: ,Appl2B(}Ei:/:) 'P'v IL.. ~CEe.-
Inspection DateOX>- //- &>0 Time ofInspection /.200
Inspectors Nz: ~ i. c.0r leAr-'.. -S
Owners I Mg Name .J ')::g~
Re-Inspection Date
Fire Department I. 0.# .s-s-z
Title
This building has been assessed by the Zephyrhills Fire Department. Utilizing the Codes and Standards of, NFPA Minimum
Standards, the State Fire Marshals Uniform Fire Safety Rules and other local fire safety codes. Revised 08-12-99
White Copy - File
Yellow Copy - Business