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BUILDING PERMIT 09704
CITY OF ZEPHYRHILLS Permit
(813) 788-6611 Date .<{ /~ Cf /00
61.59
PLUMBING
l...( 75". <?Y
BUILDING
g).~
l' 5"". ~
MECHANICAL
12')6. ~_0
>~O. f~
I "i 0 < C?.12.
ELECTRICAL
Sewer Conn
Property Owner: 60., d.a..>"o .t-
Job Address: '5' '7 'J 3 19 -
Parcell.D. # " ,- 2l, - 2 (- OO( 0 ,-
gr<<'^k
Water Conn:
Zoning:
~
Water Meter:
T.I.F.'s:
)#1
,/Vol
() 1700 . 06 'fo
Radon Gas: JJ,. '13-
E'.
FINAL ~.s ~C> (
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Valuation or
Contract Price
City License Registration #
State Certified License#
re '" Rr' J(
BUILDING 1 ef
Ftr. A"'/..-aJO J'/C
Pre SLB tfJ-ZZ--t>t!> Si /Z-
Lintel V1tJ-10;tJ)<!l 5/2.
FRM. fa - e'J.-ol".) @
Insul. CL
WL lJ-/-t'X:J 5' IC.
DATE
U
Inspector
)'1/710. Q9
p~r5' ')I..(J1~~
Slg._-_~~Hy
Company
Address
Telephone#
ELECTRICAL PLUMBING ( 3 go
Tp. Servo Sla /~f4~;:'i?~
Rough In ItJ.....2-7-LJ~ Tub Set IO-~ -CJ. .
Meter Can )Water .
Const. Pole 9...~ M- SewerV///ij--C:V ~/e
,
Pool ./ Final
Pre-Meter l./Z-2'2.-<'/1 j/{
Final
F~ /3~ Cf-I-co$~
.501.:.tl4r "
UJ",,!.; .~
MECHANICAL ~3
Breakers
Ducts Insl. /('J -a-m/iif')
Compressor
Final
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($ 25.00 I shall be made for each trip for each tra~~
a. Wrong Address Y2 ft)1{ .
b. Condemned work resulting from faulty construction. '. -L- j7 ~ . ....
c. Repairs or corrections not made when inspection called. _
d. Work not ready for inspection when called. ()~ ,~J
e. Permit not posted on job site. '{Jd-(Y 0 /
f. Plans not at job site. 'c-'..... 1-
g. Work not accessible. \ ?
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
APPLICATION FOR PElWIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
~") ,
~CEIVED 8/ rJ N(}J
PLANS REVJ:EW FEE
OWNER'S NAME GryrQCYI ~.?~"-' ~n8,I"vUc PHON~J.813l?' )
~
k.p\-Ij( htl \S I ~ 33s--fD
BLOCK ., q
CO l.\-O
JOB ADDRESS ~7 rS
I C);-1-.- S, -t-Y E' e. -+
LEGAL DESCRIPTION: LOT(S) L\~. S
PARCEL ID # II d.-l4' ~\ ODI D D7QCC>
SUBDIVISION
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: ~NEW CONSTRUCTION
D ADDITION
DALTERATION
D REPAIR
D INSTALL
D SIGN
PROPOSED USE: ~SGL FAMILY DWELLING
D COMMERCIAL
D MOVE
D DEMOLISH
OMULTI - FAMILY
D INDUSTRIAL
0# OF UNITS
D SWIMMING POOL
o MOBILE HOME
o OTHER
BUILDING SIZE
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
('()YI~ h--u..c + n~U D\DCk..- S\ ~ Ie .(:c..vY"\1 Ij hom <...
SQUARE FOOTAGE ILP 4- 3.. ~ HEI GHT
DESCRIPTION OF WORK
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
f.?3I BUILDING $ S'~ 0,", '" - VALUATION OF TOTAL CONSTRUCTION
I2SI ELECTRICAL otoa AMP SERVICE IS) FLORIDA POWER D W.R.E.C.
[gJ PLUMBING
~ MECHANI CAL $ :l3~S' .- VALUATION OF MECHANCIAL INSTALLATION
,
o GAS D ROOFING o SPECIALTY 0 OTHER
TYPE OF CONSTRUCTION: 181 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES [8 NO
SIGNATURE
~
Z- ,:/ ><t'
COMPANyJ.Y\ r3n rt..k.. E, O\ssOCl cd-c S.
STATE CERT OR REGIST # c~~e 0434 ~;;l.
CITY PROCESSING # 3~1
BUILDER
******************************************************************
COMPANY rY\a.x -h n cS I e,c. +11 c. I T VlC,.
STATE CERT OR REGIST # E.. e... 00 \ 3449
CITY PROCESSING ~
**********************************************************
SIGNATURE
;;f}/~r ~~~
P 1lA/Yl \o{( S cC-' Suo ~e.Vl CVl+.
COMPANY . . _. ~
STATE CERT OR REGIST # GFC, ~ 7S04
CITY PROCESSING # I ~C?? 0
PLUMBER
* * * **** ** **.*** * ***** **** * *** ** *** ** * **** ** * ,* *** * ** ** **~****** ** **. -r: ~
YBCBABICAL;/L . COMPANY ou...+ he r VI G:.Yn -Pol + ~ VI \- . ....JA" I Q."
~ STATE CERT OR REGIST # /(N1 t:Jx:.':::JIStJ2. ~
SIGNATURE r CITY PROCESSING # ,_"3
*****************************************************************
OTHER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
0)
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit lnay be subject to ~deed restrictions" ~hich
may be more restrictive than City regulations. The undersigned assumes responsibility for
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 o~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".
~'AA~~~r
SIGN~~; w~~R "'oR AGENT 6
~~
~ . ~.~r-
SIG T RE: CONTRACTOR
acknowledged
19_
STATE OF FLORIDA
COUNTY OF
The foregoing 'instr~ent was
Before me this _____day of
by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____ day of
by
acknowledged
19
(name of person acknowledged)
Owho is personally known to me, or
(name of person acknowledged)
C1ho is personally known to me, or
Owho has produced
(type
and whoO did 0 did not
of identificationl
take an oath.
o who has produced
(type of identificationl
and who Odid ~id not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
,.
FORM 600A-93
PROJECT NAME:
AND ADDRESS: S 713, lc;~ Sf.
OWNER :tP{) I.j)DJJ cy ~Lu..19 -Y E'p BRI)J;Z
Department of Community Affairs
FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION
Residential Whole Building Performance Method A
BUILDER:
PERMITTING a/7ft Or CLIMATE. /'
OFFICE: ~t:?HrR#/L~ ZONE: 41~1 51_1 61_1
PERMIT NOJI1()'1-k!> JURISDICTION NO'-~//6 00
CK
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)
b. 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: 8132
CENTRAL
New Construction
Single-Family
o
1.
2.
3.
4.
5. 1202.00
6. 1.00
7. 0.00
Single Pane
8a. O.Osqft
8b.120.1sqft
Double Pane
O.OOsqft
O.OOsqft
9a.R= 0.00 , 162.20 ft
10a-1 R= 5.00, 963.80sqft____
10b-2 R=11.00, 298.20sqft____
11a.R=22.00 , 1322.20sqft____
12a. R= 6.00, uncond
13. Type: Central A/C
SEER: 10.00
14. Type: Heat Pump
HSPF: 6.60
15. Type: Electric
EF: 0.88
16.
17.
18.
2
CF CV
19.
19a.
19b.
86.59
23291.53
26898.78
-------------------------------------------------------------------------------
-------------------------------------------------------------------------------
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.
I Hereby certify that the plans and
specifications covered by this calcu-
lation are in compliance with the
Florida Energy Code.
PREPARED BY:
DATE:
I hereby certify that this building is
in compliance with the Florida Energy
Code.
OWNER/AGE~~~
DATE: q-II-CO
BUILDING
DATE:
*******************************************************************************
SUMMER CALCULATIONS
*******************************************************************************
=== BASE ===
=== AS-BUILT ===
-------------------------------------------------------------------------------
-------------------------------------------------------------------------------
g~~i~--~;;~-~-~~~;-:- POINTS I
TYPE
SC ORIEN AREA x SPM x SOF = POINTS
-------------------------------------------------------------------------------
E 26.70 82.2 2194.7 SGL TINT E 26.7 107.1 .93 2659.4
S 13.00 82.2 1068.6 SGL TINT S 13.0 98.3 .86 1097.6
W 80.40 82.2 6608.9. SGL TINT W 34.0 107.1 .94 3441.1
SGL TINT W 23.2 107.1 .93 2310.8
SGL TINT W 23.2 107.1 .93 2310.8
-------------------------------------------------------------------------------
.15 x CONDo FLOOR / TOTAL GLASS = ADJ. x GLASS =
AREA AREA FACTOR POINTS
ADJ GLASS
POINTS
GLASS
POINTS
-------------------------------------------------------------------------------
.15
1,202.00
120.10
1. 501
9,872.22
14,820.66 I
11,819.68
===============================================================================
NON GLASS------------ I
AREA x BSPM = POINTS TYPE
R-VALUE
AREA x SPM = POINTS
-------------------------------------------------------------------------------
WALLS----------------
Ext 963.8 1.0 963.8
Adj 298.2 .7 208.7
Ext NormWtBlock In 5.0
Adj Wood Frame 11.0
963.8
298.2
1.00
.70
963.8
208.7
DOORS----------------
Ext 20.0 4.8
Adj 17.8 1.6
96.0
28.5
Ext Insulated
Adj Wood
20.0
17.8
4.80
2.40
96.0
42.7
CEILINGS-------------
UA 1202.0 .6 721.2
Under Attic
22.0 1322.2
.90
1190.0
FLOORS---------------
SIb 162.2 -31.8 -5158.0
Slab-on-Grade
.0
162.2 -31.90 -5174.2
INFILTRATION---------
1202.0 10.9 13101.8
Practice #2
1202.0 10.90 13101.8
===============================================================================
TOTAL SUMMER POINTS I
24,782.72
22,248.54
TOTAL x
SUM PTS
===============================================================================
SYSTEM =
MULT
COOLING I TOTAL
POINTS COMPON
x CAP x DUCT x SYSTEM x CREDIT = COOLING
RATIO MULT MULT MULT POINTS
-------------------------------------------------------------------------------
24,782.72
.37
9,169.61 I 22,248.54 1.00 1.100
.340
.860
7,156.02
===============================================================================
*******************************************************************************
WINTER CALCULATIONS
*******************************************************************************
=== BASE ===
=== AS-BUILT ===
-------------------------------------------------------------------------------
-------------------------------------------------------------------------------
g~~i~--~~;~-~-;;~;-:- POINTS I
TYPE
SC ORIEN AREA x WPM x WOF = POINTS
-------------------------------------------------------------------------------
E 26.70 -3.4 -90.8 SGL TINT E 26.7 -2.0 .62 -32.9
S 13.00 -3.4 -44.2 SGL TINT S 13.0 -10.2 .91 -120.7
W 80.40 -3.4 -273.4 SGL TINT W 34.0 -2.0 .69 -46.7
SGL TINT W 23.2 -2.0 .62 -28.6
SGL TINT W 23.2 -2.0 .62 -28.6
-------------------------------------------------------------------------------
.15 x CONDo FLOOR / TOTAL GLASS = ADJ. x GLASS =
AREA AREA FACTOR POINTS
ADJ GLASS
POINTS
GLASS
POINTS
-------------------------------------------------------------------------------
.15
1,202.00
120.10
1.501
-408.34
-613.02 I
-257.52
-------------------------------------------------------------------------------
-------------------------------------------------------------------------------
NON GLASS------------ I
AREA x BWPM = POINTS TYPE
R-VALUE
AREA x WPM = POINTS
-------------------------------------------------------------------------------
WALLS----------------
Ext 963.8 1.1 1060.2
Adj 298.2 1.8 536.8
Ext NormWtBlock In 5.0
Adj Wood Frame 11.0
963.8
298.2
2.90
1. 80
2795.0
536.8
DOORS----------------
Ext 20.0 5.1 102.0
Adj 17.8 4.0 71.2
Ext Insulated
Adj Wood
20.0
17.8
5.10
5.90
102.0
105.0
CEILINGS-------------
UA 1202.0 .6 721.2
Under Attic
22.0 1322.2
.90
1190.0
FLOORS---------------
SIb 162.2 -1.9 -308.2
Slab-on-Grade
.0 162.2
2.50
405.5
INFILTRATION---------
1202.0 4.1 4928.2
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= 86.6
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 Tint
SINGL CLR DBL TINT
I------x--------------I
INSULATION. . . . . . . . . . . . . . . . . .
Ceiling
R-Value......... 22.0
R-10 R-30
I------------x--------I
R-O R-7
I--------------x------I
Wall
R-Value......... 5.0
Floor
R-Value......... 0.0
R-O R-19
Ix--------------------I
AIR CONDITIONER.............
SEER. . . . . . . . . . . . . . . . . . . . .. 10. 0
10.0 SEER 17.0
Ix--------------------I
HEATING SySTEM..............
Electric HSPF............ 6.6
6.8 HSPF 12.0
Ix--------------------I
WATER HEATER................
Electric EF.............. 0.88
0.88 0.96
Ix--------------------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.
Address:
Builder
Signature:
Date:
City/Zip
Florida Energy Code for Building Construction - 1993
Florida Department of Community Affairs
FL-EPL CARD93
11111111111111111111111111111111111111111111111111111111111I
2000105026
Permit No.
q7o~
Rcpt: 435682
DS: 0. 00
08/21/00
NOTICE OF COMMENCEMENT
County of tD.s c!. 0
Rec: 6.00
IT: 0.00
Dpty Clerk
State of _r'CY'd()-
THE UNDERSIGNED hereby gives notice that improvement will be made to certain
real property, and in' accordance with Chapter 713, Florida Statutes, the
following information is provided in this Notice of Commencement:
1. Description of Property: Parcel No. j I ;;;2(..p d.-I QO, 0 01<100 coY-D
(Legal description of the property and street address if available)
b\och- \Acr'v\ v
ne.-w s i (~I c ~,rnll J
I
I, JED PITTMAN PASCO COUNTY CLERK
" 08/21/00 12: 1~m 1 of 1
'-, OR 8K 442 t PG 1014
2.
Gt:HitH.al Desc:Li1-ltion of Improvement
3R.,
L
Otmer Information: Name GDvdon cu"\d ~eu..u 0.... 'T{,.n~vl ~
Address ~ S );;). Qhes +c..rO,.. City Ze..,~ r hi} l.s State Fe 33~'f J
Interest in Property:
OL0V\-e..Y'""
Name of Fee Simple Titleholder:
(If other thsn owner)
Address
City
State
Contractor: Name 'Ie-n SY'""V\1c. ~ ilis. 0 c' CA. + ( ~
Address 3S"S-\?- Q...hes.-\-~ y Dr. City L-W ~ yo ''''I , l..s
5. Surety: Name
4.
State Pc 3.3JLJ J
Address
City
State
Amount of Bond: $
6. Lender: Name
Address
City
State
7. Persons within the State of Florida designated by Owner upon whom
notices or other documents may be served as provided by Section
713.13(1)(a)(7), Florida Statutes:
Name
Address
City
State
8. In addition to himself, Owner designates
of to receive a copy of the
Lienor's Notice as provided in Section 713. ~.3 ( 1) (b), Florida St.atutes.
9.
Signature of Owner:
C!2-0-A-
Sworn to and subscribed before me this 21st day of August ,
by Paula Darlene Tenbrink who presented Florida Driver's License
#T516~664-49-874-0 as identification.
Notary Public:
" 2000.
My Commission Expires:
,,'~-';'.~r~', SUSAN HATCHEr!
~1'f.' '1"-\ MY COMMISSION. ' CC 1l~1}:!Cl'i
;"~hr.'~~ Bonded ThruNob.,y Public U~~nlers
flj"",
';;:jAi'I tlAtoti!:It
:.1 i (. :' ,;;""ION # CC 830396
R,.,J"d Thru Not~ry Public Und8nwtln
BOUNDARY SURVEY
Client: TENBRINK CONSTRUCTION
Work order number: 12957-ZH
Date of Survey: JULY 24. 2000
b
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NORTH LINE BLOCK 79
140.00'
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LOT I
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LOT 8
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SOUTH LINE BLOCK 79
----- "
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9th. A VENUE
30.0'
Lots 4 and 5, Block 79, CITY OF
I as recorded in Plat Book 1, Page
I . Records of Pasco County, Florida.
6O.ookR&M)
----- "-
I . + NW CORNER
)< BLOCK 78
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LEGAL DESCRIPTION
C. Fred Deuel and Associates, Inc.
5151 Gall Blvd.
Zephyrhills, Florida 33541
Phone: (813) 762-6717
Fax: (613) 782-5426
SECTION 11, TOWNSHIP 26 S., RANGE 21 E.
PASCO COUNTY, FLORIDA
K
ZEPHYRHILLS,
54, Public W
S
SCALE: 1" = 30'
~ I I
O' 30' 60'
SURVEYORS NOTES:
1. No underground installations or improvements have been
located except as noted.
2. No instruments of record reflecting el18ements, rights of
way, end/or ownership were furnished tbis surveyor except
8JI shawn.
3. This survey was prepared lfithout the benefit of a title
search.
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WIre Fence
Wood Fence
o..rtlead UIlIly IbI
UIIIlr Poll
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SectIon
= Home
~ CoIarJ Company LandI
Plat IIDck _. Pave -
Cemelfne
PoIM II CommIrICell1el1t
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Penr8*1I ~ Morunenl
PoInt II ~1Irilg
PoInt on Une
FOIIId 111)11 Rod
FOIIId InIn PIpe
FOIIId Concrwt. Morunenl
FOIIId Mal oil a.c
SIl 1 It Rn Rod (LB 107)
SIl Mal oil 1M (l.B 101)
Per ~ o.:r1ptIon or Record Plot
CoIculallld
F1eId IIeaIured
PIoporlIoned SectIon IlreaIalown
RadU
Chord lWance
Chord !lIcIfng
Paleo County Secllon Comer
C. .I'red /Jeue/ and Associate~ /nc.
Zephyrhllls St. Petersburg
Certificate of authorization number LB 107
Not valid without the signature and the original
raised leal of a Florida licensed surveyor and mapper.
The property described hereon was surveyed under my
direction and supervision, the sketch hereon is a true and
accurate representation of the same and this survey meets the
Minimum Technical Standards set forth by the Florida Board of
Professional land Surveyors in Chapter 61G17-6 Florida Administrative
Code pursuant to Section 472.027, Florida Statutes.
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HlllOS
TENBRINK & ASSOCIATES
LOTS 4 & 5 19TH STREET
SQ. FEET PRICE
MAIN OR LIVING AREA 1,202 $ 40.00
OTHER AREA UNDER ROOF 442 $ 15.00
OTHER
VALUATION $ 54,710.00
FEE SHEET $ 290.00
ADDRESS $ 20.00
DRIVEWAY $ 20.00
BUILDING: $ 475.00
CREDIT: $ -
BUILDING LESS CREDIT: $ 475.00
ELECTRICAL: $ 87.08
PLUMBING: $ 62.50
MECHANICAL: $ 35.00
RADON: $ 16.44
TOTAL $ 676.02
SEWER: $ 1,278.00
WATER: $ 350.00
IRRIGATION: $ - )(
TOTAL: $ 1,628.00
I
I
WATER METER:I $
IRRIGATION METER $
180.00 I
- X
SUB-TOTAL L~~~~~.~~-P
T IF'S: $ 1,480.00
99% $ 1,465.20
1% $ 14.80
TOTAL: $ 3,964.02 r
~tft)i/btl
*==
PERFORMANCE BUSINESS PRODUCTS. INC. 813-7111-8008 FAX 813-719-7Gll1
EJ .t~
CITY OF ZEPHYRHILLS
ZEPHYRHILLS, FLORIDA
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DATE ~ - :;L? -00
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SERVICE ADDRESS ~ 76f!!JZ - / 9 ~ ~ 110
~ \,.( WATER
SHUT OFF SERVICE 0 ~.
o SEWER
WATER ACCT. NO.
MAILING
TURN ON SERVICE
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READ METER
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o GARBAGE
~.IN CITY
INSTALL METER
CHECK METER
o OUT CITY
--L No. OF UNITS
OTHER
_ DEPOSIT AMOUNT
-tn ,0~ ~
- AMOUNT LAST BILL
_ DATE
c::.
--..
_ MISC. CHARGE
WORK COMPLETED BY
& DATE COMPlETED
ORDER TAKEN BY
Retain white form in office at all times.
Send pink & yellow forms to Water Service Dept
Water Service [)ept. to sign yellow form & return to office.
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PASCO COUNTYtt FLORIDA
Permit No.
, l
Date Permitted _
" /,
Builder Name/Owner Name
'..' ..~~;r
i 1,' .; (
County Parcel No.
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'-. ;.
AddressILocation
Subd.
Classificationffype of Use
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How Determined
TRANSPORTATION IMPACT FEE CALCULATIO~
EXEMPT 0
t
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
" '.
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EXEMPT 0
RESIDENTIAL
NONRESIDENTIAL
No. Units
Gross Sq. Ft. (GSF)
RJtl' ERL: - 52.00/YeJr
or SO.142/DJ)'
ERU Assign No,
Assl'~~rllenl ,- (!'<o Units) x ($0 142)
\ (No. DJ)'s)
Assessment -
(GSF) x (ERU) x (0.142) x (No. Days)
100
TOTAL FEE $
TOTAL FEE $
NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED UNTIL THE AMOUNTS LISTED
HAVE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTI"G OFFICE OF PASCO COUNTY. !
Acknowiedgement below does not imply acceptance of concurrence. but simply receipt of a copy of this form. placing
the building permit owner on notice of this assessment and the conditions of payment for same. "
Date
Received By
----- ---------------------------------------------------------------------------------------------
OFFICE L'SE ONLY
TRANSPORTATION REC. NO.
RESOURCE RECOVERY REC. NO.
DATE
DATE
BY
BY
White
Applicant
Canary
Trans/Finance
Canary
RR/Finance
Pink
Office
Green
Bldgllnsp
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feecaice
PC93113094/D
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