HomeMy WebLinkAbout00-9947
Permit
.
Q'd
Ie;. .
5/7/01
BUILDING PERMIT
~11.~
BUILDING
~1.7Z
ELECTRICAL
CITY OF ZEPHYRHILLS
(813) 788-6611
b). ?!3
PLUMBING
09947
Date IIl3a/oo
?S. "
MECHANICAL
Sewer Conn
Water Conn:
127 S - ~
J'~o. ~.
Property Owner:
Job Address:
Parcell.D. #
Radon Gas: 17. "!.!
Water Meter: I 'la. ~
TI.F.'s:
.W
7fl
Zoning:
Energy Code:
DescriPtion of Work (,""$ I ~ {;;.~ "y
r /'~ . ""de,(' F' P '): 20 p~
OW{lll " "J
Cr y~+4(
A1?
FINAL
L#11I(ot
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.
DATE
Inspector S'
City License Registration #
State Certified License#
P~'m;t F~.'~
Slgnatur +-h
Company
Address
Telephone#
tlp~
Valuation or
Contract Price
tot} I 7Q). ~
~ I t'(.
)"6 ~-{) Z35
De.. ~ : J" t.J: II i .",,1" .,:; ~.
PLUMBING 192.(:) MECHANICAL
SLB V'12 -I 4_00 .s It.. Breakers
Tub Set 2 - /4 - "I 5"~ Ducts Ins!.,;?..... / 4" ~ l)J
Water ~ - 2.0-(!! ~ Compressor
Sewer ~...../6,.p ~ Final
Final
~y~"" G,,,(~.
BUILDING 'J7 'f
(; Ct s+
P~.t" UJ
~j
-I:..
ELECTRICAL
Ftr.
Pre SLB J2~1t; -DC) 3 n...
Lintel ;~'2.. 1-oQ ~
FRM. --.!4-/:)/ ~
Insul. CL
WL ;}-q, t!J I oS Il.
Tp. Servo
Rough In z~ lit-/) J Sf(
Meter Can
Canst. Pole
Pool
Pre-Meter A/...//.....I.J/ SR_
Final
~~8~ l2...lS-0t!)S~
~I?
-
Driveway ') J2.fD-t:::> L } Il
~ I,. 1e.-tJ f Y te..
a.
b.
C.
d.
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 each trip for each trade:
vJ<<)I-Q ~~.., l .
f~:J
Wrong Address
Condemned work resulting from faulty construction.
Repairs or corrections not made when inspection called.
Work not ready for inspection when called.
Permit not posted on job site.
Plans not at job site.
Work not accessible.
e.
f.
g.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
RYMAN CONSTRUCTION
HIGHLAND LOOP
SQ. FEET PRICE
MAIN OR LIVING AREA 1,325 $ 40.00
OTHER AREA UNDER ROOF 415 $ 15.00
PATIO SLAB: 157 $ 10.00
VALUATION $ 60,795.00
FEE SHEET $ 314.00
ADDRESS $ 20.00
DRIVEWAY $ 20.00
BUILDING: $ 511.00
CREDIT: $ -
BUILDING LESS CREDIT: $ 511.00
ELECTRICAL: $ 83.72
PLUMBING: $ 62.50
MECHANICAL: $ 35.00
RADON: $ 17.40
TOTAL $ 709.62
SEWER: $ 1,278.00
WATER: $ 350.00
IRRIGATION: $ -
TOTAL: $ 1,628.00
I
1
WATER METER:I $
IRRIGATION METER $
180~00 I
SUB-TOTAL $
2,517.62 I
T IF'S: $ 1,480.00
99% $ 1,465.20
1% $ 14.80
TOTAL: $ 3,997.621
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
DATE RECEIVED
PLANS REVIEW FEE
OWNER'S NAME M i\.-tI tv> D ':sO"S' ~~ h JtVt: W~
~~bL E6\\Jc.,. -Z~~
LEGAL DESCRIPTION: LOT (S) 3d-.
-:s~, "Z S' "2. \. C:>\OO;, 66006 ...6SZ D
PHONE
JOB ADDRESS
SUBDIVISION 6A"-.
~
BLOCK
PARCEL ID #
(OBTAIN FROM PROPF.RTY TAX NOTICF.1
WORK PROPSED: ~CONSTRUCTION
o ADDITION
DALTERATION
o REPAIR
o INSTALL
DSIGN 0 MOVE D DEMOLISH
PROPOSED USE: D~AMILY DWELLING DMULTI-FAMILY 0# OF UNITS
D COMMERCIAL
D INDUSTRIAL
D SWIMMING POOL
o MOBILE HOME
D OTHER
~
DESCRIPTION OF WORK ~
BUILDING SIZE 4~ ~ 3~ I~ "
c:J RESTAURANT & ~EALTH DEPARTMENT APPROVAL
~&..uvvt--{
SQUARE FOOTAGE
\\~o
HEIGHT 2:Jl
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 CONSTRUCTI
D BUILDING
$
~D 100D
Z-CO
PERMITS REQUESTED
.~.'.,.'"
~'"
VALUATION OF TOTAL CONSTRUCTION
D ELECTRICAL
AMP SERVICE
~ORIDA POWER
D
W.R.E.C.
o PLUMBING
o MECHANICAL
$
3c>D
VALUATION OF MECHANCIAL INSTALLATION
D GAS
D ROOFING
D SPECIALTY
D OTHER
TYPE OF CONSTRUCTION: ~OCK
D FRAME
D STEEL
D OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES ~
COMPANY RYH.\PJ CONaTRUCTION, Hrc
STATE CERT OR REGIST # ('BC 03513Ll
CITY PROCESSING # 274
******************************************************************
ELECTRICIAN
SIGNATURE \~ ~
COMPANY El'.5T Pll sca ELECTRIC
STATE CERT OR REGIST # ER-0014591
CITY PROCESSING #
******************************************************************
PLmmER
SIGNATURE
~~L(
COMPANY DHJNIS WILI.L1)MS
STATE CERT OR REGIST # RF-05260
CITY PROCESSING #
J4ECBANICAL
SIGNATURE ~ ~ '----
~
***********~******************************************************
COMPANY. ~l'.~R~ Gl'.~ ~Nn l'.lc
STATE CERT OR REGIST # CAC-043498
CITY PROCESSING #
r *******~**********************************************************
OTHER COMPANY RYMAN ~()NS'T'RU~'T'T()N. TN~.
STATE CERT OR REGIST # RC-0061648
SIGNA~ '. _ ----- CITY PROCESSING #
*****************************************************************
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 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 SectionsH 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 ~AH or ~A,etc.H, 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 V DO NOT NEED TO RECORD AND POST A ~NOTICE OF COMMENCEMENT".
~~R
STATE OF FLORIDA (J. "" J\
COUNTY OF COUNTY OF __,llJ/l.../t )
The foregoing instrum.ent wa;l'\acknow+~dged The foregoing instrument wa, ac~nowledged ')
Befor~jme this-11- d~ of tV()vl.fi~ 1.~C1Ck)c)Before this Cl-day 0 o'vUf 1~~t)L
by l...gllJ I V\ ~ J L4.flr Yf\ ~_ by . i ~~_..-.--
f (name of persorl ac nowledged) r7f'J (name of person acknow dged)
~o is personally known to me, or ~o is personally known to me, or
'I
Owho has produced
(type
not
o who has produced
(type
[):I.id no
1
C
re ~~ ~~~~H~ing acknowledgement
"6~
~~~MY Commission CC800247
"h.. .~{t EXpIrA~ l::anll~r:y -:t 200]
Name typed, printed or stamped
S ure 0 person ta ing acknowledgment
"8~ Angela L Helms
!N *Mv Commission CC800247
Name t yp~!:1' ;""~ ~f'~t~aauag' J? ~mped
1111I1111111 11I11 1111I 11I111111I 11I1111111111111111I1111111I .
2000139694 .
Rcpl: 453225
DS: 0.00
11/07/00
NOTICE OF COMMENCEMENT-
State af~ndQ Countyaf PMt!D
,
Rec: 6.00
IT: 0 . 00
Dpty CJerk
THE UNDERSIGNED hereby gives natice that impravement will be made
to ceJ:tain J:eal pJ:aperty, and in accaJ:dance with ChapteJ: 713,
Flarida Statues, the fallawing infannatian is pravided in this
Notice of Commencement:
1.DescJ:iptiaa a f I'rapeJ:ty: I'ax:cel Na.,' '3'/- ). 7-d f- d co. --0. Q Ci:t)- 03 dO
.
Name of Fee Simple Titleholder:
(If other than owner)
R
AddIess City
4.Contractor: Name RYMAN CONSTRUCTION, INC.
Address 37325 S.R. 54 w.
State
City ZEPHYRHILLS Staten 33541
5.Surety: Name
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 o~ o~ documents may be se~ved as p~ovided by Sectio~
713.13 (I) (a) (7), Florida Statutes:
Name
Address
City
State
a.In additio~ to himself, Owne~ designates
of to ~eceive a copy of the Lieno~'s
Notice as provided in section 713.13(1) (b), Florida Statutes.
9.Expiration date of Notice of Commencement (the expiration date is
1 year from the date of recording unless a different date is
specified. )
Signatw:e af Owned:a t? -;. J:int Name ~fJl1R.uJ fl ' u..h')i.t{J{
SWorn ta and subseti ed before me t ia' ] day of II) fYj.p~~'hv~
~:::~ ~lic:s41 ~QP!4c j~ 00
My Commission Expires:
""6~fa AI'~L"eIfTJS
~"~MY Commission CC8oo247
......,..f' Expires Janua/y 3, 2003
C
Department of Community Affairs
FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING
FORM 600A-93 . Residential Whole Building Performance
PROJECT NAME: Model #1 Face E. BUILDER: f?v........,.. Co... u.
to'. ND ADDRESS,: L::ot- 32 U.,~D PERMITTINd' " f
'-" 'OFFICE: Zk!(.Jky, 11, I }
OWNER: MA.~ ""'~~ Wo...~ PERMIT NO. 99Y7
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
).4.Heating System:
I
'~S.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: 6251
CONSTRUCTION
Method A
CENTRAL
CLIMATE /
ZONE: 4111 51_1 61_1
JURISDICTION NO. ~/,.oo
CK
1.
2.
3.
4.
5. 1300.00
6. 1.00
7. 0.00
Single Pane
8a. O.Osqft
8b.116.7sqft
New Construction
Single-Family
o
Double Pane
O.OOsqft
O.OOsqft
9a.R= 0.00 , 187.10 ft
10a-1 R= 5.00, 1036.15sqft
10b-2 R=11.00, 306.20sqft-===-
11a.R=22.00 , 1300.00sqft____
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
19.
19a.
19b.
88.82
24869.92
28001. 75
-------------------------------------------------------------------------------
-------------------------------------------------------------------------------
I Hereby certify that the plans and
specifications covered by this calcu-
lation are in compliance with the
Florida Energy Code.
PREP~~ s=r~
DATE: \ \ S- e () r ;;>
I hereby certify that this building is
~~d~~mPlia~orida Energy
OWNER~' -- _ _ .~
DATE:, V
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.
BUILDIN7 );FIILALj6~ (~
DATE: J p) vo
f
c
,..,
./ "
*******************************************************************************
~== BASE === I === AS-BUILT ===
c:=============================================================================
OR~~~--~;~-~-~~~~-:- POINTS I TYPE SC ORIEN AREA x SPM x SOF = POINTS
SUMMER CALCULATIONS
-------------------------------------------------------------------------------
N 3.30 82.2 271.3 SGL TINT N 3.3 51. 5 .86 145.4
E 48.57 82.2 3992.5 SGL TINT E 16.2 107.1 .93 1616.7
SGL TINT E 16.2 107.1 .93 1616.7
SGL TINT E 16.2 107.1 .93 1616.7
S 4.78 82.2 392.9 SGL TINT S 4.8 98.3 .73 344.6
W 60.00 82.2 4932.0 SGL TINT W 30.0 107.1 .92 2965.7
SGL TINT W 30.0 107.1 .92 2965.7
-------------------------------------------------------------------------------
.15 x CONDo FLOOR / TOTAL GLASS = ADJ. x GLASS
AREA AREA FACTOR POINTS
ADJ GLASS
POINTS
GLASS
POINTS
-------------------------------------------------------------------------------
.15
1,300.00
116.65
1.672
9,588.63
16,029.00 I
11,271. 39
NON G~~~--~--~~~~-: POINTS I TYPE
===============================================================================
R-VALUE
AREA X SPM = POINTS
-------------------------------------------------------------------------------
WALLS----------------
Ext 1036.2 1.0 1036.2 Ext NormWtBlock In 5.0 1036.2 1. 00 1036.2
Adj 306.2 .7 214.3 Adj Wood Frame 11. 0 306.2 .70 214.3
DOORS-------------~--
,F::x t 20.0 4.8 96.0 Ext Wood 20.0 7.20 144.0
~j 17.8 1.6 28.5 Adj Wood 17.8 2.40 42.7
CEILINGS-------------
UA 1300.0 . 6 780.0 Under Attic 22.0 1300.0 .90 1170.0
FLOORS---------------
SIb 187.1 -31.8 -5949.8 Slab-on-Grade .0 187.1 -31.90 -5968.5
INFILTRATION---------
1300.0 10.9 14170.0 Practice #2 1300.0 10.90 14170.0
TOTAL SUMMER POINTS I
26,404.19
===============================================================================
TOTAL x
SUM PTS
===============================================================================
22,080.11
SYSTEM
MULT
=
COOLING I TOTAL
POINTS COMPON
x CAP x DUCT x SYSTEM x CREDIT = COOLING
RATIO MULT MULT MULT POINTS
-------------------------------------------------------------------------------
26,404.19
.37
9,769.55 I 22,080.11 1.00 1.100
.340
1.000
8,257.96
===============================================================================
C\ ,....,\
· U
**********************************************************************~********
WINTER CALCULATIONS
*******************************************************************************
=== BASE === I === AS-BUILT ===
~=============================================================================
OR~~--~~~-~-~~~~-:- POINTS I TYPE se ORIEN AREA x WPM x WOF = POINTS
-------------------------------------------------------------------------------
N 3.30 -3.4 -11.2 SGL TINT N 3.3 9.6 1.09 34.4
E 48.57 -3.4 -165.1 SGL TINT E 16.2 -2.0 .63 -20.3
SGL TINT E 16.2 -2.0 .63 -20.3
SGL TINT E 16.2 -2.0 .63 -20.3
S 4.78 -3.4 -16.3 SGL TINT S 4.8 -10.2 .78 -38.1
W 60.00 -3.4 -204.0 SGL TINT W 30.0 -2.0 .58 -35.1
SGL TINT W 30.0 -2.0 .58 -35.1
-------------------------------------------------------------------------------
.15 x CONDo FLOOR / TOTAL GLASS = ADJ. x GLASS =
AREA AREA FACTOR POINTS
ADJ GLASS
POINTS
GLASS
POINTS
-------------------------------------------------------------------------------
.15
1,300.00
116.65
1. 672
-396.61
-663.00 I
-134.77
NON GLASS------------ . I
AREA x BWPM = POINTS TYPE
===============================================================================
-------------------------------------------------------------------------------
R-VALUE
AREA x WPM = POINTS
WALLS--------------__
Ext 1036.2 1.1 1139.8
Adj 306.2 1.8 551.2
DOORS------------_~--
Ext 20.0 5.1 102.0
(' j 17.8 4.0 71.2
\...
CEILINGS-----------__
UA 1300.0 .6 780.0
Ext NormWtBlock In 5.0 1036.2
Adj Wood Frame 11.0 306.2
2.90
1. 80
3004.8
551.2
Ext Wood 20.0
Adj Wood 17.8
7.60
5.90
152.0
105.0
Under Attic 22.0 1300.0
.90
1170.0
FLOORS------------___
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= 88.8
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 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
R-O R-19
Ix-------------------_I
Wall
R-Value......... 5.0
Floor
R-Value......... 0.0
r-
~/
'-.-./
AIR-CONDITIONER. . . . . . . . . . . . .
SEER. . . . . . . . . . . . . . . . . . . . .. 10.0
~ATING SYSTEM. . . . . . . . . . . . . .
10.0 SEER 17.0
Ix--------------------I
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.
\ _ n Builder ~
Address, 1..:)01: 3"- - 6~k. ~ Signat:ur ~z.. - - ---::;
City/Zip 2~h~~tl& s~sq,
Florida Energy ode for Building Construction - 1993
~, Jrida Department of Community Affairs
Date:~\dOa
I
FL-EPL CARD93
OWNER .1 '.~~:~tt A.Na -SO~If~h(~ ""A~~
JOB LOC"Tr~N ~<t ~2.. W~ Soh \I\").J~ uoop- O,,-Ie g""",,_
?I'.RCEL I,P.' };;,~~ 2;6 -~, · C 100 - 4.:)0.:0 -O~ ~ "" 't;" '"
SHO~~'~~5 "~~~7~~~;'&~RO~ OSED STRUC~URll ~ is VINg' DIH~N S IONS ..&~~?:BTj~K S .
~5~ to 7
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(NOTE EXAMPLES 1 & 2)
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PERFORMANCE BUSINESS PRODUCTS. INC. 813-719-8008 FAX 813-719-7Q.111
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CITY OF ZEPHYRHILLS
ZEPHYRHIlLS, FlORIDA
O(} ~&/13
WATER ACCT. NO.
DATE 1115<>1 ()t)
OWNERI 0
RENTER f-..y~",
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MAIUNG J7 3z~ S'f
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SERVICE ADDRESS '( 3 1 ~
Wt25"f
F( )]5'-1'
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Lolr "'32
~ WATER
SHUT OFF SERVICE 0
TURN ON SERVICE ~
INSTALL METER J(
READ METER 0
CHECK METER 0
OTHER 0
o SEWER
o GARBAGE
P IN CITY
o OUT CITY
I
_ No. OF UNITS
- DEPOSIT AMOUNT
)/'1" ~ ",,~-I-e.r-
- AMOUNT LAST BILL
_ DATE
- 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 bept.
Water Service Dept. to sign yellow form & return to office.
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PASCO COUNTY~ FLORIDA
Permit No.
/
Date Permitted
/
Builder Name/Owner Name
"f
County Parcel No.
AddresslLocation
Subd.
Classificationffype of Use
How Determined
TRANSPORTATION IMPACT FEE CALCULATION
EXEMPT 0
Why?
Rate $
Zone No.
Sq. Ft/Unit
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)
RaleERl' - 52.00/Year
or SO.142/Da\
ERU Assign No.
A~~L'~sTllenl
()\io. Units) x ($0.142)
x (No. Day~)
As~essment -
(GSF) x (ERU) x (0.142) x (No. Days)
100
TOTAL FEE $
TOTAL FEE $
The aoO\e assessment has been established pursuant to the Pasco County Ordinance No. 89-07 and Resolution No. 89-197.
as commended.
THE ASSESSMENT WILL BE CALCULATED AT THE TIME OF ISSUANCE OF THE CERTIFICATE OF
OCCUPANCY
NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSVED VNTIL THE AMOUNTS LISTED
HA VE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTI\fG OFFICE OF PASCO COUNTY.
Acknowkdgement below does not imply acceptance of concurrence, hut simply receipt of a copy of this form. placing
the huilding permit owner on notice of this assessment and the conditions of payment for same.
(
Date
Al
Received By
----- ----------------------------------------------------------------------------------------------------------------------
OFFICE CSE ONLY
TRANSPORTATION REC. NO.
RESOURCE RECOVERY REC. NO.
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DATE
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Bldg/lnsp
DATE
White
Applicant
Canary
Trans/Finance
Canary
RR/Finance
Pink
Office
feecalce
PC93113094/C