HomeMy WebLinkAbout01-0578
BUILDING PERMIT~~
0578
5 '1 \ . J::'
BUILDING
~.'{. .., "\
ELECTRICAL
CITY OF ZEPHYRHILLS
(813) 788~6611
"I Ie
-, 1. (~ ~ 5. ~-
PLUMBING MECHANICAL
Permit
/ J ....-r: V. I<
Property Owner: l) (.) ~ a O.It Ie 1\ Dr I ....
Job Address: S <1 I 1 ~ 0 I J 1"\ , \ \ L "
Parcel I. D. # I 1 . ';} t; . .~ I. 0 ,I) 0 - 00 D C U 0 J 7 Q
Date '1/2 10 /0 I
.
(k:'
Sewer Conn (2 7 ~,
? L" ot,
Water Conn: ..L ~o. -
I~ o. i:::
Zoning:
Description of Work
Energy Code:
~. ;,,\ ~ j i( Fc..N\ ~ , r
Radon Gas:
UvJ 'l 'L .'\~)
,., '" I
,,/0. _
FINAL
C.O.
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
.p.~~! ~a .tr"
algn~,~-1A..l~
Company
~s~
CTelePho~ g (3 7~ if- "tie 7 J!
PIt.<,,,,1? c~ ~l.icJ q"e".. SO\..i V...,erl"l LJ,'t1+\..r,+
PLUMBING I ~ % () MECHANICAL :) J
SLB V;,o .- tL'I-OI KL.'t Breakers
Tub Set //tz. -/:J. -D I Ducts Ins!. ~/.!z. - /t;2-0 I
Water . Compressor
Sewer J{-/5-01 HIO Finah/0~.25-O.2 ~
Final./' _ ~ .25-02 96i1f2lt
Valuation or
Contract Price
I 5 0 '10
l. I J
u;!
City License Registration #
State Certified License#
'1e/\ g r ..'\ k lr A s~C{ .
BUILDING .~ ~ I
Ftr.'tADuJ Ih--If) -0/71/3
Pre SLB /0- ~ (i-6l R. (II
Lintel li"I~-O J J1~
FRM. ,; /~-/ll-bl ,dfO
Insul. CL .J/,J.-d-IJ-01 j.f;)f)
WL ;JJ~ -JO-oI '..{JO
~1IF/9TII/~ /1-z/-1P/2i-'t
Driveway .;;). -1-0 ~ /2.L-Y
4tr"ytl,',\\s '6'1,,(
o
ELECTRICAL 7 (.
Tp. Servo
Rough In ,/
Meter Can
Const. Pole
Pool
Pre-Meter /.2--;; -01 R.L.t{
Final /fr25- 02- (2Ll(
rP.~ - 5 -0 'J- 4 .'2>D ~ln; Iu... U.
/<
L7'5J
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, ~
charge of Twenty Five and 00/100 Dollars ($25.00) shall be made for each trip for each~rad .
f .~e-
a. Wrong Address .L~
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.
Tenbrink & Associates
39128 Old Mill Lane
SQ. FEET PRICE
MAIN OR LIVING: 1,379 $ 40.00
OTHER AREA UNDER ROOF: 662 $ 15.00
OTHER: $ -
VALUATION $ 65,090.00
FEE SHEET $ 334.00
ADDRESS $ 20.00
DRIVEWAY $ 20.00
BUILDING: $ 541.00
CREDIT: $ -
BUILDING LESS CREDIT: $ 541.00
ELECTRICAL: $ 83.44
PLUMBING: $ 72.50
MECHANICAL: $ 35.00
RADON: $ 20.41
TOTAL $ 752.35
SEWER: $ 1,278.00
WATER: $ 350.00
IRRIGATION: $ -
TOTAL: $ 1,628.00
SIF'S: $ 1,694.00
97.5% $ 1,651.65
2.5% $ 42.35
TI F'S: $ 1,480.00
99% $ 1,465.20
1% $ 14.80
. ,{h
C. . \\t \" \
V"'\,''i)
. C\ VI
OWNER'S NAME 6',o,don~: 'Po...uJ C,---I-{.J\ \~V-l (,k-
JOB SITE ADDRESV: 39 I ~ g 0\ d vn \ I \ l.-CU1 e.....
"\
LEGAL DESCRIPTION: LOT (S) 03,0
PARCEL ID # ,.), - Jlo-.;LI -ClDO-OODDO-C)?> -70
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPAR~NT 5335 Sth STREET ZEPHYRHILLS, FL :33540
Phone:813-7S0-0020 Fax:813-7S0-0021 ~
DATE RECEIVED L-/7- 0 I
PLANS RBVXBW FEE !...
PHONE ~Ac~~';~5~I'gd -Cto 7b
/. ~ ...--.- --"
L-..__~. ~---..
BLOCK
SUBDIVISION
~~ ~xrl 01 (:( t-\- ; 1 }
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: ~NEW CONSTRUCTION
o ADDITION
o ALTERATION
o REPAIR
o INSTALL
DSIGN
o MOVE
o DEMOLISH
PROPOSED USE: ~SGL FAMILY DWELLING
DMULTI - FAMILY
0# OF UNITS
o MOBILE HOME
o COMMERCIAL
o INDUSTRIAl"
o SWIMMING POOL
o OTHER
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRI PTION OF WORK e.. en.s t( u..C t So J \ - f=o...m I I j io I Dck.. h (;yYl~
BUILDING SIZE SQUARE FOOTAGE d 04 I . ~ HEIGHT
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
123 BUILDING
PERMITS REQUESTED
$
$~tJO~
d,OO
'-
VALUATION OF TOTAL CONSTRUCTION
lS!I ELECTRICAL
AMP SERVICE
~
FLORIDA POWER
o
W.R.E.C.
~ PLUMBING
I8l MECHANICAL
$ d~ ;) S . 00
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: ~ BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES ~ NO
SIGNATURE
~ 7-~~
COMPANY 'T en i~( Ink. ;. Rs~ 0(, .
STATE CERT OR REGIST #. L E,~ 0434 ;;) ~
CITY PROCESSING # 3g,
le. ~
******************************************************************
BUILDER
ELECTRICIAN~?fJ COMPANY Z- <;p~y hi IIS~ Cl-€.C-t-.l C Svc
~ \ STATE CERT OR REGIST #, OCO d-.llo8
SIGNATURE~.... ~ CITY PROCESSING # CJlO
"'''{"..J
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *:* * * * * * t",\:~ * * * * *
PLUMBER COMPANY PI LUll be r.s u+- ~ ~ c:ne.V\ Ct" t.
./,-;,P / ,?,~~_ ~.f STATE CERT OR REGIST #.. (Fe os 1S" D4
SIGNATURE 174''"l:1'---Y r;c..r #-?~ CITY PROCESSING # I ~ Q{)
JJ, ~';!:!
******************************************************************
MBCHANXCAL .') COMPANY SctA..i-ht.rl'\ ~{hy~.pC"f+
..r! ~/ (). J /.. STATE CERT OR REGIST #.. Rm ot; I ~ 0 d ;;..
SIGNATURE ~ X ~ CI'l'Y PROCESSING # 53
~ *******~*********************************~*~***f**f~~~***
OTHBR
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 regulat:ions. The undersigned assumes responsibility for.
compliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIE:S
If the ~wn~r h~s hired a contractor or contractors to undertake work, they.may be required
t~ be l~censed: in accordance with state and 'local regulations~, If I th,~,c,ontfactor is not
l~censed as required by law, both the owner and contractor may be cited for a misdemeanor
violation under state law. If the ownec or inte'n<iled cQntllactor qre'uttcertain as to what
licensing requirements may apply for the intended work, they are ad~ised 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
c~ntractor (s) sign portions of the "c.9J;ltractor )C)ectio~s""of t}lis\,appljl.cation~ for which they
w~ll be responsible. If you, as the owner signs as the contractor, you are ~ndicating 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: " ,
I certify that all the information in this application is
be done in compliance with aJ1 applicable laws regulating
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 COMMENC~lENT 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".
~~~
-----;IGaURE: OWNE~ OR AGENT.
. ,I
accurate and that all work will
construction, zoning, and land
--'
~~/
SIGNP( : CONTRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
Before me this'~ day of 19_
by ~\~(..,-,ml.&-V"'?'J
(name of person acknowledged)
Dwho is personally known to me, or
STATE OF FLORIDA
COUNTY OF
The foregoing instrum~nt was acknowledged
Before me this _day of' , 19 ~
by ~.:~ 1--, VVL..-Ar~^v
(name of person acknowledged)
[1ho is personally known to me, or
Dwho has produced
(type
and whoD did Ddid not
of identification)
take an oath.
Dwho has produced
(type of identification)
and who Ddid [}iid not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
Department of Community Affairs
FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION
FORM 600A-93 Residential Component Prescriptive Method A
PROJECT NAME: I BUILDER: Tenbrink Construction
AND ADDRESS: "S't'j / 2 ~ 0 leA f\: I \ L", l PERMITTIl'JG ~ Z ,rb, ~QJ,.IMATE ../
I OFF I CE: L."o/ () "tryr ,~~NE: 4 If'l 5 I_I 6 I_I
IPERMIT NO. 0 S7B IJURISDICTION NO. l:,u.c.,O
r-TCK
OWNER: ~"~..-:,,,k I (:rv..doV'l
1. New construction or addition
2. Single family detached or Multifamily attached
3. If Multifamily-No. of units
4. If Multifamily, is this a worst case (yes/no)
5. Conditioned floor area (sq.ft.)
6. Predominant eave overhang (ft.)
7. Porch overhang length (ft.)
8. Glass area and type:
a. Clear Glass
b. Tint. film or solar screen
9. Floor type and insulation:
a. Slab on grade (R-value. perimeter)
10.Net Wall type area and insulation:
a. Exterior: 1. Concrete (Insulation R-value)
a. Adjacent: 2. Wood frame (Insulation R-value)
II.Ceiling type area and insulation:
a. Under attic (Insulation R-value)
12.Air distribution systems
a. Ducts (Insulation + Location)
13.Coolingsystem
14.Heating System:
15.Hot water system:
16.Hot Water Credits: (HR-Heat Recovery,
DHP-Dedicated Heat Pump)
17.Infiltration practice: I, 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
CENTRAL
New Construction
Single-Family
o
1.
2.
3.
4.
5. 1379.00
6. 1. 25
7 . 7 . 30
Single Pane
8a. O.Osqft
8b. O. Osqft
Double Pane
O.OOsqft
201. 69sqft
9a.R= 0.00 . 164.60 ft
10a-l R= 5.00, 876.71sqft_
10a-2 R=11.00. 200.60sqft_
l1a.R=22.00 , 1379.00sqft_
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.
..,
",
CF CV
19.
19a.
19b.
80.32
23200.39
28885.82
----------------~--------------------------------------------------------------
-----------------------------------+-----------~-------------------------------
I Review of the plans and specifications
: covered by this calculation indicates
I compliance with the Florida Energy
I Code. Before construction is completed
: this building will be inspected for
I compliance in accordance with Section
I 553.908 F.S.
I
I
I
I
I
I
I
I
I
I
I
I
I
I
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.
~ ':t?-
OWNER/A.. . ~
DATE: -,-7 00 ~
BUILDINajOFFhIAL:EUL 6~-v-
DATE: Cj ,:'5 01
, (
*******************************************************************************
SUMMER CALCULATIONS
*******************************************************************************
=== BASE === I === AS-BUILT ===
===========================~=================================:==================
GLASS----------------
ORIEN AREA x .BSPM =
I
J
POINTS :
TYPE
SC
ORIEN
AREA
x SPM
x SOF
= POINTS
-------------------------------------------------------------,------------------
N 32.38 82.2 2661.6 DBL TINT N 16.2 43.5 .90 636.5
DBL TINT N 16.2 43.5 .90 636.5
E 48.16 82.2 3958.8 DBL TINT E 14.2 81.3 .84 1036.6
DBL TINT E 34.0 87.3 .26 771.7
S 104.96 82.2 8621.7 OBL TINT' S 16.2 18.8 .40 50T.b"
DBL TINT S 16.2 78.8 .40 507.6
DBL TINT S 40.2 78.8 .39 1235.4
DBL TINT S 16.2 78.8 .85 1089.9
DBL TINT S 16.2 78.8 .85 1089.9
W 16.19 82.2 1330.8 DBL TINT W 16.2 87.3 .91 1284.8
--------------------------------------------------------------------------------
.15 x CONDo FLOOR / TOTAL GLASS = ADJ. x
AREA AREA FACTOR
GLASS
POfNTS
=
ADJ GLASS
POINTS
GLASS
PO I N'rS
--------------------------------------------------------------------------------
.15
1,379.00
201.69
1. 026
16,518.92
17,00:L07 :
8,796.50
========================c=======================================================
NON GLASS------------ f
AREA X BSPM = POINTS: TYPE
R-VALUE
AREA X SPM = POINTS
--------------------------------------------------------------------------------
WALLS----------------
Ext 876.7 1.0
Adj 200.6 .7
DOORS----------------
Ext 20.0 4.8
Adj 17.8 1.6
876.1
140.4
Ext NormWtBlock In
Adj Wood Frame
5.0
11.0
816..7
200..6
1. 00
.70
816.1
140.4
96.0
28.5
Ext Wood
Adj Wood
20..0
17..8
1.20
2.40
144.0
42.7
CEILINGS-------------
VA 1319.0 .6 827.4
Under Attic
22.0 1319.0
.90
1. 2-4 L 1
FLOORS---------------
SIb 164.6 -31.8 -5234.3
INFILTRATION---------
1379.0 10.9 15031.1
Slab-an-Grade
.0
164.6 -31.90 -5250.7
Practice #2
1319.0 10.90 15031.1
===============================================================================
'fOTAL SUMMER POINTS I
28.768.90 :
21. 021. 8,1
==========c==========================================~========:=================
TOTAL X
SUM PTS
SYSTEM
MULl'
=
COOLING I TOTAL
POINTS : COMPON
x CAP x DUCT x SYSTEM x CREDIT = COOLING
M'rrO MOLT MULT MULT POINTS
--------------------------------------------------------------.-----------------
28,768.90
.37
'10,644.49 : 21,021.81 1.00 1.100
.340
.860
6,761.45
==============================================================:=================
<J. [':xpi. rnf:,L (m dt't t.e .ot f'JCJt.l.ce of Commencement. (the expl.rat iCJn date is 1 year
fr?rrl t;.f~e. c..l~:i;:c Qf l:'cc'ordi;}g unless a c">~ffc.:-ent c"~~ is spc~if~_'=~. i
Signature of Owner:
Sworn to and subscribed before me this
~~
lD'fk.. day of
~r~ ~lIbliC:~~
My C:::l:n.il.i ssion Expires: L(-..l-7-03
-"\.-.... JAMIE L.
W~~~ MY COMMISSION .CC799573
~ .: I EXPIRES: April 27. 2003 .
. Bondlcl ThN Nolary Public UndlrwrilelS
.~
PC93053048
.~
~~~
-E]
F'ERFORMANCE BUSINESS PRODUCTS. INC. 813-'719-8008 FAX 813-719-7919
CITY OF ZEPHYRHILLS
ZEPHYRHILLS, FLORIDA
WATER ACCT. NO.
DATE
9 / 1~ tv I
OWNER/ -r- v. \"
RENTER . I e^ l)!"..'\ l("
4 ASSOc.
MAILING
SERVICE ADDRESS S'c; I :1 ~ old /!A. 1, \
L,-:;Jt .,
SHUT OFF SERVICE 0 -r
TURN ON SERVICE ~.
INSTALL METER ~
READ METER 0
CHECK METER 0
OTHER 0
,
L../\ .
~ WATER
o SEWER
o GARBAGE
Jif- IN CITY
o OUT CITY
~ No. OF UNITS
_ DEPOSIT AMOUNT
_ AMOUNT LAST BILL
_ DATE
s jlf I' WC:ttu
t"'-e+ e..,
_ MISC. CHARGE
WORK COMPLETED BY
& DATE COMPLETED
ORDER TAKEN BY
'7/Hc (0 I
Retain white form in office at all times.
Send pink & yellow forms to Water Service Dept.
Water Service Dept. to sign yellow form & retum to office.
- - -- - ~ -- ~- - ~ - ~-.___'---t ---~--'- --'-~--",--.~ .-.-------............-..........--.--..--..--------.--.-.1
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lJ'
PASCO COUNTY. FLORIDA
Permit Nu. 05 "7'd
Date Permitted q /:1(.; h; I
BuilderName/OwnerName -r;.c." K/: "'" k
4 l\S Sot,
1 '1 .
County Parcel No. i "i i)
Address/Location J'-, I ) ')
2 l - 0 f 00, Ot.i(JU().. 0 S 7 ()
o tel I~ L \, L ,., .
/. . 'q
Subd. ) v t" \ f" \. /' h. I
ClassificationfType of Use
('
:) .
'1 t \:
.i-. . .
r <:t.......!, \\1
,
C)\.A.)~ IL'f"')
How Determined
l'I
TRANSPORTATION IMPACT FEE CALCULATION
EXEMPT 0
-'
Why?
/
/
Zone No. /
-
Prep~y
j
.'
Rate $
Sq. FtlUnit ,/
/
,/
Impact Fee..~ount $
Checked By
The a9l'1(~ impact fee has been established pursuant to the Pasco County Transportation Impact Ordinance as adopted by the
B9afd 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
No. Units
(
NONRESIDENTIAL
Gross Sq. Ft. (GSF)
RatL' ERl: - .'i200/Ycar
or SO.142/Day
ERU ASSign No.
lbsL'sSTllL'nl -- (No Units) x ($0.1421
.\ (No Days)
Assessment -
(GSF) x (ERU) x 10.142) x (No. Days)
100
TOTAL FEE $
TOTAL FEE $ _
NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED VNTIL THE AMOUNTS LISTED
HAVE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTI~G OFFICE OF PASCO COUNTY.
Acknowiedgement below docs not imply acceptance of concurrence. but simply recL'ipt 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
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. t:( BY
BY
-----+-- /
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White
Applicant
Canary
Trans/Finance
Canary
RR/Finance
Pink
Office
Green
Bldg/lnsp
feecalce
PC93113094/D
PASCO COUNTY, FLORIDA
SCHOOL IMPACT FEE
Ordinance No. 01-06
Effective: February 28,2001 at 2:08 p.m.
Permit No. D 5 7 ~
Date Permitted: '9 - ~fu .-0 I
Builder Name/Owner Name Gcr\~ 1..JU1~
Parcell D: f 2 -2.4f -..(1- Of 00- 00000 - 03"1 D
Address/Location: Ji q I:II) ~U M",I/ ~N.
Subdivision:
Classificationrrype of Use:
~ngle-FamilY Detached House
o Mobile Home
o Other Residential
o Collection Fee
Total Fee
/' No
(056) t(" q([, 00
(057)
(058)
(123)
$ 1/0 1tf . I}IJ
Exempt:
Yes
How Determined:
Prepared By: ~-r~ ~~
Checked By: --.H~~Kt. ~
The above impact fee has been established pursuant to the Pasco County School
Impact Fee Ordinance No. 01-06 as adopted by the Pasco County Board of County
Commissioners. This amount is payable PRIOR to the issuance of a Certificate of
Occupancy or where a Certificate of Occupancy is not required PRIOR to the final
inspection.
NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOUNT LISTED HAS BEEN PAID AND
RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY.
Acknowledgment below does not imply acceptance or 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.
& - ,;2. B- ~O ~
Date
n:~y~
Received By
OFFICE USE ONLY
RECEIPT NO. /~/1r
DATE ~ --~ rb (J;:Z BY ;(,-~
White
Customer
Canary Pink Gold
Finance School Board Inspection
PC01005114/A