HomeMy WebLinkAbout01-0633
BUILDING PERMITN~ 063
49'1. t?:
BUILDING
CITY OF ZEPHYRHILLS
(813) 788~6611
SO
b 7. .-
PLUMBING
~5. "If
ELECTRICAL
- '-0
"! ~ v_
MECHANICAL
Property Owner:
Zoning:
17. ~
ao
NO OCCUPANCY BEFORE C.O.
FINAL
C.O,
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
Permit
Date (J -- I 2 ' 0 ,
( '2 7 i, u.:~
Sewer Conn
7" '0 c7i_.,
Water Conn: 2~C
Water Meter: I 80. OJ,!
.
3,-iL - ():;L
DATE~
DATE
~-I-o~
~-I"O~
fL
/-IJo
Valuation or c. 8; "') 1"-.-. 0"::
Contract Price 2- _. .(..
Permit Fee
re
Company
Address
Telephone# 52.!5 -- t)J/1J:8-
City license Registration #
State Certified license#
It " ; vi \.J -'-.:J
K4; 'cJl2/ J:, (. .
,
BUILDING 18 (
(.)lh..y )4 \Ii"e ~
I
PLUMBING , ~ ~
e r; (.0.. {, G {v (
ELECTRICAL J ~3
Ftr.cf:Bv vi:> 10 -g /....01 i!.L'I Tp, Servo SLB /0- ,;t:t-O / ~
Pre SLB i. . Rough In ./1-f-t12 ~L r. 1170 Tub Set .J /- ~ - 02. 818, ffJCJ
lintel ~ /-/5.-0/ ~.t> Meter Can Water ./I"J.-:JI-th ~L'(
FRM, vl-fi'-O?- RL~~" Const, Pole .//015'-0/68 Sewervl-J.,f-O:LRLl/
Insul. CL Vi -}h)")- 12U(/ 16'0 Pool Final 1/ 3-6 - O.:J.. f!?LI..{/ 1-11&
WL Pre-Meter v(:) -.2..c- D:). /2.t.~
Finah/3'-(o-'D~ ftL'f, tfJ'O
Driveway ,/ :1-5-0 ~ t<LY
51'liAy.t,'~J I d- -Itf~/ ,q-O F? :I-::2tJ -01 .1(:35 CtJrti\~ <<
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasOnS, a
charge of Twenty Five and 00/100 Dollars ($25,00) shall be made for each trip for each trade:
a. Wrong Address
b, Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called,
d. Work not ready for inspection when called,
e, Permit not posted on job site.
f, Plans not at job site,
g, Work not accessible,
{).'"I '" '( \>
MECHANICAL
.7ob
Breakers
Ducts Insl...,I i-~-()::L I2L r, J:OO
Compressor
Final \/3-t--o.:1- 'K.LL1. W,TO
.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same,
CITY OF
ZEPHYRHILLS
IINOTICE"
OF ADDJTION OR CORRECTION
BUILDING
DEPARTMENT
/CJ:LJL~
I ADDRESS DATE PERMIT ", I
611/~ O~udr (--Ua;t. 3-5'-0'2.. o~ 3l'
THIS JOB HAS NOT BEEN COMPLETED The f wing odditiqns or corrections sholl be made before the job
. will be accepted,
,
DO NOT REMOVE
~ ~L/'~/ iPd/Y>Kp-1-lJ_
II il unlawiul far any Carpent.r, Cantractor, Bulld.r, or oth.r peraanl, to
cov.r or cause to be cov.red, any part of th. work wllh flooring, lath, .arth
or oth.r material. untllth. proper Inlpector hal had ampl. lime to approve
t.... Inltallallon,
. AFTER CORRECTIONS ARE MADE CAlL
788-6611 FOR RE-INSPECTION
INSPECTOR ~
OfFICE HOURS 8 - 5 MON,-FRI.
CITY OF
ZEPHYRHILLS
IINOTICE"
OF ADD.ITION OR CORRECTION
BUILDING
DEPARTMENT
DO NOT REMOVE
ADDRESS
DATE
~ 2~LO'2-
////Z~
PERMIT .".
06
b
THIS JOB HAS NOT BEEN COMPLETED The foil 9 additiqns or corrections shall be made before the job
. will be accepted,
,
II is unlawful far any Carpenter, Cantractor, Builder, or other pel'lOns, to
caver ar cauae 10 be covered, any part af the work wllh floarlng, lath, earth
or other material, until the proper Inspector has had ample time 10 approve
the Installation.
. AFTER CORRECTIONS ARE MADE CALL
788-6611 FOR RE-INSPECTION
INSPECTOR ~
OfFICE HOURS 8 - 5 MON,-FRI.
CITY OF
ZEPHYRHILLS
"NOTICE"
OF ADDITION OR CORRECTION
BUILDING
DEPARTMENT
{o: 'l,,1) 4,~.
ADDRESS DATE PERMIT""
{,9o lo--}o'-Q Ob1
THIS JOB HAS NOT BEEN COMPLETED The foil wing odditiqns or corrections sholl be mode before the job
. will be accepted,
CD F..,,'w b~J ~ <;:~ II I,e Cooper Or
~ a J v ~" ~l" ' '5 TO Vvn.~ rod
GJ CkegJLfri ^hL.~ J..,: 51.. I:<)" ~eoI Corr" d jo^ f
DO NOT REMOVE
II il unlawful for ony Corpenter, Contractor, Builder, or other pel'$Onl, 10
cover or caUM 10 be covered, any port of the work wllh flooring, loth. earth
or other material, unlll the proper Inlpector hal hod ample time to approve
the inllallatlon.
. AFTER CORRECTIONS ARE MADE CAlL
788-6611 FOR RE-INSPECTION
INSPECTOR jJvp /- ~
OfFICE HOURS 8 - 5 MON.-FRI.
G-v)
. (
David Johnson
6907 Oak Crest Way
SQ. FEET PRICE
MAIN OR LIVING: 1,281 $ 40.00
OTHER AREA UNDER ROOF: 465 $ 15.00
OTHER: $ -
VALUATION $ 58,215.00
FEE SHEET $ 306.00
ADDRESS $ 20.00
DRIVEWAY $ 20.00
BUILDING: $ 499.00
CREDIT: $ -
BUILDING LESS CREDIT: $ 499.00
ELECTRICAL: $ 85.96
PLUMBING: $ 67.50
MECHANICAL: $ 35.00
RADON: $ 17.46
TOTAL $ 704.92
SEWER: $ 1,278.00
WATER: $ 350.00
IRRIGATION: $ -
TOTAL: $ 1,628.00
I
I
WATER METER: I $
IRRIGATION METER $
180~00 I
SUB-TOTAL $
2,512.92 WA7D 10 -/~ -() I
SIF'S: $ r~,694.01)...
97.5% $ 1,651.65
2.5% $ 42.35
y pal' I/T ptJfJc
'3 vur- p -r nl1fJi..-
Tl F'S: $ r 1,480.00
99% $ 1,465.20
1% $ 14.80
,
TOTAL: $ 5,686.92 ,
-"''''nYRHIL;LS
IINOT/CE"
OF ADDITION OR CORRECTION
BUILDINQ
DEPARTMENT
ADDRESS
6 ~/Y-
+
1-3-02.. 0.0 '3
THIS JOB HAS NOT BEEN COMPLETED The! low/ng oddlt/ons or correct/ons sholl be mode before the lob
. . will be accepted,
DATE
I~: 2Q) I)
PERMIT 'fIJt
f-
'.'.wI" Iw ~r c.."..,.,. (4,,,",,,w. ""do,. w .,h., po...... "
"w ~"M "... ,...,.... ~r....., Ih...... ~I~ "_'.0. "'h._h
I., m.,w",. ".11I 'h. "'._ I._,w ho, hOd ...."."m. " .......
'&/ol/Ol/on,
'AFTER CORRECTIONS ARE MADE CAlL
788-6611 FOR RE-INSPECTION
:E HOURS 8 . 5 MON._FRI.
INSPECTOR
CITY OF
ZEPHYRHILLS
IINOTICE"
OF ADD.ITION OR CORRECTION
BUILDING
DEPARTMENT
DO NOT REMOVE
/1'0 C)~
(. 1'1- ;({ .
PERMIT ."
@ (~ 6b.NL1/\\ (5 (Ai IttL 5/~/..,L [/;J.w, /IV IJf Ii _ AT G'\U1 Gi:.K..."'61
Lf:u
(j) '5(.";;:..~ /0.J) s rJh:r (j\J S ') 12-1 1-Iv'K t>&P.\J 1~~~i.V ,
It il unlawful for any Corpenter, Contractor, Builder, or olher peraonl, to
cover or cau.. to be covered, any port of the work with flooring, lalh, earth
or olher malerlal, untlllhe proper Inlpeclor hOI hod ample time 10 approve
the Inllallation.
. AFTER CORRECTIONS ARE MADE CAll
788-6611 FOR RE-INSPECTION
INSPECTOR p' 1R..f'0.'2-'> ')
OfFICE HOURS 8 - 5 MON,-FRI.
989907
~
PERFORMANCE BUSlIIESS PRODUCTS. INC. 813-7111-8008 FAX 813-719-7919
EJ
1'1
WATER ACCT. NO.
CITY OF ZEPHYRHlllS
ZEPHYRHILLS, FLORIDA
DATE 10 -, 12 -0 I
~t,,,, ("" '~/~;'d O~-6-:
H,f~ "Rot' _ _
&~ . }34~5
, 707 04 k. erG)'"
l o~ I (
~ERI ~ ~
RENTER . vi.
~UNGiiOf
,~
SERVICE ADDRESS
SHUT OFF SERVICE
TURN ON SERVICE
'Jl1'
fl'
o
o
o
INSTALL METER
READ METER
CHECK METER
OTHER
o
S/yl' Wct.{.ef fVl-e+y
""'---
WORK COMPLETED BY
& DATE COMPLETED
-----
ORDER TAKEN BY
~
flI WATER
o SEWER
o GARBAGE
;g IN CITY
o OUT CITY
-L No. OF UNITS
- DEPOSIT AMOUNT
- AMOUNT LAST BIll.
_ DATE
_ MISC. CHARGE
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,
I
.f
.. ItJ/~lC/ I
LuilltJ
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 Sth STREET ZEPHYRHILLS, PL 33540
Phone:S13-7S0-0020 Pax:S13-7S0-0021 9- /JLL_ 0 I
DATE RECEIVED _ -' L
PLANS REVIEW FEE __
OWNER'S NAME \ Q )fb.UO<t- ~'t} s~1"(' PHONE CONTACTY/3'~ 7/5"': 60/90
JOB SITE ADDRESS ~-9 07\ ,;/lj!! Cf!.e'S'r uJ7 / ZrIl/.45/FL, 355&
LEGAL DESCRIPTION: LOT(S) {I BLOCK SUBDIVISION OA;I'ZC/&!1'r i?5'719-rCfS *2--
- 0 '0-00000_ tJ/lO
PARCEL ID # 0 Z -26'- 21 (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: B15E'w CONSTRUCTION D ADDITION DALTERATION D REPAIR D INSTALL
DSIGN
PROPOSED USE: ~ FAMILY DWELLING
DMOVE
D DEMOLISH
DMULTI - FAMILY
D# OF UNITS
D MOBILE HOME
DOTHER
D COMMERCIAL
D INDUSTRIAL
D SWIMMING POOL
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK
$--I AJ u t.-G FFrMI LV P 06 t.-t:-/ A.J b
SQU~E FOOTAGE 17 r b--
HEIGHT
BUILDING SIZE
g'f
RESIDENTIAL:
COMMERCIAL:
ATTACH (2) PLOT
ATTACH (3) SETS
PROPERTY SURVEY
~UILDING
6ECTRICAL
~LUMBING
~HANICAL
$ (P5: t:JZ)l). ~
,
:J-C) 0
PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
OF BUILDING PLANS & (1) SET ENERGY FORMS.
REQUIRED FOR ALL NEW CONSTRUCTION.
'-/Z~
PERMITS REQUESTED
---
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
D
FLORIDA POWER
D
W,R,E,C.
D GAS
$ 3; 6l5D. ~
VALUATION OF MECHANCIAL INSTALLATION
t/1'3
.4/0
/:JJ
~
D ROOFING
D SPECIALTY
D OTHER
TYPE OF CONSTRUCTION: ~OCK
D FRAME
D STEEL
D OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT
YES ~
BUILDER
SIGNATURE
COMPANY ~~i\{ QAU ~\?~,m\)l('~
STATE CERT OR REGIST # r.Q1)OO ~,eva
CITY PROCESSING # 2'15 IJ/( -
**********************************************
PLUMBER /J~.. 1~. COMPANY ~/bV '!()Yf1t%' fll/flJb:ng
1/. ./ ' // / . STATE CERT OR /REGIST # R F - tJOtb '1 {1
SIGNATURE ~ ?(/~_. \, CITY PROCESSING # 110(,
*** * ********' ******r..**********************r:!i~**W*4J*C::f:."J*~f**Pt~. X' 'Z.:i).~
MECHANICAL COMPANY ::5" 0 /Z"..t/',( 's
STATE CERT OR REGIST #
SIGNATURE CITY PROCESSING #
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
************************************************************** *
OTHER
SIGNATURE
*****************************************************************
CONDITIONS OF PERMIT AFFIDAVIT
A: NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictions~ whic~
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 contrac~or or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor Sections" of tpis 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 ~evelopment 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
PAY I E FOR IMPROVEMENTS TO YOUR PROPERTY. IF YO INTEND TO OBTAIN FINANCING, CONSULT
W YOUR ENDER OR AN ATTORNEY B E RECORDING Y NO ICE OF COMMENCEMENT. JOBS UNDER
2,500 IN ALUE DO NOT NEE TO C D AND POST A NOTICE OF COMMENC NT".
STATE OF FLORID
COUNTY OF
The foregoing instrument was
Bef his da
by
'~o
acknowledged /
, -}:9-;:?d?
c:::--..__.__..
Name
3ig person taking
-Z Bobble Swetland
. :. ,~MY WM~' CCffi1@MIR!!
Name:;;~^.">..:,.' pri~rY* 2M4ampea
"{,:/ ,;;:~" "JNDED THRIJ TRO" FAIN INSURANCE, INC.
1, New construction 1:"'1drlilh,n
2. Single family detaclled or Multifamily attached
3. If Mul1lfamlly-No. (If unlls coverMt by this submission
4. Is this a worst case? (yes I no) .
5, Cond/Uoned floor Im~1i (;q. ft.)
6. Predominant elJ"'" l:vP.'rll'irIg (ft.)
7. Glass typ~ And fir I';":
a. Clem ql<\';<;
b lint. film or ! ;~)i::1r ,(~lI~en
8. Floor type. ami It ":;1."," IjQ r':
ct. Slrlh.c)n-pr",tfp (11 'm!lIf! + perimeter)
b Wood. rnisl' ,n., '!Iun .. sq. ft.)
c. C(mc"*~. r li<;,'rl TlI/;llue)
9. Net Wall typP., men, md'IIsulalion:
a. Exterlo~: ( 11',~rr!te block (Insulation R-value)
I, J omllrame (Insulation R-value)
": ~: I enl frame (Insulation R-value)
1['9 (Irmulatlon R-value)
(I'h~!t: __________.. _.
( ',"or-le block (Immlallol1 n"r1!1.lr!~'
I,' J()~)d frame (Insulation R.valuEl)
, ~ ll?I!1 frame (Insulation R-value)
I ('g (In!mlatlon R-value)
1 O. Celllnt~ type, area lUll! 1f'i1ulaUon:
a. Under attic (In!;ulalion R-value)
b. Single assE"tl1bly (Insulation R.value)
c. Radiant barrier Installed (yeal no)
11. Air distribution system: '.
a. Duets (Insulation + LoeatlotW,c' 'j . .~, !
b, Air Handler (LoestiOl1)' < ::F'" ' .- :>":,':J, . ,
.. . ., "',l~t., h,'"
12. Cooling system: ", ;'.'1 ~I " ~1
(Types: cen.fral.split. central-slnnle pkg., room unit, PTAC., gas. non.) r. .' ~.~: :J~' "I
-. , I :; ~- 41'" .:-':' :~:
" ' : "Ij:'l
13. Heating system: ,,;..';
(Types: heal pU'Tlp ('k!':: sf'lp. nat. gas, t.P. gas. gas h.p.. room or MAC. nOh.i
14. Hot water system: ~ ,;. ii~:,X~
(Types: elec., n:1tural g:~r,. rolar. l.P. gas. none) : "~'I ;;H'c:;:~, ~14 '
15. Hot Water Credlts~ ;i, HdJo'i't'!;:: tf~:e
a. Heat Recovl'!r~r (HFl) i ~F~~' ~1 ,t
b_ [)(ldlcated H,:"" PUPJP(DHP) : ~W::il.' :"881
. .~\i ~ -, i "'l ~. , .' .
c. Solar ,: I :1Sb.!
16, HVAC Credits . ";1 ..,.iJ;}f l
(Use: C ~-Ceillng FRn. n' eros; V(,1t, PT. Programmable thermostat, '.. i tJ.
HF-Whole house fll'1. Ml Mullitnne) .:
17. COMPLIANCE STATUS: (PASS if As-Built PIs. are less than Base Pts.) .
a. Total A uilt points' "b. Total Base points .'il;
c - (., '1.~1"'. , .
PROJECT NAME:
AND ADORE.SS:
,
.. ....~
'..,: ""'rll" .
BUILDf.A: '
pf:RMnitNG : i
O':FICE: '
OWNER: .
t_ f','" r
to." """1 _"'1'.."
b. J\ctIAO::PIlI:
OWNER AG,ENT:
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State of -:::2olZlPft
NOTICE OF COMMENCEMENT
Rcpt: 531402
DS: 0.00
09/26/01
Rec: 6.00
IT: 0.00
Dpty CJerk
County of
{>/tS-eD
THE ImOERSIGNED hereby gives notice that improvement will be made to c~rtain
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.
02- -- 2~ .- 2-1- Og)/G> -- 0/900 '-($)1900 ~P7 ~//
(Legal description of the property and street address if available)
2.
General Description of Improvement
V etu ~/;C.J tzt.-E P/ffI1/? Y 1/L-~"'1€
' ,
3 .
~~92~~nMAre : fr:.;o fOUNToY' C1ERK
OR OK 4729 PG 1871
Owner Information: Name (A-/A-Y/JG ~5C4?-rT
,
l~ddress , 7515..5ity KIbbE c./l2. CityV.Ai>8 '~/'7'
Interest in Property: , OtA_ht.J~
State FL
5~S2-S-
,
Name of Fee Simple Titleholder:
(If other th~n owner)
Address
~:r:~~
r';'~~~4\
Ll ....~~
City
State
Contractor: NamerpAv/b t<J ,J&/lAlS'i)/J
Address 7S'6~ p-r; ~/A.)b ~ Ci ty 7J /!-/)8 c/ry
5. Surety: Name ~
Address
Amount of Bond: $
6. Lender: Name
Address
State F L
33Sz,s-
City
State
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 713.13(1)(b), Florida Statutes.
9. Expl.rl1t.ion date ot Notice ol Commencement. (the expiration date is 1 year
fr?m the date of recording unless a different date is specified.)
Signature of Owner:
this
Sworn to and subscribed
~~OOI
Notary Public: U!Jn(Jj~ J /fl.j;:t~
My Commi.ssion Expires: Vo()(!de
"'l:i' Voncile T Mitchell
~~~MY Commission CC827810
~".",.,~ Expires May 30, 2003
989907
~~
PERFORMANCE BUSINESS PRODUCTS, INC. 813-719-8008 FAX 813.719-7919
EJ
CITY OF ZEPHYRHlllS
ZEPHYRHILLS. FLORIDA
WATER ACCl. NO.
DATE ,;2 - I~ O:L
~.
SERVICE ADDRESS
:$ 6-
109~ ~ (()Jt1A.t.~ ~.2~ ~or /1
o ~A~R
o SEWER
~
~
o GARBAGE
SHUT OFF SERVICE
TURN ON SERVICE
INSTALL ME~R
READ ME~R
o
J?f IN CITY
CHECK METER
o
o OUT CITY
i No. OF UNITS
OTHER
o
- DEPOSIT AMOUNT
~, '
C!tI ~~~ ~~
- ~ -----.. - MISC. CIiARGE
- AMOUNT LAST BILL
_DA~
WORK COMPLE~D BY
& DA~ COMPLE~D
ORDER TAKEN BY
\1~
Retain white form in office at all times,
Send pink & yellow forms to Water Service Dept.
Water Service Dept. to sign yellow form & return to
i
OCT-30-01 08:28 AM HERNASCO TESTING
7278560020
P.01
.JJERNASCO TESTING LAB011~'1 TOR'I'P", I^~C.,
Materials Testing and Engineering
P.O.Box 5267 · Hudson, Flortda 34674
TEL (727) 856-5565 · (362) 6981002 . FAX (727) 656-0020
ELECTRONIC FAX (775) 402-4929
:! CHR 7:1-1
/JOHN J; /J
Job No: 007 - 01446 Project: 6907 Oak l.re..t wa.y
Sampled By: Ralph Fortich Location: Dade City, Pasco County, Florida
Date Sampled: 10/26/0 J Client: David Johnson Builders
Date Reported: '.
10/30/01 Matedal; Fill
Contractor: David Johnson Builders Sampled From: Compacted Fill
ID~ '3 3
::;:-:----
FIELD DENSITY DATA
URY ISERCENT PERCENT PROCTOR
LOCATION TD DEJ~lSJTY MOISTURE DENSITY USED
10' East and 7' South from
Southwest Comer 104.4 6.3 96.3 108.4
5' South and 1 I' W cst from
Northeast Comer 103,5 7.0 95.S 108.4
6' North and 15' West from
Southeast Comer 104.0 6.8 95.9 108.4
. 1,~:..
t
PASCO COUNTY, FLORIDA
SCHOOL IMPACT FEE
Ordinance No. 01-06
Effective: February 28, 2001 at 2:08 p.m.
Permit No.
?J6 3~
Date Permitted: / p - /:1. -01
Builder Name/Owner Name V~ tJ. 7klQJ ~V'~. I~~
ParcellD: ~,tJ. - ~,,- ~ 1- O;:J.67J- lYboov - 0 I IV
AddressILocation: /'f?/I/ rOd (JA.d'T ;;~
SUbdivisio~a)l /l.IU~~
ClassificationfType of Use:
~gle-FamiIY Detached House
o Mobile Home
o Other Residential
o Collection Fee
Total Fee
X No
,
Exempt:
Yes
How Determined:
(056) ~ 6 94
(057)
(058)
(123)
$ 1"91/
Prepared BY:~ ;~;;Y~L
Checked By:
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,
$-J~-tJ~
Date
~~ ' L!Litn
Rec l\t y
OFFICE USE ONLY
RECEIPT NO.
DATE
White
Customer
Canary
Finance
Pink
School Board
PC01005114/A
BY
Gold
Inspection