HomeMy WebLinkAbout02-0976
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BUILDING
Sewer Conn /.;).7~' .~
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Water Conn: _ 3.5"0' -
PmpertV owne"- vJ~ JIL. 5 ~ Wate~ Mete" - / i 0 ' ~
JobA"",e." M?" {)Altr ~'- '-'4- . ;':~~.~..~. - I(,O~
Parcel 1.0. # _ '7 u /- ~ t1'P
_Radon Ga".J . ... '" .r ~. ", - -
Zonino'- - ~ ,
Description of Work
BUILDING PERMIT ~~ 0916
CITY Of ZEPH"ltH1US Pe""it ~
(813) 788-6611
"
(;'1,50
PLUMBING
Date ~ ... 1/ - tJ t( -
~5 . l ?-
ELECTRICAL
3~'W
MECHANICAL
CitY License Registration , -
State Certified License'
Ie-I
Permit Fe
~ignatur
Compan
Address
'!Telephone' 1~1- .-~z.. ~ -/)1-73
c.o.
NO OCCUPANCY BEFORE C.O.
Complete Plans. Specifications and Fea Must Accompany APpUcaMn.
A" work shall be performed In accordanca with City Codes and Ordinances.
Valuation or L-< tJ"O
Contract Price ,) g- I ;) J,{' I
--.:--"
Ie.<.. .:'i ~S
, o~",son -:t:l ~ '1 ~ 1(, t"
BUILDING ELECTRICAL PLUMBING
for'''' 9',<,\ /.
Ftr. -.L-;;I. -/3 -t):I. H~ L YT p. Se". SLB ': J.:2 t,..~ Nft Brea'ars
pre SLB 1.~_I.o>- tL Rough In /L/.-:l~""~ Rt-1 Tub Sat:s"'~ Ducts Insl..t{. :2.3-1:J'2A
Lintel L 3 _/ ~ -0 '- fIJ'. PLy Mater Can Water L J{ -/2. 'i " J. Im./llY comprassor -
FRM. ~::t ~ - 0 J. p- L ~~ Canst. pola .Lifo/-o,.,ll'l. Sawer 5t -).. 1- ~). "'-., i2<Y Flnalfl ,}.Q-tl 2 {2( 'f).
Insul. CL_ ,/-23-.>- R,,~ Pool Flnal____ - _p>..o:2.flW, /dD
WL :? <J -'l. ?> -0 >-(1,'- Y Pre-Maty. J {,-I J. -/1 ,,1ft JI
I Flna, .LJ..y. 0 - 01. llL-f, tIr'
Driveway J. J1 'O:J. 12tH, I/1'D - . .
. _ _ _ ..().,. {Lc..'1 r P & -1':2 .11:2. '1.;1'0 fl"d~ tct
:.IhtUll~z.r" \-tV - 3 l fP :;2 -/5-0 -;}.. ff: 50 ~t:r
REINSPECTION FEES' When exhe In.peCtion trip' an> ne..'"'' due to env one 01 the fonowino ree",n.. a
c...... at Twenty Ave end 0011 00 Done~ ($25.00) shen be mede fo' eech hip for each had'"
5he~''';j l.{-3'O'J- HrJO, {ZL'I
a. Wrong Address
b. condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection caned.
d. Work not ready for inspection when caned.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
SOh '"
5-#~(P
MECHANICAL
The payment of Inspection faes shall ba made bafora any further permits will be ISSUed '0 the parson owning
same.
CITY OF
ZE;PHYRHILLS
"NOTICE"
OF ADD.ITION OR CORRECTION
BUILDING
DEPARTMENT
DO NOT REMOVE
ADDRESS
DATE
'9/50
PERMIT .,.
b 2 { -0 097
THIS JOB HAS NOT BEEN COMPLETED The fol ing additiqns or corrections shall be made before the job
. will be accepted.
,
Y\l-,b~l~'~~l~'
OfFICE HOURS 8 - 5 MON.-FRI.
. AFTER CORRECTIONS ARE MADE CALL
788-6611 FOR RE-INSPECTION
~~
INSPECTOR ~
\I il unlawful tor ony Corpenter, Contractor. Builder, or other personl, to
cover or cau.. to be covered, any part of the work with flooring, lalh, earth
or other materlol. untlllhe proper Inlpector hal had ample time to approve
.he Inltallatlon.
CITY OF
ZE.PHYRHILLS
"NOTICE"
OF ADD.ITION OR CORRECTION
BUILDING
DEPARTMENT
DO NOT REMOVE
ADDRESS
~~5i
PERMIT ."
,q 0<- OQ'7
THIS JOB HAS NOT BEEN COMPLETED. T ,e following additiqns or corrections shall be made before the job
will be accepted.
j"" ~ u' ~ ~ ( :> $ n {ro" t [:1 t-rti,., <...f /.A..Q Y
-J-o i;.us~ rnCj;,",^er;",(,J'
~t(
be
Sf /"lf~cI
OfFICE HOURS 8 - 5 MON.-FRI.
AFTER CORRECTIONS ARE MADE CALL
78/~ RE-INSPECTION
INSPECTOR
It ia unlawful tor any Carpenter, Cantractor, Builder, or alher peraona, 10
caver or caUM to be covered. any part of Ihe wark with flooring. lath, earth
or olher malerlal. unlll the proper Inapector haa had ample lime to approve
Ihe Inatallallon.
CITY OF
ZEPHYRHILLS
"NOTICE"
OF ADD.ITION OR CORRECTION
BUILDING
DEPARTMENT
DO NOT REMOVE
'3 {) L 0'(
THIS JOB HAS NOT BEEN COMPLETE The following additiqns or corrections shall be made before the job
. will be accepted.
DATE
PERMIT #
Lkecl ~us~
<2--1"\')1 1\1-'\,0 r 11\"" 1~ r Lor, (: (. ~ '10.") S
)
OfFICE HOURS 8 . 5 MON.-FRI.
. AFTER CORRECTIONS ARE MADE CAlL
78~ iJ:1i-INS.PE~I~N
INSPECTOR f'. 'f/j1!:.u
Ills unlawful tor any Carpent.r. Cantraclar, Bulld.r, or olh.r pef$Ons, 10
cov.r or cau.. 10 be cov.red, any part of Ih. work wllh flooring, loth, earth
or oth.r matlH'lal, untllth. proper Inspeclor has hod ampl. tlm. 10 approve
,h. Inslallatlon.
David Johnson
6831 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: $ 85.12
PLUMBING: $ 67.50
MECHANICAL: $ 35.00
RADON: $ 17.46
TOTAL $ 704.08
SEWER: $ 1,278.00
WATER: $ 350.00
IRRIGATION: $ /75:00
TOTAL: $ 1,628.00
WATER METER: $
IRRIGATION METER $
SUB-TOTAL $
2,512.08 1
pCA...-f
o.:t'U
SIF'S: $ 1,694.00
97.5% $ 1,651.65
2.5% $ 42.35
]
.~
d~'
T IF'S: $ 1,480.00
99% $ 1,465.20
1% $ 14.80
TOTAL: $ 5,686.081
J LC...t/I.uf :1- c,~t'.~ fa ,\
CITY OF ZEPHYRHILLS PERMIT APPLICATrON--- '.
BUILDING DBPARnbmT 5335 8th STREET ZEPHYRHILLS, FL :33540
Phone:813-780-0020 Fax:813-780-0021
DATE RECEIVED /./~/) --o~
PLANS REVIBW FEE
OWNER'S NAME CU.AV tJ E d"co j,,/,
JOB SITE ADDRESS ~ r?:31 ~AKceGSr tJ/lY
LEGAL DESCRIPTION: LOT(S) ~ BLOCK SUBDIVISION
PARCEL ID # 02- --2-&.- 7-/- V2-~O - @ 0000 -~BTAINFROM PROPERTY TAX NOTICE)
WORK PROPSED: ~ CONSTRUCTION
PHONE CONTACT8'/3.. liS hf9a
o ADDITION
o ALTERATION
o REPAIR
o INSTALL
OSIGN
PROPOSED USE: ~ FAMILY DWELLING
o MOVE
o DEMOLISH
o COMMERCIAL
o INDUSTRIAL
o SWIMMING POOL
o MOBILE HOME
o OTHER
OMULTI-FAMILY
0# OF UNITS
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK 5/1\10<-6
BUILDING SIZE ~) X 50/'
r~/V7IL-Y
/
SQUARE FOOTAGE
~J1oo
HEIGHT
gr
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
ENERGY FORMS.
o BUILDING
$
/ w
00, a 00 - - VALUATION OF TOTAL CONSTRUCTION
,
/SO
AMP SERVICE
~ORIDA POWER
o
W.R.E.C.
o ELECTRICAL
o PLUMBING
o FRAME
o STEEL
INS TALIJ\T ION Qa d-r iJl17
ifJ;r!i
-2-/300.
~
o MECHANICAL
$
VALUATION OF MECHANCIAL
o GAS 0 ROOFING 0 SPECIALTY
TYPE OF CONSTRUCTION: ~CK
o OTHER
o OTHER
IS PROJECT IN FLOOD ZONE AREAD YES ~O
FINISHED FLOOR ELEVATIONS
SIGNATURE
COMP~Y j)/ft./ /P CU, ?"i))/~St>.v Lj?V/LPEL /,Uc
STATE CERT OR REGIST # eGo G 0 .~ /0
Y PROCESSING # /IIJ'
.v /0'
******************************************************************
BUILDER
SIGNATU
COMPANY J.1 a Ii; JI\ ELeJr ~ c... ,Ifl e.-
STATE CERT OR REGIST # G Roo /3 '-/4 Cj
CITY PROCESSING #~ q7
v
****************************************************~*
~ /// (k, ~~:~':~E(:tftEG;!~/V:1E- P:;,kr''J
w.~ CITY PROCESSING # . / I"~
*** *******j(**********************************~****::**~*.**~***
~ COMPANY cr7l/",r..-:"" ~-_ _ __
_ ~ ~.J STATE CERT OR REGIST '. __.' If. 1f1C! p. I i " I
CITY PROCESSING #.J.O f.._
**********************************~*~*~~~~~**~******
BLECTRIC
PLUMBER
SIGNATURE
MECHANICAL
SIGNATURE
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 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 ~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
PAYING CE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH OUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU NO ICE OF COMMENCEMENT. JOBS UNDER
$2. 00 IN ALUE DO ~OT NEED TO R RD AND POST A ~ OTICEjOF COMMENCEMENT".
, !
STATE OF FLORIDA
COUNTY OF
The foregoing instrument
Before thi~ V d
by
~o
o who has
knowledged
~.;;? tlL):2.,
, -
STATE OF FLORIDA(.'-7
COUNTY OF.~ t1.6 W
The foregoing instrument was acknowledged
Befor~e this4f- da; of 1~ ,~.:2tItlp-
by ~~J//n _ {)Y f.lJ.)~__
\r.i. (name of person acknowledged)
~WhO is personally known to me, or
o who has produced
~d ~c (ype of identification)
~id 'ot ake oath.
Signature of person taking acknowledgement
Name
".....rt..... Bobbie Swetland
t~~ ~IM..Y&e~MIS~ #..a:~PIRES
""),". .~~f rebruary-22,200r-
':.r.Rf.~~" BONDED THRU TROY FAIN INSURANCE, INC
..."11.., ~. & tl d
m Ie ..e eln
Name. .'. ~~~ Nc;t-tC~*~
. \ {~} February 22. 2004
'4:Rr.,\\I. ".' BONDED THRU TROY FAIN INSURANCE, INC
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FLA. 19n LAWS
F. n:'3.13
SEMINOLE FORM 401
NOTICE OF COMMENCEMENT
~:~~t:f o:'OP~5 Co } _~PARK IN DUPL'GAT.' ~~~~~ll~~!~IIIIII11III1IIII11III1III11IIIIIII~1I1
The undersigned hereby informs all concemed that improvements will be made to certain real property. and in accordancE
with section 713.13 of the Floride Statutes, the following Informatian Is stated In this NOTICE OF COMMENCEMENT.
Description of property. . ?!. ~. ~ .~~. -:. .?:'!. ~p. .~.?/! -:: .r?P.C?OO.'":: .t!?f!.??9.....................................
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~S~t0. i:3883 Rir::: ~~
02/07/02 Dpty Clerk
. ......... ............ ..0.. ............................................ ............................................................
General description of improvements ,:;P~.?:!:R-.t.)~'J:~ !?~. .()F'..,?/~.~.$.. .F/~/!1/.(-'.Y. .H.Q(I1{!i;f...........
Owner. . .w.Il.y'~~. . .5~.T.r.................................. ...... ..._. ............................................
Address. .37?/:!f .;1Ky..glp.(~~..c;~~((~. ,7?fiP.G..t;I..-r,/~. .F?... ~~$'.~s...............
Owner's interest in site of the improvement. . . . . . . . . . . . . . . , . . , . . . . . . . . . . . . . . . . . JED PITTI'1AN PASCO COUNTY CLERK
Fee Simple Title holder (If other than owner. . 02/07/02 10: 33am 1 10'931 3
OR BK 4853 PG
Name .......... ...............................................................................................................
Address .....................
.......... ......... ..... ..... ................ .................. ..... ........... .... '-0- ......_. .....
i~~.;':\I'~ Contractor .7?1J (/ I.f? . .t9.,~. .~o.H.~~P~.. .e.()/.':-:.p~~.. .1t\-!.~ .'. .. . . . . . " .,. .. . . ....... .... . . .... .. ... .
t;t!~))i.iit... If}
~ ;.j Address.. q.W.l{. .E~f?T. ..1!7:/~(P..?9A-:~.... .1)IU>5...C:.l.ry/. .F?.....~ ~:r?r: .........
Surety (if any) .... N/8:. . . . . . . . . . . . .. . . . . . . . .,. . . .. . . . , . . . . . . . . . . . .. . . .. . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . .
Address .....................................................".............................. .Amount of bond S . . . . . ... . . ... . .
Any person making a loan for the construction of the improvements:
Name ...... .M.14~. . . . .. . . . . . .................... .... .... . . .. . . . . ..... ............. . . . . ..... . .............. . .. . . ..... .. .... .
Address ........................................................................................................................
Person within the State of Florida designated by owner upon whom notices or other documents may be served:
Name.....}fA................................ .... ... ,.................. .............................. ....................
t2.-.-
Name.. ............ ~.... '.:..:.::...:." .,.-. ... .... '~b"'" .......................................................
Address.. .9JPt/. .Cr..... .!.~~.... ..................................................... ...... ...........
STA:.~:A::::,::ORD.R~ U"ONLY ...... M~ H-c.... 8:!( .....................
COUNTY OF PASCO
TRUE AJ~I~d~:~c~~~T~~VO~H;~/~g;~~~~OING IS A
OR OF PU IC RECORD I~i '.f. HIS.iftFFIC IT~~S~F~~
H ~JO. IGIAL SEfll THIS DAY OF
- 2
JED PI AI U:;' UF CIRCUIT COURT
BY ~
. DEPUTY CLERK
Sworn to and subscribed before me this ....... . . . . . . . . . . . . . . . . . . . . . . . .
...___2tiday of .... .~. . . . . . I . . uVJ . . . u, . &Jt.l.[l,
",'/.d:~ . .H..~/1j-r....U'~h............
ry Public
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'>.- -:,:. . II I 01 communitY ^""lrS _ F\.ORID^ ENERGY EFFICIENCY CODE FOR BUII.DING CONSTRUCTION
oepa "'oeon", 97 Residential Whole Building perlonnance Method ^ .CENTR^L 4 5 6
fORM 6 ,..-
L
u
--
COMPC
DESCR/~
~
ADJACE:
r---:-:::.:::.
:---
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c:
'H = HORIZON
-
PROJECT NAME:
AND ADDResS:
BUILDeR:
PERMITTING CLIMATE 0 0 0
OFFICE: ZONE: 4 5 6
PERIDT",,[fffFfI:g JURJSDICOON ""<[11 \ \ iJ
Please T e CK
-
OWNER:
1.
2.
3.
4.
5.
6.
(
~
~.
~~ sq. n.
~_ tt.
Single Pane Double Pane
~. sq. n. _ sq. ft.
__ sq. tt. __Sq. ft.
R=Y-- ,~\.n.
R=__- ,__Sq.ft.
R=_- ,__ sq. ft.
-
-
-
-
1. NeW construction or addition
2. Single family delached or MultlfamilY ....ched
3. If Multifamlly-NO. of unils covered bY Ihis submission
4. \s this a worst case'? (yes I no)
5. conditioned f\oor area (Sq. ft.)
6. predominant eave overhang (ft.)
7. G\aSS type and area:
a. Clear glasS
b. Tint, film or solar screen
8. F\oor type and insU\ation:
a. Slab-on-grade (R-value + perimeter)
b. Wood, raised (R-value + sq. ft.)
c. Concrete, raised (R-value)
9. Net Wan type, area and insu\ation:
a. Exterior: ,. concrele bloCK (Insulation R-value]
2. Wood frame (Insulation R-value)
3. Steel frame (Insulation R-value)
4. Log (Insulation R-value)
5. Other:~
b. Adiacenl: 1. concrele blocK (Insulation R-value)
2. Wood frame (Insulation R-value)
3. Steel frame (Insulation R-value)
4. Log (Insulation R-value)
10. Cening type, area and insu\ation:
a. Under attic (Insulation R-value)
b. Single assembly (Insulation R-value)
c. Radiant barrier installed (yes I no)
11. Air distribution system:
a. Ducts (Insulation + Location)
b. Air Handler (LOcation)
12. cooling system:: ..
(Type" 'en..I.,~it "html,,'ngle ""g,. room on", PTAC.. g"" no")
-
-
-
7a.
7b.
-
-
-
8a.
8b.
8c.
/~
9a-1 R=~- ~ sq. ft.
9a-2 R=-- _ sq. tt.
9a-3 R=_- _ sq. tt.
9a-4 R=-- _ sq. ft.
9b-1 R= _11- ~ sq. ft.
9b-2 R= _ sq. ft.
--
9b-3 R=_- _ sq. tt.
9b-4 R=-- _ sq. ft.
10a. r.l,'D J1:!l- sq. ft.
R=_-
10b. R=_- _ sq. tt.
10c. --
-
-
-
-
-
-
-
-
-
-
R= _~ ' ~ (condJuncond.)
_~ tcondJUncond.)
Type: v~
SEERI~
Capacity: ~
Type: ~
HSPF/COP/AFUE:...~
Capacity: ~
Type: ~
EF:~
-
11a.
11b.
12a.
12b.
12c.
13a.
13b.
13c.
14a.
14b.
15a.
15b.
15c.
-
INFllT.
INTERI
13. Heating system:
(lYp'" heat pomp. elo<:. ,""p. 031. g"'. \..P .'g"'. g"' hop"~ ,"om 0' PT AC. none)
14. Hot water system:
(Types: elec., natural gas, solar, L.P. gas. none)
15. Hot Water credits:
a. Heat Recovery (HR)
b. Dedicated Heat pump(DHP)
c. Solar
16. HVAC Credits
(V,.: CF.ceiling Fan. C".en," vent. PT .progtammable .,,-,,>1.
HF-Whole house tan, MZ_Multizone)
17. COMPLIANCE STATUS: (PASS K ....BuiIt PIS. are less than Base PIS.)
a. Tota\ ~s-Built points b. Total Base points
16.
~ C(
b PI
l-
n
n
Review of plans and specifications covered by tl-re
indicates compliance with the Florida Energy lOr
construction is completed. this building will bl
compliance in accordance with Section 553.908. F -
BUn.DING OFFICIAL: - ----=-
DATE:-
I _bY ,"",IV 1ha\, e ptens end __ - bY the """,elion ore In
compliance with th on Energy Code.
PREPARED BY: /
, hereby certify that this buildi
. DATE: ~
liance with the Florida Energy Code.
-= 1998
= DATE:--==-
-1-
OWNER AGENT: -
-4.
PASCO COUNTY, FLORIDA
SCHOOL IMPACT FEE
Ordinance No. 01-06
Effective: February 28, 2001 at 2:08 p.m.
4i~ilder Namc?/Owner Nam
Parcel/D: 0 - - -0 - 0 _ ~)"'-
Addr~~s~Location..: :L~ (1)d~/14~~ 1.- )~
SUbd'Vlslon:(O ~"': _ f: _
Permit No. OZ!7~
Date Permitted: c:2- 1/- O:Q
C/assificationrrype of Use:
Exempt:
How Determined:
~Single-Fami/Y Detached House
o Mobile Home
o Other Residential
o Collection Fee
Total Fee
Yes 4 No
(056) / t 9// >-
(057)
(058)
(123) __
$ // k 9~ -
Prepared By: ~ ~"st.?~...(
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 PAtD AND
RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY.
Acknowtedgment 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.
o - b2{J-O~
Date
~v~
Rece' ed By
~FF/CE USE ONLY
~ECEIPT NO. L.;<t, ~ It]
DATE & - 017- /)2.
White
Customer /
Canary
Finance
Pink
School Board
BY&?, U~
Gold
Inspection
:>1005114/A