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02-1047
BUILDING PERMIT CITY OF ZEPHYRHILLS Permit N2 1047 'fo'~ BUilDING 3~'t""O ELECTRICAL (813) 780-0020 25'~ MECHANICAL 3~~ p.o PLUMBING Zoning: Descriotion of Work s.d- Date 3 - ~ ~O:2.. jIiiir Sewer Conn ~ Water Conn: .~D Water Meter: If( 0 - !;I/Ro - _ lSiJJlOOL 7h/7 Ad rEL' (.Ii 7 T.I.F.'s: Property Owner: Job Address: Parcell.D. , ~e;;~/t~!{ 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 ~~ It€- C{ee.. Inspector c~~~~ Company Addre~ ~;_~_~ ;r:?iI.3 ) ? / If - 9 (//5"' ~~ T~ IlC'e, Valuation or Contract Price City license Registration # State Certified license# BUilDING ELECTRICAL PLUMBING MECHANICAL Breakers Ducts Insl. . comp~ Final r~O~h'.T~K(Y ~~(y SlB Tub Set Water Sewer Final 1/3~:u"t?;;J.. Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final c. A r,p rill ~ Ftr. Pre SlB lintel FRM. Insul. Cl Wl #3"'~LY , Driveway Ff 3 -;;)0- of).. .Lo~;)<L 'f:).;l. d REINSPECTlON 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. The payment of inspection fees shall be made before any further permits will be issued to the person owning same. r'-~" ,;";:'~:~r-:='- ~'I1CNAt~~~ ~4~\.+"...;~,,,::;tW~'e;-'-'--ij::X:,~~ ELEVATION .C~RT1FICATE , j', .Read the InItructfons on 1 - 7. ,.,.;; ." SEClDfA"~11OWNERWORMA11ON O~MIIJ. NQ. 3067-o0n Expires July 31,2002 ..'~~.'11'~> . .,I',,~' \'~~ ;:~.,Ij:~' ::~:.,iit~~tJiiJ</';::.': ;;~~~L~:Y;n};~E(rgnjr~' f~1=~:~:.i}i)r~:::;/): ..... .-._. ,. ........ ,. .lIt -*"of ~ '. -:':'"T'~ ,....,... " "',i,~ ."~M'-~~t}~~~.;.. . .; tj. ,'>"'":..:~",,, ~ ". -....., ,,'........- .,... ."'.,0'......\...... _.'-" .._....,. .... '1''''_0,.. ,~'r,', .. LA'lI1ll'EUJG'nJ:((P1'DWJ~ .....-.., t'~"1f.lrf...-h_,'~.~ HC:IUZCNT.tLD\nJt.~ . I~, ',.....,t::J;~\li~,. ;.,,1\ " 'SOI..Ia:DGPS(T'ypB~ - '.:'. n, ( ".-11.... t:I ".", 0 HAD 1827 o HAD 1lIII3 0 USGS Q.BlMlp 0 OIB: ..' ,,-,' ~" ':"l " '" ".' .,..... '. .'" of , ',' B4.t.W'Ni)~,~~ ,'c',:." 'f~'" n~,"~~::~:...- ~.~PMB.OA :';:: :~.,~~. _ . .~_ ,.If 8' 83 ...___....-;.::f ' ~ I ,..... I., f\''g..,v'!':, 81o.ni:aI8lhe~'~!E~'~"O'" ~<<b8Btmt~9J!Id,", ~" ,,: .~~'::'~:"-:.":\<< D,BSFlaltyyc (i" fllttfa"l.mrm:;1i'" ConuuirJ:l8lilll~i(t~ U?'h,{l, 'L-1011er(Oesc:dle~ . 'i'J",,,",,...., 811.ni:aI8tleBallan ..trtleBFEilS9:DNGW1929 . DNAVD19138 DOlher(Desalle~ 812.15 the 1ltiY;Ilcca!d In a Coasla BlIrier Relmces System (caRS) 881 aOherMse PrtEcIBd Area (OPA'(1 0 Yes ~ No eesg.., DaB C1.~:::;~:~~~:V~,==~~"":' '. ',..., "'.. EIertab~.. be..pid....CXlllN:bld..ldlngllaxr-. C2. fWrig DiQaiitb1iilr :~'litiijclilPil RiiiiiBtiht idlDg6i1tit ..a.tillcilll1I bIq <Xlll~-_ p&gisSlIld 7. fnodapn ~"~"a~<<~~... -- _. q.......___.....__..-._ C3. ClNriIlIa1I-ZalesA1-A1),N:.AH.A(w1I EFE), VE, V1..v.1), V ~ SFE), AA. ~AAJN:, ARlA1-A1), ARWi, MINJ ~~. :iC3iI.,," ~~b"~. 'dapnilidedlnilllm C2. SlaIB.....dallinUs8d.1flhitdalllnls.dfnntfianlhe dliLm usedtrlhe BFE In Sc:btlCarMiMit;IIIi*.J.1idJ1ft SlwIil1....... daILm<DJY8llkx1 ~~ UsehspacepcvldedalheCcxmll1ls nad ~.Qg~~p. .@~~.~~!!~~~'~.T!'I:.-:~_~.';;;:::l,~~"~'::" ~:;~','~~2I:~ ..,no "~" f- ,'. ~~QiLm,'io'C1_,r.IO:;i~..'f..:\~J1Ibr:t\:T\I"l'.1;"':1',;;..!l'i;::-';~""":"" . .... _:~ .' ': loI< ,'1>.';'(;:.....' EIevabI nEnmurBtwed _Oces tle8lvlllkrl..nnallllR _ ~Q"I the FIRM? 0 Y. 0 No ":', .: o aj"~""""'_~~"et ~~:I..:"'.j b61',;u~P,; "J!l..~t/pI) .', :.,~, "".- I":' Ob)TqJd_._ ;.....:~'"H\(i::m..'..::.'S':"!i'liP'..tJ:~)!j.~-.cm).: ""<1':1. .. . '. o c)BaDndllMlllllltZarllllllluclllBl......(V2IlI8cRr),- ".!, l. ;t-..'1If:er-"":J~I.(m)' ..'.. i . . .:: ')1.: : .' . '.' c'. .;....b o d)AlIDedgllllg8_dalllb) ., ::~'UL\-:;~'-.cm) . '.J' ' '.' "jl "j,/}...,.r:..~ o.)~...<<tC~IInI.nn.ri"._.. - ......---.,... . .. . I~ ';/ .- ~t1e~' "...' ~~U"JI!j~fei)'c~' . t.(m) ..,.. :, IJ' ~.s ',?6'S(S 0.1)'......;......--...... . '. tt.&~._--"- .-.-...... ...... --....,..... ..'?IJTL~'~. .. .................'.',... .... ...8 .' . .....t.."...... ~"""."""\""""I ~.,.. ~I:."""-''"''-' .-.-:-;,.Z i\ "t,' ~~.' .::,"_ \ ." ~ffl:=~~(taxf\lll1ls)~ll,iiiMiqpnp18 e.r.-L m)' "". :'''.' '~,,:,"I';,:' -':'1~ I . ':;'.:';:' " . o IlT...ct~_~(IaalbslIifhC3f/ Iq,n..,an)_ . ... ....._._,.. 8ECTION D-SlJRVEYat, ENGlER, CRARCHrEC'I'~I"~TION . TI1Ia cerlIlIcaIlan II b bllIpd n 888Ied bv a IIIId swveyar, ~<< 8R:hIt8ct authorized bv law b cdy eIevaIlon InfcnnalIon. I QIdffy"'" tlMtilDmltlaltit SIctblI AS, BlldCOIIthIH8ttIIIt:I/I ~ my belt tfbtIlo irteqnttbe dIbI an'lltn -- . I undtJtrt8nd thBt ~ llIIBe IIBtemeti ~ be ~ ~fne Of~ UI'Id6r 18 U.s. ~ S6ctIon 1001. Cl:ItI~NAIotE' ' . -...... . .. . .. .. IJ:ENSENMER Tm.E . .. ""'-..q .-..,. CCII'ANVNAAE . ~ ~ .---- '''-'.-' .--- ......,. ...... ..... -.---..-.--....- arY.. STAlE ZPceJE SIGNo\1lR,:'y~=~/~~..--~.._- .....---..--.......-- DAlE t:Jg--/?---oz.- TBJ:PrOEJ1/~-7r:5-~8c- <-> SEC110N B- R.OOD NRJRANCE RATE MAP fIRMt IWORIIATION ., . ~ .. . . CCIIINJVtIJ&It'l' .- ...... B2.COlIfIYNAaE f?) .., ..'.' "1., .n,'t;l~5 r,;(lroW_'l':lj:-<''''r~r';'., .~.. . ._1\0..( ;~' . , .. .oll" ":~i" :,'''''''. , ~,S;~TEF (.. R:UA ~ 11'1_11 AI ~ QA . r M . ~R= AF\lFAI;r: I;1nr: F=nA (".t'WTINIIATlnN RFPI A(".s:~ All PRFVlnl Ll:; Fn~ IMPORTANT: ~........ copy"conspondIng Inlllllk". .. sidonA . )~~..-..~~~::.::::.:;.". BWJtlGsmEET AaHSS(h*dQ-' LW._IIdlr_Na.)~P.QIDJTENlJ UNO. 1\~~{'{;WY.:?;:.~.:'.,....' aTY STATE '. 1Pca:E ~~~~.~,?~?W0 .','1" - 4 .- ..' . 8ECJDt D-8lJIMYaI, ENGIEER;<BARCIIrECTCSUnoA11ON .CCCJNIIIEDt Cqlytd1s1d11Sd"~~~(1)aJJmiIlyd1d8. (2) inlua1C.e~,8xl(3) bikqo;nr. . " ca.t.ENIS . 4. ',0 01edc hn f albdments SEC110N E - BULDING a:EVATDt IFORIMTION (SURVEYNOI'REQUIED) FORZOtENJNlJZOtEA(MI1tOUTBFE) Fa ZaIe NJ &1dZaleA (WlIIcU BFE). CDqlIBB IIBmIE1 tIIa.VI a,,.SMiIbJ C8tII:&tI/s ttI1JtrJsdtr.... ~ tJbmBIbI tire LQWA arLC:MU=. SectbJClJIJStbt~ ;/,' E1. ~.~~-'SeIId"~dapnrrat",,~"tIti1gtJ~ltisalllllk:aleil.bq~I~~_p&geI6&1d 7, IfnodlQ1maxurciiy I8pl1IIIlIiall8t1ikq~a~a~~) ,... '.... .' , . E2. The~dl1eldJnm~ I8enB1t crenclou8)dlhe~ Is _1l(m)_n(an) 0 alx7eecrD bebr(d8:kClll) lhe~""lJBde. E3. ForEWng Dapns&h~1i qllrivI <seepage 7). the nectliljlBrtaaaelBvalBdica(8ab1 bjCitIBbIikilg Is _ t(m)_iL(an) 8xMJlhe~atant pa'. . S4. FaZaleNJatr...JD:l~,~ rurillI'ls~ IsIl8~dthe~~,~ baa:adalawll tiecxrrmdy'81cxqEi! /nIIl8gII1WiatlB1ce? Dves DND O~ Thelocaldlclalnailt!!!l....lbll.,bSecb1G. .\' ..,' . ,.' · . .." .... -, . 8ECJDtF-.-.--m110l111NER(OROlllNER'SREPRESENTATNEt~lrlCA1Df~' '.. ..,....., , .... The pqllIItyQllB'rtanndlatzlldrep~.~.~~~ B,&1d Eb' ZaleA(...u~~..8d ac:al'l1llilr48ulFE)aZallNJ IIUIt . tBa ., '!~'~' ::,j( '~.1 ... J : ~:.,. .:'" ,'f ". ,. 'I'" 'I'r~' "~: ;7.,"" 1(; :'::'~'l/"' '" PRCPERTYQ\tERSai~~:~J").,.~~~!:!) . . "...... AaJ&S Sl3NAnR ca&ENTS .,',_,':",'1'-'" ,"u,i', aTY DATE i.:' STAle '1B.EPtDE 1PcaE ,~ . !!.f; , !)',':" .;- } , i. I~: I c' ..1':1 /, (,',: :", ""p'.,'",.:'. o Cleek _I allIr:tments SECrlCNG-CCMIIIJY'JECRlA11ON ~ The local araa \1Ilo IIdlO11zBd bV laraadnlllc8bUri..II8ClC11111111y'a ~ 1l1a118glllllllltcd1anc8 ClIl ~SecIIcnIA. B, C (a El, n G ci.. EIlMIbl Cd:aa ~fII'~I5f(a)81d1ilJl b81cM. c" , G1. D The ilbolBllll ka SdJ'I C wa1tiB16anCll&cb:LIll.daIto tIIl__ ~ 81d embossed bV a blnsed 8l.IV8'fOI'i qMw, a adiIID\1Ilo Is lIJIDtmd by s1Eakx:alllirbCDlyel8vlfbl.lbm.Icr'.. (hbElheDlC8.lixtd*dtle.. dlEb the CcmnenllI a8B bBbr.) G2. 0 A CXIII1Idr~u:JA~SrI:lQI E.ti'a tIM1g kxaBd ka ZaleA(1iIIIUafEW.-~ a~ BFE)aZaleNJ. G3. CJ Thetibqi~{IIIn~II~uCDlllUty~lIIlIoawen.llpllJlClBl. I I G4.PEIUT~'_.\~ ." '. '. ~ ~ ~1EPElUTISll.ED I G8. DA1Ea:RfFC'TECF~1Sll.ED Gr. 'OiIpmlihIBa.ti!Mdb: 0 NMcoo.~ 0 SUbIIirilII ~ ' GB. SIMlIiln dadkM8llttoa~ tl-~dtIBlItiIg II: i" '.J Galli: cr(tlZallAO) dlllllul,llloQatfll1dltIg.II: L.CX:M.a:FICW.'StwIi . ','" i, .:, _._1l(m) " .. _.~1l(m) DaUn: DaIIm 1111.E ,~,.,.' . " 'J , '.. , ,,'::;.. ""', ... -' ;:"~"'1 , "10" ca.MNTYtwE Sl3NA11.R: CCMSlTS ~,';~'-l-', I',':.'"",, :-<,"'~b"';'~"A .; ;r., 1'.>(_ --'; , 1EI.EPHCJE ,'" .,' ": ,",."t . ;' ~ ~'" ..'.' "I'.", DATE ,I. '. o Ql8Ck _ if atIIdIment9 ' R=UA r:nrm 1'1_11 AlIA All RI=PI Ar,J:'; All pRI=\IInll$; i=nmnN.C; .' :,;r;;F, - ,. ., ~.". FEDERAL EllERGENCYMANA~ N!Bt;( NAllONAtFLOOD INSURANCE PROGRAM u'i',.,,,, ~,.. ELEVATION C~RnFICATE Read the InIIructfons on 1 - 7. ", SEC1I)NA-ftcLrt:KITOIIINERWORMA11ON . fi", ' ~-~. <,,,.- O.M~f3. Nq. 3067-o0n Expires July 31,2002 l~ ~.,/~-" l' ,.' .\,.............,..\. ~.,;.c :... ~ f' ..' .' . ::~:.~~.j-<::::.).\ ~:~~tc:::::.i::::-:TU:Y%F;-:j}::. }~!(~~~'j;!::;!::::.::;~::..;::. ~.., \';". ":. '.;"' :' sr. ~,...~,. ~_~~~;'~n.'~,j.',..tl../\ ,)\ l'~";< lAllI1.I:E.I.QG'J~'~ '~.'t:r-,1;:~n:!..'l>,1 HCRIZ!J4TALQ\TlM~ : r,~....~_,::7~'l......; ;~,I~ "':8Cl..R:E: [JGP8(1'p~'- '.:" .q', ~.'-' ",'. (.-11-11II'<<"""'" ClNAD1827 ClHAD1983 ClUQ;SCmnotlp ClOl&:;' '.~'" .....- ,_',.'. """e" .,~: :.~ \",'<. ;' 'I" '!"~".-' _.;,:. 1... '....."..'.~.'1.. - ,. ~,~;'..;-~ , '" ,4~ f'~ . j ';_ ,. '-'~" ~. '. .',' ., -l"":'" ....i .....' SECTION B - FLOOD NIURANCE RATE MAP fIRM) a:cRIATION ,. , . -, . <XUUITVM.t.fER" .. ".' .. B2.ca.MYtw.E 0 . ,.,.' . "" B3.STAlE"1:"'( '-ftF' .j;, ,11 . .C:' ~~5 T~ J!ini~"'C.Jl',1"""''('~'" .,' C"," rl ~ IM.MAPmJPNa B5.~' ~~raxt\\l); . B7.ffiMPNEl. B8.FI..@p.E(S) B9.SASEFlOCDB.EVA~ "."',,,,,.,"......1..' 'l".,i.:'.i':,!"'i,;:':ii ".',.".',."'~',.'.'~ OA:", .1...,.:;:.'.,. :'(lalIAO..._dlDcxtV) '" . '.If - &" - 83.- . .'~'" ~ I .,. I .', A:,g...),. 81o.RtcaI8... lhe8CUt8.".aE~.~......~~or-.. ~~. ..,,!!!..~....B9..' .. "..':,:.:;,.. DflSPdt. ,\. FfiU!;....~.!,T.,l'd:JCamuirCIl..-..k\rl.:!" DOIIer(CeeQbt~..,.. 811. kdcaIe.. BaIIlII 181 btle BFE it B9: 0 NGVD 1929 0 NAVO 1988 0 C>>1er (DesaIle~ 812.18 the IJttiJ;J IocaIed In a Coastal BlIrier ResaJces SysIsm (caRS) _ a 0heMIse PrciedIld Area (CPA'(1 0 Ves rgJ No eesg... Dale C1.~~~.~~~~SECmN~~:~~~::'" -Anew EIMbI c.dbilll be 1IlJiIed.. CXJl&tndln aile bIiktI'd II CD11i*L C2. Bl*tng CJi98n ~ ~ (&II8CtillWij cIiV3i1 iiiiiiiBiit.lIIdngtriti:h lis CllI1i8caIa is bq CXIIiPeEd-see pages 6l1ld 7. r no ct:van ~r.If8lw~...III~llD'ldeatllllltha~~ C3. 8MIb.-Za8A1-A.1), N;.AH,A (\lIIh EFE), VE. V1-W), V (1iIl EFE), M. AAIA. NfJE.. ARIA 1-A.1), ARIAH. AAINJ ~ 1IImI(3,iI blIIDrt~ b"~dIipn iPdIdiltllm C2. SlllBII8'dIlJm'liIed. fll8d8Un is 6nn1an lhedam Ull8dblh8 BFEi'! SclIanB.C:awaiIII...III.bbt,~q-.fi.SbcwIllld"""'mddai.m~_lI8lQJ UIIe......~aIleCon1lBiB_a SII;Icn.Q..C!~~!I~,~~!M!~~~';'~~ .:.t..J.... :: ;~: ': " ;,;;,('\,."" .. ~.~;:.~~, 1'~; ,./.. Oai.ID~~,W:~d~','I';r", 'c..' ';,;l.;nbl]'"",,~.~:.. :>:~".:r..';'''. :. ." EIevab1l86l18nc1I11DUBBd_Does...... reiInn:lIIIIIDUII8d~CllII8 FIRM? 0 V. 0 No ,.' ."'; C,.;'. C o a)r~~......'",q~~~.:~.i,:: ~~Ib9r<Jt,(~I") ~c;fll..~ftJ1n) . ". .,l"'-......~.....,<.J ,c': Ob)Tqutl8ll*-m (.~-*lFmc'<$;\""'!"'~'J/1I.IlSb.. :~~''''~.'' ~)., .'" ",:'..l"~'J':;"I""":'J"'." '. " ,...... . Oc)Bca:mabll8ltIatZall8~2lNlcritt"e,:lHlffl~;.+lf,f~1.(m) ....,. . . ..' . ~, "" ," '.,.. "'. l' ,. Od)AIllI:hedgnge.d8llilb), i~~(;'H.'<'lr"~~t(m).::, " ':; .,." 1,.iil?';,;~~ O'~'::L~~~~ifSC;"jf~,-\"-'_=:'.' ~m) ""';'I"I~ f~<?-~;?bS> ~~s:r~~==;~:.~pB ~ ';"11; .... .... o QTdllI8Blla;lPemB___(Ioodvilrila)...C31.L'...i:L{8q.an) " SECTION D -SUR\IEYOR, ENGINEER, atARCHlTECfCERlFlCATION ThIs C8I1IlIcaIIon II b be 8lgned and sealed by a land 8UI'V8'fOI'. engIrieerior ardllt8ct authorlzsd by law b certlfy 8evatlon information. t cBIIJfy thtIt the irDrINIIlon /It SIctbII At 8, IIId C on tIiIC8ItIIk:tIIe,.... my beat II10ItJ to /nt8qNIt". dsIa tw8I/abIe... =!l"""IIIt8mett~be ~."Xtlneor~under 18 U.s. ~ =:- . CQlPNNNAIoE ' arv TI11.E . . AaR:S8 ~MEi':/~~:~/b~ STAle ZPca:E -- - DAle t:) 3"'" / ~ -0 z....... TB:EFtDE J1/ ~ - '7~ $ - .(8'2... "'L ~UA t=nmi R1_11 AI n AA r . ~ AI=VFRlI:;F lI:;lnF J:nR r..oNTll\IllATlON AFPI Ar.F~ All PAFVlOllll:; FnmnN.c; CITY STATE ZPca:E '::~~.~...,9iii:.'}.':".,""" I~~';.(/I:\..\t...L:...;:..... ~~:~~>{i'::-'irr IMPORTANT: .......... copy" CXJIIIIPOIdng kllorlllldlo.. ..... SIctIon A. BWJING STREET AIDESS(hidQ1(t. LW. aiIt, lIIdb'BtV- No.)~ P.a. RaJ'lENlJ BOXNO. ... . .'. .... SECJl)ND-SURVEYCR,ENGIEEI\~ORARaIIECI'CERI'FICA'ID(CCNIIIIED) CqJ'ftd1s1dllsd..~~tr(1)carmdyabt (2) inIIIIaD~. R(3) llti1goM.~ CCMoENTS . "CJ Qled( hn if ~..nents SECTION E - BUI.DING B.EVA11ON 1NFORMA11ON (SURVEYNOI'REQUII!D) FCRZONENJ _ZONEA(WIIHOUI'BFE) FaZa1eNJandZm8A ~ BFE), CXlII1lIBlB IIBmBE1 tm.Vl 64,.IthlSlMibJCBtII/IcsISIs t8nd8d",..1tf1POI/kIQ ~tJr8 LaIA tr~ SectbJ Cnutbt"",,~ ;, E1. ~ CJalpIItau. -'~the~ dalPm aatsilWtJ"ld:t1gtrviti1lfisadlcal8.bBi1gWI~~_ ~6 and 7. 1f1lOcJ;van 8IXJJlrIJIiy Nlpu.", IIeIdq, ~aslllthaP'4y."} , E2. The~dlhelDDntaa(hillq lasemlII1laencDu8)dlheb.tiJ;lll _1t.(m) _iL(an) 0 abovaa 0 ~(dleciCJl8)the~QmiSJllk E3. Fa 8IIdng DIQ'lInI ~ wi! qsilgs (see page 7), !he reel IiljIerftoaa EvaIIld 1Ica (8ab b) dlhellti1g II _1t.(m) _h.(an) abcM the /tiIlIl1tl$a1t lJD. E4. Fa 2mBNJcdt: IfllOqd_ runberll--'1s lhe~dlhe Idm IcafEvalsd i1 axxlI'daDwiDl t1ecmmJnly's ~ IIl8II8g8I1'I8IItClthn>>? Dyes 0 No 0 ~ The local c:tIcIaI nllStad'ylfis .ioi.nSaa, iI SeclIon Go . . . SECTION F -1"KUt'C:K1 V OIINER(OR <MNER'S REPRESENTATNE)~I'(lraoA11ON The pcpertyOlOl'riOlll8l'sdlalzlld lepesentalYa.IAII~SdD~ B, and E b'ZooeA ~a~ _81 ac:amuily-.edlFE)aZaleAO rrui lIilJl here. ' , . ,,' " " I . , 'rio, '-'<: :7.'" :, ; ;<~,/. Pfa8UYC7IH!R'S~'~N.mmzS)'.~r'I-IJ'A_tMV i ~ ,.. " ." i' ....,~, '. ','~: I , CITY D\TE STATE Ta.EPHCtE ZPca:E AlD&S Sl3NAnH CCJ&ENIS . ,. ''.,'.: ,i, ,S:'I~' ;/~ It...::.; '/", '.. '. "..' '. ~ ..'...,...J: '. I:J Check here if atbmnents SEcnoNG-cc.um'IFORIIATION(OPTDW.) The local abIIw II dDIzBd I7t l8Iaadn1R:8 tJai.iiBllertheClll1'llldy'a ~ RIIISgI!IIJIlllItmhn::e C3I ~ SecllcxwA. B, C (a E), lIld G dtil8lMlbl CerIIca ean.-....~IIn(s) and. b81art. ;" , G1. 0 The .~~ '" SICIIDn C _1Ik8n ianCllw'ctx:Ll1'Illlllllon hih88 a.t IilPIQ lIld 8l11bas8ed b'f a Il:erB 8lJV8'IOI', ~. a IIdlIBct wil auIIatzId b'f slBBalocalllirtJad'/eIMbI~.. (lrdaathelllllC8Gl dliItdl1e.. daIa in theCanml1lll aea ~.) G2. 0 A CXlIII1'IdycA:lC"",..~sdn Eb'a Idi1g IacaIBd iI Za1eA{wIhlliaFEM.~.lssll8da~ BFE)a 1maNJ. G3. 0 The bbrq au. (lame G4-G9) II ixDVkled b'aJIl'IIU1ly ~ 11BI8geI181t JUIll*'S. ' I G4.PSMT~'_.'"~' '.. I ~ fJATEPERt.fT1SSlED I GS. D\TEa:RTFrATEa:~1SSlED c;r, 'Oil parihabesllludb: 0"" CcDlludlan 0 SubllBIII8I ~ ' G8. E18'1alilutadbMlsttaa{llWt1g__~dlheldqlll: : ',I _._1t.(m) 0aIlm GO. aFE <<(kaZcneNJ) dllplui.mq.I1eIlti1g.111: _' ~ 1t.(m) DaILm LOCALa:FICW.'SNMIi. TIlLE ~~..1 ca.MNrYtwE SlGNAnR: CCJU:NTS .> ,; 'I'BJ:PttlH D\TE ,'" o Oleck here I atIII:I1n8ntS ' R=UA s:nrm "1_'\1 AlIA AA RFPI Ar.F~ All PRF\llnll.~ RlmoN.c; '" ,~'n,..' ,,~..., FEDERALEIIERGENCY~ AGENf:( r"--'~;:: ,.,'.' :;t~;r:'~;~~:'i--""-"~ NATIONAt.R.OOD~.~-~ ~:4~, '''''';''ii:.;;;~J;'';''- '-'-?iJ;::""<;)" ELEVATION .C~RTlFICATE I /~: ReId thllnItrudIonI on 1 . 7. SECmNA- PROPERTY QIVNER IFORMATION O,M~.NQ. 3067-o0n ,Expires July 31,2002 :~ :_l,',; ,':' ::~'.~~?:::..;:':.X ;;~~~::n::::::::~;;~{:X;@j/};:?:' :~~..:'.I.:,.:~....:,;,.,.:,.:..':.:~.:.:~;:{r<i:;'?:':{ ::........ . sr. o .:ba~~~ . '.; ;:J'~" '.; >~"'''''' ^'. S1R:E: OGPS(Tp~ [J UOOSQalMlp OOhr. ".., .......,- ,d.'. ';!~"'\ l' ~... I ,.-, 'd"'1""~""1" .. __-,..-:"",j'";,, ..,..... ,4..;.' ','1' . \-,. ~-. " .:. '_, 'i-,-~. SEC:l'u.S-R.OODIiSURANCERATEllAPflRMta:oRllATION :",; ~:"".. , .:: ~~' ~~)=~,,,\,f1~::.";,,, '",~,,;" ~,S:A.TEF(~ .., ,,,'.-.EIB;,~~1J,.. "B7.FRtPANa. ".. .~Rqg>~\.. ,,. ,B9.BASEFUXXlaEVATICH(S) .",,'......., , t~JI..,t' ",1.""I,.H"1-J"~ .. ~.' ~ ,.': ." '1f.......O;:,,:, ....,' "."lZcIlIAO...dIP.ullDoctQ). .1.1_ Q', _ <?2 .~H?' ../..... '.. l ,: .:. f'Y1lJ,.;:.,i.ilr:.. . .' ,'" _.,.., ..... 7... o. ()..,J ,,..,__...,..,.._ ............ . to ' .. '-', ,-' , , , 81Q. k1c:IcaBlhI8lUt8d~FIaad dIIiIcr' 89.' .-; '.~ " .i" '.' . :.. . . ,,; (",<\ ,j;,,- 811.~~~=!::.:iiEb~~.nl~3i~~. 'g~<;:*6"~~i:;"~~.;~' " 812. Is the Ix.tir;IIclc:aIm In a Co8sIS ISrier Rsscuce8 System (caRS).. aOheMlBe PIaeclBd Area (CPAYI 0 Yes jg] No ~ DaIB C1.~::~:;-:,~~~~:~-::=-==,: ." : '''.' *A.. EIIMli1ICitlbllIoI be 18q.i8d... CCI1IlRI:lb1 db b&iIlIng II~ C2. a.ti1g CIlV8n ~ ~ (SeIICth.tdiiij dIVIift .*-ti.. tdcaIg tr~ lhII c:erlIIcaIlI bBi1g CXI~ - _ pages 6 aid 7, r no cIalJan ClIaIIIIw~"'''~lD'ld8aek8thcr~.,A) --_. .... C3. 8lMlIa.-ZalesA1-A.1),AE.AH.A(WIh BFE). VE, V1-V3), V (wII BFE), AR,ARlA.ARlAE,ARlA1-A3), ARIAH,,w.t,() ~ IIImIC3IHbebV'~b"~ dapnipdedlnilBm C2. SlalBlhIdlmntis8d. fthedstum Isdlnntfianl18dlmn used trtlt BFEIn SEIclbl a QxwlIIt:ttI$,.,Dbi_tdJe&. SlDrIllld......aId dIiun<mVllliJlr:;Jo~ Usetleapa p17tIkled a..CormB1lB..d Secb1.Q.~C;~,~~.bdcamrttledalLm~;;UFt.,J. ;,'. '.', .<hM''''~'-. t)\t:'\ r,~~: ~~;'f;a;;;'~;"h':;"::~;;~'~;'~~:'~<,j;'''';;:.'' ',~ .' ._~;_...~:~:o:,:';;;/ Elevalalllflnnc8rrBt..d_Ooes tie.., ni'er81c8rrBt~~CJl1he FIRM? 0 Yes 0 No . . J,;; :'./' ; o a}~..tIxr,",_"'~~,}~~\~I~~(liI~J(il!Z...;2t(m) . .' ':''';'''''o''/J~' Ob)Tq)(tl1llltl~_1lu (.~f'l'llli~':;':,r";"$'~/1IlIlIIbi~ ."., _t(m) . ".:;""'i;.~.~r:.;',.. "'J' :...... ,. Oc)Babnd"'lIlIiIRIIIlInI:UIl~m.CIIttt"!'''d)l~lIf"~~~~ I, . . ". !' .; ,.,.,- . .' Q d)AlIad8fglllgl~)Ctllrib) " ",~;{,;;:;~~,~"';~t(m) ,'" .,' ,j; . .:.,; -l'J'i~'~ Qe)2..t~~ifffiZ''-TIt~ji::~'''''---''~''~~' ~:".' ':'<'II.f z.,;;;>#;?bSS ~=E?~=~j[=~_ ,~,-,,;~";- ,,'i~- -~'-, '" Q QTdllhlBld;lJB]DIIIll8qlRg1(1aad,\W1lI}nC3lL.a_an)_ . SECTION D -SURVEYOR. ENGINEER, a:tARCHl1'ECT~lra.iATDt ThIa certIIIcaIIon II b blllgned and sealed by a land 1UMI'fOr. """,'(1' 8R:hIt8ct authorized by law b cerUry eBvaIlon Infcrmallon. I CllllfytlJlt f>>iIbmIItIaIt.. s.ctIcNAa we (Ift"*~.... my belli fIi10da 10 irIeqnt",. dIIIIa 11..118* .- . =~fllf8eIlllllemstt~be~btf.fneor~Under18 U.s. Code, =~ 'TI'TU! .. .. ,. . .. P' CCIotPAN't' NAIAE . Aa:R:SS .. .p.. ..,... . . .. ..- art STATE ZPCOOE ~ME..:/t?'::'~"7/b~. ~ ...'..Q\1EC;3--/?-oZ- 1ElBK'tEJ?/~-7~$-6'82.,0 I+UA~R't_'1 AI~AA' ., '.;..' '.!~1 - . m::l= RI=VFAI=:I= 1=:1"': FOR t".oNTINIIATlnN RI=PI At".s:!=l All PRI=VlOl Lc; I=nmnN.C; IIPORT'ANT: ..a.a..... copylhlCllllYPOldlg In'Dn....lIou Ianl SIclIon ~ J~~,.~~~~:::.>.:::;':;. BUI.DN3 STREEt' ACa&S(kW:iQ" IN.UI,IIIdb'_NQ,)~P,Q RCXJTENI)BCXNO. '::~~:. , : ::: . . '. .' ~" . .... .... ". ". . .. . . aTY STAlE ZPCClE :.:rs~'~_;JV;,.'gr ~ . . SECmN D. SURVEYOR, ENGlER, ORARCII1'ECTc:sm=JCATION (CONI1NUED) ~td1sidesdl1ls~~U(1)CDIIIU1lyarda, (2) inllIr.n8~, R(3) tlJiktIgoM..~ CQN5NTS. ',1:1 Chedt here if dlbd.menlB SEC1DI E. BUI.DIIG B.EVATION IFORIIAllON (SURVEYNOI'REQUIRED) FORZOtEKJ_ZDNEA(MIHOUT!FE) Fa' ZaleKJ aZaleA (\1IfIIlU BFE), cxxqMIlIBmIE1 tva.Vt a,,,,/3tMJIkXJ 0IftIc:afI1s tiltrtBdtr.- AAXVI*v tDmBIIon as LelIA trLOUU=. Sscfk1n Cnut btoatf1/Bl8d, ;" E1. ~~taU8'...!SeIIa"~dlPIIlIDltsmllrb"tJaqiJ~ttisadi:aBIa.~wl~~_1lllQBI6l11d7. lfnodlvanamciBly . 18p.....IIikq.~a8lflld.1a~.~}.:.. " . . E2. The~dhldJn_~ lBenB1tall'ldDu8)dhbJllqll _ 1t.(m)_iL(an) 0 aIxMt<<D bebr (dlldtCl18) h~""lJD E3. FaIYfng CJ&pns6~"'. ql8I1iIgI (_page 7), hl1lllCt ~tcDra8BvalBd1Ca('" b)d..txiklngll _t.(m)_h.(an) aI:xlwlhe/ti18Bt~ !Jade. . . " ".: . . 64. Fa Zal8N:J cDt:,lfno qddBpll rurilerll....lI.. ~ dlhe tdJn 1ocr.*Med In amtIaD. tie CXIIITIIiy's ~ IIl8Il8g8I11sricdB1ce? Dyes DNa p~ TheIocalQ'llclal_csrIyti8'~InSec:ilonG. " . .... . . .' . ... ... SECTDfF .I"ICU'I:KI 't OWNER(ORCMNER'S 1&RESEN1'A1'NE)Q:KlnoAllON" The pcperty CJIIWrtOllB's adhatzBd .ep.......wtloWl.~SecICIiIA. B, lIId Eta ZcneA ~.FEW. ..Bf <<a:ml'uily",uBcfBFE)<<ZcneAO nui 1ilJ1he18. '.' ,'" . '.....,_ 4: ;'. . , . PRalERTYQ\tER'Sai~AUnCAZED'~i~_MwE~i , " ,- ....~-;. gf, " ,~.', r" cnY DAlE STAlE 'TEI.ePHCJE ZPcaE AaH:SS Sl3NAnR: ca.t.ENTS " ..' 'or.:'. "' ~"~ io." !;'(\.. ::l'ii.;S:':'I~;.uibfl"';"! '.~,:' . ~.' "', :1:"\";: ..... ',,, !~ "~ '- I, t- '~4 ~~~ . '. t:J Qleck here if altadmenls "-.-'. ..,..... SEC11DNG.~.~llON(CPI1DIIAI.l The local ~.lIdulz11d by_aadrllnxtb.d.... "aII'I'IIdy'I~ II'1lII&glII'Wlcdll1C8Cl11 ~SedIcIlIA. B, C (aE).lRIGdl1ls EIEMIb'I CeIIi:a ~,,~IBn(s)."bBlar. . .' i", ,"'...~i'.. G1. 0 lheIrDmablInSlcblC_tia1ian~ctlaIl.lIIIan hi has _~ 8Id 8111ba18ed by alcsnsed 8lIV8')Q'; ~ <<adtBctwm.auIIaIzBd by siiBab:alllirb_~.B1"" (hIcaBtlilDllC8li1ddl8d.... daain lheCarm1ent8 a8I bebr.) G2. D Acxxmuiydlldlii ~SdrI Eb'a tdtlg klcaIBd In Za1eA(wIxUaFEMMssued <<CXllIII'IIiy-Is BFE)aZa18MJ. G3. 0 lhetlbilV.~(IBn1I~lIjmvldedb'CDI'II'U1Iy~ mal8glllIR PJPlI8S. ' I G4.JlEIUT~'~'~ "". T. 'I a.\~lEPSUTJSSlS) I G8.DAlE~1Ea:~JSSlS) G1.lt*psnthasbelnlludb: 0 NM~w*wI 0 SutlItlriII ~ . G8.66dJld..wtbMlltlDa(kDd1g"'~d"ldqil: i' .J _,_1l(m) DaUn: G9. ElFE CI'(/nZal8AO) -'d.1xd1IatlhelUrt1g.Is: -' _1l(m) DllIIm LClCALa:FICW.'StwE. TIllE CCMoUfTYtwE SlGNA1\R! cau:NTS 1B.EPtlCtE DATE 'j ,". "'. o 08:k here' atIBcI1nentI ' F1=UA s:Mn A1~'1 AllCUIA RFPI Ars:~ All PRl=VlOII~ FnITlON.~ ~ FEDERAL EMERGENCY MANAGEMENT /1SENCY NA'OONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE C.M.B. No. 3067-0077 Expires July 31,2002 . :>FQ'~(,AiIi~lJsi):..<'. ........ :.:~../tJniler"...::.:>:..:.:::.:.:.. .. ..:~_.~.......... ~&~ ING (~Apt., UnI, SliIB, Elld.ttBklg. No.) ~ P,Q. ROOTEAND BOX NO. CD l e-y- "S . CllY Z ' V hi'! Is 5Tft . ~~!lI<dW T~-ro-''''''_'''I BUIDING USE (e.g., ReI!idenIiII. NcrH8liBIIiBI. M:libI,~. *" Use Cam'Ins 8llCbI ifllllClllllllly.) ZPCCXE 33SC(O LATIllJOEA.ONGmJOE (OPTIONAl.) ( f#/I>.#If -##N cr ##J#tItI#I>) HClRJZCM'AL CA1UM: o NAD 1927 DNAD 19113 SOURCE: 0 GPS (T)'Il8~ o USGS Qaj Map DOlher. SECTION 8. FlOOD INSURANCE RATE MAP (FIRM) N=ORMA11ON & CCM.IJNITYNlMER B2. COONTY NME (,) ,.h ,/. 5 /;( t?:2~S Ij'ctSCo B5. SUFFIX B6. FIRM INOEXCATE fIT, FR1 PAte. ! 0 ~ C .l(-[(-?J3 ~~ ( rtb.- 810. IndcaIe the SaJIt8 c:tthe Base Flood BevaIa1 (BFE) daIa or base flood ~ enIenld In 89. o FlS ProlIe Pi( ARM 0 Camu1ty 0IIEmiI1ed 0 0Iher (Describe): B11.lndcaethe eIeYaIion ~ usedfortheBFE in 89: 0 NGVD 1929 0 NAVD 1008 0 Qlher(Desaibe): B12. Is the IlJidIng Iocaled in a Coasla Ba'rier Resomls System (caRS) aea or 0IheIwise PniedIld Area (OPA)? 0 Yes g) No DesignBlI Dale SECTION C. SULDIG aEVATION I4FORMATION~ C1. Buiking eIevliia1s lie based on: 0 ConsIrudIoo Drawings. 0 Buting Under CoosIruclkln. 'Coostrudkr1 .A new EJeyaial Cer1ifIcale 'Nil be ~ when ca'1lltndon dthe buiking is aJnPeIe. C2 BuildIng ilagIan I'bntler _ (Selectlle btiking dagran most sinEr to the bt.iIcIng fa'which this alItilIcale is bei1g ~ - see pages 6 and 7. If no dapn ~ repesems the btiIcing, provide a skeEh or~.) C3. EIevalia1s - Zones A 1-A30, AE, AH, A (oMIh BFE). VE. V1-'v3l, V (with BFE), AR, ARIA, AAJAE, AAJA 1-A30, AAJAH, AAJ/ID CanPele Items C3&j belc:M amdng to the IUcing dapn spedIied initem C2. Stale the daum used. If the dlium is clrerentfioolthe dalum used ftt1he BFE in SEdxl B, convert the dalum to thciused for1he 8FE. ShatN fleId measuremenls and daItm aJMlISicn caIcuISb1. Use the spa JXovided or the Coomenls areac:t SeclionQ.~ ~ G, as apJXCpriate, to da:ument the daIum aJ'IV8ISlon. DaIum ~ Car.esDVCanmenI Elevation refeIence msk used _Does the elevatiort reference msk used ar4l& 00 the ARM? 0 Yes 0 No Q a) Tq>c:tbabniklor(ildtdng basemeriorenclosa.re) m, 91t.(m) Q b) Tq>ofnexthi!j1erfloor .....:::::::;- It.(m) Q c) BoUom c:t IC1Ml5t haizmtaI sIruduraI member <Y zmes ooIy) ~It.(m) Q d) Atta:hed ~ (tql c:t slab) .....=:- _It.(m) Q e) I..aNest eIeYaIion d madinery lIldIor equipnent servicing tie 1Uling , _ft.(m) Q f) laNest at.m1t graie (LAG) ~f:ft(m) Q g) Ii!jlest.. grade (HAG) ~9.<m) Q h) No. c:t perrnaleI1t qJllIlings (flood Y8Ills) wiIhin 1 It. above ~ gaie Q i) Tota areac:t aM pemment qmngs (lIood Y8I'Ils) In C3h ~sq. in. (sq. an) SECTION D. SURVEYOR, ENGI&R, CRARCIITECI' CERlFlCATD This certillcation is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I C8Itffy thBt the informatian in Sections A, a and C on this C8IttIicate rept9Sents my best efforls to interpret the dsta avai/8bJe. I understand fhBt any mise stBfement may be punish8ble by fine or imprisonment undBr 18 U.s. Code, SectJon 1001. ~11t'1t:I'(~NAM: UCENSENlMER B3. 5TATEF ( B8. R.OOO za.E(S) 89. BASE R.0008.EVA~) (ZmtAO, U98_dtxxilgj 'ii ... II) j~ Jji ...:! .8", e- :i,~ .en ~ p~'- 1'/ L.,;:' , . ;3 b'S ~ TInE AOORESS ~TURE ~/Z~ CalFANVNAAE CrTY 5TATE ZPCCXE CAlE c/3 - / 9-02- TEI..EPH(JE~...?-73'c~-- .(3'2-"0 l=I=MA l=nrm ~'l-11 AI Jr.: QQ ~I=I= RI=\Il=RRI= ~Inl= S:OR r.ONTINIIATlON RI=PI Ar.FR Al 1 PRI=VlOIIR FnmON~ .oRrANr: .. tIIeIe..... copy" CClItspOIIdIng hlbn., ..... SIdIDn A- BUILDING STREET ADDRESS(RidQApt, Unt SUIIe, lIIib'BkIg. No.)~ P,O. ROOTEANJ BOX NO. :F.it~~QE; ...... .::~~." CITY STATE ZPCOOE ::~:_~. ........i../....... , . . 1Ii---... SECTION D-SlJRVEYOR, ENGINEER, ORAACfII'ECT ~I.-..ATION (CON11NlJED) Copy bah sides ctlhis EIevab1 Cerlli:ale for(1) ammnity aIIdS. (2) il1SUlllll2 ~.1Ild (3) txJikilg CfM1B'. CCJ.M:NTS Q Chad< here if alb:a:j IITIElI1lB SECTION E - BlJI.DIG B.EVATION IR1RMTION (SURVEY NOT REQUIRED) FCRZOfENJ ANDZONEA(WRHOUT BFE) Fa' ZoneAO andZooeA (vAlhout 8FE), CXlITI\i6lB Items E1lh1aJljl E4. ffth9Ele411ib1 Csttt/IaIe/s intend8db'usess ~ iJIbImti/onbra LOMA trLOMR-F. SecIiaI Cll1JStbe~. E1. 8uiIdng Ilagram tamer _(Select the ~ dapn roost sinla'to the Ilti1gtrwt1k:h tIis a!ftilk:ale is bei1g ~ -see PI9lS 6 aid 7. If no divan a:curaEly represenIS the lliIlIIYJ, JmIide a sIBtI a JiK*lgIlI!ii-) E2. The tq> d the tnDniloa(n:Iudng basement a l!I'ICkBJe) ctthe tukilJ is _ fl(m) _i1.(an) 0 abowt ex 0 beIcM (d1eck 008) the ~ l$8'lt ple. E3. Fa' BuiIdng Dlagrans 6-8 'AiIh C4lriJgs (see page 7),lhe neJct hlgheriloaa eIrMEd 1Ioor (elevadat b) of the txiking is _ fl(m) _Il.(an) above the Ii!jlest ~ ple. E4. Fa' Zone AO CIlIy: If no fIoOO deplh numberis avaiaje, is the tq> ctthe IUIan liar eIBYalsd in ~ MIl the amnunily's ~ ITlallaQElII18I1t oo:hI1ce? Dyes 0 No 0 lilIcncMn. The ileal aIlcialllUltarlytlis ilblllallal in SeclIon G. SEC'TI)N F - ~I T 0IlIINER(OR CJIlINERS REPRESENTATNE)\il:KIn;;ATION The IJ'l)peIty owner rt OM1efS aJthaized represenIatiYe who ca1J;EIes SedIa1sA. B, cn:I E fa Zone A (wiIhout a FEMA-lssued a<Xl1'llU1ity-ls BFE) a Zone AO must sign here. PR<PER1Y OWNER'S ~ QWIIER'SAlJ11iCAIZED REPRESENTA11VE'S NN.E Al:JR:SS SlGNAlURE CITY DATE STATE T8..EPHCJE ZIP caE CCJ.M:NTS I::l Check here if alla:hrnents SECTION G - COIM.rf'INFORIIATION (OPTIONAl.) The kx:aI aIiciaI YiIo is aIlaized by Iav a adna1ce to lO1irister the aJTIt"IIJlily's bdpIain ITIaIllJQlllTlllIlt oohn:e ClI\ CQ'I'1JieIe SedIcnI A. B. C (a E), IIld G ct tis EIevatoo CertIIIcale. ~ the ~ iIeIl'(s) IIld sign beIoN. Gt 0 The h .fOIhakln in SeclIon C WlI! trilen fn:m olher doaJmenIaIia1 that has been signed lIld emImIed by a Iialnsed SlIIV8yOI', eIYiIiMB, a an::tiila who is auIhaiZBd by stale ex toealavto cdy eIew.ib1 inbmalIon. (IndIcaIe the SOUIt9l1ld daledthe eIEMiia1 daa in the ConmenIs aea below.) G2. 0 A CC!11JlIIIty aIidaI COO'lI*iBd SeclIon E fa a tliki1g Ioccied in Zone A (wiIhcut a FEMA-issued a CXlIllI1'lIJily BFE) a Zooe AO. G3. 0 The ibftng ilfoo.lalkln (1tem8 G4-G9) is !JOVidlld forarmuily bdpIain IIBlagElI18i 1UJIllIIe8. I G4.PERP.fTNlMER ., G5. OATEPERMTISS\.S) I G6. DATECERTFICA'TEa:ca.t'l.IAtaIOCClSSI.El ~. This pem1t has belli issued fa': 0 New CalIlIruc:tD1 0 SutIia1IiaI ~ . Ga. EIevalon ctas-bliltk:MlestiloaQnci.Ki1gbasement)dthetXJiki'lg is: _' _fl(m) Dawn: G9. 8FE a(il ZooeAO) depIl dfloodng at the IUkIng siIe is: _' _ fl(m) Dlium: l.OC-'l.. CFFICW.'S tw.E TITlE cor.M.NTY NAtA: Sl3NATURE Ca.u:NTS 'IB.EPtKJE DATE o Q\ed( here if atBtdTl8l1ls I+UA Fnrm A1_'\1 AII~ QQ RFPI Ar.F~ All PRF\Ilnll~ FnmnN.c; ,.- 'j OWNER'S NAME ,c,!Jtd 1-23 -Vi7.-!._<2J CITY 01' ZBPHYRHILLS PERMIT APPLICATIO!f"'-----' BUILDXRQ D....~ 5335 8~ STRBBT ZBPHYRBILLS, r~ 33540 ~P~.81]-7.0-0020 PaxI813-780-0021 DATB R.CBIVBD PLANS RBVIBW PHB PHONE CONTACi'$("3) 71 r~ 9 tlS //J....U-fv1 ( /Is 1-':, i SUBDIVISION 0 ,;{ ':) [) erv1uJ( I ku-kl ~+; LEGAL DESCRIPTION: LOT(S) 50 P~CEL ID # I,{- d.to- d-.l- ();)..7(),' {)OOOo-D30 0 z BLOCK 0 WORK PROPSED: []NEW CONSTRUCTION []ADDITION []ALTERATION [] REPAIR [] INSTALL DSIGN o MOVE 0 DEMOLISH PROPOSED USE: DSGL FAMILY DWELLING DMULTI-FAMILY 0# OF UNITS ~OBILE HOME [] COMMERCIAL [] INDUSTRIAL [] SWIMMING POOL [] ornER (OBTAIN FROM PROPERTY TAX NOTICE) DESCRIPTION OF o RESTAURANT & WORK NCw fl/lob'/<e ~fX 5g/ . HEALTH DEPARTMENT APPROVAL !Iv In ~ - /1~e. el17 rellf' SQUARE FOOTAGE /5(/7 HEIGHT BUILDING SIZE 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. [(BUILDING [9"'ELECTRICAL ~ PLUMBING ISYMECHANICAL PERMITS REQUESTBD $ 35; o{X)/~oo 0 VALUATION OF TOTAL CONSTRUCTION I AMP SERVICE o FLORIDA POWER o W.R.E.C. $ VALUATION OF MECHANCIAL INSTALLATION o GAS o ROOFING o SPECIALTY o OTHER TYPE OF CONSTRUCTION: 0 BLOCK o FRAME o STEEL o OTHER FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREAD YES 0 NO SIGNATURE ,~ . l~'17l~ . COMPANY e9o.-r.k r Tr eLM f..O r- + /Yam -es 0GJ~f- STATE CERT OR REGIST # .74-()tJ1Y) i./ to '1 CITY PROCESSING # BUILDBR **.******.*.******.****.***********************..**,******..****** BLBCTRXC~ I SIGNATURE -~ Lf7~ H ~ .,..-:- / r/L' COMPANY e ~ J;::' Ie c!-'t'f{ c... STATE CERT OR REGIST # ESCJ06 ()() ~ ( CITY PROCESSING # .****************.**************************.********************* PLUMBBR ""~'--" (; rrv,., " ~ '~--!)..7 ..~~. //~ l . /" - I COMPANY <9o.:::i-V y- STATE CERT OR REGrST CITY PROCESSING # r SIGNl\.TURE ~**********************************..**** ****** *******t.t**.**. . MBCBAH'ICAL / " . .'. COMPANY: C. e /r c 0/1 d ( V. /Ol't / I ( C' ~ ~l' //- 'ST.ATE CERT OR REGIST # tIll-eo <:t:t'l55' SIGNATURE .. , ' ~ CITY PROCESSING # ******************......************.*.************************** OTBBR COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ***************************************************************** .........,\.., A ...'::_~:~...~' :c . ~ r~ .Ili....., ..,."', ~JIff "'.f(. . ~.' f ~fv^y:,~.;~q'8 p;;qupd 'pad&l ameN . . ,. ~~.~ ".., ,; ..... . . ,~~t~=lbPd 'padA:-=l ameN .,;t. '._ ~..,..... 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Sl aq 's~o::tOl!.:r-=lUOO ~o .:rO-=loe.:r::tuoo e pa~lq seq ~aUMO aq-=l J1 la.:rom.:raq~~n.!l "ll99-99L-E19 '-=luam~.Tl!dao 6uTPl1na sllTq.:rAqdaZ JO A-=lT;) aq::t -=lOl!=luoo o=l pas1Ape a.Te Aaq-=l I}{.TOM papua=lU1 aq=l .TO} ATdde Aem B4uama.T1noa.T fiu1suaoTT ::tl!qM O=l Be u1l!-=l.Taoun a.Tl! .To::toe.T~UOo P9PU9-=lUT ~o .:raUMO 9q-=l}1 "Met a::tl!::ts ~apun u01::teToIA .:roueamapsTm e .:ro~ pa4To aq Xem .:r040&.:r4UOO pue .:raUMO aq4 q40q 'Ml!T Aq pa.:r1nba.:r Sl! pasuaoTT ~ou sl .:r04oe~4uoo aq::t J1 "suol~eTn6e.:r ll!OOT pue e4e4S q4TM eou&p~OOO& uT pasueoTT aq 04 pe~Tnba~ aq ~em Aaq4 1}[.:rOM 9~l!::t.:rapun 04 s~0~oe.:r4uoo ~o ~04oe.:r~uoo e pa.:rTq seq .:reUMO aq~ JI S~I~I'llaISNOaS:il}l lIOJ.:lY'dJ.NO:l aNY S}lOJ.:lY'dJ.NO:l O:ilSN:il;)I'lNn "a 'su01::toT~~sa.:r paep alqeoTTdde ~ue q::tlM eoueTTdmoo ~oJ ~::tlT1q1suodsa.:r samnsse pau61s.:rapun aq~ 'suo~~eTn6e.:r ~-=ll;) ueq4 aAl~ol.T~sa.:r a~om aq Aem qOTqM nsuo14oT.:r4sa.:r paap~ O-=l ::toa~qns eq Aem ::tTW.:red slq::t 4&q4 spue::ts~apun pau6Ts.:rapun aq~ SNOI~;)I}lJ.S:illl O:il:ila .il0 :il;)IJ.ON "V J.I1\V01.i1.i1V J.IHH~d .il0 SNOIJ.laNO:l ~ EJ PERFORMANCE BUSlflESS PRODUCTS, INC. 813-719-8008 FAX 813-719-7919 CITY OF ZEPHYRHILLS ZEPHYRHILLS, FLORIDA WATER ACCT. NO, DATE ,3- 5=o~ OWNER/ ~~ RENTER. .. ~ ;{;~Q}.(--- MAILING SERVICE ADDRESS SHUT OFF SERVICE 0 , TURN ON SERVICE t( INSTALL METER ~' READ METER 0 CHECK METER 0 OTHER 0 0 SEWER 0 GARBAGE ~ IN CITY 0 OUT CITY ~ No. OF UNITS _ DEPOSIT AMOUNT ..-J--;( -~ Jj ;/YYJ~ _ AMOUNT LAST Bill _ DATE _ MISC. CHARGE IM:>RK 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 Dept. to sign yellow form & return to office. F~B-le-e2 11:00 AM PACHD ENY HEALTH DCDE ce 3:52:5236~13 P.01 . . STAtE or FLORIDA DEPARTMENT OF HEALTH ONSITt SEWAGE Tll.EJl.TMENT JI,NO DISPOSAL SYSTEM CONSTRUCTION ~~ ~ENTRAX *: 51-SE-01797 CATE PArD: FEE PAID: .$ RECEI~T OSTDSNBR : 02-7565--N CO~STRUCTION PERMIT FOR: r x JNew Syetem [ ]ExistinQ System ( ] RQpair [) Abandonment AP~LICANT: Kandal~, Bev.rly ] Holdinlil Tank 1 TliImpocc.ry Innovative Other NA il.GENT: 45, >>8ftfte'tt LaZOll:'Y PROPERTY STRUT AODRESS:_Chutezo .~ Ze>>h~lehJ.l1. PI. 33541 l..OT: 30 SLOCK: 0 SUBD!VISIOI't: Idoevood [Section/Town!hip/Ran9~/Pa%cel No.} PROpeRTY tD t: 1.2'210270000000300 , (OR TAX 10 NUMBE~l I SYSTEM MOSt BE CONSTRUCTED IN ACCORDANCE. WITH SI?ECrfICATIONS AND STANOARDB or CHAPTER 64E-6, FAC OtPARTMENT APPROVAL OF SYSTEM COts NOT G;~ARANTEE SA~1SFACTORY PERFORMANCE FOR ANY SPECIfIC rIM~ ~ERIOO. ANY CHANGE: IN MATERIAL FACTS wtUCH SnVF.:D AS A BASIS FOR ISSUANCI, or THIS PERMIT, REQtJIll.E TR! APPLICMlT 1'0 MODUli THE PER~!!T APPLICATION. SOCH MOOlFICATIOlIS ~..AY RE;SULT IN THIS ?ERMIT BEING MACE NULL AND VOIO. ISSUA~:CE or THIS PERMIT DOES NOT EXEMPT T~E APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE OR ~AL PERMITTING REQUIRED FOR PROJlERr~ OEVE~OPMEN1. SYSTEM DESIGN AND SPtCIFICATIO~S 1- ~, · , "',e.r MUI,.TI-CHAMBJ~R~DIIN SER.IES: (Y MU1TI-CHAMBI~R~D/[N SERIES: [Y T gOO J G.allons BElittle 'rANK A 0 ] Gallons N Q J GALLONS GREASE INTERCEPTOR CIU'ACITY K 0 lGALLO~S DOSING TANK CAPACITY [ 0 IGA~LON$ @ 10 lDOSES PER 24 H~S * PUMFS[ 0 D [ 333 ) SQUARE RIO ]SQUAli A TYPE S'tSTEM: [ CONrIGU~TION: N E' I E: L D FEET PRIMARY DRA!NI1'IU.D SYS'l'&:Jll FEET SYSTEM I ~ )ST~DARO l M ]rILLED [ y )T~E~CH [ M JBED { N jMOUND I w 1 ; N i LOCATION TO 8ENCHMARK: a~l Nail w/(!'range Ilibbon On Cit.rUB Tree Mea%' IS.,t.~Q ELEVATION OF P1\OPOSEO S'tSTEH SIn ( 40.0 1 [ tNCHES I [ _LOW J BEN(:nMARK/REFERENCE POINT BOTTOM or OAAINFIELO TO BE (14.0 ) ( tHOlES ) r BELOtI) BENC:Hl"".A~K/REFERr.liICE PorN'! FILL REQUIRED: ( 0.0 lINCKES EXC:AVATION REQUIRtD: 0.0 I INCHES OTHER RtMARI<5: [81:] 8.h~ f'or 3 ~ckoo. 1547 .q It. HoI:.u. HOlle. Co" ~ ec + T() c e l)+rO\.. ~ tV Ct {Er SPEClfICATIO~S BY: H1Adalono. ~t~ TITLE: tH $pec1al~.~ II APP'il.C"'ttl !~: Hindalonq, Jeff 9(1-1 ~.~ TITt.E: EM Speoialist II Pasco r~r" OATt ISSOEO: 2/14/02 EX~IRATI0t-: DATE: '/14103 OH 4016, 0)/'1 (Obsolet.. previous e~1elofts Vh1ch ~y nc~ ~ used' (Stoelt NIoI..E': 5'64-001-40016-0) lutGI_coIII_.OU-IJ Page 1 or 2 1 . d 2EEl-61.1.-E18 ~~auuaa .1:::1 ans dOl:21 20 81 qa~ . /{eJldaJ1 /.-D +- 30 c..ho./tt\'- 5:k I Z'"~~r-h:lI~ PI. 6Y-~~-~J-oa/o- cOOOO-03CO) ~v' ~I .?- ~X 581 f1, 1-1, ./ II,; I ...., , / , ::~ I ~ -7 ' "J ';;) "' ~ ~ ~r ~ &0' C ho...v--{-er s.fr'€e.~' I'~;io't'.. ..K' e.e5 eJ, ^ 1 J f (fl 0 J 1tV1 IVo be. (e (\'1' 1,1 .}o . 1d1 Co u Y1 {. \./ W Q... k r ....-',' ....- -:,"'''~'~.'''' ,.'.. ......... . . . . " ....~~,...-.':'''''~..,.-:''\.,'--:;t.~'.",.., .' , ,."-<' .\ \' . .. . Pooket; penetrom.eter Test.' X /5IJl) .X /SSfJ X bl)!J II . .. .. ..~_M" of ~ ~ ..- - ~:,I.) lIMa""'U . TaD .. "1411'1 .. _ o.ptJl Of \lW fClloW, . 171iD1 1500 I" ~t t.Me t.b.I JoWII. ".N~ u4 IICND4 IlIIcnm to --~. . X !)SD X L SSO X '/~tJ~ . ~l""'" , .~YJ~~ ~ Tbi8 81te Round.ed. '1)oWlCl.',to: , -' \ I' IS" tJ 0 P8Jlr, , ~ . ..,"" . . :1" , . . . ',1' . .~.',. , ' , .....', " t' " .' . ........ sa ."r .. rr .. .. .. .., . mlXlmum . 4iiilt ".GIn' 2r Ie zr .. ..,....,...,.-~.......'_._...,....~....,.,- , . t , , : , I II Q I i t ~ . 0 I ~ t , \ e-" . . , I ~ 1.11 i . 131/10/02 11:52 GDDWINS Kl!'E CENTER., 8105418781 :1 i :1 ' , , , . ~~'IC~I".I'l"'~':'~:"::'.'~";:" . " ' .'..',', ."...." ,- ~.! . . ~.... ~ - . ; I " \ ; '~J , Ii 11-;', :'1, , , . :\ i , , , ; , I L ! i: ,l Ili1L Tn .'....,.. " \ ~ I \ j i \ ' I , \ II ...-' ,~..,~. I, ,,, I !' ",.'. , . I' : \.~, .;-(~ 1'; I' ,', \ I.........l...... .' 1 '1'1 ,.... ..... 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February 12. 2002 I, James Wagner, president of Gator Transport, give Donna Moon permission to apply for and pick up permits under my company name in the City of Zephyrhills. ~~~ ~~ ~/ty 0.1 ?ef2h,!~,I/J dj13/o:r D..r aar.. ~1.... "0 ."v'.." ".r.lly a..th...L.. Nt _ ... ~A1f/. N......,.. WAf.'''''''. 71'1 _ W. .........lIwd. L. . n .... ....... _1 bV _hi. 1.'t.r t~.t I, .u..n K. Willie.. do -j)/JNHIl. M~A " ' up ..a~.nlcal p.r.i'. gn .~ ~.h.l'. If you to .. 1ft .nlf 1I'1::1c I hev. anv It"." :10"' pl.... '..1 'r.. to 'l:al1 ... Thank ~"4j. / &..IJ~.'~~ c.caa'788 Net:ary,. ~~~ ".~.--.....~, ~.~.-: l"".,+_ _ ' ......1_1. .; ," "-~'.' ,: '.. t C.),'fil; . f - 1:1.... 1r Ib.d .1111 Lit M....I..~~JII ACE Air :m==- SaIH . s.mc. 941-688.2238 FAX 941-686-9798 WArS 1-800-282.7841 923 W. Memorllil BMS, l.aIceIend. Florida 33815 d.-// 3/0 :J- I' I Cry Or- &phyrht!/.s Dear Sir: Please be advised by this letter that I. Robert K. Krul. do hereby authorize 'bOr\~;^- ~~ to sign and pick up electric permits on my behalf. If you have any questions please feel free to call me. Than Ie vnll Q/f~ Robert K. Krus ESOO00061 Notary: ~ ~oP~~ , . 'r i ~-~ f<, ~.f~ fA, . ct ~'~~-ry ~ ....b..c S1'ch:j c!. pcrlda My .' :..:..~~. Z:xpr.-~ )'.1" '-J. 7JJ.A COilUi-~::~"!.' , .".,1' ,~.",,>,"'!._,"i"'_' '~"'''''i-- State Cer1lfIed ElIctrIcII - e8OOOOOe1 All' CondMlol.tg CAC0387&5 ~~ l~ * ,\ ~ !r~ ~{ ~'. c.;, ~ '" . c:o- ~ '-I') , 1'1~'l~ 'I~..... ~ ~ , i i I . ....1 ' DfI . '11':' , " "". t.~4~~; 1__. ~~.I~L"" ~ "~y f,UIII.'.O .... : 01/1111/02 11:52 G:JDWINS HOt'E CENTER ~ 8105418781 ;l/ :}1 . , ....~'''ltol,.'tt'.,;..''",............~'';,' ....... ':"~".':"1"""'. '::' ,_ ..". -.1 ~ i I ~. \ l. ~j I i '1- -.\. \ . ~ ' ". I ' , . ~ . ! . I ,\. .l \r \ ~ I i , I i \ . i \ i \, \l ; i. ~ .l . . ,,- .11. ' " 11 .'....:""",' '1 I 6'-.:: . ' , " , .. .."t"Io'. , ..: ,:,:,.:~'::'I~' i' I ! ! I~ . r. ..' 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X !)SD X LSSO x . 1~t1~ , ~,....... . .~yJ;~,~ -' Tbi8 81te Round.ed 'DoWlrl.',to: , ' '\ " IS tJ c) PSJir, " ' ..\.. , " ~ . . 1.1 I . ,....', " It ' , " " .' . , . K €Jtcio-ll , /.-D + 30 c.-hO-ftt v- sJ I ~~~r-h:li~ PI. 6Y-~~-~J-QQl'70- 00000-0360) ~v' ~I .?-'is'X 581 f1, H, I I .; I~ ( "'\ , / " r" " '- ~ ...../ , ~ ~ , ~ 1ft; -7 ' ~ ~ ~O' o hcqr-{-er 8h--'€et-. I J~ ;;) 0 I l' e-e~ lJeJ, rJo b( (e(llA~ f ~ e. JbI' COur1 {\./ Wa.kr PASCO COUNTY, FLORIDA SCHOOL IMPACT FEE Ordinance No. 01-06 Effective: February 28, 2001 at 2:08 p.m. Permit No. Date Permitted: Builder Name/Owner Nams:=.11d.~ U.A 4A1Y.tJ-I-C- ParcellD: 1'/-,.2t?- 2/- Oa7() - 00000 - ~<3.DO Address/Location: J! 6 /9 {! ~~;;Zn.J - \vf6. Subdivision: Classificationffype of Use: Exempt: o Single-Family Detached House ~Mobile Home o Other Residential o Collection Fee Total Fee K No . Yes How Determined: /oJ/7 ~- 5''' D~ (056) (057) t /17 (058) (123) $ Prepared By: (5(~~ V~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. :.:3 - cJJ../- f) 2- Date ~~ > V~~ Receive OFFICE USE ONLY RECEIPT NO. DATE White Customer Canary Finance Pink School Board PC01005114/A BY Gold Inspection