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BUILDING PERMIT
Permit. N2
CITY OF ZEPHYRHILLS
(813) 780-0020
1 1 1 8
Date g - 2f?--oz
BUilDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn / ~ 71r' ,p:1)
Water Conn: '350" p{)
Water Meter: / f'o' t9--O
T.I.F.'s:
Pmperty Owne" --IJ ~J.
Job Address: 3TI tf ~
Parcel I. D. "
~~
fi/ll Av~,
Zoning:
DescriDtion of Work
Energy Code:
S,b
Radon Gas:
cf2/J.. 8'8
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
/., - - (J,9..
DATE
~ !")- tJ~
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
Permit Fee
~ignature
Company
Address
\delephone# lt3-7JY- 4~35
Valuation or
Contract Price
~ 7, 9 ';).0, (){)
City License Registration #
State Certified License#
j)JJv;J :1OhltS0n 111lt<1itJ E'It( ~f;'c' (!l,a5f JiiW/f5 5);')11 n r s
'-:#,,~
BUilDING ELECTRICAL PLUMBING MECHANICAL
Ftr.~-a~tJJ~-5-0~ /1.L'1, /ffOTp. Servo . SLB '/Y-I'i-tfJ:Z #jO/~reakers .
Pre SLB J ,-/-2"1,'0 1.1<L '1 Rough In '7- /tf. O,ti- {'J.. 'f Tub Set 7 /Cr (') z ~l y Ducts Insl. '/'-/9 - t? 'Z '.fj Y
Lintel Meter Can Water V /tJ., 2 5-.::' 2.. ~ I:i!3Compressor
FRM. 7-iCJ:,O-2--(RL'I). Const. Pole y't/','1-IJ:l~lY sewe:f'~t)':5-0Z.f/ll:. g~ Final1./7-/)'.-o;l i?t. '1
InsuI.CL/"%-I..J-IJ2R.'-Y Pool t./-/v,-(J::2. ,.eL~ Final_ -/:yO:;) RL'1
Wl Pre-Meter //1-'-/-0,':) ,l({~ j II)'e)
Finall/1-/S-01J. J(LI.1
Driveway ,/1 -Cj-tJ2 f2Ly, H'56
FP 1f-'f-d'J- ~'Y5 Ih',k~ K r
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:
t---p //- - ~' -- LIIu(r~
a. Wrong Address 5 - CJ 2 ,5::> ~ I f..-~
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.
~J) 3-~'-o~ 1<1-
CITY OP ZEPHYRHILLS PERMIT APPLICATJCON
BU:ILD:IRQ DBPARTllBHT 5335 8th BTRBIIT ZBPIITlUI:ILLB, PL 33540
Phone, 813 -780-0020 Pax, 813 -780-0021' '1 "\ 0-_ f) d--.
DATB RBCE:IVBD :.:'\ ~ ~ to.
PLAlIfB RRV:IBN ~BB
OWNER'S NAMB Nttlf~,ffo/
JOB SITE ADDRESS '3 'I 3'-1 q P " C K-t +1-'., )4 ;/1 Ave.
LEGAL DESCRIPTION: LOT(S) !)tJ BLOCK
PHONE CONTACT 997-/ '1&:1-
1(t.f~ <{~~
SUBDIVISION
P~CEL ID # 03 -J.b-dl-~-ODOOO - 0500
WORK PROPSRD: ~NEW CONSTRUCTION o ADDITION
(OBTAIN FROM PROPERTY TAX NOTICE)
DALTRRATION
o REPAIR
o INSTALL
DSIGN
D MOVE
D DEMOLISH
PROPOSED USE:~GL FAMILY DWaLLING
DMULTI - FAMILY
Off OF UNITS
D MOBILE HOMB
o OTHER
o COMMERCIAL
o INDUSTRIAL
o SWIMMING POOL
o RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK S/NGtG' F/rP1 It V J2:er;//16VcE:'
,
BUILDING SIZE 34'6" 'f... 73' 'f " SQUARE FOOTAGE d. 0 ~7s
HEIGHT
9/
RESIDENTIAL:
COMMERCIAL:
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUILDING PLANS & (1) SBT BNERGY FORMS.
PROPERTY SURVEY RBQUIRBD FOR ALL NEW CONSTRUCTION.
o BUILDING
PBRMITS. RBOUBSTBD
$ '60,000. 00 VALUATION OF TOTAL CONSTRUCTION
,
~oO
AMP SERVICE
~ FLORIDA POWER
o
W.R.E.C.
o ELECTRICAL
o PLUMBING
o MECHANICAL
$ 2/50&. 00
,
VALUATION OF MBCHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTIONI~LOCK
FINISHED FLQOR ELEVATIONS
, FRAME
o STEEL
o OTHER
IS PROJECT IN FLOOD ZONE ARRAO YES' ~NO
BU:ILDBR
.********.** ***************************~*********.**************
"
/
BLBCTR:ICXAR ". / .~ ' . ,1 . -.-/
SIGNATUR).,. /('}f~u!~ ~fl...~.l/'-C,L
. 'i
SIGNATURE
*******w**********************************************************
~ .4 . COMPANY &/6(; JAYl1g I~~ 6,~ 1
fdt. c'/', STATE CERT OR GIST # F- b 'i, ~
. t ,UI '. CITY PROCESSING #' /~t
· . .~...L.....~.........,................................,,>..... ..
A'.. COMPANY ~ CJ #'kcr .
. STATE CERT OR REGIST # tin tJ{) / f' II {; I
CITY PROCESSING # '
COMPANY M(.t r+; \A. 'Z I ol ~. ~ C/. TA C
STATE CERT OR REGIST ff t: e.O 0 /3 LIL.{ lj
CITY PROCESSING ff 17
PLUllBBR
SIGNJ\.TVR,E
JlBCBARICAL
* *.... * ** *****.,.{* * *.* * * *** **.. * * *.... * * *.. **..*** ****** * *.. *..* ** **
OTBBR
SIGNATURE
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #,
..****..************j******....***************************....*....**..***
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 RES~ONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they may be required
to be licensed in accordance with st~te 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, 813-188-6611.
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 contraptor that may be an indication that he is not properly licensed and is
not entitleq to permitting privileges in the City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTUION LIEN LAW (CHAPTER 113, 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. J
E. CONTRACTOR'S/OWNER'S AFFIDAVlT
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 perfor.med 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 S~nsitive
Lands, Water/Wastewater Treatment
*Southwest Florida Water Management District-Wells, CypEess Bayheads, Wetland Areas,
Altering Watercourses
*Anny Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of Health i Rehabilitative Services, Environmental Health Unit-Wells,
Was~ewater Treatment, Septic Tanks
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if till 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 Offic~al 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 pe~t is commenced within
six months of issuance, or if work authorized 'by the permit is suspended or abandoned for a
period of six months after the time the work is commenced. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be requested
in writing to the Building Official. An approved inspection must be logged during each six
month period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT ,MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDIN~ ~ICE Of!' COMMENcI!:MENT. JOBS UNDER
$2,500 IN VALUE DO NOT NEED TO RBCORD AND POST ~:T~. OF COHNENC~
)&./.<f/~ X~~-
SIGNATURE: OWNER OR AGENT SIGNATURE: CONT OR
-'--j
STATE OF FLORIDJ(/J. STATE OF FLORIDA \.... .-=7'. 0
COUNTY OF . I~(!/) COUNTY OF , ,..L.-<+:::S
The foregoing instrument was acknowledged The foregoing in~r~ent was ~wledged
Beto th s ~p of ;::,.-t , ~~ Before me this c ~ day of i_ , ~Pt~
by by
edged)
to me, or
eldgement
Signature of person taking acknowledgment
" '-;r.~r."'" Bobble SWetland
:",!~.iN ~_ MY OOU.~ISSION t call3160 E"'D1D~!:.
Name ~ : prinfCllLaqll2,Sbmped
. ", ;;.- ;t~"lONDED THRU TROY FAIN INSUIlANd, INC.
"'I;ot\'
Narl' ltwDed, p.rinted or stamped
. :~: tlOObie Swetland
~~ }:] MY COMMISSION # CC893160 EXPIP'
~.w'''''~ February 22 2004,
../ir.,fti. BONDED THRU TROY FAlN'NSURANG. ,N,;
. crtv OF
ZEPHVRHILLS
"NOTICE"
OF ADD.ITION OR CORRECTION
BUILDING
DEPA'ATMENT
DO NOT REMOVE
Cf': 5 (0
ADDRESS
3rt 3'-\-" p'
PERMIT .,.
/1/fiY
THIS JOB HAS NOT BEEN COMPLETED The following additiqns or corrections shall be made before the job
. will be accepted.
,
--rn.J.Q
DATE
I 2 -2.-0 2..
II il unlawful for any Carpent.r, Cantractor, Bulld.r, or olh.r personl, 10
coy.r or cause to be coy.red, any part of Ih. work with flooring, lalh, earth
or 01h.r materlol, unlil the proper Inlpector hal had ampl. 11m. to approy.
Ih. inllallallon.
. AFTER CORRECTIONS ARE MADE CAlL
788-6611 FOR RE-INSPECTION
INSPECTOR @J
OFFICE HOURS 8 - 5 MON.-FRI.
CITY OF ZEPHYRHILLS
ZEPHYRHILLS, FLORIDA
/') .r: /l~' A;01
r /'J- r/ . V I
---,/ .A ''--.''a _/
WATER ACCT. NO.
DATE 3hr/ir~
( I
SHUT OFF SERVICE
~.::,{ jJeJ f(~-
MAILING pfJ ~)( d S ;;J
2",lv i~;J/S, ,FL 33531
SERVICEADDRESS .3 73C(1 ?reef-tis /.{;I( fl~('- hf.So
o e( WATER
u:r/
rrI
TURN ON SERVICE
o SEWER
READ METER
o
o
o
o GARBAGE
~CITY
INSTALL METER
CHECK METER
o OUT CITY
~ No. OF UNITS
OTHER
_ DEPOSIT AMOUNT
* {I I/J;f;,y -IJ1ifi:r
_ AMOUNT LAST Bill
_ DATE
_ MISC. CHARGE
WORK COMPLETED BY
& DATE COMPLETED
ORDER TAKEN BY
Retain white form in office at all times.
Send pink & yellow forms to Water Service Dept.
Water Service Dept. to sign yellow form & return to office,
David Johnson
Lot #50 Silver Oaks Village
SQ. FEET PRICE
MAIN OR LIVING: 1,464 $ 40.00
OTHER AREA UNDER ROOF: 624 $ 15.00
OTHER: $ -
VALUATION $ 67,920.00
FEE SHEET $ 342.00
ADDRESS $ 20.00
DRIVEWAY $ 20.00
BUILDING: $ 553.00
CREDIT: $ -
BUILDING lESS CREDIT: $ 553.00
ELECTRICAL: $ 85.68
PLUMBING: $ 75.00
MECHANICAL: $ 40.00
RADON: $ 20.88
TOTAL $ 774.56
SEWER: $ 1,278.00
WATER: $ 350.00
IRRIGATION:
TOTAL: $ 1,628.00
,
I
WATER METER:I $
IRRIGATION METER $
180~00 I
SUB-TOTAL $
2,582.56 I
SIF'S: $ 1,694.00
97.5% $ 1,651.65
2.5% $ 42.35
) ',1) 1.111: Pr r
)' e, fJ ·
./
- I
TIF.S'r
99% $
1% $
TOTAL: $
4,276.56 I
David Johnson
Lot #50 Silver Oaks Village
SQ. FEET PRICE
MAIN OR LIVING: 1 ,464 $ 40.00
OTHER AREA UNDER ROOF: 624 $ 15.00
OTHER: $ -
VALUATION $ 67,920.00
FEE SHEET $ 342.00
ADDRESS $ 20.00
DRIVEWAY $ 20.00
BUILDING: $ 553.00
CREDIT: $ -
BUILDING lESS CREDIT: $ 553.00
ELECTRICAL: $ 85.68
PLUMBING: $ 75.00
MECHANICAL: $ 40.00
RADON: $ 20.88
TOTAL $ 774.56
SEWER: $ 1,278.00
WATER: $ 350.00
IRRIGATION:
TOTAL: $ 1,628.00
I
I
WATER METER:I $
IRRIGATION METER $
180~00 I
SUB-TOTAL $
2,582.56 I
} 1)lLt Ifr
{J,D.
SIF'S: $ 1,694.00
97.5% $ 1,651.65
2.5% $ 42.35
I
I
TIF'Sr
99% $
1% $
- I
TOTAL: $
4,276.561
Department of Community Affairs - FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCtiON
FORM 600A-97 Residential Whole Building Performance Method A CENTRAL 4 5 6
PROJECT NAME:
AND ADDRESS: 0-
BUilDER:
PERMITTING CLIMATE
OFFICE: ZONE: 405 060
PERMITNO.~ JURISDICTION NO.: ITIIIIJ
Please T e CK
),1M
C:;;' .. Mt ( (
OWNER:
- oOdo-ooceO-05oo
^' I~ (
1. New construction or addition
2. Single family detached or Multifamily attached
3. If Multifamily-No. of units covered by this submission
4. Is this a worst case? (yes / no)
5. Conditioned floor area (sq. ft.)
6. Predominant eave overhang (ft.)
7. Glass type and area:
a. Clear glass
b. Tint, film or solar screen
8. Floor type and insulation:
a. Slab-on-grade (R-value + perimeter)
b. Wood, raised (R-value + sq. ft.)
c. Concrete, raised (R-value)
9. Net Wall type, area and insulation:
a. Exterior: 1. Concrete block (Insulation R-value)
2. Wood frame (Insulation R-value)
3. Steel frame (Insulation R-value)
4. Log (Insulation R-value)
5. Other:
b. Adjacent: 1. Concrete block (Insulation R-value)
2. Wood frame (Insulation R-value)
3. Steel frame (Insulation R-value)
4. Log (Insulation R-value)
10. Ceiling type, area and insulation:
a. Under attic (Insulation R-value)
b. Single assemblY (Insulation R-value)
c. Radiant barrier installed (yes / no)
11. Air distribution system:
a. Ducts (Insulation + Location)
b. Air Handler (Location)
12. Cooling system:
(Types: central-split, central-single pkg., room unit, PTAC., gas, none)
13. Heating system:
(Types: heat pump, elec. strip, nat. gas, L.P. gas, gas h.p., room or PTAC, 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
(Use: CF-Ceiling Fan, CV-Cross vent, PT-Programmable thermostat,
HF-Whole house fan, MZ-Multizone)
17. COMPLIANCE STATUS: (PASS if As-Built Pts. are less than Base P1s.)
a. Total -Built points b. Total Base points
I hereby certify th
compliance with t e
PREPARED BY:
I hereby certify that
DATE: J-J~'-
e with the Florida Energy Code.
DATE: 2.-28'-0
.1,
OWNER AGENT:
16.
117.
17a.
1.
2.
3.
4.
5.
6.
po
N'-'r
/
Single Pane
/7 f. 5" sq. ft.
sq. ft.
sq. ft.
ft.
Double Pane
sq. ft.
sq. ft.
7a.
7b.
8a. R= /) 1f('3 I. ft.
8b. R- sq. ft.
8c. R= sq. ft.
9a-1 R= sq. ft.
9a-2 R= I' ii'1-- sq. ft.
9a-3 R= sq. ft.
9a-4 R= sq. ft.
9b-1 R= sq. ft.
9b-2 R= I, "'l~ sq. ft.
9b-3 R= sq. ft.
9b-4 R= sq. ft.
lOa. R= JcJ N~i( sq. ft.
lOb. R= sq. ft.
10c.
lla.
llb.
12a.
12b.
12c.
13a.
13b.
13c.
14a.
14b.
15a.
15b.
15c.
R= ~ , vll-4 (cond.luncond,)
V,A:- '"- ' , (cond.luncond.)
Type: t~f~ ~
SEERlEERlCOP: It, 0 t.
Capacity: 3 t/ l 0 1)
Type: fI f
HSPF/COP/AFUE: 7,).-
Capacity: '3 11;- v (J 0
Type: E ( t.~ ....,.
EF: '7 (
~N~S
Cj/ '7
I .'
17b.J-7QQ
Revised 1998
SUMMER CALCULATIONS
CLIMATE ZONES 4 5 6
ORIENTATION OVERHANG GLASS I SINGLE-PANE OR DOUBLE-PANE X SUMMER ~ AS-BUILT
lENGTH AREA &UMMER POM' MULTFUER SUMMER PotfT MULTJIUER OIl FACTOR - GLASS
OH(FEET) (SQ. FT.) CLEAR T1NT2 CLEAR T1NT2 (from6A.l) SUMMER PTS
N I Jt1d ?7J16 22.93 -,<;AA ?1?? ..-r,t; 'z,.. S.~D
NF 4.'t65 36.42 ~g~16 ~?7A
F J '111 it:; "Q~1 4Q.A!:l 5266 44.33 G " -2, l<7.rln
r~L Sr: <;R/;.4 4760 1;0 ~" 42.37
S " 1iJ. i"5l 44M ~7.2Q ~Q llA ~~ 4Q 7il~ /I 'K I
f:!.W 5?A2 44.31 47n7 ~Q5."
H W /' iI.'J ...~.~.Ml 44.87 47ft" 411511 . G C q '5t c:; I
J NW ~774 ~1~ ~10 28.4.5
r~ Hl In?.';1 R5ll? 93.50 78.03
en C ? 11.4 .t;( 4th l" .tJT<l trJ.C)(f,
en
:5 I~ I . 7.:. '.10:- ,q ",-;t,1Ifl 1 l";" ~,,~
CJ I
OH LENGTH
OVERHANG RATIO = OH HEIGHT
m
:5
CJ
.18 X
.18 I
WEIGHTED GLASS
X MULTIPUER
=
COMPONENT
DESCRIPTION
42.0n
COMPONENT
DESCRIPTION
EXTERIOR
::f ADJACENT
;
AREA
BASE SUMMER
X POINT. MULT. =
1.9
.7
." '~v
I
4.8
1.6
l'
~; II
7,'(
l'
o:~:J
[II EXTERIOR
g ADJACENT
c
11r7i V
l'
INFILTRATION &
INTERNAL GAINS
UNDER ATTIC
OR SINGLE
ASSEMBLY
CJ
z
:::i
ii:i
(.)
l'
a::
o
o
.....
....
HOT
WATER
SYSTEM
NUMBER
OF
BEDROOMS
.:!>
AS-BUILT
HOTWATER
SYSTEM DESC.
'H = HORIZONTAL GLASS (SKYLIGHTS)
2FOR GLASS WITH KNOWN SHGC OR SC, SEE SECTION 2.1 APPENDIX C. TINT MULTIPLIERS MAY BE
~sa:ms.R.M,a:l1NT.
.2.
SUMMER POINT MULTIPLIERS (SPM)
6A~1 SU'MMER OVERHANG FACTORS (SOF) FOR SINGLE AND DOUBLE PANE GLASS.
CLIMATE ZONES 4 5' 6
~r 1.
(.)a: th 1. O.
~o
~l Southwest 1.00 0.997
West 1.00 0.994
Northwest 1.00 0.995
OH Len th 0.0' 1.0'
6A-2 WALL SUMMER POINT MULTIPLIERS (SPM)
FRAME CONCRETE BLOCK (NORMALYfn FACE BRICK LOG
INTERIOR EXT. R-VALUE WOOD FR R-VALUE BLOCK
WOOD STEEL INSULATION INSUL 0-6.9 2.9 0-2.9 1.0 6 INCH 81NCH
R.VALUE EXT ADJ EXT ADJ R-VALUE EXT ADJ EXT 7-10.9 .6 3-6.9 .6 R-VALUE EXT EXT
0-6.9 6.4 2,2 8.9 2.9 0-2.9 2.5 ,9 2.5 11-18.9 .4 7-9.9 .4 0-2.9 1.7 1.0
7-10.9 2.3 .8 4.1 1.3 3-4.9 1.4 .7 .7 19-25.9 .2 10&UP .2 3-6.9 1.1 .8
11-12.9 1.9 .7 3.0 1.0 5-6.9 1.0 .6 .3 26&Uo .1 7& Un .8 .7
13-18.9 1.7 .6 2.8 0.9 7-10.9 .8 .4 .1
19-25,9 1.0 .3 2.4 0.8 11-18.9 .4 .3 0
26& Uo .6 ,2 1.3 0.4 19-25.9 .2 .2 r NOTE: SEESECTlON2.00FAPPENDlXC FOR MULTIPLIERS I
26 & UD .1 .1 OF ENVELOPE COMPONENTS NOT ON THIS FORM.
6A-3 DOOR SUMMER POINT MUL TIPUERS (SPM)6A-4 CEILING SUMMER POINT MULTIPLIERS (SPM)
DOOR TYPE EXTERIOR ADJACENT
WOOD 7.2 2.4
INSULATED 4.8 1.6
6A-5 FLOOR SUMMER POINT MULTIPLIERS SPM
SLAIHIN-GRADE RAISED
EDGE INSULATION CONCRETE
R-VALUE SPM R-VALUE SPM
0-2.9 -31.9 0-2.9 -1.0
3-4.9 -31.8 3-4.9 -1.7
5-6.9 -31.7 5-6.9 -1.7
7 & Up -31.6 7 & Up -1.7
6A-7A AIR HANDLER MULTIPLIERS (SPMI
Located in attic 1.04
Located in oaraoe 1.00
Located in conditioned area 0.93
Located on exterior of building 1.04
1I1~ ~UN L;HI:
R-VALUE SPM R-VALUE SPM CEILING TYPE
19-21.9 1.1 10-10.9 3.0 RN ALUE EXPOSED DROPPED
22-25.9 .9 11-12,9 2.7 10-13.9 3.43 2.98
26-29.9 .7 13-18.9 2.4 14-20.9 2.41 2.14
30-37.9 .6 19-25.9 1.8 21 &Up 1.45 1.31
38 & Up .4 26-29.9 1.1
RBS ere lit 0.70 30 & Up 0.9
RAISED WOOD
STEM WALL wI UNDER
FLOOR INSULATION
SPM
-5.8
-2.8
-2.2
-1.8
POST OR PIER
CONSmUCTlON
SPM
4.50
2.28
1.83
1.36
ADJACENT
SPM
5.3
2.1
1.8
1.0
R-VALUE
0-6.9
7-10.9
11-18.9
19&Up
6A.7 DUCT MULTIPLIERS OM See Table 6-10 for Code mlnlmuml.
DUCT
R-Value
4.2
6.0
8.0
4.2
Attic with Radiant Barrier (RBS) 6.0
8.0
42
6.0
8.0
SUPPLY DUCTS IN:
RETURN DUCTS In:
UNCONDITIONED SPACE Arnc WITH RBS CONDITIONED SPAC
1.065 1.061 1.059
1.048 1.045 1.044
1.037 1.035 1.034
1.046 1.043 1.040
1.034 1.032 1.030
1.026 1.025' 1.024
1.003 1.002 1.0
1.002 1.001 1.0
1.001 1.001 1.0
Unconditioned Space
Conditioned Space
6A-8 COOLING SYSTEM MULTIPLIERS lCSMI
SYSTEM TYPE See Table 6.3 for Code minimums COOLING SYSTEM MUL TlPUERS lCSMI
Central Unns (SEER) Ratina 7.5-7.9 8.0-8.4 8.5-8.8 8.9-9.4 9.5-9.9 10.0-10.4 10.5-10.9 11.0-11.4 11.5-11.9 12.0-12.4
CSM .45 .43 .40 .38 .36 .34 .32 .31 .30 .28
PTAC & Room Units (EER) Ratino 12.5-12.9 13.0-13.4 13.5-13.9 14.0-14.4 14.5-14.9 15.0-15.4 15.5-15.9 16.0-16.4 16.5-16.9 17.0-17.4 17.5 & Uo
CSM .27 .26 .25 .24 .24 .23 .22 .21 .21 .20 .19
6A-9 HOTWATER MUL TlPLlERSlHWMI
SYSTEM TYPE See Table 6-12 for Code minimLms HOT WATER MUL TlPUERS lHWM
Electric Resistance EF .80-.81 .82-.83 .84-.85 .86-.87 .88-.90 .91-.93 .94-.96 .97 & Uo
HWM 2820 2752 2685 2624 2564 2479 *2400 2326
Natural Gas EF .43-.47 .48-.49 .50-.51 .52-.53 .54-.55 .56-.57 .58-.59 .60-.61 .62-.63 .64-.65 .66 & Uo
HWM 2162 1936 1859 1787 1721 1660 1602 1549 1499 1452 1408
LP Gas HWM 2645 2368 2274 2186 2106 2031 1960 1895 1834 1n6 1722
Oed. HP or Solar EF 1.0-1.49 1.5.1.99 2.0-2.49 2.5-2.99 3.0-3.49 3.5-3.99 4.0-4.49 4.5-4.99 5.O-Uo -
System wnh Tank HWM 2256 1504 1128 902 752 645 564 501 451
.3-
WINTER CALCULATIONS
CUMATEZONES 4 5 6
ORIENTATION OVERHANG GLASS I SINGLE-PANE OR DOUBLE-PANE ~ WlNT&R = AS-BUILT
LENGTH AREA ~R POINT MIl.TJlUER WINTER POINT MIl.TJlUER 011 FACTOR GLASS
ON (FEET) (SQ, FT.) CLEAR TINJ2 CLEAR TINJ2 (from6A-l0) WINTERPTS
JT N , /ft! 12.32 12.1\1I fl4.' 6.64 I ~'q ~ a?l~
4 NF 1?lYl 1?~1 R17 6.42
E I 3".') !I.M 10.1\4 4!'i? 5.01 Itee ) ~;;;V" q
SE A.~ !I.12 3.17 ~AA
S L /..I).. I (,- 7.73 AI;Q ?fl.1; ~.3Q 1,~1.. 5/1}
H SW !I?? !lAA ~.AA 441;
,J W ( Ib 10.74 11.21 5.16 1;1;1; ,'I'; &J I~a
~ NW 1??? 1?1;1 fl ~I; fll\ll
Hl 11.64 12.36 4.!l1 !'i1\4
~ <C' r -l tf,~ "7. .) ,.qq.:i ~()(r,
~ ~) h .)" <..- . t; fA ..,U 1~/;;7. 3lGt'1
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COND
FLOOR
AREA
WEIGHTED GLASS
x MULTlPUER
4.79
AREA
BASE WINTER
x POINT. MUL T. =
2.0
1.8
COMPONENT
DESCRIPTION
AREA
WINTER
x POINT. MUL T. =
(6A-11THRU6A-15)
3..(>
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43."L.
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5.1
4.0
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8 ADJACENT
UNDER ATTIC
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II
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INFILTRATION &
INTERNAL GAINS
-0.28
SYSTEM
TOTAL COMPONENT BASE WINTER POINT;
BASE HEATING TOTAL BASE
SYSTEM x WINTER
MUL TIPUER POINTS
1.07 J-f t( t.{
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e
"FOR GLASS WITH KNOWN S GC OR SC, SEE SECTION 2.1 APPENDIX C. TINT MUL TIPUERS MAY BE
-4.
WINTER POINT MULTIPLIERS (WPM)
6A-10 WINTEROVERHANGFACTORS(WOF)
CUMATEZONES 4 5 6
~r
0
wa:
ulo Southwest 1.00 1.002 1.013 1.038 1.071 1.118
0l West 1.00 0.999 1.003 1.013 1.025 1.040
Northwest 1.00 0.999 0.998 0.997 0.997 0.996
OH Len th 0,0' 1.0' 1.5' 2.0' 3.0' 3.5'
1.573
1.116
0.989
20.0'
6A-11 WALL WINTER POINT MULTIPLIERS (WPM)
FRAME CONCRETE BLOCK (NORMALYrn FACE BRICK LOG
INTERIOR EXT. R-VALUE WOOD FR R-VALUE BLOCK
WOOD STEEL INSULATION INSUL 0-6.9 7.0 0-2.9 3.7 6 INCH SINCH
R-VALUE EXT ADJ EXT ADJ R-VALUE EXT ADJ EXT 7-10.9 2.1 3-6.9 2.6 R-VALUE EXT EXT
0-6.9 6.8 5.3 9.4 6.7 0-2.9 6.0 3.1 6.0 11-18.9 1.7 7-9.9 1.8 0-2.9 2.2 1.2
7-10.9 2.5 2.1 4.4 3.3 3-4,9 3.8 2.3 2.8 19-25.9 1.0 10&UP 1.3 3-6,9 12 .9
11.12.9 2.0 1.8 3.3 2.6 5-6.9 2.9 1.9 2.0 26 & Up .6 7&Uo .9 .7
13-18,9 1.8 1.6 3.0 2.4 7-10.9 2.3 1.5 1.5
19-25.9 1.1 1.0 2.6 2.2 11-18.9 1.5 1.1 .8
26& Up .7 .7 1.4 12 19-25.9 .8 .7 I NOTE: SEE SECTION 2.00F APPENDIX C FOR MULTIPLIERS I
26&Up .5 .5 OF ENVELOPE COMPONENTS NOT ON THIS FORM.
6A-12 DOOR WINTER POINT MULTIPLIERS IVI
DOOR TYPE EXTERIOR ADJACENT
WOOD 7.6 5.9
INSULATED 5.1 4.0
PM)
R-VALUE
10-13.9
14-20.9
21 &U
R.VALUE
0-2.9
3-4.9
5-6.9
7&U
WPM
2.5
-1.7
-2.4
-2.7
RAISED WO 0
POST OR PIER STEM WALL wI UNDER
CONSTRUCTION FLOOR INSULATION
WPM WPM
2.49 1.8
0.78 .7
0.47 .5
0,14 .3
ADJACENT
WPM
5.3
2.1
1.8
1.0
6A.16A AIRHANDLERMULTIPUERS PM
Located in attic 1.04
Located in ara e 1.00
Located in conditioned area 0.93
Located on exterior 01 building 1.04
6A-16 DUCT MULTIPLIERS DMl SeoT.bIt6-10for~mlnlmuma.
DUCT ETURN DUCTSln:
SUPPLY DUCTS IN: R-Value UNCONDnlONED SPACE Arnc WITH RBS CONDnlONED SPACE
42 1.099 1.091 1.086
Unconditioned Space 6.0 1.073 1.067 1.063
8.0 1.056 1.052 1.049
42 1.071 1.063 1,055
Attic with Radiant Barrier (RBS) 6.0 1.053 1.047 1.040
8.0 1.042 1.037 1.033
42 1.008 1.005 1.0
Conditioned Space 6.0 1.006 1.004 1.0
'8.0 1.005 1.003 1.0
6A.17 HEATING SYSTEM MUL TIPUERSIHSM\
SYSTEM TYPE See Tables 6-610 6-8 lor code minimums HEATING SYSTEM MUL TIPUERS IHSMl
Central Heat HSPF 6.40-6.79 6.80-6.89 6.90-7.39 7.40-7.89 7.90-8.39 8.40-8.89 8.9-9.39 9.4-9.89
Pump Units HSM .53 .50 .49 .46 .43 .41 .38 .36
HSPF 9.90-10.39 10.40-10.89 10.90-11.39 11.40-11.89 11.90-12.39 12.40 & UD
HSM .34 .33 .31 .30 .29 .28
PTHP COP 2.50-2.69 2.70-2.89 2.90-3.09 3.10-3.29 3.30-3.49 3.50-3.69 3.70-3.89 3.90-4.19
HSM .40 .37 .34 .32 .30 .29 .27 .26
Electric Strip 1.0
Gas & LP Gas 1.0 (See Table 6A-18 lor Credit Multiplier)
.5-
ADDITIONAL TABLES
CLIMATE ZONES 4 5 6
6A-18 HEATING CREDIT MULTIPLIERS (HCM)
SYSTEM TYPE HEATING CREDIT MULTIPLIERS (HCM)
Programmable Thermostat HCM .95
Mu~izone HCM .95
AFUE .68-.72 I .73-.n I .78..82 I .83-.87 I .88-.92 I .93 & Uo
Natural Gas HCM .56 I .52 I .49 I .46 I .44 I .41
LP Gas HCM .71 I .66 1 .62 I .58 I .55 I .52
6A-19 COOLING CREDIT MULTIPLIERS CCM}
SYSTEM TYPE COOLING CREDIT MULTIPLIERS (CCM)
Ceilin!1 Fans .95'
Cross Ventilation .95'
Whole House Fan .95' 'Credit may be taken (or only
Mu~izone .95 one of these system types concurrently.
Programmable Thermostat ,95
6A-20 HOT WATER CREDIT MULTIPLIERS (HWCM)
SYSTEM TYPE NOTE: A HWM MUST BE USED IN CONJUNCTION WITH ALL HWCM. SEE TABLE 6A,9. EF MEANS ENERGY FACTOR
Heat Recovery Unit With Air Conditioner Heat Pumn
HWCM .84 .78
Add-on Dedicated Heat Pump EF 2.0-2.49 2.5-2.99 3.0-3.49 r 3.5 & Un
(without tank) HWCM ,44 .35 .29 I .25
Add-on Solar Water Heater EF 1.0-1.9 2.0-2.9 3.0-3.9 I 4.0-4.9 I 5.0 & Un
(without tank) HWCM .84 .42 .28 I .21 I .17
A HWM MUST BE USED IN CONJUNCTION WITH ALL HWCM. SEE TABLE 6A.9. EF MEANS ENERGY FACTOR.
6A-21 INFILTRATION REDUCTION COMPLIANCE CHECKLIST
COMPONENTS SECTION REQUIREMENTS FOR EACH PRACTICE CHECK
Exterior Windows & Doors 606.1.ABC.1.1 Max: .3 cfm/sq.ft. window area; .5 cfm/sq.ft. door area.
Exterior & Adjacent Walls 606.1.ABC.1.2.1 Caulk, gasket, weatherstrip or seal between: windows/doors & frames, surrounding wall;
foundation & wall sole or sill plate; joints between exterior wall panels at corners; utility
penetrations; between wall panels & toplbottom plates; between walls & floor.
EXCEPTION: Frame walls where a continuous infiltration barrier is installed that extends
from, and is sealed to, the foundation to the top plate.
Floors 606.1.ABC.1.2.2 Penetrations/openings >1/8" sealed unless backed by truss or joint members.
EXCEPTION: Frame floors where a continuous infiltration barrier is installed that is sealed
to the perimeter, penetrations and seams.
Ceilings 606.1.ABC.1.2.3 Seal: Between walls & ceilings; penetrations of ceiling plane of top floor; around shafts, chc ses,
soffits, chimneys, cabinets sealed to continuous air barrier; gaps in gyp board & top plate;
attic access. EXCEPTION: Frame ceilings where a continuous infiltration barrier is
installed that is sealed at the perimeter, at penetrations and seams.
Recessed Lighting Fixtures 6D6.1.ABC.1.2.4 Type Ie rated with no penetrations, sealed; or Type IC or non-Ie rated, installed inside a
sealed box with 1/2' clearance & 3' from insulation; or Type Ie rated with <2.0 cfm from
conditioned so ace tested.
Multi-story Houses 606.1.ABC.1.2.5 Air barrier on perimeter of floor cavity between floors.
Additional Infiltration reqts 606.1.ABC.1.3 Exhaust fans vented to outdoors, dampers; combustion space heaters comply with NFPA,
have combustion air.
6A-22 OTHER PRESCRIPTIVE MEASURES (must be met or exceeded bv all residences.)
COMPONENTS SECTION REQUIREMENTS CHECK
Water Heaters 612.1 Comply with efficiency requirements in Table 6-12. Switch or clear1y marked circuit breaker (electric)
or cutoff (cas) must be orovided. External or built-in heat trao required.
Swimming Pools & Spas 612.1 Spas & heated pools must have covers (except solar heated). Non-commercial pools must have
a oumo timer. Gas soa & 0001 heaters must have a minimum thermal efficiency of 78%.
Shower Heads 612.1 Water flow must be restricted to no more than 2.5 aallons oer minute at 80 PSIG.
Air Distribution Systems 610.1 All ducts, fittings, mechanical equipment and plenum chambers shall be mechanically attached,
sealed, insulated, and installed in accordance with the criteria of Section 61 O. Ducts in unconditioned
attics: R-6 min. insulation.
HV AC Controls 607.1 Separate readily accessible manual or automatic thennostat for each system.
Insulation 604.1, 602.1 Ceilinas-Min. R-19. Common walls-Frame R-ll or CBS R-3 both sides. Common ceiling & floors R-l1.
-6.
Parcel Information for: 03-26-21-0200-00000-0500 Card: 001
Page 1 of 1
Welcome: Record Search: Parcel Search
Search Again Show Map Building Schematic Unavailable Calculate Taxes
See Tax Collector Information - Current/Delinquent Taxes
ParcellD
Classification
03-26-21-0200-00000-0500 (Card: 1 of 1)
00 - Vacant Residential
Mailing Address
HARTLEY NEAL B
6819 STEPHEN'S PATH
ZEPHYRHILLS, FL 335410655
Physical, Address
Assessment (totals)
Ag Land
Land
Building
Extra Features
$21,025
$0
$0
"
Acres
Legal Description (First 4 Lines)
SILVER OAKS VILLAGE-PHASE ONE
PB 35 PGS 63-67
LOT 50
OR 4880 PG 471
Land Detail (Card: 1 of 1)
Description Zonin
SFR OPUD 6,000.00
SFR OPUD 12,500,0011
Additional Land Information
Tax Area " 30.zH I Fema C
Building Information
Unimproved Parcel 00
Extra Features
No Extra Features
Total Assessment
Save Our Homes
$21,025
$0
Taxable Value
$21,025
0.2
ResCQde
QVGLP1
Use
0100
0100
Previous Owner
Year Month
2002 02
1987 07
1974 01
Sales History
SMITH CATTLE & GROVES INC
Book I Page T Amount
4880/0471 WD $19,800
1624/1733 QC
0780/0413 WD
Search Again Show Map Building Schematic Unavailable Calculate Taxes
See Tax Collector Information - Current/Delinquent Taxes
ht.. ./parcel.asp ?sec=03 &twn=26&mg=21 &sbb=0200&blk=00000&lot=0500&action=Submi 3/18/2002
/
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NOTICE OF COMl\ lENCEMENT
~::~t:fu~'orida 114 5 ~ 0 } 'P~~PA~. IN DU~la T.. ~~~~~I!ll~I~IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII~lh.
The undersigned IllJrebv informs all ooncerned that improvomBr tB will be mede to cortllin roo I proportv, and In acoordant.
with section 713.13 IIf the )=Iorlda Statutes. tho following informe :io1115 st8teo In this NOTICE OF COMMENCEMENT.
Description of prorwrtvo.~:. .;;(q.~.~1 :-.09;<Q. -:.O.OOO.Q.:-.~PQ............ ~S~t0. i:9276 RiT: ::::
02/28/02 Dpty Clerk
SIiMINt.
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Generol description of hnprovamuntu .. ~Jt!..t?, ?/i... .t!!1!1/t- y.. .l.~t?'t? /~. 0 .... . . . ..... . . " .. . ....... .. ..
Owne. ..~.~.J~/"dle~.. ..:...........h.:ji.... F~" ...~3.5. ~.... .... ~M~~~"'d, r~~~o fOUNTJ, C~ER~
Address .. Q" . t5.c.''f ..~.?:~..... ZfifAyr...~..~./............... ...... .1....... OR BK 4872 PG 1514
Owner's interest In sito of the improvement . . . . . . . . . . . . .. . . . . . . . . . . .
Foe Slmplo Tltlo huldor (If other than ownsr.
Name .. .ly/l! ..
.... ........,... .... ..... ....... ............... ... ...-
........ ..... ............... .... ........ ......................
Address
. . . . . . . . . . . .. . . . . .. . . . . . . . . . .. . . . . . . . . . .. ............................................................
Controotor. .7);1Vt.,P... .C:~/. ;[1!f4!.~~.~..I.~f).r.?:t?~. .IN..~... ... ......... ..._...,....... ......
Address ...9f!-:')cf, EM-:.T..K/&(:?...~. ...PIlPG..C.(~..E(...f:!~~r...,
Surety (if anyJ .......,.."..........................................
Address . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ...........,............. Amount af bond S . . . . . . . . . . . . . . .
Any person making II loon for the construcdon of the Improvemsl t6:
Name..'s;' .0.T(v.~t.. :~~ K............... ..... ............... ............, .........,............. ........... ...... .....
Addross StJ3!;..~ 11 .~lvl... .I~~.y.~~.;.Il~.,. (l.;-,.... 3??YI....................................... . '..............
ParsDn within tho Stato of Florida dosignated by owner upon whe m notictls or other documonts mav be served:
Name ,.................
. ... ......... .............................. . .......... ............. ........ ...... ....................
Addross ..................................,......................... ......................,...................................
In additiDn to himself. owner designates the fedlowino parson to rE la/ve a copy of the Usnor's Notice liS provided in Seetio
713.13 III Ih). Florida Statutes. (Fill in Bt Owner's opt/unJ.
Namo '....'...."... ~. .... ....... . . ..~.'~._ ...... . .... . . .... .. . . .
Address ......... _ , . . . , . . . ' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
THIS SPACE FOR RECORDER'S USE ONLY
. "il"';!'P' '/1~'" ............. ...... ..... .....
.kAJ.~./~........ .........................._
Ow r
STATE OF FLORIDA
COUNTY OF PASCO
THIS IS TO CERTIFv THAT THE FOREGOING IS A
TRUE AND CORRECT C?PV or THE DOCUMENT ON FILE
OR OF PUBLIC RECORu iN fH.It-: OFFICg. ~ESS MY
A 0 OFFICIAL SEAl 2T~ DAY OF
ER~, OF CIRCUIT COURT
--- DEPUTY CLERK
Sworn to 81 d 6ubscribBd before me this ,d/i? ~:.. .... ,. ... .. ....... .
~. ' III ~/~
..................... .dayof' .~.~:/......,.........,..... ......~
{.... . r:tL..0;J~-Ud4-..........
Notary Public
....~\!\~r~ Bobbie Swetland
{*'fJi.'1:~ MY COMMISSION # CC893160 EXPIRES
~.~~~~: February 22, 2004
"'~:iff..\i.~., BONDED THRU TROY FAIN INSURANCE. INC.
CDNTF(I{~CTOF: t4::
NAiYiL:: NE:I1L H('~F~TLFY
f~il)))F;~:: :~7:~.:~1.!(/ F'ICJ:::ETT~~:) iTlI!...!... (,:,~)E
c:: ......H T!~ Z: '. HI L L b '! F L :.:.!; ::,:; ;,:.:j 4;?
CJ:::NTI~.~f-fl... 1:'I=='F:/'<l T TT J t,-.I":;
F:'t1bCD C:;JUi'\I'j"",( '.' FL.Uh: I 1)(:1
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J~:)bUF OFFIce:; D
h:LCF I F'T i"-!!..Ji'tHh: ': C'(Y.,(,!.:'):T.!;:,l
DFFICT:: I){',I)E c: IT"{
FOF: :: 1;:I::SDl.JI;:CF FEE CI..II::T:I::: #: :L )'OB
FY~F~CE]... Ii O~:.:''';:.).::':,n';?:l. n"();?OO""OOOOO.n'O~500
(lCCNT
:1.:1.4
TCJT('~L (.:t1viDUNT::
COi>1PNY (~CCUUNT CENTEh~
B45() .-. 363()()() .... 2
.4.. :1.4
(:d>1UUh.!T DE~:;Ch:IPTIm"..!/T'EF~l>1"i' D(.:.t'J"{:l DFUCr;:
4.:1.4 ****** SOLID WASfE FEE ov
'.<ECEIVEl) BY f . ~ "--
m....~...~....m....m...........m................
~
II
PASCO COUNTY, FLORIDA
Builder Name/Owner Name il.e ~ Ii cvd:- (....u...
0-
County Parcel No. D3 -~ ~ - ~(-O dd7~ - 00000 - DS'OOSubDiv:
Address/Location 3 '7 3 '-{ 'f 7( (1< ~it (.5 m ; (I ~ \J -e .
SFD
Permit No. (( ( g
Date Permitted ":{ - d R- - 0 -;(
Control #
ClassificationfType of Use
TRANSPORTATION IMPACT FEE
Rate:
Sq Ft Unit:
Exempt 0 Yes 0 No
How Determined
Impact Fee Amount $
Zone No.
TAZ:
SCHOOL IMPACT FEE
Account (056) Single-Family Detached House
(057) Mobile Home
(058) Other Residential
J.:123) Collection Fee
Exempt U Yes 0 No How Determined
Amount $
PARKS AND RECREATION FEE
Land Account Land Credit
Land Total
Recreation Account
Recreation Credit Recreation Total
Zone
TOTAL AMOUNT $
Exempt 0 Yes 0 No
LIBRARY FEE
Land Account
How Determined
Land Credit
Land Total
Facility Account
Facility Credit
Facility Total
Exempt DYes D No
How Determined
Total Amount
RESOURCE FEE
TOTAL AMOUNT
4.11
ERU
Prepared By
Checked By
NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN PAID AND
RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY
Acknowledgement below does not imply acceptance of 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.
DATE
RECEIPT NO.
r, (/1 REC~~EDBY
/r1(PfJJ-DATE ~BY \J~~/VJ