HomeMy WebLinkAbout02-1178
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N2
I'
..
1178
tJ5:J. I 6"'0
BUILDING
to/~
ELECTRICAL
(813) 780-0020
5'l'S-O
PLUMBING
Date
.$D
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcel I. D. /I
T.I.F.'s:
Zoning:
DescriPtion of Work
,'I ...
:.1 .
t,
. /jitb~ Jl]-/~-~)~U~~m.
NO OCCUPANCY BEFORE c.O:> FINAL
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Valuation or .-1/ . r?r/. 7:S-
Contract Price ~ a.-Z.f.I;Z.
City License Registration # c:< .!3~
State Certified License#
Permit Fee
BUI DING ELECTRICAL /.l/b
Ftr. /S-/S/I:2 /IV-v Tp. Servo
Pre SLB '/~-J-t?,:L lPiJA:r Rough In ,/g-,:J.:J.-(}~'R-(
Lintel /7 - S- -() P RUt Meter Can
FRM. ./ 8'~L Ii -ell 1'5t3J Const. Pole
Insul. CL 0-2'15"0'2 186 Pool
Wl Pre-Meter 11J-111JZ J?J..'tjIl:z:>
Final /
PLUMBING /}~ 2)
-
MECHANICAL
SLB 0.-:J.'1-tJ(}... R'-l'f, lI.ftJ
Tub Set r/f';.2;J..()'.)... eU(
Water
Sewer / i' ~ :2 -();? tZ [1'& IQI)
Final //P-:f/-t:J:2 !!t.y l,uo
,
Breakers
Ducts Insl. ~<fot;;l._'V2. Rlf
Compressor
Final v1/J "'6/-02 R(~ /.,(Ta
Driveway
5itkw.:tk. - ft - 7 -tJ.:L 'Yro
S""h,. r-o~1~t1 ''I ,,1. . A. /J
l3f"ck., ?6t'c.'" r 'JU." ~~,. Elu, t;-3 -0)..
REINSPECTION F'EES: When extra inspection trips are necessary due to anyone of the following reasons, a
~ charge of twenty-five and 00/100 Dollars ($25.00) shall be made for each~ t' each trad~e:
---r-~~ /ZJ-/6'-t).:L <J ' , j11dJ
a. Wrong Address . 1)..L'5 ! ~. u. rf .
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
CITY OF
ZEPHYRMILLS
"NOTICE"
OF ADD.ITION OR CORRECTION
. .
B'rL """NG
DEPARtMENT
DO NOT REMOVE
11/ cO
ADDRESS DATE PERMIT + I
3153 'I ~rO~lJOU;1. /0 - ~ I, (J L.. II 78
THIS JOB HAS NOT BEEN COMPLETED The following additiqns or corrections shall be made before the job
. will be accepted.
,
II II unlawful far any Carpenter, Canlroclor, Builder, or alher ~rIOnl, 10
cover or caUM 10 be covered, any part of the work with flaorlng, lath, earth
or olher malerlal, unlll Ihe proper Inlpeclar hal hod ample lime 10 approve
'he Inl'allallon.
. AFTER CORRECTIONS ARE MADE CAlL
788-6611 FOR RE-INSPECTION
a;ii6)
OfFICE HOURS 8 - 5 MON.-FRI.
INSPECTOR
CITY OF
ZEPHYRHILLS
"NOTICE"
OF ADD.ITION OR CORRECTION
B'.:ll ~,ING
DEPARTMENT
!~
DO NOT REMOVE
I ADDRESS . ~6 PERMIT + I
~?~,1 ~~~k ~ 12,.. 117Y
THIS JOB HAS NOT BEEN COMPLETED The following additiqns or corrections shall be made before the job
. will be accepted,
(j '1rl\fJ$ ~J1#CI~G. ~C-\J.l~) Dlfr(so,{A.:& &~
~ . Tb () ~ tt f;<S,7'7J..vz l U1 It 0 .
,
It is unlawful for any Carpenter, Contractor, Builder, or other persons, 10
cover or cause to be covered, any part of the work with flooring, lath, earth
or other material, until the proper inspector has had ample time to approve
the installation.
AFTER CORRECTIONS ARE MADE CALL
780-0020 FOR RE-INSPECTION
INSPECTOR~(JJ)
OFFICE HOURS 7:30 AM - 5 PM MON.-FRI.
Sandy Development
37529 Meadow Oak Way
SQ. FEET PRICE
MAIN OR LIVING: 609 $ 40.00
OTHER AREA UNDER ROOF: 120 $ 15.00
PARKING: 867 $ 0.85
VALUATION $ 26,896.95
FEE SHEET $ 155.00
ADDRESS $ 20.00
DRIVEWAY
BUILDING: $ 252.50
CREDIT: $ -
BUILDING LESS CREDIT: $ 252.50
ELECTRICAL: $ 61.88
PLUMBING: $ 57.50
MECHANICAL: $ 30.00
RADON: $ 7.29
TOTAL $ 409.17
SEWER: $ 1,278.00
WATER: $ 350.00
IRRIGATION: $ -
TOTAL: $ 1,628.00
J
I
180~00 I
WATER METER:I $
IRRIGATION METER $
SUB-TOTAL $
2,217.17~
SIF'S: $ 722.00
97.5% $ 703.95
2.5% $ 18.05
}
f;r-t-
CD
TI F'S: $ 1,204.00 Credit to Jim
99% $ 1,191.96 Bingham
1% $ 12.04
TOTAL: $ 2,939.17 ,
~f~t (p
FORM 600A-97
FLORIDA ENERGY EFFICIENCY CODE
FOR BUILDING CONSTRUCTION
Florida Department of Community Affairs
Residential Whole Building Performance ~etho~ .. ......
THE LANDINGS - ONE BEDROOM Builder:~ let) , . .
OAK RUN APARTMENTS PHASE " Permitti~ Offj~t1 edy.PI ~.A~
ZEPHYRHILLS, FL Permit Number: 0
OAK RUN APARTMENTS Jurisdiction Number: 6//t.oO
Central
Project Name:
Address:
City, State:
Owner:
Climate Zone:
I. New construction or existing
2. Single family or multi-family
3. Number of units, if multi-family
4. Number of Bedrooms
5. Is this a worst case?
6. Conditioned floor area (tV)
7. Glass area & type
a. Clear - single pane
b. Clear - double pane
e. Tint/other SC/SHGC - single pane
d. Tint/other SC/SHGC - double pane
8. Floor types
a. Slab-On-Grade Edge Insulation
b. N/A
e. N/A
9. Wall types
a. Concrete, Int Insul. Exterior
b. N/A
e. N/A
d. N/A
e. N/A
10. Ceiling types
a. Under Attic
b. N/A
e. N/A
II. Ducts
a. Sup: Une. Ret: Une. AH: Attic
b. N/A
Glass/Floor Area: 0.13
New
Single family
I
I
Yes
715 IF
92.5 IF
0.0 IF
0.0 IF
0.0 It>
R=O.O. 78.7(p) n
R=5.0, 629.3 IF
R=30.0. 770.0 fl'
Sup. R=6.0, 40.0 ft
, ,
12. Cooling systems
a. Ccntral Unit
- ---- -_._-~-~--~-._..._-_.~------.....
I
I
b. N/A
Cap: 16.8 kBtu/hr
SEER: 10.00
c. N/A
13. Hcating systcms
.1. Elcctric Ileat Pump
Cap: 10.2 kBtu/hr
HSPF: 7.00
h. N/A
c. N/A
14. Hot watcr systems
a. Elcctric Rcsistance
Cap: 40.0 gallons
EF: 0.93
b. N/A
c. Conscrvalion credils
(fIR-! Ical recovery, Solar
DIlP-Dcdicatcd hcat pump)
15. IlV AC ercdits
(CF-Cciling fan, CV-Cross ventilation,
H F- Whole house fan,
. 1'1'- Programmahle Thennostat,
RB-Altic radiant barrier,
MZ-C-Multizonc cooling,
MZ-H-Multizone heating)
PT-C, PT-Il
Total as-built points: 8940.80
Total base points: 10095.00
PASS
I---~-._---'~-~"~--,-.._,--- :
! I hereby certify that the plans and specification~c.overed
I' by this calculation ar~' 0 pliance with the. I r~..::' '
Energy Code. J ~ -::2-ye-di..//'~,
PREPARED Bj H ATH ENGINg~ING I I
DATE: <6 /0 J OJ .
,
I' hereby certify that this uilding, as designed
compliance with the Flor nergy Code.
I OWNER/AGENT'
DATE: J-l
Review of the plans and
specifications covered by this
calculation indicates compliance
with the Florida Energy Code.
Before construction is completed
this building will be inspected for
compliance with Section 553.908
Florida Statutes.
EneravGauae@ (Version: FLRCNA-200\
FORM 600A-97
. , SUMMER CALCULATIONS
Residential Whole Building Performance Method A - Details
ADDRESS: OAK RUN APARTMENTS PHASE II, ZEPHYRH/LLS, FL,
PERMIT #:
BASE AS-BUlL T
GLASS TYPES
.18 X Conditioned X BSPM = Points Overhang
Floor Area Type/SC Omt Len Hgt Area X SPM X SOF = Points
.18 715.0 42.08 5415.4 Single. Clear SE 1.0 5.0 30.0 56.64 0.94 1592.7
Single. Clear NE 1.0 5.0 22.5 43.65 0.95 936.2
Single. Clear SW 1.0 6.7 40.0 52.82 0.98 2063.3
As-Built Total: 92.5 4592.2
WALL TYPES Area X BSPM = Points Type R-Value Area X SPM = Points
Adajcent 0.0 0.0 0.0 Concrete, Int Insul. Exterior 5.0 629.3 1.00 629.3
Exterior 629.3 1.90 1195.7
Base Total: 629.3 1195.7 As-Built Total: 629.3 629.3
DOOR TYPES Area X BSPM = Points Type Area X SPM = Points
Adjacent 0.0 0.00 0.0 Exterior Wood 21.0 7.20 151.2
Exterior 21.0 4.80 100.8
Base Total: 21.0 100.8 As-Built Total: 21.0 151.2
CEILING TYPES Area X BSPM = Points Type R-Value Area X SPM = Points
Under Attic 715.0 0.60 429.0 Under Attic 30.0 770.0 0.60 462.0
Base Total: 715.0 429.0 As-Built Total: 770.0 462.0
FLOOR TYPES Area X BSPM = Points Type R-Value Area X SPM = Points
Slab 78.7(p) -31.8 -2501.6 Slab-On-Grade Edge Insulation 0.0 78.7(p) -31.90 -2509.5
Raised 0.0 0.00 0.0
Base Total: -2501.6 As-Built Total: -2509.5
INFILTRATION Area X BSPM = Points Area X SPM = Points
715.0 14.31 10231.7 715.0 14.31 10231.7
Summer Base Points: 14870.9 Summer As-Built Points: 13556.9
Total Summer X System = Cooling Total X Cap X Duct X System X Credit = Cooling
Points Multiplier Points Component Ratio Multiplier Multiplier Multiplier Points
13556.9 1.000 1.090 0.341 0.950 4786.7
14870.9 0.3577 5319.3 13556.9 1.00 1.090 0.341 0.950 4786.7
EnerovGauae 1M DCA Form 600A-97
FORM 600A-97
WINTER CALCULATIONS
Residential Whole Building Performance Method A - Details
ADDRESS: OAK RUN APARTMENTS PHASE II, ZEPHYRHILLS, FL,
PERMIT #:
BASE AS-BUILT
GLASS TYPES
.18 X Conditioned X BWPM = Paints Overhang
Floor Area Type/SC Ornt Len Hgt Area X WPM X WOF = Points
.18 715.0 4.79 616.4 Single, Clear SE 1.0 5.0 30.0 8.34 1.03 258.2
Single, Clear NE 1.0 5.0 22.5 12.00 1.00 270.1
Single, Clear SW 1.0 6.7 40.0 9.22 1.01 371.5
As-Built Total: 92.5 899.8
WALL TYPES Area X BWPM = Points Type R-Value Area X WPM = Points
Adajcent 0.0 0.0 0.0 Concrete, Int Insul, Exterior 5.0 629.3 2.90 1825.1
Exterior 629.3 2.00 1258.7
Base Total: 629.3 1258.7 As-Built Total: 629.3 1825.1
DOOR TYPES Area X BWPM = Points Type Area X WPM = Points
Adjacent 0.0 0.00 0.0 Exterior Wood 21.0 7.60 159.6
Exterior 21.0 5.10 107.1
Base Total: 21.0 107.1 As-Built Total: 21.0 159.6
CEILING TYPES Area X BWPM = Points Type R-Value Area X WPM = Points
Under Attic 715.0 0.60 429.0 Under Attic 30.0 770.0 0.60 462.0
Base Total: 715.0 429.0 As-Built Total: 770.0 462.0
FLOOR TYPES Area X BWPM = Points Type R-Value Area X WPM = Points
Slab 78.7(p) -1.9 -149.5 Slab-Gn-Grade Edge Insulation 0.0 78.7(p) 2.50 196.7
Raised 0.0 0.00 0.0
Base Total: -149.5 As-Built Total: 196.7
INFIL TRATION Area X BWPM = Points Area X WPM = Points
715.0 -0.28 -200.2 715.0 -0.28 -200.2
Winter Base Points: 2061.5 Winter As-Built Points: 3343.0
Total Winter X System = Heating Total X Cap X Duct X System X Credit = Heating
Points Multiplier Points Component Ratio Multiplier Multiplier Multiplier Points
3343.0 1.000 1.116 0.488 0.950 1727.9
2061.5 1.0730 2212.0 3343.0 1.00 1.116 0.488 0.950 1727.9
EneravGauae TM DCA Form 600A-97
FORM 600A-97
WATER HEATING & CODE COMPLIANCE STATUS
Residential Whole Building Performance Method A - Details
ADDRESS: OAK RUN APARTMENTS PHASE II. ZEPHYRHILLS, FL,
PERMIT #:
BASE AS-BUlL T
WATER HEATING
Number of X Multiplier = Total Tank EF Number of X Tank X Multiplier X Credit = Total
Bedrooms Volume Bedrooms Ratio MUltiplier
1 2564.00 2564.0 40.0 0.93 1 1.00 2426.15 1.00 2426.2
As-Built Total: 2426.2
CODE COMPLIANCE STATUS
BASE AS-BUlL T
Cooling + Heating + Hot Water = Total Cooling + Heating + Hot Water = Total
Points Points Points Points Points Points Points Points
5319.3 2212.0 2564.0 10095.3 4786.7 1727.9 2426.2 8940.8
J
PASS
J
EneravGauoe TM DCA Form 600A-97
FORM 600A-97
Code Compliance Checklist
Residential Whole Building Performance Method A - Details
ADDRESS: OAK RUN APARTMENTS PHASE II, ZEPHYRHILLS, FL,
PERMIT #:
6A-21 INFILTRATION REDUCTION COMPLIANCE CHECKLIST
E:f;:=,~ ::: I ::r::g i~I-I~:~?:~~~~~~ E~~~'~:~::::% & '.me"~=:d;= ~II.. . CIiECK
I foundation & wall sole or sill plate; joints between exterior wall panels at corners; utility
II i penetrations; between wall panels & top/bottom plates; between walls and floor.
I i EXCEPTION: Frame walls where a continuous infiltration barrier is installed that extends
f i frc>rTI.1.and is sealed to,the foundationtothetop pate.H._________________._____
j606.1.ABC.1.2.2 I penetrations/.op. enings.. >, "."...se.a. 'e. d. u..n .'e.ss....b.. aC.k ed by truss or jOint members.
I EXCEPTION: Frame floors where a continuous infiltration barrier is installed that is sealed
Ceiling~-----_. 1606.1.ABC~2.3.-~;:;,;D~;~;ei.:~~i:~~:~;;~~i~~:~i~~ili.~r;~lan-; of top floor; around shafts, chases,
i soffits, chimneys, cabinets sealed to continuous air barrier; gaps in gyp board & top plate;
J . I~~~:::;; ~'~::'~~h:;':::~::~; ~::~~~~;~:~~::;::.tiO' ~"le';' ~..... .
Recessed Lighting Fixtures 606.1.ABC.1.2.4 I Type IC rated with no penetrations, sealed; or Type IC or non-IC rated, installed inside a
I
! sealed box with 1/2" clearance & 3" from insulation; or Type IC rated with < 2.0 cfm from
".__HO__. ___ jcol1djtion~dsJ)ace,~ested.____.______ ___
_Multi.stQ.!Lf-:lc>_u~~L_ ---.- .2.9_6-,-1cAE3_QJ,~.5 I P y e rs ___
Add'~,,, ',fill""oo '""', 606 I ABC. 13 . :~~h~:.e~~: ;:~:~::~,'::;;"'~;~m::~: ::;":;;:;; ;~';'-h;'I;;;';';';PiY.;uhNFPA.
I have combustion air.
Floors
.CO'....P.J>NEN!.S__ _
Water Heaters
6A-22 OTHER PRESCRIPTIVE MEASURES must be met or exceeded b all residences.
Shower heads
Air Distribution Systems
SECTION REQUIREMENTS
612.1--- - - j Comply wIth effiCIency reqUirements In Table 6-12. Switch or clearly -ma;k-;ci ~ircuit --.-
-------~-------- 1______. - -- i breaker (electric) or cutoff (gas) must be provided. Extern~Lor IJJJ.ilt-ir! b~~ J~I> reqllired.
Swimming Pools & Spas 1612.1 I Spas & heated pools must have covers (except solar heated). Non-commercial pools
I I must have a pump timer. Gas spa & pool heaters must have a minimum thermal
r.:H . i efficiency of 78%.
612.1 -- ~______._ .\I',/ater !low _mJ.lst.b~ r~~tnC!~Jo no. m()rl:! !hal"!.?~.9ailo~~e~ mi~ut~ at 80 .PSIG..o
610.1 II All ducts, fittings, mechanical equipment and plenum chambers shall be mechanically
I , attached, sealed, Insulated, and Installed In accordance with the cnteria of Section 610.
i:;~ 0021........t~:~f~;:~~E:~~~~~~:~%~~t~~~;~:~I:';;;::~;:"'.m.
I i Common ceiling & floors R-11.
CtlECK
li\{tl.C CQfl!r.9-'-S
Insulation
EneravGauoe™ DCA Form 600A-97
EneravGauoe@/FlaRES'97 FLRCNA-200
-ENERGY PERFORMANCE LEVEL (EPL)
DISPLA Y CARD
ESTIMA TED ENERGY PERFORMANCE SCORE* = 82.2
The higher the score, the more efficient the home.
OAK RUN APARTMENTS, OAK RUN APARTMENTS PHASE II, ZEPHYRHILLS, FL,
I. New construction or existing
2. Single family or multi-family
3. Number of units, ifmulti-family
4. Number of Bedrooms
5. Is this a worst case?
6. Conditioned floor area (fP)
7. Glass area & type
a. Clear - single pane
b. Clear - double pane
c. Tint/other SC/SHGC - single pane
d. Tint/other SC/SHGC - double pane
8. Floor types
a. Slab-On-Grade Edge Insulation
b. N/A
c. N/A
9. Wall types
a. Concrete, Int Insul, Exterior
b. N/A
c. N/A
d. N/A
e. N/A
10. Ceiling types
a. Under Attic
b. N/A
c. N/A
J I. Ducts
a. Sup: Unc. Ret: Unc. AH: Attic
b. N/A
New
Single family
I
1
Yes
715 tl'
92.5 IF
0.0 IF
0.0 IF
0.0 IF
R=O.O, 78.7(p) It
R=5.0. 629.3 IF
R=30.0. 770.0 IF
Sup. R=6.0. 40.0 tl
12. Cooling systems
a. Central Unit
Cap: 16.8 kBtu/hr
SEER: 10.00
b. N/A
c. N/A
13. Hcating systems
a. Electric Ileat Pump
Cap: 10.2 kBtu/hr
HSPF: 7.00
b. N/A
c. N/A
14. Ilot water systems
a. Electric Resistance
Cap: 40.0 gallons
EF: 0.93
b. N/A
c. Conservation credits
(/ IR-Heat recovery, Solar
DI-IP-Dcdicatcd hcat pump)
/5. HVAC credits
(CF-Cciling fan, CV-Cross ventilation,
1 IF- Whole house fan,
PT-Programmable Thermostat,
RB-Attic radiant barrier.
MZ-C-Multizonc cooling,
Ml-I-I-Multizone heating)
PT-C, PT-H
1 certifY that this home has complied with the Florida Energy Efficiency Code For Building
Construction through the above energy saving features which will be installed (or exceeded)
in this home before final inspection. Otherwise, a new EPL Display Card will be completed
based on installed Code compliant features.
Builder Signature:
Address of New Home:
Date:
City/FL Zip:
*NOTE: The home's estimated energy performance score is only available through the FLA/RES computer program.
This is !]()t a Building Energy Rating If your score is 80 or greater (or 86 ji:Jr a US EP A/DOE EnergyStar7~esignation),
your home may qualifY for energy efficiency mortgage (EEM) incentives if you obtain a Florida Energy Gauge Rating.
Contact the Energy Gauge Hotline at 407/638-1492 or see the Energy Gauge web site at www.f.sec.ucfedufor
information and a /ist of certified Raters. For information ahout F/()rida~\' Ener&.'V Efficiency Code For Building Construction,
contact the Department of Community Affairs at 850/487-1824.
EnemvC,au{!c@ {Version: FLRCNA-20m
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PASCO COUNTY, FLORIDA
PermIt No.
.........
Date Permitted _
Builder Name/Owner Name
County Parcel No.
Address/Location
Subd.
C1assificationffype of Use
How Determined
TRANSPORTATION IMPACT FEE CALCULATION
EXEMPT 0
Why?
Rate $
/'"-
(,,_) Sq. FtlUnit
Zone No.
. PrepatedBy
""""............,
Impact Fee Amount $
Checked By
The above impact fee has been established pursuant to the Pasco County Transportation Impact Ordinance as adopted by the
Board of Pasco County Commissioners. This amount is payable PRIOR to the issuance of a Certificate of Occupancy or
utilization of the permitted structure.
RESOURCE RECOVERY ASSESSMENT
EXEMPT 0
RESIDENTIAL
NONRESIDENTIAL
/
No. Units ;'
Gross Sq. Ft. (GSF)
Rate ERU - 54.00Near
or $0. 148/Day
ERU Assign No.
Assessment - (No. Units) x ($0.148)
x (No. Days)
TOTAL FEE $
Assessment -
(GSF) x (ERU) x (0.148) x (No. Days)
100
TOTAL FEE $
,.-
r \
'\ .
-_/
NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED UNTIL THE AMOUNTS LISTED
HA VE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY.
Acknowk~-g~m;nt below does not i~ply acceptance. of concurrence. Out simpl}' rccefpt of a copy of this form, ~cing
the huilding permit owner on notice of this assessment and the conditions of payment for same. ..,.
Date
Received By
o
----- ---------------------------------------------------------------------------------------------------------------------------
OFFICE USE ONLY
TRANSPORTATION REC. NO.
RESOURCE RECOVERY REC. NO.
DATE
/( DA TE
BY
BY
White
Applicant
Canary
Trans/Finance
Canary
RR/Finance
Pink
Office
Green
Bldg/lnsp
feecal:ce
PC93113094/E
PASCO COUNTY, FLORIDA
Permit No. f I 7 ~
Date Permitted ty- /0; ~ ()::z....
Builder Name/Owner Name ~5tLft~ j) "4#'~~contr~t #
County Parcel No. 3c;-,;2.:r:)..l-tJ~a;-/)tJ3JtJ - O~.ro SubDlv:
Address/Location l' 7 z.J9 ;1J1I'<<&1flJ /Jd t{/;r
Classificatlon/Type of Use ~ - ~1z,J
TRANSPORTATION IMPACT FEE
Rate:
Sq Ft Unit:
Exempt ~s 0 No
How Determined
Impact Fee Amount $
Zone No.
TAZ:
SCHOOL IMPACT FEE
Account (056) Single-Family Detached House Amount $
~057 Mobile Home \1 rD2
o 8 Other Residential 0~~ ~VI~.g-1;1:.- Q53&
J.: 3) C2!)egUon Fee ~....'- (2-0
Exempt U Yes lJJ1'Jo How Determined
?~/2' ~
PARKS AND RECREATION FEE
Land Account Land Credit
Land Total
Recreation Account Recreation Total
TOTAL AMOUNT $
How Determined
LIBRARY FEE
L:and Account
Land Credit
Land Total
Facility Account
Facility Total
Exempt
o No
How Determined
Total Amount
/,
RESOURCE FEE
TOTAL AMOUNT
9.3.;)"
ERU
Prepared By y~~. ~ 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. .5 9tJc; t/(; DATE
RECEIVED BY
/O~tJh 2 BY
( t
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.-u~~. ~
APPLICATION FOR PElU5IT
CITY 0' ZBP~ILLS
BUILDING DBPARTH&:N'1'
, .d',-'/ - 6~
DATi: RECBIVBD---.~ ~~
PLANS REVZEW I'D
. ... " ...... .4. . ,. J.A fld' 4.. V'\ . ....._..1....
^O!'!i~~';;S~:~ G-"{' ~,. rtp::lrrMe r~ rtl~1
JO."B-"'DREs~I... L/J'/h' ~ //)_ (J h,.J b
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, LEGAL' DESCRiPTION: LOT (S) BLOCK S D~VISION
. :P~~~~:~D';';,':?:'4 ,.. as- - ? 1-()CX::JO-t;O?J.>O-'CCi'o (OBTATN FROM PROPERTY TAX NOTTCE)
WORK' PROPSED: ~ CONS'l'RUC'l'ION. 0 ADDI'rION o ALTERATI ON 0 REPAIR 0 INSTALL.
.....(c,.., .'
PHONE
~b 7- 799 .~
;: :1'". .-. :- .~~ :::
OSIGN
PROPOSEDUSE:OSGL FAMILY DWELLING
,,~,; " , ), '.--... OCOMMERCIAL
1\. ,I j. '.
o MOVE 0 DEMOLISH
~TI-FAMILY DIf OF UNITS.
l'.
o MOBILE HOME
"
o INDUS'l'RIAL
o SWIMMING POOL
o OTHER
.....'. ,. "~! , .
it..,.t' , '.' . . 0 RESTAURANT & HEAL'fU DEPAR'fMEN'f APPROVAL
DESCRIPTION ~F WO~K I_~CA " I J Un 1't1l:p1 rtWl M+ ~i \si,' ~
BUf~IH~ SIZE iR - () 1:. .C;CO SQUARE FOOTAGE 9(2('JV HEIGHT 0) r
RES~DENTIAL: ATTACH (2) PLO'l' PLANS & (2) SE'fS OF BUILDING PLANS & (1) SET ENER~Y FORMS.
COMMERCIAL: ATTACU (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS, .
PROPERTY SURVEY REQUIRED FUR ALL NEW CONSTRUCTION.
"
.,',
. ;.
. ,
~ILDI~~~, .'
~ECTlUrAL. ".
~LUMBING . .
~CHANI~" ,.. $ :'~J
o ~t.. .l ~FING.' 0 SPECIALTY'
T~~t~"'~~~~;~~CT~ON: ~~~K '
PERMITS REQUESTED
$
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE ~FLORIDA POWER O. W.R.E.C.
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."
I'~..,~.\.._:i f'J~. ,~~"
VALUA'l'ION OF MECIIANCIAL INSTALLATION
o O'fHER
o FRAME
o STEEL
o O'fHER
,,!,::: ...
FINISHED.iFLOOR ELEVATIONS
"~.f""'. ~.t.. J. . ," ,\
". j,
IS PROJECT IN FLOOD ZONE AREAO YES ~
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COMPANY F~'/s+- ClctSS f: I~c:f~
STATE CERT OR REGIST 1# ceo ~~? 0
CITY PROCESSING 1# ''I~
BLBCTRIcZAH
SIGNATURE
"'**~***********"*************Io***********:***********~ f")J A
PLUHBBR COMPANYj'YJcv1.~ 1 ~.J _ ~
SIGNATURE ~o~ A_-l J ~. ~i~~EF~is~~:":IST I J~~ 7'i "
. , -
**...*..***.**.*.*.*******.****.*************~*** .~l_
MBCJlAHICAL . COMPANY:" (. iftl II
STATE CERT OR REGIST 1# tV ro I.~O .:J
CITY PROCESSING. If . ~11 so e't:jd:1 ~
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"''''***''''''****'''************'''***************************
SIGNATURE
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0TJIa}
"iqm~"';"'ll~l(.'..\..'
COMPANY
STATE CERT OR REGIST If
CITY PROCESSING If
SIGNATURE
*************10**10...**".*"*.**.10..".*.*.*...****.*****10**********
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A. NOTICE OF DEED RESTRICTIONS
,The under.igned understands that this permit may b~ subject to "deed restrictionsU which
ma)!.~e~J::e.~e.~rict,ive ,than City regulations .Tite undersigned assumes respo~sibil~ty for
coftlpliance.with.any applicable deed restrictions.
B......UNLICENSED. CONTRACTORS AND CONTAAC'fOR RESPONSIBILI1'IgS
If the owner has hired a contractor or contractors to undertake work, they may be required
to be licensed in accordance with slate and locnl regulations. If the contractor is not
licen.ed....required by law, both the owner and contractor may be cit~dfor a misdemeanor
viol.tion'under sta~e law. If the owner or intended contractor are uncertain as to what
",. licen.ing requirements may apply for the intended work, they are advised to contact the
City of Zephyrhills Building Department, 813-788-6611.
Further.more, if the owner has hired a contractor or contractors, he is advised to have the
co~t~a~~or(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, r.ther 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 li~.ensed and is
not entitled to'permitting privileges in the City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D~-;-. '. .CON,sT~UCTUION LIEN LAW (CHAPTER 713, FLORIDA S'l'ATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a.copy of "Florida's Construction
lie~ ~w.:-: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 obt.ined 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
Ice~tify that all the information in this application is accurate and that all work will
be. done. in compl~ance with all applicable laws regulating construction, zoning, and land
development.. .
Application is hereby made to obtain a permit to do work and installation as inqicated. . I
certify that no work or installation has commenced prior to is~uance of a permit and that
all work will be performed to meet standards of all laws regulating construction, City
code., zonin~r' reguJ,ations, and land development regulations in the jurisdiction. I also
certify th.t I understand that the regulations of other governmental agencies may apply to
the intended work, and that it is my responsibility to identify what~ctions I must take to
be in compliance. Such agencies include but are not limited to: *Department of
Environment.l Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Land., Water/Wastewater Treatment
*Southwe.t Florida Water Management District-Wells, Cypress Bayheads, Wetland AIeas,
. .Altering WatercCturses:.
*Army Corps 'of Engineers-Seawalls, Docks, Navigable Waterways
*Dep.rtment of lIealth & Rehabilitative Services, Environmental Health Unit-WeltS,
W..tew.ter Treatment, Sep~ic Tanks
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill mat~rial is to be used in Flood Zone "A" or "A,etc.N, it is
understood that a drainage plan addressing a "compensating volume" will be submitted which
i. prep. red by . professional enyiueer registered in the State of Florida prior to permit.
issuance.' .
A permit i..ued shall be construed to be a licensp. to proceed with the work and not ..
authority to violate, cancel, alter, or set aside any provisions of the technical codes,
nor .hall is.uance of a permit prevent the Building Official from thereafter requiring a
cO,rr~ction .of errors in plans, construction, or violations of .ny code. Every permit
is.ued'.h.ll, become invalid unless the work authorized by such permit is commenced within
six month. of i.suance, 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 .llowed 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
WITII YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NO'rICE OF COMMENCEME T. JOBS UNDER
$2,500 IN VALUE 00 NOT NEED TO RECORD AND POST A "NOTICE OF COMMENC
SIGHA'l'UREa OWNER OR AGENT
-~ ' .', . .
,l' \-;'\;'~:"~:"~^"l.-~;.' ->/.
.S'1'ATB 01: . FLORIDA
. ~.. ... s,:'r~;'~.~ ::;.'_.
. ,;.COVIft'Y1/~,....... ......-
The""fore90ing instrument'was.acknowledged
Before methi.~ day of , 1L
~Y,,",._~ .... ..... .
.. . ....tn...of-person acknowledged)
[J who."!s personally known to me, or
~"""l"""I..~'" :.".,~''':7':'':'i'~.' __
D wh~ ha~'p~~duced
. ". (type of identification)
.ndwhoDdid Ddid not t.ke an oath.
.'.J ',~..~~~: ~~~~F~-~-~~_r. ,~'~. "~'-"""~',"'~.;;,~~"i:;::l:~:":~':' ~"'
GNATURE: CONTRACTOR
-;,~~~,!~,-,. ;",
~~:~Y O~F FLORID~ a ~Ch
~:~o;~rego~~~sinstf8E:~t ~ O~~~~~{
by
Wi. (name of person acknowledged) ..
~10 is personally known to me, or' .,
o who has produced
(type of identification)
O:lid not take. an :o.th~~'~'1i'
. .................;:;.\: I."..,. ,
. . ~.. fl9l.~f~ *....~ '''II, .. . ~
". . ........_. ......_.0. . .'
S19natureot per. on t.king .cknowledgement
-~~..... I' it ...-..".... ",~"":,,," ..,'., ~
,....,.. ..~.."' II' .". ...
JENN1fER I.. IUCH
at 01 aoos
IlON:lID 1HIOUlIH
"'''''!'llt..~~~~
M~~t~! printed ot at.mped
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