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HomeMy WebLinkAbout02-1357 BUILDING PERMIT Permit N2 fl.5:;}"~O BUILDING ~lq~ ELECTRICAL CITY OF ZEPHYRHILLS (813) 780-0020 17 5'"D St' PLUMBING 1357 Date 7-1<?~[)~ ;$U MECHANICAL ::~::,~:~., ~1t~~; ~~t. u~ Parcell.D. II ~; i 0 00 l) ~ Zoning: Energy Code: . Radon Gas: ~ -z 9 DescriDtion of Work ) ~7;,. LI..A7Lt-; -# 7 NO OCCUPANCY BEFORE C.O. FINAL ____':?-/1--- tJ 3 '2 DATE C. 0 . ..--:L:. Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. DATE City license Registration # State Certified license# .........- ,2~~ Signat Company Address Telephone# Inspector Valuation or Contract Price ~t, ~91o. 9s '35".2 - ~ )7 ~ ~7C},:;L ~N4fl~~t PLUMBING /9AO MECHANI:~~ SLB / 3---9.-1f;) /./Jc Breakers I/ro Tub Set 1//...7- 3t:J-tJ l ;170 Ducts Insl. //..7 :36/0'.2 #.52> Water . Compressor Sewer .~-.27-~~ R{'1./lfo Final ~-'1~/?~o3 .,.eZ Yr/~ Final ,..?-/Y--C/3 ~t.'1~MT" ... ELECTRICAL Ftr}O(\~ 1-)..~/oJ. t4~ f tI::reJ Tp. Servo Pre SLB ./S//5-CJ 2 6d Rough In./ J,?:.JvP.iI- lintel Meter Can FRM. . / /;; -,3 I) -t' 2 /lye Const. Pole Insul. CL j/;.). - J/J c'~ z /Ifo Pool , WL Pre-Meter ,,/'3-3 -" J RL e.r Final .,./ ,.:? -/1- tJ3 ft'1d-";.I":Jo Driveway ::- ? ." ;Cfll-A en ~ ~ 15,~i jJPz'UJ /0" /?-o-z/2li1//fiV JJ.:~ ~ _. ~-..~ 0 5/J _ Lf < 3 S- . UJ'lotU'yWvvr-TA. ~ . -~-/3.-o2138J f/.7"o REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of tw~nty.-five and 00/100 Dollars ($25.00) shaH be made for each trip for each trade: 5!,ee;,ft'f"";.. - II-V-OZ ~{.~ /-I:TO a. Wrong Add~ss / 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. Sandy Development ~eadow Oak Way J7s/fJ( 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 I l WATER METER:I $ IRRIGATION METER $ 180~00 I SUB-TOTAL $ 2,217.171 SIF'S: $ 722.00 97.5% $ 703.95 2.5% $ . 18.05 TI F'S: $ 1,204.00 Credit to Jim 99% $ 1,191.96 Bingham 1% $ 12.04 TOTAL: $ 2,939.17 I Ui4 rr ~\\\6~'~*~ 'u.nf+ ( O~N.~R'S NAME t~a. nci ,'rt'J APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT .c/2. -k:- 012- DATE RECEIVED PLANS REVIEW FEE ...... , ,-' ,/",. :.... ... '~.:' . : JOB~ADDRESS .:. . ~- ~ ' ..' " p, p:i rlY\tlf rrl-5 r tV' I PHONE 5lo 7- 7~9 .")- , . LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PAR~EL iDII ":34,95"'"- ?/-(X:.X:JO-t.:b300-'l:X::8o (OBTAIN FROM PROPERTY TAX NOTTeF-) WORK PROPSED: ~ CONSTRUCTION .'... o ADOn'ION o ALTERATION o REPAIR o INSTALL OSIGN o MOVE o DEMOLISH PROPOSED USE: oSGL FAMILY DWELLING o COMMERCIAL .1, llttrG'i.TI-FAMILY o INDUS'!'RIAL 0# OF UNITS o SWIMMING POOL o MOBILE HOME o OTHER . D RESTAURANT VESCRIP'.l'ION OF WORK Bl...,f " t J -;~>( JUy 50 BUILDING SIZE . - L . ;.;..,,). . & HEAL'fH DEPAR'fMEN'r APPROVAL SQUARE HEIGHT 0)/ · RESIDENTIAL: COMMERCIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENER~Y FORMS. ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED E'OR ALL NEW CONSTRUC'fION. ~ILDING ~LECTRICAL ~LUMBING . ~CIIANIC1\L $ o GAS, ~FING 0 SPECIALTY TY~~~'~~~':~~~~;~UCTION: ~OCK PERMITS REQUESTED $ VALUATION OF TOTAL CONSTRUCTION AMP SERVICE ~FLORIDA POWER o . W.R.E.C. VALUA'l'ION OF MECII1\NCIAL INSTALLATION o O'fIlER o FRAME o STEEL o o'rHER FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREAo YES ~ II COMPANY O~ V ~ I ~ IY\ e.nf' STA'!'E CERT OR REGIST 1# (1 f:5 c.... C> '1~ l' CITY PROCESSIN~ 1# ***************.*.*.*......*******.***************** .';\.1 COMPANY r,'tS-1- Cleo) j( (~d< STATE CERT OR REGIST 1# (:xx:> ~~'? 0 CITY PROCESSING 1# I '-I tt:J J1:LBCTRIC . I PLUHUR ll*****.*** J......:................=::J:;;;=:..i~YJ~ f1J- . , . ,on' STATE CERT OR REGIST # '!z.~ 7'i 5: SIGNATURE . . ~ ~ ""' lJJr<..X..J(JL~ CITY PROCESSING # ) .,,:' ~.'!. :. ", . ., *.*********.*.********.****..*******.**.**..*~*** ..****** * .*. '_L NJl:CRARlCAL COMPANY ,t: '>>'\ rr , ! ,.j' STATE CERT OR REGIST 1# ,... rr ro I.SO OJ . SIGNATURE ~CITY PROCESSING' # . ~11 so ~'?&; ~ ***************.*****************************.***** l,~ t t~ ..~ .: J :~_ -~".; L" , OTIID.:. COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE . ,;~-:~I)t~,,,,:, '.1,~ \lC'.\,' ..**.***~*****...***.*........*.*.......*.*.*.****.************** I, 'l:":'!"! . '~ :-: ',' . ...,' ,. . . ",.'"".,,' '-' " '~;. . ,. . '.~~.~ , ''';, .~' \': CUl,';JJ, ';:.~.U:~:'; U~:' :':i'~~Uv1J.':' l\l:'.l:';,Ul\V ~..~: A. NOTICE OF DEED RESTRICTIONS The .under,igned understands that this permit may b.e sub:)ect to "deed restriction," whi~h . ~y.b~,.IIl9~e.J;:est;rict.ive ,than City regulations . The undersigned assumes responsibility for compliance.. with.. any applicable deed restrictiIJn:s. B.'''''''"UNLICENSED . CONTRACTORS AND CONTRACTOR RESPONSJ[BILl'l'IES If the owner has hired a contractor or contral::tors to undertake work, they may be required to be licensed in accordance wilh sLale aud lc)cnl regulations. If the contractor is not licensed as' required by law, both the owner and contractor may be cit~d for a misd~eanor violation'under sta~e law. If the owner or intended contractor are uncertain as to what ",. licensing requirements may apply fOJ: the intended work, they are advised to contact the City of Zephyrhills Building Department, 813-'788-6611. . Furthe~re, if the owner has hired a contractor or contractors, he is advised to have the cont~a~~o~(s) sign portions of the "Contractor Sections" of this. application for which they . wl11be I'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~T.RUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certlfy that I, the applicant, have been provided with a'copy of "Florida's Construction lie~ L.aw:~:Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other that the "owner", I cerify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "owner" prior to commencement. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I ce~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 perlnit 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 codes, zoning" regu.\ations, 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 ~ctions 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 Sens1tive Lands, Water/Wastewater Treatment *Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Axeas, . .Altering WatercClurses:- *Axmy Corps 'of Engineers-Seawalls, Docks, Navigable Waterways .Department of lIealth & Rehabilitative Services, Environmental Health Unit-welfs, Wastewater 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.", 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 licensp. to proceed with the work and not'as authority to' violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a c~rr~ction .of errors in plans, construction, or violations of any code. Ivery peJ:llLit 'issued" shall. become invalid unless the work authorized by such permit is commenced within six months of issuance, or if work authorized by the permit is suspended or abandoned. for a period of six months after the time the work is commenced. One 90 day extension of time may be allowed for .the permit with fee charge of $15.00. The extension shall be requested in writing to' the Building Official. An approved inspection must be logged during each six month period, or the project 'will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITII YOUR LENDER OR AN A'rTORNEY BEFORE RECORDING Y UR NO'rICE OF COMMENC E JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A " OTICE OF COMMEN EN H ~~!~I\"';;:' '. SIGNATURE: OWNER OR AGENT :"",,:t,-:(~.,i,<~~; .te!'~~';..'T~'~f~;'- _,' '''~ ,'. _ STAT!:' QI,'~RIDJ\ _ ..COU1ft'Y1lo~.,....,. . '.. ~,. The"'foregoing instrumentw~s'acknowledged Before me this day of , 19.-- by " ". . ""'~'(name"ot'person acknowledged) o who is personally known to ,me, or .' ''''.. """. , [] wh~ has 'p~~uced . ',' (type of identification) and who[]did .Ddid not take an oath. ,~i:~ ;r..,~ ':..; _" : STATE OF FLORIDA .~ S ~ COUNTY OF "'L - - The foregoing igj~ent w Before m this . ay by .\t: (name of perqon acknowledged) ~10 is personally known to me, or n9~~~~~( o who has produced (type of identification) [)::lid not take. an 'oath4lI":':;'~' .'. '\t;F;,..~ .., . , AUG 01.y' . ."',:: 8OIClI!D ltE" ;: \ RII ~ CXll(i . . ,.....~..l~"'~..:::::;.J:->:;.,.~'!'.. ~U:"4 ;~...~"..,.~~'...!.........-"_..,~'~ - ""', . . ..... --. ........... Si9natu~. ot person takin9 acknowledgement ~lI.,.,..............r..t 11 _ '#_' .0--' ." -, ,'"' - ,.-,....'...1",., .... .t'..-...~.Y'i ..'.. M~...~t~~ printed or stamped FORM 600A-97 FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION Florida Department of Community Affairs Residential Whole Building Performance Method A ~._-----.._._._------ "--~-'--'-~--'-----~----_.~~- THE LANDINGS APARTMENTS - 1 BEDROOM Builder: THE LANDING APARTMENTS - PH " Permitting Office: ZEPHYRHILLS, FL Permit Number: TOWNVIEW MEDICAL ARTS PARTNERSHIP Jurisdiction Number: Central Project Name: Address: City, State: Owner: Climate Zone: I '-~--_._----_._.._----,- 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 (1l2) 7. Glass arca & typc a. Clear - single pane b. Clear - doublc 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. Frame, Wood, Adjacent c. N/A d. N/A e. N/A 10. Ceiling types a. Under Attic b. N/A c. N/A I I. Ducts a. Sup: Unc. Ret: Unc. AH: Attic b. N/A Glass/Floor Area: 0.12 Ncw Single family I I Yes 760 tl' 92.5 ft' 0.0 IF 0.0 ll' 0.0 ft' R=O.O, 79.0(p) n R=5.0, 632.0 ll' R=II.O, 332.0 fF R=30.0, 760.0 tt' Sup. R=6.0, 60.0 n 12. Cooling systems a. Ccntral Unit Cap: 23.0 kBtu/hr SEER: 10.00 b. N/A c. N/A 13. Heating systcms a. Electric Hcat Pump Cap: 17.0 kBtu/hr HSPF: 7.00 b. N/A c. N/A ] 4. Hot watcr systems a. Elcctric Resistance Cap: 30.0 gallons EF: 0.93 b. N/A c. Conservation credits (II R -Ileal rccovcry, Solar D1IP-Dediealcd heal pump) 15. HVAC credits (CF-Ceiling Ian, CY-Cross ventilation, IIF-Whole housc fan, PT -Programmable Thcrmostat, RB-Attic radiant barrier, MZ-C-Multizone cooling, MZ-H-Multizone hcating) PT-C, PT-H _ ~ Total as-built points: 9229.50 Total base points: 11242.00 PASS ---------l I I hereby certify that the plans and specifications covered by this calculation are in~i nC7ith th~lorida Energy Code. 7 . c.,j. . PREPARED BY: H oATH ENGINEERING DATE: J I J.' /e;-:J. , .. I hereby certify that this building, as designed, is in compliance with the Florida Energy Code. OWNER/AGENT: DATE: ~--------~----~-----_.- ---- 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. , BUILDING OFFICIAL: DATE: EneravGauae@ (Version: FLRCNA-20m FORM 600A-97 SUMMER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: THE LANDING APARTMENTS - PH II, ZEPHYRHILLS, 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 .18 760.0 42.08 5756.2 Single, Clear SW 8.0 7.5 40.0 52.82 0.50 1062.9 Single, Clear SE 1.0 5.5 30.0 56.64 0.95 1622.1 Single, Clear NE 10 5.5 22.5 4:t65 0.96 947.7 As-Built Total: 92.5 3632.7 WALL TYPES Area X BSPM = Points Type R-Value Area X SPM = Points Adajcent 332.0 0.7 232.4 Concrete, Int Insul, Exterior 5.0 632.0 1.00 632.0 Exterior 632.0 1.90 1200.8 Frame, Wood, Adjacent 11.0 332.0 0.70 232.4 Base Total: 964.0 1433.2 As-Built Total: 964.0 864.4 DOOR TYPES Area X BSPM = Points Type Area X SPM = Points Adjacent 0.0 0.00 0.0 Exterior Insulated 21.0 4.80 100.8 Exterior 21.0 4.80 100.8 Base Total: 21.0 100.8 As-Built Total: 21.0 100.8 CEILING TYPES Area X BSPM = Points Type R-Value Area X SPM = Points Under Attic 760.0 0.60 456.0 Under Attic 30.0 760.0 0.60 456.0 Base Total: 760.0 456.0 As-Built Total: 760.0 456.0 FLOOR TYPES Area X BSPM = Points Type R-Value Area X SPM = Points Slab 79.0(p) -31.8 -2512.2 Slab-Cn-Grade Edge Insulation 0.0 79.0(p) -31.90 -2520.1 Raised 0.0 0.00 0.0 Base Total: -2512.2 As-Built Total: -2520.1 INFILTRATION Area X BSPM = Points Area X SPM = Points 760.0 14.31 10875.6 760.0 14.31 10875.6 Summer Base Points: 16109.6 Summer As-Built Points: 13409.4 Total Summer X System = Cooling Total X Cap X Duct X System X Credit = Cooling Points Multiplier Points Component Ratio Multiplier Multiplier Multiplier Points 13409.4 1.000 1.090 0.341 0.950 4734.6 16109.6 0.3577 5762.4 13409.4 1.00 1.090 0.341 0.950 4734.6 EneravGauae 1101 DCA Form 600A-97 FORM 600A-97 WINTER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: THE LANDING APARTMENTS - PH II, ZEPHYRHILLS, FL, PERMIT #: BASE AS-BUlL T GLASS TYPES .18 X Conditioned X BWPM = Points Overhang Floor Area Type/SC Ornt Len Hgt Area X WPM X WOF = Points .18 760.0 4.79 655.2 Single, Clear SW 8.0 7.5 40.0 9.22 1.35 497.5 Single, Clear SE 1.0 5.5 30.0 8.34 1.03 256.5 Single, Clear NE 1.0 5.5 22.5 12.00 1.00 . 270.1 As-Built Total: 92.5 1024.1 WALL TYPES Area X BWPM = Points Type R-Value Area X WPM = Points Adajcent 332.0 1.8 597.6 Concrete, Int Insul, Exterior 5.0 632.0 2.90 1832.8 Exterior 632.0 2.00 1264.0 Frame, Wood, Adjacent 11.0 332.0 1.80 597.6 Base Total: 964.0 1861.6 As-Built Total: 964.0 2430.4 DOOR TYPES Area X BWPM = Points Type Area X WPM = Points Adjacent 0.0 0.00 0.0 Exterior Insulated 21.0 5.10 107.1 Exterior 21.0 5.10 107.1 Base Total: 21.0 107.1 As-Built Total: 21.0 107.1 CEILING TYPES Area X BWPM = Points Type R-Value Area X WPM = Points Under Attic 760.0 0.60 456.0 Under Attic 30.0 760.0 0.60 456.0 Base Total: 760.0 456.0 As-Built Total: 760.0 456.0 FLOOR TYPES Area X BWPM = Points Type R-Value Area X WPM = Points Slab 79.0(p) -1.9 -150.1 Slab-On-Grade Edge Insulation 0.0 79.0(p) 2.50 197.5 Raised 0.0 0.00 0.0 Base Total: -150.1 As-Built Total: 197.5 INFILTRATION Area X BWPM = Points Area X WPM = Points 760.0 -0.28 -212.8 760.0 -0.28 -212.8 Winter Base Points: 2717.0 Winter As-Built Points: 4002.3 Total Winter X System = Heating Total X Cap X Duct X System X Credit = Heating Points Multiplier Points Component Ratio Multiplier Multiplier Multiplier Points 4002.3 1.000 1.116 0.488 0.950 2068.8 2717.0 1.0730 2915.4 4002.3 1.00 1.116 0.488 0.950 2068.8 EneravGauae TM DCA Form 600A-97 FORM 600A-97 WATER HEATING & CODE COMPLIANCE STATUS Residential Whole Building Performance Method A - Details ADDRESS: THE LANDING APARTMENTS - PH II, ZEPHYRHILLS, FL, PERMIT #: BASE AS-BUILT 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 30.0 0.93 1 1.00 2426.15 1.00 2426.2 As-Built Total: 2426.2 CODE COMPLIANCE STATUS BASE AS-BUILT Cooling + Heating + Hot Water = Total Cooling + Heating + Hot Water = Total Points Points Points Points Points Points Points Points 5762.4 2915.4 2564.0 11241.8 4734.6 2068.8 2426.2 9229.5 I PASS I EneravGauoe.... DCA Form 600A-97 FORM 600A-97 Code Compliance Checklist Residential Whole Building Performance Method A - Details ADDRESS: THE LANDING APARTMENTS - PH II. ZEPHYRHILLS, FL. 6A-21 INFILTRATION REDUCTION COMPLIANCE CHECKLIST PERMIT #: COMPONENTS SECTION -'~EQU~~~f!lJ:J~TS J=Q~~CtI~p~~~mc;J;__~~~n CHECK "--'-~-- Exterior Windows & Doors 606.1.ABC.1.1 ,__ e-~axim~rn~,:Lcfll1/~.f!"--\Nind(),....._l!I"~~~c5, cfm/sglL 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 comers; utility penetrations; between wall panels & top/bottom plates; between walls and floor. EXCEPTION: Frame walls where a continuous infiltration barrier is installed that extQnd.s ---~- from, andJsn?~al~d~!Q,t~~J.Cll!.ndati.Qn tOJhe top plate. Floors 606.1.ABC.1.2.2 Penetrations/openings >1/8" sealed unless backed by truss or joint members. I EXCEPTION: Frame floors where a continuous infiltration barrier is installed that is sealed "to ~~rim~!~~ne!~atio'l~!1d seams. _~ Ceilings 606.1.ABC.1.2.3 l Between walls & ceilings; penetrations of ceiling plane of top floor; around shafts, chases, I 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 i installed that i~~~.!iled~Cl! the jJ~rlrneter,~penetrations and seams. Recessed Lighting Fixtures 606.1.ABC.1.2.4 Type IC rated with no penetrations, sealed; or Type IC or non-IC rated, installed inside a sealed box with 1/2" clearance & 3" from insulation; or Type IC rated with < 2.0 cfm from n conc!i!i()Cl~ci~~p~~,t~J>JE!<!-~_~_~n__ 'n.~ ~. Multi-story Houses 606.1.ABC.1.2.5 Air barriergn_p~iml:l~~ Clfl1ClQf..givitybet>,v,een floors. Additional Infiltration reqts 606.1.ABC.1.3 Exhaust fans vented to outdoors, dampers; combustion space heaters comply with NFPA, -- --.l ~ave coml:lwition air. n _n___. _ . .~ .. 6A-22 OTHER PRESCRIPTIVE MEASURES (must be met or exceeded bv all residencesJ COMPONENTS SECTION R~gUJ~J:nME~I~ .-- - ---..- n.______.__ ------.----- CHECK Water Heaters 612.1 Comply with efficiency requirements in Table 6-12. Switch or clearly marked circuit breaker (electricl.Cl~cutofUg~must be provided. External or built-in heat trao reauired. Swimming Pools & Spas 612.1 Spas & heated pools must have covers (except solar heated). Non-commercial pools I mo" ha"" a pomp time,. Ga, 'pa & pool he.tem mo" he"". m'"'mom the""" --~~-- 612.1------- -:~~~n~~~~_~:J;e r~strictE!..d..!Cl. no I1JQr!l than 2.5 ~~Ions p~r mi;:;;";;' at 80 PSIG. Shower heads Air Distribution Systems 610.1 rAil dOd" 'W"g" mech,"'oa' ,"o'pmeot aod p'eoom "'.mhem ,"aU he me""'",oal~ attached, sealed, insulated, and installed in accordance with the criteria of Section 610. HVAC Controls ~-----t~:~~~~eu!:~;I~~~~:~~~~~~;~~~~~~~~:.thermostat for each svstem. Insulation 604.1, 602.1 I Ceilings-Min. R-19. Common walls-Frame R-11 or CBS R-3 both sides. Common ceiling & floors R-11. EneravGauae"" DCA Form 600A-97 EneravGauae@/FlaRES'97 FLRCNA-200 ENERGY PERFORMANCE LEVEL (EPL) DISPLAY CARD ESTIMATED ENERGY PERFORMANCE SCORE* = 83.3 The higher the score, the more efficient the home. TOWNVIEW MEDICAL ARTS PARTNERSHIP, THE LANDING APARTMENTS - PH II, ZEPHYRHILLS, FL, 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 (IP) 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. Frame, Wood, Adjacent c. N/A d. N/A e. N/A 10. Ceiling types a. Under Attic b. N/A c. N/A II. Ducts a. Sup: Unc. Ret: Unc. AH: Attic b. N/A New Single family ] I Yes 760 ft2 92.5 IF 0.0 112 0.0 IF 0.0 ft, R=O.O, 79.0(p) fi R=5.0, 632.0 IF R= 11.0, 332.0 ll' R=30.0, 760.0 ll' Sup. R=6.0, 60.0 II 12. Cooling systems a. Central Unit Cap: 23.0 kBtu/hr SEER: 10.00 b. N/A c. N/A 13. Heating systems a. Electric Heat Pump Cap: 17.0 kBtu/hr HSPF: 7.00 b. N/A c. N/A 14. Hot water systems a. Electric Resistance Cap: 30.0 gallons EF: 0.93 b. N/A c. Conservation credits (I-IR-Heat recovery, Solar DHP-Dedicated heat pump) 15. IWAC crcdits (CF-Ceiling fan, CY-Cross ventilation, HF-Wholc house fan, PT-Programmable Thermostat, RB-Attic radiant barricr, MZ-C-Multizone cooling, MZ-H-Multizone heating) PT-C, PT-H I 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 FLAlRES computer program. This is not a Building Energy Rating. If your score is 80 or greater (or 86 for a us EP A/DOE EnergyStar1Mdesignation), 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 wwwftec.ucfedufor information and a list of certified Raters. For information about Florida's Energy Efficiency Code For Building Construction, contact the Department of Community Affairs at 850/487-/824. EnemvGaUlle@ (Version: FLRCNA-20m PASCO COUNTY, FLORIDA Permit No. /',,~ .::;- ~7'~ "-'; , Date Permitted /7, j') / - ,f },' ,'~ Builder Name/Owner Name , >...' / \ ~. '"'\., i J .~ ;r~_... . ,,'I L. :1' ,. , ".j L ,;..cl : { 7 . .>-1~(!,- County Parcel No. -:;' .Jj,/ .' ; -'7..'- '''' ... -j,1 ><~/ / (,' ,. .. I. ( ...., '1 /, (, (, /' '/ ) \ ,-> Address/Location~' -7..Ail/;; Classificationffype of Use / '. ;::;~ // ../' .,.,t' r'1 .. '..,.:-s:~~<:;.'t.~~ '" ',.#l~;' /~,L " ,~~ Subd. " - ~.,.... ;( Ii / J '/ T' , ,/ .1ft. How Determined TRANSPORTATION IMPACT FEE CALCULATION EXEMPT 0 Why? Rate $ Zone No. ~, Sq. FtJUnit ,I '"j' Impact Fee Amount $ PreparedBy _ __.~_.- ,~ -~~,..... Checked By The ab()ve -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 $0. 1 48/Day ERU Assign No. ,/ ~. Assessment - (No. Units) x ($O.'~ x (No. Days) Assessment - (GSF) x (ERU) x (0.148) x (No. Days) 100 TOTAL FEE $ -./ /,;" TOTAL FEE $ /~-~', 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. Acknowledgement below does not imply acceptance of concurrence, but simply receipt of a copy of this form, placing the building pe,mit owner on notice of this assessment and the cmnditiotlsof paymcnt"for '-same. ,~\ -I · Date Received By -----.--------------------------------------------------------------------------------------------------------------------------------------------- (r-, \J OFFICE USE ONLY TRANSPORTATION REC. NO. RESOURCE RECOVERY REC. NO. , ~ ,;" DATE DATE BY BY /' .,.' White Applicant Canary Trans/Finance Canary RR/Finance Pink Office Green Bldg/lnsp feecal:ce PC93113094/E ~.'.""~..T.Y~"/~_':-- '."~:~'r...;i;~'T~". ~~.,,;-... . -...-~~~~;: ~~~~~--;~~ - ,,::;:~ ~;~ -r~;~:- -:;-:t:7~-r-;- -----'1 , f': (:t,. in) J J)(', (~'I f:j i ! q- " : iJ I,..rn:; p, ef:.J h: ,~'::; .) 0 ....1 ,.) (':, (, ',!{)iif.:' i:1~Uh: J I::F i.. 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T I) ta..!;:\:::;;-rE:: F'[:!::' :OF: / c:r;' :c.; ,':'.~ ~:.:.I <> '.:.:.; (.) ..:,:.; () () i.:) (::0 ',,} ::.-:-; /.!. ~.:.:.; (:' .". .., ., ',,'0' ..I If If I .:"::0',1 (:.(.) ) :.:.~~ l " ~.:.:' .,:~. '}1:. .)(. .~\(. H. .)(. .)(. :.:.:,; :1. " (.) /{. .)(..)( .)(-.)(-.)(.)(, :.:.~.; 1 " (.:) ::',!. .)(..)(- .)(- -)(. .)(- )(. :.;.~.;:1. " () ..l .)(..)(. ,)(. .)(. )(..)(. ::jULIO iJ..I()::::;fC rF'!: ~::,Cil, II) l.>J(:,~::;TF FTC '::()t . J j) i},!(i::::;"iT 1'[1: ;::\'11 I: II Il.l(,~::TF FIT ();,) .f{ ,':',!.:.:,:.;<> . :~; ...:'" ::~; (,) () () ... ...... . -. .. 'C: ,"',} ~.:.:.~ <::.J ;~; ,'-:', ::~; ("> () () . ...n.. ,. .. ") .;'::,!:) :C,~,':'.:. :::;(> ':,~; "':'" :;;; () {);:") ,.."..... " ., (~) () li1 :C-:,':",!,:",";!,) ...... :"~.:()(>() ,1,'1 ,.'CC:[ 11,)[ n t.;'; /",r, ,:. ,,/"-~ .--- _ ( I ,_;;?,/i/ _,----- i/~ - I_'~/' ~. .~.~. ~.- .If.';'''?' , ;:::(/ ("" (-:..:..;> { r, ------------------_________________________________________________1 ": ~_-~""':c_; ~,~'.:~~-:__t~"':. .Jlta~>t~A"j:.~~,>~, -'7'::'-' ",'," ,: "..'-. "', ,.-,;:, '~'",;~':r .. ~~ .. PASCO COUNTY, FLORIDA Permit No, _ Date Permitted _ Builder Name/Owner Name County Parcel No. Address/Location Subd. Classificationffype of Use How Determined TRANSPORTATION IMPACT FEE CALCULATION EXEMPT 0 Why? Rate $ Zone No. ~j Sq. Ft/Unit Prepared By 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 - 54.00/Year or $0. I 48/Day ERU Assign No. Assessment - (No. Units) x ($0.148) x (No. Days) TOT AL 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 PERMITTI~G OFFICE OF PASCO COUNTY. ,. ~ .l . '\ Acknowiedgement below does not imply acceptance of concurrence. but s'imply receipt of a copy of this form. placing the huilding permit owner on notice of this assessment and the conditions of payment for same. Date .\ Received By' (~)-----,--------------------------------------------------------------------------------------------------------------------------------------------- ,_.c< OFFICE USE ONLY TRANSPORTATION REC. NO. RESOURCE RECOVERY REC. NO. DATE . 'voW"Y~'" ..,.... ',io DA TE BY BY .,._..iIJ'''.. ./ White Applicant Canary Trans/Finance Canary RR/Finance PInk Office Green Bldgllnsp feecal:ce PC93113094/E \. ..~ ... .~, PASCO COUNTY It FLORIDA Permit No. Date Permittcd Builder Name/Owner Name , r (,', County Parcel No. Address/Location " l f Subd. ClassificationfType of Use How Determined TRANSPORTATION IMPACT FEE CALCULATION EXEMPT 0 Why? Rate $ Zone No. /---,.Sq. Ft/Unit I " \..) v Impact Fee Amount $ Prepared By 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 - 54.001Year or $0. 148/Day ERU Assign No. .I..' Assessment - (No. Units) x ($o.i48-j x (No. Days) TOT AL FEE $ Assessment - (GSF) x (ERU) x (0.148) x (No. Days) 100 TOT AL FEE $ /"'-'"'\ '.........r". NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED UNTIL THE AMOUNTS LISTED HAVE BEEN PAID AND RECElPTED FOItBY A CENTRAL PERMITTlNGjOFFICE OF PASCO COUNTY. ~ "- t' . -'~ .---"'-- -, . - ',.-- - ""- --', -'-': ".' -,'-.,-- ,c,:. ... '- .''''- ,.-,' -i- .-' .",,-'.-' ",'-. .', ',." .'. - '-= Acknowiedgement below does not imply acceptance of concurrence. but simply rcceipt of a copy of this form. placing the huilding permit owner on notice of this assessment and the conditions of paymcnt for same. (\ . I \.J Date l Received By OFFICE USE ONLY TRANSPORT A nON REC. NO. RESOURCE RECOVERY REC. NO. DATE ";.y...~;i .,t,!!-; ~'- DATE BY BY While Applicant Canary Trans/Finance Canary RR/Finance Pink Office Green Bldg/lnsp feecal:ce PC93113094/E c... ~,;.~"\:,~ ... -.~~ "c,;.' PASCO COUNTY, FLORIDA Permit No. Date PL'rmitted _ Builder Name/Owner Name County Parcel No. t'~''''' Address/Location Subd. Classificationffype of Use How Determined TRANSPORTATION IMPACT FEE CALCULATION EXEMPT 0 Why? Rate $ Zone No. .I ~' Sq. Ft/Unit Prepared By 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. I 48/Day ERU Assign No. Assessment - (No. Units) x ($0.1-4'8) x (No. Days) TOT AL FEE $ Assessment - (GSF) x (ERU) x (0.148) x (No. Days) 150 TOTAL FEE $ ~, , . \_../ NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED UNTIL THE AMOUNTS LISTED HAYE B~EN PAID AND RECEIP.TED ,FOR BY A CENT~AL P~RM~TTI~ OFFICE OF PASCO COUNTY,' Acknowiedgement below does not imply acceptance of concurrence. but simply receipt of a copy of this form, placing the huilding permit owner on notice of this assessment and the conditions of payment for same. ~; o Date Received By OFfiCE LJSE ONLY TRANSPORTATION REC. NO. RESOURCE RECOVERY REC. NO. ..;.._..".~..."..;,........"... . ,.it' DATE DATE BY BY While Applicant Canary Trans/Finance Canary RR/Finance Pink Office Green Bldg/lnsp feecal:ce PC93113094/E "':/'0.", .,,; ',;1"'''; '- -'~~"'" - .. c PASCO COUNTY, FLORIDA Permit Nu. Date Permitted Builder Name/Owner Name County Parcel No. Address/Location l' .J' ~,: -' '.;~./ .I Subd. Classificationffype of Use c., 1 ,.;,. ,/ ,_.1-; {l-J _1/ How Determined TRANSPORTATION IMPACT FEE CALCULATION EXEMPT 0 Why? ,./--'\Rate $ \ I Zone No. ~~- Sq. FtlUnit Prepared By 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 $ (\ \ ) ~_.. NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED UNTIL THE AMOUNTS LISTED HAVE BEEN PAI~ AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY. ~ 1;,( . .- . c f - . I ' ," .... ~."",- . '7"' ". '." . Acknowicdgement below does not imply acceptance of concurrence. but simply receipt uf a copy of this form. placing the huilding permit owner on notice of this assessment and the conditions of payment for same. , #i; Date ~ Received By r-~ . ~ ----- --------------------------------------------------------------------------------------------------------------_:_---------------------------- OFfICE USE ONLY TRANSPORTATION REC. NO. RESOURCE RECOVERY REC. NO. :-r ,:.-.-.....,..,.:. ''''.-41.-.... DATE DATE "j .'.....-:,....... BY BY White Applicant Canary Trans/Finance Canary RR/Finance Pink Office Green Bldg/lnsp feecal:ce PC93113094/E 1""-' . pi".:,- ~;:\})..~ ,,~ '''~'''~;~.':/,': ' A_, ..,-...,...;;- PASCO COUNTY, FLORIDA Permit No. /r:,:~ I~~ ,~ ", ) ~-'" Date Permitted ,. .' ..I ....,;,- " Builder Name/Owner Name County Parcel No. - Address/Location Subd. ....... Classificationffype of Use How Determined TRANSPORTATION IMPACT FEE CALCULATION ,EXEMPT 0 Why? Rate $ Zone No. ~~ (__ ) Sq. Ft/Unit Prepared By 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 I i , Gross Sq. Ft. (GSF) Rate ERU - 54.00/Year or $0. I 48/Day ERU Assign No. Assessment - (No. Units) x ($O.l48-, x (No. Days) TOTAL FEE $ Assessment - (GSF) x (ERU) x (0.148) x (No. Days) 100 TOTAL FEE $ r---.. 1 I \ ) .........". NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED UNTIL THE AMOUNTS LISTED HAVE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY. ...., ,~,....~ ,,-- '. ,,-,.-, ~ \,~ '7 .~- -''' .,;;.',( ~ . -*'...-1 ,.,---,' "''", ";"'-'~_""_"''''''''''''_''''C'''' Acknowld:igemeM below does not imply acceptance of concurrence. but st"mply receipt of a copy of this form. placing the huilding permit owner on notice of this assessment and the conditions of payment for same. Date Received By ,. . \ . , r-) I . -----.--------------------------__________________________~~------------------------------------------------_______________________________________ \ . "-.~ OFfiCE USE ONLY TRANSPORTATION REC. NO. RESOURCE RECOVERY REC. NO. ii.' .-............;-,............'.'...- DATE DATE BY BY White Applicant Canary Trans/Finance Canary RR/Finance Pink Office Green Bldg/lnsp feecal:ce PC93113094/E ~":''''' \,','.." ~,./~~. ....:_;i4;.~}:~'F~~i,:_: ~.l_, ..~;~ ~I' -_.~-'~ .,-. . . .r PASCO COUNTY, FLORIDA \ -'"' Permit No. Date Permitted J,.,.,....." Builder Name/Owner Name ,- County Parcel No. Address/Location '.... ;,~. Subd. '-"" Classificationffype of Use How Determined TRANSPORTATION IMPACT FEE CALCULATION EXEMPT 0 Why? Rate $ Zone No. /~"\ Sq. FtfUnit . I Prepared By -' 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 - 54.001Year or $0. 1 48/Day ERU Assign No. Assessment - (No. Units) x ($0.14'8j x (No. Days) TOTAL FEE $ Assessment - (GSF) x (ERU) x (0.148) x (No. Days) 100 TOTAL FEE $ ,"'.-........... I . \. i ....._"'... NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED UNTIL THE AMOUNTS LISTED HAVE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY. ti T Acknowiedgement below does not imply acceptance of concurrence. but simply receipt of a copy of thi~ form. placing the huilding permit owner on notice of this assessment and the conditions of payment for same. /~ ~j Date Received By OFFICE USE ONLY " ~ DATE DATE TRANSPORTATION REC. NO. RESOURCE RECOVERY REC. NO. 'j BY BY While Applicant Canary Trans/Finance Canary RR/Flnance Pink Office Green Bldgllnsp feecal:ce PC93113094/E .....~\ , ;~~t,J;;. - "'l, " ',P ,';.' ~",,,- ;-'::"""i'if~-:- ."7\.:;:;t:.: ... . Yo "" PASCO COUNTY.. FLORIDA Permit No. Date PL'rmitted _ ". --.- Builder Name/Owner Name County Parcel No. Address/Location ../ . Subd. Classificationffype of Use How Determined TRANSPORTATION IMPACT FEE CALCULATION EXEMPT 0 Why? Rate $ Zone No. ........... / Sq. Ft/Unit Prepared By \.__...-/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 Comity 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) ..Ii' Rate ERU - 54.00Near or $0. I 48/Day ERU Assign No. Assessment - (No. Units) x ($0.14&) x (No. Days) TOT AL FEE $ Assessment - (GSF) x (ERU) x (0.148) x (No. Days) 100 TOTAL FEE $ .'-.... / ' . ) '\..~! NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED UNTIL THE AMOUNTS LISTED HAVE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY. Acknowiedgement below does not imply acceptance of concurrence. but simply receipt of a copy of this form. placing tbe huildiogpet1Piit owner on notice of this assessment and the. cQnditiod!; of payment for same.' t · Date Received By ----- ---------------------------------------------------------------------.----------------------------------------------------------------------- 1~ ,; ..~I OFFICE USE ONL Y TRANSPORT A TION REC. NO. RESOURCE RECOVERY REC. NO. DATE DATE BY BY White Applicant Canary Trans/Finance Canary RR/Finance Pink Office Green Bldg/lnsp feecal:ce PC93113U94/E