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HomeMy WebLinkAbout03-2150 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 2150 Permit Number: Permit Type: Class of Work: Proposed Use: Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: 2150 COMMERCIAL NEW CONST/COMM COMMERCIAL Address: 7:l.Sll. GALL BLVD ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 34-25-21-0110-00000-0020 75,500.00 6/12/2003 669.40 669.40 6/12/2003 INTERIOR FINISH Name: FRONTIER DEVELOPMENT Address: 7749 GALL BLVD ZEPHYRHILLS, FL. 33542 Phone: MECHANICAL FEE j jJ ff"'? ~tl ~ <i /l5CJ f fI ~U1 . i CONSTRUCTION POLE 2ND ROUGH ptUMB I DUCTS INSULA~ED'VZ ,-'?o- 0 J 1/:/; LINTEL: PRE-METER i WATER i FINAL MECHANICAL FRAME V I, ~~ 0 ---0, .as> i MISC SEWER : MISC INSULATION WALL,/ ~'-Z.-Cl PD] MISC MISC. I MISC, INSULATION CEILING. MISC, MISC. MISC, DRIVEWAY ~SC. MISC. FIRE DEPT, FINAL REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of Thirty-Five Dollars ($35.00) shall be made for each trip for each trade: (a) Wrong address (b) Condemned work resulting from faulty construction (c) Repairs or corrections not made when inspection called (d) Work not ready for inspection when called . (e) Permit not posted on job site (f) Plans not at job site (g) Work not accessible I ]l1e payment of inspection fees shall be made before any further permits will be issued to the pe"on owning same I "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for I improvements to your property. If you intend to obtain financing, consult with your lender or an attorney before recording your notice of commencement. " .-----. - Complete Plans, Specifications and Fee Must Accompany Application. _____________.. All work shall be. performed in accordance with City Codes and Ordinances___.____ I -- - - -- NO OCCUPANCY BEFORE C.O. ~ -~CO~~AT() - , r CA~ INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER UlUD !0etQ-> state of .'" .! '. i ft!2~u.i tJ.. County of 1111I111111111I1111I11111111111111111 11111 11m 11111 11111111 2003106946 rtld{!O NOTICE OF COMMENCEMENT THE tmOERSIGNED hereby gives notice that improvement will be made to c~rtain real property, and in accordance with Chapter 713, Florida Statutes, the following infor~ation is provided in this Notice of Commencement: 1. 2. able) L)~ j_ () ^-.t!-f'}'lOa.e.x-- Rcpt: 689060 DS: 0,00 06/13/03 Rec: 6.00 IT: 0.00 Dpty Clerk 3. /~<-r Information: Name ~rlt2l" ~.aA.4t;(()." llddress 7 70" ~1I IJlvJ City 2.~tPJ..l!..II"J,:'1 Jr- State YI , Interest in Property: ~ ~&)' t~ Name of Fee Simple Titleholder: -:;./f(?,q[rLRA.. D';-LLt2f2ln~4I'C.V.L-:;I' -5,~Wik~~ L.1-6'~ (If other th~n owner) / '# (0:1- Address ;O,c;i!2Inl i?/'.:'L) P~A. D. City "# ?:Q~~~aJlfl- State Pi 1;U~.,.......,~.:'" Contractor: N~me...5nu.ti ~ i:J.t.d401L ,J).4f.b.lI@h, ../?~. I,!) tl,}J '.". f;V -ei 7J;. (01 Uwi!"'''i\ Address .:xV.3/f/ c/o c Sfip~r Ci ty '/any>>_ State Pi 3:3b/O 5 . Su rct y: N':llne Address City State lunou n t 0 f Bond: $ JED PITTMANJ PASCO COUNTY CLERK 06/13/03 1.L: 02am 1 of 1 OR BK 5399 PG 543 6. Lender: Name Address , City State 7. Persons within the State of Florida designated by Owner upon whcm notices or other documents may be served as provided by Section 7lJ.IJ( 1) (a) (7), f'lorida Statutes: tJ,;mc Address City State 8. In addition to hims€'lf, Owner designates of to receive a copy of t~e Lienor's Notlce as provlded in Section 71J.IJ(1)(b), Florida Statute~. <). fxp..i.rn1 .1"11 dnte n! tICJt..i.ce of Commencement (t.he explrat.i.un d.::.te Is 1 year ir~m the ~Qte of recording unless a different date is specified.) " C":"J!.e.<Li.L (, ...----..... --7c&L ~-Vh.L.~~~ ~ ~_ V /--" ((:.'7~day of' J (1/7 p , J s..i.~of Owner: Sworn to and subscribed before me this ~\ ~) ;' 17"- 20 \..- _" Not~ry Public: CCefz'-f;J1J My C :):-;1,;11 S s ion Expires: _ ....EoNX.jljci<ElT ~ Commiaaion. 000117321 PC93053048/A iWiJ~ ~ 611<fJ2000 ~ Bonded tIwugh (IIOCH>>e4 Florida ~ Aun.. Ina. ~U6 Cc.n"'-~'- r ]4<"'\c!'S' <>O....M;Sj"J7', (~13) 62(;.-7'7CtCI CITY OF ZEPHYRHILLS PERMIT APPLICATION BUILDING DEPARTMENT 5335 8~ Street, Zephyrhills, FL 33542 813-780-0020 FAX:813-780-0021 (p - f- 0 3 DATE RECEIVED PLANS REVIEW FEE . OWNER'S NAME 6:m f-:e. a.ve !'>.br,.,..""]T - 2rL'lherh./If', LLC , I' PHONE (-1?''-J) S;; 52 - e; (t,o / JOB ADDRESS 7707 0., /I /5/,,). 2c /.7),u h: I k f Fi. S3s-4o LEGAL DESCRIPTION: LOT(S) tJ03CJ BLOCK 000 c C-' SUBDIVISION 0116 PARCEL 10 # 3Lj 2-7" 'Z I (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPS ED: 0 NEW CONSTRUCTION UJ.-1\1) 0 I TI ON DALTERATION o REPAIR o INSTALL DSIGN o MOVE o DEMOLISH PROPOSED USE: DSGL FAMILY DWELLING UJCOMMERCIAL DMULTI-FAMILY o INDUSTRIAL 0# OF UNITS o SWIMMING POOL o MOBILE HOME o OTHER c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL DESCRIPTION OF WORK .J: rl-t e ,.; c' -- h',,.,. s 1-, BUILDING SIZE SQUARE FOOTAGE 2 70<; ~ HEIGHT RESIDENTIAL: COMMERCIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS, PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REQUESTED Q--IrUILDING G:V'ELECTRICAL o PLUMBING f/A- o MECHANICAL $ 7S-: ;"-00 , VALUATION OF TOTAL CONSTRUCTION '200 AMP SERVICE o FLORIDA POWER o W.R.E.C. $ f\J//t VALUATION OF MECHANCIAL INSTALLATION o GAS o ROOFING o SPECIALTY o OTHER TYPE OF CONSTRUCTION: 0 BLOCK ~RAME o STEEL o OTHER FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREAD YES @-"NO SIGNATURE 5e ~ p~':Jc '2 COMPANY · {] ~~ STATE CERT OR REGIST l~ __ ~ CITY PROCESSING # ~********** **************************************************** BUILDER ELECTRICIAN SIGNATURE 7e<-ro.L COMPANY STATE CERT OR RE~ CITY PROCESSING # V ****************************************************************** PLUMBER COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE MECHANICAL ****************************************************************** T h~ '~D+f':"'- h SIGNATUR~ ~ COMPANY I ' ~ STATE eERT OR REGIST I CITY PROCESSINVOI' ****** **********************************************~~********** OTHER COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE **********************************************************'******* CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this permit may be subject to "deed restrictionsff which may be more restrictive than City regulations. The undersigned assumes responsibility for compliance with ~ny applicable deed restrictions, B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they may be, required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the intended work, they are advised to contact the City of Zephyrhills Building Department, 813-788-6611. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the "Contractor Sectionsff of this application for which they will be responsible. If you, as the owner signs as the contractor, you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign as contractor that may be an indication that he is not properly licensed and is not entitled to permitting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTUION LIEN LAW (CHAPTER 7131, 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 Guideff prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other that the "ownerff, I cerify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "ownerff prior to commencement, E, CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning, and land development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, City codes, zoning regulations, and land 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 Sensitive Lands, Water/Wastewater Treatment *Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses *Army Corps of Engineers-Seawalls, Docks, Navigable Waterways *Department of Health & Rehabilitative Services, Environmental Health Unit-Wells, Wastewater Treatment, Septic Tanks *U.S. Environmental Protection Agency-Asbestos abatement I also certify that, if fill material is to be used in Flood Zone "Aff or "A,etc.ff, it is understood that a drainage plan addressing a "compensating volumeff will be submitted which is prepared by a professional engineer registered in the State of Florida prior to permit issuance. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction, or violations of any code. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of issuance, or if work authorized by the permit is suspended or abandpned 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 RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENTff. SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR acknowledged 2Q_ STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowle1med Before me this _day of ,_ by (name of person acknowledged) [tho is personally known to me, or STATE OF FLORIDA COUNTY Of The foregoing instrument was Before me this _ day of by (name of person acknowledged) Dwho is personally known to me, or of identification) take an oath. Dwho has produced (type of identification) and who Ddid Diid not take an oath Dwho has produced (type and whoD did 0 did not Signature of person taking acknowledgement Signature of person taking acknowledgment Name typed, printed or stamped Name typed, printed or stamped - Smith Hudson Interiors 7707 Gall Blvd. SQ. FEET PRICE MAIN OR LIVING: $ 50.00 OTHER AREA UNDER ROOF: - $ 25,00 OTHER: - $ - VALUATION $ 75,000.00 FEE SHEET $ 380.00 ADDRESS $ - DRIVEWAY $ - $ - BUILDING: $ 570.00 CREDIT: $ - BUILDING LESS CREDIT: $ 570.00 ELECTRICAL: $ 64.40 PLUMBING: $ - MECHANICAL: $ 35,00 RADON: $ - TOTAL $ 669.40 SEWER: $ - WATER: $ - IRRIGATION: $ - TOTAL: $ - I I I I I WATER METER:I $ IRRIGATION METER $ ~ I SUB-TOTAL $ 669.40 I SIPS'I $ 97,5% $ 2.5% $ - I - I TIF'Sr 99% $ 1% $ TOTAL: $ 669.40 I PASCO COUNTY BUILDING PERMIT APPLICATION CENTRAL PERMITTING OFFICES: SHADED AREAS FOR OFFICE USE ONLY · Dade City: (352) 521-5144 FAX (352) 521 NCY: ~., SEa,. 13852 17th St.. Oade City . e New Port Richey: (72n 847-8126 FAX (7 NITS: / 7530 Little Rd.. Rm. 210 New Port Richey TRICT: eland O'lakes: (813) 929-1266 FAX (813) NSTRUCTION 4111 land O'lakes Blvd. (US 41), land THIS APPUCATlON MUST BE TYPEO OR CEIVED: AND IS VOID IF NOT PERMITTED WITHIN . --- ... - _I IS nflSAPPLiCATiONTHE-RESULr-OFA-srOPwoRKORoEiiciiiNoiice-OF-vioLATiON?-----y-=-NZ------------. 6 DWNER'S NJ.Md~/:f:i!;';;{l:.J:7~~~f;/-L{' .. PHONE I (!t.:2:i.1 5:.3;), .. qfoo I 9 JOB LOCATION: - - - ___ _..........k_ ,---=--- ---~~5$t<sUBDIVISION: ~ PARCElIDl:Sa T ~ R.il..L SU~ BLK = lOT ~PRDJECT' TAl -lDTSIZE _X_ !Ii! OWNER'S PRESENT ADllAESS:.to 5b U. rk III e- oJ i'I/II7/eDP. Cf1Y. n: lilli """'/>oLe- STAlE: p,~ ZlP: :'\"- 'Vol :: o FEE SIMPLE TITLEHOLDER'S NAME M other than OWner): address (if applicable): CITY: STATE: ZIP: ---------------------------------------------------------------------------------------------------------- DESCRIPTlON OF WORK: J..M h /)~ If}--i- 6AYlod~--R 6 LMNG ARfA PATIO: .. GARAGE; ENTR'f TOTAl UNDER ROOF: 9 # BEDROOMS -# BATHROOMS --2-. _ TYPE CONSTRUCTION: 0 BLOCK . FRAME 0 OTHER: ClJ FILL Y _ N -"" ~ IF MOBILE HOME OR RV: MAKE YEAR SIZE i= ~ a: WORK CODE u CI) w o PERMIT#: II III IV BY: &l VI FEES BLOCK PLANS ON FILE? 0 NO 0 YES MODEL NAME PRE.PAlD PLANS FEES: $ PLANS FEE: $ VALUATION $ "75; 5'60 RECEIPT #: BO;;D,NG-COMPANy~----~~~-------------------------------________________________ ::.:: ADDRESS: CITY: STATE: _ ZIP: u o cS ARCHITECT/ENGINEER: Tilt..- E~;/\j fr'O<J/) a:w ADDRESS: /40' AI. ~Aa ~,.;. ~ol CITY: T...""", , j: o MORTGAGE LENDER:_ ADDRESS: . BUILDING: $ STATE: f:1:.... ZIP: '3 '? ~o"/ ---------_u__________________________.._._________________________________________ CITY: STATE: _ ZIP: CONTRACTO~-. ~ Q Ii i ~()R<;, //1/c.., SIGNATURE:~ . ~ -' ~i ~ PHONE I I m.. I M&r ? ? 09 >< AllORESS,5, . . -:... ,,-:_ -. _ CITY. ~A STAlE: L:L ZlP: 3a!,,/() g STATE UC, Qf applicable) C!..6eO'l-Q5'02S1. PASCO CO COMPUTER 10': q;yq tl- cS TG~ If-.cscn g ELECTRICAL~TRAC~~ ~k'k'.' /IV C. (,J SIGNATURE:.. ' ] ~~ PHONE' ( ~ l q3 s - ~Cft/.J g ADDRESS: -...: - CITY. 'Tt2rl-# nq . ST.IIE::€k. ZlP: 33&, oq ~ STAT< UC I ~, ~~ E C anI? R tJ. . MScO Cl} cOMPIITER Ill#: I;?t? aPAI , U POWER CO: .!i.fL!:. SAWPOlf;~ AMPS: ~ fb ( ') Aobe;,,+ Mv....,.",/, MECHANICAL CONTRACTOR: SIGNATURE: ADDRESS: /' STATE UC , Of apPicablel_ o NEW 0 ALTERATION VALUATION: $ ELECTRICAL FEE: $ PHONE' (_I CITY: - ,..------r---' STATE: ...... PASCO CO COMPUTER 101: _ (Requiredl MECHANICAL FEE: $ . ~ ZIP: PlUMBING CONTRACTOR: ' SIGNATURE: ADDRESS: ~ STATE UC I Of applicable) , , FIXTURES: SEPnC PER , - PHONE' I_)~ CFrf. ... srA~ :.. ZIP: , PASCo CO COMPUTER 101: SEWER: WATER: PLUMBING FEE: $~ ....... - .. -'-.~~'" ('. ~, ..10 t\~~:. ,-;,;,..:-.....;.,.;1,..':-..":.,.; ..; WBJ.: ........ti-.,..", . . .. ...,.. ''''~''''e''''''',(:' OniER CONTRACTOR: . ...... C!~ PHONE' ( _ ) ~ '" :l\g~ CI'TY: STATE: _ ZIP: .~ ~ ~~1.u Of applicable) PASCO CO COMPUTER 101: ;~ '; '~O CTOR: VALUATION: S ~ ~ ~ ~;;;---u-----------~;-----____--------~;----u---------u__ RADON \ ~1t~iL--~-----------------------_________________________________________________ ~ ~.. .: ~.' .. il... N' $2,SOO IN VALUE DO NOT NEED TO TO. T., 'A.. L B. UILDING PER. MIT. F EE:..' ": 2.1JlPlIl POST A "NOTICE OF COMMENCa.1eNr ,...,.. ."""! \ ~;,: :-;.... . !.. ".. ." .. :. ~-,:\ ! : .-,:..-, t IIOTHTHEDWNER-CD~~~.~~.1lEAo.. ~~.:i::: I 'i .''''''':~ SIGN THE REVERsE SlOE Of TIIS W'~i_..:J~;:.:.::.::' ........:;..;... ......., ..~ """" ~ Of- RlAII AaEAsED 1lERlA~ 1/91 -~~ AND I\lU NOr !IF.""..,.." ov.......... _._.___ ~ OIHER BLDG. FEE: ''J~.-, ~:-: ,~',..;:~ $"''' $.~' "$, A ~jOTICE OF DEED RESTRICTIONS The unaerslgnea unaerstana that this oermlt may oe suolect to "deea restrictions' which may be more restrictive than County regulations. The unaerSlgnea assumes responsibility for compliance with any applicable aeea restrictions, : B. UNLICENSED CONTRACTORS AND >:CNTRACTm:L8~SPONSI81L1TjE~ If the owner has hlrea a contractor or contractors to;il~ake worK. they may oereoulr'P:p, e IIcensea In accoraance with state and loeal regu' lations, If the contractor IS not licensed as requlrea by I~,' both tM"lf ancwtl1!ract~r fA be Cited for a miSdemeanor VIolation under state law, It the owner or Intended contractor are uncertain a .' P tJ~at licenSing reauT?e-iWmls ~ ply for the Intenaea work, they are adVised to contact the Pasco County BUilding DIvIsion. LicenSing ~tfon at 1727) 847-8009, ,.i::,j tj '.;,:.;.........................~.....- Furthermore. It the owner has nlrea a contractor or contrlctors. ne IS aavlsea to have the COnt ctonsl sign portions OT the "contractor Block" at :nlS aOOllcatlOn tor wnlch they will be responSible. It vou\..a.Ul.:! ....,""" ~~" as me contractor, you are Inaleatlng tnat YOU, rather than the contrac. tor, are responslOle tor the WOrK. It the c::lntractor wlsnes you to sign as contractor. that may De an Inalcatlon tnat he IS not properly Iicensea ana IS not entltlea to permitting prlVlieges In Pasco County, C. TRANSPORTATION IMPACT/UTILlTIES IMPACT AND RESOURCE RECOVERY FEES The unaerSlgned understand that Transportation Impact Fees ana Resource Recovery Fees may apply to the construction (It new buildings, change ot use In eXisting buildings, or expansion ot eXisting buddlngs, as specified In Pasco County Ordinance numbers 89-07 and 90-07, as amenaea, The unaerSlgned also understands, that such fees, as may be aue, wlil be Identified at the lime 01 permitting, It IS further understooa that Transportation Impact Fees and Resource Recovery Fees must be paid pnor to receIVIng a "certificate of occupancy" or final power release. If the prOlect aoes not Involve a certificate ot occupancy or final power release. the fees must be paid pnor to oermn issuance. Furthermore, It Pasco County Water/Sewer Impact fees are aue. they must be palo prior to permit Issuance. In accoraance WHh applicable Pasco County ordi- nances. D. CONSTRUCTION LIEN LAW (Chapter i' 13, FlOrida Statutes, as amended) .~ If valualion ot work IS $2500,00 or more, I certify that I. the applicant. have been prOVided With a copy at "FlOrida Ccnstructlon Uen Law _ Homeowner's Protection gUide" prepared by the Flonda Department of Agnculture and Consumer AffairS. It the applicant IS someone other than the "owner," I certify that I have obtained a copy of the above descnbed document and promise In gOOd faith to deliver It to the .owner" prior to commencement, E, CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the Information In thiS application IS accurate ana that all worK Will oe aone In compliance With all applicable laws regulating con. structlon, zOning and land development, Application IS hereby maae to obtain a oermlt tel do worK ana Installation as Inalcatea. I certoly "hat no work or Installation has commenaea pnor to Issuance ot a permit ana that all WorK WIll be oertormea to meet stanaaras ot all laws reJjat''lg constnctlon. COUllty codes. zOning reg- ulations, ana land development regulatlo"!') In the lunsalctlon. I also certify that I understand that ttle regulations of other government agencies may apply to the Intended work, and that IT IS my responSibility to Identify what actions t must take to be In compliance. SuCh agencies include but are not limited to: , · Oeoartment at EnVIronmental Protectton - Cypress Bayt.e"as, We.lana Areas and Environmentally SenSitive Lan':Js, WaterlWastewater Treatment, · Southwest Florida Water Manaaemellt District. We!!e;, :Yl:'res~ Bavheaas, Wetlana Areas. Altenng Watercources, · Armv COrDS of Enarneers .. Seawalls. DOCKS. NaVIgable Waterways, · Deoartment ot Health &. Rehabilitative Services EnVIronmental Health Untt ' Wells, Wastewater Treatment, Septic Tanks, · US EnVIronmental Protection Aaencv . Asbestos abatement. . Federal Aviation Authorltv . Runways, I understand that the follOWing restnctlons apply .el tt't'! use of fill: · Use of fill is not allowed In Flood Zone "V" unless expressly permitted. · If fill material IS to be used In FlOOd Zone "A" it IS understood that a drainage plan aadresslng a "compensating volume" will be submitted at time of permitting which IS prepared by a profeSSional engineer licensed by the State of Florida, · If fill matenal is to be used In Flood Zone "A" in connection With a permitted building uSing stem wall construction, I certify that fill will be used only to fill the area Within the stem wall. · If fill matenalls to be used in any area, I certify that use of such fill will not adversely affect ad,acent properties, If use of fill is found to adversely affect adjacent properties. the owner may be Cited for VIolating the conaltlons of the building permit ISSUed under the attached permit application, for lots less than one (1) acre which are elevated by fill, an engineered drainage plan IS reqUired, If I am the AGENT FOR THE OWNER. I promise In good faith to Infonn the owner 01 the pennltting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be reqUired for electncal work, plumbing, signs, wells, pools. air conditioning, gas. or other installations not specifically included in the application, 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 proVI- SIOnS of the technical codes, nor shall issuance of a pennlt prevent thll Buildin;J Official from thereafter iequ:ring a correction of errors In plans, construction, or Violations of any codes, Every pennrt issued shall become Invalid unless the work authorized by suc~ permit is C~ed within $IX months of permIt 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. An extension may be requested. in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate Justifiable cause for the extenSion, If work ceases for ninety (90) consecutive days. the lob is considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE 01= r:OMM':NCEMENT MAY RESULT IN YOUR PAYING lWlCE FO IMPROVEMENTS TO YOUR PROPERTY, IF YOU INTEND TO OBTAIN r=INANCING, CONSULT WITH YOUR LENDER OR AN /Ii. BEFORE RDING YOUR NOTICE OF COMMENCEMENT. ~l .... " ,II' .' . ., J SIGNATURE SIGNATURE ~~ ~.. s;'l!'~R~.,~&J.j ...00 CTOR DATE 6 / ~~0 DATE~1<<- 4. avos I /' /:'\' .'/<' .." NOTARY? TO ~. ERO I?GE 5' ILl h , Y COMMISSION EXPIRES ~~~~MISSION '77tw8 '-1 ,ROO~;- 06/0.~V03 11:51 AMSCOT FINANCIAL CORPORATE ~ 83139291907 NO. 007 [;102 r " AGREEMENT OF LEASE THIS AGREEMENT OF LEASE made and entered into as of the Lease Date by and between Landlord 3J:),d Tenant. SECTION 1 Basic Lease Provisions 1.01 The following basic lease provisions aTe an integral part oftrus Lease and as referred to il1 other Sections of this Lease, Lease Date: March2 , 2003 (a) (b) (c) (d) Landlord: Frontier Development. Zeph}Thills, LLC Tenant: Amscot Corporation Tenant's Address: 600N. West Shore Drive Suite 120.0. Tampa, Florida 3360.9-1117 (or such other address as Tenant shall designate from time to time by notice to Landlord), (e) Demised Premises: The portion of the building in the Center which is outlined in red on the Plot Plan attached hereto as Exhibit "A." The Demised Premises contains approximately two tho'usand seven hundred twenty (2,720) square feet of Hoor area (which floor area i.s detenni.ned by measuring from the exterior face of exterior walls and from the center of in.terior or pany walls). The dimensions of the Demised Premises shall be approximately thiny- two (32) feet by el'~ty.five (85) feet. The dimensions ofthe Demised Premises and location of the Demised Premises in the Center are approximate. The Dem.ised Premises are located within the Center, and the Center is located on Highway #301, Zephyrhills, Pasco COlmty, Florida. (f) Term: The period beginning on the Rent Commencement Date and continuing for ten (10) years following the Rent Commencement Date (plus the partial month, if the Rent Commencement Date is other than the first (1st) day of a month), (g) MonthlY Rental: Tenant shall pay Landlord during the Term and the Renewal Terms (if exercised) the minimum monthly rent at the following rates: ,OSC:9\ ]67 S,SIFROOS 1.21 3045 1216/~4/1213 11:51 AMSCOT FINANCIAL CORPORATE ~ 8313929191217 NO. 1211217 [;11213 Period Rate of Monthly Rent From the Rent Commencement Date through the end of the 60th $4,306.67 full calendar month thereafter. From the 61 st full calendar month after the Rent Commencement $4,952,67 Date through the end oftbe 120th full calendar month thereafter, From the 121st fun calendar month after the Rent Commencement $5,695.57 Date through the end of the 180th full calendar month thereafter, From the 181st full calendar month after the Rent Commencement $6,549.90 Date through the end of the 240th full calendar mOl1ththereafter. From the 241st full calendar month after the Rent Commencement $7,532.39 Date through. the end of the 300th full calendar month thereafter. from the 301st full calendar month after the Rent Commencement $8,662.24 Date through the end of the 360th ful.l calendar month thereafter. (h) Secl.\rity Deoosit: and 34/100 Cents ($8,613.34) Ei ght Thousand Six HLmdred and Thirteen Dollar,s (i) Trade Name: Amscot (;) per day. SQecial Minimum Hours: Not less than five (5) days per week, eight (8) hours (k) (1) Gu,arantor: None Broker: None (m) Authorized Use: Tenant shall use the Demised Premises solely for the operation of a check cashing business, automated check cashing machines, money order sales, internet services, deferred deposit transactions, pay day or cash advance services, wire transfers, income tax preparation services, electronic filing of income taxes, refund anticipation loans, consumer loans, and other banking and financial related services, and related general office/professional services. SECTION 2 Defined Terms "Calendar Year" shall mean each calendar year wholly or partially within the Term. "Common Area Maintenance Expenses" sball include all costs, expenses and expenditures (inClUding capital expenses) of operating and maintaining the Common Areas and the Center in a manner commonly operated and maintained by landlords in similarly situated shopping centers in (he Tampa, Florida metropolitan area, including: all costs and expenditures incurred in repairing, lighting, cleaning, painting, striping, surfacing and resurfacing, policing and providing security services; the costs and expenditures of insurance; the costs and expenditures of removal ofsnow# ice, rubbish, and debris; the costs and expenditures of regulating traffic; the costs and expenditures of the replacement of paving, curbs, walkways, 05lC':'Q I '67~ ~/Fa()O"l_' 1104<; - 2 - 1216/1214/1213 11:51 AMSC?T FINANCIAL CORPORATE ~ 8313929191217 , NO,I2I1217 [;11214 landscaping, drainage and lighting facilities; the costs and expenditures for legal and accounting services, and for other professional and consulting services; the costs and expenditures for Utilities; the costs and expenditures of planting, replanting, and replacing flowers and shrubbery; lhe costs and expenditures, including counsel and appraisal fees, incurred in connection with any appeals of any Taxes; management fees paid by Landlord in an amount that is typically charged by management agents in connection with similarly situated shopping centers in the Tampa, Florida metropolitan area; and costs associated with any restrictive covenant or Recorded Agreements. Common Area Maintenance Expenses shall not include the cost of constructing any Common Areas, interest on any borrowed flmds, costs reimbursed or to be reimbursed by insora11Ce, or costs covered by warranties. Notwithstanding the above, Common Area Maintenance Expenses shall not include: (a) Costs ofTepairs, restoration, replacements or other work occasioned by fire, windstorm or other casualty to the extent covered by insurance; (b) Costs, disbursements and other expenses incurred solely in connection with other tenants, other occupants, or prospective tenants or OCCl\pants ofthe Center, or costs, disbursement or other disbursements incurred in connection with purchases, mortgagees, ground lessors or lenders of the Center, including without limitation payment of any indebtedness or disputes in connection with the foregoing; (c) Costs of the initial construction of the Center and the tenant improvements; (d) Direct costs incurred in. connection with sales, financing, refinancing, mortgaging, selling or change of ownership of the Center, including brokerage commissions, attorneys' and accountants' fees, closing costs, title insurance premiums, transfer taxes, and interest charges; (e) Costs, fines, interest, penalties, legal fees or costs of litigation incurred due to the late payments of taxes, utility bills and other costs incurred by Landlord's failure to make such payments when due provided such costs are not caused by Tenant, its agents, pennittees or licensees acts or omission; (f) Costs of a capital nature not amortized over its useful life in accordance with generally accepted accountil'l.g principles; and (g) administrative fees to Landlord. "Cost ofInsurance on the Center" shall be the sum of all premiums payable under all policies of insurance carried by Landlord in connection with the Center or which cover anyone or more ofthe bllildings or other jmprovements in the Center, including but not limited to terrorism insurance and insurance against acts of war to the extent such policies are held by Landlord and which are typically obtained by landlords in similarly situated shopping centers in the Tampa, Florida metropolitan area, and the costs incurred by landlord to repair any damage by fire or other casualty to the Center, to the extent that such cost was not covered by Landlord's insurance policies by reason of deductible amounts set forth therein, In the event that Landlord shall, at any time during' the Tem, insure the Center or any part thereof or any buildings or improvements therein under a "package policy" or a policy of "blanket coverage" insuring other property not in the Center in addition thereto, the amount of the premiums payable under such policy which are attributable to the Center an.d the buildings and improvements therein shall be determined by Landlord on an equitable basis and such amount shall be included in the Cost of Insurance on the Center for the purposes hereof, "Cen.ter" shall mean the entire parcel ofland which is outlined in blue on Exhibit "A" hereto, '1 06/04/03 11:51 AMSCOT FINANCIAL CORPORATE ~ 83139291907 NO. 007 Gl05 "Common Areas" shall mean all of the automobile parking areas, driveways, and footways, landscaped areas, loading facilities and other areas and facilities in the Center which are designated as Common Areas from time to time by Landlord and which are available for use in common by all Tenant's at the Center. "Delivery Date" shall mean the date Landlord's Work (as defined in Section 6,1 hereof) is substantially complete and Landlord notifies Tenant that the Demised Premises are ready for the commencement of Tenant's Work. Landlord agrees to give Tenant thirty (30) days advance notice of the occurrence of the Delivery Date to allow Tenant to prepare to commence the Tenant's Work. "Effective Rate" shall mean the rate per annum which is the lesser of: (a) three hundred (300) basis points in excess of the Prime Rate of Interest announced from time to time by Citibank, N.A. or (b) the maximum rate permitted by law. "Environmental Statutes" shall mean all Laws concerning the protection of public safety or the environment, whether local state or federal, including, but not limited to, (a) Federal Clean Air Act, 42 V.S.C. 91857 et seq.; (b) Federal Water Pollution Act, 33 U.S.C, ~ 1151, et seq.; (c) Resource Conservation and Recovery Act of 1976,42 U.S,C. ~6901, et seq,; (d) Comprehen.sive Environmental Response, Compensation and Liability Act, 42 U.S.C, ~9601, et seq.; (e) Federal Clean Water Act, 33 U.S,C. ~1251, et seq.; (f) Toxic Substances Control Act, 15 U.S,c. 92301, et seq.; and (g) Florida Air and Water Pollution Act, Chapter 403, Florida Statutes, as each shall be amended from time to time and those relating to the generation, use, handling, treatment, storage, transportation, release, emissi.on, disposal, remediation or presence of any material including Solid Waste, Hazardous Waste, Hazardous Substances or Hazardous Materials, as each shall be amended from time to time. "Governmental Authorities" shall mean all federal, state, and municipal governmental entities and all departments, commissions, boards and officers thereof. "Hazardous Substances," Solid Waste." "Hazardous 'Waste" and "Hazard.olls Materials" will have the meanings defined in any Environmental Statute," and shall in this Lease collectively be called "Hazardous Substances" and which shall include, without linlitation, any toxic waste, chemical pollutant, solid waste, combination of solid waste, or similar environmental hazard, which, because of its quantity, concentration, or physical, chemical or i.nfectious characteristics may cause or significantly contribute to (1) an increase in mortality, (ii) an irreversi.ble or incapacitating illness, or (iii) a s'ubstantial, present, or potential hazard to human health or the environment, when improperly treated, stored, transported or disposed, or otherwise managed, whether at such time of occurrence, it shall be deemed a violation of any Law. "Landlord's Address for Notices" shall mean the following address, or such other address as Landlord shall designate from time to time by notice to Tenant: DSC: 91367 5.5/FROOSI ,213045 - 4- 06A~14/03 11:51 AMSCOT FINANCIAL CORPORATE ~ 83139291907 NO. 007 [;106 } c/o Frontier Development LLC 10 S. New River Drive Suite 104 Fort Lauderdale, FL 33301 Attention: Real Estate Manager "Landlord's Address for Payment" shall mean the following address, or such other address as Landlord shall designate from time to time by notice to Tenant: c/o Frontier Development LLC 10 S. New River Drive, Suite 104 Fort Lauderdale, FL 33301 Attention: Chief Financial Officer "Landlord's Work" shall mean the work to be completed by Landlord as described in Section 6.01. "Laws" shall mean all federal, state, and municipal statutes, ordinances, regulations, orders, directives and other requirements of law or common law and of all departments, commissions, boards and officers of Govemmental Authorities (as amended from time to time). "Lease" shall mean this Agreement of Lease. "Minimum Hours" shall mean no less than the Special MinimumHours. "Mortgage" shall mean any institutional mortgage, deed of trust, security deed or similar seeuri ty instrument encumbering the Demised Premises. "Recorded Agreements" shall mean all agreements, covenams, easements, restrictions or other matters now of record or hereafter placed of record; provided, however, Landlord shall not execute or join in any future agreements, covenants, easements or restrictions that will materially and adversely affect Tenant's Authorized Use on the Premises, nor shall Landlord execute or join in any future agreements, covenants, easements or restrictions whereby any amounts to be paid pursua'''t to such recorded agreement shall be payable to Landlord or an affiliate of Landlord. "ReClt" shall mean all Monthly Rental, additional rent and other sums payable by Tenant under this Lease. "Rent Commencement Date" shall mean the earlier of the following dates: (i) the date which is sixty (60) days after the Delivery Date, or (ii) the date (.In which the Tenant shall first open the Demised Premises for business with the public, "Tax;es" shall mean: (a) All levies, taxes (including payments required to be made in lieu oftaxes), assessments, charges, liens, Ii~enses and permit fees, and charges for public utilities, imposed, DSC:91 J67's,$/FR0051-2l3045 - 5 - 06/12l4/03 11:51 AMSCOT FINANCIAL CORPORATE ~ 83139291907 NO, 007 Gl07 ~ assessed or charged on or with respect to Landlord or the Demised Premises or the Center by any Governmental Authority or under any Law or Recorded Agreement; and (b) All other charges, imposts or burdens of whatsoever kind and nature, whether or not particularized by name and whether general or special, ordinary or extraordinary, foreseen or unforeseen, which at any time during the Term may be created, levied, assessed, imposed or charged upon or with respect to the Demised Premises, the Center, or any improvements made thereto, or on any part of the foregoing or any appurtenances thereto, or directly upon this Lease or the Rent, or amounts 'payable by any subtenant or other occupants of the Demised Premises or the Center, or upon or with respect to the leasing, operation, use or occupancy of the Demised Premises or the Center, or upon this transaction or an.y documents to which Tenant is a pany or successor in interest, or again.st Landlord because of Landlord's estate or interest herein, by any Governmental Authority, or Wlder any Law, including, among olhers, all special tax bills and general, special or other assessments and liens or charges made on local or general improvements or under any governmental or public power or authority whatsoever, and transit ta.xes, taxes based upon the receipt of Rent including gross receipts or sales taxes applicable to the receipt of Rent, and personal property taxes imposed upon the fixtures, machinery, equipment, apparatus, furniture and other personal property used in connection with the Demised Premi.ses and/or the Center. The term "Taxes" shall not include any net income or excess profits taxes assessed aga,inst Landlord, or any corporation capital stock and franchise taxes imposed upon Landlord; provided, however, that, iJ at any time prior to the expiration of the Tenn, any net income tax, assessment, levy or charge shall be imposed upon Landlord or the Demised Premises or the Center in lieu of, in place of, or in addition to any other tax or other charge included in the definition of Taxes set forth above, and shall be measured by or based upon net income or pr.ofits derived from real estate (as distinguished from net income or profits generally), then such new tax, assessment, levy or charge shall be included in "Taxes" to the extent that such new tax, assessment, levy or charge would be payable if the Center were the only property of Landlord subject thereto and the income and profits received by Landlord from the Center were the only income and profits of Landlord. Notwithstanding the above, the term "Taxes" shall n.ot include any assessments paid pursuant to Recorded Agreements that are for the benefit of Landlord or any su.bsidiary, parent or affiliate of Landlord. "Tenant's Pro Rata Share" shall mean a fraction, the numerator ofwhlch shall be the number of square feet of floor area in the Demised Premises, and the denominator of which shall be the number of square feet of leasable floor area in all buildings in the Center. "Tenant's Pro Rata Share of Common Area Maintenance Expenses" for each Calendar Year shall be equal to th.e total amount of the Common Area Maintenance Expenses for such Calendar Year multiplied by Tenant's Pro Rata Share. "Tenant's Pro Rata Share of Insurance" for each Calendar Year shall be equal to the total amount of the Cost of Insurance on the Center for such Calendar Year multiplied by Ten~t's Pro Rata Share. "Tenant's Pro Rata Share ofTaxes"Jor each Calendar Year shall be equal to the total amount of Taxes for such Calendar Year multiplied by the Tenant's Pro Rata Share. I"\O;:(,,'QI~h'" ~/"It{)n<;I,?nn,,~ - 6 - 1216/1214/1213 11:51 AMSCOT FINANCIAL CORPORATE ~ 83139291907 NO. 007 [;108 j. "Tenant's Work" shall mean the work to be completed by Tenant as described in Sections 6.02 and 6.03. "Utilities" shall mean heat, sewer, water, electricity, and any other \.ltilities provided to, or used or consumed in or on the Demised Premises. SECTION 3 Grant Terms 3.01 Grant. (a) Landlord hereby leases the Demised Premises to Tenant; and Tenant hereby rents the Demised Premises from Landlord, (b) In addition, Tenant shall have the non-exclusive right to use the Common Areas, in common with all others designated from time to time by Landlord as being entitled to such use; subject, however, (0 the tenns and conditions of this Lease and to rules and regulations for the use thereof as prescribed from time to time by Landlord. Landlord may at any time: withdraw or add areas (0 the Common Areas and/or the Center; alter the Common Areas and/or the Center; construct or remove buildings or other improvements upon or from the Common Areas and/or the Center; and grant easements within the Common Areas and/or the Center (provided that at all times adequate parking facilities are available for common use, and. visibility to the Demised Premises is not obstructed in a material and substantial manner). 3.02 Term. The Tenn shall commen.ce on the Rent Commencement Date and shall continue for the Term, The Term shall end on the final day thereof without the requirement of notjce from either party to the other. 3.03 Term Extension Options, Provided that Tenant is not in default hereunder beyond any applicable notice and cure period at the time of exercise, that Tenant has not been in default hereunder beyond any applicable notice and cure period during the preceding twenty-four (24) months and that the original Tenant hereunder has not assigned this Lease or sublet the Demised Premises, Tenant shall have and is hereby granted two (2) separate options to extend the Tenn upon the terms, covenants, conditions and provisions set forth herein for two (2) periods often (10) years each (each a "Renewal Term"); provid.ed that at the time an option to renew is exercised, the Term shall be in effect. Such options. shall be deemed exercised by Tenant unless Tenant gives written notice to Landlord of its intention not to exercise the same at least nine (9) months prior to the expiration of the then current Term, Provided Landlord has not received notice from Ten3JJ.t of its intention not to exercise the renewal option, and provided that Tenant shaH then have the right to exercise such option, the Tem shall be extended in accordance with the provisions hereof, without the necessity of any further act or documentation by Landlord or Tenant. Landlord may request, in writing, that Tenant confinn its intent to exercise its renewal option, which Tenant shall confirm, in writing, within twenty (20) days of Landlord's request, otherwise Tenant shall be deemed to have exercised its renewal option. In no event shall Tenant have any right or option to extend or renew the Term beyond twenty (20) years from the expiration date of the original Term set forth herein, In the event any such extension or renewal. option fails to Occur in the manner aforesaid (regardless of whether such failure shall be a result DSC:913675.5/FROOS 1-21 :1045 -7- 06/04/03 11:51 AMSCOT FINANCIAL CORPORATE ~ 83139291907 NO. 007 [;109 of Tenant"s not having the right to exercise such option), then this right and option shall tenninate and be null and void without the necessity of any further act or documentation by Landlord or Tenant, and the Term shall terminate in accordance with the provisions set forth elsewhere herein. 3.04 Memorandum of Lease. Ifrequested by Landlord, Tenant agrees to execute a Memorandum of Lease, Landlord shall prepare and may record the Memorandum, whereupon Landlord stlall pay all costs, fees, taxes and other expenses of executing, d.elivering and recording the Memorandum. Tenant agrees not to record this Lease, SECTION 4 RENT ,. 4.01 Monthlv Rental. Tenant shall pay the Monthly Rental to Landlord during the Term. Tenant shall pay to Landlord a pro rata part of the Monthly Rental for the partial month, if any, immediately following the Rent Commencement Date. The payment for the fractional month, ifany, and for the first (1 st) full month of the Tenn, shall be due and payable on the Rent Com.men.cement Date, and the subsequent installments of Monthly Rental shall be due and payable on the first (lst) day of each month thereafter, commencing with the first (Ist) day of the first (1 st) full month after the Rent Commencement Date, 4.02 Pro Rata Share of Common Area Maintenance Exoenses. Taxes and Insurance. Commencing on the Rent Commencement Date, Tenant shall pay to Landlord throughout the Term, as additional rent, for each Calendar Year, upon presentation by Landlord to Tenant of a bill(s) therefore: (a) Tenant's Pro Rata Share of Common Area Majntenance Expenses; (b) Tenant's Pro Rata Share of Taxes; and (c) Tenant's Pro Rata Share ofInsurance. 4.03 Installments. Tenant shall pay to Landlord Tenant's Pro Rata Share of Common Area Maintenance Expenses, Tenant's Pro Rata Share of Taxes and/or Tenant's Pro Rata Share of Insurance (collectively, "Share") for any Calendar Year in monthly installments, in the following manner. Landlord may, at any time prior to or during a Calendar Year, submit to Tenant Landlord's reasonable estimate of the Share for such Calendar Year, Such estimate may be revised from time to time during such Calendar Year. If Landlord shall submit to Tenant such estimate, Tenant shall pay the amount of such estimate in equal monthly installments, in advance, on or before the first (1st) day of each calendar month during such Calendar Year so that the full amount of such estimate shall have been paid upon the expiration of such Calendar Year. If Landlord shall collect payments on account of the Share for any Calendar Year monthly, pursuant to this Section, then, within one hundred twenty (120) days following the expiration of such Calendar Year, Landlord shall furnish to Tenant a written statement showi'ng the actual amount of the Share for such Calendar Year and the payments theretofore made by Tenant. If the payments made by Tenant shall exceed the Share, Tenant shall be entitled to a credit for such excess. If the Share shall exceed the payments made by Tenant, Tenant shall pay to Landlord the d.eficiency within thirty (30) days after Landlord shall submit the aforesaid statement to Tenant. 4.04 Payment of Rentals. All Rent shall be paid by Tenant to Landlord at Landlordls Address for Payment, without any right of notice, demand, deduction or set-off III case of no;:r'Ql ~"7~ ""'lH)()'il_' 11()4~ .8- I . Building Permit Application Affidavit ofint~nt I I, ,J;~J ".~"';JJ ~. ,do hereby state that t is building Conrractor . Permit application for 770"1 61 is for a Location L New customer 1/,..r"L....+ c.,r-......." . or is a ~pec unit. I also will have theb~fiding permit apPlicatirn picked up within 30-days of notification that the applicatiGn is Ready. I can be contacted at or S."J "J bj e +._d. Iw.,. ,-,.. ,.... I further under tand that ~~ ' I in order to pick up the application and havel the permit issued I will need, as a minimum, to bring t1e Following: I 1. Deed showing ownership of the lot . . 2. NOC or affidavit required by Section 7~ 3, Florida . Statutes . II , 3. Utility Receipt or where 'applicable the ~eptic Permit from Health Department Signatlire: ~ ~ ..,;:l- Name: C Contractor No.: '- Go Co'1 ., i'" 'Z. 2.. PASCO COUNTY DEVELOPMENT REVIEW DIVISION INTERIOR REMODELlNGS AND ADDITIONS (To be Completed by Contractor) PROJECT: ~O~ ~ CONTROL NO: CONTRACTOR: 4YY1.'.~'. ~ oLhJi;uri~ DATE: EXISTING CONDITIONS SPECIFIC EXISTING BUILDING USE: ELECTRICAL SERVICE SIZE(S): ;;2.q) A-VV\ P NO, EXISTING BATHROOMS: "2- SF BUILDING AREA: 27C1? EXISTING L.P, GAS APPLlCANCES: YES /'No NO, EXISTING PLUMBING FIXTURES: '1. EXISTING MECHANICAL: VCJ' { Existing NC: Existing Heat: Existing Ventilation: Existing Refrigeration: /YES _,,/'{ES ~YES YES NO NO NO .........NO SPECIFIC BUILDING USE: FinCfl'le;",J ScrVI U'S SF BLDG, AREA: '2/0'1 STRUCTURAL CHANGES/ADDITIONS: (\I / II VALUATION: PLUMBING CHANGES/ADDITIONS: IV/A SEPTIC: UT. CO. Number of Bathrooms: Number of Additional Bathrooms: Number of Fixtures to be Changed Out: Number of Additional Fixtures: / h (\ ELECTRICAL CHANGES/ADDITIONS: NTEl!.lot:.. FINISH of Of&:A/ ~HELI AS' tPe:.de (>RII\Ir Change in Service Size(s): _ YES (From _ to ~ Number of Additional Lights: bV Number of Additional Outlets: 45 MECHANICAL CHANGES/ADDITIONS VALUATION: Additional NC: Additional Heat: Additional Ventilation: Existing Refrigeration: YES YES YES YES ~O .L1'JO ~O _/f;[o L.P, GAS CHANGES/ADDIT!ONA: YES ...:::(No (If YES, Separate Per:nit Required) OTHER CURRENTLY ACTIVE BUILDING PERMIT NUMBERS FOR BUILDING: THIS FORM MUST BE COMPLETELY FILLED OUT. THE PLANS WILL NOT BE ACCEPTED WITHOUT ALL ITEMS ADDRESSED. I ACKNOWLEDGE THAT ALL ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF, SIGNATURE fl1J;; 5J DATE: {, /0" /03 . 1/.". David "Hap" Clark, Jr., Building 4111 Land 0' Lakes Blvd" Rm. 205 Land 0' Lakes, FL 34639 (813) 929-1266 FAX (813) 929-1307 /1. ./' 2. ~. /4. tJ/A 5. Nllt 6. West Pasco Government Center 7530 Little Road, Rm. 210 New Port Richey, FL 34654 (727) 847-8126 FAX (727) 847-8901 Dade City 13852 - 17th Street Dade City, FL 33525 (352) 521-5144 FAX (352) 521-5149 COMMERCIAL BUILDING PERMIT APPLICATION CHECK LIST P...ERMIT APPLICATION COMPLETED AND SIGNED IN INK BY GENERAL CONTRACTOR. CORRECT TAX PARCEL 10 NO. ON APPLICATION INCLUDING ADDRESS, CONCURRENCY REVIEW PLAN FEES COLLECTED AT TIME OF SUBMITTING APPLICATION. LICENSED CONTRACTORS (each trade must sign permit application prior to permit issuance and be licensed in Pasco Countyl NOTICE OF COMMENCEMENT IF VALUE IS OVER $2,500.00. MODULAR TRAILER (trailer must be approved by D,C.A. or signed and sealed by an architect/engineer) . PROOF OF OWNERSHIP: a. Appraisal Screen b. Warranty Deed '/7. SITE PLAN: c. d. Authorization Letter Lease Agreement Allowing Modifications a. Plot Plan b. Elevation Survey (two copies) /8. CONSTRUCTION PLANS - (three [sealed by engineer/architect _ yes _ no)): f'J//c 9. ftJlA 10, (V~t 11. /' 12. 1<1"" 13. a. b, c, d, e. f, -g. h. i. -j, Foundation Plans Typical Wall and Roof Sections Floor Plans Plumbing Details Electrical Details (layout and service locations) Air Conditioning Plans (ductwork and size of units) Building Elevations (existing and proposed) Pool Construction Plans Steel Building Plans Note Flood Zone Data on Plans (if in Flood Zone A or V) COMPLETED AND SIGNED ENERGY CALCULATIONS FORMS. COpy OF CONTRACT FOR CONSTRUCTION SERVICES: AIC INSTALLATIONS. LETTER FROM POWER COMPANY AND STATE HEALTH DEPARTMENT AUTHORIZING POOL CONSTRUCTION. . PLANS REVIEW FEE (see schedule, available in our office). ENVIRONMENTAL HEALTH DEPARTMENT APPROVAL: a. Where food service is required State hotel and restaurant stamped approved b. Underground storage tanks when removed only ---- 14. INTERIOR REMODELING AND ADDITIONS FORM. \/" 15. OWNER'S/BUILDERS AFFIDAVIT. rf'i 16. LETTER OF COMMITMENT GRANTING APPROVAL TO CONNECT: a. Copy of septic from State Health Department b. Letter from appropriate utilities servicing area c. Copy of receipt for proof of payment to connect -----------------------------------------------------------------------------------------------------------. ----- NOTICE ---- CONSULT REVERSE SIDE OF THIS FORM TO DETERMINE WHICH ITEMS APPLY TO YOUR PROJECT NO PERMITS ISSUED OR MONETARY TRANSACTIONS AFTER 4:00 P,M. ---------------------------------- Commerci~ Permit Check List 3/1~------~------~~------~~-------~~------------~-~~-