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HomeMy WebLinkAbout03-2403 I I 'I ,I CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT SINGLE FAMILY RESIDENTIAL 2403 Permit Number: 2403 Issued: 10/07/2003! Permit Type: NEW SINGLE FAMILY DWELLING' Class of Work: 101-NEW CONST/SFR Proposed Use: NOT APPLICABLE Sq. Feet: Est. Value: Cost: 80,100,00 Total Fees: 3,155.48! Amount Paid: Date Paid: Address: 6811 OAKCREST WAY ZEPHYRHILLS, FL. Township: Range: Lot(s): Block: Section: Book: Page: Subdivision: OAKCREST Parcel Number: Name: DAVID W, JOHNSON BUILDER, INC Addr: 9504 FORT KING ROAD DADE CITY, FL 33525 Phone: (352)523-0473 Lic: Work Desc: SINGLE FAMILY DWELLING I J Name: COPELAND MARY Address: 6811 OAKCREST WAY ZEPHYRHILLS, FL. 33542 Phone: WATER CONNECTION RESIDENl 8UILDING FEE E 419,00 MECHANICAL FEE 666.00 RADON 67.90 18.88 WATER METER RES 3/4" ..J\I~\b~ ~' It-/( , l~j 180.00 I ('!S~ l'olnt()-~ {Z'-/ ~ ~ I ~_ L1 . /1 J rlVI'9l., ?J '15' ~7 3, !J fV'J i -r -, (tt. c CONSTRUCTION POLE 0 ~- I 2ND ROUGj-l PLUM~/I~"'~<f lfS"o DUCTS INSULATED i/r5-04 Il'!t J;:. PRE-METER -g.-p I&~ WATER t/ 2 ,2..(, -~r 0, '1 'FINAL MECHANICAL 0 MISC SEWER t/'? - Z.lvC~ -,=v , MISC ""0 MISC MISC. i MISC. MISC. MISC. 'I MISC. DRIVEWAVV ~~/-'V ~d MISC. MISC. FIRE DEPT. FINAL ---REINSPECTION FEES: When extra insPection trips are, necessary due to anyone of the following reason~ a . charge of Thirty-Five Dollars ($35.00) shall be made~_ ,Ch trip for each tr~de:, 8~ D) K2 ~,., - / J!LIG/fTJtJ,t) It1F7I1!.. / /.~j~'Of . .C"VNV, rEf /7j- orO_ (a) Wrong address (b) Condemned work resulting from faulty constru~on (c) Repairs or corrections not ade w ~ 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 "Warning to owner: Your failure to reconfil' 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_~ecording ~our notice !>f comme~~ement." NO OCCUPANCY BEFORE C.O. ____n_ _. ~ ___ r. ~~~ATDRC-- -. PERMITOFFI , CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER rg f''''-, ,~"~l ~~- PERFORMANCE 9USINESS ?RCCUC-;-S. INC. 813-.719-8008 FAX 813-719-7919 03._ /\ '/ llie T CITY OF ZEPHYRHllLS ZEPHYRHILLS, FLORIDA WATER ACCT. NO. DATE /0 -5'- ('3 OWNER/ RENTER --:--.. 11 I' J -J;' - t ./'./ H L. (c( .! C /1//1 '\ r h /1 -+ (' /"C"YV1.....{. . MAILING -- ':) c.c /"}' .~ C/~7YZ4.-J , (/ I SERVICE ADDRESS 'e Q; (l SHUT OFF SERVICE 0 TURN ON SERVICE 0...--- INSTALL METER ,~ READ METER 0 CHECK METER 0 OTHER 0 o SEWER o GARBAGE G;}-"IN CITY o OUT CITY ~ No. OF UNITS _ DEPOSIT AMOUNT _ AMOUNT LAST BIU J, : I i ~ . .,.;:-fl-;; yr.c~r v-~ _ DATE _ MISC. CHARGE WORK COMPLETED BY & DATE COMPLETED ORDER TAKEN BY Retain white form .n office at all times. Send pink & yellow forms to Water Service Dept. Water Service Oept to sign yellow form & return to office. .//,,,,,: .// //,- ",,/7 .d:-- /" v/,,,?/ (,~~ ~ ORD R GIVEN BY X. ~f / {} ;;/~ . '\, l~ Ii. jVztvt. l..1 JUN.19'2003 10:45 352 567 3830 SUNSTATE TITLE #6309 p,002/002 YUiY1I11WIIIIIIIIDUIIIHlllnUIllIIIIIRHnll STATE OF FLORID" COUNTY OF p.uco Rc=pt., 610!566 R_ : & .1'/ll1l DS, O.H IT: 1lI.1lII!J NOTICE OF COMMENCEMENT fJ&/191e3 -- .--- Dpt.y t;lerlr ~18~~fIA~e:'~ fotlN~?k OR BK 5401:>> PI; 1185 , mE undeniped, as Owner, noCflla .n partin tIIat IIIlprovelllellta...1I be lUd,e to certain real property, and in _rdaoce 1ridI Scdion 713.13. Florida Slat1ICU, tbe roUowin& infonaatioJr Is stilted in tIJe Notlce of COlll...._l: DESCRIPTION OF ~OPER't\': Lot 4, OAK CRESf EST"TES, PHASE TWO, aeeonliae to map or plat tltercof n:cordecllo Plat Book 39, rages 64 and 65, Public Retonl. otPuco COUIlt}', Florida. GENt!:RAL DE..-.cRJPTION OF IMPROVEMENTS: CBlFrame RnldeJlI:e Reli.ble Contnu:tillg, Inc. 61.9 StepbealPlltII Zephyl'llllls, J'L 33541 OW\'lllER'S IN'I'EREST IN THE PROPERTY DESCRIBED AS: S....ple and Mary B. Copeland OWNER AND OWNER'S "DURESS: CONTRACTORS AI'lD CONTRACfOR' S ADDRESS: RelIable C~ Ine. 6819 Sl&pllens hill Zephyrbllls, FL :n~l SURETY (Ib..,.) and SURETY ADDRESS: NJA AMOlo1\,,- OF BOND: S N/A NAME MG) ADDRESS OF LENDER. IF ANY, MAKING A LOAN FOR CONSTRUCTION OJrTHE JMPROVEMENTS: ...- ,.-...: eom...nity Nall_1 &.Ilk of Pnat COIlIIty Post Oftit;e Pox fi39 Zeplyrllills, f'Iorida 33539 NAME Of PERSON WlTllIN THE STATE OF FLORIDA DESIGNATED BY OWNER UPON WHOM NOTICES OR OTHER OOCTJI'oUNTS MAYBE SERVED: ;- .....:.:.::'":-.~ -, COGW1UUIlty NIItioIUlI BaRk uf Paseo CoUllty Pod ()ff'1Ce Boll 639 Zcpbyrbms, Florida 3JS39 IN ADDmoN'O OWNER DESIGNATES THE FOLWWlNG PERSON TO RECEIVE A CopY OF THE LlI:NOR' S NOTICE AS PROVIDED IN SECTION 713.13, FLORIDA STATUTIS: ,'r" CO....lll1lty NlltiOllal Bank ofpuco COtlIl'Y Post Office Boll 639 ~yrIlin., Florida 33S39 EXl"IRA nON DATE: JUDe 17. 2(104 Lanr Bene' Auonaey at Law Polt Offta: Box 1046 Dade City, FIortda 34297-1046 jtJ Ii ;JJ;tzr Neal B. Hartley, 7~ Ma~~ ~e(f STATE OF FLORIDA COUNTY OF PASCO 'Jbe roregoml insmll.ellt was aduIowleclced before l1Ie this 1'- day of JIIH 2003, by Neal B. Hartlcy.l'r'aiIkIJt DfRelidJle CODtnId"'I~"'1Io Is pel'lOllully IuIowa to DIe or wIIo produced as ideadf'reation aDd 'Who didldld not ralle oath. * and Mary B. Copelsnd - Witness ..y 1I~1Id alld offtcld seal in the County nd s..tc lut alorel18id tbt8 17" day of J_ 2003. ~rW' FlORIDA """""';:rl, ~ PASCO ~I' I' to~R9'''' r.."U THE FOREGOING IS A ........f!lf;lrtNJ:tc.~. 1:' 'liE OOCUUOOON FJLE ~"!'-!t' lllCOfW '" I -.; O'Ti$EAY.ltIIE5S MY HA D'~~FFICIAl SF,;.i r.~IS.L.L. O~Y OF ~ _ 2~ . Ctfilk 'J'! ;;, RCUIT altIRT DEI"JlY ClERK NOTARY pUBLIC ~ C~~~\ ,:~..i;:'~:'i':' ~,~~~f~~~~ '1' t.. )...__,(....-.,.._ ': . ~nJ:._,1_(...4 "" ,.._.,...,_..~.,:.(.: .,...~, t....C':j.)4S:.j.. FLORIDA ENERGY EFFICIENCY CODE FOR BUilDING CONSTRUCTION , Residential Whole Building Performance Method A CENTRAL 4 5 6 FORM 600A-01 5 PROJECT NAME: BUILDER: AND ADDRESS: PERMITTING CLIMATE 405060 OFFICE: ZONE: r------ PERMIT NO.o=IJ:IIITI JURISDICTION NO.: [LIJ=rJJ OWNER: 1. New construction or addition 2. Single family detached or Multifamily attached 3. If Multifamily-No. of units covered by this submission 4. is this a worst case? (yes / no) 5, Conditioned floor area (sq. ft.) 6. Predominant eave overhang (ft.) 7. Glass type and area: a. Clear glass b. Tint, film or solar screen 8. Floor type and insulation: a. Slab-on-grade (R-value + perimeter) b. Wood, raised (R-value + sq. ft.) c. Concrete, raised (R-value) 9. Net Wall type, area and insulation: a. Exterior: 1. Concrete block (Insulation R-value) 2. Wood frame (Insulation R-value) 3. Steel frame (Insulation R-value) 4. Log (Insulation R-value) 5. Other: b. Adjacent: 1. Concrete block (Insulation R-value) 2. Wood frame (Insulation R-value) 3. Steel frame (Insulation R-value) 4. Log (Insulation R-value) 10. Ceiling type, area and insulation: a. Under attic (Insulation R-value) b. Single assembly (Insulation R-value) c. Radiant barrier, IRCC, white roof installed? 11. Air distribution system: a. Ducts (Insulation + Location) b. Air Handler (Location) 12. Cooling system: (Types: central-split, central-single pkg., room unit, PTAC., gas, none) 13. Heating system: (Types: heat pump, elec. strip, nal. gas, LP. gas, gas h.p_, room or PTAC, none) 14. Hot water system: (Types: elec., natural gas, solar, LP. gas, none) 15, Hot Water Credits: a, Heat Recovery (HR) b. Dedicated Heat Pump(DHP) c. Solar 16. HV AC Credits (Use: CF-Ceiling Fan, CV-Cross vent, PT-Programmable thermostat, HF-Whole house fan, MZ-Multizone) 17. COMPLIANCE STATUS: (PASS if As-Built Pts, are less than Base Pts.) a. Total As-Built points b. Total Base points I hereby certify that the plans and specifications covered by the calculation are in compliance with the Frida EneflY ~ode. 11a. 11b. 12a. 12b. 12c. 13a. 13b. 13c. 14a, 14b. 15a. 15b. 15c. 16. 117. 17a. 1. 2, CK " ,). 4. 5. 6. ..{Iv j,'" (1, sq. ft. ,. f If' 1/ ft. Single Pane Double Pane IL;)., 7 sq. ft. sq. ft. sq. ft. sq. ft, 7a. 7b. 8a. R= 0 "61 ,', L ft. /, ~~ 8b. R= sq. ft. Bc. R= sq, ft. 9a-1 R= 3' 90'J- sq. ft. 9a-2 R= If I~~ sq. ft, 9a-3 R= sq. ft. 9a-4 R= sq. ft. 9b-1 R= sq. ft, 9b-2 R= 11 I'll sq. ft. 9b-3 R= sq, ft. 9b-4 R= __ sq. ft. 10a. R= '3C 13d~, sq. ft. 10b. R= sq. ft. 10c. R= b , VII.. Cr (cond.luncond,) V ,l. C' ~(COndJUnCOnd,) Type: [~ly d ( SEERlEERlCOP: i rj ( ( Capacity: ')- 'J <.S 0 0 Type: fi t' HSPF/COP/AFUE: I ~ 0 Capacity: ';J.. r- f.{' (/ 0 Type: b ,( " l EF: I t1 r f'r p ~,~ -; "'~ f.J 73 r ~I 17b. ,., i:>- f .~ DATE:' -/-03 m ' nee with the Florida Energy Code. Review of plans and specifications covered by this calculation indicates compliance with the Florida Energy Code. Before construction is co pi d, this uilding will be inspected for compliance in aceo a . on 553,9~,S, BUILDING OFFI I DATE: OWNER AGENT: DATE: SUMMER CALCULATIONS CLIMATE ZONES 4 5 6 ORIENT A TION OVERHANG GLASS SINGLE.pANE OR DOUBLE.pANE SUMMER ~, AS-eUIL T LENGTH AREA UMMER POlNT MULTlPUER SUMMER POINT MULTIPUER X OH FACTOR . GLASS ~ OH (FEET) (SQ, FT.) CLEAR TINT' CLEAR TINT' (from6A.1) SUMMER PTS N ~ '~L-.J.. 27.96 22,93 25.65 21.22 t~\Of "7 'X"( NE 43.65 36.42 39,16 32.78 J E J '6.1 'l.';..rJ ~ 59.31 49.89 52.66 44.33 ' t;q '? /7(,<;;. I~L SE 56,64 47.60 50.35 42.37 S J 1/ ,,",'1 44.66 37.29 39.98 33.49 , '1 'S 4- )~4':z, H SW 52,82 44.31 47,07 39.55 .r j w J'I/ It. I ,.. 53.48 44.87 47.65 40!'iO ,'1'1 T ? -2...f- NVV C 37.74 31.34 34.10 28.45 -"--~~ U) r~ - H1 102.51 85.02 93.50 78.03 U) A/ I'LJ 1.1:),'7 l1.'? . cd i~~- t.,...:;, / :3 I C) II OVERHANG RATIO = OH LENGTH !i OH HEIGHT II !~ I , I ! , U) U) <l: -' C) ~I FDINT,MJ.T. .18 X WEIGHTED GLASS X MULTIPLIER ,18 25.99 COMPONENT DESCRIPTION .= llftERJQ~==+ <i! i.,A,DJACENL uL 3: II! Cj~]-.=- ',j 1.9 '-t-E'--! . n/?s T-J BASE SUMMER POINTS TI ;1..( -j -9j~ T ~ ~=~==~==fA~='==r i: _ _ _ _~ '~d _ '.- nil C) UNDER A TIIC :z I OR SINGLE ::i W ASSEMBLY (,,) ----..----_..~..- 0:: o o -' u. \~~~~rg~~s .J. ,(1,:-__1.__14.31_ T 1'1- 't f if {" BASE COOLING POINTS /0 t, g-l HOT WATER SYSTEM BASE HOT WATER POINTS Ilw4 '},- As-Bum HWM 6A-22 ~"tl 2FOR GLASS WITH KNOWN SHGC, SEE SECTION 2.1.1 APPENDIX C. 3MUST MEET CRITERIA OF S. 607.1.A. TINT MULTiPliERS MAY BE USED FOR GLASS WITH SOLAR SCREENS, FILM, OR TINT. 'H = HORIZONTAL GLASS (SKYLIGHTS) T AS-BUILT GLASS SUBTOTAL COMPONENT DESCRIPTION T i s..M.ffi I AS-BUILT X FDM,M.lT. SUMMER (6A-2lHRU6A-6) I POINTS '-,--:-c' ~'I- .-tYlT),;.,- - ------. . ---or - - r~---J,;; _.LZ".. r .-----"Z: (.tQ _ - _ I~"T). .7'- AREA 'v' ~ n m .,mZJ7"f;i--' ---- ---~=~---'::Ig'l. - ::::-- -----i1.;,. ',- '.2-1.....(, --1:-'1'0;,; "'I _.L'1-~_,--,,~_ '~ __J4:3L_.m r J T Pi ~ <it- , AS-BUilT HOT WATER SYSTEM DESC. SUMMER POINT MULTIPLIERS (SPM) 6A.1 SUMMER OVERHANG FACTORS (SOF) FOR SINGLE AND DOUBLE PANE GLASS. . OHRalio i 00.11 I 12.17 18.26 i 27-35, 36-46! 47.57 .. II:' LNorth _~__ _j_1illL_jO.~9L I. 0.971 i_ 0.931 _ L.Q.Il!li...Jl.!l18, 0,776 fNorthea$LU~OO i 0,995 I 0,966 0.908. O,846.L uOJZZ 0.665 > fEast , LJcQQ_LQ.~93._J0c96.4. Qc9Q31...D.1l35_L_Q,755 LO.622 ~ ~ i-.s.out~~i=----=L1.o!L+ _QJl99__ i 0.956 - I Q.871 , ..)QJ86l_ 0.70Q . i ..Q.635.Q.580 ~ 0 ~--t..111iL;--Qc988-1 _Q..935~_O.84~J_Q.776. ~_ .JlJOLj_OJl1j9 1_ 0,618__. ~ : ISoutll"~est__j,!,QO_I__fL9.97: 0.956. i.Jl&7~-! 0.7~Ll.Jl}09 -LP.e45_l..o~L ! West . l.J..OPi_fL9!J!; Q.@()4J _O,~o.LL.Q'~_L_ 0.757 i _0,69),-1 0,630 INorthwest.--, 1.00 [0.995 0.966 0,911 I 0.857 .' 0.798 ' 0.751 ' .O~70-8 ~ OH Len h i 0.0' 1,0' 1.5' 2.0' 3.0' 3.5' 4.5' 5.5' 6.'\-2 WALL SUMMER POINT MULTIPLIERS SPM ,-- FRAME r--- . WOOD --, STEEL ~~Y~ltE_ i W__L , AJ:iTj-'ExfuIAbJ .~9. .. t_~.4._L_2.2___L 8"9 2.9 ~:!Q.L+...1l.. -f---,8- . L 4,1 1.3 11.12.9 1.9 ,.7 3.0 1.0 13-18.9 i 1.7 i .6 j 2.8 0.9 Tg:.2S:9lTo'r--'-3- T' 2.4 _ 0.8 :?6&UJL. j .~.=:....L..2_~=-I=1.r _-~ . 0.4 6A-3 DOOR SUMMER POINT MULTIPLIERS (SPM) .()QO~ TYPE ~EXTERI~Rl~_JAC~_N_T WOOD I 7.2 I 2.4 . ---. ----1.__+_. __ INSULATED I 4.8 I 1.6 6A-5 FLOOR SUMMER POINT MUL r!PLlERS SPM SLAB-ON-GRADE I RAISED EDGE INSULATION I CONCRETE ---,----i L_,..___ RNALU~_--l.. SPM . ....~ ,. _R.VALUE ., . 0-2Jl___L -31.9~J l 0-2.9 _~Jl.....+-.:~ .:_--3-(9-- ,5-6.9 I -31.7 j 1._~_~-fL_m 7 & U i .31.6 7 & U 6A.6 INFILTRATION & INTERNAL GAINS ISPMI Air Infiltration 5.17 Internal Gains + 9.14 Infiltration/Internal Gains 14.31 (Combined) 6A.7 AIR HANDLER MULTIPLIERS SPMI Located in oarnoll 1.00 Located in conditioned area 0,90 Located on exterior of building 1,02 Located in attic 1.10 CLIMATE ZONES 4 5 6 _0.718 0.651 0,611 0.623_0.491__+_ J)M5. 0.571__0,1.11 . i .1)..463 o'54Q JAIS ,_0...1.3.6__,__0,10.7 Q.5aL ,___Qc53.lLc -0,SQ3.....1_ 0.475_~_ ~:~i . n_:~~;~~ ":'-{::~l-+--K~~~- 0.674 u--uO,61!f '--6.510'-->-0:532- 6.5' 9,5' 14.0' 20.0' CONCRETE BLQ.c.l<j~QRMAL~V'J!) !INTERIOR IEXT, ________ ilNSYLATlON IINSUL R.VALUE i EXT I ADJ EXT "..n__ I__--,--~ . 0-2.9 __ I _~.5.J..1..... ~.!i 3-4,9 . 1.4 I .7 .7 5-6.9 -i 1Tl:6- i ,3 7-10.9 .mL,~_ _L4_L_.1 11-18,L_.J_.-,-4~.0. __ J~t~9_j-+--Y-l FACE BRICK LOG ---- ~-.._-_.__..-----_. ..------- R-VALUE :WOODFR ---- --- -- ~ 0-6.9 2,9 7=10.9 j- :5 - 11='18.9-' .4 - -- --- ------,-. ---+- 19-25.9 i ,2 26 &U-.' .1 R.VALUE 0-2,9 3-6.9 7-9.9 10&UP BLOCK 1.0 .6 .4 ,2 -----._--~ i61NCH i 8 INCH R.VAlUE I EXTI EXT O:i9-' !1:7---t--1,6- -j:6,9-~1T ___n -:8- 7 & U r .8 --- - .7-- NOTE: SEE SECTION 2,0 OF APPENDIXC FORMUl TIPlIERS OF ENVELOPE COMPONENTS NOT ON THIS FORM, 6A-4 CEIUNG SUMMER POINT MULTIPLIERS SPM , UNDER ATTIC i SINGLE ASSEMBLY _~-VALUE I..~_I R-VALUE_J.._ SPM_ __~9-21.9 I 2.82 t-+.O-10'il...u_i_ 12-27 ....32-25.9---i 2.55 j 11'~_~_9:~3 2~29.9_. l__2.2~ L!3.~8:9 mL ~}2 30-37.9 I 2.13 I 19_25,9 6.90 38 & Up i 1.84 I 26-29,9 5.82 RBS Credit 0.700 30 & LJp--_L-S:40 IRCC Credit 0,864 White Roof Credit 0.550 CONCRETE DECK ROOF j- . CEILING TYPE R.VALUE ' EXPOSED I DROPPED -10-13:'9 : '11.13--.L 10.4 . --14=-Z([9- .-- [~ ir:gg_- . . 21& Up '.-o.fflr-l---:;:70- SPM -1.0 :-;f.7 -u -1.7 L_ I RAISED WOOD I~'----~--"-'- ..-.... 'u.n. ___n_ ..._.. I POST OR PIER STEM WALL wi UNDER ! CONSTRUC..TlON FLQ9BJNSU~~TlON ._J=~.=;~~ .:.= ~~. 2~ ~8 1"]3- .-2.i U~__ _____ _ __________ 1.36 -1.8 i ADJACENT . 1 SPM . 5,;3 -~- ___L~ 1.8 - - 1.0 6A-8 DUCT MULTIPLIERS DM) See Table 6.10 for Code minimums, DUCT RETURN DUCTS In: SUPPLY DUCTS IN: R.Value Attic! Attic! RBS IRCC 1.107 1.108 Unconditioned Space AtticlRadiant Barrier (RBS) AttiCIWhite Roof Conditioned Space 6A-9 COOUNG SYSTEM MULTIPLIERS ICSMI SYSTEM TYPE See Table 6.3 for Code minimums COOLING SYSTEM MULTIPLIERS ICSMT Central Units (SEER) Ratina J5-7.9 8.0-8.4 8.5-8.8 8.9_9.4 9,5-9.9 10.0-10.4 10.5-10,9 11.0-11.4 11.5-11.9 12.0-12.4 CSM .45 .43 .40 .38 .36 .34 .32 .31 .30 .28 PTAC & Room Units (EER) RatillQ 12.5-12.9 13.0-13.4 13.5-13.9 14.0-14.4 14.5-14,9 15.0-15.4 15.5-15.9 16.0-16.4 16.5-16.9 17.0-17.4 17.5 & Up CSM .27 .26 .25 .24 .24 .23 .22 .21 .21 .20 .19 WINTER CALCULATIONS cqMATE ZONES '4 5 6 ORIENTATION OVERHANG GLASS SINGLE-PANE OR DOUBLE-PANE I WINTER ~'AS-BUILT LENGTH AREA Xw'NTER POINT MULTIPLIER WINTER POINT MULTIPLIER X OH FACTOR - '"JLASS .., OH (FEET) (SQ, FT.) CLEAR TINT' CLEAR TINT' (from 6A.~OI WINTER PTS JT N L. 11Jt l- 12.32 12,58 6.43 6.64 ~'1't"l U,..,-r.-:-- ~ NE I 12,00 12,31 6.17 6.42 I I E I'(f 'j. q,C41 9.96 10,54 4.52 5.01 I ' ()\'I '\ :). 5...Q- SE i 8.34 9,12 3.17 3.84 .- H S /'a (~ '" '1 7.73 8.59 2,65 3.39 r'1'1\.~ -r-/7 sw . 9.22 , 9,88 3,88 4.45 1~ t-W J L{ /Od -..- 10.74 11.21 5.16 5.56 .",l{~ It))f r NW 12.22 12,51 6.35 6,58 en H1 11.64 12,36 4,91 5.54 en 1\/ ')J,7 , 7t)L f:l,~;i HIPlIf.. "l.'-t'f ::5 C) /~! ~ 01- I ~~N{~g~}n WEIGHTED GLASS MULTIPLIER en ~ C) .18 5.44 T AS-BUIL T GLASS --f~I't COMPONENT DESCRIPTION , rnEXTERIOR ::I I ADJACENT ~ ~. AREA ~ BASE WINTER L ~~~R . POINT, MUL T. I F--=-~~ n==t I ~ .:;-~. I . r COMPONENT DESCRIPTION T WINTER AS.BUIL T AREA X POINT. MUL T. I WINTER fYI-V-!(6A:1;~~~}A-1~f ..- cTI~I~TSI) -7C;1-t-':-~--'-Tn-n3'e~ n<r' .. n7Tn?:rn !---h-G- tnnT ).,~ T t I 0 _LT. -n)--L~k i ~ ( , --f7- T~Qn~~==T-- ~ ~~DS~~;L~IC 1- .-I-"->---'------r--......M.-. ::; iii I ASSEMBLY u 1----- "J. {, tS. T 0:: f-~ (P"R1~E_TERI,.'_ I - ~ .)" 't -1.9 ... n_:h_'l..1 nn__~Q . g fBt-I~~[)(AREAl ~ u _ .:1....._---1__ . _ ---- ,. I----n l ~ I------..---------.--J--- - - I I ____,..,,_._~____,_~~____~___.__._____________ i FOR SLAB ON GRADE USE PERIMETER LENGTH AROUND CONDITIONED FLOOR. FOR RAISED FLOORS USE AREA OVER UNCONDITIONED SPACE, T (:" L_n__n__. USE TOTAL FLO R AREA OF CONDITIONED SPACE, T lL.jb ~, 7 INFILTRATION & INTERNAL GAINS -0.28 --"._.__.__._--~-_. HEATING SYSTEM Base Heating System x Multi lier ,63 .... ~ o ... 'H - HORIZONTAL GLASS (SKYLIGHTS) WINTER POINT MULTIPLIERS (WPM) 6A-10 WlNT~R OVERH.6:NG FACTORS (WOF) CUMATE ZONES 4 5 6 i wa: mO Southwest 1.00 1.002 1.013 1.038 1.071 1.118 1.168 1.225 (1)1 L West 1.00 0.999 1.003 1.013 1.025 1.040 1.053 · 1.067 Northwest 1.00 0.999 0.998 0.997 0.997 0.996 0.995 0.994 OH Len h 0.0' 1.0' 1.5' 2.0' 3.0' 3.5' 4.5' 5.5' 6A.11 WALL WINTER POINT MUL TIPLlERSIWPM\ FRAME CONCRETEBLOCK(NORMAL~ FACE BRICK LOG INTERIOR EXT, R.VALUE WOOD FR R.VALUE BLOCK WOOD STEEL INSULATION INSUL 0-6.9 7.0 0-2.9 3,7 6/NCH SINCH R.VALUE EXT ADJ EXT ADJ R-VALUE EXT ADJ EXT 7-10.9 2.1 3-6.9 2.6 R.VALUE EXT EXT 0-6,9 6.8 5.3 9.4 6.7 0-2.9 6.0 3.1 6.0 11-18.9 1.7 7-9.9 1.8 0-2.9 2,2 1.2 7-10.9 2.5 2.1 4.4 3.3 3-4.9 3.8 2.3 2,8 19-25,9 1.0 10&UP 1.3 3.6.9 1.2 ,9 11-12.9 2.0 1.8 3.3 2.6 5-6.9 2.9 1.9 2.0 26 & Up .6 7 &Up .9 .7 13-18.9 1.8 1.6 3.0 2.4 7-10.9 2.3 1.5 1.5 19-25,9 1.1 1.0 2,6 2.2 11-18,9 1.5 1.1 .8 26& Up .7 .7 1.4 1.2 19-25.9 ,8 .7 I NOTE: SEE SECTION 2,0 OF APPENDIX C FOR MULTIPLIERS I 26&Up .5 .5 OF ENVELOPE COMPONENTS NOT ON THIS FORM, 6M2 DOOR WINTER POINT MULTIPLIERS (WPM) DOOR TYPE .EXTERIOR I_~ACE~T WOOD I 7.6 : 5.9 ------:t-- ' ----- INSULATED I 5.1 4.0 6A.13 CEILING WINTER POINT MULTIPLIERS (wpM UNDER A mc I SINGLE A5SEMBL Y I CONCRETE DECK ROOF R.VALUE I WPM-/ R-VALUE WPM! C'-ceiDNG TYP-r- 19-21.9 ,87 10-10.9 1.02 R.VALUE i EXPOSED ~ROPPED _..B-25.9----1\l._j_.J.1:~_____.JlL__1 10-13.9 C1.16 __ f 1lJ5- 26-29.9 .69 I 13-18.9 .84 14-20.9 t- ,83 I .76 lt~?e;-ro:Eo -+--iH~--t-- :~~ __I~.~-L-~~-_-i~- IRCC Credn 0,905 WMe Roof Credit 1.044 6A.14 FLOOR WINTER POINT MULTIPLIERS (WPM) SLAB..QN.GRADE EDGE INSULATION I R.VALUE _~__ WPM , _ 0-2.f!._-t--.l.?_~ 3-4.9 , -1.7 ! ---5-6.9 ----2T-_~ ~&u"T--2T I WPM 4.0 II I I , I II r- RAISED WOOD I POST OR PIER STEM WALL w/ UNDER ----,------ I CONSTRUCTION FLOOR INSULATION I ADJACENT I WPM WPM --r-- WPM L._~~_~_.-.l-~ _ ~.3-= 0.78 1.7 2.1 -+___ -0.47 - -i --- ---:5L_ fl\ 0.14 .3llf--- 6A.15 INFILTRATION & INTERNAL GAlNSIWPM\ 6A.17 DUCT MULTIPLIERS DMI See Table 6-10 for Code minimums. Air Infiltration 0.87 DUCT RETURN DUCTS In: Intemal Gains -1.15 SUPPLY DUCTS IN: R-Value Unconditioned Attic! Atticl Atticl Conditioned Infiltration/Internal Gains .0.28 soace RBS IRCC White roof soace (Combined) 4,2 1.107 1.098 1.100 1.102 1.092 Unconditioned Space 1.078 1.072 1.074 1.075 1.068 1.061 1.056 1.057 1.058 1,052 6A.16 AIR HANDLER MULTIPLIERS (WPM\ 1. 1.067 1.059 Located in oaraoe 1.00 AtticlRadiant Barrier (RBS) ,0 1. 1.051 - 1.045 Located in conditioned area 0.92 8.0 1.( T.041 - - .U~ti Located on exterior of buildino 1.09 4.2 1.1 - 1.U88 - .U77 Located in attic 1.11 Attic/Interior Radiation 0, 1.073 - 1.066 - .057 Control Coatinos (IRCC) 1.u 1.052 .045 1. .095 AtticJWhite roof 1. - .070 1. - - 1.054 1. 1.UU8 1.U1U 1.0mY Conditioned Space 6.0- 1.007 1.006 1.007 1.007 I.UOO 6M8 HEATING SYSTEM MULTIPLIERS (HSMI 8:lf 1.005 1.UlJ:> 1.006 1.005 1.000 SYSTEM TYPE See Tables lHl to 6-8 foe code minimums HEATING SYSTEM MULTIPLIERS (HSMI Central Heat HSPF 6.40-6.79 6.80-6.89 6.90-7.39 7.40-7.89 7.90-8.39 8.40-8.89 8.9-9.39 9.4-9.89 Pump Units HSM .53 .50 .49 .46 .43 .41 .38 ,36 HSPF 9,90-10.39 10.40-10.89 10.90-11.39 11.40-11.89 11.90-12,39 12.40 & uo HSM .34 .33 .31 .30 .29 .28 PTHP COP 2.50-2.69 2,70-2.89 2.90-3,09 3,10-3.29 3.30-3.49 3.50-3,69 3.70-3.89 3,90-4.19 HSM .40 ,37 .34 .32 ,30 .29 .27 .26 Electric Strip & Gas 1.0 (for gas credit multipliers, see Table 6A.21) -. OJO cq 1 ~ ~ I ruv. ~ uti I 8J I tn r-F 15.00. U.E. I I I N 00'33 13 I!J Sill I ~ i 8 wi i 111;1 o .... I .... CD UJ s:b: I.~ 30.00'1 f'I~ ... _...J I (I) CD 1!iI ~ 8 II! 1 ~I III CD 1"1 ell UI CD C6i m UI CD . ~ .... . 33.'3- E -, 9P' 1'18 (,-I- -31 tal It.! I ~ w :.-a 1\1. 10.00. U.E. 110.00. ~ It I t co :.. at . I I PROPOSED SCREEN ROOM I I I I 3"X12" RISER PAN ROOF I I I I ~ ~ 10' BACK ELEVATION --= ..., ~ concrete slab wi tooter ~ 1~ SIDE ELEVATION T 7'2" 1 CITY OF ZEPHYRHILLS IINOTICE" OF ADD.ITION OR CORRECTION BUILDING DEPARTMENT DO NOT REMOVE DATE PERMIT r#- IA) jfJ,/b-d3 2'-1CJ THIS JOB HAS NOT BEEN COMPLETED. T~e f I wing odditiqns or corrections sholl be mode before the job will be accepted. -P a.-4 ~/L Ul ~ a.t:O~ l,z 4.1 ~-; It is unlawful for any Carpenter, Contractor, Builder, or other persons, to 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. OFFICE HOURS 7:30 AM - 5 PM MON,-FRI. AFTER CORRECTIONS ARE MADE CALL 780-0020 FOR RE-INSPECTION INSPECTOR ~.-c. . rJ~ ..~{) / ~ J motNER'S NAME MI./i (op'/~ JOB SITE AD~li:~s t)aJ( o~f ~.,JJt"'~/'O.1 }ol ~If CITY OF ZEPHYRHILLS PERMIT APPLICATION BUILDING DEPARTMENT 5335 8tb STRBBT ZBPHYRHILLS, FL 33540 Phone:813-780-0020 Fax:813-780-0021 DATB RBCBIVBJ) PLANS RBVIBW FRR PARCEL 10 # oJ - 'J'- )1- OJ So - 00000 ~OD'-Io BLOCK 04/ (1#/;;( ~))t~ PHONE CONTACT 7) '1- '-18 '3 f ~ ?/( f)o~wJ lr\-tJ~ LEGAL DESCRIPTION: LOT(S) SUBDIVISION WORK PROPSED: ~NEW CONSTRUCTION DSIGN (OBTAIN FROM PROPERTY TAX NOTICE) D ADDITION DALTERATION D REPAIR D INSTALL DMOVE D DEMOLISH PROPOSED USE: ~SGL FAMILY DWELLING o COMMERCIAL OMULTI - FAMILY D # OF UNITS o MOBILE HOME o OTHER o INDUSTRIAL o SWIMMING POOL DESCRIPTION OF WORK o RESTAURANT & HEALTH DEPARTMENT APPROVAL ')/'A..~}f /;""';/1 Jwtll''-''-j ." '1.7'" I, ^ -r ,. SQUARE FOOTAGE /78'~ HEIGHT U3'L/I' BUILDING SIZE 1 , 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. ~' 0" BUILDING [!(ELECTRICAL Gr' PLUMBING ~ECHANICAL PBRMITS RBQUBSTBD $ 7o.~ , VALUATION OF TOTAL CONSTRUCTION , ( )/) i) J/(1 \._ ~}'7; AMP SERVICE B" FLORIDA POWER o W.R.E.C. $ ;}, ~ 00 VALUATION OF MECHANCIAL INSTALLATION o GAS o ROOFING D SPECIALTY o OTHER TYPE OF CONSTRUCTION: 0 BLOCK Er FRAME o STEEL o OTHER FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREAO YES ~O BUl:LDBR /IJ If ~1,fit?( COMPANY IV. JD 0,", ;S,,/JJu ~<::. STATE CERT OR REGIST # C. (;.( 0"0 1J t.. CITY PROCESSING # ,,yo SIGNATURE IILBCTRIC ............................................................:.....~~ ' / COMPANY ~Q.rt\Y\. ~e~\ LJ I ~ . / STATE CERT OR REGIST # 6c./3tJo) 383 CITY PROCESS ING # q 7 SIGNATU PLUMBER ********************************************************** SIGNATURE COMPANY STATE CERT OR R G CITY PROCESSING # MBCHANlCAL SIGNATURE STATE CERT OR REGIST CITY PROCESSING # ***************************************************************** OTRBR SIGNATURE COMPANY STATE CERT OR REGIST # CITY PROCESSING # ***************************************************************** CONDITIONS O~ ~!.RMI~ AFF~~AVI~ A.. NOTICE OF DEED RESTRICTIONS The undersigned understands that this permi t m!:l y' bH ::n.1b:l'~c:t: 1:0 "deed restrictions" which may be more restrictive than City regulat:icoi1s. 'rh~! und~H"~I.i.glled assumes resp~nsibility for.. compliance with any applicable deed res tric: Ct.::HlS . B. UNLICENSED CONTRACTORS AND CONTRACTOFl FW~St?ON:SIBILITU;S If the owner has hired a contractor or ceont.raGtors to undertilke work, they Diay be required to be llcensed in accordance with state a,nd ll)Gii1 regulu<tlonn. If the' contractor is not lic6I1sed'aa required by law, both the owru:u: and contract:.n: mclY,.be ci.ted for a misdemeanor violatlon under state law. If the owner or, ili't.!ndud 'coii,t,ract:or are uncertain as to what licensing requlrements may apply for the in1:end.!d nork, they are advised to contact the City of Zephyrhills Buileling Department, 8I:~-'11~B-6611. Furthermore, if the owner has hired a contruct:OJC OJ: cont::cactors" he ,is advised to have the contractor (s) sign portions of the "Contr.ct::.or Sectd:ons" of th1s appllca'tion for which they will be responslble. If you, as the owner ui~Jns a~1 the contractor, you are indicating that you, rather than the contractor, are responuibll! fClr thEt work. If the contractor wishes you to sign as contractor that may be an indicat:ioll that: he is not properly licensed and is not entitled to permitting prlvileges in tht~ City (If Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY GOllNECTION Ff:I~S D. CONSTRUC'l'UION LIEN LAW (CHAPTER 113, FLORIDA S'I'ATUTI!:S, AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction lien Law - Homeowner's Protection Guide" prEtpared by thE! Florida Department of Agriculture and Consumer Affairs. If the applicant is fJOmeOne othel: 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 certify that all the information in this clpplicat:ion 1s accurate and tha.t all work will be done in compliance with all applicable lclws regulating construction, zoning, and land development. Application is hereby made to obtaln a perud.t to dCI work and installation as indicated. I certify that no work or installation has cOlBenced prior to issuance of a permit and that all work will be perfonmed to meet standardfl of all laws regulating construction, City codes, zoning regulations, and land developD~nt reg~lations in the jurisdiction. I also certify that 'I understand that the regulations of eIther governmental agencies may apply to the intended work, and that it is my responl!libilitJ' to identify what actions I must take to be in compliance. Such agencies include but: are no.t limited to: *Department of Environmental Regulation-Cypress Bayheads, '~tland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment *Southwest Florida Water Management District:-Wells, Cypxess Bayheads, Wetland Areas, Altering Watercourses *Army Corps of Engineers-Seawalls, Docks, Nalvigable Waterways *Department of Health , Rehabilitative Servlces, Environmental Health Unit-Wells, Wastewater Treatment, Septic Tanks *U. S. Environmental Protection Agency-Asbest:os abatement I also certify that, if fill material is to be used in Flood Zone UA" or "A,etc.*, it is understood that a drainage plan addressing aL "compensating volume" wlll be submitted which is prepared by a professional engineer regiflltered 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 Eluileling 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 perudt is ~nced wi thin si~ months of issuance, or if work authorized by the permit is suspended or abandoned for a period of six months after the time the worle: is cOlIII\enced. One 90 day extension of time may be allowed for the ~ermit with fee charge of $15.00. The extension shall be requested in wri tin,g to the Building Official. An approved inspection must be logged during each six month period, or the project will be considered abandoned. WARMING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMI!lN'l' MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN A'l"fORNEY BEFORE RECORDING YOUR NOTICE OF COMMEHCEMEH'l'. JOBS UNDER $2,500 IN VALUE 00 NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT*. ;tJ 11- JIa;itzt f!uI g: t:!t SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRAC OR STATE OF FLOR~ . COUNTY OF 1-IO~il:j it The foregoing instrument wa~ acknowledged Befo,re me this < I '1 'h day of ;)f' pr . i=!J:).OO~ by N 10-1 P-J. t+tH t 1"'-;1 J (naae of person ackno,.ledged) rn who is personal..ty known to me, or o who has produced N / A ...I (type of identification) ~~d not take an oath. STATE OF FLORIDA r-l J COUNTY OF . 1- OlZ.l~tL The foregoing in8t~nt was acknowledged Before ~ this ~ay of Ser L , ~;l 00-1 by l\j~o.. \ 12~'\';'J ...J (name of person acknowledged) Ulho is personally known to me, or o who has produced 1\.1/,4- (type of identification) and who Delid ~d not take an oath ~V11\tl j), ~{U(,~ Signature of person taking acknowledgment f)ana L. !)U rL l K , Name tYPe~~~lb~~<t &k~tamped ~ ~ .; My Commission 00243306 .,. 0, ",Jf ExpIres August 20, 2007 person acknowledgement {jan a. L. Dud {' cK Name typed, printed or stamped ~a\. Dins LDUd8Ck , . "J . My Commission 00243308 ~'t!".1 Expires August 20,2007 ------ ---^ ~~ "ERFORMANCE BUSINESS "RODUCTS. iNC. 31:3-719-8008 FAX ,313-719-7919 c 3.~ q /) 1'9 ; CITY OF ZEPHYRHltLS ZEPHYRHILLS, FLORIDA DATE a/~Jcf OWNER/ .- t~/J/} ./J ;/ I~/ ~, f.,.Y RENTER / U ~~~:r /[7 ~2tA~~~ MAIUNG &:>9/1. ~h ,?{~ -; At /'7 kt.6.s SERVICE ADDRESS hS'/1 C{)~/I/<L;;t: W~ ~: 1fT - ~/ ~ wATER WATER ACCT. NO. o SHUT OFF SERVICE TURN ON SERVICE QI " '. INSTAlL METER 'fi READ METER 0 CHECK METER 0 OTHER 0 o SEWER o GARBAGE Y IN CITY o OUT CITY i ----->-- No. OF UNITS _ DEPOSIT AMOUNT J .. I ,~L _ AMOUNT LAST BILL _ DATE _ MISC. CHARGE WORK COMPLETED BY & DATE COMPlETED ORDER lAKEN BY Iv' $/;;/01' ...~ j ., ORDEl'rtfIVEN I .' I~" I. /" 1/ ~ Retain white form in office at all times. Send pink & yellow forms to Water Service Dept. Water Service Dept. to sign yellow form &. return to office. I I . cD ...,. . m ~ I :n .i.I ~ 1&1 I~ ., - cD 10 1ft III en I I .00.0 t 1 7n .00.0 I. N hAmo is personaL1.y ;.rn.c,wn 1:0 me, or . ~ . ; I fJl cGl . . tt) I" 8t.ai ad LE~L Ita 3~~ '~ ~ ~~ ~.Gt1 ~~ {- .,.,V i~ , I . ! , . .... eN . 01 I~ I ~ II ~tQ Cb fa l:e -- NI i ..... o I&J Z :J , '0- p- I . l~ . 1= .~. an \ i ... \. ;. :.,tj CD ZL.o;L II'J & :i-rl : .00.0' 81 ;el · It) Ow en . ,;::) r- _low ~ g &1 I It ~ It) - " 10 . ~ ;2: .~ " := {", ~.. ~ .:..<R> ~~ J \.4'. :2 ;.",.\.lE -: -': ,..-, : .- ~. ~ '~~ ,}.: ... ',i1 ".... .- 0 ~l ~ :.l..: ... :- ..... ,-,~ , ,:'--- ~:,c ! 1\ ,; 'oj '1\, N'\ 't ~ . , -:s-- c. .;,. \: ~ f\.\J \"'. I I . co .... . m ~ I :n .iJ ~ ~ ~ III I~ I') - CO to 1ft lID (II I I ilAm.o is personal.ly mown 1:0 me, or .00.0 t & ~.n .00.01 I fJl cDl . _ tt) ~ o. Obi .no LElJIi.L. :3 .EL.E~ '. -- l 1 '. }--z ~.JnT ,'~ .; - U~ It f~ I I ! . ~LI ~; ~ ~JI91 i '0. \l' ~ ~... I lid 51 I ~ ~'S~ r--. ; ~ ~~ ~I I t..' tt.DO N ~ I ~.n .00.9' ::!I-J I ~ I I;!! == ~-:rl ~ , . ~ . I') ~ ?n .OO.OL N · U) OLd en . r;::) r- _1 bad .....-.- ~ ----- ~ -- I . .... t'I . m an CD Ch .... I .... o t&J Z :J . ..., 10 - I' 10 . Q) - :;- - =('. ~..~ ~ :e(' ~ ~ --: . ~~ :::2 ~'.:D ~i ~ <-. ~ '-- ;;'''..."11 ~-o ;e ~ ~ r- -,<, ~~I ; \. ., ,; ..; iI lV, 'l ~ ::)---- ~ ~ \)~ ~ ....,. .........~_...--- .-.-..-..... .'\ \ PASCO COUNTY, FLORIDA .............,....,.-...,"'.'''..............~___,.........,.,~.......'',n..'''''_..~......_.."__."..._'__.............~.,..._._"'..,._.-..".._~.,..._........._.......,.,................,,'~....."'____. Builder t'lallle/Owner Name .fl~1_1- C;Ollllty F'8r(;ell'lo, Permit N\). ...--.-.d:...Lfc23 ._____ IJate Pennltled -L~/~_z_ J::~__.n._ Control I/- __ _______n n___ __ SubDiv: --_.__._-" -~._.- -+---.-- -..-------- I' .'.. /1 .t", J; .-rj Add res s/Locatlon .l/2b.jL-.C:!:...c.~~Lec-;f-:C.' -kv/~--._______n_._.__.___u..._,_.._ __ u. ___ Classiflcatloll/Type of Use_ .3-1. ~#~.f,,-~J...,J.~:~_ ___ __.______. ___ TRANSPOHTATION IMPACT FEE Rate: ____________ Sq n Unit: ----.--.-_._m____ Exell1pt I_.J Yes ,[;yNo How [Jetermlned --~'-'---. .-....--..-----___... -'0 ____._ .______~ Impact Fee Amount -J.--.4-.-t'~,_h Zone No. TAZ: ..-------..-..-..----. -.._'---~' .... --~.- .-.~._.._--,...- ~~~:nM(~~ZT ~!i~~;~~;;I;~J::::::IOII:_- A::~,;---~-4~z~~..~.----~~. (051) Mobile Home (058) Other Residential JI2:3) Collectlqn Fee Exel1lpt [ ..1 Yes Ll./~6' Ilow Determined ______.__.____ ...'_._____.___. __'_" _.. .__ ...-.-.-....---...-.-.- .._-----~--_....---"..._._..._.. ~_.. ----. - - .--.-.. ~'---' ..- ._-~_..- -.--, .-- ----- .. ..- .....--.-.-. ~ p ARRsANfj1H~(~REATlotrFEE""-~-~:-. Land ACCOlltll La.nd CferJIt ~ ..;.....-.-......."''''''.."...."...,,*-e-.-O .,o'!........_""....'"'''~,_-...- ,~......__ --..._...-.-,......_.__,,.,..___ ",.........._.. Land Total r~ecle;'ltil)11 Acc( H It It necreation Credit Her.reation Total LUlIe 'renAL AMOUNl.t____ __ ____ /EXEmlpt ...- , I Yes ,-] No Ilow Determined - .---.--.-.--.-....-. .~'n___._.~._. '--"__"_~_U" .....__....__ ~._ T.lsfiA R'lFF.E"'.'''.....''....''. ,.. "...._~._.. '...-- ,..".-.,.-.....-...,--'-----.-,-,_........o.=__.._..".~._,..__..,.__.._...~_.'"'.'"._." ""_.. --.--. .. Latlll ACCOlltlt l.and Credit -.---..- Land Total ----. - --- "'""- .... .-.........----..:=:::.-;::._----_.~_._-- -. --- .- .-...._~-_._--..-....__..._~,-_._---- Facility AC(;()lIllt ..-"~ P'8()illty Credit ..__.___._._.___.. Facility Total Exempt [J.Ye~"- i'-] No How Delermlned _~.~._ Total Amount ___...__...._..__ 'RE'SOlIRcEtFEi~.'.-."..'m~'-_-,,-........~._-_...._----- i ........-. Effij'---.--~_..-.-"-.-.~-_...-'"-. TC)lAL AMOUNT ~:-.UlJ)..._-;jLp:..-~-l -'-"-____'_H________. _...____ ._...~.,. ,.. . "-'--' "p,.,.,. "","".~ ""'.~ .~~.......--,-~,....,o...,.". "4.,..."...."......,"..,.>>.'~....."....,_,,_........~. ,..,........ .-......'..~....._40-.-.._....... _ --....- "'"""""-'''-~'''''''.''''''''=''-'''''-'-~' ,.,...,. ..-....,--...,......~,,-~-~=........ Prepared ny "'.H_ ..._______ Checked By NO GEHTIFICATE or OCCUPANCY WIl.L. Bt: IssueD OR FINAL INSPF.CTION PErU:OJ~MEU UNllL THE TOTAL AMOUNTS L1STEU HAVE BEEN PAID AND rU:GEIPTL~D FOR BY A CENTRAL PERMITTING Of=FICe ()F PASCO COUNTY Acknowledgement below does not Imply acceptance of concurrence, but slrnply renelpt of a copy of this form, placing the building perllllt owner on notice of this assessment and the conditions of paYlnent for same. _._'--~_._.. -'-""-.-.~..-.- ..-_... .u..__n_..__.__ ---....- ..--.....---..".---.-. ----- DATE ReC RECElf'T NO. -J~ IJAI E :z};/p Jprj BY