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Home My WebLink About04-3429 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 3429 Permit Number: 3429 Permit Type: COMMERCIAL Class of Work: NEW CONST/COMM Proposed Use: COMMERCIAL Square Feet: Est. Value: Improv. Cost: 202,627.25 Date Issued: 10/05/2004 Total Fees: 13,048.21 Amount Paid: 13,048.21 Date Paid: 10/05/2004 Work Desc: NEW OFFICE BUILDING Address: 6239 FORT KING RD ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: Name: DR.MEHULPATEL Address: 6239 FORT KING RD ZEPHYRHILLS, FL. 33542 Phone: J.C.H. ELECTRICAL LLC ROMAN PLUMBING INC. TIM DONOVANS AIR CONDITIONING & E ELECTRICAL FEE PLUMBING FEE MECHANICAL FEE RADON IRRIGATION METER 1, .5 178.95 WATER CONNECTION COMMERC 131.00 TRAFFIC IMPACT FEES COMM 95.00 TRAFFIC IMPACT FEES 99% COM 24.48 WATER METER RES 3/4" 180.00 IRRIGATION CONNECTION . 1,731.40 24.28 2,403.85 180.00 175.00 [} ~P7~' ' J.un /1;iJ6 4" r .~f.~ / ~fl FO TER R I 1 DUCTS INSTALLED PRE-SLAB CONSTRUCTION POLE 2ND ROUGH PLUMB DUCTS INSULATED LINTEL PRE-METER WATER SHEATHING FRAME MISC SEWER MISC INSULATION WALL MISC MISC. MISC. INSULATION CEILING MISC. MISC. MISC. DRIVEWAY MISC. MISC. 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 The payment of inspection fees shall be made before any further permits will be issued to the person owning same nWarning 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. n Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances NO OCCUPANCY BEFORE C.O. ~~ NATURE PERMIT OFFI CAL R INSPECTION - 8 HOUR NOTICE REQUIRED ROTECT CARD FROM WEATHER DATE RECE lVED (f) , ~~hy/ CITY '""\F ZEPHYRHILLS PERMIT A--'LICATION BUILDl DEPARTMENT 5335 8TH St, Zephyrr., ~S, FL 33542 813-780-0020 FAX: 813-780-0021 PHONE CONTACT FOR PERMITTING OWNER'S NAME 0/2- ~ ()1GH-[)L 'P"'-rEL- JOB ADDRESS 6~o; f[;/t-t K,'rJ6 !2.c> PHONE 7;;l/.-789-c:lC) ,)-~ LEGAL DESCRIPTION: LOT(S) SUBDIVISION 03 -;2G~d-I--OOII{) -O'1t,tJo -t'Of(~TAIN FROM PROPF.RTY TAX NMICE) BLOCK PARCEL ID # WORK PROPSED: tJNEW CONSTRUCTION Os IGN o ADDITION o MOVE DALTERATION o DEMOLISH o REPAIR o INSTALL PROPOSED USE: DSGL FAMILY DWELLING o COMMERCIAL DMULTI-FAMILY o INDUSTRIAL 0# OF UNITS o SWIMMING POOL o MOBILE HOME o OTHER DESCRIPTION OF WORK o RESTAURANT & HEALTH DEPARTMENT APPROVAL $-r:r kk f$oi/d tJFFlCe Eo; ,d,.;J6 BUILDING SIZE SQUARE FOOTAGE HEIGHT RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. ?Zo PERMITS REQUESTED o BUILDING $ ~O 1.1 000 VALUATION OF TOTAL CONSTRUCTION o ELECTRICAL o GAS o ROOFING o SPECIALTY AMP SERVICE 0 FLORIDA POWER 0 W.R.E.C. {/JAltl'tA?-rO,L C,,,J17't:-T Ji VALUATION OF MECHANCIAL (Z;;Z2I!~ 2$ ~ /.~ , ~ 0 OTHER ~~~q 0 FRAME 0 STEEL o OTHER o PLUMBING o MECHANICAL $ FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE TYPE OF CONSTRUCTION: 0 BLOCK COMPANY I ~tC"'S uAtJ' N Je~ ~I BUILDER CQ~Q'JJO:R$ECTIO~ COMPANyePAJS-r.:- 1fl61ft r. SIGNATURE STATE CERT OR REGIST # ********************Acr1k* SIGNATURE STATE CERT OR REGIST # ~~ DOl3 Cf'i(P P~R~ SIGNATURE COMPANY 12OM.~ R U~WC. STATE CERT OR REGIST # c...FC-' 42.rRS I * **************************************************************** SIGNATURE ****************************************************************** COMPANY ~;14 U:,.~........... ./.://G ~ ~ ~ ~ ~ ,;::::--~ ____ STATE CERT OR REGIST # C4<::::'"/~//Y.1~~ ***************************************************************** ,}O ;>8 ' ~~V- COMPANY I--b YYtQ..... Pro Se~u (c e S. MECHANICAL OTHER SIGNATURE STATE CERT OR REGIST # A. NOTICE OF DEED RESTRIC~ONS ~he undersigned understan that this permit may be subjec; ) "deed restrictions" which may be more restrictive than City regulations. The undersigned assumes responsibility ,for compliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR 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, 813-780-0020. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign pOftions of the "Contractor Sections" of this application for which they will be responsible. If you, as the owner signs as the contractor, you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign as 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 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other that the "owner", I cerify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "owner" prior to commencement. 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 "A" or "A, etc.", it is understood that a drainage plan addressing a "compensating volume" will be submitted which is prepared by a professional engineer registered in the State of Florida prior to permit issuance. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building 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 abandoned fora 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 COMMENCEMENT". STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this_ day of , by STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _day of b" 1 acknowledged , 2Cl- acknowledged , 20_ . (name of person acknowledged) Owho is personally known to me, or (name of person acknowledged) C1ho is personally known to me, or of identification) take an oath. Owho has produced (type of identification) and who Odid Odid not take an oath Owho has produced (type and whoO did 0 did not Signature of person taking acknowledgement Signature of person taking acknowledgment Name typed, printed or stamped Name typed, printed or stamped Construction Management Services 6239 Fort King Rd. SQ. FEET PRICE MAIN OR LIVING: 2,448 $ 81.00 OTHER AREA UNDER ROOF: $ 50.00 OTHER: 5,105 $ 0.85 VALUATION $ 202,627.25 FEE SHEET $ 789.00 ADDRESS $ 30.00 DRIVEWAY $ - BUILDING: $ 1,213.50 CREDIT: $ - BUILDING LESS CREDIT: $ 1,213.50 ELECTRICAL: $ 178.95 PLUMBING: $ 131.00 MECHANICAL: $ 95.00 SUB-TOTAL $ 1 ,618.45 RADON: $ 24.48 TOTAL $ 1,642.93 II 10 J ~ · If ') 7 SEWER: $ 6,710.75 WATER: $ 1,731.40 IRRIGATION: $ - TOTAL: $ 8,442.15 1'75'pfiJ WATER METER: $ 180.00 IRRIGATION METER $ 180.00 SUB-TOTAL $ 10,445.081 : I SIPS'I $ 97.5% $ 2.5% $ TI F'S: $ 9,712.52 99% $ 9,615.39 1% $ 97.13 ] ~_ J) LI;.g,/. 3. ;25 t{) - <7<../7' ./ OJ -: 1/ d.-Yl.--J ~ 3 q '} J tiJ 1/ . <1'110 -0. 1, ,/O}. 'i5 /10 .., ?- L/, ?- r TOTAL: $ 20,157.60 1 ():;{~Jl. ~ 5fu1->J j C\~ ~ o ~ 717 fS~T t-J~ 't fLf) ~w cf;ffic~ P;WL J Square Feet Dollar Amount -z 4i- ~ ~l~~';. ~I ~~~ ..8; Valuation Building Electric Plumbing '?:'i.'~0 q'-c~ ':), 7-'1<+8. ::,0 Mechanical Radon Connection Fees: .f"", sewer~i I~\. t..tu water)'ub 'i ",I o. 7':;- Meter 3/'-1 LU 1t~fIl jtf\fi'Tf)/'l ~ Ilt.i--l \.;Nli;:;'F~ fl/\fv" ,!J.-- School Impact Fee: ~~ Transportation Impact Fee: Z;-fLf - ~ i -7- y:. S /} ? '1 " '. ~ ~ / ~f j 4 7 Co , ~ ,/ ~ rr TV (L .'-; f2..--6- \ \f t'l Cs f-A ....&t\J\, - I t-' t~li.c.. 11 '-I j7btJ, ~ t ~- It lY LOTA-\- f)0i 1) q '71'L "57- / i --- -~ City of Zephyrhllls Water and Sewer Impact Fee Calculation Land Use Type: Doctor or Dentist Office No. of Practitioners No. of Employees per 8hr Shift Impact Fees Within City Limits $ 1,731.40 $ 4,301.65 $ 2,409.09 $ 8,442.15 Water Distribution System Wastewater Collection System Wastewater Treatment Plant Capacity TOTAL Outside City Limits $ 2,165.29 $ 5,376.03 $ 3,008.26 $ 10,549.59 ~ ~ u S ~ rLl ~ U C .... C-'~ ~<N~ ~ Cf"! 0 ~ .... 1""'4 ~ ~ .. ~ ~~~~ ~a..!-< o """ ~ t...... r..... e ~ L"" - ... t)J)-< Ii;Iil = :::s ~ ~ ~ all ~ o ~ ~ E-4 U!.~~ ;>4 ~ = ~ U~~Z Z ~ l-I Ii;Iil 'C ~ e US ~ r-c r-c Ii;Iil ~ ~ Ii;Iil II JJ 1_ = = '::1 i .c =1 0 c::> .- ~ a - ~ = to-! ~ U .~ c::> - ~I <;;; Q) ~ bIl s:: .- -a "0 s:: =s o .rJ .~ 13 .- ..d tii rn s:: .S ~ rz - ~ -a Q) ~ z .. = ~ = ~ .::1 bIl 5 = 5: :a rIJ :;l = ;;l 0 = bIl ~ =s = ~ I t ~ .~ ~ Q) ~ y r.il ~ E-< ~ ~ 00 ~ ;,j -= :J E:: 1o4 i ~ .0' < 100 ~ ~ V) - ~ V) 00 ~ ~ ~ r.n 'S e z ! = (S ri <:> i j 1 I 10 0 0 - Q) cti p... ~ Q ; e ~ -< EO:' 00 - '" \0 CIS- .... Q E-o 100 Q) =a .- .... :; ~ :J c .s C! ~ N - C! V"') ...,. 0'1 <:> CIS EO:' ~ e '" 00 -< - \0 C! C! ...,. V"') N ...,. N 0\ - QI is Q 100 ~ 'C CIS Q ...::l 'C -g -g <<l 0 0 o ~ ~ ~ co co co 5 .5 .5 :.0 -c "C _ :;:: :-;:t "3 = ~Q)~Q)~~ <l)ij3 <l)ij3 ~~ Q) 0 ~ e <I) .... ;SP::::>~::>~ QI ~ E-o ~ o E=: i u o ~ 6 E=: ~ u o ~ ..... t: ~ u = Q a .C u ~ Q N ~ o N M Q) d o N ~ o N e ~ = Q 100 U -< -0 N ~ N ~ M ~ Q N Z M .... M f"! .... ;>- = rJJ e s e Q u I ., = CIS t.:l ~ 100 QI = JiIo1 ..., c::> ~ .... ..... 0'1 ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION Florida Department of Community Affairs EnergyGauge FlaCom vl.22 FORM 400A-2001 Whole Buildin2 Performance Method for Commercial Buildin2S Jurisdiction: ZEPHYRHILLS. PASCO COUNTY. FL (611600) Short Desc: MED Projeet: DR. Office Owner: DR.Patel Address: STATE RD. 54 City: Zephyrhills State: FL. Zip: 0 Type: HealthlInstitutional Class: New Finished building PermitNo: 0 Storeys: 1 GrossArea: 2853 Net Area: 2853 Max Tonnage: 3 (if different, write in) Compliance Summary Component Gross Energy Use Other Envelope Requirements - A Design 86.66 Criteria Result 100.00 PASSES PASSES LIGHTING CONTROLS EXTERNAL LIGHTING HV AC SYSTEM PLANT WATER HEATING SYSTEMS PIPING SYSTEMS Met all required compliance from Check List? PASSES PASSES PASSES PASSES PASSES PASSES YesINolNA IMPORT ANT NOTE: An input report Print-Out from EnergyGauge FlaCom of this design building must be submitted along with this Compliance Report. 9/1612004 EnergyGauge FlaCom FLCCSB vl.22 COMPUANCE CERTIFICATION: I hereby certify that the plans and Review of the plans and specifications covered by this specifications covered by this calculation are calculation indicates compliance with the Florida Energy in compliance with the Florida Energy Code. Before construction is completed. this building will be Efficiency Code. inspected for compliance in accordance with Section 553.908. F.S. PREPARED BY: Tim Donovan BmLDlNG OFFICIAL: DATE: q. /.r.~Jj DATE: I hereby certify that this building is in compliance with the Florida Energy Efficiency Code. OWNER AGENT' ;/?;o-- DATE: ?: /J'P~ If required by Florida law. I hereby certify (*) that the system design is in REGISTRATION compliance with the Florida Energy Code. No. ARCHITECI' : ELECI'RlCAL SYSTEM DESIGNER: LIGHTING SYSTEM DESIGNER: MECHANICAL SYSTEM DESIGNER: "7 iJeJ~V"""" C/J C if /1' '/"it? PLUMBING SYSTEM DESIGNER: (j Signature is required where Florida Law requires design to be performed by registered design professionals. Typed names and registration numbers may be used where all relevant information is contained on signed/sealed plans. 9/1612004 EnergyGauge FlaCom FLCCSB vl.22 2 Project: MED Title: DR. Office Type: Healtbllnstitutional Location: ZEPHYRHILLS, PASCO COUNTY, FL (611600) (WEA File: Tampa.tmy) Whole Building Compliance Design Reference Total 86.66 100.00 ELI!CTRICITY 86.66 100.00 AREA LIGHTS 20.92 34.03 MISC EQUIPMT 6.35 6.35 -_.~--- PUMPS & MISC 0.12 0.12 SPACE COOL 17.42 17.66 VENT FANS 41.84 41.84 Credits & Penalties (if any): Modified Points: = 86.66 J PASSES I Project: MED Title: DR. Office Type: Healtbllnstitutional Location: ZEPHYRHILLS, PASCO COUNTY, FL (611600) (WEA File: Tampa.tmy) Other Envelope Requirements Item Zone Description Design Limit Meet Req. Project: MED _.-.- -- - -- 9/1612004 EnergyGauge FlaCom FLCCSB vl.22 3 Project: MED Title: DR. Office Type: HealtblInstitutional Location: ZEPHYRHILLS, PASCO COUNTY, FL (611600) (WEA File: Tampa.tmy) External Lighting Compliance Description Category Allowance Area or Length ELP A CLP (WlUnit) or No. of Units (W) (W) (Sqft or ft) Ext Light I Private Parking Lots 0.12 Design: 0 (W) I PASSES I Allowance: 0 (W) Project: MED Title: DR. Office Type: HealtblInstitutional Location: ZEPHYRHlLLS, PASCO COUNTY, FL (611600) (WEA File: Tampa.tmy) Lighting Controls Compliance Acronym Asbrae Description Area No. of Design Min Compli- ID (sq.ft) Tasks CP CP ance SPC1 8 Food Service - Bar/Lounge 684 1 2 2 PASSES SPC2 7 Food Service - Leisure Dining 924 1 2 2 PASSES SPC2 7 Food Service - Leisure Dining 300 I 2 2 PASSES SPC3 9 Food Service - Kitcben 945 I 2 2 PASSES I PASSES I 9/16/2004 EnergyGauge FlaCom FLCCSB vl.22 4 Project: MED Title: DR. Office Type: Healthllnstitutional Location: ZEPHYRHlLLS, PASCO COUNTY, FL (611600) (WEA File: Tampa.tmy) System Report Compliance SYSl System 1 Constant Volume Air Cooled No. of Units Split System < 65000 Btulbr 1 Component Category Capacity Design Eff Design IPLV Comp- Eff Criteria IPLV Criteria liance Cooling System Air Cooled < 65000 Btu/h 10.00 10.00 8.00 PASSES Cooling Capacity Air Handling Air Handler (Supply) - 0.80 0.80 PASSES System -Supply Constant Volume SYS2 System 2 Constant Volume Air Cooled No. of Units Split System < 65000 Btulbr 1 Component Category Capacity Design Eff Design IPLV Comp- Eff Criteria IPLV Criteria liance Cooling System Air Cooled < 65000 Btu/h 10.00 10.00 8.00 PASSES Cooling Capacity Air Handling Air Handler (Supply) - 0.80 0.80 PASSES System -Supply Constant Volume , PASSES I Plant Compliance Description Installed Size Design Min Design Min Category Comp No Eff Eff IPLV IPLV liance I None 9/1612004 Energy-Gauge FlaCom FLCCSB vl.22 5 Project: MED Title: DR. Office Type: HealthlInstitntional Location: ZEPHYRHILLS, PASCO COUNTY, FL (611600) (WEA File: Tampa.tmy) Water Heater Compliance Description Type Category Design MiD Design Max Comp Elf Elf Loss Loss liance Water Heater 4 Storage Water Heater - < 100 Gal & <= 0.99 0.43 PASSES Gas 75000 [BtuIh] I PASSES I Piping System Compliance Category Pipe Dia ls Operating Ins Cond Ins Req Ins Compliance [inches] Runout? Temp [Btu-inlbr Thick [in] Thick [in I [F] .SF.F] I None I 9/16/2004 EnergyGauge FlaCom FLCCSB vl.22 6 Project: MED Title: DR. Office Type: Health/lnstitutional Location: ZEPHYRHILLS, PASCO COUNTY, FL Other Required Compliance Category Section Requirement (write N/A in box if not applicable) Check Infiltration 406.1 Infiltration Criteria have been met 0 System 407.1 HV AC Load sizing has been performed 0 Ventilation 409.1 Ventilation criteria have been met 0 ADS 410.1 Duct sizing and Design have been performed 0 T&B 410.1 Testing and Balancing will be performed 0 Electrical 413.1 Metering criteria have been met 0 Motors 414.1 Motor efficiency criteria have been met 0 Lighting 415.1 Lighting criteria have been met 0 O&M 102.1 Operation/maintenance manual will be provided to owner 0 Root7Ceil 404.1 R-19 for Roof Deck with supply plenums beneath it 0 Report 101 Input Report Print-Out from EnergyGauge FlaCom attached? 0 9/1612004 EnergyGauge FlaCom FLCCSB vl.22 7 c 0' i..' 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II: 0 W WI- > 0 0 ::I :! :.:: II: ~.., ~ Zz ;:w a: I- z ~ ~ t.) W III ~ g;: rn ~ ;:c Nov 16 04 07:40a 727-841-0894 727-841-0894 p.l N( I. ____ VA / ./ ,/ State of -1-Of2;.t'D4 ICE OF COMMENCEl\tF:NT County of H9.5CO THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property~ and in accordance with Chapter 713, Florida Statutes. the following information is provided in this Notice of Commencement: N- 1. Description of Property: Parcel No. 0:3 -tJ6-~~tJ/tJ -M' (J(}-~CJ.lo ~~ ".- - ',.-., f' >, , ',- ';:'>. .. Ii /',.: '..,',,1 iI' '" t~239 j-cr-l-/(/;oJ6 /cu 1= ( (;Cr:..,(:- f__ , ( ;( I''-'~/ Ct), ICe t ~- I-I !- ;-, 'l:"', --;. '~- 'rf I I~' :-3"3 ,s:q I~= (Legal description of the property and street address if ailable) i 2. General Description of Improvement ;5)fe lJtO~. 150 rjJ ~ ; .;;;;a- ?flcpe:6SfOAJAL {F,c/ce = =:!: ~ ~ ~ 3. Owner Information: Name ,i '::k- /},le";:/~.,- f1~-r7?L. ,,.,.-, - -, /; .,.. L"l / S-k: ~G- 7'\ Addressj_?_;(.~ 7 ( -!:I'SU;(- /(,-;:-' I ... City L/L.'''''''':4'/L.'-.-:.', ~ ~ _ _ ,- . _ - '""./ ~ -, ... "- Interest in Property: ()tr./~:.e /2- , -( State /- -- 3"",7'i?q:30 "7 Name of Fee Simple Titleholder: (If other than owner) \ j'/', \' ,,; . " ;- / Address City State 4. Contractor: Name L:oNsr~Lt' nO.0 //fl,c;ttJArSemLAJ T ~~ ,Ceo.s Address PO !3>()K ILfS- .. City Tbrt ec/UE'{' State FL MJ~ .I f 5. Surety: Name Address City State 6. Lender: Name Amount of Bond: $ IV//! t Rcpt: 790167 DS: a.Be 06/11/04 Rec:: 10.00 IT: 0.00 tip'!.>, Chrk Address City State 8. In addition to himself, Ownerdesign8tes i'~ .....0 all -"'11 ... ~... ua!.-::' Q)~ <0" c.nn 3~ C "'V ..., a ( f ...... 0 : of to recei~'e a cap}" of {he Liecror's Notice as D).... ?{ovided in SectiGn 713.13 (1 ) <b), F1Grida Statutes. ~"'1 Name. , ,'j /l, /,"-1 ? 7. Persons within the State of F10rida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13 (1) (a) (7), Florida Statutes: Address City State 9. Ex.piration date of Notice of Comrr\encerl'ft.ut (t~JC expi...ation date iB 1" yea I from the date of recordjng unJi"'ss a .djIferent date i~ specified.) M J) ,- SignatureOfOwner:L:;::{ r;~ S worn to and subscribed before me this ~ day of Notary Public: ~ ~rl~ Q ~ C JA~ ~ My Commission Expires: 1 () I d- '1 J 0 S- PC93M.W4BI r.. \ -.....l \) ~ ,2cxit-. ~.~.;..' r', (' \......' . ~ n 103110 f:, (') (') !\ (i (j C' r' . , PERFORMANCE BUSINESS PRODUCTS, INC, 813-719-8008 FAX 813-719-7919 '1-f"JJ5~ CITY OF ZEPHYRHILLS ZEPHYRHILLS, FLORIDA WATER ACCT. NO, DATE /2,(3/0</ OWNER/ RENTER ~ S~. YV\~ MAILING ~ 0 bo)( } <..( '5 ?o-rl ~[C~ \ fl. SERVICE ADDRESS {,231 POle,- Kt ~ 3<..f~/3 fJ2.eO. ~TER SHUT OFF SERVICE 0 TURN ON SERVICE uY' INSTALL METER m/ READ METER 0 CHECK METER 0 OTHER 0 o SEWER o GARBAGE ~CITY o OUT CITY ~ No. OF UNITS _ DEPOSIT AMOUNT _ AMOUNT LAST BILL II~ w;f!;r ~ _ DATE _ MISC. CHARGE WORK COMPLETED BY & DATE COMPLETED ORDER TAKEN BY Retain white form in office at all times, Send pink & yellow forms to Water Service Dept Water Service Dept to sign yellow form & return to office. Feb 17 05 11:15a 727-841-0894 727-841-0894 p. 1. State of Florida Certified General Contractor 'Class A' CGC 046542 CllSlrUClil1 Mlnlge.enl Senices If PISCI, IIC Construction Management Services PO Box 145 Pon Richey, FL 34673-0145 Phone: 727-808-2910 Email: ClDsgtDup@gte.net Fax: 727-844-3872 FAX DATE: tl. - /7- oS- TO: 8,/( B()/C.~.s5 FAX# tis- 78o-tl021 COMPANY:C;-fy tI' 2Ai!/~- B/15 [;r?,f- FROM:~ D4'-'j PGS: 2- SUBJECT: c.~ E Of=- Er-~c.. T/C:..! C4L LO.AJttl. 4c. To~ COMMENTS: -:r: Lv; L,l- ~G- --rrt€U /l)mOR./'U:J0 /0 p/l'1 T11f e{~e. 0 r:; CLJ;J T~A- (~Z I A-AJ b A-DUA-keD ELr=cTfLrc WILL 1'3~ T(-fE'~ fJ1 010 D vty 70 .st 6..A) /ft...Jy .f)tr U)?leAJ T.5 i3f ~ () I ;~.c:: P ~ Tily ~D_ Feb 17 05 11:lSa 727-841-0894 727-841-0894 p.2 CIOst'lClilO Maoag...ol Services I' Pascl, liC State of Florida Certified General Contractor 'Class A' CGC 046542 Construction Management Services PO Box 145 Port Richey, FL 34673-0145 Phone: Fax: Email: 727-808-2910 727-844-3872 C1Ds-c:oaellUd;OIl@lampabay.".com February 17, 2005 City ofZephyrhills Building Department 5335 8th Street Zephyrhills, FL RE: Change of Electrical Contractor PERMIT # 3192 I' 3'-1 ~-'1 6239 Fort King Road To Whom It May Concern: Please be advised that Construction Management Services of Pasco, LLC is changing the Electrical Contractor for the above referenced project. The current Contractor is JCH Electric Inc., License #ER 05631 The replacement Contractor is Advanced Electric of West Florida Inc., License # EC 0002287 & EC000222250. Thank you for your assistance, CONSTRUCTION MANAGEMENT SERVICES OF PASCO, LLC Larry Daly Managing Member .9Ldvanc.ed 'Ekctric ~ February 21,2005 City of Zephyrhills 7th Street Zephyrhills, FL 33540 To Whom It May Concern: I, Michael Currie, authorize Greg Berg to pull permits on behalf of Advanced Electric of West Florida, Inc. (State License # EC0002287, Pasco ID# 009117) for Permit #: 3492, 6239 Fort King Road. Michael Currie President State of Florida County of Pasco SUBSCRIBED AND SWORN before me by I personally known to me, on this Ll S\- day of f=-<-..b C-urnt-e ,2005. .~~ ~~bliC KIJlY ~/JIh. ,+'" ....... 't> JUDITH A. THEODORE ... M * MY COMMISSION · DD 278601 d}: '" EXPIRES; January 4, 2008 .,~ OF fl,cfP'" Bonded Thrv Budget NoIaIy SeIvlces PASCO COUNTY, FLORIDA Permit No. ... 3L(/( 9 Date Permitted Builder Name/Owner Name DR. Me.hu ( :P q,.T ~ Control # SubDiv: County Pafcel No. Address/Location l..o;;:z3q to.ttf V. I '-'CO ~. Classificationffype of Us~ ~ vna,y~ / D1<,O F Frc' e , ' TRANSPORTATION IMPACT FEE ' RElte: Sq Ft Unit: ;X /ii.ft Exempt 0 Yes []..Mo How Determined Impact Fee Amount $. OJ, 11 ~ . 5 ;;J... Zone No. T AZ: . . ( SCHOOL IMPACT FEE Account (056) Single-Family Detached House Amount $ (057) Mobile Home (058) Other Residential J.:l2}Y Collection Fee Exempt lj/Ves 0 No. How Determined PARKS AND RECREATION FEE. Land Account Land Credit Land Total Recreation Account Recreation Credit _.__.-- Recreation Total ...----.....--..-.--- .__.------ TOTAL AMOUNT $ Zone How Determined LIBRARY FEE ....LMA ..... "..... .... Landon, Moree & Associates, Inc. Civil & Environmental Engineers - Planners - Surveyors 31622 US 19 North Palm Harbor, Florida 34684 Phone: (727) 789-5010 Fax: (727) 787-4394 WWW.LMAENGR.COM WULF@LMAENGR.COM April 7,2005 City of Zephyrhills Buildin~ Department 5335 at Street Zephyrhills, FL 33542 Attention: Mr. Bill Burgess Re: Ft. King Road Office Building Zephyrhills, Florida Dear Mr. Burgess: Please find enclosed, 2 copies of as-built plans and a copy of the Iiftstation start-up report for the above referenced project. As Engineer of Record, I have made a physical inspection the site and reviewed other supporting documents. I find the constructed pavement, storm and utility systems and the site in general was constructed in substantial conformance with the site plans as approved by the City of Zephyrhills and other permitting agencies. Please do not hesitate to contact me should you have any questions. Sincerely, LANDON, M~REE.. A. I'lD A.lS..~S, IATES, INC. ~N$~WfvLl4 4/1/05 Fleet M. Wulf, P.E. / Project Manager . Enclosure cc: Mehul Patel Larry Daly 441-01 F:IDOCI441-01 Ft. King Rd Medical BuildinglBurgess 4-07-05.doc MAR/03/2005/THU 08:45 AM ZEPHYRHILLS BUILDING FAX No, 813-780-0021 p, 002 . T PASCO COUNTY, 'FLORIDA Permit No. " 3'1~9 Date Permitted . . Builder Name/Owner Name 1)F., Me~t>OvTd County Parcel No. Address/Location. to;;;(3q '~'6' V.,.....<P a, .' ClassificationlTyp~ofUs~ ~~ .IDR. Control # ' ' SubDiv: :() F Fr <:.'-e TRANSPORTATION 'MPACT FeE " R~ta: Exempt ,DYes []-t<tO 'How Determined Impact F'ee Amo4nt ~. ~, l J a. .. 6;< Zone No. . . . .1. I S'CHOOL IMPACT FeE." .., . Aqcount (056)' 8ingle~FamilY Detached tjouse (057) Mobile Home . (05~) Other Residential . J:t 2}r' Collection Fee " Exempt ~es D. No How Determlnr;ld Sq Ft Unit: ~ I'-/~r TAl: ,1 Amount $ . . pARKS AND.~ECREATION F~E " . Land Account . Land Credit L~lld Total Recreation Account Recreation Credit . ...__- ~I=eatlon Total -- ' ~~- ~- lone TOTAL AMOUNT, ~' yes 0 No' How Df;1termlned l-IBRARY FEE I-and Account. L tat Lr;md Credit , Facility Account. ....faci~tyefeait E~ HowOetermloe'; -RESOURCE FJ:E ", ..... .... .' '. " " .' .TOTALAMOUNT ,::;-<1)< ~ ,i!jiVJ0 r~ Facility Total Total Amount ERU ,/5' 1/'79 b-~~ ',. Prepared ay Checked ay . ! NQ CERTIF'CATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION . . . PERFORMED UNTIL THE TOTAL AM04NrS LISTED HAVE . BEEN PAID AND REGEIPTEP FQR. BY A CENTRAL PJ:RMITI!NG OfFICE,OF PASCO COUNTY Acknowledgam.ant Ilalow does liot Imply aoc~ptahoe af oOIlC!-Irranc6, but simply reoelpt of Oil copy of thlQ form, plaolng , fhe building pennlt owner on notice of tt]ls assBssment a~cl thQ conditions ot payment for same" PATE . 'RECEIPT NO. ~7 9 J/ ~ bATE RECEIVED BY /-, h/.s~y ~. ~ ' , i .~ ,r U~ U~ 1U:1~a f~f-a~1-Ua~~ - / 03/31/2905 THU 16:47 FAX 813 874 1194 TECHNICAL SALES CORP. f~f-a~1-ua~"t . p. c. ~002/002 TECHNICAL SALES CORP. 4621 No BIIi~ AM r....,..., ]lL 336U (813) 876-9Z56 FG%(lI3)874-1l94 STA.RT -UP REPORT JOB NAME lEJJ.lSJNG.J!QA.Q...:..PEec.~.B~JL~G. I EN" USER !Privat". .... ACC1!SS NUMBER l.1mJ LOCATION IUS 301 & FT KING i COllNTYlPasco CONTRACT<JR ICOMPLETE DEVElOf'M~I ....n.] ENGINEER It...ANDON:MOREE &.hAS$OCIATES .--.. i DESIGNGPM 122 mH 138 I HP 12 I lMPL 1143MM .~ VOLT li~-' PHASE ISingle. I aJ}C IlM050 j 1>ISCH !50 MAKE IEbara ] MODEL 132OGFu61~5'-.'..1 SEIlL4L#l 140464i1/5 I SER/AL#214117619t5 CTRL PANEL MF ~.J ~N I CTRL JI'.A.NEL.5'I2V j04-OB27 I OIL HEATER 1~..2.L-J FU 115.7 ...~.". &~- -.- . nTWEU TJ'J'E !FIBE~~~S.. ..._.._...____ I WETWELL SIZE ~.~ .S' MEGGER CHECK AT SlJOV BUCKTOGND !INFINITY I REDTOGND IINf=INIJ:(...._....d........1 WlllTETOGND IINI=.I~.lJV OHMS CHECK BLX TO RED ~~..~ __ ......1 RED TO W1lITE 11.0f1.0 I WH ro BLK 13.013.0 INCOMING VOLT CHECK: A-B 12471 B-C lNA! C-A IN" I ~N fiZi] B-N 62il C-N l~J VOLTAGE CHECK: PUMPS RUNNING (R) A.1I 1245 I ~ B.oC ~ (R) C-A lNAI CHECKROTA.TlON(CLOCKWISE): AMPCBECK P~lA !11.7 i P-IB 11'.5! P~lC IN"A'I P-2A 112.0 I P-2 R h~..~..l P-2 C ~ .J $ ~ COMMENTS I PVMP '"FORMED TO DESIGN CONDalONS IYES FIELD TEST !VES --..-.-,.. ill GPM 139 i BOTHCPM INA fll 71)11 ig"'-l #2 GPM 139 I #2 TDH rg--' 1 BOTH TDH I~. -..... ..- "1 PVMPSE4TED'ROPERLY ~ ~.P~J TECHNICIAN IAoMIN OGDEN .... I "-'.~'==-:=--=::J DOC_NUMBER 101~ --... .----, START..{lP DATE I ALTERNATE NAME I