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Home My WebLink About05-4094 . ,. -. CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 4094 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: 4094 COMMERCIAL NEW CONST/COMM COMMERCIAL Address: 6848 GALL BLVD ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 1,088,100.00 4/13/2005 22,167.18 22,167.18 4/13/2005 ADDITION TO MOVIE THEATRE Name: HOME THEATRE OF ZEPHYRHILLS Address: 6848 GALL BLVD. ZEPHYRHILLS, FL. 33542 Phone: MARTIN ELECTRIC WILLIAMS (INDIVIDUAL) PAYNE AIR CONDITIONING & HTG INC ELECTRICAL FEE PLUMBING FEE MECHANICAL FEE RADON .00 419.65 131.00 285,00 117.00 WATER CONNECTION COMMERC TRAFFIC IMPACT FEES COMM TRAFFIC IMPACT FEES 99% COM Not .d- , 2,416,79 111.48 11,036,52 \/, q lo(p "'-b+ ~d Jut ~ ol~ :r - . ftJ04 "ov. \. <.;. il: i ~ & 1~ ~ -" 0 .1J5~. I.('ID .,. r.:. F R 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 "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." Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances NO CCUPANCY BEFORE C.O. c- L. ~~ CONTRACTOR SIG ATURE PERMIT OFF I LL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER Date~ \-J.. (~ Phone:(813) 707 - 8336 ;L' ~ / . ~ If} yL' _lJP ~ c-' q) (,fY' Oj0- ~ JP Company Address 110 E. Reynolds Street, Suite 804 City, State, Zip Plant City, Florida 33563 ~ ~.f.vv.-~ q,. ."'{ '\ \ ( MAY t 2 20061 ' \\ BRC-REG II ".~~CE- ~,/- ..,.._~.,~::.:' FORM 54727/SOC(8-94) Rule40D-1,659, FAC, PAGE 1 OF2 44010429.002 CITY OF ZEPHYRHILLS PERMIT APPLICATION BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 813-780-0020 FAX: 813-780-0021 ~~/(a-~ DATE RECE JVBJr::~ '"_____. PHONE CONTACT FOR PERMITTIN(fI3-1It)-/~0 PARCEL ID # /-It;/7€ *1J7l1E" tJF k;::,f/7/LII/C(J,)/ft PHONE, iR'fr- ~LL gCt/~J .ze~1/7/2b'/c-tf I h. - / 0;2. BLOCK ;2b SUBDIVISION 02 ;26:2/ tYtJ /~ tJ() f161 tJ IJtl ,2t'J ?13~7ftJ-/Ai~ 33.511'2 :2./ OWNER'S NAME JOB ADDRESS LEGAL DESCRIPTION: LOT(S) (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPSED: ONEW CONSTRUCTION ~DDITION OALTERATION o REPAIR o INSTALL OSIGN o MOVE 0 DEMOLISH PROPOSED USE: OSGL FAMILY DWELLING OMULTI-FAMILY 0# OF UNITS o MOBILE HOME ~MMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER BUILDING SIZE D RESTAURANT & HEALTH DEPARTMENT APPROVAL !JO/JJT/(!l# 70 /!lift/Ie 7#&/J-77?E 7tJ )( 13 CJ SQUARE FOOTAGE 1/7tltJ HEIGHT e:26 ) DESCRIPTION OF WORK RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) ..s.E-1'--ENERGY FORMS. COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY.,.J:QRF1.s:------. )'" IF SI ERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIREr' '/'~. --- ~ PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUC ON. j I \.0 C!- ~ '-'.I;Z~~~ . / /J J< ~()q. ",/EllMITS REQUESTED _~ ~(1:J ~I $~(){"X;CCf). - VALUATION OF TOTAL CONSTRUCT~.?~.._--~-~~5 )( ELECTRICAL '(pf)fJ AMP SERVICE X Progress 3perg~ 0 W. R. E;;;J- ') o PLUMBING ,~"., 0&&':) ~HANICAL $ j~trUlf). o-cD VALUATION OF MECH IN~L~TION'_~9q' o GAS ~OOFING 0 SPE~LTY 0 OTHER --- TYPE OF CONSTRUCTION: ~BLOCK 0 FRAME ~EL 0 OTHER FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE; AREAO YES ~- BUILDER COMPANY STATE CERT OR REGIST # C GCOCO03( ~ *************************************************** SIGNATURE COMPANY J/A/!;'/l P.-lee:l}./~ ~~ STATE CERT OR REGIST # 1Ee:..(3{X)13~3 *******************************************************;,********** PLUMBER SIGNATURE ~~..f.. LJ~ , COMPANY~P.klJS Co tu) {11'^,"VS STATE CERT OR REGIST # 19'20 MECHANIC *****************************************~*::*~**A********** ~ COMPANY I\.k )(...-l)t)JO jnl>-.Ji~ ~ STATE CERT OR REGIST # ~:'OSft1()U) ****************************************************** T E ~A~^~Ja !AQ~3~ StifGN~ ",,,CI "', ifYK. f'[ Ot~~ ,~q:{j1-.? ~':~.i'L "'-j",",J:J :.~; :&WfiJ\IIl' ":',..\ t\l~A'lb~it~i l~p,;: ~~J'~ ~e ~:~b;dU COMPAN , ...........'-""'-..:;".. ......~-"... _If" . ,~ ~ ': '\:':1 ~~, ;J'} ,.<". >"..,. ." STATE CERT OR RE~IS1' A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this permit may be subject to "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 portions of the "Contractor Sections" of this application for which they will be responsible. If you, as the owner signs as the contractor, you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign as contractor that may be an indica~ion 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 aone in compliance with all applicable laws regulating construction, zoning, and land development. Appli~ation 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, Wetlapd 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 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 YOU TICE OF COMMENCEMENT. JOBS UNDER $2,500 IN ~ NEED TO RECORD AND POST A "OTIC OF COMMENCEMENT". S ~ "----oWNER OR AGENT 1 ~t[) STATE OF FLORIDA COUNTY OF The foregoing Befo e me th' by (name f person acknowledged) ~hO is personally known to me, or Owho has produced . (type of identification) a~~ WhoO~id ~d nft take an oath. L~K} LQ y)!g;fi, --f;)J.Lf1&1' 7W---> Signature of per . fL ". , '::~"~::'" ' BRENDA l BUCHANAN r~ 04 .: I ublic . State of Florida N t d pr'n ,stamt:l. . ame ype, .:. ". "~' 'l. 1SSIOIl" DO 384884 I,'" OFf\{T," ..."....., Bonded B National Notary Assn. ument ~knOWledged _ day 0 ~, zctl:5 STATE OF FLORID~ 11h~~ COUNTY OF ''-1rfi The foregoing iqs ument w~knOWledged .~ Before this ay of It I. D zoC!S- by ~o (name of person acknowledged) is personally known to me, or Name typed, ~ David Johnson 6848 Gall Blvd. SQ. FEET PRICE MAIN OR LIVING: 11 ,700 $ 93,00 OTHER AREA UNDER ROOF: $ 50.00 OTHER: $ ., VALUATION $ 1,088,100.00 FEE SHEET $ 2,858.00 ADDRESS $ - DRIVEWAY $ - BUILDING: $ 4,287.00 CREDIT: $ - BUILDING LESS CREDIT: $ 4,287.00 ELECTRICAL: $ 419.65 PLUMBING: $ 131.00 MECHANICAL: $ 285.00 SUB-TOTAL $ 5,122.65 RADON: $ 117.00 TOTAL $ 5,239.65 SEWER: $ 3,362.74 WATER: $ 2,416.79 IRRIGATION: $ - TOTAL: $ 5,779.53 WATER METER:I $ IRRIGATION METER $ ~ I SUB-TOTAL $ 11,019.18 r- PARK IMPACT FEES $ PUBLIC SAFETY IMPACT FE lItE: $ /--lcfE. $ 5% $ '. SIF'S'I $ 97.5% $ 2.5% $ i)b /111 Itf AT (J,j).. l\ ___-I I/, 15~. '\ ' - I - ;;2 ~-% - /;(7,. JJ.I[Yf~~0 / I. /1/ g 1"7. BJ'/. 'Ii( ~ =~3~"bl( _ 'I o?k.5?- qlf 1. - , I ,1. -: IIj.L{f{ - TI F'S: $ (' 44,592.00 ) -- 99% $ 44,146.0ft /5/v O!::E,q 7 1% $ 445.92 , TOTAL: $ 59,763.51 I ~i:'i~-1 s= ?,If ",Z ....... ' ill: 0 C. - n n ~ ~ l . . :l:: 1;3;;. i== :;I> ...~ . := trj. .. "0 '" . co ;:. ,t-I co . .; .. 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"\ {r-, ) - ~,QjlJ I ~o ~ >, ~ I L- - t" -= ('\ '-I A. -()--' - :;u ~ :;u -iJ ~ 0 - o o~ ~ r~1 "'7" o~ -C~ 1'] --..:;... o ~~ 0 >c ~q o o L '1.1.I L.L'o, 'l~J ~ - r - Ll> ~ - J.) i~ q ~~~ - - -fv-lv--J0 C .1 )>11l 1< 1," c: :n - ~r < ~ ~, - " . A ,^,.. A. ~J r .- n ..~ . - -;X 0: .~..~J ,..'>,: ~.. -0 . D>.. > 'i' )' , '. " /"00.. ~ T~ .!. J ....... '.. n 121 '. ~ 2 - -;() () rx V1 :-l m z ..- . I2l .. .,.. .. , 0 , , ,. , , ..... , D '. , ,I ~ ., . .., d ~ -,.. ...~ ('\ ...- ~- ~ 0 [ () :;u 0 -l _ 0 l-iJ 6~ I " ." , I 1 I rl '111, ,un U\1Ya ".7'2.1:1 .NOTICE OF COMI\JENCEMENT y; IPl1llPAlla ,,. DUt'1.I1J '...,.. ~una of Florid ~ r.t5 /' 0' } Crumty ur L- \ Tha undllra/gnlu" herobv InfOfm. all aonnarnltd thRt IMfI....venaur lU will lIn ill with sectlol') 71 :;1. 13 D. the FlorldEl 9tatnte8. aha following ;"'..rn'f1 'ion 18 alBr :di t~~f1rlll'? rtlu' pmporlY. Qnd In UOlJOrdanCf , , , ,. . 8 ,n 1 19 NO rrCE! OP COMMeNCEMENT. 08sorfplfono'prupunv .Q:?:-:~.-:..?~.-:-1:-.'.:-:_e:.~/O_ ... (90100 --(9020 ,. ... ..... - ....... ................. - .. . ". .. .. .. .... .. .. .. .... .. .... . . .. .... .. .. .. .. .. ...... .. .. .. .. .. .... .... .. .. . .. .. .. .. .. .. . SIiM/NOlS PDftM40l . . , . , , , . . , . 11111111111111111111111111111I11111111111111111111111111111I 2005035861 - - . . - .. .. .. .. .. .. .... .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. . . Genelal daa~lptlol1 of Improvements . .If:l? P. ~:7J 9:-? .''Jr::. .2 -:./f (<<;=;.0 NQl,y r;;. :71ff1+.'Ti~E. . . . . Owno. ~ .1.i.;11.1k . . .1 /(:'2.'?7.E~.. .t!E. ..-?!r.-;e.1( 7.::~~. <t.f... './ /(~. .. .. - , . , . . . . . .. .. . . .. . Addrass {fJ c--</j- wee 8l.(./,&J ;;(c.P. rG t.c z.....;.:;:....:...................... ,.,., .?" (.u,.", ...., ....... ...,............J...........~~.~(...f'/ .R... :~'.}~r.?.,.". ......, .,... . . . 4 . A . . . . . _ .. w _ _ _ .. .. . a.. a .. . ... ........ .. .. '"' ....... .. , .. .. . . .. .. .. ... .. .. . .. , . .. . .. .4 . . ... .. . . .. . . .. .. .. .. . ... .. .. .. _ .. .... ... . .... .. ... .. ".... .. .... .. .. ..... .. .. .. .. . .. .. .... .. .. .. .. .. .. .. . .. Owner's inlerelll Jrulto of dUlIlmprov....uHll .................... eo... .............. Rcpl: 859230 Rec: 10.00 Pal!!l Simple Titfr, holda, elf otfiur 1IIun OWRBrt DS: 0. 00 IT. 0 00 S~ 02/28/05 -.----~. Dpty Clerk Name ... ......... .......'/1 .f:....... - -...... -.................. ............... ~~~~~1~M~~~ 5~~~CO 1 COUNTY CLERK Address"",.." ,.,..,...'.. .... .................~..... . ......-... ...... ......... ....~~..~~...6.245 PG 1701 c_.""" J) AU (ptJ. ,QRM?e;A;) . .PtM .'1M!./l>.t9.,7T..6/!e;'6/J /liWijJQL.I A.:<'., A....... . qgj '1..7::; &A/f? . JJ('/t1..'?4IJ. €.. e7/. F< .... 7:5. C;. . .~" .. ~ .. ~ ~ . .. ~ ~ . SUlety (i' any' .....,.... A. . . . . . 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MANION ~l1J~ MY COMMISSION # OD355\2\ ">>..,~ EXPIRES: September \3.2008 ) ~",#, FI NotaI)'Discoun'-c.., ) 14lOO-3.NOTARY , !\ I) ~ () (") (") o o 105763 (i () r. <:"' . . PERFORMANyE BUSINESS PRODUCTS. INC, 81$-719-8008 FAX 81$-719-71118 CITY OF ZEPHYRHILLS ZEPHYRHILLS, FLORIDA s -.. ~ q Oi WATER ACCT. NO, DATE (I!~,k~ J.'" . OWNER/ RENTER DC\. VfJ J;;~ /.-1-.5'0 " urr C:::~L gL~p :;:z::-~~ Y/L#?'c cf r:::c "') ./ .5 ~-1 6. 53JY2. MAILING SERVICE ADDRESS WWATER SHUT OFF SERVICE 0 ~.. \ - ." ~ TURN ON SERVICE W INSTAlL METER ~ READ METER 0 CHECK METER 0 OTHER 0 o SEWER o GARBAGE ~ CITY o OUT CITY + No. OF UNITS _ DEPOSIT AMOUNT ;< 11- ~;fW ~ _ AMOUNT LAST BILL _ DATE _ MISC. CHARGE WORK COMPLETED BY & DATE COMPLETED ORDER TAKEN BY It- 7 -(}S tt 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. /1 '<'\) ~ (} -?/11:m 0- ~ - a~ '---- -- CERTIFICATEOFOC'CUP ANCY CHECKLIST FOR C,OMMERCIAL PERMITS ,CITY OF ZEPHYRHILLS, FLORIDA The following items need to be verified before a 'C.O.. is issued. -D cJ v 11. :J . VERlFYTHEFOLLOWINGFEESHAVEBEENP -;--.- {~ 1~ . Public 'Safety Impact Fees ~ / , L./ /S":2... 7/-/tJ-lte . Tran.portatiOnImpaetFe~~fd3, ~/II/j rll/;-lo-of'JJ> . Miscellaneous Fees AI)':; . Pasco 'County Resource Fee Ail? . VERIFY THE FOLLOWING HAVE BEEN RECEIVED: . DEPT. OF TRANSPORTATION. / APPROVAL {)LJ9.. . PASCOCOUNTYR-O-W APPROVAL ,;..117 ....... ~& . SOUTBWESTWATERMANAGEMENTPERMIT C~ <.?p.;l.v . ENVIROMENTAL PERMIT FROM DEP $ ~ . SEALED LJ7'i"l"'. . ~ OF 1jf, PROV AL FROM ENGINEER,OF, 'I ./. RECORI( '-Z~.d~& 6 2--< Of:? . DEPAR~NTHE~"'SIG~ATURE ONDJr;V~~~OPMEN'!4L ..~ ~~\\dI ORDER . ~ ~ ~ .wi"". 0/ . 8 TRANSACTION REPORT APR/11/2006/TUE 01:50 PM RECEIVER 818137076725 TYPE/NOTE OK I . 533SJ;.;ghth Streot !!liwE April 11, 2006 (813) 780-0020 City of Zephyrhills Building Department Zophyrbills, Florida 33540 W. A. "Bill" Burgess Dltector of Builcli.nt Licensing '" Zoning Access Engineering and Consulting, Inc. 110 E. Reynolds Street, Suite 804 Plant City, Florida 33563 Attention: Ali Shasti, M.S., P.E. Re: Horne Theatre of Zephyrhills, Inc./AEC, Inc. Project #:0503 6848 Gall Blvd. Zephyrhills, Florida 33542 Application Number:44010429.002 Dear Mr. Shasti, Regretfully, the letter received from you dated April 10, 2006 is not sufficient for receiving a sign Off by our Planning Department. In speaking with Billy Poe, our Assistant Planning Director, he said your letter must contain the following: that site was built & completed in accordance to approved site plan and that sidewalks are ADA compliant. If any questions, please contact our office, 813- 780-0020. Sincerely, G~~V.9-~ Bobbie Sharon Swetland Sr. Code Support Specialist Building Department Cc: Larry Rutan, Owner P.01/01 SG3 Fax (813) 780-0021 City of Zephyrhills Building Department 5335 Eighth Street Zephyrhills, Florida 33540 (813) 780-0020 Fax(813)780~21 April 11, 2006 W. A. "Bill" Burgess Director of Building Licensing & Zoning Access Engineering and Consulting, Inc. 110 E. Reynolds Street, Suite 804 Plant City, Florida 33563 Attention: Ali Shasti, M.S., P.E. Re: Home Theatre of Zephyrhills, Inc./AEC, Inc. Project #:0503 6848 Gall Blvd. Zephyrhills, Florida 33542 Application Number:44010429.002 Dear Mr. Shasti, Regretfully, the letter received from you dated April 10, 2006 is not sufficient for receiving a sign off by our Planning Department. In speaking with Billy Poe, our Assistant Planning Director, he said your letter must contain the following: that site was built & completed in accordance to approved site plan and that sidewalks are ADA compliant. If any questions, please contact our office, 813- 780-0020. Sincerely, G~-~.9~ Bobbie Sharon Swetland Sr. Code Support Specialist Building Department Cc: Larry Rutan, Owner Nav 28 01 03:53p Ali Shasti, M,S" P.E, 813 707 6725 p,1 ACCESS ENGINEERING and CONSULTING. INC. CIVIL ENGINEERING - LAND PLANNING - STRUCTURAL CONSUL TING SERVICES - DESIGN AND PERMITTING AprillO,2oo6 Ms. Carolyn J. Pina-Springer Brooksville Regulation Department 2379 Broad Street (U.S. 41 South) Brooksville, FL 34604 - 6899 SUBJECT: HOlDe TJaeatft of Zeplay....Ws, lae.1 AEC, me. Project No.: 0503 6848 Gall Blvd. (U.s. Hwy 301) ZephyrhilJs, Florida 33542 Application Number: 44010429.002 As-BuiIt Submittal Dear Ms. Carolyn: Enclosed please rmd the original plus one copy of STATEMENT OF COMPLETION AND REQUEST FOR TRANSFER TO OPERATION EN1TIY Form along with two certified as-buik survey plans for your use and file. If there are any questions or concerns pertaining to 1his matter, please do not hesitate to COD1act OUT PLANT CI1Y OFF XC: Mr. Larry Rutan, Owner File of Record Aitn~ M~, W\\)lctm~Vr~.s DV\\c~,--\Qd-- OrG] QC4.1 C:,'\)\ <Sr 'tiPh rrhd Is "'t\0- ~x-=#= C~\~J r-:f~O- 002\ HiIIsborough County 110 E. Reynolds Street. Suite 804 Plant City. Florida, 33563 Telephone: (813) 707-8336 Fax: (813) 707-6725 www.acces.o;encineerin!!.neT , Pasco County 5910 7d1 Street Zephyrhills. Florida 33542 Telephone: (813) 782-9577 Fax: (813) 707-6725 www.Dcccsscn!!'ineerin!!.llet