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HomeMy WebLinkAbout07-6353 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 6353 Permit umber: Permit Type: Class of Work: Proposed Use: Square Feet: Est. Value: Improv. Cost: 125,000.00 Date Issued: 1/05/2007 Total Fees: 14,160.00 Amount Paid: 357.00 Date Paid: 1/05/2007 Phone: Work Desc: FINAL COMPLETION - SAME DAY SURGERY - CONTRACTOR CHANGE 6353 COMMERCIAL NEW CONST/COMM COMMERCIAL Address: 6733 L ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 03-26-21-0010-03200-0020 Name: MAHOOTCHI, AHAD (MD) Address: 6733 GALL BLVD ZEPHYRHILLS, FL. 33542 R SOUTHERN EQUIPMENT CORPORATION FIRE PLAN REVIEW FEES TRAFFIC IMPACT FEE 1% 327.00 TRAFFIC IMPACT FEES 99% COM 138.03 13,664.97 ~1~~P~ E- 1ST ROUGH PLUMB WATER MISC. MISC. DUCTS INSTALLED SHEATHING MISC. MISC, CONSTRUCTION POLE FRAME INSULATION CEILING FIRE DEPT, FINAL 2ND ROUGH PLUMB SEWER MISC. ELECTRICAL FINAL DUCTS INSULATED MISC MISC. PLUMBING FINAL LINTEL INSULATION WALL MISC. FINAL MECHANICAL REINSPECTlON FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection trips are necessary due to anyone of the following reasons: a) wrong address b) condemned work resulting from faulty construction c) repairs or corrections not made when inspections 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. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. 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." NO OCCUPANCY BEFORE C.O. - ~-~ TOR S NATURE PERMIT OFFI CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER CI~Y OF ZEPHYRHILLS PERMIT APPLICATION BUIILDING DEPARTMENT 5335 8TH st, Zephyrhills, FL 33542 813-780-0020 FAX: 813-780-0021 DATE RECEIVED PHONE CONTACT FOR PERMITTING 813 -78.:1-' Of~ OWNER'S ~h U ~ -So rm. ~ ~ JJp~ONE [f(~ -- 7 f':; .D<f>-<5" JOB ADDRESS LEGAL DESCRI PTION: LOT (S) () ~'D BLOCK O~ O'D PARCEL 10 # 03--< b- .:2..1- DDlo - b3~OD. ~o SUBDIVISION 0 D /0 {OBTAIN FROM PROPERTY.TAX NOTICE! WORK PROPSED: k1NEw CONSTRUCTION DSIGN PROPOSED USE: DSGL FAMILY DWELLING o ADDITION o ALTERATION o REPAIR o INSTALL o MOVE o DEMOLISH DMULTI-FAMILY 0* OF UNITS o MOBILE HaM o COMMERCIAL 0 INDUSTRIAL 0 SWIMMING POOL Jd.-oTHER. yYJ 'e-C~d c=J RESTAURANT & HEALTH DEPARTMENT APpROVAL DESCRIPTION OF WORK hv\~ ~{e...L:VVl., {)fS~~@.<.f~t.~)'e~'1~ 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 PERM~T ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REQUESTED o BUILDING $ VALUATION OF TOTAL CONSTRUCTION o ELECTRICAL AMP SERVICE o Progress Energy 0 W.R,E.C. o PLUMBING ~NICAL o GAS o ROOFING o SPECIALTY VALUATION OF MECHANCIAL INSTALLATION o OTHER $ TYPE OF CONSTRUCTION: 0 BLOCK o FRAME o STEEL o OTHER FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREAD YES 0 NO ~~''''''~''"7'',,",'''' It..,... ""'----""'V~~-7T~- ~-'-.r..'. '~-'-G~--------'T"'- '_'~'rr-' ,~"- ...,-r~' '~"""""'~"':rTI~-~~-~~ 'I. -.c.,d I . I II I,,' I I I I I I ' I , j ,I I jf I r f I," I J' '":r. ~, j ~:., I 'I' ... 1h~ " 1111, "Jtll'lll t 11,1 '''1'1 'I' r ' I < ;' - . \, I I I I -' 1'[ J t1, 1J] j'l I ,,,'"1\ '11 1 I" J 111" ~J: ~lpr1Jlli "II 11111"1 Iltl' I r I r,::'~ I', f 3 '_ ,,-1':..~'j~ f' \ ,I ;. lj f IJ 1111 ( 1,1 01 fe-i'-~ lNf~II~J'ij -,~~~J..;._~~_~.....__........L~-~------- I __r:-rJ1'0h"r'~ BUILDER COMPANY SIGNATURE STATE CERT OR REGIST # ****************************************************************** ELECTRICIAN COMPANY SIGNATURE STATE CERT OR REGIST # ****************************************************************** PLUMBER COMPANY SIGNATURE STATE CERT OR REGIST # ****************************************************************** MECHANICAL J COMPANY a) "tile ~dll1l ('It f }~ C. SIGNATURE ~ ~ STATE CERT OR REGIST * (!.A.!!-f) I ~ I ~ b /' ***************************************************************** OTHER COMPANY SIGNATURE STATE CERT OR REGIST * A. NOTIGE OF DEED RESTRICTIONS Th~ undersigned understands that this permit may be subject to "de~d restrictions" which may be more restrictive than City regulations. The undersigned aSSUDles responsibility for compliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contr~ptors 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 ci1:ed 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 contractor1s) sign po~tions of the "Gontractor Sections" of this ~pplication for which they will be responsible. If you, as the owner signs as the contractor, ybu 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 indicat;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, hav~ 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. Appll~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 wiil 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 inolude but are not limited to: *Department of Environmental Regulation-Cypress Bayheads, Wetiand 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 Protectiori Agency-Asbestos abatement I also certity 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 la period of six months after the tirne.the work is commenced. One 90 day extension of ~im~ 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 ~O YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE: CONTRACTOR SIGNATURE: OWNER OR AGENT STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged Before me this.L.:Z!!!:.. day of -:r~l , 2~ by . (name of person acknowledged) ~s personally known to me, or j)~ STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged Before me this ) 71:1(' day of ~......... , 20o-Z- by (name of person acknowledged) ~o is personally known to me, or 9~ o who has produced tJ {A- . (type of identification) and wnoD did .Q-did not take an oath. o who has produced ..; ( ~ (type of identification) and who Ddid QeH.d not take an oath Signature of person taking acknowledgment Signature of person taking acknowledgement Name typed, printed or stamped Name typed, printed or stamped 813-780-0020 t<; .,'f; City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Date Received Owner's Address Fee Simple Titleholder Namel Fee Simple Titleholder Address I IlR'733 I Owner Phone Number Owner Phone Number I Owner Phone Number I JOB ADDRESS ~a..U- ~cQr.' 2~,~' :sss~1 I PARCEL ID# I 03 -~" -.::t-I- (fl:IO- () 6..2 fJ'D -- 2JO J- I:) (OBTAINED FROM PROPERTY TAX NOTICE) B ADD/ALT D SIGN D MOVE D REPAIR D COMM D D FRAME D SUBDIVISION WORK PROPOSED B D D I PROPOSED USE TYPE OF CONSTRUCTION NEW CONSTR INSTALL SFR BLOCK DESCRIPTION OF WORK SQ FOOTAGE I BUILDING SIZE 111111111111111'111'11111111111'11"'1111111111111'1111111111111111111"11111111'1111111"1111111'11111111111111'111111"11'111111111"1111'111111 1$ I D ELECTRICAL 1$ I D PLUMBING 1$ I D MECHANICAL 1$ I D GAS D ROOFING D SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO 1111111111111111111111111111111111111111111111111111111111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111 D LOT # DEMOLISH OTHER I STEEL D OTHER I HEIGHT I AMP SERVICE VALUATION OF TOTAL CONSTRUCTION PROGRESS ENERGY BUILDING D D W.R.E.C. VALUATION OF MECHANICAL INSTALLATION License # 1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans. Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects Attach (3) sets of Building Plans; (1) set of Energy Forms, R-O-W Permit for new construction. Minimum ten (10) working days after submittal date, Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance Attach (2) sets of Engineered Plans. ....PROPERTY SURVEY required for all NEW construction, BUILDER SIGNATURE COMPANY REGISTERED Address COMPANY REGISTERED ELECTRICIAN SIGNATURE Address PLUMBER SIGNATURE COMPANY REGISTERED Address MECHANICAL SIGNATURE COMPANY REGISTERED Address OTHER SIGNATURE COMPANY REGISTERED Address 111111111111111 RESIDENTIAL COMMERCIAL SIGN PERMIT I I I I I I I I I I Y/N FEE CURRENT Y/N License # I 4/ I ~ '" l!,)r, ( Y/ N FEE CURRENT I Y/N I License # I EC 00 0 17 )0 Y/N Y/N FEE CURRENT License # Y/N Y/N FEE CURRENT License # Y/N Y/N FEE CURRENT 11.......11.....11.......11111....11111......1111..11................111..111....11.......11.........11.11...111.................................. Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement Is required. (AlC upgrades over $5000) Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades NC Fences (Plot/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed""testrictions" W~ich rnaYb~ more restrictive than County regulations. The undersigned assumes responsibility for compliance With any applipa~le. deed restrictions. . lJNU~E~~~DCONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has, hired a ,9ontractof ot c:()btr~ctotstoundertake work, they may be required to be licensed in accordance with state and 10c~ltegulatidnS,lftlie c~~tr~ct~riS,n~tlicensed as required by law, both the owner and contractor may becit~dfor arnisd~meapor Viol~tion. unp~rstat~la\y: . If the owner or intended contractor are uncertain as to what licensing re<1uirem~ntsrnayappl~f(j~ th~ int~ndecly.tot~i ,they are advised to contact the Pasco County Building Inspection Division--Licensihg Section at?27 -8,47- 8?P9,l=urthefmore, if the owner has hired a contractor or contractors, he is advised to have tliecontractor(s) sign pqrti~ns of th~<li~ontractor Block" of this application for which they will be responsible, If you, as the owner sign as the . cO,ntractor" tHat may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County. TRANSPO,R~AtION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The, undersigned understands th~t Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of uS8.in existi~~~uildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and 90~07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of permitting, It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to receiving a "certificate of occupancy" or final power release, If the project does not involve a certificate of occupancy or final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances. CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law-Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other than the "owner", I certify 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. 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, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other government 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 Protection-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, US Environmental Protection Agency-Asbestos abatement. Federal Aviation Authority-Runways, I understand that the following restrictions apply to the use of fill: Use of fill is not allowed in Flood Zone "V" unless expressly permitted. If the fill material is to be used in Flood Zone CIA", it is understood that a drainage plan addressing a "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. If the fill material 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 material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties, If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating the conditions 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 inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical 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 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 codes, Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit is suspended or abandoned for a period of six (6) 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 job is 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. FLORIDA JURAT (F.S. 117.03) CONTRACTOR Subscribed and swarn to (or affirmed) before me this by Who Is/are personally known to me or has/have produced as identification. OWNER OR AGENT Subscribed and swam to (or affirmed) before me this by Who is/are personally known to me or haslhave produced as Identification, Notary Public Notary Public Commission No. Commission No. Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped CITY OF ZEPHYRHILLS PERMIT APPLICATION BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 813-780-0020 FAX: 813-780-0021 i~f^r~/ . . DATE RECEIVED ~ PHONE CONTACT FOR PERMITTING OWNER'S NAME ~I 'nCL eeJ ~ f-c:c: 't--e-r;;.Je~r-m~ ~ PHONE (Jl3 -7t' ~ -0 R~~ cvJL z:.. ~r . -.' JOB ADDRESS LEGAL DESCRIPTION: LOT (S) DOd-.O BLOCK {)S-J,co SUBDIVISION ero/c> PARCEL 10 # 03 ,;;)",10 -.:J.j - DiD,D D-.s~Do - ()t)~o (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPSED: ONEW CONSTRUCTION DSIGN o ADDITION o ALTERAT ION o DEMOLISH o REPAIR o INSTALL o MOVE PROPOSED USE: DSGL FAMILY DWELLING o COMMERCIAL DMULTI-FAMILY o INDUSTRIAL 0# OF UNITS o SWIMMING POOL o MOBILE HOME ~ER .tn ~I c.../L; BUILDING SIZE CJ RESTAURANT & HEAl.TH DEPARTMENT APPROVAL ~~ ~ ~ ~ \'\9.-<-0 '\'\In ~ .e.odr. SQUARE FOOTAGE HEIGHT DESCRIPTION OF WORK RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. & (1) SET ENERGY FORMS. FORMS. _I I NOL N6t l~~d OiP f'd-13tj IL 0 I NG ~ECTRICAL Au- 5c...L~ S,~n PERMITS REQUESTED p""" -+0 rbrMiH1n) 3ssue- ~ {)e,mtt VALUATION OF TOTAL CONSTRUCTION (Ie...Q? ( .-\-0 Qu-~ 507'+ AMP SERVICE ~progress Energy 0 W.R.E.C. ~~ING ~ECHANICAL $ o GAS o ROOFING o SPECIALTY VALUATION OF MECHANCIAL INSTALLATION o OTHER TYPE OF CONSTRUCTION: 0 BLOCK o FRAME o STEEL o OTHER FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREAD YES 0 NO SIGNATURE ~OMPANy~~)'n..$ff~~ t~;tt:&E- STATE CERT OR REGIST # c....11c!.- J ~-5t>7 /~ BUILDER ELECTRICIAN **.*7*************************** '1,,> JA~' I I ~ a ..J COMPANY Ci.-.u- ~ t:k SIGNATURE STATE CERT OR REGIST # PLUMBER **************************************~~************************** 1 S, . COMPANYS~ f..:~~- STATE CERT OR REGIST # c.,:;c..O.1 <l73~ ;)'> . *******~***ii**************************** (' . (\ t' .~OMPANy~&..~rn~,~'~L .. -1<'.-' , \ 'STATE CERT OR REGIST # SIGNATURE MECHANICAL SIGNATURE ***************************************************************** OTHER COMPANY SIGNATURE STATE CERT OR REGIST # A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this permit may be subject to ~deed restrictionsU which may be more restrictive than City regulations. The unde~signed 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 stat& and local regulations. If the cbntractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation under state law. tf 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 1S adv1sed to have the contractor(s) sign po~tions of the ~Contractor SectionsU of this application for wh~ch they will be responsible, If you, as the owner signs as the contractor, you are indicat1ng that you, +ather 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 ~owneru, 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 oone 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,U, it is understood that a drainage plan addressing a "compensating volumeu 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 Sh~ll issuance of a permit prevent the Building Official from thereafter requiring a correc ion 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 la 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 _ mo~th 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 ~N ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500.IN VALUE DO NOT NEED TO RECORD AND POST A ~NOTICE OF COMMENCEM NTu. S STATE OF FLORIDA COUNTY OF The foregoing inst~ent was acknowledged Bef~be. thisc:5tO ~ay at ~a-. ' 20lPb by b7e ~ f.- 1/\ l ~ <:::t""" _ ~e of person ack~owledged) ~ is personally known to me, or STATE OF FLORIDA COUNTY Or The foregoing ins~ent was~ledged BeforR. mb ..this .;t~V^day 'i,.f, ' 20~ by C> bt"ie..-~,,-,~ ~. ~(name of person acknowledged) ~ho is personally known to me, or - o whO has produced (type of identification) and wh~~~ _ ~no} t~~oath /~ ~ L- . /c~ Signat.~f~~9 acknowledgment . · My CommIssion DD3OIM3, ~ ....... ~ 04, 2e8lI Name typed, printed or stamped of identification) an oath. Name typed, printed or stamped 11111111111111111111111111111111111111111111111111/1/111111/ 2006252662 Rcpt: 1059467 DS: 0.00 ... .. . 12/22/06 NOTICE OF COMMENCEMENT Rec: 10.00 IT: 0.00 Dpty Clerk STATE OF FLORIDA COUNIY OF PASCO THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statues, the following information is provided in this Notice of Commencement 1. Description of Property: Parcel No. 03-26-21-0010-03200-0020 6733 Gall Blvd. Zephvrhills. Florida 33542v (legal description of the property and street address' if available) 2. General Description ofImprovement: Final Completion of new medical building with surgery center 3. Owner Information: Name: Fina Real Estate Investments LLC Address: 6739 Gall Blvd. Zephyrhills. Florida 33542 JED PITTMAN PASCO COUNTYf CLtRK 12/22/06 09: 37am 1 gO 77 Interest in Property: OR BK 7321 PG Name of Fee Simple Tittleholder: If other than owner: Address: City State Zip Code e- 4. Contractor: Ryman Construction of Florida. Inc. Address: 3(i413 S.R. 54 West, Zephyrhills, FL 33541 l 5. Surety: Name Address City Amount of Bond: $ State Zip Code 6. Lender: Name SunTrust Bank Address 211 Perimeter Center pkwy.. SuitelOO City Atlanta State Ga Zip Code 30346 7, Persons within the State of Florida designated by owner upon whom notices or other documents may be served as provided by Section 713.13 (1 ) (a) (7), Florida Statutes: Name Heriberto Gonzalez Address 5435 Gall Blvd. City Zephvrhills. State FI Zip Code 33542 8, In addition to himself, Owner designates: of to receive a copy of the Lienor's Notice as provided in section 713.13(1) (b), Florida Statutes, 9. Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of recording unle a different date is specified.) Signature of Owner: / Sworn to and subscribed before. me, tIDs/},,":daY of Notary Public: lSMlu~_ijLI- My Commission Expires: Printed Name Ahad Mahootchi ~ , 20().6 . ~) Notary Public State of J:lorida Bobbie J Knight My Commission 00416222 Expires 03/3112008 1111111111111111111I1111111111111111111I11111I11111111111111 20062!52663 Rapt: 10!59467 Raa: 10.00 DS: 0.00 IT.' 0 00 12/22/06 . NOTICE OF COMMENCEMENT Dpty Clerk STAlE OF FLoRIDA COUNlY OF PASCO THE UNDERSIGNED hert!by gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statues, the following information is provided in this Notice of Commencement: 1. Description of Property: Parcel No. 03-26-21-0010-03200-0020 6739 Gall Blvd. ZeDhvrhills. Florida 33542 (legal description of the property and street address 'if available) 2. General Description of Improvement: 20' x 40' Addition to existing medical building 3, Owner Information: Name: Fina Real Estate Investments LLC Address: 6739 Gall Blvd ZeDhvrhills. Florida 33542 / Interest in Property: Name of Fee Simple Tittleholder: If other than owner: Address: City State Zip Code e 4. Contractor: Rvman Construction of Florida. Inc. Address: 36413 S.R 54 West, Zephyrhills, FL 33541 5. Surety: Name Address City Amount of Bond: $ State Zip Code JED PITT"AN PASCO COUNTY CLERK 12/22/06 0.:37am 1 Df 1 OR BK 7321 'PG 978 6. Lender: Name Address City State Zip Code_ 7. Persons within the State of Florida designated by owner upon whom notices or other documents may be served as provided by Section 713.13 (1) (a) (7), Florida Statutes: Name Address . City State _Zip Code_ 8. In addition to himself, Owner designates: of to receive a copy of the Lienor's Notice as provided in section 713.13(1) (b), Florida Statutes. 9. Expiration date ofNoti of Commencement (the expiration date is one (1) year from the date of recording unle a different date is specified.) Printed Name Ahad Mahootchi Signature of Owner: Sworn to and subscnbed before me this ~~y of GD.L NotmyPub~ 't5~~0"! My ComnnsslOn Expires: .20~. ~J ......" Notary Public State 01 ~Iorida Bobbie J Knight My COIlIIIllssion 00416222 Expires 0313112008 ,-.., 03/02/2007 12:45 8137886773 Mar Ui.! ur U~:48a AJi Shasti, M.S" P,E, RYMAN CONSTRUCTION 813 707 6725 PAGE 02/02 p,1 ACCESS ENGINEERING and CONSUlTING, INC. -. '.7 ~&'-3Cj? CIVIL ENGINEERING - LA.ND PLANNING - STRUCTURAL CONSULTING SERVICES - DESIGN AND PERMfTTING March 2~ 2007 Mr. William A. Burgess, Cc.rtified Building Official City ofZeph)ThiUs 5335 Eights Street Zephyrhills, Florida 33542 - 4312 SUBJECT: Same Day Surgery Centers of Florida, LLC I AEC, lo~ hojeet No.: 0422 6739 Gall Boulevard Zephyrhills, Pasco County~ Florida 33542 Parcel ID No.: 03 - 26 - 21 - 0010 - 03200 - 0020 .Dear Mr. Burgess: Please be advised 1hat at the time of fiJJ.a1. inspection, the above referenced site was completed substantially in accordance with the permitted construction plans and specifications. If there are any questions or concerns pertaining to this matter, please do not hesitate to contact our PLANT OFFICE. xc: Dr. Ahad Mah.ootchi, MD., Owner .File of Record .a_ "..................._._. ~..___ .... ._... ......... ._,..." .._....... ...... "'~.........'~.,. HiJlsborough County 11 D E. Re\:nolds SMel. Suite 804 P'mt cii Florida. 33363 TclCf'lhonc: (813) 70;-8336 Fax: (813) 707004i725 \\'\\,\\'. nccc:t~IlI~iI:,,:l:rillJ!, net .. ... ..... -- ", " "..., .. .-..-. - ,..-" . "... ....~.,_........ .. --..--...--. Pa.'lCO County S910'" SIn:et Zepl1,,'rhllls. Florida 33542 Tdcphono:: (813) i82-9571 Fax: (813\707-6725 .u)y"\}.',accc~~n!!.inceri" g..OO Healthcare. Design Inc. Architects Directive: J Mclaughlin & Company Inc. (Contractor) SameDay Surgery Center (Project) November 20, 2006 The contractors unauthorized application of the substitute "Tremco Fire Spray" must he removed, as it is unacceptable to the Architect of Record due to it resting on the surface, rather than "the space between" as required. A notification of this was made on September 1,2006 for the contractor to correct the work. The engineering judgment, presented by Tremco for application of"Tremco Fire Caulk" is an acceptable application to the Architect of Record, as is any other application of "Fire Caulk" that meets 8.2.4.4.1 in that it "is between the penetrating item..." and "limits the passage of smoke." Other applications of Fire Caulk that may be presented for our review may also be approved, The contractor J. McLaughlin & Company is ordered to proceed in accordance with the approved shop drawings as transmitted to install "Fire Caulk" with the annular space as noted on the Shop Drawing. Failure, to notify the Architect of hidden or unauthorized substitutions made by the contractor shall be considered a dishonest business practice and fraudulent billing for services and materials not meeting the contract document requirements; both of which are actionable. Notice is herby officially served on the Contractoc, . The Contractor, J. McLaughlin & Company is notified to stop illegally making representations to the "Building Officials" as to the Architectural or Life Safety requirements of this project. Under Florida Law J, McLaughlin & Company Inc. does not hold a valid license for Architecture, nor are they representatives of the Owner, L3 Healthcare Design Inc or the Architect of Record of this project. Punitive and legal action will he taken if required, The Contractor has been so notified as to take action to restrain J, McLaughlin & Company's employees. Thank you Sincerely, L3 Healthcare Design Inc. :J:::~tlc AlA Architect \J 10 CI~.J 375 Douglas Ave. Suite 2009, Altamonte Springs, FL 32714 Ph: 407-865-6160 Fax: 407-865-6914 FLA. REG. AAZ....7.. 03/09/2007 08:15 """ -/~.~ ~~~ 8137886773 RYMAN CONSTRUCTION PAGE 01/02 ~~Ie ~ fJ{~tMida, 9~~ . OF FLORIDA INC. Licen,,! it ceC12S0!l14 ~ FAXCO~RSHEET A:P~DATE: .3/7/07. COMP~:. ~ 5 .tJ~M: ~ ~r11 (d.~. PAGES(II\'a.VDlNG~1 FAX: 7 f'D - ~ ~ RE: PHONE: COPY: CO.M:MENTS I INsmuCTloNs: o URGENT . ". .... .......~.. . .., ..__...._~.. . L . ~ ~.~~.~ .~.=-~... ~ . -'1-" .'--... 36413 SR 54 . Zephyrhills~ Florida 33541-2275 " Telephone 813nS2-0825 " Fax: 813n88-6773 03/09/2007 08:15 8137886773 RYMAN CONSTRUCTION PAGE 02/02 1-)'1 ~~"".~ c"";Jr ~,~ Print Dabt: 3/812007 ~~i:~:7-C;C':"'7'277~~C7':~~7~T77;c7:' Final ",", 1. Zephyrhillll FIre Rescue 6907 Deity ReI Zephyrh"18, 33542 Phone:B13-7~1 Fax: 813-780-0044 In.neded Pal1I SAME DAY SURGERY 6733 GALL BLVO(OO0825) ZEPHYRHILLS, FL 33542 Phone: 81S.783-8242 InspectionOate: 3/8/2007 2:15:00PM In!lp8CtotName: Barnett IllspectionNurnber: 1-113-07-0) 88.A InspectionCause: Reinspcction OccupancyType: HcaJtbcare PropertyUseType: Medical, Other \fKKstionCoums: 0 Hrs: 0.05 Comments: VioIatlol1a COrreeleCl Approved for CO at this time. Address numbers will be changed out to 12., Sign Here Paae 1 of 1 PASCO COUNTY, FLORIDA Permit No. { ,,35"3 Date Permitted \ :-s -0/ Builder Name/Owner Name . R 11 ("nf\_'r\ ~ 1<.: Control # . County parce.' No, 03-~lo _~I_ '00\0 -03a.(){j. cX)C;lO SubDlv: Address/Location (o73~ ~ \ \ ~) \lA. Classlfioation/Type of USfil ~()).e~c~roQ TRANSPORTATION IMPACT F.EE. Rate: ~xempt 0 yes 0 No How DE!termlnecl rno A \ C o..Q.. Sq Ft Unit: <6 \ '1 c:s Irnpac~ Fee Amount $\ \? 40L} , 00. Zone No, TAZ: SCHOOL IMPACTFE;!E: Account (056) Single-FamilY Detached House . (057) Mapile Home (058) . Other f{esidentlal . jj}3) Collection Fee . Exempt .lkfYes 0 No How peterrnln~d Amount $ PARKS AND RECREATION FEE Land Aocount . Land Credit 4lnd Total Recreation Account f{ecreatlon Credit RE!creation Total Zone Exempt 0 yes 0 No LIBRARY FE!: Lancl Account Facility Account How Determlneq Land Credit FacUlty Credit How Determined Land Total Facility Total ~xempt 0 Yes . 0 No 'RESOURCE FEE TOTAL AMOl,JNT . Total Amount .ERU Prepared By Checked By .' . NO O!:RTIFICATE Of OCCUPANCY WILl. BE ISSUED OR FINAL INSPEOTION pERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE . . BEEN PAID ANQ RI:GEIPTED FOR BY A CENTRAL PJ:RII/lIlTING OFFICE. OF PASCO COUNTY Acknowledgement lJelow does not Imply accep!ance of concllrrence, but simply recelp.t ota coPY of thl!? fonn. placing . the building pennlt owner on notice of this assessment al)d thE! condlUom. of payment for same. ,<ilk PATE RECEIPT NO. RECEIVED BY DATE BY 03/01/2007 12:04 8137886773 Mar 01 07 09:21a Ali Shasti, M,S., P,E. RYMAN CONSTRUCTION 813 707 6725 PAGE 02/02 P,L ACCESS ENGINEERING and CONSULTING, INC CIVIL ENGINEERING - L.AND PLANNING - STRUCTURAL CONSUL. TINCJ SE/,?VICES DESIGN AND PFRMITTfNG Macch 1,2007 Mr. Wojciech M Mroz., P.E. Surface Water Regulation Manager Brooksvilte Regulation Depar1Jnent 2379 Broad Street (U.S. 41 South) Brooksville. FL 34604 - 6899 SUBJECT: Same: Day Surgery C.ters of Flori..... LLC J AEC~ lne. Projeet 0..: 04Z2 6739 Gall Boulevard Zepbyrhills, Pasco Count)', Florida 33542 Applic:aliOll. Number: 46022807.000 As-Bu;1t Submitlal Dear Mr, Mroz: Enclosed please find the original plus on.t copy of STATEMENT OF COMPLETI REQUEST FOR TR.A.NSFER TO OPERA nON ENTITY Forro along with two ce plans for your use and file. tftbeR" are any questions Dr concerns pertaining to this matter, please do not besitat PLANT CITY OFFIC xc: Ci1y of Zephyr bills Dr. Ahad Mahootchi, M.D. File of Record " .", ...... ".- . ....~. ...............--..-.... ~-"......_........... HilIsborough Count)' I 10 E. Rc)'nold$ SIreet. Suite 804 Plant City, Florida. 33563 Telephone: {8 13) 707-S336 Fl)lC.: (813) 707..(,725 WWI\' .:\C~':~~I't! i n L."Crill~.m;! Pasco County 5910 71~ Street Zepltyrhills. Florida .33542: T=ltpho\Je: (IU3) 7K2-957? Fa.,: (1m) 7i17-672.~ www.acccS'l':Jla:inccri.n;.n,-" 03/01/2007 12:04 8137886773 ~~~ ~~~ RYMAN CONSTRUCTION ---".. PAGE 01/02 ~~.~ ~.7~,. 1~" License # CBC12509)4 . OF FLORIDA INC. FAX COVER SHEET DATE: ~t /0 7 " . ."' FROM: ~:6~ PAGES ~~JNGC~):. ...-- .~. --;w FAX: Jtfi> .~~ RE: PHONE: COpy: COMMENTS / INsTRUCTIONS: o URGENT ~~~ ~. <- ~ ~ t-:iSs h~71t.~~~~~L~ 1 36413 SR 54 . Zepnyrhills. FTorida33S41-227S . Telephone 813n82.0825 . Fax: 813n88-fi773 02/~~L?~~7 16:36 8137886773 PAGE 02/02 ::2/a-7/0"7 W)J...Q.. ~ ~~ ACCESS ENGINEERING ~ &~'CL and CONSULTING, INC. RYMAN CONSTRUCTION ,. ,~ ,. "I. .............--~"...... .-,,,,,,,,, ~Ii ' ~~'r",~' ...',' .(/1",' ....' l~li'('!: t)~~7~_...i' ':. 6~~} \ .: . .~., ::-"4 'ii.~~ _.. ' . .~iI, .'. ~;~,. ..- :.,,,,.~, \ U ' , . f~49:i' , ' ' ~:!-:;, ~,,,:~.~..,...~~. ~t":. ': ~ ~- -~ - --. CIVIL ENGINEERING ~ LAND PLANNING ~ STRUCTURAL CONSUl. TING SERVICES - DESIGN AND PERMITTING - - Februaty 22. 2007 Mr. Richard Burkam, Projact Manager via Fax # (813) 788 . 6719 36413 S, R. 54 2'.epbyrbills, Florida 33541 sUBJECT: Same nay Surpry Co.ten o,FIorld.. LLC I AEC, IDe. Project No.: 04~% 6139 Gall Boulevard hpbyrhills, PISCO Courrty, Plorlda 33542 p~m No.: 03.. 26 -21- 0010.. 03200,.0020 Site Jnspcctfon I Comx:tiw Action Needed, Dear Mr. Burkam.: Per OlD' ~lophone.chat concemi118 the above Ie~ p~eot today, the foUowiD8 please S,- our list ofrequi1'ed COI'leCtlve aotions. . Pleue raise bottom. of skimmer to 3 iDche!l below slOt elevation to gain clearance between skimmer and the grotmd. . On the east $ide sldmm<<, you may also oreate a sump fin' BdditiortaJ clearance. . Please provi~ rip raps or other types of emllon QOIltrol at the ends 0(8" and 12" F&'i . to avoid vcgL'ltation.srowtb _ potential blodcage. . Ift.btJre arc any questions or concems pertaining to tbf. i.natb!JI', please do not hesitate to oon~t me at 0 AN.r CITY OFFICB. " .I1LL~ ~ ~ oS ~-~~aR- ~-f... (" ,,=--. ~~/07 ---' xc: Dr. Ahad MahootDbi!, MD. via Fax # (813) 719 .3317 File of Record __.....,,_.______ ..__,."'____..._II....__J...___.- ""'-.... ....."..... ~...-...-._.,... HDlsborougb county l' 0 F., R"'IIoldn Su.t. Suite 104- Plant City, Plorldll, ~ 3 563 Telephone: (813) '07~3~ Fax: (1m) 71"-6725 www.acee!lseftlllncerlnl.lltl.i . Puco County 59) 0 7'" Street Zephyrb.Ws, P.lorIda 335..., 'folllphcme: (813) 782-9$77 PIX: (813, 70H725 mw' acecl~h' riel 8137886773 RYMAN CONSTRUCTION PAGE 01/02 ~~, ~ D{~7~" 91eC, L.icense # CSCl250914 OF FLORIDA INC. FAX COVER SHEET ATTN: < ~ FRDAoTEM:: .t;z COMPANY:~~S~~ ___ -:15 ()J'j ~ r;:::; ~ ! PAGES (JNC;=LtlDING COVJr.RmDJr.T):, FAX: '} j()... (;O~ RE: , PHONE: COpy: COMMENTS / INsTRUCl'IONS: o URGENT '- ~ ~G::J...7~(; '/~ ~ ~ -+ lc,SS'..3 ~ ".-.- ce' -'~~~~., ~-_.::::r::. ~~M_~~' ", f' 36413 SR 54 . Zephyrhi/ls, Plorida 33541-2275 . Telephone B13n82.0B25 .. Fax: S13n88-6773 03/09/2007 17:09 8137886773 RYMAN CONSTRUCTION PAGE 02/03 ,~ . Hesltllr:srB Design '''e. Marcb,9,2007 0..- Sir: We undcntaad iat the City of ZepbyrhilIs, Building Fh OepIrttnea.t would like to ha\le a copy of the .Final ApprowI Lettc:r 1l'om AReA. We COJDJnOGly MID imo this request by bulJdiq dep&rtmema. because they waat 10 maJce I," that the public; js protected, prior to any actual surP')' hems CODduct.ed. CumlntJ)' AHCA', office of pl_ and CODSh'Uction l1u compJetI8d ill' lnspcctfOD of the BuilcUns. bot tho Final license ftolb ARCA requinls much more. The licensing division will NturtI to i1IIpCCt the buildiDg. for Policies IIIKI Proc:edurcs. lnteMew stBtf; review mediattlons. equipment elle. The)' wiD expect the fuD ItaW to be 1Iaioed, !Jaw COJDI)leted drilla JncIudiDg Fire drills, code blue's etc. In order to be prepatecl for 1hi8 tho owner must oc:cupy the building for aft' Ilnd Doctor's only, ud therefore will n.ed hJs CertfflcaflC of Oc:cllp8llC)' fi'om the city prior to the final ARCA inspection. Theref'ora. the isswm~ of the City. CertI&C8te of Oc:c:up1Ulcy to the owner is not an 8utliorizatiOd to be open to cbe puhlfc, for surgery. Only the State o1&e of AHCA can gnmt that permission. "Ibe Owner, is 8pCCJ11caUy awwe that he is Dot authoti2ed to be Oplll. to 1bo public DOl' to ~rm my -Say what .0 e\'er until he nceives hi8 State ARCA UCIIlIe. Tbe Owner~ will Wriw a letter to the City to CODfinn tMt he is aWII'e of Chis lWtrictiOll. And our office by this JetlI:r agrees to copy you with !be approvaI letter hm AHCA WhCb W!l receWe It .in about 60 days. To COVer themselves fhxn liabWty. sewnI buiJdins cIepu1meQfI have issued CatitIcaae of OcC\lp8llciee to pnvioua projec:ts of oars by placing exact wotdiug 011 to the ~c BUch as "Certificate of OccuprlDC)' is sra=d1br Staff and Oogton' ; FaciJiCy w1IJ acqUire '. licenlo &om the Office of The Florida Asency for Health Care ~ prior to boinB open to cbe public or perfomrlng any Surge..."." We hope that rhis clarifies the &imina of licensure and occupancy. L3 HeaJtbeare Design In&; ~~. VJce Pns.idcnt Project COOIdiDatiOD. 375 Doua'a Avo. Sulle 2ODB, AI......o.... ...rI..... FL 327t4 ....: 407-88508180 Fax: 407-11I5-8814 FLA. 1.1.&11111"" , ~'d +lSSS9B~O. OWl .~eIS3a 3~~OH~i~3H Ei Wd9t:E ~ODa SO ~ew 03/09/2007 17:09 8137886773 a3/B9/2a07 15:48 8137793318 RYMAN CONSTRUCTION AHAD MAHJDTCHI MD I PA PAGE 03/03 I-IA<:i1:. IU Ahad Mabootchi, MD Ophthalmologist (813) 779-1138 March 9, 2007 Dear Building Inspectors, This letter is to clarify that DO surgery win be peQOfDlm in, the new Surgmy Center at 6733 Gall Blvd. untn AReA has ai\'1m us Hcense to do so. Abed Mahooiehi, MD Th. .Eye OiDic of Florida 6739 0a1l Blvd, ZephyrhiUs) FL 33542 "."'~'''f'''.''''','''' iL " '! ';; ,(; Mar 08 2007 8:29AM MAR/O~/2007/TUE 10:26 AM . ' SAME DAY SURGERY CENTERS ZEPHYRHILLS BUILDING 1 813 783 8240 FAX No, 813-780-0021 ...- ?-~\rl'-~'" to;' ,.' .,". .' :,'eli!i~-'i' '~, ~-'~> . .~~r ' . i f-li. ,\:I~ , , PASCQ. ~OUtfTYrF~OR~D~ ~ . .. , , " I i ! . 1 , i ; ,) I ! I I ! ~ I i ! ! p.imIt Nu. ," t d~ ' o.te PtnnllJiij' ~--9-o/ !:'UIIU~ r'f"'lI~"'~~""m"; 'Q.,.....:..~'I"" (1r~~" ~~f## " . COlJnty farce) No. OBwS,l.o.Al_ ~IO ..()'SQ.oO.~O aubD!V~ 'AddreulLoo.n. ~.,73~ ~~ \ . IBJ IJ~ . _ . OIa_ltloctionlTYpeofU~~ ~ ~~Q~nrO ~~1I"r'~ " TRANSPORTATION IIIPAcr PSI!,' ' Rate: , Sq ~ Unit (l ~~Cz, FxGmpt 0 VBtI 0 No . HowP~ " " ImpI~FeeAm~ $,\'6404. 0,0, ~8'Na,.. . . ' I SCHOOL IMflAQT PIPE' . ' Aaoount (0116) Slngle-PlmUy Oetaohed /'klUse .' . 'OOT) Mc~UI HonJ. . (058). . Other ltMI-n*J '. . . ..J:lp) COIlllOllon Fee . Ex~?1 MY"'" 0 NQ How P8~ ' . fAfu~fr~D'ImC~TION PEa ': .. . " ' . " ',. Land AaCOUl\t ' Land Cf'Bd1C lfmd Total , d>- w;. . t;aDl1illUol') Account f"tcreaIlD~ Crd . . "1""- ~~ ~oteJ, , " Zone TOTAl-AMOUNT:, ',S" E!~nipf 0 y~ ' 0 No How,D_~ Ub.Jtt\Ry PEts ; . . ~Cf Acootllt " !-and Credit 00 ..1>..' TAl: . 'r.... ", ... An-.:lU" " " , . r . I' ,--<l!tV f I . I ! I I'acflty AocouJ\~ 15xeRq:lt' 0 Y. . 0 No 1._ 1ot., ~ -, f~o"l1y TatIIl , 0 ,Tat.1 Aenaunt ' . . . ~ ~. . FlOfIIty qr&4It Haw 08twtnMd . ~ ..,~:.. prsJ"lr.d By : (Q~~Y CciLj)-Bal . OMq(ed By ~ '.,015 .~ NO oaAtff'JCATI: Of OCOU~ANCY WILL ~ ISStJ~D Oft FINAL INSPscT;DH PE~OftMJm UJm&.'THS ToT"'- AMOllfTa LfI'JaJ HAVI! . .IiU!~N PAlDANQ .' '. , "~~P ,.OR BY A o~ PJ!""'ITTIHG oPrICItOP PA80~OQlI1m', , , Aat,,-~lMIlDwdall ~1mati1~cIl'~rrIMI,'buf.P6'~df.. CO~of'w, iJmJ, PIIaina. : " . -' 'lbtl_d~g /l'INJfIIt~;dr'''~C11 ar.... ~ .~b1 ~C1'~I..... . :. ~ ~NO,~~ey~/pty4~ . . u p.2 p, 002 " " . .