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HomeMy WebLinkAbout09-9294 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 9294 BUILDING PERMIT Permit Number: 9294 Address: 6836 MEDICAL VIEW LANE Permit Type: COMMERCIAL ZEPHYRHILLS, FL. Class of Work: ADD /ALT COMMERCIAL Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 02- 26 -21- 0290 - 00000 -0020 Improv. Cost: 85,000.00., m._ Date Issued: 7/06/2009 Name: HAITI INVESTMENTS I LLC Total Fees: 24,669.84 Address: 38819 OTIS ALLEN ROAD Amount Paid: 11,325.04 ZEPHYRHILLS, FL. 33542 Date Paid: 7/06/2009 Phone: (813)782 -0825 Work Desc: INTERIOR B /OUT MEDICAL SQ. FT 2999 -PRMT EXIST_ FOR FOUNDATION 9284 RYMAN CONSTRUCTION O FLORIDA IN BUILDING FEE 841.49 ELECTRICAL FEE 185.63 FIRST CLASS ELECTRIC INC PLUMBING FEE 123.75 MECHANICAL FEE 86.63 WILLIAMS DENNIS (INDIVIDUAL) SEWER CONNECTION COMMERC 4,152.89 WATER CONNECTION COMMERC 1,324.38 SONNY'S DISCOUNT APPLIANCE, INC. FIRE PLAN REVIEW FEES 162.00 TRAFFIC IMPACT FEES 99% COM 17,615.14 TRAFFIC IMPACT FEE 1% 177.93 i pS g ' e- i o'a � es�rce � . � 1 �,.r� � ��' ., � q9' k� Ja Ll/ - 35 5 — -' l i - J °ro — 133• 4 '45" ` fd eit'I 'o°s ;b. ,i1 c . s ,111!`,;e..,, e 9 f1 , !* P `v , , FOOTER 2ND ROUGH PLUMB MISC INSULATION CEILING FOOTER BOND DUCTS INSULATED SEWER MISC. ROUGH ELECTRIC LINTEL MISC MISC. 1ST ROUGH PLUMB PRE -METER INSULATION WALL MISC. DUCTS INSTALLED WATER MISC DRIVEWAY PRE -SLAB SHEATHING MISC. MISC. CONSTRUCTION POLE FRAME MISC. MISC. REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection trips are necessary due to any one 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 befo - - • . rding your notice of commencement." , 6442..- apr 4 4 fti, , CONTRA R SIGNATURE PERMIT OFFI FR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: Date Received: Site: t 36 cam-) ii Ln Permit Type: — l`b '-` CNA- lC ', ..f Approved wino comments: ❑ Approved w /the below comments: IQ Denied w /the below comments: ❑ AD Il ,_541161-i 1 0 off p 11 1 This comment sheet shall be kept with the permit and/or plans. A.. -/ 7 A( Kalvin Switzer P s Examiner Date Contractor and/. ' omeowner (Required when comments are present) iiiiiii$11hill1111NIi IhilliI iI EIW • 2009088789 STATE OF FLORIDA, COUNTY 4ROA THIS IS TO CERTIFY THAT THE FO[ EGOJN'e ` ' P �\ Rcpt 1250544 R ec C TRUE AND CORRECT COPY OF THE DO ~ 1 s\ DS: . pt0 Clerk ON FILE OR OF PUBLI ECORD IN 7 HIS"OFFICE 06/26/09 Vy,IT E S MY HAND OFFICIAL SEALTH / / DAY OF ∎fii. .�.v ' 2 ('`� PRULR S. O'NEIL, PRSGO GLERK 6 GOI'IPTROLLER ULA S. \•' EIL, CL: RK & C•Mfa'f'ROO L 06/2609 1 :0 A 1 PG af g n OR BK 8 i (� EY _ ; rG■ �� �'?' l)TY CLERK' NOTICE OF COMMENCEMENT Permit No. Property Identification No. 0 2- a 6-dl- 0 2,9 0 - 00000 - 0 02 O THE UNDERSIGNED hereby give informs you that the improvement will be made to certain real property, and in accordance with Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. 1.Description of property (legal descrlpdon:) t) a u Ro ai PC t e SS I On'. �e4 4.e,+ Tr a) Street Address: (4013(v Me ;co.. v . y i_n 1�6 S� P4- 02 L p } 2 2.General description of improvements: _„ ; a h u ; l d_ kit \s S F L 3 3 S y Z 3.Owner Information '1 a) Name and address: l-k. TAJC S4 "CA} S T LLC. 3 g g i 9 0-1-. s #I(2.n RA Zepti t(s FL b) Name and address of fee simple titleholder (if other than owner) c) Interest in property 3 5'10 4.Centracter Infonitatlon a) Name and address: IZ Lo„ s it r 4 c , b) Telephone No.: - 7 2- p 2 f Fax Opt.) $ Q � �; �� 5 �L 3 �y 1 .Surety Information Fax No. (Opt.) g g - 411 a) Name and address: b) Amount of Bond: c) Telephone No.: 6.Lender Fax No. (Opt.) a) Name and address: Phone o. 7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served: a) Name and address: b) Telephone No.: Fax No. (Opt.) 8.In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes: a) Name and address: b) Telephone No.: Fax No. (Opt.) 9.Expiration date of Notice of Commencement (the expiration date is one year from the date of recording unless a different date is specified): WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. STATE OF FLORIDA COUNTY OF PASCO Si ature of weer or Owner's Autho d O cer/Director/Partner/Manager flL Pr int ,<J Th instrument was acknowledged before me this _ day of �krn ' Q , 20 0 , by Ak IS o � ar‘ (type of authority, g in fact) for t4 ii 4-; �� ve_f -1-�+P„A-1-f � LLC (name of (• .* ty, e. officer, stee, attorney ( party on behalf of w • � instrument was execute. . Personally nown / - Y V OR Produced Identification Notary Signature lakr / Type of Identification Produced Name (print) - o y l . p • ./N Verification pursuant to Section 92.525, Florida Statutes. Under penalties of per' , I declare that I have read the foregoing and that the facts stated in it are true to the best of my knowledge and belief. FORMS/NOC,rvsd2007 Srg o atural Person Signing Abov O1tY pv ¢ _ Notary Public State of Florida Bobbie J Knight My Commsio 00 oea Expires 03/3 n 764225 • Ryman Construction - 6836 Medical View Ln- Permit # 9294 Build Out SQ. FEET PRICE MAIN OR LIVING: 2,999 $ 71.39 OTHER AREA UNDER ROOF: - $ 91.00 OTHER: - $ - VALUATION $ 214,098.61 FEE SHEET $ 825.00 ADDRESS DRIVEWAY BUILDING: $ 841.50 ELECTRICAL: $ 185.63 PLUMBING: $ 123.75 MECHANICAL: $ 86.63 SUB -TOTAL $ 1,237.50 RADON: TOTAL $ 1,237.50 SEWER: $ 4,152.89 1 DOCTOR WATER: $ 1,324.38 1 DOCTOR IRRIGATION: $ - TOTAL: $ 5,477.27 WATER METER: pd for @ shell prmt # 6929 ck#3143 (2) 3/4' meter IRRIGATION METER $ - I pd for @ shell prmt # 6929 ck#3143 (1) 3/4' meter FIRE DEPARTMENT FEES PLANS TOTAL: $ 162.00 INSPECTION TOTAL: PERMIT TOTAL TOTAL: $ 162.00 PUBLIC SAFETY IMPACT FEES POLICE previously pd under prmt#6929 FIRE previously pd under prmt#6929 5% $ - previously pd under prmt#6929 TOTAL: $ - SUB -TOTAL $ 6,876.77I PARK IMPACT FEES $ - n/a SIPS: $ - n/a 100.0% $ - 1.0% $ - TOTAL: $ - T I F 'S : $ 17,793.07 PAYING 25% TIF © PERMITTING $4,448.27 99% $ 17,615.14 $4,403.79 1% $ 177.93 $44.48 TOTAL: $ 24,669.84 1 DUE AT PERMITTING $4,448.27 + $6,876.77 = $11,325.04 • GALA NCE OF 75% TIF DUE BEFORE CO $13,3 ,., • SQ. FEET PRICE MAIN OR LIVING: 2,999 $71.39 OTHER AREA UNDER ROOF: - $94.00 OTHER: - $- VALUATION $214,098.61 FEE SHEET $825.00 ADDRESS $30.00 DRIVEWAY $30.00 BUILDING: $901.50 ELECTRICAL: $185.63 PLUMBING: $123.75 MECHANICAL: $86.63 SUB -TOTAL $1,297.50 RADON: $29.99 TOTAL $1,327.49 SEWER: $- WATER: $- IRRIGATION: $ - TOTAL: S- WATER METER:I $ IRRIGATION METE W $- I FIRE DEPARTMENT FEES PLANS TOTAL: INSPECTION TOTAL: PERMIT TOTAL TOTAL: $- PUBLIC SAFETY IMPACT FEES POLICE $- FIRE $- 5% $- TOTAL: , $- SUB -TOTAL $1,327.49 PARK IMPACT FEES $- 1 SIF'S: $- 100.0% $- 1.0% $- TOTAL: $- 71 F 'S : $17,793.07 99 °/ $1 1 °/ $177.93 TOTAL: $19.120.56 City of Zephyrhills Water and Sewer Impact Fee Calculation Land Use Type: Doctor or Dentist Office No. of Practitioners 1 /--, No of Employees per 8hr Shift Impact,Fees Within City Limits Outsi City Limits Water Distribution System $1,324.38 $1 655.48 Wastewater Collection System $2,662.00 $3 327.50 Wastewater Treatment Plant Capacity $1,490.89 $1;863.62 TOTAL $5,477.27 $6,846.59 \\\N"----- RYMAN CONSTRUCTION OF FL -6834 MEDICAL VIEW LN -PRMT #7840 B /OUT -WEST UNIT SQ. FEET PRICE MAIN OR LIVING: 2,500 $ 76.00 OTHER AREA UNDER ROOF: - $ 91.00 OTHER: - $ - VALUATION $ 190,000.00 FEE SHEET $ 750.00 ADDRESS DRIVEWAY BUILDING: $ 765.00 ELECTRICAL: $ 168.75 PLUMBING: $ 112.50 MECHANICAL: $ 78.75 SUB -TOTAL $ 1,125.00 RADON: TOTAL $ 1,125.00 SEWER: $ 4,152.89 1 Doctor WATER: $ 1,324.38 1 Doctor IRRIGATION: $ - TOTAL: $ 5,477.27 WATER METER: $ - Pd for @ Shell prmt# 6929 ck #3143 (2) 3/4' meter IRRIGATION METER $ - I Pd for @ Shell prmt# 6929 ck #3143 (1) 3/4 meter FIRE DEPARTMENT FEES PLANS TOTAL: $ 152.88 INSPECTION TOTAL: $ 30.00 PERMIT TOTAL TOTAL: $ 182.88 PUBLIC SAFETY IMPACT FEES POLICE $ - FIRE $ - 5% $ - TOTAL: $ - n/a SUB -TOTAL $ 6,785.15 PARK IMPACT FEES $ - I n/a SIF'S: $ - 100.0% $ - 1.0% $ - TOTAL: $ - n/a T I F : $ 14,832.50 25% = 3,708.13 75% = 11,124.37 before premeter I 99% $ 14,684.18 at permit issuance 1% $ 148.33 TOTAL: $ 21,617.65 I E � - Ryman Const - 683416836 Medical View Ln -Shall Only I eA 1 td-, I �� " ' � SQ. FEET PRICE P- MAIN OR LIVING: 5,499 S 54.00 CA)14$ . 161)711/1)-7 OTHER AREA UNDER ROOF: - $ 91.00 FF�� OTHER - $ - VALUATION $ 296,946.00 FEE SHEET $ 1,071.00 ADDRESS $ 30.00 DRIVEWAY $ 30.00 BUILDING: $ 1,152.42 I/ ELECTRICAL: $ 35.00 ✓ PLUMBING: $ 35.00 ✓ MECHANICAL: $ - SUB.TOTAL $ 1,222.42 RADON: $ 54.99 `l TOTAL $ 1,277.41 SEWER: $ - Applicable © Build Out WATER: $ - Applicable ® Build Out IRRIGATION: $ - Applicable 0 Build Out TOTAL: $ - Applicable © Build Out WATER METERS Applicable Build Out L:2-.‘ {RRIGATION METER' $ - Applicable © Build Out (t) L/ FIRE DEPARTMENT FEES l PLANS TOTAL: $ 219.92 INSPECTION TOTAL: PERMIT TOT AL I TOTAL: $ 219.92 PUBLIC SAFETY IMPACT FEES POLICE $ 896.34 t/ FIRE $ 962.33 5% $ 92.93 L ....- TOTAL: $ 1,951.60 SUB -TOTAL $ 3,448.93 PARK IMPACT FEES $ - I Not Applicable SIPS: $ - Not Applicable 100.0% $ - 1.0% $ - TOTAL: $ - Not Applicable T I F 'S :I $ - Applicable 0 Build Out 99% S Applicable 0 Build Out 1 % $ Applicable Q Build Out TOTAL: $ 3,448.93 APPENDIX 13 -D FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION SUBCHAPTER 4 - Commercial Building Compliance Methods Form 400C -04 Central Building Prescriptive Envelope Method Climate Zones 4 5 6 Project Name: nn� �11 Zone: Address: Cr, 15 3 it/ edr't;s1.. i t ;secs) Building Classification: CS , Zi. Code: 35 Z Buildin. Permit No.: ����,�� Builder: Qv tM0.� Permitting Office: -, - �� e1 Owner: Jurisdiction No.: le I GOOD BUILDING ENVELOPE INFORMATION ENVELOPE COMPONENT Nonresidential Residential Semiheated U1actor R -value 7 (Mentor R -value (- factor R - value Roof type: e 6 � 3 f 1 a' 7 Wall type: ar .7'Z' ^7 ' 4" Z Floor type: Fenestration Max. U Max. SHGC Max. U•(actor Max. SHGC Max. U- factor Max. SHGC • Fixed/operable All orientation Fixed /operable All orientation Fixed/operable All orientation Vertical glazing type, % of wall: $J' / y - 1 s le 2. -2- K y v • Skylight type, % of roof: ,V 4- SYSTEMS INFORMATION / SYSTEM Type (describe system) Size (capacity) Sizing talc. Efficiency p S Rating Air-conditioning system C e A. `rel \\ 7 ap‘ 0 0 C5 / Heating system L/ ` Q c t' 6 6 a "-r C) Ventilation ,� f Ducts Location: CJU , Co A. eL c ! ,c)- Fan Power: Piping Fluid design operating temp: Size of pipe: Hot water Electric power Drawings Y N Operations manual available upon completion: N Motors Open or enclosed Poles S speed Horsepower: �� r. AS Lighting power dens) a 1p Lighting Space type: - � � ° q g p density �' PRESCRIPTIVE MEASURES Components Section Requirements Check Operations Manual 102.1, 410, 413 Operations manual provided to owner. X. Windows & Doors 406.1.ABC.1.1 Glazed swinging entrance & revolving doors: max. 1.0 cfm /ft': all other products: 0.4 cfm/ft'. !` Joints /Cracks 406.1.ABC.1 To be caulked, gaskcted, weatherstripped or otherwise sealed. NA K Dropped Ceiling Cavity 406.1.ABC.1.4 Vented: seal & insulated ceiling. Unventcd seal & insulate roof & side walls. ,{� J� Reheat 407.1.BC Electric resistance reheat prohibited. ' -•f ' HVAC Efficiency 407.1, 408.1 Minimum efficiencies: Cooling Tables 407.I.ABC.3.2A -D; Heating Tables 407.I.ABC.3.2B, 407.I.ABC.3.2D, 408.!.ABC.3.2E K thru 408. LABC.3.2G. HVAC Controls 407. LABG2 Zone controls prevent reheat (exceptions); separate thermostatic control per zone; combined HAC control 5 ° F deadband • (exceptions). y Ventilation 409.1 .ABC.3 Motorized dampers regd. except gravity dampers OK in: 1) exhaust systems and 2) systems with design outside air intake or exhaust capacity 5300 cfm. . HVAC Ducts 410.1 ABC Air ducts, fittings, mechanical equipment & plenum chambers shall be mechanically attached, sealed, insulated & installed per Sec. 410.1.ABC. Fan power limitations. Balancing 410.!.ABC.4 HVAC distribution system(s) tested & balanced. Report in construction documents. 7 Piping Insulation 41 LI.ABC In accordance with Table 411.1.ABC.2. x ! Water Heaters 412.I.ABC Performance requirements in accordance with Table 412.1.ABC.3. Heat trap required. N. Swimming Pools 412.1.ABC.2.6 Cover on heated pools; Time switch (exceptions): Readily accessible on /off switch. /117T' { Hot Water Pipe Insulation 412.I.ABC.4 Table 411.I.ABC.2 for circulating systems. first 8' outlet pipe from storage tank, between inlet pipe and heat trap. ��r / Water Fixtures 412.1.ABC.2.5.2 Shower heat water flow restricted to 2.5 gpm at 80 psi. Public lavatory fixture max. Flow 0.5 gem; if self -closing valve 0.25 gallon 1411 „ circulating, 0.5 gallon noncirculating. Automatic control required for interior lighting in buildings <5,000 s.f.; Space control; Exterior photo sensor; Tandem wiring where R h/�.. Lighting Controls 415.1 ABC 1 -3 linear fluorescent lumps >30W. � If required by Florida law, I hereby certify that the system design is in compliance with the Florida energy code. Registration number ARCHITECT: - - - - -- ELECTRICAL SYSTEM DESIGNER: - LIGHTING SYSTEM DESIGNER: • MECHANICAL SYSTEM DESIGNER: PLUMBING SYST 1 ESIGNER: . 1 1 hereby certify tha �•'ans an pecifications covered by the calculation are in compliance Review of plans and specifications covered by this calculation indicates compliance with the with the Florida Ene e. S Florida Energy Code. Before construction is co pl this uilding will be inspected tor PREPARED BY: 'kid DATE: 1� — / � d I comp ce in •0 nee with Section • .9r:, F. • I hereby certify that this • ' g'� c. t .. 1 itI the Florida Energy Code• B L: . . OWNER AGENT: , , .— Zle. DATE: (es VVV DATE: /. / FLORIDA BUILDING CODE — BUILDING 13 -D.5 I, a. APPENDIX 13 -D Form 400C Central Building Prescriptive Envelope Method Climate Zones 4 5 6 Opaque Elements Nonresidential Residential Semiheated Assembly Insulation Min.' Assembly Insulation Min.' Assembly Insulation Min.' Maximum R -value Maximum R -value Maximum R -Value Roofs Insulation all above U -0.063 R -15.0 ci U -0.063 R -15.0 ci U -1.282 NR Metal building U -0.065 R -19.0 U -0.065 R -19 U -1.280 NR Attic and other U -0.034 R -30.0 U -0.034 R -38.0 U -0.614 NR Walls, Above - Grade Mass U -0.580 NR U -0.151" R -5.7 ci U -0.580 NR Metal building U -0.113 R -13.0 U -0.113 R -13.0 13-1.180 NR Steel framed U -0.124 R -13.0 U -0.124 R -13.0 U -0.352 NR Wood framed and U -0.089 R -13.0 U -0.089 R -13.0 U -0.292 NR other Walls, Below -Grade Below -grade wall C -1.140 NR C -1.140 NR C -1.140 NR Floors Mass U -0.322 NR U -0.322 NR U -0.322 NR Steel joist U -0.350 NR U -0.350 NR U -0.350 NR Wood framed and U -0.282 NR U -0.282 NR U -0.282 NR other Slab - On -Grade Floors Unheated F -0.730 NR F -0.730 NR F -0.730 NR Heated F -1.020 R -7.5 for 12 in. F -1.020 R -7.5 for 12 in. F -1.020 R -7.5 for 12 in. Opaque Doors Swinging U -0.700 U -0.700 U -0.700 Nonswinging U -1.450 U -1.450 U -1.450 A,�b Maaix U ttttl ��by1Max. Mx. b A&set lv Ma�C. U l M Fenestration (1 ixF d/e �perable) �C (All tx PperaableY A ax. ll (1�7x OOpera le) 5� b (I I - On nnatigns/North Orieented� orth - Orien ti /North Vertical Glazing, % of tom] wall 0 - 10% Uo,„d -1.22 SHGC„„ 0.40 U11„.d-1.22 SHGC,,1 0.40 U11„ SHGC,, NR U-1.27 SHGC„„ „ 0.61 U.,„ -1.27 SHGC„„,, 0.61 U„„„ 127 SHGC „ „ „ NR 10.1 - 20% U11.„11 -1.22 SHGC,,, 0.25 Ua -1.22 SHGC,,, 0.40 U11.,11-1.22 SHGC,u NR U 1.27 SHGC„„ „ 0.61 U,„,„,-1.27 SHGC„„„,, 0.61 U -1.27 SHGC„ „ NR 20.1 - 30% U1,..11-1.22 SHGC „ 0.25 U -1.22 SHGC.11 0.40 Ur,,-l.22 SHGC „u NR U . „ , , , - - 1.27 _ SHGC„„ „ 0.61 U„�„ -1.27 SHGC„„,, 0.61 _ U„ 1.27 SHGC„„,, NR 30.1 - 40% Ur,,. -1.22 SHGC,,, 0.25 U SHGC,,, 0.40 U11 SHGC,,, NR U„, „ -1.27 SHGC.„,, 0.44 U -1.27 SHGC,„ 0.61 U„ SHGC„„ NR 40.1 - 50% U6,„a -1.22 SHGC,, 0.19 U,, 4 -1.22 SHGC,,, 0.31 U11., -0.98 SHGC,, NR U -1.27 SHGC „„„ 0.47 U„ -1.27 SHGC „„, 0.47 U, -1.02 SHGC, „ „ NR Skylight with curb, glass, % roof 0 - 2.0% U,11-1.98 SHGC,11 0.36 U,11-1.98 SHGC„„ 0.19 U,, -1.98 SHGC,u NR 2.1 - 5.0% U.11-1.98 SHGC,,, 0.19 U,,, -1.98 SHGC,,, 0.19 U.,r1.98 SHGC,u NR Skylight with curb, plastic, % roof 0 - 2.0% U,11-1.90 SHGC,u 0.39 U,,, -I.90 SHGC,,, 0.27 U,11-1.90 SHGC „, NR 2.1 - 5.0% U,1/-1.90 SHGC,, 0.34 U,,, -1.90 SHGC,,, 0.27 U,,, -1.90 SHGC,,, NR Skylight without curb, all, % roof 0 - 2.0% U.11-1.36 SHGC,,, 0.36 U,11,-1.36 SHGC,o 0.19 U,,, -1.36 SHGC,,, NR 2.1 - 5.0% U,, -1.36 SHGC,,, 0.19 U.,,-1.36 SHGC,,, 0.19 U.11-l.36 SHGC,,, NR ' The following definitions apply: ci = continuous insulation; NR = no (insulation) requirements. -- Exception to 402.1.C.1 applies for mass walls. 13 -D.6 FLORIDA BUILDING CODE - BUILDING • WALL R•VALUES BUILDING COMPONENT DESCRIPTION WALL WALL WALL WALL WALL TYPE 1 TYPE 2 TYPE 3 TYPE 4 TYPE 5 Exterior air film Stucco , BIdck J to Stud Firring strip Insulation 1 / Wall board F f Solid Other Other Other e C ,tor Interior air film RTOTAL .7 `ti3- f.2. - U = 11R a / 1 l eCi( AREA Weight (lb/sq. it.) - IF FRAME: Size x Inches O.C. ROOF /CEILING R- VALUES BUILDING COMPONENT DESCRIPTION ROOF 1 TYPE ROOF TYPE TYPE 3 TYPE 4 T PE 5 Room air film u :/ Wail board 1 L19 Truss `� Insulation rr/� c% © `CA ) , Other l w i 0-- Other e (7 f 0 P f r' t 0 $ Other `J IA t '' �7 Other �/ Outside air film "' 3 1 R TOTAL 3 a,,_32" U =1 /R t OS:I AREA (sq. ft.) D b o U= TC IF FRAME: Size x Inches O.C. Zephyrhills Fire Rescue 6907 Dairy Road, Zephyrhills, FL 33542 Fire Marshal Bus (813) 780 -0041 Kerry Barnett Fax (813) 780 -0044 E -mail: kbarnett@fire.zephyrhills.fl.us Plan Review #: 09 -049 Project: Interior Build -out Number of Pages: 3 June 18, 2009 I have received and reviewed the plans for a interior build -out located at 6836 Medical View Lane and will allow this project to move forward. Paying for permit, contractor acknowledges complying with the following items below. Should anyone have any questions, please do not hesitate to contact the Fire Marshal's office. 1. Ensure any penetrations to the existing firewall are sealed appropriately to maintain rating of the firewall. 2. Certified fire extinguishers shall be located within 75' of travel. 3. Door separating the corridor from the waiting area, the door swing shall be in direction of egress. Change the swing. 4. Ensure the secondary egress has either a hotel latch or panic hardware. 5. If mechanical room is being used a plenum (vent in door or wall to draw air in from corridor area), duct detectors shall be required, fire damper will have to be installed in vent, no storage will be allowed in room and room will have to be labeled as such. 6. Contractor shall advised occupant that employees shall receive fire extinguisher training on a periodic basis. Inspections Required: 1. Fin. KERR x:47`_ TT, FIRE MARSHAL ** *Please be advised this review of plans submitted is a cursory review to assist the contractor in compliance with applicable fire safety codes. This review is not intended to be a fmal approval of the submitted plans. It is the contractor's sole responsibility to ensure that the plans are in complete compliance with all applicable NFPA codes and local ordinances. In the event that further examination or site inspection reveals areas of non - compliance, it shall be the contractor's sole responsibility, at their sole expense to bring those areas in compliance. The City assumes no responsibility for the contractor's failure to be in compliance with all applicable NFPA codes and local ordinances. . ZEPHYRHILLS FIRE DEPARTMENT 6907 Dairy Road, Zephyrhills, FL 33542 Fire Chief Keith Williams Bus (813)780 -0041 Fax (813)780 -0044 FIRE SERVICE USER FEES Occupanc No.: Plan No.:4 " ' 4 4 Contractor: e■-/ fiKrw - Business Name: 4 5 - INT t' Billing Address: 3454'3 , 5,e Business Address: lv ,f534... vi* • r( 2 •1/4 k$ 33s3�/ Business Phone No.: Billing Phone No.: Business Fax No.: Billing Fax No.: Contact: Contact: PLAN REVIEW FEES INSPECTION FEES _ PERMIT FEE _ FALSE ALARM FEE Site Plan , Annual N/C _ Sprinkler $50 _ 1stAlami N/C N4 01- Family /Commercial Vallin 1st Re- inspection N/C _ Standpipes $50 _ 2nd Alarm N/C 7�J Minimum Charge $25.00 , 2nd Re- inspection $100 Fire Pump $50 3rd Alarm N/C . Plan Revisions DBL , 3rd Re- inspection $250 _ Hoods $50 _ 4th Alarm $100 II 4th Re- Inspection $500 _ Fire Alarm $50 _ 5th Alarm $150 SPRINKLER SYSTEMS (Business closed until _ LP Gas $50 _ 6th Alarm $200 _ 0 - 25 Heads $50 violations corrected) _ Natural Gas $50 _ NON COMPLIANCE $150 26 plus Heads $100 SPRINKLER SYSTEMS _ Fuel Tanks - per tank $50 STANDPIPE SYSTEM Hydro Undergrounds $45 _ Sparklers $100 0 Per Riser $50 Hydrostatic Test $65 per system ` Fire Works $500 FIRE PUMP Acceptance Test $45 per system _ Camp Fire $25 fl Per Pump $100 Hydrant Flow $75 _ Controlled Bum $100 _ FIRE ALARM SYSTEM _ Hood/Duct $50 0 - 25 Devices $50 _ FIRE ALARM SYSTEM _ Place of Assembly $50 Annual 26 plus Devices $100 _ System Acceptance $50 — Fire Protection $25 SUPPRESSION SYSTEMS _ Recall Acceptance $50 — Flammable Application $50 Annual Wet $50 _ OTHER _ Waste Tire Storage $50 Annual Dry $50 _ Fire WalUSmoke Wall $15 per wall Generator < KW $100 CO2 $50 _ LP Gas $25 per tank Generator >30 KW 150 Other $50 _ Natural Gas $25 per system Bio-Hazard Waste $100 Annual — KITCHEN EXHAUST _ Fumigation Tenting $50 ❑ Hood/Ducts $50 _ Tent 10)x10' or greater $1 per ten — Torch Pot/Applied $50 _ OTHER — Fire Pump $45 _ Haz. Materials $100 Annual _ LP Installation per tank $50 _ Fire Suppression $30 _ Fuel Tank Installation $50 _ System Acceptance (Per Tank) $50 _ Exhaust Hood/Duct $30 El Natural Gas Installation $50 _ Re- inspection DBL (Per System) (other than annual) _ 0 Spray Booth $50 0 Inspection scheduled DBL and cancelled less than _ _ 24 hours _ Construction Insp. N/C Emergency Vehicle Ao $50 FALSE ALARM _ PLANS TOTAL ,j§ ' INSPECTION TOTAL PERMIT TOTAL TOTAL GRAND TOTAL �l�r Comments: Date: / � � r 4, Ins ctor: 1 / ACK/49 Pasco County Parcel: 02- 26 -21- 0290 - 00000 -0020 001 Page 1 of 2 Search Again Show Map Generalized Building Schematic Frequently Asked Questions Estimate Taxes Other Agency Data: Tax Collector School Board Supervisor of Elections Data Current as Of: Weekly Archive - Saturday, June 13, 2009 Parcel ID 02- 26 -21- 0290 - 00000 -0020 (Card: 001 of 001) Classification 19 - Professional Service Building c Mailing Address I Property Value HAITI INVESTMENTS I LLC t Ag Land $0 38819 OTIS ALLEN RD Land $99,566 ZEPHYRHILLS, FL 335403009 Building $493,230 Physical Address - See All 2 addresses (First Shown) Extra Features $10,405 6834 MEDICAL VIEW LN ZEPHYRHILLS, FL 33542 ( Market Value $603,201 Legal Description (First 4 Lines) Assessed (Save Our Homes) $0 See Plat for this Subdivision I- Taxable Value $603,201 DAUGHTERY ROAD PROFESSIONAL CENTER III PB 53 PG 024 LOT 2 OR 8001 PG 1508(TS) Land Detail (Card: 001 of 001) Line II Use IlDescriptionll Zoning II Units II Type II Price I Condition Value 1 II 1900 II PROF.BLDG II 000P 1112,000.00 II SF II $5.17 II 1.00 II $62,040 2 I 1900 I PROF.BLDG 0 000P 1 13,121.00 SF $2.86 1.00 I $37,526 Additional Land Information Acres II 0.58 II Tax Area II 30ZH II FEMA Code II -- IlCommerical Codell PDRP1AA Building Information - Use 19 - Offices Professional or Medical (Card: 001 of 001) Year Built 2008 Stories 1.0 Exterior Wall 1 Concrete Block Stucco Exterior Wall 2 None Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle Interior Wall 1 Drywall Interior Wall 2 None Flooring 1 Carpet Flooring 2 None Fuel Electric Heat Forced Air - Ducted A/C Central Baths 2.0 Line Description _ Sq. Feet Repl. Cost New 1 BAS 2,700 $276,426 I 2 II SFB I 2,700 II $221,141 3 II CAN II 104 $3,174 Extra Features (Card: 001 of 001) Line IT Description I Year I Units I Value 1 I PAV ASP I 2008 9,600 JI $7,452 2 II PAV CON II 2008 II 1,750 II $2,953 Sales History Previous Owner RYMAN NELSON : DOTTIE Year Month Book/Page Type Amount 2008 I 11 II 8001 / 1508 II WD II $ 2008 1 11 fl 8001 / 1505 II WD I) $ 2003 II 09 0 5532 /0577 I WD 0 so http: // appraiser. pascogov. com / search /parcel.aspx ?sec= 02 &twn= 26 &rng =21 &sbb= 0290 &b... 6/16/2009 Z _ / DAIRY ROAD t6 ASPHALT RIGHT O WAY) L (23's ASPHALHAL PAVEMENT) PAVEMENT) vf�K , ,� N00•05'37•E 11,66' 8 11 rn z v) _( E. y x to = x n a y r ti > N Z O C1 . � 0 0 2 c --.— n a r Em ,w 13 ` p 54 4} B x ` 1 1 .N Z C O VI 4 -1 N N 1 y _, TI m W 0 m A D ` r, C 1 0 o P. Tl o frF .. z F y V 1 < Cs e' Z < -... `�I >: — ?.c . ` ■ D r a r. T as A y ,. ' , ,. 0 V Its aE" :^�' f � 3s C t e-\''''-':-1.,,z4' -\u. * - ,+� 54 . q x " .f r a 0 'D 2 r - V O > o; A Z CI I 0 -y qq � oN T V ,98 101 3.00,0O.00S i 4 --' z - _ i -- �x f >'N 00 1 813- 780-0020 City of Zephyrhills Permit Application Fax -813- 780 -0021 t� - Building Department #92,94 Date Received • Q Phone Contact for Permlttln , ft 7/•1 - 40 C i 6 (-Law w I c Owner's Name H CA 1 k t Tildes %,.,e., q�, \ t � s •L. / � L L C Owner Phone Number i • 2-0g2-.C - 0 Owner's Address 13 D f I O# s 1't./1 �f, A 1 Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address ` , JOB ADDRESS 1 6 n O 3 4 t i �A ke a r C 4' y r e Ln • LOT # 2- SUBDIVISION D P Ci PARCEL ID# o 2 -2 6"11- 01'3 a - 00000 - ooz 0 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED - NEW CONSTR Fg1 ADD /ALT n SIGN n MOVE Q DEMOLISH - INSTALL REPAIR PROPOSED USE SFR ni COMM j j OTHER Irouidwarvaimmolmo TYPE OF CONSTRUCTION BLOCK T - i FRAME n STEEL n OTHER 1 DESCRIPTION OF WORK ( . T1 .4e.r , a c 6...... 1d out (Ex :s 4-.. -, ) ke / 1 ) S 4 e 1 1 ( ar m ; - di 2 BUILDING SIZE C -1 X 50' SQ FOOTAGE 27 0 0 HEIGHT I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BUILDING $ g ; oo D VALUATION OF TOTAL CONSTRUCTION CKI ELECTRICAL $ D AMP SERVICE 2 v0 X PROGRESS ENERGY Q W.R.E.C. X PLUMBING $ CAV // MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION 0 pac_ n GAS 1 ROOFING n SPECIALTY Q OTHER FINISHED FLOOR ELEVATIONS I 0 �OD ZONE AREA nYES , IXINO BUILDER ,;_ ' -N / ( , : 1 COMPANY ��/N (An C .►� T (� � . + r t. C . SIGNATURE G " ` . REGISTERED & Y ! N FEE CURRENT I Y / N 1 S Address 364 [ L 41 2 "t Us .- 1 License # Icac as" o 9 i y II _ ELECTRICIAN ��a'i 411 p ` IJM .AY 1 [ Utj7 ��5 SIGNATURE p 4al %/ - +,.' TERED I Y / N I FEE CURRENT I Y / N 1 �� ` ,- Address I � 1 0 S } . 4 Q � dy � I License # I / •S�6_ - 00 �'G 7 PLUMBER J/1/ // Q ` COMPANY ben W1. S (t l 4 M f SIGNATURE � ��' �y y + , / [' A' J � �� g ' � p GISTERED I Y ! N I FEE CURRENT I Y / N Address 1 3 6 1 l L , C-& J . 4 Z L {a7v 1 License # I C FC - i y Z S6 o Z URE ` /' COMPANY 1 S Y/ N 'r SIGNATURE REGISTERED I Y! N I FEE CURRENT I Y/ N I Address ( I 5" 1 t"kvJ t i 3 0 I I License # I F- M oo t o 6 1 OTHER COMPANY SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N I Address I License # RESIDENTIAL 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 COMMERCIAL 'Attach (3) complete sets of Building Plans plus a Life Safety Page;-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 SIGN PERMIT Attach (2) sets of Engineered Plans. ""PROPERTY SURVEY required for all NEW constriction. ' Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over 82500, a Notice of Commencement is required. (A/C upgrades over 85000) 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 A/C 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" restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions. 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 Pasco County Building Inspection Division — Licensing Section at 727 -847- 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the 'contractor Block" of this application for which they will be responsible. If you, as the owner sign as the contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County. TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of use in existing buildings, 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 ail 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 "A', 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, l 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 • - AN TTORNEY BEFORE RECORDING YOUR N N. • C OF • MENCEMENT. FLORIDAJURAT(F.S.1 • / / at, OWNER OR , � CONTRACTOR ., /� S schrgswom a (( ad) ere 1 this u • = • - • and sworn • (or : y.: •) • a this .N f1. •J • �� r Vtho is/a = • : - •. ally known to me i r e produced Who is/are %- rsonally known to me • -- : ve produced identification. as identification. Notary Public Notary Public C. • • ion Np. Co 'rssion �� 1111.74 . Name of Notary ty • stamped 4 • e of Notary type c u ry �. r o 4, Notary Public State of Florida O ~►� Y P 4 '('• Nota 1 i h " orida Bobbie J Knight r My � 225 14 or Exp b ± "" " ; ^ � 4 7 My res 03/31/2012 DD764225 for ao Exp .A q�: P. 01 /0 TRANSACTION REPORT AUG /05 /2008 /TUE 00:03 PM FAX(TX) # DATE START T. RECEIVER COM.TIME PAGE TYPE /NOTE FILE 01 AUG /05 00:03PM 97886773 0:00:16 1 OK SG3 9090 •.0 1:(q, •:: . • ' .7 i s ,. t ' x_1 1 '` .PASCO COUNTY, FLORIDA . . • • Permit No. ', • • • Date Permitted ~ 5-0 9 .1 • Builder Name /Owner Name � y/YI Control # ' • County Parcel No. QZ- 2-0o -2/ U 29' - Q000 0 � - 00 2 0 SubDiv: • _ (p Address /Location bg8 ( ffD �1ed, ai I/ Classification/Type of Us ie# CW/ . : : . . . . . TRANSPORTATION IMPACT FEE ; Rate: 3 �3 9 ; S f=t Unit : Z q/� 9 / 7 • Exempt . [] Yee ❑ No How Determined - . , , • Impact Fee Amount $.. / 7, 793.117 • Zone No. TAZ: • SCHOOL IMPACT FEE Account (066) •Single - Family Detached House Amount $ NA' • ' ' • ' . (057) Mobile Home • _ • • (058) . Other Residential . - ' 123) Collection Fee • • Exempt •a Yes ❑ No How Determined . PARKS AND; RECREATION FEE . ' • Lend Account • • Land Credit Land Total ' • Recreation Account 'Recreation Credit ' . Recreation Total Zone • • • - TOTAL AMOUNT $ N Exempt ❑ Yes ❑ • No How Determined ' • • LIBRARY FEE • • • • • . • Land Account Land•Credlt Land Total • Facility Account • • . Facility Credit • • Facility Total Exempt ❑ Yes • ❑ No How Determined • . Total Amount • #A'• RESOURCE FEE ERU ' •TOTAL AMOUNT '• • • • . • Prepared By • 6)52...i Checked By . • • NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED•OR FINAL INSPECTION PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE • • ' BEEN PAID AND • • R!CEIPTED FOR BY A CENTRAL PERMITTING OFFICE•OF PASCO COUNTY • . • Acknowledgement below does not Imp y acceptance of concurrent*, but simpty.raoeipt of copy of thiq forth, placing • the bullding pemtlt owner on nafice of Ihla assessment and the conditions of payment for same., 1 pATE. RECEIVED BY . • - • ;�, _11 :J ; 1 PASCO COUNTY, FLORIDA ' .c1t0 929 Y' Permit No. Date Permitted V 5-0 9 Builder Name /Owner Name �9u,1a » (� Control # County Parcel No. 01- 2- -2 / -0 2 -0000 O'0O SubDiv: Address /Location (0 6 & Ned ' C g 1 t ' ' ad 4 "l t- Classification/Type of Use 0 OVV'/Ilif.r Cap q/} TRANSPORTATION IMPACT FEE Rate: "7 f, 39 Sq Ft Unit: 2 9 / Exempt ❑ Yes 11 No How Determined Impact Fee Amount $ / 7, 793.07 Zone No. TAZ: SCHOOL IMPACT FEE Account (056) Single- Family Detached House Amount $ NA (057) Mobile Home (058) Other Residential 123) Collection Fee Exempt Yes ❑ No How Determined PARKS AND RECREATION FEE Land Account Land Credit Land Total Recreation Account Recreation Credit Recreation Total Zone TOTAL AMOUNT $ /V R" Exempt Yes ❑ No How Determined LIBRARY FEE Land Account Land Credit Land Total Facility Account Facility Credit Facility Total Exempt ❑ Yes ❑ No How Determined Total Amount ' RESOURCE FEE ERU TOTAL AMOUNT Prepared By g,,,.. � } Checked By NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY Acknowledgement below does not imply acceptance of concurrence, but simply receipt of a copy of this form, placing the building permit owner on notice of this assessment and the conditions of payment for same. DATE RECEIVED BY RECEIPT NO. DATE BY i 1 i f i i I i i i I � • • i i I i 1 i 1 r r