HomeMy WebLinkAbout12-13245 CITY OF ZEPHYRHILLS
5335-8TH SIREET
�si3��so-oozo 13245
BUILDING PERMIT
Permit Number: 13245/12975 Address: 7050 GALL BLVD
Permit Type: COMMERCIAL ZEPHYRHILLS, FL.
Class of Work: ADD/ALT COMMERCIAL Township: Range: Book:
Proposed Use: MEDICAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 30-26-20-0000-00200-0010
Improv. Cost: 1,090,000.00
Date Issued: 7/11/2012 Name: FL HOSPITAL OF ZEPHYRHILLS
Total Fees: 6,703.08 Address: 7050 GALL BLVD
Amount Paid: 6,703.08 ZEPHYRHILLS, FL. 33542
Date Paid: 7/11/2012 Phone: 813 783-6189
Work Desc: RENOVATIONS OF BREAST CANCER CENTER 11,000 s ft
BORRELL ELECTRIC CO MECHANICAL FEE �907.50 BUILDING FEE 3,127.50
COASTAL MECHANICAL SERVICES LLC FIRE PLAN REVIEW FEES 772.08 FIRE INSPECTION FEES 270.00
COASTAL MECHANICAL
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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 wiil 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)aondemned work resultlng
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� plans not at job site g)work not aooessible.
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.
"Warning to owner: Your failure to reaord a notice of commencement may result in your paying twice for
improvements to your properly. If you intend to obtain financing,consult with your lender or an attorney
before reoording your notice of aommencement."
Complete Plans,Specifications Must Aacompany Application.All work shall be pertormed in a000rdance with
Ci Codes and Ordinances. NO OCCUPANCY BEFO C.O.
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CONTRACT R SI ATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
Zephyrhills Fire Rescue
6907 Dairy Road, Zephyrhills, FL 33542 .
Fire Chief Bus (813} 780-0041
Keith Williams Fa�c (813) 780-0044
9 July 2012
Plan Number 12-023
Project: Florida Hospital Zephyrhills- Simpson Breast Health Center, 7050 Gall Blvd
Number of Pages: 44 Pages
This Officer has reviewed the plan for renovation and construction of health care
occupancy located at 7050 Gall Blvd, Zephyrhills. Plans are approved as submitted with
the following conditions:
1. Assurance of fire safe practices and in place in accordance to NFPA 1.
2. All existing fire/fire-smoke walls must be inspected to insure integrity after
demolition.
3. All construction practices must be conducted in a safe manner
4. New firewall construction shall be inspected.
5. All fire wall andlor fire smoke walls shall have a stenciled, label or placard
identifying the wall as same. Must meet requirements of General Notes item
#19 on Page A0.0.
6. All sprinkler installation shall be performed by a Florida licensed Fire
Protection Contractor. No identified contractor listed.
7. All Fire Alarm installation shall be performed by a Florida licensed Fire
Alarm Contractor. No identified contractor listed.
8. Fire Alarm strobe only in storage room(120) shall be converted to horn/strobe.
9. Fire extinguishers and/or cabinets may be field located far accessibility, and
aesthetic purposes.
Payment of permit fee indicates acceptance of the requirements of these review
comments.
Inspections Required:
1. Firewall Inspection(s). First layer screw, second layer(if applicable) screw
and tape and mud final.
2. Fire Sprinkler rough-in, hydrostatic and final inspection.
3. Fire Alarm acceptance final inspection.
4. FinalInspection.
Review and approval of the submitted plans does not relieve the contractor from the
responsibility of correcting any deficiencies noted during inspection.
Respect lly submitted on 9 July 2012 by,
�/���.�:�%�•-^_�
Keith A. Williams, EFO, CFO, CMO, MIFireE
Fire Chief
Fire Safety Inspector, #148104
Z���dY�HILLS FIRE DEPARTMENT
� 6907 Dairy Road, Zephyrhilfs, FL 33542
Fire Chief Kei�h Wiliiams Bus ($13)780-0041 Fax (g13)i80-U044
FIRE SERVICE USER FEES
Occupancy No.:
Plan No.: / � Contractor:�o �.. . ,
Business Name: �+- � � c�r-- - ,c�u/� Biilipg Address: ` �D - , ",��
Business Address: v /�,�-�<e(�, ,� �3
Business Phone No.: 1�-- 7 �-�hf 8y Billing Phone No.: 3-- D - l
Business Fa No.: Billing Fax No.:
Contact: ����- �r .��,p.r Contact: A- �s
PLAN REVIEW FEES INSPECTION FEES PERMIT FEE FALSE ALARM FEE
SiteP n N/C Annual N/C Sprinkler s50 1stAlarm N/C
n�a,���,�i��� so
c�ai .06 sf 1st Re-MSpection N/C Standpipes E50 2nd Alarm N/C
(Minimum Charge a25. � 2nd Re-inspecti� a100 Fire Pump S50 3rd Alarm N/C
�Plan Revisions DBL 3rd Re-inspection a250 Hoods �50 4th Alarm g�pp
4th Re-Inspection $500 Fire Alarm Z5p 5th ql�� $��p
SPRINKLER SYSTEMS (Business closed until LP Gas E50 6th Alarm $200
�0-25 Heads S50 violations corrected) Natural Gas �50 NpN COMpLIANCE �150
26 plus Heads a100 SPRINKLER SYSTEMS Fuei Tanks- �r mok y5p
S7ANDPIPE SYSTEM ydro Undergrounds a45 gpa��� s�pp
� Per Riser S50 Hydrostatic Test s65 �sys�m Fire Works �5pp
FIRE PUMP Acceptance Test a45 per cyscem Camp Fire 325
� Per Pump a100 Hydrant Flow 375 Controlled Bum a100
FIR�ALARM SYSTEM Hood/Duct �p
�0-25 Devices $50 FIRE ALARM SYSTEM Place of Assembly a50 Annual
26 plus Devices $100 �System Acceptance S50 Fire Protection E25
SUPPRESSION SYSTEMS Recall Acceptance a50 Fiammable qpplication $50 Annual
Wet 350 OTHER Waste Tire Storage S50 A„m,ei
�rY $50 u Generator<KVV 3100
CO2 350 LP Gas ZS per rank Generator>30 K4V 150
Other S50 Natural Gag� 27 0 325 va ar�� Bio-Hazard Waste a'I OO Annual
KITCHEN EXHAUST Fumigation Tenting s50
�Hood/Ducts $50 TeM 10'�c10'w greater a15 Par�eM Twch PoVApplied s50
OTHER Fire Pump a45 Haz.Materials a100 Annual
LP Installalion per lank a50 Fire Suppfes5lon s30
Fuel Tank Installation a50 System Acceptance
(Per Tank) a50 8 Exhaust Hood/Duct S30
�Nafurai Gas insfallation $50 Re-inspection DBL
(Per System) (other than annual)
�Spray Booth S50 �Inspection scheduled DBL 8
and cancelled lesa than �
+��'!'�"�'�' - 24 hours
¢ l p d, v � Construdion Insp. N/C
�O D. �1 U Emergency Vehicle AG a50 �p FAI.SE ALARM
NS TOTAI _� INSPECTION TOTAI.�� PERMIT TOTAL�, 'r TOTAl.I____ _)
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GRAND TOTAL �
Comments:
---Qate:_�" `Z U! �- -----
— -- - ---- — ------ --------- - - - --------
Ins{�ctor:� � �
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department ,�'����
Da,te Received '�
� ' � �� � Phone Contact for Permittin (p� (� _ 3
Owner's Name c � Owner Phone Numbe� �13° �g 3 -
Owners Addresa ZC�� p �Q L L Owner Phone Number �
Fee Slmple Titleholder Name �( lyJSp� .AL �plr� Owner Phone Number �
Fee Slmple Titleholder Addresa C� � (.LL Z�� •('��(`s L-'1 3��t-( (
JOB ADDRESS Z�S� C�AC..t_. � LOT A� ��
SUBDIVISION PARCEL ID# 3 '�J -o��j ° a - � ° l O 5 O--
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROP03ED e NEW CONSTR e ADD/ALT � SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM Q OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q
DESCRIPTION OF WORK t�C�10 V A t, Q�- J i yy�� ;o� ���q�'(' �t N�- -
BUILDING SIZE �---� gq FOOTAGE ����� HEIGHT
QBUtLDING $ VALUATION OF TOTAL CONSTRUCTION
'�11� ptx�
QELECTRICAL $ � G� �O AMP SERVICE � PROGRESS ENERGY Q W.R.E.C.
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QPLUMBING a ,,� �,�j a�►� ���-�
C��l c�r.� � � N�c
QMECHANtCAL $ ` �lQ ��Q VALUATION OF MECHANICAL INSTALLATION ;�.{��,3z�f�S"
3 P�� �'c�` se.7r
QGAS Q ROOFING Q SPECIALTY � OTHER �� (`r��t 2
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER `COMPANY �d��� �N��'r(�.���oN
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Addreas �SD F_ r� =.�kS�.�,ti� ��-�� � 33 � License# � �'�Q
��'2�g"y�oc,���,
ELECTR C AN �°�`�1 1 �� J COMPANY i I.�. ( ��-ti-�t�,
��� �GN,_ATU�so=� \ � REGISTERED Y/ N FEE CURRE� Y/N
�M�
�Ad+rtress 7�' License#
�f`��X��. `�tu- �.1
PLUMBER � �\� COMPANY ��(.z S�A� V`(L�Ch���tA�--`Jr 1�U�
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
13"��° ��o z I
Address Llcense#
MECHANICAL '�Di Q�� COMPANY C CL St,tL y�/I ^ � ��c.�L. :�G�2 U ic�= S-�
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��SIGNATURE ��� REGISTERED Y/ N FEE CURRE� Y/N
Address ��
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# �
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Buflding Plans;(1)set of Energy Forms;R-O-W Permit for new construction,
Minimum ten(10)worlcing days after submittal date. Requlred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary FadllUes 8 1 dumpster,Site Work Permit for subdivlsfons/large proJects
COMMERCIAL Attach(3)complete sets of Buildfng Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new constructlon.
Minimum ten(10)working days after submfttal 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 requlred for all NEW consVuction.
Directlons:
Fill aut application completely.
Owner&Contractor sign back of application,notarized
If over 52500,a Notice of Commencement la required. (A/C upgrades over 57500)
" Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of AppHcation Only)
Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Foohag ,.v ,
TTa���38 1M.a21�2 ,.
Driveways-Not over Counter if on public roadways..needs ROW ' �n�'�a{�^�'!'? ���duq y�s�o� �""�°;'--:�., �
;,- . ,. � ,. .�yx3 �,�:�:1 rV �. i:' ►i
_ . �, a •,n�,��rrrma� '�,� y•,-'
r,!6r�7{�.:3rr4j b10�Od "'�7:..�� �'
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions"
which may be more rest�ictive 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 Iocal 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 Bufiding 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 responsfble. 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, ff 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'SIOWNER'S AFFIDAVIT: I certify that all the information in this appiication 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 Environmentaliy 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 flll:
- Use of fill is not allowed in Flood Zone"V"unless expressly permitted.
- If the fill materiai 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 materiat is to be used in Flood Zone "A" in connection with a permitted building using stem wail
construction, I certify that fill wili be used only to fill the area within the stem wall.
- If fill material is to be used in any area, 1 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 rnay 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 O�cial 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
just�able 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 T OUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR L DER OR ATTOR ORE RECORDING YOUR NO IC OF C E NT.
FLORIDA JURAT(F.S. 117.03)
OWNER OR AGENT � �� �� CONTRACTOR
u e�and swo or ffirme bef e e thl Subscribed and swom to(or afflrmed)before me this
�, �'� ' LtiC�- bY
. o f !a�"personally nown t�..A�e or ha ave produced Who Is/are personally known to me or has/have produced
as Identlficatlon. as identlficatlon.
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Commission N f y — � — '�� Commission No.
�""r'��,''�.� SUSAN L.dEqNfTT
Name of Nota �` My�i111A�xpires Auq 11,20t2 Name of Notary typed,printed or stamped
Commitsfon#OD 812112
�1�N�jlNpyph NMbnal Notary Assa.
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DBPR- GOODWIN, PAUL JOSEPH III; Doing Business As: COASTAL MECHANIC... Page 1 of 1
11.30:32 AM 6/8/2012
Licensee Details
Licensee Information
Name: GOODWIN, PAUL 70SEPH III (Primary Name)
COASTAL MECHANICAL SERVICES, LLC (DBA Name)
Main Address: 394 EAST DRIVE
MELBOURNE Florida 32904
County: BREVARD _ ��' � 'jvr� Z
License Mailing:
LicenseLocation: 394 EAST DRIVE
MELBOURNE FL 32904
County: BREVARD
License Information
License Type: Certified Plumbing Contractor
Rank: Cert Plumbing
License Number: CFC1426768
Status: Current,Active
Licensure Date: 08/02/2005
Expires: 08/31/2012
Special Qualifications Qualification Effective
Construction Business 08/02/2005
View Related License Information
View License Comulaint
1940 North Monroe Street.Tallahassee FL 32399 Email Customer Contact Center Cus[omer Contact Cenrer 850 487 1395
The State of Florida is an AA/EEO employer Coovriaht 2007-2010 State of Florida.Privacv Statement
Under Florida law,e-mail addresses are public records.If you do no[want your e-mail address released in response to a
public-records request,do not send electronic mail to this entity Instead,contact the office by phone or by traditional mail.If you
have any questions,please contact 850 487 1395
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'IK Result Report P �
06/08/2012 10:26
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Addressee Start Ti�e Ti�e Prints Result Hote
918137648505 06-08 10:26 00:00:36 001/001 OK
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Result OK: Co�municatfon OK, S-OK: Stop Coamunication, P4M-OFF: Power Switch OFF,
TEL: Rx from TEL, NG: Other Error, Cont: Continue, No Ans: No Answer,
Refuse: Receipt Refused, Busy: Busy, M-Fu11:MemorY Full,
LOUR:Receiuin,g len9th Over, POUR:Receiuin9 pa9e Ouer, FIL:File Error,
DC:Decode Error, MDN:MDN Response Error, DSN:DSN Response Error.
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Thi.:I_..st�utnent Prepared By: I I�IIII II�II IIIII I IIII IIIII II��I IIIII IIIII(IIII IIIII IIII IIII
Name: Rodda Construction Inc.,250 E.HiQhland Drivt, I,nkel�rr�d.Fl. 33813 2012111134
Permit No. T';rx Folio No. Rcp t:1445325 Rec: 18.50
DS. 0.00 IT: 0.00
NOTICEOFCOMMENCEMENT 07/02/12 K Garcia, Dpty Clerk
STATE OF Florida
COUNTYOF Pasco
THE IINDERSIGNED hereby gives notice that improvements wi11 be made to certain real property,and in accordance with
Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement
1. Description of property: (legal description ojproperty,and street address if available)
Florida Hospital ZephyrhilLs Simpson Breast Center Legal: 35-25-21-0010-10500-0000
7050 Gall Blvd PAULA S 0'NE I L,Ph D Pq5C0 CLERK & COMPTROLLER
ZephyrhiUs,FL 33541 07/02/12 01:22 m 1 of 2
2. General description of improvement:Renovation of Simpson Breast Center OR BK ���0 PG 1�13
3. Owner/Tenant information
a. Name and Address: Flvrida Hospital ZephyrhilLr, 7050 Gall Blv�Zephyrhills,FL 33541
b. Interest in property:Owner
c. Name and address of fee simple titleholder(if other than owner):
4. Contractor:
� a. Name and address: Rodda Construction,Inc.,2S0 E.Highland Drive,Lakeland,FL 33813
b. Phone number:863-669-0990
S. Surety
a. Name and address:N/A
b Amount of bond$
c. Phone number:
6. Lender
a. Name and address:N/A
b. Phone number:
7. Persons within the State of Florida designated by Owner upon w/eom notices or other documents neay be served as
provided in section 7I3.13(I)(a)7.,Florida Statutes:
a. Name and address:
b. Phone number:
8. In addition tn himself,Owner designates the following person(s)to receive a copy of the Lienor's Notice as provided in
Section 713.13(l)(b).,Flo�ida Statutes:
a. Name and address: Rodda Construction,Inc.,250 E.Highland Drive,Lakeland,FZ 33813
b. Phone number:863-669-0990
9. Expiration date of notice of commencement(the expiration date is 1 year from the date of recording unless a different
date is specified)
WARNING TO OWNER:ANYPAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED I OPER PAYMENTS UNDER CHAPTER 713,PART I,SECTION 713.13,FLORIDA
STATUTES,AND CAN RESULT IN YOU P NG TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCF_M T MUST BE RECO E D POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION.IF YOU INTEND
TO OBTAINF N G, CONSUL WI OUR LENDER OR ANATTORNEYBEFORE COMMENCING WORK OR RECOItDING
YOUR�'I E C �NCE�
�
.j` > ^.� n
(Si ture of Owner or 'sAuthor ed Officer/Director/Partner/Manager)
/ !/ , �� / N�� ��
J
(Signatory's Title/Office)
.1 r � �
The foregoing instrument was acknowledged before me this _�}' day of ._r u.•/L.1 ,2012,by�-'. C�.-t � �"' t 4(��r'L�l_.
(narne of person) as ; �,�4% !, (type of authorify,... e.g.officer,trustee,attorney cn fact)for(name oJ'party on
beJza[f of whom instrument�as ez$cuted). �,
` ;� ,�����Y„�h�y� SUSAN l.BENNETT
� /L ) � _. ° " , ��� , t L . � � s Notary Pubuc-sht�ot Plorld�
(�i�natu�e of Notdry Pu lic-State of F'[orida) • • MY Cemm.Ex�ita Au/11,2012
Coa�aion+10D ittt 1!
(Print, Type, or Stamp Gommissioned Name of Notary Public) ����r�
Personally Known�,L�OR Produced Idenh'fication Type of Ident�'ficatinn Produced
DA'I� : 07/02/12 PASCO COUNTY PROPERTY APPRAISER 13 : 14 : 38
O N — L I N E P A R C E L P R I N T O U T
PARCEL—ID: 35 25 21 0010 10500 0000 TYPE : STATUS : A DLA: 100107
SC TP RG SUB BLOCK LOT TRACT: 0328004
PARENT: 35 25 21 0010 07200 0000 DATE—SPLIT : 050205/VGL CLASS : 73
NOTES : 83Z/C #346 ;CMB 1-104-1, 1— 106-0, 1-122—O ;CMB 1-103-0 LETTER CD—
, 1-121-1, 6-0-4 , 6-0-5 HERE 94WHOLLYOK;SPL 1-103-1 OWNER CHG—
NAME : ADVENTIST HEALTH SYSTEM/ 7050 GALL BLVD
/ADDR SUNBELT INC
FS119 CODE : ZEPHYRHILLS FL 335411347
STREET ADDRESS : 7052 GALL BLVD ZEPHYRHILLS F
VALUE & TAX INFO: E X E M P T I O N I N F O : SOH HX APP
LAND AG: NUM CD H W D V T PCT HX—OVRD YEAR DATE S YR DVD%
—JUST: 2958514 001 19 0 0 0 0 0 1995 030194
BLDG: 42544522
XFOB : 247712
- - ------------------
APPR: 45750748 OR BK ��Z� 2G 1�14
SOH:
NS ASD: 34405265
RPG:
EXEM: 34405265
--------------------
--------------------
BS TXB : 11345483
S DVD:
S DSM:
S TXBL: 11345483 AREA: 30ZH ACRES : 27 . 89 SPEC HX:
BC TXB 34405265
ADD EX:
C DVD:
C DSM:
C TXBL: PRIOR YR VALUE : 31277514
PRIOR YEAR MKT: 31277514
HX VAL: 0 NON—HX: 45750748 MKT DIFFERENCE: 0
MKT CHG HX: 0 NON—HX: 14473234 PRIOR HX VALUE: 0
MC LAND HX: 0 NON—HX: 0 PRIOR HX PCT:
PHYS HX: 0 NON—HX: 0 PRIOR NON HX: 31277514
PRIOR N—HX ASD: 31277514
S A L E S :
YEAR MON BOOK PAGE SALES—AMT INST XFER QUAL ST LIFE I/V TOI
1992 10 3164 0724 QC I X
1984 11 2051 0751 V
1982 Ol 1170 1881 145000 V
1982 Ol 1170 1830 410000 V
L E G A L D E S C R I P T I O N:
ASSESSED IN SECTION 35, TOWNSHIP 25 SOUTH, RANGE 21 EAST,
PASCO COUNTY, FLORIDA
ZEPHYRHILLS COLONY CO LANDS PB 1 PG 55 FOLLOWING DESC PROP
LYING W OF DAIRY RD R/W AS NOW LOCATED TRACTS 103 , 105, 106 , 119
, 120 & 122 & E 100 FT OF TRACT 104 & E 105 . 76 FT OF TRACT 121
EXC W 187 FT OF E 267 FT OF N 172 FT OF TRACT 103 & EXC US
HWY 301 R/W & EXC R/W FOR DAUGHTERY RD; & ARBOR RIDGE
SUB PB 22 PG 44 LOTS 5 , 6 , 7 & 8 OR 3041 PG 160
OR 3154 PG 65 OR 164 PG 724 - •
STAi'��� F�ORtDA,COUN�Y,�QF'�PaSC�3�`�,• '.
THIS IS 7C�GEf�71FY THAT TH�',F�OREd01NG iSA 6, •,
TRUE ANC CORRECT GOPY�C�F•`THE DOCUMENT ' '-
ON FiLE OR OF PUBLIC REG~���N TNIS OFFICE�. : �
WIT ES MY HAND AN OF;,F,I��P+L S�AL THIS -
_DAY OF � ''��' i 2�
PAULA S EIL, RK&' PTROLLER '
.�.s�', � _.
�Y ' DERIJTY CLER#C
� �
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
� r
Contractor/Homeowner: I Q�'FG f� �S��C C�z c}'��
Date Received: ��- � � ( �
Site: 7� 5� t�`X�-�!
� ' //_
� i ,
Permit Type: ,f�PC�'1 a��`� �°� ��(�U�z�
Approved w/no comments: Approved w/the below comments: ❑ Denied w/the below comments: ❑
This comment shee shall be kept with the permit and/or plans.
�-�s"/�
Ka vi Swit — lans Examiner Date Contractor and/or Homeowner
(,,
(Required when comments are present)
7X Result Report P �
, 07/10/2012 09:41
• Serfal No. AoED�f��oo�a�
'I�: 96106
Addressee Start Ti■e Ti■e Prints Resul Note
9zza�z6 0�-�0 09:� oo:0�:�2 000ioo� cont
92'L33926 07-10 09:40 00:01:15 001/001 OK
= r wer x POLs 11 e Ort na ze ttO�� � Fr�e x.
Note = xd �, ir� _ � � i � �FCwOpaE� —co�de� x
� �1Cernet Fa�i defSt ai� :�BUli in.i� P���P�ax. IPADIiasFIP Addr�sepa�x�TX.
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Result OK: Coa■unication OK, S-OK: Stop Ca■unication, P�f-OFF: Power Sritch OFF,
TEL� R}t fro� TEL, N6: Other Error, Cont: Continue, No A�: No Ansrer,
Refuse: Re�ipt Refused, Busy: Busy, M-Fu11:Me�orY Full,
LOYR:Receiuing length Over, POYR:Receivfn9 page Ouer, FIL:File Error,
�:Decode Error, hDN:lDN Response Error, DSFI:D�I Response Error.
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