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Home My WebLink About13-14068 213H1V3M WO�Id a2ld� 1�3102ld a3bI(lb3b 3�IlON 2lf10H 8 - NOI1�3dSNI 210� lld� NOI1�3dSNI a3AObddV 1f10H1IM SHINOW 9 NI S321IdX31IW213d b I��O lIW2�3d 32ifllb'NJIS iJOl�b2ilN0� � � � � 1 1 'O'� 0�38 A�NVd��O ON 'sa�ueuipap pue sapo� i� y;inn a�uepao�e ui pawao�aad aq ��eys�ao�n��d•uo�;e�i�ddd Auedwo��d�snW suo��e��adg 'sue�d a;a�dwo� „•;uawa�uawwo��o a�qou anoA 6uipao�aa aao�aq Aauao�e ue ao aapua�anoA y;inn;�nsuo�'6ur�ueu3 ui�qo�pua;ui no�(;I •A�aadoad�no�o�s;uawanwdwi ��a�i�uy 6uiAed�noA ui;�nsa.��ew;uawa�uawwo�;o a�i;ou e pao� o;aan�ie;�noA :aaunno oa 6u�uaeM,� •sai�ua6e �eaapa�ao sai�ua6e a�e�s `�uawa6euew aa�enn se y�ns sai�i�ua �e�uawuaano6 aay�o woa� paambaa s�iwaad �euoi�ippe aq �(ew aaay� pue '�uno�siy��o spao�aa �i�qnd ay� ui puno�aq �(ew �ey��adoad siy�o�a�qe�i�dde suoi�i��sa� �euoi�ippe aq �(ew a�ay� '�iw�ad siy��o s�uawa�inba� ay�o� uoi�ippe uI �3�TlON •a�qissa�e;ou�aonn(6 a;is qo[;e�ou sue�d (�a;is qo[uo pa�sod;ou;iwaad (a pa��e�uaynn uoi�adsui ao;Apea�;ou�aonn (p pa��e�suoq�adsui uaynn apew;ou suo��aaao�ao s�iedaa (�uoi�na;suo�/y�ne;wa; 6ui;�nsaa�aonn pauwapuo� (q ssaappe 6uoann(e :suoseaa 6ui�no��o�ay;�o auo�ue o�anp/Gessa�au aae sdi.� uo��adsui ea}xa uay�n(�)(Z)08'£SS a;n;e� epuo�� y;inn/��dwo� ��inn saa;uoi�adsuiab :S33d NOIL�3dSNI3b '�SIW '�SIW 3Wb2i� 3lOd NOIl�fl2ilSN0� '�SIW '�SIW JNIHlb'3HS 8b'1S-32id .l`dM3/�Rid �SIW 2l31b'M 4311b1SNl Sl�(14 '�SIW IIHM N011�dlflSNl 2l313W-32ld BWflld HJf10211S1 '�SIW �SIW 131N11 �Ril�3l3 HJf102i '�SIW b3M3S Q31Mf1SNl Sl�fld aN08 a3100� � j� G" C/ ' .�% �P�',/ �V� /;� � � �� . , � �� 1 . � �ll S31b'I�OSS�d 3�HlldM 80'69l S33�M31/�3LI Nb�ld 3211� I 1SN0�aNb�3�Nb'N3INIHW�12�1�313 0£'ElL 33�l`d�IN\fH�3W 48'L9L 33�JNIBWfIId �NI JN18Wflld Nb�H31 l� DS 868Z S3Jl3dOd l3aOW32i 2iORi31X3 '8 2i01�131N1 ��saa ��oM :auoyd ELOZ/6Z/5 �P!�d e��a ZLLL-098ZE l� OaNd�2i0 85'L8L`6 :p!�d �unowb► ZLLL09 X09 'O'd :ssa�ppbr gg•L81�� :saa� �e;ol N3f Wb'illlM'81Sa1 dab�H�lb N3H0� �eWeN £LOZ/6Z/5 :panss� a;ed 00'068`9Z6 :;so� •no�dw� Ob00-OOE00-0000-�Z-5Z-�E �Jeq�nN I��d :an�en •;s3 S�lIH2lJlHd�Z�O Jlll� :uoisinipqng :;aa� a�enbg :uoi;�ag :�ao18 :(s);ol 1b1�2�3WW0� :as� pasodo�d :�008 :aBuea :diysunnol �dl�b�WWO� 1"ld/aad :�IaoM�o ssel� 'l� 'SIIIH�IJlHd3Z lb�I�iJ3WW0� :ad�Cl;it,u�ad a/�l9 ��b�J 6�tiL :ssa�PP�d 890�6 :�aqwnN ;iw�ad lIW�J3d 9NIalIf19 $9 � OZ00-08L(£T8) 133b1S Hl8-S££S ' Sl"11H21�1Hd3Z �O lLLl� Jacqueline Boges From: Verne Riggall Sent: Monday, August 05, 2013 5:14 PM To: Jacqueline Boges Subject: Popeyes Jacqueline; Popeye's is ready to go. Chief Verne E. Riggall,Chief Zephyrhills Fire Rescue 6750 Dairy road Zephyrhills, FL 33542-1631 813-780-0041-Office 813-780-0044- Fax 813-714-6328-Cell vri��all@fire.zephvrhills.fl.us i bd � � � � y C� � � � a, � � a o � � � � o � � .� r � .. � � b � � � � � � � � A � d � � », � p d � � � � � � bd � � a z w � � ►-3 � d a w p �d � � ° � � Z � W ~, r�n N ~. p�. ,,�� -C � �' y � � l� e Ul � O b � � � p �' � O (�j � � � ao � o o � CJ1N o � � � � `° � � ° `° r-C �d r" � � o � `"3 x � � � � o � x � c� o � � o � � x b� � � ~ � r _ � a � � t"jr' w � � t� a � M� � w ` ' � � � � c Q O � � d '� 7d � � � d O C� � � o � n � � � z n b � n � b � � � � � 8 � °� � � x � �' N �' (� � � .p � o '� � r" W � �'' a, d � �. w w i� � �-. �' � � � � � � O 'd o0 � � -P O � � SQ. FEET PRICE MAIN OR LIVING: 2,818 OTHER AREA UNDER ROOF: - $ 88.00 OTHER: - $ _ VALUATION $ 297,000.00 FEE SHEET $ 1,079.00 ADDRESS DRIVEWAY BUILDING: $ 1,100.58 ELECTRICAL: $ 242.78 PLUMBING: $ 161.85 MECHANICAL: $ 113.30 SUB-TOTAL $ 1,618.50 TOTAL ; 1,618.50 SEW ER: WATER: IRRIGATION: $ - TOTAL: ; - n/a WATER METER: n/a IRRIGATION METER $ - n/a FIRE DEPARTMENT FEES PLANS TOTA�: $ 169.08 INSPECTION TOTAL: n/a PERMIT TOTAL TOTAL: S 169.08 PUBLIC SAFETY IMPACT FEES POLICE FIRE 5% $ - TOTAL: _ - n/a SUB-TOTAL $ 1,787.58 PARK IMPACT FEES n/a SIF'S: 100.0% $ - 1.0% $ - TOTAL: ; - n/a TIF'S: n/a 99% $ - 1% $ - TOTAL: $ 1,787.58 Jacqueline Boges From: Chuck Adair[chuckadair@wallace-associates.comj Sent: Wednesday, May 22, 2013 6:34 AM To: Jacqueline Boges Cc: JohnWallace@wallace-associates.com Subject: Popeye's Chicken Permit Yes,John can bring you a copy when he comes up this morning for the FMC projects. Our contract is for$297,000.00. Chuck Adair Wallace Associates, LLC Senior Vice President/C.O.O. 5435 ML King Street North St. Petersburg, Florida 33703 Phone: 727-520-0700 Fax: 727-520-0789 CGC#058394 From: Jacqueline Boges [mailto:jbogesCalci.zephvrhills.fl.us] Sent: Tuesday, May 21, 2013 4:39 PM To: Chuck Adair Subject: RE: Popeye's Chicken Permit Let me check with the plan reviewer on this ? Do you by chance have contract showing actual cost of job.We were given $126,810 for entire job. Jackie Boges (ext 3513) What Greater love can a man give...... From: Chuck Adair [mailto:chuckadairCa�wallace-associates coml Sent: Tuesday, May 21, 2013 3:57 PM To: Jacqueline Boges Cc: )ohnWallace(a�wallace-associates.com Subject: Popeye's Chicken Permit Jackie, Is the Popeye's Chicken permit ready? Can you send me the fee sheet. Chuck Adair Wallace Associates, LLC Senior Vice President/C.O.O. 5435 ML King Street North St. Petersburg, Florida 33703 Phone: 727-520-0700 Fax:727-520-0789 CGC#058394 i � Document A101 TM - 2007 Standard Form of Agreement Between Owner and Contractor where the basis of payment is a Stipulafed Sum � AGREEMENT made as of the 14th day of May in the year 2013 (In words, indicate day,month and year.) ADDITIONS AND DELETI�NS: BEIWEEN the Owner: The author of this document has (Name, legal status, address and other information) added information needed for fts completion.The author may also Legacy HSTd Rock LLC have revised the text of the original AIA standard form.An Additions and C/O Legacy QSR Management LLC Deletions Report that notes added 147-12 105�'Avenue information as well as revisions to Jamaica,NY 11435 the standard form text is available from the author and should be and the ContraCtoi: reviewed.A vertical line in the left (Name, legal status, address and other information) margin of this document indicates where the author has added Wallace Associates,L.L.C. necessary information and where 5435 Dr.M.L.King Jr. Sireet North the author has added to or deleted St.Petersburg,FL 33703 from the original AIA text. This document has important legal for the following ProjeCt: consequences.Consultation with an (Name, location cmd detailed description) attomey is encouraged with respect to its completion or mod'rfication. Interior/Exterior Renovations for Popeye's ChiCken AIA Document A201 T"�-2007, 7441 Gall Blvd. Generai Conditions of the Contract Zephythills FL 33541 for Construction,is adopted in this document by reference.Do not use The AtChiteCt: with other general conditions unless (Name,legal status, address and other information) this document is modified. Oliveri Architects 32707 US Hwy 19 N. Palm Harbor,FL 34684 The Owner and Contractor agree as follows. Init. aA Document A101 TM—2007.Copyright�1915,1918,1925,1937,1951,1958,1961,1963,1967,1974,1977,1987,1991,1997 and 2007 by The American Institute of Architects.AII rights reserved.WARNING:This AFA°Document Is protected by U.S.Copytight Law and Intematlonal Treatles.Unauthorized reproduction or dlsMbution of this AIA�Document,or any portion of It,may result in severe civll and criminal penalties,and wlli be prosecuted to the � / maximum eztent possible under the law.This document was produced by AIA software at 09:31;44 on OS115/2013 under OrcJer No.0027672036 1 which expires on 08/23/2013,and is not ior resale. User Notes: (1362710339) TABLE OF ARTICLES 1 THE CONTRACT DOCUMENTS 2 THE WORK OF THIS CONTRACT 3 DATE OF COMMENCEMENT AND SUBSTANTIAL COMPLETION 4 CONTRACT SUM 5 PAYMENTS 6 DISPUTE RESOLUTION 7 TERMINATION OR SUSPENSION 8 MISCELLANEOUS PROVISIONS 9 ENUMERATION OF CONTRACT DOCUMENTS 10 INSURANCE AND BONDS ARTICLE 1 THE CONTRACT DOCUMENTS The Contract Documents consist of this Agreement,Conditions of the Contract(General,Supplementary and other Conditions),Drawings,Specifications,Addenda issued prior to execution of this Agreement,other documents listed in this Agreement and Modifications issued after execution of this Agreement,all of which form the Contract,and are as fully a part of the Cantract as if attached to this Agreement or repeated herein.The Contract represents the entire and integrated agreement between the parties hereto and supersedes prior negotiations,representations or agreements,either written or oral.An enumeration of the Contract Documents,other than a Modification,appeazs in Article 9. ARTICLE 2 THE WORK OF THIS CONTRACT The Conh�actor shall fully execute the Work described in the Contract Documents,except as specifically indicated in the Contract Documents to be the responsibility of others. ARTICLE 3 DATE OF COMMENCEMENT AND SUBSTANTIAL COMPLETION §3.1 The date of commencement of the VJork shall be the date of this Agreement unless a different date is stated below or prrnision is made for the date to be fixed in a notice to proceed issued by the Owner. (Irtsert the date of commencement if it d�ers from the date of this Agreement or, if applicable, state that the date will be fixed in a notice to proceed.) _ / V 1'he date of construction commencement shall be 25 days after the latter of: 1) execution of contract agreement 2) issuance of permits by authoriries having jurisdiction 3) evidence of Builder's Risk insurance If,pnor to the commencement of the Work,the Owner requires time to file mortgages and other security interests, the Owner's time requirement shall be as follows: §3.2 The Contract Time shall be measured from the date of commencement. I §3.3 The Contractor shall achieve Substantial Completion of the entire Work not later than Ninety-one�days � from the date of commencement,or as follows: 75� Init. aA Doeument A101 TM—2007.Copyright�1915,1918,1925,1937,1951,1958,1961,1963,1967,1974,7977,1987,1991,19g7 and 2007 by The Am rican Institute of Architects.All rights reserved.WARNIN6:This AIA�Document is protected by U.S.Copyright Law and Intemational Treaties.Unauth rized reproduction or dist►ibution of this AIA�Document,or any portion of it,may result in severe eivil and eAminal penafties,and will be proseeuted to the 2 / maximum extent possible under the law.This document was produced by AIA soflware at 09:31:44 on OSl15/2013 under Order No.0027672036 1 which expires on 08/23l2013,and is not for resale. — User Notes: (1362710339) (Insert number of calendar days.Alternatively, a calendar date may be used when coordirrated with the date of commencement.If appropriate, insert reguirements for earlier Substantial Completion of certain portions of the Work.) Portion of Wo�k Substantial Completion Date ,subject to adjustments of this Contract Time as provided in the Contract Documents. (Insert provisions, if arry,for liquidated damages relating to fai[ure to achieve Substantial Completion on time or for bonus payments for early completion of the Work.) ARTICLE 4 CONTRACT SUM �4.1 The Owner shall pay the Contractor the Contract Sum in current funds for the Conh-actor's performance of the Contract.The Contract Sum shall be Two Hundred Ninety-Seven Thousand Dollazs and 00/100($297,000.00), subject to additions and deductions as provided in the Contract Documents. §4.2 The Cantract Sutn is based upon the following alternates,if any,which are described in the Contract Documents and aze hereby accepted by the Owner: (State the numbers or other identification of accepted a[ternates.If the bidding or proposa!documents permit the Owner to accept other alternates subsequent to the execution of this Agreement, attach a schedule of such other alternates showing the omount for each and the date when that amount expires.) §4.3 Unit prices,if any: (Idenh;fy and state the unit price;state quantity limitations, if any, to which the unit price will be applicable.) Item Units and Limitations Price Per Unit(50.00) §4.4 Allowances included in the Contract Sum,if any: (Identify allowance and state�.rclusions,if arry,from the allowance price.) � Price Landscape/Irrigation $5,000.00 Repair Site Light Poles $2,000.00 Repointing Brick $1,000.00 Mechanical Work as Required $5,000.00 ARTICLE 5 PAYMENTS §5.1 PROGRE8S PAYMENTS §5.1.1 Based upon Applications for Payment submitted to the Architect by the Contractor and Certificates for Payment issued by the Architect,the Owner shall make progress payments on account of the Contract Sum to the Contractor as provided below and elsewhere in the Contract Documents. §5.1.2 The period covered by each Application for Payment shall be one calendar month ending on the last day of the month,ar as follows: §5.1.3 Provided that an Application for Payment is received by the Architect not later than the 1 st day of a month, the Owner shall make payment of the certified amount to the Contractor not later than the 15th day of the same month.If an Application for Payment is received by the Architect after the application date fixed above,payment Init. aA Document A101 TM—2007.Copyright 01915,1918,1925,1�37,1951,1958,1961,1963,1967,1974,1977,19g7,1 gg1,1997 and 2007 by The American Institute ot Architects.All rights reaerved.WARNING:This AIA Document is protected by U.S.Copyright Law and Intematiooal Treaties.Unauthorized 3 reproduction or distribution of this AIA°Doeument,or any portion of it,may result in severe eivil and eNmfnal penaRfes,and will be prosecuted to the / maximum extent possible under the law.This document was produced by AIA sottware at 09:31:44 on 05/15/2013 under Order No.0027672036 1 which e�ires on 08/23I2013,and is not Tor resale. — User Notes: (1362710339) 813-780-0020 City of Zephyrhilis Permit Application Fax-813-780-0021 Building Department Date Received phone Contact for Permitttn — Owner's Name Owner Phone Number Owner's Address � �� Z � �m�i�C " `�wner Phone Number Fee Simple Titiehoider Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS / fQ � r LOT# � SUBDIVISION , PARCEL ID# (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED e NEW CONSTR 8 ADD/ALT iN � SIGN Q Q DEMOLISH INSTALL REPAIR �— PROPOSED USE � SFR COMM � OTHER TYPE OF CONSTRUCTION Q BLOCK � FRAME � STEEL Q DESCRIPTION OF WORK C_Ld�1 I�� ^ dY EE�� Q s D �U/�! CQ,I� BUILDING SIZE �— SQ FOOTAGE�� HEIGHT �BUILDING $ � �/ �S'X�. VALUATION OF TOTAL CONSTRUCTION �u u �ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. �PLUMBING $ `� �`��J I � � QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION , y I`I �� i� �y. �GAS � ROOFING Q SPECIALTY 0 OTHER � y�Ci/ J FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO ��-�--� BUILDER � �� f I m J�/� COMPANY ��-��C"� 'S��10�/25' ��L.C SIGNATURE In U•� REGISTERED Y/ N FEE CURRE� Y/ Address � ' License# W�j'� � ELECTRICIAN � COMPANY SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N Address ,_Licens � PLUMBER � COMPANY SIGNATURE � � REGISTERED Y/ N FEE CURRE� Y/N .(t�a � Address License# � MECHANICAL COMPANY ��/i/ /�O wCQ'� Q,� ��G, SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address ?S Tc� Gw�r�/9t.�' �(i.o�pd//� License# ��Y Ug�J 7�� OTHER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address 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. Requi�ed onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities 8 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 ali new projects.All commercial requirements must meet compliance SIGN PERMIT Attach(2)sets of Engineered Plans. '*'*PROPERTY SURVEY required for all NEW construcGon. Directions: Fill out application completely. Owner&Contractor sign back of application,notarized If over$2500,a Notice of Commencement is required. (A/C upgrades over E7500) '* 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 Application Only) Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/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'SlOWNER'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 exp�essly permitted. - If the fill material is to be used in Flood Zone "A", it is understood that a drainage p�an 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 fitl material is to be used in any area, I certify that use of such fill witl 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 shal► 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) OWNER OR AGENT CONTRACTOR Subscribed and sworn to(or affirmed)before me this Subscribed and swom to(or affirmed)before me this by bY Who is/are personally known to me or has/have produced Who is/are personally known to me or has/have produced as idendfication. as identification. Notary Public Notary Public Commission No Commission No. Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped - 813-760-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department �� Date Received �-2 —'3 phone Contact for Pertnitting 7d/� -,Sp�s � �� T�rm Owner's Name 1:��N ��rt1Q�� S. ��ec Ti2u � Owner Phone Number Owners Address / •�� L7U/� �Q 07'7 a �(,�. � l„ Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simpie Titleholder Address JOB ADDRESS /7� I ��LL [�LV�� LOT# C�] SUBDIVISION ��H��C��A� pqRCELID# �T'�5��/�Q � �QWQ �003� (OBTAINED FROM PROPERTY TAX N TICE) WORK PROPOSED B NEW CONSTR e ADD/ALT SIGN Q � DEMOLISH INSTALL REPAIR PROPOSED USE SFR Q COMM O OTHER TYPE OF CONSTRUCTION BLOCK � FRAME Q STEEL Q DESCRIPTION OF WORK -�'N�JeI U r/I"D C��/ 1O 12. �C�iDDEG BUILDING SIZE 7Z"O N 38/�6� SQ FOOTAGE �O� HEIGHT ��,� �� BUILDING $��/ �/O VALUATION OF TOTAL CONSTRUCTION �� e f5 r `�p Pla�- QELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W R.E.0 /� � � Sl I� �PLUMBING $ �(U /�� /`1Q/U'EL LJ % �`�/ 3� C' l r�✓ �MECHANICAL $ VALUATIONOFMECHANICALINSTALLATION ��1 �I(JC _ �� 1�D ��b. OGAS � ROOFING � SPECIALTY � OTHER /� � � �'^ -�-0 FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO '�L � :S \7J BUILDER � ,/> �, v COMPANY �a• D . SIGNATURE '�� REGISTEREO Y/ N FEE CURREI. Y/N Address License# ELECTRICIAN ��Q f�� t, V COMPANY T Q.�, SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N Address p1� License# V�, f� /� PLUMBER � �� ,`, COMPANY �� l7.�. SIGNATURE V REGISTERED Y/ N FEE CURRE� Y/N Address License# MECHANICAL //.�1 � COMPANY 1. (�. �• —1 SIGNATURE T ✓• �� REGISTERED Y! N FEE CURRE� Y/N Address License# —� SIGNATURE �""/ � COMPANY /Q,�, � REGISTERED Y/ N FEE CURRE� Y/N Address License# 1111111111111111111111111111111111111111111111111111111111111111111 RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(i)set of Energy Fortns;R-O-W Permit for new construction, Mmimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facalities&1 dumpster;Site Work Pertnit for subdivisionsAarge projects COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Fortns.R-O-W Permit for new construction. Minimum ten(10)working days after submittal date Required onsite,Construction Plans,Stortnwater Pians w/Silt Fence installed, Sanitary Facilities&1 dumpster Site Work Permit for all new projects.All commercial requirements must meet compliance SIGN PERMIT Atlach(2)sets of Engineered Plans. ""PROPERTY SURVEY required for all NEW construct�on. Directions: Fill out application completely Owner 8 Contractor sign back of application,notarized If over 52500,a NoGce of Commencement is required. (A/C upgrades over 57500) " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notanzed letter from owner authonzing same OVER THE COUNTER PERMITTING (Front of Apptication Only) Reroofs if shingies Sewers Service Upgrades A/C Fences(PIoUSurvey/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 dces 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,Fiorida 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 pertormed 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-Welis, 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,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 A ATTORN Y BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JUR,4T(F.S.11 . OWNER OR AGENT • CONTRACTOR ��Subscribed and s o(or a rtne before me this',� c,,.a Subscribed and sworn to(or affirmed)before me this a,01� by�r�S e h�., � l��i V C.,r � bY Who is/are personal known to e or has/have produced Who is/are personally known to me or has/have produced s�1fa as identfficatwn. as identification. .�.�s��z1��}� Notary Public �— Notary Public Commission No. Commission No. Name of Notary rype�qy � �. c stamped ,�� Name of Notary typed,pnnted or stamped *��* MY COMMISSION�EE 050451 EXPIRES:January 29,2015 �f''EOS n�'��F �d Thru Budget Notary Services aL$ �� '� � City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: x"G� e� � Date Received: _� �Z�—/3 Site: �� .(Ql�-1( �l v� `— ' r� ,Q c�/� 2 � l� s� ��f Permit Type: ��i'�dY / ��'�'`C llr �fNa Approved w/no comments: Approved w/the below comments: ❑ Denied w/the below comments: ❑ This comment sheet shall be kept with the permit and/or plans. ._�(�.—� c� Ka1vi Switz —Plans Examiner Date Contractor and/or Homeowner (Required when comments are present) . � � . _ 3 � w,� � � � � � � �� . . ,. .. � , �.,.. � �� - � n ` " , ° , '- '� �",: <� � '��-„ ,�,- � `s, . �" . ^t=ua.. r � �. . „ , , w, �w. � . . . , � _. �r �a�, .� r- , s� ,;� -�,i � R'�rr� �`- -� �.� � ' �- .'; } 1 ,. ,�- ,r , :�^ . '}°,i�� .+.r.•? � ' � ' -x '� a.i .; �,� ,,�r. ;.7 i ' +�r, �,C 3a.s 1 � � �r. ' w_ �`a• "" `. .,.;,�, ,r ' - '�'�v r�:�, `�`.�--'� ,� -,• � ��:, n s� � , , :z�": -��, �",�, � � � st ; --�9. � ^ . � �s��- ��, -,��'�2��'�-�.,5�� , � 6�,�_ ,h � , � .r • , rq�7�. a;�� r4w,,k,� ,Ak�� fr,$^ '9rv''. PROJECT SUMMARY Short Desc: POPEYES Description: Popeye's Chicken ! Ow ner: Enter Owner's name here � � Addressl: 7441 Gall Blvd. City: Zephyrhills Addtrss2: State: Flarida 7ip: 0 Type: Dining:Cafeteria/Fast Food Class: Renovadon to existing buildi Jurisdiction: ZEPHYRHII.L.S.PASCO COUNTY>FL(511600) ' Conditioned Area: 2695 SF Conditioned&UnConditioned Area: 2695 SF � No of Stories: i Area entcred irom Pfans 2700 SF Permit No: 0 Maac Tonnage 0 ; If d�fferent,write ia: � 3 EnergyGauge 5ummil�FlalCom-2010 Section 506.4 Compliant SoRware.EfFective D�e:March 15,2012 3/28/2013 Page 1 of 7 Compliance Summary Component Design Criteria ResWt � i RENOVATED ENVELOPE PRESCRIPTIVE PASSES � LIGHTING POWER 1,832.0 2,784._5 PASSES LIGHTING CONTROLS PASSES EXTERNAL LIGHTING PASSES HVAC SYSTEM None Entered P�� None Entered WATER HEATING SYST'EMS None Entered PIPING SYSTEMS PASSES ' Met all required compl�ance from Check List? YeslNo/NA � � { t i IMPORTANT MESSAGE Info 5009 -- -- -- An input report of this design building must be submitted along with this , Compliance Report ° ; � � EnergyGauge Summitt�FlalCom-2010.Section 506.4 Compliant Software.Eifective Date:Marc;h 15,2012 3/28/2013 Page 2 of 7 CERTIFICATIONS b ��u��i�� ; ,,��.�`� ST E N�V ��, . I hereby certify that the plar,�'� . ..•�o ve y t ' calculation are in complian e Floritla Energy Code ,•'Q;' �pa3 � i � Q• � prep ,. Building Official. " ;it1� �� 3 :2 I " Date• i•p :C?: ri��••.,��•�L O P\�•�``� I ce�t'rty ihat ihis building is in bq ��s�`�brida Energy Efficiency Gode ,��►��t�et��. € Owner Agent: Date: If Required by Florida law, I hereby certify(')that the system design is in compliance with the Florida Energy Efficiency Code Architect: Reg No: # � Elecvical Designer: Reg No• . Lighting Designer: Reg No: Mechanical Designer. Gary Stenlund Reg No: 40439 � Plumbing Designer: Gary Stenlund Reg No: 40439 � {') Signature is required where Florida Law requires design to be performed by registered design professionals Project:POPEYE.S 'I�tle:Popeye's Chicken Type:Dining:CafeterialFast Food (WEA Ftile:FI,_TAMPA_INTF.RNATIONAL_AP.tm3! Prescriptive Envelope Comptiance Item Zone Ikscription Design Criteria Meet Req. Glass Jining Percent glass Max allowed 000 50.000 Yes Sk ii hts dinin Percent Skyli ht Max allowed .000 5.000 Yes Meets Shell Envelope Requirements--PASSES EnergyGauge Summit�FlalCom-2010.Section 506.4 Compliant So(tware.E1fec6ve D�e:March 15,2012 3/28/2013 Page 3 of 7 , � Pro,ject:POPEYFS � Title:Popeye's Chicken � 'i)�pe:Dining:CafeterialFast Food ' (WEAFile:FL_TAMPA_INTERNATIONAL_AP.tm3) External Lighting Compliance � Descriptbn Category 'IYadable? Ailowsnce Area or Length ELPA CLP ` (WNnit) or No.of Units (W) it'�') (Sqtt or ft) Ezt Light 7 Main enuies Yes 30.00 3.0 90 b00 Ext Light 9 Drive-up windows at fast food No 400•00 1.0 40� g�0 restaruants Ext Light 10 Building facades(by linear foot) No 5.00 72.0 36� (�0 Ext Light 11 Other(doors)than main entries Yes 20.00 3•0 60 100 T'radable Surfaces: 700(W)Allowance for Tlradable: 810{W) PASSFS � f All External Lighting: 2100(W) � Complicance c6eck includes a excess/Base allowance of 1304.00(W) � Ext Light 9--400W fmm the excessBase allowance was appiied to this , item to comply Ext Light 10--240W from the excess✓Base aUowance was applied to this � S �tem to cwnply � � Prn,�ect:POPEYES ' 1'ftle:Popeye's Chicken ` Typec DWng:cateaerialFase Fooa � (WEA Flle:FL TAMPA_INTERNAI'IONAL_AP.t�n3) } Lighting Power Compliance � � Space Ashrae Descrlption Ares Height No.of Design Ettective AUowance � ID (s9.ft) (R) Spaces (�'�') (W) (�'�') . Dining 8 Fcwd Serv�ce-L.eisure 1,498 9.0 1 1265 I 1 fi{) 1,348 Dining ' Kitchen 7 f�ood Service- Kitchen I.197 7.0 1 b72 672 1.�37 Design : 1937 f W) PASSFS Effective: 1832 (W) Altowance: 2784.513(W) Passing requires Design to be at most 100% of Criteria EnergyGauge Summit�FlalCom-2U10.Section 506.4 Compliaant Software.Effec6ve Date:March 15,2012 3/28/2013 Page 4 nf 7 rroj�c:Po�vEs Tide:Pbpeye's Chicken TyPe:�ini�8:CafeteiiaJFast Food (WEA File:FL_TAMPA_IN1'ERNATIONAL_AP.tm'i) a Lighting Contrnts Compliance � � Arronym Ashrs�e Description Area Design Min Compli- � ID (stl.ft) CP CP ance ` Dining S Food Service-Leisure Dining 1.498 3 i PASSES s Kitchtn 7 Fooc1 Service-Kitchen 1,197 1 l PASSES �—P SAS ES —� , ; S�rstem Report Compliance ; No.ot'Units ' Component Category Capadty Design Eff Design IPLV Comp- , Etf Criteria lPLV Criteria liance � i i None i � Plant Compliance Description Installed Size Design Mio Design Min Category Comp No EFf Eff IPLV [PI�' �� — None � Water Heater Compliance Cat orti� �� Min Design Max Comp I)escription 'I`vpe e8 E}�' Eff Loss Loss liance None� EnergyGauge Summil�FlalCom-2010.Section 506.4 Compliant Sofiware.Effec6ve Date:Maroh 15,2012 3/2R/2013 Page 5 of 7 Projcct:POPEYES Tjtle:Popeye's Chicken Type:Ujni�:Cafeteria/Fest Food (WEA File:FL_TAMPA_IN7'ERNA1'IONAL_AP.tm3) Piping System Compliance Category Pipe Die Is Operating Ins Cond Ins Req lns CompB [incbes] Runout' Trmp [Bta-in/hr Thick[in] T6ick[inJ [FJ .SF.F] Domestic and Service Hot Water 0.50 False 10_5.00 0.28 0.50 0.50 PASSES Systems �PASSES � EnergyGauge Summit�FlafCom-2010.Section 50fi.4 Compi'iant Software.Effective Da�e:March 15,2012 3/28/2013 Page 6 of 7 \ �y N z o � 0 " o � ] ti 3 � y ro �• �• � a � � R z d N �' y � rt � � C cD b' rt v�i ^' n � y � � � A � � n "a �. � o � � o b o � ,� o � �c O � � co ,�. � � ''d O �' � y �-C � n � � � �_ � � � ¢. _ � . � � o � � � � � � � 0 � d b Z A o � �. cVf N n ��'7 � A '� O � d a a v� C 01 3 e� �a u� � N � y � � �, o y � � �° � � �. 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C � �G � � o .�. �' � ? � � � i� � ,►��' ,t '�•e ° vv', "�3 � � y � �'� z � � � � � ° � � o � � � � � w •� � � � ❑ ❑ \ N O�0 N O �+ W � f9 OQ � � C � C C. � A Mr O O� .. � F . # � � � I � , , �.��.-��4 -.}� �: 4 � ' f w A �� _ .. � , �,�_ . ,' , ,x' ��.S�k� ��,�.�'" .r ':x�R` �r��' d n:. ��- ,a�, ,<3 � � k,� � � � � � .�,,� �' .` � � � . 1 c� e ` -as fi �� -��;��*'�-:�� a � s- �- � « r �-m Y, '�� ,� , � �� . T § ,K �„' 1 t � 1 z'»� r' _' ` `r p�as ,��s � � �� , � r�� i��a �'r *�d' _ '� '"r�� Y i ��x ''�°":'�,��:� �'a ��k' �'�`��,�'� ',1 g ; -�ka+v��,`�,. t�# z �'� ,g " � � � �-..x fi�� :�m .-0�2�...�9-, ..'�ro�Y:,�� - ��.-�€.'�4x.�—s fi �`�C; -��4;� �*n- ,� PROJECT SUMMARY � i Shori Desc: POPEYFS DescrPiption: Popeye's Chicken E I Owner. Enter Owners narne here 1 Addressl: 7441 Gall Bivd. City: Zephyrhills ; Address2: State. Florida � Zip: 0 Type: Dining:Cafeteria/Fast Food C1ass: Renovation to existing buildi �` Jurisdiction: ZEPHYRHILLS,PASCO COUNTY,F1.(611600) � � Conditioned Area: 2695 SF Co�itioned&UnCooditbned Area: 2695 SF No of Stories: 1 Area entered fmm Plaas 27D0 SF Permit No: 0 Max Tonnage 0 " _ If d�ffetent,write in: � i � � t EnergyGauge Summii�FlarCom-2010.Seati�on 506.4 Compliant SofMra�e.Effecfive D�e:March 15,2012 ' 3/2$/2013 Page 1 of 7 Compliance S�ry � Component Design Criteria Result � RENOVATED ENVELOPE PRESCRIPTNE PASSFS � LIGHTII+IG POWER 1,832.0 2,784.5 PASSES ' LIGHTING CONTROLS PASSES EXTERNAL LIGHTING PASSFS � HVAC SYST'EM None Entered pLAN.I, None Entered WATER NEATING SYSTEMS None Entered � � PIPING SYSTEMS PASSES $ Met all required compliance from Check List? Yes/No/NA ; � F i ; IMPORTANT MESSAGE f Info 5Q09 -- -- -- An input report of this design building must be submitted along with this ; � Compliance Report � ,� � i � EnergyGauge SummilQsl F1alCom-2010.Section 506.4 Comphant Sotlware.Effective Date:March 15,2012 3/28/2D13 Page 2 of 7 i ; CERTIFICATIONS ,�»��,,� �.��` s-cErv�� I hereby certify that the plar�'�� ••..•�o� ve y t ' calculation are in compliance � th ' �. � Florida Energy Code �Q; ��q3 . % � � Q. Prep .. Buildiog Official: ' � " � ;W� .. � � :2 ' � ` " Date: �:e:p• '�: 1 ¢ ��',,,A�..'• �L O.�':�•'.��.`� 'g I certify ihat this building is in �frp��.��S 1��,`�¢brida Energy Efficiency Code � ��+ii�i��:�� Owner Agent � Date: ` € 6 a If Required by Florida law, 1 hereby certify{')that the system design is in compliance with the Florida Energy � Efficiency Code 4 Architect: � Reg No. � [ Electrical Designer: �g No� � t Lighting Designer• Reg No: • � � Mechanical Designer Gary Stenlund Reg No. M3439 � Plumbing Designer• Gary Stenlund Reg No. 40439 � ('} Signature is required where Florida Law requires design to be performed by registered design � professionals. d Project:POPEYES 'IStle:Popeye's Chicken Type:Dining: Cafeteria/Fast Food (WEA File: FL_TAhiPA_INTERNATInNAL_AP.tm3) Prescriptive Envelope Compliance Item 7.one Description Design Criteria Meet Req. Glass d�ning Percent glass Max allowed (�C> 50.(� Yes Sk li hts dinin Percent Sk li t Mvc allowed .000 5.000 Yes Meets Shell Envelope Requir�ments--PASSES EnergyGauge Summit�FlalCar►-2010.Section 506.4 Compliant Software.Effective Date:March 15,2012 � 3/28/2013 Page 3 of 7 ! i Projed:POPEYES { 7'itle:Popeye's Chidcen i 'l�pe:Dining:CafNeiia/Fast Food � (WEA Fjle:F[,_TAMPA_INTERNATIONAL_AP.tm3) � External Lighting Compliance Descriptbn Category 'Ilradable? AUowance Ares or Leogth ELPA CLP � (WNniy or No.of Units (W) {W) iSqtt or it) Ext Light 7 Main enuies Yes 30.00 3.0 90 6W Ext Light 9 Drive-up windows at fast food No 400.0� i 0 4�0 g00 restaruanis Ext Light 10 Building facades(by linear foot) No 5.00 72.0 36U 600 Ext Light 1 f Other(doors)than main entries Yes 20.00 3A 60 100 i � 'i�adable Surfaces: 700(W)Allowance for T7radable: 810(W) PASSE-S � � All External Lighting: 2ii10(W) � Complicance check inclndes a excass/Base allowance of 1300.00(W) Ext Light 9--400W from the excessBase allowance was applied to this item to comply Ext Lighi 10--240W frnm the excesslBase allowance was applied to this ; item to comply ' Projeet:POPEYFS � TfUe:Popeye's Chicken � 'I�'Pe:Dlning:Catete�i�/East Food f (WEA Flle:FL_TAMPA_INTERNAT[ONAL_AP.tm3) 4 Lighting Power Compliance � Space Ashrae Descriptbn Area Height No.of Design Effective Allowa�e � ID ts9.ft) (ft) Spaoes (W) iW) (W) Dining 8 Food Service-L.eisure 1,498 9.0 1 1265 I 1 C� I,348 Dining Kitchen 7 Food Serv�ce-Kitchen 1.197 7.0 1 672 b7'_ 1.437 Design : 1937 (W) PASSES Effective: 1832 (W) Allowance: 2784.513(W) Passjng requires Design to be at most 100% af Criteria EnergyGauge Summit�FlalCom-2010.Section 506.4 Compliant Soflware.Effective Dake:M�ch 15,2012 3/2$/2013 Page 4 of 7 i Prnject:POPEYFS � Title:Popeye's Chkken ' T3'Pe:�ia�o8:CafeterielFast Food '"s (WEA File:FL_TAMPA_INTERNATIONAL AP.tm3) � f 1 Lighti�g Controls Compliance � Acronym Ashrae Dcscription Area Design Min Compli- ? � (sq,ft) CP CP ance + Dining 8 Food Service-Leisure Dining 1,498 3 1 PASSES Kitchen 7 Food Service-Kitchen 1,197 1 I PASSES � � � � � System Report Compliance � No.of Units Cmnponent Category Capatity Desigo Eff Design IPLV Cotnp- ; ER Cr�teria lPLV Criteria liance 9 i r a None � Plant Compliance Descripiion Installed Size Design Min Design Min Ca►e�;ory Comp No F,ff Eff IPLV IPI�' �� None � Water Heater Compliance Cat ory ��gn Min Design Max Comp I�scription 7�pe � EpF Eg [.oss L�S lianre None � EnergyGauge Summil�FlalCom-2010.5ec�ion 506.4 Compkant Software.Effecbve Date:March 15,2012 3/2A/2013 Page 5 of 7 ProJect:POPEYES Titk:Popeye's Chicken Type:Dining:cafeter;a/Fasc Fuoa (WEA Irile:FL_TAMPA_INTERNATIONAL_AP.tm3) Piping System Compliance Category Pipe Die Is Operating I�Cond Iac Req Ins Co [i�6es] Runout? Temp [Btn-Whr 1'I�ck[in] Thick[in] [F] .SF.FJ Domestic and Service Not Water 0.50 False 105.00 0.28 0.50 0.50 PASSFS Systems � PASSFS � EnergyGauge Summil�FlalCom-2010.Section 50fi.4 Com�iant SofMrare.Effective Date:March 15,2012 3/2g/Zp�3 Page 6 of 7 W � z � z ° 0 o � ' � w � �' o � � �e "d �. � � � � � cr. a � z N � "�'� _? d �+. Pt fC y � � d ►�s b fD vyi �9 f9 't r, "O "z. �J O � �1 "d "L1 O '° � O � �o° O ' � � a c�o Crot] O �' � � �C � n � � � bCi � cn -� � �' � o � . � � �D O � � � � � � O � � � � � � � ro � � O � � ; Vf N n• y � c � d d 3 � � � �. � �' � N �"h � � � O A � � � �. � � � � ° = a; �' � �d � � � � � � � 0 x � o � � � � ��-7 � �.y @: � .^'�.� � y � � � �,^�' � � �+ �, ,� e�O Q A1 � �O � � ►`3. � `� O �, C � � � tD � to �. � � � � d z o � � � � s y � � U � �. � � � � m ' � A*, o �° � �. y y � �. � � n,� y � � �' v�, o� ,..' � o ? � � � � � w G � � a. 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C "y* ��ip'' � in '� ~� Q� �� y !'� � � h�ir � � �. y '� � z/! � C � Vj O r-, � � � a �° � x � � o � A � � C/� �/1 A � � •n n rD rD v� � � m ° vv�, bd � �+ �l � �'' � � ": � a � � ¢'' � �, ' °o � � � �� y � � � � � o z �' � � a o ^ do �d � � � o � � � E � � c °'fl ;"'�o �,� � ,� � � � R � �, � v � C � d � � � � � -° u � °: � � � � o y o ,�� e m p � � � y �� z � '�^�1m � �+ o 0 � � � y � � � � ❑ � ❑ ❑ \ N � N O W � � O�Q `�C m G � C C. � A �+ O O� ZE��1f�HILLS FIRE DEPARTMENT 6907 Dairy Road, Zephyrhills, FL 33542 Fire Chief Keith Wiliiams Bus (813)780-0041 Fax (813)7�i�-U044 FIRE SERVICE USER FEES Occupancy No.: Plan No.: Contractor: �� ` � �s' Business Name: Billing Address: Business Address: 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 N/C Annual N/C Sprinkler 350 tst Alami N!C Mu1ti-Family ommer 'al .O6 sf 1st Re-inspection N/C Standpipes S50 2nd Alamt N/C (Minimum Ch 5.00 2nd Re-inspection a700 Fire Pump a50 3rd Alarm NJC �Plan Revisions DBL 3rd Re-inspeclion 3250 Hoods s50 qth qharm a�pp 4th Re-Inspection s500 Fire Alarm S50 5th Ala►m St 50 SPRINKLER SYSTEMS (Business cloaed until LP Gas s50 6th Alarm a2pp 8 0-25 Heads S50 violations corrected) Naturat Gas �SO NON CpMpUANCE �150 26 plus Heads �100 SPRINKLER SYSTEMS Fuel Tanks- Per m�r �p STANDPIPE SYSTEM Hydro Undergrounds E45 gparklers s�pp �Per Riser E50 Hydrostatic Test S65 �sys�em Fire Works 35pp FIRE PUMP Acceptance Test S45 �r�ysrem Camp Fire s� � Per Pump 5100 Hydrant Flow a75 Cadrolled Bum 3100 FIRE ALARM SYSTEM Hood/Duct s50 8 0-25 Devices 350 FIRE ALARM SYSTEM Plxe of Assembly a50 �o�,,,i 26 plus Devices 5100 System Acceptance S50 Fire p�aection s� SUPPRESSION SYSTEMS Recall Acxe�ance �50 Flammable Applicetion s50 Mnual Wet S50 OTHER Waste Tire Storage s5p n,u,o,i Dry 350 F��e weiusmo�wan S15 �w,u Generetor<KW s100 CO2 �SO LP Gas S25 permmc Ge►lerator>30 K4V 150 Other 350 Natural Gas S25 pe,sy.wn B10-Hazard Waste a!00 �►nnu.i KITCHEN EXHAUST Fumigation Tenting s5p � Hood/Duds 350 Tent 10'x10'or qreater s15 p�r tsnc Twch PoVApplied s50 OTHER Fire Pump s45 Haz.UAaterials s1 pp �„n,ni 8 LP Installation per lank S50 Fire Suppressbn S30 Fuel Tank Installation 350 System Acceptance ❑ (Per Tankj S5o 8 Exhaust Hood/Duct 330 Nafurol Gas Installation s50 Re-inspeCtlOn DBL (Per System) (other than annual} �Spray Bodh a50 �Inspedion scheduled DBL 8 and cancelled less than � 24 hours Construclion Insp. N/C Emergency Vehicle Aa E50 FALSE ALARM PLANS TOTALL(��C� INSPECTION TOTAL� PERMIT TOTAL� TOTAL,C _ _l GRANDTOTAI Comments: � c �; � ,� r, ;�� , �� ____�81E: � Insq�ctor:_ ��,�,�� Pasco County Parcel: 34-25-21-0160-00000-0030 001 Page 1 of 2 Data Current as Of: Weekly Archive - Saturday, May 11, 2013 Parcel ID 34-25-21-0160-00000-0030 (Card: 001 of 002) Classification 22 - Drive-In Restaurants Mailing Address Property Value COHEN RICHARD S REVOC TRUST & Ag Land �o WILLIAMS ]ENNY W REVOC TRUST Land �2Z2.996 PO BOX 607772 Building $z25,00a ORLANDO FL 32860-7772 Extra Features �i3,869 Physical Address 7441 GALL BLVD �ust Value �461,869 ZEPHYRHILLS FL 33541-4374 ASSeSSeCI (Non-School Amendment 1) $461,869 Leqal Descriation (First a �ines) See Plat for this Subdivision Taxable Value #461,869 ZEPHYRHILLS COMMONS PB 50 PG 93 LOT 3 TOGETHER WITH NON-EXCLUSIVE Land Detail (Card: 001 of 002) Line Use Description Zoning Units Type Price Condition Value 1 2200 DRIVE-IN OOC2 11,000.00 SF $8.10 1.00 $89,100 2 2200 DRIVE-IN OOC2 19,128.00 SF $7.00 1.00 $133,896 Additional Land Information Acres 0.69 Tax Area 30ZH FEMA __ Commercial Code OPAR2AC Code Buildinq Information - Use 22 - Restaurants (Fast Food) (Card: 001 of 002) Year Built 2004 Stories 1.0 Exterior Wall i EIFS Exterior Wall 2 None Roof Structure Rigid Frame w/Bar Joist Roof Cover Built-Up Tar and Gravel Interior Wall 1 Drywall Interior Wall 2 None Flooring 1 Quarry or Hard Tile Flooriny 2 None Fuel Electric Heat Forced Air- Ducted A/C Central Baths 2.0 Line Description Sq. Feet Repl. Cost New 1 SPA 1,506 $121,306 2 CAN 56 $1,611 3 BAS 1,341 $127,087 Extra Features (Card: 001 of 002) Line Description Year Units Value 1 PAV ASP 2004 10,615 $6,966 2 S W C 2004 900 $1,423 3 LIGHTSC 2004 4 $5,480 Sales History Previous Owner ART RESTAURANTS FLORIDA LLC Month/Year Book/Page Type �ode Condition Amount http://appraiser.pascogov.com/search/parcel.aspx?sec=34&twn=25&rng=21&sbb=0160&b... 5/22/2013 i lillll lilll lliillilll IIIII IIIII IIIII IINI ilill lllll lill llil 2013088050 NOTICE OF COMMENCEMENT Rept:1521858 Ree: 10.00 , DS: 0.00 IT: 0.00 ' PermitNo. 05/20/13 E. Mun9uia, Dpf.y Clerk Properry Identification No.r�`�'°ZS' �r ' 6�6�' ��0�' �30 THE iJNDERSIGNED hereby gives notice that improvements will be made to certain real property,and in acwrdance with Section 713.13 ofthe Florida Statutes,the following information is provided in the NOTiCE OF COMMENCEMENT. 1. Description of property(lega[description:) a) StI'CCt Add�OSS: Popeye's Chfcke�.7441 Gell BNO.,ZephyihiAs,fbrida 335A1 2. Generai description of improvements Interia/Exteiior RenovaUon fa Popeye'a Chidcen 3. Owner Information 3� Name and address: ��as�y r�ab Ro�*��c ao��a�y asR Mana�menc��c,147-12105th Avenue,Jameice.NY 11435 b) Name and address of fee simple titleholder(if other than owner) c) [nterest in property � 4. Contractor Information 8� Name and address• cn�a�nae��,wai��,n8s«�i��c,5435 Or,Mutin luther KFp Jr St North,St.Petersburg.Fbrida 33703 b) Telephone No.: 72�-s2o-o�0o Fax No.(Opt.) 72�'SZ0-0�899 5. Surery Information a) Name and address: N^ b) Amount of Bond: � c) Telephone No.: N^ Fax No.(Opt.) NA 6. Lender a) Name and address: NA � 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: on�en arcn��cg,sz�o�us rn��s N.,Pem�r+an,«,F�3ase� b) Telephone No.: 72�•�a�aszs Fax No.(Opt.) 8 ln addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 7]3.13(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 1,SECTION 713.]3, ELORIDA STATUTES AND CAN RESULT IN YOUR PAYING TWICE FOR IPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION.(F YOU INTEND TO OBTAIN FINANCING,CONSULT YOUR LE DER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOU NOTICE OF COMMENCEMEN . SI'A7'E OF FLORIDA COUNTV OF PASCO Signature O Owner or Owner's Au orized OfficedDirector artnedManager �'�./�`�'� Print Na e The foregoing instrument was acknowled�ed before me this l5 day of 1 1 �,{,1 ,20�,by�UC�` ��P Tl�,'101 as ��.1 P� (type ofauthority,e.g.officer,trustee,attomey in fact)for 'S �—p� (name of parry on behalf of w m instrument was executed). Personally Known_OR Produced Identification '� Notary Signature Type of Identification Produced �,L• Name(print) Verification pursuant to Section 92.525,Florida Statutes.Under penalties of perjury,I declare hat I have read the foregoing and that the facts stated in it are true to the best of my knowledge and belief. FORMS/NOC.cvsd2 SignuureofNa� PononSigning bow �� Notary Publie State of Florida Vickie Dunmire � My Commission D0997075 �o�n� Expiros08l25/2014 '� PAULA S 0'NEIL,Ph D PRSCO CLERK 8 COMPTROLLER �OR BK �$�� P��,321 �C'�''�Q` c ''�' � � . �i� STATE O� ��3RIQA,COUIVTY OF PASCO � ' TNIS 15 Ta CERT{FY THAT THE FOREGOING IS A � � �`��e 1�� ; *c 7RUE ANQ GORR�CT COPY OF THE DOCUMENT • ON FILE OR QF PUBLIC RE�URD fi�'fHiS OFFICE '` �' ' tt WIT E MY HANQ ANp OFFICIA.L SEAL THIS •* U� o�r�o� M cu- z��3 '� ��7 P LA S O'NEIL, CL�RK&C MPTROLLER �'`��OF R�P BY � �V`�^��DEPU?Y CLERK 05/20/2013 15:44 8138187006 TEHAN PLUMBINGINC PAGE 02/02 Fron; Ob/20/2013 10:20 #29a P,002/002 e�r,a.rRCC� t,�qr pt'�,ept1lK►�L�Pam1t Ap�iof� �-e�s�ao�ao¢1 �� DyY Il�rrhwd �Ca�ler �It�w� oMMrlr PhOir IMwMr O�Al�ns� Ow�v rNer�.Mun�Mr f � fM�N711ehe1d��M7� �� OMII�U/Ph011�(�r �� .�00 ApFlRi� I,O?* � SUYOIYIM�N . 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(AlC uPqr�dw owr l7�) " �1t dhr Ih�eaeM�Orlx Poward Atp�o�N d��+OO�M�nnNd b�ramaatr w10moYrhwd Ndlw from Wrnlr a�A�wRiiO�e �RR tMf:CQUNfiR PlipMhl�IiA p�O�M d I�CN�OdY1 �Bf00�!�l�IY�d Sr/tri 8!lViOi U�fldY AIL` �MIC��jF101�IRY�bO�� pAqw�t��MIR OMR C.bfR�M(�Op p��C W�l.JMRIf�y e�a-�eo-oo2o Ciiy af Zephyfilils Permit Application Fax-aisaeo-0oz� BuUdVng Drpartmeni Oata Recalved Phom CotUact(or Pnmittln Ormers Mama Owner Phons Number Ownors Addnss Own�r Phan�Numbe� � Fee Simple TfNehold�r Name Ownar Pho�a Number Fes Slmpla TNleholdt�Addnu JOB ADDRE33 LOT� � SUBDNISION �—�� , PARCEL iD/ (OBTAOIED FRDY FROVERiY TAX NOTICE] WORK PROPOSEO e HEW COMSTN 8 ADD/ALT Q SIGN Q Q DEAAOLISH INSTALL REPAIR PROPOSEO USE Q SFR Q COMM Q OTNER TYPE OF CONS7RUCTION Q BLOCK Q FRAME � SSEEI Q OESCRIPTION OF WORK BUILpING 8lZE Sp fOOTAGE� HEIGt1T �� QBUILDING S VALUATION OF T07AL CONSTF2UCTION QELECTR�CAL �� AMP SERVICB Q PROQRESS ENERGY Q W.R.E.C. QPLUMBING S � Vl._�}'C S `� 1r � � QMECMAPIICAL S VALUATION OF MECHANICAl.INSTALLA710N Q�S Q ROOFINCi Q SPECIAITY Q OTMER FlNiSHED fLOOR ELEVATIONS (-- FLODD 2pNE AREA QYES NO L_ � BUILOER � � COYPANY � SIGNATURE � aECi6iEpep Y/ N FEE qirtx�r Y/N Addrcss ' �leense!t ELEC7RICIAN � — CONPANY `�,. � ��` SIGNATURE __ REGISTEAEp Y/ N PEf QM�ED Y f N Addnss y .^��Se C PLUMBER � � COMPANY 81GNATURE aedsTae�n Y/ N �cw�eo, Y/N ��K _� � Addres � L�cense A MECHAN(CAL COMPANY ��R/ /�QW .�iPJG, SIGNATURE • a[c.�sr�p Y/N p�cuqna, Y!N Adarcss 7f 7c� u,*�,�yr�/9t�'fJ�vo�a.✓� Llcense n _ (��s 7g�� OTHER � COIAAANY � SIGNATURE REqSiEREO Y 1 N �tuqp&, y�►,� Addnes Llcensa EI t � RESIOENtIHL Altach(2)Pbt Plar�.z:f2)sels of Bupding Plana:(t)sat ol EnergY Fams:R•O-W Permil lor new eonstiuclion, ANnhnwn kn(10)wqkirp d0ys alter submitlal date. Req,dred oiWle.Cor�stru�n Plons,Stormwacer Plans w!S9t Fence installed. SaMlary FaaVUes R 1 dumpster,Stto Watic permit/or subdlvkbruAsrge p�ajscts COMMERCIAL Aitaeh(9)compiata sels of BuAding Pbna ptus a Lilo Sahly psptr:(1)sM of Energy Forma.R�-YJ permil for new omaVuetlon A9nlmum(m(10)woiMiq days afler wbmltlal date. Req�Gpd p�qte.Cor�stru��Plans.Sfam�walar Plans wf SA1 Penoe instaned. Sar�lary Facifitla 8 1 aumpslsr.Site Work Pertnit for all new projacts.R9 canmerdal roqWremeMs musl mee�comp6ance SIGN PER�IR Attarh(2)ae4s of Enqneer�Plans. ""PROPERTY SURVEY reQuhed br ap NEW mnstruttipn. D W cliona: " Flp out appNcat{on mmplete3y Ovmer 6 ConVaclor slgn badc o(app4ceUon,notarized If ov�r i2500,r Notico at Commencement Is requtnd. �A1C upprades ovor 37500) •• Aponl(for t�a eantractor)m Power ot Attomey tfor the omiar)�wukf bo someone w;1�nobr�ed�etler Irom owner authodzing same OVER THE GOUHTER PERMRTiNG (Fronl al AppficaUpn pmy) Rerools t(shirxpos Sewets Senrlas Upgrades NC Fencea�PwUSurveylFOOtage) Oriveways-Nnl wer Counter il on public roadways..nceds ROW ELECTRIC MAINATENANCE& CONSTRUCTION,INC. 9513 NORTH TRASK STREET TAMPA, FL. 33624 PHONE: (813)88G-3733 FAX: (813) 885-3068 AUTHORIZATION LETTER May 20, 2013 City of Zephyrhills 5335 8`�' Street Zephyrhills, Fl. 33524 To Whom it May Concern, 1, Edward Roseman, President of Electric Maintenance & Construction, Inc. give my permission to the following emplo}�ees to sign for, pick up and pay for permits on my behalf for jobs we will be working on the City of Zephyrhills. James D. Smith Gary Chmura Time Olson Raul Ramirez If you need any further information please contact me or our office manager Shirley McGowan at the number listed above. 1'hank you, Edward Roseman President Sworn to and subscribed before me this�day of , 2013. . •':a^'7�• SHIRLEY d MCGOWAN � c` �`.,i•.,�.. �h'Ci},��di:SlONFCDS?7311 �-.' Expir�ES 5eptember6,2013 Not Public ��„6.�'c'��:' 5;.�,�:aTrrullolR�PuD`.tUrJcrw+Cer� n,s-�nu-uuzu Gity of Zephyrhills Permit Application Fax-813-780-0021 Building Department Dale Received Phone Contact for Pertnillin Owner's Name Owner Phone Number Owner's Address Owner Phone Number Fee Simple Titleholder Name � Owner Phona Numbar Fee Simple Titleholder Address J08 ADDRESS LOT# � SUBDIVISION � PARCEL ID# (OBTAINED FROM PROPERTY 7AX NOTICE) WORK PROPOSED B NEW CONSTR B ADD/ALT Q SIGN Q Q DEMOLISH INSTALL REPAIR PROPOSED USE Q SFR Q COMM 0 OTHER TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEI Q DESCRIPTION OF WORK BUILDING SIZE SQ FOOTAGE� HEIGHT �BUILDING S VALUATION OF TOTAL CONSTRUCTION QELECTRICAL S AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. OPLUMBING s � �� QMECHANICAL S VALUATION OF MECHANICAL INSTALLATION QGAS Q ROOFING Q SPECIALTY Q OTHER FINISHED FLOOR EIEVATIONS �� FLOOD ZONE AREA QYES NO BUILDER COMPANY � SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address ' License# � ELECTRICIAN COMPANY � SIGNATURE REGISTERED Y 1 N FEE CURRE� Y/N Addross , Lice�s _-- ----- PLUMBER COIAPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N .(I�4�i� Addres Lfcense# � MECHANICAL COMPANY ��R/ �`O C�C�''� s �G. SIGNATURE REGIS7ERED Y/ N FEE CUanen Y!N Address �y� �'�'��A�c' //vo�o�/� Ucense# �u � 7 � OTHER COMPANY SIGNATURE REGI57ERED Y/ N FEE CURREA Y 1 N Address License# RESIDENTIAL Attach(2)Piot Plans;(2)sets oi BWldi�g Plans;(t)set of Energy Forms;R-0.W Pertnil for new consiruction, Minimum ten(10)working days after submitfal date. Requlred onslte,ConsWcBon Plans,Stormwater Plans w/Sflt Fance installed, Sanitary Faallties S 7 dumpsler;Site Work Pertnit for subdiNsfonsAarge projects COMMERCIAL Attach(3)complete sets of BuNding Plans plus a Life Safely Page;(1)set of Energy Forms.R-O-W Permit for new consWction. Mlnimum ten(10)working days after submittal date. Required onsHe,Constructlon Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilides 8 1 dumpster Sfta Work Permit for all new praJects.All commercial requlrements must meet compliance SIGN PERMIT Attach(2)sets oF Engineered Plans. ""PROPERTY SURVEY requUed for all NEW conslrucUo�. Dl�ections: Fill oul application completely Owner&Conlractor sign badc of applicallon,notarized If over SZ500,a Notice of Commencement is rsqulrad. (A/C upgradea over 57500) " Agent(for the conUactor)or Power of Altomey(for the owner)would be someone with notarized letler from owner authorizing same OVER THE COUNTER PERMfTTiNG (Front of Applicafion Only) Reroofs if shingtes Sewers Service Upgrades A/C Fences(PIoVSurveylFootaga) Driveways-Not over Counter If on public roadways..needs ROW