HomeMy WebLinkAboutSUBMITTED PAPPERSDepartment,of Community 'Affairs SN: 5077
FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION
FORM 60OA-93 'Residential Component Prescriptive Method A CENTRAL.
PROJECT NAME: :BUILDER: MICHAEL DIFRANCESCO CONST.
AND ADDRESS: :PERMITTING ;CLIMATE
:OFFICE: :ZONE: 4:_i Si_i 6'
_
OWNER: DOYLE RESIDENCE :PERMIT NO. :JURISDICTION NO.
CK
1. New constructionor addition.
2. Single family detached or Multifamily attachec
3..�,If Multifamily -No. of units
4.4If Multifamily; is this a worst case (yes/no)
5. Conditioned floor area (sq.ft.)
6. Predominant eave-overhang ,,(ft:)
7.• Porch overhang length (ft.)
B. Glass area and type: SCANNED.
a. Clear Glass
.b. Tint, film or solar screen BY
9. Floor type and insulation: St: Lucre County
a. Slab on grade (R-value, perimeter)
10.Net Wall type area and insulation:
a. Exterior: 1. Concrete (Insulation R-value)
a. Adjacent: 2. Wood frame (Insulation R-value)
11.Ceiling type.area and insulation:
a. Under attic (Insulation R-value)
12.Air distribution systems
'i3.Cool•ing system
14.Heating System:
15.Hot water system:
16.Hot Water Credits:•(HR-Heat Recovery,
DHP-Dedicated Heat Pump)
17.Infiltration practice: 1, 2 or 3
18.HVAC Credits (CF-Ceiling Fan, CV -Cross vent,
HF-Whole house fan, RB-Attic radiant
barrier; MZ-Multizone) '
19.EPI (must not exceed 100 points)
a. Total As_Built points
b. Total Base points
---------------------------------------
I Hereby certify that the plans and
specifications covered by this calcu-
lation are i mpliance with the
Florida Ener y de.
PREPARED BY.
DATE:
I hereby certify that this building is :
in compliance with the Florida Energy
Code.'
OWNER/AGENT:
DATE:
1. New Construction _
2. Single_Family _
3. 0 _
4. _
5. 2062.00 _
6._ 2.00 _
7. 8.00 _
Single Pane Double Pane
8a:. O,Osgft O.00sgft _
8b.308.0sgft O.00sgft
9a.R= 0.00 , 249.50 ft
10a=l R= 4.20., 1459'.00sgft
10a-2 R=11.00, 328.00sgft
lla.R=19.00 , 2062.00sgft
13.
14.
15.
16..
17.
18.
19,
19a.
19b,
Type: Central A/C
EER: 10.
Type: Strip Heat
`Cop: 1.
Type: Electric
EF: 0.96
2
CF
99.91
38054.89
38089.43
00
00
----------------------------------
Review of the plans and specifications
covered by this calculation indicates
compliance with the Florida Energy
Code. Before construction is completed
this building will be inspected for
compliance in accordance with Section
553.908 F.S.
BUILDING -OFFICIAL:
DATE:
1
0
0
SUMMER CALCULATIONS
BASE AS -BUILT
-------------------------------
GLASS ---------- 7 ----- -
ORIEN. AREA x BSPM'm POINTS TYPE SC ORIEN AREA x SPM x SOF = POINTS
N. 153.00 82.2
12576.6
1 SGL TINT
N
6.0
51.5
.70
216.1
1'SGL TINT
N
30.0
51.5.
.83
1280.3
:'SGL TINT
N
10.0
51.5
.83
426.8
SGL TINT
N
iomo
51.5
.83
4:26.8
SGL.TINT
N
54.0
51.5
.69
1918.9
SGL-TINT
N
24.0
51-5
.80
987.9
SGL TINT
N
19.0
51.5
.86
844.5
E 19.00. 82.2
1561.6
SGL TINT
E
19.0
107.1
.55
1109.1
S 106.50 82.2
8754.3
SGL TINT
S
24.0
98.3
.59
1399.6
SGL TINT
3
30.0
98.3
.30
885.9
SGL TINT
S
13.5
98.3
.29
387.2
SGL TINT
S
30.0
98.3
630
885.9
SGL TINT
S
9.0
98.3
.51
447.-2
W 29.50 82.2
2424.9
i SGL TINT
'W
10.0
107.1
.78
832.5
!-SGL TINT.
W
6.0
.54
346.0
----------------------------------------------
-
SGL TINT -
W
13:5
.107.1
107.1
.75
1085.7
i15 x COND. FLOOR TOTAL
GLASS = ADJ.- x GLASS
--------------------------
ADJ GLASS
GLASS
AREA
-------------------------------------------------------------------------------
AREA
FACTOR POINTS
POINTS
POINTS
.15 2,062.00
308.00
1.004 2S;317.60
25,424.46
13,480.26
NON'GLASS ------------
AREA x BSPM =.POINTS
------------ -------------------
TYPE
------- -------
REVALUE
---------
AREA
-----
x SPM,=
-------------
POINTS
7
WALLS -------- ------
Ext 1459.0 1.0
1459.0
Ext NormWtBlock
In
4.2
1459.0
1.1-6
1692.4
Adj. 328.0 .7
229.6
1 Adj Wood Frame
11.0
328.0
.70
229.6.
DOORS----------------'
Ext 20.5 4.8
98.4
Ext Insulated
4.80
98.4
Adj 18.0 1.6
28.8
Adj Insulated.
18.0
1.60
28.8
CEILINGS -------------
UA 2062.0 .6
1237.2
;_Under Attic
19.0
2062.0
1.10
2268.2
FLOORS ----------------
Slb , 24.9.5 -31.8
-7934.1,
Slab -on -Grade
.0 .
249.5
-31.90
-7959.0
IRFILTRATION ---------
2062.0 10.9
22475.8
Practice #2
-- ------------
2062.0
10.90
22475.8
TOTAL SUMMER POINTS
------------
43,019-.16
-------------------------------------------------------------------------------
--------------------------
32,314.45
TOTAL x SYSTEM =
COOLING
i TOTAL x CAP
x DUCT
x-SYSTEM
x CREDIT
= COOLING
SUM PTS MULT
----------------------------------
POINTS
COMPON RATIO
----------------
MULT
---------------------------
MULT
MULT
POINTS
.43,019.16 .37 15,917.69
---------------------------------------------
] 32,314.45.1.00
1.000
.340
: -------
.860
9,448.74
WINTER CALCULATIONS
BASE ___
__=
AS -BUILT
------------------------------------------------------
GLASS----------------
ORIEN , AREA x BWPM =
POINTS i
TYPE SC ORIEN
--------- -------------------------------
AREA
x.WPM
x WOF
=.POINTS
N 153.'00. -3.4
-520.2 i
SGL TINT N
6.0
.9.6
1.19
68.8
SGL TINT N
30.0
9.6
1.10
317.1
SGL TINT N
10.0
9.6
1.10
105.7
SGL TINT N
10.0
9.6
1'.10
105.7
SGL TINT N
54.0
9.6
1.20
.622.1
--
i
SGL TINT N
24.6
9.6
1.12
258.7
SGL TINT N
19.0
9.6
1.08
197.6
E 1.9.00 -3.4 _
-64.6
SGL TINT E
19.0
-2.0
-1.80
68..4
S 106.50 -3.4
-362.1 ;
SGL TINT S.
24.,0
-10.2
.58
-141.3
i
SGL TINT S
30.0"
-10.2
-.84
256..2
SGL TINT S
13.5
-10.2
-.90
123.6-
SGL TINT S
30.0
=10.2
-.84
256.2
SGL TINT S
9.0
-10.2
.37
-34.3'
W 29.50 -3.4
-100.3 ;
SGL TINT W
10.0
-2.0
-.21
4.3
SGL TINT W'
6.0
-2.0
-1.86
22.3
--------------------------------------------------------
SGL TINT W
13.5
-2.0
-.36
9.8
.iS x COND. FLOOR / TOTAL
GLASS
= ADJ. x GLASS
=
----------------------
ADJ GLASS
';
GLASS
AREA
AREA
FACTOR POINTS
POINTS
POINTS
-----------------------------------------------------;--------------------------
115 2,.062.00
308.00
1.004-1,047.20
-------------------------
-1,051.62
;
2,240.90
'NON GLASS ------------
-------
--------------------------
AREA x BWPM =
POINTS ;
TYPE R-VALUE
-----------------------------------------------
AREA
x WPM
=-POINTS
WALLS ----------------
Ext 1459.0 1.1
1604.9
Ext NormWtBlock In
4..2
1459.6
3.26
4756.3
Adj 328.0 1.8
590.4.
Adj Wood Frame
11.0
328.0
1.80
590.4
DOORS---------------
. -
Ext 20.5 5.1
104.5 ;
Ext Insulated
20.5
6.10
104.5'
Adj 18.0 4.0
72.0 ;
i
Adj Insulated
18:0
4.00
72.0
CEILINGS -------------
UA 2062.0 .6
1237.2 ;
i
Under Attic
19.0
2062.0
1.00.
2062.0
FLOORS--------------=
Sib 249.5 -1.9
-474..0 ;
Slab -on -Grade
.0
249.5
2.50
623.8
INFILTRATION ---------
2062.0 4.1
8454.2 ;
Practice #2
2062.0
4.10
8454.2
TOTAL WINTER POINTS
-
10,537.58
i
18,904.14
------- -----------------------------------------------------------------------
TOTAL x SYSTEM =
HEATING ;TOTAL
x CAP x DUCT
X SYSTEM x CREDIT
= HEATING
WIN PTS MULT
POINTS ;
COMPON RATIO MULT
MULT
MULT
POINTS
'10,537.58 -1.10-11',591.34
1
18,904.14y1.00 1.000~
-
1
000----1,000
-
18,904.14
WATER HEATING
BASE ___ i __= AS -BUILT
--------------
7 ---------------
NUM OF x MULT = TOTAL ; TANK VOLUME EF TANK x MULT x CREDIT = TOTAL
BEDRMS RATIO MULT
------ --------------- - - -- ---
3 '3527.0 10,581.00 i 40 .96 1.000 3234.0 1.00 9,702.00
SUMMARY
-= BASE =-- ; __= AS-BUILT-------------
-------------------------------------------------------------------------------
COOLING HEATING HOT WATER TOTAL COOLING HEATING HOT WATER TOTAL
POINTS + POINTS + POINTS = POINTS POINTS + POINTS + POINTS = POINTS
15917.1 11591.3 10581.0 38,089.43 ; 9448.7 13904.1 9702.0 38,054.89
* EPI = 99.91
*****************
ENERGY GUIDE
For detailed 'information
of the EPI rating number
or for any'ITEM listed,
ask your Builder for' EPI= 99.9
DCA Form 60OA-93
or Form- 60OB-93
010 20
30 40
50 60 70 80. 90 100
--------------------------
-------------- X-
The maximum allowable EPI is
100. The
lower.the EPI the more efficient the home
RESIDENTIAL ENERGY
PERFORMANCE RATING SHEET
ITEM - -- HOME
VALUE
Low Efficiency High Efficiency
SINGL CLR DBL TINT
WINDO,WS...................;..
Single Tint ;------ X--------------
INSULATION ......:...........
R-10 R-30
;Ceiling 'R-Value.........
19.0
;--------- X---=------- ; -
•
R-0 R-7
Wall 'R-Value...........
5.4
;--------------- X---�--
R-0 R-19
Floor R-Value.........
0.0
;X---------------------
AIR CONDITIONER..............
•
10.0 SEER 17.0
SEER/EER..................
10.3
iX--------------------
•
9.7 EER 16.0
HEATING SYSTEM ..............
2.50 COP 4.19 .
Electric COP/HSPF........
1.0
1X --------------------
0.78 AFUE 0.90
Gas AFUE.... '........
0.00
;---------------------
WATER•HEATER................
0.88 0.96
Electric EF..............
0.96
;---------------------X
0.54 0.90
Gas EF..............
0.00
;---------------------; .
0.40 0.80'
Solar EF..............
;------------------__-
OTHER FEATURES ..............
I certify that these energy saving features required for the Florida
Energy Code have been installed in this house.
Builder
Address: Signature: Date:
City/Zip
Florida Energy Code for Building Construction - 1993
Florida Department of Community Affairs FL-EPL CARD93
API-23397 WED 12:16 PM
I SU ION CERTIFICATE
�13v Id � � �
BAIT BLOWN I MA
INSULATION 7016 I,
I NSYLATION Nff If IANCI R
TTrr Nr INSYLATIo■ Owens-Corning Fiberglass
or Knau4
INSOLRTION I9511 Af0 01
.. MAGIC TRIANGLE, INC.
SIC NATYNL
FORT PIERCE: (WI) 401.1508
FRASER ENGINEERING AND TESTING, INC. VERO BEACH: (WI) U74167
STUAR76 (WI) 283.77U
3N4INDUBTUAL3hd9TREEP FORT PIERCE,FLORMA34M
Report
Of
DENSITY OF SOIL. IN PLACE
ASTM D2922
Client Mike Doyle Date February 17, 1997
Contractor Client
Site 2130 West Boothe..Drive
Foundation Fill Permit #97010384
TM
No.
Loeation
Elevation
In Plane '
Dry Density
Moisture Density
Relationship
Pereent
Compaction
Test No.
Dry
De
Density
2821
N.E. Corner
0 - 1'
107.3
2821
108.5
988
.
"
1 - 2'
107.1
98.7
"
2 - 3'
107.5
99.0
"
3 - 4'
107.7
992
Center
0 - 1'
107.4
98:9
"
1 - 2'
107.7
99.2
"
2 - 3'
107.6
99.1
"
3 - 4'
107.3
98.8
S.W. Corner
0 - 1'
107.5
99.0
"
1 - 2'
107.2
98.8
"
2 - 3'
107.9
99.4
"
3 - 4'
107.6
99.1
All elevatio
s below slal
grade.
I
Cooples Client - 1
St. Lucie Co. Bldg. Dept. - 1
_;_ t•- II
peco li suLmitted•
PAULHJDANF.0 T ,P.E.--
w
Y, c FORrPMCE: (561)4
' VEROBEACH: (561)5
FRASER ENGINEERING AND TESTING, INC. STUART. (661)7
3M4INDUSTRIAL 13sd STREET FORT PIERCE, FLORLDA 3"
Report
Of
MOISTURE DENSITY RELATIONSHIP
AST'M 1557-70
Client Mike Doyle Date _ February 17, 1997 .,
Contractor Client
Site 2130 West Boothe Drive
Foundation Fill Permit #97010384.
110
106
1041
8
10 12 14
Moisture - Percent of Dry Weight
Teat
Test
. Sample
Optimum
Max Dry
Soil Description
No.
Method
Location
Moisture %
DeatilriP.C.F.
Tan and gray, slightly
2821
B
Composite
11.3
108.5
silty, slightly clayey,
ine- sand.
yr •
Copies - Or _
PAUL H. ll Ri-H, P� E. — /
IMES AIR �COND'ITIONING
R CONDITIONING CONTRACTORS
PIERCE, FL 34948
.SIDENT IAL/LIGHT COMMERCIAL HVAC LOADS
.IENT INFORMATION:
�ME :
)DRESS:
:.T STATE:
DEAN DOYLE
FT PIER, FLORIDA
LDING LOADS:
PROJECT:
CLIENT:
DATE:
DESIGNER:
DEAN DOYLE
9-26-96
GRIMES
------------------------------------------------------------------------
LOAD
AREA
SEN.
LAT.
+ SEN.
= TOTAL
PTIONS
QUAN
LOSS
GAIN
GAIN
GAIN
------------------------------------------------------------------------
IND. SGL PN&STM CLR GLS METAL
624
12,168
0
40,709
40,709
ALL 8" OR 12" BLOCK + R-19
1,232
1,774
0
904
904
OOR WOOD SOLID CORE
64
884
0
666
666
EILING R-19 INSULATION
3,600
5,724
0
8,204
8,204
LAB ON GRADE NO EDGE INSUL
180
4,374
0
0
0
------------------------------------------------------------------------
t SUBTOTALS FOR STRUCTURE:
5,700
24,924
0
50,483
50,483
F
ATION W.CFM:
LATION---W.CFM_ --
ENSIBLEE GAIN TOTAL
EMP. SWING MULTIPLIER
4
0
1,200
1,200
2,400
0
0
0
0
0
0
0
0
0
0
0.0 S.CFM: 0.0 0
0
0
0
0
0.0 S.CFM: 0.0 0
0
------
00
--------
---
0
UILDING LOAD TOTALS
----------------------------
UPPLY CFM AT 20 DEG DT:
QUARE FT. OF ROOM AREA:
24,924
51,683
X 1.00
1,200 51,683 52,
-------------------
2,349 CFM PER SQUARE FOOT: 0.
0 SQUARE FOOT PER TON: 0.
OTAL HEATING REQUIRED WITH OUTSIDE AIR: 24.924 MBH
OTAL COOLING REQUIRED WITH OUTSIDE AIR: 4.407 TONS
ALCULATIONS ARE BASED ON 7TH EDITION OF ACCA MANUAL J.
LL COMPUTED RESULTS ARE ESTIMATES AS BUILDING USE AND WEATHER MAY VARY.
'E SURE TO SELECT A UNIT THAT MEETS BOTH SENSIBLE AND LATENT LOADS.
f
� _
t
_
_
_
Y
1
t
ST. LUCIE COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
2300 VIRGINIA AVENUE, ROOM 201
FT. PIERCE, FL. 34982-5652
40%462-1553
i
DESIGN CERTIFICATION FOR WIND LOAD COMPLIANCE
This Certification is to be completed by the projectdesign architect or engineer. This Certification must be submitted with all
applications for building permit involving the construction of new residence (single or multi -family), residential addition, any accessory
structure requiring a building permit, and any nonresidential structure. This Certification shall not apply to interior renovations (provided
that no structural walls, Columns or other similar component is being effected) and certain other minor building permits. For further
assistance, please contact the Building Inspection Office at 462-1553 or 462-2172.
CERTIFICATION STATEMENT:
1 CERTIFY THAT, TO THE BEST OF MY KNOWLEDGE AND BELIEF, THESE PLANS AND SPECIFICATIONS
HAVE BEEN DESIGNED TO COMPLY WITH THE APPLICABLE STRUCTURAL PORTION OF THE BUILDING CODES
CURRENTLY ADOPTED AND ENFORCED BY ST LUCIE COUNTY. I ALSO CERTIFY THAT STRUCTURAL
ELEMENTS DEPICTED ON THESE PLANS PROVIDE ADEQUATE RESISTANCE TO THE WIND LOADS AND
FORCES SPECIFIED BY CURRENT CODE PROVISIONS.
DESIGN PARAMETERS AND ASSUMPTIONS USED: (please check or Complete the appropriate boil
1. BUILDING CODE EDITION USED IyEAR) � SBCCI ASCE 7-88 OTHER (SPECIFY)
2. BUILDING DESIGN IS (CHECK otM ENCLOSED PARTIALLY ENCLOSED � OPEN BUILDING
3. BUILDING HEIGHT: G V / FT. 4. WIND SPEED USED IN BUILDING DESIGN: I / D MPH
5.
4 6.
7.
8.
9.
10.
11.
WIND EXPOSURE CLASSIFICATION (REFER TO EXPOSURE TABLES IN BUILDING CODE IDENTIFIED IN LINE si): G�/f/r77y(-
AVERAGE WIND VELOCITY PRESSURE ON EXTERIOR FACES OF STRUCTURE: 2 c7. PSF
PEAK WIND VELOCITY PRESSURE ON EXTERIOR FACES OF STRUCTURE: / PSF
IMPORTANCE/USE FACTOR (OBTAIN FROM BUILDING CODE): /k D
LOADS: FLOOR •� PSF ROOFIDEAD: I / PSF ROOF/UVE PEF
WERE SHEAR WALLS CONSIDERED FOR STRUCTURE (CHECK ON4 YES NO If NO, why? (attach
explanation)
IS A CONTINUOUS LOAD PATH PROVIDED (CHECK ONE) YES ✓ NO _ If NO, why? (attach
explanation)
12. ARE COMPONENT AND CLADDING DETAILS PROVIDED (CHECK oW YES
explanation) ,
13. MINIMUM SOIL BEARING PRESSURE Z PSF
NO_
AS WITNESSED BY MY SEAL, I HEREBY CERTIFY THAT THE INFORMATION
t CERTIFICATION IS TRUE AND CORRECT, TO THE BEST OF MY KNOWLEDGE AND
NAME: CERTIFICATION NO:
DESIGN FIRM: DATE: I%9 l 97c
If NO, why? (attach
C S �
STATE OF FLORIDA PERMIT �
DEPARTMENT. OF HEALTH AND REHABILITATIVE SERVICES DATE PAID
ONSITESEWAGE DISPOSAL SYSTEM, FEE PAID
CONSTRUCTION PERMIT RECEIPT
Authority: Chapter 191, 'FS &- Chapter IOD-6, FAC �[3,-`
CONSTRUCTION. PERMIT FOR:
`..
[We] New System
[ ] Existing System [ )
Bolding Tank (
] Temporary/Experimental,
y.
'[ ] Rerai:r
[ ] Abandonment ( ]
Other(Specify)
.,:
fur
APPLILANT.: ®A
� Yii�fr ��b "✓j f �
AGENT.:
�.-<i l ��'
I__ � � �,p j
4.
PROPERTY STREET
`.`-i.i';��a..,�
ADDRESS:-
'��".%
<l��ii`�- ,d- �{dej .
i
y'"�r'•r
r
tr. �;-
LOT: BLOCK: SUBDIVISION:
PROPERTY ID #: [SECTION/TOWNSHIP/RANGE/PARCEL NUMBER]
- - [OR TAX ID NUMBER] -
_co_�
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 1OD-6, FAG.
REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS ;FROM THE. 'DATE OF ISSUE. ALL OTHER: PERMITS.
EXPIRE ONE YEAR FROM THE DATE. OF ISSUE. HRS APPROVAL OF SYSTEM I DOES NOT GUARANTEE SATISFACTORY
PERFORMANCE. FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A
BASIS FOR ISSUANCE OF THIS PERMIT,. REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH.
MODIFICATIONS MAY RESULT IN THIS: PERMIT BEING MADE NULL AND VOID.
SYSTEM DESIGN AND SPECIFICATIONS
T GPD] SEPTIC TANK AEROBICG UNIT CAPACITY r MULTI-CHAMBERED/ItL SER%ES [Ef]
_'
A [ ] [GALLONS / GPD] CAPACITYMULTI=CHAMBERED/IN SERIES:[ ]
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 12150 GALLONS]
K [ ] GALLONS PER DOSE DOSING TANK CAPACITY DOSE -RATE [ ] PER. 24. HRS NO. OF PUMPS: [ ]
D,
] SQUARE FEET
PRIMARY ➢RAINFIELD
SYSTEM
R
( ] SQUARE FEET
_ '� -
.SYSTEM _
A
TYPE 'SYSTEM:
[ jSTANDARD
(. ] FELLED.
I.
CONFIGURATION:
[ ) TRENCH'
( ] BED
N
F
LOCATION OF BENCHMARK.;.
I
ELEVATION OF PROPOSED SYSTEM SITE It
] [INCHES/FT]
E
BOTTOM OF DRAINFIELD
TO HE [ >
]�(INCHES'J.FTf
L
MOUND
POINT
POINT
D FILL REQUIRED:_ [aFs`.]I INCHES EXCAVATION REQUIRED: [ %:7' 1 INCHES
O �. `. �,. 4 ! 'i 7;..i<r t'.. re .`f '+-s iPz4� f. der .'I- •� °t.
T
H
E
R
SPECIFICATIONS BY: TITLE:
,APPROVED BY: TITLE:,'
'DATE' ISSUED: r iF^, �f•. f - _ - -
r-
HRS'A form 4016, Mar 92 (ObsoteteS-preJious editions- which gray not be used)
(Stock Number: 5744-001-4016-0)
EXPIRATION DATE:r
Page 1 of 2
BUILDING DEPARTMENT
INSTRUCTIONS:
PERMIT NUMBER: Permit tracking number byCPHU.
:APPLICATION FOR: Check typo of permit; if -other" specify type in blank..
APPLICANT: Property owner's full name.
TELEPHONE:. Telephonenumber for applicant or agent:.
I
AGENT:
Property owner's legally authorized representative.
MAILING ADDRESS;,
P.O. box or street mailing address for applicant. or. agent.
LOT, BLOCK,. SUBDIVISION or
PROPERTY.ID#;
27 characters ID number for property. (CPHU.may require property appraiser ID# or section/townshiptrangelpareel number;)-+
SYSTEMDESIGN AND
SPECIFICATIONS:
'
TANK: Minimum specifications from Chapter IOD-6;PAC.
DRAINFIELD: Minin um specifications from Chapter IOD-6, PAC.
OTHER:. Other specifications, such as: operating permit requirements, low -volume flush toilets, variance provisos..
SPECIFICATIONS BY: Name of individual providing specifications. If designed by a registered engineer must be. sealed..
APPROVED BY- County Public Health Unit(CPHU) personnel reviewing and: approving permit:.
DATE ISSUED Date permit. is.'issued by CPHU..
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EXPIRATION DATE: One. year from date issued if the system has not been installed. Permits for system repairs become void 90.days from the
date issued.
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