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HomeMy WebLinkAbout20-22783 CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 22783 BUILDING PERMIT SINGLE FAMILY RESIDENTIAL �_ * ,P..ERMITINFORMATION LOCATION:INFORMATION' Permit#:22783 - Issued: 7/07/2020 Address: 8012 BROAD POINTE DR Permit Type: NEW SINGLE FAMILY DWELLING ZEPHYRHILLS, FL. Class of Work: 101-NEW CONST/SFR Township: Range: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Sq. Feet: Est. Value: Book: Page: Cost: 347,525.25 Total Fees: 20,158.75 Subdivision: ZEPHYR LAKES Amount Paid: 20,158.75 Date Paid: 7/07/2020 Parcel Number: 35-25-21-0140-00800-0060 a ' :'*. :=CONTRACTOR.fNFORMATION `OWNER'INFORMATION Name: DR HORTON INC Name: DR HORTON INC Addr: 12602 TELECOM DR Address: 12602 TELECOM DR TAMPA, FL. 33637 TAMPA, FL 33637 Phone: (813)549-1968 Lic: Phone: 813-549-1968 Work Desc: CONSTRUCT SINGLE FAMILY 3,085 SQ FT APPLICATION FEES 3_ PEUWING FEE 267.00 SEWER CONNECTION RESIDEW 2,090.00 ELECTRICAL FEE 400.50 WATER CONNECTION RESIDENT 1,010.00 MECHANICAL FEE 186.90 SCHOOL IMPACT FEE-sfr/1% 83.28 SCHOOL IMPACT FEE-sfr/100% 8,328.00 TRAFFIC IMPACT FEE 1% 36.32 TRAFFIC IMPACT FEE 99% 3,595.68 BUILDING FEE 1,890.60 POLICE IMPACT FE 254.00 FIRE IMPACT FEE 273.00 PUBLIC SAFETY 5% 26.35 PARK FEE F 769.56 WATER METER RES 3/4" 473.78 IRRIGATION METER 473.78 Inspections Required n. FOOTER 2N_D_R_0_U_GR_PLU Misc INSULATION EILIN 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: (c)With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c)the local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or first reinspection,whichever is greater,for each such subsequent reinspection.REINSPECTION FEES: 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 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." Complete Plans,Specifications and Must Accompany Application.All work shall be performed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. CONTRACTORS SIGNATURE PERMIT OFFI PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER i vr%SCO COUNTY, FLORIDA Permit No. ��� Date Permitted Builder Name/Owner Name Control W County Parcel No. H�-2.6- 2-1-0 6&7W)ffvr7 SubDiv: r Address/Location is 0 ik.a_ rkG ..a} Classificationlrype of Use ` TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: Exempt ❑Yes ❑ No How Determined Impact Fee Amount &3 .6Z) Zone No. TAZ: t SCHOOL IMPACT FEE Account (056) Single-Famlly Detached House Amount $ �f{1'� 2-6 ! (057) Mobile Home (056) Other Residential } 123) Collection Fee Exempt Yes ❑No How Determined PARK_ S AND RECREATION FEE- Land Account Land Credit Land Total Recreation Account Recreation Credit Recreation Total Zone TOTAL AMOUNT Exempt ❑Yes ❑ No How Determined LIBRARY FEE . Land Accoun# Land Credit Land Total Facility Account Facility Credit Facility Total Exempt ❑Yes ❑ No How Determined Total Amount!_ _ RESOURCE'FEE ERU TOTAL AMOUNT Prepared By f Checked By NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION PERFORMED UNTIL THE TOTAL AMOIJhTS Lli"STIED HAVE BEEN.PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY Acknowledgement below does not Imply acceptance of concurrence,but simply receipt of•a copy of this form,placing the building permit owner on notice of this assessment and the conditions of payment for same. DATE RECEIVED BY RECEIPT NO. DATE BY City of ZephYrhi\is Permit Aop\iCati �������OO Building Departmentorttlili.co Phone Contact for Permittin Date Received Owner's Address 3S Owner Phone Number Fee Simple Titleholder Name Owner Phone Number F Fee Simple Titleholder Address JOB ADDRESS . [�&k I k SUBDIVISION [&t)� "On Lrkk�_kRCEI ID# (OBTAINED FROM PROPERTY TAX NOTICE, WORK PROPOSED NEW CONSTR ADD/ALT SIGN DEMOLISH E�' INSTALL REPAIR PROPOSED USE SFR COMM OTHER TYPE OF CONSTRUCTION E2- BLOCK FRAME STEEL DESCRIPTION OF WORK deac&-5- 'i BUILDING SIZE J FOOTAGE xi r HEIGHT SQ �--leU\L3NG mic VALUATION OF TOTAL CONSTRUCTION =ELECTRCAL AMP SERVICE �—� PROGRE8GENERGY F--1 YY.R.EC. =pLUMB\NG =MECHANiCAL VALUATION OF MECHANICAL|NGTALLAT\ON . ` �--�o4� r-z� ROOFING SPECIALTY F---1 DTHER ___ FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YEG NO BUILDER COMPANY �ioNxJuR� REGISTEREDL���L� r��uvmm�^ L_Y/N_� Address Uoonae# -ELECTRICIAN ���P�N� 3|oNATURE Rsomrsnso L Y/ N I pEsoonnsN LY/lN I Address License# ,LUMBER COMP/ND' 3\oNATVRE nsuonemsu LY/ l rssrunnsx L� /NL_� Address Liconse# mEoHAm|oAL compxmv 3|aN«TUnE REGISTERED ` LV1'N pltF CUnRExv LY/N � Address eii,6q mjM License# )THER COMPANY ` � 5|oNATVRE REGISTERED LY/_N Y/N -1 ' Address Liconoo# lESlDENT\AL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, Minimum ten(1n)working days after submittal date. Required onoi0a.Construction Plans,Stormvw$er Plans v/Slit Fence installed, Sanitary ociffies&1dumpatar Site Work Permit for subdivisions/large projects . _� :oMMEQC�L A8aoh(2)complete s��of8uUding Plans plus a Life S� � � Paym(1)setufEnorgypS.R-6-WPerm|tfornewoons0aoUon. Minimum ten(1V)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Slit Fence installed, Sanitary Facilities&I dumpster.Site Work Permit for all new projects.All commercial requirements�must meet compliance UGN PERMIT Attach(2)sets of Engineered Plans. °=°PROPERTY SURVEY required for all NEW construction, ' xm��|ons� � Fill out appliue8oncompletely. ownnr&Contractor sign back of application,notarized if over$2sno'a Notice of Commencement iorequired. (A/C upgrades over$7500) ` Agent(for the contractor)m Power of/Ntorne�(for the owner)would bo someone Withnotarized letter from owner authorizing same >VERTuE COUNTER PERMITTING (copy of contract required) ' �mofs if shingles Gawom Service Upgrades A/C Fences(P|ot/Suwoy/Footago) Driveways-Not over Counter ifun public madvayn..needsROW ' - 813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021 Building Department . Date Received Phone Contact for Permitting 1 ,-Ownees.Name Owner Phone Number ;_-:Owners Address Owner Phone-Number Owner Phone Number " JOB ADDRESS' -.LOT# SUBDIVISION L PARCEL ID# I (OB..TAINEO-FROM".PROPERTY TAX 140TICE). WORK PROPOSED NEW CON§TR ADD/ALT. SIGN = [ `:DEMOLISH e INSTALL 8 iiEPAIR PROPOSED USE Q SFR Q COMM Q OTHER TYPE OF CONSTRUCTION " •Q BLOCK 0 FRAME STEEL = DESCRIPTION OF.WORK .BUILDING SIZE .� SQ.FOOTAGE;= HEIGHT, 7 =BUILDING $ VALUATION OF -'TOTAL CONSTRUCTION' I =ELECTRICAL $ � AMP'SERVICE 0 DUKE ENERGY' C] W.R.E.C. =PLUMBING r$` =MECHANICAL VAL•LIATION OF MECHANICAL INSTALLATION =GAS Q ROOFING 0_ SPECIALTY, Q OTHER FINISHED FLOOR ELEVATIONS .FLO.O02ONE AREA MYES NO BUILDER COMPANY SIGNATURE ' REGISTERED Y/ N j FEE CURREN . Y/N Address License# ELECTRICIAN COMPANY SIGNATURE REGISTERED' Y/°N FEE CURREN Y N Address , •License PLUMBER 'r COMPANY SIGNATURE REGISTERED Y%-N FEE CURREN Address -License.# I' i� MECHANICAL ...;' COMPANY ,. SIGNATURE` REGISTERED Y/ N j FEE CURREN Lyl,N ' Address V License-#1 OTHER COMPANY SIGNATURE REGISTERED Y/,N,,,.. ;,• FEE,CU(R'REN• .. YY`/.;N,.- Address License# RESiDENTIAt Attach{2)'Plot`Pians;(2)'-sets-of`dtuiidiog'Plaris;..(1)',set•ofEherQyForMsr'R;O=',WI' miit for new.construction,, Mihiinum.ten.{f 0);worklrig:'days'after`submi#tai=tlateui'retl onsite;'Gbnsta�cfiorl Plans,8tornil"e'r plans. Silt Fence installed, Sanitary:Facilities kj�dumpster;Site Wdrk�Permit�forsubdivi'sions/large•prdjscts• COMMERCIAL Attach(2)compietesets of,.Building Plans;plus a:Lif.. "' ty;Page;' setbf7Energy,Fo�ms.R-O-W Permit fdr,new construction. Minimum ten(10),workingvdayps after,s.,ubmittat date..Req''uired=ansite;Construction-Rlansy';Stormwater Plans'w/SiltPened installed, Sanitary Fadiiittes&1 dU'nil siiW`Si'i'"Work Perm'it`for ail'ne'w projects.All commerclal.requirements must meet compliance SIGN PERMIT Attach(2)sets of Engineered'Plans: '•'*PROPERTY$-U*Vg-Y.'required for all'NEW cbristruction. Directions: Fill out application completely. Owner:•$Contractor sign:back of aplicatioa,notarized If over$2500.a Notice'of.Commencement is required. (A/C upgrades.over$7500) Agent(for the contractor,)or.Power.of Attorney:(for the owner).would be someone:with notarized-fetter from-owner authorizing same OVER THECOUNTER!P.ERMITTING -• (copy;'of contrabt.required) Reroofs if shingies Sewers Service Upgrades-A/C Fences(Plot/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW D.R. Horton-8012 Broad Point Dr-3,085sgft Column Es SQ. FEET PRICE MAIN OR LIVING: 3,085 $ 112.65 OTHER AREA UNDER ROOF: - $ 88.00 OTHER: - $ - VALUATION $ 347,525.25 FEE SHEET $ 1,780.00 ADDRESS $ 30.00 DRIVEWAY $ 45.00 BUILDING: $ 1,890.60 ELECTRICAL: $ 400.50 PLUMBING: $ 267.00 MECHANICAL: $ 186.90 SUB-TOTAL $ 2,745.00 v TOTAL $ 2,745.00 v v SEWER: $ 2,090.00 WATER: $ 1,010.00 IRRIGATION: $ - TOTAL: $ 3,100.00 WATER METER: $ 473.78 IRRIGATION METER $ - T73c7 6 FIRE DEPARTMENT FEES V PLANS TOTAL: INSPECTION TOTAL: PERMIT TOTAL TOTAL: $ - PUBLIC SAFETY IMPACT FEES POLICE $ 254.00 FIRE $ 273.00 5% $ 26.35 TOTAL: $ 553.35 SUB-TOTAL $ 6,872.13 PARK IMPACT FEES $ 769.56 SIF'S: $ 8,328.00 100.0% $ 8,328.00 1.0% $ 83.28 TOTAL: $ 8,411.28 T 1 F'S: $ 3,632.00 99% $ 3,595.68 1% $ 36.32 TOTAL: $ 2-0, 166, 7S O .fiyr, Single Family Dwelling Plan Review Comments 1. F,F.E shall be a minimum of 8" above the road elevation and an engineered site plan. 2! Lots shall be graded to comply with R401.3 'of the.F.B.C: 3. Compaction test required if 24" or more of fill.dirt is brought in at any one place. 4. Tie in survey required before pouring concrete. 5. Driveways require aR.O.W. use permit. All 4 sides of driveway thru the sidewalk shall have expansion material. 6. All setbacks shall be met. 7: .All.property markers shall be uncovered.an&marked attime..of first inspection. 8:- All A:D.A.-requirements shall be met: 9.. No electric,plumbing;mechanical, or framing shall.be covered without an inspection and approval first. 10: All Garages shall comply with section R3026 of the F.B:C. (Fire Separation): IL Appliances shall not be installed in a location where-subject.to mechanical damage unless protected by approved barriers. M303:4 of the FB:C 12. Water heaters shall comply with section P607.3 of the F.B.C. 13. Foundation supports for A/C units shall.b:e raised at least 3" above finished grade. M1308.1 . 14, Return air in all bedrooms. F.B.C. M1620.4' 15. Smoke dete_ctors.are to be installed in accordance with R313.1 of the F.B.C. 16:All glazing requirements are to be.iri accordance with R308A of the F.B.C. 17. All means of egress are to be in accordance with R311 of the F.B.C. 18. "Green gypsum board" shall not be used as a backer in showers or tubs.R702:4.2 F.B.C. 10: Combination-type AFCI breakers are.required at all locations requiring an AFCI type breaker. 20. Carbon monoxide alarms will be required in new construction that.uses fossil-burning heating or appliances or an attached garage. They shall be installed in accordance with the F.B.C: 21. All plumbing,mechanical, and electrical shall be separate from unit to unit: This includes all underground plumbing and electric. 22. All 2016 NX.C. Codes will be enforced: 21 Tamper- Resistant.Receptacles in accordance with 406.11 of the 201. N.E:C 24. In accordance with the Land Development Code,lots shall be sodded before final at least 10 feet around the structure. 25. 14403.5.3Hot.water.'pipe insulation. Insulation for hot water pipe with a minimum thermal resistance (R-value) of R-3 shall be applied to the following: Piping ,!.inch (19.1 mm)and larger in nominal diameter.. Piping serving more than one dwelling unit. Piping located.outside the conditioned space. Piping from the waterheater to a distribution manifold. Piping:located under a floor slab.. Buried in piping. Supply and return piping in recirculation systems other than demand recirculation systems. 25:Blower,door test shall be provided.before C.O: 26. A cove of the energy cacls shall be with permit at all times 27. Copu of that insulation report-tshall be provided ivith permit before LlnaL 28:No fence.-pool or screen enclosure :is issued with this permit F.F.E.-Finished Floor Elevation F.B.C- Florida Building Code 6t'Edition R.O.W.-Right of Way. . A.D.A.-.Americans with Disabilities Act . N.E.C.-National Electric.Code (2016) PLOT PLAN DESCRIPTION:(AS FURNISHED) LOT 6, BLOCK 8, ZEPHYR LAKES SUBDIVISION PHASES 1A, 2A, 2B, AND 4A AS RECORDED IN PLAT BOOK 80, PAGE(S) 37-48, OF THE PUBLIC RECORDS OF PASCO COUNTY, FLORIDA. \ \ PP/ �qC , h FLOOD'i:ONE"Y," B 4 r4�S qp f Ar'PROxIMATE 3 �J V8a DELINEATION L114E 9 4 F SCALED FROM FEMA MAP.__. � FLOOD ZONE."Y' 4OT Ciz / / 1" 30' \ GRAPHIC SCALE &40C S o'Y// 15 30 FLOOD ZONE "AE' / EL=55.1 04' ^N, FLOOD ZONE. "AE" / Rqb f 1a0"% i B SOT �7f/ QyQb 9 �, IV / ^�� Cock 8 LOT ON LOT CALCULATIONS6 428 SQ. FT. 2�? NY " LIVING AREA = 1.104 SQ. FT. GARAGE = 437 SQ. FT. /. :-:cti: "'1• r 1` 7@O / (�/ry ENTRY = 43 SQ. FT. LANAI = 0 SQ. FT. ?0' PATIO — 80 SO. FT. DRIVEWAY = 410 SO. FT. PRC -'•.1':`s"• :, b A/C PAD = 12 SO. FT. WALKWAY = 30 SO. FT. d• / �� N/ IMPERVIOUS = 33% 10. / = 2116 SQ. FT. =N~ry• '' i :.:, ::.': Uf / SOD = 4,312 SO. FT. OFF LOT CALCULATIONS / RIGHT OF WAY = 665 SQ. FT. DRIVE APRON = 133 SQ. FT. PUBLIC S/W — 276 SO. FT. CI;- SOD = 256 SQ. FT. Ck WtY �� TOTALS AREA = 7.093 SQ. FT. DRIVEWAY = 543 SO. FT. SIDEWALK = 306 SO. FT. eROgp \ SOD = 4,568 SQ. FT. SO.�Oe R�- DRIB `\n PRC ROAOwAY L� PREPARED FOR: Curve Table Curve/ Length Radius Delta Chord Bearing Chord H'Ii-HOWN' ar.:w Ct 55.13' 1150.00' 2'44'48' N8826'20'W 55.12' FfC1d�dCGl'Shcd{4�' C2 9.77' 980.00' 0306' S6542'46'E 9.77' BUILDING SETBACKS c3 305.44! 1175.00• 14'533W S6925'36'E 304.58' FRONT: 20' C4 63.29' 1175.00' 3'05'10' S63'31'21'E 63.28' GARAGE: 25' 1 C5 242.15' 1175.00' 11-48'28'1 S7058.10-E 241.72' REAR: 15' SIDE: 5" SIDE STREET: 15' NOTES: LEGEND: 1. PROPOSED ELEVATIONS SHOWN HEREON ARE — BUILDING SETBACK LINE PI POINT OF INTERSECTION BASED ON THE APPROVED ENGINEERING PLANS PC POINT OF CURVATURE PREPARED BY HAMILTON ENGINEERING & — —— CENTERUNE PT POINT OF TANGENCY SURVEYING INC.. ———— RIGHT OF WAY LINE RP RADIUS POINT 2 ELEVATIONS ARE BASED ON NAVE) 1988 PROPOSED ELEVATION PRC POINT OF REVERSE CURVATURE PCP PERMANENT CONTROL POINT DATUM. TYP TYPICAL PROPOSED DRAINAGE FLOW CS CONCRETE SLAB THIS PLOT PLAN IS INTENDED FOR PERMITTING PURPOSES ;r:�'°: CONCRETE �C) PE PLAT CALCULATED ONLY. THIS IS NOT INTENDED FOR THE CONSTRUCTION OF A/c AIR CONDITIONER PB PLAT BOOK THE PROPOSED STRUCTURE. THE CONTRACTOR AND/OR PGS PAGES OWNER ARE REQUIRED TO VERIFY ALL SETBACKS, BUILDING S/W SIDEWALK SQ. FT. SQUARE FEET DIMENSIONS, AND LAYOUT SHOWN HEREON PRIOR TO ANY F.E.M.A. FEDERAL EMERGENCY MANAGEMENT AGENCY CONSTRUCTION. F.I.R.M. FLOOD INSURANCE RATE MAP NAVD NORTH AMERICAN VERTICAL DATUM D&UE DRAINAGE&UTILITY EASEMENT THIS IS NOT A SURVEY DE DRAINAGE EASEMENT(PUBLIC) THIS IS A PLOT PLAN ONLY UE UTILITY EASEMENT(PUBLIC) D&AE DRAINAGE&ACCESS EASEMENT FLOOD NOTE: I HAVE ExAMINED THE F.I.R.M.MAP NO.1210100293F. SURVEYOR NOTES: DATED 09 26/2014`AND FOUND THE SUBJECT PROPERTY APPEARS TO LIE 1. THE SURVEYOR HAS NOT ABSTRACTED THE PARTIALL IN ZONE'X&A['.ZONE"X',AREAS DETERMINED TO BE LAND SHOWN HEREON FOR EASEMENTS, RIGHT OUTSIDE THE 0.2X ANNUAL CHANCE FLOODPLAIN.ZONE'AE' DENOTES AREAS DETERMINED TO BE SPECIAL FLOOD HAZARD AREAS WBJECT TO OF WAY. RESTRICTIONS OF RECORD WHICH INUNDATION BY THE IX ANNUAL CHANCE FLOOD EVENT BASE FLOOD MAY AFFECT THE TITLE OR USE OF THE LAND. ELEVATIONS DETERMINED TO BE 85.1.THE SURVEYOR IWAKES NO GUARANTEES AS TO THE ABOVE INFORMATION.PLEASE CONTACT THE LOCAL 2. NO UNDERGROUND IMPROVEMENTS HAVE BEEN F.I;M.A.AGENT vERIFlCATioN. BEARING BASIS: LOCATED EXCEPT AS SHOWN. A5hft BEARINGS SHOWN HEREON ARE BASED ON THE NORTHWESTERLY LINE 3. NOT VALID WITHOUT THE AUTHENTIC OF LOT 6 BLOCK 8 BEING N2456'04E.PER PLAT. ELECTRONIC SIGNATURE AND THE AUTHENTIC A M E R I C A f\I ELECTRONIC SEAL OF A FLORIDA LICENSED (FIELD DATE:) REVISED: SURVEYOR AND MAPPER. 8eM : ,,... o^'' Digitally signe db yJamew SCALE: 1" 30 FEET S U R /EYI N G Baleman DmJamesW.Boleman,APPING INC. APPROVED BY J13 -American Suveying&Ma pp ing, CERTIFICATION OF AUTHORIZATION NUMBER LB#6393 ..,a^,:((d Inc,ou=HB, 190901 LOT 6, BLOCK 8 3191 MAGUIRE BOULEVARD, SUITE 200 �°�J.+" m a_l=U oleman@asmccrpcmte.co FOR JOB NO. ORLANDO, FLORIDA 32803 a Date:2019.09.2411:0824-a4.00' FIRM 426-7979 DRAWN BY; DSB WWW.AMERICANSURVEYINGANDMAPPING.COM JAMES W. BOLEMAN PSM 6485 DATE PLOT PLAN OB-20-19 KJW PASCO COUNTY Receipt Date: 04/11/2016 BUILDING CONSTRUCTION SERVICES Receipt Number. 1997.728 PAS CW 8731 Citizens Drive COUNTY FLORIDA 100f-' Suite 230 OPFN'SPACM.VIBRANT PLACES. New Port Richey,FL 34654 727-847-8126 NOT A PERMIT Paid By Check# CC Auth# Cashier ID Workstation Check 1185351 SLEBLANC BCCCP29W Fee Description Amount Paid Impact Fee Residential Solid Waste Single Family 13.67 Total Payments: $13.07 P.ayor Address Phone DR Horton Comments: City of Zephyrhills Solid Waste Address:8012 Broad Pointe Drive Parcel ID: 35 25 210140 0000 0060 While you will.be paying your bill with Pasco County Building Construction Services,the full amount of the credit card or e-check fees,NOT shown above,Is collected by First Billing payment services. myreportslreportslIPASCOPRODIPASCOICustomer Receipt v1frpt Print Date: 10/20/2020 Page 1 of 1