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Home My WebLink About22-5051City of Zephyrhills 5335 Eighth Street ��.�t��,r{�� '��? ��„�t�s1 t`�„ �,, ��ta, ,Av,.� eta... Zephyrhills, FL 33542 B5051 r2022 ».» Phone: (813) 780-0020 Fax: (813) 780-0021 Issue Date: 11l03/2022 Permit T e: uilding New (Residential) t � ;? \s \-: , �,;, ,, ,.:,^ .»grh »s ,},� .l 1 \ i�` t t. \c . .is ,., r \2'lt t -\,., ,, �•; ,`t, a,. .iT. l \:: \ a > \'t U.{ \; \�... t it .,tE \.,tizsht ?,� '.s t1\S�,t-,t.,l`,,3 �,<,.ti�'t`; U„:?, ",..a,i ,\:,'sue.., \,v,�:�"�r,,., fis, t; .l '..:» ,.,.ti\\s;-�c`'1C��33� ^,s,U\��..Ztt.ts\\,\�..1,\\s< ,,.';,., ,\i�,so\7??.�, 1�s �,t �\:, ?Z•.:., �ti,.1;. 6501 Bar S Bar Trl 04 26 21 0140 00300 0140 \tl e: „ s i tt ti l ty \ t -:\ t ..�»m s 3„ U4».ry.. l`�.a-.@1i\.ti tt t„�,`<„ ,?y \`•;a,kt?Z�,t l;\Ze s ;'.fit°\.a1r11<. 1::,. AN Name: LENNAR HOMES LLC-OWNER Permit Type: Building New (Residential) Contractor: LFNNAR HOMES LLC Class of Work: SFR Construct Address: 4600 W Cypress St 200 Building Valuation: $457,920.00 TAMPA, FL 33607 Electrical Valuation: $68,688.00 Phone: (813) 574-5700 Mechanical Valuation: $32,054.40 � c Plumbing Valuation: $45,792.00 Total Valuation: $604,454.40 Total Fees: $21,095.88 Amount Paid: $21,095.88 { Date Paid: 11/3/2022 10:05:36AM t t.. ,`t ,. ,;. s.. 4 L•.: ,\?. � s ;,,.. ist t '. l s...l \ v \. 1. � S. .. t .t. A h� . � 1\....z\. v 1 ,A,. t. , _:A \.. , fit, 2„,. {tr �2 ... AU .:AZ �\Z s \ t; A? Is t S ;. stti \ �: . i.. v #..-= J t i 2\t\lt. e• `,1 .. 41i E..�.. v.. � \A CONSTRUCT SINGLE FAMILY 3326 SO FT y ,.1. t rtr +.,. < \r *. „.�.. l,\\ Si \. ..� \ \ \. �. l a S.:, t \ .0 1 ? \.,., �,}• � �.,. s � \ 11 <., \ � �\lr �\ L t il`, \'?ltt � - \\ 3/4 Water Meter Fee (Cale) $732.71 Building Plan Review Fee $180.00 SIF 1 percent Fee $83.28 Sewer Connection Residential Fee $2,090.00 Mechanical Plan Review Fee $0.00 Transportation impact Fee - City $36.32 Water Connection Residential Fee $1,010.00 Park Impact Fee - Single Family/Townhome $769.56 Electrical Plan Review Fee $0.00 Mechanical Permit Fee $200.27 Electrical Permit Fee $383.44 Driveway Fee $45.00 Address Fee $30.00 Building Permit Fee $2,329,60 Plumbing Permit Fee $268.96 Public Safety Impact Fee -Admin $26.35 Irrigation 3/4 Meter (Cale) $732.71 Public Safety Impact Fee -Police $254.00 Plumbing Plan Review Fee $0.00 School Impact Fee - Single Family $8,328.00 Transportation Impact Fee $3,595.68 REINSPE TION 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 subsequent reinspection. 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 permit 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." accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NOCCUPANCY O BEFORE 2' CO1.11*ACTOK SIGNATURE l� ITHOUT APPROVED wwD INSPECTION I IIIy r w + tt ow 0 r i w r, a r' r,:. A r IL 813-780-0020 City Of Zephyrhllls Permit Application Fax-813-780-0021 Building Department Date Received Phone Contact for Permitting 908 770 -- 7763 Owner's Name CAL HEARTHSTONE LOT OPTION POOL 03 L P Owner Phone Number 813.574.5700 Owner's Address 1 23975 Park Sorrento, Ste. 220, Calabasas, CA 91302 Owner Phone Number Fee Simple Titleholder Name I N/A Owner Phone Number Fee Simple Titleholder Address N/A JOB ADDRESS 6501 Bar S Bar Trail LOT # 0314 SUBDIVISION Abbott Square PARCEL ID# 04-26-21-0140-00300-0140 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED f NEW CONSTR 8 ADD/ALT SIGN DEMOLISH INSTALL REPAIR PROPOSED USE SFR COMM OTHER TYPE OF CONSTRUCTION BLOCK FRAME STEEL DESCRIPTION OF WORK Single Family Residence / Pool / Screen Enclosure / Fence BUILDING SIZE U/R SF' 3816 SO FOOTAGE 3326 HEIGHT BUILDING $ 457920 VALUATION OF TOTAL CONSTRUCTION tyiELECTRICAL $ 68688 LYJPLUMBING $ 45792 MECHANICAL $ 32054.4 =GAS Yi ROOFING FINISHED FLOOR ELEVATIONS E= PROGRESS ENERGY W.R.E.C. AMP SERVICE VALUATION OF MECHANICAL INSTALLATION SPECIALTY OTHER FLOOD ZONE AREA 11 IYES DO BUILDER COMPANY Lennar homes, LLC SIGNATURE i _ REGISTERED Y / N FEE CURREN Y / N Address 43 W Boy Scout Blvd Suite 600 Tampa, F1,License # 33607 CGC1518166 ELECTRICIAN COMPANY Edmonson Electric, Inc. SIGNATURE REGISTERED Y / N FEE CURREN �/N Address License # EC13005408 — PLUMBER COMPANY Bayonet Plumbing, Heating & AC, Inc SIGNATURE REGISTERED Y ( N FEE CURREt Y / N Address License # CFC042998 MECHANICAL COMPANY ayone�Plum�bing, �Heafin�g&C, Inc SIGNATURE REGISTERED Address License # CAC058062 �� d OTHER COMPANY C Sterling Quality Roofing, Inc SIGNATURE REGISTERED Y / N FEE CURREN Y ( N Address License # �CCC057991 RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects COMMERCIAL Attach (2) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new construction. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. '*`"PROPERTY SURVEY required for all NEW construction. 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 $7600) — Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (copy of contract required) Reroofs if shingles Sewers Service Upgrades A/C Fences (Plot/Survey/Footage) Driveways -Not over Counter if on public roadways..needs ROW 0 . MENA ILI [ell Myl 144:8 go] A I N W ft"IMTA 4 LTJI 1 *1 ilk 16.111111111 11100MOI I Imill Z01=1:4 WM I MMOIN A ILI k 9:4 0 1 elk K010A 01-11 ILI 5 a ILI F-110 M I WtALOLO] gugLM JURAT (F.S. 117.03) OWNER ORAGENT Subscribed and sworn o (or affirmed) before me this W312022 —by Christopher Smith Who is/are personally known to me or as identification. Notary Public Commission No. GG 296057 Stephanie Farmer .......... Subscribed and sworn to (or affirmed) before me this 8/3/2022 by Christopher Smith Who_!s/are personally known to me or has/have produced as identification. Notary Public Commission No. GG 296057 Stephanie Farmer 'T 71�� DESCRIPTION: LOT 14, BLOCK 3, ABBOTT SCOUARE PHASE !& SITE E PLAN A V ACCORDING TO THE PLAT THEREOF, RECORDED IN PLAT BOOK 89, PAGEfS128-35. OF THE PUBLIC RECORDS OF PASCO COUNTY, INOT A SURVEY^,- R ORMA ALL ELEVATIONS REFERENCED TO NORTH APE RIC:AN VERTICAL Soft UM OF 7988 INAVD 881 ,is -1F71 1-N Prepared for and Cen7fied 7 l 1eno"I—eve t LOT 13 BLOCK 3 587`530T E;P' Y!O.OGPi LZ0 POPOSEU 2 STORY RESIDENCE .AN .r ;Nf,, cc FfV'Al p GARAGE[ LOT 14 BLOCK 3 ...... s 54 587.53e7 L,P; J!C.11 I LOT IS BLOCK 3 ENTRY II 72 5 2C s 3 CONC WALK O G o t SEC, 4, TWR 26 S, RNG 21 E. PASCO COUNTY, FLORIDA (ABBOTT SQUARE) Scale: 1 = 20 4 V% d- 5z LOT a 6QSO. FT. LIVING AREA = i916SQ. FT. ENTRY R_37 SO. FT. GARAGE __ 45 __3_SQ- FT COVERED LANAI ^__—.SCT. FT. PATIO - 24 SO. FT. '.., CONC. DRIVE = 483 _._SO. FT. AfC & CONIC PAD .__.-t8 SO. FT. SIDEWALK = 3i SO. FT. LOT OCCUPIED - 47 __SF 2` OAK AREA TO IRRIGATE R 53 tl -� 10-00` PUSLiC UTPLtTY EASEMENT NOTES: LEGEND: PROPOSED LOT GRADING vPe AA PeOP05ED DRAINAGE FLt>u MINIMUM FLOOR ELEVATIONS: PROPOSED PAD ELEVATION" 95.70 0000. -, PROPOSED GRA^F LIVING AREA: 96.37" FRONT SET BACK a zz' GARAGE AREA: =_°xouc , extsr-NG GRADE SIDE SE i BACK ^ 75 _ ELEVATFONSREFERENCEDTO PROPOSED ELEVATIONS AND GRADING NORTH AMERICAN SIDE Ski BACK, CORNERLOTi--15 VERTICAL SHOWN HEREON ARE TAKEN FORM THE ENGINEERING PLANS OF 1 DATUM OF 1988 REAR SFTRACK= 15 `A6807 SQUARE RESIDE.NTIALPREPARED APPARENT F!00D HAZARD ZONE:'AE'BF" m 897 COMMUMIT'.NO. 120235 BY'R,RA'?ROViDED SYCLIENo SURVEY ABBREVATIONS ;MAP NUMBER 12 TOIC-0289-F; EPECT /E DATE 09 26i2014 Al -ne Ne ^ A , AC-1, �> >r v-• Nvte Ol <IQ, sr csr >en ` 1N - *' C LEGEND AE-n M1+JM t4^L . JN,kC EA4.kr1NS. FJ 4 R :4S (I C hi Np 'h_ t1 E F.FA i.N F ;A (API FAST J ERMAN `O RC o�s.M1 i Yh 4R N 4 e; °-`'a" IF O 11PN t OW XREL; T)n � R },}oME til T 1U �i ) dM-9 htN MAK tt NI- ASFs N 4 ..,C KtE> U VFYCW G RC C cuIA c Y(f fJ 4 MI -MfAt 1hFD III -PVM1 Ni RtF '<>h £ C4 _OtINt R(le M,3^ii t4 l NOv, o",16AC-R.. I OtA,4 M1A �tte� - 2�F'2h h N 4 MC)'VUME N:.£-an COt NIP rCXV N R ;N c } 2(�M >J_.3 A'R3 Ff„11} 11 A- IIA Ob C R ) iU 61\k NC t"' Bfi�C --W�-- CM - CP A - e A 4 k)N t h. qA,-tMt'iR MIEN(. StMRN J F Y' S JL P`aN )F SMtd NC M1ri \? OS 0 J ANK INhn-FOIN1t e & Se R Jt t}N CIJ N, ,VP inlow — AI 1 NI ;NCI CR(11 C6 W-e ri t")PaF 91N O N ` '! to I�R4 CN ICFVt R4: tT YFnS :MErvi ( LLJy -- \/','+.., tGVEN(.t �5'=tl A,�}�fTTi'�ftN(LE fY-FC,UNL .N<H„�'Pe Ppa P.A BUVK PFM NhRNRL(MF [£t (-.H�N(E MGkT tAi hl�rM1�J6UY 2011 512 SURVEYOR'S NOTESt ,�_ SURVEYORS CERTIFICATE 1. Current title information on the sub eet ro rty had not bec } J P Pe This in dettribe i 768 W ntc. Oak Urrve Tarpon Springs. Florida Date o SRc Pfann: 6-1-22 certifies ftlnnished to initial Point Land Surveying, tLC atthe time o tns t propertYw n no- s on and Rhone 727}-631-1940 ttWG>:AS-L!4BL.3-SITE SITE PLAN 1 mects $p to P.j This Ike ch wu prepared w oute the benefit of trtic scareh a,". set y the F er; d Fi... daPLS, 123v9Pl icoro 68fi 8183 a PiI No tnstrune cs of record seflectleg o ne ship as nnents or Sur Ps in�,V\�y#�yT'{{ right qt Wa} WE forntshed to the uodcrstgnea unless w Cvv- 5 CFrit�Mrtifi@,ty/pi -, .x.l� „i�a�£l.+f�,rp }g3 ShOWFt f E eo _ 4 ' n $ecran 7E.�R(�` lo�'!C:$n?ta �p ;` ""n by D'R 34 Read,, —lks, and oche; stmitar ite ns shcoon hereon, oFe e taker Checked bx�`N ' tr-om qr e ring Mans P"d arc bje¢t to s .vep. I REV(StONS '"'j 4t Tf s S TE PLAN da not nfic t o d itc:^ r e—LershiEx i 64 Tt ,s SITE PLAN is bj,,Tt to Matters shown on the Plat„ys, � 'ABBOT T SOUARE PHASE 1 A- - - - -F !ey Date 6,1 Dimelwons shaven hereon are in Peet and docimai ponions OFFS elaVEYOR A. then o .Q,t P.1 C.<nt actor aind ow r are to c IT` A se£ba k bu,idinIS __. _�� 3 dimens a s - d ayout shown hereon price to n} construed n NOT 7THE O and imme dotely advise initial R :tt land Surreyh>g, LLC. of a SIGNS, G - ' 'F''` f devraflo f on n otTiidtran Shown hereon F i+fuFC "'so 5o will be LICENSED ee�., a�� $ 1 Initial Point Lana Surveying, LLC. Parcel Tax ID: \/R/\ - v- 0i A S S : -l"" ["= I v�' Notice to Building Official of Use of Private Provider Effective January 20, 2003 Oil Qffil I i � I wa� Services to be provided: Plans Review X Inspections Note: If the notice applies to either private plan review or private inspection services the Building Official may require, at his or her discretion, the private provider be used for both services pursuant to Section 553.791(2) Florida Statute. STEVE SMITH the fee owner, affirm I have entered into a contract with the Private Provider indicated below to conduct the services indicated above. Private Provider Firm: VIRTUAL REVIEW ASSIST, INC. Private Provider: Address: 747 5W MD AVE- SUITE 170,301,357,& 358, GAINESVILLE, FL 32601 Telephone: 813-376-3088 Fax: N/A Email Address (Optional): deb@virtualreviewassist.com Florida License, Registration or Certificate #: (LIC # BU1967/ PX2300/ BN4615) I have elected to use one or more private providers to provide building code plans review and/or inspection services on the building that is the subject of the enclosed permit application, as authorized by s. 553.791, Florida Statutes. I understand that the local building official may not review the plans submitted or perform the required building inspections to determine compliance with the applicable codes, except to the extent specified in said law. Instead, plans review and/or required building inspections will be performed by licensed or certified personnel identified in the application. The law requires minimum insurance requirements for such personnel, but I understand that I may require more insurance to protect my interests. By executing this form, I acknowledge that I have made inquiry regarding the competence of the licensed or certified personnel and the level of their insurance and am satisfied that my interests are adequately protected. I agree to indemnify, defend, and hold harmless the local government, the local building official, and their building code enforcement personnel from any and all claims arising from my use of these licensed or certified personnel to perform building code inspection services with respect to the building that is the subject of the enclosed permit application. I understand the Building Official retains authority to review plans, make required inspections, and enforce the applicable codes within his or her charge pursuant to the standards established by s. 553.791, Florida Statutes. If I make any changes to the listed private providers or the services to be provided by those private providers, I shall, within I business day after any change, update this notice to reflect such changes. The building plans review and/or inspection services provided by the private provider is limited to building code compliance and does not include review for fire code, land use, environmental or other codes. The following attachments are, provided as required: 1. Qualification statements and/or resumes of the private provider and all duly authorized representatives. 2. Proof of insurance for professional and comprehensive liability in the. amount of $1 million per occurrence relating to all services performed as a private provider, including tail coverage for a minimum of 5 years subsequent to the performance of building code inspection services. (signature) Print Name: Address: Telephone Please use appropriate notary block. ST,ATEOF -FLORIDA — COUNTY OF -HILLSBOROUGH Individual Before me, this day of ,20_personally appeared who executed the foregoing instrument, and acknowledged before me that same was executed for the purposes therein expressed. Corporation LENNAR HOMES LLC Print Corporation Name (signature) Print Name: Christopher Smith Authorized Acient Address:700 NW I OZth_Ave Miami, FL 33172 Telephone No. 813-574-5700 Corporation Before me, this 22ND day of MAY -202-2 personally appeared' of Lennar Homes, LLC a corporation, on behalf of the state corporation, who executed the foregoing instrument and acknowledged before me that same was executed for the purposes therein expressed. N30= Print Partnership Name By: (signature) Print Name: Its: Address: Telephone No.: Partnership Before me, this day Of 20_ personally appeared partner/agent on behalf of a partnership, who executed the foregoing instrument and acknowledged before me that same was executed for the purposes therein expressed. Personally known XI; or Produced identi cation Type of identification produced rLo d J_,� Signature of Notar Print Name ASHLEE CALLAHAN Notary Public, Stamp:irk AS HiEE CALLAHA Commission Expires: pubjt� v State of Florida GG 244456 m. Expifffi NOV 30,2022 N OVEM BER 30, 2022 Or", 11 tlonDl Notary A*9! VR//\ VIRTUAL REVIEW ASSIST Private Provider Plan Compliance Affidavit Private Provider Firm: Virtual Review Assist, Inc. Private Provider: Debra Anne Klahr, BU 1967 Address: 747 Southwest 2 d Avenue Gainesville, FL 32601 Phone: 813-391-2959 Email: liqUI�—Vii-tualreviewa.ssist,coin Project: New SFR & 'S-Z I Address(s): Bar S Bar Trail I hereby certify that to the best of my knowledge and belief the plans submitted were reviewed for and are in compliance with the Florida Building Code and all local amendments to the Florida Building Code by the following affiant, who is duly authorized to perform plans review pursuant to Section 5531.791, Florida Statute and holds the appropriate license or certificate: Name: Debra Anne Klahr Plan Sheets: CS,1.0,1,1,2.0,'1.1,3.2,FI,4.1,4.2,5.0,6.0,7.2,7.1,8.0,DI,D2,D3,SN, SNI,S3,S4,SS, ST,S5, S6,WPI,PAI.0,PAI.I,PAI.2,PAL3, SHLO, SHLl,SHL2,SHI.3,SHI.4,SHL5 Florida License/Registration/Certification #(s) and description: FS468 Certified Standard Plans Exam�iner License #: PX2300 Signature of Reviewer* SWORN AND SIJBSCRIBED�l fore me by Debra Anne Klahr being personally known to me or having produced as identification and who being fully sworn and cautioned, state that the 4 regoing is true and correct to the best of his/her knowledge or belief. p5y� tee- c6lu)"ar% Si a®re ofNotaryPrint Name Notary Public: NOTARY STAMP BELOW My commission expires: ASHLEE CALLAHAN Notary Pubic - State, of Florida COMMiSSIOr ,' GG 244456 MY C-Mm es Nov 30, 2022 Bonded through N NoaIy Assn. ❑ COMMERCIAL BUILDING SERVICES DIVISION Of RESIDENTIAL BUILDING PERMIT DATA SHEET rafflAMTEV-6tyff ��l E Mfflff r"Ma"Mm DATE: 9/22/2022 y IVBuilding E] Inspection Only VI'lumbing E] Ins ection Only W Mechanical El Lnspection Onl WElectrical -Amp Ej Inspection Only t? Roof El Gas F1 Medical Gas Ej Fire Sprinklers ❑ On Site Piping Ej Fire Line E] Irrigation D Fire Alarm ❑ Potable Backflow Assembly ❑ Fire Line Backflow Preventer 1:1 Irrigation Backilow Assembly E] Demolition El Walk-in Cooler ❑ Refrigeration E] Hood ❑ Ansul ❑ Fence/Wall E] Grease Trap E] Other ❑ Other FqnfF,H",r.j1I1rW Te Construction: Risk Category: I Occupancy Load O an a sification: Assembly business Day Care/Educational cy C' E--= = FEI Factory Hazardous E== Institutional ❑ Mercantile 'idnftal Storage E== Utility Residential Building Use: Single Family Alteration IpLevel 1 10 1 Level 2 [E]Level 3 6KNew Construction ❑ Interior Finish ❑ Interior Remodel Exterior Remodel E] Addition El Revision Overall Size: 40 X 62 Number of Stories: 2 Total Sq. Ft.: 3816 Living Area: 3326 Covered Area: 490 # of Bedrooms: 6 # of Baths: 3 Cost per square foot: Estimated Value; Roof Type: j Shin [:]Tile ❑ Built-u ❑ Metal El Other Squares: 22_ Zoning: Wirdborne Debris: 0jnside V',,Outside Energy Code: 405 -2020 Flood Zone: AE Base Flood Elevation: 89.7'NAV[)88 Finish Floor Elevation: 96.37'NAV[)88 ? Hydrostatic VentsM Yes No Sq. Ft. Enclosed Space Below BFE: I # of Vents: I Total Sq. In. Permanent Openings 9 Central A/C Heat Pump El Window A/C El Gas A/C ❑ Gas Heat 0 Electric Heat ra r1WIffral-lirml Irl, Sanita!y Sewer Storm Sewer Catch Basins Potable Water Underground Fire Line WMI"M Front Rear Left Right 21 As per Approved Site Plan Comments: CITY OF ZEPHYRHILLS TO CONFIRM FLOOD ZONE INFORMATION 4 } Kermit No. i Date Permitted Builder Name/Owner Name - Control # County Parcel No. O :3 0 Ci 140 Sub Div: Address/Location 50 Classification/Type of Use t TRANSPORTATION IMPACT FEE Rate: Sq. Ft Unit: Exempt 0 Yes No How Determined Impact Fee Amount S 3� Zone No. TAZ: SCHOOL IMPACT FEE / % Account (056) Single -Family Detached House Amount $ a � d (. 2— (057) Mobile Home (058) Other Residential (123) Collection Fee Exempt =Yes = No How Determined_ PARKS AND RECREATION FEE Land Account Land Credit Land Total Recreation Account Recreation Credit Recreation Total Zone Total Amount $ t Exempt =Yes =No How Determined Land Account Land Credit Land Total Facility Account Facility Credit Facility Total ExemptEl Yes No How Determined Total Amount RESOURCE FEE ERU Total Amount Prepared By, ��tl �_�Checked By NO CERTIFICATE OF OCCUPANY WILL BE ISSUED AL INSPECTION PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY ACKNOWLEDGEMENT BELOW DOES NOT IMPLY ACCEPTANCE OF CONCURRENCE, BUT SIMPLY REECEIPT OF A COPY OF THIS FORM, PLACING THE BUILDING OWNER ON NOTICE OF THIS ASSESSMENT AND THE CONDITIONS OF PAYMENT FOR SAME. DATE RECEIVED BY RECEIPT NO DATE BY a 0 0- pt ��%Ixzlga 0 .,. I� girlI�imW .... ..... . .. h