HomeMy WebLinkAbout22-5192City of Zephyrhills
5335 Eighth treet£i?ztNO
!001110
v5 1
Zephyrhills, FL 33542
- 5192- 22
Phone: (813) 780-0020
Fax: (813) 780-0021
Issue Date: 1112912022
Permit Building New (Residential)
MET,>t
6806 Ripple Pond Lp 04 26 21 0140 00100 0150
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Name: LENNAR HOMES LLC-OWNER Permit Type: Building New (Residential) Contractor: LENNAR HOMES LLC
Class of Work: Townhome t
Address: 4600 W Cypress St 200 Building Valuation: $211,560.00 .
TAMPA, FL 33607 Electrical Valuation: $31,734.00
Phone: (813) 574-5700 Mechanical Valuation: $14,809.20�.....
Plumbing Valuation: $21,156.00
Total Valuation: $279,259.20 y
Total Fees: $13,575.45 w
Amount Paid: $13,575.45
Date Paid: 11/29l2022 7:34:54AM
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CONSTRUCT TOWNHOME 1400 SQ FT AS
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Public Safety Impact Fee -Police $254.00 3/4 Water Meter Residential Connection Fee $732.71
Electrical Plan Review Fee $0.00 Driveway Fee $45.00
School Impact Fee - Single Family $3,353.00 Water Connection Residential Fee $1,010.00
Fire Wall/Smoke Wall Inspection $15.00 Plumbing Valuation Fee $0.00
Mechanical Plan Review Fee $0.00 Mechanical Permit Fee $114.05
Plumbing Permit Fee $145.78 Building Plan Review Fee $180.00
SIF 1 percent Fee $33.53 Public Safety Impact Fee -Admin $26.35
Electrical Permit Fee $198.67 Park Impact Fee - Single Family/Townhome $769.56
Building Permit Fee $1,097.80 Transportation Impact Fee - City $34.80
Sewer Connection Residential Fee $2,090.00 Transportation Impact Fee $3,445.20
Address Fee $30.00
FINS EC I® FEES: (c) With respect to Reinspection fees will comply with Florida Statute 55 .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."
Complete Plans, Specifications add fee 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.
1A ) .6 : W*)
CONTRACTOR SIGNATURE PE IT OFFICE
REQUIRED;iERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE
PROTECT
r., a - FROM WEATHER
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received Phone Contact for Permitting 908 770 7763
1 1/ 1 1 1 1 1 1 1 1 Jill
Owner's Name CAL HEARTHSTONE LOT OPTION POOL 03 L P Owner Phone Number 813.574.5700
Owner's Address 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 6806 Ripple Pond Loop LOT # A015
SUBDIVISION Abbott Square PARCEL ID# 04-26-21-0140-00100-0150
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR P8 ADD/ALT SIGN DEMOLISH
INSTALL REPAIR
PROPOSED USE �/ SFR COMM OTHER
TYPE OF CONSTRUCTION �/ BLOCK FRAME STEEL
DESCRIPTION OF WORK Multi -family / Screen Enclosure / Fence
BUILDING SIZE U/R SF 1763� SO FOOTAGE 14®® HEIGHT 18=
BUILDING $ 211560 VALUATION OF TOTAL CONSTRUCTION -)
ELECTRICAL $ 31734
Uti
PLUMBING $ 21156
Vi MECHANICAL $ 14809.2
GAS IJ I ROOFING 0
FINISHED FLOOR ELEVATIONS
4301 W
Address
ELECTRICIAN
SIGNATURE
Address
PLUMBER
SIGNATURE
Address
MECHANICAL
SIGNATURE
Address
OTHER
SIGNATURE
Address
AMP SERVICE
VALUATION OF MECHANICAL INSTALLATION
SPECIALTY = OTHER
FLOOD ZONE AREA YES Do
Lermar Homes, LLC
Y / N FEE CURREN Y / N
License# I CGC,1518166
Edmonson Electric, Inc.
Y / N FEE CURREN
License # EC13005408
Bayonet Plumbing, Heating & AC, Inc
Y / N FEE CURREN Y / N
License # I CFC042998
Bayonet Plumbing, Heating & AC, Inc
Y / N FEE CURREN Y / N
License # CAC058062
C Sterling Quality Roofing, Inc
Y / N FEE CURREN Y / N
License # 1 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-VIA 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 $7500)
Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
COMPANY
REGISTERED
Suite 600 Tampa, FL 33607
COMPANY
REGISTERED
COMPANY
REGISTERED
IY
-D
I
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
NOTICE OFDEED RESTRICTIONS: The undersigned understands that this permit may besubject to^demd^restrictions"
which may bemore restrictive than County regulations. The undersigned oasumeoreoponoibi|hyforonmp|iancovvhheny
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 |ew, both the owner and contractor may be cited for 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 tocontact the Pasco County Building Inspection Division —Licensing Section at727-847-
8UOQ. Furthennnna, if the owner has hired a contractor orcontractors, he in 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 been indication that he ienot properly licensed and ianot entitled topermitting 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 tothe construction of new bui|dingo, change of
use in existing bui|dinga, or expansion of existing bui|dingo, as specified in Pasco County Ordinance number8Q'O7 and
90-07. as amended. The undersigned also undarotanda, that such feee, as may be due, will be identified atthe time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a "certificate of uooupancy" or final power release. If the project does not involve a certificate of occupancy or
final power re|eano, 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 Statubes, as amended): If valuation of work is $2.50O.UUnrmore, |
certify that |, the epp|ivan(, 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", | certify that | have obtained n copy of the above described document and promise in good faith to
deliver iLtothe ''mmner^prior tocommencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT: 1 certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable laws regulating oonaLmntion, zoning and land development. Application is
hereby made to obtain a permit to do vvnMh and installation as indicated. | certify that no work or installation has
commenced prior to issuance of permit and that all work will be performed to meet standards of all laws regulating
oonntruotion. County and City oodes, zoning regulations, and land development regulations in the jurisdiction. | also
certify that | understand that the regulations ofother government agencies may apply to the intended work, and that it is
myresponsibility toidentify what actions | must take tobeincompliance. Such agencies include but are not limited to:
Department ofEnvironmental Protection -Cypress Bayheade, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment,
Southwest Florida Water Management Diotrict-VVe||a, Cypress Bayheado, Wetland A^aao, Altering
Watercourses.
- Army Corps of Engineers -Seawalls, Docks, Navigable Waterways,
- Department of Health & Rehabilitative Services/Environmental Health Unit-VVe||n, Wastewater Treatment.
Septic Tanks.
- USEnvironmental Protection Agency -Asbestos abatement,
- Federal Aviation Authority-Runwaye
| understand that the following restrictions apply tothe use nffill:
- Use offill imnot allowed inFlood Zone ^trunless expressly permitted.
- If the fill mehaha| is to be used in Flood Zone ^A^. it is understood that a drainage plan addressing a
"compensating volume" will be submitted ottime ofpermitting which is prepared by e professional engineer
licensed bythe State ofFlorida.
- If the fill material is to be used in Flood Zone ^A^ in connection with a permitted building using stem wall
construction, | certify that fill will be used only hofill the area within the stem wall,
- If fill mebaha| is to be used in any area, | certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent propertiea, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots |maa than one (1)
acre which are elevated by fill, an engineered drainage plan is required.
If | am the AGENT FOR THE CJVVNER. | promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction, | understand that o separate permit may be required for electrical worh,
p|umbing, oigne, weUo, poo|a, air conditioning, gaa, or other installations not specifically included in the application. A
permit issued aheU be construed to be license to proceed with the work and not aoauthority to vio|mte, oonoei a|ter, or
set aside any provisions of the technical oodea, nor oheU issuance of permit prevent the Building D#iuie| 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 iosuence, 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 naquested, 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.
RAT V=.s.117on
OWNER onAGENT—
Subscribed
8JI12022 - by Christopher Smith
as identification.
ZPY—Notary Public
Commission No. GG 296057
Stephanie Farmer
CONTRACTOR &��
Subscribed and sworn to (or affirmed) before me this
A/W022 by Christopher Smith
Who is/are personally known to me or has/have produced
as identification.
Commission No. _GG 296057
Steohaniemnne,
Notary Public
r
'A, REVE-A' ASSIS
Notice to wilding Official of
Use of Private Provider
Effective January 20, 2003
Project Name: 6806 Ripple Pond Loop
Parcel Tax ID: 04-26-21-0140-00100-0150
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.
the fee
owner, affirm I have entered into a contract with the Private Provider indicated below to conduct the services
indicated above.
li I F11121 I i FIX � F" I
Private Provider Firm:
Private Provider:
Address: 747 SW 2ND 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 persom-iel, 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
No,:
Please use appropriate notary block.
STATE OF 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
itAuthorized Acient
Address: 700 NW 107th Ave
Miami, FL 33172
Telephone
No. 813-574-5700
Corporation
Before me, this 22ND day of
MA-Y, 20 22,
personally appeared
of
Lennar Homes, LLC a
corporation, an
behalf of the state corporation, who
executed the foregoing instrument and
acknowledged before me that same was
executed for the purposes therein
expressed.
Personally known X ;or Produced identi cation— Type of identification produced
EM=
Print Partnership Name
By:
(signature)
Print
Name:
Address:
Telephone
No,:
Partnership
Before me, this
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.
Signature of Notary- Print Name ASHLEE CALLAHAN
Notary Public Stamp:
�WE
ASHtEE CALLA44N
� -A 4 notary pu�ojj� < State of FloridaCommission Expires:
QG 244456
NOVEMBER 302022 COTTIM, Expires Nov 10, 1022
,
F-31 COMMERCIAL BUILDING SERVICES DIVISION Of"RESIDENTIAL
BUILDING PERMIT DATA SHEET
TRACKING #
FOLIO # 6806 Ripple Pond LooD
Reauired Permits
I • #- I
I ally-10 110 0 Z braloo"942003 rol kalad
WBuilding
El Inspection Only
WPlumbing
[:] Inspection Only
WMechanical
El Inspection Only
VElectrical —Amp
n InsEection Onl,
Roof
[:] Gas
F
Ej Medical Gas
❑ Fire Sprinklers
On Site Piping
El Fire Line
❑ Irrigation
❑ Fire Alarm
El Potable Backflow Assembly
El Fire Line Backflow Preventer
❑ Irrigation Backflow Assembly
E] Demolition
[] Walk-in Cooler
❑ Refrigeration
Hood
E] Ansul
E] Fence/Wall
❑ Grease Trap
Other
0 Other
mm�l ,
Ty pe Construction:
Risk Catego
Category:
Occupancy Load
tD
Factory n, Classification:
E=
Residential
Assembly
Hazardous
Storage E=
Business Day Care/Educational
Institutional Mercantile
nal E:::=
❑ Utility
Building Use: Single Family Alteration 1—Level I 1[:]'Leve12 Level 3 511,
6KNew Construction ❑ Interior Finish ❑ Interior Remodel E] Exterior Remodel Ej Addition ❑ Revision
Overall Size:
26-8 x 71
Number of Stories:
1
Total Sq. Ft.:
1763
Living Area: 1400
Covered Area:
363
# of Bedrooms: 2
# of Baths: 2
Cost per square foot:
Estimated Value:
Roof Type: Shingle
[-]Tile
El Metal El Other Squares: 19
Zoning:
Wi orne Debris:
Sairiside,
V,,'Outside
Energy Code: 405-2020
Flood Zone: x
Base Flood Elevation:
Finish Floor Elevation:
Hydrostatic Vents?
rol, Yes Na I
Sq. Ft. Enclosed Space Below BFE:
# of Vents:
Size of Vents:
Total Sq. In. Permanent Openings
Ed Central A/C
El Gas A/C
5<1 Heat Pump
D Gas Heat
❑ Window A/C
El Electric Heat
1031==2rj=
Sanitary Sewer
Storm Sewer Catch Basins
Potable Water
Underground Fire Line
M=
Front Rear Left Right
Asper Approved Site Plan
Comments:
\/"RA
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: tq—cy,irtualreviewassist,com
Project: New SFR
Ixtim
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
553.791, Florida Statute and holds the appropriate license or certificate:
Name: Debra Anne Klahr
Plan Sheets: 1,2,3,4,5,6,7,8,9,10,10.1,L1, FP-1,SN, SNLS3,S4,S5,SS, D1,WP,PAL0,PAl.l,PAL2,PAL3, SHLO,
SHLl,SHL2,SH1.3,SHL4,SH1.5
Florida License/Registration/Certification #(s) and description:
FS468 Certified Standard Plans Examiner
License #: PX2300
Signature of Reviewer:
SWORN AND SUBSCRIBED before me by Debra Anne Klahr
being,2asonally known to me or having produced as identification
and who being fully sworn and cautioned, state that the
foregoing is true and correct to the best of his/her knowledge or belief.
kltAA P 0 (_�t U GY�C*A
iganature of Notary Print Name
Notary Public: NOTARY STAMP BELOW My
ASHLEE CAI ' LAHAN
Notary Pub';lc -State of Florida
"M'
commission expires:
w GG
Com?ojss�on 244456
:
My Con, m. EXPIre s Noy 30. 2022
Bonded thfouglh National Notary Assn.
NESCRIPTIONz LOTS 13- I S, BLOCK L ARBOTT SQUARE PHASE IA,
ACCORDING TO THE FLAT THEREOF, RECORDED IN PLAT BOOK „-
PAGE ___. OF TiE PUftUC RECORDS OF PASCO COUNTY, FLORIDA.
_ PROPOSED Et E VATIONS AND GRADING
SHOWN HEREON ARE TAKEN FORM THE !!!
ENCiINEERdNCi PLANS CTF
'ABBOTT SQUARE REMDENTIAI.. PRE!'A(tED
BEr"WRA` PROVIDE[) BY CLIENT
I e,
s,a1f
hiS SITE P{.AN P epared far anct Certf Led 7 c,
ALL ELEVATIONS REFERENCED
TO NORTH AMERICAN
VERTICAL DATUM OF 1988
(NAVD 88) e
CL
Seale: I = 20
>_ 01
0
m LL O n
� p "z' - °S
TWw TOP OFWALL
h I " to
e
BW^ BASE OF WALL
U CL 1 0 G
s 2'QAK4"
m
. m 10 00 PUEKjC U1!L! I'( EASEMENt' Q.
LEGEND: i
i-- PROPOSED LDRAFNA6E FLOW
10000) PROPOSED GRADE
E-00.00 ^^ EXIS71NG GRADE
mmv
LOTGRACING TYPE - A
PROPOSED PAL? ELEVATION = 101.10
FRONT SET HACK a 20
SIF3E SET HACK w 7.5
SIDE SET BACK ICORNE:R LOT; s 15
REAR SUBACK - 15
LOT =_��.`,t_SU. FT.
LIVING AREA mt4 SCt. FT.
PORCH =_124� SCT. FT.
GARAGE _SO, FT.
COVERED LANAI �.6 t 2 SC.L F r
PATIO -,N(R SO, FT.
POOL AREA s_N/8SO f- I
CONC- DRIVE __ 4 _.SC2 PT_
ACC & CON[ PAC? m_ _—_Sfo FT.
SIDEWALK m_ SO, FT.
LOT SOD A..._SO FT.
IC`W SOD NrA -SO, FT.
LOT OCCUPIED =._ZQ . FFS
AREA TQ IRRIGATE
PROPOSED.
MINIMUM FLOOR ELEVATIONS:
LIVING AREA: 1 Q 1.77'
C,ARAGE AREA:
ELEVATIONS REFERENCED TO
NORTH AMERICAN VERTICAL
DATUM OF 1488
SITE PLAN
tNOT A SURVEY1
SEC, 4. T RFF, 26 5, RNG 21 E.
PASCO COUNTY, FLORIDA
(ABBOTTSOUARE)
APPARENT FLOOD HAZARD ZONE X COMMUNf1Y NO 12CQ45 NOTE. ENTRY WArKS ARE 3.0 C ONCRE T E
StlRVEYAf38REVRTiON (MAP NUMBER I2IOTCr-0289F)EFFECTVE ?ATE 09'76,`2014 c'SAICUNITS ARE.92xaz
N f E 4 iht Ri " -
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Al-R 1M M1k At FIN- IF _RE P iklEIN IF INDICFiLcE i
RS 0. ;$=CF
WrE SF IT �.{ 1ECA' EX. !Rt£bi N ;.ff i 1Vf f eIsF
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(( N t A"tV 4,t lN). rir�LRl tf M1k tn£ f( _N,. F : i'FkF K (N i,£iei EI
^C'WrR, of -IN th €
m 4ENk yJh f (!v { f .. LI h i 'A 3fit ti C Na : R NV ft. ht r4'Jtk.KS
A4R-1 RR {zATtDec !V C i hl n N F N Y(£.P IV `F j5) 1 ) Y I" MMFd MFt 10e i ( (An
C"-r iu," yyt {yC NA t .t' t tcE C.I,S Kt r.i N N i4` i U
IN, t }ry e4 it f aRi MF !Ef:P i !1A ik( ( N .FR ih'S t✓:^U'F E t i F=t.{RB irl
(,I-(ONt NFTF MAES fP�Gf ,LINE} Nit-�!. I"E I'P^t A''Ftt f'il t Pi OhdA.,.1 Ift If Elf FM N'It,NS 4F
CStat,L7 Nti S.i1{i ?N42NG.E �.,_ ....®.._.... .�. �.._..,n___..._,__�. ...m...._
TOR h5401 SURVEYOR'S NOTES: SE1R � TV
1.) Cwrent title mf€ eo s@on on the subject P ape€ty had not eoers Thvs r oMf- kirt defmber
'?ate of Sfte Plan. 41922 - plane and
_ fet-nfctted to tnstfa! Point Land Su'veyhtq, e! C at €f ['ne of this
}WG ASf 13 I9-0# SITE SITE PLAN Fee abt �$yq}e„� as rae to
-- -- 2.)1 This sketch wr s prepored without the benefit t of a tfCle search. sus s i, f ""�` Of nr
No fnstrurrionts of eecoti ee@eel ng (Nvneian.p,ac menls or S i`a` et P Ci5 t tits h i
e � rights -of way were f rushed to the under g red unie:s otherwise EepP 7.Q " , Tefa AHr{ t4YstratNue Code,
shows 1 erean. -k�' t o SL'ction 472 027, Florida St e.
Carawn by D. R 3.) R.ads walks aLtd other fF,Uar iter, s shown t e reort were take q!�
yhecked by_)H fro e engmeedng Plan, and xre FIRPYt to on—Y.
") This SITE. PLAN does riot wfiect nor determine osvnershp.
tE ViSit3ft&S 6.y Tt is iFTE "LAN is sub)e0 t. _11ens shown on the Prat of w�
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Initial Point Land Surveying, LLC.
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Date Permitted
Builder Permit No.
ParcelCounty No. SubDiv:
Address/Location
+WI
Classificati
Classification/Type of I Use
t
Rate: Sq. Ft Unit: �
Exempt E) Yes No How [determined
Impact Fee Amount Zone No. TAZ:
SCHOOL IMPACT FEE
Account (056) Single -Family Detached House Amount $
(057) mobile Home
(058) Other Residential
(123) Collection Fee
Exempt = Yes = No How Determined.
Land Account Land Credit Land Total
Recreation Account Recreation Credit Recreation Total
Zone Total Amount $
Exempt =Yes =No How Determined
LIBRARY FEE
Land Account Land Credit Land Total
Facility Account Facility Credit Facility Total
Exempt Yes No How Determined TotalAmount
Prepared By Checked By
NO CERTIFI ATE OF OCCUPANY WILL BE ISSUED DR FINAL 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
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