HomeMy WebLinkAbout22-5208City f Zephyrhills'
5335 Eighth Street`
"
Zephyrhills, FL 33542
ENR-005208-2022
Phone: (813) 780-0020
Fax: (813) 780-0021
Issue Date: 11/15/2022
Permit Building New Si ni 1
S
6751 Ripple Pond Lp 04 26 21 0140 00100 0950
N9�#1\
Name: LENNAR HOMES LLC-OWNER Permit Type: Building New (Residential) Contractor: LENNAR HOMES LLC
Class of Work: Townhome
Address: 4600 W Cypress St 200 Building Valuation: $214,147.65
TAMPA, FL 33607 .
Electrical Valuation: $32,122.15
Phone: (813) 574-5700 Mechanical Valuation: $14,990.34`( fi
...r
Plumbing Valuation: $21,414.77 b
Total Valuation: $282,674.91
Total Fees: $13,592.52 f " u
Amount Paid: $13,592,52
Date Paid: 11/15/2022 10:30:26AM t
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CONSTRUCT TOWNHOME 1517 SQ FT AS
Water Connection Residential Fee $1,010.00 3/4 Water Meter Residential Connection Fee $73271
Address Fee $30.00 Transportation Impact Fee - City $34.80
Electrical Plan Review Fee $0.00 Transportation Impact Fee $3,445.20
Fire Wall/Smoke Wall Inspection $15.00 Building Plan Review Fee $180.00
School Impact Fee - Single Family $3,353.00 Public Safety Impact Fee -Police $254.00
Mechanical Permit Fee $114.95 Plumbing Valuation Fee $0.00
Driveway Fee $45.00 Public Safety Impact Fee -Admin $26.35
Plumbing Permit Fee $147.07 Mechanical Plan Review Fee $0.00
SIF 1 percent Fee $33.53 Park Impact Fee - Single Family/Townhome $769.56
Electrical Permit Fee $200.61 Sewer Connection Residential Fee $2,090.00
Building Permit Fee $1,11014
REINSPCT'ION 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."
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.
CON CT SIGNATURE PE IT OFFICE
PERMITI IN 6 MONTHS WITHOUTINSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECTT
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 , I I a A I I I a I I I I I I I I '�i�er
Owner's Name Lennar Homes, LLC Owner Phone Number 813.574.5700
43 W Boy Scout Blvd Ste 600 Tampa, FL 33607
Owner's AddressF o 01 -, Owner Phone Number F
Fee Simple Titleholder Name I NIA Owner Phone Number
Fee Simple Titleholder Address NIA
JOB ADDRESS 6751 Ripple Pond Loop 1 LOT # RK::]
SUBDIVISION Abbott Square Phase I PARCEL ID# 04-26-21-0140-00100-0950 1
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED
9
NEW CONSTR
ADDIALT
SIGN
DEMOLISH
INSTALL
REPAIR
PROPOSED USE
SFR
COMM
OTHER
TYPE OF CONSTRUCTION
BLOCK
FRAME
STEEL
Single
Family Residence / Pool / Screen
Enclosure / Fence
DESCRIPTION OF WORK
BUILDING SIZE I U/R SF 19 01--1 SQFOOTAGE1517 HEIGHT
UV( BUILDING $ $214,147.65 J VALUATION OF TOTAL CONSTRUCTION
r_71
[,(JELECTRICAL L$32,122 15 AMP SERVICE F'X-] PROGRESS ENERGY W. R. E, C.
PLUMBING $ $21,414,77
MECHANICAL I$ $14,990.34 VALUATION OF MECHANICAL INSTALLATION
�`
GAS 10 ROOFING SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES Do
. I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
BUILDER
COMPANY
SIGNATURE
REGISTERED
14301 W Boy Scout Blvd Suite 600 Tampa, FL 33607 1
Address
ELECTRICIAN
Ga a as
COMPANY
SIGNATURE
REGISTERED
Address
11034 Skipper Road, Tampa, FL 33613
PLUMBER
ffsk2,GaPeauuCOMPANY
SIGNATURE
REGISTERED
Address
[P 0 B,, 5308, Bayonet, FL 34674-5308
MECHANICAL
COMPANY
SIGNATURE
REGISTERED
Address
P.O. Box 5308, Bayonet, FL 3467:4:5=308=
OTHER
COMPANY
SIGNATURE
REGISTERED
Address
14211 Shoal Line Blvd, Spring Hill, FL 34607
Lennar Homes, LLC
L_Y2 N J FEE CURREN L_y LN_J
License# EC::15
18166
[Edmonson Electric, Inc.
I Y/ N FEE CURREN LY LNJ
License# =EC1300
Bayonet Plumbing, Heating & AC, Inc
YIN FEE CURREN Y/N
License # I CFC042998
Bayonet Plumbing, Heating & AC, Inc
L.Y / N FEE CURREN LY
_LN_j
License # 1062
C Sterling Quality Roofing, Inc
�N FEE CURREN
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 & I dumpster, Site Work Permit for subdivisionsllarge 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 $7500)
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
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 1, 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 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 W" 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, after, 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.
OWNER ORAGENT
Subscribed and sworn So (or affirmed) before me this
IMMOE_ by Christopher Smith
Who is/are personally to me or#askia�d
—as identification.
ZPV� . ....... .. . . ... . ........ ---Notary Public
Commission No. GG 296057
Stephanie Farmer
Name
STEPWIEFAMER
E*M 1`01HUNY 15, 20
Subscribed and sworn to (or affirmed) before me this
by _Christopher Smith
Who or has/have produced
as identification.
Notary Public
Commission No. GG 296057
Stephanie Farmer
Name of NE 0001i I
MPH" FMER
ll FobvW 15, 2023
k-&d Tw 7my F* k=00 swww
11
... ...... .... ... I ....
am
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13
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0, �'Illlt%
I
V
RTUAL. REVif.%-, ASSICT
v I
Notice to Building Official of
Use of Private Provider
Effective January 20, 2003
Project Name:
Parcel Tax ID:
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 Finn:
Private Provider:
Faun=
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.
X
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
By:
(signature)
Print
top Name: Chrisher Smith
Its: Authorized Agent
Address: 70Q 071b_Av
Miami, FL 33172
Telephone
No. 813-574-5700
Corporation
Before me, this 22ND day of
MAY 20 22
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.
Partnership
Print Partnership Name
M.
(signature)
Print
Name:
Its:
Address:
Telephone
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 X ;or Produced identi cation Type of identification produced
I; or"nt,
Signature of Notar Print Name
_ASHLE,E CALLAHAN
Notary Public Stamp:
A ASH EE
Commission Expires: notary Pubk?' State of Norida
GG 244456
NOVEMBER 30, 2022 E%PV65 Now 10, 202
Private Provider Firm: Virtual Review Assist, Inc
Private Provider: Debra Atine Klahr, BU 1967
Address, 747 Southwest 211d Avenue
Gainesville, FL 32601
Phone: 813-391-2959
Einail, luc i virtLialre�,,ie,vassist ..coxii
Project.: TOWNI-IOUSE - 6 UNITS
Adclress(s): 6727,6731,6735,6743,6747,6751 Ripple Pond Loop
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,�,6,7,8,9,10,10.1,10.2,L-1,FP-1,SN,SNI,S3M,S4Tvl,SS,S5.1,S6.ST,SS,D-1,NNT,
PA I .0,PAI.1, PA 1.2,PAI .3,'SHI ASH1.1,SHI 2,SHl.3.SH`1 A,S111 .5
Florida License/Registiutioti/Cei-tification #,(s) and description-
FS468 Certified Standard Plans Examiner
License #: PX2300
Signature of Reviewer:
SWORN AND SUBSCRIBED before me by Debra Anne Klahr
being personally known to me X or having produced as identification
and who being fully sworn and cautioned, state that, the
f0—re.-O—ing istrueand correct to the best of his./her knowledge or belief
ke Ashlee Callahan
Signature of Notary Print Name
Notary Public: NOTARY STA MP BELOW My
ASHLE CNV"
mycomma"mmm
commission expires: EVM: NQVWW 30,2D26
U011 +-
[—COMMERCIAL BUILDING SERVICES DIVISION
TRACKING �40(05 4 BUILDING PERMIT DATA SHEET
FOLIO # FIRE MARSHAL #01 -
_eAuired Permits
0 On Site Piping
01
El Walk-in Cooler
El Fence(Wall
log
Building Use:-----5
04i Aew Construction
verall Size:
Emmim
31111113111-:W, t�rt
El Fire Line
■F
Refrigeration
fiiIrrigation
AWILLU1,91a,101 -11 ,
71 Interior Finish 0 Interior Remodel
Number of Stories-
o-10
pill
Cost per square �foot
Elm
maim
"Ev4�Central �A—
IC
Gas A/C
WiM,
X"SIDENTIAL
DATE: '5" z jj O-Z
EXAMINER:
10M.
I Uccupancy Load
Fay Care/Educational
Mercantile
Alteration IQLevel I Level 2 10—Level 3
El Exterior Remodel El Addition El Revision
Total Sq. Ft.:
010 j
of Bedrooms-
7 # of Baths:
Estimated Value:
Energy Code: �/Q�
sh Floor Elevation:
Sq. Ft. Enclosed Space Below BFE:
lalzll
-na. A . Pir
Lai
m
9439 '79 44-
9US 169-
..... .. ....... .
tAk'i #if d71V:. O'$ 4a.IM, BLOCK f, ABBO TSOUARE PHASE to
_SO
U
SITE E PLAN
ACCfORNNGTO THE PLA7THEREOF, RECORDED IN PLAT ROC3P.--,
PAGE ___, OF rHk.. PUBLIC RECORDS OF PASCO COUNTY, FLORlDA.
(NOT A SURV6Tf
TNS SFr PIANh'epamd for av'
F �P12C,7PC)S:E33-ELEVATffStfs
0 Certi5ed'fo;
AND GR,it7.NG t �taa
to arfhr»er
£ NCh%N HEREON ARE TAKEN FORPk THE t
ENGINEERING PLANS OF
LOT 94
`P$E3Cl, s SOt_fARE RESIDENTIAL-, PREPARED j E
BLOCK 1 Ytg r
Bl'"WRA-PR0V1DEDRY LENT
Scale., T u
cCauc Ax, rNn n auAr,1,
I OT � ' `ry7„ 34 SCi. F7.
1WING AREA 4.,.k, FT
�.
PORCH FT.
GARAGE .� I �8� SDI. FT
C11—RE" C ' NA€ F " n ; �&
PATIO
POOL.ARE A �C�.FT.
CC)R C C} I1 E� Loa— SQ- FT,,
s
&rC&CONCPAD - 1 _So, FT,
k""'AK' {
SIDEWALK
LOT OCC JP€Ef3 _ %
AREA TOIRR;GATE .. t#:
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AU ELEVA.T16'NS KEFEP.ENCE#.T
Al
TO NORTH AMERICAN
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E
oa ry
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NOTE. MIRY lx A{KS AR•E.3`CONC
LEGEND:
PROPOSED ORAOJAGE FLOW
IOC.C€6 - PROPOSED GRADt
Im
E-R0.00 > EX6714VG GRA#.i"'F,
4 ,;
NOTES;
LOTGRADING TYPE - A
PROPOSED PAD ELE VAMON ^, 95.90
EJ
FRONT SEI BACK - 20 r���-^y
C R.2
S DE SET BACK.- 0
'v40e SET SACK ico""' ER Lun m 16
.......____..,_._._....
i
ao ##�
Fl_a
REAR SET SACK w 5'
PROPOSED:
MItNifvlltM FLOOR ELEVA €ONSv
LIVING AREA:. 96,572 �
GARAGE AREA:
ELEVATIONS REFERENCED TO
O -i AMEWC>AIN VERTICAL
DATUM OF 1988
SURVEY AEEREV 7I kNS
I
APPAREKSSY FLLSO
IK'tAPfifUMBER,
O ' at
PROPOSED LOT 95
1STOW "PL A BLOCK
? {
Pt A.{N 1500
E -EV °TH-
GARA EL
S� C:
PROPOSED
STI RYVMA LOT 96 Epllkll
PLAN €397
r 'rH BLOCK #
GARAGE P
�uwawi
1 -D � VUA LOT 97 1
ftAr 3s7 BLOCK 4
GARAGEL P .Er i3I
-. PROPOSED
I Siam WLLA LOT 98
MAN P3a7
El-FIV TW BLOCK 1
GAAt AGs R E
PF'xsED r
5TOR# vi: LA LAN LOT 99
. ,397 b:
Oxv T€#` BLOCK i
GARAu L
PROPOSED
€ ST"")Kr im'LA
PLAN#S00 LOT 100
FL£S 7H`
C. ARA fr P BLOCK t
sMMI a r
527'3g'S3'E tP 112,00fp)._—
TRACT'H-3
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5Ummyon'S NOTES,
1-1 curramutle of-mat;onon she sulxjeEt propo,ly had not h "en
Thh, cer
kaseOf Site rk t` XB-'2 furni ncoa to Initial Pont end Sorveying, LLC P, the tmvOf tnK
Prop .
P
Stmli3l!5:8.. 1L�0-e, u'�_
SIT E PLAN
iYkB
2.)ThtS SRe^tCYt wac pr?pwrec3 svk.haut the itenefii ofa£i:le,eatc3l,
�
No rnnrurnents of rer£vol refl"Ling c)Wnernip, eaSCR ncs or
'ile:
ng` u Tway were furnuhad to She undem§ned, untess othen,`Se
-
shrema' he n.
uc -
'.?`txi sRn f.,N: l?.75`
3.1 Roads safss, and atTtet kiss'u4ar 3errc; sNow•t i Fri eDdn a^iere c�a6'
:, oe engine nng plans and am subject to son'e '
4„; -fhr rfTE ftAN does not POW "or drtea non, ownership.
I YStt3FS;
6,L"'hrs Sic ?LRN ss sui jecR to rrrifite,�s shavn an T7t>" t'faY of
'ASBOTT55DUARE PHASE 9,A
€ Pi.} Dimens ons s.NP vn hereon are in feet and d "cirriX po ^ o /
thereof.
{ 74 (*ntrActar and awn,w are to v rNy a € setlxmks, lsusldinw
NO
nfimcnsiom. and layout Oho— hereon P'ne W a' ky ct9"'ast £1 afia,
3ncl inZrs3erJiaCNlk NCib`iY4'.#FFItAi€Pa{nt L.�nLi�W1'U"}VfYtJ, iLC Of l:'£j=
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dewati9.n from infoplation shown hereon. retium, to do*,.L,wMhe
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SEC. 11, TWP. 25 5, RING 21 E.
PASCO COUNTY. FLORIDA
(ABBOTT SQUARE)
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Initial Point Land SYrve) inn, LLC.
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' Permit No.
Date Permitted LL
Builder Name/Owner Name Control #
County Parcel No, SubDiv:�
Address/Location
Classification/Type of Use
TRANSPORTATION IMPACT FEE Rate: Sq. Ft Unit:T
Exempt ED Yes 0 No P� tt How Determined
Impact Fee Amount ' C Q Zone No. TAZ:
Account (056) Single -Family Detached House Amount $
(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 $
Exempt =Yes = No How Determined
LIBRARY FEE
Land Account Land Credit Land Total
Facility Account Facility Credit Facility Total
Exempt ElYes No How Determined Total Amount
RESOURCE FEE ERU
Total Amount
Preparedtiy Checked By
O CER I TE OF OCCUPANY WILL BE ISSUED OR 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