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HomeMy WebLinkAbout22-5284' "' i iIssue Date: 12/14/2022 �W � o i 1t i III Name: LENNARW W HOMES L Cw W"�i Ni no � ..�IType:BuildingII n W N �R d e I aContractor I I� N � AI G II HOMES S L �L Class of Work: 4 Construct Phone: (813) Address: 4600 W Cypress St 200 Building Valuation: $320,640.00 Valuation: $22,444.80 AmountPlumbing Valuation: $32,064.00 Total Valuation: $423,244,80 Total Fees: $20,189.83 CONSTRUCTDate Paid: 12/14/2022 3:45:28PM FAMILYIN A 'Address8.00 Plumbing Permit Fee "200�3�21 5.68 Electrical Permit Fee $280,48 ReviewMechanical Plan Review Fee $0,00 Public Safety Impact Fee -Admin $26.35 Electrical Plan Water Connection Residential Fee $1,010,00 Building Plan Review Fee $1 woo Mechanical Permit Fee $152,22 Plumbing Plan Review Fee $0.00 3/4 Water Meter Fee l $73271 Building Permit Fee $1,64120 Transportation Impact Fee - City $36,32 Driveway Fee $45.00 SIF 1 percent Fee $8328 Park Impact Fee - Single Family/Townhome $769.56 Sewer Connection Residential Fee $2,09000 • * r ar i'- # � # " • . 1; # ♦ '� it Il�li!. 813-780-0020 w City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Date Received Phone Contact for Permitting 908 770 Owner's Name 7CA7HEARTHSTON7EL T OPTION POOL 03 L P Owner Phone Number 813.574.5700 Owner's Address 23975 Park Sorrento, Ste. 22Q Calabasas, CA 91302 Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address N/A 6335 Ten Acre Court LOT # 11214 JOB ADDRESS Abbott Square 04 26®21-0150m®12®®-0140 SUBDIVISION PARCEL ID# (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED 11 J II NEW CONSTR ADD/ALT SIGN DEMOLISH INSTALL REPAIR PROPOSED USE SFR COMM OTHER TYPE OF CONSTRUCTION BLOCK FRAME STEEL DESCRIPTION OF WORK I Single Family Residence / Pool / Screen Enclosure / Fence BUILDING SIZE U/R SF 2672 SQ FOOTAGE PEI HEIGHT 28' � 1 IyJELECTRICAL J_yJrPLUMBING $ 320640 $ 48096 $ 32064 MECHANICAL $ 22444.8 =GAS ROOFING FINISHED FLOOR ELEVATIONS BUILDER SIGNATURE Address 4301 W Boy ELECTRICIAN ` SIGNATURE Address PLUMBER SIGNATURE Address MECHANICAL SIGNATURE Address OTHER SIGNATURE Address VALUATION OF TOTAL CONSTRUCTION PROGRESS ENERGY W.R.E.C. AMP SERVICE VALUATION OF MECHANICAL INSTALLATION ` SPECIALTY = FLOOD ZONE AREA OTHER YES Do Len Dar Homes, LLC Y ! N FEE CURREN Y / N License # I CGC1518166 Edmonson Electric, Inc. Y / N FEE CURREN Y / N License # EC13005408 Bayonet Plumbing, Heating & AC, Inc Y / N FEE CURREN I Y / N License # CFC042998 Bayonet Plumbing, Heating & AC, Inc Y / N FEE CURREN Y / N License # I CAC058062� C Sterling Quality Roofing, Inc L_Z_L N J FEE CURREN Y / N License # GCC057991 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) COMPANY REGISTERED Suite 600 Tampa, FL 33607 COMPANY REGISTERED COMPANY REGISTERED COMPANY REGISTERED COMPANY REGISTERED — 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 as NOTICE {JFDEED RESTRICTIONS: The undersigned understands that this permit may besubject bo^deed^restrictions" which may bemore 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 wmrk, they may be required to be licensed in aocnndonwy with state and local regulations. If the contractor is not licensed as required by |aw, both the owner and contractor may be cited fora 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. Furthennore, if the owner has hired a contractor orcontractors, 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 oontractmr, that may been indication that he is not properly licensed and ienot 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 (othe construction of new bui|dingo, change of use in existing bui|dingo, or expansion of existing bui|dings, as specified in Pasco County Ordinance number88-07 and 90-07. as amended. The undersigned also underntandu, that such fneo, as may be due, will be identified etthe time of permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to receiving e "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 CountyVVater/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, aoamnendmd): |fvaluation ofwork is$2.58OOOormore, | certify that |, the mpp|ioant, 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 a copy of the above described document and promise in good faith to deliver ittothe ''mwner''prior tocommencement. CONTRACTOR'S/OWNER'S AFFIDAVIT: | certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating conotruotion, zoning and land development, Application is hereby made to obtain a permit to do work 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 |mwe regulating nonetrudion. County and City oodeo, zoning regulations, and land development regulations in the jurisdiction. | also certify that | understand that the regulations of other 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 o<Environmental Protection -Cypress Boyheads. Wetland Areas and Environmentally Sensitive Lands, VVater[0/aetewaterTreatment. - Southwest Florida Water Management Diatrict'VVe||o, Cypress Boyh*ado, Wetland Areeo, Altering Watercourses. - Army Corps of Engineers -Seawalls, Docks, Navigable Waterways. - Department of Health & Rehabilitative Services/Environmental Health Unit-VVe||o, Wastewater Treatment, Septic Tanks, - USEnvironmental Protection Agency -Asbestos abatement. - Federal Aviation Authn/ity-Runwayo | understand that the following restrictions apply tothe use uffill: - Use offill ianot allowed inFlood Zone ^V~unless expressly permitted. - If the fill material is to be used in Flood Zone ^A^, it is understood that e drainage plan addressing a "compensating volume" will be submitted at time ofpermitting which is pnapon*d by a professional engineer licensed bythe State ofFlorida. If the fill material is to be used in Flood Zone ''A^ in connection with e permitted building using stem vvoU construction, | certify that fill will be used only tofill the area within the stem wall. - If fill material 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 propertiee, 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 | am the AGENT FOR THE QVVWER. | promise in good faith to inform the owner ofthe permitting conditions net forth in this affidavit prior to commencing construction. | understand that a separate permit may be required for electrical vvork, p|umbing, oigns, vveUs, poo|m, air conditioning, gao, or other installations not specifically included in the application. A permit issued shall be construed to be license to proceed with the work and not aaauthority hoviolate, oanoa|, a|har, or set aside any provisions of the technical codoa, nor shall issuance of 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 ianuanoe, 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 naqueated, in writing, from the Building Official for o period not to exceed ninety (OO) days and will demonstrate justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned. |n*Ju*Ar(rS.1n,m) Subscribed and sworn ro (or affirmed) before me this W312022 by ����onally known to me or hasihave pmduGed as identification. Z411_5_7�Notary Public Commission No. ss296057 Stephanie Farmer CONTRACTOR Subscribed and sworn to (or affirmed) before me this 8/3/2022 by Christopher Smith Who is/are personally �nown to me or has/have produced as identification. Commission No Stephanie Farmer Name of N STEPWEFAMER -Notary Public M1M III 111111 �M +4 I \/RA S11 R %,V A 3 T v u� I � v 1 ' Notice to Building Official of Use of Private Provider Effective January 20, 2003 Parcel Tax ID: 04.26.21.0150.01200.0140 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: VIRTUAL REVIEW ASSIST, INC. Private Provider: Address: 747 SW 2ND AVE- SUITE 170,301,357,& 358, GAINESVILLE, FL 32601 Email Address (Optional): 2 Fax: N/A 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 pennit 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. Individual (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 _ 0 (signature) Print Name: Christopher Smith its: Authorized Agent Address: 700 NW 107th Ave Miami, FL 33172 Telephone No. 813-574-5700 Corporation Before me, this 22ND day of MAY 2o22, 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. Personally known X ;or Produced'cation_ Type of identification produced Print Partnership Name By: (signature) Print Name: Its: 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-LL (1 0 _n Print Name ASHLEE CALLAHAN Notary Public Stamp: ASH EE i. CALLAHAN State of Florida N 1NOW Public - Commission Expires: M colimsslo 11 r. # GG 244456 ' �Ry ConiEV05 Noy 30, 2022 NOVEMBER 30, 2022 r""W . " , m, xp N a ti on a i Notary hssn, Page 2 of 2 \/V\ 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 2nd Avenue Gainesville, FL 32601 Phone: 813-391-2959 Email: h LCX Project: New SFR Address(s): 6335 Ten Acre Court 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: CS,A1,A2,A3,A4,A4.1,A5,A6,A6.1, SN0,SNI,S3,S4,S5,S6,SS,ST, SII,SI2,WPI.0,PAI.0,PAI.1,PAI.2,PAI.3, SHLO, SHI.LSHI.2,SHI.3,SHI.4,SHI.5 Florida License/Registration/Certification 4(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 or having produced as identification and who being fully sworn and cautioned, state that the for for oing is correct to the best of his/her knowledge or belief. r 0 g 77 a-,V\ ur ignature of T�OWII Print Name Notary Public: NOTARY STAMP BELOW My commission expires: q A A 31, �4 2 2 k TRACKING # FOLIO # 6335 Ten Acre Court u�,i :1 � ^r 9/08/2022 Building 0 Inspection Onl VPIumbing ElInspection Only WMechanical ❑ Inyection Onl Electrical Amp El Ins ection Onl Roof ❑ Gas I 1 ❑ Medical Gas 0 Fire Sprinklers ❑ On Site Piping ❑ Fire Line ❑ Irrigation ❑ Fire Alarm Potable Backflow Assembly ❑ Fire Line Backflow Preventer ❑ Irrigation Backilow Assembly ❑ Demolition ❑ Walk-in Cooler ❑ Refrigeration ❑ Hood ❑ Ansul ❑ Fence/Wall [] Grease Trap ❑ Other ❑ Other 1-111mri i / Type Construction: "B Risk Category: Occupancy Load y Care/Educational C} am Classirication: Assembly _ �J Business _ �,,rcantile FactoryHazardous Institutional � © Rasidential - Storage E= ❑ Utility Building Use Single Family /Alteration Level I [Level 2 'Level 3 New Construction [] Interior Finish ❑ Interior Remodel ❑ Exterior Remodel ❑ Addition © Revision Overall Size: 30 x 46 Number of Stories: 2 Total Sq. Ft.: 2672 Living Area: 2217 Covered Area: 455 # of Bedrooms: 5 # of Baths: 2.5 Cost per square foot: Estimated Value: Roof Type: ® Shingle ❑Tile ❑ Built-up ❑ Metal ❑ Other Squares: 18 Zoning: Wi orne Debris: ❑ Inside Outside 0 Energy Code: 405-2020 Flood Zone: X Base ]Flood Elevation: Finish Floor Elevation: Hydrostatic Vents? ❑ Yes ' No Sq. Ft. Enclosed Space Below BFE: # of Vents: Size of Vents: Total Sq. In. Permanent Openings [] Central A/C --® Heat Pump ❑ Window A/C ❑ Gas A/C ❑ Gas Heat L] Electric Heat On Site Piping SanitaKy Sewer Storm Sewer Catch Basins Potable Water Underground Fire Line Front Rear Left Right 21 Asper Approved Site Plan Comments: t Z-�z 64 106.97 103.53 �w�LTYPE'B'L I �FF:107.87 N PAD:107.20' 106.45 99.89 �€107.17 103.32 TYPE 'A' ( FF•102.17 TYPE 'B' PAD:101.50 FF:10' .7 N 106.56 PAD:1g7.40 99 88 i t -0 107.16 103.10 ( ' TYPE 'A' 0 FF:101.97 TYPE'B' PAD:101.30 0 FF:107.97 ry 106.35 PAD:107.3q 99.63 106.96 102.90 I � TYPE 'A' I r FF:101.770 TYPE 'B' PAD:101.10 0 FF:107.67 64 106.15 PAD:107.00 99.39 33' 18" RCP @ 0.30% 106.76 102.18 TYPE 'A' FF:101.67 TYPE 'B' n PAD:101.00 0 106.15 PAD:106 0t'�'_ 99.14 io d d a a a a m TYPE 'A' FF:109.17 I ry � 20 � 1-----119 18 ( DESCRIPTION: LOT 14. BLOCK 12, ABBOTT SQUARE PHASE 18, ACCORDONITSG - THE PLAT THEREOF, RECORDED IN PLAT BOOK PAGE , OF THE PUBLIC RECORDS OF PASCO COUNTY, FLORIDA ALL ELEVATIONS REFERENCED FO NORTH AMERICAN VERTICAL DATUM OF 1988 NAVf) 881 'I- - "RE"'I'l. F-T, lZrPF7"o LOT 27 BLOCK 12 LOT 26 BLOCK 12 z SITE PLAN (NOT A SURVEY'i LOT 13 BLOCK 12 N 89'5 150 E iP! 132 91 �P, N00,0810 W (PI 5 Is I.! SEC, 4, TWP, 26 5, RNG 21 E. PASCO COUNTY, FLORIDA (ABBOTT SQUARE) Scale: 1 20' -W 89'51 SO- E 25 00 [PI 15,0 :Pi 640 3 5X3 5 C S-A,C 413 -1/ -11 1 3 CONC PROPOSED WALK LOT 14 , 2 STORY RESIDENCE ENTRY 4 7 22 BLOCK 12 PATIO I, 0, PLAN 2216 'LE V A "AR GEL o 46 411 640 229 N 89'51 50 E P' 32 9! 'PI L07 15 BLOCK 12 I 0i -_!jM__SO FT LIIANG AREA FT, PORCH __JJ,_SC) FT GARAGE - _SO F1 COVERED LANA" -N_1A_SQ FT PATIO -_L9__SC), FT POOL AREA FT CONE DRIVE FT AC & CONC PAD -J2_SO FT SIDEWALK FT LOT SOD FT R/W -SOD --N4&--SO FT 2- OAK LOT OCCUPIED IP AREA TO IRRIGATE 1000 PUKC UTiLf"YEA-SEMEST PROPOSED NOTES, LEGEND: MINIMUM FLOOR ELEVATIONS. LOT GRADING TYPE aA PROPOSE 1) DRAONAGE LIVING AREA� 102,17 GARAGE AREA PROPOSED PAD ELEVATION 0150 ?00 001 PROPOSED GRADE ELEVATIONS REFERENCED TO FRONT SET BACK - 20 E,)0 00 FXISTrNG GRACE NORTH AMERICAN VERTICAL 50F SET BACK - 7 5 DATUM OF 1988 SIDE SET BACK !CORNER LC)�; 10 PROPOSED EfCVA`T0NS AND GRADING SHOWN HEREON ARE TAKEN FORM THE REAR SET SAVF - IS ENGINEERING PLANS OF A8BOTT SOUPDIF RESIDENTiAL', PREPARED APPARENIPLOODHAZARD ZONE 'X COMMUdPTYJNQ (2Q235 BY WRA'PROFICED by CLIENT SURVEY ABBREVATIONS ,!MAP NUMBER 12) DIC-0289-F EFFEChVE DATE 09 26 2014 II XI T) 1 N, rrlsc,-iw, —IdNe"a"01 LEGEND DRANAIII, t AlIEWN' S , IcfNvD RIO`LIi Nz KI N IN: �kl � INIISIN) 1,11 F'fiERrXX�'n_FVPcH1 11 -1INCL 10P r For id PAPP KINI !,IF - �()WFS' FI OCe nEVAH(It, PIT R)VL EO.crtar N, Pf _P eh IZI "A 11. LZ�Nlbci f iFA, - _r Z ME �,IJW� 1Ja 1c, 11�ck, IF,' � a,, WCxL,,EH IC �IAIUIATEV 11.FK1 INNER ral - 111AWREII, I> NTFIN N111 I,N&D a-', N11, AW) I - LEN I KR, ND I Oel IT W, - . IrREU IND sK A ."FRAuR Yo-IIN �U - clean 11P PKI - NO CORN01 ­, IND I mokonnuer" �;P - V, i :a()" F110 P. 6, h, uuir,,,,11 IIIA -I `NM I 1AIN LINK WNCE J�'1'11�:;%.es- I '1�111PAARF War 1�, VIIA F "fit Mh1 � ", , � V, rPI,- ae0I N', 0 N1 "FP Q­G1, 11e W H 10INI CI' e,1rVr ­R11 '�PNI EZI.IoT Alkl.ni kl dk I_ 19 111' ROOF F. PEI—El' IT YIN I -IrSior N T I L CuH PH su"Veyolim Nam. SUAVE LOLO-5191 1,) C."arit talk info Intrivon on the subject P'. This -enfee N I w1lbe, 2ae of 1110 Plan -1 29 22 1 frii honed to Initial Point Land Striseyng, FLC Plate d w 1708 ate, Oak Dme Tepper Springs, Fiiando Phone I SITE, PLAN 'hoots[ S 0 Th,s,kemh —, phapareal mth­t the boneh? Of x Free search, 'U" Set "I f L O"CoPLI SP, 17123,Rgmallcm, N.,hatrurim nts ofe,cd'ollectring ownership, ealianene, or SUE 1, , 5 in h rights-orway were funirshed to the B#8183 undersigned, unless othervalel 53- 53 londa AFIM', e Co e, show, hereon 3.) Roads walks. and Other 1­01 1itene In— ake' hole.h vere tp a ecto 72027 FloudaFtte S _h-kesf 0yJH fron, eaSpneenne; plan, and are "object to Rowee survey V ­­1 4 Ira:: SITE PLAN tip es not flea no, dote,- ,Ip =_' �l REVISIONS ­ 6:)'Th S17E PLAN issubject to matters shown on the For of cRg C v P, 'ABBOTT KOQARf PHASE IS' t Z1,11. 6.) dimensions shown hinKan are in fee'? and clecirnai pconah tre—f SSI OR 7P .) Cons And owner are to verify aP setbacks, banding4� lug 3 thelonnom and FA"`k ""Wo he'—' Pnra` to anY Ho"ItIv h 1 NOT V L and InIF edlately dIlle inalai Point rand Surveying, LUC of any I SIGNATURE deelation from Information shown hereon. Falion, to do YF w,11 be LICF CED, at "sior s sole risk, 'N , R i Initial Point Land Surveying, LLC, :3 PASCO COUNTY, FLORIDA Permit No. 1�1>280 Builder Name/Owner Name 4441(l �16 Control # County Parcel No, O�O/ ZV�Q 4(�b Subl)lv: Address/Location & 07 TRANSPORTATION IMPACT FEE Rate: Sq Ft Unit: Exempt 11 Yes E] No How Determined Impact Fee Amount Aa2-- Zone No. _ TAZ: Account (056) Single -Family Detached House Amount $ (057) Mobile Home ' (058) Other Residential _Q 23) Collection Fee Exempt L_j Yes []No How Determined PARR Uji 11 FEE Land Account Land Credit - Land Total Recreation Account _ Recreation Credit - Recreation Total Zone TOTAL AMOUNT $ Exempt Yes No How Determined Land Account Land Credit Land Tota . I Facility Account Facility Credit Facility Total Exempt [I Yes No How Determined Total Amount TOTAL AMOUNT ERU Prepared By Checked By _DATE _- RECEIPT NO, DATE � BY