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Home My WebLink About23-6030Emu EM Address: 4301 W Boy Scout Blvd 600 TAMPA, FL 33607 'hone: VSTRU T SINGLE FAMILY Mechanical Permit Fee Public Safety Impact Fee -Admin Driveway Fee SIF 1 percent Fee Park Impact Fee m Single Family/Townhome Water Connection Residential Fee Address Fee Sewer Connection Residential Fee Transportation Impact Fee Irrigation 314 meter (atc) City of Zephyrhills 5335 Eighth Street ehyrhills, FL 352 l Phone: (513) 780-0 20 Fax: (13) 780-00 1 Issue gate: 04125120 3 4 Class of Work: SFR Construct Building Valuation: $271,440,00 Electrical Valuation: $40,716.00 Plumbing Valuation: $27,144.00 Paid.Total Valuation: $358,300.80 Total Fees: $20,42953 Amount Paid: $20,429.53 Date Contractor: LENNAR HOMES LL MOO Public Safety Impact Fee -Police $254,00 $135.00 Electrical Kermit Fee $243,58 $2635 Electrical Flan Review Fee MOO $45,00 3/4 Water meter Fee (Ualc} $794,92 $83.28 Plumbing Permit Fee $17 Y2 $769.56 Plumbing Plan Review Fee MOO $1,140,00 School Impact Fee - Single Family $8,32&00 $30,00 Building Plan Review Fee $180.00 $2,400.00 Transportation Impact Fee - City $36.32 $3, 95.68 Building Permit Fee $1,397,20 $794,92 complyREINSPECTION FEES: (c) With respect to Reinspection fees will Imposedlocal government shall impose a fee of four times the amount of the fee for the initial inspection or propertyfirst 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 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. I a. 11119!a., accordance` NO OCCUPANCY BEFORE C.O. CONTRACTOR SIGNATURE t r, PE IT OFFICE 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 « Building Department Date Received Phone Contact for Permittin 408 ) %70 /763 @_...r_t I� mow-i:S._.E�I:J1:..... Owner's Name CAL HEARTHSTONE LOT OPTION POOL 03 L P� Owner Phone Number 813 574.5700 23975 Park Sorrento, Ste, 220, Calabasas. CA 91302 Owner's Address �.. � � Owner Phone Number [� Fee Simple Titleholder Name _ Owner Phone Number Fee Simple Titleholder Address I N/A JOB ADDRESS 6788 Back Forty Loop LOT # 2505 SUBDIVISION Abbott Square ] PARCEL ID# 04-26-21-0160-02500-0050 �t (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED I Z'I NEW CONSTR F__] ADD/ALT SIGN DEMOLISH INSTALL REPAIR PROPOSED USE SFR 0 COMM OTHER TYPE OF CONSTRUCTION BLOCK 0 FRAME STEEL �^ DESCRIPTION OF WORK Single Family Residence 1 Pool I Screen Enclosure 1 Fence BUILDING SIZE U/R SF 2262 SO FOOTAGE 1764 HEIGHT 28 BUILDING $ 271440 VALUATION OF TOTAL CONSTRUCTION ELECTRICAL $ PROGRESS ENERGY W.R.E.C. 40716 AMP SERVICE PLUMBING $ 27144� MECHANICAL $ 19� VALUATION OF MECHANICAL INSTALLATION 40-e o3e) GAS I.! I ROOFING = SPECIALTY = OTHER� FINISHED FLOOR ELEVATIONS r �'y (' FLOOD ZONE AREA ry tYES I o BUILDER COMPANY LCnnar Ilomes, LLC SIGNATURE Y REGISTERED Y I NJ FEE CURREN LY 1 N _... Address OI NV Bo caut Blvd Suite 600 Tampa, FL 33607 License # C.GCISI8166 ELECTRICIAN COMPANY Edmonson Electric, Inc. SIGNATURE REGISTERED YIN PEE cuRREN LILN Address License # I EC13005408 PLUMBER COMPANY Bayonet Plumbing, Beating & AC, Inc SIGNATURE REGISTERED Y / N PEE. CURREN _Y / N Address License # CFC042998N� MECHANICAL COMPANY I Bayonet Plumbing Heating & AC, Inc-� SIGNATURE REGISTERED LYLN� FEE CURREN Y I N Address License # CAC058062� C St erl ing Quality Roofing, Inc OTHER 9 COMPANY y g+ SIGNATURE f REGISTERED EE CURRENY/ N Address License # 1 CCC057991 IIIIIIIIIIIEI!1IIIIt6IIlIIIIIIIIIIIIIIIIIIIIIIIIItIBIIIIIIIIIIIIII 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 Farms. R-O-W Permit for new construction. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w' Silt Pence 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 Aftorney (for the owner) would be someone with notarized letter trom owner authorizing same OVER THE COUNTER PERMITTING (copy of contract required) Reroofs if shingles Sewers Service Upgrades A/C Fences (PloUSurvey/Footage) Driveways -Not over Counter if on public roadways -needs ROW NOTICE OF DEED'RESTR[CTIONS: 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 into 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 Linder 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, alter, 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. I 2TV4 II 0"UT Tat" Mao] re I Ai I =*101TIMA na,"RumcuralwagaNg agAgM IM-01M LIZ 1941121MAZIM11 0 OWNER OR AGENT Subscribed and sworn o (or affirmed) before me this 2LI11111 _by Christopher Smith Who is/are personally known to 92e or4a&ihswe-pFoduGe4 as identification. Notary Public Commission G 296057 Stephanie Farmer Nome of Notary typed, printed or —stamped ELISSAKHOLLEW Subscribed and sworn to (or affirmed) before me this 2L211121 by _Christopher Smith AhLis/are personally known to me, or has/have produced as identification. ---------- ---- — ------- ----- --- .._Notary Public Commission No. /t -26 �7 Stephanie Farmer Name of Notary typed, printed or stamped Kq Pm�� :1 --- --- 41-a--4-+-i#1-I-i-1-T-1- 9 ». 264' - 24" RCP — -24' - 18' RCP @ d 3d%----_----- � SD-7{-24 a O 24 - 36" RCP @ 0.30% m TYPE 'A' @a' FF:99.27 PAD:98.60 N tV 4 23` 22 21 26', 19'. v�j m h- PHASE II o PHASE I DESCRIPTION: LOT S. BLOCK 25, ABBOTT SQUARE PHASE Z SITE PLAN ACCORDING TO THE PLAT THEREOF, RECORDED IN PLAT BOOK 90, PAGES 28-33. Or THE PUBLIC RECORDS OF PASCO COUNTY, )NOTA SURVEY) FLORIDA --- -- - ---- — This SITE PLAN Prepared for and Certified To: PROPOSED ELEVATIONS AND GRADING Lennar Homes SHOWN HEREON ARE TAKEN FORM THE ENGINEERING PLANS OF 'ABBOTT SOUARE RESIDENTIAL`, PREPARED BY WRA" PROVIDED BY CLIENT I I ' a LOT31 i LOT - BLOCK25 j BLOCK 25 z `IP yb\ /9 O. _ N 88'08'23- W IF) I I0.50' (PJ { S,C,''/ 1 I 2 CONIC 25 7 o� 42.0 3 2'X3.2' � 33.3 _...,�_ 7 WALK --{-- - LOTS ENTRY C/S A/C PROPOSED o 1 LOT 32 a BLOCK 25 _ 2 STORY RESIDENCE 147, .BLOCK 25 w b b PLAN 1763 GOELEV "B" I LANAI GARAGEL ry 54' 0' . )... m 0 42.0 6,0. ._.._..-_,._._._ _.. 4111, ------------ LOT 33 LIP,BLOCK 25 ABBOTT PHASE I i PEI 89, PGIS) 57-62 ! 1 NOTES LOT GRADING TYPE = A PROPOSED PAD ELEVATION=97.40' FRONT SET BACK = 20' SIDE SET BACK= 7.5' SIDE SET BACK (CORNER LOT) =10' REAR SETBACK = 15' PROPOSED: MINIMUM FLOOR ELEVATIONS: N 88-08`23' W (P) I )ELSE' (P) LOT BLOCK 25 < = 10.00' PUBLIC UTILfTY EASEMENT PC6 SEC. 4, TWP, 26 S, KING 21 E. PASCO COUNTY, FLORIDA (ABBOTT SQUARE PHASE 2) Scale. 1" = 2Q' (PI ALL ELEVATIONS REFERENCED TO NORTH AMERICAN VERTICAL DATUM OF I986 LNAVD 88)� LOT 4420 SQ. FT. LIVING AREA = 728 SQ. FT, ENTRY 62 SQ,FT. GARAGE 379 SQ. FT, COVERED LANAI 60 —SO. FT. PATIO = NA __SO. FT. POOL AREA = NA SO. FT. LIVING AREA: 98.07' LEGEND: CONC. DRIVE = 328 SQL FT. GARAGE AREA: PROPOSED DRAINAGE FLOW A/C & CONC PAD = 10 �SQ. FT. ELEVATIONS REFERENCED TO J SIDEWALK 42 SO, FT. NORTH AMERICAN VERTICAL (00.00) = PROPOSED GRADE SIDE YARD SWALE =�_SQ' FT. DATUM OF:; 1988 E-00.00 = EXISTING GRADE CONSERVATION AREA = NLA _SQL FT. LOT OCCUPIED 36 _ _ Flo APPARENT FLOOD HAZARD ZONE: 'X'COMMUNITY NO, 120235 AREA TO IRRIGATE - 64 % SURVEY ABBREVATIONS (MAP NUMBER 12101C-0289-F) EFFECTIVE DATE: 09/26/2014 ARC -LENGTH )D)=DEED INV- INVERT PC=POINT OF CURVE IR)- RECORD LEGEND A/C-AIRCONDITIONER UP- DRAINAGE EASEMENT LB-LICENSEDBUISNESS DEC- POINT OF COMPOUND CURVE .RNG-RANGE �r^ V�INYL fENCE AT -ALUMINUM FENCE EL OR ELEV- ELEVATION IE- LANDSCAPE EASEMENT PCP- PERMANENT CONTROL POINT RRS-RAILROAD SPIKE > 7;i'CQNC -�- --�f — FAE •SAE FLOOD ELEVATION EOP - EDGE OF PAVEMENT LEE - LOWEST FLOOR ELEVATION VE - POOL EQUIPMENT R/W - RIGHT OF WAY LIM- BENCHMARK ESM'T=EASEMENT LS- LICENSED SURVEYOR Do - PAGE SEC - SECTION WOOD FENCE C-CURVE F/C=FENCE CORNER IM)- MEASURED PI= POINT OF INTERSECTION SAW -SET NAIL AND DISK =-ASPHALT -- --- ICf-CALCULATED FCM- FOUND CONCRETE MES- MITERED END SECTION PK-PARKER"LON LE#8183 G < CENTERLINE 0. CHAIN LINK FENCE CLF-CHAIN LINK PENCE MONUMENT NCF^NO CORNER FOUND =PROPERTY LINE SIR -SET i/2'IRON ROD LH#8183 __ x CMP-CCtRRUGATEO METAL PIP FIP=FOUND IRON PIPE OfA-OVERALL DOB= POINT OF BEGINNING 'ram - TEMPORARY BENCH MARK �� ^BRICK OCT.- COLUMN FNsD-UNDIRONROD OHM^ OVERHEAD WIRED) POC- POINT OF COMMENCTMENT 'tO3-TOP OF BANK CONC- CONCRETE FN6i7-FOUNDNAIL&DISK O.R -OFFICIAL RECORDS POL-PONTONUNE 'FWP- TOWNSHIP ALUMINUM`ENCE FOP -FOUND OPENPIPE LEI -PLAT PRC-POINT OF REVERSE CURVE UE-UTYIJTYEASEMENT COVERED _ C,IS-CONCRErEStTB FPP- FOUND PINCHED PI PE PIS -PLAT BOOK PRM-PERMANENT REFERENCE MONUMENT VF-VINYL FENCE — CST -CLEAR SIGHTTAANGLE _ JOB #15907522505 SURVEYOWS NOTES: SURVEYOR'S CERTIFICATE 1708 Water Oak Drive t.) Current title information on the subject property had not been This certif that ske ch of the hereon described Tarpon Springs, Florida Date of Site Plan: 3-7-23 TP furnished to Initial Point Land Surveying, LLC. at the time of this ro ert was S SITE PLAN I P Y �Q b ��i l , upervision and Phone: (727)-8.11-1990 DwG:as-vHaLSBLzsslTe meets th �wq° CAL- of Practice for FloridaP S7I23G gmaiLcam 2.) This sketch was prepared without the benefit of a title search. s ey and of Land LBO 8183 No instruments of record reflecting ownership, easements or S 42239)3.20 sd Rle rights -of --way were furnished to the undersigned, unless otherwise 3 Shown hereon. purslO t Section 4t<RaPI: �e11ey Drawn by: DJB 3.) Roads, walks, and other simifar items shown hereon were take at" Checked by:JH from engineering plans Ind are subject to survey. ) a+ 4.1 This SITE PLAN does not reflect nor determine ownership. REVISION$ ,. E 1D 31 1Q� '00' S.J This SITE PLAN is subject to matters shown on the Plat of ✓p A_� "ABBOTTSOUARE PHASE IS' JeffM fpA r4p,�(� 6.) Dimensions shown hereon are in feet and decimal portions a thereof. FLORIDA 04rY NA �I RAND Q N 7.j Contractor and owner are to verify all setbacks, building MAPPER dimensions, and layout shown hereon prior to any construction, NOT VALID WITHOUT THE ORIGINAL and immediately advise Initial Point Land Surveying, LLC. of any SIGNATURE AND SEAL. OF A FLORIDA deviation from information shown hereon- Failure to do so will be LICENSED SURVEYOR AND MAPPER Initial Point Land Surveying, LLC. New Development Check List Parcel#: IQY-64 / -0160-OAS-00 - 0050 Address: (0 ),�?g /-?,,c Setbacks:Front go , 5 Rear 34 Sides 7,S Elevation: Garage: Roof Shingle Dimension/Architectural; r, --L L1291—k-0 \/R/\ v A U A L R E V E W AS S ST Notice to Building Official of Use of Private Provider Effective January 20, 2003 Project Name: 6788 Back Forty Loop Parcel Tax ID: 04-26-21-0160-02500-0050 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. 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: DEBPA ANNE KLAHP Address: 747 SW 2ND AVE- SUITE 170,301,357,& 358, GAINESVILLE, FL 32601 Telephone: 813-376-3088 Fax: NIA 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 The following attar. eats. are provided as required: 1. Qualification statements and/or resumes of the private provider and all duly authorized -representatives. I. Proof of insurance- for professionaland comprehensive liability in,the.amount of $1 million per o courrenoe relating to all services p,erfoimed as a private provider, including tail coverage for, a minimum of 5 years subsequent to th6 pmformancepf building code inspection services.,' 1ndividual CorpDration Partnership Print CoiporationName PAntPartnfrshipName By::;;!:� By: (signature} (signature) (signature) Print Print print Namelh tIsto her S�rrfth Name, its: Authorized A rat Its. Address:_JQQ_Njy`10 tFt �. �. Address: ToJcphDn(-, Miami FL 33172 Telephone, Telephone No, 81 3.r574-5700 No.: Plea�e use appropriate notary bl'ock STATE OF FLbROA COUNTY OF HILLSBOROUGH CorpDrat16n 'Partnership B Dfo if, m e-, this day of B,foxeme,tbis 22ND day of BeforomD,tbis day 20—persDnally MAY --,2o-22 of appezrDd personally appeared personally appeared who * executed the foregoing instrument, Of and, acknowledged before me that same Lennar Homes LL a p artex/agent on behalf of was executed for the purposes therein corporation, D I n -behalf of the state corpoTalion, who a partnership, who executed the executed the f6xegoing instrument and foregoing instrument and ackziow.WgDa before me that same, was aclmowlt-dg 0d before me that same executed for the purposes therein was extoutedfor the purposes therein ex (I. pressed, expressed. -Personally known X or P r o du r, e d iden# cation Type of identification produced Sipatre ofNot, .PrintNamc ASHLEE CALLAHAN P. % NotaiyPublic Stamp: ASHLEE CALLAHAN i MY COMMISSION # HH 296Q80 COmlnission Expires; EXPIRES: November 30,2026 �. � -D I -- 0 VR/\ VIRTUAL REVIEW ASSIST Private rovl er Private Provider Firm: Virtual Review Assist, Inc. Private Provider: Debra Anne Klahr, BU1967 Address. 747 Southwest 21d Avenue Gainesville, FL 32601 Phone: 13-391-2959 Email: luny &..viz 4lr vi xv s istt.coni Project: New SFR Back Forty Lp 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 ow yerfrAUK *, and holds the appropriate license or certificate: Name: Debra Anne Klahr Plan Sheets CS,1.1,1.2,2.1,2.2, 3, 4;5,6.1,6.2, 7, SN,SNI, S3,S4,S5, S6,SS, ST,DI, D2,WPI,PAI.0,PAI.1, PAI.2,PAL3,PA1.4, SHI.O,SHI.I,SHI.2,SH1.3,SHI.4,SHI.5 Florida License/Registration/Certification #(s) and description: FS468 Certified Standard flans Examiner License #: PX2300 Signature of Reviewer: SWORN AND SUBSCRIBED before e by Debra Anne Klahr being personally known to m or having produced: as identification — and who being fully sworn and cautioned, state that the fo eoing is true and correct to the best of his/her knowledge or belief. Pi Sina o Notary znt azne commission expires: ASHLEE ItAAS �� MY OOMMISS N [—COMMERCIAL BUILDING SERVICES DIVISION RESIDENTIAL BUILDING PERMIT DATA SHEET TRACKING # FIRE MARSHAL # 1 DATE: 3/29/2023 FOLIO #; 6788 Back Fbr�ty Lp EXAMINER: Debra Klahr PX230C Required Permits Building Plumbing Mechanical Electrical - Amp El Inspection Only Inspection On ❑ Inspection On ❑ Ins ection Onl Roof Gas El Medical Gas ❑ Fire Sprinklers El On site piping El Fire Line ❑ Irrigation [l Fire Alarm El Potable Backflow Assembly El Fire Line Backflow Preventer ❑ Irrigation Backflow Assembly Demolition El Walk-in Cooler Ej Refrigeration ❑ Hood Ansul Fence all E:1 Grease Trap El Other ❑ Other Rviildinv Dntn Type Construction: v Risk Category: Occupancy Load ! ancy Olamificaation: Factoxy Assembly W �liazardods 3usiness Day Care/Educational nstitutional F Mercantile Residential ®� _ ��Storage [ Utility Building Use: SINGLE FAMILY RESIDENCE / Alteration':Level 1 ®;bevel 2 QL eve13 if New Construction ❑ Interior Finish El Interior Remodel El Exterior Remodel ® Addition ® Revision Overall size: lumber of Stories: Total Sg® Ft,: 25 X 54 2 2265 Living Area: Covered Area: # of Bedrooms: 4 1764 01 # of Baths: 2b Cost per square foot: Estimated Value: Roo f e: Shin le ®Tile Built-u ❑ fetal El Other Squares: 16 Zoning: Wi orne Debris. Energy Code: 405-2 0 j'inside Outside Flood Zone: X Base Flood Elevation: Finish Floor Elevation: hydrostatic �enls `Yes No Sq. Ft. Enclosed Space Below FE. # of Vents: Size of Vents: Total Sq. in, Permanent openings Central A/C X Heat Pump Window Aft Pas AJ _ [ ,Cas FIeaf El Electric Beat Front Rear Left Right As per Approved Site Plan Comments: 1 ggq, Permit No. � Cate Permitted Builder Name/Owner Name �� .. � . � , � > :,� ..w: ry trot # County ParcelNo. �{Ik Iv,,LL—.�`.' e U Address/Location Rate: Sq. Ft unit: r Exempt 0 Yes 0 No How Determine Impact Fee Amount 5 .._.. _ Zane No. TAZ: SCHOOL IMPACT FEE Account (056) Single -Family Detached House Amount � (057) Mobile Home (Ca l) 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 Zane Total Amount Exempt =Yes No Hove Determined LIBRARY FEE Land Account Land Credit Land Total Facility Account Facility Credit Facility Total Exempt El Yes No How Determined Total Amount RESOURCE FEE ERIi Prepared By # ' m Checked 6y C RTPFI klrE OF OCCUPANY WILL RF ISSUED OR FINAL INSP CTION PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE BEEN PAID AND RECEI TED 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 __._