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HomeMy WebLinkAbout23-6189N � City of Zephyrhills 5335 Eighth Street Zephyrhills, FL 33542 NFL-006189-2023 Phone: (313) 730-0020 Fax: (813) 730-0021 Issue oats: 05/08r2023 Permit T (pe: Building Residential 70k,xt .�... ,t,IN t�'t� t .\\ s\ \.,. \ �, a� \ t .1. x\} S �\ �q ..\ tl \ \t.\ \ �\)\1;ltil \ g ` a 11\ \ \ \t \ ft,i t \ i\ \ \ 1\ \ a1.1"'SS� t t., 4���. y .� a,.." r��C' ��v v,.tit �v�., ,v,'.3?�v<1 �.�,??\�,�,.s,. � v�,��ry, a 1.,, ,. t.<a�� � \ At\\.­.1�.;v�a ,. �11�,�5 s 15 26 210230 00000 0140 38064 Fallstone Way tll Name: LENNAR HOMES LLC Permit Type: Building New (Residential) Contractor: LENNAR HOMES LLC Class of Work: Townhome Address: 4301 W Boy Scout Blvd 600 Building Valuation: $250,320.00 r TAMPA, FL 33607 Electrical Valuation: $37,548.00 ..wy Phone: Mechanical Valuation: $17,522.40°� Plumbing Valuation: $25,032.00 Total Valuation: $330,422,40 Total Fees: $14,333.47 `7 Amount Paid: $14,33147� Date Paid: 51812023 1:55:41PM �. CONSTRUCT TOWNHOME 1634 SQ FT Public Safety Impact Fee -Admin $26.35 Public Safety Impact Fee ®Police $254,00 Address Fee $30.00 Park Impact Fee - Single Family/Townhome $769.56 Building Plan Review Fee $180.00 Mechanical Plan Review Fee $0.00 Electrical Permit Fee $227.74 Transportation Impact Fee $3,445.20 School Impact Fee ® Single Family $3,353.00 SIF 1 percent Fee $33.53 Plumbing Valuation Fee $0.00 Water Connection Residential Fee $1,140,00 Mechanical Permit Fee $127.61 Fire Wall/Smoke Wall Inspection $15.00 Transportation Impact Fee m City $34.80 Driveway Fee $45.00 314 Water Meter Residential Connection Fee $794.92 Sewer Connection Residential Fee $2,400.00 Building Permit Fee $1,291.60 Electrical Plan Review Fee $0.00 Plumbing Permit Fee $165.16 REINSPECTION 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 ether governmental entities such as water management, state agencies or federal agencies. "Warning toowner: 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 worts shall be performed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. Pi CONTRACTOR SIGNATURE PE r IT OFFICE PERMITIRES IN 6 MONTH ' S WITHOUT APPROVED INSPECTION, NOTICECALL FOR INSPECTION - 8 HOUR . VTR 78uil city of Zephyrhills Permit Application Building Department Fax-813-780-0021 Owner's Address 4301 VV Boy Scout Blvd, Ste. 6qq, Tampa, FL 33607 Owner Phone Number Fee Simple Titleholder Name N/A owner Phone Number Fee Simple Titleholder Address I N/A 38064 Fallstone Way 10014 JOB ADDRESS LOT # SUBDIVISION} Townes at Autumn Palm PARCEL to# 15-26-21-0230-00000-0140 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR F—I ADD/ALT SIGN DEMOLISH INSTALL REPAIR PROPOSED USE SFR COMM OTHER TYPE OF CONSTRUCTION 10 BLOCK FRAME STEEL ,�-OBUILDING $ 250820 VALUATION OF TOTAL CONSTRUCTION �, ELECTRICAL $ 37548 AMP SERVICE PROGRESS ENERGY W.R.E.C. 0PLUMBING $ 25032 P s a b MECHANICAL $ 17522 $ VALUATION OF MECHANICAL INSTALLATION i GAS 10 ROOFING SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS ( FLOOD ZONE AREA DYES LJ O III BUILDER COMPANY LcnuarITorrlLLC; SIGNATURE REGISTERED L_X.LN_j FEE CURREN Y / N 4301 Boy Scout Blvd Suite 600 Tampa, FL 3360? CGCIS [8166 Address License # ELECTRICIAN COMPANY Edmonson Electric, Inc. SIGNATURE 7 REGISTERED Y/ N FEE CURREN Y 1 N Address License# EC13005408� PLUMBER COMPANY Bayonet Plumbing, Pleating & AC, Inc SIGNATURE J' REGISTERED YIN FEE CURREN Address License # CFG042998�= bi Plumbing, umn MECHANICAL COMPANY Bayonet g, Heating & AC, Inc SIGNATURE REGISTERED Y ! N J FEE CURREN Y ! N Address License # cAc058062 OTHER COMPANY C Sterling Quality Roofing, Inc SIGNATURE REGISTERED Y ! N FEE CURREN Y / N Address License #GGC057991 ItlilllEll�llkltliiiE9BttllgliES18F�F��[81�46eE9ltAEFF1Ek��6��IF1l1P 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, Stonnwater 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 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. It It 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 • County. TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands ha Tr n rtati n F In., R R v F ma I h i n f n if i N I IWIL Uli I (;QfL[ly Ulaif I riavie 56farlQu a 7upy 31 frie 7_977Q lesunDea aocument ano promise in g deliver it to the "owiner"prior to commencement. CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work .......... ....... "I'll, .11 1 1 1 iet�qd�..�Lcatt*n_k_ hereby made to obtain a permit to do work and installation as indicated. 11 ertify 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 # 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 1compensating 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. 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 MIN the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension WAMw Awww 4IMM& OWNER OR AGENT :;�__ --' Subscribed and sworn ro (or -affirmed) before me this mMaM by Christopher Smith Who islare_persariallykvown to me or#aslt�aue"procitrc;�t� as identification. Notary Public Commission G 2960557� Stephanie Farmer Name off Notary typed, printed or -stamped • Subscribed and swom to (or affirmed) before me this _E1 812o1-1__by Who �own to me or has/have produced as identification. Notary Public Commission No. 6 7 Stephanie Farmer of Notary typed, printed or stamped rMT449M M.M Services to be provided: Notice to Building Official of Use of Private Provider Effective January 20, 2003 38064 Fallstone Way 15-26-21-0230-00000-0140 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: VIRTUAL REVIEW A55I5T, INC, Private Provider: DEBPA ANNE KLAHR Address: 747 SW 2ND AVE- SUITE 170,301,357,& 358, GAINESVILLE, FL 32601 Telephone: 813-376-3088 Fax: N/A Email Address (Optional): deb@virtuctireviewassist.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, envirommental or other codes. The following arta,ohments. are provided as required: 1. Qualification statements and/or resumes of the private provider and all duly authorized representatives. 2.. goof' of insurance for professional and comprehensive liability inthe. aluountof $1 million per o courrenoe relating to all services performed as a private provider, including tail coverage for a nririirnum of 5 years subs D quent to the perfprrna'nc e of building code insp e otion. se ices. Individual qorporation Partnership I Lr_ . I -(signature) Print Name: Address, Telephone No. please use appropriate notary block. STATE OF FLORIDA COUNTY OF HILLSBOROUGH Individual Bel fore tbiS�-Clay of 20____, personally appeared who executed the forego'ing insi trument, and acknowledged before me that same was executed for the purp9ses therein expressed. . Print Corp oratioMI 1 n Name By: Print Christopher Smith Address:-ZQQ-N���� Miarn, FL 33172 Telephone, No, 813-574-5700 Corporation Befolleme,this 22ND day of MAY 20 M2 Pomona* appeared, of Lennar Homes LLeozporaiiort, on ..,behalf of the -state oorporation, who executed the f6rogoing instrumbilt and aoionowlod'god before mf, that same was executed for the purposes therein expressed. PrintPartnorshipNmue Bye (signature) Print Name: Address; • - TDIephDne Partnership Before one, this day of per&6naRy appeased p artum/agDnt on behalf of a partnership, who executed the foregoing instrument and acknowledgod before me that same was txecuteffor the purposesthorein expressed.. 'Pen on all.y known�X or-Produoodidepti-iication. Type of'identif.icationproducod Sipai m ofNotU." ASHLEE CALLAHAN WWI', NotaTypublic Stamp-, ASHLEE CALLAHM My COMMISSION # HH 295980, November 30,2026 F-XPIRE commission Expir es; VR/\ VIRTUAL REVIEW ASSIST Private r ovi er Plan Compliance Affidavit Address -Private Provider FIn: Virtual Review Assist, Inc. Private Provider: Debra Anne Klahr, BU 1967 Phone: $13-391-2959 Email: tu!pyCa)vii-tualre.vie*Aassist.coni Gainesville, FL 32601 and holds the appropriate license or certificate: Name: Debra Anne Klahr Florida License/Registration/Certification #(s) and description: FS468 Certified Standard Plans Examine` License #: PX2300 Signature of Reviewer. _7 SWORN AND SUBSCRIBED befgX e by Debra Anne Klahr being personally known to me� or having produced as identification and who being fully sworn and cautioned, state that the 4eego' is true and c7ect to the best of his/her knowledge or belief. 11 ZI ofNc t Name commission expires: °Aam ASHL CALLAHAN nlv�'*a COMMISSION HN 205900 EXPIRES. November 30,2026 [� CCTIVCMERCIAI BUILDING SERVICES DIVISION BUILDING PERMIT DATA SHEET TRACKING # FIRE MARSHAL # 1 FOLIO # 38064 Fallstone E] Potable Backflow Assembly l Coolerl� Rff "RESIDENTIAL DATE: 3/29/2 23 EXAMINER: bebra Klahr PX230C Electrical -Amp � �iF'f ��!' '► � Diu El Irrigation El Irrigatioo Backilow Assembly ly e Construction: -8 I Risk Category: Occupancy Load ( mpancy Classiiicaiion: Assembly business ay Care/Educational m.. , Facto Hazardous nstitmional' t3 D Mercantile .. . Residential R � Storage [ CTtilny Building Use: -�jINGLE FAMILY TOWNHOUSE f Alteration Level 1 Leve12 Level 3 New Construction ❑ Interior Finish ® Interior Remodel Ej Exterior Remodel EJ Addition [J Revision Overall Size: Number of Stories: Total Sq. FC: 28 X 63 2 256 Living Area: 2634 Covered Area: 452 # ofBedrooms: # of Baths: 2b Cost per square foot: Estimated Value: R df thin le Nile Btailt�u Metal [� Other cares: 24 Zoning: WipAborneDebris: Energy Code: ;Inside Outside 4 5-2 2 Flood one: X Base Flood Elevation: Finish FloorElevation: Hydrostatic Vents? ElYes No Sq. Ft. Enclosed Space below f> # of Vents: ettts: Total Sq. Inc Permanent Openings Central A/C ?C heat Pump :::E Window �i1C ® Gas A/C ®Cas heat Electric Heat Front Rear � Deft 21 As per Approved Site Plan LM _ P.V. 14 M 40_.,. c plow, �r. 85 �b 83.66 a J, .30 84.10 F.F. L. = 84,83 F,REL. =-I A qC OD s F d•S pit .d � �3`� 3 83 Ln �.. C 2.94 83.4 $3.9I <. . a . (-2)IM1111111 I,, IN S LET S-2 v "i , — -- 2a Pi 3.38 PROP. CROSSWALK —� 2.8SCa a (TYP.) ' BEET - l i 8 I 2,46 � TO THE PLAT THEREOF, RECORDED IN PLAT BOOK $9, PACiFf S) I I B-1 14, OF THE PUBLIC RECORDS OF PASCO COUNTY, FLORIDA, ---------------------- N II NOTES: -------- LOT GRADING TYPE = N/A PROPOSED PAD ELEVATION - N/A FRONT SETBACK = 15' { U SIDE SET BACK - IIT vg 100 s REAR SETBACK = 20' ALL WALKS 3.0' UNLESS NOTED ALL A/C 3.2'x3.2' /E/U/D= INGRESS EGRESS/ UTILffY/ DRAINAGE ESM'T LOT - 16957__SO. FT. LIVING AREA = 5336 SO. FT- o ENTRY = 672 SO FT. - GARAGE 1848 SO. FT. Ez COVERED LANAI = 868 SO. FT, ---SQ. LOT. PATIO = NA FT. 17 POOL AREA = NA SO. FT. "SO. CONC. DRIVE 2400 FT. o A/C & CONIC PAD 80 SO. FT. 0 10 0 SIDEWALK 324 SO. FT.' SIDE YARD SWALE = NA SQ. FT, CONSERVATION AREA = NA SO, FT. SEC, 15, TWP. 26 S, RNCi 21 E. PASCO COUNTY, FLORIDA (TOWNES AT AUTUMN PALMS) TRACT "H' LANDSCAPE BUFFER S 9, . P o ( o0 7 i 1 1 t i 3 I i l l 2 S7 ATTA RESID UNIT -A UNIT-8 k/NIT-C UNIT-C 1532 7516 w 1624 1624 � V V b 0 0 LOT LOT LOT LOT 16 15 14 13 70' 6.7 6{7' 6.7' SITE 1708 Water Oak Drive NOTRwRVEY} Tarpon Springs, Florida ... Phone: j727j-831-1990 F(ofidaPLS7123@gmaii.com LB# 8183 o' D o. n 10.0' ^F9q f� Scale: 1 ° = 20' °i Initia€ Anint 1 aril Ci inic 8 UNFf-C UNIT{ UN(T-6 UNIT -A C 7624 w 1624 1516 1532 � V w u5 , LOT o LOT LOT LOT N o LOT 12 11 to 9 1 8 Z 6.7" 6.7' Z ,f'4 y TO a X:w- a LOT OCCUPIED 68 % 16,36 AREA TO IRRIGATE 32 -�--% 6J 11.3 1 7 3' 100'..t 113, i t 113 100` 113 100 { i +; 7 3 i f 100 1 1.3' 1 1 3 10,0 tr.7Q;0x t .. ,t �9 d + t 4.,,�1 it •' 584'S6'0ELE(P) 11348'(P) "x'`24�. 28.30'(P) i 1800` P !`^"]E300 P I : II ', I IBdo' li Li 1$3.Ci(3'�� 7 H e.-i •'. ( , I II10 P : 7 16 0 P " L •+ 2833'(P) .`��. JOB i 4 :589'S60$'EjP( 0 ;,,: .. 3 ` �, 76_ .:27 3'T 7b '- 273 1596952 �-/tea-'.'�2.7 -..4 i x 15969520DID r, r. 15969520012 " " ' ., , ; 15369520013 EALLSTONE WAY ROADWAYTRACT"C S89'5608 E(P) 32&99 JP) p9 15969520014 15969520015 CITY OF ZEEiiTRHlLLS PROPOSED: LOWEST FLOOR ELE VATIAFFU/0 EASEMENT 15959520015 .LIVING AREA.84.83" . _I ALL ELEVATIONS REFERENCED NOTE: CONSTRUCTION GRADING PLANS PROPOSED ELEVATIONS AND TYP£ RADING, SHOWN HEREON ARETAKEN GARAGE AREA � TO NORTH ELEVATIONS REFERENCED TO OF HAVE MINIMAL FFORMTHE ENGINEERING PLANS "MASER UM 19 NORTH AMERiCAN VERTICAL DATUM OF VERTICAL DATUM OF )9$8 GRADING/ELEVATION ONSULTING PA', PROVIDED CLIENT 1988 iNAVD 88) INFORMATION _._ .. ____.�__. _ _ _ _.. _.. _... -. +0.85.- NATIONAL GEODETIC VERTICAL SURVEY ABEREVAMNS1 DATUM OF 1929 AjfaLDEI {DI DEED END OF C,_._._.._....._._...__. . PC PPERMANNTC RECORD Dfrtw!'}By.CWt. Party C6`eI@f:JH REVISIONS POINT NUN, FTNcF2 AT ALUMI^U.I CO UEE BFE 6ASE FISJOfl FLLVATiON FL OR Ft�V-"i EVAT1pN Et Ft FIEA C ASTiQN iiii—E iE -LOWFE-FLOORS 13F LOWES FOORELEVP.T16N PCP PFRPAANENF{ONTROL POINT RIO RAMC F. F/E -PQO. OUTAMEfJF RRS^RRit ROAD SPIKE Checked By: JH BM BENCHMARK ..URVE P PPV I FNT FOR FDGEQ EA.. Ell" FPS_WNT - I 1 URA Y R lS C S.D. JFO (M7 -MEASURED P P R N RG #'OF'WAY f PAGE E File" PI POINT pr iNTERSECEION SEC - SECTION ICI-CALC'UTAT'ED 4 PEN TERi.INE F/C -FENCE FCM FOUND CON(REIE MONUMENT MFS-EArEREDENDSFC'f'ION NCI -NO CORNER FOUND PK-PARKER KALON SN&D^0, r NAIL AND DISK LBee 1 AN Date of Site Plan:06.08-22 CWC POH-POINTOFSENNNING SIR--SETT/2"IRONRODLK-383 CLF^CHAIN IJNKFFNCE FIR - FOUND IRON PIPE O/A-OVERALL PO <:- POINT OF COMMFNCTMENT FIRM- TFMPORARYBENCH MARK DWG:L9-16-TC4+AP-SITE,DWG CMP CORRULA tD METAL PIPE FIR = FOUND IRpN RODOHW <OVFRHEAD WIRF(SI POE POINT ONLINE 106 ^'OPOE HANK COL^COLUMN FN&D- FOUNT) NAIL& DISK OR -OFHCtALRECORDS PPC = POINT OF REVERY CURVE ",WP fOWNSIi1P This SITE Plan Prepared for and Certified TO: CONC-CONCREIL FOP -FOUND OPEN PIPE 0) �-PLAT PREA- PERMANENTPEFFRFNCF. MONUMENT USA UTi IFY1-ASE.MENT Lennar Homes C/S- CONCRETE SIAe EPP- FOUND PINCHED PIPE PH -FIAT BOOK PUS= PU611C UTILITY EASEMENT SURFACE TYPE FENCES CONC At )MINUM FENCE r Mt,ti ASPI-IAl I VINYL FENCE -BRICK IN. DFENCE - SANf3 R, CHAIN FINK FENCE' �; t �COVERF.D OVERlIFA01OWEA ()HP --- OHP LEGEND: �"-�-- PROPOSED DRAINAGE FLOW j00.00) = PROPOSED GRADE E 00.00 = EXIST#NG GRADE 2° OAK ^= 70INGRESS EGRESS/U.E IF D.E APPARENT FLOOD HAZARD ZONE X COMMUNITY NO. 120235 (MAP NUMBER 12 10 1 C-0452-P) EFFECTIVE DATE' 09/26/2014 SURVEYOWS NOTES: s.) Current title Information on the subject Property had not been furnished to Initial Point Land Surveying, LLC, of the time of this site plan r 2.j This sketch was prepared without the bent of a title search, No instruments of record reflecting ownership, easements or rights•ofway were furnished to the undersigned, unless otherwise shown hereon. 3.) Roads, walks, and other similar items shown hereon were taken from engineering plans and are subject to survey. 4.) This site plan does not reflect nor determine ownership, 5.) This site plan is subject to matters shown on the FEW of "TOWNS N AUTUMN PALM 6.) Dimensions shown hereon are in feet and decimal portions thereof. 7.) Contractor and owner are to versify all setbacks, building dirriens(ons. and layout shown hereon prior to any construction, and immediately advise Initial Point Land Surveying, LLC of any deviation from information shown hereon. Failure to do so will be at users sale risk. see 4� To This certifies that ske properly was made under my s yractice for surveys as in Chapter 5J-17.fl51 throur 5J-1 053, FI rarer 2t pursuant to Sect 47� start:, ate; ' .01 ^t10:143 1001 Ji Jeff M. Hartir Wp.; Date FLORIDA PROFESS.: UR%WIPAND Pj'R LS#7123 LB#8193 NOT VALID .I 'jj� `iNATURE AND SEAL OF A FLOR1i JJ C7R AND MAPPER Builder Name/Owner Name ��Y�2 ' Control � County Parcel No. ... f / C)tL tl SubDiv: s is Address/Locations` f Classification/Type TRANSPORTATION IMPACT FEE Rate: Sq. Ft Unit: Exempt Yes 0 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_ PARKS AND RECREATION FEE Land Account Land Credit Land Total Recreation Account Recreation Credit Recreation Total Zone Total Amount $ Exempt =Yes = No How Determined I Land Account Land Credit Land Total Facility Account Facility Credit Facility Total Exempt 0Yes No How Determined Total Amount RESOURCE FEE ERU Total Amount Prepared RY ` �.. . Checked By NCI€RTIFI E OF OCCtIPANY WILL RE fSSIlED OR FINAL INSPECTION PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE BEEN PAID AND RECIPTED 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