HomeMy WebLinkAbout06-5868
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813}780-0020
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
5868
Permit #:5868 Issued:
Permit Type: GENERAL BUILDING PERMIT
Class of Work: 101-NEW CONST/SFR
Proposed Use: SINGLE FAMILY RESIDENTIAL
Sq. Feet: Est. Value:
Cost: 154,000.00 Total Fees: 3,808.85
Amount Paid: 3,255.50 Date Paid: 6/29/2006
Address: 39511 MEADOWOOD LP
ZEPHYRHILLS, FL.
Township: Range:
Lot(s): Block: Section:
Book: Page:
Subdivision: MEADOWOOD ESTATES
Parcel Number: 13-26-21-0140-00000-0690
Name: NEW MILLENNIAL LC
Addr: 7303 N. NEBRASKA AVE
TAMPA,FL. 33604
Phone: 813310-5041 Lie:
Work Desc: NEW SINGLE FAMILY RESIDENCE
Name: NEW MILLENNIAL LLC
Address: 7303 N. NEBRASKA AVE
TAMPA, FL 33604
MECHANICAL FEE
WATER CONNECTION RESIDENl
FIRE IMPACT FEE
67.41 RADON
419.00 WATER METER RES 3/4"
273.00 PUBLIC SAFETY 5%
17.50 SEWER CONNECTION RESIDENl
180.00 POLICE IMPACT FEE
26.35
1,616.00
254.00
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DUCTS INSTALLED PRE-SLAB CONSTRUCTION POLE 2ND ROUGH PLUMB
DUCTS INSULATED LINTEL PRE-METER WATER
SHEATHING FRAME MISC SEWER
MISC INSULATION WALL MISC MISC.
MISC. INSULATION CEILING MISC. MISC.
MISC. DRIVEWAY MISC. MISC.
REINSPECTION FEES: Reinspection fees will comply with Florida statute 553.80 (2)( c) when extra inspection
trips are necessary due to anyone of the following reasons: a) wrong address b) condemned work resulting
from faulty construction c) repairs or corrections not made when inspections called d) work not ready for
inspection when called e) permit not posted on job site f) plans not at job site g) work not accessible.
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 permits required from other governmental
entities such as water management, state agencies or federal agencies.
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
"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."
b(V\L~ ~-.
CONTRACTORS SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020
City of Zephyrhills Permit Application
Building Department
Fax-813-78U-UULl
Date Received
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Owner's Name
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Owner's Address
Fee Simple Titleholder NamJ
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Owner Phone Number
Owner Phone Number I
Owner Phone Number I
Fee Simple Titleholder Address
SUBDIVISION
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SQ FOOTAGE I
Loop
PARCEL 10#1
LOT #
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JOB ADDRESS
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DESCRIPTION OF WORK
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ADD/AL T
REPAIR
COMM
FRAME
\ 3 - 1.<0 - 1 \ - QlYC - OOD() -O<.oq 0
(~TAINED FROM PROPERTY TAX NOTICE)
S~GN D MOVE D
DEMOLISH
PROPOSED USE
TYPE OF CONSTRUCTION
NEW CONSTR
INSTALL
SFR
BLOCK
D
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OTHER
STEEL
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WORK PROPOSED
OTHER I
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....11....11.1111..11....11.1111......11111111111..........11...111.11.....11111...111....11..11....11111'.....11.11....11..111111111..'1.1111.11..
HEIGHT
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BUILDING SIZE
D BUILDING 1$ -7:' 300 I VALUATION OF TOTAL CONSTRUCTION
\ .
D ELECTRICAL 1$ 2 -,00 I AMP SERVICE 0 PROGRESS ENERGY V' D W.R.E.C.
~t.'c:. _
0 PLUMBING 1$ '3 'goo I (<.ow ~<<o c;A.y..ecJ ~l't /
D MECHANICAL 1$ ':) &0:::::' I VALUATION OF MECHANICAL INSTALLATION ~~
0 GAS D ROOFING 0 SPECIALTY D OTHER
FINISHED FLOOR ELEVATIONS I ~ \. 5~ I FLOOD ZONE AREA DYES DNO
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License # I (. Gc ISv'7~c;/ I
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License # I {3C- 13 0tJ7otJ 2.. I
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I N FEE CURRENT Y N
License # IR/Fo036~ II I
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, License # 1~~7'r9g I
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Address
COMPANY
REGISTERED
Address
ELECTRICIAN
SIGNATURE
Address
PLUMBER
SIGNATURE
Address
MECHANICAL
SIGNATURE
OTHER
SIGNATURE
Y/N
FEE CURRENT
Y/N
Address
License #
III 111111111111111111111111111 1111 ' I , 11111111111111..' 11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fonns
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster
COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms.
Minimum ten (10) working days after submittal date. Required on sIte, Construction Plans, Sanitary Facilities & 1 dumpster
All commercial requirements must meet compliance.
SIGN PERMIT Attach (2) sets of Engineered Plans.
....PROPERTY SURVEY required for all NEW construction.
I III, 1111111 11111 , j 1111I . III 1111111111111111111111111111111111 .. 1111111, 1111 , , . 1111111111 . 1I1111 , 1111111111111 , 111111 III · 1111111111111111111111111
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement Is required. (AlC upgrades over $5000)
.. 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 (Front of Application Only)
Reroofs Sewers Service Upgrades AlC Fences (PloUSurvey/Footage)
Driveways-Not over Counter if on public roadwaysooneeds 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 I, 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 "V" 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 properti~s, the. ow~er 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 s~t forth in
this affidavit prior to commencing construction. I understand that a separate perm~t may ?e requlr~d for elect~lc~.1 work,
plumbing, signs, wells, pools, air conditioning, gas, or other ~nstallations not specifically In?luded. In the.appllca\lon. A
permit issued shall be construed to be a license to proceed With the work a~d not as authorlo/ ~o vlolat~, cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the B~t1.dln9 OffiCial from the~eaft~r
requiring a correction of errors in plans, construction or violat~o~s o! any codes. Every ~ermlt Issued. shall become. Invalid
unless the work authorized by such permit is commenced Within SIX months o.f permit Issu~nce, or If work authorized. by
the permit is suspended or abandoned for a period of six (6) months after the time th~ work IS commenced: An extension
may be requested, in writing, from the Building Official for a period not t~ exceed mn~ty (.90) da~s and will demonstrate
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the Job IS conSidered abandoned.
WARNING TO OWNER: YOUR FAilURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT INYOUR
PAYING lWlCE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 117.03)
CONTRACTOR
Subscribed and swom to (or affirmed) before me this
by
Who Is/are personally known to me or has/have produced
as Identification.
OWNER OR AGENT
Subscribed and swom to (or affirmed) before me this
by
Who is/are personally known to me or haslhave produced
as Identification.
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed, printed or stamped
Name of Notary typed. printed or stamped
State of
FlC4"i JA
NOTICE OF COMMENCEMENT
P~S(D
County of
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property,
and in accordance with Chapter 713, Florida Statutes, the following information is provided in
this Notice of Commencement:
1. Description of Property: Parcel No. \'3. '2.1;., -0 'l \ - () \'-{O - O~()CO -- D'<::.q 0
"3<1.5\\ ('J\e~~o~\)ol lco() lCo'\- l,.,,\ -I'e,~tl~'.)"'~~ e~~..te~
(Legal description of the property and street address if available)
2. General Des~ription of Improvement \-J~~ 5i\...')\e. Fk~: l,,\ e.e&~ Je;Jt-e
1111111111111111I111111111111111111111111I111111111111111111
2006128406
3. Owner Information: Name
tJ"<N
M~~l~~i~ ~
L..'- l.
Address ('C~
~. Nt~r"'~"'A ~u~ City 1A.Mpl...
State
~L
Interest in Property:
~~
Rcpt:1009S84 Rec: 10.00
DS: 0.00 IT: 0.00
06/23/06 - Dpty Clerk
Name of Fee Simple Titleholder:
(If other than owner)
Address
4. Contractor: Name M'k~",l. ~ ':>\..('t~ \(...
R Address lW~ ~, "'''t~r~'''~(). .j\~Q.....
5. Surety: Name
Address
City
State
City
I":"'
\ ....,.,..p '-
State Pt. 3660<../
City
State
Amount of Bond: $
JED PITT"AN, PASCO COUNTY CLERK
06/23/06 09:~.m 1 {'11.9
OR BK 70:)1 PG ~
6. Lender: Name~e+\ 15- ~Ic-x:y-
Address31OC) C....l")-lrc\ At~ ~ <;n= Iqf~ City~. 'Pe-\-ec-~ h ,~ State H-.
o
7. Persons within the State of Florida designated by Owner upon whom notices or other
documents may be served as provided by Section 713.13 (1) (a) (7), Florida Statutes:
Name
Address
City
State
8. In addition to himself, Owner designates
of to receive a copy of the Lienor's Notice as
provided in Section 713.13 (1) (b), Florida Statutes.
9. Expiration date of Notice of Commencement (the expiration date is 1 year from the date
of recording unl s a ifferent date is specified.)
~ ~ V\ (\( \ \ \-t..1
day of S I.(A/ '-
, 20 t t.
Signature of Owner:
NEW MllLENIAl, L.l.C.
39511 MEADOWOOD lP. Permit #5868
SQ. FEET PRICE
MAIN OR LIVING: 1,750 $ 88.00
OTHER AREA UNDER ROOF: - $ 88.00
OTHER: - $ -
VALUATION $ 154,000.00
FEE SHEET $ 642.00
ADDRESS $ 30.00
DRIVEWAY $ 30.00
BUILDING: $ 714.84
ELECTRICAL: $ 144.45
PLUMBING: $ 96.30
MECHANICAL: $ 67.41
SUB.TOTAL $ 1,023.00
RADON: $ 17.50
TOTAL $ 1,040.50
SEWER: $ 1,616.00
WATER: $ 419.00
IRRIGATION: $ -
TOTAL: $ 2,035.00
WATER METER:I $
IRRIGATION METER $
180~00 I
FIRE DEPARTMENT FEES
PLANS TOTAL:
INSPECTION TOTAL:
PERMIT TOTAL
TOTAL: $ -
PUBLIC SAFETY IMPACT FEES
POLICE $ 254.00
FIRE $ 273.00
5% $ 26.35
TOTAL: $ 553.35
/'
~
'6.0
91.1
n
SUB-TOTAL $ 3,808.851
PARK IMPACT FEESI $ 769.56 ~
SIF'S: $ 4,314.00
100.0% $ 4,314.00
1.0% $ 43.14
TOTAL: $ 4,357.14
TI F'S: $ 1,588.00
99% $ 1,572.12
1% $ 15.88
TOTAL: $ 10,523.55 I
City of Zephyrhills - Building Dept
Phone: (813)-780-0020
FAX: (813)-780-0021
-----------------------------------------------------------------~
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I TO: Judy/Gail FROM: Karen I
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: FAX #: 727 -815- 7000 FAX #: 813- 780-0021 :
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: DATE: 6-9-06 # OF PAGES: 7 :
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: MESSAGE: It's me again. I need three more addresses. The contractor has assigned :
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: numerics but need to go through our normal process. Any problems, please call me. :
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: Thanks. :
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: Parcel: 11-26-21-0010-12400-0010 Type: Single Family Home :
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: Facing: 5th St (shows 5331 but vacant land) Lot #: 001 :
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: Parcel: 13-26-21-0140-00000-1220 Type: Single Family Home :
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: Facing: Meadowood Loop Lot#: 122 :
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: Parcel: 13-26-21-0140-00000-0690 Type: Single Family Home :
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: Facing: Meadowood Loop Lot#: 69 :
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--------------------------------------------------------_________J
Parcel Information for: 13-26-21-0140-00000-0690 Card: 001
Page 1 of 1
,.:n5\ \
Search Again Show MaD Building Schematic Unavailable Estimate Taxes
See Tax Collector Information - CurrenUDelinquent Taxes Frequently Asked Questions
ParcellD 13-26-21-0140-00000-0690 (Card: 001 of 001)
Classification 00 - Vacant Residential
Mailing Address Assessment (totals)
NEW MILLENIAL LC Ag Land $0
7303 N NEBRASKA AVE Land $18,055
TAMPA, FL 336044918 Building $0
Physical Address Extra Features $0
legal DescriDtion (First 4 Lines) Total Assessment $18,055
MEADOWOOD ESTATES PB 15 PG 106 Save Our Homes $0
LOT 69
OR 6888 PG 1015 Taxable Value $18,055
land Detail (Card: 001 of 001 )
Line Use Description Zoning Units II Type I Price I Cond Value
1 0100 SFR OOR2 8.000~ SF I 2.25 I 1.00 $18,000
2 0100 I SFR I 00R2 140.0 SF .39 1.00 $55
Additional land Informatior k' )
I Acres II 0.19 " Tax Area " 30ZH I Fema Cod'" XIV Res Code IIZHLGLP511
Building Information '---""
I Unimproved Parcel 0 I
Extra Features (Card: 001 of 001)
line I Description I Year II Units I Value I
Sales History
Previous Owner CSA PROPERTIES LLC
Year Month Book I Page TY~AmOunt
2006 03 6888/1015 II WD 39,000
2005 08 6565/1145 WD $15,000
1998 05 3938 / 1605 WD I $0 I
Search Again Show MaD Building Schematic Unavailable Estimate Taxes
See Tax Collector Information - CurrenUDelinquent Taxes Frequently Asked Questions
http://appraiser.pascogov . com! search! offline _ tca.asp?sec= 13&twn=26&mg=21 &sbb=O 140... 6/9/2006
Map - Pasco County Property Appraiser Page 1 of 1
Pasco County, Florida Section 13, Township 26, Range 211, 1.6 miles SE of ZE
When I click on the map:
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http://maps.pascogov.com/maps/showmap.asp?N ame=PascoMap _ N ew&mdi= 147 41973&m... 6/9/2006
JUN-13-2006 04:54 PM
NEW.MILLENNIAL
23687470
P.03
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JUN-13-2006 04:58 PM
NEW.M.ILLENNIAL
23687470
P.08
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(813) 236-0307
FAX#(813)236-8747
:~l)) II MEADOWOOD LOOP
Zephyrhills.FL.
13.26-21-0140-00000.0690
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Proposed Site Address House Sq. R.
1300 sq. It hving
400 $(1. ft. gamge
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17'10 tOlal MI. n.
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JUN-14-20136 16:52
PASCO COUNTY DEV REVIEW
727 815 7131313
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.City .of Zephyrhi116 - B~~g Dept
"Phone; (813F7 ~p-0020
FAX: (813)-7Sar.0021
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: FAX'#: 1.27--815-1000 FAX #: 813-1~0-0021 :
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i MBSSAGE: ~t" me ~ I n~ tbroe1nme eddresses. Tbe C(lDttaCtor has ..signed :
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. Lot#; 122 . " 3qS3~
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PERFORMANCE BUSINESS PRODUCTS, INC. 813-71e-8008 FAX 813-7111-71110
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WATER ACCT. NO.
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CITY OF ZEPHYRHILLS
ZEPHYRHIUS,FLORIDA
<0- ~~ 'J l'
DATE
OWNER!
RENTER
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N l2...L.U rTu....l l 0 r-r..rv-.. 1. i"I. 0 1 r
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~ATER
MAIUNG
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SERVICE ADDRESS 2q~1 \
.. ',:-, ~ " SHUT OFF SERVICE 0
TURN ON SERVICE Q.....--
INSTALL METER l3"
READ METER 0
CHECK METER 0
OTHER 0
5{4(1 WI'~
p~ -Ai 5~G::,~
WORK COMPLETED BY
& DATE COMPLETED
o SEWER
o GARBAGE
I9-"'IN CITY
o OUT CITY
-L No. OF UNITS
- DEPOSIT AMOUNT
- AMOUNT LAST BILL
_DATE
_ MISC. CHARGE
ORDER TAKEN BY
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Retain white form in office at all times.
Send pink & yellow forms to Water Service Dept.
Water Service Dept. to sign yellow form & retum to office.
mELD DENSITY TESTS
(Nuclear Density Gauge Method)
'E&r Ie!! INC-
GEOTECHNICAL & MATERIALS
ENGINEERING, lES11NG & lNSPEC110N
1'.0.80)( 1S"1J1. TAM1'A, 1'L011.lP^ ~~IiA4' 813/11'72.7811
PRo.TEeT: PROJECT NO: TL-8446-681
CLIENT: DATE: August 7, 2006
TEST LOCATION DEPTH DENSITY J\II01~1'URE COl\11'ACTION COMl'AC1'JON REMARKS
NO, WET DRV % TEST NO. 'V.
(pel) (pef)
Fill Mar.crial - 95% Req'd.
Building Slab Area
S' N. 8ml 5' E. of SW corner 0-12" 106.0 100.3 5.7 90" Thic1cnc~~ of rill
approximately 2'
2 Center of Slab 0-12" 116.3 111.0 'L8 100 ThiclC1lc~~ ofFill
approximately 2'
3 5' S, and 5' W. orNE corncr 0.12" 108.0 104.0 3.8 94" ihickness ofFill
811llfoximMcly 2'
OATli. SAMPLli:O:
8/4/06 AB
"Failure
REPORTS TO:
New Millc!\nial Homes
A tin: Sue ParI< (2)
COMPAC1'10N MJ\XIMllM DRY 01'TlMUM
TEST NO. DENSITY (Pd) MOISTURE
%
I 111.0 11.6
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'E5r ~ INC
GEOTECHNICAL & MA1ERlALS
ENGINEERING, lESTlNG & INSPECTlON
P.O. HOlt t573J . TAMl'A. \lL01UDA 3~~A4 .Il131172.78J1
FlELD DENSITY TESTS
(Nuclear Denllity Gauge Method)
CLIENT:
~
PROJECT NO:
TL-8446-681
PRO,lEeT
DATE:
August 11, 2006
'v" ::f4f 6K~R
TEST LOCATION DEPTH DENSITY MOISTURE COM!' ACTION COMP ACTION REMARKS
NO. WET DRY "10 TEST NO. 0/.
(pcl) (pel)
Pill Material ~ 95 % Req'd.
BlIilding Slab Area
4 RetC!lt ofTcst No.1 0-12" 11$.6 111.3 3.9 1 100 Thickncss of fill
S' N. and 5' E. of SW comer apprtlxlma\ely 2'
S Retest ofTcst No.3 0-12" 114.0 107.2 6.3 1 96 Thickness offill
S'S and 5' W. ofNE comer approximntely 2'
1)AT~ SAMPLED:
Sf! 0/06 CR
COMP ACTION MAXIMUM DRY Ol'TIMUM
TEST NO. DENSITY (pet) MOISTURE
0/1>
1 ) 11.0 11.6
REPORTS TO;
New Millcnniall-lomes
^ttn:SueP~ (2)
dtIIOOlt.O(l$.f41
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PASCO COUNTY, FLORIDA
Permit No. ' .' e;)-?? 6 <i
Date PermItted 6: ~.? 7- 0 ~
. ., ,
~erNa~l'InerName 7:l,l~/fR/.U'~C JC_CQntrol# . ... ..
County Parcel No. /3 -01& - C:)/- o/lIiJ- ~OOa?- M7()SubDlv: )o/~~~.
. ,
Classificationrrype of Us~
Sq Ft Unit:
Address/location $
TRANSPORTATION IMPACT FEE '
Exempt 0 Yes ~ No How D~termlned
Impact Fee Amount $, /;Sf?J? - Zone No.
SCHOOL IMPACT FI;E:
Account (056) Single-Family Detached House
(057) Mobile Home
(058) Other Residential ,
J.:I23) Collection Fee
Exempt U Yes "Q'NO How Determined
TAl:
Amount $
//$;f;~ 11/
PARKS AND RECREATION FEE
land Accoullt land Credit
Land Total
Recreation Account
Recreation.6rediC'
~..,..-......_-
R~creatl6n Total
Zone.
....~...........,. ..
TOTAL AMOUNT. $
.--,,...-p--
Ex~----o Yes 0 No
'---~_.------~-
HowOetermlned
~IBRARY fEJ;:
Land Account
land Credit Land T~.!~l,
. ---------~'-----~-
Facility Cr 't---~ Facility Total
Facility Account
Exempt
How Determined .
Total Amount
RESOURCE FE:E'
TOTAL AMOUNT
Prepared By
'~r'
Checked By
, ERU
cp)~
t/21l1J
(j I L))
NO C!:RTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION
PERFORMED UNTIL. THE TOTAL AMOllNTS LISTED HAVE
, . BEEN PAID ANI)
RECEIPTED FOR BY A CENTRAL PERMITTING OfFICE OF PASCO COUNTY
\ { ~{(.o-()lp
DATE
RECEIPT NO. qm2/
DATE
\.l -l&Oite
Acknowledgement below does not Imply accep~ahce of conc!Jrrence, bufslmply receipt .
the building permit owner on notice of this assessment a~d thE! cond/llon .