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HomeMy WebLinkAbout10-10866 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 10866 BUILDING PERMIT SINGLE FAMILY RESIDENTIAL , .. ,DNS ': E1" >' tn.' k' E 1, ,, , "'' .. n..'' 7I - '.;§ ,";e 1 . 3 ` " „, s . _ ;' V , Permit #:10866 Issued: 8/26/2010 Address: 37722 AARALYN RD BLDG 7 #69 Permit Type: GENERAL BUILDING PERMIT ZEPHYRHILLS, FL. Class of Work: 105 -NEW CONST /MULTI 5+ UNIT Township: Range: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Sq. Feet: Est. Value: Book: Page: Cost: 139,773.45 Total Fees: 10,603.04 Subdivision: EILAND PARK TOWNHOMES Amount Paid: 10,603.04 Date Paid: 8/26/2010 Parcel Number: 03- 26 -21- 0230 - 00000 -0690 4 7 .' '77 °: mo' r . .. ` `` . ( Name: LENNAR HOMES INC Name: LENNA HOMES Addr: 15550 LIGHTWAVE DRIVE #210 Address: 15550 LIGHTWAVE DR #210 CLEARWATER FL 33760 CLEARWATER FL 33760 Phone: (727)479 -1740 Lic: Phone: (727)479 -1700 Work Desc: NEW TOWNHOME 1371 SQ FT BLDG 7 # 69 S IN .72.00 L - I AL 135.00 PL :IN 90.00 MECHANICAL FEE 63.00 RADON 13.71 SEWER CONNECTION RESIDEN1 2,010.00 WATER METER RES 3/4" 311.25 WATER CONNECTION RESIDEN1 641.00 FIRE PLAN REVIEW FEES 93.27 FIRE INSPECTION FEES 13.50 POLICE IMPACT FEE 254.00 FIRE IMPACT FEE 273.00 PUBLIC SAFETY 5% 26.35 PARK FEES TOWNHOMES 769.56 SCHOOL IMPACT FEE -sfr /100% 1,740.00 SCHOOL IMPACT FEE -sfr/ 1% 17.40 TRAFFIC IMPACT FEE 99% 3,445.20 TRAFFIC IMPACT FEE 1% 34.80 4'11 ((e.:S6\k'a - - � 1 t . • 0 2 Roll - LU B N ULA TIN ILIN FOOTER BOND DUCTS INSULATED SEWER MISC. ROUGH ELECTRIC LINTEL MISC MISC. 1ST ROUGH PLUMB PRE -METER INSULATION WALL MISC. DUCTS INSTALLED WATER MISC DRIVEWAY PRE -SLAB SHEATHING MISC. MISC. CONSTRUCTION POLE FRAME MISC. MISC. REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection trips are necessary due to any one 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 prope • . If you intend to obtain financing, consult with your lender or an attorney before recording your noti • - commencement." _ ‘1144111110 K)g' fir 41 ft,' , CONTRAC r %�"'— I RE PERMITOFFI - - PE ' M � EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER Lennar Homes- 37722 Aaralyn Rd Bldg #7 unit#69 1371 sq ft- Permit #10866 SQ. FEET PRICE MAIN OR LIVING: 1,371 $ 101.95 OTHER AREA UNDER ROOF: - $ 91.00 OTHER: - $ - VALUATION $ 139,773.45 FEE SHEET $ 600.00 ADDRESS $ 30.00 DRIVEWAY $ 30.00 _ BUILDING: $ 672.00 ELECTRICAL: $ 135.00 PLUMBING: $ 90.00 MECHANICAL: $ 63.00 SUB -TOTAL $ 960.00 RADON: $ 13.71 TOTAL $ 973.71 SEWER: $ 2,010.00 WATER: $ 641.00 IRRIGATION: $ - TOTAL: $ 2,651.00 WATER METER: $ 311 25 I3/4 METER IRRIGATION METER $ FIRE DEPARTMENT FEES PLANS TOTAL: $ 93.27 INSPECTION TOTAL: $ 13.50 PERMIT TOTAL TOTAL: $ 106.77 PUBLIC SAFETY IMPACT FEES POLICE $ 254.00 FIRE $ 273.00 5% $ 26.35 TOTAL: $ 553.35 SUB -TOTAL $ 4,596.08) I PARK IMPACT FEES $ 769.56 I SIF'S: $ 1,740.00 100.0% $ 1,740.00 1.0% $ 17.40 TOTAL: $ 1,757.40 n T I F 'S : $ 3,480.00 n z6 811960 14 +/ ►1/Y� 99% $ 3,445.20 l� T 1% $ 34.80 � 3 Lt 7 TOTAL: $ 10,603.04 `f 1, l City of Zephyrhills BUILDING PLAN REVIEW COMMENTS 4 Contractor/Homeowner: 47/ P -6 Date Received: eq3 d Site: 3 7 7 7 D4 l // 4 7 #CO 9 Permit Type: Ale4d /UG 4 Avw /37/j, !`i Approved w /no comments: ❑ Approved w /the below comments: -F Denied w /the below comments: ❑ c , cl_at This comment sheet shall be kept with the permit and/or plans. / 4 , 1 „ 5 „, rn twIz �� Kalvin Plans Examiner Date Contractor and/o ,r• omeowner (Required when comments are present) 1&2 Family Dwelling Plan Review Comments 1. F.F.E. Shall be a minimum of 8" above the road elevation and a engineered site plan. 2. Lots shall be graded to comply with R401.3 of the F.B.C.. 3. Compaction test required if 24" or more of fill dirt is brought in at any one place. 4. Tie in survey required before pouring concrete. 5. Driveways require a R.O.W. use permit. 6. All setbacks shall be met. 7. All property markers shall be uncovered and marked at time of first inspection. 8. All A.D.A. requirements shall be met. 9. No electric, plumbing, mechanical, or framing shall be covered without an inspection and approval first. 10. Water heaters shall comply with section P607.3 of the .F.B.0 11. Foundation supports for A/C units shall be raised at least 3" above finished grade. M1308.1 12. Return air in all bedrooms. F.B.C. M1620.4 13. Smoke detectors are to be installed in accordance with R313.1 of the F.B.C. 14. All glazing requirements are to be in accordance with R308.4 of the F.B.C. 15. All means of egress are to be in accordance with R311 of the F.B.C. 16. "Green gypsum board" shall not be used as a backer in showers or tubs. R702.4.2 F.B.C. 17. Combination -type AFCI breakers are required at all locations requiring a AFCI type breaker. 18. Carbon monoxide alarms will be required in new construction that uses fossil - burning heating or appliances or an attached garage. They shall be installed in accordance with the F.B.C. 19. All plumbing, mechanical, and electrical shall be separate from unit to unit. This includes all underground plumbing and electric. 20. All 2008 N.E.C. Codes will be enforced. 21. Tamper- Resistant Receptacles in accordance with 406.11 of the 2008 N.E.0 22. In accordance with the Land Development Code, lots shall be sodded before final at least 10 feet around the structure. F.F.E.- Finished Floor Elevation F.B.C- Florida Building Code R.O.W. -Right Of Way A.D.A. - Americans with Disabilities Act 813 -78U-UUZU la ity 01 L I IyI I IIIIJ rui ma rNNnvauvi i / � � (j� /_ Kl �j Building Department D l Date Received- Phone Contact for Permitting 8 / ii ii, -- `o 3 6 3 Owner's Name _ 4 &V /A/Q A ri OAFS Owner Phone Number (TOO) � 9 C I -- / l c2 0 33w Owner's Address 4676 7"5 - 0 4/.6/17240,4 11C 1 A Ccfa,�444/ Z- . Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS 3 7722 4 Reo 2EPyy�e ,9/t4r, 33S o LOT # r !O 9 SUBDIVISION 674/gN0 . / RC� PARCEL ID# 0 3%240.2- 0.230— 00000-6 6 / fr i0 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED . ril NEW CONSTR ADD /ALT ( 1 SIGN I I MOVE I I DEMOLISH INSTALL REPAIR PROPOSED USE I ( SFR I COMM ( I OTHER TYPE OF CONSTRUCTION BLOCK I I FRAME I 1 STEEL I 1 OTHER I f DESCRIPTION OF WORK A/ EA/ Co/t/Sri2.uGT ON " 7 °w^/ 140A 4.E' BUILDING SIZE SQ FOOTAGE 1,3 7/ HEIGHT & J7VI 9 n B $ 3 / 65-0 VALUATION OF TOTAL CONSTRUCTION n ELECTRICAL $ g y0 AMP SERVICE ® PROGRESS ENERGY - 1 1 W.R.E.0 PLUMBING $ Y3 .75 MECHANICAL $ 1 /.7 9.5-- VALUATION OF MECHANICAL INSTALLATION I I GAS I 1 ROOFING I 1 SPECIALTY I I OTHER FINISHED FLOOR ELEVATIONS /, n / FLOOD ZONE AREA AYES ENO 7 BUILDER . //� COMPANY L,FivNAg. /7 / SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1 Address A ' 41' 0 At A✓E67ttN ' 8ic ND ---r;fteA, ce- 534o Q License # CSC/ 0R 557 .51 ELECTRICIAN ��/ COMPANY 40/yoN 3o i1/ �L 6 ..Z/Si C . SIGNATURE ,....3.....__ REGISTERED I Y) N 1 FEE CURRENT I Y / N Address , / (J y •.SK /f _ /ud/ tfie 336/ 3 License # EC 00 0.25 PLUMBER COMPANY BM l i . ' / / A > & A4 6 & SIGNATURE REGISTERED j Y/ N FEE CURRENT Y/ N Address l03V- mv Y 30 S /ZI vc21//Ea/F2 33576] License # CFG /So 0 MECHANICAL 8' /O //ET/C6'»ld /4/6, /16#977'vlr, 0 /�C- SIGNATURE REGISTERED ( Y/ N 1 FEE CURRENT I Y/ N Address // Q. •%O)C .53 a',yOA/Fr/O /Nr P License # CS'C OS$ 0 6 2 OTHER COMPANY Co N /6- ( qi i y /PcoF/NG, _rya. SIGNATURE r �1 REGISTERED ( Y/ N I FEE CURRENT Y / N I Address T2 //. 51/04L L /NE' &—vO �SP4411 /IfL4 LL3SW607 License # CO CO 57 99 RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -0 -W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Slit Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms: R -0 -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 $5000) Agent (for the contractor) or Power of Attomey (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 A/C Fences (Plot/Survey /Footage) Driveways -Not over Counter If on public roadways..needs ROW tions" NOTICE OF DEED RESTRICTIONS: The undersigned understands t t ais permit may oe fo comp) d e any which may be more restrictive than County regulations. The undersigned 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 on contractor is not licensed as required by law, both the owner and contractor may cited for a misdemeanor lviolation for under state law. If the owner or Intended contractor o County Building Inspection Division—Licensing r tS ction at 727-847 - intended work, they; are advised to contact th e Pasco 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign n as the portions of the "contractor Block" this application s not properly I censed is not entitled to le. y permitting prvileges Pasco contractor, that may ay b be an indication that P ` County. TRANSPORTATION IMPACTlUTILITReSIMPACT e Recovery F Fees may may app E COV i ER c YnEESt i o of new eng of that Transportation Impact Fees an d use in existing amended. in The undersigned dersi ned existing that such fees, in es, Pasco County be due, Ordinance number identified at the. 89-07 and of 90 -07, as amended. The undersig permitting. It is further understood that final Transportation power release. If the project does a certificate occupancy o� receiving a certificate of occupancy P 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. 5 CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as o f t "Flo ) ridf valuation on rk is 2,50 00.00 or more, I Homeowner's certify that I, the applicant, have been provided with a copy other than the owner", n I c by tha 1 have obtained Department Agriculture copy of the described document and promise in faith to other than the "owner ", ( certify that it to the "owner" prior to commencement. that all work CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all construction, this app an land de Application cation is will be done in compliance with all applicable laws regulating ion has hereby made to obtain a permit to do � installation ork will be to e m l eet t standards of all laws regulating ing commenced prior to issuance of a perm I and that construction, County and City codes, zoning regulations, l agencies es may apply ntended that is cer that I understand that the regulations of other government my responsibili to identify E nvt o nviron me n I ta I P otect bn- Cypress Bayheads SWetland Areas include but are not Environmentally t - Sensitive Department of En Lands, Water/Wastewater Treatment. Bayheads, Wetland Areas, Altering - Southwest Florida Water Management District - Wells, Cyp ress Y 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: P ermitted. Use of fill Is not allowed in Flood Zone unless ex ress) Y p If the fill material Is " be used bmitted at time of permitting which o is prepared r by a engineer - "compensating volume will be submitted by the State of Florida. If the fill material is to be used in Flood Zone "lA"he a connection ectlo the withtem yr mitted building using stem wall construction, I certify that fill will be used only to f 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 l attached per , application for lots les than the conditions of the building permit issued u nder the acre which are elevated by fill, an engineered drainage plan is required, T FOR THE , I promise In good faith to inform a remit may permitting required conditions ed forelectr electrical work this I a I d a AGENT trical w A this affidavit prior to commencing condttucting, l as s or other installations not specifically included in the application. plumbing, e d shall wells, pools, air to be a g issued shall be co #o be a license to proceed a the work a permit prevent the d ing Official from thereaalid permit aside I permit Building shall become invalid set aside any provisions errors in plans, construction or violations of any codes. Every p the technical codes, nor shat issuance requiring a correction of er unless the work autho rized by such permit is commenced within six months of permit issuance is commenced. u thorized b m a y p is es te d , I d or B abandoned for a period of six (6) months after ve days, ninety job i considered abandoned. ill co In writing, from the Building Official for a period not exceed ninety (90) days and will demonstrate ma requested, I Justifiable cause for the extension. If work ceases for ninety (90) consecutive MAY RESULT IN YOUR WARNING TO OWNER: YOUR FAILURE TO R PROPERTY. OP IC U I • 1*, ;l C' CAM IN PROVE E TS TO YOUR PRTY.. IF YOU -I ND ND 70 0 = AI FINANCING, CONSU T PAYING TWICE F IM „I ;li , ;__Y BEFORE RECD DING YOU WIT YOUR LE O FLORIDA JURAT (F.S. 117.03) ' CONTRALTO' '!'�_ ` OWNER OR AGENT Subscribed and sworn to (or a rni ' 4i0E «' s � v 40S ? Subscribed and sworn t � 4htJ L p2�N by produced Wh•1� -re personally known to me or has/have Identification. Who ear ersP onally known totem , r has /have p as Identification. 000" ./V T _ Notary Public Notary Public / Commi �o. . . . Z3 DD 77jf OZ3 Commission No. - ' Name of Notary typed, printed or stamp= _ ,., . Commission DD 774023 Name of Notary typed, pri ci '' :mmission DD 774; '� Q; � I arn N 108 9311100 . ,;far. s o es June 6, 2 12•00.369 0 , `'' Expires June 6, 2012 Vi a,,,, ,. T Fin ,, ;; ; �` 0undatlltlN TroyNonIMYroomr .1 385-1019 FORM 1100A -08 FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION Florida Department of Community Affairs Residential Performance Method A Project Name: 1371 ST CROIX 214 A N B Builder Name: LENNAR rr / Street Permit Office: CM 04- 4 1 City, State, Zip: TAMPA , FL , Permit Number. / O f3 41 Owner. LENNAR Jurisdiction: j' Design Location: FL, Tampa 1. New construction or existing New (From Plans) 9. Wall Types Insulation Area 2. Single family or multiple family Multi- family a. Concrete Block - Int Insul, Exterior R=4.1 998.67 ft b. N/A R= ft 3. Number of units, if multiple family 1 c. N/A R= ft 4. Number of Bedrooms 3 d. N/A R= ft 5. Is this a worst case? Yes 10. Ceiling Types Insulation Area 6. Conditioned floor area (ft 1371 a. Under Attic (Vented) R =30.0 686.00 ft b. N/A R= ft 7. Windows Description Area c. N/A R= ft a. U- Factor: Dbl, U =0.60 182.25 ft SHGC: SHGC =0.32 11. Ducts b. U- Factor: N/A ft2 a. Sup: Attic Ret: Attic AH: Interior Sup. R= 6, 265 ft SHGC: 12. Cooling systems c. U- Factor: N/A ft a. Central Unit Cap: 28 kBtu /hr SHGC: SEER: 14 d. U- Factor: N/A ft2 13. Heating systems SHGC: a. Electric Heat Pump Cap: 28 kBtu/hr e. U- Factor. N/A ft HSPF: 8.2 SHGC: 14. Hot water systems 8. Floor Types Insulation Area a. Electric Cap: 40 gallons a. Slab -On -Grade Edge Insulation R =0.0 1371.00 ft2 EF: 0.92 b. N/A R= ft2 b. Conservation features c. N/A R= ft2 None 15. Credits Pstat Glass /Floor Area: 0.133 Total As Built Modified Loads: 33.08 PASS Total Baseline Loads: 40.16 I hereby certify that the plans and specifications covered by Review of the plans and .••'• � •YKE ST A , .. .... this calculation are in compliance with the Florida Energy specifications covered by this , A. c,. ;FO - Code. ` calculation indicates compliance - ,, �.�• • `,.= s'..., with the Honda Energy Code. ,,,,.-ti ` "� ` 1 ` PREPARED B • 01 — i _ .4 Before construction is completed ' 1 , " '. - ti 6�: : DATE: this building will be inspected for t�7 i l&I , a compliance with Section 553.908 * ..-- 5 4, , - I her certify that this building, as design:.4 ' •m fiance Florida Statutes. .� ."./. ,: ' with the Florida Energy Code. - p 'O .. � R� . OWNER/AGENT:— L %, BUILDING 0 1 1,' L: if DATE: ��t7% DATE: A // - Compliance requires certificatio 1 by by the air air handler unit manufacturer that the air handler enclosure qualifies as certified factory- sealed in accordance with N1110.A.3. 3/24/2009 1:29 PM EnergyGauge® USA - FlaRes2008 Page 1 of 5 FORM 1100A -08 FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION Florida Department of Community Affairs Residential Performance Method A Project Name: 1371 ST CROIX 214 A N B Builder Name: LENNAR Street Permit Office: City, State, Zip: TAMPA , FL , Permit Number: Owner: LENNAR Jurisdiction: Design Location: FL, Tampa 1. New construction or existing New (From Plans) 9. Wall Types Insulation Area 2. Single family or multiple family Multi- family a. Concrete Block - Int Insul, Exterior R=4.1 998.67 ft b. N/A R= ft= 3. Number of units, if multiple family 1 c. N/A R= ft= 4. Number of Bedrooms 3 d. N/A R= ft= 5. Is this a worst case? Yes 10. Ceiling Types ypes Insulation Area 6. Conditioned floor area (ft') 1371 a. Under Attic (Vented) R =30.0 686.00 ft' b. N/A R= ft' 7. Windows Description Area c. N/A R= ft= a. U- Factor. Dbl, U =0.60 182.25 ft SHGC: SHGC =0.32 11. Ducts b. U- Factor. NIA ft' a. Sup: Attic Ret: Attic AH: Interior Sup. R= 6, 265 ft' SHGC: 12. Cooling systems c- U- Factor. N/A ft2 a. Central Unit Cap: 28 kBtu/hr SHGC: SEER: 14 d. U Factor. N/A ft' 13. Heating systems SHGC: a. Electric Heat Pump Cap: 28 kBtu /hr e. U- Factor: N/A ft' SHGC: HSPF: 8.2 14. Hot water systems 8. Floor Types Insulation Area a. Electric Cap: 40 gallons a. Slab -On -Grade Edge Insulation R =0.0 1371.00 Hz EF: 0.92 b. N/A R= ft2 b. Conservation features c. N/A R= ft2 None 15. Credits Pstat Glass/Floor Area: 0.133 Total As Built Modified Loads: 33.08 PASS Total Baseline Loads: 40.16 H�7 I hereby certify that the plans and specifications covered by Review of the plans and .• *-cTiE S .., this calculation are in compliance with the Florida Energy specifications covered by this - v . • ,. , p Code. lib V, indicates compliance i � `�•, 's . �+ e. C with the Florida Energy Code. f, ;. PREPARED B m• - % l ..4'.......... Before construction is completed a: 'ti v 3 :J, DATE: - t his building will be inspected for C :. ; a: compliance with Section 553.908 t e �. ° - f n Florida Statutes. I hereby certify that this building, as desig � r compliance • ;. d l c .. _ � , . pS ,S • with the Florida Energy Code. ' t7 D WE OWNER/AGENT: 1 1 //∎ BUILDING FF IAL: /i DATE: war/ i' ` ,,. ���� DATE: � � y� // - Compliance requires certificati. n by the air handler unit manufacturer that the air handler enclosure qualifies as certified factory- sealed in accordance with N1110.A.3. 3/24/2009 1:29 PM EnergyGauge® USA - FlaRes2008 Page 1 of 5 • PROJECT Idle: 1371 ST CROIX 214 A N B Bedrooms: 3 Adress Type: Street Address Building Type: FLAsBuilt Bathrooms: 0 Lot # Owner: LENNAR Conditioned Area: 1371 SubDivision: # of Units: 1 Total Stories: 2 PlatBook: Builder Name: LENNAR Worst Case: Yes Street Permit Office: Rotate Angle: 315 County: HILLSBOROUGH Jurisdiction: Cross Ventilation: No City, State, Zip: TAMPA , Family Type: Multi- family Whole House Fan: No FL , New/Existing: New (From Plans) Comment: CLIMATE / IECC Design Temp Int Design Temp Heating Design Daily Temp V Design Location TMY Site Zone 97.5 % 2.5 % Winter Summer Degree Days Moisture Range FL, Tampa FL_TAMPA_INTERNATI 2 39 91 75 70 645.5 54 Medium FLOORS # Floor Type Perimeter R -Value Area Tile Wood Carpet 1 Slab -On -Grade Edge Insulatio 54 ft 0 1371 ft 0.2 0.25 0.55 ROOF / Roof Gable Roof Solar Deck V # Type Materials Area Area Color Absor. Tested Insul. Pitch 1 Gable or Shed Composition shingles 723 ft 114 ft Medium 0.9 N 0 18.4 deg / ATTIC V # Type Ventilation Vent Ratio (1 in) Area RBS IRCC 1 Full attic Vented 300 686 ft N N CEILING V # Ceiling Type R -Value Area Framing Frac Truss Type 1 Under Attic (Vented) 30 686 ft 0.1 Wood WALLS Sheathing Framing Solar , # Ornt Adjacent To Wall Type Cavity R -Value Area R -Value Fraction Absor. 1 N Exterior Concrete Block - Int Insul 4.1 407.56 ft 0 0.8 2 E Exterior Concrete Block - Int Insul 4.1 591.11 ft 0 0.75 DOORS # Ornt Door Type Storms U -Value Area 1 E Insulated None 0.6 20 ft2 3/24/2009 1:29 PM EnergyGauge® USA - FlaRes2008 Page 2 of 5 WINDOWS Window orientation below is as entered. Actual orientation is modified by rotate angle shown in "Project' section above. Overhang V # Omt Frame Panes NFRC U- Factor SHGC Storms Area Depth Separation Int Shade Screening 1 N Metal Low -E Double Yes 0.6 0.32 N 31.5 ft 1 ft 0 in 10 ft 0 in HERS 2006 None 2 E Metal Low -E Double Yes 0.6 0.32 N 63 ft 1 ft 0 in 10 ft 0 in HERS 2006 None 3 N Metal Low -E Double Yes 0.6 0.32 N 31.5 ft 1 ft 0 in 1 ft 5 in HERS 2006 None 4 N Metal Low -E Double Yes 0.6 0.32 N 9 ft 1 ft 0 in 1 ft 5 in HERS 2006 None 5 E Metal Low -E Double Yes 0.6 0.32 N 47.25 ft 1 ft 0 in 1 ft 5 in HERS 2006 None INFILTRATION & VENTING / — Forced Ventilation — Run Time Fan V Method SLA CFM 50 ACH 50 ELA EgtA Supply CFM Exhaust CFM Fraction Watts Default 0.00036 1295 6.03 71.1 133.7 0 cfm 0 cfm 0 0 COOLING SYSTEM ✓ # System Type Subtype Efficiency Capacity Air Flow SHR Ductless 1 Central Unit None SEER: 14 28 kBtu /hr 840 cfm 0.75 False HEATING SYSTEM • # System Type Subtype Efficiency Capacity Ductless 1 Electric Heat Pump None HSPF: 8.2 28 kBtu/hr False HOT WATER SYSTEM ✓ # System Type EF Cap Use SetPnt Conservation 1 Electric 0.92 40 gal 60 gal 120 deg None SOLAR HOT WATER SYSTEM FSEC Collector Storage Cert # Company Name System Model # Collector Model # Area Volume FEF None None ft2 DUCTS / - Supply — — Return — Air Percent V # Location R -Value Area Location Area Leakage Type Handler CFM 25 Leakage QN RLF 1 Attic 6 265 ft Attic 8 ft Default Leakage Interior 3/24/2009 1:29 PM EnergyGauge® USA - FlaRes2008 Page 3 of 5 TEMPERATURES Programable Thermostat: Y Ceiling Fans: Cooling X J X e Feb X Ma (( X Ap X Ma X Ju Jul (X Au X Sep X O X Nov X De Heating 7C ] Jan X Feb t X] Mar [ )C ' A Ap pr r l X J Ma y X " Jun n rd Jul [X1 Au uf Xi Se p f X ct I Oct IN Nov f X] Dec Venting X11111 Jan .X Feb [X] Mar [X Apr [X111111 May X' Jun Jul [X Aug X Sep X Oct Ni Nov IXl Dec Thermostat Schedule: HERS 2006 Reference Hours Schedule Type 1 2 3 4 5 6 7 8 9 10 11 12 Cooling (WD) AM 78 78 78 78 78 78 78 78 80 80 80 80 PM 80 80 78 78 78 78 78 78 78 78 78 78 Cooling (WEH) AM 78 78 78 78 78 78 78 78 78 78 78 78 PM 78 78 78 78 78 78 78 78 78 78 78 78 Heating (WD) AM 66 66 66 66 66 68 68 68 68 68 68 68 PM 68 68 68 68 68 68 68 68 68 68 66 66 Heating (WEH) AM 66 66 66 66 66 68 68 68 68 68 68 68 PM 68 68 68 68 68 68 68 68 68 68 66 66 3/24/2009 1:29 PM EnergyGauge® USA - FlaRes2008 Page 4 of 5 • FORM 1100A -08 Code Compliance Cheklist Residential Whole Building Performance Method A - Details ADDRESS: PERMIT #: TAMPA, FL, INFILTRATION REDUCTION COMPLIANCE CHECKLIST COMPONENTS SECTION REQUIREMENTS FOR EACH PRACTICE CHECK Exterior Windows & Doors N1106.AB.1.1 Maximum: .3 cfm/sq.ft. window area; .5 cfm/sq.ft. door area. Exterior & Adjacent Walls N1106.AB.1.2.1 Caulk, gasket, weatherstrip or seal between: windows /doors & frames, surrounding wall; foundation & wall sole or sill plate; joints between exterior wall panels at comers; utility penetrations; between wall panels & top /bottom plates; between walls and floor. EXCEPTION: Frame walls where a continuous infiltration barrier is installed that extends from, and is sealed to, the foundation to the top plate. Floors NI 106.AB.1.2.2 Penetrations /openings > 1/8" sealed unless backed by truss or joint members. EXCEPTION: Frame floors where a continuous infiltration barrier is installed that is sealed to the perimeter, penetrations and seams. Ceilings N1106.AB.1.2.3 Between walls & ceilings; penetrations of ceiling plane to top floor; around shafts, chases, soffits, chimneys, cabinets sealed to continuous air barrier, gaps in gyp board & top plate; attic access. EXCEPTION: Frame ceilings where a continuous infiltration barrier is installed that is sealed at the perimeter, at penetrations and seams. Recessed Lighting Fixtures N1106.AB.1.2.4 Type IC rated with no penetrations, sealed; or Type IC or non -IC rated, installed inside a sealed box with 1/2" clearance & 3" from insulation; or Type IC with < 2.0 cfm from conditioned space, tested. Multi -story Houses N1106.AB.1.2.5 Air barrier on perimeter of floor cavity between floors. Additional Infiltration reqts NI 106.AB.1.3 Exhaust fans vented to outdoors, dampers; combustion space heaters comply with NFPA, have combustion air. OTHER PRESCRIPTIVE MEASURES (must be met or exceeded by all residences.) COMPONENTS SECTION _ REQUIREMENTS CHECK Water Heaters N1112.AB.3 Comply with efficiency requirements in Table N112.ABC.3. Switch or clearly marked circuit breaker (electric) or cutoff (gas) must be provided. External or built -in heat trap required. Swimming Pools & Spas N1112.AB2.3 Spas & heated pools must have covers (except solar heated). Non - commercial pools must have a pump timer. Gas spa & pool heaters must have a minimum thermal efficiency of 78 %. Heat pump pool heaters shall have a minimum COP of 4.0. Shower heads NI 112.AB.2.4 Water flow must be restricted to no more than 2.5 gallons per minute at 80 PSIG. Air Distribution Systems N1110AB All ducts, fittings, mechanical equipment and plenum chambers shall be mechanically attached, sealed, insulated and installed in accordance with the criteria of Section N1110.AB. Ducts in unconditioned attics: R-6 min. insulation. HVAC Controls N1107.AB.2 Separate readily accessible manual or automatic thermostat for each system. _ Insulation N1104.AB.1 Ceilings -Min. R -19. Common walls -frame R -11 or CBS R -3 both N1102.B.1.1 sides. Common ceiling & floors R -11. 3/24/2009 1 :29 PM EnergyGauge® USA - FlaRes2008 Page 5 of 5 ENERGY PERFORMANCE LEVEL (EPL) DISPLAY CARD ESTIMATED ENERGY PERFORMANCE INDEX* = 82 The lower the EnergyPerformance Index, the more efficient the home. ■ 1. New construction or existing New (From Plans) 9. Wall Types Insulation Area a. Concrete Block - Int Insul, Exterior R =4.1 998.67 ft' 2. Single family or multiple family Multi-family 3. Number of units, if multiple family 1 b. WA R= ft2 c. N/A R= ft2 4. Number of Bedrooms 3 d. N/A R= ft2 5. Is this a worst case? Yes 10. Ceiling Types Insulation Area 6. Conditioned floor area (ft 1371 a. Under Attic (Vented) R =30.0 686.00 ft' 7. Windows" Description Area b. WA R= ft2 a. U- Factor: DbI, U =0.60 182.25 ft2 c. N/A R= ft: SHGC: SHGC =0.32 11. Ducts b. U- Factor. WA ft' a. Sup: Attic Ret: Attic AH: Interior Sup. R= 6, 265 ft' SHGC: 12. Cooling systems c. U- Factor. N/A ft2 a. Central Unit Cap: 28 kBtu/hr SHGC: SEER: 14 d. U- Factor: N/A ft' SHGC: 13. Heating systems e. U- Factor. N/A ft2 a. Electric Heat Pump Cap: 28 kBtu /hr SHGC: HSPF: 8.2 14. Hot water systems 8. Floor Types Insulation Area a. Electric a. Slab -On -Grade Edge Insulation R =0.0 1371.00 ft' Cap: 40 gallons b. N/A R= ft2 EF: 0.92 c. N/A R= ft2 b. Conservation features None 15. Credits Pstat I certify that this home has complied with the Florida Energy Efficiency Code for Building Construction through the above energy say' g features which will be installed (or exceeded) •' 01 THE ST inspection. Othe _ r = 0 • P ,�, � EPL Display Card will be completed � v :. � in this home before final ins t. based on installed Code compliant fea ' ,.�', . o , � • �� � a; 0 11 "` '� .� �� Date: Z 0 0 . a Builder Signature: Address of New Home: City /FL Zip: •• Air' 5 o wE *Note: The home's estimated Energy Performance Index is only available through the EnergyGauge USA - FlaRes2008 computer program. This is not a Building Energy Rating. If your Index is below 100, your home may qualify for incentives if you obtain a Florida Energy Gauge Rating. Contact the Energy Gauge Hotline at (321) 638 -1492 or see the Energy Gauge web site at energygauge.com for information and a list of certified Raters. For information about Florida's Energy Efficiency Code for Building Construction, contact the * *Label required by Section 13- 104.4.5 of the Florida Building Code, Building, or Section B2.1.1 of Appendix G of the Florida Building Code, Residential, if not DEFAULT. EnergyGauge® USA - FlaRes2008 wrightsoft Building Analysis Job: ST.CR01X 1371 �9 Date: 6/20/2007 Entire House By: S.P. Bayonet Plumbing Heating and Air 8950 New York Ave. Hudson, FL 34674 Phone: 727 -868 -4636 Fax: 727 -863 -7237 Pro'ect Information For: LENNAR FL Desi • n Conditions Location: Indoor: Heating Cooling Tampa, FL, US Indoor temperature ( °F) 70 75 Elevation: 10 ft Design TD ( °F ) 29 20 Latitude: 28 °N Relative humidity ( %) 95 50 Outdoor: Heating Cooling Moisture difference (gr/Ib) 75.4 63.5 Dry bulb ( °F 41 95 Infiltration: Daily range - 15 (L ) Method Simplified Wet bulb (° - 80 Construction quality Average Wind speed (mph) 15.0 7.5 Fireplaces 0 Heatin • Component Btuh/ft Btuh % of load Walls 4.2 2569 14.9 Wal- Ventilation Glazing 37.3 6908 40.2 sects Doors 17.6 353 2.1 Ceilings 0.9 640 3.7 Infiltration Floors 33.6 2036 11.8 Infiltration 3.3 2659 15.5 Ducts 803 4.7 Piping Glazing Humidification 0 0 Floors Ventilation 1227 7.1 0 Ceilings Adjustments 0 Total 17195 100.0 Coolin • Component Btuh/ft Btuh % of load Walls 3.3 2001 9.7 Walls ventilation Glazing 60.7 11226 54.6 Internal Gains Doors 20.5 409 2.0 1 Ceilings 1.8 1253 6.1 , " ' I Floors 0 0 0 • r Ducts Infiltration 1.1 920 4.5 G infiltration Ducts 1206 5.9 Ventilation 831 4.0 Internal gains 2720 13.2 Ceilings Blower Adjustments p 0 Glazing Other Total 20566 100.0 Overall U -value = 0.273 Btuh/ft - °F Data entries checked. ,„ ,1„ s ofrt- Right - Suite® Universal 7.1.08 RSU05714 2009 -Mar-25 09:00:24 A /cC 1371 ST CR X.rup Cato = MJ8 Orientation = 3 Page 1 Wri htsoft • Project Summary Job: ST.CROIX 1371 9 Date: 6/20/2007 Entire House By: S.P. Bayonet Plumbing Heating and Air 8950 New York Ave, Hudson, FL 34674 Phone: 727-868-4636 Fax: 727 - 863 -7237 Project Information For: LENNAR FL Notes: Desi • n Information Weather: Tampa, FL, US Winter Design Conditions Summer Design Conditions Outside db 41 °F Outside db 95 °F Inside db 70 °F Inside db 75 °F Design TD 29 °F Design TD 20 °F Daily range L Relative humidity 50 % Moisture difference 64 gr /Ib Heating Summary Sensible Cooling Equipment Load Sizing Structure 15164 Btuh Structure 18529 Btuh Ducts 803 Btuh Ducts 1206 Btuh Central vent (38 cfm) 1227 Btuh Central vent (38 cfm) 831 Btuh Humidification 0 Btuh Blower 0 Btuh Piping 0 Btuh Equipment load 17195 Btuh Use manufacturer's data n Rate /swing multiplier 1.00 Infiltration Equipment sensible load 20545 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Average Fireplaces 0 Structure 2616 Btuh Ducts 261 Btuh Heating Cooling Central vent (38 cfm) 1640 Btuh Area (ft 1371 1371 Equipment latent load 4516 Btuh Volume (ft 10968 10968 Air changes/hour 0.45 0.23 Equipment total load 25061 Btuh Equiv. AVF (cfm) 82 42 Req. total capacity at 0.70 SHR 2.4 ton Heating Equipment Summary Cooling Equipment Summary Make LENNOX Make LENNOX Trade Trade Model Cond ARI, ref no. Coil ARI ref no. Efficiency 8.2 HSPF Efficiency 14 SEER Heating Input Sensible cooling 0 Btuh Heating output 0 Btuh @ 47 °F Latent cooling 0 Btuh Temperature rise 0 °F Total cooling 0 Btuh Actual air flow 1000 cfm Actual air flow 1000 cfm Air flow factor 0.063 cfm /Btuh Air flow factor 0.051 cfm /Btuh Static pressure 0 in H2O Static pressure 0 in H2O Space thermostat Load sensible heat ratio 0.82 Bold/italic values have been manually overridden Printout certified by ACCA to meet all requirements of Manual J 8th Ed. wrightsort Right- Suite® Universal 7.1.08 RSU05714 2009 - Mar -25 09:00:24 .CCN 131 ST CROIX rup Calc = MJB Orientation = S Page 1 • R 11111111111111111111111111! 11111111111111111111111111111 I U I 2010120775 Rept:1322173 Rec: 10.00 DS: 0.00 IT 0.00 08/23/10 K. Garcia, Dpty Clerk NOTICE OF COMMENCEMENT Permit No. PAULA S.0'NEIL,Ph.D.PASCO CLERK & COMPTROLLER 08/23/10 02:2m 1PG Property Identification No. 03 -26 -21 -0230- 00000 -0690 OR BK 84 3 THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. 1. Description of property (legal description :) Lot 69 EILAND PARK TOWNHOMES Plat Book 60, Page 102. a) Street Address: 37722 Aaralvn Road Zephvrhills, FL 33542 2. General description of improvements: Single Family Residence / Pool / Screen Enclosure / Fence 3. Owner Information a) Name and address: Lennar Homes Inc. 15550 Lightwave Drive Suite 210 Clearwater, FL 33760 • b) Name and address of fee simple titleholder (if other than owner) c) Interest in property 4. Contractor Information a) Name and address: Steve Smith -- 15550 Lightwave Drive Suite 210 Clearwater, FL 33760 • b) Telephone No.: (727) 479 -1733 Fax No. (Opt.) 5. Surety Information a) Name and address: N / A b) Amount of Bond: N / A • c) Telephone No.: Fax No. (Opt.) 6. Lender a) Name and address: N / A Phone No. 7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served: a) Name and address: Steve Smith -- 15550 Lightwave Drive Suite 210 Clearwater, FL 33760 b) Telephone No.: (727) 479 -1733 Fax No. (Opt.) 8. In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.13(1) (b), Florida Statutes: a) Name and address: N / A b) Telephone No.: Fax No. (Opt.) 9. Expiration date of Notice of Commencement (the expiration date is one year from the date of recording unless a different date is Specified): WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. STATE OF FLORIDA COUNTY OF PASCO Signature of Owner or Owner's Authorized Officer/Director /Partner/Manager Steve Smith Print Name The foregoing instrument was acknowledged before me this 12 day of August , 2010 , by Steve Smith as Director of Construction (type of authority, e.g. officer, trustee, attorney in fact) for (name of party on behalf of whom ' ment was executed). Personally Known X OR Produced Identification Notary Signature Type of Identification Produced Name (print) Elissa M. Holleran Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true to the best of my knowledge and belief. .49:71%.:N ELISSA M. HOLLERAN .; 4•■ ..= Commission DD 774023 �a � "� ' - Signature of Natural Person Signing Above FORMS /NOC,rvsd2007 . -� d ; Expires June 6, 2012 '�' Sanded T n, Troy Fein Inwrance 800- 385.7019 STATE OF FLORIDA, COUNTY OF PASCO THIS IS TO CERTIFY THAT THE FOREGOING IS A TRUE AND CORRECT COPY OF THE DOCUMENT ON FILE OR OF PUBLIC RECORD IN THIS OFFICE WITNESS Y HAND A OFFICIAL SEAL THIS DAY OF • 2 4 � P UA LA S. O'NE , CLE &COMPTROLLER �`Y DEPUTY CLERK • a; = 1�i ; PASCO COUNTY, FLORIDA Permit No. M.50ro Date Permitted Q- Zt -/O Builder Name /Owner Name t eiv/,1ay I77JYt'1� Control # County Parcel No. 03 26-21-6 -b 2.�o ... /Alm -406 SubDiv: �� / G( �6�i Address /Location 8772 Z /44-01-(7 /j ,Zi /J/dj - 7 # /O � Classification/Type of Use 'Taal Gi TRANSPORTATION IMPACT FEE , Rate: Sq Ft Unit; /37/ Exempt D Yes 0 No How Determined Impact Fee Amount $ ? � , A7 r Zone No. TAZ: SCHOOL IMPACT FEE /;75-74 Account (056) Single- Family Detached House Amount $ . (057) Mobile Home (058) Other Residential 123) Collection Fee Exempt Yes D No How Determined PARKS AND RECREATION FEE Land Account Land Credit Land Total Recreation Account Recreation Credit Recreation / Total Zone TOTAL AMOUNT $ 769. 56 Exempt 0 Yes 0 No How Determined LIBRARY FEE Land Account Land Credit Land Total Facility Account Facility Credit Facility Total Exempt ❑ Yes 0 No How Determined Total Amount /CV/ RESOURCE FEE ERU TOTAL AMOUNT Prepared By Checked By NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY Acknowledgement below does not Imply acceptance of concurrence, but simply receipt of a copy of this form, placing the building permit owner on notice of this assessment and the conditions of payment for same. DATE RECEIVED BY RECEIPT NO. DATE BY . ��.-r^' � - -~ - - • • , •/�`J� : v •:: "r. • •`�SC,: ' }.Nl Y ' |l'+ /DA CONTRACTOR #: 999999 -~ ' � I�f/cE IA-Fick L NAME: LENNAR TAMPA DA:oIEIO� R :".::EiPT Hil'irR, '2 963 1, • ADDR: MANAGERS ACCOUNT ` 1 OFF��CE: LAND G LAKES C/ST: 15550 LIGHTWAVE DR, FOR: SUITE 210 CLEARWATER FL 33760 CHECK # 07452 SOLID WAST C ZHL BP# 1O�3, 10864,10865 0867 (5) TOTAL CONTRACTOR: 999999 BLD PERMlTS` TOTAL AMOUNT: 39..1O ACCNT COMPNY ACCOUNT CENTER AMOUNT DESCRIPTION/PERMT DATA DR/CR 114 B45O - 363O0O - 2 7.82 ****** SOLID WASTE FEE 6O 114 B450 - 363000 - 2 7.82 ****** SOLID WASTE FEE 60 114 B450 - 36 - 2 7.82 ****** SOLID WASTE FEE 60 114 B450 - 363000 - 2 7.82 ****** SOLID WASTE FEE 60 114 B45O - 363000 - 2 7.82 ****** SOLID WASTE FEE 60 �� h |xECEIVED BY �x�� -_- °^� °~,= -- /l� 3/ 67-Q-43-- .. PASCO COUNTY, FLORIDA >re • a f* / 0 it IVY' Permit No. Date Permitted Q. %O Builder Name /Owner Name Control # County Parcel No. 03' 26-2/-6 23 _ of d ._46& SubDiv: � ad'I, Address /Location e 77 2 Z G A ,Z( /l) ) 7 # (O Classification/Type of Us - TRANSPORTATION IMPACT FEE Rate: Sq Ft Unit: 137 Exempt I I Yes I ( No How Determined Impact Fee Amount $ ' / �&0 / Zone No. TAZ: SCHOOL IMPACT FEE / Account (056) Single - Family Detached House Amount $ /7.57'/ `b (057) Mobile Home (058) Other Residential 123) Collection Fee Exempt [] Yes [l No How Determined PARKS AND RECREATION FEE Land Account Land Credit Land Total Recreation Account Recreation Credit Recreation Total Zone TOTAL AMOUNT $ 769, ,5 Exempt Yes 1 ( No How Determined LIBRARY FEE Land Account Land Credit Land Total Facility Account Facility Credit Facility Total Exempt 1 1 Yes ( 1 No How Determined Total Amount /0/`9" RESOURCE FEE a ERU TOTAL AMOUNT 7 Prepared By Checked By NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY Acknowledgement below does not imply acceptance of concurrence, but simply receipt of a copy of this form, placing the building permit owner on notice of this assessment and the conditions of payment for same. 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