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5335EigNh Street
Zephyrhi|ks, FL33542
Phone: (813)78O-0O20
Issue Date: 09/26/2022
Permit T Me: Buildinc
New (Residential)
21
Name: LENNAR HOMES LLC-OWNER
Permit Type: Building New (Residential)
Class of Work: Townhome
Address: 40OOVvCypress St2O0
CONSTRUCT T0WwHOME1634 SIDFT[[
S|p1 percent Fee
Building Permit Fee
Address Fee
Public Safety Impact Fee -Adm|n
Water Connection Residential Fee
School Impact Fee-Ging|nFami|y
Mechanical Permit Fee
Irrigation 3/4 Mom,
Transportation Impact Fee 'City
Transportation Impact Fee
Building Valuation: $234,987.90
Electrical Valuation: $35,24D19
Mechanical Valuabon:$1o,44e1n
Plumbing Valuation: $23,488.r9
Total Valuation: $310.1n4.O3
Total Fees: $14,482J8
Amount Paid: $14�62.78
Date Paid: 9/26/2022 4:47:17PM
$3353 Fire Wall/Smoke Wall Inspection
$15l0
$1.214.94 Park Impact raa-Gingle Fanxly/Townxomo
*768.56
*30.00 Public Safety Impact Fee -Police
$254.00
$26.35 Electrical Permit Fee
$21024
*1.010.00 Driveway Fee
$4e.00
$3.353.00 AdminFee / (Provider Service >
$180.00
$122.25 Sewer Connection Residential Fee
$2.090.00
$732.71 x/4Water Meter Residential Connection Fee
*732.71
$34.80 Plumbing Permit Fee
$157.49
$3,445.20
REUNSPECTION FEES: (c)VVith respect to Reinspection foes will comply with Florida Statute /2
local government shall| fee offour / the amount mfthe fee imposed fwrtheinitial i
Complete Plans, Specifications add fee Must Accompany Application. All work shall be performed in
accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 City of Zephyrhills Permit A lication Fax-813-780-0021
Building Department
Date Received
Phone Contact for Permitting 908 770 7763
Owner's Name Lennar Homes, LLC Owner Phone Number 813.574.5700
Owner's Address 4301 W Boy Scout Blvd Ste 600 Tampa, FL 33607 Owner Phone Number
Fee Simple Titleholder Name N/A Owner Phone Number
Fee Simple Titleholder Address NIA
JOB ADDRESS 37685 Leafside Lane LOT # 0030
SUBDIVISION Zephyr Court PARCEL ID# 15-26-21-0220-00000-0300
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR 8 ADD/ALT SIGN 0 DEMOLISH
P INSTALL REPAIR
PROPOSED USE u v u SFR E:] COMM L� OTHER
TYPE OF CONSTRUCTION 10 BLOCK 0 FRAME STEEL O
DESCRIPTION OF WORK I Single family Residence / Pool / Screen Enclosure / Fence
BUILDING SIZE U/R SF 2086 SQ FOOTAGE 1634 HEIGHT 2 Story
r'rTrrrl'rrrTr'7'T'-ITrT_r1r_ —t—m 1"Yt�me ... mrm# r7Trrr'Immr—r
BUILDING $ $234,987.90 VALUATION OF TOTAL CONSTRUCTION tl { `l
!.1 (ELECTRICAL $ $35,248.19 -�
� • t AMP SERVICE
PLUMBING $ $23,498.799
® PROGRESS ENERGY ® W.R.E.C.
t
MECHANICAL $ $16,449.15 VALUATION OF MECHANICAL INSTALLATION M, .
=GAS I �/ I ROOFING SPECIALTY OTHER °a
FINISHED FLOOR ELEVATIONS • FLOOD ZONE AREA 11YES Do
1--i— . . .
BUILDER COMPANY Lennar Homes, LLC
SIGNATURE REGISTERED Y / N FEE CURREN Y / N
Address 430 W Boy Scout Blvd Suite 600 Tampa, FL 33607 License # CGC 1518166
ELECTRICIAN COMPANY Proven Electrical Concepts, LLC
SIGNATURE REGISTERED Y / N FEE CURREN Y / N
Address 5728 Golden Owl Loop, Land O Lakes, FL 34638y License # I EC13009068 _l
PLUMBER COMPANY Bayonet Plumbing, Heating & AC, Inc
SIGNATURE REGISTERED Y / N FEE CURREN
Address P.O. Box 308, Bayonet, FL 34674-5308 License # l CFC042998
MECHANICAL COMPANY Bayonet Plumbing, Heating & AC, Inc
SIGNATURE REGISTERED Y / N FEE CURREN Y / N
Address P.O. Box 5308, Ba onet, FL 34674-5308 License # CAC058062
OTHER COMPANY C Sterling Quality Roofing, Inc
SIGNATURE REGISTERED LY / N FEE CURREN Y / N
Address 4211 Shoal Line Blvd, Spring Hill, FL 34607 License # 1 CCC057991
111111111111i1I11111111111111111111111111111111111111illllllld11111
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction,
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects
COMMERCIAL Attach (2) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new construction.
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster. Site V/ork 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 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
NOTICE OFDEED RESTRICTIONS: The undersigned understands that this permit may besubject to^deed^restrictions"
which may bemore restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake wmnk, they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by |aw, both the owner and contractor may be cited fora misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work, they are advised tocontact the Pasco County Building Inspection Division —Licensing Section at727-847-
8U00. Furthermnre, 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
ounirau1or, 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 bui|dings, or expansion of existing bui|dingu, as specified in Pasco County Ordinance number 80'87 and
80-07. as amended. The undersigned also undernianda, that such feea, as may be due, will be identified atthe time of
permitting. It iafurther 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 CountyVVuter/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, oaamended): |fvaluation ofwork io$2.50O.0Oormore, |
certify that |, the upp|ioant, have been provided with a copy of the "Florida Construction Lien Law —Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the "owner", | certify that | have obtained a copy of the above described document and promise in good faith to
deliver ittothe ^ownar''prior (ocommencement.
CONTRACT{]R'E/OVVNER'SAFF|DAV|T: | certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable |ovva regulating conskuotinn, zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. | certify that no work o/ installation has
commenced prior to issuance of permit and that all work will be performed to meet standards of all laws regulating
oonatrucUon. County and City oudes, zoning regulations, and land development regulations in the jurisdiction. | also
certify that | understand that the regulations ofother government agencies may apply to the intended work, and that it is
myresponsibility toidentify what actions |must take tobeincompliance. Such agencies include but are not limited to:
- Department ofEnvironmental Protection -Cypress Bayheadx, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment.
Southwest Florida Water Management Dinbioi-VVo||u, Cypress Bayheado, Weiland A/eus, Altering
VVo(omouraoa.
Army Corps ofEnginmero-Seowa||n.Docks, Navigable Waterways.
- Department of Health & Rehabilitative Services/Environmental Health Unit-VVe||s, Wastewater Treatment.
Septic Tanks.
- USEnvironmental Protection Agency -Asbestos abatement.
- Federal Aviation Authority-Runweys.
| understand that the following restrictions apply 0uthe use offill:
- Use offill ianot allowed inFlood Zone ^V^unless expressly permitted.
If the N| maha/io| is to be used in Flood Zone ^A^, it is understood that a drainage plan addressing u
^compenouting volume" will be submitted attime ofpermitting which is prepared by professional engineer
licensed bythe State ofFlorida.
- If the 0| moie/io| is to be used in Flood Zone ^A" in connection with o permitted building using stem wall
construction, | certify that fill will be used only Uofill the area within the stem wall.
- If fill material is to be used in any area. | certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent propediea, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
acre which are elevated by fill, an engineered drainage plan is required.
If | am the AGENT FOR THE OWNER, | promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior hocommencing construction. | understand that separate permit may be required for electrical work,
p|umbing, signa, vveUo, poo|n, air conditioning, gam, orother 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 vio|ab*, manoe|, a|k*r, 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 1aouanoe, 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 nequesb*d, in writing, from the Building Official for period not to exceed ninety(Q0) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned.
FLORIDA JumAT(F�. 117o3
OWNER OR AGENT f
Who is/are personally known o Subscribed and sworn to (or affirrned� �®r me �this
as mentification
Notary Public
Commission No. HH 000460
DlissaM.Holleran
Name of Notary typed, printed or stamped
An Bor" Thm Troy Fain tnautara $00.3W70J9
I I'll I I IN:=
Subscribed and sworn to (or affirmed) before me this
��-May-22 by AsB,e Callahan
o,
as identification.
Notary Public
Commission No. HH 000460
Elissa M.Bnllemo
Name of Notary typed, printed or stamped
Ile
Bonded Thm Troy Fain Instance 600-US-7019
Permit No.e
Date Permitted
17
Builder Name/Owner Name Control #
County Parcel No. % IQ - DOZO SubDivd�
Address/Location 37455
Classification/Type of Use)n d f
TRANSPORTATION IMPACT FEE Rate: Sq. Ft Unit:
Exempt D Yes No How Determined
Impact Fee Amount S ` Zone No. TAZ:
SCHOOL IMPACT FEE yy
Account (056) Single -Family Detached House Amount $ 3 66 •cam~'---
(057) Mobile Home
(058) Other Residential
(123) Collection Fee
Exempt Yes = No How Determined -
PARKS
•
CreditLand Account Land • Total
Recreation Account
Recreation Credit
Recreation Total
Zone
Total Amount $ 70/` 1JP
Exempt =Yes
No
How Determined
LIBRARY FEE
Land Account
Land Credit
Land Total
Facility Account _ _
Facility Credit
Facility Total ®
Exempt Yes
No
How Determined
)
Total Amount .
RESOURCE
Prepared By
(fm
Checked By
No CERTIFICATE OF OCCUPANY 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 REECEIPT OF A COPY OF THIS
FORM, PLACING THE BUILDING OWNER ON NOTICE OF THIS ASSESSMENT AND THE CONDITIONS OF PAYMENT FOR SAME.
RECEIPT NO DATE BY
DESCRIPTION: LOT(S) 25-32, LEAFSIDE TOWNHOME PLAT, ACCORDING
SEC. 15, TWP. 26 S, RNG 21 E.
SITE PLAN
TO THE PLAT THEREOF, RECORDED IN PLAT BOOK 88, PAGE(S)97-98, OF
PASCO COUNTY, FLORIDA
NOT A SURVEY
( )
I
THE PUBLIC RECORDS OF PASCO COUNTY, FLORIDA.
I GARDEN COURT
(ZEPHYR COURT)
GARDEN STREET
I PLAT BOOK 3, PAGE 103
I
� THE NORTHERLY BOUNDARY
LOT 11 I
BLOCI<5 I
(50'PUB(JCR.O.W.)
3_PG
I LOT 9
I BLOCI<6
-
N ------ -PER
LINE OF TRACT 19 _ I TRACT "E" LANDSCAPE BUFFER
-------
- ---------- -----------------------------
_({ 7.0
(PRIVATE) S 89-58'S0" E (P)
164.67` (P)
7 LANDSCAPE BUFFER
�---------
28.33' (P)
18.00' (P) T 18.00' (P) T 18.00' (P) T
18.00' (F) 18.00' (P)
18.00' (P) 28.33' (P)
X -----
/8 J OO/
j 15.0'
. 15' D.E (P) I I
I I
I
20.0'i
1 i 20.0'
ALL ELEVATIONS REFERENCED
r) Irn____ l� - -1 - -
Q I n
I I
n 1 �-
���
�-
TO NORTH AMERICAN
VERTICAL DATUM OF 1988 \`b 10.0'
(NAVD 88) c
b
O
m
PROPOSED ELEVATIONS AND TYPE
GRADING SHOWN HEREON ARE TAKEN
c
FORM THE ENGINEERING PLANS OF "MASER',
",
CONSULTING P.A. PROVIDED BY CLIENT
0
O
LOT = 16961 SO. FT.
LIVING AREA = 5336 SQ. FT.
ri
ENTRY = 672 SO. FT.
0
GARAGE = 1848 SO. FT.
" 1
COVERED LANAI = 868 SQ. FT.
W
PATIO = NA SQ. FT.
POOL AREA = NA SQ FT
_4NAI LANAI LAN/
18.3' 18.0' 1 18.0,
UNIT -A UNIT-B UNIT-C
1532 1516 1624
w w
V y
u b
LOT 32 o LOT 31 LOT 30
a
18.0' PRO
2S
ATT)
RESIE
UNIT-C
1624
Ln
144'-8" o
"Coxyz7
LANAI
-ED 18.0'
RY
1ED
ICES
UNIT--
1624 w
v
X00*
10.0'
AN I N LANAII 15- D E (P)
18.0' 1 18.0 18.3'
UNIT-C UNIT-B UNIT -A
1624 1516 1532
w
V
LOT 27 b LOT 26 L T 2
I
Z 6.7' 6.7' Z
4
l 0.0,
CONC. DRIVE = 2400 SO. FT.LU
v
A/C & CONC PAD = 80 SO. FT " u
SIDEWALK = 324 SO. FT. � • /
67
m m 7.0'
Z ti
iu w
0.0'--1 1
SIDE YARD SWALE
= NA
SO. FT.
�:
11.1
1 i 3
100
1 1.3
10.a'•'
f
'
1 1.3
0
1 i 3
1oa
I
1 1.3
1 1 3
loon
1 1.3
°ioo'
CONSERVATION AREA
= NA
SQ. FT.
lo0
,
i
L
A
(
I
LOT OCCUPIED
= 68
/o
,:; .I '
1
I I p
`
i
I
I
AREA TO IRRIGATE
-
/o _ -
_ -
I
I' T.:
1 • I
a
p�
x�
180�>/
eI
is
.
I ci
I
P
+
18"18.0
0`P.
2
3' P2833'
NOTES-
r:: `,�
<• . . � s ISI
58'S0" W (P) 164.67' (P)
•
,.
;:'.
,.
.
<
LOT GRADING TYPE = N/A
_ .
°
.......�=�
PROPOSED PAD ELEVATION = N/A
FRONT SET BACK = 15' 19 0'
SIDE SET BACK = 10'
15' FROM INTERIOR ROADWAY OR PARKING AREA
I O' FEET FROM EDGE OF A RECREATION AMENITY
I O' FROM EDGE OF A STORM WATER RETENTION/DETENTION AREA
REAR SETBACK = 20'
ALL WALKS 3.0' UNLESS NOTED
= 10' INGRESS EGRESS/UTILITY
DRAINAGE EASEMENT
(38.00` PRIVATE R.O.W.)
PROPOSED:
LOWEST FLOOR ELEVATIONS:
LIVING AREA: 81.80'
GARAGE AREA:
ELEVATIONS REFERENCED TO
NORTH AMERICAN VERTICAL DATUM OF 1988
+0.85' = NATIONAL GEODETIC VERTICAL DATUM OF 1929
A/C =AIR CONDITIONER
(D)=DEED
INV=INVERT
PC=POINT
OF CURVE
(R)- RECORD
Drawn By:CWC
Party Chief
AF =ALUMINUM FENCE
D.E= DRAINAGE EASEMENT
LB =LICENSED
BUISNESS
PCP
= PERMANENT CONIROL POINT
RNG _ RANGE
"
CheC ked By: JH
JOB #4731
BEE = BASE FLOOD ELEVATION
EL OR ELFV = ELEVATION
L FE
= LOWEST FLOOR ELEVATION
P/E =
POOL EQUIPMENT
RRS = RAIL ROAD SPIKE
BM = BENCH MARK
EOP = EDGE OF PAVEMENT
LS =
LICENSED SURVEYOR
PG =
PAGE
R/W = RIGHT OF WAY
File:
C = CURVE
ESM'T = EASEMENT
(M)
= MEASURED
PI =
POINT OF INTERSECTION
SEC = SECTION
(C) = CALCULATED
F/C = FENCE CORNER
MES
= MITERED END SECTION
PK =PARKER
KALON
SN&D = SET NAIL AND DISK LB#8183
Date Of Site Plan: 1 2-13-2 1
4 = CENTERLINE
FCM = FOUND CONCRETE MONUMENT
NICE
= NO CORNER FOUND
POB
= POINT OF BEGINNING
SIR = SET 1/2' IRON ROD LB# 8183
CLF = CHAIN LINK FENCE
FIR = FOUND IRON PIPE
C/A
= OVERALL
POC
= POINT OF COMMENCTMENT
TBM -TEMPORARY BENCH MARK
DWG:L25 32-ZEPHYR-SITE
CMP = CORRUGATED METAL PIPE
FIR = FOUND IRON ROD
OHW = OVERHEAD WIREIS)
POT
= POINT ON LINE
TOB = TOP OF BANK
COL -COLUMN FN&D = FOUND NAIL & DISK O.R. = OFFICIAL RECORDS PRC POINT OF REVERSE CURVE TWP = TOWNSHIP This SITE Plan Prepared for and Certified To:
CONC = CONCRETE FOP = FOUND OPEN PIPE (P) PLAT PRM '= PERMANENT REFERENCE MONUMENT U.E = UTILITY EASEMENT Lennar Homes
C/S = CONCRETE SLAB FPP = FOUND PINCHED PIPE PB = PLAT BOOK P1LE = PUBLIC UTILITY EASEMENT
ii Water Oak Drive
Tarpon• •s, Florida
Phone-(727)-831-1990
FloridaPLS71239•mail.com
0.
s i
W°.IN YW",
2G.I.W
fWP.1S `WP ,
GI W 2G t
0
I 01.11
Initial Point Land Surveying, LLC.
LEGEND
SURFACE TYPE FENCES
- CONC ALUMINUM FENCE
= ASPHALT VINYL FENCE
r� r�
= BRICK _ WOOD FENCE
SAND/DIRT CHAIN LINK FENCE
COVERED OVERHEAD POWER
OHP - GHP
LEGEND. -
PROPOSED DRAINAGE FLOW
(00.00) = PROPOSED GRADE
E-00.00 = EXISTING GRADE = 2" OAK
= I O' INGRESS EGRESS/U.E & D.E
APPARENT FLOOD HAZARD ZONE: "X" COMMUNITY NO. 120235
(MAP NUMBER 12101C-0452-F) EFFECTIVE DATE: 09/26/2014
1.) Current title information on the subject property had not been
furnished to Initial Point Land Surveying, LLC at the time of this site plan
2.) This sketch was prepared without the benefit of a title search. No
instruments of record reflecting ownership, easements or rights -of --way
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 Plat of "LEAFSIDE
TOWNHOME PLAT"
6.) Dimensions shown hereon are in feet and decimal portions thereof.
7.) Contractor and owner are to verify all setbacks, building dimensions,
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 user's sole risk.
This certifies that
under m$ Z
REVISIONS: if YV
5J 17.051 througlSJ I .053, FI is dml
REMOVED BUFFER Section 7 7 t to StatuDate:
EASEMENT REAR PROPERTY 10:34
8-26-22 Z O
Jeff M. Hartley
FLORIDA PROFESSI RtF1D
NOT VALID Wl11 f/ (�d/1
OF A FLORIC7�N ��� R
✓ was made
1 Practice for
rs In Chapter
e, pursuant to
go
= Date
LS#7123 LB#8183
NATURE AND SEAL
R AND MAPPER
Project Name:
VIRTUAL
I R I UAL REVIEW ASSIST
Notice to Building Official of
Use of Private Provider
Effective January 20, 2003
2913MMUSIM
Parcel Tax ID: 04-26-21-0000-00300-0000
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.
I— Steve Smith the fee
owner, affirm I have entered into a contract with the Private Provider indicated below to conduct the services
indicated above.
Private Provider Firm: VIRTUAL REVIEW ASSIST INC.
Private Provider:
Address: 747 SW 2ND AVENUE - SUITES 170, 301, 357 & 358, GAINESVILLE, FL. 32601 1
Telephone
Email Address (Optional): deb@virtualreviewassist.com
Fax: N/A
Florida License, Registration or Certificate #: (LIC # BU 1967 / 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, environmental or other codes.
The following attachments are provided as required:
1. Qualification statements and/or resumes of the private provider and all duly authorized representatives.
2. Proof of insurance for professional and comprehensive liability in the amount of $1 million per
occurrence relating to all services performed as a private provider, including tail coverage for a minimum
of 5 years subsequent to the performance of building code inspection services.
Individual
(signature)
Print
Name:
Telephone
No.:
Please use appropriate notary block.
57�1 �" �W
Individual
Before me, this day of
20_, personally
appeared
who executed the foregoing instrument,
and acknowledged before me that same
was executed for the purposes therein
expressed.
Corporation
LENNAR HOMES. LLC
Print Corporation Name
1.2
(signature)
Print
Name: Christopher Smith
its: Authorized Agent
Address: 700 NW 107th Ave
Miami, FL 33172
Telephone
No. 813-574-5700
Corporation i, 22ND
Before me, this day of
MAY —2o22,
personally appeared
of
Lennar Homes, LLC a
corporation, on
behalf of the state corporation, who
executed the foregoing instrument and
acknowledged before me that same was
executed for the purposes therein
expressed.
Partnership
Print Partnership Name
-0
(signature)
Print
Name:
Its:
Address:
Telephone
Partnership
Before me, this day
of 120—,
personally appeared
partner/agent on behalf of
a partnership, who executed the
foregoing instrument and
acknowledged before me that same
was executed for the purposes therein
expressed.
Personally known X or Produced identication_ Type of identification produced
Signature of Notar 1L Print Name _ ASHLEE CALLAHAN
Notary Public Stamp:
ASME CALLAHAN
Notary pubgState of F[orlda
�
Commission Expires: i- U420 Cqjjjmj$5j0r. p CGG 244456
m
NOVEMBER 30, 2022 W 0 Coqjm. Expl(ej Nov 30, 2022
d
'�.d thrm National Notary AM,
,Bon1jh"-
11 Jill,
164P � 44.
BUILDING SERVICES DIVISION
BUILDING PERMIT DATA SHEET
TRACKING # OFIRE MARSHAL #01 -
FOLIO #
/ :U4615 Required Pvmits
DATE:
EXAMINER:IlllP7
Building
ection On
Pluirbi;g —,12SNechanical
Inspection Oniy-
Inspection Only
lectrical Amp
ction.Only
El Medical Gas
E] Fire Sprinklers
On Site Piping
El Irrigation
I EJ Fire Alarm
D Potable Baekflow Assembly
F]Fire Line Backflow Preventer
Irrigation Backflow Assembly
Demolition
Walk-in ooler
El Refrigeration
Grease Trap
Ul= =111-1
Constr
06M
Risk Category: Mg
Occupancy Load
mpancy lassification:
El Factory
X!�esidentia][E�
ay Care/Educational
I i • R
nal 0 Mercantile
E=-=
Building Use: Alteration Iff Level I Iff Level 2 ■ Level 3
O�Tew Construction El Interior Finish F Interior Remodel E] Exterior Remodel E] Addition E] Revision
ota q.
# of Bedroom
MANAM,013
WITIN —1,
WE Metal■ibtbteer S�uares.
W
01II w
d orne Debris:
TE tide rEj, Outside
EnerLwv Code:
il tloS
Flood Zone: M Base Flood Elevation: Finish Floor Elevation:
Hydrostatic Vents? 10,'—Tes V14• Sq. Ft. Enclosed Space Below BFE:
# of Vents:
Size of Vents:
.4
Total Sq. In. Permanent Openings
� Central
FGasA/C
4!9-Heat Pump El Window A/C
11 Gas Heat El Electric Heat
Sanitary Sewer
Storm Seer Catch Basins
Potable Water
Underground Fire Line
IE=
VR/ \
VIRTUAL REVIEW ASSIST
Private Provider
PI-A-4 ci'�m-rljpaeeA'J' avit
Private Provider Firm: Virtual Review Assist, Inc.
Private Provider: Debra Anne Klahr, BU1967
Address: 747 Southwest 211d Avenue
Gainesville, FL 32601
Phone: 813-391-2959
Email: Luc alreviewa�ssistxoM
y�� m
Project: TOWNHOUSE .a UNITS
are in compliance wi the Florida Building Code and all local amendments to the Florida Building
Code by the following afflant, who is duly authorized to perfarm plans review pursuant to Section
553.791, Florida Statute and holds the appropriate license or certificate:
Name: Debra Anne Klahr
FS468 Certified Standard Plans Exan-Iiner
License #: PX2300
Signature of Reviewer:
SWORN AND SUBSCRIBED before me by Debra Anne Y-lahr
being personally known to me or having produced as idencation
and who being fully sworn and cautioned, state that the
fi regoing is true and correct to the best of histber knowledge or belief
Wature of Notary Prmt �a�me
Notary Public: NOTARY STAMP BELOW My
ASHLEE CALLAHAN
Notary Fo\^\/>e
\\/
244460Mires Nov 30, Z 22
Bonded throuional Notary Assn,