HomeMy WebLinkAbout22-48945335 Eighth Street
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38194 Fallstone Way 15 26 210030 08100 0010
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Name: LENNAR HOMES LLC-OWNER
Permit Type: Building New (Residential) Contractor: LENNAR HOMES LLC
Class of Work: Townhome
Address: 4600 W Cypress St 200
Building Valuation: $235,800.00
TAMPA, FL 33607
Electrical Valuation: $35,370.00
Phone: (813) 574-5700
Mechanical Valuation: $16,506.00
Plumbing Valuation: $23,580.00 J�'
Total Valuation: $311,256.00
Total Fees: $13,735.43
Amount Paid: $13,735.43
Date Paid: 10/13/2022 7:39:34AM<""
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CONSTRUCT TOWNHOME 1513 SO FT TAP
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Electrical Permit Fee $216.85 Water Connection Residential Fee $1,010.00
Building Permit Fee $1,219.00 Park Impact Fee - Single Family/Townhome $769.56
Public Safety Impact Fee -Police $254.00 Driveway Fee $45.00
School Impact Fee - Single Family $3,353.00 Transportation Impact Fee - City $34.80
SIF 1 percent Fee $33.53 Sewer Connection Residential Fee $2,090.00
3/4 Water Meter Residential Connection Fee $732.71 Public Safety Impact Fee -Admin $26.35
Plumbing Permit Fee $157.90 Admin Fee / (Provider Service) $180.00
Transportation Impact Fee $3,445.20 Mechanical Permit Fee $122.53
Address Fee $30.00 Fire Wall/Smoke Wall Inspection $15.00
REINSPECTIO 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 other governmental
entities such as water management, state agencies or federal agencies.
Complete Plans, Specifications•• fee Must AccompanyApplication.
accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
CONTRACTOR SIGNATURE PE IT OFFICE
PERMIT
r EXPIRES
r • MONTHS WITHOUT APPROVED INSPECTIO
CALL • r r • • r NOTICE REQUIRED
PROTECT
rl! • r r WEATHER
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received Phone Contact for Permitting F 908 770 7763
1 1 1 1 1 1 1 1 1 1 1 111111
Owner's Name Lennar Homes, LLC Owner Phone Number 813.574.5700
Owner's Address 1 4301 W Boy Scout Blvd, Ste. 600, Tampa, FL 33607 Owner Phone Number
Fee Simple Titleholder Name I N/A Owner Phone Number
Fee Simple Titleholder Address N/A
,JOB ADDRESS 38194 Fallstone Way
LOT # 0048
Townes at Autumn Palm 15-26-21-0030-08100-0010
SUBDIVISION PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ADD/ALT
P
SIGN DEMOLISH
INSTALL REPAIR
e
PROPOSED USE SFR COMM
OTHER
TYPE OF CONSTRUCTION BLOCK FRAME
STEEL
DESCRIPTION OF WORK Multi -family / Screen Enclosure / Fence
t?/R SF 1965 SQ FOOTAGE 1513
BUILDING SIZE I
HEIGHT 28'
BUILDING $ 235800 !1 VALUATION OF TOTAL CONSTRUCTION
ELECTRICAL $ 35370 AMP SERVICE
PROGRESS ENERGY W.R.E.C.
i f
PLUMBING $�
23580
�jMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION;
ILr J 16506
GAS � ROOFING SPECIALTY OTHER (�
FINISHED FLOOR ELEVATIONS 17777] fff FLOOD ZONE AREA YES Do j
BUILDER COMPANY Lennar Homes, LLC
SIGNATURE REGISTERED Y ! N FEE CURREn L.I/ N
le
Address 4301 W Boy Scout Blvd Suite 600 Tampa, FL 33607 License # CGCI5I8166
ELECTRICIAN COMPANY Edmonson Electric, Inc.
SIGNATURE REGISTERED Y / N FEE CURREF Y / N
Address FT License # EC13005408 ®�
PLUMBER COMPANY Bayonet Plumbing, Heating & AC, Inc
SIGNATURE REGISTERED I Y / N J FEE CURREF Y / N
Address All License # I CFC042998
MECHANICAL COMPANY Bayone�Plum�bing, �Heatin�g&C, Inc
SIGNATURE REGISTERED Y/ N
Address I License # CAC058062
OTHER COMPANY C Sterling Quality Roofing, Inc
SIGNATURE REGISTERED Y / N FEE CURREN Y / N
Address License # 1 CCC057991
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 Work Permit for all new projects. All commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
"""PROPERTY SURVEY required for all NEW construction.
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required. (A/C upgrades over $7500)
Agent (for the contractor) or Power of 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 m contractor or
contractors to undertake work, they may be required to be licensed in accordance with state and |ooe| regulations. If the
contractor is not licensed an required by |ew, both the owner and contractor may be cited for misdemeanor violation
under state |em. If the owner or intended contractor are uncertain ootowhat 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. Furthemnone, ifthe owner has hired a contractor orcontractors, 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
oontuactor, that may be on 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 tothe construction ofnew buildings, change of
use in existing bui|dingo, or expansion of existing bui|dingu, as specified in Pasco County Ordinance number8Q-O7 and
90-07. as amended. The undersigned also underotando, that such fees, as may be due, will be identified otthe time uf
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving o "certificate of occupancy" or final power n*|*ane If the project does not involve e certificate of occupancy or
final power na|*ese, 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, asammendad): |fvaluation ofwork io$2.5OOOOormore, |
certify that |, the opp|ioeni, have been provided with o 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 it tothe ''mwner^prior tocommencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT: | certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable |avvo regulating conetruoiion, zoning and land development, Application is
hereby made to obtain a permit to do work and installation as indicated. | certify that no work or installation has
commenced prior to issuance of permit and that all work will be performed to meet standards of all |avva regulating
uonotruction. County and City nndes, zoning regulations, and land development regulations in the jurisdiction. | also
certify that | understand that the regulations ofother government agencies may apply tothe intended work, and that it is
myresponsibility toidentify what actions | must take iobeincompliance. Such agencies include but are not limited to:
- Department ofEnvironmental Protection -Cypress Bayhemda, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment.
- Southwest Florida Water Management Dinkio1-VVm||u, Cypress Bayheeda, Wetland Areas, Altering
Watercourses.
- Army Corps ufEngineera-Saawa||o.Docks, Navigable Waterways.
- Department of Health & Rehabilitative Sen/i000/Environmental Health Unit-VVe||o, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency -Asbestos abatement.
- Federal Aviation Authority-Runvveys
| understand that the following restrictions apply tothe use offill:
- Use offill innot allowed inFlood 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 o
"compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State ofFlorida.
- If the fill msdario| in to be used in Flood Zone ^A" in connection with a permitted building using stem wall
construction, | certify that fill will be used only tofill the area within the abam 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 edwame|y affect adjacent pnopertiea, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for |da less than one (1)
acre which are elevated byfill, enengineered drainage plan iarequired.
If | am the AGENT FOR THE OWNER, | promise in good faith to inform the owner ofthe permitting conditions set forth in
this affidavit prior to commencing construction. | understand that e separate permit may be required for electrical wnrk,
p|umbing, oigno, weUe, pon|o, air nondbioning, gaa, or other installations not specifically included in the application. A
permit issued shall be construed to be e license to proceed with the work and not as authority to vio|ahe, canoe|, ebe/, or
set aside any provisions of the technical oodeo, nor shall issuance of 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 inouanue, 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 naquested, in writing, from the Building Official for e period not to exceed ninety (80) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned.
OWNER OR AGENT
_
Subscribed and sworn r. (—or affirmed) before me this
Who is/are personally known to me or has�have produced
as identification.
Notary Public
Commission No. oszeaos7
Stephanie
CONTRACTOR
Subscribed and sworn to (or affirmed) before me this
7/28/2022 by Christopher Smith
Who is/are personally known to me or has/have produced
as identification.
Commission No. sszyoosr
Notary Public
I - I R W/ 15 MPH SIGN
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�83
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'S'INLET S-8---
83.20
X
8250
82.75-/
83
A'A"D
i > 82.89
13+00 (P-7),
81.5 -
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81.5 -
DESCRIPTION: LOTS) 47-54, TOWNES AT AUTUMN PALMS,
ACCORDING TO I'HE PLAT THEREOF, RECORDED IN PLAT BOOK
PAGEis)—OFT4'IF PUBLIC RECORDS OF PASCO COUNTY, FLORIDA
LOT-_17027
SQ.FT-
LIVING AREA =
5336
SO_ FT.
ENTRY -
6.72
SQ FT.
GARAGE
I8488So
FT.
COVERED LANAI
868
SO, FT.
PATIO
NA_„_
SO. FT
POOL. AREA -=
NA
SQ.FT.
CONC DRIVE -_
2430
SO, FT.
A/C & CONIC PAD -
80
FT.
m Q
SIDEWALK --
_SO,
_ 324__SCE
FT-
c
v w
SIDE YARD SWALE
_ NA
SQ. FT
< Q
CONSERVATION AREA
NA
SC FT.
r- >
LOT OCCUPIED -_
68 __
t/o
c
AREA TO IRRIGATE -
3Z
%
NOTES
SEC. 15, TWP. 26 S, RING 21 E.
PASCO COUNTY, FLORIDA SITE PLAN
(TOWNES AT AUTUMN PALMS) (NOT A SURVEY(
ROADWAY TRACT "C
CITY OF ZEPHVRHILLS 713ASIS OF BEARING
8 834'"W P 1,4663'IP
I/E/U/D EASEMENT
0
,,FZ O
Ig3381"X
�6 ,}'
�... •iGi16
fl
20 LI
s
50" N89'S842 E(PI
C21 i
I. I8�00 �PJ
Il �;- f 1800 IF)
18. 0 (P)
"Is,
'100
II
�'
��
11 3'
10o % I'II
1 1 3
1(-3
-'�'-n
L 100'
1 1 3
100
1 1 3
I
100`�
1 1 3�i
I too" 100.1
i 3� 1 1 9
LOT' GRADING TYPE N/A
PROPOSED PAD ELEVATION N/A
FRONT SETBACK = 15'
SIDE SET BACK = 10'
REARSETBACK -20"
ALL WALKS 30 UNLESS NOTED
ALLA/C 32x3-2"
100 m
w
w
w
w
r (',�
10.0'
o
Do
0
z
z
z
z
�W
y
47
LOT
LOT
LOT
LOT
LOT
LOT LOT
SLOT
LOT
48
0 PRO 49S
ED
50
5I
52
w
53 S4
a
55
2 STORY
....-
_..
...ATTACHED
RES DENCES
1 UNIT -A
UNIT-8
UNIT-(-
UNIT-C
UNIT-C V
UNIT-C
UNIT-B UNITT-A
1532
I516
1624
1624
1624
1624
1516 1532
-
183 1 78.0 1 180 1 18.0 1 18.0
10.0.
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1708 Water Oak Drive
Tarpon Springs, Florida
Phone: (727)-831-1990
FloridaPLS7123@gmaitcom
LB# 8183
Scale, 1 " = 20'
Initial Point Land Surveying, LLC.
LEGEND
SURFACE TYPE FENCES
a
AsrHAlr Nv N<F
WO(Yl'fNC(—
�: snNO<olaT cnaln NK=,Nee
-COVI 2111) OVER... AD POi£/PIF
— OHP — ME
LEGEND:
I I—= PROPOSED DRAINAGE FLOW
(00.00) PROPOSED GRADE
E-00. DD - EXISTING GRADE 2 OAK
10' INGRESS EGRESS/tJ-E E, D-E
APPARENT FLOOD HAZARD ZONE X' COMMUNITY NO. 120235
(MAP NUMBER 121 DI C-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 f tie 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
i, EfU'D = INGRESS EGRESS/
TRACT "H" N 89-58-42" E (Pl } X /82 j �82 S0�
5/
engineering plans and are subject to survey.
UTILITY/DRAINAGE ESM'T
10.24
4.) This site plan does not reflect nor determine ownership.
LANDSCAPE BUFFER
SOUTHERLY LINE OF TRACT 96
f_____
5.) This site plan is subject to matters shown on the Plat of "ZEPHYR
----
- .______________
-- —
_ _ _ _ _
.__ _ -
—-- __._._-_________.____----
PB 1, PG 55
COURT..
CURVE
RADIUS ARC LENGTH
CHORD LENGTH CHORD BEARING DEI TA ANGLE PROPOSED:
6.) Dimensions shown hereon are in feet and decimal portions thereof
C20
NOTE C:ONSTRtJCTION
69 00 19.91
19.B4_ _ _ S 71'06 53` E1631 58" LOWEST FLOOR ELEVATIONS_
LIVING AREA
7.) Contractor and ownerare to verify ail setbacks, building dimensions,
layout hereon to immediately
C21
GRADING PIANS
69.00 17.82
12.80 S B4`42 09"' E 10'3835 :84.20'
AREA
and shown prior any construction, and
advise initial Point I ng,ILL C. of any deviation from
HAVE MINIMAL LINE
BEARING DISTANCE
ELEVATIONS REFGARAGE
_-
ERENCED 70
information shown eA reon fSur,ailure
Ium to do so will beat. user's sole risk.
GRADLNGiELEVATiON L1
S 89°5834` W 5.26
At 1, ELEVATIONS REFERENCED PROPOSED ELEVATIONS AND TYPE NORTH AMERICAN VERTICAL DATUM OF
INFORMATION
TONORI"ITAMERICAN GRADING SHOWN HEREON ARE TAKEN I 1988
SUR S TE
- -
VERTICALDATUM OF 1988 FCORM THE ENGINEERING OF 0.85' =NATIONAL GEODETIC VERTICAL
Phis certifies that sle$ 0 h FjPe, �s d property was made
SURVEY ABBREVATION5
ONSUL7 NG P POVIDEDSBY CLIiF_NTR DATUM OF
q
der m su crvis4�`n [anda " of Practice for
v p �,�ssdo�,� rS
All 1I11(ONI 11 I11Nl R Ill FILM
Nv wv1 R`
_ _. _ _
Ill rO Nf of "I ltvt IRi - If F ORD Drawn By CWC Party Chief: JH REVISIONS:
surveys ass y urveode, in Chapter
1]`M
A( A UMINUM f CN(t f) rif-col" I All M NT
6 ^I ( coHI f
"F —Fif u I (ONIROI 1111NT RN 2ANG1
Checked 8 JH JOB H»60
5J-17 051 7 uF{j'�Sfl(d pursuant
»'J- 3 y jp� tILI($/� Code, pUrSllant t0
I! IUSl: FLOG()" KVl TION ORE SV-II(NATION
11 li1 NCH MAIII( i(i� fl)GE ()k 1'AVF:Mf:NI
( Cl1 RVI: IaAT ASFMINI
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Y _ _ -
I( A(r.
(J NI OF'NT(RS[(.I!ON SE( Sf(1ION FIIC_
- - - - -
2
Section 47 ' r-� S i
`.
�" Date: Z�22.p��yy2,.. j�
III <Y, 1AAlF 1.( FI N(FE(GRNOR
— esi—I,NJSr-ON
K PARIHIKAI. ON SN.Sr) S:T-11 All)1IS.(1. 3rl91[33
Date of Site Plan.07-OS-72 CWC
_......_ -....
,, - -6F-
r cf Nn auNF I 1 M I I IND 1 ON(2111 MONUMI
( ( /'NIINKFFN11 II'� FOI.INDR1)NIII1F:
M AI?K'f FIR FOUNDRONR(O
- N; N( I NO coRtaa rouNO
O/A OVI RAI
oli+il (YV(R,{-Al)W2rISj
101 = rGmn or IIII INNING, Sua a 1/1 1110N RGo I-faa R a3 ..
(I, IOol l((JMMIN(TM[o, 'f3M I—CIFARYFif—IMARK D\Y,/G_L47-54-T@AP-SITEDWG
( POCI N: 109 'O'OI BANK
STi AT 7 b _ Date
Jeff M Harticy ( --
m
FLORIDA PROFES rSUNj2' 7P,�tR LSO123 I B#8183
���,.-..._._ffif PRR"A_<-
lORRUGAFFM
( Ix- r <11.uMN I Is. r ouNl NAZI a us(
<I. a Ol f "Al. RI —I'DI
a( o,aT or "IF of "If L uevr, TWr - 11 WNs llr This SITE Plan Prepared for and Certified To:
NOT VALID ��f H€-0R t ATURE AND SEAL
��++
<UN(-101011 TE 10° I()UNDG1h
:)s (Ori11 S:Af3 � fauNnr brHnrnme
III RLAI
ef) nreool<
iM f Praof N' Rf( I It N(E MOrner' Ni U.! UHIITY—tha NT Lennar Homes
ur rUpucu 'I �,/al MINT
OFA FLORtLhf ..VF 9N..' RAND MAPPER
1 U FE A 5 S 1 S T
Notice to Building Official of
Use of Private Provider
Effective January 20, 2003
Project Name: 38194 FALLSTONE WAY
Parcel Tax ID: 15-26-21-0030-08100-0010
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.
the fee
owner, affirri-i 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: DEBRA ANNE KLAHR
Address: 747 SW 2ND AVE- SUITE 170,301,357,& 358, GAINESVILLE, FL 32601
Fax: N/A
Email Address (Optional): deb@virtualreviewassist.com
Florida License, Registration or Certificate #: (LIC # BU1967/ PX2300/ BN4615)
I have elected to use one or more private providers to provide building code plans review and/or inspection
services on the building that is the subject of the enclosed permit application, as authorized by s. 553.791, Florida
Statutes. I understand that the local building official may not review the plans submitted or perform the required
building inspections to detennine 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.
[CAMS am]
(signature)
Print
Name:
Address:
Telephone
Please use appropriate notary block.
STATE OF FLORIDA
COUNTY OF —HILLSBOROUGH
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
By:
(signature)
Print
N.,: Christopher Smith
Its: Authorized Agent
Address: 700 NW 107tb Ave
Miami, FL 33172
Telephone
No. 813-574-5700
Corporation
Before me, this 22ND -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.
Personally known X ;or Produced identication Type of identification produced
Partnership
Print Partnership Name
By:
(signature)
Print
Name:
Its:
Address:
Telephone
No.:
Partnership
Before me, this day
Of 1 20_3
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.
Signature of NotarnLL 0 Print Name ASHLEE CALLAHAN
Notary Public. Stamp: . .... .
ASHLEE CALLAHAN
publj�= state of Florida
Commission Expires: G6 244456
NOVEMBER 30, 2022 CorTIM. Expife5 Nov 30,2022
Ayl NntlOnBl NOWY A,ka9,
Page 2 of 2
\/RA
VIRTUAL REVIEW ASSIST
Private Provider
Plan Compliance Affidavit
Private Provider Firm: Virtual Review Assist, Inc.
Private Provider: Debra Anne Klahr, BU1967
Address: 747 Southwest 2nd Avenue
Gainesville, FL 32601
Phone: 813-391-2959
Email: lucvavirtualreviewassist.com
Project: New SIR
Address(s): 38190,38194,38198,38202,38206,38210,38214,38218 Fallstone Way
I hereby certify that to the best of my knowledge and belief the plans submitted were reviewed for and
are in compliance with the Florida Building Code and all local amendments to the Florida Building
Code by the following affiant, who is duly authorized to perform plans review pursuant to Section
553.791, Florida Statute and holds the appropriate license or certificate:
Name: Debra Anne Klahr
Plan Sheets: 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,LI,SN,SNI,S3,S4,S5,S6,SS,ST,D1,WP,
PAI.0,PAI.1,PAI.2,PAI.3,SHI.0,SHI.1,SHI.2,SHI.3,SHI.4,SHI.5
Florida License/Registration/Certification #(s) and description:
FS468 Certified Standard Plans Examiner
License#: PX2300
Signature of Reviewer:
SWORN AND SUBSCRIBED before me by Debra Anne Klahr
being personally known to me or having produced as identification
. . ......__ ®__and who being fully sworn and cautioned, state that the
fo going is and
d correct to the best of his/her knowledge or belief.
01
Signature of Notary Print Name
Notary Public: NOTARY STAMP BELOW My
'-A
commission expires:
2 4 4
T' COUIM
ISSHOr G
MV
COMMERCIAL BUILDil`1G SERVICES DSIONRESIDENTIAL
BUILDING PERMIT DATA SHEET
TRACKING
FOLIO # 38194
FIRE MARSHAL #01 -
Reauired Permits
8-9-2022
•^ • a
Building
Q Ins ection Only
Plumbing
❑ Ins ection Onl
Mechanical
❑ Ins ection Onl
fZ Electrical Amp
❑ Inspection Onl
Roof
❑ Gas
❑ Medical Gas
❑ Fire Sprinklers
❑ On Site Piping
❑ Fire Line
❑ Irrigation
❑ Fire Alarm
❑ Potable Backflow Assembly
❑ Fire Line Backflow Preventer
❑ Irrigation Backflow Assembly
❑ Demolition
Walk-in Cooler
❑ Refrigeration
❑ Hood
❑ Ansul
❑ Fence/Wall
❑ Grease Trap
❑ Other
❑ Other
Type Construction:
V-B
Risk Category:
Occupancy Load
O aney Classification:
Factory
Residential R 3
Assembly _
11 Hazardous L
❑`Storage
ay Care/Educational
Business Nercantile
nstitutional
❑Utility
Building Use: Single Family / Alteration Level 1 ❑Level2 Level 3
if New Construction ❑ Interior Finish ❑ Interior Remodel ❑ Exterior Remodel ❑ Addition ❑ Revision
Overall Size:
18-4 x 63
Number of Stories:
2
Total Sq. Ft.:
1965
Living Area: 1513
Covered Area:
452
# of Bedrooms: 2
# of Baths: 2.5
Cost per square foot:
Estimated Value:
Roof Type: ® Shingle
❑Tile ❑ Built-up
❑ Metal ❑ Other Squares: 13
Zoning:
i oe Debris:
❑;,Inside
Outside
Energy Code:
405-2020
Flood Zone: X
Base Flood Elevation.
Finish Floor Elevation:
Hydrostatic Vents?
❑;Yes VNo I
Sq. Ft. Enclosed Space Below BITE:
# of Vents:
Size of Vents:
Total Sq. In. Permanent Openings
® Central AIC
❑ Gas A/C
® Heat Pump
❑ Gas Heat
❑ Window A/C
❑ EIectric Heat
111r0r?3V=-
SanitaKy Sewer
Storm Sewer Catch Basins
Potable Water
Underground Fire Line
Setbacks
Front Rear Left Right
❑✓ As per Approved Site Plan
Comments:
z�4_z'�' K!t
Permit No.
Date Permitted
Builder Name/Owner Name Control #
County Parcel No. 2,6 Z 00,3D/OR00 001 D SubDiv: ',cis
Address/Location v� �?(��! N��
Classification/Type of Use
TRANSPORTATION IMPACT FEE Rate: Sq. Ft Unit: Il
Exempt o Yes 1—I No (, How Determined
Impact Fee Amount S 1 aft) ) 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
Zone
Exempt =Yes No How Determined
LIBRARY FEE
Land Account Land Credit
Facility Account Facility Credit
Exempt = Yes No How Determined
Recreation Total
Total Amount $�l
Facility Total
Total Amount
RESOURCE FEE ERU
Total Amount
Prepared By w{rChecked By
I
NO CERTIFICATE OF OCCUPANY WILL BE ISSUED OR
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.
DATE
RECEIPT NO DATE
RECEIVED BY