HomeMy WebLinkAbout22-5100BNR-005100-if.
22
Issue Date: 12/06/2022
Permit Type: Building New Residential)
0
BEER
6851 Ripple Pond Lp 04 26 21 0140 00100 0780
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: $211,560.00
TAMPA, FL 33607 Electrical Valuation: $31,734.00
rN
Phone: (813) 574-5700 Mechanical Valuation: $14,809.20
Plumbing Valuation: $21,156.00
Total Valuation: $279,259.20
Total Fees: $13,575.10
Amount Paid: $13,575.10
Date Paid: 12/6/2022 10:19:46AM
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N IMINMTWOME
CONSTRUCT TOWNHOME 1400 SO FT AS
77"77-7777MT,
021 'j`461,,,ffl �,0MR,,,Ng
t
"gr SRO, Z
t 11R
,A
Public Safety Impact Fee -Admin $26.35 Mechanical Plan Review Fee $0.00
3/4 Water Meter Residential Connection Fee $732.71 Plumbing Valuation Fee $0.00
Park Impact Fee - Single Family/Townhome $769.56 Electrical Plan Review Fee $0.00
Mechanical Permit Fee $114.05 Transportation Impact Fee - City $34A5
Building Permit Fee $1,097.80 Address Fee $30.00
Transportation Impact Fee $3,445.20 Building Plan Review Fee $180.00
SIF 1 percent Fee $33.53 Electrical Permit Fee $198.67
Plumbing Permit Fee $145.78 Fire Wall/Smoke Wall Inspection $15.00
Sewer Connection Residential Fee $2,090.00 Public Safety Impact Fee -Police $254,00
Water Connection Residential Fee $1,010.00 School Impact Fee - Single Family $3,353.00
Driveway Fee $45.00
REINSPECTION FEES: (c) With respect to einspection 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.
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your property. If you intend to obtain financing, consult with your lender or an attorney
before recording your notice of commencement."
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.
CONTRACTOR S
..TP
,CT", s,"'T"r
PE IT OFFICEE)
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER i
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received Phone Contact for Permitting gag 770 --
7763
Owner's Name CAL HEARTHSTONE LOT OPTION POOL 03 L P Owner Phone Number 813.574.5700
Owner's Address 23975 Park Sorrento, Ste. 220, Calabasas, CA 91302 Owner Phone Number
Fee Simple Titleholder Name N/A Owner Phone Number
Fee Simple Titleholder Address
N/A
JOB ADDRESS
6M1 Ripple Pond Loop
LOT# A078�
SUBDIVISION Abbott Square PARCEL ID#
04-26-21-0140-00100-0780
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED
NEW CONSTR ADD/ALT
SIGN DEMOLISH
INSTALL REPAIR
PROPOSED USE
SFR COMM
OTHER
TYPE OF CONSTRUCTION
BLOCK a FRAME
STEEL
DESCRIPTION OF WORK
Multi -family / Screen Enclosure / Fence
BUILDING SIZE U/R SF 1763 SO FOOTAGE F400
HEIGHT 189
vBUILDING L211560 VALUATION OF TOTAL CONSTRUCTIONN
ELECTRICAL $ 31734 PROGRESS ENERGY W.R.E.C.
LIKiAMP SERVICE
PLUMBING $ 21156
MECHANICAL $ 14809.2�� VALUATION OF MECHANICAL INSTALLATION
a,
GAS ROOFING SPECIALTY OTHER
FINISHED FLOOR ELEVATIONS E=
FLOOD ZONE AREA Li YES Do
I II
BUILDER COMPANY Lcrmar Homes, LLC
SIGNATURE REGISTERED Y L N__J FEE CURREN Y / N
Address 4301 Boy Scout Blvd Suite 600 Tampa, FL 33607 License # CGC1518166 ��
ELECTRICIAN COMPANY Edmonson Electric, Inc.
SIGNATURE REGISTERED Y / N FEE CURREN
Address License # EC13005408
PLUMBER COMPANY Sayonet Plumbing, heating & AC, Inc
SIGNATURE REGISTERED Y/ N FEE CURREN Y I N
OR
Address License # I CFC042998
MECHANICAL COMPANY Bayonet Plumbing, Heating & AC, Inc
SIGNATURE REGISTERED Y/ N FEE CURREN Y I N
Address License # CAC058062
OTHER COMPANY C Sterling Quality Roofing, Inc
SIGNATURE d REGISTERED Y / N FEE CURREN
Address License # �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 OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work, they are advised to contact the Pasco County Building Inspection Division —Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this application for which they will be responsible, If you, as the owner sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Trans ortation Irn act Fees and Recourse Recover Fees ma a I to the construction of new hiii1din rhi
OWNER OR AGENT
Subscribed and sworn fo- (or affirmed) before me this
8/312022 by Christopher Smith
3re personally known to me or lias.(hav
as identification.
J7_� &___ Notary Public
Commission No. 65Isons7
Stephanie Farmer
Subscribed and sworn to (or affirmed) before me this
813/2022 by Christopher Smith
Who is/are p�rsonally known to me or has/have produced
as identification.
Notary Public
Commission No. sazssns
Stephanie Farmer
w
DESCRIPTION: LOTS 77-82, BLOCK 1, ABBOTT SQUARE PHASE IA, SITE PLAN � —ALLELEVATIONS REFE
SEC, 1 1, TWP. 25 S, RNG 21 E.
ACCORDING TO THE PIATTHEREOF, RECORDED IN PLAT BOOT( 89, RENCED
PAGE(Sj28-35, OF THE PUBLIC RECORDS OF PASCO COUNTY, ;NOT A SURVEY) TO NORTH AMERICAN PASCO COUNTY, FLORIDA
VERTICAL DATUM OF 1988 ABBOTT SQUARE
PROPOSED ELEVATIONS AND GRADING (NAND 881
SHOWN HEREON ARE TAKEN FORM THE
ENGINEERING PLANS OF I
I ABBOl7 SQUARE RESIDENTIAL', PREPARED I o N
BY "WRAPROVIDED BY CLIENT I
AND FENCE AREA �OPEN SPACE
49'S3` KIP) 112,00
I RACT "B- I'
I ACCESS/DRAINAG LANDSCAPE/WALL MAINTENANCE 3 J
This SITE PLAN Prepared forandCrtified To:32 /20
1
Lennar Homes !o (I 0`IPI `� 62 � i •�
ONb _
LOT = 202 5 SO_ FT- 1� 207 A-e , 19.8 35 LIVING AREA = 8634 SO FT o U ENTRY a. i I -- --� 1
PORCH = 124 SO. FL. o ^ E
GARAGE -1484 SQ_FL ^' /IN PROPOSED
1 STORYVILLA LOT77 o
COVERED LANAI = 612 SO, FT. 8.o PLAN 1500 BLOCK I IM
PATIO
N^7A SQ. FT. 3.2'x3.z. ELRAGE L o
POOL AREA C/SA E I
- N/ASQ. FL / GARAGEL j
CONIC. DRIVE = 1418 SO, FT. = I
A/C& CONC PAD = 60 S0, FT, 195 S87'4953"e IP1 112.00 LP)
SIDEWALK vYYy 69-a~
582 SQ. FT H.o -
LOTOCCUPIED 630'
AREA TO IRRIGATE = 36 % PROPOSED a
' IN A I STORY VILLA ENTRY 13.A' I.
RJ PLAN 1397 __
H.0' GARAGER BLOCK81 - 3 21 5�+ I '+.�
N
3.2X32'
2 ICS A/C
M
e -
2 S 67'49S3" E IP) 11 Z00' IP) '- N
Z E. - 62.5'62,5
I ,:
32X32
z o3 ^ 4 A/C ^ PROPOSED
Scale; 1 - 20 STORY va A
V q Q a ^H.0' N PLAN 1397 LOT 79 5.3
'o- Q�
ELEV'TH' BLOCK 1 21 5 d FL
� z `` I,G GARAGEL ENTRY 138'
� w
g o
z b
Is / S87'49s3 ELP 11200(Pf Q {���„
A.0' /
CL
6. • .i m IQ�Q
`. PROPOSED _ o
w ^ -
N 4..�p NAt, I STORY VILLA ENTRY R o
= 2" ODIC < d 8.0 PLAN 1397 LOT 80 0 3
TW= TOP OF WALL ELEV "TH' BLOCK 1
32X32 GARAGE 5.3 j
+ 10.00 PUBLIC UTILITY EASEMENT CIS -A/C ,^P f,
NOTE: ENTRY WALKS ARE 3 CONIC _ _ - S87'4953 EF) uzoo -IP) N 3 I.
LEGEND: _ ciswc r s ---__— -- __c l
PROPOSED
-�►= PROPOSED DRAINAGE FLOW 80
1 STORY VILLA 3
0
)00.00) = PROPOSED GRADE PLAN 1397 LOT81
N NA ELEV 'TH" BLOCK 1 --k 21.S
E-00-00 =EXISTING GRADE ��, 'S, m GARAGEL ENTRY 138
�Ob t9.5' S87'49'S3"EIPI 112.00'fP)�
NOTES:
LOT GRADING TYPE -A 21 PROPOSED 1'
PROPOSED PAD ELEVATION -- 103.30" _ 1 STORY VILLA p
FRONT SET BACK = Z0 E A.o' PLAN 1500
3-
2X3.2' N ELEV"TH"
SIDE SETBACK =Z5' g� C/SAC GARAGE L0182 I S
SIDE SET BACK (CORNER LOT) =15- m m 98 N Y 441 BLOCK 1 3 4 1� 2
REAR SETBACK IS ..._. 207 8.0 0 05' f
PROPOSED:
MINIMUM FLOOR ELEVATIONS:
LIVING AREA:103.97' S&7°4953•E)Pj i1200')P) j 2�°IPL_-__._..,
GARAGE AREA: i p—TW 100. 16
ELEVATIONS REFERENCED TO i w OT83 Wro09n woo33a
NORTH AMERICAN VERTICAL ; BLOCK 1 .4
DATUM OF 1988 1
APPARENT FLOOD HAZARD ZONE: "X` COMMUNITY NO. 120235
SURVEY ABBREVIATIONS )MAP NUMBER 12 10 1 C-0289-F) EFFECTIVE DATE: 09/26/2014
AI ARC ENGTH it _ pEE T INV - wv R vc A =o N Or CURVE (R'= e=_CORD LEGEND A— =ENCe
A/C=XR CONDITIONER DRANAGE`AN'NAN 9-llC NSF 90rSUESS PCr LR NI OV'C04 OUN`J CURVE PNC, RANuf.
A ALUM NUMFENCE LORELLV LEVANON E= LANDSCAPE FASEMrNF PCP- PERNANL NT CON' 20 POINT RRS- RAIL ROAD SP:KI:. +3t7,•S�-CONIC —
U—
E-BASE FT CLOD T— ON top, EDGE OF PAVEMENT LFL -LOWES VA ILOOPE EON PTO UI POLOPMEN: Ose-REa0 OF WAY
M=BENC MARY ISM EASEMENT =LI CTNSEP SURVEYOR PG- AGE SFC -S C'ON WOOD FENCE
C CURN r,C - I EICL COsNLR fMI - MEASURED PI-PONT Of NTERSECTION SNdp=Sr NAIL AND t>SK 'ASPHALT � 1 —
I -ULC A I CM., I CUNJ COWRE TE "Es -MTER p NDSEc—1 °r -PARK R"LON ti-83
CEMi LIN MONUMLN NC -NC CORNERFOUND R PRNH Yt1NF SR-SETICF RONRODIB1,818i C A-N.INKCENCF
C. 4CHAN NYFIFNCE FIP=FOUND IRON PHPE OIA- OVERA! P013 POINT OF BEGINNING TENT- TEMPORARY BENC IT MARK �-`BRICK —� —T
C P-1 RRUGA1fLMFTA I,,_ FOUND.RONROD ONW'-CO Rt AD SORES) POC PO Nr Of (OMOL NCTMENT TOR - TOP OP BANK
CO =CO UMN INRD=FOUNDNA;! &DSX OR. -O OW RECORDS POL ON ON UNF SO,FOWNS �'IP A.JM NUM fEN(E
CONE -CONCRETE OP=FOUND OPEN PIPE ('I ^IIAT PRC OINI OF REV`ZSE C[/RVE
C/S CONCITFSITT J-�•=UTI VcASEMFNI -COVERED
CO- It SIGHT TRIANGLE HIP - FOUND PINCHED PIPE P ISATBOOIC PRM^PERMANENTRFFFRENCEMONJMLNI VF,VINYLIENCE
JOB #5629 SURVEYOR'S NOTES: SURVE,1(RRjUqfTIPICATE 1708 Water Oak Drive
9.) Current title information on the subject property had not been This ced�„ifai� at�pW�ce reon described Tarpon Springs, Florida
Date of Site Plan: 6-5-22 P P A" 9c-'R I )
furnished to Initial Point Land Surveying, LLC at the time of this ro ert - a rvision and Phone: 727 -831 1990
)WG.AS2./7 82-B1-SrIE SITE PLAN meetsti0're ptfc�-' s7ofIS, ce for FloridaPLS7123Cagmail-core
?.) This sketch was prepared without the benefit of a ttife search. sury s as tsjbRFth e r a B*d of Land LB# 8183 °
No instruments of record reflecting ownership, casements or S a eri
pc r(ghIS of -way were furnished to the undersigned unless otherwise S - Fl 1 dn��ztr� i� � Ned
shown hereon. r to Section 4, �1, i L�$F��eY
Drawn by DJB 3. Roads, walks, and other sim➢ar items shown hereon were taken to f?
Checked bylH from engineering plans and are subject to survey. "E e6Jdt2 .07.29
4,) This SITE PLAN does not reflect nor determine ownership.
IEVISIONs �- ( Ito.-04'00'
5.) This SITE PLAN is subject to matters shown on the Plat of
-ABB0T7 SQUARE PHASE I A"----�r,-'?'�q�Z- "= �, �2�- _..........
6.) Dimensions shown hereon are in feet and decimal portions .leff M- Ha,��yy����''rryy UrveJ0 at, 77��
thereof. FLORIDA PR06E11(t}'{�U.VEYOR AND V
7.) Contractor and owner are to verify all setbacks, building MAPPER NO. LS#7123 LB#8183
dimensions, and layout shown hereon prior to any construction, NOT VALID WITHOUT THE ORIGINAL
and immediately advise Initial Point Land Surveying, LLC, of any SIGNATURE AND SEAL OF A FLORIDA 11
deviation from information shown hereon. Failure to do so will be LICENSED SURVEYOR AND MAPPER Initial Point Land Surveying, LLC.
at users sole risk.
Ell
Permit
,*ato PemIy7Q—v-7AW
B Wider Name/Owner Name Control#
County Parcel No. SubDiv:
Address/Location A7,004
333���
TRANSPORTATION IMPACT FEE Rate:
Sq Ft Unit: / VOO
Exempt I E] Ves E] No How Determined
Impact Fee Amount 7 Zone No,
TAZ:
SCHOOL IMPACT FEE
Account (056) Single -Family D stached House Amount
$,3�
(057) Mobile Home '
(058) Other Residential
23) Collection Fee
Exempt � Yes E] No How Determined
EC ATI FEE
Land Account Land Credit Land Total
Zone - I
Exempt []Yes No
Recreation Total
s 76 �SZ f_
Land Account Land Credit Land Total
Facility Account _ Facility Credit Facility Total
Exempt [] Yes E] No How Determined Total Amount
ERU
TOTAL AMOUNT
PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN, PAID AND
RECEIPTED F09-01-Y-, n,,illrsr-Lvjl-t-*-EF-IPIF-141-,F—R
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.
_LATE RECEIVES B �Y
RECEIPT N. — DATE BY
W, I
�M=s�Mjm
Algiffin
0
Project Name:
Parcel Tax ID:
Services to be provided:
V
`Z T
v P' Notice to Building Official of
Use of Private Provider
Effective January 20, 2003
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 553.79](2) Florida Statute.
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: DEBPA ANNE KLAHR
Address: 747 SW 2ND AVE- SUITE 170,301,357,& 358, GAINESVILLE, FL 32601
Telephone:
F-59SYMKITM:
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 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.
13WOM
(signature)
Print
Name:
Address:
Telephone
No,:
Please use appropriate notary block.
STATE OF -FLORIDA —
COUNTY OF -HILLSBOROUGH
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
Name: Christopher Smith
its: Authorized Agent
Address: ZQQ NW 107t11 �v
Miami, FL 33172
Telephone
No. 813-574-5700
Corporation
Before me, this 22ND day of
MAY 20 2_2
personally appeared
of
Lennar Homes, LL —,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 identi cation- Type of identification produced
Partnership
Print Partnership Name
RIA
(signature)
Print
Name:
Its:
Address:
Telephone
No.:
Partnership
Before me, this day
Of 20_
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 ofNotarY—) "Lk �Qe Print Name ASHLEE CALLAHAN
Notary Public Stamp:
V ASHLEE CALLANAN
Commission Expires: Notary NbU < State of Norida
GG 244456
NOVEMBER 30, 2022 'Canim. Expires Nov 30, 2022
.N500W Notary Assn,
VR/\
VIRTUAL REVIEW ASSIST
Private Provider
Plan Compliance Affidavit
Private Provider Firm: Virtual Review Assist, Inc.
Private Provider: Debra Anne Klahr, BU 1967
Address: 747 Southwest 2 d Avenue
Gainesville, FL 32601
Phone: 813-391-2959
Email: lu —virtualreviewassist.co,iii
Project: New $6 54*r
Address(s): 6851 Ripple Pond Loop
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, 10. 1, L LFP- 1,SN,SN 1,S3,S4,S5,SS,D LWP,
PA L0,PA 1. 1,PA 1.2,PA I .3,PA 1.4,SH L0,SH 1. 1, SH L2,SH 1.3,SH 1.4,SH L5
Florida License/Registration/Certification #(s) and description:
FS468 Certified Standard Plans Examiner
License 9: PX2300
Signature of Reviewer: e,
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
Z�
e and correct to the best of his/her knowledge or belief.
RI &�ne-p rj0'k1C'VAr-V--"
§ignature of Notary Print Name
Notary Public: NOTARY STAMP BELOW My
commission expires:
ASHLEE CALb
Pu I" SL'.
otary Public Suitonda
Notary
7
Commission # GG 74-1,4`6
L`��
My
Mv Comm, Expires '<,
F
Sondeclthrougfi
ecl� IC,'
Natrona!
'�-'nc
FOLIO68' .. - '• • LoOD
TRACKING #
FIRE MARSHAL #01 -
Required Permits
9/22/02
.b • Klahr PX23011
Building
❑ Inspection Only
'Plumbing
❑ Ins ection Only
WMechanical
0 Inspection Only
'Electrical Amp
[-1 Ins ection Onl
Roof
❑ Gas
❑ Medical Gas
❑ Fire Sprinklers
® On Site Piping
❑ Fire Line
E:1 Irrigation
❑ Fire Alarm
❑ Potable Backflow Assembly
❑ Fire Line Backflow Preventer
❑ Irrigation Backflow Assembly
❑ Demolition
El Walk-in Cooler
❑ Refrigeration
❑ Hood
❑ Ansul
Fence/Wall
❑ Grease Trap
❑ Other
❑ Other
UMMOMM
Type Construction:
V"g
Risk Category:
Occupancy Load
O ancy Classification:
Factory __�
Residential �
Assembly Business ay CarelEducational
Hazardous Institutional r ercantile
Q-Storage ��� [] YJtility
Building Use: Single Family 1 Alteration Level 1 Level 2 Level 3
New Construction ❑ Interior Finish ❑ Interior Remodel ❑ Exterior Remodel ❑ Addition ❑ Revision
Overall Size:
26-8 x 71
Number of Stories:
1
Total Sq. Ft.:
1763
Living Area: 1400
Covered Area: 363
# of Bedrooms: 2
# of Baths: 2
Cost per square foot:
Estimated Value:
Roof Type: ® Shingle
❑Tile ❑Built-u ❑ Metal ❑ Other Squares: 19
Zoning:
Wi orne Debris:
Inside Outside
Energy Code: 405 2020
Flood Zone: X Base Flood Elevation: Finish Floor Elevation:
Hydrostatic Vents? ❑ Yes No Sq. Ft. Enclosed Space Below BFE:
# of Vents:
Size of Vents:
Total Sq. In. Permanent Openings
9 Central A/C
El Gas AIC
® Heat Pump ❑ Window A/C
❑ Gas Heat ❑ Electric Heat
Sanitary Sewer
Storm Sewer Catch Basins
Potable Water
Underground Fire Line
Setbacks
Front Rear Left Right
❑✓ As per Approved Site Plan
Comments: