HomeMy WebLinkAbout22-5191City of Zephyrhills
5335 Eighth Street
zephyrhills, FL 33542 BNR-005191-2022
Phone: (813) 780-0020
Fax: (813) 780-0021 Issue Date: 11/29/2022
Permit Building ew (Residential
r"r,
r, a
6800 Ripple Pond Lp 04 26 21 0140 00100 0140
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
Phone: (813) 574-5700 Mechanical Valuation: $14,809.20
Plumbing Valuation: $21,156.00
Total Valuation: $279,259.20
Total Fees: $13,575.45 Ya
w
Amount Paid: $13,575.45( "
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Date Paid: 11/29/2022 7:34:54AM
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CONSTRUCT TOWNHOME 1400 SO FT AS
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Plumbing Permit Fee $145.78 Park Impact Fee - Single Family/Townhome $769.56
Building Permit Fee $1,097,80 School Impact Fee - Single Family $3,353.00
Transportation Impact Fee $3,445.20 Public Safety Impact Fee -Police $254.00
Electrical Permit Fee $198,67 Mechanical Permit Fee $114.05
Mechanical Plan Review Fee $0.00 SIF 1 percent Fee $33.53
Water Connection Residential Fee $1,010.00 Address Fee $30,00
Fire Wall/Smoke Wall Inspection $15.00 Public Safety Impact Fee -Admin $26.35
Electrical Plan Review Fee $0.00 Driveway Fee $45.00
Sewer Connection Residential Fee $2,090.00 3/4 Water Meter Residential Connection Fee $732.71
Plumbing Valuation Fee $0.00 Transportation Impact Fee - City $34.80
Building Plan Review Fee $180.00
REINSPECTION FEES: (c) With respect to Reinspection fees will comply with Florida Statute 55.80(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.
rj )jdL--
CONTRACTOR SIGNATURE PE IT OFFICE
rMIT EXPIRES
w: • MONTHS WITHOUT APPROVED
."
PROTECTCALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
CARD FROM WEATHER
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received Phone Contact for Permitting 908 770 7763
1 1 1 1 1 1 1 1 1 1 1 1 1
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 I N/A Owner Phone Number
Fee Simple Titleholder Address
N/A
JOB ADDRESS
6800 Ripple Pond Loop
LOT
# A014
SUBDIVISION
Abbott Square
PARCEL ID#
04-26-21-0140-00100-0140
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED
II./ I'
h
NEW CONSTR 8 ADD/ALT
INSTALL REPAIR
SIGN
DEMOLISH
PROPOSED USE
SFR COMM
OTHER
TYPE OF CONSTRUCTION
BLOCK FRAME t
STEEL
DESCRIPTION OF WORK
Multi family i Screen Enclosure / Fence
U/R SF 1763 SO FOOTAGE 1400
BUILDING SIZE I
HEIGHT 18`
LIII�JBUILDING
$ 211560 VALUATION OF TOTAL CONSTRUCTION 25
V ELECTRICAL
$ 31734
PROGRESS ENERGY
W.R.E.C.
AMP SERVICE
PLUMBING
$ 21156
I1�/ (MECHANICAL
�=GAS
$ 14809.2
VALUATION OF MECHANICAL INSTALLATION
ROOFING SPECIALTY
OTHER
FINISHED FLOOR ELEVATIONS
FLOOD ZONE AREA
YES Do
BUILDER r COMPANY Lermar Homes, LLC
SIGNATURE REGISTERED Y L_N__j FEE CURREN Y / N
Address 4301 Boy Sco 1vd Suite 600 Tampa, FL 33607 License # CGC1518166
ELECTRICIAN COMPANY Edmonson Electric, Inc.
SIGNATURE REGISTERED Y L_N_j FEE CURREN
Address License #
�EC13005408
PLUMBER COMPANY Bayonet Plumbing, Heating & AC, Inc
SIGNATURE REGISTERED Y L N__J FEE CURREN Y / N
Address License # (CFC042998
MECHANICAL COMPANY Bayonet Plumbing, Heating & AC, Inc
SIGNATURE REGISTERED L.Y( N
t
Address License # I CAC058062
OTHER COMPANY C Sterling Quality Roofing, Inc
SIGNATURE REGISTERED Y / N FEE CURREN Y / N
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 wl 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 e contractor o/
contractors to undertake wmnk, they may be required to be licensed in accordance with obde and |ooe| 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 a(727-847-
80O0. Fudhennore, if the owner has hired e contractor orcontractors, he in advised to have the contractor(s) sign
portions of the "contractor B|nok^ of this application for which they will be responsible. If you, as the owner sign as the
contractor, that may baan indication that he is not properly licensed and is not entitled hopermitting 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|dingo, or expansion of existing bui|dinge, as specified in Pasco County Ordinance number8Q-U7 and
90-07. as amended. The undersigned also understendo, that such feen, as may be due, will be identified at the time of
permitting. It in further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving o "certificate of occupancy" or final power na|emae If the project does not involve m certificate of occupancy or
final power re|eeae, 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, aoamnended): If valuation nfwork ia$2.5OUOOormore, |
certify that |, the app|ioant, have been provided with a copy of the "Florida Construction Lien Law —Homeowner's
Protection Guide" prepared by the Florida Deportment of Agriculture and Consumer Affairs. If the applicant is someone
other than the ''ovvne/'. | certify that | have obtained o copy of the above described document and promise in good faith to
deliver ittothe "owner^prior tocommencement.
CONTRACTC>R'S/C]VVNER'SAFF|D/\V|T: | certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable |owa regulating conntruction, zoning and land development, Application is
hereby made to obtain m permit to du 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 |ewo regulating
uoneiructinn. County and City cpdee, 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 Boyheadu, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment.
- Southwest Florida Water Management Oimhiot-VVe||e, Cypress Bayheedo, Wetland Aveas, Altering
Watercourses.
Army Corps ofEngineeru-8eavva||e.Docks, Navigable Waterways.
Department of Health & Rehabilitative Semicea/Environmental Health Unit-VVe||o, Wastewater Treatment,
Septic Tanks.
U5Environmental Protection Agency -Asbestos abatement.
- Federal Aviation AuthoriLy-Runvvoyo.
| understand that the following restrictions apply tnthe use offill:
- Use nffill ionot allowed inFlood Zone ^V^unless expressly permitted.
- If the fill material in to be used in Flood Zone ^A^, it is understood that o drainage plan addressing a
"compensating volume" will be submitted at time ofpermitting which is prepared by e professional engineer
licensed bythe State ofFlorida.
- If the fill material is 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 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 propertiea, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots |mae than one (1)
acre which are elevated by fill, an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction, | understand that m separate permit may be required for electrical work,
p|umbing, uigno, woUo, pon|s, air condidoning, ges, or other installations not specifically included in the application. A
permit issued shall be construed to be license to proceed with the work and not aaauthority to vio|oba, conoe|, e8er, or
set aside any provisions of the technical oodoe, nor shall issuance of permit prevent the Building Official from thereafter
requiring o correction of errors in p|ano, construction or violations ofany codes. Every permit issued oheU become invalid
un|ana the work authorized by such permit is commenced within six months of permit iaouonoe, 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 nequeoiod, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned,
omNen OR AGENT_Subscribed and sworn f-o (or affirmed) before me this
Who ii/are personally known to me or hasihava-pfG46Ge4
as identification.
Notary Public
Commission No. GG 296057
Stephanie Farmer
Subscribed and sworn to (or affirmed) before me this
813/2n22 by
Who is/are personally known to me or has/have produced
as identification.
Notary Public
Commission No. Gsz96os7
Stephanie Farmer
DESCRIPTION: LOTS 13 18, BLOCK I, ABBOTT SOUARE PHASE, IA,
ACCORDING TO THE PLAT THEREOF RECORDED IN PLAT BOOK —
PAGE OF THE PUBLIC RECORDS OF PASCO COUNTY, FLORIDA
PROPOSED Ft OVATIONS AND GRADING
SHOWN I IERECIN ARE TAKEN FORM IHE PILL
ENGINEETV1`46 PLANS OF
-ABBOTT SQUARE RESIDEELPAi -. PREPARED
BY _WRA'PROVIDED BY CLIENT
iq
E, l"', A Is Prat trect
ALI ELEVATION[ PEIVRENCFD
TO NORTH AMERICAN I
VERT,CAL DATUM OF 1988
ENAVD 88)
0
Scale: 1 = 20' <
Cr
LL
z
TW- TOP OF WALL 0j, 6- f
BW- BASE OF WALL U A. R
0 4
2'OAK
F
10.00 PUB! IC 0 TILITY EASEISIENT�—
n
LEGEND: I
, If<
-- PROPOSED DRAINAGE FLOW
(00 00) - PROPOSED GRAVE
E-CiO00- EXISTING GRADE
LOT GRAFNNG TYPE - A
PROPOSED PAD ELEVATION - 101. 10
FRONT SET BACK - 20
SIDE SET BACK - 7.5
SIDE SET BACK (CORNER i 01) - 15
REAR SETBACK - 15
LOT FT
LIVING AREA -_0_04 __SCL FT
PORCH -j_ZA,___,SCF FT,
GARAGE - SO, F1,
COVERED LANAI SO, FT,
PATIO -_N4A_SCL FT,
POOL AREA N SO. F F
CON( DRIVE FT,
A/C & C ONC PAD R (2jS -,SCF FT_
SIDEWALK SO, Fj,
I -OF SOD N/A__ SO PT.
R/W SOD SO, FT,
LOT OCCUPIED 'R,
AREA TO IRRIGAFF
PROPOSED,
MINIMUM FLOOR ELEVATIONS,
LIVING AREA 10 1 77'
GARAGE AREA:
ELEVATIONS REFERENCED TO
NORTH AMERICAN VERTICAL
DATUM OF 1988
SITE PLAN
I NOT A SURVt Y)
SEC 4 TWP 26 S, RNG 21 E.
PASCO COUNTY, FLORIDA
(ABBOTT SQUARE)
APPARENT FLOOD HAZARE)ZONE X (CEMMUNITYNO QOS35 NOTE, ENUPYWALKSARE 3000NCRETE
ABBREVATIONS
RMAPNELA48ER 1710ICV289RFFFFCrtVF DATE 09,126,2914 C;CA/C Ut3:fS ARE 3 2 X3 2
LING111 S), lAm Ill 111N, " I'll, is: , lF I I V1,
A,, , 14,,011slI11W I, 11111fils"'Mi` 01 , 1 01 lt� I I I1111 AA —I
11 A—Ml. I- I I -RE11TI1 It I ANDY APF I'All ME Ell PI I IF —All I 'It—, `I- A -I
"Ar I, ""'I "' " , -, ('let V 1111 Ill E: "A"l 1, 1 111, 1 1111".oT III 11A'
W Nit t All I -I AY 'At All i, 6( q I
-a, I I 01 (Elk , MI AII'llf V I— 11-1-1-1-10N I M1 L Nr
—WIF rIE-1-4l, 11-11.1-1-111
'CONt l It MIN IlIfNt
",o � P I— �
A, AA I I It ,I t "atv �l IIP 1,1 ENI) IRI to "WE 11vt tIll FlAol
11 - I 1A101T1 I Ill IOMM"' '--
I 'Is lll� All leElt!'I
Ellt(,I .It AM, I r 011MIA, W- Ill' 11 "1 Ito I I ItIl I go, W" T I —
"'M,It If'
,
mo r ?" 011PPIE slAitl I'Volo
, _s, VI'N- fr`EPI i""'
SUR
JOB #5401 VOITS NOTESI TE
1,) CuriOlt Title IliformotIon on the subject ptoperty, TKId riot been This mail ke f de,,mpe
CE,,FFIf SIto Plan: 4-13�22 furnished Ill Initial Point Cel"I Suave do LLC m tiro ti'lle Of this "rope a n. iand
2W_GAi L 12 11181 SITE 51 1 NE RAN abf a, to,
2.) ThIs,keoh was prepared -thout the beneftof a title search. surows I, to : rl�
N. lostwrileno of record I ofFeC11119 oet'llel INT), roscroVot' IT Sw yor n.R$PiP' 051 - I, rot"
File FlEghb-of-woy welt, fuirlshed to th-mcfersigned unlesT otherwise 7 Mtfeda AVAleenure Corte,
shevo-, peteen -hamI o Section 472 Q77, tKf. St e
Lrr— loy. CUP 3,It R.Atd,. wilks, and othor sireilv, olls show,, hole011 were tsklll aw
.m engsrTeerin9 Elam and arc subject to su"ey.
"I Th,, SITE PLAN does not to fleet determineo`,lTI1'F`E,P
RMSIONS 5.) Pit, SITE PLAN is subjed to I-nartol-h— In it,, Flat of
'ABBOTT SOUARE PHASE, IN D., t
6,) Dilren—, shown hereon air , feet net of"It-)f Polito L
thereof 123 t8#811
7.; Col tractor d owner are to verify all -Zoacioi, bulldro
dir --ri ono, "d Ieout o,~' hereon prior to any —IstEo too
NOT VA I ftLsd W*
andr—AmSfy rdo,Ie Initial P.lPt L"Id S—oy'rlq, LLC of Y SIGN TURE
Fadore tod—eMill, Ise LICEt4SED SURV APPER
'tuser's solewk
IA I I NCI
1708 1XITt" Ok D"',
To,ree, Spn'lqs' ri
Phone (7;!71-83 1
Fk,T,d,PLS7I23XFqoIE,
LEPE 8183
11
Initial Point Land Surveying, U-C
Permit No. (51W
Date Permitted
Builder Name/Owner Name Control
County Parcel No. 6 ( 24 0/1/0 P,6�M�SubDiv: _A6L,
Address/Location —&—gQ2--f4-d—/e
Classification/Type of Use
TRANSPORTATION IMPACT FEE Rate: Sq. Ft Unit:
Exempt o Yes EJ No How Determined
Impact Fee Amount 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_
PARKSAND RECREATION FEE
Land Account Land Credit — Land Total
Recreation Account Recreation Credit Recreation Total
Zone Total Amount $2�f.
Exempt =Yes = No How Determined
LIBRARY FEE
Land Account Land Credit Land Total
Yes No How Determinffl-9
Exempt E-1 A
Facility Total
Total Amountl:�__�
RESOURCE FEE ERU
•
I
mm
RECEIPT NO — DATE BY
0
9
Project Name:
Parcel Tax ID:
SOW=
\/-RA
Notice to Building Official ®f
Use ®f Private Provider
Effective January 20, 2003
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, 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: DEBRA ANNE KLAHR
Address: 747 SW 2ND AVE- SUITE 170,301,357,& 358, GAINESVILLE, FL 32601
USE=
HEMbam
a 0
Florida License, Registration or Certificate #: (LIC # SU1967/ 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 perfonned 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
Corporation
Partnership
LENNAR HOMES, LLC
Print Corporation Name
Print Partnership Name
By:
By:
(signature)
(signature)
(signature)
Print
Print
Print
Name:
Name: Christopher Smith
Name:
Address:
its: Authorized Agent
Its:
Address: 700 NW 107tlaAve
Address:
Telephone
Miami, FL 33172
No.:
Telephone
Telephone
No. 813-574-5700
No.:
— -V.'M-AWY1'1PWX I
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
Before me, this 22ND day of
MAY 202-2,
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
Before me, this day
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.
Personally known X ; or Produced identi cation Type of identification produced
Signature of Notar Print Name ASHLEE CALLAHAN
Notary Public Stamp: ASLAR - AN
H�E CAL
pubij� - State of Florida
Commission Expires: ;�l GG 244456
ItCotTIM, Expires Nov 4, 2022,
NOVEMBER 30, 2022
t rouSh t4wonDl Notary Am,
VR/\
VIRTUAL REVIEW ASSIST
Private Provider
Plan Compliance Affidavit
Private Provider Finn: Virtual Review Assist, Inc.
Private Provider: Debra Anne Klahr, BU 1967
Address: 747 Southwest 211d Avenue
Gainesville, FL 32601
Phone: 813-391-2959
Email: 1yZf.Cqayti1tLiq ireviewassist.coni
Project: New SFR
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: I,2,3,4,5,6,7,8,9,10,10.1,L1, FP-1,SN, SNI,S3,S4,S5,SS, DI,WP,PAI.0,PAI.l,PAI.2,PAI.3, SHLO,
SHI.l,SH1.2,SHI.3,SHIA,SHI.5
Florida License/Registration/Certification #(s) and description:
FS468 Certified Standard Plans Examiner
License #: PX2300
Signature of Reviewer: zL
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
foregoing is true andrjt to the best of his/her knowledge or belief.
�Z"o kmw C
zgnature of Notary Print Name
Notary Public: NOTARY STAMP BELOW My
commission expires:
ASH�-EE CALLAHAN
O'Ub�ic - ,E� of Horida
Notc,r7 St
Commi-sion �'GG 2444!1 6
My omm, F ' X,--C'S NOV 30, 2022
CI
ry ASSIP
n000ed ASSIP
11-5 COMMERCIAL BUILDING SERVICES DIVISION Of RESIDENTIAL
BUILDING PERMIT DATA SHEET
TRACKING #
FOLIO
FIRE MARSHAL #01 -
Required Permits
WBuilding
Fj Ins ection Only
VPlumbing
El Inspection OnL
VMechanical
El Inspection Only
VElectrical Amp
[j Inspection OnLy
Roof
[:1 Gas
I
L_
[] Medical Gas
El Fire Sprinklers
❑ On Site Piping
F] Fire Line
E] Irrigation
Ej Fire Alarm
El Potable Backflow Assembly
[:] Fire Line Backflow Preventer
El Irrigation Backflow Assembly
[:1 Demolition
El Walk-in Cooler
El Refrigeration
n Hood
E] Ansul
n Fence/Wall
0 Grease Trap
E] Other
E] Other
Type Construction:
LB
i Risk Category:
� Occupancy Load
OWaney Classification:
act0Ty
"Residential l
Assembly
Hazardous
'Storage=
usmoss ay Care/Educational
Institutional F:Mercantile
0r�u,ty
Building Use: Single Family Alteration -'Level I Level 2 [E]Level 3
VNew Construction n Interior Finish E] Interior Remodel n Exterior Remodel ❑ Addition Ej 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-up
Fj Metal El Other Squares: 19
Zoning:
Wirdborne Debris:
El ,,
DInside,
Pf Outside
Energy Code:
405-2020
Flood Zone: X Base Flood Elevation: Finish Floor Elevation:
Hydrostatic Vents? ®'Yes No I Sq. Ft. Enclosed Space Below BFE:
# of Vents:
Size of Vents.
Total Sq. In. Permanent Openings
9 Central A/C
El Gas A/C
Z Heat Pump
0 Gas Heat
El Window A/C
E] Electric Heat
MUM.
Sanitary Sewer
Storm Sewer Catch Basins
Potable Water
Underground Fire Line
Setbacks
Front Rear Left Right
F-11 As per Approved Site Plan
Comments: