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Home My WebLink About22-5411City of Zephyrhills 5335 Eighth Street Zephyrhills, FL 33542 BNR-005411-2022 Phone: (813) 780-0020 Fax: (3) 80-0021 Issue Date: 01110/2023 817 ZEMEMNEIM� LENNAR HOMES LLC-OWNER Permit Type: Building New (Residential) Class of Work: SFR Construct 4600 W Cypress St 200 Building Valuation'. $284,640.00 TAMPA, FL 33607 Electrical Valuation: $42,696.00 (813) 574-5700 Mechanical Valuation: $19,924.80 Plumbing Valuation: $28,464.00 Total Valuation: $375,724.80 Total Fees: $19,952.23 Amount Paid., $19,952,23 Date Paid: 1/11/2023 7:24:19AM Em. nsportation Impact Fee - City $36,32 Address Fee $30.00 ctrical Plan Review Fee $0.00 Water Connection Residential Fee $11010.00 lation 314 Meter {Cale} $732,71 Driveway Fee $45.00 1 1 percent Fee $83.28 Transportation Impact Fee $3,595.68 robing Plan Review Fee $0.00 Public Safety impact Fee -Police $254.00 iool impact Fee - Single Family $8,328.00 Public Safety Impact Fee -Admin $26.36 �hanical Permit Fee $139,62 Mechanical Plan Review Fee $0.00 R impact Fee - Single Family/Townhome $769.56 Sewer Connection Residential Fee $2,090.00 Iding Permit Fee $1,46120 Building Plan Review Fee $180,00 Water Meter Fee (Calc) $732,71 Plumbing Permit Fee $182.32 ctrical Permit Fee $25148 1111 111�111111 1111111,11IIII!I1� 11111 111 1 ___ - __ __ I � 0 , ''� ' 0 417111��* A' II T 6 accordanco with City Codes and Ordinances�. N6'OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. 01MICToR WMIIATM'PEfAIT OFFICEU PEREXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REOUIRED 813-780-00,U City of Zephyrhills Permit Application x 780-0021 Building Department .t" Date Renewed Phone Contact for Permitting 908 770 7763 Or III IN go ET3ZE ""70e.»`r Owner's Name CAL HEARTHSTONE LOT OPTION POOL 03 L P Owner Phone Number 8135i4.50 Owner's Address 239?5 Park Sorrento, Ste. 220, Calabasas, CA 91302 Owner Phone Number C Foe Simple Titleholder Name I N/A Owner Phone Number Fee Simple Titleholder Address I NIA JOB ADDRESS 6386 Beverly Hills Drive LOT# 1232 SUBDIVISION Abbott Square � PARCEL ID# 04-26-21-0150-01200-0320 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR 8 ADD/ALT L ] SIGN 0 DEMOLISH INSTALL. REPAIR PROPOSED USE SFR COMM OTHER TYPE OF CONSTRUCTION f BLOCK 0 FRAME STEEL DESCRIPTION OF WORK Single Family Residence i PaoI1 Screen Enclosure i Fence BUILDING SIZE U/R IF 2372 �� SQ FOOTAGE 1936 HEIGHT �^° �rre^cur^9rrr°�emr-r�rrb�e®rmr0�e�s—eme�—�a��*^ BUILDING $ 284640 VALUATION OF TOTAL CONSTRUCTION d.A tELECTRICAL $ 42696tltly�� AMP SERVICE PROGRESS ENERGY W.R. E.C. 1.� P PLUMBING $ 28464 (MECHANICAL $ 1g��4 8 VALUATION OF MECHANICAL INSTALLATION 0 a t GAS ® ROOFING = SPECIALTY L J OTHER FINISHED FLOOR ELEVATIONFLOOD ZONE AREA EJ S YES DO -7 BUILDER COMPANY Lennar I Iomes, LLC� SIGNATURE I ee° REGISTERED Y/ N FEE CURREN Y! N 4301 W Boy Scout�y 3 Suit 6 tmpa, FL 33607 < CC15181F6 Address 6 License # ELECTRICIAN COMPANY Edmonson Electric, Inc, SIGNATURE REGISTERED Y/ N FEE CURREN Y I N Address License If I EC13005408 PLUMBER COMPANY Bayonet Plumbing, Heating & AC, Inc ,SIGNATURE REGISTERED Y I N FEE CURREN Y 1 N� Address License # CFC042998 �� MECHANICAL COMPANY I Bayonet Plumbing Heating & AC, Inc SIGNATURE e s REGISTERED Y/ N FEE CURREN Y I N Address F L� Licanse# I CAC058062 OTHER COMPANY C Sterling Quality ROOfEng, Inc SIGNATURE �� REGISTERED Y I N FEE cURREN Y( N Address License# 1 CCC057991 0!![9l9�$tYIIICi��'ft[E91!(f61E1B!/@E11161111E9111iFEf�ili1119I�1I RESIDENTIAL. Attach (2) Plot Plans; {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 (PloUSurvey/Footage) Driveways -Not over Counter if on public roadways -needs ROW E= 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 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 buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and 90-07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of permitting. It is further 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 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, as amended): If valuation of work is $2,500.00 or more, I certify that 1, the applicant, 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", I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "owner" prior to commencement. CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: Department of Environmental Protection -Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment. Southwest Florida Water Management District -Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. Army Corps of Engineers -Seawalls, Docks, Navigable Waterways. Department of Health & Rehabilitative Services/Environmental Health Unit -Wells, Wastewater Treatment, Septic Tanks. US Environmental Protection Agency -Asbestos abatement. Federal Aviation Authority -Runways. I understand that the following restrictions apply to the use of fill: Use of fill is not allowed in Flood 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 a "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction, I certify that fill will be used only to fill the area within the stem wall. If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties, 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 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. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other 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 violate, cancel, alter, 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 issuance, 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 requested, 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. OWNERORAGENT Subscribed and sworn S (or affirmed) before me this 10127!2022 by Christopher Smith Who is/are personally known to me orb as identification. Notary Public Commission No....... GG 296057 AV:A]ffl� [gM2fA1F_1W I _Q_' Subscribed and sworn to (or affirmed) before me this 10)27/2022 by ChristopherSmith Who is/arrsonallyknown to me or has/have produced as identification. Commission No. GG Stephanie Farmer Stephanie Farmer NameNM:J1 NameofNgMj I 'L MVH" FARM low Notary Public Permit No. Coate Permitted Builder Nam/Owner Name Control County Parcel No, Subiu; Address/Location l t Classification/Type of Use i 6 TRANSPORTATION IMPACT FEE Rate: � Sq. Ft Chit. —L Exempt Yes 0 No How Determined Impact Fee Amount c 3 - Zone No. TAZ:— SCHOOL IMPACT FEE Account (056) Single -Family Detached House Amount f ? (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 Recreation Total Zone Total Amount Exempt =Yes No Flow Determined LIBRARY FEE Land Account Land Credit Land Total Facility Account Facility Credit Facility Total Exempt Yes No How Determined Total Amount RESOURCE FEE ERCI NORJTlFYe OF �OCCUPANY WILL BE ISSUED OR FINAL INSPECTION PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE SEEN PAID AND RECEIPTED FOR BY A CENTRAL PERIVRITING OfFICE OF PASCO COUNTY ACKNOWLEDGEMENT BELOW DOES NOT IMPLY ACCEPTANCE OF CONCURRENCE, BUT SIMPLY REECEIPT OF A COPY OF T FORM, PLACING THE BUILDING OWNER ON NOTICE OF THIS ASSESSMENT AND THE CONDITIONS OF PAYMENT FOR SAM] DATE RECEIPT NO DATE BY � FF;107,97 PAt3;107.30 � i i:107.42 106.0 �— RETAININGWALL #5 493 CF TYPE `A' I ca FF:108.07 PADA07.40 l:107.27 105.9 f TYPE a J i ^ eel' r ie L; Iw '" 11 I IIM�IJ�lllll I , �I�� I 4 OEM FOUND L l f i - MONUMENT NO ID. =-- 5TYPE 1.12' E a4-34 FF:107.47 Q i PA0:106.80 103.94 TYPE 'B` FF:107.87 i PAQ:107.20 106.45 1 — 0107.17 103.32 f" r TYPE'B' DESCRIPTION: LOT32, BLOCK 12, ABBOTT SQUARE PHASE 18, SITE PLAN ACCORDING TO THE PLAT THEREOF, RECORDED IN PLAT BOOK 89, PAGE(S)57-62, OF THE PUBLIC RECORDS OFPASCO COUNTY, INOT A SURVEY) FLORIDA.� his SITE PLAN Prepared for and Certifted7a� PROPOSED ELEVATIONS AND GRADING Lennar Homes i SHOWN HEREON ARE TAKEN FORM THE ENGINEERING PLANS OF "ABBOTT SQUARE RESIDENTIAL', PREPARED LOT = G325 „_SQ. FT. BY "WRA" PROVIDED BY CLIENT. LIVING AREA=19�3(;i__S0. FT. PORCH = 20 SO. FT, t-_.._ _..._._..._ .._.. GARAGE = 4SQ. FT, COVERED LANAI = N1„A qSQ. FT. PATIO =.23 _SO. FT. POOL AREA =NIA „--.SO. FT. CONIC. DRIVE = 507 SO, FT. A/C & CONC PAD = 7 SQ. FT. SIDEWALK = 29 FT. —SOL LOT SOD = NSA _SO. FT, R/W SOD = N^SQ. FT, LOT OCCUPIED = 4§% AREA TO IRRIGATE = 54 % BLOCKI2 N8T53'07"WJP) I15.00') W �: IN ^ �. ?! • . j ( 225 65.0` L _ u. '0i ' `� PROPOSED 1 STORY RESIDENCE j L• 22.5' 128' 4.3' ENTRY PLAN 1941 Q + 3 CON C ELEV Q .. t WALK •.1 3.7 GARAGEIR 0 ^i • �� `� _. LOT32 Q m o IN BLOCK 12 t .�ck n lu '� ..• � . .in 31.T• 25.6,(P) • O N 87'53'07' W (P) I t 5.00' (PJ LOT31 BLOCK 12 0 NOTES: d 0 POL LOT GRADING TYPE = A PROPOSED PAD ELEVATION = 108,00 FRONT SET BACK - 20` SIDE SETBACK - T5' SIDE SETBACK )CORNER LOT) =15' REAR SETBACK - 15 2" OAK PROPOSED: * = 10,00' PUBLIC UTILITY EASEMENT MINIMUM FLOOR ELEVATIONS: LEGEND: LIVING AREA: 108.67' GARAGE AREA: _;% PROPOSED DRAINAGE FLOW ELEVATIONS REFERENCED TO (00,00) = PROPOSED GRADE NORTH AMERICAN VERTICAL E-00.00 = EXISTING GRADE DATUM OF 1988 SEC. 11, TWP. 25 S, RNG 21 E, PASCO COUNTY, FLORIDA )ABBOTT SOUARE) Sole: 1" = 20' z7 sz 7 xa.T -- CsA/° IO¢'w id 111P�A �++, _G4p 27.5' G O H Vol 1 t i I i APPARENT FLOOD HAZARD ZONE: W COMMUNLIY NO, 120235 SURVEY ABBREVATIONS (MAP NUMBER 12101C-0289-H EFFECTIVE DATE: 09/26f2014 A - ARC, I ENGTH D'-DEED INN - INVERT PC - POINT OF CURVE +) �ALL ELEVATIONS REFERENCED � TO NORTH AMERICAN VERTICAL DATUM OF 1988 NAVD 88; A/C -An CONDMONIR I I D-E- DRAINAGE EASEMENT - i&-LICENSED SUSNESS PCC OINI Of COMPOUND CURVE Ev RECORD RN. -RANGE �!-`-��-'v VINYIFrNCE AF=ALUMINUM RNCE EL p1 R.EV EL[VAION IE-LANDSCAPE EASEMENT PCP PEMAN1 NT CONTROL POINT PM - RAIL ROAD SPIKE f37=�=CONE 0--.--0--- R E BASE c. O(?JI-LEVATION O EDCl CV AVEMENT IfE=LOWET FLOOR f EVATiON P/E POOL FOUIPMENT LFW=RIGHT Or WAY 4M n BENCH MARX C CU2VE SM'T-EASEMENT FFNC( CORNER IS- LICENSED SURVEYOR PG=PAG. M � MEASURED PI -� POINT C F E TERSECT,'ON I ) SE= FCEION SN&0-SEi"NA:L.ANDOSX "- hSPl1ALT WOODFENCE l i --- (Cr CALCC.ATrJ CMaMIF N']CONCRETE 'c i° MFS-MITEREDEND SFCtION P!(=AYKtR KAiON LEC8183 4 a CENTERLINE CLP-CHAIN LINK PENCE FIR= FCIUNOIRON PIPE TIP-rO ND' @ NCI-LAVERCORNERILF6UNh PONTPPOREYIJNE O/A-OVERALL P05 OD I SIR =SEEM TEMPORCINRARY MFNVHx Bfa3 1't3M=Tt`M^C)RARY6ENCH MARK �Af3RICK CHAIN LINK FENCE x-fF CMP-CORRUGATEDMCTAE PIP FIR s FOUND IRON ROD OINOF COMMElNG DHW rOVERHLAD W4REISI POCe PtklNr OF COMMENCTMENT TOB - TOP OF BANK Co' To LIMN CONC-CONCRETE FN&D- FOUND NAILS DISK O.R. =OFFIOALAM C)S POL� POINT ON LINE TWP=TOWNSHIP ALUMfNUM FENCE C/S- CONCRETE SLAB F011, Nb OPEN PIPE fp =PLOT PRC POINT OP REVERSE CURVE U-E=UIUTY CASEMENT �=COVERED _ \\ C. CLEAR vGH'JrrtIANGLF `PP'FUUNp PINCHED PIPE ME - PLAT BOOK PRM- PERMANENT' REFERENCE MONUMENT yc VINYLFENCE JOB #5726 SURVEYOR'S "NOTES: - SURVEYOR'S CERTIFICATE 1.) Current title information on the subject property had not been This certifies tt�, y'the hereon described ,,*"1 i furnished to Initial Point Land Surveying, LLC at the time ofthis property �[�yj{} e upervision and SITE PLAN meets 111C`A e ip Practice for 1708 Water Oak Drive Tarpon Springs, Florida P 9 Phone: (727)-83 t 1490 FloridaPLS7t23CagmaiLram Date of Slte Plan. 7-t t-22 DWG.AS-PHIS-s`€ 2.) This sketch was prepared without the benefit of a title search. surv4 ova '° ,, �oard of Land LB# 8183 xd ° No instruments of record reflecting ownership, easements or S tfi IC�7 Y1e pile: prawn by pJ6 rights -of -way were furnished to the undersigned unless otherwise shown hereon. , Flo i Is( aG p u uantltoSection 477 C:k# F � tHartl y 8) Roads walks, and other similar items shown hereon were take sue, 4l Da �r'� 5 Checked bylH from engineering pions and are subject To survey. L �22.Q8. REVISIONS - 4•) This SITE PLAN does not reflect no,determine ownership. >' F10 •� 04it} f 6.) This SITE PLAN is subject to matters Shown on the Plat ofs l A ABBOTT SQUARE PHASE 18' - —,-,t- 6,) Dimensions shown hereon are infect and decimal portions Jeff M �i 11 _---•`.. Qp Ge Fi ORtDA 1FTshS U`�i°1'ORAND thereof MAPPER NO.-de4s�® 83 7.) Contractor and owner are to verify all setbacks, building dimensions, and layout shown hereon pimr to any construction, NOT VALID WITHOUT THE ORIGINAL and immediately advise Initial Point Land Surveying, LLC. of any SIGNATURE AND SEAL OF AFLORIDA deviation from information shown hereon, Failure to do $o will be LICENSED SURVEYOR AND MAPPER at user'. sole risk. ��ccynsse9 14'tYtuT�. Kra I �f Initial Point Land Surveying, LLC. I C) I JO- 0 la(Y)- V7 /\ 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: 111��4L, Av gqLi�vicLwas- - _J-qL -- —5ist,com Project: New SFR Address(s): 6388 Beverly Hills Drive 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 affitant, 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: CS,1,2,3.1,3.2,FI,4,5,6,7,8, SN, SNI,S3,S4,S5,SS, DI,WP,PAI.0,PAI.1,PAI.2,PAI.3,PAI.4, 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 beforej)acby 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 orrect to the best of his/her knowledge or belief. Signature of ' otary U P4rin�arne�--- Notary Public: NOTARY STAMP BELOW My LUCERO KING My COMMISSION # HH 310390 EXPIRES'July2,2026 ...... .... ... \/RA V IR-1 UAL REVIEW ASSIST 1 Notice to Building Official of Use of Private Provider Effective January 20, 2003 Project Name: �::'' �' I !Ili ii 'IN 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 553.79](2) Florida Statute, I— Ste , the fee owner, affirm I have entered into a contract with the Private Provider indicated below to conduct the services indicated above. =�L REVIEW &SSIST, INC, Private Provider: DEBRA ANNE KLAHR Address: 747 SW 2ND AVENUE - SUITES 1 Telephone: 813-376-3088 Fax: N/A 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 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. aniount of $1 million per occurrence relating to all services performed as a private provider, including tail coverage for a rninimum of 5 years subsequent to the perforinance.of building code inspection services, :(signature) Print Naive: Address: M -111M.-M Individual B efore me, this day of 20— personally appeared who executed the foregoing instrument, and acknowledged before me that same was executed for the purposes therein ocpressed. Corporation Print Corporation Name (signature) Print Name: Chrlst2pher Smith its: Authorized Aggnt_ 0 111� I Address: 70"� 10 f vt- Miami FL 33172 Telephone No. 813-574-5700 Corporation Beforeme,this 22ND day of MAY 2o 2.2 personally appeared of �L:�ennar �Home�sLLQ�. 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. ME= Print Partnership Name M (signature) Print Name: nag= Partnership Before me, this day of .20 personally appeared p artner/agent on behalf of a partnership, who executed the foregoing instrument and acknowledged before me that same • Personally known X ; or Produced iderti cation_ Type of identification produced Signature of Not PrmtNatne —ASHLEE CA-L—LAHAN— NotaryPublio Stamp: 'ASRLEE CAUAHAN Commission Expires: Piotary pubjlt State Di Fiofl6 G6 244456 NOVEMBER 30,2022 0, E%;j(a5 NOW 40, AVLA Page 2 of 2 rQJ111 COMMERCIAL BUILDING SERVICES DIVISION VIRESIDENTIAL BUILDING PERMIT DATA SHEET L FIRE MARSHAL #01 - Required Permits Imm, Building VI'lumbing VMechanical Electrical Amp El lnspeqt�iono■ Ins ection (Onil U��on Only Elln�p_ection On�y El Medicaii l Gas El Fire SA II III prinklers El On Site Piping— El Fire Alarm Potable 11ackilow Assembly E] Fire Line IIIII II Backfiow Preventer DIrrigation Backflow Assembly El Walk-in Cooler Refrigeration r rease Trap F Construction: V-B lRiisk Category: Occupancy Load n, Cla sification: Factory ly Hazardous Day Care/Educational institutional []Mercantile Residential 'Assemb Storage= - Building Use: Sin le Family Alteration Level I Level 3 ILevel 2 VNew Construction El Interior Finish E] Interior Remodel E] Exterior Remodel ®addition Revision Overall Size: Number of Stories: Total Sq. Ft.: 40 x65 1 2372 Living Area: Covered Area: # of Bedrooms: 4 1936 436 # of Baths: 2 Cost per square foot: Estimated Value: Roof jypL. Shingle Tile ilt -u etal ®Metal Other Zoning: Wi orne Debris: "'JeDr's. Energy Code: 405-2020 Inside ide Outside Flood Zone: X Base Flood Elevation: Finish Floor Elevation: Hydrostatic Vents? Sq. Ft. Enclosed Space Below BFE: # of Vents: Size of Vents: Total Sq. In. Permanent Openings Central A/C Heat Pump —- 0Window A/C El Gas A/C El Gas Heat El Electric Heat On Site Piping Sanita Scwcr Storm Sewer Catch Basins Potable Water Underground Fire Line Setbacks Front Rear Left Right Asper Approved Site Plan Comments: