HomeMy WebLinkAbout22-5437I
Phone: (813) 574- 700
City of Zephyrhills
5335 Eighth Street
t ephyrhill , FL 33542 R- 47- 2
Phone: (313)780-0020
Fax. (13) 7 0-0021 Issue gate; 01/1012023
RM
f fRM
Class of
Building Valuation: ! t0
Mechanical Valuation: Electrical Valuation: $40,716.00
Valuation:Plumbing Valuation: $27,144,00
Total 0i
Total Foos: $19,865.11
Amount
Date Paid: 1/1112023 7:24:19AM
Y 1764 SQ FT ***AS
Irrigation314 Water Meter Fee (Cale)
$IF I percent Fee
Public Safety Impact Fee -Admi
Transportation Impact Fee
Plumbing Plan Review Fee
Electrical Permit Fee
Electrical Plan Review Fee
Transportation
6458 Garden Wall Way
itr ctor. L NNAR HOMES LLC
ti
$73211 Building Plan Review Fee
$180:00
$83.28 Driveway Fee
$45.00
$2US Public Safety Impact Fee -Police
$254,00
$3,595.68 Plumbing Permit Fee
$175.72
$0.00 Address Fee
$30.00
$243.58 Park Impact Fee - Single Family/Townhome
$769,56
K00 Mechanical Permit Fee
$135,00
$73 .71 Sewer Connection Residential Fee
$2,090,00
$36.32 wilding Permit Fee
$1,397.0
$1,010.00 School Impact Fee - Single Family
$8,328.00
$0.00
t
•, i' 4'.. iF.
agenciesentities such as water management, state M*
Complete Plans, Specifications add fee Must Accompany Application. All work shall be performed in
accordance fl... and Ordinances. OCCUPANCY BEFORE
NO OCCUPANCY BEFORE C.O.
,(313.780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received
Phony Contact for Permitting 908 770 7763
Owner's Name GAL HEARTHSTONE LOT OPTION POOL 03 L P Owner Phone Number 813.574.5700
Owner's Address 23975 Park Sorrento, Ste. 220, Calabasas, GA 91302 Owner Phone Number
Fee Simple Titleholder Name NIA Owner Phone Number �m
Fee Simple Titleholder Address
I N1.4
JOB ADDRESS
36458 Garden Wall Way
LOT# 0714
SUBDIVISION Abbott jftUare � PARCELto#
€i4-26-?i-Q150-OQi00-014Q
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED
��hh
It !I
NEW CONSTR F_I ADDIALT SIGN
DEMOLISH
INSTALL REPAIR
PROPOSED USE SFR COMM OTHER
TYPE OF CONSTRUCTION BLOCK FRAME STEEL
DESCRIPTION OF WORK
Single Family Residence I Pool I Screen Enolosure /Fence
BUILDING SIZE
LT112 SF�6�
SO FOOTAGE
1764
HEIGHT
-e^-
BUILDING
$
271440
J11
VALUATION OF TOTAL CONSTRUCTION
��I
lal #ELECTRICAL
$ 40716 __
PROGRESS ENERGY
W.R.E.C.
AMP SERVICE
PLUMBING
$
27144
II.� (MECHANICAL
�
1�90Q0 $
VALUATION OF MECHANICAL INSTALLATION
w
�$
GAS IZ i ROOFING = SPECIALTY OTHER
v t
FINISHED FLOOR ELEVATIONS
r
FLOOD ZONE AREA DYES D0
g
BUILDER COMPANY LennaT IIoines, LL(;
SIGNATURE REGISTERED Y / N_ FEE CURREF Y / N
Address 4301 W Boy Scoff vd S &00 Tarnpa, FI. 33607 � License # CGC15I8166
ELECTRICIAN COMPANY l dm4nse�n Electric, Inc.
SIGNATURE REGISTERED Y / N FEE cuRREn Y ! N
Address License# EC1300540$
PLUMBER 7A COMPANY Bayonet Plumbing, Heating &HOC, Inc
SIGNATURE 7 REGISTERED YIN FEE CURREE Y 1 N
Address License# CFC04299$��
MECHANICAL 7 COMPANY Bayonet Plumbing Heating & AC, Inc
SIGNATURE REGISTERED LILN J FEE CURRE1
Address License # CAC058062
OTHER COMPANY Quality Roofing, Inc
SIGNATURE REGISTERED Y / FEE CURREN Y ( N
Address License #
11111111111111111111M
1111lEllllllllflll111@IB1111111111111111111@1@111
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy FormS, R-O-W Plermitfor 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
County.
TRANSPORTATION IMPACTIUTILITIES 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'SIOWNER'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.
understand that the following restrictions apply to the use of fill:
Use of fill is not allowed in Flood Zone W" 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.
OWNER OR AGENT
Subscribed and sworn a (or affirmed) before me this
_Lmm by Christopher Smith
Who is/are personally known to me or#a&44av4*ro4woe4
as identification.
Notary Public
Commission No. GG 296057
Subscribed and sworn to (or affirmed) before me this
_L11111,1022 by _Christopher Smith
Who islare ersonally known to me or has/have produced
as identification.
47,:;��
- / — _, —Notary Public
Commission No. GG 296057
Stephanie Farmer Stephanie Farmer
Name Name NameofNNM:j
, I
0-1., STOWIE"ER "4&
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1 E*es fetru" 16, 20
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DESCRIPTION: LOT 14, BLOCK 7, ABBOTT SQUARE PHASE 1B, SITE PLAN
ACCORDING TO THE PLAT THEREOF, RECORDED 1N PLAT BOOK 89,
PAGES 57-62, OF THE PUBLIC RECORDS OF PASCO COUNTY, (NOT A SURVEY)
FLORIDA.
ha SITE PLAN Prepared for and Certified To:
PROPOSED ELEVATIONS AND GRADINGLennar Homes
SHOWN HEREON ARE TAKEN FORM THE
ENGINEERING PLANS OF
"ABBO'TT SQUARE RESIDENTIAL_`, PREPARED
BY "WRA" PROVIDED BY CLIENT j
LOT
= 44 DSO. FT.
LIVING AREA
=_1_2�_SO. FT.
PORCH
= 62
GARAGE
___SQ-FT.
= 379 SO, FT.
COVERED LANAI
= 60 SO. FT.
PATIO
=NSA SO. FT.
POOL AREA
= N--JA SQ. FT.
CONC. DRIVE
= 36_Q _SQ. FT.
A/C & CONIC PAD
= 10 SO. FT.
SIDEWALK
= 42 _SO. FT
LOTSOD
= N(ASCL FT.
R/W SOD
= NSA _SQ. FT.
LOT OCCUPIED
- 37 KE,
AREA TO IRRIGATE
= 63 %
2" OAK
* I0.00 PUBLIC UTILITY EASEMENT
LEGEND
PROPOSED DRAINAGE FLOW
(00,00) PROPOSED GRADE
E-00.00 = EXISTING GRADE
NOTES:
LOT GRADING TYPE - B
PROPOSED PAD ELEVATION -7 105.30
FRONT SETBACK --20
SIDE SETBACK-- T5
SIDE SET BACK )CORNER LOT) t10'
REAR SETBACK= 15'
PROPOSED:
MINIMUM FLOOR ELEVATIONS:
LIVING AREA: 105.97'
GARAGE AREA:
ELEVATIONS REFERENCED TO
NORTH AMERICAN VERTICAL
DATUM OF 1988
ALL. ELEVATIONS REFERENCED
TO NORTH AMERICAN
VERTICAL DATUM OF 1988
)NAVE) 88)
(CDD) RIGHT-OF-WAY
TRACT"A"
GARDEN WALL WAY
N BT48'04" E (P)
BASIS OF BEARING
�
5 CONIC�WALK
r N
84 4804" E (P) 40 00'(P)
rr '.
;�tf�
i'P PC
ff%'9
5) 6114(P)
r to
° Rn
16.0',. CONC
.� IWALK
7.9'
18.T
.i \63' 7.5'
ENTRY
i
6.3'
o
PROPOSED
LOT 13 0
2 STORY RESIDENCE
LOT 1 S
BLOCK 7 r
o PLAN 176.3
ELEV "S'
BLOCK 7
c
GARAGE w
i,I
4
?
LOT14 }
°
BLOCK 7
'v
7.5'
25.07.5'
v
AN F.
0
3.2'X3.2!I
k3y
CIS AI1I
,SpR
/SOS
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u w RnI
I Ln
i
_______ Xk ,
N
8T48'04" E (P) 40.00' (P)
YiQ -------
TRACT "B-6"
8/
(CDD) ACCESS/DRAINAGE/
LANDSCAPE/ WALL
MAINTENANCE AND FENCE AREA
OPEN SPACE
SEC. 4, TWP, 26 S, RING 21 E.
PASCO COUNTY, FLORIDA
(ABBOTT SQUARE)
Scale: 1 " = 20'
APPARENT FLOOD HAZARD ZONE:'X' COMMUNITY NO. 120235
SURVEY ABBREVATIONS
�� )MAP NUMBER 12101C-0289-F) EFFECTIVE DATE: 09/26/2014
AI -ARC IFNGTH
LDI.DEED IW=:MART PC-POINTO URVE (�1)-RFC O.RD
LEGEND
A/C f AIR CONDTIOaFF
AF-ALUMINUMF NCL'
i DRANAGE EESFMEN IB UCFNSED BUSNESS PCC PONT OF COMPOUND CURVE RNG^RANGE
VINYL FENCE
i_,ONC
B _aDASt-r1000 .tFVA tOIv
TOR`LEV ELEVATION LAN JSCAPF EASEMENT PCP Il IIYAN NT CONTROL POINT RRS- RALROAD SPIKE
OP EDG OF PAVEMENT F' C)EVt STILOORF EVA ON R/E POOL EQUIPMENT lMt -R(GII `l WAY
a1R,3 .y,
BN=3ENO M I(
C CURV(
SM T �-EAS MEti IS-LICI N4 :SURVEYOR PG- AGE SF -SECTION
WOOD FENCE
-AS1—I
KI CAICut A )
IC FENCE CORNER iMj - MI ASJRLD PI-IONI OF NTERS[CrION SN6C;=SFTNAIi-ANDD4Y
t CNTtRNE
It'M n. FOUND CONCRETE MES- MIT ERED F ND SE CTION PLC-PARKEIRMLON Las-3
MONUMENT NET -NO CORNER FOUND ROP.R.UN SIR -SKI 121ONROi;.Bx&1D3
OALNLINKFENCE
CtiAtN Ne ENCE
: p t=OIUD. RONN,PIPE O,A-OV OVERALL PO-3 POINT OF BEf NN hG &Rfmt M-C 2ARY QENt N7JARK
1�..... BR. GrC.
CpR'3UCA �D MEIA =. (
Us- FOUND IRON ROD OHW-OVERHEAD FORERB POC ,CANT OF COMMENCTMIN- C;3 u'p O�'3ANN
CO..^COLUMN
CONC
ESL
fNFD=FOUND NAZI fiDISK O.R. -Of WE RECGYRDS POl ONT`7N :NE 1Y/P K'OWNSI IIN
ALUM NitM FENCE
G'S A CO -
DNCRF1
FOP-FOUNDOP.NPIPE Ir --[AT ERE POINTO REVERSF CURVE U -C-UTi ITY EASEMENT
^COVERED _' �i
,,
CS. -CLEAR SIG IiiANG...
A, s
FPP -FOUND MNIC HERD PRE PB= PLAT BOOK PRM '. RMER ET R... REINCE MONUMt N7 VF- VINYL FENCE
JOB #5810
SURVEYOR'S NOTES: SURVEYOR'S CERTIFICATE
1708 Water Oak Drive r c
Datc of Site Plan 8--5-22
9.) Current title information on the subject property had not been This certifies that sketch of the hereon described
fumishedtoInitial Point Land Surveying, LLC. at the time of this propertywas yyckSkYfA. u rvlslon and
SITE PLAN „„,,��„.�J
s ve she IC je) ,� io+t�
2.) This sketch was prepared without the benefit of a title search. s ve s r t' 7d of Land
No instruments of record reflecting ownership, easements or S - gh
s Florida
Tarpon Sol tog -
p p
Phone:(727)-831-1990
FloridaPLS7123@gmaiLcom
LB# 8183
iwG:Asrt 6_ 4e �srre
-
yle,
rights -of -way were furnished to the undersigned, unless oth,—Ae I 3 Irr ,a
hereon,
Drawn by: DUB
shown ur(meant Section * 32 7 FI Idn to
3.) Roads, walks, and other similar items Shown hereon were take p a LJa'�e�
�hecked byJH
-
from engineering plans and are subject to survey tie 2022
4. This S[TE PLAN does not reflect nor determine Ownership.
A
"S'
L Y'
S.) This SITE PLAN is subject to matters shown on the Plat of t 0, >1
"ABBOTT SQUARE PHASE ➢IS -- � as Ek.^0 �'1 �� Q�I
� R _-
6. Dimensions hereon In feet decimal Jeff M
shown are and portions
FLORID tE3Nr5CSiR AND
I
V
thereof,
MAPP_R 4t936.7ry3�8
7.) Contractor and owner are to verify all setbacks, bui ding
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
deviation from information shown hereon. Failure to do So will be LICENSED SURVEYOR AND MAPPER
Initial Point Land Surveying, LLC.
:1 Z.2uj
F A U: I UH4 �IU
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F E �B' TYPE'B' Ty Ty T T P'
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F 101-67 IF.102.27 ItF. 447 IFF. 5 7 JF� 5 7] 7] IFFY FF:102.97 J,
AD:101.0IRAD:101.6 I W%D:10230 D: 103. 1 NAD,:103,.8 I IMD:104.5 I IMD:1053 I D:106.0WD:106.70 AD:1063 PAD:104M
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• 103.50104,24lO4.98 10 5.
Permit No.
Date Permitted
Builder NameMwnet Name Control
County Parcel No subiv.
Address/Location
Classification/Type of Usei r t.' l
TRANSPORTATION IMPACT PEE Rate. Sq. Ft Unit. 1
Exempt 0 Yes 0 No Now Determined
Impact Fee ,Amount ' - Zane No. TAZ:-
SCHOOLIMPACT FEE
Account (056) Single -Family Detached House Amount
(057) Mobile Home
(058) Other Residential
(123) Collection Fee
Exempt = Yes C3 No How Determined.
PARKS AND RECREATION PEE
Land Account Land Credit Land Total
Recreation Account Recreation Credit Recreation Total
Zone Total Amount $ 7
Exempt OYes No How Determined
Land Account land Credit land Total
Facility Account Facility Credit Facility Total
Exempt 0Yes No How Determined Total Amounk=4�---
RESOURCE FEE E U
Total Amount
Prepared 9y P Checked By
NO CFRTIF F OCCUIPAWY WILL RE ISSUED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN RAID AND RECEIPTED FOR BY A CENTRAL PERNIFITING OFFICE OF PASCO COUNTY
ACKNOWLEDGEMENT BELOW DOES NOT IMPLY ACCEPTANCE OF CONCURRENCE, BUT SIMPLY REECEIPT OF A; COPY OF THIS
FORA, PLACING THE BUILDING OWNER ON NOTICE OF THIS ASSESSMENT AND THE CONDITIONS OF PAYMENT FOR SAME,
DATE RECEIVED 6Y
RECEIPT NO DATE 6y
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 21 Avenue
Gainesville, FL 32601
Phone: 813-391-2959
Email: wkg�-alreviewassist,com
Project: New SFR
Address(s): 36458 Garden Wall 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 afflant, 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
Florida License/Registration/Certification #(s) and description:
FS468 Certified Standard Plans Examiner
License #: PX2300
Signature of Reviewer:
—7
SWORN AND SUBSCRIBED before ma* 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 and correct to the best of his/her knowledge or belief,
---o <�-qKta Signature .*ota Print T-Jante
commission expires: ff?
\/R/\
VIRTUAL REVIEW ASSIST
Notice to Building Official of
Use of Private Provider
Effective January 20, 2003
I Pre'')i ;�� Sli ject Name: J'A I
Parcel Tax ID: 04-26-21-0150-00700-0140
Services to be provided: Plans Review X Inspections
Note: If the notice applies to either private plan review or private inspection services the Building
Official may require, at his or her discretion, the private provider be used for both services pursuant to
Section 553,791(2) Florida Statute.
I— Steve Smith , the fee
owner, affirm I have entered into a contract with the Private Provider indicated below to conduct the services
indicated above.
Private Provider: DEBRA ANNE KLAHR
Address: 747 SW 2ND AVENUE - SUITES 1
Telephone: 813-376-3088 Fax: N/A
ME=
1111111111 !Ill 1� I !!!I! Ill 11111 lillmils !Ill � I I � ::1 -
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 t e require
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,
(signature)
Print
Name:
Address:
Telephone
No.:
STATE OF FLORIDA
COUNTY OF HILLSBOROUGH
Individual
Before me, dais 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
(signature)
print
Name:Shrlstopher Smith
Authorize ent
Address:-ZQQ-NW--1--0-7th—A —Ve
Mia �1FL�3�172
Telephone
No. 813-574-5700
Corporation
Beforeme,this 22ND day of
MAY -,2o-2,2
personally appeared
of
Lennar Homes LLQ 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
M
(signature)
Print
Name:
Its:
Address:
Partnership
Beforeme,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. of Notaxn PrintNamo . ASHLEEL—ALLAHAN
Notary Public Stamp:
Commission Expires:
NOVEMBER 30, 2022
AsHLEE MLAHA
Wary pubvic 4. State of Florida
0njMj5Sj6r.# GG 244456
IV I-ExplraS NOV 10, 1022
LhrDqh Nnt)onnt NOIArrNY hgan
..............
Page 2 of 2
COMMERCIAL BUILDING SERVICES DIVISION VRESIDENTIAL
BUILDING PERMIT DATA SHEET
Fl�ftlll �121 �
Required Permits
nr��
LOMUS"1110M ffiwm��
g VBuildin
nlib
V Plumbing
Mechanical
VElectrical Amp
El Ins ection OnI
Inspection Only
Ins
Inyeetion 0�11,,._
oof
;VV�Roof
s
[I Gas
EJ Medical Gas
Ej Fire Sprinklers
El On Site Piping
El Fire Line
Irrigation
El Fire Alarm
El Potable Backflow Assembly
Fire Line Bacidlow Preventer
El Irrigation Backflow Assembly
El Walk-in Cooler
E] Refrigeration
W
MUTM
0 Fence/Wall
F
El Grease Trap
04=1 ' ,i
T e Construction: V-B
Risk
Occupancy Load
n, sification:
C'n'
OWI Factory
c tory
—Category:
Assembly
Hazardous
us
R13 mes, )Day Care/Educational
'Institutional E],A4ercantile
Residential
'Utility
Building Use-, Single Family_/
Alteration I —Level I Fffi Level 3 Q [[:[,,Level 2
VNew Construction Interior Finish 0 Interior Remodel
E] Exterior Remodel El Addition El Revision
Overall Size:
Number of Stories:
Total Sq. Ft.:
25 x 54
2
2265
Living Area:
Covered Area:
# of Bedrooms: 4
1764
501
# of Baths: 2,5
Cost per square foot: �
Fstimated Value:
�ile�EBuilt-U�Metal
Roo e: ma C
00ther quares:--j6-
Zoning:
Wi orne Debris:
Energy Code: 405-2020
Inside
Outside
Flood Zone: X
Base Flood Elevation:
Finish Floor Elevation:
Hydrostatic Vents?
� ---V�
®;Yes
N o
Sq. Ft. Enclosed Space Below BFE:
# of Vents:
Size of Vents:
Central A/C
9 Heat Pump
E] Window A/C
Gas A/C
El Gas Heat
El Electric Heat
On Site Piping
Sanitar Sewer Storm Sewer Catch Basins
Potable Water Underground Fire Line
omm
Front Rear Left Right
ED As per Approved Site an
Comments: