HomeMy WebLinkAbout23-5539rN
CONTRACTOR SIGNATURE
City of Zephyrhills
1
5335 Eighth Street
Zephyrhills, FL 33542
BNR-005539-2023
Phone: (813) 780-0020
Issue Date; "�:'
Fax: (813) 780-0021
PEIA IT OFFICE()
THOLIT APPROVED
.e1`2\20 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received Phone Contact for Permitting 908 770 __ 7763
Owner's Name CAL HEARTHSTONE LOT OPTION POOL 03 L P Owner Phone Number 813.a74.5700
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 I
NIA
JOB ADDRESS 36532 Camp Fire Terrace LOT# 2202
SUBDIVISION Abbott Square PARCEL ID# 04-26-21-0160-02200-0020
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR 8 ADD/ALT 0 SIGN DEMOLISH
P INSTALL REPAIR
PROPOSED USE 0� SFR (� COMM 0 OTHER
.._..II
TYPE OF CONSTRUCTION 4BLOCK FRAME STEEL
DESCRIPTION OF WORK I Multi -family ! Screen Enclosure / Fence
BUILDING SIZE I UIR IF 2086 SO FOOTAGE 1634 HEIGHT 28
-r rrrrrrmTrv". . rum r-s^
f BUILDING $ 250320 VALUATION OF TOTAL CONSTRUCTION
,, ELECTRICAL 1" 37548 AMP SERVICE ® PROGRESS ENERGY W.R.E.C.
t_
PLUMBING $ 25032 -p
II./ (MECHANICAL $ 17522 4 VALUATION OF MECHANICAL INSTALLATION
Y♦ r
GAS ® ROOFING SPECIALTY 0 OTHER
FINISHED FLOOR ELEVATIONS I FLOOD ZONE AREA DYES Do
-.-.�1-F-g-1-i-1..-5,-S�.i-C 6-W-. . .-. . 1-.1°.-8...- . FAO- .-.-.-.., .-.-.-.-:-1... . Fri-:-.
BUILDER COMPANY Lennar LC
SIGNATURE REGISTERED Y / N FEE CURREN I Y / N
Address 43 1 N Soy _ out Blvd Suite 600 Tampa, FL 33607 License # -C C1518166
ELECTRICIAN COMPANY Edmonson Electric, Inc.
SIGNATURE REGISTERED Y / N FEE CURREN I Y / N
Address License# EC13005408
PLUMBER COMPANY Bayonet Plumbing, Heating & AC, Inc
SIGNATURE REGISTERED Y / N FEE CURREN I Y / N
Address License# I CFC042998
MECHANICAL COMPANY Bayonet Plumbing, Heating & AC, Inc
SIGNATURE REGISTERED Y / N FEE CURREN I Y / N
Address I License # cAC058062
OTHER COMPANY C Sterling Quality Roofing, Inc ^1
SIGNATURE REGISTERED Y / N FEE CURRE< Y / N
Address License# CCC057991
Illlliillllllllllll IIIIIIIIIIIEif1111B1111111111111111111111111/1111
RESIDENTIAL Attach (2) Plot Plans; sets of Building Plans; (1) set of Energy Forms, R-O-W Permit for new construction,
Minimum ten (10) work Ig 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.
1-4 /.-"-4a-. . . . . 1�1®• •
15irections:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required. (AtC 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
ASCO
FLORIDA
a COUNTY!
Permit No. 5
Date Feit d �� —
Builder Name/Owner game Con
trol #
County Parcel No, < , ubDiv.
Address/Location
ClassificatioriType Of Usq
TRANSPORTATION IMPACT FEE Rate. So. Ft Unit:
Exempt Yes No How Determined
Impact Fee Amount Zone No,
Account (55) Single-Farrilly Detached House Amount
(057) Mobile Horne
(3) Other Residential
123) Collection Fes
Exempt Yes No How Determined
TI F
Land Account Land Credit Land Total
Recreation Account
Recreation Credit
Recreation Total
Zone
TOTALAMOUNT $
Exempt Y8s
How Determined
LI Y F
Land Accounf
Land Credit
Land Tout
Facility Account
Facility Credit
Facility Total
Exempt 0 Yes E] NO
HOWDetermined
TotgjAmount
TOTAL AMOUNT
Eta
Crocked By
Vn�
RECEIVED EY
EC IFT NO, DATE BY
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 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.
19,04 11, fficilSkIel I Wou.011 RN I Ul R.R."RTA -4. 1711 =1 0 1 *M COX101 I I = 1.401:14:4 rm I W101 I M ILI IN 4 0111112 &X93 .1 r-A I kin a I k, 010"11 a
OWNER OR AGENT
Subscribed and sworn r0 (0r affirmed) before me this
1112U2 by Christopher Smith
Who is/are -personally known to me or#asA4av&-pro4uGQ4
as identification,
Notary Public
Commission No. GG 296057
111112 by Christopher Smith
Who is/are personally known to me or has/have produced
as identification.
Commission No. GG 296057
Stephanie Farmer -Stephanie Farmer
Name 8T~IE "ER Name of NJ Si ER
ow"Yosewn IGO Mile
a* f E*m Fewmy 15, 20 EVIM February15,2023
.7
Notary Public
DESCRIPTION: LOT 1-4, BLOCK 22, ABBOTT SQUARE PHASE 2,
ACCORDING TO THE PLAT THEREOF, RECORDED IN PLAT BOOK
PAGE , OF THE PUBLIC RECORDS OF PASCO COUNTY, FLORIDA.
PROPOSED ELEVATIONS AND GRADING
SHOWN HEREON ARE TAKEN FORM THE
ENGINEERING PLANS OF
(-ABBOTT SQUARE RESIDENTIAL', PREPARED
By
'WRA PROVIDED BY CLIENT
r ALL ELEVATIONS REFERENCED
TO NORTH AMERICAN
VERTICAL DATUM OF 1988
NAVD 881
NOTES
LOT GRADING TYPE •-A
PROPOSED PAD ELEVATION-11350'
FRONT SETBACK -- 20'
SIDE SET BACK -= Z5'
SIDE SET BACK (CORNER LOT) = 10'
28.3�.
1v,
SITE PLAN
(NOT A SURVEY)
This SITE PLAN Prepared for and Certified To:
Leona, Homes
(CDD) RIGHT-OF-WAY
TRACT "A"
CAMP FIRE TERRACE
N 89'48'04` E (P)
BASIS OF BEARING
SEC. 4, TWP. 26 S, RNG 21 E.
PASCO COUNTY, FLORIDA
(ABBOT( SQUARE PHASE 2)
Scale.- 1 " = 20'
-.- 271 27.7'
N 89.48'04 E (P) 92,68 (P)
•..I 18.00'IP)i ) ila 00(P) I)'E, 2834 P) 7JZS0PC
)
{ 1 4 I N 89 48'04E (P)
QS'(P)
TRACT "B-7A"
ry
ICED) PARKING AREA
100 "'l100 (�{{f_,' 100, �h 100 '
11,0' 1 1 0 1,0 I I 0 4 w
ENTRY
w Lt
ENTRY
ENTRV
w
ENTRY
10.0100
Z
-'
m
TO
63
obi'
TOCis
o_
4b
° m
o
PROPOSED
IZR PROPOSED
PROPOSED
o PROPOSED
w
o� W
Q
-'
ISTORY
TOWNHOME
ISTORY
ETOWNHOME
_=
ISTORY
TOWNHOME
(STORY
o OWNHOME
b
- y
�'
PLAN 1532
RI PLAN 7624
1 o PLAN 7624
,p
o PLAN 7532
rnrl
' ELEV'TH"
�' ELEV "TH'
= ELEV "TH"
v ELEV "TH"
GARAGEL
GARAGE w
L„ GARAGEL
GARAGER
LOTS
(
LOT 4
LOT 3
LOT 2
BLOCKLOT22
k
BLOCK 22
BLOCK 22
BLOCK 22
BLOCK 22
1
18.0'
173
17.3
18.0'
J ANA
;.,
w Nam^
(ANAL
U
NAI�^C
0.0'
73 j`\
3 3
3 3 / ; 3\
I 31
13 �
I Q O'
f—
it
I
I �'I
I
I
2834-IP)
1 I8-00-jPl 1 1800'El
1
28,34'(P))
N 89.48'04" E (P) 92,688 (P)
TRACT "B-T"
(CDD) OPEN SPACE
LOT
= 9083
SQ. FT.
LIVING AREA
= 2682
SQ. FT.
ENTRY
= 280
SOL FT.
GARAGE
= 9S4
SO. FT,
REAR SETBACK = 15'
NOTE: ENTRY WALKS ARE 3.0' CONC
COVERED LANAI
= 436
SO, FT.
C/S-A/C UNITS ARE 32X3.2'
PATIO
= NA
SQ. FT
POOL AREA
=_ NA
SQ. FT.
PROPOSED:
-- 10.00- PUBLIC UTILITY EASEMENT
CONC. DRIVE
= 800
SQ. FT.
MINIMUM FLOOR ELEVATIONS:
A/C & CONC PAD
40
SO, FT.
LIVING AREA: 1 14,17'
LEGEND:
SIDEWALK
= 186
SO, FT
GARAGE AREA:
--- PROPOSED DRAINAGE FLOW
SIDE YARD SWALE
= NA
SO, FT,
ELEVATIONS REFERENCED TO
(00.00) -�PROPOSED GRADE
CONSERVATION AREA = NA
SO, FT,
NORTH AMERICAN VERTICAL
LOT OCCUPIED
=- 60
%
E-oo.00==ExlsrwGGRADE
AREA TO IRRIGATE
__ 40
%
DATUM OF 1988
APPARENT FLOOD HAZARD ZONE: 'X" COMMUNITY NO. 120235
(MAP NUMBER 12101C-0452-F) EFFECTIVE DATE: 09/26f2014
SURVEY ABBREVIATIONS
A ARC LENGTH
ID) - DEED
INV-INVERT
PC -IONI Of CURVE
(R!=RECORD
LEGEND
A/C -AIR CONDITIONER
DI - DILINAGL EASEMENT
LB -LICENSED Fusaff SS
PCC POINT OF COMPOUND CURVE
KING -RANGE
}
VINYL FENCE
t ALUMINUM FENCE
EL OR ELEV -- ELEVATION
L_E- LANDSCAPE FASEMENT
PCP PERMANENT CONTROL POINT
IRS =RAIL ROAD CPCE
B
(INC
--�
RE- BASE FLOOD ELEVAT ION
LOP EDGE HE PAVEMENT
E- LOWEST FLOOR ELEVATION
PCE POOt IQUIPMTO
R/W -RGHT OF WAY
BU BENCHMARK
C'rtiV'
SMT- EASMENT
T`ENC_CORNER
LS- LICENSE[) SURVEYOR
MUERI 'J
°G-PAC,
PI=PAN O iNTERS�LTION
SEC -SECTION
AND DI4K
iB#8183
wASPITALI
WOOD FENCE
fC) CALCUJi IED
F N=MENT CONCRETE
C
M.S-M R t ION
IFS
HE -PARKER KALON
,NAIL
CyAl,N LINK FENS€
c CENT-li. N.
I E=-CHAR NXFENCE
MONUMENT
.ice>FOLND RON"CIF
ErFSEC
NC =NO CORNER FOUND
O/A-OVE4A L
t01 t'iY UNF
POP POINTOf TIEGNN,NC,
VI -SE 12-¢ON ROp LpF 8183
SO - HET
9M-TEMPORARY RENCH MARK
FEEL"
-----3(
CMP=CORRt CA -D rvi`TA P
F2=FOUND'RON ROD
OHW>OVERHEADVIPREIS'
POC PC) O`COMMENCTMENT
OB-TCP OF BANK
COLTCOLUMN
CONC-LONE ROTE
C/S couch"" SL48
FN&D=FOUND DATE&DIS
f0-FOLINO OPEN PIPE
0.2-OFFICiALRF.CORDS
( P =PEA
PDi POINT ON LINE
PRC POINT OF REVERSE CURVE
TWP= CA NSHIP
L.E=UTE-TY ASEMENR
COVERED
ALUMINUM FENCE
% _
CST- CI EAR SIGHT TRIANGLE
R'PP- FOUNO PINCHED PI PE P8 A PLAT BOOK PRIM PERMAWPit
REFERENCE MONUMLN I V-=VINYL FENCE
JOB #5927
SURVEYOR'S NOTES:
1.) Current title information on the subject property had not been
furnished to !nitidl Point Land Surveying, LLC. at the time of thisppv
SITE PLAN
2.) This sketch was prepared without the benefit of a title search.
SURVEYOR'S CERTIFICATE
This certifies th- %&A hereon described
property we'd � �ervision and
meets th a s �� active for
� j
survey S,p� s t 0*4114 t/ tx Nd of Land
1708 Water Oak Drive
Tarpon Springs, Florida
Phone: 727-871-1990
( )
FIOr)daPIS7123F rr iLcom
�i
LBH 8183
Date of Site Plan: 4-8-22
DWG ASPF BEl +-3L22-S:TE
No instruments of record reflecting ownership, easements or
rights -of -way were furnished to the undersigned, unless otherwise
hown hereonDrawn
3.) Roads, walks, and other similar items shown hereon were take
from engineering plans and are subject to survey.
4. This SITE PLAN does not reflect nor determine ownership,}
6.) This SITE PLAN is to the Plat
Su eyp e, 7_ raU
5J o r dr.rt d
sS c o 4 2�77);FTey
S[atu -a !Checked 1date: 24�9.13
�t1 7RIUA9'�a�
T �'y,
�r"" (L'J1An 4T }X.
"le
by. DJB
byJH
REVISIONS
subject matters shown on of
"ABBOTT SQUARE PHASE 2"
Jeff M- H �' �'
P(
6,) Dimensions shown hereon are in fee[ and decimal portions
thereof-
FLO RIDA �7ntdRin'@�'�"8.(t�,(!'�R AND
7,1 Contractor and owner are to verify all setbacks, building
MAPPER NO C i�t,
NOT VALID WITHOUT THE ORIGINAL
dimensions, and layout shown hereon prior to any construction,
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,
at user s sole risk.
.Lz o o �5c
IN
-ml 0 111 ,
I
M
ror,t Kecxr
I oq
v
a
V1i R7 UAL REV4 ASSIST
Notice to Building Official of
Use of Private Provider
Effective January 20, 2003
Project Name: 36532 Camp Fire Terrace
04-26-21-0160-02200-0020
Parcel Tax ID:
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.
MIT= —
owner, affirm I have entered into a contract with the Private Provider indicated below to conduct the services
indicated above.
151 � V1111 I 111 IFF1 I
Private Provider Firm:
Private Provider:
Address: 747 SW 2ND AVE- SUITE 170,301,357,& 358, GAINE5VILLE, FL 32601
riiii►M
Email Address (Optional):
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.
Individual
(signature)
Print
Name;
Address:
Telephone
Please use appropriate notary block.
Individual
B c fo r e me, this -day of
1 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
W
(signature)
print
Name: Christopher Smith_
Authorized Ment
Address: 700 NW 1071b-A—ve—
Miami, FL 33172
Telephone
No. 813-574-57QO
Corporation
Beforeme,this 22ND day of
MAY 20 2_2
personally appeared
Lennar Homes, LL_C a
—corporation, on
behalf of the state corporation, who
executed the foregoing instrument and
acRnowledgod before me that same was
executed for the purposes therein
expressed.
Partnership
Print Partnership Name
1-0
(signature)
Print
Name:
Its:
Address:
Telephone
No.:
Partnership
B efore 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
was executed for the purposes therein
expressed.
Personally known X or Produced identi cation_ Type of identification produced
Signature of Notar Print Name
� U mi Z ASHLE.E CALLAHAN
Notary Public Stamp: E CALLAH-A
ASHLE
Notary PUbft? St4te of Frtc)rida,
Commission Expires:
Conjmjssi6r. # GG 244456
NOVEMBER 30,2022
EXPI(ej soy 10, 2022
NVO Notary AkP!
..... . . . . . O.
Page 2 of 2
VR/\
VIRTUAL REVIEW ASSIST
Private Provider
In Compliance Affidavit
Private Provider Firm: Virtual Review Assist, Inc.
Private Provider: Debra Anne Klahr, BU1967
Address: 747 Southwest 2,d Avenue
Gainesville, FL 32601
Phone: 813-391-2959
Email: I iL-y L C(vvi viewassist.com
Project: New SFIr
Address(s): 36532 Camp Fire Terrace
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: 1,2,3,5,6,7,8,9,10,11,12,13,14,15,16, Ll,SN, SN1,S3,S4,S5,S6, ST,SS,Dl,Vv`P,PAl.0,PAl.1,
PA1.2,PAL3,PAIA, 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�b fore me by Debra Anne Klahr
being personally known to in or having produced as identification
and who being fully sworn and cautioned, state that the
e an ing is true d correct to the best of his/her knowledge or belief ia
g is gL M�tllsl�
i g ature of Notary Print Name
commission expires:
AL; AHAN
pi t�j� S��i� e of [orIda
[3
COMMERCIAL BUILDING SERVICES DIVISION VRESIDENTIAL
BUILDING PERMIT DATA SHEET
DATE: 11/16/2022
Renuired Permits
1WBuilding
[:1 Inspecq!2n Qnly_
V Plumbing
E] Inspection Only
VMechanical
El lnspection QAIL_
WElectrical - Amp
. -- ❑Ins e -ti!2n Onl
IV Roof
❑ Gas
F
0 Medical Gas
E] Fire Sprinklers
E] On Site Piping
0 Fire Line
E] Irrigation
El Fire Alarm
1:1 Potable Backflow Assembly
E] Fire Line Backflow Preventer
E] Irrigation Backflow Assembly
E] Demolition
E] Walk-in Cooler
E] Refrigeration
E] Hood
El Ansu I
Ej Fence/Wall
0 Grease Trap
E] Other
E] Other
BuildinLy Data
Construction:
V- 8
Risk Category:
Occupancy Load
_Type
ancy Classification:
'Factory
:Residential
Assembly Day Care/Educational
Hazardous Institutional I== FED'Mercantile
PStorage E=
Building Use: Single family Alteration 1Level 2 Level 3 �11 Level I
VNew Construction E] Interior Finish Ej Interior Remodel ❑ Exterior Remodel ❑ Addition El Revision
Overall Size:
18 x 63
Number of Stories:
2
Total Sq. Ft.:
2086
Living Area: 1634
Covered Area: 452
# of Bedrooms: 3
# of Baths: 2.5
Cost per square foot:
Estimated Value:
Roof Type: Z Shingle
E]Tile El Built-up ❑ Metal ❑ Other Squares: 15
Zoning:
Wirdborne Debris:
0, ,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
Central A/C
Z Heat Pump E] Window A/C
Heat E] Electric Heat
I ,1T1WT?-JF2TM1M-
Sanitary Sewer
Storm Sewer Catch Basins
Potable Water
Under round Fire Line
NMT11"
Front Rear Left Right
21 Asper Approved Site Plan
Comments: