HomeMy WebLinkAbout23-5544City of Zephyrhills
5335 Eighth Street .?.....4.
Zephyrhills, FL 33542
Phone: (813) 780-0020
Fax: (813) 780-0021 Issue Date: 01t23t2023
04 26 210150 01100 0110 6400 Ten Acre Court
\\ A ?? 3 \ t v
Name: LENNAR HOMES LLC-OWNER Permit Type: wilding New (Residential) Contractor. LENNAR HOMES LLC
Class of Work: SFR Construct
Address: 4600 W Cypress St 200 Building Valuation: $241,800.00
TAMPA, FL 33607 Electrical Valuation: $36,270.00
Phone: (813) 574-5700 Mechanical Valuation: $16,926.00
Plumbing Valuation: $24,180.00
Total Valuation: $319,176.00
Total Fees: $19,669.49
Amount Paid: $19,669.49 1
Date Paid: 1t23t2023 3:47:58PM�
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CONSTRUCT SINGLE FAMILY 1528 SO FT AS
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Mechanical Plan Review Fee $0.00 Plumbing Permit Fee $160.90
Transportation Impact Fee $3,595.68 Park Impact Fee - Single FamilylTownhome $769.56
Building Plan Review Fee $180.00 Mechanical Permit Fee $124.63
Irrigation 3t4 Meter (Calc) $732.71 Public Safety Impact Fee -Admin $26.35
Driveway Fee $45,00 SIF 1 percent Fee $83.28
Public Safety Impact Fee -Police $254.00 School Impact Fee - Single Family $8,328.00
Plumbing Plan Review Fee $0.00 Transportation Impact Fee - City $36,32
Building Permit Fee $1,249.00 Electrical Permit Fee $221.35
Electrical Plan Review Fee $0.00 Address Fee $30,00
Water Connection Residential Fee $1,010.00 Sewer Connection Residential Fee $2,090.00
3t4 Water Meter Fee (Cale) $732.71
REINSPECTION FEES: (c) With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c) the
local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or
first reinspection, whichever is greater, for each subsequent reinspection.
Notice: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permit required from other governmental
entities such as water management, state agencies or federal agencies.
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your property. If you intend to obtain financing, consult with your lender or an attorney
before recording your notice of commencement."
Complete Plans, Specifications add fee Must Accompany Application. All work shall be performed in
accordance with City Codes and Ordinances. NO OCCUPANCY FORE C.O.
NO OCCUPANCY BEFORE C.O.
I I- L
TQR SIGNATURE
lip
L __�► ° Ill�''.tr
PE*IT OFFICE
ITHOUT APPROVED
r+r INSPECTION
.. K-41A rM r0', . `
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received Phone Contact for Permitting 908 770 _ 7763
x I I ,- - r r' T r r r_7Big i'1f'Tr-TT'l
Owner's Name CAL HEARTHSTONE LOT OPTION POOL 03 L P I Owner Phone Number 813574.5700
Owner's Address 1 23975 Park Sorrento, Ste. 220, Calabasas, CA 9 3302 Owner Phone Number
Fee Simple Titleholder Name I N/A Owner Phone Number
Fee Simple Titleholder Address
I N/A
JOB ADDRESS
6400 Ten Acre Court
LOT# 1111
SUBDIVISION
Abbott Square
PARCEL ID#
1 04-26-21-0150-01100-0110
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED
V]INSTALL
NEW CONSTR
8 ADD/ALT SIGN DEMOLISH
REPAIR
PROPOSED USE
0 SFR
= COMM OTHER
TYPE OF CONSTRUCTION
10 BLOCK
O FRAME STEEL 0
DESCRIPTION OF WORK
I Single Family Residence / Pool / Screen Enclosure / Fence
I U/R SF
2015
1528 2�
BUILDING SIZE
SO FOOTAGE
HEIGHT
-re- m
mmr'm
mrr®r
BUILDING
$ 241800
VALUATION OF TOTAL CONSTRUCTION
�V
1.! )ELECTRICAL
7 � l
$ 36270___
PROGRESS ENERGY W.R.E.C.
PLUMBING
AMP SERVICE
d
$ 24180
II✓ (MECHANICAL
$ 16926
VALUATION OF MECHANICAL INSTALLATION
OGAS
ROOFING
j
F-1 SPECIALTY = OTHER
I r
FINISHED FLOOR ELEVATIONS
1 t-1 G R 1 1 1 1 1-i i d i t
-�
FLOOD ZONE AREA DYES DO
'il__�1 L,
BUILDER
SIGNATURE
Address
ELECTRICIAN
SIGNATURE
Address
PLUMBER
SIGNATURE
Address
MECHANICAL
SIGNATURE
Address
OTHER
SIGNATURE
Address
11111111
COMPANY
REGISTERED
4301 W 13oy Scout Blvd Suite 600 Tampa, FL 33607
COMPANY
REGISTERED
COMPANY
REGISTERED
COMPANY
REGISTERED
COMPANY
REGISTERED
IIIIIIIIIIIIIIII1111111111111
Lennar I Tomes, LL.0
Y / N JFEE CURREN Y / N�-
License # =-CC1518166
Edmonson Electric, Inc.
y I N__J FEE CURREN Y ( N
License # I EC13005408 -
Bayonet Plumbing, Heating & AC, Inc
Y / N FEE CURREN Y / N
License # CFC04299$
Bayonet Plumbing, Heating & AC, Inc
Y/ N FEE CURREN Y l N
License # CAC058062
�C Sterling Quality Roofing, Inc
Y / N FEE CURREN ®Y / N
License # CCC057991��
IIIIIIIIIIIIIIIIII111111111111
RESIDENTIAL Attach (2) Plot Plans, (2) sets of Building Plans: (1) set of Energy Forms, R-O-W Permit for new construction,
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects
COMMERCIAL Attach (2) complete sets of Building Plans plus a Life Safety Page, (1) set of Energy Forms. R-O-W Permit for new construction.
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
"PROPERTY SURVEY required for all NEW construction.
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required. (A1C 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
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.
I I W i J I
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J I I fe =101 U 4 -,a WM I gr&l In I'S by: 4111 0,:2F_ 21 ]Z611IN
FLORIDA JURAT (F.S. 117.03),
OWNER OR AGENT
Subscribed and swoi7�.2(orlffir�m;d)b�f.re before me
IM712022 - by Christopher Smith
Who isfare personally known to me or-ha��
as identification.
"4 Notary Public
Commission No. GG 296057
Subscribed and sworn to (or affirmed) before me this
w-1-11 by Christopher Smith
Who is/are personally known to me or has/have produced
as identification,
_—za ,&_, Notary Public
Commission No. GG 296057
Stephanie Farmer Stephanie Farmer
Name Name ofN
STOU9K"ER f.10. p Si RE FAMER
3 comm%"mmw CWM*8WfG02%W
E*Mll'"111105.2023 E*MF$bA"15.=
Permit No. 4
J Date Permitted -I::
Builder Name/Owner Naha Control #
County Pahl No. 2 } f SubDiv: .`
Address/Location -0 _12-'
Classification/Type of Use i
TRANSPORTATION IMPACT FEE Rate: %_ Sq. Ft Unit:
Exempt 0 Yes 0 No How Determined
Impact Fee Amount Zone No. TAZ:
SCHOOL IMPACT FEE
Account (056) Single -Family Detached House Amount $ � �a �v z-
(D57) Mobile Home
(058) Other Residential
(123) Collection Fee
Exempt =Yes = No Hoer Determined_
PARKS AND RECREATION FEE
Land Account Land Credit Land Total
Recreation Account Recreation Credit Recreation Total
Zone "Total Amount $
Exempt =Yes = No Hoag Determined
LIBRARY FEE
Land Account Land Credit Land Total
Facility Account Facility Credit Facility Total
Exempt11 Yes No Hoeg Determined 'Total Amount
RESOURCE FEE ERU
Prepared By Checked By
Nf CERTIFICATE CIF �CCLIPANY ViPILL RE ISSt�ED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN PAID AND RECEIRTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY
ACKNOWLEDGEMENT BELOW DOES NOT IMPLY ACCEPTANCE OF CONCURRENCE, BUT SIMPLY REECEIPT OF A COPY OF THIS
FORD, PLACING THE BUILDING OWNER ON NOTICE OF THIS ASSESSMENT AND THE CONDITIONS OF PAYMENT FOR SAME.
MM
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RECEIPT NO DATE BY
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DESCRIPTION: LOT 11, BLOCK 11, ABBOTT SQUARE PHASE 16,
SITE PLAN
SEC. 4, TWR 26 S, RING 21 E.
ACCORDING TO THE PLATTHEREOF, RECORDED IN PLAT BOOK 89,
PASCO COUNTY, FLORIDA
PAGES 57-62, OF THE PUBLIC RECORDS OF PASCO COUNTY,
FLORIDA
)NOT A SURVEY)
fABBOTT SQUARE)
his SITE PLAN Prepared for and Certified To:
ALL ELEVATIONS REFERENCED
PROPOSED ELEVATIONS AND GRADING Lennar
Homes
TO NORTH AMERICAN
VERTICAL DATUM OF 1988
SHOWN HEREON ARE TAKEN FORM THE
(NAND 88)
ENGINEERING PLANS OF
-ABBOTT SQUARE RESIDENTIAL-, PREPARED
BY WRA- PROVIDED BY CLIENT
Scale: 1 = 20
CURVE DATA (P)
CURVE RADIUS
ARC LENGTH i CHORD LENGTH_' CHORD BEARING DELTA
ANGLE
C25 62JX)
4,09" 4.09'
N 88'21'23" W 3°46'42"
LOT
= 4800 SCL FT
LIVING AREA
= 721 SO, FT.
PORCH
= 30 SO, FT.
GARAGE
= 397 SO. FT
COVERED LANAI
= 55 SO. FT.
PATIO
= NN[A SO. FT.
POOL. AREA
= NSA SQ. FT.
CONC. DRIVE
= 328 SQ. FT.
A/C & CONC PAD
= 10 —SO - FT.
SIDEWALK
= 55 SQ. FT.
LOT SOD
= N_ A SO, FT.
R/W SOD
= NSA SO, FT.
LOT OCCUPIED
= 33
AREA TO IRRIGATE
= 07
= 2'OAK
* - 10.00 PUBLIC UTILITY EASEMENT
LEGEND:
,.r•--► PROPOSED DRAINAGE FLOW
(00.00) PROPOSED GRADE
E-00.00 _- EXISTING GRADE
NOTES:
LOT GRADING TYPE =6
PROPOSED PAD ELEVATION = 98. 10'
FRONT SET BACK = 20"
SIDE SET BACK= 75
SIDE SET BACK (CORNER LOT) =10'
REAR SETBACK ---= I5-
(CDD) RIGHT-OF-WAY
TRACT"A'
TEN ACRE COURT
N 89.4516- E (P)
BASIS OF BEARING
;—J—
S CONIC WALK y S BT45'16` W (P) 35.91- R
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5.3'
PROPOSED
2 STORY RESIDENCE
o
p o PLAN 1525
Q
° o ELEV `A-
'-'
GARAGE R
LOT I I
BaolA�
BLOCK 11
25 0"
LOT) 0
-
BLOCK I I
LANAI 250
r'
�-fn rh9 I,
3'
75 S
a
a
m
TRACT 'B-3'
CDC) ACCESS/DRAINAGE/
LANDSCAPE/ WALL
7 S' MAINTENANCE AND FENCE AREA:
OPENSPACE
F9a
bg1\
PROPOSED:
_ '_i \`
MINIMUM FLOOR ELEVATIONS:
NOV 10 E (P) 40,00" IP)
LIVING AREA: 98.77'
TRACT 'B-3'
GARAGE AREA:
(CDD) ACCESS/DRAINAGE/
ELEVATIONS REFERENCED TO
LANDSCAPE/ WALL
NORTH AMERICAN VERTICAL
MAINTENANCE AND FENCE AREA,
DATUM OF 1988
OPEN SPACE
APPARENT FLOOD HAZARD ZONE: "X" COMMUNITY NO. 120235
SURVEY ABBREVATIONS
(MAP NUMBER 12101C-0289-F) EFFECTIVE DATE_ 09/26/2014
Al'ARC LENGTH ID' -DFED
INV- INVERT PC - POINT OF CURVE R^RECORD LEGEND
NC^AIR (ONJ TONER
AY N FREE
AY
D.E DRAINAGE`ASFMENI
IF -(ICE NNE D 6UISNESS
-
PCC POINT OF COMPOUND CURVE
I1
RNG - RANGE
i CONK
aNYLiINCE
AtUtAi
F BASE FLOOD ELEVATO
3V-BEN I MARK
Fr OR EEV E NATION
EO EDGF OF PAVE MEN!
lF- IANDSCA°E EASEMENTPCP
I f E 4 I OWES I I L OOR REVA ON
PERMANENT
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SURVEYOR'S NOTES:
SURVEYOR'S CERTIFICATE
1708 Water Oak Dive
Date of See Plan: 8-9-22
9.) Current title Information on the Subject property had not been
furnished to Initial Point Land Surveying, LLC at the time of this
SITE PLAN
This certifies that -owki if the hereon described
�j
property wa;�ur t��ri�ljt pervlston and
meets [he*, i�'ct t Ctlen for
SS''77.iii
Tarpon Springs, Flor da
Phone i 727`-831-1990
FlOridaPL57123@gma(I.cOm
OWC, AS"11 B' I. BE 11-SITE
2.) This sketch was prepared without the benefit of a title search.
No instruments of record reflecting ownership, easements or
rights -of -way were furnished to the a dersigned. unless otherwise
surveys 4 E jQN,rd of Land
Seyt r aPile:
5J- hlr�edshown
LB#1 8183
by DJB
hereon.Drawn
3.) Roads, walks, and other similar Items shown hereon were take
Se I n 77. CL}' (t)2y
pStan
Checked by JH
REVISIONS
from engineering plans and are subject to survey.
4. This SITE PLAN does not reflect nor determ Inn ownership.
os
1 Date R&108.30
�^7 �j
,` � �sr�l s�� �1L'kt
is SITEPLAN IS Subject too on me Plat of
ABBOTT SQUARE PHASE 16 ow
SC .
6.) Dimensions hereondecimal portions
c retie feels
Jeff M 7 aiT
FLORIDA ppCC��LaR AND
Q
)nContractor and owner arc, to venfy all setbacks, building
MAPPER NO�ENyj� L
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 wilt be
at users sole risk.
LICENSED SURVEYOR AND MAPPER
Initial Point Land SUFVeyin(g,
LLC.
lll� MM
VR/\
VIRTUAL REVIEW ASSIST
Private Provider
Plan Compliance Affidavit
Private Provider Finn: Virtual Review Assist, Inc.
Private Provider: Debra Anne Klahr, BU1967
Address: 747 Southwest 2" Avenue
Gainesville, FL 32601
Phone: 813-391-2959
Email:
Project: New SFR
Address(s): 6400 Ten Acre Ct
I hereby certify that to the best of my knowledge and belief the plans submitted were reviewed for and'ard 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
Plan Sheets: CS,LLL2,2,3,4,5,6.1,6.2,7, SN, SNI,S3,S4,S5,S6,ST,SS,D1,D2,WPI,PAI.0,PAI.1,
PAL2,PAL3,PAL4, SHI.0,SHI.1,SHI.2,SHI.3,SHI.4,SHI.5
Florida License/Registration/Certification 4(s) and description:
FS468 Certified Standard Plans Examiner
License #: PX2300
Signature of Reviewer:
SWORN AND SUBSCRIBED before pie -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 an c rrect to the best of his/her knowledge or be ief.
10 C'
Signature of tary Print Name
Notary Public: NOTARY STAMP BELOW My
commission expires:
VIR 1 U A, L REVIEW A, SS IS I
Xotice to Building Official of
Use of Private Provider
Effective January 20, 2003
Project Name: — OURT
Parcel Tax ID: 04-26-21-0150-01100-0110
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 • VIRTUAL REVIEW ASSIST, HIC. M
Private Provider: DEBRAANNEKLAHR
Address: 747 SW 2ND AVENUE - SUITES 170, 301, 357 & 358, GAINESVILLE, FL. 32601
Telephone: 813-376-3088 Fax: N/A
111pilli pi�Iiilpiyyrplpl,��
Ill IN 11"i -
Florida License, Registration or Certificate #: (LIC # BU1967 / PX2300 f 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 pen -nit 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 $1 million per
occurrence relating to all services performed as a private provider, including tail coverage for a minimum
of 5 years subsequent to the performance of building code inspection services.
(signature)
Print
Name:
Address:
Telephone
Please use appropriate notary block.
�a ug M ".'
•liffimme 0001=1
Individual
Before me, this —day of
20_, personally
appeared
who executed the foregoing instrument,
and acknowledged before me that same
was executed for the purposes therein
expressed.
Corporation
LENNAR HOMES. LLC
Print Corporation Name
B
(signature)
Print
Name: Christopher Smith
Authorized Aq ent
Address: 700 NW 107th_Ave
Miami, FL 33172
Telephone
No. 813-574-5700
Corporation
Beforeme,this 22ND day of
MAY 20 2_2
personally appeared
M
Lennar Homes, LLC -a
—corporation, on
behalf of the state corporation, who
executed the foregoing instrument and
acIcnowledged before me that same was
executed for the purposes therein
expressed.
Partnership
Print Partnership Name
By: -
(signature)
Print
Name:
Its:
Address:
Telephone
Partnership
Before me, this day
of 20—
pers6nally appeared
partner/agent on behalf of
a partnership, who executed the
foregoing instrument and
acknowledged before me that same
was executed for the purposes therein
expressed.
Personally known X ;or Produced identi cation- Type of identification produced
Signature of Notar Print Name ASHLEE CALLAHAN
Notary Public Stamp:
ASHLEE CALLA A
pubilc , State of F(Drida,
Commission Expires:
11MI$Sjor. # GG 244456
EXPIC'el Nov a0' 1022
NOVEMBER 2022
COMMERCIAL BUILDING SERVICES DIVISION WRESIDENTIAL
BUILDING PERMIT DATA SHEET
TRACXIIG 4
FOLIO # 6400 Ten Acre Ct
DATE: 10/28/2022
EXAMINER: Debra Klahr PX230(
WBuilding
ElIns pe tion Only
r--2'Plumbing
V EJ Inspection Only
Mechanical
V [:] Inspection Only
Electrical Amp
W [:1 Ins �ection �Onl
Qj Roof
El Gas
[—
I
Ej Medical Gas
0 Fire Sprinklers
El On Site Piping
F] Fire Line
E] Irrigation
El Fire Alarm
❑ Potable Backflow Assembly
Ej Fire Line Backflow Preventer
El Irrigation Backflow Assembly
Ej Demolition
F-1 Walk-in Cooler
El Refrigeration
El Hood
❑ Ansul
E] Fence/Wall
Ej Grease Trap
❑ Other
El Other
Type Construction:
Risk Category:
Occupancy Load
Ovancy Classification:
(Factory
aesidential
Assembly Day Care/Educational
Hazardous E= F1 Mercantile
Institutional E:::
Storage
Building Use: Single Family /Alteration 0"Level, I 01 Level 2 IQ Level 3
Pf New Construction Ej Interior Finish ❑ Interior Remodel E] Exterior Remodel El Addition R Revision
Overall Size:
25 X 54
Number of Stories:
2
Total Sq. Ft.:
2015
Living Area: 1528
Covered Area: 487
# of Bedrooms: 3
# of Baths: 2.5
Cost per square foot:
Estimated Value:
Roof Shingle
E]Tile ❑ Built-up El Metal El Other Squares: 14
Zoning:
Wrorne Debris:
Ej,,nside Pf'Outside
Energy Code:
405-2020
Flood Zone: X Base Flood Elevation: Finish Floor Elevation:
Hydrostatic Vents? IEI!Yes No T—Sq. Ft. Enclosed Space Below BFE:
# of Vents:
Size of Vents.
Total Sq. In. Permanent Openings
[R Central A/C
El Gas A/C
9 Heat Pump El Window A/C
[I Gas Heat E] Electric Heat
Sanitary Sewer
Storm Sewer Catch Basins
Potable Water
Underground Fire Line
Front Rear Left Right
As per Approved Site Plan
Comments: