HomeMy WebLinkAbout23-5545City of Zephyrhills
N
Z
5335 Eighth Street
Zephyrhills, FL 33542
BNR-005545-2023
Phone: (813) 780-0020
Fax: (813) 780-0021
Issue Date: 01/23/2023
Permit Type: Building New (Residential)
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... .. . . .
04 26 21 0150 01100 0100 6392 Ten Acre Court
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Name: LENNAR HOMES LLC-OWNER Permit Type: Building New (Residential) Contractor: LENNAR HOMES LLC
Class of Work: SFR Construct
Address: 4600 W Cypress St 200 Building Valuation: $271,440.00
TAMPA, FL 33607 Electrical Valuation: $40,716.00
Phone: (813) 574-5700 Mechanical Valuation: $19,000.80
Plumbing Valuation: $27,144.00
Total Valuation: $358,300.80
Total Fees: $19,865.11
Amount Paid: $19,865.11
Date Paid: 1/23/2023 3:47:58PM
"M
CONSTRUCT SINGLE FAMILY 1764 SQ FT AS
Building Permit Fee $1,397.20 Electrical Plan Review Fee $0.00
Plumbing Plan Review Fee $0.00 School Impact Fee - Single Family $8,328.00
Public Safety Impact Fee -Police $254.00 Irrigation 3/4 Meter (Calc) $732.71
Park Impact Fee - Single Family/Townhome $769.56 Building Plan Review Fee $180.00
Mechanical Permit Fee $135.00 Driveway Fee $45.00
Electrical Permit Fee $243.58 SIF 1 percent Fee $83.28
Public Safety Impact Fee -Admin $26,35 Plumbing Permit Fee $175.72
Transportation Impact Fee - City $36,32 Sewer Connection Residential Fee $2,090.00
Mechanical Plan Review Fee $0.00 3/4 Water Meter Fee (Calc) $732.71
Water Connection Residential Fee $1,010.00 Transportation Impact Fee $3,595.68
Address Fee 0.00
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 BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
A
CONT CTOR SIGNATURE PE IT OFFICE
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received Phone Contact for Permitting�08 770 __ 7763
-1 _r-rr -ter- e .T7 r r. -. .... -.... - r I I r �' _
Owner's Name CAL HEARTHSTONE LOT OPTION POOL 03 L P Owner Phone Number 813.574.5700
Owner's Address 23975 Park Sorrento, Ste. 220, Calabasas, CA 91302 Owner Phone Number
Fee Simple Titleholder Name I
N/A Owner Phone Number
Fee Simple Titleholder Address
NSA
I
JOB ADDRESS
6392 Ten Acre Court
LOT# 1110
SUBDIVISION Abbott Square PARCEL ID#
04-26-21-0150-01100-0100
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED
P
NEW CONSTR e ADD/ALT
INSTALL REPAIR
SIGN DEMOLISH
PROPOSED USE SFR COMM
OTHER
TYPE OF CONSTRUCTION 4rJI BLOCK FRAME 0
STEEL
DESCRIPTION OF WORK
Single Family Residence / Pool / Screen Enclosure / Fence
�7�R SF 2262 1764
28
BUILDING SIZE SO FOOTAGE
HEIGHT
r9armrT°r•mmr^rrr�rrr-r-r-r�r•m-r-v-mr�mrrrmlm�mm-r-r-r-+-r-mm-rrrrr
f BUILDING $
VALUATION OF TOTAL CONSTRUCTION
2 11440
tl ELECTRICAL
$ 40716�
PROGRESS ENERGY W.R.E.C.
jj�am�//((
19 P
7
$ 27144
AMP SERVICE
��'
�PLUMBING
flJ IPMECHANICAL
7 f
$ 19000.8
VALUATION OF MECHANICAL INSTALLATION
GAS � ROOFING SPECIALTY =
OTHER
FINISHED FLOOR ELEVATIONS
FLOOD ZONE AREA
LiYES DO
BUILDER q COMPANY
Lennar Homes, LLC
SIGNATURE REGISTERED Y / N FEE CURREN L11 N
Address 4301 W Boy S(�Bhrd a Le60Q Tampa, FL 33607 License # CGC1518166
7 .�—.
ELECTRICIAN COMPANY Edmonson Electric, Inc.
SIGNATURE REGISTERED Y / N FEE CURREN I Y / N
Address °' License# I EC13005408
PLUMBER Z COMPANY Bayonet Plumbing, Heating & AC, Inc
SIGNATURE REGISTERED L_Y_LN_j FEE CURREN
Address {' License # I CFC042998
MECHANICAL COMPANY Bayonet Plumbing, Heating & AC, Inc
SIGNATURE REGISTERED L_YI_N__j FEE CURREN Y ( N
Address License # I CAC058062
OTHER COMPANY C Sterling Quality Roofing, Inc
SIGNATURE REGISTERED Y / N FEE CURREN I Y / N
CCC05
Address r--� � license # 7991----�
IIIIIIIrllitllll Illlllllllllllllllltillllllllllrlltllilrllllllllll
RESIDENTIAL Attach (2) Plot fans; (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 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 DEAD REST RICTIONS: 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, WaterA/Vastewater Treatment.
Southwest Florida Water Management District -Wells, Cypress Bayheads, Welland 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.
OWNER ORAGENT
0 (o a� irm; d) bef
ore
me this
Subscribed and sworn s
10/2712022 by Christopher Smith
Who is/arepersonally known to me or
as identification.
1-112— by Christopher Smith
Who is/are personally known to me or has/have produced
as identification.
,,—Notary Public Notary Public
Commission No. GG 296057 Commission No. GG 296057
Stephanie Farmer Stephanie Farmer
NamegM:J, Name of N
STEPHM FWER MVKqM FAMER
X comaiwim 9 00 2W
E*M FOWNY 15, 2023 A,'
DOM$ 1`01INUM 16, M3
Dow" rftTMyF*MWX"8*WT0'9
Exempt o Yes 0 No Now Determined
I?
Impact Fee Amount `G? Zone No. TAZ:
SCHOOL IMPACT FEE
Account (056) Single -Family Detached House Amount $ 6
(057) Mobile Nome
(058) Other Residential
(123) Collection Fee
Exempt = Yes = No Now Determined_
PARKS AND RECREATION FEE
Land Account Land Credit Land Total
Recreation Account Recreation Credit Recreation Total Zone Total Amount $ 2`tt_
a
Exempt =Yes = No How rr
LIBRARY FEE
Land Account Land Credit Land Total
Facility Account Facility Credit Facility Total
Exempt Yes No Now Determined Total Amount 4'
RESOURCE FEE ERU
Total Amount
+ . i •, i * i
i + i
7=111,111: Is i i i !
r . ik....
W=
RECEIPT NO DATE 6Y
u
PA0:108.00 :a
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TYPE B'
FF:107.47
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106,04
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TYPE 'A' TYPE 'A' TYPE 'A' TYPE 'A TyP
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TYPE'A' TYPEW TYPEW
FF:10207 FF111.I7 FF:101.07 FF:T.0.0"FF:�,,47 FF:98.97 FF:98.37 FF:98 07
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--------------
TYPE 'S'
FF:101.27
PAD:100.60
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TYPE Vrn
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PAD:100.60
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TYPE 'B'
FF:101.17
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PAD:100.50
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TYPE'B'
FF:lGO.87
PAD,100.20
49.30-
099.90-97.58
TYPE 'B 1
FF:100.77
PAD:100.10
�99.71-96.14
I' F F.'l'0O.5 7
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0 99.53-96.30
L- - - - - - - - - - - - -
36'- 30"
WEST RIGHT
LINE PE�
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--,24'- 18" RCP @ 0,14%
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24" RCP @ Ok
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36 e5
OESCRIPTION: LOT 10, BLOCK I I, ABBOTTSOUARE PHASE I B,
SITE PLAN
ACCORDING TO THE PLAT THEREOF, RECORDED IN PLAT BOOK 89,
PAGES 57-62, OF THE PUBLIC RECORDS OF PASCO COUNTY,
(NOT A SURVEY)
FLORIDA.
SITE PLAN Prepared for and
Certified To:
I rr,
PROPOSED ELEVATIONS AND GRADING Lennar Homes
SHOWN HEREON ARE TAKEN FORM THE
ENGINEERING PLANS OF
"ABBOTT SQUARE RESIDENTIAL`, PREPARED
BY "WRA" PROVIDED BY CLIENT
LOT
= 4800 SQ. FT.
LIVING AREA
= 728 SQ. FT.
PORCH
= b2 -SC, FT
GARAGE
= 374 SO, FT.
COVERED LANAI
=-60_SO. FT.
PATIO
= NSA SQ. FT.
POOL AREA
= N4A SQ. FT.
CONC. DRIVE
= 360 SQ. FT.
A/C & CONC PAD
=11:_SO. FT.
SIDEWALK
= 42 SO, FT,
LOT SOD
= N�SQ. FT.
R/W SOD
= NA A SO. FT,
LOT OCCUPIED
4 XT
AREA TO IRRIGATE
=_66 o/r,
0 = 2" OAK
- = 10 00 PUBLIC UTILITY EASEMENT
LEGEND:
i -►= PROPOSED DRAINAGE PLOW
(00 00) _- PROPOSED GRADE
E-00-00 = EXISTING GRADE
NOTES:
LOT GRADING TYPE =B
PROPOSED PAD ELEVATION = 98_50
FRONT SETBACK � 20'
SIDE SET BACK = 7.5-
SIDE SET BACK (CORNER LOT! =10
REAR SETBACK = 15
PROPOSED:
MINIMUM FLOOR ELEVATIONS:
LIVING AREA: 99.17'
GARAGE AREA:
ELEVATIONS REFERENCED TO
NORTH AMERICAN VERTICAL
DATUM OF 1988
SEC. 4, TWP, 26 S, RNG 21 E.
PASCO COUNTY, FLORIDA
(ABBOTT SQUARE)
ALL ELEVATIONS REFERENCED
TO NORTH AMERICAN
VERTICAL DATUM OF 1988
(NAVD 88)
(CDD) RIGHT-OF-WAY
TRACT"A"
TEN ACRE COURT
N 89.45' 16- E (P)
BASIS OF BEARING
5' CONC WALK S 84'45' 16� W (P) 40,00 (P)IV
H
PC
S 89U15 16' W (P)
( , 1 35 91 (P)
in
CONC
WALK; IS J w 7,g
T5' a
O O
O
ENTRY
6.3' a
A
m ' PROPOSED COS 4 v
LOT 9 2 STORY RESIDENCE p _ BLOCK 1 1
BLOCK I i PLAN 1763 0
0 ELEV "A' dl
p GARAGEL
0
LOT 10
BLOCK I I
\q0 T5' 25.0' 1_ANAI 175
!32'X3.2' u
'C/S-A/C
i
el
{
_ __________
N 89-4516` E (P) 40,00' IF) Y9)R
J/
TRACT 'B-3"
(Coo) ACCESS/DRAINAGE/
LANDSCAPE/ WALL
MAINTENANCE AND FENCE AREA;
OPEN SPACE
w 'R
:7v
APPARENT FLOOD HAZARD ZONE: -X" COMMUNITY NO. 120235
SURVEY ABBREVATIONS (MAP NUMBER 121O1C-0289-1) EFFECTIVE DATE 09 2612014
A-ARCtENGT
- ON
D-DEED
NV -INVERT
"C -PONT OF CURVE
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LEGEND VINYL EENCE
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IT LICENSED 4US-O
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N P VMANEN7 CONTRO.. POW'
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erE BAR =OODELEVAUO
DR OEV F VA'tON
E-iANDSCA ASEMIN
L.W S LOOREL VA 4DN
P/E- OOL FOUIPME17
RRS, RAILROAD SPIRE
RAV-R S O1 WAY
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EIA F N'CH MARK
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ESM -EAS` T
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PG - FACE
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M1I^MEAS IREJ
-ON
P1=.ON O NERSECTiON
SN&-^-tL NAIL ANDDSH—
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CM-E-CUND CONCRRETE
MES -MTOYED NO SEC
PK^ \RKL4'V+'ON
ROE =R Y LINE
ETNi'S
< IA N L NK (-ONCE
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MONUMEN
FIT' -FOUND RON PIPE
NC` - NO CORNER FOUND
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AVM- T:MRC I 5c`NCt'-MFlRtt
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f'12-FOUNDII30N ROD
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POC LOIN O`COMMENCTMENi
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fOH -TOIO RANK
l 7
COI.=Co�LMN
CONC=CONCRETE
iN1D-FOUND NN IL&DISK
OR--OFFICIALRECORJS
POL 'IONT ON.INE
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ALUMINUM FENCE
CS^CONCRETE""
10P UNDOPENPIPE
(PI -PLAT
PRC LOIN O REVERSE CURVE
OF=UTI Y.ASEMENr
>COVERED �\
CST=O—RS 11F TRIANCLC
EPP- OUNDIINCHEOPIPE
PET =PLAT BOOK
PRM- PERNIAN..NT REFERENCE MONUMENT,
V, -ONY ILRic E
JOB H5815
SURVEYOR'S NOTES:
L) Current title information on the subject property had not been
furnished to Initial Point Land Surveying, LLC at the time of this
Y 9-
SITE PLAN
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 undersigned, unless otherwise
shown hereon.
3. Road 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 ownershi p-
Plat
SURVEYOR'S CERTIFICATE
This certifies that s FelCd ,�� the hereon described
property wa; ur 'ilTl4ipervision and
meet, the tr, a t 1, ! practice for
�'wi' 'Y'/,�!
surveys 7tCf rd of Land
SiI .a /_ [lLaa
3 F/ 1 ar} I It, -v
purstytnt tq Section 472 I«S�(E'
a s I
' Dale( �Q�'30
f _ i
e (a9 32.J 84i00
1708 Water Oak Drive
Tarpon Springs, Florida
Phone: (727)-B31-1940
NoRdaP 123@ malcom
g _
LBN 8183
i` 3
�4 st
4 (r IT
Date of SRe Plan: 8-8-Z2
PWGAS-f>H18 i70-BLI )-S.TE
Pile
Drawn by: DOB
;Checked by:JH
(REVISIONS4
5.) This SITE PLAN is subject to matters shown on the of
'ABBOTr SQUARE PHASE ! B`
�� aT FL RIDA _ ��_ ,�_
as`: '
6.) Dimensions shown hereon are in feet and decimal portions
Jeff M.�
FLORIDA I�ppnn ! 1 ZtrR AND
thereof
{
MAPPER Np' �C9y� 3 L
)Contractor and owner are to verify all setbacks, building
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 Ladd Surveying, LLC.
at user s sole risk.
I
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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 2" Avenue
Gainesville, FL 32601
Phone: 813-391-2959
Email: lq��y'�yjLqUa leviewassist.com
Project: New SFR
Address(s): 6392 Ten Acre Court
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: CS,1.1,1.2,2.1,2.2,3,4,5,6.1,6.2,7, SN, SNI,S3,S4,S5,S6,SS,ST,
DI,D2,V,T1,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 befor '�-TKe 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 tru orrect to the best of his/her knowledge or belief.
F"
Signature lrof*\J Print Name
Notary Public: NOTARY STAMP BELOW My
L1jCERO KING
commission expires:
MY COMMISSION # livi 314394
2,2026
EXPIRF-S� July
V I R 1 UAL REVIEW ASSIST
Notice to Building Official of
Use of Private Provider
Effective January 20, 2003
. . . . . . . . . .
Project Name: 16
isil I C; -OURT
ParcelTaxID: 04-26-21-0150-01100-0100
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 ProviderFirm: VIRTUAL REVIEW ASSIST, INC. 0
Private Provider: DEBRA ANNE KLAHR
Address: 747 SW 2ND AVENUE - SUITES 170, 301, 357 & 358, GAINESVILLE, FL. 32601
Fax: N/A
Email Address (Optional): deb@virtualreviewassist,com
Florida License, Registration or Certificate 4: (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.
(signature)
Print
Name:
Address:
Telephone
No.:
Please use appropriate notary block.
11116-1:101 1 W
Individual
Btforeme, this —day of
120— personally
appeared — who executed the foregoing instrument,
and acknowledged before me that same
was executed for the purposes therein
expressed.
Corporation
LENNAR HOMES. LLQ--
Print Corporation Name
By:
(signature)
Print
Name: Christopher Smith
Its: Authorized Aaent
Address: 700 NW 107thAve
Miami, FL 33172
Telephone
No. 813-574-5700
Corporation
Beforeme,this 22ND day of
MAY 2o_22,
personally appeared
of
Lennar Homes, LLC - a
—corporation, on
behalf of the state corporation, who
executed the foregoing instrument and
acknowledged before me that same was
executed for the purposes therein
expressed.
UM=
Print Partnership Name
0
(signature)
Print
Name:
Its:
Address:
Telephone
Partnership
Before me, this day
of
personally appeared
partner/agent on behalf of
a partnership, who executed the
foregoing instrument and
acknowledged before me that same
was executed for the purposes therein
expressed.
Personally known X ;or Produced idemi cation Type of identification produced
Signature of 'Notar Print Name ASHLEE CALLAHAN
Notary Public Stamp:
ASHLE CALLAHAN
A VNI ate of FlOrida
Expires:Commission Expires: �:i 1 **1 I'll
NOW PUbjjC ?. State
244456
NOVEMBER 30, 2022 N mm. Expleei Nov 10, 2022
a€t�� ihror.�h.t•?atlana; Notary Assn
Page 2 of 2
[—COMMERCIAL BUILDING SERVICES DIVISION VRESIDENTIAL
BUILDING PERMIT DATA SHEET
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ElIns Eection Ont,
VPlumbing
Ej Ins ection Only
V Mechanical
0 Lnaction OnI
VElectrical Amp
El Inspection QnlZ
11 .
Roof
F1 Gas
I
El Medical Gas
El Fire Sprinklers
❑ On Site Piping
E] Fire Line
[:1 Irrigation
[] Fire Alarm
El Potable Backflow Assembly
Ej Fire Line Backilow Preventer
1:1 Irrigation Backilow Assembly
El Demolition
El Walk-in Cooler
[:1 Refrigeration
M Hood
El Ansul
El Fence/Wall
E] Grease Trap
El Other
[:] Other
I a M rl If IT-2-17 W,
Ty e Construction: L
Risk Category:
Occupancy Load
an Classification:
ac cy C
OVF to
Residential
Assembly usiness �5ay Care/Educational
rl n, t nal E== n"Mercantile
Hazardous E= Institutional 0 V
Storage E= ❑ Utility
Building Use: Single Family l Alteration 1 —Level I Level 3 Fla Level 2
geNew Construction El Interior Finish E] Interior Remodel Ej Exterior Remodel El Addition El Revision
Overall Size:
25 x 54
Number of Stories:
2
Total Sq. Ft.:
2265
Living Area: 1764
Covered Area: 501
# of Bedrooms: 4
# of Baths: 2.5
Cost per square foot:
Estimated Value:
Roof e: Shingle
®Tile 0 Built-up ] Metal ❑ Other Squares: 16
Zoning:
W i orne Debris:
El1nside Outside
-k"-
Energy Code:
405-2020
Flood Zone: X
Base Flood Elevation:
Finish Floor Elevation:
Hydrostatic Vents? ®'Yes VNo =
I
Sq. Ft. Enclosed Space Below BFE:
# of Vents:
T_S&_e of Vents.
Total Sq. In. Permanent Openings
9 Central A/C
El Gas A/C
Z Heat Pump E] Window A/C
El Gas Heat 0 Electric Heat
Sanitary Sewer
Storm Sewer Catch Basins
Potable Water
Underground Fire Line
M�
Front Rear Left Right
As per Approved Site Plan
Comments: