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HomeMy WebLinkAbout23-5824City of Zephyrhills 5335 Eighth Street Zephyrhills, FL 33542 Phone: (313) 780-0020 Fax: (313) 780-0021 Issue Date: 0311412023 Permitit i'Residential 04 26 210150 00900 0040 3654 Smithfield Lane } '. A �v t : � LvRv � � }z•, � �v\ �. , � sii., Al \���\�ti k}l \��vv z R�� ��� Name: LENNAR HOMES LLC-OWNER Permit Type: Building New (Residential) Contractor: L NNAR HOMES LLC Class of Work: SFR Construct Address: 4600 W Cypress St 200 Building Valuation: $365,400.00 TAMPA, FL 33607 Electrical Valuation: $54,810.00 Phone: (813) 574-5700 Mechanical Valuation: $25,578.00 Plumbing Valuation: $36,540.00 Le Total Valuation: $482,328.00 Total Fees: $21,049,67 Amount Paid: $21,049,67 Date Paid: 3/14/2023 11:27:42AM ° \.. , s: t t \ \\ \ . \. `t. a � }`} ,, ? . k>•r s t , } , itlG \ t " CONSTRUCT SINGLE FAMILY 2580 SQ FT ,. •.; ..:..Z .. ,\.. ..\ .\i \ ...".Z \ }'k. `: .} \. L. \ Ali .•.. ,. {,. Y. ;..\ ....\\ .t \t`£...\ \. t„r-, , ,}.}.1:.'�. �',}. @P ., ., •�}, , t.',v?, ��\�'V va}. �>t��v}.,k , ,. tr ,.`�Ut�,}.�}�.�� a;1\vs „\, ,,A\ s�t�£} ,1��.�..vs}., sL �c� F t „aaa.. �1 vb\ .?., `,.. u`�" fix.. . �v �, :� �,. Fst,,.�4,t nZv�,S*;� � l', u,�:, Water Connection Residential Fee $1,140,00 School Impact Fee - Single Family $8,328.00 Transportation Impact Fee - City $36.32 Public Safety Impact Fee -Police $254.00 Driveway Fee $45.00 314 Water Meter Fee (Calc) $794.92 Building Plan Review Fee $180.00 Plumbing Plan Review Fee $0.00 Building Permit Fee $1,867.00 Address Fee $30.00 Park Impact Fee - Single Family/Townhome $769.56 Sewer Connection Residential Fee $2,400.00 Plumbing Permit Fee $222.70 Transportation Impact Fee $3,595,68 Mechanical Plan Review Fee $0.00 Public Safety Impact Fee -Admin $26.35 Electrical Plan Review Fee $0.00 SIF 1 percent Fee $83.28 Mechanical Permit Fee $167.89 Irrigation 314 Meter (Calc) $794.92 Electrical Permit Fee $314,05 I SP CT°I FEES: (c) With respect to Reinspection fees will comply with Florida Statute 5 0(2)(c) the local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or first r in pection, whichever is greater, for each subsequent rein pection. Notice: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permit required from other governmental entities such as water management, state agencies or federal agencies. "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your property. If you intend to obtain financing, consult with your lender or an attorney before recording your notice of commencement." Complete Flans, Specifications add fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. NO OCCUPANCY BEF C.O. NO OCCUPANCY BEFORE C.O. CONTRACTOR SIGNATURE a L �,14; "t * V. — PE f IT OFFICE THOUT APPROVED INSPECTION ,,$l3-780- 020 City of Zephyrhills Permit Application Fax-813a80-0021 Building Department Date Received Phone Contact for Permittin 908 770 __ 7763 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 v/A Owner Phone Number Fee Simple Titleholder Address N/A JOB ADDRESS 36524 Smithfield Lane LOT# QQQ4 SUBDIVISION AbbottSquare��� PARCELto# 04-26-21-Q15Q-QQgQQ-QQ4Q ttt���t (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR 8 ADD/ALT SIGN DEMOLISH INSTALL REPAIR PROPOSED USE 4�j"Y� U SFR COMM OTHER TYPE OF CONSTRUCTION t(�I BLOCK FRAME STEEL DESCRIPTION OF WORK Single Family Residence 1 Paol / Sereen Enclosure l Fence BUILDING SIZE U/R SF Q45 So FOOTAGE 2580 HEIGHT 2g BUILDING r365400 jI VALUATION OF TOTAL. CONSTRUCTION ELECTRICAL $ 54810 I1 AMP SERVICE Do PROGRESS ENERGY W.R.E.C. (PLUMBING E 36540 I �����j1 CE 1.� c �vp _ d II.� !MECHANICAL $ 2557$ VALUATION OF MECHANICAL INSTALLATION (9 GAS L® .t ROOFING SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES Do BUILDER COMPANY Lennar Homes, LLC SIGNATURE REGISTERED �_Y 1_N__j FEE CURREt )LN_j Address 01 W Boy Scout Blvd Suite 600 `Pampa, FL 33607 License # CGC1518166 ELECTRICIAN COMPANY Edmonson Electric Inc, SIGNATURE REGISTERED _Y / N FEE CURREN Address License# EC13005$0$ �� PLUMBER * COMPANY Bayonet Plumbing Heating & AC, Inc SIGNATURE REGISTERED Y 1 N FEE CURREN YIN Address License # CFC04299$ MECHANICAL COMPANY Bayonet Plu�CIRREI��� SIGNATURE REGISTERED YIN Address _ License # CACOS$062 OTHER COMPANY �Sterlin�gQual�ityRoof�ing, ncSIGNATURE REGISTERED N Address License # 1 CCC057991 BPB69�ileEiB9��t69l186sEii1lEEiBtltFlI1B119l6l11&itBIE&@9ptltElF911 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. (AIC 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 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 AGEN­f_r�� o (Ora IrmeT� ) befo re me Subscribed and swornthis srirzoza by Christopher Smith Who istare personally known to me or#�� as identification. Notary Public Commission 6_296051 Stephanie Farmer Name of Notary typed, printed or stamped 9 wwmmm" J(n WX E*m Mw 6, 2024 OR Subscribed and sworn to (or affirmed) before me this ,11112023 by —Christopher Smith Who is/are personally known to me or has/have produced as identification. Notary Public Commission No.. 6 7 o Stephanie Farmer / Name of Notary typed, printed or stamped 0MINm m0,, *Mhftt2024 is Permit No, Lute Permitted 3— Builder Name/Owner Name Control County Parcel No, ubD v: ` TRANSPORTATION IMPACT FEE Rate: Sri, Ft Unity G a Exempt 0 Yes 0 No Flow Determined Impact Fee Amount Zane No, TAZ. SCHOOL IMPACT FEE Account (056) Single -Family Detached House Amount (057) labile Home (0 ) Other Residential (123) Collection Fee Exempt = Yes = No How Determined_ PARKS AND RECREATION FEE Land Account Land Credit Land Total Recreation Account Recreation Credit Recreation Total Zone Exempt =Yes = No Iffim How Determined Total Amount Land Account land Credit land Total Facility Account Facility Credit Facility Total Exempt Yes No How Determined Total Amount RESOURCE FEE ERU Total Amount im Checked By F OCCUPANY WILL BE ISSUED OR FINAL INSPECTION PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERNInTING OFFICE OF PASCO COUNTY ACKNOWLEDGEMENT BELOW DOES HOT IMPLY ACCEPTANCE OF CONCURRENCE, BUT SIMPLY REECEIPT OF A COPY OF THIS FORM, PLACING THE BUILDING OWNER ON NOTICE of THIS ASSESSMENT AND THE CONDITIONS OF PAYMENT FOR SAME. M IN 12 11 1 10 9 0 7 5 4 3 00 2 TYPE'B' EV TYPE'B TY PE 'B YPE 'B YPE B TYPEW TYPE'B' TYPE 'B PE 'B T PE V T P yp P FF:110.67 3 957 FF:101.97 FF:103.07 .10 FF 4 7 F,10 1 FF:105.27 FF:106.37 0 FF:107.37 FTFy:l08.47 09 FTFyV 9.57 -1 FTFY 10�B67 98. 901 PAD:101.30 PAD:10240 .1 DAD:103,50 PAD:104.601 IPAD:105.7C PAD:10630 [780 PAD: 108.90 �Ap L 9 JADAMOO 0 0 0 0 287- 42" RCP (@ 030% - 42" RCP @ 0.30%1-0--3-.85• --- V - 18 " RCP (b) 1. ---------- 10 a)- CD - — — — — — - — — — — — - — — — — — - — — — — — - — — — — — 35'- 18" RCR @ 2.01%- FT—YPFB' [ F TYPE T PE 3 Y E B TYPE 'B' 1 TYPE 'B' TYPEW Typ E E' TYPE BO'7 YPE'B' E 'B' TYPE' T TYPEV TYPE'B' O��2'�'�7 FF 1 3 7 FF:103.87 0 8 FF:104,87 FF:105.97 35 F 1 9 7 F F. 10 7 FTF:10&17 FF 1 oq� -1 4 FF:109�47 JIFF:110,37 FF:110,37 FF:111,47 10 C ADIIOIIOO AD:103.2C AD:104.20 AD:105.30 1()5 0 AD:106�4 IPAD:107,5( AD:108,8( 108 8C PA0:109,70 PAD:110,80 1 5 6 9 110970 10 11 cn 01 T T T T T T T T T T 1-0 10l 0 o 0 o f m o IP 0 �CK,9 BL 24' - 18"iCP @ 0.30%12�, DES6".., TION:LOT4,BLOCK9,ABBOTTSQUAREPHASEIB, 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. PROPOSED ELEVATIONS AND GRADING "'� This SITE PLAN Prepared for and Certified To: ALL. ELEVATIONS REFERENCED SHOWN HEREON ARE TAKEN FORM THE Lennar Homes TO NORTH AMERICAN ENGINEERING PLANS OF VERT ICAL DATUM OF 1988 'ABBOTT SQUARE RESIDENTIAL', PREPARED INAVD 88) '.. BY'WRA` PROVIDED BY CLIENT'`------------- --' TRACT'A' jCDDJ RIGHT-OF-WAY SMITHFIELD LANE N 89-45'3I"E (P) BASIS OF BEARING f � `N 89`4531' E IP) 45.00' Ip) '. 5 CONC WALK _ PC rm fj v/Ip�T S 8945'24- W fPJ LOT — SG25 SQ. FT, 135,00' IF) _ _ _ �_ , •._ ti J -- LIVING AREA — 1 i 10 SQ. FT. ti CONE' g PORCH = 6�50. FT. P 'I' WALK GARAGE = 4_�SQ. FL. r� i L _ . ' COVERED LANAI = N/A SO. FT, PATIO = FT. 6 0 i t �� 1 'zs' i�SO POOL AREA = N1A SO., ET, ?. 7.5� 20.0 CONE DRIVE = 77 SO. FT, ENTRY 10.0' A/C & CONC PAD —�50. FT. SIDEWALK —_34 _SOF FT. LOT SOD = NSA S0. FT, R/W SOD SO. FT. ORoPOSED LOT OCCUPIED o _�� /o LOT 3 �, SIDENCE z sT PiLAN 2551 p;-Aty 7ss! LOT 5 AREA TO IRRIGATE =�4 % BLOCI<9 S ti POv'A' w o GARAGE R BLOCK 9 o ! w I 1 a a = 10.00' PUBLIC UTILITY EASEMENT p p 7.5' 30,0' T5- LEGEND: 3x6 PROPOSED DRAINAGE FLOW 0b`- asX3is PATIO C/S-A/ -/� 0gDS/ (00,00) = PROPOSED GRADE jtp3 I E-00.00= EXISTING GRADE { I NOTES: LOT 4 r BLOCIC9 LOT GRADING TYPE =B ,� PROPOSED PAD ELEVATION = 104,20' FRONT SETBACK= 20' - SIDE SET BACK - T5' 1 SIDE SET BACK (CORNER LOT) =10' I, ; REAR SETBACK -- IS FHY S 89'4524" W F) 45,00' )P) Y/O, PROPOSED: ��°� TRACT'B-6" =6)/ MINIMUM FLOOR ELEVATIONS: IC DD, ACCESS/DRAINAGE/ LIVING AREA: 104.87' LANDSCAPE WALL GARAGE AREA: MAINTENANCE AND FENCE AREA, ELEVATIONS REFERENCED TO OPEN SPACE NORTH AMERICAN VERTICAL DATUM OF 1988 APPARENT FLOOD HAZARD ZONE "X" COMMUNITY NO. 120235 SURVEY ABBREVATIONS )MAP NUMBER 1210 t C-0289-F) EFFECTIVE DATE: 09/26/2014 SEC. 4, TWP, 26 S, RNG 21 E. PASCO COUNTY, FLORIDA (ABBOTT SQUARE) Scale, 1 Lt LENGTH A/C Inl=DEED INV=:.NVERT PC^POINT OF CURVE (R) .RECORD LEGEND - A/C=AIR CONDITIONER D-� DRAI'WAGEEASEOENT l8-LICENODBLSNESS PCC LOIN OF COMPOUND CURVE RNG-RANGE VINYL FENCE AF=ALUMINUM FENCE 11 OR El EV ELEVATION LE= LANDSCAPE EASEMENT PCP -! RMANENT CONTROL POINT PRS- RAPL, ROADSPLKir CC\K: RFE - BASE FLOOD ELr-T10N EDP =EDGE OE PAVEMENT IFE^LOWEST FLOOR ELEVATION P/E - POOL OUPMENT PFK- VCJI I Or WAY 8M BENCri MARK C CURVE ESMT-EA M N F/C-FENUCOR'' LS- LLCUISED SURVEYOR !G=[AG U-OEW OE INTRSECTION EC --SEC r'ON' SSE'hAIL WOODPEIVCE ASPHOIT —'- '— IC CALCI JAT-A CM - FOUND CONCRETE (Mi"MEASURED MIS-RPTLPD NDSEC<ON PC -(ARM 2SA.ON SN&C AND DI S I sA 18, CE""A"A IUF -CH NV -_I MONUMENT Cih FOUND I,R N➢OE NCF-NO CO N R SOUND O/A- OV.PAL- R PRO A - .,N ' POS ION COFOGSICINGTEMPORARY- - S R SE'. Z ON ROD t.SR 8183 T3M 'B-hl`i,`MARK C4AN LINK`ENCt �BR:CK —x- x- -- — RR C 1.-CORAUCATEC META fi ! COL -COLUMN FIR u DIRONROD OHW-OVE-EAD WIRED) PGC-FOEh?O�COlviMLNCTMENT ,Off �TOt OF BANK CONE -CONCRETE DF IN FOUND NAIL &DISK FO. SOUND OPEN PPP- OR.-OFFIL'Ai_ RECORDS I'I -PLAT LOT (OIN'ON FINE PRY° -LOIN O REVERS1 DAVe ' TOWNSHIP t E U} YEAS-MEM A-UMINUMFENC` `, X !^COVERED C,S=�NCRETESLAe CS = CLEA R SSGHT MANG E p2..cOJNJ °INCHED PIPE !B-PLAT BOOK PRIA PE RMANEM REFUTENCE MONUMENT, V -OPYL FENCE JOB k6289 - SURVEYOR'S MOTES: 1.) Current title information on the subject property had not been furnished to Initial Point Land Surveying,LLC. at the time of this SURVEYOR'S CERTIFICATE This certifies that of the hereon described a propertywl-A c L� eti4gyi�.upervision and 1708 Water Oak Drive Tarpon Springs, Florida Phone: (727)-831-1990 Date of Site Plan. I L29-22 DWG AS -PH I BTTB 9-SIT 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. meets the; 1 is e ds�6 ,Practice for survey is and of Land S [ y„� f}ed 5 to r�t hjstr v "J pur=ant to Section 47I Y, CT(2y 'V ey F7oridaPLS7 t 23C'Lgrnail,com LBft 8183 P Dle: Drawn by: OlB - Checked by:JH 8.) Roads, walks, and other similar items shown hereon were take from engineering plans and are subject to survey- S �Date:QZ .17 'u ',T"' REonsaOns 4.) This SITE PLAN does not reflect nor determine ownership, fr, This SITE PLAN Is subject to matters shown on the Plat of ) t okUU 51 540' 'a '_ � CA R " TSQUARE PHASE t B 6.) Dim rti Dimensions shown hereon are in feet and decimal poons a s LO DA � �• �-� e Jeff MM FLORID, I AND Rt C /� Q thereof. thereof 6YtR�'OR MAPPER N0I1trs 7.) Contractor and owner are to verify all setbacks, building I 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 Ladd Surveying, LLC. at users sole risk. New Development Check List Parcel Address: Setbacks: Front XI-t - 7.)L I )� Rear K �- Sides --Z--,5- Elevation: ---P- Garage: 914 I Roof Single Dimension/Architectural: /o\ Notice to Building Official of Use ®f Private Provider Effective January 20, 2003 Services to be provided: Plans Review X 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. fflfi�� owner, of I have entered into a contract with the Private Provider indicated below to conduct the services indicated above. Private Provider Finn: VIRTUAL REVIEW ASSIST, INC. Private Provider: DE RA ANNE KLAHR Address: 747 SW 2ND AVE- SUITE 170,301,357,& 358, GAINESVILLE, FL 32601 Telephone: 813-376-3088 Fax: N/A Email Address (Optional): deb@virtualreviewassist.com Florida License, Registration or Certificate #: (LIC # B111967/ 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 detennine 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, enviro ental or other codes. The following atta�Ghmentq are provided as required: 1. Qualification statements and/or resumes of the private provider and all duly authorized representatives. I Proof of insurance for professichaland oosnpxebensive liability in the, amount.of $1 million por o ccurrence 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..' ICndividuai Corporation Partnership . Print ColporationNamo PrintPartnershipNarae By: By: (signature) {signature] {signat<ixe) Print Print Name: NaMD Christ her Sry�it Print Name: Address: its: Authorized A pnl its; Address: 70 W 107ihye. Address; Telephone Miami FL 33172 - T 4ephone- I elephone No. 313®57 -5700 Please use appropriate notary block. STATE OF FLORIDA COUNTY OF I-IILLSBOROUGH 1-I B afore me, this day of 24®, personally appeared • who executed the foregoing instrument, and aoltnDWIedged before me that sable was executed for the purposes therein exlaxessede . . Corporation Beforeme,this 22ND day of MAY . 20 personally appeared ' of Lnnar Dome LLG a corporation, on behalf oftho state corporation, who exeuuted the foregoing instrument and acicz owledged before me that same was exeeutod fox the p oses tlxerDm expressed. Personally known X or_ Produoed identitcation Type of identzf°ioation produced - 5i& aatarq ofNot arV l din PrintNaxne } jL Notal'yPublio Stamp: Comirdssion Expires: B efore e, this day Of 20 , personally appeared p ex/agent onbehalf of a partnership, who executeatho forD e a0mowle,aged before Me that same - - T>nn� �.ri•F� 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 2nd Avenue Gainesville, FL 32601 Phone: 813-391-2959 Email: luc &)yirt,ua1reviewassist.qom yj_� Project: New SFR Address(s): 36524 Smithfield Lane 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 Plan Sheets CS,A1,A2,A3,A4,A5,A6.1,A6.2,SNO,SNI, S3,S4,S5,S6,SS, ST,SI l,S12,WPl.0,PAI,0,PAI.l, 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 before me by Debra Anne Klahr being personally known to me_or having produced as identification and who being fully sworn and cautioned, state that the r mg is true d co i� ect to the best of his/her knowledge or belief A I i ture of Not Print Name Notary Public: NOTARY STAMP BELOW My r151", COMMERCIAL BUILDING SERVICES DIVISION RESIDENT lAL BUILDING PERMIT DATA SHEET FIRE MARSHAL #01 - uilding El inspection 0n1v Plumbing Inspection OnI ecbanical III Gas Electrical Amp —1wsp ic�tio—li—o n —1y Fire Sprinklers On Site Pipin El Irrigation El Fire Ala El Potable Backflow Assembly El Fire Line BII a ckflow Preventer AI 11 El Irrigation Backflow Assembly El Walk-in Cooler III El Refrigeration El Hood E] Fence/Wall El Grease Trap mffl�� jype_Construction: F�7� Risk Category: Occupancy Load OWa Classification: ney C =� Factory Assembly E::� iness Day Care/Educational Hazardous E:== itutional r-I'Mercantile = Residential Storage E== ity Building Use: _jo�Iefa�Kllre�sidency [— ../ Alteration F Level I JQLevel 2 Level 3 luf New Construction E] Interior Finish E] Interior Remodel Ej Exterior Remodel E] Addition El Revision Overall Size: Number of Stories: Total Sq. Ft.: 30 x 53-4 2 3043 Living Area: Covered Area: # of Bedrooms: 6 2580 463 # of Baths: 3 Cost per square foot: Estimated Value: Roo�e. Shingle —L!!�� D Buiiilit-:�u El etal El Other Squares: 20 p M Zoning: W' orne Debris: Energy Code: 405-2020 ®,:Inside Outside Flood Zone: X Base Flood Elevation: Finish Floor Elevation: at' Hydrostatic Vents? Sq. Ft, Enclosed Space Below BFE: 4 of Vents: Size of Vents: Size Total Sq. In. Permanent Openings 9 Central A/C ®Pleat Pump E] Window A/C El Gas A/C El Gas Heat EJ Electric Heat Sanit �ta Sewer Storm Sewer Catch Basins _.� Potable Water Underground Fire Line Front Rear Left Right As per Approved Site Plan Comments: