HomeMy WebLinkAbout23-5826� : • i
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Issue Date: 03/14/2023
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04 26 210160 02200 0060 36514 Camp Fire Terrace
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(Name: LENNAR HOMES LLC-OWNER Permit Type: Building New (Residential) Contractor: LENNAR HOMES LLC
Class of Work: Townhome
Address: 4600 W Cypress St 200 wilding Valuation: $50,320.00
TAMPA, FL 33607 Electrical Valuation: $37,548.00
Phone: (813) 574-5700 Mechanical Valuation: $17,522.40
Plumbing Valuation: $25,032.00
Total Valuation: $330,422.40
Total Fees: $14,333,47 7
Amount Paid: $14,333.47 .w.
Date Paid: 3/14/2023 11:27:42AM
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CONSTRUCT TOWNHOME 1634 SQ FT
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Mechanical Permit Fee $127,61 Transportation Impact Fee a City $34.60
314 Water Meter Residential Connection Fee $794.92 Plumbing Valuation Fee $0.00
Mechanical Plan Review Fee $0.00 Water Connection Residential Fee $1,140.00
Park Impact Fee m Single Family/Townhome $769.56 Plumbing Permit Fee $165.16
Address Fee $30.00 Transportation Impact Fee $3,445.20
Fire Wall/Smoke Wall inspection $15.00 Public Safety Impact Fee -Admin $26.35
SIF 1 percent Fee $33.53 Public Safety Impact Fee -Police $254.00
Building Plan Review Fee $180,00 Sewer Connection Residential Fee $2,400.00
Building Permit Fee $1,291 A0 Electrical Plan Review Fee $0.00
Electrical Permit Fee $227.74 Driveway Fee $45,00
School Impact Fee ® single Family $3,353.00
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 rein pection, whichever is greater, for each subsequent rein pec ion.
(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 regards 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.
i tt�
xt S
CONTRACTOR SIGNATURE PE IT OFFICE
PERMIT EXPIRES IN 6 MONTHS
I WITHOUT INSPECTION
CALL FOR 1NOTICE
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
a Building Department
Date Received Phone Contact for Permitting 9Q8 770 __ 7763
Owner's Name CAL HEARTHSTONE LOT OPTION POOL 03 L P Owner Phone Number 813.57A.5700
Owner's Address 23975 Park Sorrento, Ste. 220, Calabasas, CA 91302 Owner Phone Number ��TT
Fee Simple Titleholder Name N/A Owner Phone Number
Fee Simple Titleholder Address
NIA
JOB ADDRESS
36514 Camp Fire Terrace
LOT # �06
SUBDIVISION Abbott SCtUare PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED
E'er iI
NEW CONSTR ADD/ALT
SIGN
DEMOLISH
INSTALL REPAIR
8
PROPOSED USE SFR COMM
OTHER
TYPE OF CONSTRUCTION BLOCK E] FRAME
STEEL
DESCRIPTION OF WORK
Multi -family l Screen Enclosure I Fence
BUILDING SIZE SC I FOOTAGE 4
HEIGHT
T
BUILDING
$ 250320 ���
VALUATION OF TOTAL CONSTRUCTION
tel tELECTRICAL
TTDPP
$ 37548
PROGRESS ENERGY
0 W.R.E.C.
J
AMP SERVICE
,11�
—.
N.f' (PLUMBING
$ 25032
y
�J !MECHANICAL
7 JGAS
$ 17522 4
VALUATION OF MECHANICAL INSTALLATION
0 ROOFING SPECIALTY =
OTHER--�
FINISHED FLOOR ELEVATIONS
FLOOD ZONE AREA
YES I o
BUILDER �7 COMPANY Lennar 11omcti, LLC
SIGNATURE REGISTERED Y / N FEE CURREN Y / N JJ
Address 4_ M tV Boa Scout Blvd Suite 600 Tampa, FL 33607 License # I CGC1518Ib6
Edmcans®n Electric, Inc.
ELECTRICIAN COMPANY
SIGNATURE REGISTERED -Y / �! fEE CURREN Ly / N
Address License# EG13045408
PLUMBER COMPANY Bayonet Plumbing, Heating & AC, Inc
SIGNATURE REGISTERED YIN FEE CURREN Y / N
Address License #
CFC042998�
MECHANICAL COMPANY Bayonet Plumbing, Heating & AC, Inc
SIGNATURE REGISTERED Y / N FEE CURREN Y / N
Address License # CAC058062�
OTHER COMPANY C Sterling Quality Roofing, Inc
SIGNATURE REGISTERED Y / N FEE CURREN Y / N
Address License # I CGG057991
ll6pBttOI9FIIE9tli1liB1Il1p!l111tEt88IF@It1iFF111iF0@EfI111Iil961898
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, (A/C upgrades over $7500)
Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (copy of contract required)
Reroofs if shingles Sewers Service Upgrades A/C Fences (Plot/Survey/Footage)
Driveways -Not over Counter if on public roadways..needs ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions,
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work, they are advised to contact the Pasco County Building Inspection Division —Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor($) 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, 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 OR AGENT
Subscribed and sworn o (or affirmed) before me this
3,112023 — by _ Christopher Smith
Who is/are personally known to me or4asA4ave-pFo4uGe4
as identification,
—Notary Public
Commission 413296OS;77
Stephanie Farmer
Name of Notary typed, printed or — stamped
,p t;=MW" # M Omit
31,2023 by Christopher Smith
Who is/are personally known to me or has/have produced
as identification.
Notary Public
Commission No, 6 _7
Stephanie Farmer
Name of Notary typed, printed or stamped
Builder Name/Owner Nacre t ��� �� Control #
County Parcel No. t' t 1 � 2- d C� j u Div:
Address/Location
Classification/Type of Use
TRANSPORTATION IMPACT FEE Rate. Sq. Ft Unit:
Exempt Yes 0 No Flew Determined
Impact Fee Amount Zone No. TAZ:-
SCHOOL IMPACT FEE13-r
Account (OS) Single -Family Detached House Amount $
(057) Mobile Home
(058) Other Residential
(123) Collection Fee
Exempt EDYes = No How Determined
PARKS AND RECREATION FEE
Land Account lend Credit Land Total
Recreation Account Recreation Credit Recreation Total 1, �
Zone Total Amount % "d•
Exempt =Yes = No How Determined
LIBRARY FEE
Land Account Land Credit Land Total
Facility Account Facility Credit Facility Total
Exempt11 Yes No How Determined Total Amount
RESOURCE FEE ERU
NO CERTIFICATEF OCCUPANY WILL BE ISSUED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOUNTS LISPED HAVE
BEEN PAID AND RECEIPTED 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
FORM, PLACING THE BUILDING OWNER ON NOTICE OF THIS ASSESSMENT AND THE CONDITIONS OF PAYMENT FOR SAME,
DATE RECEIVED BY
RECEIPT NO DATE BY
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DESCRIPTION: LOTS 1-5, BLOCK 22, ABBOTT SQUARE PHASE 2, SITE PLAN SEC. 4, TWP, 26 S, RNG 21 E.
ACCORDING TO THE PLAT THEREOF, RECORDED IN PLAT BOOK 90,
PAGES 28-33, OF THE PUBLIC RECORDS OF PASCO COUNTY, fNOT A SURVEY) PASCO COUNTY, FLORIDA
FLORIDA.(ABBOTT SQUARE PHASE 2)
11 - ------ This SITE PLAN Prepared for and Certified To
PROPOSED ELEVATIONS AND GRADING Lonna, He-,
SHOWN HEREON ARE TAKEN FORM THE
ENGINEERING PLANS OF
'ABBOTT SQUARE RESIDENTIAL', PREPARED
BY "WRA" PROVIDED BY CLIENT
- ---- ---- -----
ALL ELEVATION'S REFERENCED
TO NORTH AMERICAN Scale: 1 20'
I VERTICAL DATUM OF 1988
! : (NAVD 88) I TRACT "A'
- - ------- -
iCDD) RIGHT-OF-WAY
CAMP FIRE TERRACE
Ili------ ------ ------
N 89'48 04 E I Pj
BASIS OF BEARING
IN
27 3 273
5 CONC WA L K
N BT48 04- E LPJ 128,68'(P)
I
2 7274 83 F
F Ti:
PC
VT0E4
N89,4804 E!P)
03,89 JP)
I
J cs 1 0
hCro 10,0
10,0
I I'D
I 10
I'D
110 i 1 0
Il'o
US 3
63,
63
'63
ca
10.0
"K
-
0
7d ENTRY
ENTRY 6, 3F
63 ENTRY
ENTRY 6,30
63 ENTRY P,
ENTRY 7.0
A
108-8
LOT 10
LOT 9
LOTS
LOT 7
T,, LOT 4,
LOT 5
co
BLOCK 22
B LOCK 22
BLOCK 22 �S
B I
LOCK 22
22
P BLOCK22,
LOTIi
BLOCK 22 -:F
PROPOSED
PROPOSED
PROPOSED o
PROPOSED
PROPOSED
PROPORE5'�
BLOCK
LOT
22
2STORY
2STORY
2STORY
2 STORY =
1211ORY
2STORY
ATTACHED
RESIDENCE
ATTACHED
RESIDENCE
ATTACHED
RESIDENCE
ATTACHED
RESIDENCE
ATTACHED
I RESIDENCE
ATTACHED
RESIDENCE
UNIT -A
UNIT-C
UNIT-C
UNIT-C
UNIT-C
UNIT -A
1532
1624
1624
1624
1624
1532
18.0
173
173
173
173
18r,
Oro LANAI
is LANAI
LANAI
LANAI
LANAI_'
uSA
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to
NOTES: N 89'48 04 E IF) 128 68 (P)
LOT GRADING TYPE °-A TRACT "B-7-
(CDD) OPEN SPACE
PROPOSED PAD ELEVATION 112,40
FRONT SET BACK =- 20
LOT
SO. FT,
SIDE SET BACK - T5 LIVING AREA
-_40I0 SQLFT.
SIDE SETBACK (CORNER LOT) =10 ENTRY
= 476 SQ. FT.
REAR SETBACK- 15 GARAGE
=___11356_SO, FT
10.00 PUBLIC UTILITY EASEMENT COVERED LANAI
= 652 SO. FT.
NOTE: ENTRY WALKS ARE 3.0 CONIC PAI-10
=NA_SO. FT,
PROPOSED: CS -A C UNI FIE AIRE 3 2 X12 POOL AREA
-NA SO. FT,
MINIMUM FLOOR ELEVATIONS: CONC. DRIVE
SQ. FT,
LIVING AREA: I] 3,0T LEGEND: AIC & CONC PAD
_L2_00
= 54 --SQF FT -
GARAGE GARAGE AREA: PROPOSED DRAINAGE FLOW SIDEWALK
= 0, FT.
ELEVATIONS REFERENCED TO (ro SIDE YARD SWALE
h) - PROPOSED GRADE
- _NA, -SO- FT,
NORTH AMERICAN VERTICAL CONSERVATION AREA
=--NA SO, FT,
E-00,00 � EXISTING GRADE LOT OCCUPIED
64___ %
DATUM OF 1988
AREA TO IRRIGATE
36 %
APPARENT FLOOD HAZARD ZONE: X COMMUNITY NO 120235
(MAP NUMBER 12 10 1 C-0452-F) EFFECTIVE DATE: 09,26 2014
SURVEYABBREVATIONS ��
11 - All LED1,11
IN, - DEC.
INS=INVERT
P( - POINT OF 1URF`1
H;
LEGEND
All - AIR CONDIT ' ONER
AT _1Lt1M NUMFNCE
,1 - DRAINAGE EASEMENT
15_�tc!FNINP BUFOlESS
P C POINT OF COMPOCINAT li-JIVE
NE
RDO � IONCAL
ONC ___il
VINYL FENCE
-- - ----
Sri
El OF I Y-ELENATION
EOP � INGE OF PAITICLIT
IF LANDSCAPEEASEM ENT
lFE - I,OWFS- FLOOR EL' . DATfON
PC MANFNI CON TROT DANT
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SIR - IS I I - DON ROD L14 K 11,1
i EM - TEMP"ORARY M NCH MARR
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C, 11 - CIX ama
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POC , POINT OF COMM E SE, IMENI 106
- U'UP OF CANK
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- FOUND NAIL F, DjSX
OR OFF11VS RECORDS
POL-POINT �
Val - TOPDNS( VP
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OP-IOUNDOPENPIPE
, PLAT
TV - POINT 01RtlVEASI CLOVE
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CCrFAR SIGHT rRIANGLE
FOUND PINCHED MPH
PS -PLAT BOOK
,IE
NT REFERENCE MONUMENTVF=�,Nyl1FEF
JOB #6295
SURVEYOR'S NOTES:
SURVEYOR'S CERTIFICATE
1708 Water Oak Drive
Face of Site Plan I I -28-22
Current title rnl.-al,.n on the subject property had not been
furnished to Initial Point Land Surveying, LLC at the time Nfthis
SITE PLAN
i
This certifies that sk t l�foftha hereon described
property Eva, "%-,ion and
Tarpon Spring,, Florida
Phone: 1727)-1;3 1-111.
PI
Lvs`G_��!i 11112 1- sLzzSITE
This
meet, IF '_eo�J� &.Practice ficK
IR a
FkRrYK,PLS7123C�qrr,,Lc
Om
24 sketch was prepared nath-t the benefit ofa utle,earrild
�a
121 Vrd of Land
LB# 8183
Ile
No insti uments of record reflecting own -NIT eale-Ut, or
rights -of -way were furnished to the undersigned, unless othervu,
evesuwey
�qj
S J
e 5 hed
A2, 'A
Draw,) by: DJB
shown hereon.
11 t KA: ion 4
0 "On Ley
-
hecked by.JH
3.) Roads, walks, and other arrilIP, items shown harcou, were take,
from engineering plans and are subject to survey.D
Stat I-, ate: 2(:�.62 17
TEVISIONS -
4.) This SITE PLAN does riot reflect nor determine
LiDo wrersh,p
5.) THIS SITE PLAN to Plat
eyEl 5.485 �c
HW VI001
-uhielt matters shown on the of
ABBOTT S OUARE PHASE 2
1*, F RIDA 4!
F
6.) Direen
Dimensions shown ),clean are in feet and decimal P.M.-
i-Mirm- E
A
JA',
thereof,
, I Q
FLORIDA I�Fs f FIK � 17 .tV MAPPER
7.) Contractor and owner are to verify all setbacks, building
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
at users D)e risk.
LICENSED SURVEYOR AND MAPPER
Initial Point Land
Surveying, LLC.
\/R/\
v R T UA1, V W A SS 1 S, T
Notice to Building Official of
Use of Private Provider
Effective January 20, 2003
Project Name: 36514 Camp Fire Terrace
Parcel Tax ID: 04-26-21-0160-02200-0060
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.
owner, affirin 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: DEBRA ANNE KLAHR
Address: 747 SW 2N[) 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 # 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
qorporation
Print CoiporationName
(signature)
Print
Name: Christo her Smith
its: Authorized AggDt
Addrem 700 NW 107Lh Av
Miarn, FL 33172
Telephone
No. 913-574-5700
Corporation
Before, me, this 22ND day of
MAY 20 2
personally appeared
Of
Lennar Homes LLC a
corporation, on
'behalf of the state corporation, who
executed the f6regoing instrument and
a61qioWledgtd before me that same was
executed for the purp p s es therein
expressed.
review for fire code, land use; enviroane�ntal or other Codes.
The following atta.cbments are provided as required:
%IWI lilt
•I-MV . Y . . . . . . . . . j- - I -M, _MM&jTW
of 5 years subs equtnt tothe performance, of building code itspection services.
M
(signature)
print
Name:
Address*7
Telephone
?least use appropriate notary block.
STATE OF FLORIDA
COUNTY OF HILLSBOROUGH
ludMdual
Befbreme, this day Of
---------------------- � 20____, personally
appeared,
who executed the foregoing instrument,
an , d acknowledged before me that same
was executed for the purposes therein
Partnership
PrintParmershipName
By:
print
Name,.
Its,
Address:
1i�
Partnership
BeforDme'tiris day
of 20,
pers6nally appeared
p cr/agent on b chalf of
a partnership, who executed the
foregoing instrument And
acknowledged before me that same
'Was exeDutoddor the purposesthorein
expressed,
Personally known X �or_ P dumd iderrli-tcatiork Type of identifloation produced
sig.natare, of Notan PrintNarae
ASH.LEE C.ALLAHAN....
NotaryPublir, Stamp:
corniftission Expirm. XPI
Page 2 off.
\/RA
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: lugy(a�Lvirtualreviewassist,coin
Project: NewSMVII�—
Address(s): 36514 Camp Fire Terrace
hereb% certiL that to the best od were reviewed for and are in
�qlml , W-10
==g U111din, NIJU lsvtly UU1,110114CU LU P IUIIII pudm IV,'? low pursua u Lo 3m;uun JJ-1. 171, r-
and holds the appropriate license or certificate:
Name: Debra Anne Klahr
Florida License/Registration/Certification #(s) and description:
FS468 Certified Standard Plans Examiner
License #: PX2300
Signature of Reviewer: -,4
SWORN AND SUBSCRIBED before me by Debra Anne Klahr
being personally known to me.11", or having produced as identification
and who being fully sworn and cautioned, state that the
reg."ing is true and Lcorrrect to the best of his/her knowledge or belief,
s
Signature
ry
re of Not Print Name
Not Public: NOTARY STAMP BELOW My
F COMMERCIAL
TRACKING #
FOLIO # 36514!2�Fir�e er
FIRE MARSHAL #01 -
VI"RESIDENTIAL
UVWX W11 02R§E1P1Adi�5,(11MW1W1%
Building
InsDection Only f
Plumbing
EJ Inspection Only
Mechanical
Inspection Only
Electrical Amp
El Fire Sprinklers
El On Site Piping:
rrigation
El Fire 111lm
El Potable Backflow Assembly
E] Fire Line Baeldlow Preventer
El Irrigation Backflow Assembly
El Walk-in Cooler
EIRefrigeration
aim W—A31TO I
El Grease Trap
jype �canstrucdaa:
EE=
Risk Category:
Occupancy Load
ancy C la sification:
act
OV�R Residential
Assembly Day Care/Educational
Hazardous E= nal E== ]Mercantile
Q
'Storage
Building Use: single family townhouse I Alteration Level I Level 2 Level 3
y I I 1Q,
lwf New Construction ❑ Interior Finish El Interior Remodel Exterior Remodel D 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:
�Bl
Est 'mated Value:
�M
Roof T e: X Shin g e
Tie U —Y4—
uilt_n�
t-up eta t er Scares:
P
Zoning:
Wi . orne Debris:
DInside Outside
--Z,
Energy Code:
405-2022 Supplement
Flood Zone: X
Base Flood Elevation:
Finish Floor Elevation:
Hydrostatic —V- —ent—s?-7Q",,Te—s No
Sq. Ft. Fnelosed Space Below BFE:
of Vents:
Size of Vents:
Total Sq. In. Permanent Openings
Central —A/C
El Gas A/C
Z Heat Pump 0 Window A/C
El Gas Heat El Electric Heat
On Site Piping
Saraita Sewer Storm Sewer Catch Basins
Potable Water Undergraund Fire Line
Front Rear Left Right
As per Approved Site Plan
Comments:
is=