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Home My WebLink About23-5837City of Zephyrhills 11 � 5335 Eighth Street 4 k y ��4,h� Il y {j \.\2 yodeam�iJw ti G ItS`# \` 2 'Ill `ti+�� ;,`•} S�, i phyrhills, FL 33542 Phone: (313) 7 0-0020 Fax: (313) 750-00 1 Issue gate: 03t1412023 r 1i 1 t: .z. �.. ..��3:, - S"t., � 1 s sy ,.$r. z•1.\ywnl r�\i , �.: ,, 2 �, fi a >: fi ...1 1}\�\:. sy vilk.s �yy .�� ,ti `.zi:y�t '�z� �s.. � .�, ��; 't�i��1.�? „J,�, , lk� `Y��u��};1, �z�ttl ��. ,; �'.. tFit. 1. .,�� ,� ,, ��., tea„ ti\ti 04 26 210160 01500 0010 36526 Flats Strut t � • � ,1„ y , �z, ..t<,";d �z, z zt. Afit ti}�.:: 1 � .}z� t � \Sy <. 1 ti, z.yJ i\� iti �ti gip:.,,., `z � .b J, .}.ti ,z�: . L`<.z£`<' A Z�;'\41 �1��y::. Name: LENNAR HOMES LLC-OWNER Permit Type: Building New (Residential) Contractor: LFNNAR HOMES LLC Mass of Work: SFR Construct Address: 4600 W Cypress St 200 Building Valuation: $437,160.00 TAMPA, FL 33607 ' Electrical Valuation: $65,574.00 Phone: (813) 574-5700 Mechanical Valuation: $30,601,20 Plumbing Valuation: $43,716.00 Total Valuation: $577,051.20 Total Fees: $21,523.29 Amount Paid: $21,52.29 .� C Date Paid: 3/14/2023 11:27:42AM CONSTRUCT SINGLE FAMILY 3092 SCE FT i• \ l # >2.s U' z nl z 1 ) \ z ` 4: s1 � }\1. \7 v x ,� \t, t. t }3 �� z l\l Public Safety Impact Fee AAdmin $2.35 Park Impact Fee - Single Family/1`ownhome $769,56 Building Permit Fee $2,225.80 Plumbing Permit Fee $258.58 Public Safety Impact Fee -Police $254.00 SIF 1 percent Fee $83,28 Electrical Plan Review Fee $0,00 Plumbing Plan Review Fee $0.00 Address Fee $30,00 Mechanical Plan Review Fee $0,00 Water Connection Residential Fee $1,140.00 School Impact Fee - Single Family $8,328.00 Building Plan Review Fee $180.00 Transportation Impact Fee - City $36.32 3f4 Water Meter Fee (Catc) $794.92 Irrigation 3f4 Meter (Cale) $794.92 Transportation Impact Fee $3,595.68 Sewer Connection Residential Fee $2,400.00 Electrical Permit Fee $367.87 Driveway Fee $45.00 Mechanical Permit Fee $193.01 REINSPECTION FEES: () With respect to Reinspection fees will comply with Florida Statute 55a0(2)() 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 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 rather 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 ice 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 BEFORE C.O. NO OCCUPANCY BEFORE C.O. col RACTQR SIGNATURE PE IT OFFICE APPROVED�*ERMIT EXPIRES IN 6 MONTHS WITHOUT CALL FOR INSPECTION - ,;4 HOUR NOTICE REQUIRED PROTECT 813-780-0020 City of Zephyrhills Permit Application Building Department Phone Contact for P� Date Received Permitting 770 V POOL� ___ _1_11 0 P Owner's Name FCAL HEARTHSTONE LOT OPTION POOL 03 L P Owner Phone Number Owner's Address 23975 Park Sorrento, Ste, 220, Calabasas, CA 91302 Owner Phone Number I Fee Simple Titleholder Name Owner Phone Number 813.574,5700 Fax-813-780-0021 Fee Simple Titleholder Address F N/A JOB ADDRESS 136526 Flats Street LOT # SUBDIVISION Abbott squarePARCEL 1D# (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR 8 ADD/ALT SIGN DEMOLISH INSTALL REPAIR PROPOSED USE SFR COMM OTHER TYPE OF CONSTRUCTION BLOCK FRAME STEEL DESCRIPTION OF WORK Single Family Residence (Pool (Screen Enclosure !Fence BUILDING SIZE UIR SF 3643 SCI FOOTAGE HEIGHT "I `1111111_r-" ; BUILDING 1rw ----------------- 437160 I VALUATION OF TOTAL CONSTRUCTION ' 1 ELECTRICAL r65574 AMP SERVICE E�o PROGRESS ENERGY W.R.E.C. PLUMBING EE= 0 MECHANICAL r30601 2 VALUATION OF MECHANICAL INSTALLATION = GAS W1 ROOFING O SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA CIYES Do BUILDER COMPANY 11 ...... ar Homes, LLC SIGNATURE REGISTERED YIN E CURREN Address 4/1 W Boy Scout Blvd Suite 600 Tampa, IT. 33607 License # I CGC1518166 ELECTRICIAN COMPANY FEdmonson Electric, Inc. SIGNATURE REGISTERED Y/ N FEE CURREN Y/N Address License # PLUMBER COMPANY Bayonet Plumbing, Heating & AC, Inc SIGNATURE REGISTERED Address License # MECHANICAL COMPANY [Bayonet Plumbing, Heating & AC, Inc SIGNATURE REGISTERED YIN FEE CURREN Y/N L Address License# CAC058Q62 OTHER COMPANY C Sterling Quality I R 11 o .11 o .1 f i 11 Dg ;,I Inc SIGNATURE REGISTERED L_Z_LN J FEE CURREN Y/N Address License # 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 wl Silt Fence installed, Sanitary Facilities & 1 clumpster; 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 & I clumpster. 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(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'SIOWNER'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 AGENT _:=� Subscribed and sworn a (or affirmed) before me this 3M2023 _by_ Ch w—ho—is/are personally known to me or44asAiave-pFe4uG" as identification. 1. Notary Public Commission p"/V<96057 Stephanie Farmer Name of Notary typed, printed or stamped 9ff:J 311=23 ----by Christopher Smith who islare personally known to me or has/have produced as identification. -----Notary Public Commission No. K7= Stephanie Farmer / Name of Notary typed, printed or stamped ELMUM, HOLUM 'V E*WhO4,2024 I INVOICE NUMBER INVOICE DATE INVOICE DUE DATE INVOICE STATUS INVOICE DESCRIPTION INV-00010381 03/11/2023 04/10/2023 Due NONE REFERENCE NUMBER FEE NAME TOTAL BNR-005837-2023 3/4 Water Meter Fee (Calc) $794,92 Address Fee $30.00 Building Permit Fee $2,225.80 Building Plan Review Fee $180.00 Driveway Fee $45.00 Electrical Permit Fee $367.87 Electrical Plan Review Fee $0,00 Irrigation 3/4 Meter (Calc) $794.92 Mechanical Permit Fee $193,01 Mechanical Plan Review Fee KOO Park Impact Fee - Single Family/Townhome $769.56 Plumbing Permit Fee $258.58 Plumbing Plan Review Fee KOO Public Safety Impact Fee -Admin $26.35 Public Safety Impact Fee -Police $254.00 School Impact Fee - Single Family $8,328.00 Sewer Connection Residential Fee $2,400.00 SIF 1 percent Fee $83.28 Transportation Impact Fee $3,595.68 Transportation Impact Fee - City $36.32 Water Connection Residential Fee $1,140.00 36526 Flats Street Zephyrhills, FLORIDA 33541 !:ii!!!��illi;!�i:ii:� 11� $21'5 2129 A REMITTANCE INFORMATION TOTAL City of Zephyrhills 5335 8th Street Zephyrhills, FL 33542 March 11, 2023 5335 8th Street, Zephyrhills, FL 33542 Page 1 of 1 Exempt 0 Yes 0 No Flaw Determined fined Impact Fee Amount � Zone No. TAZ: SCHOOL IMPACT FEE Account (056) Single -Family Detached House Amount 2- (OS7) Mobile Home (658) Other Residential (123) Collection Fey Exempt =Yes = No How Determined„ PARRS AND RECREATION FEE Land Account Land Credit Land Total Recreation Account Recreation Credit Zone Exempt =Yes = No Flow Determined Recreation Total Total Amount $ , l LIBRARY FEE Land Account Land Credit Land Total Facility Account Facility Credit. Facility Total ExemptEl Yes No Flow Determined Total Amount RESOURCE FEE ERU Total Amount Prepared By Checked By CERTIFI TE OF OCCUPANY WILL BE ISSUED OR FINAL INSPIECTION PERFORMED UNTIL THE TOTAL ANIOUNTS LISTED HAVE BEEN PAID AND RECEIPTED FOR BY A CEINTRAI 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, BATE RECEIVED BY RECEIPT NO DATE BY y �-261'- 24" RCP @ 0.300/'o-E Ln SDI/ Ln LO e « 17, wommaim.51 , T mm TW: 104.81 DESCRIPTION: LOT f, BLOCK IS, ABBOTTSQUARE PHASE 2, SITE PLAN SEC, 4, TWP. 26 S, RING 21 E. ACCORDING TO THE PLATTHEREOF, RECORDED IN PLAT BOOK 90, PASCO COUNTY, FLORIDA PAGES 28-33, OF THE PUBLIC RECORDS OF PASCO COUNTY, (NOT A SURVEY) FLORIDA (ABBOTT SQUARE PHASE 2) This SITE PLAN Prepared for and Certified 7o: Lennar Homes LOT = 7039 SQ.FT. LIVING AREA = 1324 SQ. FT. DATA ENTRY = 55 SO, FT - GARAGE = 496 SO, FT CURVE RADIUS ARC LENGTH CHORD LENGTH CHORD BEARING I DELTA ANGLE 1 COVERED LANAI = NA SQ FT C2 1500 24,17' 21.64 N 44'0232' W 92' 1849" � j PATIO = 24 __SO, FT. POOL AREA = NA SQ FT CONC. DRIVE = 360 SO, FT. ASSC & CONC PAD = 14 SO. FT SIDEWALK37 SO, FT. SIDE YARD SWALE NA SO, FT_ CONSERVATION AREA = NR SQ. FT-. LOT OCCUPIED = 33...... AREA TO IRRIGATE 67 % * .a 10,00' PUBLIC UTILITY EASEMENT Tay = TOP OF WALL BW = BASE OF WALL LEGEND: u_.--ii = PROPOSED DRAINAGE FLOW (00,00) - PROPOSED GRADE E-00.00 - EXISTING GRADE NOTES: LOT GRADING TYPE =A PROPOSED PAD ELEVATION--98.50" FRONT SET BACK m 20' SIDE SET BACK- T5 SIDE. SET BACK (CORNER LOT( -10' REAR SETBACK =- 15' PROPOSER MINIMUM FLOOR ELEVATIONS: LIVING AREA: 99.17' GARAGE AREA: ELEVATIONS REFERENCED TO NORTH AMERICAN VERTICAL DATUM OF 1988 N (CDD) RIGHT-OF-WAY TRACT 'A" 5 CONIC WALK l t N�9'4&04 E(P) 51 08 (P) \ w CC?NC 4 WALK p 6 I 75' 23.3' � a I o . ENTRY 16.7 o PROPOSED 1 LOT 2 I 2 STORY RESIDENCE BLOCK 75 it P &5 i '•1 ELELEVEV "A" I — o GARAGER e I a i ZS' 40.0' -__- e i j w ! 16.3 =ro u, d 4 4.0 X6.0 o 1 PATIO 27X27'.. .' ,.. C'SRC' LOT I IS) ) w BLOCK 15 it # .0 �l NX IN 89"48 04" E jP( 62,25 P) CCU' LOT 23 LOT 22 BLOCK 15 , I BLOCK 15 i 1 f I ALL ELEVATIONS REFERENCED PROPOSED ELEVATIONS AND GRADING TO NORTH AMERICAN SHOWN HEREON ARE TAKEN FORM THE VERTICAL DATUM OF 1988 ENGINEERING PLANS OF (NAVD 88) 'ABBOTT SQUARE RESIDENTIAL', PREPARED APPARENT FLOOD HAZARD ZONE: "X" COMMUNITY NO. 120235 BY "WRA" PROVIDED BY CLIENT SURVEY ABBREVATIONS )MAP NUMBER 12TOIC-0289-F) EFFECTIVE DATE 09/26/2014 A ARF LENc t I IDi D=.D INv DIVER FC - FONT OF C URSA RECORD LEGEND t A'R fONt lON_R I DRAI EDGE AS M�U i3 -LICENSEDS BUSN PCf ON O COM OINDCl 13VE RUN - CANGE V+M1YL �ti�C-Et Ad—AWRAIRUMFENCE EL OR ETV f VAi ON - - LANDSCAPEASEM 4 PC° RMAN N CONTROL POIN1 R S-IA ROAD SEKi CONC 4 4 &AS �CVID .EVAt ON tOi R6C O PAV�ivtN Ft LOW S-F OOR EL V410N Fz- 00 O .PMEN- ,W^RC i Or WAY M 9ENW MARK } S. LASEN N - S .CEO D SURVEYOR C = A< WOOD .NCE CURVC- S G SF T TN i<1 ClLfV A'-➢ r C F=tJfF 7RIv R (Ml MFANR D f+--PGh O INT.iLS _;;ON 4Nbp •SlTN4 _AWC DISK F AL CM FOUND (ON:RErE N S MITERED ND SECTION PC -PARK RCA ON iBP8183 (NTE 21 Nf CHAIN ;.NC FENCE LF • CHA N tNF F=NG. MCNIARN7 ��=NO CO IEI FOIND PSO OY UN, SIR SET R ON ROD B# 8183 CM mLG12RJGAT,DMETA !t - 'EOUNDRON '�E OtA=OV AL °Q3 OV `3.4 BEGINNING Blvt^i1WCR1,�Y BtNEiLMARK r- LOLP40WMN FlR-FOIfNCI IRON ROD 04W-OVERN'AD_,RE °OC J+M 01 COMMENCTMENT :OB>l0 O`BAN -K COEN b'U4CREiE f N .- I OUNU NAI & DDE O- . -n ICALRECOSDS POt t OW ON N( W = r >WNSt II' 1� 1 ALUMNUSFENCE Sw CONICKET SIA(i C�' FOt NJ OPEN PE P, =CA 'RC^ CCiTCTR /NPS C.rrCB C.F-Utl AS£MENT =COti,R2EG ?^CLEARS.GH?TIttANG,E U,P,OuG INCHEDIrPc Pn PiAT. .1 PRM PERMANENT REFENCE naONOMEN VF NNY:'t'NCL 1�_41 JOB 46292 SURVEYOR'S MOTES: SURVEYOR'S CERTIFICATE 1708 Water Oak Drive I') Current title information on the subject property had not been This certifies 0.rlEYlkil the hereon described Tarpon Springs, Florida )ate of Site Plan: 12-24-22 �i�b�®I P furnished to Initial Point Land Surveying, LLC. at the time of this propert ,lek� rdt}g}q' N*y upervision and Phone: 727)-831-1990 SITE P AN )WG:AS-PNZB-Lt-f3L15-SITE meet�plQ,pilcw1b1t3iOfFdp�f Practice for Flor(daPLS7t23C gmaiLcom 2.) This sketch was prepared without the benefit of a title search. s#'01,11., SUrvy}'aiT1`daaard of Laand LB#8tS3 No instruments of record reflecting ownership, easements or NI�...,,rights-of wad= were furnishoc to the undersigned unlessotherwise 5 d iin'{strtg„�Ned shown hereon.suiLon 47t :R $f Ra rtIe Dawn by D1B 3t Roads, walks, and other similar items shown hereon were taker P .WoC s^ +� _ ._. [Tate 3.02.1 Checked by 11 i from engineering plans and are subject to survey. A.) This SITE PLAN does not reflect nor determine ownership. P c; " REF/I$IOtJS 11 -05'00 "I I' , 912 St This SITE PLAN is subject to matters shown on the Plat of I ? E_.. 'ABBOT? SQUARE PHASE 2' ---gyp -P `� --w ------ 6.) Dimensions Shown hereon are in feet and decimal portions Jeff R1 0 4hate FLORID , "I I C%EYOR AND V 7.1 Contractor and owner are to verify all setbacks, building MAPPER NO.IASr hIrtt 8 (II3 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. New Development Check List Parcel M -2'-2 / —0/ ( 10 — Cy '—Oc.)1V Address: Setbacks: Front " 5 Rear �'�I n5 Sides 2I-5.L/-6I'3 Elevation: A Garages Roof Single Dimension/Architectural: 2 1 Notice to Building Official of Use of Private Provider Effective January 20, 2003 Project Name: 36526 Flats Street 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, fflffdoll� the fee owner, affirm I have entered into a contract with the Private Provider indicated below to conduct the services indicated above. Private Provider Firm: VIRTUAL REVIEW ASSIST, INC. Private Provider: DEBRA 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 # 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 any 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; DriviTounental or other codes. The following attachments are provided as required, 1. Qualification statements and/or resunnes of the private provider and all duly authorized representatives. I. Proof of insurance for professioualand comprehensive liability in,the. amount .of $1 million per o ccurrence relating to all services p rfofnic-d as a private provider, including tail coverage for, a minimum of 5 years subsequent to the performa'rce of building code inspection services, (signature) . print Narae: Address Telephone I�To.. 'Please use appropriate notary block° STATE OF FLORIDA . COUNTY OF H1LLSBCRCUGH B efore me, this day of 20____, personally appeared who_ executed the foregoing mstruznent, and acknDWIedged before me, that same was executed for the purposes therein express�de Partnership PrintPartnershipName By- ' {signa�uxe} print Name Its Addrem Telephone No, B efom e, this day of 24, personally appeared p erlagentonbehalfof a partnership, who executed the foregoing instrument �nd aolmowledged before me that same was executed.forthepiarposestherem expresse . expressed.. Personally known X �; or i'roduced ideniitcation Type of ideniification produced Sigaatam ofTeotar i'rintNMne ASHLEE CALLAHAN NotaryPublic Stamp RSHGEE CAL Commission E pires, C ht IS i N i $t? of°" X R Now 30, 2026 F iLx P J errs .ni Corporation Be,foreme,this 22ND day of MAY 20 —22 personally appeared of enn r Homes, LLC a corporation, on behalf of the state corpom don, who executed the foregoing instrument and aolamowledged before me that same was executed for the pup oses therein d 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 211 Avenue Gainesville, FL 32601 Phone: 813-391-2959 Email: I icwa�virtualreviewassist.corn kic-N-WIV-14-11 - Project: New SFR Address(s): 36526 Flats Street 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,1.0,1.1,2.0,3.1,3.2,FI,4.0,4.1,5.0,6.0,7.0,7.1,8,0,SN,SNI, S3,S4,S5,S6,SS, Dl,D2,WP,PAI.0,PAI,I, PAI,2,PAI,3,PAI.4, SHI.0,S1iI,I,SHI.2,SHI.3,SHI.4,SHI.5 Florida License/Registration/Certification #(s) and description: FS468 Certified Standard Plans Examiner License #: PX2300 I" Signature of Reviewer: SWORN AND SUBSCRIBE me by Debra Anne Klahr being personally known to m.r?re or having produced as identification I and who being fully sworn and cautioned, state that the f re ing is true and correct to the best of his/her knowledge or belief. Of No PrKini-Kame 0 MIMMM2 If5i COMMERCIAL BUILDING SERVICES DIVISION VRESIDENTIAL BUILDING PERMIT DATA SHEET 1 11 RUNNIM Reauired Permits Plumbing 7 1 V Mechanical 11!n!�Pection�(Onlv El Medical Gas VEle trical Amp In pection 0n1v I E] Fire Sprinklers On Site Piping irrigation E] Fire Alarm E] Potable Backfflow Asse bly Fire Line Backilow Preventer E] Irrigation Backflow Assembly El Demolition El Walk-in Cooler 0 Refrigeration El Hood E] Ansul El Grease Trap El Other Other V® Risk Category: Occupancy Load a ification: C'a8s ncy E= 0W.""Fa, Factory Assembly E— Hazardous FB,,sness ay Care/Fducational 'lost utional []Mercantile Residential O'Storage E= Util� iry Building Use: 5INGLE FAMILY RESIDENCE Alteration [—Level I F(iLevel 2 1151"Level 3 1,9 New Construction Ej Interior Finish E] Interior Remodel Exterior Remodel Addition Ej Revision Overall Size: Number of Stories: Total Sq. Ft.: 40 X 50 2 3643 Living Area: Covered Area: # of Bedrooms: 6 3092 551 # of Baths: 3 Cost per square foot: Es imated Value: Roof T e: X Shin le Buiitsu Metal M_Other Squares: 24 Zoning: —Tile WipdborneDuebbris- Energy Code: 405 -2020 �de E nsi 'Outside Flood one: X Base Flood Elevation: Finish Floor Elevation: Hydrostatic Vents; F�Yes 'No- Sq. Ft. Enclosed Space Below BFE: # of Vents: T-Size of Vents: Total Sq. In, Permanent Openings 10 Central A/C 0 - H eat Pump Window A/C Ej - El Gas A/C El Gas Heat E] Electric Heat Sanitary Sewer Storm Sewer Catch Basins Potable Water Under round Fire Line M� Front Rear Left Right As per Approved Site Plan Comments: