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Home My WebLink About23-5930City of Zephyrhilis IM""111 5335 Eighth Street Zephyrhills, FL 33542 BNR-005930-2023 Phone: (813) 780-0020 Fax: (813) 780-0021 Issue Date: 04/11/2023 Permi; i e: Buildinlil qu !rResidential 04 26 210160 02500 0030 6802 Back Forty Loop _77, 77", 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: $312,600.00 TAMPA, FL 33607 Electrical Valuation: $46,890.00 Phone: (813) 574-5700 Mechanical Valuation: $21,882.00 Plumbing Valuation: $31,260.00 Total Valuation: $412,632.00 Total Fees: $20,701.19 Amount Paid: $20,701 , 19 Date Paid, 4/11/2023 3:28:11 PM CONSTRUCT SINGLE FAMILY 2073 SQ FT SIF 1 percent Fee $83,28 Park Impact Fee - Single Familyrrownhome Irrigation 3/4 Meter (Ca1c) $794,92 3/4 Water Meter Fee (Ca1c) $794.92 Electrical Plan Review Fee $0.00 Mechanical Permit Fee $149A1 Public Safety Impact Fee -Police $254,00 Water Connection Residential Fee $1,140.00 Driveway Fee $45.00 Mechanical Plan Review Fee $0,00 Sewer Connection Residential Fee $2,400�00 Building Plan Review Fee $180.00 School Impact Fee - Single Family $8,328.00 Transportation Impact Fee $3,595,68 Plumbing Permit Fee $19630 Plumbing Plan Review Fee KOO Electrical Permit Fee $274.45 Address Fee $30.00 Building Permit Fee $1,60100 Public Safety Impact Fee -Admin $2635 Transportation Impact Fee - City $36.32 REINSPECTION FEES: (c) With respect to inspection 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 foe 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. R 0 SIGNATURE PE IT OFFICE PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION 5 W071 "i" I Mk I 19191 813-780-0020 City of ZephyrhillS Permit ,Application Fax-813-780-0021 ,y Building Department Date Received Phone Contact for P70:n.rPhou,..mie 9070 __ 7763 Owner's Name CAL HEARTHSTONE LOT OPTION POOL 03 L Pr 813,574,5700 23975 Park Sorrento, Ste. 220, Calabasas, CA 91302 Owner's Address Owner Phone Number Fee Simple Titleholder Name I N/A� Owner Phone Number _• Fee Simple Titleholder Address I N/A JOB ADDRESS 1 6802 Back Forty Loop LOT # 2503 SUBDIVISION Abbott Square PARCEL ID# 04-26-21-0160-02500-0030 ....��.•....,...,,...•.® (OBTAINED FRORR PROPERTY TAX NOTICE) WORK PROPOSED II,/ it NEW CONSTR � ADD/ALT SIGN DEMOLISH H 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 U R SF 2605 So FOOTAGE 2073 HEIGHT 2 � rnm 11' BUILDING $ 312611 00 VALUATION OF TOTAL CONSTRUCTION ELECTRICAL $ 46890 AMP SERVICE I PROGRESS ENERGY W_R_E.C_ �! PLUMBING $ 31260 1-1- 0 MECHANICAL $ 221882 VALUATION OF MECHANICAL INSTALLATION ) =GAS I 1 ROOFING SPECIALTY = OTHER 7 r— y FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES ' o BUILDER COMPANY I Lennar I Ionics, LI,C Ar SIGNATURE REGISTERED Y / N FEE CURREN Y / N Address 430 Boy Scout Blvd Suite 600 Tampa, FL 33607 License # I CGC1518166 ELECTRICIAN COMPANY EdmonSon Electric Inc. SIGNATURE REGISTERED Y / N FEE CURREN Address License# EC13005408 PLUMBER COMPANY Bayonet Plumbing, Heating & AC, Inc SIGNATURE _ REGISTERED Y / N FEE CURRENnY 1 N Address License # CFC042998� _ MECHANICAL- COMPANY Bayonet Plumbing Heating & AC, Inc SIGNATURE REGISTERED Y / N FEE CURREN Y / N Address �'__ License # CAC058062 _� OTHER COMPANY I C Sterling Quality Roofing, Inc SIGNATURE REGISTERED Y / FEE CURREN Y 1 N Address License # CCC057991 ////1@/////11/1@/11111@III111@11//It@11111111@11111@11111111111/111 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) Remofs if shingles Sewers Service Upgrades A/C Fences (PloUSurvey/Footage) Driveways -Not over Counter if on public roadways.. needs ROW 1 1NOTICE 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. ArmyCorps 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. FLORIDA JURAT (F.S. 117.03 OWNER OR AGENT Subscribed and sworn o (or Vaffirme�d) before me me ,1111=23 by Christopher Smith Who islare personally known to me or as identification. Notary Public Commission (3296057 Stephanie Farmer Name of Notary typed, printed or —stamped — ELISSAM HOLLEW Q mlH14 OM � comwon# 0 ExomsJuits6,2024 Subscribed and sworn to (or affirmed) before me this 1121M 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 Nam �� ,� � •� � -� ` : � � Control # County Parcel No. � t ?, r �.., �� 1 22 50 C &SubDiv: � c. ' LC(t4 9 Address/Location --L6 01 —>� r �f Classification/Type of Use i `l f i"aA t t.• TRANSPORTATION IMPACT FEE Rate; Sq, Ft Unit:-_ c) — Exempt Yes No How Determined Impact Fee Arnount__$ Zone No, TAZ: SCHOOL IMPACT FEE Account (056) Single -Family Detached House Amount (057) Mobile Home (058) Other Residential (223) Collection Fee Exempt =Yes = No How Determined_ PARRS AND RECREATION FEE Land Account Land Credit Land Total Recreation Account Recreation Credit Recreation instal Zone Total Amount Exempt =Yes =No Flow Determined LIBRARY FEE Land Account Land Credit Land Total Facility Account Facility Credit Facility Total Exempt 0Yes No Hover Determined Total Amount RESOURCE FEE ERU Total Amount Prepared By Checked By No CERT FC TE �C tIPANY !!L �E IS tiEE2 OR FINAL INSPECTION PERFORMED UNTIL THE TOTAL AMOUNTS LISTED 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 FOR(, PLACING THE BUILDING OWNER ON NOTICE OF THIS ASSESSMENT AND THE CONDITIONS OF PAYMENT FOR SAME. DATE RECEIVED BY RECEIPT NO DATE BY 1p'l i.24' - 18" RCP @ 0,30% ii PUA F 98.0 TYPEW 7 FF:9&07 PAD97,40 PHASE 11 PEA p FF7 9 6:9T F: 7 87 PAD TYPEW FF:97.77 PAD:97.10 Typ"aaa A FF:97.77 p lln7- DESCRIPTION: LOT 3, BLOCK 25, ABBOTT SQUARE, PHASE 2, ACCORDING TO THE PLAT THEREOF, RECORDED IN PLAT BOOK90. PAGES 28-33, OF THE PUBLIC RECORDS OF PASCO COUNTY, FLORIDA. LOT = 4420 SO, FT, LIVING AREA =--2-52SO, FT. ENTRY = 32 SO, FT, GARAGE = 396 SO. FT. I COVERED LANAI 104 —SOL FT, PATIO - = NA -SCL FT. POOL AREA FT. CONC. DRIVE FT, A/C & CONIC PAD - 10 SCIF FT SIDEWALK - 61 SO. FT - SIDE YARD SWALE - A NL— SOF FT, CONSERVATION AREA =-N-A--SO, FT. LOT OCCUPIED = 43 % AREA TO IRRIGATE - 57 % SITE PLAN (NOT ASURVEY) This SITE PLAN Prepared for and Cer0fiRfil To Lerman Homes LOT33 LOT 4 4 BLOCK 25 BLOCK 25 '01 1 Bb -08'23'� al --------- N 88 110 50,p) \X1 (p) 3 CONIC ---• &7 WALK 3118 LOT 34 el , 36.3 01 PROPOSED - 205 BLOCK 25 i" LOT - E 2 STORY RESIDENCE 17,0' - BLOCK 25 1 PLAN 2074 8.0 LANAI ELEVA 3 2X3 2' es GARAGE L M 0 ut Ors-POC IN 62RO -2-�7 - ---------- '/'q LOT35 d,>6 v N88`Q8'2X\X1IP) 110,5 IPJ "3tS II BLOCK 25 1 APPARENT LOT2 FLOOD LINE j ZONE AE BLOCK 25 SEE-• 92 a7- o SEC, 4, TWP. 26 S, RING 21 E PASCO COUNTY, FLORIDA (ABBOTT SQUARE PHASE 2) Scale: 1 20' (P) I LL �9 E- U0 0 I PC 6 NOTES: LOT GRADING TYPE - A PROPOSED PAD ELEVATION -- 97 10 FRONT SETBACK - 20 SIDE SETBACK - T5 SIDE SET BACK (CORNER LOT) - 10 REAR SETBACK = 15 ALL ELEVATIONS REFERENCED TO NORTH AMERICAN PROPOSED: 10.00 PUBLIC UTILITY EASEMENT VERTICAL DATUM OF 1988 MINIMUM FLOOR ELEVATIONS: (NAVD 88) LIVING AREA: 97.77' LEGEND: GARAGE AREA ELEVATIONS REFERENCED TO PROPOSED DRAINAGE FLOW PROPOSED ELEVATIONS AND GRADING SHOWN HEREON ARE TAKEN FORM THE NORTH AMERICAN VERTICAL (0000) = PROPOSED GRADE ENGINEERING PLANS OF DATUM OF 1988 E-00,00 = EXISTING GRADE ABBOTT SQUARE RESIDENTIAL', PREPARED APPARENT FLOOD HAZARD ZONE: X'& AE 3FE 92 COMMUNITY NO, 120235 BYWRA PROVIDED BY CLIENT SURVEY ABBREV TIONS (MAP NUMBER 121 DIC-0452-F) EFFECTIVE DATE, 09,26/2014 AI 4CIENCTH IN' - DED) IN-FG/en - PC - POIN! Or CURVE el - RECORD LEGEND '/"- AIR CONDITIONER AALUMINUM 'ENCE D - DRAINAGE LASSIMENT L9 -CENa D BURNESS LEE - POINT OF COMPOUND CURVE ROG - RANGE VINYL FENCT - _ BSI F-ONEHELFATTeN EL OR ELEV- ELEVPH ON FOP - EDGE OF Vv/E:MINT !,[-LAN SCAPE EASEMENT ICE- IFORREPT FLOOR FT [SECTION PCP - PERMANENT CONTRM PaNT P/F - POOL FCRJEPMESU RRS-PAS RCAOrria CES-RICE11 OF WAY Be - RENCH MARK E - CURVE FSM T � EASEMENT LS - LICENSED SURVEYOR PG -PALL RAGr SEC - PECTK)N I)ODIENUI =--1IIALF IC� - OPLCU�,I,,-ED CINON- F E/C - FENCE CORNER (M - FOLINI i C ONCREl' (OF NIEASUR�l NES - MILTREDEND SEC T-N G - POIN7 OF fNTFPSFC I fON RK -PARAOR '(AEON SN&D-L"EMILANDDISP L-ols 183 GINNILINKFENCE CLF - CHAIN U -ENTF NK MONUMENT NOF - NO CORNER POINTS I - PRO-LRFY LINE S! R - SE I 1/ 2 R ON I I Ill I CMP_C )GAT'MOIIALEFP ORRF 11P 11 FOUND NION PIPE I TY -D`O�Nr) RONROD O/A - OVERALL 0-IW-OVFRHE RD -POINI OF BEGINNING P IOC- POINT OF COMMENCTMEN I TSM, EMPGRARY BENCH "A T TOP [IFFIK COL -COLUMN CONC - CONCRETE N6,, - GO NAIL & DICKTWP-TOWNPHIP El Q.R.OTCALRECORDS 'SOL POINT ON UNE 05 - OF BANK ALUMINUM FENCE C5 c oNCOFTE111 , , -OHN", , _ 1) OPEN PHY ptJ` P - PC POIN OF -REVERS', CURVE UE-UTLAYE/AEFFENT R, CLEM SIGHT TRIANGLE FP FOUND PINCHED EST I B li-Al BOOT( Pi -Al 13 PACE MANENT REFERENCE MONUMEN r PF,- R V1 - OFFAL FENCE JOB #1ER0'1522103 SURVEYORS NOTES: 1,) Current title information on the subject property had not been furnished to Initial Point Land Surveying LLC at the time of this SITE PLAN SURVEYOR'S CERTIFICATE This certifies h lU4Q;JPiF hereon described est property a 4werPmon and 1708 Water Oak Drive Tarpon Springs, Florida Phone: (727)-831-1990 Date of Site Plan. 1-5-23 —AS-PH2 DWG L343125-Sl TE — 2.) This sketch was prepared without the benefit of title search No Instruments of record reflecting ownership, easernents or rights -of -way were furnished to the undersigned, unless otherwise shown hereon. tracts th(1S, R;� ractice for �s R'"'eysp 1 .BKVrdf Land W. � 5 we e I gned 5 Ad1M C lo, I R B pursWnt il5 ection 47;. R Wei FI.NdaPLS7I23SRgrEaiI.c om LBB` 8183 aP- Fit, — Drawn by: DJB — 3.) Roads, walks, and other similar items shown hereon,wen e taker, a -V Checked by:JH from engineering plans and aresubject to Survey. 4.) This SITE PLAN does not reflect nor determine Ownership, 5.) This SITE PLAN Plat ate:il e)6E :29/. 4'00' 3 — REVISIONS is subject to matters shown on the of ABBOTT SQUARE PHASE 2 6.} Dimensions shown hereon are in feet and decimal portions 0 01 Jeff I I Q F DA P J RAND IF thereof. MAPPER NO, L t3iiih% 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, LEO, of any SIGNATURE AND SEAL OF A FLORIDA d,,Sjavoo B om information shown hereon Failure to do so will be - - -1 LICENSED SURVEYOR AND MAPPER Initial Point Land Surveying, LLC. New Development Check List Parcel M o o a. Beic< For+-) Z'o 91 Setbacks: Fret C) Rear CA Sides-2-1--il— Elevation; Garage: Roof Single Dimension/Architectural: r \/RA R, UAL 1", E'V EW ASSiS'T Notice to Building Official of Use of Private Provider Effective January 20, 2003 Project Name: 6802 Back Forty Loop 04-26-21-0160-02500-0030 Parcel Tax ID: 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. Mon owner, alfirn I have entered into a contract with the Private Provider indicated below to conduct the services indicated above. Private Provider Firm: 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 #. (LIB 13U1967/ 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 The following atta�cbments. are, provided as required: 1. Qualification statements and/orresumas of the, private provider and all drily authorized representatives. 2.. Proof of insurance for professional comp rehensive lialailiiy in:t%e. zrrousat.of 1 mill per o courreneo relating to all service's p erforzned as a private provider, including tail'coverage for. a minimum of S years subsequent to the p=formance ofbuilding code inspection services. Individual �Slgnatuie� . print Name, .Address Telephone T°IeOeuse appropriate notary block. STATE OF FLORIDA . COUNTY OF HILLSBOROUGH In . •dual B dore m e, this day of 20� personally appeared. who exeeuted the foregoing mstinnent, and arknowledged before me that same -was executed for the purposes therein expressed, Bye �Slgnatllrej Print Name. Jts; .Address: ' Telephone NO. - B afore me, tbis day of 20�, personally appeared T er/agent onbebalf of a partnership, who exeoutedthe foregoing instruraDnt and acknowledged before m e that sore was exeouted.forthe purposes therein Mprgss ed. Personally known X or- Produced identi-toation Type of ident�oation producod Signature ofNotat� PrbatName, ASHLEE CALLAHAN Notaxyl?ublio Stamp; ° ` pID i NN 5 Coaiamission Expires; VR/\ VIRTUAL REVIEW ASSIST Private Provider Plan Compliance Affidavit ProviderPrivate Private Provider: Debra Anne Klahr, BU 1967 Address: 747 Southwest 21 Avenue Gainesville, FL 32601 Phone:813-391-2959 Email:`luc �virtualreyiewassist,cwn Project: New SFR NOW • #.0� • mpi• •I:, MI'm and holds the appropriate license or certificate: Name: Debra Anne Klahr i Florida License/Registration/Certification #(s) and description: FS468 Certified Standard Flans Exam' er License #: PX2300 g t Signature of Reviewer: SWORN AND SUBSCR BED 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 fo ego' g is true d c greet to the best of his/her knowledge or belief. ina Nat Print Nacre commission expires:gyp da �° YCOMMISSION # MHi 29WO [—COMMERCIAL BUILDING SERVICES DIVISION RESIDENTIAL, BUILDING PERMIT DATA SHEET TRACKING # FIRE MARSHAL, # l - ANTE: 3/25/2023 `OLIO # 6802 BACK FOPTY LP EXAMINER: 6 bra'K6ahr PX230C Ile aired Permits Building Pitt bing Mechanical Electrical Amp El ins ti tiara 0n1v In�ecaon �Ounl E] I"ns ection Nand [-1 lns ectian Oral Roof Gas E] Medical Gas E] Fire Sprinklers C] On Site Piping 0 Fire Line Ej Irrigation ® Fire Alarm D Potable Backflow Assembly; Ej Fire Line Rackilow Preventer E] Irrigation Backllo w Assembly G] Demolition ❑ Walk-in Cooler El Refrigeration ®)Flood [] Ansul g] Fence all [ Grease "Trap [I Other El Other Buildine Data Type Constructiow Risk Category:; Occupancy Load ii an ey Classiileatiatrs: Assembly `l3usiness ay Care/Educational =Factory - Hazardous � institutional [ Mercantile Residential ~3�� ( Storage�:Utility Building Use: SINGLE FAMILY PE IDENCE / Alteration 01"IL.evel I [Level 2 Level 3 New Construction ❑ Interior Finish Interior Remodel E Exterior Remodel E] Addition ® Revision Overall Size: Number of Stories 'Total S a Ft.: 25 X 62 2 2605 Living Area: 2073 Covered Area: 532 # of Bedrooms: 4 # of Baths: 2.5 Cyst per squat Enos; VlueiI2of T e: Shirt le Tie i3uilt-�Estlmated dotal C] Other Scares: I Zoning: Wi orne Debris: Energy Code: Q'Inside ,Outside 405�2022 P Flood one: X Base Mood Elevation: Finish Floor Elevation: Ilydrosttic Vents? Sq. Ft, Enclosed Space below I3F: # of Vents: Size of Vents: Total Sq ina Perrrtanent Openings 21 Central A/C X heat PumpWindow A/C [� Gas A1C Gas Heat ❑ Electric. Heat Setbacks Front Rear heft Right 21 As per Approved Site Plan Comments: