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HomeMy WebLinkAbout23-5933City of Zephyrhilis 5335 Eighth Street Zephyrhills, FL 33542 BNR-005933-2023 Phone: (813) 780-0020 Fax: (813) 780-0021 Issue Date: 04/11/2023 1% Perml �c)e:Buildil�,��i,�,�'I'll��,�,l��,, �Residential 57 7lei 04 26 210150 00600 0060 6237 Back Forty Loop Name: �sidentlal) Contractor: LENNAR HOMES LLC Mass of Work: SFR Construct Address: 4600 W Cypress St 200 Building Valuation: $320,640.00 Electrical a ua on: $48,096.00 Mechanical Valuation: $22,444.80 Phone: (813) 574-5700 Plumbing Valuation: $32,064.00 Total Valuation: $423,244.80 Total Fees: $20,754.25 Amount Paid: $20,754.25 Date Paid: 4/11/2023 3:28:11PM CONSTRUCT SINGLE FAMILY 2217 SC FT Building Plan Review Fee $180.00 Park Impact Fee - Single Family[Townhome Irrigation 3/4 Meter (Calc) $794.92 Mechanical Permit Fee $152.22 Address Fee $30,00 Sewer Connection Residential Fee $2,400.00 Driveway Fee $45,00 Mechanical Plan Review Fee KOO Public Safety Impact Fee -Police $254,00 Public Safety Impact Fee -Admin $26,35 Building Permit Fee $1,64120 Water Connection Residential Fee $1,140.00 Transportation Impact Fee - City $36.32 SIF 1 percent Fee $83.28 3/4 Water Meter Fee (Calc) $794,92 Electrical Plan Review Fee $0.00 Electrical Permit Fee $280.48 Transportation Impact Fee $3,595.68 Plumbing Permit Fee $20032 School Impact Fee - Single Family $8,328.00 Plumbing Plan Review Fee $0,00 REINSPECTION FEES: (c) With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c) the local government shall impose a fee of four times the amount of the fee imposed for the initial Inspection or first reinspection, whichever is greater, for each subsequent reinspection. Notice: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permit required from other governmental entities such as water management, state agencies or federal agencies. "Warning to owner: Your failure to record a notice of commencement may result In your paying twice for improvements to your property. If you intend to obtain financing, consult with your lender or an attorney before recording your notice of commencement." Complete Plans, Specifications add fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances, NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. CONTRACTOR SIGNATURE a a,14v*r. PE IT OFFICEC) OUT APPROVED INSPECTION i 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department Date Received Phone Contact for Permlttin 90$ ) 770 _ 7763 Owner's Name CAL HEARTHSTONE LOT OPTION POOL 03 L P Owner Phone Number 813,574.5700 Owner's Address 1 23975 Park Sorrento, Ste. 220, Calabasas, CA 91302 Owner Phone Number Fee Simple Titleholder Name I N/A� Owner Phone Number Fee Simple Titleholder Address I N/A JOB ADDRESS 6237 Sack Forty Loop LOT # 0606 SUBDIVISION Abbott Square PARCEL ID# 04-26-21-0160-00600-0060 (OBTAINED FROM PROPERTYY TAX NOTICE) WORK PROPOSED n f!� i[ NEW CONSTR ADD/ALT SIGN DEMOLISH P INSTALL 8 REPAIR PROPOSED USE 0� SFR � COMM OTHER TYPE OF CONSTRUCTION U V A BLOCK FRAME STEEL DESCRIPTION OF WORK I Single Family Residence / Pool / Screen Enclosure / Fence UtR SF 2672 2217 2$' BUILDING SIZE SQ FF"OjOTAGE HEIGHT BUILQING $ 320640 I VALUATION OF TOTAL CONSTRUCTION ELECTRICAL $8096 _ PROGRESS ENERGY W.R.E C. "j AMP SERVICE PLUMBING $ 32064w m y MECHANICAL $ 22444.8 I�J VALUATION OF MECHANICAL INSTALLATION • �! GAS ROOFING [::] SPECIALTY = OTHER r—� FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA Li YES ' o BUILDER COMPANY Lennar Ilomes, LLC SIGNATURE REGISTERED Y! N FEECURREN Y/N 4301 W Bo Scout Blyd Suite 600 Tampa, FL 33607 CGC151$166 Address � License # ELECTRICIAN / COMPANY EdmonSon Electric, Inc. SIGNATURE REGISTERED Y / N FEE CURREN I Y / N Address License# EC13005408� PLUMBER_ COMPANY Bayonet Plumbing Heating & AC, Inc SIGNATURE 6 __ REGISTERED Y! N FEE CURREN Y I N Address License # I CFC042998 MECHANICAL COMPANY Bayonet Plumbing, Heating & AC, Inc SIGNATURE REGISTERED Y / N FEE CURREN Y (N_ Address License # CA658062� OTHER COMPANY C Sterling Quality Roofing, Inc SIGNATURE REGISTERED Y / N FEE OURFEN I= Address License # 1 CCC057991 IIIIflilllliillllliltll111FllIIIIItlipfl111I99IAlIe8AII1li&Ilttlil4G RESIDENTIAL Attach (2) Plat Plans; (2) sets of Building Plans; (1) set of Energy Forms, R-O-W Permit for new construction, Minimum ten If 0) 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 (PloUSurvey/Footage) Driveways -Not over Counter if on public roadways -needs ROW NOTICE OF DEt-D 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, Welland 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 ORANENT Subscribed and sworn a (or affirmed) before me this 3121=3 by — Christopher Smith who is­/a�rsonal!yknown tome or#a&A4ave-p;�q� as identification. Notary Public Commission 4G 296057 Stephanie Farmer Name of Notary typed, punted or stamped # Wv, E*ms June 6.2024 3121/2023 by Christopher Smith_ Who is/are )nally known to me or has/have produced as identification. -- -------- --Notary Public Commission No.6 7 Stephanie Farmer -Name of Notary typed, printedorstamped— gEXOM June 0,2024 m:] Permit No.. Date Permitted — Builder Name/Owner Name Control t County Parcel No. I d t: SubDiv:m ,i%. __° > Address/Location I Classification/Type of Use ( 'rai 11 TRANSPORTATION IMPACT FEE � Rate: Sq. Ft Unit: Exempt Yes El No low determined Impact Fee Amount Zone No. TAZ: SCHOOL IMPACT FEE r Account (056) single -Family Detached House Amount $ t "`C (057) Mobile Horne (058) 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 Total Arnount $ Exempt =Yes =No Flow determined LIBRARY FEE Land Account Land credit Land Total Facility Account Facility credit Facility Total Exempt Yes No How Determined Total Amount RESOURCE FEE ERU Total Amount Prepared By checked By INCO't�TIEITE F CCLIPANY WILL RE ISSUED OR FINAL INSPECTION PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE BEEN PAID AND RECEI#TED FOR BY A CENTRAL PERMITTING OFFICE Or PASCO COUNTY ACKNOWLEDGEMENT BELOW DOES NOT IMPLY ACCEPTANCE OF CONCURRENCE, BUT SIMPLY REECEIPT OF A COPY OF THIS FORMA, PLACING THE BUILDING OWNER ON NOTICE OF THIS ASSESSMENT AND THE CONDITIONS OF PAYMENT FOR SAME. DATE RECEIVED BY RECEIPT NO DATE BY a THE NORTHEAST 1 '4 Or THE SOUTHWEST 1 /4 OF SECTION 4-26-21 I I f Strucwre Table O PHASE 1 A I � ' j r .,...... 'BOOK 61, - T CS-5 ( I TYPE 'D' DBI 71 _ 7 5 I ^► I WITH SKIMMER (C213) i�%em oat E0P:94.40 I y RIM:94.40 T :> A > s 24' RCP(NW)IE.90.00 to ( I TRACT "A" CS 50 SILVERADO PHASE 1A I I 5 TYP£'C' DBI PB St, PG 71 ,.� j I co E0P:90.42 '`.."°.... RIM:90A2 24" RCP(SE)IE:87.40 OWNER: . I /'� SIEUERADO ) SILTFE CE - T TYPE TYPE9 CURB INLET (. I E0P:95.44 FFER & WALL ESMi, PS '61, PG 71 RIM:95.27 60" RCP(S)IE:78.20 V E E O P M E N T 60" RCP(NW)IE:79.86 DISTRICT SD7-2 TYPE 9 CURB INLET I E0P:95.82 RIM:95.65 60" RCP(SE)IE:8026 I 60" RCP(N)1E:80.26 )j 18" RCP(NE)IE:91.79 SD7-14 ' I SD14-1 TYPE 9 CURB INLET E0P:95.83 1 RIM:95.66 _ I 18" RCP(SW)i E:91.83 j sa8-1 i TYPE 9 CURB INLET EOP:95.00 I RIM.94.83 71' - 18" RCP @ 0.30%- 48" RCP(W)IE:83.96 48" RCP(NE)IE:83.95 I 97.67 END.. -i1L- = 9 9.71 TYPE A FE:98.57 AD:97,90 167'-60" RCP @ 0.3( 24" RCP @ 5.35% r P A R C E'I_- 2 Sur 1� LONY COMPANY 1, PAGE 55 3 a-o�n'rn� DESCRIPTION. LOT 6, BLOCK 6, ABBOTT SQUARE PHASE i B, SITE PLAN SEC. 4, TWP. 26 S, RING 21 E. ACCORDING TO THE PLATTHEREOF, RECORDED IN PLAT BOOK 89, PASCO COUNTY, FLORIDA PAGES 57-62, OF THE PUBLIC RECORDS OF PASCO COUNTY, (NOT A SURVEY) FLORIDA. This SITE PLAN Prepared for and Certified To: (ABBOTT SQUARE PHASE 2) Lennar Homes LOT = 5357 SQ, FT LIVINGAREA = 930 SO. FT_ CURVE DATA IF) ENTRY FT. CURVE RADIUS ARC LENGTH CHORD LENGTH CMORD BEARING DELTA ANGLE GARAGE = 40f —so. FT C51 A?, no S3.OS 53.03' N41"20'17"W Q'S 1'4S" COVERED LANAI = N/%A SQ. FT PATIO = 19 SQ.FT POOL AREA lA _SO. FT. CONC. DRIVE = 373 SO, FT. Scale: 1 = 20' A/C & CONC PAD = 12 SO. FT. SIDEWALK = 36 SO. FT_ SIDE YARD SWALE = NISA SO. FT_ CONSERVATION AREA = N/A SQ. FT. LOT OCCUPIED = 34 % AREA TO IRRIGATE = 66 % ti LOT 5 i BLOCK 6 i BASIS OF BEARING 1 ?�� N86'13'49'E(PI 110.00IPl a '6 c 46 IT O ~ a LOT 6 30X60 2 STORNCE PR:EA w PL .ni- BLOCKb PATIO ,b++ o © E O m P v GAENTRY A 2 m rnmG43.0' 3SX3C C(S-A/C --- - —_— ____.�-_ m v � 2U?�, S 88'S473" E (P) 1 12.38' (PJ LOT 7 I BLOCK 6 I I 0M ,a+ _ `t WALK Oil Qi -NI' YPb i NOTES: LOT GRADING TYPE _• A PROPOSED PAD ELEVATION= 97,90 FRONT SET BACK =- 20' SIDE SET BACK = 75 SIDE SET BACK (CORNER LOT) =10' REAR SETBACK= IS .._._.._.__.._____......_._.__._._, ALL ELEVATIONS REFERENCED PROPOSED: TO NORTH AMERICAN DATM MINIMUM FLOOR ELEVATIONS: * = 10.00 PUBLIC UTILITY EASEMENT VERTICAL TO8)OP 1988 LIVING AREA: 98.57' LEGEND: J GARAGE AREA:---s.. PROPOSED DRAINAGE FLOW PROPOSED ELEVATIONS AND GRADING ELEVATIONS REFERENCED TO SHOWN HEREON ARE TAKEN FORM THE NORTH AMERICAN VERTICAL 100,00) = PROPOSED GRADE ENGINEERING PLANS OF DATUM OF 1988 E-00.00= EXISTING GRADE "ABBOTT SQUARE RESIDENTIAL", PREPARED BY "WRA PROVIDED BY CLIENT APPARENT FLOOD HAZARD ZONE. "X"" COMMUNITY NO 120235 1 j SURVEY ABBREVATIONS (MAP NUMBER 12 10 1 C-0289-F) EFFECTIVE DATE: 092612014 A ARC1ENGT (III ` NEED N\/a INNE 4T PC PONI OF CURVE To - RECORD LEGEND A/C AIRCONDITIONER DI - DRAINAGE EASEMENT 113-I_CFNSSD BUiSNESS PCC POINT OF COMPOUND CURVE RNG=RANGE VWYL FENCE AE ALUMINU'T rFNCE CONIC LORELV VATtON f.-iANUSCA �EASEMCNi °CP fRRMNEM CON 40. OhNi .RK-RAI ROA-SPIKE 2"' 0"-t}ASE l00!)�i£VA ION p EDCEO PAVEMENT LF:- :OWEST GOORELVALON P/E 00 :DUlPM.:N. EW-RGh OF WAY IM RENOf MAR' FSM'T EASEMENT LS^ 1JCCNS[D SURVEYOR FC 'AGE j WOODEENCE SECD-SEEN I.� ( CURVE F/C PENCE CORNE2 kro its EIERODE '-PONTC INTERSECTION SN6D-SITNAIL ANDDISK 4 'ASPHALT -'— ICI CAiC AT !) fCM-fOt NL CONCRETE h1lS-M FORERF&jND PK--AFK KAON tl3x-iEJ tD'Ar LINCINK CtiA-N INK FEN<E CF,Coll LI AIf ENCE MONUMENT O/A-OwKALI ER FOLN`J E CP OFBEGIE S'R�-TIP IRON BFNC fiBi&3 CMPn Ct�RRUGFl :.D M.`.Tfl1. PIP IIF=FOl1NGiRON IPF O/A-OVERRL POp -POIN1 OF pECINNiNC pM=T-MPORARY pENCH MARK C�-DRICK —x- -x— — CdOWMfJ FIR=FOUND RON ROD O''IW-0VF2NEhD WIREiS� PO( POIN£OF COMMENCTMENT 08=T? OF SANK LL..�,.. ..��JJ CONIC - GONER TE NBN T60 NDNAtt&DISK O.R. - '1111ALRFCORDS I., O=M'ON LINK LvA- OWNS'1� ACUMINII FENCE CS_FONCRTf FiAR 'OP FpLNDOGNIPE (P) -M T "RC .DINT OF REVERSE CURVE U.F-U1111YEADMENT =COVERED \` CST- CLt ARSIGHT£RIANG,.: If" FOUND PNCHED PIFE Pp^PLAT BOOT( PRM -PERMANENT Itf FERENCI MONUMENT VF=VINa FFear JOB #1FaoaS20RA -- - SURVEYOR`S MOTES: SURVEYOR'S CERTIFICATE 1708 Water Oak Drive S.) Current title information on the subject property had not been Date of Site Flan: i-S23 This certifies that sketch of the hereon described Tarpon Springs, Florida furnished to Initial Pwni Land Surveying, LLC. at the time of ihis property w24mili its;WR}i 4161�� lA supervision and Phone: (727)-831-1990 DWG:AS HI B-1 rBL6-SITE SITE PLAN meets th Ic 7e@!ractice for FtondaPLS7123@ maitcom y 2.) This sketch was Prepared without the benefit of a title search ..Fg �' 7 surveygds___"'e��iii"' �ato of Land LB# 8183No instruments of record reflecting owne ship, easements orf File: y tights -of -way were furnished to the undersigned, unless otherwise ) „ o neshownhereon.Drawn b: D.IB oe i n 4}tley .) Roads, e i in and other similar items shown hereon were take Stat9es v Checked b 'JH 5oTh TSITE PLAN his PLAN does nod reflect nor determine survey. „y Date: ( 103,1 7 Y 9 gP 1 REVISIONS - ) or determine ownership. ` �` £ *kTY'`0+5 j shown on the Plat of RR 3a , 4'00' I y o to ., f +L'" t o bl. �k8,at o lS IIII,, "ABBOTT SQUARE PHASE IS Jeff M f^rg'' ? n 6.) Dimensions shown hereon are in feet and decimal portions FLOR(DA$iiR�%� NA tJ AND thereof MAPPER NQ:If�� 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 LICENSED SURVEYOR AND MAPPER Initial Point Land Surveying, LLC. at user`s sole risk New Development Check List Parcel a �,,-O e�,1�00 C�-,e,7 c rL-) Setbacks:Front e ear �� Sides (f) c)%5.d" Elevation: /I Garage: A Roof Single Dimension/Architectural: Notice to Building Official of Use of Private Provider Effective January 20, 2003 Project Name: 6237 Back Forty Loop 04-26-21-0150-00600-0060 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. I STEVE SMITH , the fee owner, affirm I have entered into a contract with the Private Provider indicated below to conduct the services indicated above, Private Provider Finn: 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 #, (LICBU1967/ 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 deternune 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 minim urn 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 pen -nit 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 'Godo, land use- envirommental or other codes. The following atta.obmentq are provided as required: 1. Qualification statements and/or resurn es of the private provider and all duly authorized representatives. 2, Proof of insurance for professional and comprehensive liability in:tho.arnount.of 1 million per o ccurrence relatin g to all servic6s paerformed as a private provider, including tail coverage for a minimum of 5 years subsequentto the performance of buil,ding cede inspection services." Individual gorporation P2rtnership . {signaiuxe) . Print Dame: ,Address° . Telephone 'Please use appropriate notary block. ,STATE OF FLORIDA . COUNTY OF HILLSBOROUGH Individual B6mme,this day of 20____, personally appeared Who executed the foregoing instruiatnt, axed acktiowledged before me. that same was executed fox the purposes therein expressed. Corporation Beforetne,tbis 22ND day of MAY 20 2 personally appeared of Lenn r Flames LLC a corporation,6n behalf of the state corporation, who executed the foregoing kstrume,nt and acic owlpdged before = that same was executed for the purposes therein expressed. By: (signature) :Print Name, Its° .Address. Telephone WIMMEM B afore me, this day Of 20 personally appeared p or/agent on beiaalf of opartnership,�t ument and g* b60TQ, Ine, that same Pusonally known X or- Produced idea# cation Type of idfmtffloation produced Signature ofNotaTN PrantName ASHLEECALLAHAN NotaxyPublrc 5tanzp, EA:�t HL AN Commission Expires; COMMI59 SSION 9 IRS: C 0, Q2& VR/\ VIRTUAL REVIEW ASSIST Private Provider Plan Compliance Affidavit Private Provider Firm: Virtual Review Assist, Inc. Private Provider: Debra Anne I{lahr, BU 1967 Address: 747 Southwest 21 Avenue Gainesville, FL 32601 Phone: 813-391-2959 Email: lq?e T yirftialr viewassi t.com Project: New SFR Address(s): 6237 BACK FORTY LOOP 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 wilding 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 t. a 1, Florida License/Registration/Certification 4(s) and description: FS468 Certified Standard Plans Exaim r License #: PX2300' Signature of Reviewer: z2 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 f egoing is true and correct to the best of his/her knowledge or belief. Signature of Notary int N e Notary Public: NOTARY STAMP BELOW My commission expires: pp`S`y']PY 6 (fin, ,pl p F4aeY9Fw6a ea&^Sba A� ay'OP h1Y Go�4 Flti 9II0 - CMMERCIAL BUILDING SERVICESDIVISION SIDENTIAL BUILDING PERMIT DATA SHEET TRACKING # FIRE MARSHAL #01- DATE: 3/25/2023 FOLIO # 6237 BACK FORTY LP EXAMINER: Debra Klcahr P 230C Re uire d Permits Building I�lumbing Mechanical Electrical Amp E] Inspection Only � Ins ection OnI �] Ins ection tend [� Ins ection Onl Roof El Gas El Medical Gas Fire Sprinklers n Site Piping [ j Fire Lire ❑ Irrigation ® Fire Alarm El Potable Baekflow Assembly [:1 Fire Line Backilow Preventer [l Irrigation Baeldlow assembly El Demolition E Valk -in Gaoler ❑ Refrigeration ® Hood El Ansul Fence alI � grease T'r°ap [� ®ther [ either B Ming Data jype nstruetion Y®B IRisk category: Occupancy Load it aney Classification: Assembly business ay Care/Educational Factory Hazardous nstitutional � .� E I Mereantile Residential [;Storage ❑Utility Building Use: SINGLE FAMILY RESIDENCE / Alteration Level i ® Level 2 [ ;Level 3 } New Construction 0 Interior Finish Interior Remodel El Exterior Remodel ❑ Addition Revision Overall Size: Number of Stories: 'Total S . C: 0 X46 2 27 Living Area: 2217 Covered Area: 55 # o Bedrooms: # of Baths: 2.5 Cost per square foot: EstimatedValue: Roof e: Shingle [Nile Built-u ®fetal ❑ Ch er uares: 1S Zoning: Wm0orne Debris: energy Code: 405-2022 SUP =inside C9utside Flood Zone. X Base Flood Elevation: Finish Floor Elevation: Hydrostatic Vents? ®°,Yes No S. Ft. Enclosed Space IeIow RFE: # of Vents. Size of Vents: T atal Ssld Inn Fri rrranerrt Cipenins Central A/C X Beat Pump ® Window A/ was Aft has Fleat Electric Beat s Front Rear Left Fight As per Approved Site Plan Comments: gg- 5Wi b ti