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HomeMy WebLinkAbout23-5967City of Zephyrhills vAS � t 3 535 Eighth Street ephyrhill , FL 33542 Phone: (813) 730-00 0 Fax: (31) 70-0021 Issue taste: 0411112023 Per ii ii i i \ S S v v t sS k Sr, .AS.t A, t s 04 26 21 0150 00600 0010 6283 Back Forty Loop Mir v :. $: S Name: LENNAR HOMES LLC-OWNER Permit Type: wilding New (Residential) Contractor: L NNAR HOMESLLC Mass of Work: SFR Construct Address: 4600 W Cypress St 200 Building Valuation: $365,400.00 h TAMPA, FL 33607 Electrical Valuation: $54,810,00 Phone: (813) 574-5700 Mechanical Valuation: $25,578,00�� Plumbing Valuation: $36,540,00 Total Valuation: $482,328.00 Total Fees: $21,049.67 1� Amount Paid: $21,049.67`" Date Paid: 4/1112023 3:28:11 PM CONSTRUCT SINGLE FAMILY 2580 SCE FT Transportation Transportation Impact Fee - City $36.32 Mechanical Plan Review Fee Plumbing Plan Review Fee $0.00 Plumbing Permit Fee $222,70 Building Plan Review Fee $180,00 Electrical Permit Fee $314.05 Mechanical Permit Fee $167,89 Public Safety Impact Fee -Admin $6.35 3/4 Water Meter Fee (Cale) $794,92 Irrigation 3/4 Meter (Cale) $794.92 Driveway Fee $45,00 Building Permit Fee $1,867.00 Public Safety Impact Fee -Police $254,00 School Impact Fee - Single Family $8,328,00 Sewer Connection Residential Fee $2,400,00 Water Connection Residential Fee $1,140,00 Transportation Impact Fee $3,595.68 Address Fee $30.00 SIF 1 percent Fee $83,28 Electrical Plan Review Fee KOO Park Impact Fee - Single Family/Townhome $769.56 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 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 dater Management, Mate 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 Plan, Specifications add fey Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. NO OCCUPANCY F® C.O. NO OCCUPANCY BEFORE C.O. / 1, CONT T S �GNMRE PE IT OFFICE WITHOUTPERMIT EXPIRES IN 6 MONTHS INSPECTIONCALL FOR - 8 HOUR NOTICE REQUIRED 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department Date Received hone Contact for Permitting 908 770 �7763 IFT_ V Owner's Name CAL HEARTHSTONE LOT OPTION POOL 03 L P Owner Phone Number 1813,574,5700 Owner's Address 123975 - Park Sorrento, Ste, 220, Calabasas, CA 91302 Owner Phone Number Fee Simple Titleholder Name [ N/A Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS 6283 Back Forty Loop LOT # 0601 04-26-21-0150-00600-0010 SUBDIVISION PARCEL ID# (OBTAINED rRom PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADDIALT SIGN DEMOLISH INSTALL EJ REPAIR PROPOSED USE SFR COMM OTHER TYPE OF CONSTRUCTION BLOCK FRAME STEEL f DESCRIPTION OF WORK Single Family Residence 1 Pool / Screen Enclosure / Fence LVJ( U/R SF 3045 HEIGHT BUILDING SIZE o1 = BUILDING $365400 VALUATION OF TOTAL CONSTRUCTION ELECTRICAL E810 E, PROGRESS ENERGY W.R.C, AMP SERVICE PLUMBING MECHANICAL $ 25578 VALUATION OF MECHANICAL INSTALLATION GAS 1.9 i ROOFING SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS [ ---------- FLOOD ZONE AREA YES 0 Li D 111111,44W BUILDER COMPANY Lennar I lomcs, LLC SIGNATURE�Mm� REGISTERED I E��JY / �NFEE �CURREN�Y N�� Address 4301 CGC1518166k Boy Scout Blvd Suite 600 Tampa, Ti� ] License# ELECTRICIAN COMPANY I Edmonson Electric, Inc, SIGNATURE REGISTERED [�t�l CURREN Address License# I EC 13005408 PLUMBER COMPANY Bayonet Plumbing, Heating & AC, �Inc SIGNATURE REGISTERED Y/ N PEE CURREN LYIN_ Address License# I CFC042998 MECHANICAL COMPANY Bayonet Plumbing, Heating & AC, Inc SIGNATURE REGISTERED L_ZLN J FEE CURREN Address License# I CAC058062 OTHER tf COMPANY Elality Roofing, Inc SIGNATURE REGISTERED Y/ N FEE CURREN Address License# [C&057991 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, Stounwater Plans w/ 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 & 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(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 OR AGENT -_ Subscribed and sworn to (or affirmed) before me this ----.by — Christopher Smith-__ Who is/are personally known to me or-�>dus®A� as identification, Notary Public Commission G 296057 StephanieFarmer Name of Notary typed, printed or stamped 9 EUSSAKHOLLMN W Expimsmofi,2024 W*ftT"f&k—W3W74'$ MJ 4,q Subscribed and sworn to (or affirmed) before me this ­023 by Christopher Smith Who is/are personally known to me or has/have produced as identification. ---Notary Public Commission No. 7 ..... . ...... Stephanie Farmer Name of Notary typed, printed or stamped RELISUMJ01ma 0111 ",Nl 9 M:3 to Permit No, '5f�'7 Date Permitted Z_t� Builder Name/Owner Name Control County Parcel No. 2Y2LZ_.L_Z /5ubDiv: 466) P-' Address/Location 2 Classification/Type of Use tz' 6,5 TRANSPORTATION IMPACT FEE Rate: So, Ft Unit: Z Exempt 0 Yes 0 No How Determined Impact Fee Amount �%32_ Zone No. TAZ:_ SCHOOL IMPACT FEE Account (056) Single -Family Detached House Amount (057) Mobile Home (058) Other Residential (123) Collection Fee Exempt = Yes = No How Determined_ PARRSAND RECREATION FEE Land Account Land Credit Land Total Recreation Account - Recreation Credit Recreation Total Zone Total Amount $ Exempt =Yes = No How 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 Elm= ME Checked By _ WILL BE ISSUED OR FINAL INSPECTION PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMUTING 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, RECEIPT NO DATE BY 7-15 'E 9 CURB INLET 1:9510 1:95M RCP(W)IE:90.95 1-16 'E 9 CURB INLET 1:94.99 1:94.83 RCP(S)IE:88,69 RCP(E)IE:90.72 RCP(N)IE:89.19 1-17 'E 9 CURB INLET 1:94.58 1:94A1 RCP(S)IE:90.03 RCP(E)IE:90.03 1-18 'E 9 CURB INLET 1:94.58 1:94.41 RCP(W)IE:90.10 1-19 'E 9 CURB INLET 1:94.99 1:94,83 RCP(W)JE:90.79 1-20 'E 9 CURB INLET 1:94,98 1:94.81 RCP(S)IE:90.78 Klrv1:y5.ut) 18" RCP(NW)IE:91.58 18" RCP(E)IE:88.92 SD11-8 TYPE 'C'DBI EOP:94.50 RIM:94.50 18" RCP(SE)IE:91.85 SD11-14 24" FES EOP:92.25 RIM:92.25 24" RCP(N)IE:90,00 1 5.52 rTYPE �A p yp Ty T T r I F1:9 7 p p P� .9 9 AD:97A -92'- 18" RCP @ 0.30% 1 9f 7-Y-1 CN —24'- 18" RCP @ 0.30 1 1 TYPE'B' )EV 37A7 FF:97.47 :96. 80 PAD:96.80 M 25 to 1 1 t6 0) 37—"95-87— Y 7PE '!B 07 0-7 MATCH LINE SEE SHEET C212 m DESCRIPTION: LOT I, BLOCK 6, ABBOTT SQUARE PHASE 18, SITE PLAN SEC. 4, TWP, 26 S, RNG 21 E. ACCORDING TO THE PLAT THEREOF, RECORDED IN PLAT BOOK 89, PASCO COUNTY, FLORIDA PAGES 57-62, OF THE PUBLIC RECORDS OF PASCO COUNTY, (NOT ASURVEY) FLORIDA, (ABBOTT SQUARE) LOT = 5237 SOL FT. LIVING AREA = I 1 10 SO. FT. PORCH =�SQ. FT, ' CUf2V GARAGE = 403 SQ.FT, C46 COVERED LANAI = N/A SO, FT PATIO = 18 SO. FT, POOL AREA = N�/A _SQL FT. CONC. DRIVE = 350 SQ. FT. /VC & CONIC PAD = 12 SO, FT. SIDEWALK = 36 SO_ FT. LOT SOD = N�/A SO. FT, R/W SOD = N�SO. FT. LOT OCCUPIED % AREA TO IRRIGATE = 62 % TRACT'B-6` �! (CDD) ACCESS,/DRAINAGE/ LANDSCAPE' WALL MAINTENANCE AND FENCE AREA, OPEN SPACE N$4'1422'&(P) tif.Q0fP1 i 250'IP;... � n --•.J O z ..-_.--... -�.. 53'-4' 201T i P a m �, .-._._ 47.3' �.— _ 36.8' 3L...:a GIr µ , 3� 0 CONIC .Q�� 1 C/S AlC r, o --'1 I WALK�I ^-f T rT � PROPOSED 205 ENTRY 4,7' � T -�-=— �� � } Qr:-0 m 30X60'i- 2STORYRESIDENCE PATIO I_-, PLAN 2B51 . rn KP. F. ,O 2 n 11 maBLOCK LOT 1 o ELEV'A. 6 ' o rn o© n,�,. o I &.3m �diGARAGE L �:. f m 52.0' �_� 6=8.v........._._ N $4'48'i E (P) Z R RDEN WALL WAY S $!31'45" W iP) Ra' (PI J 1 I( TRACT "A" �, (CDD) RIGHT-OF-WAY BASIS OF BEARING { I \ LOT 2 1 i BLOCK 6 MOM LOT GRADING TYPE =A PROPOSED PAD ELEVATION = 9750 FRONT SET BACK =20' SIDE SET BACK TS SIDE SET BACK (CORNER LOT =10' REAR SETBACK = 15 PROPOSED: MINIMUM FLOOR ELEVATIONS: LIVING AREA:98-17' GARAGE AREA: ELEVATIONS REFERENCED TO NORTH AMERICAN VERTICAL DATUM OF 1988 SURVEY ABBREVATIONS *= IQ-QOPUBLIC UTILITY EASEMENT LEGEND: V!— PROPOSED DRAWAGE FLOW (00,00) =- PROPOSED GRADE E00-00 = EXISTING GRADE APPARENT FLOOD HAZARD ZONE: "X" COMMUNITY NO. 120235 (MAP NUMBER 12101C-0289-F) EFFECTIVE DATE: 09/26/2014 his SITE PLAN Prepared far and Certified To: �Lennar Homes ALL ELEVATIONS REFERENCED I TO NORTH AMERICAN VERTICAL DATUM OF 1988 i (NAVD 88) PROPOSED ELEVATIONS AND GRADING SHOWN HEREON ARE TAKEN FORM THE '.. ENGINEERING PLANS OF "ABBOTT SQUARE RESIDENTIAL PREPARED BY "WRA" PROVIDED BYCLIENT A,ARCLooGB (DI DEED NV - INVERT PC -POIN O CueVC (F, RECORD LEGEND '. A C - AIR CONDI ONER AT ALUMINUM PENCE D. -. DRAINAGE FAIESAF11 a -LICENSED NS! D 1111SNESS FCC CRNT OF COMPOUND CURVE RNG - RANGf VIENTI NCE BfE BASE FLOODEEVATON ET CRELEV IT EVATION FOP EDGE OF PAVEMENT F - I ANDSCAPI EASEMENT tIt - I OWE KT N OOREI. VATIDN PCP RMANENT CONTROL POIN'i P/E -POOE EQuTTMENT RRS-RALRDADSUME-- R/W -TGHT OF WAY BM- BENEOI MARK C CURVE SM'T-AS MEN" LS- LICENSED SURVEYOR PG -PAGE SEC =SI CTION WOODFENCE IASPHAIi ----• is -- It I ^ CAI CJ TEU F1C FENCE CORNER CM FOUND CONCRETE Fal -M AS/RED MES - M I RE D END SEC ION IS -PONT OF NTERSECP.ON °K -PARKER SALON SN&D - SF. T NAit AND DSI( L@g6183 ':ENTAILU MONUMENT NCF-NO CORNER. FOUND a ROPER,Y FINE SIR -SF t 2' KONRODCBB 8183 < AN INKfENCE Cr-CHAIN RLNKED ME CARE-CORftU6Ai£D M£TAEPP F_=FOUND DONYIPE O/A^OVERALL POP POINTD EDc NfVNC, IBM -TEN ORARY5CNCH MARK COI COONCR O' =CUNC PEiE R=FUtJND IRON ROD FN&D-FCUdD NAIL&DSK O.-IW^ OVERHEAD WDE(S1 O.R. �OINIALRECORDS POC -POINT OF COMMFNCTNTNT 'OLPONTON O TOP - TO O SANK 'D'- TOWNSHIP `1�ATIS A_CIMiNiJMFENCE C/ _ ^ION 2 : SLAB FOP FOUND OPEN"PE 1°l -P A, P2C POINTOFREVF,O CG'Vr P' EASEMENT V` =COVERED �` CtT CE�Ah S G 17 TRIANGLE FPP FOUND , INCHED PPE PB PLAT 800X PRM = eRMtAN. NT RE _RCNLE MON IN9 N , VI VF r VINYL FCN..,F I,JOB 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 2.) This sketch was prepared without the benefit of a title search, No instruments of record reflecting ownership, easements or rights -of -way were furnished to the undersigned, unless otherwise shown hereon. SURVEYORS CERTIFICATE This certifies that s I hereon described ��fl property waste urs it ervision and meets the ��ee..''ti 'S - active for " •r f r.yey of Land in r I R (11i CClI _ FI rl a ArJ� *" rt(ey a 12�^y 7 Flo S 1708 Water Oak Drive •. Tarpon Springs, Florida P- _ Phone: i 727)-$31-1940 9 .f FdndaPLS7123@ mal.corn LB# 8183 Date of Site Plan: 12-30-2 !JlY1G:AS-RIJ I E-L I-BLF-SITE File Drawn b DJB y` 1) Roads walks and other similar Items shown hereon were taken from engineering plans and are subject to survey. 4.) This SITE PLAN does not reflect nor determine ownershio. PLAN is Piat pursuintto/section tr a 4���. � 3.13 E1 e57:2 � '00' ��'�;,y,,, ROSS Checked by:JH REVISION$ 5.) This SITE subject to matters shown on the of "ABBOTT e FLORIDH SQUARE PHASE 1 B" 6.) Dimensions shown hereon are in feet and decimal portions Leff M- H�$Jji�lh thereof. FLORIDA P AND MAPPER NO %4J, 10 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 a' deviation from information shown hereon. Failure to do so will be LICENSED SURVEYOR AND MAPPER Initial Point Land Surveying, LLC, at users sole risk. New Development Check List Parcel #: I — 0/-�-O -0"00 Oc" C) Address:,/,,' )— tq,? Pk ( �( -f—) 2-0c) Setbacks: Fret Rear r is Elevation: ----A-- Garage. Roof Sirs nmens gle Diion/Archit ectural: !;,-ill U A L W A S S i S RV Notice to Building Official of Use of Private Provider Effective January 20, 2003 6283 Back Forty Loop 04-26-21-0150-00600-0010 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 Firm: VIPTUAL REVIEW ASSIST, INC. Private Provider: DEBRA ANNE KLAHR Address: 747 SW 2ND AVE- SUITE 170,301,357A 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 penult 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 attachments, are provi&d as required: I. Qualification statements and/or resurnes of the private provider and all duly authorized representatives. 2..PToof of insurance for professionaland com#ehensive liaWlity in,theJamountof $1 millionper occiirrencetelating to all 'services peilf-bimed as aprivate provider; including fail coverage for arninimuin ..of 5 years subsequent to thb perfprm' c of building code, inspection services. Individual -(signature) Print Narne;_ Pleaseuse use appropriate notary block. STATE OF FLORIDA COUNTY OF HILLSBOROUGH Individual BtforDme,,tlds day Of 20— personally appeared who executed the forego"ing instrumcut, and acknowledged before ro.5 that same was exDG:utf_d for the purposes therein expressed. . _11�orporation Print CoipomfionName; (Signature) Print .Namo._�;h �Isto �her S�rrlth Authorized Ag�. Miami, FL 33172 Tdephono No. 813-574-5700 Corporation Btforrmo,this 22ND day of MAY 20 2-2 personally appeared Lennar Homes LLB a c.Drporaflon, 0 1 n 'behalf of th6statD corporation, who executed the f6rDgaing instrument and acicowled Dabi-,foTD Me that same was ­ 9 executed for the putppsest4ereba expressed. Partnership PrffitPartaershipName By; (signature) Print Name, Address: Telephone No.: Partnership Beforo one, this -day Of 20 personally appeared p aitaer/agmt on behalf of a partnership, Who executed the foregoing instrument and aoknowledgedbebrome that same was oxecutefforthepurpo.ses therein expressed,. :Personally known X or 4-Pio du oo d identit cation— Type of identification produced sign?, are of Notan, PrintNamo ASHLEE CALLA AN NetaiyPublic Stamp; ASHLE# CALLAHAN Commiss ion A i�My COMMISMON #HH 295980 EXPI RES:. PMTel 9. nf 2 VR/\ VIRTUAL REVIEW ASSIST Private Provider Plan Compliance Affidavit Private Provider Finn: Virtual Review Assist, Inc. Private Provider- Debra Anne Klahr, BU 1967 Address: 747 Southwest 21 Avenue Gainesville, FL 32601 Phone: 813-391-2959 Project: New SFIt Address(s): 6283 BACK FORTY LOOP 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,Ai, 2,A3,A4,A5,A6.LA6.2,SN0, N1, 3,S4,S5, 6,S ,ST,SIi,S12, 1.0,PA1.0,PA1.1, PA1.2,PA1.3,PA1.4, SHI.0,SI4i.1,S111.2,SHI.3,SHI.4,SHI.5 Florida License/Registration/Certification 9(s) and description: FS468 Certified Standard Plans Examiner License #: PN2300 Signature ofReviewer: � � SWORN AND SUBSCRIBED before e by Debra Anne Ill being personally known to me`' or having produced as identification and who being fully sworn and cautioned, state that the foregoing is true and correct to the best of his/her knowledge or belief. t !gnat re of No tint N e Notary Public.- NOTARY STAMP BELOW My commission expires: p Fa Ah9 Y COMMISSION # N 295980 t ie EXPIRES: November 30,2026 lam^° COMMERCIAL BUILDING SERVICES DIVISION RESIDENTIAL BUILDING PERMIT DATA SHEET TRACKING ## FIRE MARSHAL #01- DATE: 3/25/2023 FOLIO # 6283 BACK FOPTY LP EXAMINER: ebra Kla r PX230C Re aired Permits Building Plumbing Mechanical Electrical Atop El Ins ection Onl ® Ins ection Onl ® Ins ection Onl [] Ins ection Onl hoof [:1 Gas El Me ieal Gas El Fire Sprinklers ® On Site Piping E Fire Line El Irrigation [l Fire Alarm E] Potable Backflow assembly Fire Line Baeldlow Preventer E] Irrigation Backflow Assembly E] Demolition [l Walk-in Cooler El Refrigeration El hood El Ansul [l Fence allCrease Trap EJ Other El Other Buildine Data T e Codstruetion: - Risk Category: Occupancy Load ancy Classification: Assembly �- Business Day Care/Educational :Factory Hazardous institutional ( Mercantile Residential R ©;Storage [� � [�tTtility Building Use: SINGLE FAMILY RES.IDENCE Alteration ;Level I � Level 2 Level 3 ® New Construction ® Interior Finish Interior Remodel ® Exterior Remodel ® Addition ® Revision Overall Size: Number of Stories: Total S€ . Ft,: 30 X 52-82 305 Living Area: 2580 Covered Area: &5 # of Bedrooms: 6 # of Baths: 3 Cost per square foot: Estimated Value: Roof T e: in le 'Tile Built-up Metal Other S wares: 20 Zoning: Wi orne Debris: Energy Code: ;inside Outside 405-2020 Flood Zone: X Base Flood Elevation: Finish Floor Elevation: Hydrostatic Vents ®Yes, No Sq. Ft. Enclosed Space Below BFE: # of Vents: Size of Vents: Total Sq< Ina Pertnanedt (ipenings ® Central A/C X heat Pump Window A/C ® was A/C ❑ Cas Heat] Electric heat On Site Piping Sanitary Sewer Storm Sewer Catch Basins Potable Water Undereround Fire Line Front _ Rear pI�I� nIIII� �� am ` a��� y '� 1� �ti i