HomeMy WebLinkAbout23-5970City of Zephyrhilis
5335 Eighth Street
ephyrhills, FL 3342
Phone, (13) 70-0020
Fax: (813) 780-0021
issue gate: 04111(2023
PermI 1l1 (Residential
04 26 210160 02500 0040 6794 Rack Forty Loop
vvl v "` v lv 4v l ttv1<
21
Name: LENNAR HOMES LLC-OWNER Permit Type: wilding 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 'm
Plumbing Valuation: $31,260.00
Total Valuation: $412,632.00
Total Fees: $20,701.19 ix
Amount Paid: $20,701.19 to .
Date Paid:4/11/2023 3:28:11PM al
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CONSTRUCT SINGLE FAMILY 2073 SQ FT
Public Safety Impact Fee -Admin $26.35 Transportation Impact Fee A City $36.32
Building Plan Review Fee $180,00 Public Safety Impact Fee -Police $254.00
SIF 1 percent Fee $83.28 Irrigation 314 Meter (Calc) $794.92
Mechanical Permit Fee $149,41 Park Impact Fee ® Single Family/Townhome $769.56
Sewer Connection Residential Fee $2,400.00 Plumbing Permit Fee $19.30
Driveway Fee $45.00 Plumbing Plan Review Fee $0,00
Transportation Impact Fee $3,595.68 Electrical Plan Review Fee $0.00
Water Connection Residential Fee $1,140,00 314 Water Meter Fee (Calc) $794,92
School Impact Fee - Single Family $8,328.00 Mechanical Plan Review Fee $0,00
Electrical Permit Fee $274A5 Address Fee $30,00
Building Permit Fee $1,603.00
FIN PECTI FEES: (c) With respect to ReInspection fees will comply with Florida Statute 553. 0(2)(c) the
local government shall Impose a fee of four tunes the amount of the fee Imposed for the Initial inspection or
first reinsp ction, whichever is greater, for each subsequent reinspection.
Notice: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permit required from other governmental
entities such as water management, state agencies or federal agencies.
"Warning to owner Your failure to record a notice of commencement may result in your paying twice for
improvements to your property. If you intend to obtain financing, consult with your lender or an attorney
before recording your notice of commencement."
Complete plans, Specifications add fee Must Accompany Application, All work shall be performed in
accordance with City Codes and Ordinances, NO OCCUPANCYC.O.
NO OCCUPANCY BEFORE C.O.
4' f
CO RAGTOR SIGNATURE PE IT OFFICEPERMIT EXPIRESyON
INSPECTIONCALL FOR
813-780-0020 'City of Zephyrhills Permit Application
Building Department
Date Received
Phone Contact for Permitfinlit 408 770
Owner's Name CAL HEARTHSTONE LOT OPTION POOL 03 L P Owner Phone Number
Owner's Address 23975 Park Sorrento, Ste. 220, Calabasas, CA 91302 Owner Phone Number
Fee Simple Titleholder Name NIA _ Owner Phone Number
Fax-813-780-0021
1813.5743700 1
Fee Simple Titleholder Address I NSA
JOB ADDRESS 6794 Sack Forty Loop LOT # 20$
SUBDIVISION Abbott Square PARCELto# 04-26-21-0160-02500-0040
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CON STR F__1 ADD/ALT SIGN DEMOLISH
h
PNSTALL REPAIR
PROPOSED USE 0 SFR COMM OTHER
TYPE OF CONSTRUCTION 10BLOCK FRAME STEEL
DESCRIPTION OF WORK Single Family Residence I Pool / Screen Enclosure / Fence
U/R sF 2 2073 28'
BUILDING SIZE SO FOOTAGE HEIGHT
�—� BUILDING $ 46890 AMP SERVICE 312600 VALUATION OF TOTAL CONSTRUCTION
I� NELECTRICAL $ PROGRESS ENERGY W.R.E,C.
Y � .J'
PLUMBING $ 31260
0 MECHANICAL $ 21882 VALUATION OF MECHANICAL INSTALLATION
GAS ROOFING SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS J FLOOD ZONE AREA DYES I o
BUILDER ..- COMPANY LctanarIlomes ILC; �
SIGNATURE REGISTERED Y I N FEE CURREN Y 7 N
Address License # GC;151816
4301 W B Scout Blvd Suite 600 `Sampa, FL 33607 _ C-7
ELECTRICIAN COMPANY Edmonson Electric Inc.
SIGNATURE REGISTERED Y / '. i FEE CURREN
Address r _......�® _� m_ License# EC13005408�_J
PLUMBER COMPANY Bayonet Plumbing, Heating & AC, Inc
SIGNATURE REGISTERED Y / N FEE CURREN Y / N
Address ®®T4 License # CFC042998
MECHANICAL COMPANY Bayonet Plumbing, Heating & AC, Inc
SIGNATURE REGISTERED Y / N__J FEE CURREN L_Y / N
Address License # CAC058062
OTHER (' COMPANY C Sterling Quality Roofing, Inc
SIGNATURE REGISTERED Y / N FEE CURREN Y / N
AddressLicense# I CCCO57991
Itltfll@IStiIIIIl11116IIIIIII!lI11881iEilIQlIIIIIitBit�ttitFttltRlll
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans, (1) set of Energy Forms, R-O-W Permit for new construction,
Minimum ten It 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. (AC 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 AIC Fences (PloUSurvey/Footage)
Driveways -Not over Counter if on public roadways..needs ROW
� . 4
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.
ym I w0im W 111401,1112tox0j.11 F-1110 0 2 hX1110
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FLORIDA JURA T (F.S.
OWNER ORAGENT
Subscribed and sworn to (or affirmed) before me �this
312112D23 by Christopher Smith
,Who is/are personally known to me or#asA4ave-pr94vGe#
as identification.
G 296057 Notary Public
Commission
Stephanie Farmer
Name of Notary typed, printed or stamped
9 44 1 IN` MISSAM, HOLLERAN
# OR 00WD
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Subscribed and sworn to (or affirmed) before me this
3/212023 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
aagWSSAM.H(XIEPAN
t
Permit No.
Date Permitted
Builder Name/Owner Name �� 2 � � t�� � Control #
r
County Parcel No. - 5 67 ,f SubDiu: - c
Address/Location
Classification/Type
TRANSPORTATION IMPACT FEE Rate: Sq. Ft knit:
Exempt ED Yes 0
No Hour Determined
Impact Fee Amount Zone No. TAZ:
SCHOOL IMPACT FEE 7 1
Account (056) Single -Family Detached House Amount $ I Cj
(057) Mobile Horne
(058) Other Residential
(223) Collection Fee
Exempt = Yes = No Hour Determined_
PARKS AND RECREATION FEE
Land Account Land Credit Land Total
Recreation Account Recreation Credit Recreation Total
Zone Total Arnount $ '
Exempt =Yes = No Hour Determined
LIBRARY FEE
Land Account Land Credit Land Total
Facility Account Facility Credit Facility Total
Exempt Yes No Hour Determined Total Amount
RESOURCE FEE ERLI
Total Amount
Prepared 6y _ Checked By
NO CER�CATE=CCUP�ANYWILL BE ISSUE 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
FORM, PLACING THE BUILDING OWNER ON NOTICE OF THIS ASSESSMENT AND THE CONDITIONS OF PAYMENT FOR SAME.
DATE RECEIVED BY
RECEIPT NO DATE BY
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DESCRIPTIONI LOT 4, BLOCK 25, ABBOTT SQUARE PHASE 2, '
ACCORDING TO THE PLAT THEREOF, RECORDED IN PLAT BOOK 90,
PAGES 28-33, OF THE PUBLIC RECORDS OF PASCO COUNTY,
FLORIDA,
LOT
= 4420 SOL FT,
LIVING AREA
= 952
SO. FT.
ENTRY
= 32
SQ.F.
GARAGE
396
SQ. FT.
COVERED LANAI
= 104
_SO. FT.
PATIO
= NA
SO. FT,
POOL AREA
NA
SOL FT,
CONIC. DRIVE
= 328
SO_ FT.
A/C & CONIC PAD
= 10
SO. FT.
SIDEWALK
= 61
SQ. FT.
SIDE YARD SWALE
= NA
SO. FT.
CONSERVATION AREA
= NA
SQ. FT.
LOT OCCUPIED
43 __
%
AREA TO IRRIGATE
= 57
%
SITE PLAN
(NOT A SURVEY)
This SITE PLAN Prepared for and Certified To:
Lennar Homes
LOT 32
I
i
P MT
LOT S
BLOCK 25
I
BLOCK 25
Q�
Fe
---------
11
N 88'08'23" W 110.50
S� U I
(Pj (P)
.o---_
-- -- c �'-
LOT 33
32X3.2. C?
E/S-A/C `N I.ANA1
BLOCK 25
LOT 4 8 0
4
i
PROPOSED
2 STORY RESIDENCE
rn o, '
PHASE I S
BLOCK 25 Le
PLAN 2074
PB 89, PGS.57-62
m o` o
m rci
GARAGE
GARAGE R ENTRY 17.0'
w ,
.__26_0 8.0
37.0' _ �
22 _
_______.__ _
1 ai
----'-°-I,
_ 3' CCiNC 33.B--rl o
WALK Z.
LOT34
� Z��40 N88-0623-W
(P) I10So (P)
q •
BLOCK25
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. ,I
j
I
LOT3
BLOCK 25
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PC 6
(P)
SEC. 4, TWP, 26 S, RNG 21 E.
PASCO COUNTY, FLORIDA
(ABBOTT SQUARE PHASE 2)
Sole: 1 " = 20'
NOTES:
LOT GRADING TYPE =
A
PROPOSED PAD ELEVATION =97.20'
FROM SETBACK -- 20"
SIDE SET BACK -, T5
SIDE SET BACK (CORNER LOT) -10"
REARSE(BACK= 15
-
ALLELEVATIONSREFERENCED
* = 10.00' PUBLIC UTILITY EASEMENT
TO NORTH AMERICAN
PROPOSED:
VERTICAL DATUM OF 1968
MINIMUM FLOOR
ELEVATIONS:
(NAVD 88)
LIVING AREA: 97.57' LEGEND:
GARAGE AREA
PROPOSED DRAINAGE FLOW
PROPOSED ELEVATIONS AND GRADING
ELEVATIONS REFERENCED
TO
SHOWN HEREON ARE TAKEN FORM THE
NORTH AMERICAN VERTICAL oo.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
SURVEY ABBREVATIONS )MAP NUMBER 12101C-0289-F) EFFECTIVE DATE: 09/26/2014
AI^AaCZNGn
DI -OPED
LNV - INVERT
PC- (Co' OF CURVE
I I-.EEORD
LEGEND VNV rl NICE
AC-Ae COND'ONER
A -^ALUMINUM F-NC_
Dt DRAINAGEIAS`MEN
LICENSED1 SN:SS
'CC POINT OF COMfO ND CURVE
°CP
2NC-R'A Gf
R"•CONC
""LJ
= ELEVAI ON
El. OR ELN lPAVE MN
E EDC OF FAVCMEN
ftOWSCA°Lt ASEM M
LEE ELE VA'ION
PERMANENT 20t POINT
P/ POC EQU`PMt NI
RIPS —ALL ROAD SFKE
R/W=RICIION WAY
�'.�"£f'I
ne ENC. ARK
C, 3ENCN MARK
C �CURV
SMT EAS
M
VEV0¢
LICENSED SURVEYOR
LS=LICE NS
°G PACE
S
WOOUIENCE
[�=ASP.4ALr --
ICI CALCOA'nD
/C NC CORNER
CORN
CNI,FOUNOCON RETE
RE,D
lM,�M A ll �D
MES-MTFRED -NJ SECTION
P - OIN OF N €RSECT(ON
°K rA R rsALON
0 -SE' NAIL
SN&D=S =NAIL AND DISK
3PSie3
f CENTER!N`
MONUMENT
NCF�NO CORNER POLING
4 1201'Cf2IY PINE
S =EE L11RONRORILE BItt3
CNANl UK FENCE
C t- C IAIN I IN'C FENCE
CMf+=CORRl1C�AlFD ME IN °
PIN - FOUNDRON MIKE
O/A-OV`RALI
°OH ID AT Oht3ECiINNING
TI3—TIMIORARY B:NCM MARK
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CFCN1-Ct
FIR -FOUND IRON ROD
OHW-OVERFLADWIREKI
POC POINTOFCOMMENCIMENT
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CON<=CONCRE?E
CR
FN&D-FOUND NN. A DISK
OR. ^OFFICIALRECORDS
(G Nr OYLe
µEn= OWNS. �P
ALUMINUM FENCE..
OK-CONCR ESLA3
OP=FOUNDO -N °IPE
IP -PLAT
PAC ON O,'REVERSE CURVE
t.E - UT IYEASEMENT
^'COVERED �l
EN - CLEAR SIGFrr nEANE,,I.
.RPA FOUND PINCHED PITS
Pt3=PLAT 3OOK
PRM 1f2AtANcNT REIE RE,NCE MONUME Nt
V,-VINYL rf NICE
JOB 815907s22504
SURVEYOR'S MOTES: - SURVEYOR'S CERTIFICATE
1708 Water Oak Drive
Date of Site Plan: 1-5-23
DWG:AS-112-L4-(3L2rSlrF
1.) Current title information on the subject property had not been
furnished to initial Point Land Surveying, LLC. at the time of this
Y 9-
SITE PLAN
This certifies 1N7 P VP hereon described
�+
property a.0 �tl�ervis:on and
�
meetsY „`$f � actice for
Tar oo Springs, Florida
p
Phone; t727)-83t-1990
FlondaP(57123@ maitcom
g
2,) This sketch was prepared without the benefit of a title search.
curve ' SBI rjs2' 4 a B�M of Land
LBT 8783 Y '°
No Instruments of record reflecting ownership, easements or
t Ned
EEC:
rights -of -way were furnished to the undersigned unless otherwise
SF( Adl T IItraativv��g..
IN
shown hereon.
0i yk trey
Drawn by OJB
3,) Roads walks and other similar Items shown hereon were taken
purStu aSection ,
St- t
bate•.'003. � 6
Checked by:IH
from engineering plans and are subject to survey.
&.) This SITE PLAN does not reflect nor determine owne ship-
O
1
t, �i4'00'
`4Ti C Ix art
RE�Isr®nos
5.) This SITE PLAN is subject to matters shown on the Plat of
`ABBOTT
l
ss v1'�• Z? ........._
R( l�
Kta G ENE .
SOUARE PHASE 2"
6.) Dimensions shown hereon are in feet and decimal portions
Jeff - pp�,E' Be
PLORIDA P �L�StYOR AND
ll��
V
thereof,
MAPPER NO. LS IIiNk 183
7t 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 Paint Land Surveying, LLC of any
SIGNATURE AND SEAL OF A FLORIDA
o-^
deviation from Information shown hereon. Failure to do so will be
LICENSED SURVEYOR AND MAPPER
Initial Point Land Surveying, LLC
New Development Check List
Parcel
Address; 13 ^,c
Setbacks: Fret Rear Sides
Flir e fon:
Roof Single Dimension/Architectural: �; �`
Notice to Building Official of
Use of Private Provider
Effective January 20, 2003
Project Name: 6794 Back Forty Loop
04-26-21-0160-02500-0040
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.
owner, affirm I have entered into a contract with the Private Provider indicated below to conduct the services
indicated above,
Private Provider Finn: VIPTUAL PEVIEW A55IST, INC,
Private Provider- DEBPA ANNE KLAHP,
ANNIMM
Email Address (Optional): deb@virtualreviewassist.com
Florida License, Registration or Certificate #: (LIC # BU1967/ PX2300/ BN4615)
I have elected to use one or more private providers to provide building code plans review and/or inspection
services on the building that is the subject of the enclosed permit application, as authorized by s. 553.791, Florida
Statutes. I understand that the local building official may not review the plans submitted or perform the required
building inspections to determine compliance with the applicable codes, except to the extent specified in said law.
Instead, plans review and/or required building inspections will be performed by licensed or certified personnel
identified in the application. The law requires minimum insurance requirements for such personnel, but I
understand that I may require more insurance to protect my interests. By executing this form, I acknowledge that I
have made inquiry regarding the competence of the licensed or certified personnel and the level of their insurance
and am satisfied that my interests are adequately protected. I agree to indemnify, defend, and hold harmless the
local government, the local building official, and their building code enforcement personnel from any and all
claims arising from my use of these licensed or certified personnel to perform building code inspection services
with respect to the building that is the subject of the enclosed permit application.
I understand the Building Official retains authority to review plans, make required inspections, and enforce the
applicable codes within his or her charge pursuant to the standards established by s. 553.791, Florida Statutes. If I
make any changes to the listed private providers or the services to be provided by those private providers, I shall,
within I business day after any change, update this notice to reflect such changes. The building plans review and/or
inspection services provided by the private provider is limited to building code compliance and does not include
review for file code, land use. enviiommental or other codes.
The following attachments. are provided as required:
1. Qualification statements ' and/or resurnes of the private provider and all duly authorized -representatives.
I. Pro of of insurance for professional and comprehensive t I aWliamo
J y in�thej unt of $1 million per
o ccuaenoe relating to all service's p,eilfoimed as a private provider, including tail coverage for. a rniriimum
of 5 years subsequent to the per-forl-nanc, e,of building code inspection services.,
In&Vidna,l
-(signature)
Print
NaMD:
Addressi
Telephone
No.:
Please use appropriate notary block.
STATE OF FLORIDA
COUNTY OF HILLSBOROUGH
7LVfflWdnj
B eforD me, this_day of
20—personally
appeared
Who executed the foregoing instmnaeta,
and acknowledged before mae that same
-was executed for the purposes therein
expressed.
qqrporation
_LENNAR HOMES LLC
Print CoiporationNamq
(signature)
Print
Name. Chrl8t. its: Authorized cLent
Addrcw3DQ
Miami FL 33172
Telephone.
No913-574-5700
Corporation
B,,forem5,this, 22ND day of
-MAK 20 2-2
personally appeared,
Of
Lennar Homes LLC,
corporation, on
behalf of the -state rorporation, who
executed the f6ragoing instrument and
acknowledged before me. that Same was
executed for the purp p s e s, therein
expressed.
Partnership
PrintPartnersbip Name
By-,
(signature)
Print
Na=-
Address,
Telephone
No.:
WIMS=%
Brforome,this day
of 20�
personally appeared
p artner/agant on behalf of
a p a rtn er ship, who exe- outtdthB
foregoing ins. annent and
ar,knowledgvd before me that same
was mecuted-for the purposes therein
expressed.
- '0 VersonallX orY known— 7 gRroduce;d identiteation— Type ofidmtif ic4i nproduotd,
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PH -at Name ASHLEE CALLAHAN
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ASHLEE CALLAH
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VIRTUAL REVIEW ASSIST
Private Provider
Plan Compliance Affidavit
Private Provider Firm: Virtual Review Assist, Inc.
Private Provider: Debra Anne Klahr, BU1967
Address: 747 Southwest 2n' Avenue
Gainesville, Fl, 32601
Phone: 813-391-2959
Email: ItigyyCq)_yirtualreviewassist,com
Project: New SFR
Address(s): 6794 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 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,1,1,1.2,2.1,2.2,3,4,5,6.1,6.2,7, SN,SNI, S3,S4,S5, S6,SS,ST,Dl,D2,WP1,PAl.0,PAl.l,
PAI.2,PAI.3,PAI.4, SHI.0,SHI.1,SHI.2,SHI.3,SHI.4,SHI.5
Florida License/Registration/Certification #(s) and description:
FS468 Certified Standard Plans Examiner
License #: PX2300
Signature of Reviewer:
L
SWORN AND SUBSCRIBED ,afore me by Debra Anne Klahr
being personally knownor 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.
l P4ri i�Name igknature �ofNo
Notary Public: NOTARY STAMP BELOW My
commission expires:
F05'. COMMERCIAL BUILDING SERVICES DIVISION VRESIDENTIAL
BUILDING PERMIT DATA SHEET
am"
Required Permits
1-�
F-1 Ins ection OnI
El Inspection OnI
El Medical Gas
IElectrical Amp
[:]Ins ction EOn_yI
El Fire Sprinklers
El On Site Piping
El Irrigation
Ej Fire Alarm
El Potable Backflow Assembly
1 El Fire Line flacliflow Preventer
[E] Ir igation Bacliflow Assembly
El Demolition
ff];Wa -in Cooler
El Refrigeration
Trap
I as Construction:"�
Risk Category:
Occupancy Load
Cb's "ney sification:
OV,,,Facto'y
Residential
Assembly
Hazardous =�
E=
Business
F—H, Day Care/Educational
itutional E= jo �Mercantile
ity,
Building Use: SINGLE FAMILY RESIDENCE 1 Alteration —Level I 1 ❑ Level 3 01, Level 2
El New Construction Interior Finish E] Interior Remodel Exterior Remodel Ej Addition Ej Revision
Overall Size:
25 X 62
Number of Stories:
2
Total Sq. FC:
2605
Living Area: 2073
Covered Area:
532
# of Bedrooms: 4
# of Baths: 2,5
Cost per square foot:
Estimated Value:
Roof Type: El Shingle
E]Tile El Built-up
Metal ❑ Other Squares: 17
Zoning:
or
Wi orne Debris:
®;Inside
s
7 rEl 1"" 1 n i d e
� Outside
Energy Code:
405-2022 SUP
Flood one: X
Base Flood Elevation:
Finish Floor Elevation:
Hydrostatic Vents?TEPY�es
�N
Sq. Ft, Enclosed Space Below BEE:
# of Vents:
Size of Vents:
Total Sq. In. Permanent Openings
10 Central A/C
D Gas A/C
Heat Pump
El Gas HeatElectric
Window A/C
Heat
�1
Sanitary Sewer
Storm Sewer Catch Basins
Potable Water
Ilnaier round Fire Line
Setbacks
Front Rear Left Right
As per Approved Site Plan
Comments: