HomeMy WebLinkAbout23-6203City of Zephyrhills
5335 Eighth Street
qmw
Zephyrhills, FL 33542
Phone: (813) 780-0020
Fax: (813) 780-0021
Issue Date: 05/08/2023
Permit T e: Building New Residential)
r,'' M, N11111111111111111111-a- N11�2M, R
04 26 210160 02000 0070 36511 Camp Fire Terrace
Rg , 0
Name: LENNAR HOMES LLC Permit Type: Building New (Residential) Contractor: LENNAR HOMES LLC
Class of Work: Townhome
Address: 4301 W Boy Scout Blvd 600 Building Valuation: $250,320.00
Phone:
Mechanical Valuation: $17,522.40 TAMPA, FL33607 Electrical Valuation: $37,548.00
Plumbing Valuation: $25,032.00
Total Valuation: $330,422,40
Total Fees: $14,333.47
Amount Paid: $14,333,47
Date Paid: 5/8/2023 1:55:41PM
"M
",17, 7--7-7
ON
CONSTRUCT TOWNHOME 1634 SO FT
Fire Wall/Smoke Wall Inspection $15.00 Electrical Plan Review Fee $0.00
Plumbing Permit Fee $165.16 3/4 Water Meter Residential Connection Fee $794.92
Building Plan Review Fee $180.00 Public Safety Impact Fee -Police $254,00
Building Permit Fee $1,291.60 Sewer Connection Residential Fee $2,400.00
Transportation Impact Fee $3,445.20 Plumbing Valuation Fee $0.00
School Impact Fee - Single Family $3,353.00 Mechanical Permit Fee $127.61
Driveway Fee $45.00 Water Connection Residential Fee $1,140.00
Mechanical Plan Review Fee $0.00 Park Impact Fee - Single Family/Townhome $769.56
Electrical Permit Fee $227.74 Public Safety Impact Fee -Admin $26.35
Transportation Impact Fee - City $34.80 Address Fee $30.00
SIF 1 percent Fee $33.53
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.
,2_1LJ GONTRACTORSIGNATURE PEfAIT OFFICE()
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
81380-0020 City of Zephyrhills Permit Application
y ..
Building Department
Date Received Phone Contact for Permitting 908 770
TT—FTU a r'I
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 I N/A Owner Phone Number
Fax-813-780-0021
1813.574.5700 1
Fee Simple Titleholder Address
I N/A
JOB ADDRESS
36511 Camp Fire Terrace
LOT# 2007
SUBDIVISION Abbott Square PARCEL ID#
04-26-21-0160-02000-0070
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED
q
NEW CONSTR 8 ADD/ALT
INSTALL REPAIR
SIGN
DEMOLISH
PROPOSED USE
U�'u� SFR a COMM
OTHER
.Y
TYPE OF CONSTRUCTION IL.,JI BLOCK FRAME �
STEEL 0
DESCRIPTION OF WORK
I Multi -family / Screen Enclosure / Fence
BUILDING SIZE U/R IF 2086 SO FOOTAGE 1634
HEIGHT
b BUILDING
$ 250320
VALUATION OF TOTAL CONSTRUCTION
bl 1ELECTRICAL
$ 37548
I
PROGRESS ENERGY
W.R.E.C.
AMP SERVICE
f j �r
1✓ (PLUMBING
$ 25032
ILMECHANICAL
V
._�
17522.4
VALUATION OF MECHANICAL INSTALLATION
.t .. -
r
GAS I✓ 1 ROOFING � SPECIALTY =
• r
OTH,ER--q
f
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA
r—�
DYES I o
BUILDER
SIGNATURE
Address
ELECTRICIAN
SIGNATURE
Address
PLUMBER
SIGNATURE
Address
MECHANICAL
SIGNATURE
Address
OTHER
SIGNATURE
COMPANY
1 REGISTERED
4301 Wfilay Scout Blvd Suite 600 Tampa, FL 33607
COMPANY
REGISTERED
COMPANY
REGISTERED
COMPANY
REGISTERED
COMPANY
REGISTERED
Address
11/1/11111111111111111111111111/11111
Lennar I Iomes, LLC
Y / N FEE CURREN
License# CGC1518166
Edmonson Electric, Inc.
Y / N FEE CURREN I Y / N
License# EC13005408
Bayonet Plumbing, Heating & AC, Inc
Y / N FEE CURREN
License # CFC042998
Bayonet Plumbing, Heating & AC, Inc
Y / N FEE CURREN
License # I CAC058062
C Sterling Quality Roofing, Inc
Y IV FEE CURREN I Y / N
License # I CCCO57991
/11/1/1/1////1/1111/11111111
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)
Reroofs if shingles Sewers Service Upgrades A/C Fences (PloUSurvey/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 contractors) sign
portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I
certify that 1, the applicant, have been provided with a copy of the "Florida Construction Lien Law —Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs, If the applicant is someone
other than the "owner", I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the "owner" prior to commencement.
CONTRACTOR'SIOWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
Department of Environmental Protection -Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water[Wastewater Treatment.
Southwest Florida Water Management District -Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
Army Corps of Engineers -Seawalls, Docks, Navigable Waterways.
Department of Health & Rehabilitative Services/Environmental Health Unit -Wells, Wastewater Treatment,
Septic Tanks.
US Environmental Protection Agency -Asbestos abatement.
Federal Aviation Authority -Runways.
I understand that the following restrictions apply to the use of fill:
Use of fill is not allowed in Flood Zone W" unless expressly permitted.
If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
construction, I certify that fill will be used only to fill the area within the stem wall.
If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
acre which are elevated by fill, an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension
may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned.
OWNER OR AGENT
Subscribed and sworn ro (—or affirmed) before me this
X=023 - by — Christopher Smith
Who is/are personally known to me or hasAhave prqduGed
as identification.
Notary Public
Commission tj� G5 296057
Stephanie Farmer
Name of Notary typed, printed or stamped
—, ELISUR NOLLF"
com MIS,*ii # HH 000460
EXplMJitne6,2024 iois
3128Q023 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
0 XEX
4
EOMJU06,2024
Z: TxuTWnIorg
I
DESCRIPTION: LOTS 5-10, BLOCK 20, 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.
PROPOSED ELEVATIONS AND GRADING
SHOWN HEREON ARE TAKEN FORM THE
ENGINEERING PLANS OF
"ABBOTT SQUARE RESIDENTIAL', PREPARED
BY'WRA" PROVIDED BY CLIENT
ALL ELEVATIONS REFERENCED
TO NORTH AMERICAN
VERTICAL DATUM OF 1988
L (NAVD 88)
28.34(P))
\ 0
1
Z )
o I
wz
P
wz
LOT i i
BLOCK 20 S
ro �
)
1I GO
5 CONIC WALK
NOTES:
LOT GRADING TYPE =A
PROPOSED PAD ELEVATION=112,40'
FRONT SET BACK = 20'
SIDE SET BACK = T5'
SIDE SET BACK (CORNER LOT) =10'
SITE PLAN
(NOT A SURVEY)
This SITE PLAN Prepared for and Certified To:
Lennar Homes
TRACT "B-8"
(CDD) PARKING AREA
AND OPEN SPACE
N 89-48'04` E P) 12&68(P)
18.00'(P) 18.00'iP) I800'(P) IB.Eci(P)
18.0
17.3'
IT3
17.3'
113
UNIT -A
Z. UN7T-C
Z UNIT-C
Z UNIT-C
2 UNIT-C
1532
Is 1624
1624
a° 1624
1624
PROPOSED
PROPOSED
a PROPOSED
;PROPOSED
PROPOSED
2 STORY
P 2 STORY
L6 2 STORY
a 2 STORY
2 STORY
ATTACHED
ATTACHED
It ATTACHED
ATTACHED
ATTACHED
RESIDENCE
w
n RESIDENCE
a RESIDENCE
v RESIDENCE
w
a RESIDENCE
d
" LOT 10
d
LOT 9 v
°o LOT 8
1.
- LOT 7
o
LOT b
BLOCK ZO
BLOCK ZO
- BLOCK 20
BLOCK 20
BLOCK 20
0
0
7.0' ENTRY
ENTRY 63
6.3' ENTRY
ENTRY 6.3
63 ENTRY
`� to.o •loa '
w LI I
-o
o'
�34'(P)I
273'•
SEC. 4, TWP. 26 S, RNG 21 E.
PASCO COUNTY, FLORIDA
(ABBOTT SQUARE PHASE 2)
Scale.- 1 ° = 20'
2
UNIT -A
1532
z
PROPOSED I
co+
2 STORY
ATTACHED
-'
RESIDENCE
�.
P d
LOT 5
b BLOCK 20
m LOT 4
g BLOCK 20
ENTRY TO
P
10.9
v V W
3' 6.3\ w 6.3' b.3'
I10 1LEI ii.0' I10 i
•'Je0 10.0 L4.10,0; l loo w
N89'4804'E(P)
\\.
IB-QO (P) 18.0o`(P)' tA.00 REF) 28.3R' PI ,\\ /PC
,S 89'48'04" W (P) 128-68' (P)
��__�, 2J3' �F .273 �� ^T•
BASIS OF BEARING
N 89`48'04- E I P)
CAMP FIRE TERRACE
TRACT "A"
(CDD) RIGHT-OF-WAY
LOT = 1261 1 SO FT.
JOB # LIVING AREA = 4010 SO. FT.
ENTRY = 476 SO. FT.
= 10.00 PUBLIC UTILITY EASEMENT
15905522005
GARAGE
= 1356
SO. FT.
REAR SETBACK = i
15905522006
COVERED LANAI
= 652
SOL FT.
NOTE: ENTRY WALKS ARE 3.0' CONC
C/S-A/C UNITS ARE 3.2 X3.2"
15905522007
PATIO
= NA
SO. FT.
PROPOSED:
POOL AREA
= NA
SO, FT.
MINIMUM FLOOR ELEVATIONS
15905522008
CONC. DRIVE
= 1Z00
SO. FL '.
LIVING AREA: IT 3.07'
LEGEND:
15905522009
A/C & CONIC PAD
= 54
SQ. FT,
GARAGE AREA:
_- - = PROPOSED DRAINAGE FLOW
15905522010
SIDEWALK
= 272
SQ. FT,
ELEVATIONS REFERENCED TO
(00,00) = PROPOSED GRADE
SIDE YARD SWALE
= NA
SO. FT.
NORTH AMERICAN VERTICAL
-
Eoo.00 = EXISTING GRADE
CONSERVATION AREA NA
LOT OCCUPIED = 64
SO. FT.
B/R
DATUM OF 1988
APPARENT FLOOD HAZARD ZONE: "X" COMMUNITY
NO. 120235
AREA TO IRRIGATE
= 36
_ %
-
(MAP NUMBER 12101C-0452-F) EFFECTIVE DATE:
09/26/2014
SURVEY ABBREVATI
A)=ARC LENGTH
(D) - DEED
INV=INVERT
PC=POINT OF CURVE
(R)=RECORD
LEGEND
A/C -NR CONDITIONER
AF- ALUMINUM FENCE
DE- DRAINAGE EASEMENT
-ti-LICENSED BUISNESS
PCC POINT OF COMPOUND CURVE
RNG-RANGE
s
^INYL FENCE
--V---u--.-
BFE- RASE FLOOD ELEVATION
EL OR ELEV=ELEVATION
EDP - EDGE OF PAVEMENT
�E-LANDSCAPE EASEMENT
LEE^ LOWEST FLOOR ELEVATION
PCP PERMANENT CONTROL POINT
P/E=POOL EQUIPMENT
RIG =RAIL ROAD SPIKE
RJW - RIGHT OF WAY
Ytf*�'i'COEF
8M=BENCHMARK
C-CURVE
ESM'T-EASEMENT
F/C-FFOUNDCRNC
LS-LICENSED SURVEYOR
RAJ
PG=PAGE
PI=PARKER
SEC
SN&D^SET NAIL. AND DISK
.; ;-ASPFIALT
WOOD FENCE
-- �
ICi=CALCULATED
ECM. - FOUND CONCRETE
ER
MES"NOECORNER
RINTERSE[TIQN
PK -PARKER KALON
= CENTERLINE
MONUMENT
R FOUND
NCF=NVERACL RFOUND
rt
SIR -SET
SIR SET ij
BENCH
CHAIN LINK
FENCE
CIF - CHAINLINKfENCE
CORRUGATED METAL PIP
FtR=FOUNDIRONPIPE
OVERALL
POINT OF
POB- POINT OF BEGINNING
TEMPORARY M
TOE- TEMPORARY BENCH MARK
RK
"BRICK
COP-
COL^COLUMN
FIR^FOUND1ftON ROD
CUW
OHW =OVERHEAD WIRE(S)
PVC =POINT Q�[OMMENCTMENT
i0@a TOP OF BANK
CON
FN&D^FOUND NAIL &DISK
O.R.-OFFIGALRECORDS
POL=POINT ON LINE
TWIT A TOWNSHIP
ALUMINUM FENCE
C/S=CONCRETE SLAB
CONCRETE
FOP^FOUND OPEN PIPE
FPP^ FOUND PINCHED PIPE
(PI =PLAT
PB-PIATBOOK
FRC= POINT OF REVERSE CURVE
PRM= PERMANENT REFERENCE MONUMENT
U.Ea UTILITY EASEMENT
><^COVERED
CSTCLEAR SIGHT TRIANGLE 1 11 L FENCE
SURVEYOR'S NOTES: SURVEYOR'S CERTIFICATE 1708 Water Oak Drive
I-) Current title information on the subject property had not been This certifies that sketch of the hereon describe Tarpon Springs, Florida
Date of Site Plan: 11-28-2 P
furnished to Initial Point Land Surveying, LLC at the time of this property was rp606WWWftq upervision and Phone: (727)-831-1990
SITE PLAN y 1Jj ractice for FlondaPLS J123@gmaif.com DWG:ASFH2-L4-I P@L20.SITE meets the �a S „
2.) This sketch was prepared without the benefit of a title search, surveys iDtt b Ord of Land LB# 8183
No instruments of record reflecting ownership, easements or S IPJ red
File rights -of -way were furnished to the undersigned, unless otherwise S r 011, IQ�t�r
shown hereon. ursu t to ectlon e 1, e ley
Drawn by: DJB 3.) Roads, walks, and other similar items shown hereon were take Pta -
Checked by:JH from engineering plans and are subject to survey. /^� Date:.2 2J*44'.Q4
4.) This SITE PLAN does not reflect nor determine ownership. qy' {�Q 4C},') (j fl'
REVISIONS �SIATEt7F' 'P1
5.) This SITE PLAN is subject to matters shown on the Plat of r - b
"ABBOTT SQUARE PHASE 2"
6.) Dimensions shown hereon are in feet and decimal portions Jeffhe M Y�
FLORIDA Vlit IYsS 1�ibQ'('i AND
7.) Contractor and owner are to verify all setbacks, building MAPPER NO.I��
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 P,
deviation from information shown hereon. Failure to do so wil( be LICENSED SURVEYOR AND MAPPER Initial Point Land Surveying, LLC.
at user's sole risk y g'
F
EL
VIRTUAL REVIEW ASSIST
Private Provider
Private Provider Firm: Virtual Review Assist, Inc.
Private Provider: Debra Anne Klahr, BU 1967
Address: 747 Southwest 2,d Avenue
Gainesville, FL 32601
Phone: 813-391-2959
Email: lqcyf& irtgalreviewassist.com
- ,.,v 1L_
Project: New SFT
Address(s): 36511 CAMP FIRE TERRACE
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 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16, LI, SN, SNI, S3,S4,S5,S6, ST, SS, DI,WPI,W2,W2.1,
PAI.0,PAI.1, PA1.2,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:
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
re g is true and cor ,Xect to,4he best of his/her knowledge or belief.
LALUY)
12 of
WfnFt Name-
0 Notary
gnature of 'Notary
Notary Public: NOTARY STAMP BELOW My
commission expires:
My CAAOSSMHHMLIEESEES, ICCOAANLL
#LL
AAHHHH
AA2IN I9
5980::E�PIRES. November 30,2026
Project Name:
MM
Services to be provided:
v Rl -1 U A !- R E V 1 E W A S ", I 'S T
Notice to Building Official of
Use of Private Provider
Effective January 20, 2003
36511 Camp Fire Terrace
04-26-21-0160-02000-0070
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.
M04949MME
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 A5515T, INC.
Private Provider: I)EBPA ANNE KLAHR
Address: 747 SW 2ND AVE- SUITE 170,301,357,& 358, GAINESVILLE, FL 32601
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 permit application.
I understand the Building Official retains authority to review plans, make required inspections, and enforce the
applicable codes within his or her charge pursuant to the standards established by s. 553.791, Florida Statutes. If I
make any changes to the listed private providers or the services to be provided by those private providers, I shall,
within I business day after any change, update this notice to reflect such changes. The building plans review and/or
inspection services provided by the private provider is limited to building code compliance and does not include
review for fire code, land use, en-virommental or other codes..
The following attachments are provided as required:
1. Qualification statements ' and/or resumes of the private provider and all duly authorized representatives.
2.. Proof of insurance for professional and comprehensive I abilit i y in..the.'amount .of $1 minion
pe'r
o ccurre;nce relating to all services p.6,rfoimed as a private provider,* including tail' coverage, for a Minimum
of 5 years subsequent tothe performance .of building code inspection services.
Individual
Pant
Naroe:
Address' .
Telephone
No.:
Corp oration
LENNAR HOMES, LLC
Print C. 01-POTBtionNalde
BY:
Flint
N.e: Christopher Srrith
its: Authorized Aa ent
Address-. 700 NW 107th Ave
Miami. FL 33172
Tel6nhone,
Print P artnership Name
By:
Name:
Its.
Address:
No. 91 3.r574-5700
Pleaseuse use appropriate notary bl'ock
STATE OF _FLORIDA.
C0UNTY OF HILLSBOROUGH
Individual
Corporation
22ND
Moremt-,, this day of
Befqlme,tbjs day -of
20—pclsonally
MAY io 2-2
appeared
personally appeared.
who executed the foregoingof
*
and acknowledged before m5 that same
Lennar Homes, LLC � a
was executed for the purposes therein
corporation, rpDraAon, on
e5cpress;d.
-behalf of th6state Corporation, who
-dt instrument
executed he foregoing i 511t and
ackiowltdgDd before me- that same was
executed for the purposes therein
expressed.
Personally known X or- Produced idcr#oationmld � Type of idfioitionpToduced
% Aor
Telephone
N,r-. ..
Partnership
13 afore me, this day
of 20�,
p=6nally appeared
partner/agent on b ehalf of
�L partnership, who exf,-cuted the
foregoing insfrolaent and
acknowledged before me that same
Signature ofNotaiN PrintNauie ASHLEE CALLAHAN
NotayPublic Stamp;
ASHLEE CALLAHAN H
commissionExpires: COMMISSION # HH D295980
MY
EXPIRES: November
30
W36,202�6
'W
[—COMMERCIAL BUILDING SERVICES DIVISION RESIDENTIAL
BUILDING PERMIT DATA SHEET
121#111#130ml I I I Amiga
FIRE MARSHAL #01 -
Remdred Permits
I
I DKIMAL12 I I feint 0 4 6
Building
[I Ins ection Only
V Plumbing
[] InMection Only
V Mechanical
E] Ins ection Only
VElectrical Amp
E] Inspection OnI
Roof
El Gas F
0 Medical Gas
El Fire Sprinklers
❑ On Site Piping
0 Fire Line
E] Irrigation
Ej Fire Alarm
El Potable Backflow Assembly
Fire Line Bacliflow Preventer
ElIrrigation Backfiow Assembly
El Demolition
El Walk-in Cooler
El Refrigeration
❑ Hood
❑ Ansul
El Fence/Wall
El Grease Trap
E] Other
E:1 Other
Construction:
Risk Category:
Occupancy Load
n Classification:
a cy C
Og',,",Fact
`Factory
s tial
Re iden
Assembly E::�
Hazardous E:�
"StorageUtility
:1 �
ri
usmess ay Care/Educational
st1t tional E E]Morcantile
"
Building Use: SINGLE FAMILY TOWNHOUSE i Alteration 1 —PLevol 2 Level 1 [[—:]",Level 3
[
46 New Construction El Interior Finish E] Interior Remodel El Exterior Remodel ❑ Addition El Revision
Overall Size:
18 X 63
Number of Stories:
2
Total Sq. Ft.:
2086
Living Area: 1634
Covered Area:
452
# of Bedrooms: 3
# of Baths: 2.5
Cost per square foot:
Estimated Value:
Roof <j Shingle
[]Tile El Built-up
Metal F-1 Other Squares:
Zoning:
Wi orne Debris:
EllInside,
Outside
Energy Code: 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. In. Permanent Openings
Central A/C
21 Heat Pump
Heat
F1 Window A/C
El Electric Heat
re'riva"31"11
Sanitary Sewer
Storm Sewer Catch Basins
Potable Water
Underground Fire Line
0 Tl NIP"
Front Rear Left Right
Fv� As per Approved Site Plan
Comments:
Permit No.
Date Permitted 23
I L
A KI /A NameControl #
Builder Name/Owner me,
County Parcel No. 2— 0 0 2c?(�� 0�60Q Su
Address/Location p 1 1 1 70
Classification/Type of Use Sq. Ft Unit:
TRANSPORTATION IMPACT FEE Rate:
Exempt Yes 11 No How Determined
Lj —3
Impact Fee Amount i CL Zone No. TAZ:—
SCHOOL IMPACT FEE 3
Account (056) Single -Family Detached House Amount$
(057) Mobile Home
(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 Amount
Exempt =Yes = No How Determined
LIBRARY FEE Land Total
Land Account Land Credit
Facility Account _ Facility Credit _ Facility Total
Exempt El Yes No How Determined _ Total Amount
RESOURCE FEE ERU
Total Amount
Prepared By
Checked By
NO CERTIFN�,ATE OF OCCUPANY WILL BE ISSUED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
I'UG *FFICE OF PASCO COUNI
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