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Home My WebLink About23-6614Issue Date: 07/17/2023 ".",ermit Type: Building New (Residential) Address4301 W Boy Scout Blvd Suite 600 Tampa, FL33607 Phone: ;813>574-5700 CONSTRUCT SINGLE FAMILY 1*08QpT Irrigation 3/4 Meter (Calc) Building Permit Fee Mechanical Permit Fee Electrical Permit Fee 8|F 1 percent Fee Park Impact Fee 'Single Fami|y/Townhumo 3/4Water Meter Fee (Co|n) School Impact Fee - Single Family Transportation Impact Fee-oty 6640 Back Forty Loop Contractor: LENNARHOMES LUC Building Valuation: $2x1.n6O.0O Electrical Valuation: $34.704.08 Mechanical Valuation: $18.18528 Plumbing Valuation: $23,136.00 Total ValuwUnn;$3V5.38s.on Total Fees: $20105.01 Amount paid'*2U.1O5.01 $784�92 Sewer Connection Residential Fee $1.196l0 Plumbing Permit Fee $120.98 Water Connection Residential Fee $213.52 Public Safety Impact Fee f\dmin $8328 Address Fee *709.50 Transportation Impact Fee $794.92 Driveway Fee *8.328.00 AdminFee / (Provider Service } $36.32 p"micSaoaty|mpemFoe-Poncv $2,^00lm $155.68 $11.14O�0O $26.35 $3,595.68 $45.00 $180.00 $254.00 ROOM i, may be found in the public records of this county, and there may be additional permit required from other governmental entities such as water management, state agencies or federal agencies. accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 ,. . I Building Department Date Received Phone Contact for Permitting 908 770 __ 7763 Owner's Name CAL HEARTHSTONE LOT OPTION POOL 03 L P Owner Phone Number 813.574.5700 Owner's Address 1 23975 Park Sorrento, Ste. 220, Calabasas, CA 913022 Owner Phone Number Fee Simple Titleholder Name I N/A J Owner Phone Number (W�� Fee Simple Titleholder Address I N/A 6640 Back Forty Loop LOT # 2604 JOB ADDRESS Abbott Square 04-26-21-0160-02600-0040 SUBDIVISION PARCEL ID# (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED II✓ 11 NEW CONSTR ADD/ALT SIGN [ DEMOLISH INSTALL 8 REPAIR PROPOSED USE SFR Q COMM L� OTHER TYPE OF CONSTRUCTION m BLOCK Q FRAME ^_ �J L J STEEL DESCRIPTION OF WORK Single Family Residence / Pool / Screen Enclosure / Fence BUILDING SIZE U/R SF 192$ SQ FOOTAGE 144 $ HEIGHT 1$ MBUILDING $ 231360 VALUATION OF TOTAL CONSTRUCTION I✓ (ELECTRICAL $ 34704 PROGRESSENERGY W.R.E.C. • r AMP SERVICE PLUMBING $ 23136 /J (MECHANICAL $ 16195.2 VALUATION OF MECHANICAL INSTALLATION tky �• r p y =GAS ROOFING F-1 SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES DO 4 BUILDER COMPANY Lennar Homes, LLC SIGNATURE REGISTERED Y / N FEE CURREN Address License # 430 W Boy Scout Blvd Suite 600 Tampa, FL 33607 CGC1518166 ELECTRICIAN COMPANY Edmonson Electric, Inc. SIGNATURE REGISTERED I Y / N FEE CURREN Y / N Address License# EC13005408 Ba onet Plumbin Heating & AC, Inc PLUMBER � COMPANY � g, � SIGNATURE REGISTERED I Y / N FEE CURREN Y / N Address License # CFC042998 MECHANICAL COMPANY Bayonet Plumbing, Heating & AC, Inc SIGNATURE( REGISTERED I Y/ N FEE CURREN Y I N Address ( License # CAC058062 OTHER COMPANY C Sterling Quality Roofing, Inc SIGNATURE REGISTERED I Y / N FEE CURREN I Y / N Address License # CCC057991 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 subdivisionsAarge 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 Attomey (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 (PloVSurvey/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'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: Department of Environmental Protection -Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment. Southwest Florida Water Management District -Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. 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 "V' 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. 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 OWNER OR AGENT Subscribed and sworn o (or affirmed) before me this Vv 23 by Christopher Smith Who is/are personally known to me or hasAave preduwd as identification. Notary Public Commission G 296057 Stephanie Farmer Name of Notary typed, printed or stamped C. Ft.I KCommissirm�NN 0 Fa3we6,2024 'W,k,surgr#840�9:1701, Subscribed and sworn to (or affirmed) before me this ua+zoza by Christopher Smith Who istare personally known to me or has/have produced as identification. f Notary Public Commission No. IIWW6k7 Stephanie Farmer Name of Notary typed, printed or stamped ELMUKIQUEPM . Commission*ONow ` Expires June6, 2024 $'� u�„+�„pc. 6iiMail%'Fn1RW9tk6 74te 4 vmmrfflmmro�� County Parcel No. Address/Location Permit No. �X Date Permitted 717-20 Control # SubDiv:—, TRANSPORTATION IMPACT FEE R/a t e; O . Ft Unit: Exempt 0 Yes 0 No How Determined n Impact Fee Amount 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 - PARKS AND RECREATION FEE Land Account Land Credit Land Total Recreation Account Recreation Credit Recreation Total Zone Total Amount Exempt =Yes = No How Determined RESOURCE FEE ERU Checked By �111!'� RECEIPT NO DATE BY N:ia2as3s.os E:586256.18 93.60-94.31 ". 1 97.26 95.76 rn I 4 ! TYPE ci 95.68 -96.56-94.70... ---- 93.72 o # M I I A 9 4.4 ao± ! E ® I j�`"��-..,.....� •-, } I PAp:94.40 ui ! 1 TYPE °B' x TYPE 'A'cc I FF:97.17 Ff:96.07 97.11 95.550 m PAD :96.50 r �o AD:95.40 0 ` ! k 93'85 - - 94.56 9 - u TYP€ A' N 095.48 96.430-rn 93.92 0 ! FF.. 7.97 I @l ( TYPE `B' AD:97.30 TYPE `B' TYPE 'A' I m�ii I AD:94. 50 FF:97.17 FF:96.07 I p_ 96.91 95.350 AD:95.5E us PAD:95.40 j (N i -`" � ( c 93.90 094.61 9; TYPE 'A' t 95.28 - 96.23 I 93.87 A EBTYPE'A n°0 0 I�I TYPE B .9F:967 FF:96,07 FF:95.17 oo PAD:9fi0 P:95.PAD:94.5 .Cj ' 0 I I 1 `r: m 95.13 9fi.08 ----- 93.67 TYPE 'A' _-- 93f65 -94.36 93 fF:97.67 - - PAD.97 00 25' - 18" RCP @ 0.30°9A , t n I TYPE 'B' � TYPE A - +- I FF:96.97 v FF95.77 I ( TYPE `B' } 170' - 18" RCP @ 0.30°� a SD11-11 PAD:96.30 �- PAD:95.10 ' ! I i ui ,.+ I O FF:95.17 i 96.88 95.31 1 IOPAD:94.5 ' - 54" RCP -- I 95.34--96.29 93.46 m 1 y TYPE 'A' I i TYPE '8' TYPE 'A'- j N FF:46.97 u' rn M95.67 1 y ff:97.97 ( I I o N 0 r "t ° 127' - 54" RCP @ 0.30°/a PAD:97,30 ! I IPAD:96.301 PAD:95. ! a I SD6.1- 97.11 - 95i 54 � 95S4 96.49 -- 93.49 � i us env 1 m I a rn a+ TYP€ 'A' i " I I TYPE 4 TYPE 'A' I i M Ff:98.17 a I FF.97.47 y° Ff:95.97 1 d2 ! PAD:97.50 I z I 0 PAD:96.80 v� AD:95.301' - 18" RCP @ 0.30% TYPE PG 55 PEW 1 95.74 96.690--.,.- 93,78 Ff:95. 97.31 95.75 � fa FF:95.77 ! I I - I e I PAp:95.10 ro PAD9`. TYPE y AI FCm FF:98.37 PEA PAD:97.70 a ' ({ FENCE 1' F:97.47 F.95.97 u ! I I 220' - 18" RCP @ 0.30,- ! 97.51 -- 95.JSD11- 1 48' - 24" RCP @ 0.30% 38' 18"RCP@0.30•/O---- - -- ---- in °D ------------ / TYPE A' `--------- --- �./ 109�� 24' - 18" RCP @ 0.30% 93.92 r, FF:98.57 ( 95.76--- 9 I AD:97. 0 ( SD6-12 __ p6-11 0r SD6 3 208' 36" RCP @ 0.3G I 1 112 SS ' 97.69 96.190 o �,p 93.78 � 'Sp11-3 94.84 PAD.97.90 ! ( f y o 95.79 DESCRIPTION: LOT 4, BLOCK 26, ABBOTT SQUARE PHASE 2, SITE PLAN SEC. 4, TWP. 26 S, RNG 21 E. ACCORDING TO THE PLAT THEREOF, RECORDED IN PLAT BOOK 90, PASCO COUNTY, FLORIDA PAGES 28-33, OF THE PUBLIC RECORDS OF PASCO COUNTY, (NOT A SURVEY) FLORIDA Prepared for and Certified To: (ABBOTT SQUARE PHASE 2) Lennar Homes ALL ELEVATIONS REFERENCED TO NORTH AMERICAN VERTICAL DATUM OF 1988 (NAVD 88) 4> Scale: 1 " = 20' 1 I I e� LOTS LOT 13 iJ BLOCK 26 i q�p5� BLOCK 26 :O. N 88-08'23' W (P) 110.50' (P) 2 IPI PROPOSED v 1 STORY RESIDENCE m g a s a, PLAN 1450 30X6.0' o LOT 14 °' PA71O ELEV "B' _ "* a tN BLOCK 26 irl "� GARAGE R o 9.0' 1J N LOT 4 !^ 3.5X3 5 BLOCK 26 ,d 20.5' m •� !^. o F_ O C/S-A/C ENTRY 4.0' ^ 3' ¢¢ONC j 2 0 O 2 25.0' 7. o VT+�ALK 52.¢' v i LO `I ) V 122.5' /9q LOT 15 ; '8S/ N 88'08'23" W (P) 1 10.50' (P) qb\• BLOCK 26 LOT3 i BLOCK 26 a. I n w m 1 � 1 _ 1 o I 2 � I PCP 6 NOTES: LOT GRADING TYPE = A PROPOSED ELEVATIONS AND GRADING PROPOSED PAD ELEVATION=95.10SHOWN HEREON ARE TAKEN FORM THE ENGINEERING PLANS OF FRONT SET BACK = 20' 'ABBOTT SQUARE RESIDENTIAL', PREPARED SIDE SET BACK = 7.5' BY'WRA' PROVIDED BY CLIENT LOT = 4973 SO. FT. SIDE SET BACK (CORNER LOT) =10' LIVING AREA = 1448 $Q. FT. REAR SETBACK=15' ENTRY = 93 SQ. FT. GARAGE = 387 SO. FT. PROPOSED: + = 10.00' PUBLIC UTILITY EASEMENT COVERED LANAI = NZ_A SQ. FT. . FT. MINIMUM FLOOR ELEVATIONS: PATIO = 18 POOL AREA = NA SO. FT. LIVING AREA: 95.77' LEGEND: CONC. DRIVE = 328 Q. FT. GARAGE AREA: PROPOSED DRAINAGE FLOW A/C & CONIC PAD = 12 Q. FT. ELEVATIONS REFERENCED TO SIDEWALK = 49 SQ. FT. NORTH AMERICAN VERTICAL (00.00) = PROPOSED GRADE SIDE YARD SWALE = N/A SO. FT. DATUM OF 1988 E-00.00 = EXISTING GRADE CONSERVATION AREA = " SO. FT. LOT OCCUPIED = 47 % APPARENT FLOOD HAZARD ZONE: "X" COMMUNFFY NO. 120235 AREA TO IRRIGATE = 53 % SURVEY ABBREVATIONS IMAP NUMBER 12 10 1 C-0289-F) EFFECTIVE DATE: 09/26/2014 AI - ARC LENGTH ID) - DEED INV- INVERT PC - POINT OF CURVE (R) - RECORD LEGEND A/C - AIR CONDITIONER DE^ DRAINAGE EASEMENT LB -LICENSED BUISNESS PCC- POINT OF COMPOUND CURVE RNG^RANGE VINYL FENCE AF -ALUMINUM FENCE EL EL OR ELEV m ELEVATION LE ^LANDSCAPE EASEMENT PCP - PERMANENT CONTROL POINT RRS - RAIL ROAD SPIKE 5 r+,N. BFE- BASE FLOOD ELEVATION EDP MT-EAEOF PAVEMENT LFE-LENSED FLOOR ELEVATION PJE - POOL EQUIPMENT SEC - SECTION WAY BM -BENCHMARK ESM FENCECORN (MI=CEASUR SURVEYOR P-POINT SN&D -STION WOOD FENCE C"CURVE FC- FENCEC CONCRETE MES MEASURED PI^PARKER KINTERSECTION SNSp-SET NAIL AND DISK -ASPHALT ICI -CALCULATED FCM -FOUND CONCRETE MES - MITERED END SECTION PK -PARKER K PROPERTY U SIR - SET c - CENTERLINE CHAIN LINK FENCE CUT= CHAIN LINK FENCE MONUMENT NCF-NO CORNER FOUND R-PROPERTYLINE SIR- SETI/TIRONRARY ROD LBN Bi83 FIR -FOUND IRON PIPE OHW OVERALL POE- POINT OF BEGINNING TOM-TOPOF TEMPORARY NC'MARK `BRICK CMP- CORRUGATED METAL PIP FIR FOUND FOUND DNAILp OHW-OVERHEAD WIRDSI POC - POINT OF LINE CTMENT TOP-TOFOFBANK COL-CCLUMNONCR FNPD-FOUNDNNPIPE DISK O.R. -OFFICIAL RECORDS POL - POINT ON LINE TWP- TOWNSHIP ALUMINUM FENCE C/S C CONCRETE ESE FOP ^ FOUND OPEN PIPE PS FLAT B PRIM - PERMANENT REVERSE CURVE V E - IN11TY EASEMENT -COVERED _ C/5-CLEARSIGHT TB FPP- FOUND PINCHED PIPE PB - PLAT BOOK PRM- PERMANENT REFERENCE MONUMENT,VF- \\ CST >C SIGHT TRIANGLEVINYL FENCE JOB 158 512W4 SURVEYOR'S NOTES: SURVEYOR'S CERTIFICATE 1708 Water Oak Drive 1.) Current title information on the subject property had not been This certifies ereon describe Tarpon Springs, Florida Date of Site Plan: 5-24-23 furnished to Initial Point Land Surveying,LLC. at the time of this p property ac&AlutiifArjy 34#pgrvision and Ph, ne:(727)-831-1990 IN DWG:AS-PH2-L4-BL26-SITE SITE PLAN meets tt I 9 ''P actice for FlohdaPLS 712399mail.com 2.) This sketch was prepared without the benefit of a title search. survey s 8 d of Land LB# 8183 No instruments of record reflecting ownership, easements or un/ i C pte�fi"t' -� 1 pp,, R< vpa File: rights -of -way were furnished to the undersigned, unless otherwise r a Admir�t{{t ytf geed shown hereon. c on 471,6Z7,,� rtle Drawn by DUB 3,) Roads, walks, and other similar items shown hereon were take Stat s•i ''��99 ir Checked bylH from engineering plans and are subject to survey. O REVISIONS 4.) This SITE PLAN does not reflect nor determine ownership. T (E ?ate .O6.t? 6.) This SITE PLAN is subject to matters shown on the Plat of 1alt Q4'Qp' 4hL 'ABBOTT SQUARE PHASE 2' Jeff M H f (((yyyC e 6.) Dimensions shown hereon are in feet and decimal portions FLORIDA P I f i 40YOR AND Q thereof. MAPPER NO. LS �1nStlt9 83 74 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 nI= m Plan Model Elevation �50 -61 Garage Lot Size Block Lot Parcel #. 60o — Address: Cf� —2— o Setbacks: Front 015--Rear Sides 1 1) Elevation: Garage: 2,0 Roof Shingle Dime nsion/Architectural: 0 1- IN ')�e &JI 4 \/'A k Notice to Building Official of Use of Private Provider Effective January 20, 2003 Project Name: Parcel Tax ID: 04-26-21-0160-02600-0040 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: VIRTUAL REVIEW ASSIST, INC. Private Provider: 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 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; environmental or other codes. The, following attachments. are provided. as required: 1. Qualifeation statements ' and/or resumes of the private provider and all duly authorized representatives. 2., Proof of insurance for professional .and comprehensive liability in,the. amount of $1 million per o ccurrancD relating to all services perfoirned as a private provider, including tail coverage for a mhumum of 5 years subsequent to the performance of building code inspection services., Tmdividual Print Telephone 'leasense appropriate notary block STATF, OF FLORIDA COUNTY OF ALLSBOROUGH Individual B efore me, this -day Of 20— personally 5-ppearDd who executed the foregoing instrument, and, acknowledged before me that same was executed for the purposes therein expressed. Corporation LENNAR HOMES. LLC Print Corporation Name By: Print Name: Christopher Smith its: Authorized Agent Address: 700 NW 107th Ave Miami, FL 33172 Telephone, No,813-574-5700 Corporation Bf,foreme,thjs 22ND day of MAY 2OZ3 personally appeared, of Lennar Homes, LLC a -Corporation,, on behalf of the state corpoT afion, who executed the foregoing instrument and acluiowled . gDd before me that same was executed for the purposes therein expressed. Partnership Print Partnership Name In Print Name: its Address: Partnership Moremo,this day of 20— personally appeared p artner/agent an behalf of a partnership, who executed the foregoing instrument and acknowledged before me that same was executedfor the purposes therein expressed. Personally known X or- Produced identification Type of identificaition. produced Signature of Notar., PrintName ASHLEE CALLAHAN NotaryPublio Stamp: ASHLEE CALLAHAN comrfdssion Expires: MYCOMMISSION # HH 295980 EXPIRES: November 30 2026 Page 20f2 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 2,d Avenue Gainesville, FL 32601 Phone: 813-391-2959 Email: Lucy Qvirtualreviewassist.com _ Project: New SFR Address(s): 6640 BACK FORTY LP 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, AI,A2,A3,A4,A5,A6,A7, SNO, SNI, S3, S4,S5,S6,SS,ST, S I 1,S 12,WPI, PAI.0,PAI. 1, PAI.2,PAI.3,PAI.4, PA1.5,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 4: PX2300 \ /I 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 e oing is true d c rrect to the best of his/her knowledge or belief. 1 /VW Ashlee Callahan e ofNoNotary/ Print Name Notary Public: NOTARY STAMP BELOW My commission expires: CALU'\VAW M C PS"�F_E 144viv,2950 y mbef ZO, 2026 F_XPIRF-S, 111116 [—COMMERCIAL BUILDING SERVICES DIVISION RESIDENTIAL BUILDING PERMIT DATA SHEET MAMA= III] PRIALK9MINIMMINK91 or 1 .1 W.1111 DATE: 6/27/2023 EXAMINER: Debra Klahr PX230( Building 0 Ins pe tion Only Plumbing Ej Inspection OnL Mechanical 0 Ins ecfion Only_ Electrical Amp E❑I Ins eclion OnLy Roof [:1 Gas I I ❑ Medical Gas [:1 Fire Sprinklers El On Site Piping El Fire Line ❑ Irrigation M Fire Alarm [:] Potable Backflow Assembly El Fire Line Backflow Preventer ❑ Irrigation Backflow Assembly El Demolition El Walk-in Cooler El Refrigeration El Hood ❑ Ansul 0 Fence/Wall El Grease Trap El Other ❑ Other Rff ffiff T41M. TjTe Construction: Risk Category: Occupancy Load anc Classification: YC 8s OV,,,Fac 'Factory Residential Assembly Hazardous -Storage RDy Care/Educational Institutional E cantile Building Use: SINGLE FAMILY RESIDENCE Alteration 1❑—Level I Level 3 Level 2 1,6New Construction ❑ Interior Finish El Interior Remodel El Exterior Remodel ❑ Addition E] Revision Overall Size: 30 X 65 Number of Stories: 1 Total Sq. Ft.: 1928 Living Area: 1448 Covered Area: 480 # of Bedrooms: 3 # of Baths: 2 Cost per square foot: Estimated Value: Roof Type: 0 Shin le []Tile Ej Built-up 0 Metal El Other Squares: 22 Zoning: Wi orne Debris: [EDIIInside V-11, 0 u t s i d e Energy Code: 405-2022 SUP Flood Zone: X Base Flood Elevation: Finish Floor Elevation: Hydrostatic Vents? ryes „No ] —Sq. Ft. Enclosed Space Below BFE: # of Vents: Size of Vents: I Total Sq. In. Permanent Openings 9 Central A/C El Gas A/C ® Heat Pump F1 Gas Heat El Window A/C El Electric Heat re-NIMT3111=1 I. SanitaKy Sewer Storm Sewer Catch Basins Potable Water Underground Fire Line Front Rear Left Right As per Approved Site Plan Comments: