HomeMy WebLinkAbout23-6777Name: Lennar Homes, LLC
Address: 4301W Boy Scout Blvd Suite 60
Tampa, FL 33607
CONSTRUCT SINGLE FAMILY 2217 SQ FT
�~��� ^�� ��^�������0�~NN�� �~w�� ��w �.�'x—mo�mwwxww
6335 Eighth Street
Zoohvrhi|ls.FL33542
Phone�(813)7G8-O820
Permit Type: Building New (RvoidenhaV
Class of WomSFR Construct
Building Valuation: $320.84o.0O
Electrical Valuation: $4V.O88.O0
Mechanical Valuation: $23,444.80
Plumbing Valuation: $32.064.00
Total Valuation: $423.244.80
Total Fees: $28.75425
Amount Paid: $20.75425
Date Paid: 83G/2O23 10:21:03AM
6489 Back Forty Loop
Contractor: LENNARHOMES LLC
Public Safety Impact Fee -Police
$254l0 Plumbing Permit Fee
$200.32
Electrical Permit Fee
*280.48 Admin Fee / (Provider Service )
$180.00
Public Safety Impact Fe*-Admin
$28.35 Address Fee
$30.00
3/wWater Meter Fen(Ca|*
*794.92 Sewer Connection Residential Fee
$2.400.00
Irrigation 3/^Meter (Ca|c)
$794.82 School Impact Fee ' Single Family
$8.328.00
Driveway Fee
$45.00 Transportation Impact Fee
*3.595.68
T,ennponehvn |mpampee-City
$38.32 S|F 1 percent Fee
$88.28
Building Permit Fee
$1.643.20 Water Connection Residential Fee
$1.140.00
Mechanical Permit Fee
$152.22 Park Impact Fee ' Single Fami|y/Tvwnxomo
$769a6
REUNSPECTIOh/FEES: (c)With respect tmRmmspmctonfees will comply withFhorida Statute 55380(2)
local government shall impose mfee offour times the amount mfthe 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 aswater management, state agencies orfederal agencies.
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.
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED KSPECT104%
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received Phone Contact for Permitting [:9:0:8=770 __ 7763
Owner's Name CAL HEARTHSTONE LOT OPTION POOL 03 L P Owner Phone Number 813.574.5700
Owner's Address 1 23975 Park Sorrento, Ste. 220, Calabasas, CA 91302 Owner Phone Number
Fee Simple Titleholder Name I N/A I Owner Phone Number
Fee Simple Titleholder Address I
N/A
JOB ADDRESS 6489 Back Forty Loop LOT # 0510
SUBDIVISION Abbott Square PARCEL ID# 1 04-26-21-0160-00500-0100
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR 8 ADD/ALT SIGN DEMOLISH
P INSTALL REPAIR
PROPOSED USE u u SFR Q COMM OTHER
TYPE OF CONSTRUCTION BLOCK FRAME STEEL
DESCRIPTION OF WORK Single Family Residence / Pool / Screen Enclosure / Fence
BUILDING SIZE UJR SF 2672 7 SQ FOOTAGE 2217 HEIGHT 28'
BUILDING $ 320640VALUATION OF TOTAL CONSTRUCTION
' f 'ELECTRICAL $ 48096 ® PROGRESS ENERGY W.R.E.C.
AMP SERVICE
PLUMBING $ 32064
jMECHANICAL $ 22444.8 VALUATION OF MECHANICAL INSTALLATION
=GAS ROOFING Q SPECIALTY OTHER
FINISHED FLOOR ELEVATIONS I FLOOD ZONE AREA YES Do
V
�``� Lennar Homes, LLC
BUILDER COMPANY
SIGNATURE REGISTERED Y / N FEE CURREN I Y / N
Address 4301 W joy Scout Blvd Suite 600 Tampa, FL 33607 License # I CGC1518166
ELECTRICIAN COMPANY =Edmonson Electric, Inc.
SIGNATURE REGISTERED Y / N FEE CURREN I Y / N
Address License # f EC13005408
PLUMBER COMPANY Bayonet Plumbinq, Heating & AC, Inc
SIGNATURE REGISTERED Y / N_J FEE CURREN
Address License # I CFC042998
MECHANICAL COMPANY Bayonet Plumbing, Heating & AC, Inc
SIGNATURE®� REGISTERED Y / N FEE CURREN Y / N
Address License # GAC058062
OTHER COMPANY C Sterling Quality Roofing, Inc
SIGNATURE REGISTERED Y ! N FEE CURREN T Y / N
Address License # 1 CCC057991
IIIIIIIIIIIIIIIIIIII111111111/I/1//IIIIIIIII/IIIIIII11111/11/111111
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 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 (Plot/Survey/Footage)
Driveways -Not over Counter if on public roadways..needs ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may basubject to "deed" matrioUnna^
which may bemore 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 o non(raohu, or
contractors to undertake wmrk, they may be required to be |ivanoad in accordance with state and local regulations. If the
contractor is not licensed as required by |avv, both the owner and contractor may be cited fore 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 kmcontact the Pasco County Building Inspection Division —Licensing Section at727-847'
8009. Fuhharmon*, if the owner has hired a contractor or ooninactoro, 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 an the
oonbaoior, that may been 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 tothe construction ofnew buildings, change of
use in existing bui|dingn, or expansion of existing bui|dings, as specified in Pasco County Ordinance numbor80-07 and
90'07. as emended. The undersigned also underatonda, that such feos, as may be due, will be identified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Foan must be paid prior to
receiving a "certificate of occupancy" or final power release. If the project does not involve u certificate of occupancy or
final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco Counh/VVater/8ewer Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW (Chapter 71%.Florida Statutes, mmamnended): |fvaluation ofwork io$2.5O0.U0ormore, |
certify that |. the opp|ioant, 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 itVuthe ''mwner'prior Vocommencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT: | certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable laws regulating oonotnuotion, zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. | certify that no work or installation has
commenced prior to issuance of permit and that all work will be performed to meet standards ofall laws regulating
cunotruction. County and City oodeu, zoning regulations, and land development regulations in the jurisdiction. | also
certify that |understand that the regulations of other government agencies may apply to the intended wnrk, and that it is
myresponsibility hnidentify what actions | must take tnbeincompliance. Such agencies include but are not limited to:
- Department nfEnvironmental Protection -Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment.
- Southwest Florida VVu8er Management Oioirint-VVa||o, Cypress Bayheadn, Wetland Areae, Altering
Watercourses.
- Army Corps ofEnginaaro-SaawoUo.Docks, Navigable Waterways.
- Department of Health & Rehabilitative Semioos/Envirnnmental Health Unit-VVe||o, Wastewater Treatment,
Septic Tanks.
- USEnvironmental Protection Agency -Asbestos abatement.
- Federal Aviation Au(hnhb+Runvveye.
| understand that the following restrictions apply hothe use offill:
- Use nffill ionot allowed inFlood Zone ^\y'unless expressly permitted.
- If the fi|| 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 ofpermitting which is prepared by professional engineer
licensed bythe State ofFlorida.
- If the fill material is to be used in Hood Zone ^A^ in connection with n permitted building using stem wn||
construction, | certify that fill will be used only hnfill the area within the stem wall.
' If fill material is to be used in any area, | certify that use of such DU will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent proportioa, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots |ena than one (1)
acre which are elevated byfill, onengineered drainage plan iurequired.
If am the AGENT FOR THE OWNER, | promise in good faith to inform the owner ofthe permitting conditions set forth in
this affidavit prior to commencing construction. | understand that a oepaneVo permit may be required for o|oothoa| wnrk,
p|umbing, oiQne, vvaUn, poo|o, air oondi\ioning, gao, or other installations not npeoiDoe||y included in the application. A
permit issued shall be construed to be license to proceed with the work and not ooauthority Vnviolate, nonoe|, a|tor, 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 ioouono*, 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 roqueahyd, in writing, from the Building Official fora period not to exceed ninety (AU)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 fo- (or affirmed) before me this
7/10/2023 by Christopher Smith
Who is/are personally known to me or hasAiave pizodwi;94
as identification.
Notary Public
Commission q19Z
Stephanie Farmer
Name of Notary typed, printed or stamped
Subscribed and sworn to kv affirmed) before me this
Name of Notary typed, printed or stamped
Exempt D Yes ED No How Determined
'7-
Impact Fee Amount 3U�/- Zone No. TAZ:
SCHOOL IMPACT FEE
Account (056) Single -Family Detached House Amount $
(057) Mobile Home
(058) Other Residential
(123) Collection Fee
PARKS AND RECREATION FEE
Land Account Land Credit Land Total
Recreation Account - Recreation Credit Recreation Total
Zone Total Amount $_7�5k--
Exempt [::]Yes E] 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
Total Amount
Prepared By Checked BY
i.21ER.T.F.2.1` CCU1A.Y W.LLL I.SSUED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN PAID AND RECEIFTED FOR BY A CENTRAL PERMTTTING 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,
ME
RECEIPT NO DATE BY -0
DESCRIPTION: LOT 10, BLOCK 5, 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: (ABBOT SQUARE PHASE 2)
Lennar Homes
PROPOSED ELEVATIONS AND GRADING
SHOWN HEREON ARE TAKEN FORM THE
ENGINEERING PLANS OF
"ABBOTT SQUARE RESIDENTIAL", PREPARED
BY "WRA" PROVIDED BY CLIENT
Scale: 1 20'
9
PCPi
6
iLOT 9 V1
BLOCK 5
S 88'08*23" E (P) I
25.06- (P)
(P) 111
LUrt
CL 56.6' 3.5'X3.5, 272
LU
0-- C/S-VC 41.3'
'< 9 ct
225 0
2! PROPOSED 3' C 1
0
<ct 2 STORY RESIDENCE ENTRY Vi
LK l7 rr1 <
LOT 10 &0' PLAN 2216 4.7'
Cj O LU 't ., , ., ,
�u BLOCK 5 iz *1
0 3AX
U U� rn PATIO ELEV"B" 4
ILL GARAGE Ca UJ N l,- Q
ri)
Ux
6
rn 0
96
z LA
56.6' X
46.0' < z V
LA 22.
S 88*08'23"E (P) 125.06- P)
LOTH
BLOCK 5
cn
ALL ELEVATIONS REFERENCED
TO NORTH AMERICAN
VERTICAL DATUM OF 1988
(NAVD 88)
NOTES:
LOT GRADING TYPE = A
PROPOSED PAD ELEVATION =97. 10'
FRONT SET BACK = 20'
SIDE SET BACK = 75
SIDE SET BACK (CORNER LOT) = 10- LOT = 5628 SO. FT.
LIVING AREA = 930 SO. FT.
REAR SETBACK = 15' ENTRY = 26 SO. FT.
GARAGE = 414 SO. FT.
COVERED LANAI SO. FT.
PROPOSED: I 0.00'PUBLIC UTILITY EASEMENT PATIO = 19 SO, FT.
MINIMUM FLOOR ELEVATIONS: POOL AREA = NA SO. FT.
LIVING AREA: 97.77' LEGEND: CONC. DRIVE = 360 SO, FT.
GARAGE AREA: PROPOSED DRAINAGE FLOW A/C & CONC PAD = 12 SO. FT.
ELEVATIONS REFERENCED TO SIDEWALK = 28 SO. FT.
NORTH AMERICAN VERTICAL (00.00) = PROPOSED GRADE SIDE YARD SWALE =—NZA SO. FT.
DATUM OF 1988 E-00.00 = EXISTING GRADE CONSERVATION AREA =—NjA SO. FT.
LOT OCCUPIED = 32 %
APPARENT FLOOD HAZARD ZONE:"X" COMMUNITY NO. 120235 AREA TO IRRIGATE = 68 %
SURVEY ABBREVATIONS (MAP NUMBER 12101 C-0289-F) EFFECTIVE DATE: 09/26/2014
A) = ARC LENGTH (D) = DEED INV = INVERT PC = POINT OF CURVE (R) — RECORD LEGEND
A/C — AIR CONDITIONER D.E= DRAINAGE EASEMENT LB =UCENSED BUiSNESS PCC = POINT OF COMPOUND CURVE RNG = RANGE M7.; VINYL FENCE
AT = ALUMINUM FENCE EL OR ELEV = ELEVATION L.E = LANDSCAPE EASEMENT PCP = PERMANENT CONTROL POINT .5777 — CONC
BEE BASE FLOOD ELEVATION RRS = RAIL ROAD SPIKE 0 ------- 0—
EOP = EDGE OF PAVEMENT LEE = LOWEST FLOOR ELEVATION P/E POOL EQUIPMENT R/W = RIGHT OF WAY
BM = BENCH MARK ESM7 = EASEMENT LS = LICENSED SURVEYOR PG = PAGE SEC SECTION WOOD FENCE
C — CURVE F/C = FENCE CORNER (M) = MEASURED P1 = POINT OF INTERSECTION SN&D = SET NAIL AND DISK ASPHALT
(C) = CALCULATED " = CENTERLINE FCM = FOUND CONCRETE MIES = MITERED END SECTION PK =PARKER KALON L13#8183 CHAIN LINK FENCE
CUP = CHAIN LINK MONUMENT NCF = NO CORNER FOUND k = PROPERTY LINE SIR = SET 112- IRON ROD LB# 8183
FENCE F�P —FOUND IRON PIPE O/A = OVERALL POB = POINT OF BEGINNING LEM = TEMPORARY BENCH MARK BRICK X X
CMP = CORRUGATED METAL PIPf
COL = COLUMN FIR = FOUND IRON ROD OHW = OVERHEAD WIRE(S) POC = POINT OF COMMENCTMENT TOB = TOP OF BANK
CONC = CONCRETE FN&D = FOUND NAIL & DISK O.R. = OFFICIAL RECORDS POL = POINT ON LINE TWP = TOWNSHIP ALUMINUM FENCE
C/S = CONCRETE SLAB FOP = FOUND OPEN PIPE (P) = PLAT PRC = POINT OF REVERSE CURVE LLE = UTILITY EASEMENT = COVERED
CST = CLEAR SIGHT TRIANGLE EPP = FOUND PINCHED PIPE PB = PLAT BOOK PRM = PERMANENT REFERENCE MONUMEN VF = VINYL FENCE
JOB#15908520510 SURVEYOR'S NOTES: SURVEYOR'S CERTIFICATE 1708 Water Oak Drive SEE
Date of Site Plan: 6-24-23- 1.) Current title information on the subject property had not been This certifies that sketch of the hereon described Tarpon Springs, Florida Ps N
furnished to Initial Point Land Surveying, LLC. at the time of this property was N TWP Mt and Phone: (727)-831-1990 �RGPI'W RG E
SITE PLAN _% supervision a EZ
DWG:AS-PH2-L I O-BL5-SITE meets the C4# Le f Practice for FloridaPLS7123@gmaii.com Tw, " MP 15
�.
2.) This sketch was prepared without the benefit of a title search. It &I -and LB# 8183 aGWRGAE
No instruments of record reflecting ownership, easements or S i r
File: rights -of -way were furnished to the undersigned, unless otherwise J- 53, o ' aIX, fi I ey
shown hereon.
Drawn by: DJB — 3.) Roads, walks, and other similar items shown hereon were taker sgant ie c t I r, 14 CARtn7l 9. P9
Checked by:JH from engineering plans and are subject to survey. iey09:45:10
— REVISIONS 4.) This SITE PLAN does not reflect nor determine ownership. 0
5.) This SITE PLAN is subject to matters shown on the Plat of S STATE OF P,
"ABBOTT SQUARE PHASE 2"
I ill 171 e10111A N
6.) Dimensions shown hereon are in feet and decimal portions Jeff M.
thereof. FLORID R AND
7.) Contractor and owner are to verify all setbacks, building MAPPER NQ.1
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 001
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.
Plan Model Elevation
Garage
Lot Size
Block
Lot
q,5
Parcel #:--2�-2 �,- � -O;10
Address:
C
Setbacks: Front 5
Rear Sides —fL,
---2.-.5-
I
Elevation: Garage;
Roof Shingle Dimension/Architectural:
—A I N, �)e�4 0 �C,
Notice to Building Official of
Use of Private Provider
Effective January 20, 2003
Project Name: 6489 Back Forty Lo
Parcel Tax ID: 04-26-21-0160-00500-0100
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:
Address:
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 affa.ohments. 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 liability in.the. amount of $1 million per
occurrence relating to all services p,oTfoimed as a private provider, including tail coverage for. a Minimum
-a ptrform, of building code inspection services.
of 5 years subsequent the ance.
Individual qprporation Partnership
I . .
-(signature)
Print
Address
Telephone
Please use appropriate notary block.
STATE OF FLORIDA.
COUNTY OF. HILLSBOROUGH
Individual
day of
20®, personally
appeared
Who executed the foregoing instrument,
and acknowledged before me that same
was executed for the purposes therein
expressed.
LENNAR
CorpDration
B,,f,r,m,,thjs 22ND day of
MAY 20z:�3
personally appeared.
of
Lennar Homes, LL.Q
corporation, on
behalf of the State oorpoT ation, who
executed the foregoing instrument and
acimowkd*gDd before me that same was
executed far the purposes therein
PrintPartnershipNama
By:
(signature)
Print
Name:
Address:
Telephone
No.:
Partnership
tnership
B afore me, this day
of
personally appeared
p artner/agent on b elialf of
a partnership, who executedthe
foregoing instrument and
a6knowledged before me that same
was txtuuted for the purposes I therein
expressed.
Personally known .XAor_ Produced identification Type of ideiitiBcation produced
signature of Notax-v L PrintName ASHLEE CALLAHAN
NDtaiy Publio Stamp:
commission Expires�
IAY C0IMMHS$J0N'
!RES: No EXP v 30,Z 2"
Page 2 of 2
VR/\
VIRTUAL REVIEW ASSIST
Private Provider
Plan ComMliance Affidavit
Private Provider Firm: Virtual Review Assist, Inc.
Private Provider: Debra Anne Klahr, BU 1967
Address: 747 Southwest 211 Avenue
Gainesville, FL 32601
Phone: 813-391-2959
Email: Lucy@,&virtualreviewqssis , t.com
Project: New SFR
Address(s): 6489 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,A 1,A2,A3,A4,A4. LA5,A6,A6. 1,SNO,SNI,S3,S4,S5,S6,SS,ST,S I I,S 12,WP 1,
WP2,WP2.I,PAI.0,PAI.1, PAL2,PAL3,PAIA, 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 #: PX2300
Signature of Reviewer:
7
SWORN AND SUBSCRIBED befQfeme by Debra Anne Klahr
being personally known to me or having produced as identification
and who being fully sworn and cautioned, state that the
fo eg mg is true and)�orrect to the best of his/her knowledge or belief.
in Ashlee Callahan
'ig aiure of Notary Print Name
Notary Public: NOTARY STAMP BELOW My
commission expires:
a
ASHLEE CAL LAHAN
My COMMISSION # Mi 295080
EXPIRES: Novelliber 30,2026
10—il COMMERCIAL BUILDING SERVICES DIVISION 01"RESIDENTIAL
BUILDING PERMIT DATA SHEET
992am
I JIM% Im
� 17-VA' MAM L46 a6j'�41
FIRE MARSHAL #01 -
Required Permits
DATE: 7/22/2023
EXAMINER: Debra Klahr PX2304
Building
❑ lion On
Inspec I y
IV Plumbing
E I Inspection Only
Mechanical
E] Ins pe tion Only
Electrical _Amp
❑ inspection Only
Roof
0- Gas
❑ Medical Gas
❑ Fire Sprinklers
❑ On Site Piping
❑ Fire Line
E] Irrigation
Ej Fire Alarm
Ej Potable Backflow Assembly
❑ Fire Line Backflow Preventer
❑ Irrigation Backflow Assembly
El Demolition
El Walk-in Cooler
❑ Refrigeration
E] Hood
E] Ansul
El Fence/Wall
E] Grease Trap
El Other
El Other
M.-SHIT21-171M
Type Construction:
Risk Category:
I Occupancy Load
OVaney Classification:
Factory
Residential mi'l
--Assembly Ebusiness "Pay Care/Educational
Institutional ❑Mercantile
nStorage E=FJtility
Building Use: SINGLE FAMILY RESIDENCE 1 Alteration 1011"'Level I lu"Level 2 11:1 Level 3
New Construction El Interior Finish F-1 Interior Remodel ❑ Exterior Remodel El Addition ❑ Revision
Overall Size:
30 X 46
Number of Stories:
2
Total Sq. Ft.:
2672
Living Area: 2217
Covered Area: 455
# of Bedrooms: 5
# of Baths: 2.5
Cost per square foot:
Estimated Value:
Ro2fjy2e. Z Shingle
F�Tile E] Built-up 0 Metal El Other Squares: 18
Zoning:
Wi
orne Debris:
El'Inside Outside
Energy Code: 405-2022 SUP
Flood Zone: X
Base Flood Elevation:
Finish Floor Elevation:
Hydrostatic Vents? ['Yes Z,"',,No
I Sq. Ft. Enclosed Space Below BFE:
of Vents:
Size of Vents:
I Total Sq. In. Permanent Openings
R Central A/C
El Gas A/C
0 Heat Pump M Window A/C
0 Gas Heat El Electric Heat
On Site Pinine
Sanitag Sewer
Storm Sewer Catch Basins
Potable Water
Underground Fire Line
Setbacks
Front Rear Left Right
r7l As per Approved Site Plan
Comments: