HomeMy WebLinkAbout15-16807 ; CITY OF ZEPHYRHILLS
� " 5335-8TH STREET
(sis)�so-oozo 16807
BUILDING PERMIT
PERMIT INFORMATION . _ LOCATION INFORMATION
Permit Number: 16807 Address: 37506 LILLY BEA AVE LOT 156
Permit Type: RE-ROOF ZEPHYRHILLS, FL. ,
Class of Work: ROOF REPLACEMENT Township: Range: Book: ',
Proposed Use: MOBILE HOME SUBDIVISION Lot(s):156 Block: Section:
Square Feet: Subdivision: GRAND HORIZONS
Est.Value: Parcel Number: 34-25-21-0010-02800-1560
Improv. Cost: 8,950.00 � � OWNER INFORMATION
Date Issued: 12/07/2015 Name: FISCHER JAMES &JUDITH
Total Fees: 120.00 Address: 37506 LILLY BEA AVE LOT 156
Amount Paid: 120.00 ZEPHYRHILLS, FL. 33542
Date Paid: 12/07/2015 Phone:
Work Desc: REROOF METAL
CONTRACTOR S �" APPLICATION FEES
A.BA TLETT ROOFI G F T F RERO F RE DENT A 120.00
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� ' ` Ins ections Re uired ' �
DR IN ROO INSP
TAPE JOINTS ROOF INSP/
FINAL Z- �iZ�lJr/
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 such subsequent reinspection.
NOTICE: In addition to the requirements of this permit, there maybe additional restrictions applicable to this properly that
may be found in the public rec of this county, and there may be additional permits required from other governmental
ities ch as water management, state agencies or federal agencies.
"Warning to ow r: Your, ilure to record a notice of commencement may result in your paying twice for
improveme to your p perly. If you intend to obtain financing,consult with your lender or an attorney
before recording your notice of commencement."
Compl Plans,Spe ' �cations 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.
SIGNATURE PERMIT OFFI R
�EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER �
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City of Zephyrhills
BUILDING PLAN REVIEW CO1wIlU1ENTS
Cantractor/Horneowner:
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Date Received: � �-'��� s�
Site: ����� ���/��
Permit Type: � � /��C'-''
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Approved w/no comments:, `k Approved w/the below carnments: Cl Denied wlthe below comments: O
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This com�nent sheet sha1l be kept with the permit and/or plans. ��
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Kalvin S ' .--P `s Examiner Date Contractor and/or Homeowner
(Required when comments are present)
11/04/2615 10:51 72�8634273 ABC SUPPLY C� INC PAGE 04/25
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iviar�uuf�cturer. 'tiz�zo�as�oar�ug�#ing Company •
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Pxoduct I�ta�n�: Msste�cc�t:aib�'a,�e? � .
1?aa�ei pas�z�irpticnn: 36"wide coverage�vitl�314"hig1�ribs at 9"ci.c. � .
�at�a�: Minimum 29 ga., 80 ksi stee�. Galva��zed Goa�d steel�A�S�,A,653}
ar Gaivalum� coated steet (AS'� A,7��} or �simted stee� �,A,S�
A.755j, -
I �Tew Und�riayment: Minimum twdexlay��zt as pex ��C ?.U�7 �e�tiom 1507.4.5,1..
R�qu�zed�ox n�w cons�rruuciinn and optivn�l far reroo;�tng ccros�vctio�►.
��sting Underlayment: C}ne iayer of aspb►slt s?,u�es av�r a�ze laye�r o�`�f30 fe�#��'oa:�reroo�iag
(aFtianal3 coz�st�uct�iom o�y. � . .
Deck I)esari�t�az�: Matz�. x 5132" t�ic� A.�'.A.rate� plywoad or m�in.�a/," #hick wood�lank
. {z�aaa S� �f�.�2} �or ne�vv az�d existi�g const�ccti.ons. Desi�goed by
�ers�ac�i:qsta��cd as pca�FBC 2014. �
Sia,pe: 112:i2 or�r io accar�ance wi�FBC 2414 Sectior� 150'7.4.2 ,
D�ign U�1ift I�s�e: 45.�ps��fs�tener sgacin,�of 24"a.c.
� {,Eactoz o��a�ety�2} 113.i�sf a�f�s�eaer s�acing o£12"o.c. • ;
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�'an�l Aitac�t: #9-iS or#�0-�4 a� �.5"��g wr�od s�rew with washer .
I, At pane�euds �,ia 5.S"-3.5"-3.5"o,c.ac�ass�an��width
At ia'te�,x�:e�ia�e (r�9"o.c.�c�ss p�nel widt�.
5idete�Att�e�t: �14"•14�s 71$"lo��i�5 with washer a�,7 m�r.24"o.c.
Tesx�ta�da�ds: ka>�assembly t�sted iu accc�rdance w�.�UL580-9��CT��ft Res�st�ce
of �.00f Asse�nbli�°, LF,�,�$97-98 `Upli� ��si� f,or Roof �overing
�yste.ms'aar�d FM 447�1 Sectxox�5.5`Itesisfance tv Foot Traffic'.
Coc�e C�plianr�e: �`he�x+nduct ctescribed he�iu�b��s d�ntmstra�i+�ompliaace with FBC �
� 2{I�4�ecii�oaa 1507.4 .
�'roduct��imitations. Desi�wind loads sb�Xt be cietez�oa�izxed far each praje�t is�aecarc�ce
. witb FBC 2034 Section 16Q� ar A�CE'7-1.0 us�i�ag at�owabie stress
desig�t. Tlt� murirxnun fast,�nar spacivag 1,i�t�d btc�tei�a �a.'Ll �,ot be . �
�ceerted. 'I'rii��roduct x� uot appr�ve�t fvz vse i�a�te HCtgh Velocity
�uarxca�e Zane. Fii'� C�SSi�iC�tO]i is aot wi� sco�e o� t�is �
Bvaluatio� Iie�art. JE�e�ex to k�3C 2U�4 Sectirna 15t?S and cuurent �
. a�proved raafiag matea�iaf� dire�tozy oz� ,A,S'S� ��OS/UL79� r�ort
. ' , �rQm an accredited�ahoratory�iar�tre ra�gs o�'�is p�t�c�t. ' . 4
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, ' L ' ABC SUPPLY CO INC PAGE 0bf25
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C/O Richard Bartlett
38408 3rd Ave. � Zephyrhiils, FL 33542
(813) 782-5585 � (352) 523-1944 � (813) 973-7737
Lic. #CCC 1325499
One of the Largest, Oldest, Most Dependable Roofing Companies in Central Florida
Specializing in Mobile Home White Commercial Rubber, Shingles & Color Meta!Roofing
RESIDENT�AL • COMMERCIAL • MOBILE HOME
LICENSED - INSURED - BONDED
• MEMBER OF THE CHAMBER OF COMMERCE& BETTER BUS/NESS BUREAU •
Serving Zephyrhills, Dade City, Crystal Springs, Quail Hollow, Wesley Chapel, and Surrounding Areas. �
We have re-roofed or repaired more roofs(15,000)in the past 41 years, fhan the four local leading roofing companies combined.
We do not charge extra fees for credit card purchase.Most companies charge 3 to 5%.
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Date � `� �
Name � �� Z l s
Address 8 �
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Home Owner:
Richard C.Ba , t&0 er A.Bartlett Roofing of Central FL,Inc.
THANK YOU .
Your Business is Appreciated:
Payment upon completion unless previous arrangement made.Warranties pertain to original owner.
All arrangements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado and other necessary insurance.
Our workers are fully covered by Workmen's Compensation Insurance.Customer is liable for any charges incurred in collecting this bill.
Rotten wood is an extra$35.00 per sheet(4-ply).Rotten fascia is$2.00 per linear foot. TOt81 �� `�'
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� 2015154294
I B O A
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' �N �t��D � /�I/� Am..
ermit No. Parcel ID No O LJ �' "'�
N O J
B O'+
NOTICE OF COMMENCEMENT �/Q'�) N �
late o(���t�c.ti County o� 1'IICJ�C J � W
HE UNDERSIGNED hereby gives notice that improvement will be made lo certain real Droperty,and In accordance wilh Chapter 713,Florida Statules, �-~-1�
�e following in(ormation Is provided In Ihis Notice af Commencement: 3 �
Description ot Property: Farcel IdentifitaLon Na. ' � � O� S ; B"
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Street Address: � � �'�- d– "�– . ���
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Generol Descriptlon o!Improvement �
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Owner Informatlon or Lessee infortn lfon If lfie L�essee contraded(or�he improvement: �
� /-!J�G/'7�'e 1
�N e •
Address „ Clry State
� Interest in Property: �'�
Name of Fee Simple Sillehotder:
(If diNerent trom Owner listed above)
Address City � S1ale
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Contrector ' /
�Im�me���R.r �r o!1{Illf�i��� r�
ctl_Q_ ��ty S�a�a " �
Address cA/�"7 i�J'1 �{�Q� 33 sL.�'1
Conlractor's Telephone No.: �f I d d J u � La
Surety: �,
� Name ' �� � �
Cil S�ate O�D �
Address Telephone No.: � �
Y AAN � �, �
Ambunt of Bond: S �N o � e • �.
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Lender. �� � � ��
' Name • � �
Clly Slate N�m,,7 �m .� �a p� s �p„
Address o� , a oO
LendersTelephoneNo. . . �,,.�Nn`�•• � �
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I Persons within Ihe Stala of'Florida d'esignatad by lhe owner upon whom notices or other documenls may be servad as provided by 3 o':j� � � ' p�
• d�
i Seclion 713.13(1)(a)(7),Florida Slalules: ��� �•r,� • w ,' g,��
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fName F1��, ��
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, Cit Slate �r 3 t�y� � �
Address Y '� v "� � • �
I Telephone Number o1 Designaled Person: � p
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� In addition to h(mself,lhe owner des(gnales �++
i lo[eCelve e copy of lhe Llenor's Nalice as proviCed In Secllon 713:13(1f(b),Flarida Statutes. �
� Telephone Number of Person or Enliry Designated by Owner:
i
i i, Expirelion date ot Notice o(Commencement(the expiration date may riot be before the comptetlon of construction and finel payment lo the
cantractor,bul will be one year hom the dale of recording unless a different date is spadfied): W Y
WARNING TO OWNER: P;NY PAYMENTS MADE'BY TME OWNER AFTER THE EXRIRATION OF THE NOTICE OF COMMENGEMENT � z V � W
ARE CONSIDERED IMPROPER PAYMENTS UNDER'CHAPTER'71,3,�PART 1, SECTION 713.13 FLORIDA S7ATUTES, AND CAN W LL (n J
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENi`S TO YOUR.PROPERTY. A NOTIC� OF COMMENCEMENT MUST BE O �LL — J U
RECORDED AND POSTED ON THE JOB SITE�BEFORE��THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN'FINANCING,CONSULT U � � O= J �
WITH YOUR LENDER OR AN ATTORNEY HEFORE COMMENCING WORK OR RECORDING.YOUR NOTICE OF COMMENCEMENT CPj z U (� J�O
�
Under penalty of perJury,I declare lhaf I have read the foregoing nolice of commencemenl and lhal lhe facls sta[ad Iherein are lrue lo lhe best � (� � � Q N � W
of my knowled�and balieL – 1 � � _ �- W W � n- �
iTATE'OFFLORIDA �r,� C� � S z J �2
:OUNTY OF PASCO +6�Y,�`"RICHARD C.•BART�ETT G� �'C ' � �- � �- L� Q O
�� MY COt.A955iON N FF�1098 �y� � (pwner or Lessee,or Owners or Lessee's Aulhorized � = O O � �
�Lxi �R�����Y��•Z017 OK rlDir adPartner/Manager �
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� Tt���s rn Fs�� �
Signa ary' iUe/OKce/ W
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�h e f a r e g o i n g i n s t r umenlvias acknowledged before me this day o�,ZV�bY`-f�'� C � l.��L. w � � � (, ,
j as (lype o f u l�ri ty,e.g.,a e r,l r u s t e e,a tt a m e y i n f a c l)f o r � � � � Q O J
i I (name of p o halt menl was execuled).
O � CCL.L = Qw
Personelly Known O 93 Produced IdentNfcation�-- Notary Signa r J W G � � z
' Name Print � U U � ��^
Type of Identificalion Produced� l ���h�� � O � 0 � � �
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wpd atalbcslnoticecomm ence men I_p c05304 B
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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
' � Building Department
Date Received. -
, z ��f f � hone�Confact fo�:Permittin . . , . .
� . . , .�
Owner'a Name �� ( Ownar Phone Number �
� Owner's Address � ' Owner Phone Number
Fee Simple Tltleholder Name � � �Owner Phone Number � '
Fee Simple Titleholder Addresa k �
JOB ADDRESS LOT# �
SUBDIVISION � � PAFtCEL ID# ' �
(OBTAINED FROM P.ROPERTY TAX NOTICE)
WORK PROPOSED a ��NEW CONSTR '�' ' ADD/ALT [�`�� .SIGN`- `Q� ` Q� DEMOUSH
B. •INSTALL 8 REPAIR . �
PROPOSED>.USE Q � SFR. Q COMM " ' ' Q - •OTHER � '
TYPE OF CONSTRUCTION � .Q ` BLOCK' " 'Q FRi�ME Q � STEE " Q ` _
DE3CRIPTION OF WORK� ^
BUILDING SIZE' � � � SQ FOOTAGE;�; , .,.HEIGHTY��.. �
OBUILDIPVG $ VAL'UATION�.'OFr`TOTAL�CONSsI'RUCTION`�J ` "
QELECTRICAL $ ` AMP SERVICE �•'Q �•PROGRESS'ENERGY Q W.R.E:C.
' Q PLUMBING ?�$ - ����
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QMECHANICAC $• VALUATION OF:MECHANICAL INSTAL�AI'ION. . �(�Ci"
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QGAS ROOFII�G . SPECIALIY Q .- OTHER� , v lJ�' "
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', FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QY�S. ,NO
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BUILDER COMPANY� �' ' � � � � ' � � �
SIGNATURE REGISTERED Y/ N "'�FEE CURREK � ,Y'/N` ' '
Addr�sa - , � ; ;.. Ltcense�#:- : � .
ELECTRICIAN, . - �.'COMPANY� - ' .• .
SIGNATURE '' � REGISTERED Y/ N F�;cu�n=' � ` '�Y-/N' . `
Addre� � � _ _. _ .. • � _ , �.. _ . :Llcense: - � , . �
�. - # ,
PLUMBER ` COMPANY .. � _ - . ._.
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SIGNATURE�`` � _ i REGI3TERED, X_/•.N::. -_jFEE,CURrtEn., ;'; Y/-N..
Address � ' . :I.loense# . j -. ' ..,
, . . :�:t,�,
MECHANICAL: . ., - ' ..,COMPANY ' A.� ,
P.'z`r.r•.
SIGNATURE � " � ' ' � �� �IS7EBED, Y.l_N_ .�yFEECURREA. Y./N- • -
/�ddeess,` ��` ` �i ' ' . �.` ' y • � nse -
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a�:
OTHER _. ::;� , ';COMPANY,_ �,. .
SIGN�►TURE�'"'�." . - ' . ° ` ` " REGISTERED` ' Y/ s :.; FEE.CURRE�"� ' Y/N
���OS$ .:.r.,. '•:.� ' s,,'"� ._, � • �`:, ,. � - uC811S9#` , ' '
_ , � a , ._ � . . .. �.., .., . .,�. .,; , . _ _ .. . .., . ,
RESIDENTIAL�aq, ����Atta;cfi'(2�)4Plof�:P,lans;;(2)sets:'of+Building�Flans;``(1):s'ef'ofEnergy!Foirns;R-0=1NPerm,itfornew��nshuctfon,,,_ '
: AAlnimum ten e1A tworitin da , ` � -V T� ` " � �
. _�,,�;:�:,.,.;,, ,�;.,;(;_,��., . , ,g�,, ,ys>after;submiffal'date.,.Requlred�onsife,;:Construcdon-Rlans;StormaraferPlans�w/'SIItFenc;einstalled,
� Sanitary F,adlides;&,;1;dumpste�;Site•,Work;Per►nit forsubdiv.lsions/large:projects;.:�.. .��;,-� " ' ' • -' ,_ , ___
COMMERCIAL Attach(3)�oomplete-sets of�Builtling Plans plus alife S�afeqr�Page;(1)set of Energy Fortns.R O-W Pertntt for new.constructlon.
Minimum ten(10)working days'after submlttal date..Required onsite,ConsUucUon Plans,Stortnwater Plans w/Silt Fence Installed,
Sanitary.Fadlitles.&_] dumpster..Site Work Permit for all new�proJects�"All commercial..re�ulrements.must meet campilance -
SIGN PERMIT AttacFi(2)"sets�of�Englneered;Plans.:'.=:._:,_�: , _ -• - ' . � ' , . .
••'•PROPERTY SURVEY reguired for all;NEW construcUon. - . �
,.,�_ ,.. _ _ �- ;,:
Directlons: ;�:..�� . .. � . ,
FIII out appUcatlon completefy.
Owner 8 Contracbr sign back of applicaUon,nota�ized
If over a2500,.a;Notice,of,.Commencament la required. (AIC upgrades over 57500) . .�
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" Agent(for the conVaotor)'or Povtirer.of Altoriiey'(fordie:owner).woujd be�someone with notarized letter from owner authodzing same
r F ,-• _:1:, . ,..,..y.�" i 's� ;.?.�'ti_� : .'_ n.
DVER�THE COUNTER�P,ERMITTING ,-:�(Front�,of�Applicadon-Only)`-• ,;`y L
Reroofs if shingles' Sewers ` Service Upgrades,'pJC ',F.,ences(Plot/Survey/Footage) _
,:_. . .__ .. _. . ... .: ..,�• -:.. c_ .... �.. _ ,.,
.. .._ ...,,:, - .:�„.Q,,:::.:.„:';:z, , ._. , � :.. , . � , . ...
Drivewaya-Not over Counter if on pubifc roadways:.rieeds ROW �� '
, � . , , ,
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EED REST.RICTIONS:�The undersigned,;under�tands�;tl�t;this���rmi�.may,..b,e;subJect;�to;,;deed,,r,resUlctiorfs �:-
NOTi�E OF.D . , - -`�� �'-
t ^;' � k i �"' 1 A S �� ,"rt.r..?.' ..bv,A�+.,.
which may�.be;more�=r.esttictirre>thefn'�Cou%ity'�r�g"rilattons The::underslgned}`�ssume'slrespon�i�bllltyfor"c6mp11ance with:'any��°-
. � ' ?: ` �. L. .�
applicable�deed=resttictions. .:. ::..,::_:-.-.:��::�;�:�:;:>�..�:���- •. � --� . -.. _ .• _ . . : :�-• �_- ,� , .,. . ,
UNGCENSED-�CONTRAC.TORS ANb;CONTRACTOR�RESPON$IBILIT'IE�S: -=1fi°tlie owner'�has'��hired��a�conttactor or
coniractor's to undertake.work, the ma'ytb.e;reqi�i'r;ed�to:�be::licens'ed�ln��:accordance:with�ta�e:and,local-.re ulatlons:�=1f;;the;;�;°:_ • , ,
, Y,... _ .... �..�_�::: .. .::...:: _.9..-�: _. .:...... . -
contractor�i§'=not���ltcensed-'�s'requlced'tiy`law,�tiottf��the owner �nd=cont�actor4may-be;clted:for.°'a�irilsiiemeanor vlol�tion
under state law. If the owner or IMended�;cont,r,a�tur;ere;.un�ert�in es to what�Iicenaing,requlrementsti'may�epply,�for�"tiie�-�;,;�•,;_���:,
, t �,_.. ,.�,,:.
Intended�i�oNi, they are'adytsed to contact-the.Pasco County.Building,�Inspection��Dlvislon'-Ltcensing;Section at 727-847-
8008. Furthermore� tf the owner`has�Fiired e conUac'tor o�contractor`s, he Is advised to have the contractor(s),,sign.w _,,,
_ ^�it`+t3:'�'+.. y' + '."' `
portions of the�"contrector,:8lock".of.:thls�appilcatlon�f.or:.which,.they;wlll:.b.e-responsible.-..If.-you,.�as::the_owner"sign�'es'the°' �� �� �
. _.�,.� , �,
contractor; that�may�tie;an indlcatlon"that'iie`is nof:propeHy`Iicen"s"e'd"'and°`Is'i1'ot'entiNed"fo perniitting p�ileges In Pasco "
Counly. � . _ . w =:.:�,�.;;,.�t::- ..,�:_. _ ;.
TRANSPORTATION�IMPACTIUTILITIES�rMRA�`�ANb RESOUItCE R@COVERY FEES: The�undersigned understands �;
that'Pransportatlon Impact Fees,and.Reco.utse.Recove_ry._Fees may��applyzto:the:constructton.of new.buiidtngs,�change�'of_�:-���:�=-y��_�=�._ �'
use in exi$Hng buildings, or.�expar�si�r�ri�of��ezisti�r�',btiildings��as specifled.in Pasco County Ordinance number 89-07 and ;
90-07� as amended.,.:The-und,ersigned also:uriderstsnds; th�it`such fees;-as���may:�e:<due;.�ntOF�=belde,ntifled at theEtitrie'`;of;�y=�-�����>;�r`�.��; f
permitting. It is fu�tfier understood that Transportation Impact`Feea.and�:Resoucce.aReco�e"r•ji�"Fees.,must`be paid prior to ;
receEving a'certiflcate:of�occupancy"or��flnai�.power,-�elease: :If�the proJect�.Ydoes snot�Involve<a^ce�tificafe+of oc:cupancy�o��'�4��� ::.:,: .
final power:release�,tlie•fees tnus�t�tie paltl;p�lor�.to;permit Issuance. F.��t�ermore;=ff:Pascv,CountytlWater/Sewer3;lmpact,;�.-� �;�h,� ,
fees are due;_they_must_be�pald�;p�tor.�o„permit,l§s4�iqce:in..accordance�witl�;appllcatite.Pasco'�County�ordir�ances. � , ��
CONSTRUCTION"LIEN'LAYV�(Cheptar T13�Florlda_Statut�a�.as,amended): if valuadon of work is a2,500.00Eor=:more�.k�..:.,;:•::��-v::_.
certify that .I; -#he.�applicant;_•have..be.en=:provided;�with:-a=coQy��-of:;the��'Florida•�`�onstivction� U�n:'L'aw-�Homeoiivne�'s
Protection Gutde" prepared by tFie Flo�lda Deperfiner�t;of Agric.ultnre and ConsumerAffaics:. If the applicant Is someone�_.,,.;:,= •_;
other than the`ow�er", I certffjr��th�t l�t;i�ye�o�,ta)ne,dra��copy.of..the:abQva:rlescrlbed�locu�ent�and:p.romise�.in,good`,faHh..to ._ _ ��
.. ;,,_.�,_�.:.,...�.�.. ... ;� . . ,
,..� �...:_._ �;,-.�.�...: . -,< <..U;:.,_ ,. � , .
deliver It to::the:":.owner"piioe to�commencement: � -� ' - ��, ..- �
CONTRACTOR'SIOWNER'S AFFIDAVIT: I.ceitity.hth�at�all�_thg�.lnf.crmatltm:I�;thi���pplicatlon ts accurate.and that all work
wili'be done in compliance with all.appllcable'I`a`ws regulatlng construction� zoning and�°land��development. Application Is . •
hereby made=,to:obtain'..a;permit�:,Co..do�,�wofk;�,and�if�sfallatlon es indi�afed:�:�':I��certffy that no work�or• Installat(on has _
commenced p�lo� to Issuance of:a permit and that�all work will be pertormed�to meet..standards-•of all laws regulating�,
construction, County and City codes, �oning regulattans, and land development r.egulatlons�=ln'ttie`Jurisdlction._�I::ai'so
certify that I unde�stand that the regulatlons of a�ther�government agencies may�apply�to the.intended work, and that tt is ,
my responsibility to identity•what,acttons I must;take,;to befln>cotrlpliance,:,S..uch.agencles�include bufi-are.not Ilmited-.to:, �� �
. �.,,4,....�, t:._.. ,. ,�.,,..._,�,�t
- DepaRment`of E�1v(ronmental>�Pr+otectton=Cypr�ss.�6eyfiead�, V�ledend Areas and Environmentally Sensftive
Lands,WaterMlastewater Treatment. �
- Southwest FloNda Water Management':l�Istrict:Wells, Cypress.��Bey�ead�� Wetland , Areas� Altering `
Watercourses. !
I - Army Corps of Engineers=Seawalls�'Ddcks, Navigable Waterways. ,
- �.Department of:Health:�.8:-Relaabllitatiy,e..SarvlceslEnvtronm.ental Health�Unit-Well.s�:Wastewater�Treatment; � ;
Septic'Tanks. ' . �� • -� - . _ •
- US Environmental Protection Agency-Asbestos abatement..:. •
- Federel Aviatton�AuthoriL`y.;'Runuvays: ", � ""�
. 1 , yd'�,, . �
I u�Sderstahd.that the:.folloiiving:�est�lct�ons apply'to tfie use of fliL•�
- �Use of fill is not allowed in'Flo.o.d.Zone"V"unless expressly permitt�d. ,
- if'the :flll'mateNal=`is �to�be��used:-ln4;Flood�Zone. "A", it is understaod that�a dralnage plan addresstng a
"compensating volume" will be submltted at#ime of:permitting which ts prepared by a professtonal engineer - -
, ,.._.,,;. : .._. _
� Ilcensed by�the:.State�of Flofida:. � �� ��
� - If th� flll material°.ts`to:be,u�ed ir� Flood Zone "A" in�connectton•vulth:a•�ermltted builditlg using stem wall
'� ' construction, l certiry th.at:flll:�v�iJll:b.e-u'sed only#o iill the area within�the�stem tivall. -
- If flll material is to be used�in any�area;� l�-certlfy that .use of�such 811 wlll not adversely affect adJacent
properties. If use of..flll Is.,found,to.-.adver.s�ly.�f�ect edJaeent��pra�perties,.the owner may be cited for violating. '
the-co�di#lons�.of the_building�.permtt-Issued=under tha�at�acfied�permit appUcation� for lots�.less�-than:one (1)
'� acre which ere elevated�by illl; a�,engineered dralnage�plan Is�equired. • •
, If I am the AGENT�FOR.THE OWNER;.;I,promise In good.faith to Inforfn the�owner of��the permltting condRlons set torth In
this aifidadlt`prtor to commencing coristruction. �I unde[stand thet.a-separate permlt may be requlred for elecMcal'.work, . ,
:.�Y �: �„ . ..
I plumbing, signs� wells,:pools;. air.condltiontng,-.geis,.ro��.othe� Install�tlons nol.spec�laally included-in.the��pplicat(on. .A , _
i permit Issued"shall be construed to be��a�`li�ense'�to��pi�oceed wlth tFie wo�k and not�as.:authoNty:to,vlolate,'cancel;�alter� or '
I set aside any'provislons of�the.teclinical..code�;�nor shall issuance�of a.permlt.pcevent the Bulldirig Official from thereafter..
� requiring a-correction_af errors ln•plans;-conshuction.or.'violations of any codes. :Every p�ermtt;lssued>sfiail become°invalld �
'I unless the�work�author(zed.by such.permit:�is:;cor�menced�within „sfx.w.m,onths of�permit Issuance�.or af work.authorized by
the permit is:suspended�or,,,aba ;for�a:petiod:,of-six��)<montti�.;affe�;the tlrne the�work=ts�commenceit. .:An.extension
may be requested.,ln writin� ,_. o tFie.�Bullding.Official for a perlod��nof to_exceed��ntnety.�(90)�days a�d�wlll�,demon�trate
Justifiable cause tor:ihe ensio . if wock ceases�for ninety.{90)cons.ecutive:day.s,..t. �� �ts considered abandoned:`
WARNING TO O ER: �Y UR..FAILIJRE..TC3.R�EC.ORD.A;(�OTI F:�C M ` �EMENT�:AAAY°RESULT IN��YOUR�
PAYING TWICE: OR= F : ,.OVEMEI�S�Tfl_YOUR.+PROPERtY:2i1 ;.YO. � . , `�bBTA1N�FiN�wE1N,Cs;'CONSULT. '
_w�..T�l_Y_OUR LE D A11��A,TTOR �0'.�i�� ,JR�1 :i p '� �' � ' -�� --- - -— -- - '
FLORIDA JURA�,(F: •. .0 - . . - ' . : .. -
OWNER OR A08NT C�NTRAC �
I Subsaibed and r re me thls Subecrlbed'a ' •to(ot�a et��b�fore me'tlii&. , ,
, , y... . -
IMiols/arep o y,knovm e.or,haaA�eve.p,r!oduced , Who.is/are onallykno •.to.me:ocftaslhave•produced • •
asldentlBcatlon. • esldentlflcaUon. � I
Nota Publlc . � � •�'� � Nota Public
ry ry
ti,,,, - ' ,,•••�::'i;�., JACQUELINE BOG �
Commis�lon No: Commis o . o. : .�= �
':,; ,;; Expires December 12,2018 • I
.,.�.
Name o►Notary typed,printed ar stamped Name of Notary' " � ',
I �