HomeMy WebLinkAbout16-17415 I ' I
CITY OF ZEPHYRHILLS '
5335-8TH STREET �
' (813)780-0020 17415 �
�rJ � BUILDING PERMIT -� �
i
�.=" �PERMIT INFORMATION � LOCATION INFORMATION - �
Permit Number: 17415 Address: 6300 BRENTWOOD DR � ;
Perm,'t Type: ADDITION/ALTERATION ZEPHYRHILLS, FL. �'�
Class of Work: 434-ADD/ALT RESIDENTIAL Township: Range: Book: �
Propos�d Use: NOT APPLICABLE Lot(s): Block: Section: �
;Squa��e Feet: • Subdivision: SILVER OAKS
Est. Value: Parcel Number: 03-26-21-0120-00000-0930 '
Impro�v. Cost: 78,200.00 ' OWNER-INFORMATION
� Date issued: 6/09/2016 Name: DENSLOW, RICHARD
Tot�l Fees: 835.00 Address: 2950 NEWMARKET PL
Amount Paid: 835.00 BELLINGHAM WA 98226-3872 '
Date Paid: ' 6/09/2016 • Phone: (678)642-2327 ;
Wo�k Desc: CONSl'RUCT FOR 2ND FLOOR IN RV GARAGE 14.4 X 64.8 SQ FT LIVABLE SPACE
� CONTRACTOR S APPLICATION FEES
SUNSCAPE BUILDERS INC BUILDING FEE 535.00 1
MARTIf� ELECTRIC ELECTRICAL FEE 90.00 j
PLUMBI�IG UNLIMITED OF FL LLC PLUMBING FEE 97.50 ;
AIR CONDITION SOLUTIONS INC MECHANICAL FEE 112.50 I
I
� �
� . ' i
d�,� � � �
� .� '
, ,� �
� �
' I • � Ins ections Re uired ' '
FOOTER II 2ND ROUGH PLUMB ISC INSULATION CEIL NG I
FOOTER BOND DUCTS INSULATED SEWER MISC. �
ROUGH ELECTRIC LINTEL MISC MISC. i
1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE-SLAB SHEATHING MISC. MISC. I
CONSTRUCTION POLE FRAME MISC. MISC. ;
REINS�ECTION 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
�I 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 property that
may be found in the public records of this county, and there may be additional permits 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 properly. If you intend to obtain financing,consult with your lender or an attorney;
� before recording your notice of commencement." i
Compl�ete Plans,Specifications 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. �
� �
� �
� �� �
� /
CONTRACT - ATURE PERMIT OFFI R �
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
, CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
� PROTECT CARD FROM WEATHER �
�
i
I IIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII
2016090189
�
i
Permit No. Parcel ID No 03-26-21-0120-00000-0930
NOTICE OF COMMENCEMEN7 �
State oi FLORIDA Counry ot PASCO
THE UNDERSIGNED hereby gives notice thal(mprovement will he made lo certain real property,and in accordance with Chapter 713,Florida Statutes,
the following information is provided in this Notice of Cammencement:
1 Description of Properry: Parcel Identification No. 03-26-21-0120-00000-0930
I : si le�nddress: 6300 Brentwood Drive,Zephyrhills,FL 33542
2. �e i eral Desaiption af Improvement addition of 2nd floor loft within existinq RV qaraqe
� 3. I er Information or Lessee informatfon if the Lessee conlraded for Ihe improvement:
�Richard L Denslow
I 6300 BrentwoodPbrive Zephyrhills FL
Address Ciry State
lnteresl in Praperty: OW�e�
Nal e of Fee Simple Titleholder.
Ipf diflerent from Owner listed above)
Adtlress City State
a.�co�traccor. Sunscape Builders,Inc
15818 U�a�1 Dade City FL
Address City State
ConVactors Telephone No.: 352-279-3168
5. Sirety:
Name
Address City State '
Amount of Bond: 5 Telephone No..
8. Lelnder.
IName a � W Y
'I Address City Stale � w � � � ;W
Le�nders Telephone No. �z ? O � �J }
J
7 P Irsons vrithln the State of Florida designated by the owner upon wfiom notices or other documents may be served as provided by Q� � � J N � ��
S iction 713.13(1)(a)(7),Florida Statutes: �W� � (Q a ,a
W w
� Z ��
Nime �� I— p �L � Y
A�tldress City Stale �� Q � � V
Telephone Number of Dasignaled Person: �g— } U �
I o�-- o- � v
8. InI addition to himself,lhe owner designates af_ (� Q O p �
to receive a copy of the Lfenor's Nolice as provided in Sec6on 713.13(1)(b),Florida Statutes. S� � � Q J
Telephone Number of Person or Entity Designated by Ommer. ��- U m p � V
9. ESmiration date of Notice of Commencement(the expiration date may not be before the complelion of construdion and flnal payment lo the �� � a Q � w
contrador,but will be one year from the date of recording unless a diHerent date is specified): � LU Q p } p Z
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE FJ(PIRATION OF THE NOTICE OF COMMENCEMENT U U � � O
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART i, SECTION 713.13, FLORIDA STATUTES, AND CAN �- � p �
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERIY. A NOTICE OF COMMENCEMENT MUS7 BE � I— z W � (n
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT ,�,�, � .['J Q
Vy1TH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT J
Ulnder penalty of perjury,I dedare that I have read the foregoing notice of commencement and that the fads stated iherein are true to the best �_ � Z = �}
o(my knowledge and behef. /� �F � � � m
STATE OFIFLORIDA .N�
COUNTY OF PASCO L��
gnalure o er or Lessee,or Owners or Lessee's Authorized � � � ,
Oficer/Director/PaMerlM anager
�`�� •�
Signatory's Title/Office �v � , �d�
�e(oregoing insWment was aGcnowledged before me this�Q_day of�,20�by Q:CSfY'.d c� l7!v�S�.OW .4 n y ���\' � e `'�
N+
� � as (type of euthoriry,e.g.,officer,tnistee,attomey in tad)for � � � . O
� � of party on be om instrument was executed). f , �
� �"• � . �
\d\tylKnovm�0�Produced Idenfification� Notary Signah re � � ,� • y
`ent�cation Produced C�11��Q�/��',L 1rV�i Name(Print) (�v�� l� �� �
_ ���,y �
��9 ITeC0.00.00 CATHY CHARLTON '7!� ° • �
� J. R., Dply Clerk NOTARYPUBLIC �� � ,
5TATE OF FLORIDA �
, CanmN FF083069
,Ph D PASCO CLERK 4 COMPTROLIER Expires?J21/2018 �
0 48am 1 f 1 �
�380 P� 656
1 __..__ - - -- - ----
. �
.����
� .34�
's�.ry il�
City of Zephyrhills
, BUILDING PLAN REVIEW COMMENTS
.
Contra¢tor/Homeowner: v��`��" ��c I d��Ys �C-
�
' ' Date Received: S l� -� �6 ,
Site: � �j(�� �J�''L�(�� ��-� ,
� , � � _��� 6�
Pemut ype: 2 �� �L -�� /-�l.
Approved w/no comments:❑ Approved w/the below comments: � I�enied w/the below comments: �
� �,�e�t
oo� , V� i f��/
'n / � I
� �"r�� 10��/v� �r i l�u. 5 7�����1�1�`�'Axj
, I II
� , �
I
,
� I
�
I
1 1 I
I i
This comment sheet shall be kept with the permit and/or plans. ' '
�
I � �d � �� ' ` G ! �
Kalvin�Switzer ans Examiner Date Contractor an or Homeowner
� (Required when comments are present)
i '
�
i
i
I Q I
�
�A� - I
, I � I
. :�.:
�
City�of Zephyrlulls �
� BUILDING PLAN REVIEW COIVT�ENTS I
� ���� �j�l����--s ����. �
Con� actor/Homeowner:
�
Date Received: ��c �--� !�
Site:1 . �j �j�� �}�'1,T"���� �E�.
PerinitType: � �� �� � /%t Y,�� � ���� �T" �
,
Approved w/no comments:❑ Approved w/the below comments: � Denied w/the below comments: O
�
�o�� ���1�1�-� l"V�� ��� S/7-� '
. i
d��,� ��lU�, �»-, �. 5��������
� �
i `- \ �
-�C..w ` i ��.•, y �tc�G_ To �S��1�'Z _ �C�5 �C'� rl c �i�" �l 2 r w�a. I
1� �t �+cC�o. S�s`r�..� �,n:� � � � �✓1 � w:�c� 1U ly w �n�o.�- s�-�.pS . �
� `
-�a.��ln♦ � Z Oh,Q� CJeS w�' S c..n.� ���.? �•�C.� v�0 r� 1rQ��+ L�
1 �.-� � �3T.�',� '
J
_ i
i
�
, �
This!comment sheet shall be kept with ti�e pennit and/or plans: ;
, .
� �
�-a� �� .
Kalvin Switz�r ans Examiner Date Contractor andlor Homeowner
(Required when comments are present)
- � '
� , �
-_l�- _-- --- --- - ---- -- - - - -----_- _----- -------- -- - -.--- - - - _-
' 'i
i -
�n____, ____�_ .�.��..___�.a_., . _., SUNSCAPEBU/LDEl3S/NC.
� � 158180.5 NwY301
� � . � DadeCi4�fl 3�523;
� � Ph,352.52318811
I SllI1SC�1?c + cec��seo9o,'
' 3l,liL���S' � www.sunscap�bui/de�com�
I N C:O R P O R A T E_D� ;
'May 4,� 2016 �
�
. City of Zephyrhills '
Building Department
Please be advised that I, Roderick P Cameron, President of Sunscape Builders, Inc. hereby grant �
permission for ]ames R Cameron, Vice President to submit and collect permits and supporting ;
docu �entation on my behalf. Please contact me with any questions regarding this notice. '
Sincerely,
Roderick P Cameron
�
Signature '
�
I
, , ,
Notary signa re
�``� ' MEl1SSA�.CUMMINGS
; ''��'�'�.,�";- MY CAM6t�NS!U;���FF 234956
;
EXPIRES•,���::�?�),2019
�� Bondad Thm Notnrr'r 'r.��c Undenrtiters
Notar� Stamp ' �'A���' ,
Personally known or produced ID � ��
Nota ,ry date �� \ l"� � � � (�
�
� �
� �
�
I
I
�
I
. . i - � �
t ' �
I ;
813aeo-oozo City of Zephyrhilis Permit Application Fax 613-7aaoo2�
�
f Build�ng Deparkment ' '
�
Da#e Recelved .�'�r�,(���� - Fhoe�e-Contact for Permittin <_ - � �
4wner'a Name /�F c�a.c�- �tWtS�c��..1 Owner Phot►s Number �7$ " �''�Z"2 3 2?
Owner`s Address �.,03�d ��¢r�Pu.r�cac�.. �C': � rk1�5 S"'Y'LOwner Phone Number �— �
Fee 3lmple TI eholder Name �� - � `Owner Phone Number '�— �
' �, ,� ,�.__
Fee Simple TII eholde,r Addr,ess °'
JQS�I,GDRES3 �O 3 OGl 3rQ,�.��,.,�r,Z, +."7r. �+y�ti1:��g,� I�G-� 3�J y Z LOT# C� {
« , �
suso�visiob. S:t�cr c�.�.3- P�w�,O PARCEI.ID# C�3-�40-21-o��e,�.-avc,00 - d g,�c.� . �
� . (OBTAINED FROM PROPERTYTAX NOTICE)� i
WORK PROROSgD '^NEW CONSTR •." - ADDiALT [`�' " SIGN" Q Q DEMOLiSH i
• e� • INSTALL � ;, REPAIR . - i
PRQPQSED�USf Q SFR � `[� COMM'� � OTHER ;
TYPE OF CO�ST.RUCTION��� Q � BLOCK � FRAME C� STEEL `Q �
DESGRIPTIQ�N OF WORK ��� x^�E�d�r' �oF� I.v� c�o�, :r.s; ' i
I - , �R.. QX�s�'iv► 2 V d' QI(i��,CaS: i
I + N t r� - r j! M ya i ++�"�, Qxe�y�i
BUILDING SIZE ° �y y K �'y � SQFOOTAGE ./O�''4 HEIGHT.. f� u S c� � �
;� , , e�ryc�.� I
QBCiI�DING $ VALUATION UF TOTAL CONSTRUG710N �
� �$.o�d .�� . ;
r � � . _ . .
�
QELECTRiCAi: � � AMP SERVICE Z� ' n PRt3GRESS ENERGY Q W.Ft.E.C. ;
'�/7UCa;' WGa��My avru�e_._. ;
' ...1
QPi:UMBING $ ^� .
5��� � ,
MECHANICA� V,+�l "� ��
� i � UATlON CiF MECHANIGAI INSTAILATIfJN `��� t��
�
��� . [� aooF�s�� 0 s�Eci�.rr-� o�E�. ; �
;
FINISMED F400R ELEVATIONS FLOOD ZONE AREA QYES (I�D
St,7�%,��'i.ti .
� r , ;
!
BUtLDER " �3,� �COMPANY �•.�+►s �,, �v�l:a.e,r ,3.�rfi,,,, �
SIGNATURE ReGISTEtte� Y/ N FEE CURREK Y/N !
i • � �
Addre$ �S'`$I S6 J� 301 ,'�,,o.G: .r1-�3��3 . � L"icense# C,BG. /2�"804�0 � �
II , � " I
ELECTRiCU�I OMPANY =� �c�c`�+%� +�le.c,�'r:t,;. ,i,,�. �
SIGNATURE i' ^ REGISTERED Y/ N FEE CURRE� 'Y/N I
.o. �� `�3�� � .� , �
Addres� X . ct�,.. �-L 33 2�.P- , , ` _ucense#.; s��t 3 t���3 g 3 � 'd�°
PLIIMBER —' OMP<ANY • • ��. �i w �2 "`�i
,�' � � � 4 .� .tr. v�t*►„:��. o�'r �{nr'.c�e.. Ll.�., �
SIGNAI'URE � _ REGIS7ERED Y L:, FEE,cuwten. - Y/N ;
, -. , ., f
O 2 �O
Addre� Y N� r3 � cs7 r��o r � ucense#� �F�. -�5"7cS'/� __�, �i
` , �����
MECHANtCAI. ��LIMPAMY: , (Y�{y r �
'SIGN R � � .` y ' ,
ATU E� � "�" ._ ftEG18TEREp 4' .`�.{ FEE RRE� Y/N .
��ldr�� o'�$�'.� � ;� Pr� L(cense# C�+►�iGl�y�� ��
I . . . �.
OTH�R �I � , • ,. CQMPANY.; :� � �
SIGNATUREi�'� " ' �- � ' `' �' ` REGI57ERED Y/ N__. ,FEE.CURRE� Y/N . , �
Addrs� -- - -� - � , �� Ltcense# �
� ;
, a .,. :.. . .: =�,. - , . ..
� -
•,. � .---� ,.. ,;-.•�-: � - ,; ,_
_... :. .
- RESI0ENT1 `'; `r SAttach(2};Rtot�.Ptans;..(2},;sets�of�Bu[!i!i'ng"Plans;?(1}''sei of Energy�Forms;`R=0-W`Permit fornew i�nstn»cfion, ,�.`��
Mlnimum�ten;(,1,p)�,working days;after�sub'inittal:date:::Rqiqulred.ansite;ConstrticNon=Plans;Stormwater'Plans w/Siit Fence fnskalled,
�'. '�Sanitary Eac{i4tiess&=1:=clumpster�,Slte'.Watfc;Permit<for-�sutidiVistonsAarge>prbJects �•� � - _
i . ��...�.3�x._,: > �
COMMERC i Attach(3)'oomplete�seb'"ofBuittling£Plans�plus a life 9afety Page;'(1�)set of Energy Fotms.R-C3-W Permit for new:canstreicHan. i
Minimum ten(10),warking days after submit�l date. Requfred onsite,ConsWctlon Plans,Stormwater Plans w/Sflt Fence insfalled,
, Sanitary Facliltles�1 dumpster.Site Vltark Perinit for ai!new'prnjects:Ati�commerclat�equicements must meet comp!lance
StGN'PERM�T At#acti"(2)'sets of Engineered•Plans.:;�m4:,:;,._.'�- ",<�:. � , , • ' . -
"'"`PROPERTY SUR1/EY reguired for all,IVEW,construction.
i -
Directions: j • .. � - .. . , .
Fill out applicatlon completely.
thvnsr�Cantrac�r s�gn back of appllcaUon.notariz�i
if ovar$a2500,a Notice,af.Commencement i$requirad. (A/C upgrades over 57900)
,�,;:.u,.�.�i':: ,
'• Agent{for the�coritiaotor)'or'Pdsnier`ofiAttomey(for#tie�owner}would be�sameone wifh�notarized letter from awner authorizing same
I
D,V.ER THE�OUNTER.P.ERMIT7ING�-�--• (Front of�Apptication�Oniy)��
Reroofs if shingies Sewers� Service Upgrades A/C Fences(i'lot/Survey/Footage),...,,,;,,
- - ..,. _ireP�C,,.. , . .
i _U.. .-.. �__ _ ,.-.. .,-. . , -
privevrays-Not over Counter if on public roadways..needs ROW ' ';"-��j:�`' ' ' } ,„ ' ,
;;C,�: ,'. .i°. ��z.. . ' ,
. •Yt ��,;e,:) t, � '_ '
I �,.� , . .._�.- , , • " '
I
NQTiCE O�DEED RES.TR1CT10�lS: The ander�lgned:-understands°:th�t,,this.,��ttnit;may be.:sub�ecfi.,t�r"deed",rastric#io�s":';`v,�v.., . , �
, .. .. - . . .. .,.m, .... . ,.. .. -n � :.�_.. :... ;
whtch may be-more-resttiathre�llia�n Cdunty�teg�ilations :Thetiunder`slgned;as'siimes�responslbiltty,far comipliance""�witFi'"any
appilcable'd�ed restrlctions. � - � . ' ., , N �f –..
UNl.10ENSED-C.tJNTRAiCTQRS=Att;lDr�CClNTRAGTOR:�RESPONSIBi�ITT1ES:=�{f�tiie�owner has�•hiced=�a-contt�actar or
contractors to undertake work,�they r�ay.b,e.�..r.�qu'Ired;+to��e<Itcensed in:a�cacdanc�:with,s't,ate;:and�lacal,regulatians._;alf�the��,r x �- � �
� ,..�:�.. -,<
contractor €s�riot�licettsecf::as��requi�ed"6y taVv; tiotfi-:the.awne'r aii���con�ractor-may tie ct#ed=for=a=misi�eme�noc violatlon
under state law. if the owner ar.intended{contractor,���are,uncertaln as to what llcensing.requi�e�nents.;may�:apply-�for"the����;•= �t=� �,
intended wark;they are advfsed to coritact the Paaco Caanty 8ullding I�tspectlon�;Divlslon-1,Icensing;�ec#!on at 727=847-
. _. . � .� �.,�.._ .
3009. �u�tti�ermore, tfi ttte�owner has"filriad�a�con`#'racto�br"coritrectbrs� he is aduised to have tiie contracto,r(s}t�sign _. , .
�ortians of the_"cantracto� Block° of..this application for.,which they,.,.will be reaponslble:. :If�you���as�the own`e�sign�as'tNe ``''-�';`�==''?�
;,ontractor, tt�at may'be�n ind�ca�on•ttief�he is`not ptop�riy-licensed'arid��ls ricit�ent�ieii'�o�petmifting piiull�ages ln Pasco
Couniy. _ ' ' ...�. ....:.... .... . . .. .�,: �
1'RANSPORTATION.lMPACTlU71lITI�S�CMpAGT?�A�1b�REg�?URCE RECQVEE�Y�FEES:���'h8 unde7slgned untlerstands
that Tr�r�sportation Impacf Fees:�nd.Recourse:Recave.ry.�ee�may{�ppiy.�to�.fF�e iconstnac#ion,of,newzbuiidings,?change°of`=� W:=�'=,='r ' :
use in existing buildings,`�r�expanst�in,ofae�Istf��g;�Ybuildings, as spealfied.in Pasco Counfy Ordinance number 89-07 and
9o-O7, as amended,,_T��-underslgned also,��nderstands; th�E�such fees;-;as;-�may��e�dtte,3-wltE�:be id'entified at the'tlme�of:- ';�~.,:',`- `
permitting. It is tu'rtlier understood that Tra�gporkatlon.Impact°Fees and�'Resoucce__Recovery��Fees:.r�us# be pald prtar to
regelving a °certiflcate-of�aecupancy°.or flnaF-power..:release.= :lfi�.Elis proj�cE;�does;noE involve,zarcerti�cafe.:of o�xttpan�'+a��=�:`.�:-'�-�.,
iinat powerrelease;=#he>:fees-n�u�t�-be paid`pcior�#o permit tssuance. F�i�tkNer•more;-�ff�Pasco,Countq�llVaterlSewer�lmpact�-..-:-; �� �
Fees are due,.:they.�riust:be;paidwphor,ko.permit�Issyance�In.acca�rdance.wltF�appliaatile--Pasco��Countyr�ordlitances,
C�N�TRUCTION�:IEN°1�AW(Chspt+�r 718�Fbt�ita Statu�te�,a�amended): if vatuation af work is,$2,500.O.Ozor more; { ��... , : .
certify that I; =the�:appliaan#,. have-been ;pravided:�with-�a--copy= vf-the LL":Florida='°Construction;_Lien`'�Laiiw--Homeov�rner's
Pr�teckton Gutde" pr�paeed by the'Fiarlda Deps�tmer�t af Agrlculte�re and Gonsumer..�Affairs. If the appllcant Is someone� :.� . .,�.
other ihan the'owner", i certify ihat_tfiave.o�.talned�a copy.of..#he.ab�ve.des.cN�ed`docuri�entrand-:pmmise��in,good:faith�to.�.,. . ; �.,,
delive�ittvthe'ovrine�'-.prio�:toscomrtiericement:�'.�° .. .� � ,. , - - , , . � . . - _..
CONTRACTOR'SIAWNER'S AFFIDAYIT: i ceit�'y;:,thatwal��_the:�lryformation in,thi�•applicati�n i� accurate.�nd that aii work '�
will'be done in compltance with ail appllcable law's regulating constructlon� zoning and�.land�development. Application Is
hereby made to obtatn.:a;permlt,to do.wofk,:�and =InstaHatlon as tndE�fed:.:-�I�cer.ttfy,#li'at no work:at tnstatta#fian'has�
aommenced p�ior #o issuance of'a`permif"`and that':all�work wilf be pertormed ta.meet standards-of all laws regula�ing- '
canstructionR Counly and Gity codes, zoning eegulatlQns, and tand develope�ent regulatloris�ln the jiiflsdtctlon. �I.aiso•
aertiiy khat 1 under�tand #hat the reg�alatians of other government agencies may�appiy_ta the�lntended wrork� and that it is
my responsibility to(dentlfy•what,acttons I mus.t�take,to besin:.cortlpllance�;S.uch agencles�i�clude but�are.:not Ilmlted to: -
- Depar#fi�ient of Er�vlranmental>�Profectioti'=Cyrptess:'Bayheads;��tftetland Areas and Environmentally Sensi#ive
Lands,WateNWastewater Treatment. -
- Southwest F1orRda Water Mana�emerit ::t�fst�tct Wefts, Cypiess. �ayh�ai!"s; We#land Areas, Aitering
Watercourses. _ -
- Army Corps nf Engineers�Seawalls�Docks, Navigatile Waterways.
- Depa�tmsnt af Health�.$ Ret�ab(Iitafix,e:�:SecvtceslErn►ttattmenfal NeatEh Unit VStelis� Wastewater�Treatment,
Septic Tanks. � ' � � '
- US Environmentai�Protec#lort Agency-Asbestos�abatement.
- Federal Avt�ttonAuthori4y,kRunways�
I understand that the folfow�rig�restNctions'apply to�the use of fllf:• .
- Use of f{It is nm�,allo�wed in,fFload:Zone"V"unless expressiy permitted. � � " �
- If the fiil mateHal is to_be-used':in:��Iood 2one. °�!", (t. is understaad that a drainage plan addressing a
"compensa#Ing volume"witt.be submttted.at#lme of per=tnitttng wlilch ts prepared by a professianal �ngac�eer. �
Iicensed by.the.�.State of FMotlda: -
- !f ihe fi!! material-:ts to be.used tn Fiood �one 'A" Ins connectbn�with.s-�erm�t�d bufl�ing using st�r�i waN
constructian., i.certify that till wlll;b.e,used oniy.#o fill the area wlthin�the�stem�waii.
- if flll material�ls to� be used 1n -any areat 1-�aert(fjr that .use. of such flll wl11 not adversely affect adJacent
' prape�ties. 1f use of fltl is fopnd to advets�Ey,�ffec#ad�acent=-praperties,.the awner may be cited for violating
the conditio.ns of the�building-p'errriit Issued'•under the at�ached�ermit appltcation, for�lats less than.one (1)
acte whlch are elevated=by f!1!;art englneered dralnage plan is required. ,
if i�m the AGENT.FOR THE OWNER, I;promise in good fatth M inform the�awner of-the:permttting-condftlans set forth in
lhls affldavit��prior ta ootnmencing const�uctlon. -f u�iderstand #hat_a-s�paraQe p�cmit may bs req�lred for electrical work,. - .
olumbing, signs,rve��s, p�.�1s; ait cr�ndl#oning..9�s,;,o��_oth�r installa�"nns_not��pec�fically inctuded-in.the�applic�tion. .A . .
�ermit Issued shall be construed to be a'°iicense ta:proe��d.•aith ttie;w�ark`and'not-as:author.tty to.�viclate,�cancel; alter, ar � '
3et astde any provistans a#t�e techntcal:codes;�nor shait issuance�of a permft.pcevent the Bulldirig C�'fct�l�om th�reafter �
�equiring a carrectlon-_a0,�r�ors 0n.�plans, cons#ivction or vlolatlons of any cod�s��-Evsry p'ermlt issued shaGl�become�invafld
�nl�ss the wark authorized.by such permit:�s.commence��withtn stx rnonths af permlt tssuanae. or if wark autho�izsd by
�ie peemff is suspended ar>abandoned;for:a,perlo�of�six��t3)�mant�is;;aRe�:the-tiin�the�wa�`k��ts commencgd. :An eactenstan
may be requested, in writing,,f�am the Building.Offi�lal fbr a period::nat�to excee��ninetj��(90}days a�d will dema�strate
ustif�abfe cause for.�the extenslo�. If work;cease�.for nit�ety�9Q}cons.ecutive.day.sr.4th��ob.is.constdered aba�doned:"
NARNING TO OYVNER: YQUR.EAII.URE•Tt?.,;R�CQ�tDrAx�NQTlGE t?F;�r.COMMEI�lC6MENT�:MAYhRESilRT IN�°YQUR
�AYINC 7WlGE.FQR;IMPROVEMEN�'3-TO Y�OUit:�PRt3PERTY:;�IF�:YO.EI�ifi�'�E�61D'�TQ���lHTAIN��FIN�NE11VCy;�CONSULT
IT U D O. W� O E��. �10 �1 6`=' ... � �. ;�+ �p r. � ._ , C., , ...
=LQRIDA JURA�'{F. 1 , - ._ � . , ..
�WNER 4R AOEN, � ' :.. ___ .___-- -•��R'T�@l5� _ �r...r,,._-�-— -- :--— __--- - - - - �� - —
�utiscritied and awo (or a Rned}befare t�1 i�s Stihscxtbed and�swam�tc{ar afffnned}�b e�tM� � ��l��1
tn�l-t-, by YV�(:u ii � ('7�1���V�C�rC'. vr��Pnr�� �byr . •. , " . , r � . � �(�
Nho s/are personally knaw�to.me.or hasR�ave produced Wfio°Is/are p.ersoneliy:�cnown�to rn,e or:ha�ihave�prodOced • �1.;��7�'��-._
+r�l ��`,rQ�fa,�as EdenU�catlon. � es iden��caHo». U
���fa`.�„`��y�,•�Ch�Notary Publtc . Ndtary Publlc
:om ss n tVo. �'F C`7�i�l�r Commtssion tdo.
— � _� .
Ja otaty typ ,pdnRed or sRamped C�- e of Notary typed,Pr�hted ar st�mped
NdTARY PUBL(C �
' . STA7E OF FLORIDA
, . Ca�nun#FF083069 .
F.7cplres 2J21/2016