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Home My WebLink About16-17715 CITY OF ZEPHYRHILLS � ` � 5335-8TH STREET ,-' �si3��so-oozo 1 77 -5 PLUMBING PERMIT PERMIT INFORMATION LOCATION INFORMATION Permit#:17715 Issued: 9/09/2016 Address: 5221 1 ST ST ' Permit Type: PLUMBING ZEPHYRHILLS, FL. , Class of Work: ELECTRIC SERVICE REPLACEME T Township: Range: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Sq. Feet: Est. Value: Book: Page: Cost: � 968.30 Total Fees: 100.00 Subdivision: SHAW LAKE RIDGE Amount Paid: 100.00 Date Paid: 9/09/2016 Parcel Number: 10-26-21-0040-00200-0050 ; CONTRACTOR INFORMATION OWNER INFORMATION Name: WISE GUYS PLUMBING INC Name: COOLIDGE MARK&TAYLOR LILA Addr: 10387 CARROLLWOOD LN #303 Address: P.O. BOX 1937 l"AMPA FL 33618 ZEPHYRHILLS. FL. 33539 Phone: (813)968-4357 Lic: Phone: 813-748-4515 Work Desc: REPLACE ELECTRIC WATER HEATER& ELECTRIC DONE BY ELECTRICIAN �i APPLICATION FEES PLUMBING�FEE 60.00 ELECTRICAL FEE 40.00 II 'I , , INSPECTIONS -QUIRED 1ST ROUGH PLUMB 2ND ROUGH PLUMB � SEWER �I ,/I WATER 'I y � ' FINAL �I � � �� I �I � 1 I REINSPECTION FEES:(c)With respect to Reinspecti n ees will comply with Florida Statute 553.80 (2)(c)the local government shall impose a fee of four times th 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 may be 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 �I entities such as water management, state agencies or federal agencies. I The payment of inspection fees shall be made before any further permits will be issued to the person owning same "Waro�ing to owner: Your failure to record a notice of commencement may result in your paying twice for � improvements to your property. If you intend to obtain financing, consult with your lender or an attorney � !I before recording your notice of commencement." Compl;ete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. Complete Plans, Specifications and Fee Must Accompany Application. All work shall be pertormed in accordance with City ,, Codes ancJ Ordinances. �i I � �� y�� . i p CON RACTOR PER OFFI '� PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO j CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED ' PROTECT CARD FROM WEATHER i SEF'-0f-�016 17:5� From: 8139fi879C1 Tot8137800021 Pa�e:��2 � ; � w��rsts�.uMa:a�rc�nvc Ti�,voice CF�04'd1b9 P,p.�OK 2727�77 TAMPA,FL 33688-2777 US � (813)958-4357 wise�,►uyspiumbing c�i yah4o.com ; waseguysplumbxng.r.om �1,OWE'$#1854. . .,.. . ' ' ' �LI-�AYLOR, ^ '. .-' •a . . �' 7921 GALT.�UULEVA�tA 5221 1 ST S'�REET I 2EPHYRFl1�.LS,�L 33541 . ��PYiYRH1LLS��,33542 813.748.451 S "� �:a � • c.. ?'i,•; 'nn;�--- • • �i �i.:�°F t �1V�� ' ..��`;�''fve"�""� '� �'��.'.+',.,� •� .��;�� ✓ _ •i g�� .' . "rµL:�','��.• � 1433ti� ` 0$12412016 . . :�768.3U � �._ b9/23/2016'.,�a_ ..�1�Iet30 ; PO N�7M8F.R � . 32�83209 RO(3ER �.Y� N�t... 1�:� .Lrr`F�: " � '' ` ,.,�. �y t•,y�, s„ �'• .�.i•, � ...�. �'1�7�3T �y 4 :.•� •. c. •,.. x. ,�ij�;:}'�'• ,�"'�;>', t� AJ.�� • '�;c .'!.v.az_.P..�.�.Y.��m:?'4 s , _'�`a..w" '�4..u3:. ..._..:1'�.°'L'...� .e-�wi..•e%'�,,,�< � c�s�za;iaoi6 ��w,��'�nvs z�s ao . osna,no i e .�u woc�ss �°•oo i I 08124/?Oi6 ��.rrszox�r� � sa.tio U$124/2016 ATIDTIiONA'�. 443.30 MI7ti1TIONAL WORK NEC�SSAR FOR PRQFER TNSTALL 08/24l�O16 CHEGAC,�D AND SE'[rHE TEN�P� TU1�E ACCOitDIIVG TO SPECS,NQ xSStlES CQC SIGNEp 't'HANIk YOU FOR YOUR BU51hl6SS BAI,ANCE DL1� �7��0 � �i � i 'i il V I ' I �� i � � � I I I � il i ; ' ' /��olN� e li /`^�jV')"/ I LOfilOfl � "V c.:��'�;. 3F' City of Zephyrhills BUILDING PLAN REVIEW COMMENTS i � Contractor/Homeowner: �o�, �G[. � Date Received: ��3/�! (O I ZZ/ � �T-�_ site: �' i " GZ -�P.� �� Permit Type: �� Approved w/no comments. Approved w/the below comments: ❑ Denied w/the below comments: ❑ � � �I ,� �; �� ; ;� �I ;I ,I � �� , � � � GI �i � f�� I , � I I � This co'i unent sheet shall be kept with the permit and/or plans. � � ' � l- � � � . Kalvin Switzer— ans E' iner Date Contractor and/or Homeowner ' (Required when comments are present) � a�saso-oo2a City of Zephyrhills Permit Application Fax-813-780-Od21 � �' Building[lepartment � i' _ _ ' - -----� _ ._.- _�. .,_ -- Date Received ;,;- � .� . ' ,� . ,,��A � :� _ . "Ph'oria Coiitact#or•Permittin ;� � -�-- ;G:,, . ' .,'.��r �'' �2 � (/ '� : ... ,;,v. Owne�"s Name l�A " �"'1 `� ' � � -�';=�-��- Owner Phone Number c:.al3 ��_ �1� .. � � Qwner's Address I S� � .� �* � Owner Phone Number Fee Simple Tltleholder�Name. � � Owner Phone�Number � � � ; _ • i Fee Si�ple Titleholder Address , soa�oRess � ' o� � Z-N;3)S 3 3 S y.�. �.o�# �__,� SUBDtitl$iON �"`�"'�� 1LJ�� PARCEL IC}# �� WOF2#C��PROPOSED ' NEW CONSTR '�AI3I}IALT" � 5��NED FQ PROPER'rr T�7�CEI��M��$� jI e INSTALL 8 REPAIR ' PROPQSED USE Q SER ' "Q � CQMM�' Q UTNER , TYPE OF CON87RUC7'ION 'Q BLOCK Q " FRAME � S7EEL Q. II DESCRIPTiON-OFWORK � 1rn� a �{�1�7n ��`�,Tt.i C. 1 � ' � i BUILDING SIZE� �— �, 3Q FOOTAGE��- HEIGHT �� ; BUtLDING �_____� VALOATION OF TOTAL CONSTRUCTIC1tV i� ' QELECTRICAI. r�r�� AMP SERVICE Q PROGRESS ENERGY �Q W.R.E.C. � � J��+ .I �M PLUMBING $��r},'3� �� !:, MECHANtCAi. $ , VALUATIQN O�MECNANIGA�.INSTA�lATtON � ' � � ' ` �� i �I, GAS Q •ROQRtNG .Q SREGIALTY � OTHER � FINISHED FLOOR ELEVATIONS �� FLQOD ZONE AREA QYES NO h ` i �� - ' �, �,i _BtlILDEE2—-- _- -_�,_- -- — - --- -- -------CQ":S�'t�`^'-- -— --.— _. __—_ _---__.�— � SIGNAT�RE REGISTERED Y/ N FEE CURRE� Y/N Address License#� � �^ ELECTRICIAN- i �J r COMPAPtY . , SIGNATURE 1�� REGISTERED Y/ N FEE CURRE� �Y/'N I+ — Address License#-�_ � I� � PI.UIUIBER ;COMPANY ��. � � C • , 31GNATURE �j ,REGISTERED. , Y/ N FEE URRE�' . Y/• �� ; /� Address �� 3r7' . Cacense# �{��C')'�� l�� ; , MECHANtCAL � COMPAN1t - SIGNATURE ' ' REGISTERED �.. Y/ N , FEE CURRE� Y/N . Adc3ress' � � ` , � �icense#;� � � C?TtlER � � � � ' " GOMPANY � � i SIGNATI,IRE � - ' � � � � REGIS'TERED Y/ N ��e CuttRE� Y/N . � Address - - �c � � . 'L'icense#- ` � , � I RE3lDENTIAL �Attach(2};E!!nt Pians,(2),sets��of:Builiiirig;Plans;(1).set of EnergyFtirms;R-O'-VY Permit f6r new constnictton, " 'i . �Minimum ten,(,10),working.day.s•�aRer submi##aI:date:M Reguired'onslte,`Gonstruction Ptans;Stortnwafer Plans w!Siit Fence instailed, Sanitary FacillUes:&.'1 dumpster.,-SIte;Vllork�Rermit.for subdivisionsLlarge projects, �' ' - � - COMMERC4AL Attach{3}cainplete sets of Building�Plans plus a"i:ffe Safetyr Page;`{i}set bf Energy Focros.R-O-W Perm3t for new cans#tuctian. Minimum ten(10}working days after submittai date. Requlred onsite,Conskructfon Pians,Stortnwater Plans w/Silt Fence instailed, Sanitary FacUfties&1 dumpster.Site Work Perm(t for all new.proJects:°AI6 commercial requlrements must meet compllance SI�N PEC�tMiT Attach(2}sets af Engineered,Plans.. �;; � � �- . - � � � "*"PROPfR1Y SURVEY required inr'ati NEW constniction, " �lrec#lorts: . . Fill qut applicadon campietely. Owner 8�Contractor sign back of appl(caUon,nota�ized � ° � ` tf avar�2500,a Notice of Commencement Fs reguired. (AtC upgrades over�T500} ~�f��`�'"'"�- '" Agent(for the contractor)-or Power of Attomey(forthe owne�)would-be"sorrieone with notarized letter from owner authorizing same , � , � �YERTHECOUFETER;PERMITTING_,.�.., _{�ront.ofAppiica�an..Oniy} 2eroofs ifishingles � Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) I, �� _ _ .. �_ - � Driveways-IVot aver Counter af on pubtia roadways:nee(fs ROW" f , ' � . I r t � NOTICE OF DEED RESTRICTIONS: The undersigned under.stands that this:p�rmit may be subject to"deed"restrictions" which may be.more restcictive than County regulatlons. �The undersigned assumes responsibllity for compliance with any appllcable deed restrictions. UNLICENSED CONTRACTORS AND- CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or contractors to undertake work, they may be required,to tie:licensed in accordance.with state and�local regulations. If the ' contractor is not I(censed as required by law, both the owner and contractor may be c(ted for a misdemeanor violation under state 1aw. If the owner or Intended contr;actor are,uncertain as to what Iicensing.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 h(red a contractor or contractors, he is advised to have the contractor(s) sign portions of the "contractor Blockp of this application for which they will be rasponsible. If you,.as.the owner sign as the cont�actor, that may be an indication that he is not.properly licensed and is not entitied to permitting privileges tn Pasco County. TRANSPORTATION�IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY�FEES: The undersigned understands R--- ---_-that Tr�resportation_ImQact_Fees and Recourse_Recove.ry Fees may appiy to.the construction of new buildings, change of use in existing buildi�gs, or':expansion:of ezistin,g`buildings; as spectfled-in Pasco County-�rdlnance-number89=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 fs further understood that Transportation Impact Fees and�Resource Recovery Fees must be paid prior to receiving a "certificate of occupancy" or flnal 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. Ft�rthermore;if Pasco-County Water/Sewer Impact ' fees are due, they must be-pald prior to permit issuance-in accordance with applicable Pasco�County ordinances. CONSTRUCTION LIEN LAW(Chapter 713� Florida Statutes,.as amended): If valuatfon of work is$2,500.00 or more, I certify that I, the applicant, have. been.provtded with a copy- of the °Florida Construction,Lien. Law—Homeowner's Protection Guide° p�epared by tlie Florida Departmenf of Agrioulture and ConsumerAffairs. If the applicant is someone other than the"owne�", I certify that.l have.obtained a copy,of the above.described document and promise In;good faith to � deliver it to the:°owner"•prior-to,commencement:� � CONTRACTOR'SIOWNER'3 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 �egulating 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 pertormed to meet standards of.ali laws regulating� construction, County and City codes, zoning regulations, and land development regulatlons-in�the jurisdiction. I also certify that I u�derstand 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:.corr�pliance: Such�agencies include but are not limited to: - Department of Environmental Prbtection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, WatedWastewater Treatment. - Southwest Florida Water Management District-Welis, Cypress. Bayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers-Seawalls, Docks, Navigable Waterways. - Department of Health $ Rehabilitative ServtceslEnyironmental Health Unit,Welis, Wastewater Treatment, Septic°TanKs. � _ I __ -_ US Environmental Protectior�Agency-Asbestos abatement. — -- FederalAviationAutho�ity-Runways:___�-- -- ----- - - _------- --------- ----�_---- - I understand that the foliowing,restricfions apply to�the use of flll:� - Use of fll is not allowed in Flood Zone"V"unless expressly permitted. - If the fll matecial-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�connectfon with.a permitted building using stem wall construction, I certify that fill�:wlll;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 suah�flll will not adversely affect�adjacent p�opertfes. If use of flll is found to adversely:affect ad)acent properties, the owner may be cited for viofating the conditions of the,building•permit issue.d�under the attacfied permit-application, for-Iots,less than one (1) acre which are elevated by�flll,.an englneered drainage.plan is required. . � If_I am the AGENT FOR THE O.VIINER, I�promise iri good faith to inform the�owner of�the permitting:conditions:set forth in this affidavit prior to commencing construotion. I�understand that a separate permft.may be�required for electrical work, plumbfng, signs, wells,_pools,,afr conditioning,.gas,_.or;other_installations not speciflcally included in the�application. �A permit issued shall be consfrued'to be a license to.proceed with the�work,and.not=as,�authority�to.violate; cancel, alter, or set aslde any provisions of the�tecfinlcal oodes; nor shall issuance�of a pecmit.prevent the Buildirig Official from thereafter requiring a cocrection_nf ecrors,in.plans;-const�uction,or.v(olations of any codes., �Every-permit�(ssued siiall,become invalid � unless the.work aufhorized.by such permit�ls.commenced�witFiln sfx..months of permit=issuance, or if work authorized by the permit is.suspended or abandoned for a�period of six(6) months`after':the tlme the�work(s commenced. An extension may be requested, in.writing; from the'Buildl'ng,Official for a perlod,-not,to exceed�ninety (90)�days and4 will demonstrate ' justifiable cause for the extension. If work ceases for ninety(90)cons.ecutive days,..the job,is considered abandoned.,� _ _ _ ` - �- � •�__ _ � . .. _ � . . , , . . , . WARNING TO 'OWNERc YOUR:FAILURE�TO.�REC.ORD A:,NO.TICE.OF,-COMMEN.CEMENT MAYrRESUlT IN YOUR �PAYING.TWICE,FOR,:IMPROVEMENTS�TO:Y.OUR-:PROPERTY..IF�YOU�INTEND�TO'OBTAIN-FINANCING; CONSULT ' WITH�YOUR�LENDER�OR AN ATTORNEY BEFORE�.RECOR�ING YOUR'NDTICE°OF°COMMENCEMENT: FLORIDA JURAT(F.S::11;Z.03) � • , . , ` , . . ' OWNER O CONTRACTOR ' � Subscribed and swom�o(or�aHi befor�me'this � Subscrlbed and'swom to(or affirmed)�before me'this by/'�/thly�G !� ..7,�/inJ a�" ' :by;.��;,ra;:., r�.- ', �: ,,;;:.: - : '. ' Who islare persona�l y.known�to.me,or.haslhave:produced, •Who Is/are p.ersonally knouvn to•me or has/have�produced � �./J L � ' `'as'IdentlficaUon. as IdentlfipGon. S / '72�/ D _ , I ��'N- !/�� Notary Public � � � Notary Public � - , _. . .. • � �,-- � . , Co ml'sslo "•f/73 1�ln. . Commission No. � ,��- . , • �� , Name f N tary typed,printed or . OORE Na e of Notary typed,printed or stamped. V�'�= b1Y COMMISSION#FF 173819 . ; . =,; .._ A•. :,c EXPIRES:November 4,2018 , � - I `?,�,'R��:� Bonded Thru Notary Publie Undenrtitrrs � i _ Y� a�s:�l'o-oozo City of Zephyrhills Permit Application Fax-813-780-0021 • Building Department Date Received I� � � Phone Contact for Permitting • — i ^7 y Owner's Name�� S � b r Owner Phone Number l � ( � / � Owner's Address J � �' Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titl�holder Address I JOB ADDRESS S ZZ I � � �/T� LOT# � SUBDIVISION I �— PARCEL ID# � (OBTAINED FROM PROPERTY TAX NOTICE) WORK PF30P0�ED B . NEW CONSTR e ADD/ALT 0 SIGN Q Q DEMOLISH INSTALL REPAIR PROPOSED U9E Q SFR Q COMM � OTHER TYPE'OF CON�TRUCTION Q BLOCK • Q FRAME � STEEL Q DESCRIPTION OF WORK r`/'� !� yTG,/ C C✓ BUILDING SIZ� SQ FOOTAGE L� HEIGHT i QBUILDING $ VALUATIOIV�OF'TOTAL CONS'fRIJCTION � W ELEGTRICAL $ a� AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. QPLU �BING $ � ` � �� QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION /A IW /�u/ 1�`� ��/ ! � �GAS Q ROOFING Q SPECIALTY � OTHER �� ' � I FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO � f � , � � BUILDER I COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N � Address License# � � ' /, I ELECTRIGIAN COMPANY ?/�T j!! � tC�rr L SIGNATURE ' REGISTERED Y/ N FEE CURRE� Y/N i I Address �V f'J 3 Qq G� �� License# -�G b(S�3� � � � PLUMBER , COMPANY� I I SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N I i Address License# ' , MECHANICAL ;; COMPANY SIGNATURE ' REGISTERED Y/ IV FEE CURRE� Y/N , ; i� . - Address ; License# _ - I i OTHER - �� COMPANY � SIGNATURE S - REGISTERED Y/ N FEE CURRE� Y/N Address License# ' i RESIDENTIAL i� Attach.(2)PIoY'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,Con§truction Plans,Stormwater Plans w/Silt Fence installed, Sanita.ry.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 VUork Permit fo�all new projects.All commercial requirements must meet compliance SIGN PERMIT ', Attach(2)sets of Engineered Plans. i , ""PROPERTY SURVEY required for all NEW con'struction. ' Directions: , • Fill out application completely. � Owner&Contractor sign back of application,notarized If over$25�00,a Notice of Commencement is required. (A/C upgrades over$7500) " Agent(forthe 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/Suroey/Footage) DrivewaysuNot over Counter if on public roadways..needs ROW I i -- - � � - -- — --- _ -�:.-...«.�;�.��:�.�a , c � NOTICE O�DEED RESTRlC71t?NS: The undersigned understands.that this,permit may be subject.ta"deed"restrictiorts" which may.be mare restrictive than County regulatians. Thezundersigned assumes'cesponsitiiiity far�compl�ance�ivith�.any" � appticabie deed restricfions. � � � ' ' - � - � UNLiCENSED CONTRACTORS AND CC?NTRACTOR RESPONSlBlLlTIES: !f tfie�owner-has hired a contractor or contractors ta undertake work, they may be required to be•licensed in accordance with state and.lacat�regulations.- if the r "- contractor is not licensed as required kiy fawr, botfi the awner and�cant�acfor may:6'e�cited for=-a m"isdemeanor vioiation under state law. If the owner or intended contractor are uncertain as to what licensing requir'ements��may��apply for�;the�� intended work, they are advised to contacf the Pasco Courity Building lnspection�Division=Licerising Section.at 727-847- 8009. Furtherrnare, if the awner has hired��a contractor or contractors, he�is advised ta 'have the contractor(s) sign„ po�tians of the "contractor Biock" of this appiication for which they wiil be respansibie. if you, as tiie owner sign as�the ' contractar, #hat may be an indication that he�is not proper(y licensed and�is not..entitled fo permitting pri'vileges in Pasco County. � � - - ` TRANSPORTATION IMPACTlUTlLITlES lMPACT AND RESfJURGE RECOVERY FEES: The undersigned understands that Transportatian Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of°" ` use in existing buildings, or expansion of,existing buiidings, as specified in Pasco County Ordinance number 89-07 and 90-07, as amended. The undersigned alsa understands, that such.fees, as may.be due, will 15e identified at:#tis tit�ie=of�- � permitting. It is further understood that-Transportation lmpact Fees and Resource�Recavery. Fees must be paid prior ta ' rece�ving a "cer#ificate of occupancy" or flnai power retease. ff the praject daes not invalve a certificate of occupancy�ar:�_• fnai power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco Caunty Water/Sewer lmpact: fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances. CONSTRUCTION LlEN-LAW(Chapter 718;Florida Statutes,.as amended): !f valuatian of work is$2,500.00 ar more, l: , . certify that I, the applicant, have been provided witli a capy. af the�"Fiorida Con`struction Lien Law—�Homeowner's Protectian Guide° prepared�by the F(orida Department of Agricialture and Consumer Affairs. If the applicant'is someone other than the"awner", I certify that! have abtained a copy of the above described document and promise�in good faitti to deliver.it to the"owner"prior to commencement. CONTRACTOR'S/OWNER'S QFFIDAVIT: t certify that all the infarmation in this application is aacurate and that all worli wilt be done in compiiance with alt applicable taws regulating construction, zoning and land�development. Application is hereby made to obtain a permi# to do wark and installation as "indicated. ! certify thaf na wark or installation has commenced prior to issuance of a perrriit and that al! work will,be perfarmed #o`meet standards of all laws regulating construction, County and City cades, zoning reguiations, and land development regulations in the jurisdiction. 1 also certify that I:understand fhat the regulations of ather government agencies may apply to the intended work, and that it is my responsibility to identify what actians I must take to be in compliance. Such agencies include but are not limited ta: - . . �Departmenf�of`Enviconmental Rrotectian-Cypress Bayheads, Wetland Areas and Enviranmentally Sensitive ��` Lands,Water/Wastewater Treatment. - Sauthwest. Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering _. VUatercourses. - ��Army Gorps of Engineers-Seawalls, Docks, Navigable Waterways. - Department af Health & Rehabiiitative Services/Environmentat Health Unit-Wells, Wastewater Treatm�ent, Septic Tanks. � - US Environmental Protection Agency-Asbestos abatement. - Federal Aviation Authority-Runways. ! understand that the fallawing restrictions appfy ta the use af fill: - Use af fiN is no#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 "comp�nsating volume" will be subrrtitted at time of permitting which-is-prepared-by_a professianal engineer licensed by the State af Fforida. � `'-- � - If the fitt ma#erial is to be used in Ftood Zane "A" in connection with a permitted building using `stem wal! construction, 1 certify that�ll will-be used only to fill ttie area;within the stem wall. ' - !f��II materia! is to be used in_any area, ! certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties, fhe awner may be cited for violating the conditions of the building permit issued under the a#tached permit application, for lots less than one (1) acre which are elevated by fill,an erigineered drainage plan is required. , If I am the AGENT EOR THE OWNER, ! promise in good faith#o inforrrt the awner af the permitting conditions set forth in this a�davit prior to commencing canstruction. I understand that a separafe permit may be required far eiectrical wark, � plumbing, signs, wel(s, paols, air conditioning, gas, or other"installations not specifically included in the appl�ca#ion. A permit issued shall be construed to be a license to proceed with the work and nat as authority to violate, cancel, alter, ar � set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Buifding Official from thereafter requiring a correctipn of errors in plans, canstructian or violatians af any codes. Every permit issued shali become invalid unfess the work authori�ed by such permit is commenced within six manths of permit issuance, ar if work authorized by '� the permit is suspended or abandoned for a period of six(6)months after the#ime the work is carrrmenced. An e�ens�on I may be requested, in writing, from the Buildirig Officia! for a periad nat ta exceed nine#y(90} days and will demonstrate �� justifiable caease for the extension. If wark ceases far ninety{90)consecutive days,the jab is considered abandoned. i �� WARNiNG TO OWNER: YOUR FAILURE TO RECORD A NOTICE OE COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR lMRROVEMENTS TO YOUR PROPERTY. IF YQU.�INTEND°TO t�BTA1N.FINANCING;CONSU�T , WITH YClUR LENDER t?R AN ATTC?RNEY BEFORE RECORDING YOUR Nt3T10E C1F COMMENCEMENT,..._--.-=-- ---_-----�—�`-' PLQRIDAJUf2A7{�.5.447,03) _ �..____.__. _ --. _____ _ __��___ _- --- - ` � �^�_ _____,� OWNER OR AGEl+iT COW7RACTORr "� �„� ._„__„ 3ubscribed and si+rom ta{or affirmed)befare me this Subscribed and s to(or affiRned}before me this � bY � Who is/are personally known to me ar haslhave produced " Who islare personaNy known to me or haslitiave produced as identifl+catian. �. as identtficatian. 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JOHNSON � Driver license # J525-541-67-261-0 �� IS � PROVED TO PULL PERMITS FOR � . 4I . � MY PLUMBING COMPANY � , , ti � '1 a � '(, . , � ��a� G��'G�� - r�/� �-�.� � G�'�`� � , ALBERT E. WISE r •��'>"•• DARLENA M.MOORE �'�;• , :*4 �= MY COMMISSION 0 fF 173619 H��a; EXPIRES•November 4,2018 ��Rf,��°��` Bonded Thru Notary PubGc Undeiw�Aers I II �� I f �1 i I �I