Loading...
HomeMy WebLinkAbout16-17953 �' CITY OF ZEPHYRHILLS � il 5335-STH STREET �' (si3)�so-oo20 17953 ;! DRIVEWAY PERMIT PERMIT INFORMATION LOCATION INFORMATION Permit Number: 17953 Address: 5422 23RD ST Perrriit Type: DRIVEWAY ZEPHYRHILLS, FL. , ' Class of Work: DRIVEWAY/REPLACEMENT Township: Range: Book: ', Proposed Use: NOT APPLICABLE Lot(s): Block: Section: ' Squa;�e Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 12-26-21-0040-00500-0020 Impro�. Cost: 2,400.00 OWNER INFORMATION Date Issued: 11/22/2016 Name: GEOHAGAN, LARRY Total Fees: 40.00 Address: 5422 23RD ST Amo�ant Paid: 40.00 ZEPHYRHILLS, FL. 33542 Date Paid: 11/22/2016 Phone: Wo'rk Desc: REPLACE CONCRETE DW 20 X 49 II CONTRACTOR S APPLICATION FEES HOMEOWNER DRIVEWAY 40.00 � �� , � \�� , I Ins ections Re uired DRIVEWA� FINAL II 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 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 Ientities such as water management, state agencies or federal agencies. The payment of inspection fees shall be made before any further permits will be issued to the person owning same "Wa�ning 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' �� before recording your notice of commencement." ; Complete Plans, Specifications and Fee Must Accompany Application. , All work shall be pertormed in accordance with City Codes and Ordinances � � /�� � �, �'�Gk e�� �Or CONTRACTOR PERMIT OFFI PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED I �� PROTECT CARD FROM WEATHER I i _ �� , ,� . r� i� ' �i � .:� _ ,, � -PERMIT=APPLYCA'PIOId :�� �' �. � � ,' . ..... .:. ; � I �DRIVEWAY:P.ERMYY:AP.PLICATION ' �CONSTRU.CTION�WITHTN:P.UBL:IC-RIGHT OF=WAY i411 information must be-filled-in completely :City.of�Zephyrhilis "5335�8�'Street,Zephyrhills,.'FL 33542 ` Telephone.813.780.000 Fa 813J80.0005 � 'it.a..a -y - "ii:;,'r,��:'�'r=n _ _ ��;Y�;.+,: ..r.:�rF"i" :F7z." ii�.q ^t`' �y ,y�`Sf.;�'.;;:,"> - '-:�'�-�.''.i'�;:.;.',.,t�..z [�"��'»0�.�����I V wlia} ;:�:��';;'��,".��i:i^ �},.4,��a w.�g,Q��s�.r_;'%%:�. ^.�;„S:4: ��� :ti �; n. .v.:«t>: .R',.�.. '.��,-,x.4.,: ��{�'y,.�, �.:{•y,xr'7F�- ,.x; -.t. sc� .-�r�„11�!7Ei3;r.,.�x'" t:N7,.r.., v_x„�`: .3«:.: '•.t:� ��,.. >sd h��:'ii`� .r.,i'%z,��,u,�'"r`3,�; ,i�. ..ar.�.:s, X' x�.?. _r�;,%+#:r a.5�. f-.�¢�;::••S. - �7� �:" t"�;i`,Au..; , (x 4` >.�.. :,p':F �!f.re:�'i= ��:.s .�I, r�( - :�,: ,-.r, ;t�ts,;:ib:.....,.�,.r:x'?��r�.;,.. ?:xv.atr;.�,;=, 4�;:. r'Xi E�<�, ` ir, :"r..1„n`E.*, '"t-r � ;'} �. 'r 5�� '.trv:.;�F .�'P.^.c: 3�0�;. W�.ar sf ta:<" :.7'F• :'�' ..?�.n"'1�."f..r=e�i�-�if�sC.r"-?e.:cF`:'CY �b±..`'W.t ���L"!iV`.,. faF�JO� a.� .� u2 } i.�a✓a�wt.✓ bJ*'7-i"".Na. _ S'<"s ..i?"r',Y� ��. � ,z� ":ti } Y_���Yr.v� � �� �(� r•'-�;.�:fy;� ....fi?^+'�...�"3'r«6�5�e'l �.3f�'__". t"�f: �".;u"L�',d�q5�i ,w .t5t�3;" - an N�b''', T.. ;�� � - r�r^: :�:�°.�,;%' �'a`��;."x• _ �,;...1-„�h.�;-�(' ;�.;.�:C�€�., fc:r�s'�s°%.�.,irs";&r :;fS''':.�L'�J' '�UI�� P,II��^�3 n�=r.+,=:�:;:�;�. s-..�y�:s�...,,�,..:;;;:af--€..,�.n?:i'=�ti,3' y..,-,�:;,=�u: ,ii ��•' :Ir �Oj�!'�5r f�'�^QP�.�. .s�, :t�r.. ,.ac.,.E,; ..r,- ,.r4...�� �b�lC;�OT �w. r,--� �.�'�''�' }�? ��.-=1..,-�...c.;t:" . I ':PRO]ECT .7 B:SITE: �PROPERTY'OWNER Address: 2Z 2 �1. Name: 'R. � �t' - � Uni�#: � Address• 2 �� S Unit: ! Parcel Identification Number: / — -�1��� O'� Ci .State .Zi � S �- � � ��Z� Phone• !�-q9 Fax: ' ' � ZG7 S ' � IINTRACTOR: Com an : � Name• � Contractor's LiceA e#: E-Mail: : Phone• ` Cell: Fax: � II ; A ��CHITECT/ENGINEER: , � . � - � Name: Firm Name: Adciress• City: State: Zip: Sta'te License#: Phone: Cell: Fax: I Descriution of Proiect p� � TYP F DRIVEWAY -/� LENGTH OFDRNEWAY CULVERTS NEEDED II RESIDENTIAL DRI1/EWAY �WID7N OF DRIVEWAY ( )REINFORCED CONCRETE I�COMMERQAI.DRNEWAY R.O.W. p(CAVATION O CORRUGATED MATERIAL � I;PUBLIC ACCESS DRNEWAY DEPTH LINEAR FEEf ( )BOX CULVERT � � ( )OTHER(IXPLAIN) I CONSTRUCTION MATERIAL CURB CUT REOUIRED � � II,�PHALT YES NO r/CONCREfE _ � HEAIDWALL REOUIRED? YES NO � i �� ' NOTICE TO APPLICANT: If actual work exceeds scope of this descriptiore,additional permits or drawings �will�be required. UTlLETY LOCATIONS REOUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 Page 1 of 3 � i � �, 8- . �� . i� , PEI�I�'APP�ECA'�IOI� a II � ' �i IITILITIES L�CATE CONFIRMATION IVUNIBER: ; � � PitOVIIDE SKETCH FE1S TFEIS 14REA, EF I�DDITE0119LCL S��tCE IS REQUIIi�ED, /ATTACH TO THIS � I�PPLICATI0110. i � ��� , � � �� � �� � ; � � , II � AFFIDAVIT: Application is hereby made to obtain a permit to do work and installations as indicated. I certify that all foregoing ; informati�on is accurate and that all work will comply with all applicable codes. I understand these codes shall take precedence over all ' approve �construction documents,_and issuance of this permit is verification that I will notify the property owner of florida Lien Law req.,F.S�713. , The issuance of this permit does not ensure compliance with deed restrictions and I understand that additional deed i restrictions may apply to this property. A19 wo�shatl com I with the curr+ent Florida Buildin Cocle Public Works Desi n Manual and FDOT Desi n � PY 9 . 9 9 IStandard5(if applic�ble). (Public Works Design Manual online link:www.ci.zephyrhiils.fl.us/public works.asp) � APPLICATIOIV IS VOID UNLESS SIGNED WITH PROPER IDENTIFICATION AND WITNESSED BY A PERMIT � ' TECHNICIAN OR NOTARY PUBLIC. ' NOTE: 4he C6ty of Zephyrhills is not responsible for maentenance or repairs of driveways. Drivew�ys shall not alter/ I interFere with existing sbormwater treatment and/or conveyance. ; PROPERT'OWNERS: By signing this application: I certify that I have read and understand the owner/builder disclosure � statemeii t. (please initial) � L�-Q �� �wV ,��� �'� � (-2� —��p � Applicantl Pri t Name Applicant Signature Date Permit Technician Signature (or)Notary Signature Date Applican I�is( )personally known to me or produced as identification. (type of identification) Page 2 of 3 !I , I� �' li � r �� � � P�f i�tM17'APpLICATION I' �� �� � 4�FICE U5E ONCY (� Pt1BL�C l�Q�U&�O1U�.1� I Co�ncrete (tnin.G� Y H ��,'t�t 1�J 2lC 6E't" ca+4 �� Asphalt Base(min.6'� Y N ' �� ' "halt(min. i�/�'� Y N �� � a Lengkh(min. 19� � �Y IV . � � WidEh(10'min-20'max) � N � , E�ti5tln9 stdewatk. Y , , �� � Nev'r s3dewatk. Y N i �� ' ADd compltant Y N tJ', • (� ' ; Exp�nslon maberia!req�lred. Y �1 ( C�t�Uguous paricing pad. Y � I Trfa" guiar�are(9'W x?'L) : N � Visi',iiity triangte o.k,? N � S(cte set badc(3'min.R.4.W.} Y� ' N F�an;+Ret�tetnt Fee � + a Adi�Etio�!t�esc�f �s�s�f�wotic�rs de�itt�.d ��btic Nt�rks Dira�e�s�nci�,�r desi�e�ee: . . (� i �R��CE$ . #4? -' '�.�.{- �o _ ' _ _ � I I � i �� � i Permlt appllcattan appmved by: - � E7ate: ,� � � i Page S of 3 ' - . .. � - --- --- - 2- 51 5—'l��f"1,� `..�►)Q C�'1�hh --�'1:�-Cf�M- vMl11'�tX-br'W__� - --- - -- -- - } � ' ,,,�.3�x.L� Q� � � , ' 7� ..� ,,� ..._._ .__-- ,,���t� i ._._ _..�_. ,��17C�d►.:5iya"i7 `�C1►7yr+t� 2+t'!�'►'�e+�� , �.. � .,.' `` _ � —.,._..� � �� ,.,'�Q ,�� .1�3y�7t� /"},y�iat+► tYotSf� '�8��rr+ �-f'h�M�r'� ,� ` ti ,� .�i n'� � � `�� .--� o n � ,�......__ Q �._.__ •, .__----.� .,e„ _._-�, � .._. � ._ �. ,.._�f _ -- � � ��.M;����� r„��M �Q..�-��J1�'f' CI��1.L�M ',�71'��� � �' _ � —----. . ;;�,,,'-, ;,.�•M;a y� r �+�..�- �►9 � �s �a�c�+c�-� � �,�N�� ' ,, •�,-.. :; ,,'� - ._._ , � � 4 0 �j�`�il.� N. �Sr� ?4S� . � 0 ��$i.� r"� �' �� C7��� ..�.—__._...___ `,,� �-~,� ! ""�o v ��,o.� ��L�� rjQJ 3�,�.� �������d -�� d '3��'N �����-� ' �I�b' . �� �.;---,.,. ��� � � �,.�„'�?1�NQ�- =r � � -�� � � .� ,�� �"''�t ! ��'CJ ���� t� _I — ` ��,���N4� �N :a�k� __— __ 9 } �- ,�1 ----� ; � _ .• �f-� x ,v� + � � � � � � I ,��'�?N0�! � ;, ;��1151xa j ' • f -�(ooq � � �.... _} _.��J b�i�'� �._.,...�-�-�-- ______�__._._--�� d i . � � ',� � � � � --� `�'� � ,8� ; . , i i __..,_.. -�-- --r�- ,,� � ����� �� �� ���h.��' . . j _—______.. .._ _....� ; �� " ,��d��d i�o��J � ._.. _ . � f: , . �w o�! � .' � I.L / ��t��'=�; � � r . �� ' r����� � . � : I� i il , • �i � II � li �v ■!'Pasco CounryP1oper:y r x r e�Pasm Coumy PmpeAy: z - ` 9', r- ... __..�.�._-----_ C: �O 9is.paz[ogov.com/mapsltfind=l2-26�21-0040-OOSQO 0:l10 � �� � e�ADPs *Boo7miaAs ..— .. _. ._ ouwr6oal � � r� i�� 12-2621-0040�DOSOo-D020 X • f 8� - -� I. Parcel(Hypheneted ID) ' `- &°"� +' n " " ' i�-z6-n�now�oosoo-ooxo � � i : '` . 'i:aatt � a��• gPnra n , 'ISTADO ,� �� �� Pb C P� GEOHA6AfJ'LARRI'6.RIT4 K , i , � ; � .,�--�` - .-'f 5412 23RO 5T : , � ";"p�:�- •'.� Acres: 0.25 , - ! %•-..- ,.�b � � ,.`,;'� Land � � iz-zazt-0oso k��nt.-`s .'-':; A9: S i � ZEPTfYRH[IGtfi5 T-��-";.-t Land Market: $13,680 ` �fi • ;�; � � pa s rosa ._ � :=z. �-, Building: $63,414 • '; 4 `��=�`�s .,��;-.� Flaturcs: y14,442 , ����e' `- � % ApDralsed: �93.536 � , �, h� _r�:�� i��� �� � � �__,�`-. . . c �—� � _ '; a �t,.� _:.;�pr 01 30ZH � � me.�a � - �t •._ ... . �� a:ri: � �-- - _ _-I; .- - - - � - - - , ZHLGI.P3 C i � tlick fa-parrei infortna[ion C + � � � � Z44Lbt4 ' ' � }r )�' �I , � 9 6 ' "__" ' ' .�.,.,.�__.._.e 11^ � i_ ' '____' - j 0 2o iQlt e .�� f • o.aepAyA�iI1Lfl i � Esd,H aE,DeLorme,NGA,US�;,��,,,x occpu � {� ' '1 'p ( _ _ y � i e � I i I i I I .`����f:. +� --� �i+" .- , ..� . • .. _,. � ' '.�,,., .. . - ' ' �,�� �,��`� �' .�.. ,�. � .. . ��4�K 4�+,�'.Ft{�.�,�+ ,� ,,,;'� �.�;. � ,++� � �� ��*� 4 ��� �s '�ti.�'� '�S.'�`��"� ?�t � � �"�e l � ��1� `��a�„�� �� ..+ " � ,, , 4.ti� ; � �; � �� � �.``?�,N,�..�+'i't ��4��.,,f 4 �� ♦ ,���� �{�.,�,1', � t*,. �� �+e'x - +!f' 4 F �n a� f:. � lt � � � ! �'!i, +� f:. If �.:�'�C�iy r,"lw��.,,y� � `�1t'� v'n� '� � , �`� '"`�� ,«+T�'~4�� � -Ti..:�' '+A �,.. . a..�,� i' y�.r �� +wi,�..� �r� i ' �^� i �"'. � z�. . ;a F• ,�, i e . • sr r;.�,: k ���.iyr� �* f .F � ,�, '• i, r ,` �4 .� t#4 ` "S „Jr ' � . , ' + � a r / , ��,}iy� 1 '� .,Y x *�f! �M�. .. µ' � , ��); •'� * � � � �� `'' `i ` ., 1 � ��F �� t �! r'� d y ,�`��4 �, ',;__ ,1 7L, t.. �..w�. l:� � +, ' F ,�.♦ .x�.y+» . �,t " d, � � � �� y' � .F i� y� ' �y'�'� � Y L ' �, � .ay�J,�� _ •�'' y`� �.„„ - R . :� �.�'�` �� r �s�k� �V y. � ' ! y � � � sf� 1� � { I �" I � x,, 4` F ',:4� ( x �Y �'� � �... T�i' - ^� � 1 _�t ���-'{ ~ �'� ��9: r j y q �� i I ;,�'R,�, .,� � •,.. r � ,ti` +� * r i ��� w� �'' , . �' �' ,y�y�' �s�t Mt r... Y : �Y �� µ- *y ��}�,, � S �'�5�, • , T��r � i^yM� �'"" t x �y .�j � 7,.. '�,;. ��,4� � .- �+�`; ' .m� ..rN, ; �. .�:.:� . ' �"'�s. ''i; Y uy�• ` - 4� I II »� k „��';� `h�; , : �a ^ . ' .� ,. _ , ° t. , �t ` .r�- Y •�,,,,,,,�,�,� ,� �"r..s��' ^ �.� , .� �. `s, � y , •% { ' + .�'+ �� , �� ' • A ,�y.��I� . .. �Y t !' '* * i . A � y c �� � . . `�� . i�:t� h�� *a�:} .+2��� ,�.. � t J .'?.� ��Y# ��r�� � .S Y'L � �k"� y�..i '� N'�, ` r� ,�}. �;,��',��,r,S"!��'��,�.y** ^ i. '� f. ;��' �* �.j? �`Y` . ;' � ����'� �. i` — 1. a�3-��eaoo2o Cit�+of Zephyrhills Permit Application Fax-813-780-0021 '� 8ullding Department I — Da#e Receivedl �l . . - : Phane-Cantaet for Permlitin - t3wner's Nam�! 'L��� .C�.y t b �A C��t� owner Phone Humbe� I . I Owner's Addross ���� G- � �p S . Owne�Phone Number j Fee Simple Tl t l�eholder Nam� rL AC{�Y � R��� ��� �I�CGI���� � Ovirner Phane�Number ' ! �;� Fee Slmple Titleholder Asldress 5 .�2, G � R� J Z�G p/►'��R��(/�JJ�' , FG+ JOB ACIDRESS ���� �, c� �A T. [/G+ �YI��I Gv� �V• LOT# �� i S�Ba�V�S�oN� ��Plf Y�. �f�l��r� p,��E��a# 1,�,��. -�l=d D D- 118� — �Z � I , . (OBTAINEDFROM,PROPERTYTAXNOTICE) j WORK PROPASED t.NEW CONSTR ADD/ALT � StGN '� � Q DEMOLtSH i { �_e.. INSTALL 8, � REPAIR � PROAOSEDa SE Q SFR [� `COMM Q �t?THER ' TYPE M�F CONBTRUGTION [� " �� BLOCK " [] FRAME `.��]' STEEL Q DESCFtIPTlO�OF WORK� } I"��/•►OV� � E'i P J,+r�G� G�/1jG��j�'G ��j V C,VV�� ,�..fD� J BUILDtNG SI�E �� � � SQ FOOTAGE�� - ,,HEIGHT�,C� . � BUI�DiNG $ .����. -� � .� � � �` '��L�1� d,�-' VALUATION�OF TOTAL CONSTRUCTION • ' I [�ELECTRIGAL $ ' AMP SERVICE Q PRtiGRESS ENERGY Q 'W:i2.E.C. OP!�MBtNG $ ` � , ,, qC�� v/ QMECHi4N1CAl. $ VALCIA7lON OF`MECHANiCAL INSTALLATIE?N � ' �,�1:.� i � _ �� � Q� , Q R{�4FlNG .Q SPEGIAl.TY � � OTHER�; - FINISHED FI.00R ELBVATIONS FLOOD ZONE AREA QYES NO � � � - � � - � , -- --�:d6�€3��: - - _-- __—__-- _--- - ------- Ctalliip�tFlY_._ _ _..._____ ----- --___ :__�_.�_ SIGNATURE� REGISTERED Y/ N FEE CURREP Y/N ` Address Llcense# �� � Y ElECT�IClAtV; t� - `COMPANY� � � . SIGNATURE� � REGISTEREb Y/ N FEE'CURRE�� 'Y/N " � Acidres ' * , . , .. Ltcense#.�` ' � PLUMB�R°'� . ,. . . COMPANY . . , SIGNATURE t „REGIS7ERED Y./,-N FEE CURRE� -,' Y.•/N. Address� License,# �.-- � ,,�., , !I MECHANICA�:' �. ' COMPANY � SIGNA7URE�I � � � ' ` REGI$TERED., Y.,/ N _ � FEE CURRE� Y./tN ,�� _ . , Address� ` ''�r � " �- � � . Cicense#� - fJTHER ;�) , , - " ' - ' �CQMPANY } SIGNATURE� "•=> . `"" • §� �'- "� �'REGISTERED' '' "'Y/ N... FEE cURitEn• Y/N Addre�ssx. � ,, � ,�:� «. - � . _ .,,' . ,_ �. . , _ Ci+�nse# ` P � � � � ?' .Y''�i�;��, � ..ya.a . '{�i": ,... , RESli?EN'F1�:;:•;�Attac�i"(2),.Plof Plans;(2}sets:of;Bt'iildin�rtPlans;(�1}�sef of.Energy`Forii�s:F2�W'Feniiit far new cons#fucttari, � �: ,�. ,Minimum ten�:1A;wo, in ,d@: ;after"„"submitital-date::R�°"ulred ansite;ConetiiicUon=Plans;3tonnwate�'Plans w7 SilYFence ins#alled, ,.,_ . ,�,:._,. _>._� E, .) �.�4 .9 Ys e4 �� �Sanitary Facl�llties;&�,1.;dumpster^Slte�Wp►icPPermit;#or;subtlivisipns/large:proJe,cts,�:._�`,.::� "' ' ' ' � COMMERCIht. Attach{3)`"ridmptate sets of Buitdti�g Plans plus a'�I:ite'Safeity Page:(1}set of Energy Farms.R-O-W Permit tor nev+r c�nstrui�lon. � Minimum ten(10)worlcing days after submittal date. Requlred ansite,Construc#lon Plans,Stormwater Plans w/Silt Fence ins#alled, _ - � j SaniQary Facilltles&1 dumpster.Site Work Perinit for all new.projects:Al{cammercEal re�uirements.must meet compllance � � � . SlGN PERM II Attacti'(2)"sets of Engin�ierr,ed:�i�ns.,:� ,.".�-� ... .. �;u- . - - - """PROP�RTY SURVEY reguired for�II.IVEW_r,onstructian, � Direa#bns: �� _ � ._. � �. _ Fill out applicatlan completely. � . Owiter "Cantractar slgn back of appl[caflon,notarized � If over�2500,a Notice,of Commeocement is requirad. (A!C upgeades over�75a0) _.: -. , ,.. -,�.<.;;���. , _. .. . .,-. .., __ _.,,,.,,,..:_...._- .. .. ._. , .,_ ,;. ..,..,: " Agent(for ttie cii�ntractcir�'o�Power of�ttorr`mey(fo�the owner)vrould be someone with notarized letter from owner authorizing same � , :.,� -. �VER THE GOUNTER:PERMITPfNG�;,� -;;(Front o,f-ApPlication Oniy}- , • � � - '" ` ` ` ',��f ` ' Reroofs if shingles Sewers , ; Servlcei Upgradas.:�lG,� .- ;Fences(Plot/Survey/Foatage) � " ' ' � � ' � Drlvew�lya-Not over Counter if,an.pubiic�roadwayis.�:neecls ROW , - . � . ^ , -��` , � .� ; .��. . ; - .' , ,. _ S � r NCtTiCE t?F DEED RESTRIC'flONS.. The undecslgr�e��undet�tands:#h�t�#hls:pqrmlt�may.;,be:sub�e,c�,to,"deed".;restrickioris"T�...::..�,���.;�� which may�be�iriore�restir:tct(v��th���Counly�r+egr�lafCons:`�The:underslgned��assumes�'��espanslbllity';t'or.caiF�ip'llanr:e witli"any �"_ `"" appltcable.deed�restrlattons. • - -. _ � - - , - - - ,,.;_.. �_ . .:� , � .v. , .; .�,.; , , , ..: - UNLICENSED-�.CONTRACTCIRS .RI�D CON�RACTQR�RESPONS1BILiT1ES::'=°ff°tiie°�owner-has���hlred`ya-`cair�tractor or cont�actors�to undertake work,.ttrey may..be;requlred:to.:tie,ltcensed Irt accordance.wlth,�tate.and�locadwcggutatl!a�,s.s��If�th'sr•�' � � � contractor`ls:no# itcensed>`as're�lied'tiy law,'66#ti-the ownet and�contractoTrmay�be��r.lt�i!'for�a�misdemearicir vialafion under state law. If the owner or I�t�ndedkcontr;actor;are.;uncerte6n a� tm what Ilcenaing;requir��ents�may�a"p"'ply.a�for.�the'�����•����,�°� fn#ended�workF tHey are advlseii'to�coritact{tfie�Pasco-County Bullilliig°iitspectlon�D�vtslon--l:Icea�sing Sea#lan at 727-847 8009. Furthemnore, tf the awner�'fias�`hii�cl-aycontracfoP cir coritractors, h��ts advlsed ta have 'the contractor(sj,,slgn,, ,,;e, „: . portlans afthe��°contr�ctoc,8loak°.,of thlsqappllcatlon�f�or�whlch.they,.wUl,.b�.r.esponslble.•.,If.you,_as•,the ciwn`ec"�ign'�as'fhe`" :.�`;` � _,M....x..�.>.x.: contractar,�that t»ay be an iridication thaf'F�e�is iiot:proper3y licensed and"Is:iio#er�tl#led t� pemilfting ptirril�ge�3 in Pasca .. County. � . _ , ..�. , .�.�_ _.,.>. �,... ..:=� �..,.f TRANSPARTATlONsIMPAGT/UTll:1TlE�rfMPAGT�ANC?RESQU�tCE RECOVEEtY REES;T�he�untlersigned at�d��stands that Transpartatian lmpacf F��s and.Reca.urse.Recove�yr:Fees m'ay.�;apply:to:th�ycon�tnicQ(an,of new bulldtng�,?change'of'�k��`�-������ use ln existing bulldings,�or�:expar�sl�n�rof=+eiitskin�:�bulltlings��as speclfled.In.Pasco County O�dlnance number;89-47 and 90-U7, as amended..;.-T;,he undezs�gned a1so:understands� ti��t�such fees;�jas��tnay��e�<due;awlft:=be Idenfi�ed at thea'tiine��of`E~: :Y{:;,�-�"�� errnitting, It Is furtfie�understood that Tra�s ortatfon Im act'Feea and��Resou�ae,:Reeove" Fees,:mu'st be eild rlar to P P p �,.. ry; P P receE�rtng,a'ce�flflcate_of oc�cupancy"-or flnal-povuer�elease:� :l�_the proj�ct;:doe�s..riot Irnrolvesarcett�icate of occupanc�tlor:`::�°�=:;_" , final power-release;-'the-,fees mu�t��e�pald;pclor to.permft Is�uance. Ft��#hermore;�If:Pasca;.CountyRWater/Seu�rer�;lmpact� �•- ;�;�;•.�{ . ,: . � ., .. feesaredue�_they.must:be*pald..prlcr#opermit�l�suance=ln.accordance:wtthappllcatife�Pasco�,.County;ordlnances�. � CONSTitt1CT10N L1EN"t:AVa'"dCh�pfsr 7`�6���tar#da�tat�t�a��as ar�endl�dy: tf vaivation af�rork l�$2,500.OQ or�more,.1 -�:; . ;;�.�;� cer#ify that,l, �he �appllcant;:�have�been-provlded �with--a�copy of.:the�"Elorida `Constructtan: 41en_Law Honneowner's Pratec#1on Gu�de" prepared by tFie Ftoi�da Dsp�artmenf af AgrlcuEt��e and Consum�r;Affairs. If th+�appticant is someone- ; �, . � ,,; n Mr..�s.A: . � . .�=. � other than the"ow�er", I certl ,that.l;have.obtalned�a�copy.of.,#he:above.-.descrlbed;docuii�ent=and�.promise��.ln,good'falth.to � . �.;,. fY .._: deliver it to:the;'awner.":.prior��hi.xcomrt�encemeril:�' . } , . . : __ COMTR�►GTOR'SlOWNER•S AFFIDAViT: i.cer,tify.�:ttia#-all�:th�ylnformattdn::in•thl�appllcatlon is accurate�nd ths�t all work " will'be don� in campliance wlth all.appllcable 1aws regulating constructlan� zoning and��land'�development. App�!lcatlon Is hereby made to ob#ain,-.a:pecmit;:#o:.do;work,;and�:ihstaliatlan as Indi�ated:,=:.•I�certify that nof wark�ar tnstall�tion tias' commenced prlar to Issuance of`a permlf��and�that.all work wlll be pertormed to meet.standards•�of all laws iregula�ing� construc#ton� County and G1ty codes, zoning regulatl�ns, and land devetapmer�t cegtilatiaris=in t�ie.Jurisdtctton::=1�a!'so- certlfy thak I understand that the regulattons of ather government agencfes may�apply�to.the Intended,work, anc�that it is my�esponsibi#ity to Iden#{�y.what,acttons!must-kake.to be,ln�aarr�pl#ance;�;Such agencles lnclude bu#�arer.notllmitec!to: � .- • - Departmeo�# of E�rvironmental-'Prote�iiori=Cypre"ss;`Bajihead�; 1l1%N�and Areas and Environmentaliy Sensitive Lands�Water/Wastewater Treatmenk. � � - Southwes# Fbrld� Wa#er Manageritent�::�Dfs#riat-Vttelts; °CYPress.2_8ayhead's; "We#iand' Areas, A1ter�ng VVatercourses. - � -�5: - Army C�rps ot Englneers-Seawatls*`Dacks,Navtgable 1Naierways. . - Depar#ment of,Hea{th�;i�,,Retrabllitatl�erSer,vices/�r�vironmentai�-Hi�aith�Unit:Weti.s� Wastewater�-Tireatment, Se�tic Tanks:.` .. " _ - ..- - - � , _ ---- US Envlronrrien#a1 Protectlan Agency-Asbesto�a6afement. - - -- -- - - - - - ' - - - Federal AvlattonAuthorl .f�unwayss� .. � �!-... . 1 understand.that the.follaiiv#ng:resUlctions apply to the use of flll:• - Use of�ti ls not allowed ln'�Iood-Zone'V"unless expressly permltte�d. . - If the flll"mate�lal-Is fo-be usecl�In :Flood Zone. "A°� It Is understood that a dratnage plan addressing a "campensa#ing votume�will be submltted at.#ime of permitting vvhlch is prepared by a professianai engineer " " Ilcensed by'�he St�te of-Florlda. ;� , . - If th� #il! materlal�is to:be used 1n Flood �one 'A" in�connec�ic�n�wlth�a p�rmltted batlding using s,tem walt, : � , aonstruction� I certify that�Il:�r�ll.�be<used only.to#111 the area wlthln the�stem�walL - - If fiA materla! Is to be used ln any area� f .certlfy that .use of such flll witl �at adversely affect adjacent prapertles. If use:of fili is fonnd:,to advers�ly:.�ffect adJa%ent��pr�perties,.the owner may be cited for vioi'a#tng the condlllons_of the bullding�.permlt Issued-under the'attaclied.�armit appl(catlan;:far..lots.less�.than.one (1) acr�whlcti are eleivated�tiy flIl,�rt englneer�ed dralnage pian Is requlred. If I am the AGENT FOR THE OVIINER, I�pmmise In.goad_falth to Inform the owner of-#he permltting condftlons s�:t forth In this afFfdavlt'prtor fo aommencing ciinstn�ctl�an. 1 undetstana that a-separ�te petmlt may be required for etectrl+ra!work, pturniaing, signs, wetls,,poots;,air conditioning,-.g�s,�'or other instaii�ttoris not.spec�ically included�in.fhe�application. .A . permit Issued shall be constcued to b`e a�Iicense`to�proceed wMth tF�e. work and not-as:authorlty:to:vlalate;'aancel, alter, or �, set aslde any�provistans of t�ie tecliotcal.cad��;�nor shali is�ua�tc��of a.permlt.pr.event the 8ulldlrig Ofttcial fram tl�ereaftec requlrin.g a,correction af etrors In;plans;-constnictlan or vlolatlons of-any codes. �very-perrntt�lssued�sfiall�becbm�e invalid unless the work authorized.by such permlt:�3s-commenced wlthin si�c.,�months of permlt Issuance, or If work au#hcErized by the permit is susp�nded�or.abandoned-for:a;perfad;of�s�C�)montt�s,:r�fter#he;tlnne#he�wo�'k�is commenced. An extenslon may be requested� In wrtting,irom tNie,Bullding,Ofilclal for a petlod:not to exceeid'nttieqr=(90���ays and-vir1U demionst�ate �us#I�abte cause for.�the extension: If w�rk aeases,far nlnety.(90}cons.ecutive.day.s,._the�ab�1s consi.dered abaadoned. r � � WARNING T� QWN�f�: YOUR:.FA11.lJRE.T�.,-R�ECQttQ.A.N4TIGE.OF.�C�MMENCEME�tTaMAY:�RESULT IN�YOUR PAYING TWtCE;.FOR.�,IMPROVEMENTS�TCI:YOUF�:.PRRLIPERTY:���IF°.YOU=1N'FE�ID�TQ''�BTAIN�-FIN�4(�E�NG;'Ct)NSULT I, WIT U A '!7'O FQRL� � O �Q �.�t OU � = Y� 'Q ' �, . E , FI.ORIpA Jt1ftA�(F.S:t'17.03} � n _. ,. . ,.._ .._.,.t., ,.. _- .._ OWNER OR AOENTf�' 1_� _.~ ---~_ .�"c��V����, CONTRAGTOR r^�;��(s w��"�"��"� - Subsc�Ebed andswo�t ta o aiflrm d)b tne this _' � Substxlbad and'�m�#�{ota ed b tti t�. by L.,���.i G�-��,��at:�`uv �by . L.���� ��a�-�9-�-�.�i--v�-) Wh lare pe onall-�nown to`rne or;has/have,p o�duced Who. re ere nalty k(iewm to nte�o-ha�have.•produced � . . �Ct?a'[ as Id`enUifii�N4n. � _ ��.: ��2r�'t�.�Sa.. as td�n�ficatian. ���. f ���f t � . � bllc . �t'` ' � Notary Publlc "�:s'y"s;•. .JACQU INE BOGES � .r"�- Com lon N 'P �`�= �si��,�zc r Gom� No. _ . ;?;, xP,: Expires becember 12,2018 -��'�' Bf�: _.: s:- Commission#FF 150422 •� - Name oi I�ota Name oi Notary iyped,�} ,�I�;�t� ganded Thru Troy Fain lneuranes 8Q0.3d5��019 -+