HomeMy WebLinkAbout16-17728 CITY OF ZEPHYRHILLS /�
5335-8TH STREET �
. (si3)�so-oozo �� 17728
, BUILDING PERMIT
I PERMIT INFORMATION LOCATION INFORMATION
Permit,Number: 17728 Address: 5912 12TH ST
Perunit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL.
Class of Work: 434-ADD/ALT RESIDENTIAL Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-02100-0130
Improv. Cost: 500.00 OWNER INFORMATION
Date Issued: 9/23/2016 Name: MUNIZ JOSE
Total Fees: 180.00 Address: 12139 LEANNE DR �
Amount Paid: 180.00 DADE CITY FL 33525-5929
D„ate Paid: 9/23/2016 Phone: 352-437-0313
Work Desc: ADDITION 360 SQ FT
CONTRACTOR S APPLICATION FEES
HOMEOWNER BUILDING FEE 60.00
HOMEOWNER ELECTRICAL FEE 60.00
HOME�i WNER MECHANICAL FEE 60.00
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I . Ins ections Re ired
FOOTER I 2ND ROUGH PLUMB MISC INSULATION CEILING
FOOTER BOND DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC.
DUCTS If��STALLED WATER MISC DRIVEWAY
PRE-SLAB SHEATHING MISC. MISC.
CONSTRUCTION POLE FRAME MISC MISC.
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
II 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.
"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 Must Accompany Application.All work shall be performed in accordance with
� City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
I NO OCCUPANCY BEFORE C.O.
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CONT ACTOR SIG A RE PERMIT OFFI R
PERMIT 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 COMMENTS
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Contractor/Homeowner: _ ��� ���1 Z
Date R ceived: — ��—��
Site: �Cf l Z �����
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Permit ype: � �� 3(Q� CS �
Approv d w/no comments:❑ Approved w/the below comments: Denied w/the below comments: ❑
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This cornment s et hal�. k ,�.�with the permit and/or plans.
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Kalvin S�i itzer ans Examiner Date Contractor and/or Homeowner
� %' (Required when comments are present)
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FORfVIS, -
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I� ' FLORIDA BUILDING CODE,ENERGY CONSERVATION
FORM 402-2010 Residential Building Thermal Envelope Approach ALL CLIMATE ZONES
Scope:Corppliance with Section 402 of the florida Building Code,fnergy Conservation,shall be demonstrated by the use of Form 402 for single-and multiple-family residences of three
stories or less in height,additions to existing residential buildings,renovations to existing residential buildings,new heating,cooling,and water heating systems in existing buildings as
applicable.To comply,a building must meet or exceed all of the energy efficiency requirements on Table 402A and all applicable mandatory requirements summarized in Table 4026 of this
form.If a brilding does not comply with this method or Alternate Form 402,it may stp,�Gomply.:under�Section 405 of the Flo�ida Building Code,Energy Conse�vation.
PROJEQT NAME: S��Z L�L I�1 �� BUILDER:
AND ADIDRESS: /� �
PERMITTIPIG � �
OFFICE: �f-�
OWNER�I� N� PERMIT NO.: Z JURISDICTION NO.: 6 ! �(J�
General instructions: ,
1 New construction which incorporates any of the following features cannot comply using this method:glass areas in excess of 20 pe�cent ot conditioned floor area,electric resistance
heat and airj handlers located in attics. Additions<600 sq.ft.,renovations and equipment changeouts may comply 6y this method with exceptions given.
2.Fill in all the applicable spaces of the"To Be Installed"column on Table 402A with the information requested.All"To 8e Installed"values must be equal to or more efficient than the '
required lev�ls.
3.Completelpage 1 based on the"To Be Installed''column information. �
4.Read the Fequirements of Table 4026 and check each box to indicate your intent to comply with all applicable items.
5.Read,sigp and date the"Prepared By"certification statement at the bottom of page 1 7he owner or owners agent must also sign and date the form.
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Piease Print CK
1. New Iconstruction,addition,or existing building y
2. Sing le-family detached or multiple-family attached 2:
3. If m itiple-family-No.of units covered by this submission 3
4. Is thil a worst case?(yes/no) .4
5. Conii tioned floor area(sq.ft.) 5. O�
6. GIasS type and area:
a.U-factor 6a.
b.SHGC 6b.
c Glass area s�. Sq n
7. Perc�lntage of glass to floor area 7, %
8. Floorltype,area or perimeter,and insulation:
ba.Slab-on-grade(R-value) 8a.R= lin.ft.
.Wood,raised(R-value) 4
c.Wood,common(R-value) 8b.R= sq.ft.
d.Concrete,raised(R-value) 8c"R- •, Sq•n•
�e.Concrete,common(R-value) 8d'R- S9•ft:
8e.R= y,
' 9. Wall tl pe,area and insulation: -
�.Exterior: 1 Masonry(Insulation R-value) ga_i, p= sq.ft.
2. Wood frame(Insulation R-value) - �
� 9a-2. R= s .ft.
q
.Adjacent: I Masonry(Insulation R-value) 9b_�. R_ Sq ft
2. Wood frame(Insulation R-value) 9b-2. R= Sq,n,
10. Ceilin type,area and insulation:
�.Under attic(Insulation R-value) 10a.R= sq.ft.
II Single assembly(Insulation R-value) 10b.R= y,ft,
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17. Air distribution system:Duct insulation,location,Qn
�I.Duct location,insulation 11 a. R=
b.AHU location ��b
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a.Qn,Test report attached(<0.03,yes/no) 11c.Test report attached? Yes No
' 12. Cooli II s stem:
�9 Y
, bI Type 12a.Type: �
i Efficiency 12b.SEER/EER: '
13. Heatin s stem:
� Y ,
13a.Type:
II
a Type 13b.HSPF/COP/AFUE:
b�E�ciency �
14. HVAC Sizing calculation:attached 14. Yes o
15. Hot w Iter system: �
�Type i5a.Type:
b�Efficiency . 15b.EF:
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I hereby certiry t at the plans and specifications covered by the calculation are in compliance with the Florida Review of plans and specitications covered b thi calculation indicates compliance with the Florida,
Energy Code. Energy Code.8efore construction is c p d, is huilding wili be inspected tor compliance in
accordance with Section 553.9 y+
PREPARED BY� DATE. � .
CODE OFFICIAL. y ry _ � ` .,z '
, I hereby certify that this building 1s iqynmpliance with the Florida Energy Code: , q _ � 3, +
' OVJNER AGENT:Ii • "��! � ,
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DATE: •DATE:
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� �C'4 at �- ``4 " `� `�p' , �. ,,. , 2010 FLORIDA BUILDING CODE-ENERGY COMSERVATIOfi!
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,1�, PORMS
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BUILDIASG COMFONENT PEAF6RN}ANCE CRlTER1A' lNSTALLEp YAW£S:
U-Factor<0.65 U•Factor=
Windows(sea Note 2): SHGC=0.30 "SHGC= � -
' %ofCFA<_20% " "
S i hts U-Factor<0.75'
°la of GFA=
...Doars:Exterior door U-Factor i'. ` ;U-Factor<0,65 �`: " U-Fector=
Ftoors: Slab•on-grade ", No requirer��nt, ; , R-Value� � •
flver u�conditioned s aces see No#e 3 R-13 `- s • � �
Walls—Ext.and Adj.(see Nate 3);
Frame R-13 R-Value=
Mass (see Note 3)
Inierior of waA: R-7.8 R-Value=
E�Rerior ot wall: R-6 R-Value=
Ceilings(see Notes 3&qj R_30 R-Value= Test repor[
Reltectance 0.25 Refleetance= Attached?
Yes1No
Air distribution system(see Note 4)
Duchvork&air handting unii: Location: Test re art
Unconditioned space Noi aliowed p
Conditipned space Atteched?
YesJNo
Duct A-value . R-value z 8 R-Value=
Air Ieakage Qn � Qn<p.p3 ��_
Air conditionin s stems see Note 5 SEER=13.0 9EER=
Heati�g system
Heat pump{see Note 5} Cooling: SEER=13.0 SEER=
Heating: H5PF=7.7 HSPF=
: s �
C,as fumace � �� AFUE 78% AFUE_
Oil furnace AFUE 78I A�UE_
Electric resistance:Not allowed(see Note 5)
Water heating system(storage typa}
Eiectric(see NOte 6): 40 gai:EF�0.92 Ga�lons=
�I Gas fired(see Note 7}: 5Q gal:EF=p,90 EF=
� 40 gal:EF�0.59 Gailons=
� Other(describe); 50 gak EF=6.58 = EF=
{1)Each compo�ent present in the As Proposed home must meet or exceed each of�he applicable performance criteria in order to comply with this code using ihis method;
otherwise Secfion 405 comptiance must be used.
(2)Windows and doors qualifying as glazedienestration areas must complywith both the maximum U-Factorand the maximum SHGC(solar Heat Gain Coefficient)criteria
and have a maximum total window area equal to or less ihan 20%a of the candiGoned tloor area{CFA);otherwise Section 405 must be used for compliance.
Exceptiorr Additians of 600 square feet{56 m2}or Iess may have a ma�cimum glass to CFA of 50 percent.
(3)Fi-values are for insulation material only as applied in accordance with manufacturers'installation instructions.For mass walls,the"interior oi wall'requirement must be
met except it at teast 50%of the,.R-6 insulation required for the"eacterior of wall"is installed exterior of,or integral to,the wall.
{4}Ducts&AHU instaited substantiaity 2eak fiee per Section 403.2.2.1.Test by Ctass 1 BERS rater required.
E�cception:Ducts installed onto an existing air distributian system as part of an addition or renovation;duct must be R-6 installed per Sec.503.2.7.2. +
(5}For ait oonvenfionat units with capacities greater than 30,OOd 8tuthr For other t}rpes of equipment,see Tables 5032.8(1-8).
Exception:The prohibition on eteofric resistance heat does nat apply to additions,renovations and new fieating sys#ems instaited in existing buiidings.
(6)For other eleetric stor�qe volumes,minimum EF=0.97-(0.00132 z volume). 'j
{7)For ofher naturai.gas"sforage valumes,mirsimum EF�0.87-jQ.0019 x volume}. ;
TABLE 4D28 MANpATORY REQUIREMENTS
COMPONBNTS SECTION . REQUIHEfNENTS CHECK
To be caulked,gasKeted,weatherstripped or otherwise sealed.Recessed lighting IGrated as meating ASTM E
Air leakage 402.4 . 283.Windows and doors=0.30 cfrtVsq.ft.Testing or visuai inspection required.Fireplaces:gasketed doors&
.'r; � > ' : outdoor combustion air.
Geitingstknes watis �30`s-,2.1 ~ R-19 space permitting.
Programmable thermostat 403.1 1 Where torced-air fumace is primery syslem,programmable thermostet is required.
Air distribution system 403.2 Ducts in eriics or on roofs insulated to R-B;other ducts R-6.Ducts tested to Q��0.03 by a Class 1 BERS rater.
� Heat trap required for vedical pipe dsers.Gompty with eHiciencies in Tab2e�03.4.32.Provide switch os cleady
Water heaters 403.4 marked circuft breaker(electric)or shutoti (gas).Circulating sysiem pipes insulated to=R-2+accessibie manual
OFF switch.
Spas and heated paols must have vspor-retardant covers ar a liquid cover or other means groven to reduce heat
Swimming pool&spas 403.9 fo'ss except if 70°l0 of heat from site-rocovered energy.Oifftimer switch required.�as heaters minimum thermai
efticien =78% 82%after M16/13.Heat um ool heaters minimum COP�4.0.
Sizing calculation peAormed 8 attached.Minirrium e�ciencies per Tables 5032.3.Equipment effic7ency verification
Coolingtheating equipmerst 403.6 required.Special occasion cooling ar heating capaciry requlres separaSe system or variabie capaciry system. (
Electric heat>14kW must be divided into two or more sta es. �
Lighting equipment 404.1 At least 50%of permanently installed Iighting IiMures shall be high-eHicecy lamps.
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2010 FLORIDA BWLDIN{a CODE—E�tERGV CONSERVATIQld ' �`�t`'-`-`���Q'SLFk::��C 5�j�{`�'�'y�
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�; BuNding Q�partment
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Date Recetved \'
.i� � P..hane Cantact for P�a�t�41e� —
Owner's Na I e. \ + �'v� Owner Phone Number ���I� 9 �3�
Owrner's AddFess '�� � c.., 1 C.— � � y Owoer Phone Number � �
Fee Sfmple 7ltleholder Name �- � Owner Phone Number �
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Fee Slmple Titleholder Address
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JOB ADDRE3S � �� � '�'�` r�'C'—'+ LOT# �
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SUBDtVIS10H �� _ � PARCE�iD# , .
(OBTAINED FROM PROPERTY TAX NOTICE)
VYORK PROPOSED ^NEw COtdSTR • ADDlA1.T Q S{G1V [� Q DEMOi.lSii
INSTAI,L 8 REPAIR
Pl20POSEp:��SE � SFR Q COMM � OTHEF2
TYPE OF CQNSTRUCTION [�` BLOCK " � �RAME �� BTEEC Q
DESCRIPTiON OF WORK � � 1 �t ' .G � U�'1 �{J �
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BUII.DiNG SiZE` ' SQ'FOOi'AGE�� HEIGHT=
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��������'' � �� VAI.UATION.+JF TO`i'AL Ct3NS'i`R1:ICTiOT�t
�EI.�CTRICAI $ " AMP SERVtCE PF20GRESS ENERGY W.R.E.C.
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QPL�MBING � $ '� ��
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QM�GHRNICAL $ VALUATlO,N OF�MECHANICAL INBTRLLATION � �"
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Q . Q/ ROOFlNG Q SPECtALTY � OTHER �
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FIIVIBHED F��OOR ELEVA710NS FLOOp ZONE AREA QYES. NO
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SIGNATURE �C�„5 REGISTERED Y/ N FeE cuRrtEn Y/N " .
�ddres . Llcense# �� �
E�ECTRICtAN ��t , Ct}MPAi�tY
SIGNATURE� � � � REGISTERED Y/ N FEE CURRE�°` �Y/N"
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Addre' Ucense#,� �
31GNATURE �, , _l, R t?MFAN p Y/ N FEE CURRen Y/N
Addre� ' License,# (. , ��
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SIGNAT �.""""� �� '�_� � GISTERED Y.../ N FEECURRE� X/�N
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Add ""I �� ', ' . ' Ucense# � �
OTHER • �� � .��CONlPAAIY,
SIGNATURE� "- - . " � ' ' REGISTERED � Y/ N.., FEE CURRE�' Y/N
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Addre$ti ', . Clcense# '
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RESIDENT - Attacti'(2);Pto#�.P,lans;h(2)sets•-of<BulldfngxPians;{1)sef'af=Enet�y=Forms;R-0=W;Reriqit for new coi�sUvct[on,
Minimum�tenn(10);working days after,;subrnittal�date::R'equired ansife;;ConstriicBon�Pl'ans;�Starmwater'Plans w/SilYFence instatied,
"���'SanilaryFacdllUes�&,1;dumpste,r,cSiteWo���Permitforsubdiyisions/large;projects . ' - '
COMMERCI�L Attach(3)�+oamptete sef's ofBtiilillog"Plans ptus a Ltfe$afety Page;(1}set of Energy Forms.Ft-O-W Perm3#for new construc�on.
Minimum ten(10)working days after submittal date. Requlred onsite,ConstrucNon Ptans,Starmwater Plans w/Silt Fence installed,
8anitary FacillUes 8�1 dumpste�.Site Work Permit for all new,projects:All commercial requlrements must meet compllance
SlGN PERM T Attac�i{2)"sets of'Engltieered;F'laris.,_ � • �; -
' ""•PROPERTY SURVEY required for a0 NEW construction.
Dlractions: �� - � . '
FIII out 2pplicatlon wmpletely.
Owner&�Contractor sign back of appltcadon,notarizad
If cver�2500,a Natice of Commencement!s reqaired. {AtC upgrades over;7500}
" Agent(far the conVactor)or Power of Attomey'(for tFie owner)would be someone with notarized letter from owner authorizing same
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DVER 7'HE GOtlNTER.PERMITTING-- •- (Front af-Appllcation Only} -
Reroafs if sh ngles Sewers Service Upgrades A/C Fences(PIoUSurvey/Faotage) ,
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Drivewt�ya-Not aver Gounter tf on publEa roadways..need`s ROW
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� N�'T9C���DEED RE�'�RiCTiOM�. 1'h�under�3gn�d unders�t�r:�ds:�hat#his:.p�r:rni#.m�y.be.subje�t to°deed"_restricttons"
i w4�lch m�y be<mar��e�ti�icti�re�th�n G�ucity.�eg�ala�ions:�'Th��vn'd�rsig�ed assum��-"Pespe►nsibility far�caPnpliance wifFi��eiy
app9lcak�4e deed-rest�i�ttons.
l IANL.iCEN�ED C�NT�tA�T�RS ARlD CCINTi3A�TOR RE9i�R�N�I�lLlTlE�. -!f the o�roer has �hired a e:ontraatt�r or
contracQa�rs to under�ake work, the ra�a be>cequired<;to:be•:Ilc�ns�d In accordanc�.wtth stat�.and•lacal_reg�la4lans. If�khe
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contnact�r t� not licensed as required by law,`bcath the owner and�convactor�may b��cited-for a•misdemeanor viol�tton
u�der state iaw. If the owr��e or int�r�dedx contractar��re unc�rt�ln �s� #o vuhat iicensing.requlre�ent� m�y4 aRPty-�fior the
i�Qended�rrork,they are ad"visecf tc�¢;�an���t the`Fa�co�au�tty�uifding Qn�pectton.Divislon--LfcensEng��ection at 727-8�47-
�¢D09, �urkhe�mare, tf the owrner h�s hlreai � cmntractor or c�ntractors, he Is advised to have the cor�#raator(s) s4gn
portions of the °contractor 81a�ck� of this app�loattora for whtch 8hey wlll be re�ponsibleo. :Sf yo�, �s,.#he ov°ar9�r slge�`as�th�
co�ttsa�c���, khat-ra���r b� ar� indi��t8m� #h���h� is ��4.properiy licerisad and�ts not ent�ied to p�rinitting privlleges In Pasco
Gasue�ty.
T�tAMSP��RT�Tl�9N..IMPAGT/UTIL�TIE�:IMP10.C'C AE���tES��l�t�E RECOV�RY�FEES; �"h��ar�derslgr��d und�rs#a�nds
4Poat�'rar�sp�rtation Innpac�Fees and.Recour��R�c�vecy.Fees rney��apply;�to�the construcE4ore af�e�r butld6ngs,°�h�nge�i►f"
use ln ettisting bulldings, o�..exp�ns��n•of�ezistin,y�bullslirigs. as �p�cified.in Pa�c� Couroty Clydlnance nurnb�r 89-Q7 and
90-07, �s �mended._The undersign�d at�o:und�rstands, that�such fe�s��.��,�nay�tierdue;:�wrill:.be idenOtfl�d at the��tim��of
per�ittln�. it 1�fi.rrtFier undeP�ta�d that Tra�nspmr��fion impact Fe�s and°R��ource,RecoVer�y�Fees.mus� be paid pri�r ta
rece�ving a "cet#iflcate-�f�ecupancy°' or tinaF pav�er..�tease. :If�he p�o�ec#.doas.nat,fnvatve::�,;c�rt3ficate �fi occupan�y.-or
fina! pouve� releas�;.the f�es mu�t b+� pat� pr�or�a per�►6t lssuanc�. F��thermore;"i�Pascc��County iNaQert.�ewer�Impa�t
fees a�e du�., they,must be=paid-.prlor Qo permit�issuance•tn accoedance wltti gpplt�abl�Pa�cv Cot�nty oi�tllr��nc�s. -
CONSTR�9�Te13N�IEiV'LAW(Giti�pter 713� Fso�lsla 3t�t�te��a�amended): If val�a�on of work is�2,500.00�or rr�orer a
certify that t, the �pplica�t,_ have.been provtded with a capy of the "Floeida Co��truction Lien .Lawr—Homeowner's
Protectlor� Guide" pre�ared by,th+� FE��Id� Dep�rtr�er�f of a4gricu6#��� and Consunn�rAffairs. If the appti�anf is so�reone
othee than the"owrrer", I cert9€y.#hat I h�ve.obtain�d`�''coPY:af..�he�abo�e..descrlbeddb�uin�r����nd.prornise in,good f�ith to
delive�It t�:th�.:"o`nrn��".pr�or�Qo�e�mre��ncement. ' '
�Q►NTRA�TOR°�/OWIi'P�iER'�A��IDA!/pT: I.aerki�y.th:at-a01 the..9nf.ormatign in°�Ihl��pplicatl��is accurafe�nd fhat a!!work
witl'be done in compl3ance with al{ appticabie I�ws r�gut�ting consQructlon� za�ning and land de�elc�pm�ra�, Ap�plicatlon i�
hereby m�de #o ob�ain .a .p�rmit..Ccs do work,,.a�d iins#aii�t€on as 3ndi�ate.d:- °I cer`tify that no wark:or lnstallation has
ce�mmen�ed p�(oe ta Issuae��e of a perrrift anii th�8`�!! vv�rk �EI be performe� to m�et standards of �i� taws regutaking�
c�n�truction, Coun�r and City aodes, zt�ning regula#Ionso and land davelopc��tt regalatio�s•in the �urisdictton. I �i's�s �
certify th�t I u�derstand thak the regulations of other gmvsrnment ag�ncies m�y��pply�#o the 1nt�nded work, and that ft is
my respor�sibili�+to id�n�ify�what.act(�ns 1 must•take:to be,in:.ca�pliance. �;uch.ag�n�le�ir��lud�bu#are.no�llraaited#a '
- Dep�rttri�r�� �f Er�vironm�antal�Pre�tect3o�-Cypres�.�Bayh'ead�, We�l��nd Ar�as and Environrv�ent�lly Sensitive
L�nd�,Vi9��erNV�s#ewat�r Treatment.
- Southwest �lor�da Wa4ea� ➢4�aatag�mee�t: .l�is#r��t li�e@I�; t%YPress.'".�ayhead�; We#aand Areas, Aitering
Wa�ercourses.
- Army�Co�ps of�ngl�eers-Se�wraUs, Ducks, �Iavlga�ble 4llfaterways.
- Depar@ment of Me�lth & R�i��b9li�ative Serdi�esl�nvftonmenlal F�e�lth llr�tt�lMells, Wastew�ter=Tre�4m�r�tr
S�ptic Tariks. _
- l�� E�viro�rr»entai 6'rote�4f�n Ag�ncy-P��b�st+�s sbat�rt9en#. �
- �ed�raQ Av6attoet;Ae�thorlQy..�n�vays.
1 underst�nd that the.follorwtng..restrictlons appiy to th�u�e of flll:�
- Use o�fill Is not allowed ir�:Fl�od:Zone"V"unless expressly perrriitted.
- if the fiiit materisl is to be used: in �fiood Zone. "A", tt. 1s undersQmod that � drainage plan addressing a
°compensatir�g vodume"vwill be s�bmi#t�d at�iene �f perm3tting wliich is prep�r�d by a profession�i engineer
IOc�r�sed b�Rhe State of fl�tlda �� ,
- !f the fill-r�aterlal�is� to b� used fn Fir�od �vne 'A" ink conn�ctimr��tnrlth���g�ermitted building u��ng stem wali
� constructlon, I certify that fiq:vulll,b.e us�d only.to.t11!th�area wlthin tt�e�s#e�a wal�.
- If�i91 m�terlai is to be used in any �rea, I �certify th�t .use of such 41i1 wlll n�t adv�r��ly ��fec4 adjacent
prop�rties. if use af fifl is f�und�to adee�seFy:afiect adjace�t prc�pe�ti�s,.t�u�ow�reP may be clged for violating
tY�� �onc9�ions_of th� buitding:permit iss�ed conder th� att�ched ��rmit �p�licatioa�� f�r lats less than one (1 j
acr�w0�lati ar�el�vaterf�by flll,�rt engin�er�d drainag�pl�t�i�requ3r�d. �
!f i am the AGENY FCIR THE Q'IPVNER, �,�proml�e I�t good faltkt#o lnforen�th�awr�ec.�f the per.mitting condltfans s�t fr�rth fn
this affidav(t-priar to ccammencing con�tructia�n. I understaird thatra���parak�permlt rt��y be requirec!for eleat�cal wrork,
plumbing, sqgns, wretls,.poois; alr cortdtfioNng,,.gas,.or oth�r. in�t�il�#lons not,sp�actiicaily (nc0eaded-in.tMe applicatian. .A
permit is�t�ec6 shall be construed to be�a°lice�se to proc�ed writh t6��nvork and;no�as:authoHty:to,vlolate,aancel, alter, or
set asld�ar�y provisions e�the#ech�E�a�c�d�s;�noa�shati Is�uance e9f�a.permit.pceve�t the BuNdir�g O#ficial from thereafter
r�q+�lring���e�tio�af erc�rs-In:plans;cc���ti�ucttc�n or vi�tation��f���y codes. �very pi�rmit ls�ued"stia�l 6ecome invalid
un0ess the wark autha�rized by such permlt_is.aoEnmenced•wt�h6n s�c..m�nths of perrr�lt 4s�uanc�e, csr if work autP�orized by
the permlt.is.susp�nded ar.abando��d:for a;period.of s�x:(�)�mont�s,.�if�e�th�tQm�the�wo�k•Is corr�m�naed. An e�ctension
may ba req�+�sted,_in writing;.from the,�uil�tng;OfFic6a1 far a perlod rrot..to.exceed'rainely`(90}�d�ys a�d wip demonstr�t�
jus#�iabie'cause for.�#he�xtensior�. If w�rk ceas�es:for ni�tety(90)�o�s.�cutive d�ys...th�jab�is considered aba�doned.
9AfARMlNC 3'� t�1NNE13; Yl�U!'�.FAl�.fl�RE:��A!.,.R��.��tt?A.MO'�'!��.���C@��4l�NCI�ME��' flAAY RES�Jl:T fN=YQtlR
E�AYIPI�T�Vp�E;FCIR;INI9�tUV�N1EN.'�I:S TO,YCIUR;PROPER�'Y. !�°Y0.41zlN�EV+l9?��YQ�K?�T/�1�P�����NE1�1�1NG;'C.CtN�Ul.°T
WIT Y lD . D �D A TTO N � OR�}�•�Q�1+ t�' �UR' ,�� `d] � �� ' C�
FGORlDA.lUt�AT(E:S.1.1ZA3j _ . . . .
OWNE6t OR AdIER1�7��I !""V�l.as✓' CONTRA�TO ` ca5�'�--- �
Subscrlbad and�vva �(ar a�f8rm�d} re m�itrf� Subscribed and'swom to( afflrmed)�bt'on� ;thl�—
by �..'�' [1!{1i� _ .by p�` ',tf"
UVho is/are perso liy knovm to_me or;haslh�ve produced Who Is/are persanal own:M me ar hat�/hav,e:•produced
as ldenU�caUon. ' as identlticaBan.
Note�ry Publlc , No#aty Pubfla
Commfssfon�4a.` Comtflt�slon.Pto.
Name of IVotaty�rped,printed ar s4�rt�p�s! iV�me af Idotatey fyped,Rrtnted or st�mp�d
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