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HomeMy WebLinkAbout16-18017 ,ii �� � � CITY OF ZEPHYRHILLS 5335-8TFi STREEI� (.s�s��so-oozo 18a17 - BUILDING RERMIT � PERMIT INFORMATI4N � LOCATION INFORMATION Permi# Number: 18017 Address: 5610 6TH ST Permit Type: RE-ROOF ZEPHYRHILLS, FL. Giass �of Work: ROOF REPLACEMENT Township: Range: Boak: Propased Use: COMMERG(AL Lot(s): Block: Section: Squa�re Feet: Subdivision: CITY OF ZEPHYRHILLS Est.Value: Parcet Number: 11-26-21-0010-05800-0180 Improv. Cost: 7,3Q6.00 OWNER 1NFORMATION Datei Issued: 12/21J2016 Name: JANCA PHILLIP TODD & DAVIS STEPH Total Fees: 75.00 Address: 5610 6TH ST Amo�unt Paid: 75.00 ZEPHYRHILLS FL 33542-3410 D�te Paid: 12/21/2016 Phone: 813-714-6537 Wo'rk Desc: REROQF SHINGLES CONTRACTOR S APPLICATII3N FEES WIDNER ROOFING lNC REROOF RESIDENTIAL 75.00 ` f� � � ,� � l ��� Inspections Re ired DR INR� OFI � TAPE JQI TS ROOF ItUSP FINAL I REINS�ECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c)the local gavernment shati impose a fee of four times fihe amounfi of the fee imposed for the initiai inspection or first reinspection,whichever is greater,far each such subsequent reinspection. NOTIC�: In addition to the requirements of this permit,there maybe additional restrictions applicable to this property that may be faund in the public recards af this caunty, and ther.e may be additional permits required from other governmental �� entities such as wafier management, state agencies or federal agencies. "1Na�ning ta owner; Your fai[ure to recard a notice of commencement may result in your paying twice for impr�vements ta your property. If you intend ta abtain financing,consult with yaur lender or an attorney �� befare recording your notice of commencement." Complete Plans,Specificatians Must Accompany Application. All wark shall be perfarmed in accordance with �� Ci Codes and Qrdinances. NO OCCUPANCY BEPQRE C.O. � NO OCCUPANCY BEFORE C.O. � CONTRACTOR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN fi MONTHS WITHflUT APPRt3VED INSPECTION � CALL FOR INSPECTION -:8 HOUR NOTICE'REQUIRED PRt3TECT CARD FROM WEATHER � * � IlIIIlIIIIIlIII!lflllllllllllNlfflflllllNllllillllllllfNl 2016199286 N Ng PertnitNo. ParcellONo I/-�6 `- r�-�^�(�/4/�Q�,�(/t/-0��� ��.�-�+ . m m N � � N071GE Q�G0INMENGE11+1ENT � � .�•t a State of Catmty ot__ �"� � $` fl ' �M THE UNOERSIGNED hereby gives notice lhat improvement will be made!o certain rea1 prope[ty,and fn accordance w(ttw Chapter 713,Flodda Statntes, ...�ai the toftowtng infa�natian is provided in this Nottce of CommencemenE: •• ld 1. DescripUon of Propeely_ Parcel ldentificatlun No. 'Z.�- C4�- � �'- (� C� �O� Street'�ddress: 15�+(� �o� � S , p m t�9 v � 2. General p e scri p t ion of Improvemen t .0 6'1 I) n � ro 3. Ownerlintortnation ar Lessee information i(tFie LessBe wntraded forthe improvemenL � F � II l ' il .sb l� "a%�--S�- ,Address Gtiy State ..Inle �in Propetty: �"'i�l/�. , Name f Fee Slmple TiUeholder. {!f diiferent Uom Qvmec Gsted abavej +''D N Address Gty Staie ��D �. Confreclor. � m ti�" �I Name j g x m Z Addres's 2 t�y 7 9J-� City St2t ,�+7 �� ConGaGtor's Telephone No.: ��.J'_I�T 1e�.7/ �J�v-`� ��z s. s�.ery: `���'f��9 Name Wpmi N � � Addre&� Gty Stete -o � c� AmoUnt o(8ond: E Telephone Na.: �~m x 6. Lender. �.�q„' Name ►+o �� v Address� City StaSe y Lender`g Telephone No. � � r ? Person I wfthin the State pf Ftorida designated by the awner upon whom�notices or other documents may ba served as provided hy � A $edfoni�13.13(1)(a)(7),Florida Slatutes: Name ' ' � � � ,J�j'4 -s Addmssl) ' Gty State �� � � ', � �+�� Telepholle Numbee ol Qesignated PeCsam � 9. In addifi�n to himself,the owaer designates - of� � a � � II to receive a capy o!the LienaPs Nopce as roWded In Section 973.13 1 ' �' �� t'°� ��"' � � " P ()(b),Florida Statutes. � � flp Telepho�e Numher ai Persc�or Enttty Destgnated by Qwner. ��'f��' --__�,°`-.4''[�g�qp • � b� t. E�rfratioP date of Notiee of Comme�eement(the e�atration date may�ot be before the compie8on of constn�ctton and finai peyment to the � • �=� �� , �.,� cdnlrador,bul w(11 be one year trom 4he date o!recording uniess a dlHerent date is speciTied�: � c+ � � � WARNI�G TO OWNER ANY PAYMENTS MADE BY THE OWNER AFfER 7HE EXPIRATION OF THE N4TICE OF COMMENCEMENT �;�� ARE CS7NSIDERED lMPROPER PAYMENTS iJFtLtER CNAPTEi2 713, PART 1, SECTION 713.13, F2QRlDA SCATUTES. AND CAtd RESUI'f�)iN YOUR PAYING TMCE FOR IMPROVEMENTS TO YOUFt PROPEftTY, A NOTICE OF COMMENCEMEN'f MUST BE � � • �' RECOROED AND POS7ED QN THE JOB SlTE BEFORE THE FIRST!l+ISPEC210N. !F YOU iNTEND Tt}OBTRIN FiNANC�NG,CONSUIT WTfH Yt3UR lENtlEF2 OR AN AtTOftNEY 8EFt3RE COMMENCiNG WORK OR RECOROING YOUR NOTICE OF COMMENGEMENT �� � � Under p��,atty ot perjury,t dedare that i have read the fqregoirsg notice of comme�zemeM and thai the tads stated iherein are tnie io the best � d(myknlo�wledge and belieL �� () � � :TATE�OF Ki,ORlDA - � � ��' � w '"'j :t]UNTY OF PASQO y R4,.,J� o C� '�'�" W S � � +V Noiary Putrik Spte ot Ftorida ' � �� � }' f�� t n ure ot Qvmer or L` ee,ar Owner's or Lessee's Authorized � r" F-- Sherry Witlner � CJ (/� �y � � • My Cammtssion FP�?St85 � ��reclodParUier nager „Q ('� O S ,¢ �y �r a •��uNw� Expirasi?l092017 � � (� k„_ � Q � . - tg�atorys�K�elo�ice , O [�= �'"�� _l � he foregafng instn9nent was admowiedged before me this�ay of �,20��6y � �s � O ~ � ¢ � �� as 9uS\.t.S2� �y t1_ CC C� U ¢ype at a ritY.e.g.,otttcer.hus e.a ey irt fact)Tor � =Q � � � i (ne pa_ on alf of whom InSttvme w exe led). � k- Q � u- �' � ersone�ty Known C�R Produced IdanOficadon❑ Notary Signature ,,,'u' �;; ,,,',��+.� V Q (� � � , �'� ��..._ r rye of Fdeniitiratiol Aroduced Name(Prirxty .�� _,,,,;,� � ,Q r � Q -� p �- C� [Ap u.. V � � �� Q a � O � tYuz ¢ � woc� y.. � � � c3 c3 � O � �� � . � � ,`� —�� � �tlatalbcsJno?tceca encement�c053048 � F. j,1j — � �.'�' � ��°G' � Q } ca� t— t— O 5' n. [o � ` � . `l . . � i Widner Roofing-A. �i 24748 Roberts Barn Raad I74' 1�IiDNER R�aF1N� Lee:813.714.653� � Shext, - „ �.—.. E-maii: LSi I �All Kinds of Roofing' Lic. #: I s���l i N rz ���J CS 3�cc� �� �t Z�� , �� � � �e� „ �e. �z � �� {,�S��s �4- -�-e..��-_ �,�s���=�— ��� ��--�-- � ` c ,N�f�. (1 a�-u= P�j ",��' r �-- �� �, { ,� �� .��-��q�+�'� , � �u .� 1 `��(f v�� ((�� ��:� � �s � ��-�- �-��� , 3�,� ,�1��.�.����.. �- �5 ��,��le�.s� �--- ���.. � �a�e,� �---s-{'� � ����,� u.N ,� �; �I�.�� �'-� � `� 1.��2 �I ��a��.�.;��..� �= ��` �-�-�. � ��c.,�:w c�e �X ��f�-- i�'�'�� �'. ,�� �'�t i�/�Q ���� �� -'e/�1 J`�-- `�,,��--�`����.._ 5 Yt e�.� 1"'�~� j �-'-�t d I � � � �-- Z--A��t�� ��� �� .�d1U� .��c 2. �1 I � !�t'i�.�`�7�J�' � � uvl 1 � C�c�1�`2- " �- �}!c� �Q��2�''-- U �,���... �-t_� a- -C t�- , �,��£ �t-.�-,% � „ � ��,-�; �-�_ �-�`-� ���. s�-�-��-�4-� �- .,���,��-f�l l s�M��. �NS I��d �� ,cle�..a �'," _ �l � ,,,2_--.=���� '9v�'-'L !K� -���i � ,�-�w�.� . Y l.a�e �/u •�,...Q.s`� t��'!.,�r �`� � c ca.s � � '7 3 0�"� �-� ��� � $ . �� S�-. �l� � +�.,)Q �� � u.c�=Q- R4 o��a..�d.�c �" "7`� `=D�l`� co�� �-� ��' � s ��.:..,�— � �,,��__ _ � .�- , �.� ��. ���.�.��� ������� �.�� � � $ � �e c� �� ��'�..� �� ���.� �°��t`-�`�- . .�.0--- `�.. � ��� � � � ' � � D ; �a�� �"�y-�, e ��..�./�`� � a _ �_ .�-�-�--, ��C. ��` � � � �, '��y���`. � J������ ��� � � �_. _ ;I il �,�.� ��� �..�.-� � � �s_ ��___ � _ • --� `� ��� II ��� ` ��. � � � �-��� �a���-- �- � � - � , e7�a- eo-oozo City of Zephyrhills Permit Application Fax 813-780-0021 Bullding Department Date Recelved • �.0 , • .::�Phone=ContacYfoc:PernifBln � I 3. _ � ��� Owner'�Plamle (�cl�e., �l �� Own�r Phone Number � Owner's Address �0 �� �-� L Owner Phone Number• Fee Simple TItleFiolder:Name - Owner Phone Numbe� Fee Simple T(tleholder Address A JOB ADDI2ES3 �O �'S LOT# � SUBDIVI310� . - PARCEL ID# ' '-.2 � - ���� 'CC��OO— Q(�C . (OBTAINED F.ROM�PROPERTY,TAX NOTICE) WORK PROP SED x;..NEW CONSTR , ADD/ALT C'_] SIGN' '[] • � Q DEMOLISH ,., � .B. INSTALL 8 ,,,•REPAIR PROPOSED:.U$E , : Q SFR. [�. COMM . Q � OTHER` TYPE OF CONSTRUCTION'4� �Q" '>'BLOCK " `Q FRAME � :[�: STEEL `Q p �. DESCRIP710N OF WORK' - .,.l. ..: BUILDING:SIZE�`� • "3 S =' SQ.FOOTAGE�"� ,HEI,GHT .. � I » - QBUI DING $ � VAL.UATION'>:OF`.TOTAL CONSTRUCTION �� QELECTRICAL $ ' AMP SERVICE. ` =.Q'� '�PROGRESS ENERGY Q W:R.E:C. OPL I MBING - (.$ � . . . 1�,: , OME� HANICAL' - ^ $ " � � "VALUATION OF�MECHANICAL`INSTALLATION. ��. . :� ' � �:'� . - _ ,. ' '- ; - � Q� � ROOFING Q „ SPEGIAL7Y,::�,_,.,.;OTHER, ., . • � FIfVISHED FL� OR ELEVATIONS FLOOD ZONE AREA ,QY�S. ,NO ,. ...,:. 'x� ..., �,; .. �� , -- .. 'n ' :`i' -r.. .�;.- ''ii;.i• __ . BUILDER COMPANY• -�.'�' .. .- . .. . � � , . . SIGNATURE REGISTERED Y/ N .� '`����FEE'CURRE� "' k Y/'N` " � � ���:. � :s.a. ,_�% -_ � ,. . - .. Address �. ��= ;�. _.. - � : �t;; .. :Llaense�# - � , �° :.. . ... . .. , . ,ra .,. „ �• � ., _ ..� , � . .:x,.,;., . ,.. _ _y , . , ELECTRIC ,.. .. - - . ' - }•;COMP.,ANY' . - �F� i.<���; .�._.<<_ -'t; , _:., : - � SIGNATURE�" � REGISTERED Y/ N FEE_GURRE��� `'z � �{ .;:,y�LN;: r.. ' ,,,. r. .l' - _ �r " ., �±��>,^a ,.- :.. .,..;' . .. :� . �a . Addreas . - , . .. . , , , . , . . � � ` �License�#�;- f e . . - _ . �.:;;::;,,, . .. � .->i. � ,�4 �.. - .� C � . . PLUMBER�` .. . . °� .C.OMPANY �:;.>.,�,;,. ...;� ',e = _ ,:t � - SIGPWTURE` "'=. . , � , .. . .. , � .r....: , ._, . . .., - - `��is.tE�o �X/,;N;: .;�:Cua�n:x: Y=/N. Addre� ' , - , � . - `�License#J . _ . . , , . ._ : - , _,. _ . _ . ,,....,,. ,. . ..... .:,.- . .. .�; . �... y 1.. ,.,e�•..i. . ' ' ,i"��' : ` MECHH�►NICAL`' ' , ;' •• � - , �. � '' COMPANY. -..^ , . .. SIGNA7URE� ,.=i'�.. .... � � ,. � _ , � .- ,- . ;�.� , � .� ;.. .,.r:,.�.�,. .. , REGISTERED , Y/_,N FEE CURRE�--.. Y./�N t. .r.. . .. ..:. Address�� = =a . . - ,... ... � . .. � - - - - ' ' t� � Libcense#.� . .., , ' � OTHER -,� ,._ c , . � ,, , -- _ �. , •- :;. .,,.. rc .:,. , _ � +"COMPANY" ~� . ..� � - .�'^ �.�t�� . .. SIGNATURE•: 'z';*. ' �--.,.. .� .-, - , , ;o-� ; .,_. , . - , . . :.. ; .. .,,., ,. .: .. . , ._,i,,. :,. ;�....,a .:r9::"?•. �: �.� ,: . . . . . ,:REGISTERED . Y/ I?F�.�. - .: . . ��E�Cu�n• Y/N -,. ...,..: ._ , �.�.. . _. - �: :. : . : - :; ,, . . Address •� ( � C/ . f .< . .. ; .... , . . �.I°�"'�°�� .�^-� �_ `�'� =Ucense#�.' 'CCC-p' 7'� �2— " RESIDE °t7 . .. ��,.<:..<�....: _�. ��_-.. � . .. , .... , . , . _.. . . N AI��..�Atta'ch�_(2)aPlot�Plans;r(2<)sefs�of'Bu6ding�f�lans;(1)set'of=En'ergy=Fo"r►ns,R=O=VU°Permy�for new�construcUon,. . . i.: . . _" �-��_��;Minimum�.ten#.(�1;0)_aworl�ing�d�ys�,afCe.r;;subm�Etal�:def"e.�sR'equlred onsite;'ConsUiictlon�P.lans;Storinwate��Plans�w/SIIt Fenc'e installed, ' � San(fe`ry'Fadlttites_s&tl�dwrr�pster„Slte,.Worlc_,Pertnit;#or.sutidivislons/large.�projects�`�:�,��;��; ">>�..�,>.'�;� '�:s��' � . COMMERCIAL Attech(3)•eompleie'sets of'Bullding Plans plus a Ufe Safety Page;(1)set of Energy Forms.R-0-W Permit for new construceon. ' � _ _ _ Minimum ten(10)working days after submlttal date. Requtred onsite,ConsUuc�4lon Plans,Stom►water Plaris w/Silt Fence installed,' ' - Sanitary Fecilitles 81 dumpster.Stte Work Permit for all new:projects::All commerc(al_requirements_must meet compllence "`` " - - SIGN PERMIT AttacFi(2)°sets ofEngineefedsPlans:i;,.f;�:�.s�;-,,::�3<..=:;F,;,- �- . .: �' ._- ' -� . I ••"PROPERTY SURVEY requlr�d for all NEW constructlbn._. __ _ . i` . - DI"r"ec�lons: II :-:_rsa���;t....,.�:� .. -- � �- FIII out applicatlon oompletely. Owner 8�Contractor sign back.of appltcatlon,notadzed Ifover�2500,a Notice:of.Commencament Is rsqulred. (AIC upgrade�over s7500) . II .,,.;:,,����,:s;��?t:>'' - --� _ _ < " Agent(foli the contractor)cr Powie�of Attortiey'(for the owner)�would be someone with notarized letter from owner authorizing same OVER.THE.COUN.T,ERuPERMITTING�- --�:-•(Front�of•Application�Only) -�-- ` � '"� � � Reroofs If shirigles Sewers Servica Upgrades A/C Fances(PIot/Sunrey/Footage) Drivewa II -Not over Counter if on public roaduvays:.needs`ROW` , { � ,.�, _ �� . � � � � .a.�.i•,.r._,._ ,c s.::c•�r..^:x�n'...,e..:� .� .. ._..- g�.^-'.r.x. �.._.s.:..<.�-. . ,... , ' _ :;�i1� . wr.r•.��„�" _._ � .... .. =-' � ., 1- .3 '��.. o� ^ .• �.. �•� �„ '(, -,�.t�1;5:'Jv'1 � � C7:�_.i:�li iu.'. k1 �.l:.�' ;; . : � ,i ' �•";e�j i?i' � " "� ' ��' �� ` ' �:)_/'•�C•E��:;if•'t;..�. �' L,�. , ., ' . .r�` �lII::`;Y:",r[���. y • : .. � �� �:, ,� . ..,.� . , < ��;�. , . . , ;, ,:��� ;, .�,._a:,. ,- ,. �� • .. . �; �,:�Jf•i,'�Ic�� ,.o..Iili+. 'yr! _ � f ti�':�:::i .w �(ii��...�., , . ' ,. L�. _��a'i`- - • .- .. ,.. � ..,�-x._�:.... .,- ...�K.. .�...._... � . . . ... 1 .. ..._._ }�,,�- -�.:ri�i:`.!S:» ldOTICE Qr��DEEQ RE8TRIC'CION9�:. The.qndersigne�fi;under�tands��h�t�#his:;.��rm�f,:i,»a�y;;be,sub�ect:ta"deed.".-rostr'Ictiaris",::v.,,.,,. .;.. i' . . ,... .. ,i.Siy t �a "� "v.,- � '' :�a i�; �y �' S.f�err:s.':.. j +`:i"`.s.•.�i.r,e;t.'.t��i� which may.tie<mare��r�"s"tFdctlVe`=ttia�t'Gounty�rsg�iletPon's:�.i�na�u�P+aer���r;a.a'�i�s�um�s r"espons�blllty�fo�compliance:with any appllceble'deed=reatttctions. .:{>,;.�.;-::,,�`:�.t�� ' � __:. . ... _ .._ -- - ��::�.:"'`=�`�='`T' .; . -•. �;�.�. .,...�.... .._ .... -:E UNliCENSEDt`�CC►NTRACTORS°AN� CO�NTRACTOEt RE�iP�N�IBi�ITiI�S:=�.-rrlf�t�e�auvner�has"#iirecl"°a:"ct�r`w.ti��'ctor ar contractors.to undertake work;:they m` �"�``' ay.ibeireiqirir;ed.stti:;lae;llcense,di�lrt;accor.dance:withr;state�andk local'�r+�gulaNpns_'«�if�the����:��° �N„__ . . r.•.. ' '"'.'�; contractot=fs'•nat-llcensecf:'as==tequl�zl;'tiy law,•tioth��th� owner a;nd-�co�at�actof°may�`tie�'cifeif�for=�a�ml�derrieanar vtola#1an under state law. .If the awner.ar Intended>,,cont„r;�i,�tor,.ere„uncertain �s:to.what Itcenaing�,.requlrements��may���apply f�ffir�tiie��-�����:�=�'; fntended'work, ttiey are:edvlseii"t_o ciantact ttie Pa�co Cdunty�8uildirig�Inspectibn l�'1'vi�lon-L•Ics[�,,s"Ing 8ection at.727-&4�7- 8008. Fu�tttermare, if tFre owner`#�as"t�ir�+d a ccin�actar'or contreotors. he Ts aiivised to have rthe cort�+tracta�r{s)�,ssfign,=,,=+::�;��y • portians of the "conttectar.Black".of.this�appllcationMfo_r.;,which,:they:wil�:,:b.ea.r,espor�sible..�If.you,�as:the owne�r signg'as the contfactor; thet�r►�y'be an indica�on tl�a#'Fie'�1's`i�iot`ptoperly„Ilce�isei�'�an�"'ts'"not."+eritl�eil fa perml�tiiipg..p�tuileges ln Pasca_. , County. .�. _ . . .. . .. ._.._ ... � ' ...,........_..�:.�:_...........� y4.:�>��:��..�,:�,:� TRAN�PORTAT1t�N.iMPACTIUTILlTIES>[NIpAC��Nb�l'tE�AU�CE RECOV@RY fEES:"The°unde�sl�ne�"understands thatTranspar#etion impact Fees;and.Reco.urse.Recavery.fees,may;app�y�atn�tt�e�constntctlan.�:of.new�b.uildings��change��iif�°?�`m"�==="�`� use in exisNng buildUgs, or.�exp�r�si�n of"e�fati�,�:�bulliNngs, as speclfled.In Pasco County Or�linance number 89-07 �nd 90-�7, as amende�d�;.;:.'�he undez�lgned a�so;.�ndersta�ds; thait�;such fees;as�majit:��rRduerhw111�=be Iderittfled a#theRt��ie4ofs��-�:.4���` .�_��_... permilting. It Is ftirthier underefcod that Trai�i�p�o�tation Impact�Fees an�`��Resourc�:�Rec"oiisry�Fees`�<,mus# be pald prlar to rece�ving-a"cerfi#ica#e._of occupa�yy"':ar�firtal�power�eleasers..4�the.project=.does:no�tnvofve:a�r.�rt#�cate af occuparicy�OTa�'K�.'"'.''a`� .. _ _ . :... finai powe��release;�ther:t'ees.ii�u�.t;�tie p�id;;p'r`ior to,,ermit issuai�ce. F�itthermore;,-iE�Pasco��Coun �WaterlSewerf:lmpact�.,-;;��tY:=� . ,,P::.� ,.�.�>, . .,..:.,.,,: �',. . tees are.due,.theyWxnust;be;.paltl=p�lor ta-,permit�lsstlance°:�n,accocdance with:applicatile:Pasco'.iCounty,�ordtrtances. � Ct�PtSTRUCTtON`l:fEN"[:AVN�Chspter 715,Flar�cla Statutes,aa am�nded): tf vaiva�on of work is�2,500.OQ#or morre;.,}:.�,�. =;�.i;. .,... certify tliat I� �he :applicent;:-have,:beer�. pravtded��with a-copy--,of`�ther�"Florlda��ConstFuction,Lien�,.Law--Homeowne�'s Protectlon t3uide"prepared by tlie'F1�if�a DepecEme�t�of Agrlcutt�re and Consti,m�r,-Aflal�s. 1#Ehe appltcant is sameone, ,,. -_:�;-�f ather than#hQ"owner", I certify�.th�t l�.tiave�abta.tned�akc�ipy.of:#he:ab.Qva:rles�c�lbe`d:�ocui�entand:'p�misi�`In;g'o.od;:falth�:to �- .=..s dsliver!t to.ttie.'owciei"p�iot-to���comEiiencement:`; . _ . , .` � .. - �. . . " - . , . . _ GONTRACTOR'S/OVYNER'�A��IDAViT: i.certtfy,k#t:��#>��ft:th�e,infiormatian:�in-th1�appltcetion i�accurat�.�nd tha#ali wark will'be done In compllance.with all.appllcable laws regulating aonstructlon, zoning and::land`'devetopm�nt. Appllcatlon,Is , hereby nxade to;ob#etci~.a.permlt��to,�do:woflx;,and;l�istallat�on as Iritlt�eti�d:f-=�=;lk certlfj► #Ftat no wa�rk��or tnstallation tias; commenced�p�lor to I'ssuance of'.a permit°�and that�:all��vork wlll be pertormed�ta meet-standaTds�af�all laws regula�ing� ' constnlatlon, County and City codes, zoning regulatinns� and land development regula�oiis�in�tiie�jtir�sdtct#on:==`i-�a}'so: aertiiy that i under�tend that the regulatlons of ottier�gavernment agencles may�apply:#o:.the�lntended.work� and that tt(s " my responstbll(ty to Identlf�►•what.actlons I.m�ust.takei;to,be,;ln compllar�,,ce.��#S,uch{agen,cles�lnclude�butaa�e:not Ilmtted to:,� ��� � � - Depar"tment of Er�vlronmentat=�Protec�ori=Gypress'Baytiead�� 1Ne�and Areas and Envlronmentally Sensitive Lands,Water/Wastewater Treatment. ...,� , , �, ' ;��}� � � .- - South�uest Flortda IlVater Manageme'i�t�m:1�[sfr.Ict:We11s;�'=Gypt�es.s.'..8�yk�esil�';� �Wet�and' Areas, Altering Watercourses. ` -`'; .•.:t :.r,,_:�� ;_ ,.:�r,,., - . � - Army Corps af Englneers�Seaw�ills,'Docics�Navlgatile Waterways, - - . Department, of;Heaith€,&<<Ret�abititat�%e�,,Se.niices/Envit+onmentai�F#ealth�11hit:Wetts;�V1�asteuit�iterz Tre�tment; Septic Tanks;... '�'`:' _ .. . � ' • - _ v . - US Envlronmental�Protectlan Agency:Asbestos�bate.men� � Federal�Avlatbn:Authorltj►:��Runways�:�� '� f undecstai�d.that�the.tohowing:3irestN�tlons apply to t6ie use of flll:� - �Use of�tl is nat aflowed in:iFfioodl,Zone"V"unless expressiy penmitted. - If the�zflll�miat��ialN-ls°�fo'�b'e�use�l:`�In.:Flood Zone. "A", (t Is under"stoad thaf"a dralnage plan addressing a �compe�sattng volume".wllt be submttted at#ime of.peFfnittt�g whlch {s prepared by a prafessiana! engineer�" Ilcensetl.by-#he;�tate�of�Fl6Hda: � � -: �- . - tf th� �ili>��meterlal�.is'ta be;used In Flood Zone "A" lra�connectiot��with���ermttted 6�itding using s#em wall. ,. � const�uctlon, l certi ;tfiat�,flit:wlll:b.e-used onty.to.f111 the area�withln�the�stem��wall: � � � ` . �`Y, wa - If flll rri�te�lal`.Is to be used-�ln•.any area; 1 �aertlty..that .uaa.of-:such flll wlll not adversely atfect adJacent : ., propertles,, tt':us�:of filt:is.fatind:#o.,.adrters�ly:..�ffeat adJa+�ent�;Prctpertles�.the awner may be ci#ed for ariot�ting..' - the cond�lons.of�t�e bi�llding�perrrilt-�I�sued>>u�de�tha`att�cfied._�ermlt�appllcatlon��for:lats�.le"ss�than�one (1) acre wliicli are e[evaterl��6yAfl11;_a�t englneersd dr�lnag�plati is required. � If I am khe Ai3ENT,FOR TM���OWNER,;I�.promise,In:good,.falth#o Inform'4he��a.wner.of��the permltting condl#lans set forth tn 4hls affidavtt prlcr Co comrrier�cing cvnshvctld�. �I understand thet a s�parate�permlt may be tequlred for efe�trlcet:wark. .. _. plumb3ng,:signs� we11s�.,poois,. eit'.t�nditionEng;=:ga�sr oc.ott��r:. install�#ions nat.spec�tcsatly included�fin.the apptication. .A - permtt Issued shall be aonstrued to"be'a`Ilcense`�to�'proceed wtkh'tNe,;viiock and�notrvas:authoHty�b:,.vlolate;�-c�ncel,�alter, ar set aside e�jr�provlsEons cif the'teclinlc�l.c.�des;,nor shalt Issu�nce�af a.permtt.prever�t th�e 8ulldlrig Ctft�ciall'rom thereafter ,....<.,.,., . requlring a cocrectlan�;ai;errors In�pians;.consUuctlon,orvlolatlons of-any�codes:��:��rery-�p�armtt��I.ssued�stialF-6eaome�-invalid unless the work authaNzetl_by sach perrtalt:�(�.cotrtmenced wilthln,s�.monlhs of�permlt l�su�nc+�. or if work authot�zed by � �.�;. the permit isssuspended�ar:abar�doned:far:a,period�of:-sGc:�)�mant�is�aftet�the tir�e.the�wotk�Is commen�ed., An e�ctensian may be requested� In.wriflin`g,�from_tHe;Bulldtng,Oifl�clal�tor� perlod�not-to exceed'rnfnet�w(90)`day§ ai�d4ini111`dernanshate �ust�3able'cause fior.�#he ex#enston. If work ce�s,�>for nitte#y.{90}consecutive�dax�._th\�ob�is consfdered a�a�donei�. . � a � �- .. �.- 5� ..,�. _ � WARNING TO 4YVNER: YOUR:.�AIl.ttRE;FTt1..-RE�Q�tQ.A��14'��6E�:O�:�C�DMMEM��!lE�WT;MAY�RESt1LT IN�YOUR . PAYtNG TWiCE,FOR�iMPROVEMEN'fiB�.T;O:Y:0U1:�:PR`t��ER�TY:`�I��:Y�OU;1�1'�`E�ID+��T���587'AIN"FiNiA�1�1NG�;�ONSUC.T WIT AN° O� �. 1, •R�1 . ' � ; ��: - , .. . _ _ . ,,,.. :,�;�� .. , .;�; . .:,: .- .. . ;�::. :.. ,_ . ,.�.. . _._: ��_n..��.�-�_ :� __��,o��a�a a�t�t���Fss:.t�_ a3)�-- - ------ - ..� ..- , - .. _�------ - - - --- - i ----- -- aww�a aR ao�et�r �.. cc�t�r�e►cTo�t . -- l�/�,..��;,� � - — -- Se crlb and swo M or a�In»ed}before e fhls Sub b erad'swom-to{ot affinned}�b�One nta�tMb . ' a! by �.c-� i.�a1.�n.r� ���?�1�::�._ �..�� �.-��:�,�2�__ � o tsfare personallylmown to•me. . -Who.ls/ere;p.ersonalty,lmown�to•:me;,eHiealhav,a�pr+�i�sad• • ° as l��ri��attpri:` _ - as tdentl�catlon. �/.�� � . . . . _,��„���,� � Notary pubtic . IVotary Pubtic � Co misslon No•: Com�tsaton�FEo._ ��.f���,_ �.�/� ��f��k���C.L ��L�r���'c�'�"�.--- Name of Notary lypedt pr#nted or siamped Nams o!Notary typed,prtnt ed . ..:��.x_a—= _ -- � � " :�i��'.'�;�. DEBRA ELAINE RUFFELL" � ;:�+,.��,�I`�`a D`ni'�t E�Lq��RUFFELL •.�: 'Co -.' s�`� : .Commtssion#�G 045343 i�: ::� ,_= y�ira�;�!n�# G p��q�� •".�'r�}�P� �n�ires Navember 7�2�20 • ���:;�`�c�~�o�daa Ttr�T yvmbar 7� +"�0 . •, 4,:;;;c'��;�r.+•_d�hru Troy Fain Insurance 80a395�1019 x. +�Y F�In Inaurnnw�mts