HomeMy WebLinkAbout20-22507 CITY OF ZEPHYRHILLS
533S-STH STREET
(813)780-0020 22507
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
PERMIT:INFORMATION LOCATION INFORMATION
Permit#:22507- Issued: 2/21/2020 Address: 3120 NUBBIN RIDGE LN
Permit Type: NEW SINGLE FAMILY DWELLING ZEPHYRHILLS, FL.
Class of Work: 101-NEW CONST/SFR Township: Range:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Sq. Feet: Est. Value: Book: Page:
Cost: 267,656.40 Total Fees: 19,084.97 Subdivision: HIDDEN RIVER
Amount Paid: 19,084.97 Date Paid: 2/21/2020 Parcel Number: 24-26-21-0110-00000-2680
CONTRACTOR INFORMATION OWNER INFORMATION
Name: LENNAR HOMES LLC Name: LENNAR HOMES LLC
Addr: 4600 W. CYPRESS ST STE 200 Address: 4600 W. CYPRESS ST STE 200
TAMPA, FL. 33607 TAMPA, FL 33607
Phone: (813)574-5743 Lic: Phone: 813-574-5700
Work Desc: CONSTRUCT SINGLE FAMILY 2,376 SQ FT
APPLICATION FEES
PLUMBING FEE 207.00 SEWER CONNECTION RE IDEW 2,090.00 ELECTRICAL FEE 310.50
WATER CONNECTION RESIDENT 1,010.00 MECHANICAL FEE 144.90 SCHOOL IMPACT FEE-sfr/1% 83.28
SCHOOL IMPACT FEE-sfr/100% 8,328.00 TRAFFIC IMPACT FEE 1% 36.32 WATER METER RES 3/4" 473.78
TRAFFIC IMPACT FEE 99% 3,595.68 POLICE IMPACT FEE 254.00 FIRE IMPACT FEE 273.00
PARK FEES SF 769.56 PUBLIC SAFETY 5% 26.35 BUILDING FEE 1,482.60
9
Inspections Re uire
F 0 UTER 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 INSTALLED 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
first reinspection,whichever is greater,for each such subsequent reinspection.REINSPECTION FEES:
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
entities such as water management, state agencies or federal agencies.
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your property. If you intend to obtain financing,consult with your lender or an attorney
before recording your notice of commencement."
Complete Plans,Specifications and Must Accompany Application.All work shall be performed in accordance
with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
ONT ATO SIGNATURE ! PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIOlf
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
' 1NsTR#2020030135 OR Bit 10056 PG 2846 Pegs 1 of 1
0212012020 11:56 AM Rcpt:2137341 Rec:10.00 OS:0.00 iT:0.00
Nlkkl AlvarezSowles,Esq.,Pasco County Clerk&Comptroller
Pemdl No.- -- Parcel ID No 24-26.21-0110-CODOO-2680
NOTICE OF COMMENCEMENT
State of--Florida County of Pasco
THE UNDERSIGNED hereby jWs notice that Improvement wli be made to cotaln real property,and In accordance with Chapter 713,Florida Statutes,
the lb3owing @domnalfon is provided in this Notice of Cornmencemar t
1. Desuiptton of Prop rV..Legal HIDDEN RNER PHASE 2 PS 70 PGS 102-110 LOT 2t8 _ --
sirwAddrets: 3120 Nubbin Ridge Lane zephrynnls FL 33541
2. General Decnzfptan of Improvement Single Family Resfdence I Psi!Screen Enclosure I Fence -
3. Ownerkdarmatam Cattier Heroes,LLC.
Name
46D0 W Cyoreas St.Ste 200 Tarttoa FL•33507
'Address -
Interest in Property:
Name of Fea Slmpta Titleholder: NIA _
(If other than owner) City
State �.�- �L?
Addrest -- - ' r'"* i
4. Camredo: LennarHOmes-LLC L.,I
4600 W Cyaress St,.Ste 200 Temua FZ 3360T w Oj
Address city - Stem : IfConhacW4 Tatephane Na: 813.574.5700
Address - --- Clty
Amount of Bond:S _ Telephone No.:
6. tender: NIA
Name
Address - - - - City- State
(endefs Telephone No:
7. Persons within the State of Florida deslgnoled by ft owner upon whom nallces or otter documents may be served as provided by
Section 713.13(1)(a)(7),Florida Statutes:
Leririar Horties:.LLC: Q Q i-s -1 J
Narita
U) v U
IX
4600 WW Cypress St.Ste 200 Tampa FL.33607 t} � CD I— C� OL j
Telephone Number of Designated Person: 813.574.6700 _ U I N II-
a. In addtfon to himself,the owner designates NIA- -- of_ Q W LU ~ Q
LU
to receive a copy of the Uenw%Notice as provided In Section 713.13(1)(b),Florida Statutes.
Telephone Numbera'Person or Entity Designated by Owner. LL-
e. ton date of Notcs of Commencement is one arfrom One date of reeor U O
LL-
Etpba �- ' J
ye ding unless a different data to specified; � � U �(„>
t >- WO
WARNING TO OVVNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT IX Q
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I.SECTION 713.13 FLORIDA STATUTES,AND CAN
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS 70 YOUR PROPERTY. A NOTICE`OF COMMENCEMENT MUST BE U Z - LU
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT, D
STATE OF FLORIDA L, Cl. Q
COUNTY OFPINNELLAS �` CC U.. T Q
Signatureaf Owner dr Owneea Authorized Oilcan/DhedolPaMerlMarreger Q p ry C) W
Vice President _ L16 0: "?
titgnatoryaTltr11of8ce - LS. d Q W
The toragotrg instrument was edmowledged before me thte day of January by U)
Stave Robert Smith as Vice President - (type of authority,n .,dace:,buelse,attomay In fed)for
U) " U V r
Lennarli0rnes.LLC (nameafp whomlreWmantwasexcruted).
Personally Known NOR Produced Identfieaton❑ Notary signs
Type of Identification Produced - Noma(Pft) llssa Holleran
itam Inu t the best to Seaton sedge,ndbee Sebrtea Under penalties of pa! ,I e2-3. '18_»mt I have reed the fm'e9oL;g and that the fade stated In
t ere title W the best of my ktowledge and beget
Ell ►i,�IOL(EAAN 5lgnehea of Natural Person Signing Above
Gtmregtlod0FFgdMI
F.�ra,au.•a,2rig
wpdetwbcsA=fomn raff+eVAVg him(ssre W'g5-MI
Lennar Homes-3120 Nubbin Ridge Lane-2,376 sgft
o umn ts
SO. FEET PRICE
MAIN OR LIVING: 2,376 $ 112.65
I
OTHER AREA UNDER ROOF: - $ 88.00
OTHER: - $ -
VALUATION $ 267,656.40
FEE SHEET $ 1,380.00
ADDRESS $ 30.00
DRIVEWAY1 $ 45.00
BUILDING: $ 1,482.60
ELECTRICAL: $ 310.50
PLUMBING: $ 207.00
MECHANICAL: $ 144.90
SUB-TOTAL $ 2,145.00
TOTAL $ 2,145.00
SEWER: $ 2,090.00
WATER: $ 1,010.00
IRRIGATION: $ -
TOTAL: $ 3,100.00 /
WATER METER:j $ 473.78 („��
IRRIGATION METER
FIRE DEPARTMENT FEES
PLANS TOTAL:
INSPECTION TOTAL:
PERMIT TOTAL
TOTAL: $
PUBLIC SAFETY IMPACT FEES
POLICE $ 254.00
FIRE $ 273.00
5% $ 26.35
TOTAL: $ 553.35
SUB-TOTAL $ 6,272.13
PARK IMPACT FEES $ 769.56
SIF'S: $ 8,328.00
100.0% $ 8,328.00
1.0% $ 83.28
TOTAL: $ 8,411.28
T I F'S: $ 3,632.00
qq%l $ 3,595.68
1% $ 36.32
TOTAL: $ 19,084.97
24-26-21-0110-00000-2680 1 Pasco County Property Appraiser Page 1 of 1
Parcel ID 24-26-21-0110-00000-2680 (Card: 1 of 1)
Classification 00000-Vacant
Mailing Address Property Value
LENNAR HOMES LLC Ag Land $0
4600 W CYPRESS ST STE 200 Land $29,207
TAMPA , FL 33607-5995 Building $0
Extra Features $0
Physical Address
3120 NUBBIN RIDGE LANE,
ZEPHYRHILLS, FL 33540 lust Value i $29,207
Assessed (Non-School Amendment,1) $29,207
Legal Description (First 200
characters)
HIDDEN RIVER PHASE 2 PB 79 PG Non-School Taxable Value $29,207
102 LOT 268 School District Taxable Value $29,207
Jurisdiction
CITY OF ZEPHYRHILLS
Land Detail (Card: 1 of-1)
Line jUse 'Code IDescription ,_n--oninglUnits IlType (Price Condi_tionV_alue _
1 0100V CP1-1 SFR MPUD 6,000.00 SF $4.75 1.00 $28,500_
2 010OV CP1-2 SFR ! MPUD J 785.00 1 SF ( $0.90 1.00 $707
Additional Land Information _
Acres Tax Area _FEMA_Code _Res Code Com Code Condo Code
0.16 30ZH -- fv HDRV- ----1 HDRV DH,RV
Building Information (Card: 1 of 1)
Unimproved Parcel
Extra Features (Card: 1 of 1)
Line _Code IDescription IYear ;Units !value___._.
No Extra Features
Sales History
Previous Owner: DUNE FL LAND I SUB LLC
Month/Yea !Book/Page Month/Year _ Type DO_ R Code �C-._o_n_d_.tiof n__lAmount
01/2019_9 54 / 3547 Warranty Deed 05 ! Vacant $4,965,000^
09/2011 j 8606 / 3376 1 Warranty Deed 0_ 5 _ ! Vacant $0
06/2010 _ / 1872 _ Certificate of Title`s 12 Vacant $0
12/2005 6748 / 0891 ! Warranty Deed ! Vacant _ $0
12/2005 ! 6748 / 0894 ; Warranty Deed Vacant _ $0
12/2005 j 6748 / 0889 Warranty Deed I Vacant I $0
i
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https://search.pascopa.com/parcel.aspx?parcel=2126240110000002680 2/19/2020
v PAsc().,.do uN t ty R6ceiptDate
' Z01 1/Z01 6DAS BUILDING.CONSTRUCTION:SERVICES Rec6ipt:Number: 1640614
UL 0731 Citizen0r*
COUNTY 'FL-RI 1-
qqiW230.
OM4.9PACES;KIDPAW PLACES. New Port Richey,FL 34654
727w847-B126.
NOT A, PERMIT
Paid i3v Check# .&C.Aufh 4, Cashier ID. Workstation
Check m 01408712 MLA.RNOL;b Bddco.59w
Fee DiestflOtidn Amount Paid
IM04ct Fee Re§id.6h.tial Solid WdMe,Single.Fatbily 49.14
$49.14
Address Phdhd
IENNAR HOMES
CotTiftlierits;
PERMIT&667
24; -2
31 90*NURBIN.RIDGE LANE
While,y'6ij'w"lllb6p40'n'-:j6blowliti, iis ihefullamd"oft6trefli
.21 ur. Pasm unty Ru ei�W uni car of e-chdckf6eii NOT i6wn ag&G,k 601le"t-te'd by ilr7s't
Billing payment servic es.-
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myreportslrqportslIP-ASCOPRODIPASCOICustomer-Recel*pt vlf;rpt Prifit Date-.1 04/0-9/2020 Page 1 of 1.
PASCO COUNTY FLORIDA
Permit No. Z 2_5�7
t Date Permitted 2-1�_�
Builder Name/Owner Name -LA finMe-s'
Control#' "
County Parcel No. 2 4—Z�-Z(-611[ ::::tO k 00-4&DubDiv: mdde-A
Address/Location 3( 7—D IJQA&ll I�rO
;r ClassiflcatioMType of Use �Y) 4wZ
4
e.t TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit:
Yes
Exempt [] ❑ No How Determined
Impact Fee Amount $. 3> (0,32,, Zone No. TAZ:
• JiY. ,
SCHOOL IMPACT FEE
Account (056) Single-Family Detached House Amount $ i�f'l 2,6
(057) Mobile Home
(058) Other Residential
123) Collection Fee
Exempt [� Yes ❑ No How Determined
PARKS AND RECREATION FEE-
Land Account Land Credit Land Total
Recreation Account Recreation Credit Recreation Total
Zone TOTAL AMOUNT 17(of
Exempt ❑ Yes ❑ No How Determined.
LIBRARY FEE
Land Account Land Credit Land Total
>'
Facility Account Facility Credit Facility Total
b�
ft•-
Exempt ❑ Yes ❑ No How Determined Total Amount
RESOURCE FEE ERU
TOTAL AMOUNT
Prepared By Checked By
NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED.OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN PAID AND
RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE.OF PASCO COUNTY
1ST
f. Acknowledgement below does not Imply acceptance of concurrence,but simply receipt of a copy of this form,placing
the building permit owner on notice of this assessment and thQ conditions of payment for same.
DATE RECEIVED BY
' I '
RECEIPT NO. DATE BY
Q
Single Family Dwelling
Plan Review Comments
1. F.RE, shall be a minimum of 8" above the road elevation and an engineered site:plan.
2: Lots shall be graded to comply with R401.3 'of the F.B.C. .
3. Cornpaction test required if 24", or more of fill dirt is brought in at any one.place.
4: Tie in survey required-before pouring concrete.
5. Driveways require a R.O:W. use permit. All 4 sides of driveway thru the sidewalk shall have
expansion material.
6. All setbacks shall be.met.
7. All property markers shall be uncovered,and marked at time.of first inspection.
8: All A.D.A. requirements shall be met:
9: No electric,,plumbing;niechanical, or framing shall be:covered without an inspection and
approval first.
10. All Garages'shall comply with section R302:6 of the F.B.C. (Fire Separation).
11. Appliances shall not be installed in a location where subject.to mechanical.damage unless
protected by approved barriers. M3034 of the F:B.0
12. Water heaters shall comply with section P607.3 of the F:B.C:
13. Foundation supports for A/C units'shall be raised_ at least 3" above finished grade. M1308.:1:
14. Return air in all bedrooms. F.B.C. M1620.4
.15. Smoke detectors are to be installed in accordance with.R313:1 of the- F.B.C.
16: All glazing requirements are to be in accordance with R308A.of the F.B.C:
17. All means of egress are to be in accordance with R311 of the F.B.C.
18. "Green gypsum,board" shall not be used as a backer in showers or tubs. R702A.2 F.B.C.
19: Combination-type AFCI breakers are required at'all locations requiring an AFCI.type breaker.
20. Carbon monoxide alarms will be required in new construction that uses fossil-burning heating
or appliances or an attached garage. They shall be'installed in accordance with the F.B.C,
2:1. All plumbing,mechanical, and electrical shall be separate from unit,to unit. This includes all
underground plumbing and electric.
M All 2016 N.E.C. Codes will be enforced.
i
23. Tamper-Resistant Receptacles in accordance with 406:11 of the 2016 N.E.0
24. In accordance with the Land Development Code, lots_ shall be sodded before final at least 10
feet around-the structure.
25. R403.5.3Hot water pipe insulation
Insulation-forhot:water'pipe with a minimum thermal resistance_(R-value) of R-3 shall be applied to the
-
following:
Piping 31;inch (19.1 mm)and larger in.:nominal diameter.
Piping serving more than one dwelling unit.
Piping located outside the conditioned space.
Piping from the water heater to.a distribution manifold.
Piping.located under a floor slab.
Buried in piping.
Supply and return piping in recirculation systems other than demand recirculation systems.
25.Blower.door test shall be provided Before C.Q:
26.A cony of the energy:cacls shall be.with permit at all.times
27 Cony offinal insulation report shall be provided with permit before real
28:No fence,pool or'screen enclosure :is issued with:thispermit
F.F.E.-Finished Floor Elevation
F.B.C- Florida Building Code 6 h Edition
R.O.W.-Right of Way;
A.D.A.-Americans with Disabilities Act N.E.C.-National Electric.Code (2016)-
i
813-180-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received Z__ Phone Contact for Permitting L 813 363 28
F. .. I I I I I I I I I I I I I I I I I I I I I I
Owner Phone Number
Lermar Homes,LLC �8 3.574S700
Owner's Name
Owner's Address 4600 W.Cypress St.Ste.200,Tampa,FL 33607 Owner Phone Ndmber
Fee Simple Titleholder Name I N/A Owner Phone Number
Fee Simple Titleholder Address N/A
JOB ADDRESS 3120 Nubbin Ridge Lane LOT# 0268
SUBDIVISION Hidden River Phase 2 PARCEL ID# 24-26-21-0110-00000-2 680
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ADD/ALT SIGN CJ DEMOLISH
P INSTALL F-1 REPAIR
PROPOSED USE 0 SFR 0 COMM OTHER
TYPE OF CONSTRUCTION 10 BLOCK Q FRAME STEEL
DESCRIPTION OF WORK SingleFamily Residence Pool/Screen Enclosure/Fence
BUILDING SIZE I U/R SF 2376 —1 SQ FOOTAGE936 HEIGHT 1 StOrY
rf�w 9
BUILDING IS^0-b VALUATION OF TOTAL CONSTRUCTION
ELECTRICAL 1$ � AMP SERVICE F3(� PROGRESSENERGY W.R.E.C.
OPLUMBING 1$
0 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
=GAS 0 ROOFING Q SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES Do
_111-4-111-4-11 11 a ar-'sue-iI I a a a a a 111-1-1116- a . .
BUILDER COMPANY Lermar Homes,LLC
SIGNATURE REGISTERED Y/ N FEE CURREN LY_LN_j
Address 14600 W.Cypress St.Ste.200,Tampa,FL 33627�1 License# I CGC1518166
ELECTRICIAN COMPANY =Edmonson Electric, Inc.
SIGNATURE /V REGISTERED Y/ N FEE CURREN Lill N
de
Address 1034 Skipper Road,TaXpa, FL 336.13 License# EC13005408
PLUMBER COMPANY Bayonet Plumbing,'Heating &AC, Inc
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address P.O. Box 5308, Bayonet, rL 34671,F<08 License# J'CFC042998
MECHANICAL COMPANY Bayonet Plumbing, Heating &AC, Inc
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address P.O. Box 5308, Bayonet, FL 346,j74-5308 License# I CAC058062
OTHER COMPANY [C Sterling Quality'R bofing, Inc
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
pVing Hill, FL 34607 CC057991
Address F4211 Shoal Line Blvd, S License# 116
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new,iconstruction,
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans wl Slit Fence installed,
Sanitary Facilities&I dumpster;Site Work Permit for subdivisions/large 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&I clumoster.Site Work Permit for all new projects.All commercial requirementis must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
****PROPERTY SURVEY required for all NEW construction.
11-11-111-111.4 . . . . . . . . . . . 6111.& . . . . . . . .
Directions:
Fill out application completely.
Owner&Contractor sign back of application,notarized
If over$2500,a Notice of Commeficement is required. (A/C upgrades over$7500)
Agent(for the contractor)or Power of Attorney(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/Survey/Footage)
Driveways-Not over Counter if on public roadways,.needs ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed" restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work,Ithey may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing 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 hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the
contractor, that nay be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT!AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 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 is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
final power release, the fees must be paid prior tolpermit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713, Florida Statutes, as amended): If valuation of work is$2,500.00 or more, I
certify that I, the applicant, have been provided ,with a copy of the "Florida Construction Lien Law—Homeowner's
Protection Guide" prepared by i'the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the "owner", I certify1that I have obtainedla copy of the above described document and promise in good faith to
deliver it to the"owner"prior to commencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify ithat all the information in this application is accurate and that all work
will be done in compliance with all applicable laws regulating 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 performed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand 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 compliance. Such agencies include but are not limited to:
- Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,Water/Wastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
- Department of Health & Rehabilitative,Services/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
- Use of fill is not allowed in Flood Zone W" unless expressly permitted.
- If the fill material 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 connection with a permitted building using stem wall
construction, I certify that fill will 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 such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
acre which are elevated by fill, an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of1six(6)months after the time the work is commenced. An extension
may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety(90)consecutive days, the job is considered abandoned.
WARNING 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 OB AIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATORNEY BEFORE!RECORDING YOU N TICE OF GIOMMENGEMENT.
FLORIDA JURAT"TWJJ
) Ji
OWNER OR AGECONTRACTO
Subscribed and sw i ed b e 1 is Subscribed and t med) rem this
LL-Jdrl-zu by Ashlee Callahan 22-Jan-20 by Ashlee Callahan
Who is/are personally known to me or has1havePF9dUGed Who is/are personally known to me or hasihaveffedue
as identification. as identification.
Notary Public Notary Public
Commission No. FF985637 Commission No. FF985637
Elissa M.Holleran Elissa M.Holleran
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
-
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FF
71.80
EL
71.85
ell
EL
74.65
267
20
If 308
4,1
FF
22- 7
74
PF EL
73.15
FF
11 PHA
Ui | 7 PF EL '
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,?64 �
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