HomeMy WebLinkAbout20-1057 v
A. City of Zephyrhills PERMIT NUMBER
5335 Eighth Street
Zephyrhills, FL 33542 BNR-001057-2020
` Phone: (813)780-0020
Fax: (813)780-0021
Issue Date: 01/07/2021
Permit Type: Building New (Residential)
Propre,Lrty Number Street Address
35 25 21 0150 01500 0180 17875 Broad Pointe Dr
Owner Information Permit Information Contractor Information
Name: D R HORTON INC Permit Type:Building New(Residential) Contractor: D R HORTON
Class of Work:SFR Construct
Address: 12602 Telecom Dr Building Valuation:$105,000.00
TAMPA,FL 33637 Electrical Valuation:$7,000.00
Phone: (813)549-1968 Mechanical Valuation:$5,000.00
Plumbing Valuation:$7,500.00
Total Valuation:$124,500.00 I
Total Fees:$18,374.50
Amount Paid:$18,374.50 `� v
Date Paid:1/7/2021 2:00:45PM
P.10—i V al Description
CONSTRUCT SINGLE FAMILY 2,362 SQ FT-ZEPHYR LAKE
Application Fees
Water Connection Residential Fee $1,010.00 SIF 1 percent Fee $83.28
Mechanical Permit Fee $65.00 Driveway Fee $45.00
Building Permit Fee $555.00 Transportation Impact Fee $3,595.68
3/4 Water Meter Fee(Calc) $473.78 Address Fee $30.00
Park Impact Fee-Single Family/Townhome $769.56 Public Safety Impact Fee-Admin $26.35
Electrical Plan Review Fee $37.50 Sewer Connection Residential Fee $2,090.00
Electrical Permit Fee $75.00 Plumbing Plan Review Fee $38.75
Irrigation 3/4 Meter(Calc) $473.78 Plumbing Permit Fee $77.50
School Impact Fee $8,328.00 Mechanical Plan Review Fee $32.50
Building Plan Review Fee $277.50 Transportation Impact Fee-City $36.32
Public Safety Impact Fee-Police $254.00
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 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 permit 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 add fee 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.
CON V
TOR SI ATURE PE IT OFFICE
PERMIT EXPIRES-IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
r`-`
t F/ Cf).GCUITY, L ►RID►�►�
Permit No. �
Date Permitted l
Builder Name/Owner Name V' +fr� Control#'
County Parcel No. :3'2 2�2a ? p i 50b b(�o subDiv: ? 1:�
Address/Location 7Z 15
ClassificaflonlType of Use
TRANSPORTATION'IMPACT FEE . Rate: Sq.Ft Unit:
Exempt []lies C],No t_How Determined
Impact Fee Amount. $: . �Z� Zone No. TAZ;
SCHOOL'IMPACT=FEE. /
Account (056j Sli gle=Family Detached"House Amount $0 (.,
• (057) Mob1le Home
{ (408}, OftiAesid®ntlal
1.23)• .Colleftlori Fee
Exempt [�Yes. Q,No How determined
PARKS AND'RECREATIOWFEE-
Land AocbUht 'Land Credit Land Total
Recreation Account Recreation Credit Recreation Total
Zone _ TOTAL AMPUNT 7&F.
'Exempt Yes No How Determined'
LIBRARY FEE
` Land Account Land-Credlt Land Total
Facility Account Facility Credit Facility Total
Exempt ❑Yes Q No How Determined Total Amount _
RESOURCE FEE ERU
TOTAL AMOUNT
Prepared By i• �'� Checked By
NO E'RTIFICATE;,OF OCCUPANCY;WILL.BE ISSUED OR FINAL INSPECTION
PERFBRMED:UNTIL"I'iMIti''PX AM614NTS LISTED HAVE
BWPAID°AND
RECEIPT D FOR BY A CENTRAL.PERMnTIN®OFFICE-OF PASCO COUNTY
AckiioNdedgement belOwdoes not Imply aoce,w"of concurrence+but simply aftlpt of•a oopY of.this form,-placing
e bulidtng perrntt bwrssr on notice of thle'assessment and the condltlons of payment for seine.
DATE RECEIVED BY
RECEIPT NO. DATE BY
s
Q
k k
Single Family Dwelling
Plan Review Comments
1. F.F.E. 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. Compaction 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,.mechanical, 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. M303.4 of the F.B.0
12. Water heaters shall comply with section P607.3 of the F.B.C.
13. Foundation suliports for AX 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 R3111 of the F.B.C.
16. All glazing requirements are to be in accordance with R308.4 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 riot be used as a backer in showers or tubs. R702.4.2 F.B.C. .
10. 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.
21. All plumbing,mechanical,- and electrical shall b.e separate from unit to unit. This includes all
underground plumbing and electric.
22. All 2016 M.E.C. Codes will be enforced.
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 for hot water pipe with a minimum thermal resistance (R-value) of R-3 shall be applied to the
following:
Piping.3t. 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.O.
26.A copy ofthe energy caels shall be with permit at all times
27. Copy of rnal.insulation report sdiall be provided with permit before final
2.8.1 No fence, pool or enclosure :is issued with This permit
F.F.E.-Finished_ Floor Elevation
RB.C-Florida Building Code 6th Edition
R.O.W.-Right of Way
A.D.A.=Americans with Disabilities Act N.E.C.-National Electric Code (2016)
CITY OF " " BUILDING
ZEPHYRHILLSNOTICE DEPARTMENT
OF ADDITION OR CORRECTION
D • NOT REMOVE
ADDRESS DATE PERMIT#
.2� ) C Lod pe,A� /0
THIS JOB HAS NOT BEEN COMPLETED.The following additions or corrections shall be made before the job
will be accepted.
G' ,L
It is unlawful for any Carpenter,Contractor,Builder,or other persons,to AFTER CORRECTIONS ARE MADE CALL
cover or cause to be covered,any part of the work with flooring,lath,earth
or other material,until the proper inspector has had ample time to approve 780-0020 FOR RE-I N7ICTION
the installation.
OFFICE HOURS 8:00 AM-4:30 PM MON.-FRI. INSPECTOR Vi
--- uity ot /ephvrhU\s Permit Application R������nO
Building Department
. .
�D�ate Received Phone Contact for Permitting
Nam Owner Phone Number
Owner's Name lac-
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS
F:;a IS 'SISO OM-CO C-)±2aM
uuBDNoox»N /o-
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED ' wmvoomsrn ADDA\LT F---\ a(GN F--\ �—� DEMOLISH�__] ' INSTALL [_] REPAIR
PROPOSED USE �—� SFR �—1 COMM �--) OTHER
TYPE OF CONSTRUCTION �—��' BLOCK [--1 FRAME �--1 STEELBUILDING SIZE
SQ FOOTAGE 736 HEIGHT '
[__1BU|LD\NG coo VALUATION OF TOTAL CONSTRUCTION
F--lELE[Tg|CAL ��PSERV|CE �--| PR3GREaaENEREY �—1 vV.R.E.C.
ilp=pLUMB\NG
�--l�E�MANk��L ���L|NoTAL�f�|oN
^--� VALUATION- - ---'''''
[--�GNS ROOFING [—� � SPECIALTY �--7 OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA |� |YE8 NO
BUILDER COMPANY nc
SIGNATURE nso/enEnso
Address
ELECTRICIAN COMPANY
SIGNATUREnEa/orsnso
Address
PLUMBER COMPANY
SIGNATURE nEmarsnso
Address LinmnnaMECHANICAL
] COMPANY 0113', '\k
SIGNATURE REGISTERED YVN
Address
OTHER ���P�mY
SIGNATURE ns�/oren�o
FEE CURREN
Address Uoanan#
RESIDENTIAL Attach(2)Plot p\
Minimum ten(m)working days after submittal date. Required nnmnm.Construction Plans umnnvater Plans wYSilt Fence installed,
Sanitary Facilities 81dumcmtan Site Work Permit for subdivisions/large projects __�
COMMERCIAL ���oh(�)onmp�ohss��of�ui|dingP|onop\ueaLKe8���Pagn;(1)set ofEne�yFnnns.R'��Y` e��it for new 'conatruo8on.
Minimum ten(1O)working days after submittal date. Required onoita.Construction Plans,Stonnwater Plans v/qi\t Fence instoUad
Sanitary Fa�|�en&1dump� c Wor
k '
SIGN PERMIT Attach(2)sets of Engineered p|�ns.
****PROPERTY SURVEY required for all NEW construction. '
Directions- I
Fill out application completely.
Owner&Contractor sign back of application,notarized
|f over$25oo'a Notice uf Commencement isrequired. (VC upgrades over$750V)
� Agent(for the contractor)or Power of Attorne�(for the owner)would be someone with notarized letter from owner authorizing'
same
OVER THE COUNTER PERMITTING (copy of contract required)
Remofaifshingles Sewers Service Upgrades A/C Fances(P|o88umey/Fodogo)
Driveways-Not over Counter ifnn public modwmys.oaedoROW
NOTICE OF DEED RESTRICTIONS: The unders I igned understands that this permit may be subject to "deed" restrictions"
which may be more restrictive than County regulaiions. The undersigned assumes responsibility for compliance with any
applicable deed restrictions. ' i
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors.to undertake work, they may be requirled 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 underlain as to what licensing *requirements may apply for the
intended work, they are advised to contact the Pa I sco 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 applicati6n for which they will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he is n6t properly.licensed and is not entitled to permitting privileges in Pasco
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 powe' r release. If the project does not involve a certificate of occupancy or
final'power.release, the fees must be paid prior t' permit 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, Mori I da Statutes, as amended): If valuation of work is$2,500.00 or more, I
certify that 1, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and.Consumer Affairs. If the applicant is someone
other than the"owner", I certify that I have obtalne,d a 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 that 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 an8 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 takle 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
- Army Corps ofEDgineera'Se@VvaUa, Docks, Navigable Waterways.
- Department of Health & Rehab UitoUxe mental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
i
- ua c//,nu'm'e//ta/ Protection Agency-Asbestos abatement.
Federal Aviation Authority-Runways. 1
| understand that the following restrictions apply hz use offill: '
- Use of fill ia not allowed iO Flood Zone V"unless expressly permitted.
- If the fill material is to be used in Flood Zone 'YY', it is understood that a drainage plan addressing 8
"conOpenasd\ng volume" will be submitted at time of permitting which is prepared by o professional engineer
licensed by the State of Florida.
- If the fill [Oatoda\ is to be used in F\dod Zone ''/Y' in connection with a permitted building using otnnl vva|\
construction, ( certify that fill will be use!d only to fill the area within the stem wall,
- If fill material is to be used in any area, | certify that use of such fill vvi\|' 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 1 1 n 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'of six(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 OBTAIN RNANClNG, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA '
OWNER uuAGENT CONTRACTOR
Subscribed andby 3Unu � �uuecnueoamosvmmmyramm�ad)uem�memm
Who islare personally known to me or has/have produced Who Islare personally known to me or has/have produced
|
| identification.by
as Identification. as - -
\
Pubh � Public`
Commission No. Commission No.
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
� �"�� �p�°082 =~
813-780-0020 City of Zephyrhills Permit Application Fax s13-7s0-0
Building Department
£ Date Received Phone Contact for Permitting --
• .. �'•4.' a . ... ... .... ... .
Owner's.Name Owner Phone Number
.Owner's Address Owner Phone Number
Owner Phone Number.
71.
JOB ADDRESS' -•LOT# C$
4 SUBDiVESiON �- - Y"K l��✓¢huY 11GC 6 PARCEL!0#
{OB•TAiNEO�EROiZP.ROP.ERYa6 T`AX,NOTICe)•:
.•WORK PROPOSED ri!l W CONSTRs RDD/ALT � SIGN [� 0 '`DEMOLISH•
_ e INSTALL 8. REPAIR
PROPOSED USE, SFR Q COMM [_� OTHER
TYRE OF CONSTRUCTION BLOCK 0 FRAME STEEL
-DESCRIPTION OF.WORK
.BUILDING SIZE SQ-FOOTAGE:= ,HEIGHT
=BUILDING $ VALUATION OF'TOTAL CONSTRUCTION'
=-ELECTRICAL $ AMP'SERVICE DUKE ENERGY W.R.E.C.
=PLUMBING (_$`
=MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
=GAS ROOFING SPECIALTY C] OTHER
FINISHED FLOOR ELEVATIONS ••.FLO.OD:Z ONE-AREA . YES . NO
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRER.: Y•J'N
Address License#
ELECTRICIAN. COMPANY
SIGNATURE REGISTERE6' "Y/':N ' FEE CORREn
Address . License
PLUMBER COMPANY
SIGNATURE ----'' REGISr ERED•. Y 7:N' FEE
Address License.# F,
MECHANICAL COMPANY 1.
SIGNATURE' REGISTERED Y/ N FEE CURREr,
Address License-#.F�•_
OTHER COMPANY
SIGNATURE RECZiSTERED Y'/.•N,,.•, ... FEE,CU�RR`Et,`.. Y.•.:/.N, -
-Address .License#
RESIDENTIAL A4tadh-( )=Plat'ixlan ;,{2}"+set$:af i�ildi g.PlerSs,, �).set,ofErie[gy;Forms,'R4..0W'Pemjitfornew:canstruction,,
nMihimum;ten:(10)Wbrking:`d ys after sUia►t3lfte!4tl `ta:�`RepuI'red onsite;'Gonstr eticii'Pians,StdrmvJa er Piin's 7 Silt Fence installed,
Sanitary:Facilities kj; dumpster;'.,Sife Wdr'k.�Permit-f6rt.Obd!visions/lArge-projects'
COMMERCIAL Attach(2)>omplete,sets-of;Bujldittg•Plansiplus'apLife;;$afety.Page;'(1=)•.set'oF,EnergyForms.R-0=W Permit fdr:new construction.
Minimum ten(1'Q);wgrking�days aftgrs.,ub i(ttaI•date.,F ep,W4ired�onsite;Construgtien-P.I,ansy Stormwater l?lans w/ailt'Fence installed,
Sanitary Facilities&1 dwripsfer.$ii`e Work Permit for ail•new projects.All commercial.requirements must meet compliance
SIGN PERMIT Attach(R)-set$.of l:ngireere'd•'Plans.
"PROPERTY Sjl'E 1/EY'requited for ail'NEW ccnstruction.
Directions:
Fill out application completely.
Owner,,&•:Contractor sign.back of,,applicafion,notarized
'if over$2506,a Notice bf:Commen_cement 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,RERMi7SING - (capy;'of•cootract.required)
Reroofs if shingf s 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- CONTRACT OR RESPONSIBILITIES:- If the owner has hired a contractor or
contractors to undertake work, they may be required to be licensed in-accordance with.:state and local regulations. 'If the
contractor is not licensed as required by law, both Ithe 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 may 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_understandt,'thot-such fees, as may-be due, will be identified at the"time of
permitting. It is further understood that Transportati on.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 to permit 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 71.3,-Florida Statutes, as amended): If valuation of work is$2,.5.00.00 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.the Florida Department of Agriculture-and:Consumer.Affairs. If•the•applicant is someone
other than the"owner", I certify that.I have obtained a copy of the-above described document and promise in good faith to
deliver it to the"owner".prior to commencement.
CONTRACTOR'S/OWNER'S`AFFID:AVIT: ('.certify that,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'lan'd 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 otheri government agencies may apply to the-intended work, and that it is
my responsibility to identify what actions I mvst.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�Pro.tectiomAgency-Asbestos.abatement.
- Federal Aviation AuthorityRunways.
I understand•that'the following restrictions.apply-to•the•use of fill:
- Use of fill is not-allowed in Flood Zone"W uhless-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. j
- 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 of,six(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'.INT9Nb To-OBTAIN FINANCING,'CONSULT
WITH-YOUR.LEND.ER.OR AN ATTORNEY'BEFORE RECO:RDIN:G.YOUR.NOTICE.OF-COMMEIYCEM.ENT.
FLORIDA JURAT'(F.S. 117.03)
OWNER OR AGENT CONTRACTOR
Subscribed and sworn to(or affirmed)before me this Subscribed and sworn to(or affirmed)before me this
by j by
Who Is/are personally known to me or has/have produced Who is/are personally.known to me or has/have produced
as identification. as identification.
Notary Public I Notary Public
Commission No. Commission No.
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
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