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Home My WebLink About92-2028 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 Permit N':: 202811 / - 7- 7~ Date EL~ P~ ME~AL Job Address: Legal Description: Lot Blk. Zoning CI: Energy Code Readout: Estimated Cost: .3 I - 6 ~V' /ri) ~ ?-12-1C W,A ,g~/Y1 Fee ~-. Of) ~ SIGNATURE (}/ ~ a /' COMPANY Complete Plans, Specifications and Fee Must Accompany Application All work shal! be performed in accordance with the above and all City Codes and Ordinances. OCCUPATIONAL LICENSE #~-c;,!). -f~~ ~A.~;~~~ - BUllDIN~ - PLUMB _____ Ftr. SLB Pre SLB Tub Set Lintel Water FRM. Sewer Insul.CL Final WL ADDRESS TELEPHONE /I ELEC'fRLQAL Tp.Serv. Rough In Meter Can Const. Pole Pool Pre-Meter Final ME~AL - Breakers Ducts Insl. Compressor Final Driveway Reinspections: When extra inspection trips are necessary due to anyone of the following reasons, a charge of ten ($10.00) dollars shall be made for each trip. (a) Wrong Address (b) Condemned work resulting from faulty construction (c) Repairs or corrections not made when inspection called for (d) Work not ready for inspection when called. The payment of reinspection fees shall be made before any further permits will be issued to the person owning same. STANDARD HOME SERVICE CORPORATION STATE CERTIFIED SPECIALTY STRUCTURES CONTRACTOR.. SCC 045072 1532 U.S. 19 SOUTH, CLEARWATER, FLORIDA 34624, Toll Free 1 +(800)62~150 SALES CONTRACT ....... ,/ Cultomer (Owner) Name (I): ,/<j Ii' /y" Date: /.- t...,-.. - 9 :2.... - Job Address: ;/ ''14)1 j) /) Clty/StatelZlp: .<;-' -P, I" .1 "<., /-;>', ..,-._, ",.l; /s'/ 'TT rv ~/e :::.; .g- 051 6,A::/J/r;? ("4,' Telephone Number: >7S'. 3 .3 -/ ? ~: ,~. ....D./1. .:--' /....-j'./ //.jJ /.; /:-- (/::;~i? Y.. /_ ::- .t. ,../ / :-..... -- ... ..c:-.... Park Name & Addre..: ,.:, WE HEREBY SUBMIT SPECIFICATIONS AND ESTIMATES FOR: ft. x 1) Furnish and Install 2 Inch thlch foam board insulation on mobile home roof. ~ICo'l(:>>~". "~l(.XSlze 2) Furnish and install Perma-seam Roof-over on mobile home roof size: ;:z ~-' ft. x ..../-, ,"1 . ....... 3) Furnish and install "~'~rxvalence around Roof-over, color: /7 j<"t:::,'/J! ;;Z. 4) State whether the heating system is Electric or Gas: ~;/ r'" (" .7 A! / c/ , Customer Initials: . NOTE: I hi rrdJIe home has GAS HEAT, a mechanical contractor will need to Inspect and perhaps change the exhaust vent in conjuctlon With the Installation of this roof. over as described below. Gas Hea t .,,(' /'/i 1//; '~r;-1;/ /' / 'j. c '.// ~.:.j)l/ AN~A":~OI '.' //.~ /<:/ ?-,,('<'/-J/ / ;/. -/"'::l' // /1/' ..:J/.7 "'!{' /',,: or LJ'VU ' . , . .. ... ' All material is guaranteed to be as specified. All work to be completed in approximately two wseks, weather permitting, unless stated otherwise and in a workmanlike manner according to standard practices. The roof-over shall be installed to the above listed mobile home size and does not include roof-over the carports, Florida-rooms, or other room additions unless specifically included in the above specifications. Seller (Contractor) is fully insured and requires worker's compensation insurance on all installers as well as liability insurance. Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders, and will become an extra charge over and above the estimate. This agreement is contingent upon strikes, accidents or delays beyond our control. Customer (Owner) to carry fir., tornado, hurricane and other necessary insurance. Seller (Contractor) is not responsible for damage to mobile home resulting from rain or other acts of God or acts of nature during the installation of the roof-over, nor is contractor responsible for latent defects in the mobile home or failure of the roof-over performance caused by such latent defects including but not limited to inferior mobile home structural integrity. Upon Customer's (Owner's) failure or refusal (beyond the 3 day right of cancellation) to accept delivery of the roof-over listed above, seller may at it's option be entitled to 101 liquidation damages, or an amount of damages as may be awarded by a court of competent jurisdiction. Customer (Owner) fully agrees that Seller (Contractor) reserves the right to obtain credit information with regard to customsr's credit history and Contractor may cancel any work to be performed or in the alternative, Seller (Contractor) may require prepayment (in the case of a non-finance sales contract) if customer's credit history is unsatisfactory. Unless stated otherwise, payment is due upon substantial completion of the work detailed above and Customer (Owner) agrees to pay reasonable attorney's fees and all collection costs as well as 1 1/2 1 interest per month for any amounts past due. This contract is a final written expression of all agreements between Buyer and Seller. This agreement mar be modified only in writing signed by both the Customer (Owner) and Seller (Contractor). Buyer understands and agrees that he s in no way obligated whatsoever for any additional work on their property except for what is stated in this contract. Buyer's right to cancel. This is a home solicitation sale, this agreement can be cancelled by mailing a notice to Seller (Contractor) before midnight of the third business day after you sign this offer to purchase. 5) Special Instructions: /~'-f) < ",' . "ill.i' /) /-../ .-l' ./ / /.., . - - r.v r;,o ../J , ,/ j;" ,.,/. .(/ j/ -/ to':.,. /)l/~' //'1 -L-I;:/ /' / .< t./ ...-- ,...,. / /r/ / ( , ,/ /,--/" ~::;l U +1'7"/) L:;, (/ / (~,.' ' .. (.~- -//./ .t#c.-04:-.'" ",l':' .~~~., (~.,~,:." ~// ft. ft. ilt r e p I ace me n t w 1 ) 1 be ate x t r.l char!.;': . '--:\ /1.: . "7 y- c/ /(' i ..- / .),-1- .p'7 ' ~ / r I ' /.... ,-::-:" ";) /" I,. --- ~) (/J/ -' r-- ;/1//{) ........ J ..:::; ../.,: I .,.. , ~l ;~r~/ /') . i -~l //' /Y'1. c r:-J);:. I ~,;.,.I..( .- &tI~7 _:/ ~//,. ' '---1 l"':} ,/1:-/ .( / ,/' / , L' . ... . I I .1..../ / --I'. ./c;') --7' / .../\ / -/ ,./ / /Y ..- /. ... I 1 ---' .: ,/ ..--- ... i / /~ ...c L ---7- - I ;:" 1/ /, /"";; - / / .,_t../ ./ / " ~ STANDARD HOME SERVICE CORPORATION HEREBY AGREES TO FURNISH MATERIAL AND LABOR COMPLETE IN ACCORDANCE WITH THE ABOVE FOR THE SUM OF: . I "c::;>/- '--j' , --., 06 C) ~V' c ~~/:J/\E.J.. /o!.-^'I DOLLARS ($ '-:;;(.).:<7<-_. ~//>-/;1 rf#t? / PAYMENT TO BE MADE AS FOLLOWS:....;. , ), AUTHORIZED SIGNATURE: ,;' ..\,/,. ,/ /- /;:;. ~l __ .cO'.c.4, ..y-/ (..r' X -~)~~/-< CONTRACT IN B K. YOU ARE KEEP IT TO PROTECT YOUR NOTICE TO OWNER. DO NOT SIGN ENTITLED TO A COpy OF LEGAL RIGHTS. THIS HOME IMPROVEMENT THE CONTRACT AT THE TIME YOU SIGN. \.. CUSTOMER ACCEPTANCE, THE ABOVE PRICES AND CONDITIONS ARE SATISFACTORY AND ARE HEREBY ACCEPTED. STANDARD HOME SERVICE CORPORATION IS AUTHORIZED TO DO THE WORK AS SPECIFIED. PAYMENT WILL B1= MADE AS OUTLINED ABOVE. ~IGNATURE: " / / ./> /.-:-;...., .. .'. I / ~- //' , SiGNATURE: ~/ DATE: Vt m~ ~o ~'t"\ .... -,). . ;:, -I 111 ",TiI ~V1 V'\ ~ ~ x.~../ ~ 'VI; (j\ t,.f ~ ~!-.>~ ~ I l~ ~ r- ~ ...~ :. ~ < p..:) -=~~m ~IG' ito~()) ~ c: It- 1(/1 '-^", 1 i.t>,~ ~ "'.S' l"'s.i.Vl r---.. I~ ~ t!1b> ~~ ~ I~ ~"Ifl~ r- ~v' ~ .~ i~ ~ R~ .If;i:r. , .......-/ I f) b'Nt> ~g~ -n ~: tI) ~ c..n ()) ~ r;;; () : . ~ >- >,} ~ ~ ~ ~ q: ,-n ~~ ~ ~ >' ' " -f -f tf\ (I) I...." ...... -l : "~ ...,. ~ :m r- I _ ~ -J (/7 i~ ~ I'" 10 (\' 1 (ll ~ :> ,- 0...... t-1,!~ o "" fJ7 i c;- t., I.. :.. I 6' <::> '_ :--t t-3~ _, ~ n) -.;::. I- o to)~N - (.f' ,'c cn'b o =<> ~_. <. z 0' ';:a (' 0 ~8 '"" .. .-n - ... .. ~ .... ~=:: .... - o .. _ 1:1 ... .. -- - .... ... tIt_ - ... 1:1 ... .... - _ ft _0 <S? - .... 1:1 .. 1:1 .... "'/ oetlQ 0 ~ . -n;l r:.-/ _0_ " -r:/" .. .. -::::- ~::;.:- I: " , .... '<? g ./" . ~~ CJ:I~ :ti tJ'I - :cO N;: s .... %.~ .0 ::t z V\ 0;,." 1ri"'~ o .... l-;~ ~I ~ :l'>> ~I~ ~ ~ '0 ,- I", G'.,j; ~ ~ p..:) r- , ~ ~ ",~ l'CI ~ !I l::: iZ- "' iG' ~I~ ~ 10 ~ \> \ \ \ ., I~ I,f:>. r\ c:. b' 'm ~ !i') .... ! ....' I~ i"c 1;0 ~~ ftl i~~ :; '<. .. > .... ~,'o a- :2 I'.: - 0'" .. I~ ".:::. ~ - I~ M ,..6' I" r- ,> c' !~ 2 m :e. ; ':-' ~I~I :~!~I ~ I~i!l' ~ c:~ _ I~'r \ ~ .~~- 1;"- ~ ~ z. 0 ~ tD .... r- r- "' .Tli b:-~ '" 0 0 ~ - .., :t '" Toil fY ,......, ~ ! r ~ !:~~, ",2>> il i T7'~~ ~~~ if ~~m / 1 V\ t ,... > ;:t) ~ I , f'~ !~~ r:h ~~B 5- g III ~'" ~ ~ ii' ~ ;11!/>. - \, I~ :0 :2: r.c: \J\ Fit? I-n~ I~"'" :oi, G'\<: m~ ~ \" APPLICATION FOR PER~IT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT S+o.."'c!c:t ,<,' 0 ADDRESS /(!; 0/ s;. ,,'1 S "-/"t <- OWNER -:s- 0 \..... V\. B ~ 14 '" ~ ..- JOB LOCATION 3 8" lO S \ S~t' \.J,'c..e eo"" r . PHONE ~~~ - ~ \ 99 Cr-"'~V\. ~ JU-Crv ,LOT SIZE_X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D. 4~ '2. - L" - L.\ - ::r:. 'D - 0 -- WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install ____Sign/Temp. ____Sign _Move ____Demolish PROPOSED USE: ____Single Family ____M/F ____IF of Units .____M / H 1<.001''':;' Clv...lJ'- Other ____Commercial ____Indust. ____Swim. Pool ____Restaurant & Health Department Approval BUILDING SIZE: x Square Feet, Height RESIDENTIAL: COMMERCIAL : ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FOR~S.** ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORtlS.** **COPY OF CONTRACT REQUIRED. ~ILDING PERMITS REOUESTED $ .~O 2..'1 ~ Valuation of Total Construction ____ELECTRICAL AMP Service Florida Power Corp. _\-l.R.E.C. ____MECHANICAL $ Valuation of Mechanical Installation ____PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block ____Frame ____Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** SEgrp.N , Company .s....~~ c1 0.. C J State Cert. or Regist. # City License Registration # -***************************************** /t-oPl e S'1~ S. e '( oJ " c... f? Co f". ELECTRTCTAN Company State Cert. or Regist. # City License Registration # ****~************************************* Signature PLUMBER Signature Company State Cert. or Regist. # City License Registration 1 ****************************************** MECHANICAL Signature Company State Cert. or Regist. ~ City License Registration # ****************************************** OTHER Signature Company State Cert. or Regist. # City License Registration # APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undtrsigned understands ~hat this perlit lay be subject to "deed restricti~ns. which may be lore restrictive than City regulations. The undersig~d ~5sules responsibility for co_pliance with any applicable deed res~rictions. B. UNLICENSED EDNTRACTORS AND CONTRACTDR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they lay be required,~o be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, b~th the owner and contractor lay'be cited for a .isdeteanor violation under state law. If the owner Dr int~nded contractor are uncertain as to what licensing require_ents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Department, (813) 788-6611. Further.ore, if the owner has hired a contractor or contractors, he is advised to have the contractor!s) sign portions of the "Contractor Sections" of this application for which they will be responsible. If you, as the owner sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign as contractor that aay be an indication that he is not properly licensed and is not entitled to permitting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - HOleowner's Protection Guide" prepared by the Florida Departlent of. Agriculture and Consuler Affairs. If the applicant is sOle~ne other than the "owner", I certify that I have obtained a copy of the above described doculent and pr~mise in good faith to deliver it to the "owner" prior to cOI.encelent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the information in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land developlent. Application is hereby lade to obtain a pertit to do work and installation as indicated. I certify that no work or installation has coemenced prior to issuance of a per_it and that all work will be performed to meet standards of all laws regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other governmental agencies may apply to the intended work, and that it is my responsibility to identify what actions I lust take to be in compliance. Such agencies include ~It ~l~ not limited to: * Deparhent of Environmenial ReQulatie.n - Cypress Bayheads, Wetland Areas and Envirc,nmentally Sensi hie Ldnds, Water/Wastewater Treatlent * Southwest Florida Water Mananelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses * ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways * Departlent of Health ~ Rehabilitative Services, Environmental Health Unit - Wells, Wastewater Treatmen:. Septic Tanks * US Environmental Protection Anency - Asbestos abatement I also certify. that, if fill laterial is to be used in Fle.e.d Ze,ne "A" or "A,etc.', it is underst{I[ld tli~t. a drainage plan addressing a "colpensating volule" will be sublitted which is prepared by a professional engineer reqistEied in'the State of Florida prior t,~ permit issuance. A perlit issued shall be construed to be a license to proceed with the Nork and not as authority to vioj~te, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a penit prevent the Building l!ffici~l fl(llIl thereafter requiring a correction of errors in plans, construction, or violations of any code. Every permit issued ~haJI becole invalid unless the work authorized by such pertit is ce'lIIlenced within six months of issuance, or if lie,) t; autllill Ized by the perllit is suspended or abandoned for a peric1d of six _onths after the ti/fle the \tork is cOKlmenced. One 90 day i!;:t,t'ISIOII of tillie, lliay be allowed for the permit Kith fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection lust be logged during each six lonth period, or the project will be considered dbdlldoned. 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 AllORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE SIGNATURE ------------------------------ ---------------------------------- OWNER OR AGENT CONTRACTOR DATE DATE ----------------------------------- --------------------------------------- NOTARY AS TO OWNER OR AGENT_____________________________ NOTARY AS TO CONTRACTOR ----------------------------- MY COMMISSION EXPIRES MY COMMISSION EXPIRES ------------------ ---------------------- . . CENTRAL F ERMITTING OFFICES: . Dade City: (904) 521-4206 410 E. Meridan Ave, Rm 234, Dade City . New Port Richey: (813) 847-8126 7432 Little Road, New Port Richey . Land O'Lakes: (813) 996-2203 9930 Land O'Lakes Blvd (US 41), Land O'Lakes THIS APPLICATION MUST BE TYPED OR PRINTED IN INK AND IS VOID IF NOT PERMITTED WITHIN 6 MONTHS ------------------------------------------ PASCO COUNTY BUILDING PERMIT APPUCA nON SHADED AREAS FOR OFFICE USE ONLY :lil: (,) . OWNER'S NAME: 9 m JOB LOCATION: 15 PARCEL 10#: S _ T _ R _ SUB Z OWNER'S PRESENT ADDRESS: ~ o BLK LOT x . FEE SIMPLE TITLEHOLDER'S NAME (if olher Ihan owner): address (If applicable): CITY STATE ZIP ------------------------------------------ . DESCnlPTION OF WORK: LIVING AREA: # BEDROOMS PATIO: # BATHROOMS: :lil: g ...J m Z o . IF MOBILE HOME OR RV: MAKE i= c. ~ (,) (/) w c - -- GARAGE: ENTRY: TOTAL UNDER ROOF: TYPE CONSTRUCTION: 0 BLOCK 0 FRAME 0 OTHER: :lil: 9 m g . ELECTRICAL CONTRACTOR: (,) SIGNATURE: ~ ADDRESS: !Z STATE L1C # (if applicable): 8 POWER CO: YEAR SIZE ;:~::~&~K*r=:::::~; . WORK CODE :m:\1#.dh"%'$$~ PLANS ON FILE? 0 NO 0 YES MODEL NAME: VALUATION: $ --------------------------------- . BONDING COMPANY: 'Sl: ADDRESS: CITY STATE ZIP (,) 0 . ARCHITECT/ENGINEER: ...J m a: ADDRESS: CITY STATE ZIP w ~ .... . MORTGAGE LENDER: 0 ADDRESS: CITY STATE ZIP ---------------------------------- . CONTRACTOR: SIGNATURE: ADDRESS: STATE L1C # (if applicable): PHONE# ( CITY STATE PASCO CO COMPUTER 10#: ZIP PHONE # ( CITY STATE PASCO CO COMPUTER ION: SAWPOLE: ZIP AMPS: . MECHANICAL CONTRACTOR: SIGNATURE: ADDRESS: STATE L1C # (if applicable): o NEW 0 ALTERATION VALUATION: $ PHONE # ( CITY STATE PASCO CO COMPUTER ION: (Required) ZIP . PLUMBING CONTRACTOR: SIGNATURE: ADDRESS: CITY STATE L1C # (if applicable): # FIXTURES: - SEPTIC PER #: PHONE # ( STATE ZIP PASCO CO COMPUTER ION: SEWER: WATER: WELL: . OTHER CONTRACTOR: SIGNATURE: ADDRESS: STATE L1C # (if applicable): TYPE CONTRACTOR: CllY PHONE#( ) STATE ZIP PASCO CO COMPUTER ION: VALUATION: $ JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT" (permit form 10/91) EDITIONS OF THIS FORM RELEASED BEFORE 1/91 ARE OBSOLETE AND WILL NOT BE ACCEPTED BY CENTRAL PERMITTING STAFF . . .. NOTiCE.... BOTH THE OWNER AND CONTRACTOR OF RECORD (License Holder) MUST READ AND SIGN THE REVERSE SIDE OF THIS APPLICATION .. ' CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understand that this permit may be subject to "deed resbictions' which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any applicable deed resbictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES II the owner has hired a contractor or contractors to undertake work, they may be required to be licensed In accordance with state and local regula- tions. 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 unoertaln as to what licensing requirements may apply for the Intended work, they are advised to contact the Pasco County Building Division - Uoenslng Section at (813) 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 conlractor, you are Indicating that you, rather than the contractor, are responsible for the work. If the conlractor wishes you to sign as contractor, that may be an Indication that he Is not properly licensed and Is not entitled to permitting privileges In Pasco County. C. TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES The undersigned understand that Transportation Impact Fees and Resource Recovery Fees may apply to the construction of new buildings, change of use In existing buildings, or expansion of existlng buildings, as specified In Pasco County Ordinance numbers 89-07 and 90-04, as amended. The undersigned also understand 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 m:Jsl be paid prior to receiving a "certificate of occupancy" or final power release. If the project does not Involve a certificate of oocupancy 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. D. CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended) If valuation of work is $2500.00 or more, I certify that I, the applicant, have been provided with a copy of "Rorida Construction Lion 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. E. CONTRACTOR'S/OWNER'S AFFADAVIT I certify that all the information In this application is accurate and !hat all work will be done in compliance with all applicable laws regulating conslruc- tion, zoning, and land development. Application is hereby made to obtain a permit 10 do work and Installation as indicated. I certify that no work or installation has commended prior to issuance of a permit and that all work will be performed 10 meet standards of all laws regulating construction, County 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 Inetude but are not limited to: o Deoartment of Environmental RBQ41ation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, WaterlWas~water Treatment o ~OlJthwest Florida Water ManaQement District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses o Armv Corns of Enoineers - Seawalls, Docks, Navigable Waterways o Department of Health & Rehabilitative Services Environmental Health Unit - Wells, Wastewater Treatment, Septic Tanks o US Environmental Protection AQencv - Asbestos abatement I understand that the following restrictions apply to the use of fill: o Use of fill is not allowed in Flood Zone "V. unless expressly permitted. o If 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. o If 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. o If fill material is to be used in aDl/. 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. 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 elecbical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be conSlrued to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provision of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, conSlruction, or violations of any code. 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 months after the time the work is commenced. One or more extensions of time, for periods not 10 exceed 90 days each, may be allowed for the permit. The extension shall be requested in writing to the Building Official. An approved inspection must be logged during each six-month period, or the project will be 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 FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. SIGNATURE(~~ CONTRAC R t-lARot..D 6e..>6 :ro+-4 NGO~ DATE 01- O-r-C1Z r:t..pP cT5;z..5341loZ.~'2.J ~ (e~) NOTARY AS TO CONTRACTO ~~ DoNA-I\f. ~\)1r D ~ NOTARY PUBLIC, STATE OF FLORIDA MY COMMISSION My commission expires Jan. 28, 1995 EXPIRES Bonded thru Patterson - Becht AgencY SIGNATURE OWNER OR AGENT DATE NOTARY AS TO OWNER OR AGENT MY COMMISSION EXPIRES