HomeMy WebLinkAbout09-9053 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780 -0020 9053
BUILDING PERMIT
MIT
Permit Number: 9053 Address: 39516 CHARIOT LN LOT 236
Permit Type: PARK MODEL ZEPHYRHILLS, FL.
Class of Work: PARK MODEL SET -UP Township: Range: Book:
Proposed Use: RV PARK Lot(s): Block: Section:
Square Feet: Subdivision: MAJESTIC OAKS
Est. Value: Parcel Number: 24- 26 -21- 0000 - 00100 -0090
Improv. Cost: 10,650.00 _.: _ f '' _ a m 0 :j
Date Issued: 4/23/2009 Name: MAJESTIC OAKS LLC
Total Fees: 1,710.75 Address: 39516 CHARIOT LN
Amount Paid: 1,710.75 ZEPHYRHILLS, FL. 33542
Date Paid: 4/23/2009 Phone: (813)783 -3477
Work Desc: PARK MODEL SET UP
BUTTERFIELD MOBILE HOME SERA" MODEL SETUP 60.00 PARK MODEL ELECTRIC 40.00
CRANDALL, RICHARD PARK MODEL PLUMBING 40.00 PARK MODEL MECHANICAL 35.00
BUTTERFIELD MOBILE HOME SETUP SEWER CONNECTION RV /PARK 502.50 WATER CONNECTION -RV /PARK 160.25
BAHR'S PROPANE GAS & NC, INC. TRAFFIC IMPACT FEE 99% 864.27 TRAFFIC IMPACT FEE 1% 8.73
1
PARK MODEL M' ECHANICAL V
PARK MODEL PLUMBING
PARK MODEL SET -UP
PARK MODEL ELECTRIC
REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection
trips are necessary due to any one of the following reasons: a) wrong address b) condemned work resulting
from faulty construction c) repairs or corrections not made when inspections called d) work not ready for
inspection when called e) permit not posted on job site f) plans not at job site g) work not accessible.
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.
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
"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."
CONTRA "*R SIGN - ' E PERMIT OFFI �R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner:
//tcaK (d
Date Received: 1 'Cf
Site:
39L / Gam, , ,6 7
Permit Type:
di,-,e /node/ Se / 6e,
Approved wino comments:❑ Approved w /the below comments: Denied w /the below comments: ❑
1 ,, ,
` / !
/ . 1 d 04 .4 '
This commen ee all be kept with the permit and/or plans.
f:-.3)/ -,• irk
d/o r omeowner
Ka1v' Switzer an s Examiner Date Contractor
wh ji comments are present)
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. Mate of Florida
DEPANNMENT OF
{ •
HIGHWAY MEET MEM AND morroR VEIIICL.ES
TAIWASSISNI, PLOSUM, 32399-01160
MOD EnakaNsom, 111
E..ucotslite Director
March 20, 2002
•
Mr. Bert A. Moore, Financial Eger
Manufsctuxed blousing Foundation Systems
•
Oliver Technologies, Inc.
Post Moe Box 9 (467 Swan Avenue)
Hohenwald, Tenucssee 38462 •
•
Thar Mir. Moore: .
We wish to ackr nwiedge receipt of lroar apes one and test !cants raboreyigg tbstt
i+ti u Leingimdinsi SW :axing end Lateral Btaaing System,1101 V„ listed below complies with .
the specifications and *iodations set by tips Departm tof Sgty sad Motor Vehicles,
Rules 15C-1.0105, 15C-1.0107 erid 15G1.0108. Florida Administrative Code.
Installation instructions must be available at the installation site.
•
1101 V Lotsgitudbaal Stabilizing and Lateral Drools* Sy stem
NO2 " • This systm is for replizeement of longitudinal anchors. This system cats only be
used with sidewafl onehor spa fttg cZf'5 A4". Maximum strut owls 45 °.
If you have any (T estioae, please atdviae at (407) 623 -1340. •
•
•
Sincerely,
•
Pbil Sorg*, Program Manager
Buxean of Mobile bile and
lleere:tiwaad Vehicle Commotion
�y �y
L •
Division. of Motor Vehicles
PR:srV
r rv:szor+s! tea, stctzwsx as resat. • new= Laments - mama vntar • Axotaftentanivz raiSMICSIS
1Yait tt'ktran
MOM* Florida 33399'O t
, Inc I
QUVER TECHNOLOGIES, INC, vrittion
FLORIDA INSTALLATION INSTRUCTIONS FOR THE
mrtnn ?PRIM AI 1 ATOSI entiNrielt(it
MODEL 1101"V" Man .1415)
LOWPITVOINAL ONLY) FOLLOW STEPS 1-9
MR ADDING LATERAL ARM t Stcpv 10-15
POP rautcnrri APPLICATION?! lellaw Swum S.1?
ettalINOLNIS STAMP Ft400411M 'Mum
_
1. SPECIAL ciRCLUSTANCE.S: H the totiowina conditions °Dour - ATOP, Cantiont TAnhnolnerioto i-Rrill-9ild_TAlT •
3) Pier height exceeds 48' b) Length of nor* ex:els 78' c) Roof eaves exceed 1W d) Sidewall height exceed 95"
a) Location is within 1600 feet of coast
INSTALLATION CIF GROUND PM
2. Remove weeds and debris In an approximate two foot square to expose firm soli for each ground pan (0) .
Place around Dan 1C1 directly below chassis loobsarn . Prises er drive nen firmly Info knit flesh with nr
SPECIAL NOTE: The longitudinal "V" brew system serves as a pier under the home and should be loaded ea any
other pier, it is recommended that after ieveling, plum and one-third inch (1/3") before home is lowered compietely on
to piers. complete at 4 Ihrtfugh 9 below then removaiacks.
ilinmejaanumunimanteLmumarcuarost
NOTE: WHEN IMEITALUNG THE 1.0110111JOINAL SY1171412(0, A MINIMUM OF 2 Immo PER FLOOR SECTION IS REQUIRED. SOIL usi
Writalit settatto_u est, trteu ;CI tt. 1 MIII1t1l' 011 1111.1.. W'&( 14t 1.I■/./ *Lae co astuttor:n nor asanstst ruszr oast-rune Ass larrrtAtrt-n.
ITS ITS *5 FOOT ANCHOR MUST es USED. IF PROSE TEST READINGS ARE BETWEEN 273 At 380 A 41 ,ANC34(1111 NAY R II4Ph IMO
qftptitia AMHflRS INT774 tpAt:+01 THIS AND ECTAVAjZlict PLAT9II WW1 C4" VIIRTIOAL 11!* A! ALSO Weal ?Mtn f)t4 W+follrtg ntnbr2r etn
mewl vt-t•toti. toe, ilL1N1ItA:11111,4 11 !maw PLEMWRIA ;mutt .
4. Select the corract square tube brace (E) length for sat • up (pier) height at support locatbn. (The 18" tube Is always
u‘seti T.Fre.. 130MA W4! IijnE.Pit:Ufle! MiTri t".- luoe De uteo DV UMW. ens fifitlee O enor., Aft iterlr_: Oft fa_
Mil Trl an rmnrctrt stu-set orosontatnetn
PIER HEIGHT 125" ADJUSTABLE • 1.60" ADJUSTABLE
•
7 314" to 25" 22" . _ 1 Er
t 24 34" to 32 114' 32"
ie•
; -Aq• +., Al A A"
adjustrmet.
6. Plat..e l-bean atit i0OSelv On the bottom flame of the 1-
7. Side the selected 1.25' tube (E) Into 2 1.50 tube (E) and attach tol connecters {P) and fasten loosely with bolt and nut.
OfIrtibett &gime thrra Min 7 tn onsets the, mmtyrirrt thr, Iffilb 410 tesneet.k. in niftna AS
411, 1
• ■••■•••• 1111.1 IV 11%._11,17 • 11_1.111Vilk, CY 1 A& ,11•11.1 1 11,1. I., /MI TIk . P..1. • 11..■ •••1111. PS ' .11 • 111,, ,1111"..111, ntnr.
NOTE; THEME OP THIS SYSTEM REQUIRES VERTICAL. TIES SPACED AT 51.4^.
FOUR FOOT t4') %ROUND ANCHOR MAYEN USED EXCEPT WHERE THE HOME MANUFACTURER SPECtrtn hielehm .
anc,.nors be'size-zi aocordino to inrque conditiOn. Any frontlf3dtilfer5 r.pecitz. f dowell anchor load; in excess r.f
1 1 . IN,/ • GI G.11...111 0,1,114C1111 I...11.1a . 1.14 11.1/171 ■011111. •Jrr (111.1./ 231.71.11", tn. ./1[1.11 IfT1.1 MI .0.111 4,111,1,0.11 XII 1.1.1.61,111,1TIS 1,111.7111 .1 ?VIM 7/7 Li
!h t 4'1 N (HI ierritll tt fet-' ieerfzli trantt. nt IP.Irmnrt 1 Thn lennt.tr nnnla in r.l.itts.r
zn. ,
•
.4 aft?? .1031 `1
ttl4.27:1A A 1
•
sow 2
ll'i " tlaUSING CON('' EF RWJNfcR 1 f OQTER n:vil.iroi fi,i!'
16. A concrete runner, footer or slab May be User) 11'1 place of the steel gsound pan. .
al) The comet. shell be mink urn 2500 psi mix
b) A concrete runner may be *Star Inngia dine( or transverse, and mutt be e r rirsm rm of 8' deep with a riwd.mum width of 18 Inches
Iatghudksddy oc 18 inches ttaseverae to allow proper distance hawses the imam* bet and the edge of the concrete (See below).
c) . Footers r t t hews rainimtsn surface arse of 441 3q. h. (Le. 21• swans), and must be a minimum Or deep. .
d) if a full stab is used. Hors depth must be a 4' minimum .
bbedal inspector, of the syslem bombe lnetailabon is 'tot WNW.. Pettus must itioN for s t asset 4 from the mete bolt to the edge
et the carla+ete.
NOTE: The bottom of all foaling., pads. stabs and runners invest be per focal Jurisdiction.
LONGITUDINAL: (Model 1101 i.0 W')
17. a - sknrply install the bradei t m mmnedhoater OR Whwn kt slkig In curisd concrete use Pprt #
..1 (d 1? 191101 (dryaet) CA bracket Is attached bibs cariaeie using (2)'518"3' mrit:rate wedge boils (Simpson pert +f
516230(14 sarxr or Pampers equivalent). Raw the CA breast in desired bonbon. Madt lx* We loth. then using* WV gametes
masonry b i t . d r u a hole to a m i n i m u m depth o f a-. Make aum rot t b s t - a n d come* is Mom out tithe holes I e wedge bolts ido dr>aed
holes, ten pleas 1101 (gayest:) CA break& t onto wags both and Mut wedge b fl lake s hpapmK and dd ,i the wedge butte
dawn by hitting the nut (meddr8A ewe not b hit life top of tweeds eeds en bolt). ait . ,per n are is or asitw na too
by Wising rush.
LATE) get 1101 TC'+1"
1a. Forest set (part # 1101 I CA) an sknply install the (anchor bolt Into runner/rooter. For drys set lam (fit # tact -D- ACA)
mart bolt )tote bCedtons. 'Oren using s Sr diem mammy bit. MP a hoist) a Mb irewn depth ii S'. Make stoat a1 dust and concrete is -
blown out of the (tole. Pta:a wedge bolts (Simpson part #8182300H Xs' or Powers agt estop) i 10 (D) tonere% dry transverse Si connector and 116 drd� hole. if needed. tek a hemmer and Tightly drive the the *edge /mks do by Mtatg ihsnLIt (mt eking 3Ure not hk
the top Of threads on bCt), then remove the nut. v., .. • • ,.•_, .....: • .. ...a r, _.. ,.. _ L._ ii; : .,, ., . �-u:
19. When using part # 1101 C111i1r (wet»at) or 1101 CVD (dryea ), iced par is 17 & 1&
Notas: .
1. LENGTH OF HOUSE IS THE ACTUAL BOX SIZE
2. * . STABL2ERRR.ATEAI'I'DIRA ETELOCAi'ION (,eedst,
be wirb•18 hdtesdFosri�'�f�tifld t raonaela)
a ga I_CCA'TCN OF LC7f+k �'1i1JC�NAL f JLY
4. 1RAhE 'SE &LONG •TUDWI: LOCAflONS
•
._w a_ f.l:i,t_► ,f . *A- 1 }l • r ii * *. t " e ;'1+ F1"
BRACES FOR U P Tad 4112 ROOF 'gCH �M Y
ALL WIDTHS; AND UP TO 52'
• • i ",Ii: - 1.1, A • • ;i1 • • a 1 1: •
• tli�:4' • • .�� tai • • ' iii ! i 1 ' 1 1 all
r ---.
ALL WIDTHS; AND LENGTHS OVER 52' TO 80' _
IIIII • • -- ill � • Ill • iko ■If ; • il! t. • Il • t • id t l pi - I mi . • Ill 1 I •
HOMES WITH 5112 ROOF PITCH REQUIRE: PER FLORIDA REGULATIONS
6 systems for home lengths up to 52' and 8 systems for homes over 52' and up 80'. One stabiiizer
plate and frame tie required at each lateral bracing system. •
•
•
seam mar opmer."nM / • ,/ , . -... •
!cadet i i i ae �` w. `; I
(tome m� %,..
sped 7i 1 • 1 • r • 1
imadloes lot seams' I _ „�,� ,, 1 , 1 i T�'p • i I
rf `T oo loamons ma a 5 - • *meager ;
armor. Per Fars% coat. -f • <1.1- Itertinietree elm ��
.../....., > ,4*---- ___------•-• iblk r h E 0∎44j�/ C = GROUND PAN ' `, /- / D it GROUND PAN CONNECTOR
i ' ' - 'r• U BRACKETS TRANSVERSE /� /' a _ �, P.^t ereoa Tg,E6COPiVO V BR . •
:'',/ bare - •%!'�t1► E : .Y ACE 1.S BOT
" � , _ i oa►+txtera
• mom Pan J TOM TUBE AND 1.25 TUBE
v IN
i' � � F at "V` �AICE 1 . 8 E A M CON EC-
T ORS ASSE BLY
E - 11.01 , 1 • H : TELESCOPING Th18VERSE • .
ARM ASSEMBLY
•/ .sown !. s: 1- TRANSVERSE ARM S-BEAM
., r - Oround Pr, CONNECTOR ' i Jr V -MN BRACKET
<.:N.....-''''jt;?%..-." :. Atsnrcs l+oe►a (1 'PH • Longitude dry .- • >'. Mam —
concrete bracket w _ �� • part A 1101 ,� ". "ae. , /", 141
• rt!: _ 0> 1 +g er s r�w
Wet bracket part '..
1101 WCPCA not '� ` real -tax 2 t7 Model 1101 CVO .,. •
shown '
. errt a wls
-.SEAM COMEGion at T Model 1101 CVW .
not shown
r -
:.,..r_..._ C = .� - re FOOTERIRUNNER I
imams an r .: �` ' D %s CONCRETE U BRACKET TRANSVERSE l
{raptors smart *NM roma � 1 1 . , , I R (CAI1f1. W1h gad 5 -1r'Z° x 2 l
Jar OMANI Mpg ay In : Imam or 4.101 tbs. These .. I t' 1 i' , ,' re + E :?1:t.ESCOPR+IQV BRACE
si r e c ire - f ' �'i° mat"
t 'TUBE ASSEMBLY Wl 1.5 BOT
' ., + T( 1NtT U8EA D N.2S'R1BE
.f' `+�► _ ' � -' F = li" BRACE Iii CO 1 R ASSEMBLY 1 INSERT 1
f , ,. '' ! 0 z ..-. ,,,700:„.... ..y � , s , (0onne w b 8 - 1l ' x 4' catrtage bat I
& a
. gaeedae "lap conned s }
/ „ •> i , 'e®• 1 H s TELESCOPING i RAINSVERSE ARM
.1 • tcno:u v - ASSEMBLY
'Raalst ! = TRANSVER,SEAR I
M I-BEAM CONNECTOR
mo t►" .: �� ( grgrade 3 112' x 2 112 carnage be t
. // ,
E- Bawl' `• �,. V.
e ' J.! CONCRETE *V" BRACKET (connects with
�. aar (1.51 t � +' grade 8 - t'2' x 4' cartage bolt &Hurl
1 •1 ceners U
Power' Burner V
' Model # 1101 C "V ..—,
5, 1, OLIVER TECHNOLOGIES, INC. ' T*leanur a 1- 799.4555
.) / 1.000 "284.7437 Fax: 931
wvny.tiNverled)40091mt.ton
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Date Received , 1.0' 0 Phone Contact for Permitting Z IS -- Y 9,,S
Owner's Name AM C -FI 14S LL C. Owner Phone Number 03-723 - 3
Owner's Address OW W L ' C a / v i e l b e ' k R fli Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address J I
JOB ADDRESS J / 1 t C . h a...7/0 U L 4 i) e- I LOT # 2 '")
SUBDIVISION MC�I e.� G 0 a t., PARCEL ID# 2(c -co te � ?Q
J (OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED F1/' NEW CONSTR ADD /ALT 1 I SIGN I I MOVE 1 1 DEMOLISH
INSTALL REPAIR
-
PROPOSED USE 1 SFR I I COMM I I OTHER I I
TYPE OF CONSTRUCTION I 1 BLOCK
� I I FRAME I I STEEL I I OTHER 1 416hi /t- J ' u'/ I
T
DESCRIPTION OF WORK Ct '4 / N - hd . ( Se /Cp
BUILDING SIZE /3 x 3 $ SQ FOOTAGEV7 L7 HEIGHT
BUILDING $ l0, J VALUATION OF TOTAL CONSTRUCTION
I I ELECTRICAL $ 2-6,(`' AMP SERVICE 1 I PROGRESS ENERGY W.R.E.C.
I I PLUMBING $ % J CJ /1 n .)
I I MECHANICAL r2s , VALUATION OF MECHANICAL INSTALLATION
GAS 1 I ROOFING I 1 SPECIALTY I 1 OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IYES I,_-4 d
de
BUILDER `- , f !^ COMPANY 8 r/t-- :F le�={-e�' el 1 P
SIGNATURE c -� �� c - � :I REGISTERED I Y/ N I FEE CURRENT / I Y / N
G
Address !o3 ( / 66,f / R41 7tihc,, , t I (U 1-3 Z License # 1/ % U O?
ELECTRICIAN � COMPANY £j1_,1 trig l / eI f'i U
SIGNATURE c ;..+ REGISTERED I Y! N I FEE CURRENT I Y/ N
Address 6 ?335 ?-t-4 4 Cl z 33C` 0 Q � License# tR £O ` /2 �O
PLUMBER �� J \ COMPANY Axc. -C'' " �< a' / - AA r (- J
SIGNATURE L- -` �'`� y„ ` REGISTERED I Y / N I FEE CURRENT I Y ! N I
Address ' / ( ( l � C� l Y-t1 • , i )h� v i ((� 3 3 5 ` ( � License # ` �G�° z y?
- --
MECHANICAL f 8 1 ✓,1 p ae A/G
/ = COMPANY
SIGNATURE -- -" REGISTERED I Y/ N I FEE CURRENT I Y/ N I
Address 1 7 11- P - // Al/t?/? R 2 J'j y-1 ?c` l License# CAG Qy 3cl`ZP
OTHER COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1
Address License #
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (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 & 1 dumpster; Site Work Permit for subdivisions /large projects
COMMERCIAL Attach (3) sets of Building Plans; (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 & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
* ** *PROPERTY SURVEY required for all NEW construction.
IIIIIIIIIIII111111Il111111tillfil11111IIIIIIIIIIIIIIIIIIIIIIII11 1111IIIIII111111111111111111il111111111111111111111111ttllltllllliltllllit11111t11
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required. (A/C upgrades over $5000)
** 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 (Front of Application Only)
Reroofs Sewers Service Upgrades A/C Fences (Plot/Survey /Footage)
Driveways -Not over Counter if on public roadways..needs ROW
which NOTICE
may be more restrictive DEED RESTRICTIONS: a County regulations. The undersigned as assumes responsibility bilty for compliance restrictions"
which which my Y
applicable deed restrictions.
UNLICENSED CONTRACoTOR CONTRACTOR e required to be RESPONSIBILITIES:
en Ba dance with state and locale regulations. r contractor
contractors to of undertake w they may
con
er t st a is not li te law. If c thhe owner er r or required nded co are uncertain as to what licensing t requirements may violaion
under a the on o
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 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 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 (Chaptr b provided wh Statutes, copy of he "F orida Construct on Len Law —Hom owner's
certify that 1, the applicant, have be p
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.
w be done i n o with all applicable laws regulating construction, zoning and land development. Application is
wne in compliance with all app
here mby men c ede r o obtain a per ior to Issuance of a ermit and that will be perforrmed to of all laws ll regulating
commenced prior p
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that 1 understand that the regulations of other government agencies may apply to the intended work, and that it is
my responsi to ids t of actions I must take
Protection-Cypress ess Bayheads Such
Wetland Areas and Environmentally lt
- Sensitive
Department of E
Lands, Water/Wastewater Treatment. Bayheads, Wetland Areas, Altering
- Southwest Florida Water Management District - Wells, Cyp ress Y
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.
1 understand that the following restrictions apply to the use of fill:
- Use of fill is not allowed in Flood Zone "V" 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 casing 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, tructionl s I in good
inform permit may be permitting conditions
red for electr electrical forth
lwork,
this affidavit prior to commencing con
plumbing, e d sh wells onstrued be a license to proceed e with the work and not as authority horiity to violate, cancapplication.
l, alter, or
permit issued ph all be c
r aside any s uiring a correction of errors the in plans, co construction or violations of any cods. , Every t perm t issUed Official
hall become invalid
rq ectn of r in by
unless m it work it is suspended oor a b by ndoh andons d period od of six (6) within six months of
after the time the is co mmenced An extension
the permpended r b
may be requested, in writing, from theBuilding k elases O ffo ri ninety (90) days, the job is ed ba l ndon eds trate
justifiable cause for the extension. If
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMM OBTAIN FINANCING, MAY RESULT IN Y R
L
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. F YOU INTEND
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 117.03).. _ _� -- �- ��
___ CONTRACTS'
OWNER OR AG S ubscrlb and sworn to (or affirm
Su00 ri 7 and sworn • (or - rrmed) bef, - me is � b <, yt , (3 � _ t Before m this 5, a --f A, 7 b `.41# mg e , � C�.
Who is /are rsonally o me or has as ider u - d
Who is /are • = = ly kno.•• to me
ap identification. --
produced
;41 - 1 (Cyi 1 ` Notary Public
J ( `1 - I ���∎ Noi.ry Public I �+`� C �� --
Commission No.
Commission No.
Name of Notary typed, printed or stamped TONI SCHMIDT
Name of Notary typed, printed ( or stamped
o�'" ; " c TONI $CFtMIDT *� ' * MY COMMISSION # DD 616391
* MY COMMISSION # DD 616391 * - 2010
* - �T 1� EXPIRES: November 20, 2010
„ -4 Bood Budget eta Services
� Oc F��
d '1AleOF F ,,, Bonded Thru Budget Notary Services