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Home My WebLink About13-14133 CITY OF ZEPHYRHfLLS 5335-8TH SIREET � (813)780-0020 14133 BUILDING PERMIT ,�-'" Permit Number: 14133 Address: 7242 GALL BLVD Permit Type: DEMOLITION ZEPHYRHILLS, FL. Class of Work: 636-DEMOLITION Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 35-25-21-0010-07200-0000 Improv. Cost: 10,000.00 ; : � Date Issued: 4/26/2013 Name: KIM-MP MULTI STATE LLC C/O KIMCO Total Fees: 75.00 Address: 3333 NEW HYDE PARK RD STE 100 Amount Paid: 75.00 NEW HYDE PARK NY 11042-1205 Date Paid: 4/26/2013 Phone: (610)677-5800 Work Desc: INTERIOR/EXTERIOR DEMO SITE PANAERA BREAD �C�i � i 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 fl 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 pubiic records of this rnunty, 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 oommencement." Complete Plans, Specifications Must Acxompany Application.All work shall be pertormed in acxordance with Ci Codes and Ordinances. NO OCCUPANCY BEFO C.O. CONT CTOR SIGNATURE PERMIT OFFI R � PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 8t3•780-0020 City of Zephyrhilfs Permit Application Fax•813•7$01Sp21 B�o�ng f�epartment �ate Recoivetl ��2G_�y I �'' � �—�- � PhoneContactforPennitting�I'''rl-T'1 � � G�.�I_ ..., �/ �"� I �' OwnefsNama {�W(\ I�w��s� LL� Y ` �ZG{, Owner Phorte Numb¢r qwners Address �e�,7 E,,,p/t¢ �p �"0. � � �"�'"'�--� wn rPhoneNumbar � �•d�ia� Fee Simpts Titlehalder Neme Owner Rhon4 Number �ee Simgle TitlehotderAddress � JOBROORES3 rai�ol 1 . � rl'li{ � ,3�jt1�t+ � LOT# � SUtl�iVISIOM � PARCEL 16#f S c47 �a��L�y�"� Q(�}"(� D � �OBTAIN�DFROM PROFERTY TAX 07071GEJ WORK PROFOS@CT NEW CON57R 8 gp()/�,f S�CsN INSTALL � C� QEMOLtSH PROPpSE�USE Q SfR � COM � OTHER TYPE OF CONSTRUCTION Q BiOC 7� FF2AME � STEEL Q —� DESCRIPTION OF WqRK 1 p�/(/ � �Qw • a = ' a ' n /Ll�mps�l gUILflING ZE SQ FOOTAGE �0 f n e)oS uf Q NElGHT BU�LOING S / b�.Q� VALUATiON OF`TOTAL CONSTRUCTION [�JE TRiCAt� S �y,� AMP SFRyCE [�] PRQGttESS ENERGY a VO-�A Q W R.E.G. PLUMBINQ S 00•oD �� ; VAE UAT{ON OF MECFtAPitCAL IMSTALiATiON ��S [� RppFING Q SPECIALTY Q QTkER FINISHED FLOOR EIEVRT S —� FLOOD ZONE AREA �YES NO 8��R I COMPANY l �_ ` SIGNATURE I < <�1�C 1�� V�q� � �J R[GISTERED Y/N Feeauwten Y/N Addroas � •� j��M3� / License R �C �S� j'� � � " . ��D EIECTRtCiQN ��— SIGNATURE � GQMPANY FEGISiERED Y 1 N fC#CURREN �Y/N Addrexs ^—� LiFense� �� 1��/ P��R � COMPANY � SIGNATURE ftE01STCREO Y f N FEE CURREh Y/N Address Licenae N�_va—�_---_—� MECHANICpL � CQINpANY � SIGNATURE � ^ � RBGI9TEAE0 Y l N FEE CIiRREk Y/N Atitl�B88 ��_� �'�'�] „�,��, License p � I ��E� � COMPANY SIGNATURE REGlSTERE+J Y I N fEE CURREh Y 1 I� ACdress Licnnse# � �� 1111117tIt1ilt11t11111 / flllllli / / t111111111I1111lI1111111111111111t RESiDENTWL Rttach(2�Plol PJana;(2)sels of Building ptans;(i)set of Enerqy Forms;R-O-W Parmit tw new canstruct�on, MinFmum len(1Qywprich�g dayt aRer submittai tle1e. Requ'aed onsle,Construqian ptarrs,Stormwater Plans w/Siit Fence instaNad, COktMEi2ClAL AttaeEi 3)compie(g yets o 6 dGing Plan p us a L far5afa�Pa es�tr seto{��S Mirtimum ten(t0}worWng dayg aryqr submittat daie. ftequ cd onslte?Constnact on plans,SS onrn�raier P ns w/Si]kFer�;e nstailed, Saaftery FacikOes S 1 dumpster.Site Work Permii iw aN new projeus All commercial requirements musl meeE campliance 51GN PERMiS A[terJf(2)sqls ot Engineered piana, ""PROPERTY SURVEY required for aA NE W construclion. DIlBCtipDt: Flii out applicat;on comp�atcry, Oumer d Cantracta sign baGc M applicqtioh,notarized Itovar 57660,a Notita ot Commencemant ts requEred. (AJC upgrades aver 57500) " Agent(far tha canlractor)or Power ot Attomey{for Itce m+mer)wpNd be someene wilh notarized(olter irom rnmer a�iho�iz�rrg same OVER THE COUNTER pERM�TTiNG {Fronl W qpp&oation Only) Raroots it sh[ngl�a Sewers Servica Upprades AIC Fencea{A[oVSurroylFaotage) DAveways-Not nver Countar if on public roatlways..needs ROW HOTICE OF OEED RESTRiGTIONS� The undersigned understands that Ehis permit may be subject to"'deed"restrictions" u�hich may be mor@ restrfctive fhan County regulations. The undersigned assumes responsibi(ity tar compiiartce wiih any appiicabie deed re5tricUons. UNi.ICENSED CONT#2qCTORS AMD CON'fRAC7pR RESPdNSE6lUTlES: H fhe owner has hrred a coniractor or contrectors to undeRake work,they may be required to be ticensed in accordance wllh stale and local rer�ulafions. If the contractor is not licensed as requfred by law,bolh the owner and coniractor may be cited for a misdemeanor violation txtder state►aw. Et!he owner or intsnded conErac3or are uncertain as!o ufiai licensing requfremenls may appty for!he intended work,they are advised to conlact fhe pesco County Building lnspecEion Divis�on--E.icensing Section at 727-847_ 8009. Furtt�ermore, If the owner has h'ued a contractor or contractors, he is advised fo have the contraelor(s) sign porf3ons of the"eoniracktu Block"of Ehis eppficaUan for whicti they wilt be responsibfe. tf you, as the ow�er sign as the cantractor,that may be an indicat�n that he�s no1 properly licensed and is no1 entitied to permilEing privileges in Pasco County TRANSPORTAT#ON IMFAC7/UTIU7lE81MPACT AND R�SdURCE RECOV�RY FEES; The undersigned undersiands ihaf 7ransppriation lmpacE Fees and Recourse ReCOVery Fees may appfy to the conslructlon of new buiidings,change of use in exisiing buildings,or expanslon qf existing buildings,ss specified in Pasco County Ordinanco number 89-Q7 and 90-07,as amended. ThQ undersigned atso understands,that sueh tees,as may be due,�vlli be identifiQd at the time of perrnitting, It is further untierstood thai Transpor{atfon fmpact Fees and Resouroe Recovery Fees must be paid prior to receiving a"certiflcate af bccupaney'or final pnwer release, ff 2he project tlaes not invalve a cerfificate af occupancy or finai powsr release,the fees must be paid pr�pr to permit issuance. Furthermare,ii Pasca County Waterl8ewer impact fees are due,they must be paid pri�to permit issuance in accordance with applicable Pasco Couniy ordinances, C4NgTi2UCTION LIEN lAW{Chapter 713,Ftorida 5tatutus,as amended), tf valuatian of work is$2,500.00 or more,I ceAify that I, the applicant, have been pravided with a copy of the "Florida Gonstruction f.1en Law—yomeowner's Protection Guide"prepared by the Florlda Deparkmeni of Agriculture and Consumer Affairs. If the applicant is someone ather than the"owner",t rzriifyr that i have obtained a copy ot the above�escribed dacument and promise in good falth io deliver ii to the"owne�'pric�r;p commencemont. C�MTRAG7dR'3/OWNER'S AFFIOAYIT: I certify that atl the Enfwmation in this application is accurete and lhat all wark urill be done(n compliance with afi applicable laws regutating construc6on,zoning and land development. Appllcation is hereby made ta obtain a perrt�( to do work and insiallation as indicafed. f certify that na worlc or instafiat€on has commenced pripr tq issuanCe of a permii and that a!I work will be performed to mse! standards of a11 iaws regulating construcfion, County and City codes, zoning regulalions, and land development regulations in the jurisdlcfian. i aisa ceRify that I understand lhat the regulations of other govemment agencies may appty ta the intended work, arul that it ts my respansibility to identi[y w�at acNpns i must take to be in compifance. Sach agencies inctude trut are not firt�ited tn. - Department oi�nviranme�fai Protection-Cypress Bayheads, Wetland Areas and Envirortmentally Sensitive l.ands,WaterlWastewater Treatrnent. - Sarthwest Flotida Water Management Dfstrict-Weffs, Cypress 8ayheads, W�tland Areas, Attering Watercnurses. ° Army Carps of�ngineers-Seawalls,Docks,Na�igable Waterways. - Departmerrt of Health & Rehabiiitative ServicesiEnvirnn+r�ental HeaNh Unit-Welfs, Wastewater Treatment, Septic 7anks. - L!S Environmen4a!Protection Agency-Asbesios abatement. - �ederal Aviation Authwi#y-Runways. �understand that the faltowing restrlc#ians apply ta the use ot filt: - Use of fitl is nof a]Iowed in Flood Zone`V"unless expressiy p�mitted. - tt the fi11 material ls to be used in Flood Zone "A', it is understaod itiaf a drainage plan addressing a 'compensating volume"wi�l be submitted at time of permitEing which is prepared by a professional engineer. licensed by the Siale of Floric#a. - If the fill malerial is ta be used (n F[ood zone"A"in connection uvilh a permiited buifding using siem wall construction,t certify tha#fitl will be userl onty!a fifl the area within the stem wall, � if fitt matetfal is ko be used ir� any area, i certify ihat use ot such fill wi11 not adverseiy atfect adjacent Properfles, If use of fill is fo4md to adversely affect adjacenl propertles,the owner may be cited for violafing ihe condltfons of the building permi! 'rssued under the ai#ached permit a�plication, for lots fess than one(7) If t am the AC3EN��R THE EiWNER Itp om�se in�good fa fh to n olrm theownea ot the permitiing condilions set forttti in tMs affida�ff prior to commencing eonst�ucfion. I understand that a separaie perrr�t may be required tor elecErical work, plumbing,sigrts,wel[s, poofs, air cbndilioning, gas, or other instaltations not specifica[ly induded in the appi;cation. A petmit lssued shall be construed to be a ticense to proceed with ttte wprk and noi as authorify!o violate,cancel,alter,or sei aside any pravisians of the technital codes,nor shail issuancs of a permit prevent the Building Offreiat from thereafter requG�ing a correction af errors in ptans,consiruciion or violations of any codes. Every permit issued shall becprne invafid unless tite vvork authorized by guch permil is commenced within six months of permit issuance, ar if work eulhorized by Ihe permit is suspended or abandoried for a pe€iocf of sfx(6)morrihs after the time the work is commenced. An extension may 6s requested,in writing,frarn fhe Building p(ficiai fvr a period naf to e ceed ninety(g0}days and w1U demanstrate justCt�able cause for the extensian. If wark ceases for ninety(90)consecuti ays,the joh is considered abandoned. WARNlNG TO OWNER: YOUR FAILtJR�t0 RECORD A QTt E O N(ENCEMENT MAY RESULT lN YOUR PAYING TWIGE FOR IMPROVEMENTS 70 YQUR PFtOPERTY. I Y END 70 06TAIN FINpNCING,CONSULT UVITH YOUR L NDER OR AN ATTO N Y BEFO E RECORDIN �-�, fL6RIpA JURA7(F.3.117.03) OF CrdMMENCEMEN7. f JC J QWNERORAG�IVT �h �.1/�//`j CON7RRCTOR `� S " ed and 5xro b(p, d)beto r y�th SubscribeE and t n t d r d}b (ore Ihis ey C v� 10-af.�1'� ny _.._ � �� o mb r hnsJhave produced yyha{�ere _._ es�enGfication. n known 10 me or hasRisve produced _e as iaentirECatiort. � , ,_Natary puhGc Natary Putrllc m�aslon NO.��s ._y �` OQd_.M` .._..�,.y. � P Comrru sion No. !. O� ,J �J�C��V nf{rr�n Sb►!\o�t A� � ~ eme of Notary lyped,pmtad ur sfarnped Mame at No1 s sry Typed,pnnied or stampecf zos"a�.``.'b<< SANDRAERRINGTON Commonwe��th of p��Sy�� * MY COMMISSION#EE 068451 NOTARIAL SEAL * EXPIRES April28,2015 ,��'��LQ� � , RANDI SMENKMAN,NpTARY P�g��C `�r9T P°P Bonded Thru Budget Notary Services ' P�Q� Lower Merion Townshf ,Mont ome FOF F�� M Commission Ez ires A�il e,Z0�5ounty Bt3-380-06�0 City of Zephyrhills Permit Application Faz-$13-T80-002t Bullding Deparimen( Oate Receivad �j� .- o, ,_, n��-�--� Phone Contactlor permittirtg Ownofs Nama Qy�n t�)W (,(,� � �jL '(� S�vner Phona Number Owner's Address ��i,i c.,pfti�' tM� �, �� @r � �`r�t0'.t,,Phone Number � Fee 3impte 7itleholder Name ��"`� Owner Fhone Number � Fee S3mple 71t1ehoiderAddress JbBADDRESS ��C�L � . � r�\� 1 ��+ � f LOF# � SUBk3tYlSION ��—�� PARCEL 10A' S��a�"QU,�^� Q�"� {� (UBTRINEDFROM PRpPER'tY iA7(NOTICE� WORKPROPOSEp e NFWt4rrsrn� AODlAL7 � SIGN INS7ALL H�pp�� 0 � DEPdpi,IS1i PROPQSEO USE � SPR � CpMM �� QTH[R 7YPE OF CpNSTRUCTtON Q BLOGK Q FRAME � STEEL � �^"'—"—'-------� DESCPoPTION CJF WORK BUlLDING 5t2E C�__!� Sp ppOTAGE� HEIGHT � �BUILOING a VAlUATIQN OF TOTA�CONSTRUCTIQN QELECTRICAL �� q�P SERVICE � PROGRESS 6NERGY O W R.E C. �PlUMB1MG �� Qtu[ECHAMICAL �'� 1�q�UATION t1F MECHAryICAI MSTALLATIqN �---�—_-__� QGAS ROOFING [� SPFCIALTY � OTHER FINfSHED FLOOR EL �� FLOp3]ZONE A(2EA QYES NO BUINATl1RE CO#APAMY ('('_ � 1"\�G �CA � V� (0 f RCGISFElYEp Y/N FEE CURREK Y J N dlddreas �� •7 le7 J Q 331y License# ��s��y�� ELECTRICIAN COMPANY � SIGNA7URE ffEG75TERED Y/ N KEE CURREN Y I N � Address — „_ Cicense#��mm� � PLUMBER � COMPANY r��_ ^ I SIGNAFURE REGIS7ERED Y i N Fee curtn�n Y I N Addrosa �_ License# r�—�a�—� MECHANICRL � COMPANY __ I SIGNATURE REGt37EKtED Y 1 N F6E cUwa�n Y J N ! Addrass � Licensei� (a—� OTNER � �6�pA�Y � � SICiNATURH REG�9TERE0 Y 1 N FEE GURREh Y!N Adtlreas I.icensef � � 1I111111111EIIfE11l1111EIIIIIItEl1I11i11fIiI11111111111IttI11t11iF1 RE3t0EM17At� Attpch 42J Plot Pians:l2)sels of BuUding Ftana;(1)set of Encrgy�anns;R�O�W Permit for new consUucl�an. Minimum ten(1Q)warlc(np deys afler submittaf daie Required onsite,Carys4ruction Rlans,Sformwater plans w1 SiIE Fence instaiied, Sanilary Fadlities&7 dumpster,Site Work Pemeit!or su6divisionsltarge projects COHIMERCIAL A11ach{3)comp3ele se;s od fl�xldirtg Planx plus a Lfle Safety page;(t)gg!cN C•nergy Forms.R-O-W i��rmrE for new conslrucuon. Minim¢m ten(i0}working days afEer submqtal tlate. Require�!ensile,ConsWdian Plans,Stam�waler P�ans w/Sf1l Fertce inslallad, San(!ery Facd7Ue9 8 1 dumpater,Sile Work Permit for s1E new�rrqects.All cornmercial requirements must meel complisnce SIGN PERMIT Attach(2)se15 of Enpineet0a7 Plans. ""PROPERTY SUt2VEY requiretl for aN NEW tonstruaion. fliracNOns: FiR out appticalion completely_ Owner&Cantractar s�gn 6ack oE appl�cation,riq3arized [t over 52500,a Notlee at Commaneement is roqulretl, (q1C upgrados over L7500J " Agent(for Ihe contrectarj a Fower ot A�tomay{for tt�e pwner}wouFd be sameone witE�rtotaeizad le�ter Irom owner authorizing same OVER TNE CQ13N7ER PERMITTW�, (FroM afiApplicatian Ordy) Reroofs if shingles Sevrers Sarvlas Elpgraiies A.�C Fences{PIoUSurvey/FOUfage) Orirownys-Noi nver Cowiter ii on public rosdwsys„needs R44V iVOTICE OF[1EED RESTRlCTI�NS: The undersigned understands that this permit may be subject to"desd"restnckions" which may be mwe res4rictive Ihen Caunty regu�ations. The undersigned assumes responsibility for compliartc�with any applicable deed restrictians. UNLICENSED CONTRACTORS AND CONFRACTQR RESPONSIBILITIE5: lt the owner has htted a cantractor or conuactars to undertake work,they may be required to be licensed in accordar�ce wlfh state anrl Iocai regulatlons. !f the ContraCtor is nat licensed as required by law, bath the owner and contractor may be cited far a misdemeanor violation under state law. II the owner or intended Contractor are uncertain as to what licensing requirements may apply for the intended work,they are advisBd to contact the RasCa CounEy Buiiding Inspecfian D�vislon---Licensing Section at 727-&37- 8Q49. Furtharmore, it fhe owner fias hEred a aon#ractor or contractors, tte is adv(sed to have ihe canfractar{s) s+gn portians af the"contractor Blodc"of ihis appflcation for wh�ch fhey wilf be responsible. If you,as the awner sign as the cqntractor,that may be an�ndicaiion ihat he is not properly licensed and is not entiiled to perrnit8ng priv€leges in Pasco Caunty. TEtANSPORTATIdN IMPACTlUTtIITIES lMPACT AN[3 RL8pURCE REGOVERY�EE$. The undersigned undersfands thet Transpartation Impact fees and Recourse Ftecovery Fees may apply to the cor�struction o1 new buildings,change of use in existing buifdings,or expansian of existing buildEngs,as specified in pasco County Ordmance number 89-07 and 90-07,as amended. The unt�rs)gned alsa understands,that such fees,as may be due,witl be identified af the time of permitting. tt is turlher undersfood that Transportation fmpact Fees and Resource Recavery Fees must Be paisi prior ta receiving a"certificate of occupancy"or(inal power release. It the proJect does not involve a certificate of occupancy or fina!power�elease,fhe fees must be paid prior to permit issuance, Furtherrnore,if pasca Couniy WaterlSewer lmpact fees are due,they must be paki prior ta permit issuance in accwdance with applicable Pasco Couniy ordinances. COW&TRUCTIOM L16N WW{Chapter T13,Ftorida Statufes,as ameaded): If valuation of work is$2,500.00 or more,I certlfy that 1, the applicant, have been provided with a copy of lhe "Flarida Construction Lien Law�—Homeowner's Pratection Guide"prepared by the Fiorida Deparirnent of AgriCUlture and Cansumer Affairs, lt the applicant is someone other than the'bwner",1 certiTy tha!I have obtained a copy of the above described tlocument and promise in goad faith to deliver it ta the"owr�er"prior to commencement. C4N7RACTQR'S/OWlVER'S AFPIDAVIT. I certity that all the informaiiprt in this applicaiion is accuraie and that aIl work wifl bs done in compfianee wifh alI applicable kaws regulaking construction,zoni�g and iand develnpment Application is hereby made ta obtain a permit to da work and installation as indicated. I eeriify that no wo€k or installatian has comrnenced prior ta issuance of a permit and that al!wark witl be per#�rmed to meet standards of all laws requlating consiructia�, County and City codes, zoning regulations, and lend development regulations in the jurisdiction. I also certify fhat I understand that the regulations ot other government agencies may apply to the intended work,and that it is my responsibility to ideniify what ac#ions i must take 10 be�n compliance. Such agencies include but are nok limited to: - [7epartment af Envirorunenlal Protection•Cypress Bayheads, Wetland Areas and Environmenkally Sensifive Lands,Wa#er/Westewater Treatment. - Souihwest Florida Water Mana�err�nt Districi-Wells. Cypress Bayheads, Weiland Areas, Altering Watercourses. � - Army Corps of Engineers-Sea�valls,Docks,Navigable Waterways. - Department of Health & Rehabilitative 5erviceslEnvironmental Health Unft-WeUs, Wastawater Treatment, Septic Tanks. - US Environmental Protection Rgency-Aspestos abete�nent. - Federal Avlation quihorily-Runways. 1 understand that the following restric6ons apply to the use of fi4: - Use af fiil is nnt allowed in Ftood Zqr�e"V"unless expressly permi#Eed. - !f the fi�l material fs to be used in Flood 2one "A", if is understaod that a drainage plan eddressing a "compensating volume"will be submltted at time oi permit[ir�g which is prepared by a professionaE engineer licensed by the State of Flarida. - !i fhe fflf material is #o be used in Flood Zone"A"in conneciion with a permiffed building using stem wal! conatruction,I certify that fill will be used only io fiH the area within the stem wall. - if fill material fs to be used in any area, I certi�y thaf use of such fill will npt adversely affec( adjacenk properties. If use of fill ig found lo adverse)y afFect adJar,ent prope�ties,the owner may be cited for violating the cpndiUons of fh6 buikting permit iss�red tmder the attached permit a�plication, far tots less than ane(1) acre v�fch are elevated 6y fiIl,an engineered drainage plan is requfred. kf I am the AGENT Ft7R THE OWNER,1 promise in good falth to Jnfo�m the owner of ihe permltting conditions set#orth In this a�davit prior to commencing consiruction. I understand that a separate permit may be required fpC efeciriC81 worlc, pVumbing, signs,welfs, pools,air cortditioning, gas, ar other installations nof specifical{y inGuded i�the application. A psrmit issued shall be consfrued to be a license to proceed with the work and not as auihoriry to violate,cancel,aller,or set aside any provislo�u of the iechnical codes,nor shaA issuance of a permil prevent the Buifding O�cia!from ihereafler requrring a correction o#errors in plans.ConstruCtiarf or violations of any codes. Every permii issued shall become invalid unless the work aulhorized by such permlt is commenced within six months of permit issuance, or if work auEhorized by the permit is suspended or abandoned for a period o(six{6)mortths after the time fhe work Is commenced. An exlension mey 08 requested,in writirx,�,from the Bui{ding Officiat Por a petiod nnf to exceed ninety(9d)days and will demonsirate justifiabte cause for Ihe exfension. ff wark ceases for ninety(90)consecut� e days,fhe job is considere@ abandor�d. WARNING TQ QWNEft: YDUR FAILURH TO RECORD A OA9MENCEMENT MAY R6SULT IN Y�UR PAYING TWtCE FOR IMPROVEMENTS TO YOUR PROP TY. TO QBTAIN FINANCING,CON8ULT WITH YO R C.END AN ATT RNEY BEPdRE REC RDIN NOTtC F COMMENCEMENT ,�^. FLORIOA JURAT(F.S<11?'.03) [ X/ OWNEtt OIt AGENTC�� 'N�� CONTRACTOR �"'� 5u an b�wom r r ad�ore I pI SuDsuihed and s or aff ed)be o me fs � �o`�b^�a bY � o are per m h sqwye produced NRw isrnre ersanatl knorm lo me or ave produced as idenGficqfion, ___ ___ ___as idenpfia�pdn, -- � -�iy��k�~��NOtary Public � olary PuE�Nc p� u C fn�sslan No. � Ll� Comrn;ssi n Na. �� y S' � �lYY'l/1 �TYI/�CS(� L r[',n0'1_ N otery�yped,printed or iemped Naume ot Nota ry typod,pnnied or stampe � OSPkV.PLB( SANDfiA ERRINGTON r �. .,`� Commonwealth of Penns Ivanla * MY COMMISSION N EE 088451 NOTARIAL SEAI '` EXPIRES April28,2015 'i�$��(�� ' � RANDI SkENKMAN,NOTARY PUBLIC `�9, e°` Bonded Thru Budget Notary Services P� Lower Merion Township,Montgomery County FOF F�� M Commission Ex lres A dl 8,2015 eia-rao-oazo City of Zephyrhills Permit Applicatipn hax-613 780-0p21 Du[k11ng OepaAment Opt�f2ecelyed "^'—� Phone Cont�ct for Permitt�fng � j ..� Z I�TT —_... ! . _ OwoeYS Nama ��aS ,�,,/�/��i�� L� �l�ner Phane Numbar Owners Address 7a[3 C.pllcj p �� 4 �� wn r Phone tVumbet Fee Stmple Tltleholder Nama +��Q� 4wner Phone NumDer Fee Simpb Titleholdor Addresa � �o�AOORFSS �dya 1 . '� r�;( L 3s�#I l4T# � sueo�v+siorr �aRCe�io,v 3Sa�S�'r�1�0�10—p&$'Qi9"00 " I (407A11FED FfiOM PR+DPERiY FA%NOTICE� WQRK pROAOSED e NEW CONSTR ADD/ALT �J SIGN fNS7ALt � a�pqFR � 0 DEMUUSH PROPOSEp USE Q SPR � COMM � OTHFR rl'PE OF CONffiTRUCTION � 9lOCK O FRAME � S7EEL Q DESCRIPT10At OF WpRK (�� ,7� BUIL4ING SIZE Sq F007ACaE� HEIGHT UtLOING s ,�fr^f yrci� VALUqTION OF TOTAL CON5TRUCTlpN ELECTRiCAL S AMP SEFtVICf a �C� Q PROGRFSS EN@RGY yy,q,E,�. PLUMHING � � [�MEGHANICAL s VAl.UA7tON OF MEGFtANICAL INS7fU.t�yTlpM �� [� ROOFING � SPECIAL7Y� O7HER F!NlSFt�D FL 5 FLp00 ZONE AREA �� QYES IVO �J _.._.. BUILOER COMPANY (Y' ACC^1�C0�\ ��IO 51ONA�'URE HCGIBTERE6 Y!N Fee cuw+En Y 1 N Address 1 . }� . 7 107�Itt 33.';l y t,icense x��'(�/�44�� .ECrr¢�citw CQMPANY SIGNATURE fuEGisteReo Y! N fEE WpREh Y 1 N'I��- �ldtJfSSB "�—^------� Licensn/� P�UMBEit � COMPANY SIGNATURE REGiSTERED Y 1 N �ee auart�N Y 1 N Address � Liaense f �— � MECNA1iICAL COMPANY ��. . � SIGNATURE necssrer�EU Y!N FEECURAEt. Y1N Address ��N-_�� -�� Liaense Ai�� QTHER COfuIPANY 3IGNATURE REGI5TEREA Y/N PFECURREN Y�� ... � Address � 111111IIIIIItII / tf1tt11EAtittlllllfl111t111111f'f �51�I41t�llllitl R�SIOEMTlAt qf�aeh(2}FIo(p1e�s�(2?sels of 8uildinp Plans;(1)se1 of Enargy Forms;32-0•W Permit for new consiruction, AfFn(mum ten(tp)vp�G�g pHY;�fter submirial tlele. Requked prtsile,Construct[an Plens,Stomm�ater Plans w1 Silt Fence instaAed, 5enilary Faa`lities d 1 dumpsler,gile Wo�ptrm��for aubdivisionsAarge projeUs COMM�RClA! Attecti f31��p�eta yels ot 8uiltling Plans p1u8 a lite Safety page;(1j set at Energy f orms.ff-O-W permit tor new cons�ruciion. Minim�m ten(1 p)wrork�r�g dayg�her submitta!tlate. Required onsite.Conatn,�d"wn Plans,5tormwaler P1ans wf Sih Ferice instailod, Sanilary FaciliNes d i dumpster,Site Wwk permit ta alf new projects.All commercie�requuaments must meat compiiance SIGN p�RMIT Atiach i23 se�s of Eng�neerad pfans. ""AROPER'fY SURVpY required for ali NEW cortstruction. D1racSans: Fi�out appl'icatfurt completely. Ovmerd Contractar sign bepk W apptication,notarized It oYSt$YSOP,a Noilce o4 Commenoement is required, (NC upgretles avsr 575DO) " Agent jfor Ihe contraaorj or Powsr of AIlomey(fa!he owner]would be someona wipi noiarizerf laffer Irom owner authorizing same OVER THE COUNTER PERMtTTIMG (Front of Applicatwn pnly) Reroots it sttin��ns Snw�e�s Service Upa�ratles A/C Fances�PIOUSurveylFoatage) Driveways.No(over Countarlf on public roaUways.,neetls RRYJ NOTICE OF C7EED ft�S1'Ft�CTIONS: The undersfgned understands that this permi{may be subject to"desd"resfrictions" which may be more restrictive than County regutations. The undersigned assumes responsibility for cvmpliance with any applicable deed resfrictions. UNLIC�NSED CQNTRAGTOiiS AND COfVTRACTOFt RESPONSIBILITIES: li fhe owner has htred a cantractor or cantraotors to undeRake wark,they may be requ�red to 6e licensed in accordance,,+rifh state arttl local regulations. If the contractor is not licensed as repuired by law, bath the owner and contractor may be cited for a r�risdemeanor vioiation under state law. If the owner or intended coniractor are unceRain as to what licensing requfrements may apply for the intended work,they are advisetf to contact the PasCO Cour�ty Building Inspecfion pivisfon---Licensing Section at 727-847- 8009. Furthermore, if the owner fias hired a coniraCkor ar contractors, rie is �vised lo have the contractor(s) sign portians af tlte"CUt1tf8CfOf BIOCk"of this appticalion for which they wilf be responsib�e. If you,as the owner sign as the contractor,that may be an indicaiion that he{s not prnperly licensed and is not entitled Eo permitiing privileges in Pasco Couniy. TRAMSPORTATlON IMPACTIUTILITIES IMPACT AND R�SqURCE RECaVERY FEES, The undersigned underst8nds that TransportaGan Impact Pees and Recourse Recavery Fees may apply to the construction of new buildings,change of use in existing buildtngg, pr expansion of existing buildings, as specified in Pasco County Ordinance number 89-D7 and 9fl-07, as arr�ended. The undersigned a(sa undersiands,thaf such fees,as may be due.wifl be identified a#tY�time of permikting. It is furiher undersfood that Transportation impact Fees and Resource Recovery Fees musi Be paid pnor ta receiving a"ceriiFicate of occupancy"or�inal power release. If the proJect does not involve a certificate of oecupancy or finai prnrrer release,the tees must be paid prior to permit issuance. Furthermore,if pasco County WatertSewer impaCt fees a�e due,they must be patd priar ta permit�ssuance in accordance with applicable Pasco Caunly ordinances. CpNSTRUGTION LtEN LAW(Chapter 713,FCorida Statuies,as amended): If valuatian a#wark is$2,5U0.00 or more,I certify that I, the appliCant, have been provided with a copy of the "Florids Construction Lien Lacv--Homeowner's Protectfon Guide"prepared by the Florida Department of Agricuiture and Cansumer Affairs. Ii ihe applicant is someone other than lhe"rnrrner",J certify that I have obtained a copy af the above described document and�romise in good faith to detiver i!Eo the"owner"priorlu commencemeni. CONTRACTqR'S/OWN�R'S AFF'IDAWT. !certify thal all the informalion in this application is accurate and that ail vmrk wifl be done in comptiance with ali applicable Caws regulating consEruction,zaning and land development. Application is hereby made to obfain a permit to da work and installation as indicaied. I ce�iify that no work or installaiion has commeneed prior ta issuance oF a permit ar�d that aq work witf be periormed in meeE standards ot ail taws regulating construction, Caunty and City co8es, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations ot other governmenl agencies may appiy to the intended wortc,and that il is my responsibility to identify what actlons i must take to be in con�pliance. Such agencies include but are nat limited to: ' OeAa�nteni of Environmental Protection-Cypress Bayheads, Wetiand Areas and Enviranmentally Sensitive Lands,Wa#er/Wastewater T�eatment. - Southwest Florida Wate� Management Disiricl-Wells. Cypress Bayheads, Weitand Areas, Altering Waterc:ouraes. - Army Corps of Engineerx•Seawatis,Docks,Navigable Walerways. - Department o#Health & Rehabilitatfve ServiceslEnvironmental Heaith Unit-Wetls, Wastewafer Treatmerit, Septic Tanks. - L!S Envi�onmentaE Proteciion Agency-Asbesios abatement. � Federai Aviation Authority-Runways. I understand thai the foltowing resUictians apply#o Ehe use of tfll: - Use of fill is not allowed in Ftood Zone"V"untess expressty permitted. - !f the fl11 material is to be used in Flopd Zone "A", it is urtderstood khat a drainage plan addressing a "compensatIng votume"will be submitted ai time of permitking which is prepared by a professionat engineer licensed by ihe State of Fiorlda. - !f the fill material is to be used in Fload Zone "A"in co�nection with a permiited building using stem wail cons{ruction,i certii'y that filf will be used only io fifl ihe area within the stem wail. - {f ti11 material is to be used in any area, I certify that use of such fil! will not edversely afFect adjacent praperties. If use of filf is fqund io�dversety aff�cl adjaoent properties,fhe owner rnay be ci#ed for violating the cpndltions oi the building permit isstreri under fY�attached perm;t appl�eation, for tots less Ihan o�(1j acre whlch are eievated by fltl,an engineered drafnage plan is repuired, tf I am th�AGENT Ft7R THE OWNER,1 promise in good falfh io lnforrn the owner of the permfiting condRions set forth!n this affidavit prior ia cnmmencing construclion. I understand that a separate permit may be required far efectricaf work, plumbing, slgns,wells, poois, air conditipning, gas, or oiher installations no#specifically inGuded rc�the application. A permit issued shall be constr�ed#o be a license to proceed with the wark and not as aulhority to viotate,car►cel,aller,or se1 aside any provisions pf the teclmical codes,nar shail issuance ot a permit p�event fhe Buitding Official frorn ihereafter requir(ng a correctbrt of errors in plans,construction or violations af any cades. �very pem�ii issued shall becorr�e invalid uNess the work authorized by such permit Es commenced within six months of permit issuance, or ii work authorized by lhe permit is suspended ar abandoned for a period of six{6)months after ihe tl the work is commenced. An extension m�y be reques#ed,in writing,from the Building O�cial#or a petiod nnE tn exc ed ninety{g0}days and wiil demanstrate justifiable cause for the sxiension. IF wark Ceases tpr ninely{gp}co u i s,Ehe job is considered abandoned. WARNING TO flWNER: YOUR FAILURH TO RECORD A NOTICE F O ENCEMENT MAY 3tESUlT IN YOUR PAYtNG TWtCE FOR IMPROVEMEN`fS TO YOUR PROPERTY. IF Y TAIN FINANCING,CONSULT WITH YOUR END R R N ATTORN Y B��ORB RECORDING Y NO i OMMENC N7 � FLORIDAJURAT(p.S.11�.03) J( owaeRatnG�Nr��C�I'�nLP�/ic� cor�rrrnero� Sub 'bed an b�vrom b{o�afti d�fprC(�e Sub5Ui6Cd and s E A � a(orC lh / CJ �o��b-�3. by t aaMave ptotluced 4t4w isJnr ersnne l�nawn Io me or hesthave protluced siden'td'ication, _ --- -- *sidentdicalior�. r Waa�y r��ni�a � issianNO. � O� �� ,.. , olarypublic Comen;ss n No. r � n A � me oE lary ryped,priMed or stamped Name of Notary typod,printed a stam e ��"RY`0"� SANDRA ERRINGTON � ;••••.%� * MY COMMISSION#EE 088451 Commonweaith of Penns Ivanla * EXPIRES'Aptil28,2015 ��A�� 1��P�.�j'� NOTARIAL SEAL RANDI SHENKMAN,NOTARY PUBLIC �°TF,F FLC�� 8onded Thm Budget Notary Services lower Merion Township,Montgomery County, M Comm7ssion Ex ires q g,2Q�5 .� �� - ss`�� '� �? � �� rc h i t� �, ��. ctu r�l � The Design-Bui� � � � � � Admitted in; o m p a n y LA Lic.#6684 FL CGC#1504430 NY Lic.#032101 MD GC#22380884 VA Lic.#0401 014247 NC-Lic. #12152 PA Lic.#RA404159 OH-Lic.#ARC 1115461 GA Lic.#RA012017 TX-Lic.#23115 AL Lic.#6381 MA-Lic. #31706 WA Lic.#9425 IL-001.021899 MD Lic.#15438 1'N Lic.#103878 FLA Lic.#AR0016160 CO Lic.#ARC402305 NV Lic.#6710 TO: Ci 0� C � +h �,\ Date. I�-o�b� )o`Z . � Regarding. ,n�p,(Q a � Coc�e �26 p3 2 a4a � � . ' � s To whom it may concern� We, the undersigned, hereby authorize_ t��Cho(a ��,1{�q to act on our behalf in all manners related to applying for and o tammg any and all permit related applications and activities, including signing any documents on our behalf All acts carried out by the authorized, on our behalf, shall have the same effect as acts of our own This authorization is valid until further written notice from Barr Architectural Studio Sincerely, Name. a, ��' Date. _ Z Signature: � - Notary Name: q � n � Signature Notarized this day of c o in the year aDla ��PRY�PUB��, SANDRA ERRINGTON * ' � * MY COMMISSION#EE 088451 EXPIRES April28,2015 rr9rF�f f`pa��P Bonded Thru Budget Notary Services Architecture • Construction Mana ement • Plannin • Interiors S011 SOUTH STATE ROAD 7,SUITE#107,DAVIE,FLORIDA 33314 TEL(954)418-BARR FAX(954)212-2962 AR0016160•CGC1504430 Pasco County Property Appraiser- Physical Address List for: 35-25-21-0010-08800-0000 Page 1 of 1 Welcome : Records Search : Par el D tail • �—' , c e s . P h y s i c a l A d d r e s s e s �`e� r Physical Address List for Parcel: 35- 5-21-0010-08800-0000 Displaying 21 records View in groups of: 10 25 50 100 500 c � Street Number Street Name +� Uni �252 GALL BLVD �252 GALL BLVD 1 �z52 GALL BLVD 2 7254 GALL BLVD 7300 GALL BLVD 7302 GALL BLVD 7304 GALL BLVD 7306 GALL BLVD 7320 GALL BLVD 7326 I� 1��K GALL BLVD 7330 GALL BLVD 7334 GALL BLVD 7338 GALL BLVD 7340 _ _ LL BLVD C�7342 � Gql I R� ��n� �46-------------- GALL BLVD 7348 GALL BLVD 7348 GALL BLVD 1 7348 GALL BLVD 2 7352 GALL BLVD 7400 GALL BLVD Pasco County Property Appraiser Page Layout Modified: 2/17/2009 1:10:37 PM The Local Time Is: 10/31/2012 10:54:08 AM http://appraiser.pascogov.com/search/physadd.aspx?parce1=2125350010088000000&eas... 10/31/2012 i iiiiii iiiii iiiii iiiii iiiii iiiii iiiii uiii iiiii iiiii iiii iiii 2013074015 Pertnit No. �'��d C,n �+�.v�� Parcel ID No � � � �^�� _ ��U—Q�'a�"�'V�� NOTICE OF COMMENCEMENT State oi ��/��/t Counryof ��.SCU THE UNDERSIGNED hereb � y gives notica that improvement will be made ta certain reel properiy,and in accordance with Chapter 713,Flonda Statutes, the tollowing infortnation is provitled in this Notice of Commencement:, 1 Description of Pro erty: P/arcel Identifiption No. .5 '��C51 O -• (��L(��-(�� Street Address: 2"f Z A LC f�t 4'/) ZC'�l 1'��Q/•///L S� t-� `� _ � Z. Generel Desaiption of Improvement_[�C'V�� Ut c�GJ i1 C-IC EX l�j(AY At�x �`�',i/�"��,�65,q.�S�i�?.�1E, �h�.i dc � o �` , S �"l� '1%n•Z K 3. Owner Infortnation or Lessee infortnation i(the Lessee conVacted for the improvement:_ DSpl01005979 I TeCO.00�00 ��E � `�� --� �� 04/26/13 L Serio Dply Clerk �(v -�, Ne� �� - ��c '� - Address ' / �,��-�,� ��- �+<<i� �,.� Interest in Property ��/q/�f—' ��ty State ' Name of Fee Simple Tdleholtler G1.�1I/1�Y I�W �/�J,[ �(� ?� S�L -7� t�-J ��J N G�O('r(`�d' nt homppp'yyy,��er listed above) rZ ��,\ �� Address /' �� - �� L��w�� 4. ConVa or _{��2l�% fa^��-�� t�CCRy tate [ T 1 me N f� � A �l'� `�'�/�q Fl Address 1 ContractoYs Telephone No. � 1� '��' �'*7 ��ry State 5. Surery Name Address Amount of Bond: $ ��ty State TalephoneNo. _ pRULA S 0'NEIL Ph D PqSCO CLERK & COMPTROLLER 6� Lender. 04/26/13 12:51 m 1 Of 1 Name �� PG �� Address OR BK Lenders Telephone No. �i State � Persons within the Stete of Florida designated by the ovmer upon whom notices or other documenls mey be aerved as providad by Section 713.13(1)(a)(7),Florida Statutea: Name Address 7elephone Number oi Oesignated Person: C�ry State 8. In addition to himself,the owner desipnates of to receive a wpy oftha Lienor's Notice as provided in Section 713.13(1)(b).Florida Statutes. Telephone Number ot Person or Entiry Deslpnatetl by pwner 9• Expiration date of Notice of Commencement(the e�iration date may not be be►ore the completion of consWction and final payment to the contrector,but will be one year Gom the date of recordinp unless a diBerent date is specified): WARMNG TO OWNER: ANY PAVMENTS MADE BY THE OWNER AFTER 7HE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPIER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PqYING TWICE FOR INWROVEMENTS TO YOUR PROPER7Y A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE F�RST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITN YpUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT Under penalty ot perjury,I dedare that I bave read the foregoing notice o/ encem t and tha the fa stated therein are Uue to the best of my knowledge and belief. STATE OF FLORIDA � COUNTY OF PASCO � ro eraF Lessee,or Owners or Lessee's AuthorizeC r/DirectoNP aMedManager �'� �' (�'�;��t r� % -fi c �� q� Siymtoys Tdle/Office The foregoing insWment was acknowled e fo�me this ' �y o{�'(,� Zd^j bY 'V�N�,Q,�� C L as � �� - ___ ��_k/ / i �� 'n (ry of authoriry e,g„oK , ,attomey in tact)for S'�� (name pa beh ot 'nsVument executetl). Personally Known�Q produced Identification❑ - Notary Signature Type of Identmca6on Protluced Nama(Print) STEFANIE M. DOYLE Notary Public, Notary Seal State of Mlssouri wpdate/6cslnoticecommencernentycp53048 Solnt Louis Cfiy Commisslon # 09403344 My Commisslon Explres July 1 b, 2013 a�s-�SO-oo2o City of Zephyrhilis Permit Application Fax-813-780-0021 Building Department Oate Received Phone Contact for Permltting _ Owner's Name Owner Phone Number Owner's Address Owner Phone Number � Fee Simple Titieholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS � L L L V �, LOT# C� SUBDIVISION . PARCEL ID# (08TAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD/ALT �� SIGN Q � DEMOLISH INSTALL 8 REPAIR PROPOSED USE [� SFR [� COMM �� OTHER TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q DESCRiPT10N OF WORK ' �=-1 v � BUILDING SIZE �V SQ FOOTAGEC� HEIGHT �J QBUILDING $ `� O� ( VALUATION OF TOTAL CONSTRUCTION �ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. OPLUMBING $ �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION OGAS Q ROOFING Q SPECIALTY � OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO BUILDER COMPANY t��.l� Q�N.1 t�U(�(��i� SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address ' License# ELECTRICIAN COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# � PLUMBER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# MECHANICAL COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address Ucense# � OTHER COMPANY SIGNATURE ' REGISTERED Y/ N FEE CURRE� Y/N Address License# � RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bufiding 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 8 1 dumpster;Site Wotic Pe►mit for subdivisions/large projects COMMERCIAL Attach(3)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 8 1 dumpster.Site Work Pennit 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. Directions: Fill out application completely. Owner 8 Contractor sign back of application,notarized If over$2500,a Notice of Commencement ls required. (A/C upgrades over 57500) "" Agent(for the contracior)or Power Of Attomey(for the owner)would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/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 compiiance with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or contractors to undertake wo�k, 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 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 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.certi�cate 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 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 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'SIOWNER'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. Apptication 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"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 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 INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMME CEMENT. FLORIDA JURAT(F.S 117.03) OWNER OR AGENT CONTRACTOR ' � Subscribed and swom to(or a�rmed)before me this Subscribed and swor to or afflnne re me ' -t�S"-� bY b �1� c� . Who islare personally known to me or has/have produced Who islare rso II no r haslhave produced as identiticatlon. as identification. Notary Public � �� Notary Public Commission No. Commission No. � �� a�-� � /1 d �� NO�PUBLIGSTATE OF FLORIDA LV' au n � •�=-LWII Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped _��ssion#EE011295 ',,,�o°�Expires: AUG.30,2014 $pTiDgD THRII ATLANTiC BONDING CO3 INC.