HomeMy WebLinkAbout14-15616 -
� �
I • CITY OF ZEPHYRHILLS
� 5335-8 H STREET
' , � �sis)� o-oozo 15 6
� FENCE ERMIT �
- PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 15616 Address: 5120 18TH ST
Permit Type: FENCE ZEPHYRHILLS, FL.
Class of Work: FENCE REPLACEMENT Township: Range: Book:
Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-20100-0160
Improv. Cost: OWNER INFORMATION =-
Date Issued: 8/29/2014 Name: LEW IS KELLY M
Total Fees: 50.00 Address: 5120 18TH ST
Amount Paid: 50.00 ZEPHYRHILLS FL 33542-2154
Date Paid: 8/29/2014 Phone: 813-778-2097
Work Desc: REPLACE FENCE 200 ' X 6 ' WOOD B ON B
CONTRACTOR S APPLICATION FEES
HOMEOWNER FENCE 50.00
�
Ins ection Re uired =
FINAL -
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REINSPECTION FEES: Reinspection fees will comply ith Florida Statute 553.80 (2)(c) when extra inspection
trips are necessary due to any one of the following re sons: a)wrong address b) condemned work resulting
from faulty construction c) repairs or corrections no made when inspections called d)work not ready for
inspection when called e) permit not posted on jo site fi) plans not at job site g)work not accessible.
NOTICE: In addition to the requirements of this permit, ther 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 managemen , state agencies or federal agencies.
The payment of inspection fees shall be made before an further permits will be issued to the person owning same
Complete Plans, Specifications an Fee Must Accompany Application.
All work shall be performed in accor ance with City Codes and Ordinances
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ON CTOR PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS ITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
�����r���T ����T�� �� ����p���� ���°� �r - C�PYRIGNT 2t104 F.L.A. SUR►/EYS C(JRP.
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���' ,���y ��s'�`��,�@J THIS SURVEY D�ES NL7T REFLECT DR
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FLLIRIDA STATUTE 61G17-S.004!
CTWO SITF BENCHMARKS REQUIRED FI7R C�NSTRUCTIOAf)
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512tI Z�ttt ST.
r ZFPHYRid•ILLS FL
LEG�L D�S�I�IPTI�i+r : �����- ��-;��- '"��
LL7TS 1d APdD 17,�LDCK �ft1, l9fiP 17� TO-!E 3Lfis��t C1F ZEPtPYk'HILLS„ �CC€ll�dll G TL3 FHE '°
MAP f1R PLa1T Tt{£REIlF AS RE!°QR17c17 IA' PLr'kT&7d7K 1, PA,GE 54 AAlB 5�r4 I7F T1fE PU&LIC a � Z� �a ��
RECf1R11S IlF P�iSCD C17UNTY, FLORIBA GRAPHIG SCFlLE
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Y.El.LY Wf'tNLGAP4UTN NDTE} IF �#APLICA�£E, FEMCES SNL7t�N t�e�`irdTiE'R
RCCR��7ITED FfdiP�E L�NIIERS Etlkt rJ.4 17FF LIF�'�'S tAPt'�Fi7X. L�CATIQld QNLY)
SUAISFATE TTTLE ACE,�lCY F(7U,�lDATION/UTFLITIES DISCLAIMER
FlRST AMERICAh{ TPTLE INSURAPlCE C[J. NOTE�
APPROXIINATE WATER B�UNIIARIES FQUNDATILTN BENEe9TH TFfE SURFACE DF TNE' GRQUND
NOTEr ALL APPROXIMATE k/ATER NAS NDT BEEN LOCATEIl.
BClUA/DARdES ARE GRAPHIGALLY DISTINCT UNDERGROUNIl UTfLITIES HAVE N�T BEEIV LQCATED.
FRlJM QTHER Pi7RTIL7NS QF THE Bt7UPl11ARY.
� THE 1�ATER BIJUNDARY THAT IS REFLECTED PI�(]��� $Y CDU�TTY
IS APPRDXIAfATE L�CATI�AI OlJL Y AND D17ES ��� ����
11�LIT REf'LECT TXE LEG,9L L17CATIlIAI DF THE CE3�MLT�TP�`Y PA�tEL
WATER BOUNDARY FOR TNIS PARTICULAR �����.
PARCEL QF LAND. (�'L€3�7I3 �f��7E: "T�", °�°, ,•D�°� S� "� �R�' Y�1C3T
�L1T�� tEMA FLI71fD F{��r�RD l�fAPPiftrG: TtfIS IJAT� PRt3f3l1CT 1d�rS Al£7 DESIG�rD I�T DESIGIdA.TED FLt}€7D Ht�AI�D �OI>TE AREA.}
TtJ" !`�9e4fCE PRE'CISE £h°✓ 17UT FLL7f17I R?S'K DE'T�RfKIAt�TfI1AlS T!-fIS PR lJCT IS r'�17T
.SUIT,�BLE F£7R £NGII��E,47�G APPLICHTPJNS R,f�D CAf�+N£TT B� USED IIETE"RPtlllVE
f.$St7LUTE T1ELIhiEfiTll7RtS QF FLL3CID BQliMItARIES CA[.L 1-FJ�T-rE'fPA �9FiP flfi' E,`�,arL AJIITE1 PRl''PE,'?TY �b/t1f�R SHIIULD DBTAI/V
A hfAP SPECfALFST AT �>4dtd,FE'hYA.CTI2G✓h/IT/TSD/FQ-�fAF17.HT1� l�R17'TEPJ F'Lf11t11 �'BnrE DEFERMIR�kTt[IPi
CER.TIFIC�`PION : F12fI�P L't!R Lt7CAL PEf219IT.LRtu, PiAhf.R71dG,
.4ND B��FLDIR�Ci IlEPtdRFMENT PRIQR Tfl �d1VY
I CERI�FY TriP,T T�IS SilRVEY �JAS t�A[3� UN�ER A�Y �IRECl1t3N �D "iH�T IT �AEETS cc��sraucr�c�,v Pt�n�vrr�G �u�r��� cc�r�sruucrrQ,v
7WC M1NI'�Jlt� T�CHNICA� STANDARDS rsE i FGRTH �Y THE BOARD OF ?RCF�SS6(3i�lAL
LAIVD SURVEYORS AND MAPPERS �N CFi�PTER 61G��-fi, FLORI�JA AOt�INISTRATI!!�
-GODEo PURSUA,NT TO SECT(ON-�r72.�27, F'�t3RIDl� STANTES.— — - -- - ----�°s�TE�_-- ----,-_ - ------_--- -- - -
IN CI7P�PLIANCE WiTH �,A,C,
r'�1ELf� 6iGi7-6:Q�3f C5) 4E� Ci.r L�CATiQiJ 0�
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SUR�Y DF+ . E€�SEME�l7S �R RIG:iT-��-4l�iY ❑�' RECC�Rll,
� � � � GTFE4 ?HAN TH�SE GP� REC�R➢ ?LAT�:S
BY :_ -�'"�`'" " � SIGNATtlRE ATE : �1�����" �EQUIRE�7, THIS TtVF0�P14TI�N MUST ��
— — - FURNISNE� T� ',HE S�14VEYQR Ai�D MAPP�R�
II�LAIQD F. I3��iRD. I'I� ����a6 A�A�Y �. �'Ii�F�T�1I3, P�_ �59[51 �LIAtT01�1 � PIAi�T�'�D, PI� �2453
JEFFRY H. I�3�GOSS, I'T.� ,���88 �E�RGE �2. RICI'��2�II�, IS #���3&
�OT A CERl1FICAT14i4 .'1F ?iTLE. ZCPIif��, EASEAd�NTS OR FRE�i�Ols� OF EA1GllM�RIIAdCES.
h10 i VA�.IL? M�ITHOU i SUR�YO�c'S SiGfV�TURE AR�D EM�05SEQ SEt�L
SUR�Y IS VA�iD FOR 90 DAYS. PLEASE REFEli it3 REVERSE SiCE GIi GENER�L f9lOTES & A,BB�E�A<T10i'vS.
� 5s23 U5 HIGH�AY 1� !�EVISIQl�S
.�.y .�o�p ��'����P� ����p NE�; P{�RT RICNEY, FL 34652
727-842—�711 FAX 727—�42-271�
PRCIFESSIO�lAL LA�iD SllRVtY�f�S & MAPPERS—L� 656 ��g�d 7��� STREET �2�9 �RO,�ECT h!p: �
+ L��CGU, F!Of�fDA 33777
DRA��N �Y: S.J. CAD CHECKED BY: �8 � 727-549-1�Q1 �AX 7�7-549—:70i Qpt—�D5B2
.
M A__�
I 93. LQT LINES SHOWN AS SOB SHALL�E DE�MEll ` �
( GENERAII N01`ES BASIS OF BEARIi\G
ABSTRACT NOT I2EVIEWED AND ASSTJMED TO BE THE SAME AS PLAT OR c,, ,
. LEGAL bESCRIPTION . �_
1. A=ARC DISTANCE 94. Nt/TE: LEGAL DESCRII'TIOIY PT{OVIDED BY y
2• AE=ACCESS EASEMENT CLIENI'ITPTLESS O'TB�,'RWISE NOTED. , .
3. B.E._$UFFEI2 EASEMENT 95. EA$EMENTS ANU 1ZIGHT OF WAYS SHOWN AR�
4. BM=BENCFIMARK PER RECORDED PLAT OR AS FURNI3kIED
5. BOB=BASIS fJF BEARtNG BY 7'F�CLILNT
6. BRG�BEARING 96. FOT.TNDATION LINE BELUW TI3�bURFACE OF
7. C#=+Ct.TRYE NLTMBER T�C1i0UN1?IS NOT REFLECTEB
8. C=CA,LCULA"I'EI} 97. TFIIS SURtrEY IS NOT TO BE USED FOR
9. CB=CATCH BASIN CONS'TRUCT[ON PURPOSID
10. CFIB=CHORD BEAI2It�tG U1VTlER ANY CONDTl'ION LTNLES5 OTHEI2WISE
!1. CFID�CFIORD STATED
12. CLF�CHAINI,INK FENCE 98. NU UNDERGROUND INSTALLATTONS OI2
13. CM=CONCRETE MONUMENT 1MPROVEME1�1T3 HAVE BEEN
24. CO=CLEAN OUT LOCATED EXCEPT AS NOTED
15. CONC=CONCRETE 99. NO INSTRUMENl'8 OF RECORD REFLEC'TTNG
16. CSW�C01�CTtETE STDEWAI.TC _ EASEMENTS,RIGHT CIF
27. C1'V CA$LERISER R'A.YS,ANDH?R OWNII2SI�IIP WERE FUR2ltISL�Lt �
, 18. CUE�OLLYER COUNTY UTILITY EASEMEIV'I' THIS SURVEYOR
19. D=p�ED EXCEPT AS SHOWN
Z0. DE�IIRAINAGE EA3EMEN3' lOD TFiER�r1RE NO YISIBL�E7+TCROACFIME1�iTS
il. DH=DIZILL HOLE EXCEPT THOSE AS
22. DI=IJIROP INLET DELINEATED ON THI5 PLAT OF S[JRVEX
23, EL�C�ELEC1'EtIC i01. TIES AItE T4 PLAT B{3UNDARIES IJNLESS
24. EOP=EDGE OF PAVEMENT OTHERWISE NOTED
2S. EOR=EDGE OF ROAD 102. TI3II2E MAY BE ADDTTICINAL RESTRICTIONS
26. EdW=EDGE t3F WATER t�PIDIUFC EASE113�IVTS THAT
Z7. F=AS LABELED OR TOUND IN THE FIELD AR�NOT RECORDED ON SAID PLAT TIIAT MAY
28. FCC ffi FOUND CROSS CUT BE FO�7ND IN TI�
29. FCM=FOLTi�!C4PIC12ETE MUNUit+SEPI'T PUBLIC RECORDS OF TIiIS COUNTY
30. FDH=FOUND DRILL HOLE 1U3.BOB IS BABED ON I20W OF SU&1ECT PROPEKTY
31, FFE=FIIVISH FI,OOIt ELEVATION PII2 PLAT OR AS SHOWN
32. FH=F'II2E FIYDRAN"P 244.FElYGES MEANDER.Ui�t AND dFF fdiYE,
33, FiP='FOUND IRO1V PIPE APPROXIN7ATE LOCATION ONLY UNI.ESS 5TATEb
34. FIIt�FOUND.IRON EtOD , dTHERWIS�.
35. F1Y=F(3UND NAII,
36. FND=FOUND -
37. FPK�FOUND PK NAIL
38. FPKBcZt=FOTTND PK NAIL ANA DISC .
39. GTE�TELEPTiONE RISER
40. LBE=LANDSCAPE BUFFER EASEMEIVT
41. LME�LAKE MAI1VTElYANCE EASEMENT
42. LP=LIGHT PdLE �
43. M=MEASURC�MENT
44. ME=MAIN'TENANC�EtLSEMENT
45. MIi=MANHULE `
46. NTS�NOT TO SCAL�+
47. �IiP'=OVERfIEAD POWER '
48. OHU=OVERHEAD UTILTTI'LINE
49. P=PLAT
50. PAS.CO.ElYG.TJtEPT=FASC4 COUNi'Y "
ENGINEEI2ING DEPARTMENT
51. PC=POINT OF CURVATUR�
52. PGP=1'II2MANEPIT CONTROL POINf
53. PI=P+C3INT OF IlYTERSECTIt7P1
54. PK=PARKER KALOriT NAIL
55. PLS=PROFE5SIONAL LAND SURVEYOR �
Sb. POB=POINT OF BEGTNI+iING
- 37. POC a POINT OF CONIMENCEMENT
58. PP=POWER POLE
59. PRC=P{}INT OF REVFI2SE CtJRYE
60. PRM=PERMAI�TENT REFEIZENCE Mf1NUMEIWT
61. P3M=PROFESSIONAL SURVEYOR AND MAI'PEI�
62. PIT&DE=PLTBLIC UTILFFY&DRAINAGE .
EASEMENT
63. PUE=PUBLIC iJTILITY EASEMENT
64. (R}�RADIAL
65. R=RADIUS
66. RNG=RANGE
67. ROW=RIGFTT-OF-WAY �
68, RR SY'K=RAII.ROAD SPIICE
69. SAT=3ATELLTf E DTS�I , . �
7Q. SCC=SET CE2(}SS C(.)"f
7I. 5DE=STREET DRAIIVAGE EASEMENT
72. SDH�SET DRILL HOLE
73. SEC=SECTTON
74. SiR=SET SB"TRON ROD W1TFI CAl'#LB SS69
75. SN=SET NAII.
76. TECC�TAME'A ELECTRIC CbMPAlVY
77. TBM�TEMPK3RARY B�NCH MARK
- 78. TVR=TELEVISION 12ISER --- -
79. TOB�TOP OF BANFC
8Q TP=1RARFSMtTTER PAD
81. TWP=TOWIVSFIIP -
82. UE�LJ1'II.ITY F.ASENl�NT
83. iJ'TR=t11vITED TELEPHf}l�tE RISER
84. W=WATER SERVICC . '
85. WB=WATER BOX .'
86. R'�=WOOB I�EIYCE
87. WPP=WOOD POWER POLE
88. WREC=WITHLACOOCHEE RIVER�I.ECTRTC
C4MPANY �
89. �=DELTA OR CENTRAI.ANGLE OF CU12VE �
9U. DIMEIVSION3 ARE IN FEET AND IN DECIMAI.S -
��a�
91. ELEVATIONS SHOWN HER�ON AR�N.G.V.I1.
UNLESS O"I'IiERWISE STATED ` � "
92. ALI.PAYSICAL IMP120V�MEI�iTS SfIL}WiY ,
VVt7'AOUT L1Ill3ENSTONS ARE F012
INFQI2MATIONAL PURPOSES ONLY.THAT THEY
DO EXIST,BUT R'LRE NUT �
NECESSARILY MEASi3RED IN THE FIELD.
s�3aeaoozo City of Zephyr ilis Permit Application Fax-813-780-0021
Build ng Department
Da.e ReceBv�Ed � ��'j��y� �'(�j 77$ l�/�
/' Phone Contact or Permittin __
Owner's Name ��(( (�u�� Ourner Phone Mumber ��3 `77� l`�`o
Obmer's Address � � j � S�r O�nmer Phone Number ��/'�77 g—av y7
Fee Simple Titleholder fVame Oumer Phone Number
Fee Simple Titleholder Address
JOB ADDRESS ��z° 1 �f`' � ��
L.OT#
SUBDINISIOM PARC L ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
MlORK PROPOSED � NEW CONSTR� ADD/A T 0 SIGN Q Q DEMOLISH
INSTALL REPAI
PROPOSED USE Q SFR Q COMM 0 OTHER �t���
TYPE OF CONSTRUCTIOM Q BLOCK Q FRAM 0 STEEL Q
DESCRIPTION OF VN06iFC ����0�t�, QKt� f� I/��J`c'll l � � //?�l/d.tL �Lb� D p;•� �
BUILDING SIZE � SQ FOOTAGE �" liEIGHT �( ���4`'7'
QBUILDING $ VALUATIO OF TOTAL CONSTRUCTION
� [�ELECTRICAL $ AMP SERVI E Q PROGRESS ENERGY � W.R.E.C.
QPLUMBING $
OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION `S���
�
OGAS Q ROOFING Q SPECI LTY 0 OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER ��I� ��5 C AlIPANY �� �'�`��
SIGfdATURE RE ISTERED Y/ IV FEE CURRE� Y/N
e4ddress License#
ELECTRICIAN CO MPANY
SIGMATURE RE ISTERED Y/ N FEE CURRE� Y/M
Address License#
PLUMBER _ C MPAMY
SIGNATURE RE ISTERED Y/ N FEE CURRE� Y/N
Address License#
MECHANICAL C MPANY -
SIGtdATURE RE ISTERED Y I N FEE CURRE� Y/N
Address License#
OTHER C MPANY
SIGNATURE RE ISTERED Y/ N FEE CURRE� Y/N
Alddress License#
RESIDEMTIAL Attach(2)Plot Pians;(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.—R quired-onsite,-Construction Plans;Stormwater Plans-w/-Silt-Fence installed,---- -
Sanitary Facilities�1 dumpster;Site Work Permit for ubdivisionsllarge projects
COMIMERCIAL Attach(3)complete sets of Building Plans plus a Life S fety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
Minimum ten(10)working days after submittal date. R quired onsite,Construction Plans,Stormwater Plans�w/Silt Fence installed,
Sanitary Facillties 8 1 dumpster.Site Work Permit for II new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engfneered Plans.
""PROPERTY SURVEY required for all NEW constru tion.
Directions:
Fill autapplication comptetely. U TI-1�R1 Z�l� �`� t"���� l-I.O+�E Ow����
Owner&Contractor sign back of applicallon,notarized ��EL�-Y �'C W L S
If over 52500,a Notice of Commencement is required. (A/C upg ades over 57500) 5'f�2�.- � �{
°' Agent'(for the contractor)or Power of Attomey(for.:the�owner,)would e someone with notarized letter from owner authorizing same
OVER THE COUNTER PEF�MITTING ;;."�1(Front of Application Qnly) , � �� "'` ��` ` ` ��. -� -
Reroofs if shingles Sewers;�,;; • Service Upg�ades;A%C ._,;Fence (PIoUSurvey/Footage) ' ,
� ;i�,: \, t, .�_ � :' ,,:. -' i ,1, �' ., • --
Drfveways-Not over Counter if on'public roadways„neetls-ROW ,,.+ � ��, ;, , =' ' ` --i -
idOT'ICE OF DE�D �tE�TRI�T'ION�: The undersign�d understands that this permit rnay be subject to"deed" restnctions"'-
; vvhich may be mare resfrictive than County regula#ions. The undersigned assumes responsibility for compliance v�rith anj�
�� applicable deed restrictions.
t!�!LlCEtdS�D CONTF��ICTPJ�t� �e►PID �9�fd�'��'�'�9R i����OPl�t�ll�!'TlE�: If the owner has hired a cantractor or
contractors to undertake work, they may be required fio be iicensed in accordance with state and iocai regutations. If fhe
contractor is not licensed as required by la�nr, both the owner and contractor may be cited for a misdemeanor violation
under state law. If fhe ov�rner ar intended contracfor are uncertain as to rrvhat licensing requirements may apply for the
intended wark, they are advis�d to cantac#the Pasco County Building Inspection Division—Licensing Section at 727-847-
8009. Fu�thermore, if the awner has hired a contractar or cantractors, he is advised to have the cantractor(s} sign
portions of the "contractor Block" of this applica#ion for which they wilt be responsible. lf you, as the owner sign as the
contractor, thak may be an indication that he is not properly licensed and is nat entitled to permitting privileges in Pasco
Counfy.
7�YVSP0�2TA'�ION IMP�Cl'll1YBLYTI�S I�ii���lf AP➢� ���OUfRC� FtEGOi/fERY��ES: The undersigned understands
that Trartsportation lrr�pact Fees and Recourse Recavery Fees may apply to the constructian of nev+r buiidings, change af
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-Q7 and
90-07, as amended. The undersigned alsa understands, that such fees, as enay be due, wil! be idenkified at the time of
permitting. it is further understood that Transportafian Impacf Fees and Resource Recovery Fees must be paid prior to
receiving a "certificate of occupancy" or final po�nrer release. If the project daes not involve a certificate of occupancy or
fina! powrer release, the fees must be paid priar ta p�rmi# issuance. Further�are, if Pasco County VVater/Sewer Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
�O�tSTRi1CTl�N L.1��! L�IfV{Cha�t�r 7'��, �lesei���t��u�+��, �� �rneet�Q���: If valuation of vtirork is$2,500.OQ or mare, !
certify that I, the applicant, have been provided with a copy of the "Fiorida Canstruction Lien Law—Hameowner's
Protection Guide" prepared by fhe f=lorida Department of Agriculture and Consumer Affairs. !f the applicant is someone
other than #he"owner", I certify that 1 have obtained a copy of fhe above described dacument and promise in goad faifh ta
deliver it to the"owner" prior to commencement.
�O�tYR�1CT'�Ft'S10Vit�1�R'� �1�FI��VIT: 1 certify that alE the information in this applicafion is accurate anci that al! v►rork
will be done in compliance wi#h all applicable laws r�gulating construction, zoning and land development. Application is
hereby made to obtain a permit ta do work and 9nstallation as indicated. ! certi#y that no wark or installatian has
commenced priar to issuance of a permit and that all work will be performed to meet standards of all laws regulating
conskruction, County and City codes, zoning regula#ians, and land development regulations in the jurisdiction. I alsa
certify fhaf 1 understand thaf the regulations af other government ageneies may appEy fo the intended vvork, and that it is
my responsibility to iden#ify what actions I must take ta be in compliance. Such agencies include but are not limited to:
- Depa�tment af �nviranmental Pratection-Cypsess �ayheads, Wetland Areas and Environmentally Sensifive
Lands, VVaterM/astewater Treatment.
- 5outhwest Fforida Water 1V�anagement District-WeNs, Cypress Bayheads, Wetland Areas, Altering
Watercours�s.
- Army Corps of Engineers-Seawalls, Docks, Navigable Watervvays.
- Department of Nealth $� Rehabilitative SetviceslEnvironmental Nealth Unit-V1/elEs, Wasfewater Treatment,
Septic Tanks.
- 4JS Environmen#af ProEection Agency-Asbestos abatem�ent.
- Federal Aviation Authority-Runvuays.
I understand that the follo+nring resfrictions apply to the use of fiU:�
- Use of fill is not allowed in Fioad Zone"V"urtless expressiy permitted.
- If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating volume" v�ritl be submifted at time of permittirtg vfrhic� is prepared by a professional engineer
licensed by#he State of Florida.
- !f the fl4 materiaE is to be used in F1aod Zone "A° in cannec#ion vuith a permitted building using stern w+all
constructian, I certify fhak fill witl be used anly to fill the area within the stem wail.
- If fil! material is #o be used in any area, ! certify that use of such fil! vui!! not adversely affect adjacent
properties. #f us� of fill is �ound to adversely affect adjacent properties, the auvner may be cited far vialating
the conditions�of the building permi# issued under th� attached permit applicakion, for lots less than ane (1)
acre v�rhich are elevated by fil1, an engineered drainage plan is requ9r�d.
If I am the o4G�N7 FOV�T9i� OVNI��I�, I promise in good faith to inform the owrneP of#he permitting canditions set forth in
this affidavit pr3or ta commenc'sng construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air eonditianing, gas, or other insfaliations not specifically included in the application. A
permit issued shall be construed to be a license to proceed uvith the work and not as authority to violate, cancel, alker, or
set asicle any provisions of the�echnical cades, nor shall issuance of a permit prevenf tha Building OfficiaE from therea�fer
requiring a correction of errors in plans, canstruction or violations of any codes. Every permit issued shall become invalid
ur�less the work authorized by such permit is commertced tnrithin six manths of permit issttance, or if tinrork aufhorized by
the permit is suspended or abandoned for a period of six(6) months after the time the work is commenced. An ex#ension
may be requested, in writing, from #he Building O�cia! faP a period nat to �xceed ninety (90) days and �nrill demons#rate
jusfifiable cause for the exfension. (f�ork ceases for ninefy(90}conseeutive days, the job is considered abandoned.
iNA�cr"+3��i� TC� C9;t�#��FZ: ��l�.l� F�al.��� T� {������ � �i0'�"1�� t)I� Ct'11�i�ENG���i�1T �AY ��S11[.T 1AI YOUFt
PB�Ylldf�'TVIIICE �Of� CiWPRQVE�iiI�P11fS 7"�J YC1�DFt�1�O��R"�(. 9�YOII IN�'�N� 1'O OB7�1iNV �iiv�iP➢�i�9G;�ON�iDL�" -
{�UITH YOU�t L�NiC�EF� i��t�N�TTf�R�9�Y��iFOR� �2��C�(�3d�1N�YO111�HItJ'TIC�G1F�OM�ENCE[�iL[�f3".
FLORIDA JURAT(F.S. 117.03
�� j befor�
�b��b d and wom t a ed . ����`1~�
GQR�'TE2�CTOP�
Subscribed and swar— n�fo(or affirmed)before me this
by by
Who islare personally known ta me or haslhave produced Who tslare personally knawn ta me ar haslhave pfoduced
____as Identtfication. ' as identification.
�
� Nota Public ��� Nokary Public
,,µeYPko.•, `t .;'�:rs:�;.r JOELE.BACON
Commis ,.•�r•• w � • Commfssion No. ,. •,;: � •
_.; . u�.��;�•.:r�-,-f'fi-1�T9�3--- , . �
;; �;x•."� ''Y�tstss�tir,:;Z�,2448 f --;�g�, ��: E�xp�ires June 29,2018
Name pf Nota Zd�•'r nt r"�' , Name of Not rype , �a •ore