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813-780-0020 City of Zephyrhills Permit Application Fax-813-7�0-0021
<br /> Building Department
<br /> NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions"
<br /> which may be more restrictive than County.regulations. The undersigned assumes responsibility for corrapliance:with an�
<br /> applicable deed restrictions.
<br /> UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
<br /> contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the
<br /> contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
<br /> under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
<br /> intended work, they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
<br /> 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
<br /> portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the
<br /> contractor, that may be an indication that he is not properly licensed and is not entitfed to permitting privileges in Pasco
<br /> County.
<br /> TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
<br /> that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
<br /> use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
<br /> 90-07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of
<br /> permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
<br /> receiving a "certificate of occupancy° or final power release. If the project does not involve a certificate of occupancy or
<br /> final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
<br /> fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
<br /> CONSTRUCTION LIEN LAW(Chapter 7'i3, Florida Statu#es, as amended): If valuation of work is $2,500.00 or more, I
<br /> certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
<br /> Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
<br /> other than the"owne�', 1 certify that I have obtained a copy of the above described document and promise in good faith to
<br /> deliver it to the"owner' prior to commencement. ,
<br /> CONTRACTOR'S/OWNER'S AFFIDAVI'T: I certify that all the information in this application is accurate and that all work
<br /> will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is
<br /> hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
<br /> commenced prior to issuance of a permit and that all work will be perFormed to meet standards of all laws regulating
<br /> construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
<br /> certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is
<br /> my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
<br /> - Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br /> Lands, Water/Wastewater Treatment.
<br /> - Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
<br /> Watercourses.
<br /> - Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
<br /> - Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
<br /> Septic Tanks.
<br /> - US Environmental Protection Agency-Asbestos abatement.
<br /> - Federal Aviation Authority-Runways.
<br /> I understand that the following restrictions apply to the use of fill:
<br /> - Use of fill is not allowed in Flood Zone"V" unless expressly permitted.
<br /> - If the fill material is to be used in Flood Zone "A'°, it is understood that a drainage plan addressing a
<br /> "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
<br /> licensed by the State of Florida.
<br /> - If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
<br /> construction, I certify that fill will be used only to fill the area within the stem wall.
<br /> - If fill material is to be used in any area, I certify that use of such fill will not adversefy affect adjacent
<br /> properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
<br /> the conditions of the building permit issued under the attached permit application, for lots less than one (1)
<br /> acre which are elevated by fill, an engineered drainage plan is re.quired.
<br /> If I am the�►GENT F012 TFIE OVUNE7Z, I promise in good faith to inform the owner of the permitting conditions set forth in
<br /> this affidavit prior to'commencing construction. I understand that a separate permit may be required for electrical work,
<br /> plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
<br /> permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
<br /> set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
<br /> requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
<br /> unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
<br /> the permit is suspended or abandoned for a period of six(6) months after the time the work is commenced. An extension
<br /> may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
<br /> justifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned.
<br /> WARNING TO OWMER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br /> PAYIfVG TWICE FOR IMPFtOVEMENTS TO YOUR PROPERTY. IF YOU IPITEND TO OBTAIN FINANCING, CONSULT
<br /> _ WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDiPIG YOUR NOTICE OF COMMEI�ICEMENT.
<br /> FLORIDA JURAT(F. 7.03) - -
<br /> OWPIER OR AGEN �- CONTRACTOR�[1 ��t.aG_
<br /> Sub cri ed and swo�n,to(or affirmed)before me this ` Subsc'be and sw to(or affirmed)before me this
<br /> S by I�QY)V1Ge.. �aB/1 � by�h�,/2'fp�
<br /> o /are personallv known tm m �r haslhave produced Who is/ re Nersonallv known to me or has/have produced
<br /> as identification. as identification.
<br /> �D�(jq�s,yil��2� Notary Public _���c.Q.Q�n � Notary Public
<br /> Commission No. � Commission No. ,�"°�� Nota P � f
<br /> ro� r� � c a e o oriaa ? : Susan Ann La�allee
<br /> . Susan Ann Lavallee c� _ oQ My Commission EE 2i8�e
<br /> Name of Nota ed, ' ,tarxi� Name of Notary type pri ��t`br st iWjS@€1���22iZo�s
<br /> rY tYP �R s o7/2212ois
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