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a�a-7so-oozo � City of Zephyrhiils Permit Application Fa�c-813-780-OD21
<br /> Building Department
<br /> = l NOTlCE dF DEED RESTRIC'EiONS: i'he undersigned understands ihaf this permii may be subjed to"deed'restrictians"
<br /> which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
<br /> applicable deed restrictions.
<br /> UNLlCENSED CONTRAGTORS AND GdElTRAG74R RESPQNSIBILPi`fES= tf the owner has hired a cg�tradar or
<br /> contractors to undertake work,they may be required to be licensed in accordance with stete and local regulations. If the
<br /> contractor is not licensed as required 6y law,both the owner and contractor may be cit�d for a misdemeanor violation
<br /> under s#ate law. 1f#he owner or infended contractor are uncertain as fo what licensing req�irement�rr►ay apply#or#he
<br /> intended work,they are advised to wntact the Pasco County Building Inspection Division—Licensing Section at 727-847-
<br /> 8009. Furthermore, if the owner has hired a contractor or co�tractors, he is advised to have the contractor(s) sign
<br /> portions af fhe"canfractor Block"of this application for which ihey wil]be respansible_ If you,as ths owner sign as#ha
<br /> contractor,fhat may be an indica#ion that he is not properly liceatsed and is not entiUed to Qertnikting prnnleges in Pasco
<br /> County.
<br /> TRANSPORTATiOH IMPAGTlUTIIITtEB tiVtPACT AND RES4UR�E I2ECOVERY FEES: The undersigned understands
<br /> tY�at Transportation Impact Fees and Recourse i2ecovery Fees may appty to the construction of new buildings,change of
<br /> use in existing buildings,or expansion pf exis6ng buildings,as specified in Pasco Courrty Ordinance number$9-07 and
<br /> 90-07,as amended, The undersigned also understands,that such�ees,as may be due,wifl be identifed at the time oP
<br /> permitting. tt is further understoad fhat Transpartafion Impact Fees and Resource Recavery Fees must be paid priorto
<br /> receiving a"certificate of occupanc�'or final power release. If the project does not involve a certifiqte of ocxupanc.y or
<br /> flnal power release,ihe€ees must be paid priar to permit issuance_ Furthermare,"tf Pasca Couniy Water/Sewer(mpact
<br /> fees are due,fhey must be paid prior to permit issuance in accordance with applicabte Pasco Caunfy oMinances.
<br /> CONSTRUCTION LIEN LAW(Chapter 793,Plorida Statutes,as amended)_ If valuatian of work is$2,500.00 or more,I
<br /> certity that 1, ihe applicant, have been grovided with a copy of the "Flarida Ganstruc6on �ien Law—Hameawner's
<br /> Psotection Gnide"prepared by#he Florida Depatimenf of Agricui#ure and Gonsssmer Afl'airs. �#the appticant is someone
<br /> ather than the"owner',f certify that I fiave obtained a copy of the above described document and promise in good faith to
<br /> deliver it to the"owner"prioc to commencement
<br /> CONTRAGTOR'SIOWNER'S AFFlDAVt7_ i certiiy fhat alt the infarma6on in#his appt"scation is accurate and that atl work
<br /> wiil be done in campliance with all app(icab(e faws regulating constructiqn,zoning andYand devefopment Appfication is
<br /> hereby made fo obtain a permit to do work and installation as indicated_ ! certify that no vuark or insta4tation has
<br /> cammenced prior to issuance af a permit and that ait work wiil be pe�`aRned to meet standards of atl Iaws regula5ng
<br /> construction, County and City codes, zoning r�gulafions, and land development regulations in the jurisdiction. I also
<br /> certify that 1 understand that the regutations of other government agencies may apply ta the intended work,and that it is
<br /> my responsibilify to identify what acfior�s 1 mus#take ta be in comptiance. Such agencies include bu#are nof limited ta:
<br /> - Department of Environmental Protection-Cypress Bayheads, WeUand Areas and Environmentalty Sensitive
<br /> Lands,Water/Wastewater Treatment
<br /> - Sauthwesf Floada Water Management Disfrict-Wells, Cypress Bayheads, Wet�and Areas, Alfering
<br /> watercourses.
<br /> - Army Corps of EngineersSeawalls,Docks,Navigable Watennrays.
<br /> - Department of Heaiih & Rehabitifative SenricesfErivironmerrtal Heat#h Uc2it Wells, 1Nastewater Treatment,
<br /> SepUc Tanks.
<br /> - US Environmental Protection Agency-Asbestas aba#ement.
<br /> - Federal Aviation Authority-Runways.
<br /> 1 unders#and that the foifowing resfrictions appty to the use af fitl:
<br /> - Use af fill is not atlowed'm Ftaod Zone"V"untess expressly pennitted.
<br /> - IF fhe fill maferial is to be used in Fioad Zone "A", iE is uaderstaad fhat a drainage plan addressing a
<br /> "compensating votume"wi(t be submitted ak time ofi permitting which is prepared by a professional engineer
<br /> ticensed by the State af Florida.
<br /> - t€fhe fill materia!is to be used in �load Zone"A in cannedion with a permitted buffding using s#em wall
<br /> constnzction,t certify that fitl witt be used onty to fi0 the area within the stem waiL
<br /> - If fiIl material is to be used in any area, I certify that use of such fitl will not adversely affect adjacent
<br /> groperties_ If use of fiH is found fo adversety af[ect adjacent properties,it�e owner may be cited far violating
<br /> #h8 conditior�s of the buildng permi#issued under the aftached permit applicaiion,for iots less#han one(1)
<br /> acre which are elevated by fill,an engineered drainage plan is required_
<br /> !f(am the A6ENT FOF2 TNE OWNER,!promiss in good faith to inform the owner of the permitting conditions set for#h"sn
<br /> tiiis affidavif prior ta commencing constructian. 1�nderstand that a separate permif may be required for electrical work,
<br /> plumbing, signs,wells, pools, air conditioning,gas, or ather installations not specifically inGuded in the application. A
<br /> permit issued shall be construed to be a lice�se to proceed with the work and�not as authority to viofaie,cancel,alter,or
<br /> set aside any provisions of the techrzi�cat r,odes,noc shaff issuance of a permit preverst fhe Buildirtg fl#ficiaE frorn fhereafter
<br /> requiring a correction of errors in plans,construction or violations of any codes. Every permit issued shatl become invalid
<br /> unless the work aufhorized by such perrnit is commenced wifhin six mpnfhs of permit issuance,or if work authorized by
<br /> the permit is suspended os abandoned€or a period of siac(6}months after the Ume the wotic is commenced_ An e�cfensian
<br /> may be requested, in writing,from the Building Cffficial for a period not to exceed ninety(90)days and will demonstrate
<br /> justifiable cause far the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned.
<br /> WARNING TO CIWNER: YOUR FAiLURE TO RECORU A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br /> PAYING TWICE FOR IIIAPROVEfiAENlTS TO YQUR PROPERTY. IF YOLI INTEWD TO CIBTAI NANCING,CONSt1LT
<br /> WIT#i Y011R LENDER OFt AN ATTO BEFORE i2ECQ12DIN�YQllit I30TIGE O CO C ENT_
<br /> FLORIIIA JURAT(F.S.i 17. � 11
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<br /> . OWNER OR AGENT CQNTRACTOR ��
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<br /> W�io�}ya�re na1Iy kno to e or ha�s/have prod Ais/a�re���n�ly•known to,�q��or haslhave pmdu�cet -,�-
<br /> �'J/bC/l,�iL/��siden6fiption. K/1J�``fG� hl�itllcl� asidenGficatian.
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<br /> �,_Comcnission#GG 445343 _ ;,, Commi�sion# 42�
<br /> :;;��o:.Expires November 7,2020 ;y.�Q;�Exp,��s S,�lovember7.
<br /> �F °P` BondedTliru'froyfaminswance600,385-I019 �:;;oP�g�*; .Qpnds,dThruUoyfainlnsurence800aB5�7D14
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