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813-780-0020 City of Zephyrhills Permit Application Fax•813.780-0021 <br /> Building Department <br /> NOTICE OF DEED RESTRICTIONS:The undersigned understands that this permit may be subject to*deed'restrictions'which may be more restrictive <br /> than County regulations.The undersigned assumes responsibility for compliance with any applicable deed restrictions. <br /> UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES:If the owner has hired a contractor or contractors to undertake work,they <br /> 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 <br /> contractor may be cited for a misdemeanor violation under state law.If the owner or Intended contractor are uncertain as to what licensing requirements <br /> may apply for the intended work,they are advised to contact the Pasco County Building Inspection Divislon—Licensing Section at 727-847-8009. <br /> Furthermore,If the owner has hired a contractor or contractors,he is advised to have the contractors)sign portions of the"contractor Block'of this <br /> 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 <br /> not entitled to permitting privileges in Pasco County. <br /> TRANSPORTATION iMPACT1UTILITiES 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 use in existing buildings,or <br /> expansion of existing buildings,as specified in Pasco County Ordinance number 89-07 and 90.07,as amended.The undersigned also understands,that <br /> 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 <br /> Fees must be paid prior to recelving a*certificate of occupancy'or final power release.If the project does not involve a certificate of occupancy or final <br /> power release,the fees must be paid prior to permit issuance.'Furthernore,if Pasco County WatedSewer Impact fees are due,they must be paid prior <br /> to permit issuance in accordance with applicable Pasco County ordinances. <br /> CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes,as amended):If valuation of work is M500.00 or more,t certify that 1,the applicant, <br /> have been provided with a copy of the"Florida Construction Lien Law—Homeownees Protection Guide"prepared by the Florida Department of <br /> Agriculture and Consumer Affairs.It the applicant Is someone other than the"owner,I certify that 1 have obtained a copy of the above described <br /> document and promise in good faith to deliver it to the"owner"prior to commencement <br /> CONTRACTOITSIOWNEWS AFFIDAVIT:I car*that all the IMoenation In this application is accurate and that all work wit be done in compliance with <br /> all applicable taws regulating construction,zoning and land development.Application is hereby made to obtain a permit to do work and installation as <br /> 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 <br /> laws regulating construction,County and City codes,zoning regulations,and land development regulations in thejurisdic6on.I also certify that I <br /> 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 <br /> 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 Sensifive <br /> Lands,Water/WastewaterTreatment. <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 adversely 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 required. <br /> III am the AGENT FOR THE OWNER,I promise in good faith'to inform the ownerof the permitting conditions set forth in this affidavit prior to <br /> commencing construction.I understand that a separate permit may be required for electrical work,plumbing,signs,wells,pools,air conditioning,gas,or <br /> other installations not specifically included in the application.A permit issued shaft be construed to be a license to proceed with the work and not as <br /> 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 <br /> thereafter requiring a correction of errors in plans,construction or violations of any codes.Every permit issued shall become invalid unless the work <br /> 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 <br /> 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 <br /> exceed ninety(90)days and will demonstrate justifiable cause for the extension.If work ceases for ninety(90)consecutive days,the job is considered <br /> abandoned. <br /> WARNING TO OWNER:YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR <br /> PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.IF YOU INTEND TO OBTAIN FINANCING,CONSULT <br /> FLORIDA JURAT(F.S.117.03) !1 / <br /> OWNER OR AGENT CONTRALTO �_ 1 <br /> tr�js� sl o{o ffirme aremgthis u m edam to ra ) r <br /> i�J1;Y4��� yY:s f 3�� 1�( 1 <br /> Wh we personally known to me orhasfhave produced Who Ware personally known t6die or asdhave produced <br /> as idnnenifcafion. as Identi8ca on <br /> +�/ r Public ji "tary Public <br /> Commission No. Commission No. <br /> Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped <br /> '�'l'4^.'^tf`:r'1.+^+./ti"c: �^"4�"tiyrl^4�at'�.r'St`.�d"',;/`J�.t",✓`��� <br /> p.*r'v pkrl Notary Public State of Florida G y pt�Y�oa� Nolan Public State of Florida <br /> Carol Martin �'a > ? r Carol Martin <br /> y �_ MY Commission GG 189304 � � �c o"` My Commission GG 189304 <br /> y r o' op Expires d 3/22/2022 Y+yor�; Expires 08122/2022 ' <br /> `a <br /> '>•air'"h�°�+l'"�-'�r,.�'Y'tl'.l�,.e"V`,�',✓v",.a°•wl+4r++s<,� •.,,,i'�ya,••�y/',�da..ti.n..:'..�.••v'h�4r'+.�00�.r ..^.+`�"• <br />