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<br /> 813790-0D2G City of Zephyrhills Permit Applicadon Fax-813a60-0021
<br /> Building Department
<br /> NOTICE OF OEEO RESTRICTIONS:The undersigned understands that this pamdt may I a subject to"deed"restriclarte which may be more restrictive
<br /> than County rogulationo.The undersigned assume:rcoponsibl9ty for compliance vdth any applicable deed restric5crls.
<br /> UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES:It the owner)has hired a contractor or contractors to undertake work,they
<br /> may be required to be licensed in accordance vAh state and local regulations.If Ste contractor is not licensed as required by law,both the owner and
<br /> contractor maybe cited for a misdemeanor vlota9on under state Isar,if the owner or intended contractor are uncertain as to what licensing requirements
<br /> may apply form intended work,they are advised to corset the Pasco County Building Ir pection DI'Mion—Licensing Section at 727-e47-8009.
<br /> Furthari rcre,1 the owner has hired a contractor or contractors,"is advised to have the vordrador(s)sign pardons of Ilia-contractorBlock'of this
<br /> application far t+Teich they Will be responsible.If yar.,as the owner sign as the eon:raator,t(tat may be an indication that he is not Drapery licensed and Is
<br /> not enticed to permitfing privileges in Pasco County.
<br /> TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE F ECOVERY FEES:The undersigned understands
<br /> lNitTransportetion Impact Fees and Racaume Recovery Fees may apply to the construction of nevr buidirgs,ohonge of use in extolling buildings,or
<br /> expansion of existing buildings,as specified in Pasco County,Ordinance number 80-07 anlf 90-07,as amended.The undersigned also understands,the_
<br /> such fees,as may be due,till be Idend led at the time of palnitting.It is further underl J that Transportation impact Fees and Resource Recovery
<br /> Fees must be paid prier to receiving a'certificate of occupancy'or final power release.if IF:a pro)ecl does not Involve a certificate of occupancy or final
<br /> power releas%lie fees must be p"prior to permit issuance.Furt;iermore,if Pasco Ceurtiy Water/Sawor Impact fees are duo,they must be paid prior
<br /> to permit issuance in accordance with applicable Pasco County ordinances.
<br /> CONSTRUCTION LIEN LAW(Chapter713,Florida Statutes,as amended)::lvaluation of vmrk is$2,EC0.00 or more,I certify that I,the applicant,
<br /> have been provided with a copy of the'Florida Construction Lien lave.—Horneowners Pro action Guide"prepared by the Florida Department of
<br /> Agriculture and Consumer Affair,If tits applicant is someone other than the"owner",I car ify that I have obtained a copy of the abase described
<br /> document and promise in good faith to deriver it to the'owner•prior to commencement.
<br /> 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
<br /> all applicable laws regulating construction,zoning and land development.Application is he by made to obtain a permit to do work and installation as
<br /> Indicated.I certify that no work or Installation has commenced priorto Issuance of a permit(ard that all wotk I:fa to padonnod to meet standards of all
<br /> la::s regulating construction,County End Cite codes,zoning regulation,and land develop@@@@@@ant regulations in the jurisdiction.I also certify that I
<br /> understand that the regulations of other govemmerl aoendes may apply to the Intended If
<br /> f dc,and thai it Is my responsibility to Idardlfy wiriat actions I
<br /> must take to be In compliance.Such agendas Include but ore notlimitedto: II
<br /> Department of Environmental Protection-Cypress 5ayhead ,Wetland Areas and Environmentally Sensitive
<br /> Lands,Water/WastevvaterTreatment.
<br /> Southwest Florida Water Management District-'Nelis, Cypress Bayheads, Wetland Areas, Altering
<br /> Watercourses.
<br /> Ariny Corps of'Engineers-Seawalls,Docks,Navigable Watenvays.
<br /> Department of Health & Rehabilitative Services/Envirenm ntal Health Unit-Wells, Wastewater Treatment,
<br /> Septic Tanks.
<br /> US Environmental Protection Agency-Asbestos abatement.
<br /> Federal Aviation Authority-Run:vays.,
<br /> I understand that the following resUiclions 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 Ili Flood Zone "A", it Is]understood that a drainage plan addressing a
<br /> 'compensating volume"will be submitted at time of penniiting 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 w ll 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 attac ad permit application,for lots less than one(1)
<br /> acre which are elevated by fill,an engineered drainage plan s required.
<br /> If I am the AGENT FOR THE OWNER,I promise in pad faith to inform the owner of the p rmitting conditions set forth in this affidavit prior to
<br /> commencing construction.I understand that a separate permit may be required for etecalcil rank,plumtlrig,signs,wells,pools,air conditioning,gas,or
<br /> other installations not specifically Included in the appllcallon:A permit issued shall be constived to be a license to proceed with the work and not as
<br /> authority to violate,cancel,alter,or set aside any provision of the techNcal cedes,nor shall Issuance of a permi:prevent the Bu.lding O6id2i from
<br /> thereafter requiring a eorrecton of ewers In plans,cansfruotion or violations of any codes.Every pea-ill issued shall become uhval.d unless the av:k
<br /> authorized by such permit is commenced within six months�orpennit Issuance,or if vark adthcrized 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 corking,from the Building�clal fora period not to
<br /> exceed ninety(90)days and will demonstrate justifiable cause for the extension.Ifwork ceases for ninety(93)crosecuhve 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 YOp INTEND TO OBTAIN FINANCING,CONSULT
<br /> WITH XQUIR LEN OR AN ATTOR
<br /> FLORIDA JURAT(F. 1 .03)
<br /> OWNER OR AGENT CONTRACTOR
<br /> Subcald and cwo f (or amrm before a this Subs toed vforLto or a firmed)b.re
<br /> vile i 12re personal know t Ic me cr ha Rta produced Who via
<br /> rsonalt known o me er hacthave produced
<br /> as idenbfca'on. astd aaa
<br /> •aL NotayPuJic t r //JJryry _ _vNotaryPublic
<br /> Jssion No. Commission No. t �t:.l
<br /> t
<br /> Name OFNoloiy typed,printed or stamped Name of Notary r,printed or slam a
<br /> .......... SYLVIA WEBER FALL
<br /> `�• Notary Public-State of Florida
<br /> tVA ` Commission 11 GG 953343 Notary Public State of Florida
<br /> err My Comm,Expires Jan 30,2024` +T Tracy L Agiter
<br /> Bonded through National Notary Assn.' ,'r� My Commigiaft HH 001E03
<br /> Nall") Expirets0511812024
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