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a,3-rau�o2n City of Zephyrhilis Permit Application Fax-813-78 OU21
<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 rk,they
<br /> may be required to be licensed in accordance with state and local regulations.It the contractor Is not licensed as required by law,both the owr er 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 req iirements
<br /> may apply for the intended work,they are advised to contact the Pasco County Building Inspection Divislon—Licensing Section at 727-847.8C 09.
<br /> Furthermore,if the owner has hired a contractor or contractors,he is advised to have the contractor(s)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 lieen ed and is
<br /> not entitled to permitting privileges in Pasco County.
<br /> TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES:The undersigned unde tends
<br /> that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of now buildings,change of use In existing buildi gs,or
<br /> expansion of existing buildings,as specified In Pasco County Ordinance number 89-07 and 90-07,as amended.The undersigned also unders ands,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 receiving a"certificale of occupancy"or gnat 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.Furthermore,If Pasco County Water/Sewer Impact fees are due,they must be F aid 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$2,500.0D or more,t certify that 1,the app icant,
<br /> have been provided with a copy of the'Florida Construction Lien Law—Homeowners Protection Guide prepared by the Florida Department o
<br /> Agriculture and Consumer Affairs.If the applicant is someone other than the"owner,I certify that I have obtained a copy of the above descri d
<br /> document and promise in good faith to deliver 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 hereby made to obtain a permit to do work and installs Ion 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 standarc s of all
<br /> laws regulating construction,County and City codes,zoning regulations,and land development regulations In the jurisdiction.I also certify the 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 a 'ons 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 Sensitive
<br /> Lands,WaterMastewater 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"W unless expressly permitted.
<br /> - If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan add r ssing a
<br /> "compensating volume"will be submitted at time of permitting which is prepared by a professional ngineer
<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 s am 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 djacent
<br /> properties.If use of fill is found to adversely affect adjacent properties,the owner may be cited for iolating
<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 /> If I am the AGENT FOR THE OWNER,I promise in good faith to inform the owner of 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 conditionin 1,gas,or
<br /> other installations not specifically Included in the application.A permit issued shall be construed to be a license to proceed with the work and ni t 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 f om
<br /> thereafter requiring a correction of errors in plans,construction or violations of any codes.Every permit issued shall become Invalid unless the rk
<br /> authorized by such permit is commenced within six months of permit issuance,or If work authorized by the permit Is suspended or abandoned or 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 pedoc 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 con idered
<br /> abandoned.
<br /> WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT 11S YOUR
<br /> PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.IF YOU INTEND TO OBTAIN FINANCING,CC INSULT
<br /> WITH YOUR LENDER OR AN ATTQRNEY BEFORE RECORDING YOUR ICE CIE COMMENCEMENT-
<br /> FLORIDA JURAT(F.S.117.03)
<br /> OWNER OR AGENT CONTRACTOR
<br /> Subscribed and sworn to(or affirmed)before me this a d swo ( alit m b e i
<br /> by by
<br /> Who islare personally known to me or hasthave produced Whb isla-rb personally y known to me or hasthave produced
<br /> as identification. as Identification.
<br /> Notary Public Notary P blic
<br /> Commission No. Cc mission No.
<br /> Name of Notary typed,printed or stamped Nam or lary typed,p nted or stamped
<br /> lair
<br /> COURTNEY RAE STORMS
<br /> Notary Public•State of Florida
<br /> Commission#NH 002692
<br /> --To n� ' My Comm.Expires May 21,2024
<br /> Sonded through National Notary Assn.
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