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i <br /> 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 Division—Licensing Section at 727-847-8009. <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 licensed and is <br /> not entitled to permitting privileges in Pasco 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 use in existing buildings,or <br /> expansion of existing buildings,as specified in Pasco County Ordinance number 8M7 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 receiving 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.Furthermore,if Pasco County Water/Sewer 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$2,500.00 or more,I certify that I,the applicant, <br /> have been provided with a copy of the"Florida Construction Lien Law—Homeowners Protection Guide"prepared by the Florida Department of <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 described <br /> document and promise in good faith to deliver it to the"owner'prior to commencement. <br /> CONTRACTOR'S/OWNER'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 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 the jurisdiction.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 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 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 /> 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 conditioning,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 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 /> WITH YOUR LENDER OR AN A1MRNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT- <br /> FLORIDA JURAT(F.S.117 ) <br /> OWNERORAGENT CONTRACTOR <br /> S' s dbed and swpgn to(or atfgm before me this Su cri ed and sworn(O(or affirmed before me this <br /> 21 by 11 f�A �x t�t Z� a by y r nCom � we <br /> Willa,i/are personally known to me or fiasthave produced Who i/ e personalty known to me or has/have produced <br /> as identification. as identification. <br /> Notary Public Notary Public <br /> Corn fission no. 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