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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 contractoror 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 DNislon—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 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 bulldings,'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 atthe 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 identity what actions I <br /> must take to be in compliance.Such agencies include but are not Ilmltedto: <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 thatthe 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 INT O BTAIN FINANCING,CONSULT <br /> _ 10-11— <br /> FLORIDA JURAT(F.S..y11177.03) <br /> OWNER OR AGENT '/����L�^^�""� CONTRACTO <br /> Subscribed and sworn to(or affirm d)before me this Subscribed and sworn to(or affirm <br /> e me t <br /> by by <br /> Y�hp islare personal1 knov�n me or a w ro c Who is/are�tse y knovTn fSrrC asPoade produced <br /> Zb .;,491 e as I nMlcation. _��as Identification. <br /> �710-0 <br /> v"�t./c/��l nW1 r.�-LfJotary Public " al 'yl �Q Notary Public <br /> Commission No.-"- <br /> y� L 1 Co n No. �O <br /> Re�g-__`o <br /> Name of otar typed,printed or stamped Name of Notary typed;printed or stamped <br /> TAWMY WE TURNER <br /> My CpMMISSION#GG106718 <br /> EXPIRES,kuw 09 2pZ1 <br />