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813-780-0020 City of ZephyThills Permit Application Fax-,813-7 80-0021 <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 restrfollons.'; <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-andlocal-regulatons.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 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 IMPACTIUTILITIES 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 <br /> act F.ees 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 1,the applicant, <br /> have been provided with a copy of the"Florida Construction Lien Law—Homeowner's 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,WaterMastewater Treatment. <br /> - Southwest Florida Water Management District-Wells, Cypress Bayheads, Welland 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 aropermitted 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 fqund 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 ATIORNEY BEFORE RECORDING YOUR NOTI COMMENCEMENT. <br /> FLORIDA JURAT(F.S.117.03) <br /> dAd/ <br /> OWNER OR AGENT CONTRACTOIC/47/, <br /> "Subscribed and sworn to(or affirmed)before me this Subscribed and'w - -I r a ed bet at his <br /> by !by I C AV <br /> Who is/are personally known to me or has/have produced Who Is/are personally known to me or has/have prodifted <br /> as identification. as Identification. <br /> Notary Public Notary Public <br /> Commission No Commission No <br /> Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped <br />