HARDEE COUNTY SWIMMING POOL PERMIT APPLICATION 401 West Main Street, Wauchula, FL 33873-2832 -- (863) 773-3236 DATE ____________________ CONSTRUCTION sf____________ ZONING District_________________ Permit No.___________________ Surcharge (1%) $ ________________________ Parcel ID.______________________________________ Building Permit Fee $_________________________ Plan Review Fee/specs $ _________________________ Concurrency Review $ _________________________ Electrical Fee $ _________________________ Plumbing Fee $ _________________________ _____ CITY OF BOWLING GREEN APPLICATIONS REVIEWED BY: (ALL PLANS REVIEW DONE BY BUILDING OFFICIAL) Mechanical Fee $ _________________________ _____ CITY OF WAUCHULA Alarm Fee $ _________________________ _____ HARDEE COUNTY ___________________________________________ Gas Fee $ _________________________ _____ TOWN OF ZOLFO SPRINGS ___________________________________________ Late Penalty (100.00) $ _________________________ Double Permit Fee $ _________________________ TOTAL $ _________________________ Property Owner Name _____________________________________________________________________________________________ Phone _____________________________________________ Mailing Address ___________________________________________________________________________________________________________________________________________________________ Name of Contractor ________________________________________________________________________________________________ Phone _____________________________________________ State Mailing Address ___________________________________________________________________________________________________ License No. _________________________________________ Comp Card No. ______________________________________ Job Name ________________________________________________________________________________________________________ Type and Size of Structure Project Job/Property Location ___________________________________________________________________________________________ Project: Permit to Construct/ Erect/ Install________________________________________________________________________________________________ SETBACKS: DOH Septic Permit No.___________________________ Per DOH Septic System Finaled _________________________________ Front: __________ Sides:__________ Rear: _________ (COPY ATTACHED) (Date) Construction Type: Frame ( ) Masonry ( ) Metal ( ) Mobile/Modular Home ( ) Other ( ) Project Cost: $ _____________________ APPLICATION IS HEREBY MADE TO OBTAIN A PERMIT TO DO THE WORK AND INSTALLATIONS AS INDICATED. I CERTIFY THAT NO WORK OR INSTALLATION HAS COMMENCED PRIOR TO THE ISSUANCE OF A PERMIT AND THAT ALL WORK WILL BE PERFORMED TO MEET THE STANDARDS OF ALL LAWS REGULATING CONSTRUCTION IN THIS JURISDICTION. I UNDERSTAND THAT A SEPARATE PERMIT MUST BE SECURED FOR ELECTRICAL WORK, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC. --NOTICE— This permit becomes null and void if work or construction authorized is not commenced within 6 months, or if construction or work is suspended or abandoned for a period of 6 months at any time work is commenced. There may be additional permits required from other governmental entities such as water management districts, state or federal agencies. (PREPARED PLOT PLAN DRAWN TO SCALE SHALL BE SUBMITTED) I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. _______ INITIAL DISCLOSURE STATEMENT FOR OWNER-BUILDER State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of the property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one or two family residence or a farm outbuilding. The buildings must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease more than one building you have built yourself within one year after the construction is complete, the law will presume that you built it for sale or lease which is a violation of this exemption. You may not hire an unlicensed contractor. The construction must be done according to building codes and zoning regulations. It is your responsibility as the Owner-Builder to make sure that people employed by you have current licenses required by state law and by county or municipal licensing ordinances. *** ALL FEES NON-REFUNDABLE BY RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS *** ________________________________________________________________________________________/_________________________________________________________________________________ Print Name of Contractor or Authorized Agent (if Agent, notarized letter of authorization required) Signature Date ________________________________________________________________________________________/_________________________________________________________________________________ Print Name of Property Owner (if Owner-Builder) Signature Date STATE OF FLORIDA COUNTY OF ____________________________ Before me, the undersigned, appeared ___________________________________________________ on this the _______ day of ________________________________________________, ____________ ________________________________________________________________________ Signature of Building Official or Designee who affirmed that he/she read and understood the foregoing and who signed the same freely and voluntarily and who is personally known to me ( ) or who produced ________________________________________________________________________ ______________________________________________ as identification. Date _________________________________________________________________________________ Signature of Notary Public CODE IN EFFECT AT TIME OF PLANS SUBMISSION 2004 FLORIDA BUILDING, PLUMBING, MECHANICAL & FUEL GAS CODES, 2005 NATIONAL ELECTRIC CODE.
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