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<br /> NOTiCE AF L1EED RESTRICTii�NS: The understgned undetgt�ands�#0�8t this.p�cm�t.may.be.subject to"deed"�estrictlons°
<br /> which may be�more resQ�fctive than Countya reguiations. �The undersigned assurries responsibilify far compliance with any
<br /> agp#icable deed restrlctlons.
<br /> UIdLlCENSED CONTRACTCIRS AND CONTRACTOR R�SPONSlBIL-ITIES: !f the owner has hired a contt�actor or
<br /> contractors ta undertake work, they may be required.to be.ltcensed In accordance.with state.and�loca! regulations, !f the
<br /> cantractor Is not licensed as requtred-by (aw, both the owner and canGactor may be cited for a misdemeanor violatlan
<br /> under state law. tf the awner ar intendedreorrtractor �re uncertain as ta what licensing.requiremerrts may apply��far the
<br /> intended work, they a�e advlsed to contact the Pasca Courtty 8uitding Inspectlon Dlvlslon--Lfaensing Sec#ion at 727-847-
<br /> 8009. Furthermoref tf the owner has hired a cont�aGtor or contractors. he Is advised to have the contracEor(s} slgn
<br /> portions of the "conkractor Block" of this application for whia�h they wlll be responsible.. If you� as.the owner sign as the
<br /> con#rac#or, that rnay be an indication that he is no#.prope�iy iicensed and is not entitled to permitting privileges In Pasco
<br /> Caunty.
<br /> TRANSPORTA710N�IMP;RCTtU'FIl.1TIES tMPAC'�ANb RESOURCE RECQVERY FEES: The unders€gned understands
<br /> that Transport�atfon Impact Fees and.fZ,eaourse IRecovery.Fees may��apply�#a the constn�ctlon of new bulidings, change of
<br /> use in existing buiidings, or,expansion�_of��eXistiri�=6uildings, as speclfted.in Pasco County Ordinanae number 89-07 and
<br /> 90-07, as amended. The underslgned also understands� thalt such fees�-as�may�be�due„will be identifled at the time of
<br /> permitting. it is further understaod that T�anspartation tmpact Fees and Resource Recovery Fees must be pald prtor to
<br /> recelving a°cerfiticate of occupancy"or fina) pawec=release. :if the proj�ct does not irnrolve a certificate of oacupancy or
<br /> fina! pawer�elease, the.fees must be pald prfor ta permlt lssuance. Futthermore;•if Pasco County iNateriSewer Impact
<br /> fees are duef they�must be pald prlor to permlt lssuance�ln accordance with�appltcable Pasco County ordinances.
<br /> CONSTRUCTION LIEN L.AW(Chapter T13, Flor�da Statutes�as amended�: (f valuatlon of work is$2�500.U0 ar more, 9
<br /> certify that t, #he app0icant, h�ve.been provlded with a copy of the "Flarida- Construction Lien Law—Hameowner's
<br /> Protection Gufde" preparad by the Fiorida Departmenf af Agricutture and ConsumerAifiairs.- tf the appitcant ls someone
<br /> ather than the"owner", t cer#ify that t-have.obtained a+copy of the above..des.cribed docurr�ent°and.promis�in,good`faith to
<br /> deliver it to the°owner"prior to�commencement.
<br /> CANTRACTCIR'S/OWNER'S A�FIDAVIT: I certify that aA the Informatian In thi�appllcatlon is accurate and that al!work
<br /> wi0�be done in compilance with all appi(cable laws regulating constructian, zoning and land development. AppAcatlon is
<br /> hereby made to obtain .a permit to do work,and installation as indicafed.- `1 certffy that no work or tnstaliatton has
<br /> commenced prlar to issuance af�a perrr�it and that aif wark will be performed ta meet standards of all iaws regutating�
<br /> construatbn, County and City codes, zontng regulations, and land develapment cegalatlons-fn the Jur3sdlctEon. 1 ai'so
<br /> certify that ! u�ders#and that the regulations o#other government agencles may-apply�to the lrttended work, and that it is
<br /> my responsfbility to Identlfy�what.act(ons I must take to be,in:.cort�pllance: S.uoh agencies Include but are..not Ifmited ta:
<br /> - Department of E�lvlronmental Protection-Gypress.Bayheads, Wetland Areas and Environmentally Sensitive
<br /> Lands,Wa#erJWastewa#er Treatment.
<br /> - Sau#hwest Florida itNater Management �tistrlct Wetls, Cypress. Bey.heads, Wetiand Areas, At#ering
<br /> Watercourses.
<br /> - Army Corps of Engineers-Seawalls, Docks,Navtgable Waterways.
<br /> - Department of Health'8 Retaabll(tative Seni(ces/Ernironmental Health Un1RWeils, Wastewater Treatment,
<br /> Sep#ic Tanks. .
<br /> - US Environmentaf Protection Agenca+-Asbestos abatement.
<br /> - Federai Avlattc�n Authority-Runways.
<br /> !understand that the following res#�Ictions apply to the use of fll1:•
<br /> - Use of fill Is not aUowed in Flood Zone"V"unless expressly permitted.
<br /> - lf the fili materlal 1s to be used tn Fload Zone �A", It. is understoad #hat a drainage plan addressi�g a
<br /> "compensating vofume"wil) be submftted at time of permitttng which (s prepared by a prafessiona) engineer
<br /> licensed by#he State af florida.
<br /> - !f th� fiN mate�lal fs to be used in Flaod �one "A" En�cannec�ion�vv�Eh.a�permitted buitd4ng using stem wal!
<br /> ' construction} !certlfy that fi!!<wlll�be used only.to f!I!the a�ea wlthin the�stem�wall.
<br /> - If fill materlal Is to be used in any area, I certify that use of such fill wil! not adversely affect adJacent
<br /> properties. tf use of fill is found to adversely:�ft'ect adJaeent•prr�perties,.the owner may be cited for vlolating
<br /> the candEtions af the buitding,permi# issued under the at#ached permit appiica#ion, for lots iess than.one (1)
<br /> acre wh3ch are elevated�by tllt;an englneered dr�inage plan is raguired.
<br /> If!am the ACENT�OR T'HE OV1tNER, t,�promise In good faith to tnform the owner of�the permltting conditions set forth In
<br /> this affidavlt prior ta commer�aing canstruotlon. I understand that a�separate permlt may be requtred for elect�ical worki
<br /> piumbing, signs, we0s, pools; air canditioning, .gas, or other installations not.speciflcally included-in.tMe applicatlon. A
<br /> permit lssued shall be canshued to be a license to praceed with the work and not as authority to.violste,cancet, al#er, ar
<br /> se#astde any prov�sions af the technical cades; nar shall issuance�of a.permit.pr.event the Buttdirig Of�icisl from thereafter
<br /> requiring a correcilat�af e�rors In pla�s; constn�ctfon or violatfons of any codes. Every pe�rnlE issued shatl become invalid
<br /> unless the work autho�Ized.by such permit.•is.commenced�wlthln stx months of pennit lssaance, or PF wark au#horized by
<br /> the permit is suspended or abandoned�fo�a:period of�six(8) mnnt�s after the time the�work�ls commenced. An e�ctensian
<br /> may be requested, in writing, from the Buitding,Official far a perlod not#o exceed nlnety(90) c�ays and wll) demanstrate
<br /> justi�abie cause for.the extension: If work ceases:for ninety t90)consecu#iva:days,..the�job�is considered aba�doned.
<br /> WARNlNG TO CIWNER; YQUR FAlL.URE�:FO.RECC?RD A NQTIGE:OF�C4MMEMCEMENT�MAY RESU�:T iN YOUR
<br /> PAYING TWICE.FOR IMPROVEMENTS TO YC1UR.PROPERTY. !��YO.U�IN'FEND�'�TQ�OB'�AlN��FII+tANC1NG;'CON3Ul.T
<br /> �IIIT U - 2 . _AM '�TAItIV�Y�� AR�':RECO G,; �UR' O ; `dF� ., . CE N .
<br /> PI.OR{DA.lURA3(F.S.i 17.03) ti - - - -
<br /> OWNER OR AOENT_ G�L'n'�'e- � -��??� CONTRACTOR �
<br /> Su�saibed and sr+wom r afiicmed)be ore me#his 5ubscribed and`swam fa(or aflirmed)�betore me ttiis
<br /> �5 z7llS b •by
<br /> Who�slare pe�own to.me or hasfiave produced Who Is/ere personally knowm to me•o�hasmave�prodOced �
<br /> as ldentl�callon. as identffication.
<br /> ��Cc 1..2 !� Notary Public . Notary Pub!!c
<br /> Co ! �ql}� ;"'-, JACQUELINE B ES Commfssfan.No.
<br /> . . ff�'f56�Z----- ,
<br /> ~�� =Q: Expires December 92,2418
<br /> ,y.
<br /> Name o:N6t�� �' Name of Nokary typed,printed or stamped
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