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<br /> , - o. o perm �ssuance- n accardance writh appl(cable Pasco�County ordinances.
<br /> CONSTRUCTION �1EN l.A1N{Chapter T13� Elarlda StaEut�s�as amencted}; if vatuaElon of work ls$2,500.00 or more, !
<br /> certify that I, the applicant, have. been.pravided -with a capy-of the °Florida Construction Lien Law—Homeowner's
<br /> Prateatlon Guide° prepared by the Florida Depattment of Agricu[ture and Consumer Affairs.; If tf�e applicant is sameone
<br /> other than the"owner", i certify that I have.obtained a capy oi the above descrlbed document°and p,romise in,gaod faith to
<br /> deliver it to the"ow►ne�'�prior to•commencement: � �
<br /> CONTRACTOR'S/t3WHER'S AFPIDAVIT: 1 certiiy.tha#all;the lnformation in thls appliaatlon is accurate and th�t ati wnrk
<br /> will�be done in compliance with all applicable laws regulating oonstructton, zoning and land development, Application is
<br /> hereby made to obtatn :a permit.to do work and lnstaltatlon as tndteated, 1 certlfjr that no wotk or tnstallation has
<br />' commenced prior to issuance of'a permit and that.ail work wiil be perFarmed to meet standards of all laws regulating-
<br /> constructionf County and City codes, zoning regulattons, and land development regulations�in�the �utlsdictian. 4 aiso
<br /> cert�fy that ( understand thaf the regulat�ons of other govemment agencies may apply�#a the intended wark, and that it is
<br /> my responsibility ta iden#ify what,actions I must take to be in:.campliance. S,uch agencies include bu#are nat limited to:
<br />� - C}epartment of Er�vironmental Protect�on-Cypress.8aytteads; V41et1and Areas and Envlranmentafly Sensitive
<br />' l.ands, Water/Wastewater Treatment.
<br /> - Southwest Florida Water Management .District Weils, Cypress. Bayheads, Wetiand Areas, A#tering
<br /> Watercourses.
<br /> - Army Gorps of Engineers-Seawalls, Dacks, Navigable Waterways. �
<br /> - Depar#ment of Health & Rehabilitative Serv[ceslEr�vironmenfel Health llnit W+�IIs� Wastevstater Treatmectt,
<br /> Septic Tanks. .
<br /> - US Environmentai Protectfor�Agency-Asbest�s ab�tement� __
<br /> Fedeca0��riation-}#uthorl�y-Runw►ays.- __ 4v��rd'____� __ ___ �___
<br /> I understand that the foAawing.�resfrictions�apply ta the usQ.�of flll:
<br /> - Use of�€1!is not allowed in Flood Zaae°V"unless expressly permitted. j
<br /> - If the fill material�is to be used �in :Flood Zone "A", It (s understaod that a drainage plan addressing a I
<br /> °compensating valume" wlil be submftted at time of permitting which is prepared by a professlonat engineer �
<br /> licensed by the State�of�FloNda. � �
<br /> - !f the fill materlal'is�to.be used in Flood Zone °A" in>conneclion�with_a �ecmitted building using stem wa!! i
<br /> � constn�ction, t certity that fiil wilt:be used only to.fill the area within.:the s#em.wall.
<br /> - If fill material is-ta be used~In� any�area, I �certify that use. of such fill wlll nat;;adv�Csely, affect�adjacent
<br /> properties. If use of fl111s found to adversely affect ad�acent:prope�t�e�,.the owner may be�cited#ar vlola#Ing
<br /> the conditions of tlie,building.permi# Issued�under the attached permit applicatian, for lots less than one (1)
<br /> acre which are efevated by f!1!,an engineered drainage plan is required �
<br /> if i am the AGENT FOR THE OWNER, I,�pramise°in goad faith to inform the owner of�the:p.ermltting=conditians set focth in
<br /> this aNidavik prior to commencing constructiori. I understand that a;separate permtt.may be requ(red for elsctrieal work,
<br /> plumbing, signs. wells, pools,, air_conditioning,..gas�._,or:.athec.instaliations not speci�ic�lly ina#uded in the application. A ,
<br /> permit issued shall be constr.ued�to be a�I(cense to-:proceed with the�work.a�d_nat::as:authority�to:violate,.cancel, alter, or
<br /> set aside any pravisfons of the Eeclir�ical codes; nor sha11 fssuance a€a perm�t prevent the Bultdtrig 4#�c�al.f� m., ���fter
<br /> � � .. ;
<br /> requiring a carrection af errors in plans,-const�uc#lon o�.�tolati�� of�any codes.- Every�permit Issued�'�, ���bec���ti�i ��id�;-:
<br /> unless the_work authorized.by such permit•Is-commenced wlttiln sGc,months of permft Issuance, or if work authorize�'6y'
<br /> the.permit is suspended.or.abandoned�for-:a:period af.s�C{6)�montFis after.the time the work�is commenced. An extension
<br /> may be requested, tn wri#ing;.from tFie;.Buildtng.Qfflcfal for a perlod;-not to exceed�ninety (9p)�days a�d�wilF derr�onstrate
<br /> �ust�able cause for.the extension: If warlc ceases;for nlnety{90}consecutive days,.the jab is aonsidered aba�dot�ed.
<br /> r.., ,.. � .
<br /> WARNING TQ'OWNfR: YOUR..FAlLURE�TQ.RECCIRDj A..NQTlCE;QFs-COMMENCEMENT MAY RESULT�1!� YUUR
<br /> AAYING TWICErFQR,.iMPROVEMENTS TI'J:YOUR�,PROPERTY.°:iF�YOU"�INTEND_TO OBTAIN�FINANCING��CONSULT
<br /> WITH. OU � ENDE O AN A'TTORNEY FORE:RECO Q G� OU �O �C `O ° O � E CEMENT� �
<br /> FI:ORlpA JUFiA3(F: 117.0 - , �, , . . � . . . - .;< � '
<br /> QWNER OR A T .,, ' -CONTRACTOR` ^ . ` ` ', . �
<br /> Subscribed and m a ed) e ore me thls Subscrlbed and�swom to{ar af�rrrted}before rrie��iis
<br /> �?� b ,by.,-; .,.. . .
<br /> Who Is/ar ersonally known:o.me ,r.haslhave produced. Who(s/are persanally known�ko me oc has/have'produced; • -
<br /> ' as`Ideri��catlpn. as IdenH�catlon.
<br /> "��...,�����Ym�-C$_ Notary Public . Notary Public
<br /> ��� � .. .. . . ., ,
<br /> Commission Na. ��' �>81 b''�l Commisslon.No.
<br /> iVame of Notary type Name pf Notaty typed,printed or stacnped . .
<br /> . �,VY� Notary Pubtic 5tate of Floride
<br /> r. .
<br /> Susan Ann Lavallee
<br /> �c� ..�� �t1y CommissEOn EE 2't8t88
<br /> �M fi;,e� ErpirCS 07/22l2016
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