s �
<br /> �-.
<br /> i � NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions"
<br /> ' which may be more restrictive than County regulatiorjs. The undersigned assumes responsibility for compliance with any
<br /> applicable deed restrictions. '
<br />' UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or �
<br /> contractors to undertake work,they may be required�to be licensed in accordance with state and local regulations. If the �
<br /> contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation '
<br /> under state law. If the owner or intended contracto�are uncertain as to what licensing requirements may apply for the '
<br />� intended work,they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
<br /> i 8009. Furthermore, if the owner has hired a cont{actor or contractors, he is advised to have the contractor(s) sign
<br /> portions of the"contractor Block"of this application for which they will be responsible. If you, as the owner sign as the
<br /> contractor,that may be an indication that he is not droperly licensed and is not entitled to permitting privileges in Pasco
<br /> 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
<br />' use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
<br /> 90-07,as amended. The undersigned also understands,that such fees, as may be due,will be identified at the time of
<br /> permitting. It is further understood that Transportatipn Impact Fees and Resource Recovery Fees must be paid prior to
<br /> receiving a"certificate of occupancy"or final power�elease. If the project does not involve a certificate of occupancy or
<br /> final power release,the fees must be paid prior to permit issuance. Furthermore, if Pasco County WateNSewer Impact
<br /> fees are due,they must be paid prior to permit issua ce 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
<br /> certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
<br /> Protection Guide"prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
<br /> other than the"owner", I certify that I have obtained a copy of the above described document and promise in good faith to
<br />, � � deliver it to the"owner"prior to commencement.
<br /> � CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify t at all the information in this application is accurate and that all work
<br /> will be done in compliance with all applicable laws rggulating construction,zoning and land development. Application is
<br /> hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
<br /> commenced prior to issuance of a permit and that all work will be pertormed to meet standards of all laws regulating
<br /> construction, County and City codes, zoning regul Itions, and land development regulations in the jurisdiction. I also
<br /> certify that I understand that the regulations of other�government agencies may apply to the intended work,and that it is
<br /> my responsibility to identify what actions I 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,Water/Wastewater Treatment.
<br /> - Southwest Florida Water Managemelnt District-Wells, Cypress Bayheads, Wetland Areas, Altering
<br />, Watercourses.
<br /> - Army Corps of Engineers-Seawalls,Doc s,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 thl use of fill:
<br /> - Use of fill is not allowed in Flood Zone"�"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 submittetl 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 Flootl Zone"A" in connection with a permitted building using stem wall
<br />� construction,I certify that fill will be usedlonly 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 iss�ed 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
<br /> this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
<br /> plumbing, signs, wells, pools, air conditioning, gas,l or other installations not specifically included in the application. A
<br /> permit issued shall be construed to be a license to proceed with the work and not as authority to violate,cancel,alter,or
<br /> set aside any provisions of the technical codes,nor shall issuance of a permit prevent the Building O�cial from thereafter
<br /> requiring a correction of errors in plans,constructionl or violations of any codes. Every permit issued shall become invalid
<br /> unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
<br /> the permit is suspended or abandoned for a period of six(6)months after the time the work is commenced. An extension
<br /> may be requested, in writing,from the Building Official for a period not to exceed ninety(90)days and will demonstrate
<br /> justifiable cause for the extension. If work ceases fo i ninety(90)consecutive days,the job is considered 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 ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT
<br /> FLORIDA JURAT(F.S.117.03) .
<br /> OWNER OR AGENT CONTRACTOR
<br /> S�ub cri�be,,d�and swo o affirmed efor m thi Subscribed and swom to(or affirmed)before me this
<br /> ��bY by
<br /> Who is/are p�rsonal y known to e or has/have produced Who islare personally known to me or has/have produced
<br /> �� as identification. as identificatlon.
<br /> / \
<br /> �ary Public Notary Public
<br /> Commfssion No. Commission No.
<br />,� Nam f ��rinted Name of Notary typed,printed or stamped
<br /> 3s ¢s� �►rua��•e►��.a Fan�.
<br /> _' • Conwnisdon i FF 22WQ0
<br /> �'+ �•� My Comm.E�rp Jnl 10,2011
<br />, �''�•����t�.�.
<br /> Qond�ddrau�NMlontl qodry Aan.
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