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9���'9���4� D���D ���'q'���'�9���: Yh�und�rsign�d und�rstands that this permit may be subject to"'deed" restrictions" <br /> w@�ich may be more restrictiv� than County regulations. Th� undersigned assum�s r�sponsibility f�or compliance wiih any <br /> applica,bl� deed restricfi�ns. ` <br /> ���.���i��f�� ��D�T6��C��A�� �P�� C�96��'��'��t8� ���f�OP��9�9fL6'V'I��: If the own�r ha� hir�d a �ontractor ou� <br /> conErac4c�rs �o underfia�ce uvark, th�:y may b� r�qu�r�d to b�licee�s�d ic� �ccord�nc�utri$h sta�e �r�d tac�! regu4a�Eions. lf�he <br /> contr�c��r is not licensed as r�quir�c9 by law, bc�th fhe own�r and contr�ctor may b� ciQed fo� a misdemea�ror violatuon <br /> �r�el�r �t�f� law. If tti� own�r oP 4e�k��d�d can�r�c�or ara� unce�tain as fica wha�Q 16c�r�sing rea�uor�menfs may apply far �h� <br /> int�nded work, th�y are advis�c�Q�� cantack the 6'�sco �ounty �¢�ildi�tg 8nsp�ctiot� Division--�icensing S�ctioe�.at 727-8�7- <br /> 80�9. Furkhermc�re, if the own�r h�s hired a, �antract�r ror �onkract�rs, h� i5 advised to h�ve the c�nQr�ctor(s) sagn <br /> p�r�i�ns of�he "��or�@�ac#or �la��z" of t7�is appEicattara far vuhi��i �h�y wil9 �Se respt�e�sibt�. if y�u, as fh� ov�rner sign as 4fi��. <br /> contr�c�or, khat may b� �n indication fhat he is not properly licens�d and is nn# entikled ta �ermitting privilec�es in F'asca <br /> C�urrty. ' <br /> �'G�6N11���D��'�1T���i 9����"Pd��'��.�'�9�� 661�[��1,��'��9� �����i��� I�{����(E�"��i���: T9��u�dersig��c4 unders�anc3s <br /> g�aat�'r�e�sportation 9mpact F��:s and Fdecaurse I��cov�ry F�es may a�ply to the construction of ne�w buildings, chang� of <br /> tas� in exisfing buildir�gs, or er.p�i�sia� of exi�tirr� buildir�gs, a� sp�ci��d i� Pasco County 4�rdinanc� rrurnb�r 8�-07 �nd <br /> �0-07, as �mend�ed. T'he und�PSigned also und��•stands, �hat such fe�s, as m�y b� due, will be adenkifi�d �� th� kim� af � <br /> ��rr�ni4ti��. @t Rs ft�rth�r ti�d��sf��d �t��t Trar�spo�f��io�n I�npact �ees ae�d-�esa�rce Ftecov�ry Fe�s mus� b� pai� prior to <br /> rec�iv6�g a "ce�fifica9� ofi occup��cy" or fi�al paw�r ��leas�. I$4h� pPOy��t do�s not involv� a �eH:ifcate ofi occupancy cir <br /> fi�t�l povi/eC P�le�Sej the fees tmus� b� paid prior fm permit 6ss�aanc�. �uPthermaee, e� �'ascc� County Wa�er/��wer lmpacQ <br /> fees are d�a+e, th�y mus@ be pai�i prior�o p�rmit is�tsance in�ccardanc�with�pplicable Pasco Ce�u�ty ardi�ar�ces. <br /> ���8��'�I��C�0��1 �.���9 �.G�1@�➢Q�9ro��n��P'�'030 �a¢�P6¢9�����aa�c��➢ �� ��a��o¢9�eB): If valuation �f wa�k is �2,500.00 or mor�, O <br /> ceraif}r that 1, fh� a�pticant, have b��r� pr�vid�d wi�h a co�y of the °Florida Gonstrucf6on l�i�e� Law—�om�ovune�'s <br /> Prop�c&io� Guid�" prep�red by th� Fiorida D�p�rtment of Agriculture and Consum�r Affairs. I�khe applicant is sorneone <br /> a�h��QQ�a,r� fihe"c�uvr�e�", I certify Qhat i hav�abtain�d a copy o€th�above d�sc�ib�d dacument and �arornis�in good f�i0h to` <br /> de�nv�r i�t�a the"ovvn�r" prior fio�ovnm�nc�ment. <br /> t��V���P���'��'�I�Fi199���'� G�fFB°➢�A��&�": I cerfify that all.the irifarm�4ion in �his applica4ion is accurate and that all work <br /> u�iii b� done in �or�ipl'sanc� wifh �11 applic�bi� tav+rs Pec�uiatirsg cansfruction, zonir�g and lanc9 ifev�laprm�nt, Applica#Eon is <br /> h�r�P�y m�de 40 obtain a p��mit to da woPk �nd install��ion as in�➢i��ted. I ��r�ify that na worOc or i�s�alla�ion'h�s <br /> c�rm�eric�d priar t� issuanc� �f a ��rmit �nd fhat ai! wark wil) b� perfarmed 4o m�ef standards o� att f�v�rs r�gulatinc� <br /> cons�ructicrn, County �nd City c�des, zc�ning r�g�ulaiions, �nd land devetopment regulation� in 4h� jurisdiction. 9� a�lso <br /> c�rQaiy th�t I und�rstand that th� r�g�latians of�flher g�vernment agen�i�s m�y appiy to #h� int�nd�d w�rfc, and that it is <br /> my r�spo�tsibi}ify�o id�nQify wh�f 7c#i�ns 9 m�st#��:�$c�be in complianc�. 5uch age�cies includ�b�at are�ot�imit�d fo: <br /> - Deparfinent of �nvoP�nm�npal �POk�ctio�n-Cypress �ayhea��s, VV�QI�nd Areas �nd �nvironmen��lly S�nsiliv� <br /> Land�,Ulfate�/Wa�t��ate�Tr�atr����. <br /> - Soufhwest Florida, ONater �/ianageUn�t�f D'istric�-W�IIs, Cypress �ay�eads, W�tland Ar�eas, AlYering _ <br /> W�s#�rcou�s�s. • <br /> - Arrr�y Corps of�ngir»ers-S�aw�lls, ��c8cs, Navig�ble Wat�rways. <br /> - Departm�nt of H�a1th�& R�habilita�ive �ervic�s/Environmental �4ealth lJnit-We91s, 1N�stewateP Tr�atm�nQ, <br /> S�pti�Tar�lcs. <br /> - US �nviranment�l P'Pntection P+ger��v-Asbestos abat�ment. <br /> - Federal Aviation�ufhorit�t-t�unvsrays. <br /> Y a��c6ePSf�nd th�k Qh�following r�:s�rictions apply f�fh�use c►f fi11:• <br /> - Us�of fil{is not all�vu�d in Fla�od Zon�"V"uraless expr�ssly pePmi�kec9. - - <br /> - lf th� fiN maferial as tc� be us�d i� F(aod Zon� "A", it 6s unders�ood that � dPainage p1�n acidressin� a <br /> "compensating volurri�" will be submitt�d at time of permatting which is prepared by � pu�ofessic�nal �ngine�r <br /> licertsed by fhe Sfate af�lorida. <br /> - If ihe fill material is #o b� used in �lood Zon� "R�" in conmectian with a permift�d building using sk�m wali � <br /> cor�stPUC2ior�, t c�rgify�hat fi!!wi!!b�u��d only fo-fili fh�ar�a within the st�m wa!!. � <br /> - If fill rnat�rial is �o tre �s�:d in �ny ar�a, t c�Ptify tha� tase of sucfi �H wiN a�at adv�rsely affect �djac��4 , <br /> prop�rti�s. If use of ffill is faund to adv�rsely �ffect adjac�nt properfi�s, Qhe awne�' may be cit�e9 for violaping <br /> #he condi@io�s of�h� build6ng p�rmit �ssu�d undec the atf�ched permifi �pplie�fioe�, f�r le�ts p�ss fh�n or�e ('4} <br /> acr�which are elevated by fill, a� �r�gineered drainage plan is r�quiPed. <br /> �f 1 am �he����T l�23��&�� ��9!'��(�, 1 pr�tnis� in good fiaith ta infor¢�i th�e�wnes�of the permi4ting conditiar�s s�t fort6� in <br /> @hi� a�fiid�vit prior to comm�ncing co�s#ructi�n. 1 under�tand that a s�para�� permi� may b� e�qcnr�d for �i�ctrical w�rlc, <br /> �E�rnbing, signs, w�lls, poals, a�i� cou�ditioning, gas, e�r other installat6ons �09 sp�ci�cally i�rcluded in th� applica,tion. � <br /> per�rtit issued shail b� constr��d Qo b� a lic�nse to p�'oc�ed with the vtrorlt ae�d r�a�as authority to_vioEat�, cancel, alg�s, or <br /> s���sid� �ny pravisians of fh�$�chnical cod�s, n�r sh�ll issuanc� of� permik pPev�nt�th� �uilding Official f�om th�reaft�r <br /> ��e�uiring �co�r�c4iort of erroP� irt pla�ts, c�r�str�cfior��c vio9a�ions af any cod�s. �ve�y.perr�it Issuec4 shall b���me invalid <br /> unl�ss fh� work authorized by such permit is con�m�nced wit7�in six rr��nths of��rrnif iss.uance, ��r if� work authc�rizecf by <br /> 4h� p�rmit is susper�d�d or abar�don�d fa�a p�riod of six��) m�nths afker fihe time the warlc is corr��n�nc�d. P+n �x4ension <br /> rnaa� be r�quest�d, an writing, fr�rn fFae �uii�ing Ctffii�iai for a p�;riod nr�� t� exceed n's�eQy (�0) d��s and will d�m�tnstra�� <br /> ��s�ifi�bl�cause for the extensia�n. tf wor{c��ases�e�r r►inely(90) cons�cutive days, fhe job is cans@dered ab�ndoned. <br /> �/A�,�R98�➢� TC� P,�V�Pf���: 1f��.Dff� f�d��d..�9�� '�'C➢ ��[�C��B� � N➢Q�1'BCf� �� ���11i1f�'�P9�f��dBf�V�'�' 6Uii�Y ���4��11" ➢V!� �'��4.DI� <br /> [��a���14�"��C���������4P1��f��@`�'�1T�r 1���P���C��'��YYI, Q�'�t'�8� 1�9`�E��D Y� O�1��96� ��Gf�e��CQ�l4.�, c�Q��9��91L�f <br /> �9�'9°I��(Q��D� �,��8�������&G�1fT�(��(�����FQ��� ���0(�Q➢6�9��f"��D���'�8���}����ii1i�fi(��d�(��id�(�'�'. <br /> FLORIDA JURAT{F.S, 117.03) � <br /> �Ut9h��6t��Y�,G�.P�Y ��6�T9�CY�9��"�t - f,.��x,.;� [:1�` • . <br /> Subscribed and swarn to(or affirmed�bePore me lhls S scr' ed and swor or afBrmed)be <br /> by � Y. , <br /> Who is/are personally knawn to me or has/have produced o Is are persanally knowrt o rrte or haslhave pro ce <br /> as idenklficalion. as identific:ation. <br /> Rtotary Public ��f�/'�� �9otary Pubtic <br /> Commisslan iVo. C Issi n No. ""v'a""� <br /> ,_'" ... ....'".: <br /> " `'� M`F.GOMMiS5IC1tJ#FF14AE17 <br /> Name of PJotary fypecl,printed or starrnped Name of hlotary Qyped, ri•,,� , �m��R�S July 24, 2CN 8 <br /> � „OF/4�... � <br /> (9�7}398�4153 F1orldaNateryServlce•com <br />