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P10'TiCE Of� �EED ����'�OCYOOR��: The undersigned understands that this permit may be subject to"deed" restrictions"
<br /> vvhich may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
<br /> applicable deed restrictions.
<br /> lDP9LIC�NSED COB�7�ACYOR� �R9f� COR9Y�1���� ���P�O��86�ILIYGL��: If the ovvner has hired a contractor or
<br /> contractors to undertake work, they may be required to be licensed in accordance writh state and local regulations. If the
<br /> contractor is not licensed as required by law, both the ovuner and contractor may be cited for a misdemeanor violation
<br /> under state law. If the owner or intended confractor are uncertain as 4o what licensing requirements may appty for fihe
<br /> intended work, they are advised to contact the Pasco County �uilding Inspection Division—Licensing Section at 727-847-
<br /> 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
<br /> portions of the "contractor Block" of this application for vuhich 4hey �nrill be responsible. If you, as the owner sign as the
<br /> contractor, that may be an indication that he is nof properly licensed and is not entitled to permitting privileges in Pasco
<br /> County.
<br /> '��f��PO�Y'�TIOR9 Ofi�l��C'�lU�'ILB'�If�� ���/��'�'�f�� ���OU�Cf� ��COi/��lf����: 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 ofi existing buildings, as specified in �asco 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 Transportation Impact Fees and Resource Recovery Fees must be paid prior to
<br /> receiving a "certificate of occupancy" or final pouver release. If the project does not involve a certificate of occupancy or
<br /> final power release, fhe fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
<br /> fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
<br /> C0�9S7�d�C710�9 L.OI�R9 L.�►@�(Cha�4�r 7�93, IFlc�rri����a���uQ��, �� �e���e���): If valuation of work is $2,500.00 or more, I
<br /> certify that I, the applicanf, have been provided with a copy of the "Florida Construction Lien Law—HomeovNner'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 /> COGdT42k�CYOF�'S101iN�1��'S �►��I�k�VI�': I certify that all the information in this application is accurate and that all work
<br /> yvill be done in compliance with all applicable lavus regulating 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 perforrried to meet standards of all laws regulating
<br /> consfruction, County and City codes, zoning regulations, and land development regulations in fhe 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 v�rhaf actions I must take fo be in compliance. Such agencies include buf are not limited to:
<br /> - Department of Environmental protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br /> Lands, lnlaterNVasteuvater Treatmenf.
<br /> - Southwest Florida Water Nlanagement District-Wells, Cypress �ayheads, V1letland Areas, Altering
<br /> Watercourses.
<br /> - Army Corps of Engineers-Seawalls, Docks, Navigable Watenrvays.
<br /> - Department of Health � Rehabilitative Services/Environmental Health Unit-VNells, VVastewater Treatment,
<br /> Septic Tanks. -
<br /> - US Environmen4al Protection Agency-Asbestos abatement.
<br /> - Federal Aviation Authority-Runways.
<br /> I understand that the�ollowing restrictions apply to the use of fill:�
<br /> - Use of fill is not allowed in Flood Zone"V" unless expressly permitfed.
<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 submitted at time of permitting vvhich is prepared by a professional engineer
<br /> licensed by the Stafe of Florida.
<br /> - If the fill material is to be used in Flood Zone "A" in connecfion �nrith a permifted building using stem vvall
<br /> construction, I certify that fill will be used only to fill the area within the stem wall.
<br /> - If fill maferial 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 issued under the attached permit application, for lofs less than one (1)
<br /> acre which are elevated by fill, an engineered drainage plan is required.
<br /> If I am the ACI�RIT ��R TC�� Olf�9�f�7�, I promise in good faith to inform the owner of the permitting conditions set forth in
<br /> this affidavit prior to commencing construction. 0 understand fhat a separate permit may be required for electrical vuork,
<br /> plumbing, signs, vvells, pools, air conditioning, gas, or other installations nol 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 Official from thereafter
<br /> requiring a correction of errors in plans, construction 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 for ninety(90)consecutive days, the job is considered abandoned.
<br /> �,
<br /> �ild�RAll�d� T'O Ol�IRlIEf�: YOl1� ��+ILl1�� �f0 �Y����D � YV�YIC� Of� C�M�fiEYVCE�ifl�NIT i�i�V �f�SIDLT I�I YOtJR
<br /> ��VIfV� �fiIIGE �O� Il�if�@ZO!/f�i�il�Yl9�� �'O Y0991F� ��OV�E��. IF YOU &�BVfEYVID TO O�Y�lIFI �IPIP►iVC0F1G, C�R9�111L�
<br />� Vil17H Y�ll� L�fd��cR O�Z�i�c�YYO(FtN1�Y�f��O�l� �Y��C��I�IR9G lf(D�1�3 R90�ICf�Of� CONiiiii�f�V�CIEYY�VdI�P1Y.
<br /> FLORIDA JURAT(F.S. 117.03)
<br /> OIfiINE�t OR AGEWT � COW7'�tACYOR��� �
<br /> Su scribed and sworn o;(�r ffrmed before me this Subsp ribed and sworn to(or �rmed)before me this
<br /> 29/iS by �i��U l'yl i rt?S s!�9lrS by ��r-�h.� {Nl► m S
<br /> Who is/are personally known t _or has/have oroduced Who Is/are personallv known to me o has/have produced
<br /> as identification. as identification.
<br /> Notary Public Notary Public
<br /> Commission No. �Ur g 3 L 9°1 Commission No. b�i'3�� Qi
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<br /> woo•aoiNag/ue3oNep, 1� „ :�04�YPUel�'; /VANCY J �ROOKS
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<br /> 2. �••.",2�`••-�-oP�� EXPIRES February 18.2018
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<br /> s�ooae rA�rvdN --...Bna�d'°,,.;' (407)398-0153 FloridallotaryService.com
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