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f�07'IC� OF �fE�D R�SYRICY90�9�: The undersigned understands that this permit may be subject to"deed" restrictions"
<br /> which may be more restrictive than County regulations. 7he undersigned assumes responsibility for compliance with any
<br /> applicable deed restrictions.
<br /> 11P�LIGfERlSfE� COPd'�RAC70�� �R1D COR��'�1�'P�� f�f���O�I�I��LI'�V��: 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 regulafions. 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 contractor are uncertain as to what licensing requirements may apply for the
<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 which Qhey will be responsible. If you, as the owner sign as the
<br /> contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
<br /> County. �
<br /> 7�R9����Y�"TIOR� I�HP�C�11J�'IL9YIf�� ofl��A��f l�Rl� ���OUf�Cf� ��C��d��Y����: 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 I�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 power release. 6f 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 Water/Sewer Impact
<br /> fees are due, they must be paid prior to permit issuance in accordance with applicable F'asco County ordinances.
<br /> �ON�76�UCYiOP1 L.II�Fd L�1�(Cha���r 7'9�, f�l�ead� ��a��u���o a� �erti�e�d��): If valuation of work is $2,500.00 or more, I
<br /> certify 9hat I, the .applicant, have been provided vvith a copy of the "Florida Construction Lien Law—Homeo�nrner'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"ovvner" prior to commencement.
<br /> COf�T�d��T09�'SIOl4i9�R1��'� l��'�tl�l�i/I�: I certify that all fhe information in qhis application is accurate and that all work
<br /> �ill be done in compliance with all applicable laws regulating construction, zoning and land development. Application is
<br /> hereby made to obtain a permit Yo do work and installation as indicated. i cerfify that no work or installation has
<br /> commenced prior to issuance of a permit and that all work vuill be performed to meet standards of all laws regulating
<br /> construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. 6 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, VVetland Areas and Environmentally Sensitive
<br /> Lands, VlfaterNVaste�nrater Treatmenf.
<br /> - Southvvest Florida Water il�anagement District-Wells, Cypress Bayheads, Wetland Areas, Altering
<br /> Watercourses.
<br /> - prmy Corps of Engineers-Seawalls, Docks, iVavigable 11Vaferways.
<br /> - Department of Health � Rehabilitative Services/Environmental Health Unit-Wells, Vllastewater TreatmenF,
<br /> Septic Tanks.
<br /> - US Environmental Pro4ection Agency-Asbestos abatement.
<br /> - Federal Aviation Authority-Runways.
<br /> I understand fhat the following restrictions apply to fhe use of fill: ,
<br /> - Use of fill is not allowed in Flood Zone"V"unless expressly permitted.
<br /> - If the fill material is to be used in Flood Zone ",�", if is understood that a drainage plan addressing a
<br /> "compensating volume" will be submitted at fime of permitting vvhich is prepared by a professional engineer
<br /> licensed by the State of Florida.
<br /> - If the fill material is to be used in Flood Zone "A" in conneciion with a permifted building using stem uvall
<br /> construcfion, I certify that fill will be used only fo fill the area within the stem vvall.
<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 issued under fhe attached permit application, for Iots less than one (1)
<br /> acre vvhich are elevated by fill, an engineered drainage plan is required.
<br /> If I am the AC�IER9Y �OR 7FIIE Oliiil�i��, 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 4hat a separate permit may be required for electrical vuork,
<br /> plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
<br /> permi4 issued shall be construed to be a license 4o proceed vuiQh the �vork 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 permif 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 /> fhe permit is suspended or abandoned for a period of six(6) months after the time the work is commenced. Nn 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 /> �l�+�tRll�� �'O 04Alf��f�: YOIJ� IF�YLU�� �O I���C��� � R9�YIC� �� ��WiA�E�IC��fl�WT ��V ��SIDLT O�E Y0�3&2
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<br /> lfi�a�'�9 YO�� �f�NDiE�t OfFf�6V �1fYO�NO�Y �����I� ��CO�f�Y�9�lf�ll�f Y�9��fICf� �I�C�flH�ifE6�CI��N��Y.
<br /> FLORIDA JURAT(F S. 117 03)
<br /> OWlPlER O�t AGEW7' /� .���b COYVY�ACYOR� �-�i '
<br /> Subscribe and sworn to(or�ffrmed)before me this Subscri ed and sworn to(or a i d) fofe me this
<br /> 23�� by �;•� !�� � 2�3 �s�by-��-���i (M r.-.ti�
<br /> Who is/are personallv k�o has/have produced Who is are per�onal�y known to me or h�as/have produced �
<br /> as ldentffication. as identification.
<br /> l./Y 1.��'-�X�` 1��� Notary Public � � � Notary Public
<br /> Commission PJo. �'�v �3�04 / Commission No. � r����
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<br /> ..,,.,,.,.,. �:
<br /> Name o(Not ry:� ;.:�i'�nte e Name of Notary p,e�i'. �:. o�� gROOK�
<br /> _• ' !'= MYCOMMISSIQN#FF09:�6�� � ;� `��
<br /> : P; :-� oP: MY COMMISSION#FF093699
<br /> 'N"�� °` EXPIRES Februarv 18 2���3 i �:
<br /> ;�igoF�o?,' � --.',�'oFF:oP:� EXPIRES February 18 201A
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<br /> (407)398-0153 FlorldallotaryService.com (a07)398-0153 FlorfdallotaryService.com
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