|
. ;
<br /> �
<br /> �
<br /> NOTlCE OF DEED RLSTRICTlONS: The undersigned understands that this permit m y b�'i subJect to"de�ed°r�strictions"
<br /> which may be more restrictfve than Cvunty r.egulations. The undersignedlassumes ce �►an�ai6iiity far compii��nee with any
<br /> applicable deed res#ric#(ons. '
<br /> UNLiCENSED CONTF2ACTORS AND CONTRACTOR RESPC}NSIBILITIE�>: if the owti�er has hlred a contractor or
<br /> contractors fo undertak�wark, they may be requlred ta be Ilcensed in accordance wlt sta�e and lacal regulations. If tha
<br /> contractor 4s not Ifcensed as requlred by law, bo#h the owner and contracta• may be rlke� for a misderne�nar violatlon
<br /> under state law. !f th� owner ar lntended contractar are uncerta(n as to;wh�at Iicensl ra re�quirem�nts may apply for th�
<br /> intended work, they are advised to contact khe Pasca Counfy Bullding inspection Divisi�n--El.icensing See:tion at 727-847••
<br /> 8009, Furthermore, (f the awner has h(red a confrac#or or contractors�, he► is advi �d t�o have the ctyntractor(s} sign
<br /> portions of the °contractor 81ock" of fhis applicatian far whfch they will be re:apansEble� !f ou, as the oUJne3r slgn as the
<br /> contractor, that may be an indiaation that he is not praperiy ilcensed an��is t�ot entltl c! to�permltking pritirlleges !n Pascc,
<br /> County, � ' `
<br /> �
<br /> TRANaPORTA"TlQN IMPACT/UTlLITIES lMPACT AND RESOURCE RE,COWERY FE ;S; �The undersigriecl undersfands
<br /> that Transporkatlon Impact Feea and Recourse Recovery Fees may apply, to �he consf �acti�n of new bui(ciings, change of
<br /> use in exfsting bufldings, or expansion of existing buiid(ngs, as specifled;in F�asco Co nfy;4rdinanee number 89-07 and
<br /> 9o-p7, as amended, The unders(gned aiso understands, that such fees,j as may be �ae, �rlll be ldentifif�d at fihe tim� of
<br /> permit#ing. it is fu�ther �nderstood that Transpoetat3an impact Fee:� and IRe�►ource R s;ov�ry Fees must bF� p�id p�lor ti�
<br /> receiving a "certiflcafe af acaupancy" ar final power reEease. 1f the pro�ect dc�es not I volve a cer#(flcate of occupancy or
<br /> finai power release, the fees must be pald prlor ta permlt fssuance, �ur�thermore, If asc'o County Wat�srlSewer lmpact
<br /> fees are due, they rnus#be p.aid prfar to permit(ssuanca In accordance�with a��plicable asc;o County ordinanees,
<br /> GONSTRUC'f10N I,IEN�LAW(Chapter 713, Flortda Statutes, as arnendedy. (f valu tlon�of wnrk(s $2,4�00.00 or more, I
<br /> certify that i, the applicant, have been provided wifh a copy of the �F(orida Con�trucition Lfen Law—Homeown�r'�
<br /> Pro#ection Guide" prepared by the Florida Department af Agriculture and Consumer f�air;s, if the appli�,ar�t I� someon�
<br /> other fhan the uowner", i certify that i have obta€ned a capy of the abave descr(bed do um�nt and prornlss} En gt�od faith to
<br /> deiiver it to the"owner"prior to commencement. , �
<br /> CQN'fRACTOR'S1�WNER'S�►FFlDAVI7: 1 eer#Ify that all the informatio� in this appl c.atic�n is accurate ,anr� that a!I worl<
<br /> wlll be done !n complfance with all applicable laws regulating construction, zoning an lar�d develapment. Applicat(an i�
<br /> hereby made ta obtain a permit to do work and fnsfallat(on as (nd(cated, I cert( that no work or insfallation haa
<br /> commenced prlor ta issuance af a permit and that ali work wili b�� performed to m��t s'tandards of aH laws reguiating
<br /> constructian, Caunfy and City oodes, zoning regulatians, and land deveiaF�ment re uiat�ans In the jurlsdictian. i aisn
<br /> certify thaf i tanderstand that the regulations of ottier gavernment agencies may apply t� #I�e finterided wC�rk, and that 1t is
<br /> my responsibllity ta Identffy what actions I must take to be In compl!<<nce, �Sur,h agenc! ;� fr�elude but are not Iimiked to:
<br /> - Department of Enviranmental Prote�tlon-Cypress Bayheads, UVekland A,eas�and Environm�enl;ally Sensltiv�:
<br /> Lands, WaterlWastewater Treatment. � �
<br /> - 8outhwest Florida Water Management Distr(ct-Wells, �ypress Ba hea�s, Wefland Araa�, Alterinc�
<br /> Watercourses. �
<br /> - Army Carps af Engineers•Seawalis, Docks, Naviga6le UVateruvay3�, �
<br /> - Department af Heaith & Rehabllitative ServlceslEnvlronmentaE Heafth �nit,/VeHs, WaSteuvat�r Treatment,
<br /> Septic Tanks. ; i
<br /> - US Environmental Pro#ection Agency-Asbestos abatement. ' I
<br /> Federal Avfatlon Aukhorlry-Runways. � �
<br /> I understand khaf the faliowing restrlct(ons apply to fhe use of fiil:� i � `
<br /> - Use of fill (s not allowed in Flood Zone"V"unless axpressly permit#ed. `
<br /> - If the fill material is fa be used In Fioad Zane "A", it is urtderstood ��tt�t 'a dra(nage pE<�n addressing �
<br /> "compensa�ing vaEume" wi(E be subm�tted at tlme of permfttlrig vrhlGh �s prep�red by a prafess�ona) engineer
<br /> ficensed by the State of Florlda,
<br /> - !f th� flll materlal Is to be used (n Flood Zone "A" !n connectic►n wfth a �ermitted building using stem wall
<br /> construction, I certify that fill will be used only to fill the��rea with(n the ste w�ll.
<br /> - , If flll material Is to be used (n any area, I cerfify that use oi` such flii wil( not adverseiy a��fect adjacent
<br /> properties, 1f use af flll is found to adversely affect adJacent;prcrperkies, t�Q mwner may be eifed for violatlnq:
<br /> the condlfions of the buiiding perm3t issued under the attacfied permEt a�plic�t(on, far lots ltsss than one (1}
<br /> acre whlch ara elevated by flil, an engineered dra(nage glan !s required. '
<br /> If I am the AGENY FOR THE �WNER, I promise in goad faith to inform t�e �owner of th� ���ermltting eanditlons set forth in
<br /> this affidavik prlor ta commenc(ng construction. I understand that a sep�rafe permft�i�y�be requlred for electrical work,
<br /> plumbing, signs, wells, pools, air conditioning, gas, or ofher InsEa(iations nof specifi a11yi inciuded in thf� applir,ation. f�
<br /> permit issued shatl be construed ta be a I(cense to procead with the work and nof as <�utF�ority ta,violate, c�mcel, alfer, or
<br /> set aside any pro�isions af the techniaai cades, nar shaN issuance of a p�rmit preven the�BulEdlrig Oft�cf��!fr�om thereafter
<br /> requiring a correctian af errors In plans, construc#ion ar violatfans of any eod�s. Eve pet;mft lssued�shall become invali�
<br /> uniess the work au#horfzed by such permit Is commenced wlthin s!x monthe, of perm�t lss;uance, or !f work auihorized by
<br /> the permlk#s suspended ar abandaned far a perlod of six(8) months after th�� time the wor�k Is cammenced, An extension
<br /> may be requested, in writing, fram the Building.Official for a per(od no# to exceed nlriety i(90) days and wIl! dPmonsfratE�
<br /> )ustifiable cause for the exfenslan. if work ceases for ninefy(90)consecu{iv�days, #h J��b;is considered �Mb�mdaned.
<br /> �
<br /> WARNING TO OWNER; YOi7R FAILURE TQ RECQRD 1� NOTfCE Q� {;dMM�Nt�i�11!lENT NlAY RESl�LT !N YQUFt
<br /> PAYING TWlCE FC?R IMF?RCIV�MEN7S 70 YQUR PR04�ERTY. OF YQU If+lTEND TC� 4?1�3TAlN FlNANClN�G, CONSUL'Y
<br /> Wli'�YO.UR I:ENDER i�t�AN AT'['QRNEY B�FOR��ktI���RDIN(�YOU�Ft'!d0 �TI�CE �,�OE1rddMENC�MEN1_- --- -- -- ---- -
<br /> FLOFtIDA JURAT{F.S, 117.03) � ,� i !
<br /> 3 -�,�� �
<br /> OWNE42 QR AGEN3' CONTRACTQR � _5��n� I � ► l
<br /> SubsGrlbad a�b�worn to(or afflrmed)befora me this Subscrlbed and s rn ta(or affirme�)be�bre me thls . `�
<br /> Who isiare personalfy known to me or has!#�avs produced Who 4s/ar ersona � nown ta me br ha,�lhave produced
<br /> as Identlflcadan, _,T�,�s Ident(fication�
<br /> i �
<br /> I �
<br /> I �
<br /> _ . Natary Public _Notary Pub11e
<br /> Commisslon No. Co Isslon o. ' �
<br /> 1rYAr�11 I��1��1�
<br /> 4Z`5 �8 18 M1&tIi ,(8 T��`R6P� ,�.�11�t� .��.
<br /> ;8101'z6�aqwe� �sa�idx3 :>:° �;
<br /> Name of Notary typed,printed or stamped Name of Notary ed, ���, �:�. �;
<br /> , ,a,�a A�;,,.
<br /> � j i
<br />
|