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<br /> �IOTiCE OF �E�D RESTRICTIONS: The undersi ned under�tands�.that this. rmit.ma be,sub ect to"deed"restrtctlons"
<br /> 9 P� Y 1
<br /> vuhich rr��y be:more r.estrlctive th�n Coun�r�gulat(ons. �7he unders�gned assurri�� responsib911�for compliance with any
<br /> applicable d��d reshict(ons. �
<br /> tJNLIC�N�ED CONTRAC�ORS AND CONYRACTOR R�SPOiV�9�ILITIES: If th� own�r has hired � contr�ctor or
<br /> contractors to undertake work, th�y may be requlred.to be Itcensed in accordanc�:with sQate.and•local regula4lons. If the
<br /> contractor is not Hcensed �s requlred�by law, both�the o�wner and �onUactor may b�,ctQed�for a rnisdemeanor violatton
<br />� under state laa►. If the owner or int�nded�contractor��re uncertain �s to what I�cens9ng.requUem�nts may apply�or the
<br /> intended work, they are advised to contact 4he Pasco County Buildlr�g Inspection Divlslon—LEcen§ing Section at 727-647-
<br /> 8009: Furthermore, If the owner has hired a,conwactor or contractors, he is advised to hav� th� -contractor(s) sign
<br /> portions of the "�ntractor �lock" of this application foP wrhich they u�ill be responslble. If you� �s.the owner sign as the
<br /> con4ractor, th�t may be an indication tha,@ he is not.properly Iicerased ano1 9s not en8tl�d to p�rre�ftting privileges in Pasco
<br /> Cound�. -- --
<br /> TRAIdSPORTATION IIVIRACTfUTII�.ITIES�INIPAC7 ANI�RESOUitCE'RECOVERY•FEES: The undersigned understands
<br /> that Transport�tfon Impact Fe�s:and.Reco.urs� Reeov�cyr.Fees may.'�apply to°the constructlon of new buildings, change of
<br /> use in �nisting build(ngs, or expansion�of�,e�ii�tiri,g.build9ngs, �s spec�fled.iro Pa�co County Ordlnance.number �9-07,and
<br /> g0-07, as am�nd�d. The undersigned �Iso understands, that:such fees�.as=may�be�dne,..wlll:b��identified a4 the time of
<br /> �ermitting. It is further understood that Transpor4ation Impact Fees-an.d Resource Recovery=Fe�s must be paid�prlor to
<br /> receiving a "c�rt9�cate of accupancy" or f�nal powier r�lease. :If the �roject.doe� not Involve a certificate of occupancy or
<br /> fnal power reB��se, #he,fees must b� paid prior to perenit I�suance. Fu�thermore� if:Pasco County UVater/Sewer Impact
<br /> �e�s are due, tC�ey�must be-p�ald prior to p�rr�tit�Essuance�ln accordarac�with appllcable Pasco�County ordinances.
<br /> C�tdSTRiICTYON LIEN LJ�9N(Chapter T13� Fl�r�da St�tut���as a[r�ended); If b�luation of work is$2,500.00 or rr�or�, I
<br /> certify that I, �h� applicant, have-been provided wtth a� copy� of the�"Florida Const�ctfon Lten Law—iiomeowner's
<br /> PPOtection GuO�e" prep�red:by,the FlQrida Dep��tcraeret of.•Agrlc.ultur� and Consutner�A►ifairs.•sif�the,ap�licant is someone
<br /> other than Qh�"owe��r"; I�certify�t(�at B tiave.otit�itned'a copy;of.the abov�.d�s.cr�b�d�docur�enf°and.pro�0�e_In,g.o`od faith to
<br /> de0iver It to the"ovune�'prio�to•commencement.
<br /> CONTFtds►CTO�t°�/OV19N�R'�AFFIDAVIT: I ce�tify th�t ail the Infoemat�oh:'ir�4hls.a�pi�Catfon is accurate`�i�d that�II work
<br />� �ill�be done in corripliance with al! appiicable laws r�gulating construction, zoning and land development. Application is
<br /> hereby made to obtatn .a permit #o do vvo�k.�nd ins#�IlatEon as indicafed. 1 c��ttfy that no work or Installa#{on has
<br /> commenced pPior to issuance of a perm6t and that.ail work avili be p�rtormed to m�eQ standards of all laws regulating�
<br />� construction, County and City codes, zoning regulatlo.ns, and lan� d�velopment regulations in the jurisd�ction. ( also
<br /> certify�that I uaaderstand lhat the r�gul�tions of other gov�rnment a�encies may�apply�to the int�nded work, and fhat it is
<br /> �y responsibil6t�v to identEfy.what.act(ons I must take:to be,ln:.cotrlpila€�ce. S.uch ag�ncles.include but are..not Ifre�it�d to:
<br />' - Department of Env(ronmenta9 Protection-Cypress.Bayheads, 1lVetland Areas and ErnfronmentalBy Sensittve
<br /> Lands, Water/Wastewater YreaQment.
<br /> - Southwest Fiorada Water (Wanagement .DtstNct-llVellso Cypress. B�y.heads°, 4N�tland Areas, AlQering
<br /> Wat�rcourses.
<br /> - Arrny Corps of Engineers=Seawrall�, Docks, Navlgatile lNa,teeways.
<br /> - D�partment og Flealth� � Rehabilitative Services/Envirmnrraen�al Health lJnit-Well.s� INast�wtater Treatment,
<br /> Septic Tank�. �
<br /> - US Envaronmental Protectlon Agency-Asbestos abat�menQ.
<br /> - F�d�ral Avlatlon Authortty-Runvvays.
<br /> I understand thaB the following,restrictlons apply to the use of flll:•
<br /> - Use of fill is not�Ilowed in Flood Zone"V�unless expressly permitted.
<br /> - if Qh� flll materlal (s to be used in �Flood Zone "A°, IQ: is understood that a dr�inage plan addressing a
<br /> "compensating volume" wilE be �ubmitted at tlme of pemoitt(qg w6ich is p�epared by a profess(on�l �ngineer
<br /> lic�nsed by the State of Florlda.
<br /> - tf the fill mat�ria9 fs.to,be used In Flood Zon� "A" (n�connec�(on�wlt6�.a permitted building using stem wall
<br /> construction, I ce�tify tkiat-�ill,:wliB:b.e used only.to#iil th�a�rea uwtthin the�st�m•dvall.
<br /> - If fiill material is to b�• used in any area, I certify th�� use. o� �uch flll will not adverseiy affect adjacent
<br /> properties. If us� of fl11 Is fou�d to adversely:affect adJae�nt��prope�lies,.the owner r�ay be clted for viofating
<br /> th� condi�ions of the b�tlding.perm(t issued under 4he.a�Q�ched p�rmit appl(cation, for lots less than.one (1)
<br /> acre wh0ch are elevated�by flll,an engin�ered draB�age plan I�required. .
<br /> If B am the AG�NT FOR TH�OIflINER, I,�promise In good faith to Inform#he owner of the permitting conditlons s�t forth tn
<br /> thi� affidavit�prGor to commencing construction. I under�tand.thet a�separat� permPt may be requtred for eiectr�cal work,
<br /> plumbing, signs, vvell�, pools;_ alr condit(oning,.gas, vr other insta�llatlons noE•spec�flcally included-on.the applicatton. .A
<br /> p�rmit issued shall be constra�ed to be•a�lic�nse to proceed wiQh th�'�irork and nvt as:�uthorlt�to,violatea�cencel, alQer, or
<br /> set asid�any �rovisions �th�technical c,�des;:noP shall Issuance�of a.peemit.prevent ttte Bulldi�ig Oiflclal from thereafter
<br /> r�quir6ng a correction af�e�ors In�.plans, construct0on or violatlons of�ny codes. Eveey permit Is�ued�shail become invalid
<br /> unl�s� the worBc �uthorizedr,by.:.su.ch permit:�is-co�rraenc�d:irvithin s�X t�onths of permlt Issuance, or if work authorized by
<br /> the permtt ts s�spended or.abandoned fof a:perfod of�si�(6)montf�s.-�ft�r the#ime.th��uvork��is-cornmenced. An extension
<br /> may be requ�sted, In wciting, from the Building,Officlal for a perlod aaot•to.exceed nin�ty�(90) days and will demonstrate
<br /> justl�iabs�cause�or.the extensior�. If worEc c�ases:for n(n�ty(90)cans.ecutive:day.s�..th�Job 9s.considered aba�doned.
<br /> Wda1RNING TO OWNER: YOUR.FAIL:URE,T�.,R�EC.ORD.:,A MATIC� O�-COMM�NCEWIEMT.�IIIAY �tESULT IN YOUR
<br /> 4�r�YliVG TIRIIC�.1=0�'t�lMPOtOVENOENTS 1'�:.YOUR.PR�P�RTI(-.:IF�V0.9J�IN'�END�"T��=O�TAIN��IFtAt�C11dG;'CONSULT
<br /> WIIT UR D O: Ald TTORN ��� FO. ��, COR�F7 �:� . :V � , ;C :O ',.� . E .@
<br /> FLORIDA JURA�(F.�.1.1 �
<br /> OW�NER OR AC3E6dT CONTftAC'iOR
<br /> 5ubscribed and awom to(or tArmed);b�fore m�this Subscribed and'swsom to(or affirmedpbefore me'ttii�
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<br /> Who is/are, o novm to.me.or hashi�ve producad Who ls/�re ona hnown�to me•orhas/have�produced •
<br /> es IdentlAcatlon, as tdentlflcatlon.
<br /> ,.� �� �, ,
<br /> ��� ^ otery Public . ^� �� Notary Publlc
<br /> Commis fo o. ' ° � � � � Comml��lo o. ,Y p�
<br /> ,,�,tia"��:8'�'��R��1ELI�}E�BOGES �:� ��" Commission#FF•150422
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<br /> Name at Nolery. ' d _ Nam�oi Notary d;. r`o�� �
<br /> •o: xpires ecember 12,2018 '�"�' • FeininsuranceB00.385�7019:
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<br /> '�%i P�F�°�`��` Bonded Thru Troy Fzin Insurance B00-JBS-7019 �
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