|
.. 1 :r. , , 1�` ,� .r ,... ' . Ir� ' . �
<br /> { �t���> ' � •
<br /> � . . . 3
<br /> I
<br /> NQTICE QP DEEQ RES RIGTIG?NS: The understgned understands that this p�rmit may be subject to°deed°f@Stf'lCtEOC15°
<br /> whlch may be more resfi�ctive th�n Co�a'nty regulations: The under'sig�ed assumes responsibility for cvmpliance vi►itii any'
<br /> appliaabie deed restricho�s. ! �
<br /> UNLICENSED C�3NT GTQR$ AND CONTRACTCIR RESPONSiB1LITiES: lf fhe owner has hired a conftacfor or
<br /> confraat+ars to andertakp�artc.fhey may be required to be iicensed in accordance with state and local reguiatfions. tf the
<br /> contractor is nat Ilcense�l as re�uired by law, both the owner and contracEor may be cited #or a mtsdemeanot vtolatfon
<br /> under state law. !f the 'wner qr intended contractor are uncertain as to whak licensing requrrements may apply fer the
<br /> intended work, they are�dvisedi to contact the Pasco Counfy Building Inspection Division—Licensing Section at 72?-847- �
<br /> 8009. Furfhermore, if fhe awner has hired a confracfor or confractors, he is advised fo have #he conhactar(s) sign
<br /> portions of fhe "aon#ract�r Biock° of this applicafion for whreh they wiif be responsible. #f you, as the awner sign as the-
<br /> confracfar;�that:may be an indicafian that he is tlot{iroperfy ticensed and is not en#ifled #v permitfing privileges in Pasco
<br /> County. � � • . i
<br /> TRANSPORTATlON IM AGTIUTIUTIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands �
<br /> that Transporkatian Imp�t•Fee�and Recourse Recovery Fees may appty to fhe construction of neW buildings, change of
<br /> use in exisEing buildmgs or expansion of exisfing buitdings, as specified in Pasco Caunty Ordinance number 89-07 and .
<br /> 90-07, as amenti�d. T�e undersigned also understands, that such fees, as may be.due, witl be identifred at the f#me of
<br /> permifting. It is fur#her nder�toad #hat Transportation #mp�ct Fees and Resaurce Recovery Fees must be'pald priorto �
<br /> receiving � °cerEifcate of occupancy" ar ftnal power release. If fhe project does not invalve a certiflcate af occupancy vr
<br /> fina! pawer�elease, the�fees,must be paid prior to permit issuance. Furthermore, if Pasco County WateNSewer Impact
<br /> fees are due,they must be paid prior fa perinit issuance in accardance wifh appiicabie Pasco Counfy ordinances: •
<br /> GUNSTRUCTION L.tEN LAW{Chapter Ti3,Florida Sfatntes,as arn�nded}; tf vaivatlon of vuork is$2,500.Q0 or m�te, i
<br /> certify that i, #he appii ant, h�ve been pravided wifh•a copy of ths °Florida Canstructlon Lien Law—Homeowner's
<br /> Protectian Guitle" prep red by the Flarida DeparEment af Agriculture and.Consumer Affairs. !f the applicant is someane
<br /> other�than the°otr+iner°, �cettify�#hat•l.have obtained a copy af the above described document and promise in good'faith ta
<br /> deliver it to the"owner" rror to aommencement. � � ' .
<br /> CONTRACTOR'SIt�W ER'S AFFIDAVIT: I certif'jr fhat alt fhe informafion in this appiicafion is accurate and that all work
<br /> wilt be done in comptia ce with all applicabte iaws regutafing consfruc#ion, zaning and iand-deveiopment. Application is
<br /> hereby made to obtair� a per�»if #o dv warEc and instatlatfon as irtdicated. 1 ceetifjr that no vfrork or instatlatian has
<br /> commenced prior to �ssuance(of a petzn9k and #hat all wark wili be petFor.med to meet standards of a!! laws regulaf(ng
<br /> const�uckion, Caun#y a�d City;codes, zoning regulafions, and land development regulations in the Jurisdiction. I ai"so '
<br /> certify that 1 t�nderstan�that tFie regulafions of ofher governmenf agencies may apply to the infendecf work, and fhaf iE is
<br /> my responsibitiry fo idenIfify whaE ac#ions I must#ake�to�be:trr carrrpiiance. Such agencies inctude.�uf are nofi limited fo:
<br /> - Department af Environmer�tai Profection-Cypress BayFieads, Vlfetiand Areas and Erivironmentai(y Senstfive •
<br /> L�nds,VI/a�erNilastewater Treatment: , . '
<br /> - Southwest�.Florida Vlfater: Managernent District Wells, `Gypress Bayheads, Wetland Areas, AlEering
<br /> Wat�;rcour�es. i " � - ,
<br /> � - • Army•Corps af.Engineers-Seawalts�Dacks,��lavigabie IiVaferways.
<br /> - Departmer�t af Heaith &`�Refialii(ifative Servic�slErivira�mentat Nealfh Unit W�fts,..Wastewater Trea#ment.
<br /> Septic Tan�CS. � � . �
<br /> - US�Env[roi�mental��!'rotect�on Agency-Asbestos abatement.
<br /> - Fede�al A�iation Authorify-Runways. �
<br /> 1 understand that the foliowing�restrictions apply to fhe.use af fill: �
<br /> - Use of flfl is not allowecl in Ftood Zane"V"uniess expressiy permitted: "
<br /> - tf fhe fi11 rknateria is fo be used in Ftood Zone °A", it is understood tha� a cSrainage pian addressing a
<br /> ".compens�afisig vo��urrre"w�11 be submitted at•#ime of per'mitting which is prepared by a prafessidria�)`englrteet
<br /> iicensed b�r fhe St te af Fiorida. '
<br /> - !f Ehe til! aterial�is to be used in Flood Zone "A" ln conriec�ion with a permit#ed building using:stem wal!
<br /> constructi n,.l cerk#ify that fill will be`used only ta fill'fhe area within the stem watl.
<br /> - If.fill mat rial is ta be used in any a�ea, 1 certify fhat use of such fiii wiif not adverseiy afifiect.adjacent
<br /> ' properties if.use af fili �s found fo adversety affect adjac�nt propet�ies,the ovsrner may be aited for. viaiating
<br /> , fhe condif'ans•of�fhe building permit issued under the aEtached permif appiication, for lofs less than ane {i)
<br /> acre which are elsvated by fi!!,�an engineered drainage plan ts required.
<br /> !f! am the AGE�1T F�R THE�OWNER, 1 promise in goad�faitii to inform the awner of fhe permitfing canditions set forth in
<br /> this affidavit priar to commencing consfruction. i understand thaE a separafe permit inay be required for etecfrical work,
<br /> plumbing, signs� weit , poois; air conditioning, gas, or afher'installafians not spec'�caily inctuded in the application. A
<br /> permit issued shati be�consfrued�o be a license to proceed with the work and nat as authority to_vioiate, cance[, alfer, or
<br /> set�aside any pmvisio�}S Of tltE��G�IT#TC'dI COCIBS, rtor shai!issuance of a permit prevent fhe Building 4t'f"iEia!from thereaffer
<br /> �requicing..�;correctson:�o�.err:�rs:.in:platts,;.constr.uctto�.o�'violations of any cades.�Every permiE issued shall,became-ia�a(td- �--��.
<br /> unless the wark authc�rized by suah permit fs commenced within six months'of permit issuance� or if work a�ifhorizecl by
<br /> the permit is suspended or abandaned far a period ofi six(6)monfhs affer ftie time#he work is commenced. An e�ctensfion
<br /> �may be�requesEed, in�writingT from fhe Buittiing �ff'ieiai for a-perioi3 no#•tv exeeed ninety.(90} days and wiii demans#rate
<br /> justifiabte cause for fh�e eutension. 1#worlc ceases for n�rtety. (90)cQnsecutive+days,the job is considered abandoned. ,
<br /> WARNlNG TO.OWN R: YOUR FAILURE TO RECORD A NQTICE OF COMM�NCEMENT N1AY RESULT fN YOUR
<br /> Pa41(!!�C''r1NIG�FO,�IMLR.�I,IEMENTS T!D YOUR•PRC3PER?.Y. �t�YOL1,iIVTEf�i],TO.t1BTAi�1 Fit�i4t�CING,,C�ftRSULT
<br /> -.._ .... ,,.�.
<br /> WITH`YOUR I.ENi�ER�1R,�AN ATTCIRNEY"BEFCIRE°RiEGOi�����'r�i('C9UF€���tQTt�E��FrCQ'1'dEE�1��+i�FMlEN.T.--._-,__._ �_
<br /> FLORiDA JURAT(F.S,11� . ., � , r
<br /> OWNER O� ��� GON'fRACi'OR � � '
<br /> S� ` �� swom trr afli�rn efo is � � Subs ' �td swom o or affirme liefo� e '
<br /> � ' -O e�' /S by w �•- �-
<br /> (slaf tly kllo e r haslhave prodnced Who fsJare p rtai#y e ar aslhave prodnced
<br /> i a ldenli�cabon. as identificaHon.
<br /> � - , � .
<br /> ..� �� �j� , , e
<br /> ...�'���'(�! . Natary Publtc G�'�`"" � Notary Pubfic
<br /> Cammisstan Na. 1PRY AU9 ' EYEa� Comcnlsston Na '
<br /> �•,_��`��� MY G� M15�19N#� i�� ,-
<br /> 1P�;.���
<br /> � 0 2618 "�* '` c Y Gbt4bM1�64qN���949583 .
<br /> Name af Nofary e ��e ��a�rY�ervte�! � Name of hlotary typed.FrV rr�?,�d4��S;Aq�U� � �
<br /> � �� k� �rqTFOFfti�q�\o� Bandadlhra�t�d��tNoiOty$8�1��
<br />
|