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<br /> NOTiCE OF DEED RESTRICTIONS: The undersigrted understands that this permit may ba subjed to'de�"r'eslridiotts'
<br /> which may be more restridive than County regulations. The undersignEd assumas responsibifi9y for c�mpiiance with a�I
<br /> applicable dced restrictions.
<br /> UPdLiCEWSED COIdTRACTORS AR�D COEdTii�9CTOR RES�OR4S&�3L911E�: tf the ow�s has hired a contr2ctw or
<br /> contractors to undertake work,they may be requi�d to be licensed in accordance vv�th state and i�cal regulations. If th2
<br /> contractor is not licensed as required by law, bofh the owrter and cor�tractor may b2 qted for a misdem2ar�r violafion
<br /> under state law. If the owner or intended contractor are uncertain as Co v�at licensing requiremer►ts'may apply far the
<br /> intended work,they are advised to contact the Pasco Cour�ty Building lnsp2ction Division—Licensing S�ion at 727-847-
<br /> 8009. Furthermore, if the owner has hired a contrador or contractors, he is adv'tsed to have the cantraciar(s) sign
<br /> portions of the"corrtractor Bloc�'of this appiication for which they will be responsible. ff you,as fhe owner sign as tt�
<br /> conVador,that may be an indication that he is not properiy licensed and is not entitled to pemtittirtg privileges in Pasco
<br /> County.
<br /> Tt3r�PISPORTAT10P9 fllf�PACTNTILITI�S iPdPACY APdD RESOiJRCE�ECO�iERY FEE�: The undersigned tu�derstartds
<br /> that TransportaGon impact Fees and Recourse Recovery Fees may appiy to the construcHan of ne�w buildings,chartge of
<br /> use in existing buildings, or e�ansion of existing buildings,as specified in Pas�County Ordinance cwmber 89-07 and
<br /> 90-07, as amended. The undersigned also undarstands,that such fees,as may be due,wifl be identified at the time of
<br />' pertnitUng. It is further understood that Transportation Impact Fees and Resource R�overy Fces must be pa�i priar to
<br /> receiving a"certificate of occupanc�'or final power release. If the pro}ect does not irnolve a ceriificale of aeasgancy a
<br /> final power release,the fees must be paid prior to permR issuance. Furthemiore,ii P�co Caurrty WatedSewer Im�sact
<br /> fees are due,they must be paid prior to pertnit issuance in acrArdance with applicabte Pa�co Cotu�ty�nances.
<br /> COWSTRUCTIOtd LIEN LAlN(Chaptee 713,FPori�a S4aYutes,as arr�eaa�sa,: If valuation of work is$2,500.00 or rr�r�,I
<br /> certify that I, the appiicarrt, have been.provided vvith a copy of the "Flarid� Construc�ion Lten Law—Flom�awrtEr's
<br /> Protection Guide"prepared by the Florida Departrnent of qqriaitture arzd Consumer Affairs. if the app8cant(s someone
<br /> other than the"owne�',I certify that I have obtained a copy of the above desai�d documerrt and promise in good faith to
<br /> detiver it to the"owner"prior to comrt►encement.
<br /> COIdTRACTOR'S/OYHPfEPt'S AFFIDANI7: I certify that all the ir�ormation in this application ts accurate and that ati wark
<br /> wiii be done in compliance with all appiicable la�vs regulating construc�ion,zoning and lar�developrt�rtt. Apptica�ott is
<br /> hereby made to obtain a permit to do work and instalfation as indis,�ated. I cerbty that no work ar irtstatlaUan has
<br /> commenced prior to issuance of a permit artd that all vdork witl be perfomied to rn�t s#andarc)s of all laws�gulaf�g
<br /> oonsVuction, County and City codes, zoning regulatlons, and land develogment reg�lations in ttze jurisdictlon. I aRso
<br /> certify that I understand that the regulations of other govemmerit agencies may appty to the inter�ded watk,and that it fs
<br /> my resparisibility to identify vvhat actions I must take to be in compliance. Sudi agensyes irtdude but are not l'fmited to:
<br /> - Department of Emrironmental Protection-Cypress Bayhea�is� Wetland Ateas and Emrironmarttady Sensitit�
<br /> Lands,WateNVMastewater Treatment.
<br /> - Southwest Florida Water AAanagement Distrid-Wells, Cyptess Bayheads, lhhtlartd Areas, Aft�ring
<br /> Watercourses.
<br /> - Army Corps of Engineers-Seawalls,Docks,Navigable Watennrys.
<br /> - Departnent of Heatth 8� Rehabilftative Services/Environmerrta! Heatth Unif-Weits, Wast�water Treativ�nt,
<br /> Septic Tanks.
<br /> - US Environmental Protaction Agenc.}+-Asbestos abatement
<br /> - Federal Aviation Authority-Runways.
<br /> I uriderstartd that the foffowing restrictions appty to the use of fill:
<br /> - Use of flll is rtot allow�in Flood Zone"V'unless expressly pertnitted.
<br /> - If thz fill material is to be used in Flood Zone "A", it is understood that a drair�age �tan addressing a
<br /> "compensating volume°will be submitted at time of pertnitting whlch is prepered by a pro#essiw►a►engir�er
<br /> licensed by the State of Florida.
<br /> - tf the fill material is to be used in Ffood Zon� "A in conn2ction with a permitted builclitsg us'sng stem v�3f�
<br /> canstniction,I certity that fill wili be used onty to 511 the area wittiin the stem vdaA.
<br /> - If fil! material is to be used in any area, I certify 4ha4 use ofi suc� frt! will not adversely ofifect ad"�acertt
<br /> properties. if use of fill is found to adversety affect adjacent propertie�,the owner may�cited f�,c dsotatir4g
<br /> the conditions of the building permit issued under the attactied permit applicaBon,for lots tess Ynan ona(1}
<br /> acre which are elevated by fill,an engineered drainage pian is requfred.
<br /> ' If I am the AGEWT FOR THE OWPIER,1 prom'�se irt good faith fo irrFartn tt�owmer of the permitring condfUos�s set iorFh ifl
<br /> this affidavit prior to commencing construction. I understand that a separate permit may tre r�guired fiar electrical work,
<br /> plumbing, signs,wells, poals, air conditioning, gas, or other instalfations not spe '�fical{y induded in tha appiicatlan. A
<br /> permr issued shall be construed to be a licertse to proceed with the work and not as authortty to violate,car�ceJ,alter,or
<br /> se4 aside arry provisions of the tech�ical cades,nor shail issuance of a permit prevent the Buildir�Offida1 from th2reaft2r
<br /> requiring a correction of errors:n plans,construction or violatlons of any codes. Every permit Issued sh�l l�ecom�lnvaiid
<br /> unless ths work autharized by such permit is commenced within six montt►s af permii issuance,or ifi wrorfc au4horized by
<br /> the pertnit is suspended or abandoned for a period of six(6)months after the time the wlork is comm�ccecad. An extenslon
<br /> may be requested, in writing,from the Building Offiaai for a period not to exc�ed nirt2iy(90)days arrol wifl demonsba4e
<br /> justiflable cause for the extension. If work ceases for ninely(90)consecutive days,the job is ca�idered abandoned.
<br /> 1flfAR9dIWG TO O!nl6VEQ2: YOdJR FAILU6�TO RECORD�4 RSOT{CE�F C��l�gt'+CEH�iV'P E'-.�.Y Re.S.°l9LT 8tc�Sf�L4ia
<br /> PAYING TVVICE FOit fiVlPR041EMEPITS TO Y048R PROPER'rY. 1�Y�lJ iP38�43D TO OB'TAIRd�P��t�ft°x,�d�S�F1LY
<br /> IMITH YOUR LEtdDER OR AN ATTQRPdEY BEFORE REC�6aD9ttfC YOLlR�10Y1C�fDF C�l�!!l�tER1G�ER9T.
<br /> FLORIDA JURAT(F.S.117.03) i/,
<br /> OWNER OR AGENT CON�p� �{�C'\L Y'��I C�(�n�S�,/�
<br /> 2. '
<br /> Subsaibed and swom to(or aftirtned)before me this Sub�tatbed �m tA(o�t a,�r��or�j l�
<br /> by �5��� �l•J '{1�
<br /> Who Isfare personally Imown lo me or tu3sfiave produced ` . Is/ere persona!!y�o�t n to me ar ha�Jhave produced
<br /> as identification. j as ldentfiradon.
<br /> Nofary Public � 1\ ����_r Rot2ry Puh:.�
<br /> comnriasionNo. No. ;••..�`'°... ER
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<br /> Name of Notary typed,priMed or stsrt�ped Name oP Id�t�y {Uc�, �
<br /> `••.,',�oP�d*..•� EXPIRES July 24, 2018
<br /> (4071398-o�F3 FloridalloteryServlce.comw
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