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May.�6.2016 06.0� PM PAGE. �/ 6
<br /> N471G�OF DE�D R�STRICTICtJ$: 7tr�•underslgned understandb that tnle permit may ba subJect to"deed"resp�IcUane"
<br /> whioh may be more reslrloflve thsn Courriy regulaUons, The unaereigned sesumes rosponsiemty rar compilanae w�in any
<br /> Appllcebl�deed reStr�Cqona.
<br /> UNLICENS�D C4NTRACTORS AND GONTRACTaR RE5PON81BILfTIEB: If 1he oWnet heB hired a canhactor or
<br /> CantraCfor9 to undehake work,th�y rnay be required to be licansed In a4�cardAnce with state and local regulatlon9, 1!the
<br /> cantreclor la nat Ilcensed as requlred by law,both the owner and contractor mgy be cited for a migdemeanar vlalation
<br /> unde�s�ete law. if the ownar or intended eontrsotor�ro uncenaln es ta what I}c9nainq requlrement�may sppty for�he
<br /> int�nded work,ihey ara edvised tp pdntact Ihe Paaco CouMy Butldiqg InBpection Qivlsion—Licensing SepQOn e�l 727-847-
<br /> E009, Fu�thermore, ff the owner hag h)red a contractar or contrectors, h�� advised to have the contractor(�)sign
<br /> po�tiona of the"corr�aGor 81ack"of thib�pplicst{on for which they wlll be reaponel�le, (t you, aa the 4wner slgn as ths
<br /> c�ntraotor,thet may ba en indlcetlon thet he ia not prope�y Elcensad antl la nflt entlNed to psrmffting privReges In Peaco
<br /> County.
<br /> 'fRANSPORTAlYON IMPACTIU'nUTIEB IMPACT AND.RESOURCE RECQVERY FEE9: The underslgned underelands
<br /> that Transportallon Impact Fe�a and Recou�se Recovery Faes may apply t4 ihe wnet�uctlon of new buildinge,ohBnga of
<br /> tror In onlnUn9 builtlirtpn,or exp�neion ot axlsunp buiwfnpn,ee epaclrlaq In pasco GouMy Ordlnance numbet Sfl-07 end
<br /> 80•07,ea emended. Th�underelgnad aiso underetenda,th�t auch fees,ee may be due,wiil ba IdentlMd at 1ns time of
<br /> permlhing, It la furth6�r und9r9tood thst TranspartaUon ImpaCt Feee and Reaourca Recovery Fees must be paid prior to
<br /> recelving a"cQrdflc�le of occup�ncy"or flnel power rete8se, If tfie proJect daas not involva a carGfic.�t9 of oCcupBncy ar
<br /> I(r�al pownr rolm�ag,thv feae must b�peld p�ior to porrnit leauanca, Fwthermare,K Pa�co County Wecerl3ewer ImDact
<br /> toee ere due,they must be pald R�o��perml�Issuance U accordance with applleeble Pesco Couniy arGlnat�caB.
<br /> CONSTRUCI'i0N LIEN LAW(ChAptOr 7?3,flo�ida Statutea,ae amended): It valuat[on ot work is�2,500.pp pr mpre,I
<br /> csttify thst 1, the appllc.ant, heve bean provided with a copy of Ih� MFlarlda Conetructlon Llen Law—Hcmeowrrer'e
<br /> Prnt�Ctiah Guid9"prepar�d b the Florida Depar�m�nt af Ag�lculture end Consumer Atfalre. If the appllaant ia eomaprte
<br /> ofhe�lhen the"oWMer",I c6�l�y that I hsve obtelned e copy qt H1e above deaarlbed doaumant and prpmise in goad fatfh to
<br /> deilver it fo the"owne�'prlor to commencgrnent
<br /> CON?'RACTaR'9/OWNER'S AFF�DAVI't': I CarUfy lhat ap 1he Intormetiar►In thfe epplicstion is aacurate end that eU wak
<br /> witt b�dan�1n Cbmpi{artce wlth ali�ppllaehla lawa rpgul0tfnp consiru4Uon,za�n�and I�r1p dAVeicprhan� Applicatlon Ip
<br /> lMreby made to abialn e permlt to do work aed ineteOeUon ae IndiCatOd. 1 cer�ry that no work pr InstAlldtion hee
<br /> commencatl p�lor lo Issuance of a porm{t bnd thaf al�wortc will be perfomtied to ms�t etendarda of ail laws regulet'u►g
<br /> Gonetntcdan, C4unty And City wdas,mning regula110�50, and land devalapment regulaU0n6 In the jurisd�Uon. I elso
<br /> ce�Ufy thal I undmrst�nd that the reeuleUona of other qovarnment aganctes may eppty ta the intended avork,and lhat It la
<br /> my respanslb111ty to Itlontlfy whpt acti4ne i mu9t tak�ta ba In comAAance, 9uon spenaiee Inaluda but are nat Ilmitea to:
<br /> • Llepaftment of Environmental Prot�4ddn�Cypress Bayhse�ds,WeUa�1d ArQao and Environmentally Seneitive
<br /> Lend6,WetarNYastswsterTrggtmettt,
<br /> � Sout�west Flor9de Water Manegement Diat�ot•WeilA, Cyprese Bayheads, Watlend Areae, Altering
<br /> WBtercoure�e,
<br /> - A+my Co�ps of Eng(n�era-Se&wall$,pooks,Navfgahle Weterwaya.
<br /> • napartment ot H�atth � RehabilitsUve 3ervlceslEnvironmental lieatth Unit•Welis, Wastawatar Treatment,
<br /> SepNC i'anke�
<br /> • llS En�lrOrlrriOntal Prot�ollon AgpnCy+Aobvatoe e6ekem�nt, -
<br /> Faderei Avl�tlon qulhor9tyr•Runways,
<br /> I understend that the following rostrlotlane Qppiy to ihe use of flll;
<br /> - Uss of NII te not eliowed In Flood Zon�'V"unleae expressly perml�ted.
<br /> • 1f the f111 mater�al fe to bo uead lrr FI04d 7ane "A", It fe und0rdtood thqt b drolr�ega plen addr0691rtg e
<br /> "CompeoaaGng vqlume"Will be eubmHted et tlme Oi permlttln�whlah ls prepered qy a profeaefonat engln88P
<br /> Ilbensad by the State ai Florida.
<br /> • If tha flli mateflal Is tc be usad in Fload Zona°A"!n Connacllon wlth a pen�nittea byiiding�sing stem wall
<br /> conBtruCtlon,I corUfy tho!flli wlli b�u�ed only la flll Ehe erea wlthln tha stem wap.
<br /> ■ I� illl mai6r��1 IS t0 D9 u86tl In arly afbd, I certlfy that use af euch fNl wlll nat edvarsely attect adJacent �I
<br />, prapartles, It uae of flif is fou�d to BdVefE91y affBCl ad�acent pfOp8rtl86,ihe owner may be cited Por vlalaUng
<br /> the.condlNane of tha Bullding psrtnft ieeued under the ettechad parmit application, for lots ia�then o�a(1)
<br /> aCre which ero alavated by flA,�n en0lneerod drslnage plan la requtr�d, lil
<br /> II I am the AQENT FOR 7H�QUYNBFt,I promleC In�ood taith to intorm the ounl�r o!tha pam,Itting oonditiqna vet iv�th In
<br /> thl�aifldevli prlor to.commencing constructlon. I underatand that a seDnrate permlt may ba raqu►red fir electdcal work,
<br /> plumning, signa, walls, poois, atr candlt�cning,gss, nr olher Inmtppatione not speciflcally!naluded in the app4icetlon, q
<br /> parmlt fssued ahell ne CorlBtfued to bo s Ilo6ne9 tp prooBed wilh ths wOtk�ntl not as authority tp vipl�te,can�l,alior,or
<br /> de!ealdd any provistnna o1 the leohnlcai oodas,nar sh�ll 19eu�11Ce Of e permlt prevant q1p$uUdlnB CNficlel hqm the�68fter
<br /> �equlring s Cort9Cllon of errors In pfa�6,construcilon or vlolaticne oi any codos. Every parmlt Iaeuad ehall beoome invelld �i
<br /> unless th9 wGrk dulharized by such psrmit is commenced withih aa months of permit Iseuanoe,ar If work authorizOG by
<br /> the.p�rtnq 18 9uepended or ebandoned fot a petiad of slx(8)months afler ihs tims 1hg wo�{c�a cotnmencsd. An exlenslon
<br /> moy bs roqueated,In wridn9, hotri the Bulldin�Ofilclal for s perlod not to excned ninety(90)dey�and�+rlll dernonstrate
<br />� Justlflable caues 1or the extsnslon. If werk CggBdp for Nnety(80)Con86Cudve days,lhe Job Is�neidefed abandoned.
<br /> WARNING 70 OWN� : YOUR FdULURE Tq RECORD A NQTfC�OF�QMMEHCEM�NT MAY RESIJLT(N YQUR
<br /> I PAYING TWICB i M�MT3 YC YOUR PRQp�RTY, {�YOU IHTEND Tp pBTAlN FINANCING3,C4N8UL7
<br /> j F enn
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