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CVOT{GE f?F DEED RESTRIGTIQNS: The ttndersigned understands that this permit may be subject#o"deed"res#rictions°
<br /> which may be more resfricfive than County regulafions. The undersigned assumes responsibility for compliance with any
<br /> applicable desd restrictians.
<br /> UNLICEMSED CUNTRACTORS AND CONTRACTdR RESPONSIBiLtTIES: If the awner has hired.a contractor or
<br /> con#ractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the
<br /> con#ractor is nat licensed as reguired by law, both the owner and contractor may be cited far a misdemeanor violation
<br /> under sfate law. if the owner or infiended contracEor are uncerEain as to what iicensing requirernents may apply far the
<br /> inter�ded work, they are advised to cantact the Pasco County Building Inspection Division--Licen�ing Section at 727-847-
<br /> 8009. Furthermore, if #he owner has hired a contractar ar contrac#ars, he is advised to have the contractor{s) sign
<br /> portions of the "contracfior Block" of this application for which #hey will be responsible. If you, as the owner sign as the
<br /> contractor, that may be an indication that he is not properly licertsed and is not entitled to perrnitting privileges in Pasco
<br /> County.
<br /> TRANSPG7RTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
<br /> that Transportafian Impact Fees and Recourse Recavery Fess may apply ta the constructian of new buildings, change of
<br /> v use in existing buildings, or expansion of existing buildings,-as specified in Pasca County Ordinance number 89-07 and
<br /> 90-07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of
<br /> permitting. It is further understood ttiat TransporEation lmpact Fees and Resource Recouery Fees must be paid prior to
<br /> receiving a `certificate af occupancy or final power release. If the project does nat involve a certificate of occupancy or
<br /> � „
<br /> final power release, the fees must be paid prior to permit issuance. Furthermare, if Pasco County WatedSewer lmpact
<br /> fees are due,they must be paid prior to permit issuance in accardance with applicable Pasco County ordinanees. �
<br /> CONSTRUCTION LlEN LAW(Chapter 713, Florida Statutes, as amended): If valuatian of work is$2,500.00 or more, I
<br /> cerfiify that 1, the applicant, have been provided with a copy of the °Florida Cansfruction Lien �.aw—Homeowner's
<br /> Protection Guide" prepared by the Florida Department af Agriculture and Consumer Affairs. If the applicant is someone
<br /> other than the"owner", I certify that 1 have obtained a copy of the above described document and promise in good faith to
<br /> deliver it#o the"owner"prior ta commencement.
<br /> COIVTRACTOR'S/OWNER'S AFFIDAVIT: 1 certify that all the information in this application is accurate and that all work
<br /> wiii be done in compliance with ali applicabie laws regulating construetian, zoning and land development. Application is
<br /> hereby made ta obtain a permit ta do wark and installation as indicated. I certify that na work or insfiallation has
<br /> commenced priar to issuance of a permit and that all work will be performed to meet standards of a!! laws regulating
<br /> construction, County and City codes, zoning regulations, .and land development regulations in the jurisdiction. l also
<br /> certify that I understand that the regulations.of other government agencies may apply to the intended work, and that it is
<br /> , my responsibility to identify what actions 1 must take ta be in compiiance. Such agencies inciude but are not Iimited ta:
<br /> - Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentaliy Sensitive
<br /> i Lands,Water/Vl/astewater Treatment.
<br /> - Southwest Fiorida Wa#er Management District-Wells, Cypress Bayheads, tNetEand Areas, Altering
<br /> Watercourses. �
<br /> - Army Corps af Enginsers-Seauvalls, Dacks, Navigabie Waterways.
<br /> - �Department of Health & Rehabilitative Services/Environmental Healfih Unit-VVells, Wastewater Treatmenf,
<br /> Septic Tanks. '
<br /> - US Environmentai Protectian Agency-Asbestos abatement. �
<br /> Federal Aviation Authority-Runways. '
<br /> I understand that the foliowing restrictions appIy to the use of fill:
<br /> - Use of fill is not allowed in Flood�Zone"V"unless expressly permitted.
<br /> - !f the fill material is to be used in Flood Zone "A", it is understoad that a drainage plan addressing a
<br /> "compensating volume"wi11 be submit#ed at time of permitting which is prepared by a professional engineer
<br /> licensed by the State of Florida.
<br /> - 1f the fiIl material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
<br /> constructian, f cerkify thafi fill wifl be used only to fi11 the area within the stem wall.
<br /> - !f fill materia! is to be used in any area, I certify tha# use of such fll will not adversely affect adjacent
<br /> properties. if use of f(1 is found to adverseiy a�fect adjacent properties, the owner may be cited for violating
<br /> the conditions of the building permit issued under the attached permit application, for lots less than one (1)
<br /> acre which are elevated by fill, an engineered drainage plan is required.
<br /> If I am the AGENT FOR THE OWNER, i promise in good faith to inform fhe awner of the permitting conditions set farth in
<br /> this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
<br /> plumbing, signs, welis, poals, air conditioning, gas, or other instailations not specificaily inciuded in the appIication. A
<br /> permit issued shall be construed to be a license to proceed with the work and not as aufihority to violake, cancef, alter, or
<br /> set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Suilding Officia!from thereafter
<br /> requiring a correction of errors in p(ans, construction or vialations of any codes. Every permit issued sha11 become invaIid
<br /> unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
<br /> the permit is suspended ar abandaned for a period of six(6) months after the time the work is commenced. An extension
<br /> may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and wil� demonstrate
<br /> justifiable cause for the extension. !f work ceases for ninety(90)consecutive days,the job is considered abandoned.
<br /> WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br /> PAYING TW[CE FOR tMPROVEtIltENTS Tta YC1UR PRt3PERTY. tF YOU tN7'END TO'OBTAiN FINANCiNG,CONSULT
<br /> WITH YOUR LENDER OR AN ATTORN�Y BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
<br /> FLORIDA JURAT{F.S.177.03)
<br /> OWNER OR AGENT /����1_.,�t��.f.�G-+R-., CONTRACTOR � G �i�7��„
<br /> Subscribed and sworn i (or affirmed)before me this Subscribed and sworn (or affirmed before me this
<br /> -�t}-I _by 1rtV C�Yl t v4t'1� �-(ta'"1�o by�1�}�tti! IM t 1�Yt '9
<br /> Who is/are ersona y nown e or has/have produced Who is/are pna y no n toi mc a as/have produced
<br /> as identification. as identification.
<br /> Notary Pubiic Q� ��� Notary Public
<br /> Cammission No. F��� 3� CC �( Commission No. ��d�� ��l l .
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<br /> I Name of Notary typed;printed or stamped Name of Notary typed,printed or stamped
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<br /> : =�.,',�oF�.oQ� EXPIRES Febru�ry 18,2018 ;;srF.....oQ' EXf�1RES Februaiy 18.2Q18
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<br /> (407)398-0153 FlorldallotaryService.com (407)396-0153 FloridallotaryService.com
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