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Ju1.12.2016 06:08 PM JT Construction 40720549�2 PAGE. 3/ 7
<br /> h!0'CICE O�O�Ep RESTRICTIONS: The underaigned under�tands that this p�rmit m2iy bQ Subject to'd2�d`resiticFions'
<br /> whlch may be mvre restrictive fhap County regulaiton8, The ur�derslgned assumes r2spon5lbility fdr eompliance with any
<br />� appUcabla deed resttictlans.
<br /> UNI.,iGENS�b COAfTRAG1'0125 AP�D GOlUTRAC7QR RESPONSIBItJTIES: if the rnsme� has hired a contracbqr or
<br /> contractors to undettake vwrk,thay may be required ta ne ncenaea�n accordance vrtn atete ana tocai re9uta�one. it tr�e
<br /> corrtractor Is not licensed as requlred by(aw, both th9 ow112r and Ca�tYactor may be cited for a misdemeanor vialation
<br /> under state law. (f the or+mer or Intended cor►traetor are uncerta�n as tp what IiCBnsfng�equlrementa may apply fot the
<br /> i�tended work,they are advlsed to carrtac!the PasCo County�uitdln�inspeetlon Divisiarr—L.icensing Sec�ion at 727-�t7-
<br /> 8Q09, Furtherrnore, !f the ovvr►er has hfred a eornraaQt or cont�actars, he ie actvised to have the cantractor(s}s�gn
<br /> partlons of the°eonhactor�ladc'p!this applic�4ion fbr wl�ich they Wii!be responsib!e. if you,as the owner sign as the
<br /> contractar,2hat may t�e an IndlCation that he is n4t prop�rty ilCer�ed and Is not entitled ta perrtidYmg privileges in Pasco
<br /> Gounty.
<br /> i'RANSpORTATI4N IMPACTNTILITIES IMPACT AND RESOURCE R�GOVERY fEE3: The underslgnsd underst�nde
<br /> th8t 7ranspqrt�tlGn(mpdCt Fees atld Rgcoutse f2acovery Feea may appiy to the c�natruction of new buitdin�s,qttange Gf
<br /> usa In exlsting buiSdEn�s,or expan5lon oi existing t�ulidinga,as apeciEed in•Pasco Courrty O�ir�ance number 89-07 and
<br /> 90-07,as amended. The undar�i�ned al�a underetands,t�at auCh fees,a�may be due,�II be idertifred at the tlme p!
<br /> p�rmlttin�, it 18 t+lither under�tood that Tranaportation Impact Fees end Resource Recovery Fees must be pald priof to
<br /> receiving a"certificate of occupancy'or final power release, If the proJect does not Irnrolva a certtficate of oceupanCy at
<br /> flnal power re�e�ae.tlte fee�muat be paid prlor ta permit fssuance. Furthermore, if Pasco County Watar/SeWBr ImpaCt
<br /> tea�are due,they muat be paid prior#o permit iseuance in�ccordance with applicabte Pasco County ottt�nances.
<br /> C�NSTRUC7lON 1.[EN LAW(Chaptsr 713,F[orfda S�s,as amertded}: If vatuation of work is$2,500.04 ar more,I
<br /> certlfy that I, the appllcar�, have been provided with a copy of fhe "Florida eonstruc�ion Lien Law—Womaovmgrs
<br /> Proteetlan Gufd�"prep�red by the Flotida DepdRment af Agricutture and Consumer Affairs. If the applicsnt is someone
<br /> other than th9'Owl1�r",I CeCtlfy ihat I have at�&irled&Copy of the Abave desaibed doalment and promise in good faith fo
<br /> delivet it to the"owner"prior te commencement
<br /> CONTRACTOR'S/OWNER'S AFFIL�AYlT: 1 certify that�11 the information in thia ap�lication is accurate and that al1 work
<br /> will 4e done in vqmpNance with aU appiicabie laws regui�ting canstruc�ion,zaning and I�rtd devaapment. AppiiCatlpn is
<br /> hereby made t0 o�airl a permit to do work arsd instaHatian as indicated. I certify that no work or instaNatlOn ha8
<br /> cammenced{xior to issuance ot a permlt acxi that all worlc wiN be p�rformed ta meet standarc4s oi att lawa r�ul�t11'�
<br /> canehuction, County and City codes, zoning regulations, and iand developmerrt regulations in the Jurisdictfon. t afso
<br /> Certify that i ucldetetand that the regulatiorts ot ottier govemment agenCies rr�y apply ta Nte intgrtded wak,and that!t I4
<br /> my responelbility io ideMiiy what actions I must take to be in compNsnce. Such agencies(nctude but sre not iimlted to:
<br /> - Department of Environmental Protection.Cypress Bayheads, Wetland Areas ar►d Errvlronmen�lly SdnsitlYe
<br /> Lands,Wster/Wastewat$r Treatment,
<br /> - 3out1►west Florida Watet Managemem District Welis, Cypress t3ayhea�, Wetiand P,reas, Attering
<br /> Wat�ercour$es.
<br /> - Army Gorps of�nginpers.Saawalls,poctcs,Navfgable Waterways.
<br /> - Department ot Nestth & Rahabilitative 5ervices/Enviranmer�ai H�alth Unit-WeIIS, wastewater�'raatment,
<br /> �eptio Tanks.
<br /> - iJ�Eitviro�5mentel Protection l�qencyAsdestos abatement
<br /> - Federaf Aviation Authority-Runways.
<br /> 1 Understand that the Pollawlryg restr)ctlons apply to fh9 use oi flll:
<br /> - Use of�lf is not allowed{n Ftood 2one'V'uNess expressly permitted.
<br /> - ff the fi!i material �s ta be used in Ftood Zone "A", it is understood that a dr�inage ptan addf9esing d
<br /> "compansating volume"wikl be submftted at tlma of permlttln�wh3ch is prapared by a profesabnai engineer
<br /> Iican�ed by tlte State of Floritla,
<br /> - If the fiU materfal is to be used in Flood 2ona"A°in conneetion wlth a permitted buflding using stem wall
<br /> conetrucfion,i certi(y that fiil will he used only to fill the area within the atem wall.
<br /> - If fill rnaterial is to 4e uaed in any area, 1 certiFy that use of such fiA wili not advarsety aifect adjac@I1t
<br /> prapertles, If usa ot tUl�tound ta adveraoly altect ad��cant properUa�,th�ownar ntey b�clted tor vlatatin�
<br /> tha condttlons of the hullding permlt Issued under the attached{s�rmft appl�allon,1or lots less tharl one(1}
<br /> acre vfiich are elevated by Till,an engineered dra�nage plan is required.
<br /> lt I am the AGENT FOR TH�OWNER,I promfse In good taith to in(orm the owner of the pem�l�{ng conditlons set forth In
<br /> this afttdavit prior ta cammenelr�constructlon. I understand that a seEsaarate permtt may be requEred for etectrlcal work,
<br /> p�umbinq, efgns,weNs, poola, alr cundltlaning,�as, or a�her Installatiana nM apecft(cally incluped In the applicaUon, A
<br /> psrmlt lssued shsfl be conatrued to be a IlcEnse to proceed vNth the work and not as authority to vlolate,cancel,aiter,or
<br /> set asfde any provisior�s of the tecfinical c4des,nor shall issuance of a perm�prever�the�ulldkng p�ic►al from thereafter
<br /> requtriag a GORaction ot errore 1n plane,canetructlon Qr v�otatians of any codes, Every permit Issued shall become 1nv�lld
<br /> unleae tne v+ork auiharfzed by eueh permit is commenced wlehsn eix montns o4 peimlt Iss�rance,ar If wark authoraed by
<br /> tMe permtt!s sus{�ended pr abandonad�far a}�e�lad ot slx(B}months after th4 Hm�tha Hroric ks cammenced. An extenal4rt
<br /> may t�rdqupsted,in wrfting,irorrl ths BuNditx�pflic�al tor a period npi to excQed nlnety(90�day&and wlll demonstrate
<br /> Jusqflable cause for the sxtsns►on, If work oe�es�or nlnety(90)cansecudye days,the Job Is cansid6rdd abdndo(1ed,
<br /> WARNfNG Td OWNER: YdUR FAlLURE TO RECORD A NOTICE OF COMMEIJCEMENT MAY RESULT IN YdUf2 u,;�„
<br /> FAYfNG TWICE FOR IMPRbV�MEN78 TO YOUR PROPERTY. IF�QU(NTF.AIp TO dQTA1N FINANCING,GOlVSULT g�� R''�°%�
<br /> I F! U ER A A At RE ECd iRt YOU E OF C G i�5 , ��e
<br /> fWRiDA JURAT(F.S.117,Q3} • -
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<br /> OWNERQRA9�NT COliTRAG �' •
<br />' suasetbaa ana nworn m�or�+flrmoq�oerorp me ir�e u � .aun qrx to �
<br /> ey_ �S � �
<br /> YLho lataro pQrtorqlly krw+m to ma or hmsllavo produ�A w ha�huva oroducad
<br />' as 1EentHieetkn �„_„_ '"' na IdentlfknUon.
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<br /> Motary Pt�iln � No4ty Pub�la � � �
<br /> Commtsalon No. L/ 'aa n No.
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<br /> Nomo o!Notary typed,prbted or etemped Name of Nota yped,t�tnSed or stamped � �
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