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NOT[CE QF DEED RESTRICTiON3: The undecsigned understands that#his permit may be subject to"deed"restrictions°
<br /> which may be more restrictive than Counfy regula#ions. The undersigned assumes responsibiiify for carnpliance with any
<br /> a�Oplicable deed restrictions.
<br /> UN[.ICEN$ED CtJNTRACTORS AND GQNTRACTOR RESPONSSSA.ITIES: If the owner has hired.a contractor or
<br /> c�mtractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the
<br /> csmtractor is nofi licensed as required by law, both the owner and cantractor may be cited for a misdemeanor violation
<br /> under sfate Iaw. If the owner or intended contractor are uncerkain as to what licensing requirements may apply far the
<br /> intet�ded work, they are advised to contact the Pasco Caunty Building Inspection Division—Licensing Section at 727-847-
<br /> 8009. Furthermare, if the awner has hired a contractar or contractors, he is advised to have the contractar(s) sign
<br /> p�rtions of the "contractor Black" of this application for which they will be responsible. If you, as the owner sign as fhe
<br /> contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
<br /> County.
<br /> TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
<br /> tF�at Transportation ]mpact Fees and Recourse Recovery Fees may apply to the constructian af new buiidings, change af
<br /> use in existing buildings, or expansion of existing buildings, as specified in Pasco Coun#y 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 /> p+�rmiiting. (t is further understaad that Transportatian lmpact Fees and Resaurce Recavery Fees must be paid prior to
<br /> receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
<br /> final pawer release, fhe fees must be paid prior to pertnit issuance. Furthermare, if Pasco County Water/Sewer Impact
<br /> fees are due,they-musfbe paicl prior to permit�issuance in-accardance with-applicabie-Pasco-County-ordinances. - ---
<br /> CONSTRUCTION LlEN LAW(Chapter 713, Florida Stafiutes, as amended): If valuation of work is$2,500.00 or more, I
<br /> certify that 1, the applicant, have been provided with a copy of the "Florida Gansfruction zien Law—Horrteawner's
<br /> Pratection Guide" prepared by the Florida Department af Agriculture and Cansumer Affairs. If the applicant is someone
<br /> a�ther than the°owner", I certify that l have obtained a copy of the above described document and promise in good faith to
<br /> deliver it to the"owner"prior to commencement. �
<br /> CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and #hat all work
<br /> will be done in compiiance with ali applicable laws reguiating construction, zoning and land development. Application is
<br /> hereby made ta obtain a permit ta do work and installation as indicated. I certify that no work or installation has
<br /> cs�mmenced priar to issuance af a permit and that a!I work wi!! be performed to meet standards of all laws regulating
<br /> construction, County and City codes, zoning regcalations, and iand development regulations in the jurisdiction. l aiso
<br /> � certify tha# I understand that the regulations of other government agencies may apply to the intended work, and that it is
<br /> my responsibiiity to identify wha#acfiians i must take to be in compliance. Such agencies inciude but are not Iimited ta:
<br /> - Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br /> Lands,WaterMlastewater Treatment.
<br /> - Southwest Florida Water Management District-1NeI1s, Cypress 8ayheads, Wetland Areas, Altering
<br /> Watercourses.
<br /> - Army Corps af Engineers-Seawails, Docks, Navigable Vtlaterways.
<br /> - �Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
<br /> Septic Tanks.
<br /> - US Enviranmentai Protectian Agency-Asbestas abatement.
<br /> - Federal Aviation Authority-Runways.
<br /> S undersfiand that the foiiawing restric#ians apply ta the use of fiEi: � !
<br /> - Use of fill is not allowed in Flood�Zone"V"unless expressly permit#ed. ��
<br /> - lf the fill material is to be used in Flood Zone "A", it is understoad that a drainage plan addressing a
<br /> °campensating volume"will be submitted at time of permitting which is prepared by a prafessional engineer
<br /> licensed by the State of Florida. ' ��
<br /> - lf the fill material is to be used in F{ood Zone "A" in connection with a permitted building using stem wall �
<br /> construction, I certify that fill will be used only to fi(i the area within the stem wall. �
<br /> - !f fiU materia! is to be used in any area, I certify that use of such fill will not adversely affect adjacent
<br /> properties. 1f use of fil] is found to adversely affect adjaeent properties, the owner may be cited for violating =
<br /> the conditions of the building permit issued under the attached permit application, for lo#s less than ane (1,) �
<br /> acre which are elevated by fi(!, an engineered drainage plan is required.
<br /> If I am the AGENT FOR THE OWNER, ( promise in goad faith to inform the owner of the permitting conditions set forth in
<br /> tt�is affidauit prior to commencing canstruction. 1 understand that a separate permit may be required for electrical work,
<br /> plumbing, signs, vuells, poals, air conditioning, gas, ar other instaliations not speeificaiiy included in the appIication. A
<br /> permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
<br /> sst aside any pravisions of the technical codes, nar sha!! issuance of a permit prevent the Suilding O�cial from thereafter
<br /> requiring a correction of errors in plans, eonstruction or violations of any codes. Every permif issued shali became invalid
<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 far a period of six{6}mon#hs after the time the work is cammenced. An extension
<br /> may be requested, in writing, from the Building Qfficial for a period not to exceed ninety (90) days and will demonstrafe
<br /> justifiable cause for the extensian. If work ceases for ninety(90�consecutive days,the job is considered abandoned. �
<br /> IMARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br /> PAYING TWIG�FOR[NIPROVEMENTS 7{�YDUR PROPERTY. [F YOU INTEND TO'OBTAIN FIhAhICiNG,GONSULT
<br /> 1MITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDWG YOUR NOTICE OF COMMENCEMENT.
<br /> FLQRlDA JURAT(F.S.117.03)
<br /> r �— t
<br /> OWNER QR AGENT ����,a,u� CONTRACTOR Q'�L �:r,�<i�
<br /> Su scr'bed and sworn t (or affirme be ore me this Subscribed and swom to(or a ir ed)before me this
<br /> lU Z 1S by K�h.a tVl j�rj ID f�3/i�` bY P3'+�'�i-t {�/}: y��
<br /> Who is/are�rerson'�� ov�t�o r e ar.has/have produced Who is/are nally known a me or as/have pro�Fuced
<br /> as identification. as identification.
<br /> �`'�' t�'l��(C',� Notary Puhlic �-'��f�C�'����Li�"✓ Notary Public
<br /> Commission No.v v rF��;� ��}� commission No. I�f 6 9 3�v ��
<br /> Name of No#ary typed,printed or stamped Name of Notary typed,printed or stamped
<br /> ;�=�`°'RYp°84�:_ �lANCY.J BR�t�KS ,=2o�"""P"g��.. (y�t1NCY J BROOKS
<br /> ' �` = MY COMMISSION#FF093699 � '
<br /> �.�a. QQ; -� � ': MY CQMMISSION#FF093699
<br /> ;•.'�.....a?: EXPlRES Februa 18.2Q18 =9`•.........�'•°�`
<br /> �.,OFfl-.. � "',�Of�,OQ;r EXPtRES Fehruary 18.2018
<br /> �u�• .,,,.���.,.
<br /> (ao�)398-0153 FloridallotaryService.com (ao7)3se-o153 FlorldallotaryServfce.com
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