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<br /> (V�TICE O� D�ED R�;�TROCTOAN�: The und�rsigned under�Qands�.th�t this.permit.may_be,subJect tp"deed"restrictlons"
<br /> v�rhich may be,more=resteictive�th�n County�Pegulatlons. 'TFie�underslgne�`assumes respmnsibllity for complianae with any
<br /> applicable deed re�ttictions. �
<br /> UNLI+�ENSED CONTRACT4R� .AND CC7N7"�►CTOR RESPANS�BILlTtE�: �tf the owner has��hirec4 a contractor or
<br /> car�tr�otors to undertake wark, they rraay bs.regu'ired�to be;llcensed !n �ccordance.wlth s#�#e.and•iocal r�gulatlons. ;if the
<br /> contractar f� not Iicensed as req�ired��by law, both the om�mer and contcactor-may b'e�clked�for�a�mtsilemeanor violation
<br /> under state law. If#he ovvner or Intended conQca�ctcot,are•uncerkaln as to what (lcenstng.requirements rreay�apply�for'the
<br /> 'sntended work, #hey are�dvised to cr�nfact the P�saa County�uilding in�pec#ion Divislon—Licensing Section at 727-847-
<br /> 8U09. F�rihe�more, If the owner has hired � cont�actor �r coritractors,'he is advfsed�fo have #he contractor(s) sign
<br /> porkia�s of the "cont�actor Bloak" of thls app!lcatta�n for v+rhlch they wfll be Pe�panslble..If you,-as.�h� ovimer sfgri�as'fhe
<br /> cont��ctor, that may be an indication th�t he is riot.praperly,licensed a�nd�ds not�ntitied to permikking piivileges !n Pasco
<br /> Caunty.
<br /> Ti�ANSPORTATt�N-IMPACTli1TIC�'T�E�IMRAGT 1�N�3 RE��t1RCE RECAV�RY�FEE�: Th�underslgned understands
<br /> th�t Transporfati€ts� i�rapact Fees�nd.Recou�se 92ecavery.Fe��rnay•sppiy�to�the consUuction of nev�buildings,�change of
<br /> use In existing buildingst or:exparasi�in.of�ezis�6�g'�btiiidings, �s specifled In G�ascQ Caue�ty Clydinance n�mber 89-07 and
<br /> 90-07, as amended.. The unde�signed also;understands} tha�suah fees,.as>may��be�due;:wll!=be iderttl�Ied at the�time of �
<br /> permitting. It is further understood that Tra�sportat4on lmpa�t�Fees and Resou�ce Recovery�F�es::rr�u'st be paid prla�r to
<br /> receiving a "certificate.of occupancy"-or Mal powec release. :If the proje�t do�s not involve;a-c�ertific�te �f occupancy a�
<br /> final power re{ease;�the fees must be paid pri�r to permit issuance. fiunthe�mare;if Pasco-County 1NaterlSewer impact
<br /> fees are due, they mus#be..pald priar to p�Pmit�{ssuanca-i�aacordance witfi�ag�pltaabi�Pasco County ordinances.
<br /> G¢?MSTRU�Tlt�N LlEN'�W(Ct�apter 713t EOor�����atu����a�arr��nd�d�: #f valuation of work is$�,500A0:ar more, i
<br /> certify that !T �hs. �pplic�nt,_ have-been provtded with a copy of the "Florlda Construction Cfert�L'avu-.--Nam�own�c's
<br /> Protection Guide" prepared by,the Florida Depa�tmenf of Agrlcultu�e �nd Cc�nsumer Affairs. If ths �pplicant Is someone
<br /> other than#he"mwrner", I certify th�#0 have.abtr�ined��copy of.the,above.de��ribed aiocur�en��and pror�ise�in,gaod fadkh#o
<br /> deliver�t to#he°owrter."p�ioc'to-comenencemerit:
<br /> GONT(dACT�R'�OQY�NER'�A���D/4YIT: # cec�ify#hat ali the-ir�formatior�°in this application is accura�e and that�ti work
<br /> wiA�be done in compllanc�with a!I app!lcable laws regulating�onstrua#lo�t� zoning ar�d I�nd rievetoprroent. Applicat6an is
<br /> hereby made to obtain .a pea�mik to do w�rk.and Installatlon as indlcated.. I certify that no we�rk=or Installation has
<br /> comme�ced prior to Issuance of`a-permit and thaQ.all work will be pertormed�4o meet standard� of aU laws reg�alating�
<br /> construction, County and City codes, xoNng regulatinns, and land devetopment eegulat(ons�in the Jur(sdiction. I also
<br /> certify#ha�t i unders#a�d that th�regula#ians of other government agencies �ay�apply��o the intended work, and that it is
<br /> my responsibility to identify.what.a�#'tons 1 rnusd tz�ke to be,tn.c+st3lpliance. �uch agencies it�clude but are.not iimited to:
<br /> - Qepartment of Environmentr�i I�rotectton-Cypres�.Bayheads, Vifeti�nd �rea� anci Envlror�mentally Sensitive
<br /> Lands,Wat�arMlastewater Treatment. ,_
<br /> - Southwest Florida Water AAanagement Dis4ri�t-Wells, Cypr�ss. �ay.heads; Wetland Areas, AlQering
<br /> V�/atercourses.
<br /> - Army Cotps e�f EngMaees�Seavvafls, C�ocks, iVavigabte Waterw�ys.
<br /> - Depactment af Heatth & Ret�abffitat�ve ServicesiEnvironmee�t�i Fleatth Unit Wells, V�lastewater•7reatr�ent,
<br /> Septtc Tanlis. . �
<br /> - US Envirconmental�Pratection Ag�ncy-Asbestos ab�terr�ent.
<br /> - Federal Aviation AuQh�rity-Runways.
<br /> I undersQand th�t the foilowing..restfictions appiy tm the use�f flll:�
<br /> - Use of fifi is not altovved in Fiood��oe��°V"unless expres�iy pePrroitted.
<br /> - If the fill materlal, is to be used_tn �Fitrod Zon�. "A", 1#. is u��erstoad that � drainage plan addressing a
<br /> "'compensating volume" wlll be subr�ltted at 4irne af permitting which Is prepared by a professiona! englneer
<br /> Ilcensed by the State of F9orida.
<br /> - if ihe fili materlai:_is"to be used in Flood ��ne °A" In�connec�ioro wlth:a }�errv�itt�ad bupding using stem uvalt
<br /> � construction, i certify#ha#fii(w�lt::be used anly.to fill the area within the stem wait.
<br /> - ff fll! ona4erial is ta be used in any area, 1 aer�ify 4ha# use. af such fili wiit not adverseiy affect �djacent
<br /> propertf�s. Yf use of fl!f Is foUnd to advetsely�ffe�t adjacent proper�fes,.the owner may b+e cl#ed far vfodating
<br /> th� conditions af the buEldtng:permtt lssued under the attaofi�d permtt application, for lots t�ss than_one {1)
<br /> acre vuhich are elevated by f1ll,an engtneered drainage plan is a�equired. .
<br /> if I am the AGEN�'FCbR TH�C►ViiNER, I;prarailse In goad faith to lnfarm the�owner of-the permitting condittons set forth ln
<br /> tl�tis �ffidaviQ`prior#o commencing corrostruction: I undersfand �ha#;,ars,epar�te permit may be required for eiectricai wark,
<br /> plumbing, signs, vveils, poots; �fr canditloning, .gas, or other Install�itfons r��t spec�#ically �ncluded�in.the �ppli�ation. .A
<br /> pePmit issued shali be constcued to be a'licsnse to proceed wltb #he work�inc! not as authority to vialat�,.cancel, aiter, or
<br /> s�k aside�ny provisi�ns mf the tech�i�al codes; nar shall tssuance�of a.p�rrnit.pcever��thre�uUdirig Q#�l�la9 from ther�after
<br /> requiring a�orrection af errors in plans; consfnactian ar vloiatloras of any codes. Every permit Issued shall becorne invalid
<br /> unless the wark autFrari�ecf.by such permit�is_commenced�r�ifhin sUc m.anths crof permit issuao�ce� or If work authoriz�d by
<br /> the permit is susp�nded or.abandor�ed for a;perfiod ot six�{�}m�nths.after th�#ime the�work is commenaed. An extension
<br /> may be reqe�esked, In writing, from the Buitding,Of�clai for � perlod not to gxceed-nlne#y(90) days acrd wiii demanstrate
<br /> J�sti�able cause for.the extension: If work c�ases:for ninety(9Q}consecutive d�y.sr._th��ob�8s consfdered abarrdvned.
<br /> V1iA�2Ni�+G TO OWNi�R; YOUR FAILURE T4.@tE�.OEtD.�i,N�TIGE OF CONIIVIENCENIEI�T IVI�#Y RES�UI:T IN Y�IUR
<br /> Pe4,Y1WG'"i'41VICE;Fi3R,1lVlPRt)VEA�IEN,TS TCt•Ydi1R PRCi@�RTIf.,.iF�.Y0.�1riF9'fiEt��`T�����AIN�FItV�A1�C�NG,��ONSULT
<br /> �1PfT AUR E�tD C1 A� '�TQR F RE�R�E�t3R� �� �tE! :� S9 ��E'O� , E � � T�
<br /> �=ta1F8Pt`i�,a4;➢BJrBAT(P�:S:`P.97'.03j e---�- -- -- � -- . - - _ �-- - _ -- -_ _._- -- -
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<br /> OUYME6t OR�ltiEN? ". ... . „����2..»�Ct CONTRAG'��
<br /> Subscrlbed and swrorra,tp(or affinned) efore m�this Subscrlbed and'swq to(or afllrmed��befcra me tlii�
<br /> by �f .by
<br /> VVf�o Islare pe�sonally known to me ar hasthave prqduced Who.tsi�re personally ka�owmtt�me or hasfisve produced
<br /> as Identlwcatlon, as ldenBflcaQon.
<br /> hlotary Pubitc . Notary Publlc
<br /> Commisslon Mo:` Commission No.
<br /> Name of Notaty lyped,pNnked or stamped Plame of Notary typed,printed or skamped
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