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�fC��'i�E�F L��E� t�E�T�i�TE�h3�: The under�ign�d understands that this permit may i�e subject to"d��d" r�stricfions"
<br /> v�P7ich may be c-nore restric#ive fih�n Gaunty regulations. The under�agn�c� assume� resgronsibiiity for comg�liance with any
<br /> a�g�licable deed restriction�.
<br /> ��L������� ��F�T���O�� ��&� �O�J��4��0� I���P��@SI�ILITI��: If tl�e own�r has hired a contractor or
<br /> contractors to undertake work, they rr2ay be required fio 8�e licensed in accordance with state and loca9 regulations. If the
<br /> contracfior is not licensed as required by lavv, b�th fihe owner and contractor m�y be cited for a misdemeano� violation
<br /> under state law. If the owner or intended contractor are uncertain as to �hat licensing requirem�nts may apply for the
<br /> infiended work, thsy are advised to contact the Pasco County �uilding In�pection Di�ision—Licensing Section at 727-847-
<br /> 8009. Furthermore, ifi the owraer has hired a contractar or contr�ctors, he is acieeised f� have the cantractor(�) sign
<br /> p�rtions of the "confirac�or �Io�Sc" of this applic�tion far vuliich ti�ey uvill be respon�ible. Ifi you, as the o�vner sign as the
<br /> cantractor, thaf may be ar� inc�ication �hat he is not �roperly licensed �nd is not entitled to permitting privilege� in PasGo
<br /> Count}�.
<br /> 'TF�Ai��'�F�T'�T't�i� !��°�G�'/�Tl�i�l�� I�dI���T�,�D ��a�39J�t�� F�����'��'�'����: �'h� undersigned understar�ds
<br /> that Transportation Impac� Fees and Recourse Recavenl Fees may apply to the cons�r�ction of new buildings, change of
<br /> use in existing buildings, or ex�ansion of existing buildings, a� specified in Pasco County Urdinance number 89-a7 and
<br /> 90-07, as amend�d. �'he und�r�igned also understand�, tha� such fees, �s rriay be due, will be id�nti�ied at fihe �i�ne ofi
<br /> permitfing. It is further understood thaf"fransportatian Impact �ees arad Ftesource Recovery Fees must be paid prior to
<br /> receioiing a "certificate of occupancy" or final povver release. If the projecf does n�t involve a certificafe of occupancy or
<br /> final power release, the fe�s musf b� paid prior fo permit issuance. Furthermore, if Pasco Cour�fy VVaterl�ewer IrrSpac�
<br /> fees are due, they must be paid prior�o p�rmit issuance in accordance vvi�h applicable Pasco Coun#y ordinances.
<br /> �(?���'Rt�C71C��1 LiEi� LA.�'(�h�g�t�r 713y G"IO�I������U�.Q�.'J�9 a� ��a�ead��): If valuafion of work as$2,500.00 or more, I
<br /> cer#ify fhat I, the appficant, havE been provit6�d Fnrith a copy of the "Florida Construc#iQn Lien Lae�—Nomeo�vn�r's
<br /> Protection Guide° pr�pared by the Florida De�ar�rnent of.�griculture and Consumer/af�airs. If fhe applicant is �ameone
<br /> other than th�"o�ner", I cerfify that I have ob4ained a copy of fihe above described document and prorrii�e in good faith to
<br /> deiiver it to fhe"oonmer" prior ta cornmencerra�nt.
<br /> �C1�&'i°�C�'��'�l��t��i�'����I�,��/IT: I certi�j that ail the ir�forra�atian in fihis ��plication is accurafe and that�II dvork
<br /> �nrill be done in cArnpli�nce� with a!9 applicable laws rEgul�ting construction, zoning �nd land developmenf. Applicatior� is
<br /> hereby made to obtain a perrr�it #o do �vQrk and install�tion as indicated. ! c�r�ify #hat no +nrork or installa�ion has
<br /> commenced prior to issu�nc� c�f a permit an� fitiat all worl< �rill b� p�rForm�d to m�et standard� of all 6avas regul�ting
<br /> construcfion, County and City codes, zor�an� regulatior�s, and land developmera4 regula�io�s in the j�risdiction. I al�o
<br /> certi�yy �hat B und�rstar�d that fihe regulations o�other gov�rnmenfi ager�cies may apply to the intended worlc, and fihat it is
<br /> my r�spansibility to identify wh�t actions I must fake to b� irr complianc�. Such agenci�s include but ar�not limited fio:
<br /> - Departrnen# of Environrnental Protec�ion-C}o�ress �ayheads, �lv'e�land �,reas �nd Ea7r�ironmentally Sensitiv�
<br /> � Lands, W�t�r/'JV�s#ewatEr Tre�trsient.
<br /> - Southwest Fioa•id� Water I'dl�r��gemen# ai�firict-Ul/ells, Cypr�ss ��yheads, �/'Jetlar�d Areas, Altering
<br /> Watea•courses.
<br /> - Army Corps of Erigia-i�ers-Se�vv�lfs, Docks, BV��ri�a�la V�lafi�rvdays.
<br /> - D�partrr�ent of Health & Rehabilitative Ser�ric�s/Enviranrra�a�tal He�lth Unit-Wells, 1/Vastev✓ater Treafirnent,
<br /> Septic Tanks.
<br /> - 6J5 Ea-�vironmental !'rotecfiion Agency-Asbestos a�iatement.
<br /> - F�deral Avi�tion Aufihority-Runvvays.
<br /> I understand thafi the follotivir�r� r�strictions��pEy fio#he use�o�fIE:
<br /> - Use of fiiil is not allawe� in Flood �arae"V" ur�l�s�e�:pressly p+�rmifitecl.
<br /> - i� the fiill mafieriaB i� to be us�d in Flood Z�a�e "fi", it i� ur�clerstood tha4 a clrainage plan �ddr�ssing a
<br /> "compensatin� volurrie" will be submitted �t ti��e of �ermifi#ing v�✓hich is pr��ar�d by a professiora�l engir��er
<br /> licensed by the State of Florida.
<br /> - Bfi the fll materiaf i� fio Eae used in FE�ad �one "A" in ccans�ection vvi#h a perrnit�ed building using ��em wall
<br /> construction, ! certify that fill v�ill be used oi�9y to fll the are�vvithin the�tem vvall.
<br /> - Bf fi@I rri�terial i5 to �e use�1 in any ar�a, I c�rtifiy that �se ofi such fill will no# adversely affect acljacent
<br /> proper�ies. Ifi u�e c�fll is fa�nd to advers�ly afifect adjacent pro��erti�s, the o�,vner may be citec# fior violating
<br /> the conditions of the I�ui6cling �rerr��it issued unc6er the att�ched perr�rit ap�slication, for lats less �han ane (�)
<br /> acre which arE�9ev�ted by�fil9, an engineered draina��pl�n is requirecf.
<br /> If I �m the����1T ����F@� O�dP�1��, I promise i� good faitl� ta infarm t�ie a�nra�er of th� perrniftirrg conditions sef fio�th i�i
<br /> this affidavit prior fo comrnencing canstruction. I undar��ancE �hat a separate peri-nit may be required for el�ctrical rr�ork,
<br /> plum9�ing, signs, vve{Is, pools, air canditioning, gas, or o�her installations not �pecifiically includecl in the �pplicafiior�. A
<br /> perrrtiit issued sh�91 4ae const�ued to be a lic�nse to prac��cl with the wor€c ancl no�a� �ut�ority to violate, caracel, alter, or
<br /> set�side any provisions of the t�chnical c��es, nor sh�ll iss�ance of a permit preverat the 8uildir�g flfficial from thereafifer
<br /> requiring a correcti�n of error� in pl�ns, con�truction or vialatians af�ny co�es. Every permit issuzd shall �ec��e invalid
<br /> un9�ss the work authorized by �uch perra�i� is commer�ce�€within six rrionths of pzrrni# issuance, or if�rvork a�at�orizeri by
<br /> the permit is sus}�ereded ar abandonec� for a periocf of�ix(6) months after the fir�ie the vvork is c�ra�rr�enced. An extension
<br /> may be requested, in writing, ��orn the BuilcJing Official for a pe�riod n�t t� exceed �inety (90) d�ys and will dems�nstrate
<br /> justifiable cau�e for Yhe exter��ion. If vdork ceases for ninet� (9C�) consecutive days, the job is considered ab�ndan�d
<br /> 4�'��k�IR@+� 1'O ��fWE�: '1°'t��R Fl�IL��� Tt� �����@� � F�@�9�'I�� �9F ��i�11�3�N��I�i�fV'f �El�°r° @�����.�' I6� Y�UR
<br /> Ptr�"a'"6h1��Vi�E F�R @�IP��s�EF�dE�dT's�"�°��9J� PF;�f����. IF`'��L� IfV�'E�J��'t3 t?���EB� FI�,A,�3C@�I�, Cta�l�9JLT
<br /> 19V��'H YOUi�LENDER OR�AN ATT�RNEY BEFc]RF RFcnRniva vnd�Q un��n�n�rnu9��a�r��s�c�.e�
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