|
� � '_ •
<br /> _�_ _- � "Y
<br /> NOYICE�� DEED.RESTRIGTION5: �tfie�underslgnect undergtands�.t��thls;,p,�rmit.may be,sub�ect to."deed"restrictton§°
<br /> which may be.,more��resUicttve��th��-�Gountq�rieg�i�tfons. �The�.un'd"ersigr��d��ass�rines�r'esp.onsitiiiity for'compilance=wi@h"any
<br /> applicable deed rest�ictions. � . � - �• -• • � � �• • -�• '� � ' - � ' •�• ' ' .
<br /> UNLICEf�SED 'CONTRAC�OItS �AND CONTRACTOf��,R�SPONSIBILITIES:� If�the_owner .has -hired a�contractar or
<br /> cosi�r�ctars to undertake work, they may.be:.r.�,qtalred�.ta,be::licens,edrl�.�ccor.dance.witti-state�:ari�t�local�`regulations'., Ifthe
<br /> contractor ts not:�licensed as�required'`by law; both the own�r`�nd-contraetb�=inay;be��clted�for.��misdemeanor violatlon
<br /> � '• under state Iaw. If the owner or Intended>;contr,actor.:ace:uncertain �s to whaf'�Icensing;`requlroments,mayR-apply��or:the '
<br /> tntended work, they are advised to.contact the Pasco County�uild(ng inspectlon DI'viston—L•icensing Section at 727-847-
<br /> 8009. Furthermore, if the owner has hired a contractor or contractors;,���he is advised.:to;have the contractor(s):sign
<br /> portlons of the "contrector Block" of this application for whlch thep will'be�esponsible. .If you�;as.the owrier'stgn�as�the
<br /> contractor, that�may be�an Indication that�he�is.not.prope�y flc,ensed �nd is noY entftled-to pemiitting privileges in.Pasco
<br /> County. ; �- � • . � �.�.... . ... , .., ._;. :. .,, .: ; . .
<br /> TRANSPORTATION;IMPACTIUTIL�'TiES��IMRAC'-1'-Apb-RESOURCE RECOVERY�FEES;�The undersigned�understands
<br /> that Transportation Impact Fees�and.Reco.urse Recove.ry.Fees may��apply:�.to:the construction of new_buildings, change�of
<br /> use in existing buildings,�or»expansi�n:•of�iexlatin�g�buildings, as specifled.in Pascq County Ordinance number 89-07 and
<br /> 90=07, as amended.._The undersigned also;understands, th�t�such fees�.as tnayr�be:due;,,wlll.�be identified at the�-time�of
<br /> Permitting. It Is fiirtPie�understood that Transportatlon.Impact Fees and�Resource Recovery-'Fees.must be pald prior to
<br /> rece4ving a "certiflcate of occupancy,":or-finat�.powercelease. :I��the project.,does:not tnvolve�:a certfflcafe of occupancy o�
<br /> flnal power release,;the fees;mu�t be paid prior to permit Issuance. Fu�thermote;�If:Pascv County 1Nater/Se.wer��lmpact
<br /> fees are due,they.must.be=p�id.pNor to permit•Issuance-�n accordanco with appllcable Pasca�-County ordinances.
<br /> CONSTRUCTION L'IEN'LAW(Chapt�r.713�,Florlda 3tatufes�aa arraended):!tf-valuation•of work ls'$2,500.00.or more, I
<br /> certify that I, the applicant, have�tieen provided with'a copy of-the "Florida-Constructlon Llen Law—Homeowner's
<br /> Protecticrn Gutde" prepared by the Florida Department�of Agric.ulture and ConsumerAffalrs. If the applican#Js�someone
<br /> other than th�"owner", I certify that-l�have.oqtained'fa copy.of.the above..descrlbed�dbcuii�ent�and.p.r.or�l.se�tn,gQod faith to
<br /> deiiver it to the'ownec"-prior�to�cornmencement: � - ' . .
<br /> CONTRACTOR'S/OWNER'S AF�IDAVIT:�:��1.certifjr..that.ali thg�lnformeli�n:in<thi� applicatlon,is�accdrate.and that all work
<br /> will�be done in comptiance wiith all.appl(cable laws regulating cons�ruction� zonir�g and:-land�development. Appitcation is -
<br /> hereby made to obta(n .a permit.to _do. work::and Installation•as�indtcafed:.•. °I certffy�:that-no:work�:or installattora has -
<br /> commenced prior to Issuance of a pennit and that.all work will be p�rtormed 4o meet sNaridards`of ali laws regulaking-
<br /> construction, County and City codes, zoning regulatians, and land d�veloprnent cegulaUons-in the jurisd(ction. ( al'so -
<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.acttons I must•take:M be,ln:.conlpliance: S,uch agenoles include but-are.not Iimited:to: . �
<br /> - Department of E�v(ronmental°Protection'-Gypress.Bayhead�; !lV�Uand Areas�and Environmentally Sensitive
<br /> Lands,WatedWastewater Treatment.
<br /> - � Southwest Florida Water Management .:District-Welis, -Cypress."Bay�eads; Wetland Areas, A4cering
<br /> ' Watercours�s.
<br /> - Army Corps of Englneers-Seawalls, Docks, Navigatile Waterways.
<br /> � - Department of Health� 8 Rehabifltativ.e �erdtceslEnvfronmental_.Health Untt-Welis, Waste.water�Treatment,
<br /> Septlo Tanks. � _ - .
<br /> - US Environmental:Protectfon-Agency Astiestos`.abatement. . _ , �- .. ,
<br /> - Federal Avlatton�Authority-Runways. - �
<br /> I understand that the followi�ig�restrictions apply to the ase of flll:• - . ,
<br /> � - Useoffill,isnot�allowed.inFlood�Zone"V"'.uNess�.expressly��ermitted:� �- - �- �� � � ' '
<br /> - If the ffll materlal� is to be used: in.�Flood Zone. "A", it. i� understood that a drainage plan addressing a
<br /> "compensating volume" will be submitted at#ime of permftting which Is prepared by a professional engineer
<br /> Iicens�d by�#he State�of�Florida: .
<br /> - If ihe flll mater`lal ts;to be used in F9ood Zone °A" Ins connec�lon�with:a��permitted building using stem wall
<br /> � construction, I ce�tify that flll:wJll�b.e used only.to.flll the area within�the stem�wali.
<br /> - If flll ma�erlal Is �to be-used In any area� I �certify that use. of such flll will not adversely affect adjacent
<br /> propertles. If use of flll is found to adver�ely.,affect�dJacent��pr�perties,.the owner may be cited for violating
<br /> the condllions of tf�e�building:-,permit Issued�under the attacFied permit-applicatlon, for•lots less than.one (1)
<br /> acre which are elevateil�by�fllt;�n englneered dralnage plan is required. • •
<br /> If I am the AGENT FOR THE 01tMNER, i�promise In good falth to inform the owner of-the permitting conditfons set.forth In
<br /> this affidavlt'prtor to commer�cing consb�uctlon. 'I understand thet a:separate permtt may be requtred for elecMcal work,
<br /> plumbing, signs, wells,�pools; air conditioning,.gas,'or otMec installations nol•spectflcally includ�d�in.the application. .A
<br /> permit issued shall be construed to be�a�Iicense:to proceed with tFie work and not as:authoNty to.violate, cancel, alter, or
<br /> set aside any pr�visions of the.technical.codes;�nor shall issuance of a.permit.prevent the�ulldirig O#flcial from thereafter
<br /> requiring a correction.af errors in.pians; eonstruction or violations of any codes. Every permlt issued shall become invalid
<br /> uniess the work authorized.by such permit:�is.commenced�withtn sUc months of permit issuance, or tf work auttiorfzed by
<br /> the permit Os suspended or.abandoned for.a:�eNod of�six�(6)mont�s:.after the time the�workl�commencesJ. An extension
<br /> may be requested, In wrfting,.from 1he Building;Officlal for a period.not to.exceed ninety�(90) days and will demonstrate
<br /> �justifiable cause for.the extensior�. If work ceas�S:for ninety(90)cons.ecutive:days,..th�Job�Ps considered abandoned.
<br /> WARNONG TO OWNfR: YOUR.FAILURE TC1..REC.OR�,A MOTIGE:OF=COMMEMCEMEI�T:MAY�RESULT IN�YOUR
<br /> PAYING TINICE.FOR IMPRO�%EMEN'�'��TO.YOUR4�PRt�PE1t�TY.-I�°YO.tJxIN�'�EhID^TO;OB�TAIN=�If�At�E1NG;�CONSULT �
<br /> �!/� l! D �O. Af� � .O N . O.�S. O � G:: .O ` � �� '�d .� '• . , ,E � .
<br /> �:.ORIDA JURA�a(F.S��iZ.Q3�---- - --- --- — -�---- ----- - - - ------ -- -
<br /> OWNER OR AOEPIT,�e������2����w� CONTRACTO � �
<br /> ���S crlbe and r (or affi�ed)befo`e thls Subsalbed and'swom'to(or affirtned)�befiore�ne tht� �
<br /> _bY �Q� 1\ ��P��n.�'�� �26--1b •br �1�i��iitr� ;�l�/t�
<br /> VYho Igl rse , �me or•has/h�ve produced Who ls/are onallykno ta me:or-haslhava�produced: •
<br /> as Identlflcatlon. � as IdentlficaUon.
<br /> . � . .
<br /> Notery Public . Notary Public
<br /> Commisslon No:' Com aston No.
<br /> � �.�`�e Q. o�� Notary Public StaM of Florida
<br /> .
<br /> Name of N Name of Notary typed,pd t or stemped � My Commissian FF 234554
<br /> ;�i�`'���u'��; EDITH A MAHANEY �'+o,no� Ezpires0 710 6120 1 9
<br /> ;:'�,�A�� MYCOMMISSION#FF186580
<br /> t.,�o;•r:o�.•� EXPIRES January 1,2019
<br /> � (407)388-0153 Floridallotary3ervfce.com
<br />
|