i
<br /> ... i ,
<br /> � PlOTICE OF DEED RESTRlCT10P3S: The undersignec)unders4arrds Yhaf this permit m�r tse subject to"d�ed"resfidiuns'
<br /> which may be mare restrictive than County regulations. The undersigned assum�s resportslbiiily for comp!lanc�wtth arsy
<br /> ' apPlicable deed restrictions.
<br /> U�ILICENSED COI�TRF►CTORS AFfC4 CmPaTE�aCT�R �tESPClP3SeSaIL1"�11F.y: if thE owner has hired 8 t�rttractor o�'
<br /> cantradors to undeAake work,they may ba required to be licensed in accardance vdith state and locxl regulations. If tt�
<br /> cc�ntractor is nof i�c�rised as required by 1aw, fko4h Ehe awr�r anti corrtr�c4ar may be cited fiar a enlsdemeanor viotafion
<br /> i under stete law. If the owner or intended cor�6rector are unc��tain as to whaF Iicensing requirements m�y apply tor(dt�
<br /> � intended work,they are advised t�corrtact the Pasco Ccunty Buitd'sr�Ins�on Division--Licensing Se�tion at 727-&67-
<br /> � 80C39. Furthermore, i#the owner has hired � cosriradar or c�ntsactors, t� is advEseti �o h�vve �he co�fractor{s} sign
<br /> i portions of the"tx�ntractor Block"of this applicafian for which they�vill t�responsible. tf you, as th2 nwner si�n as tf�
<br /> ( conVactor,that may be an indication that he is not property licensed 2nd is not entitled ta pernt€tting privil�ges in Pasco
<br /> Caunty.
<br /> � TRAIVS�'OF7T.4710F1 IHIPACTIUTILITIIES IMPA�CT AR3D iaESOUR,CE�tECOVE�tY F�ES: The undersigned undersf2nds
<br /> ; that Transportatian Impact Fees and Recourse F2ecovery Fees may apply to the construcUon of►Zew bultdings,c�tan�of
<br /> use in exis#ing bulldings,or e�cpansiar►ag existing buildings,as speciii�d in Pasco C�unty Ordinan�number 89-47 ar�
<br /> 90-07, as amended. The undersigned atso understands,that such f�,as may be du�,rviH be identified at fitu time af
<br /> pertnitting. It is further understaod that Transpartation Irnpact Fees and Re�roures Rea�very Fees must bs paid pr3ar to
<br /> rec�iv)ng a"certiflcate o#accupanc�'ar finai pawer release. If the proJect does nat invoiv�a cer4ificafe of acxupancy ar
<br /> finai power release,the fees must be paid prior to permit issuance. Furthermore, if Pasco Cotmfy Water/Sew�sr tmpact
<br /> , fees are due,they must be paid prior to permft issuance in accorciance with appticable P�co Cotmty ardinances.
<br /> C4Pi8TRUGTION i�EN t.AW{Chapter?!S,Flortda St�tutas.av�e�srd�d}; if valuatlan of work is$2,500.40 or r�re,t
<br /> ' certify thaf i, the applicartt. have b�en provided with a copy af#Fte "Fiwida Canstrttt�ion EJen L�--Nomearn�t's
<br /> � Protection Guide"prepared by the Florida Departmer�t af Agriculture and Cor►sumer Af�airs. If tt�applicant is someone
<br /> I other than the"owne�',1 certify ihat I have abtained a capy of the atmve d�crit�d doasmerst and grarrsise in good faihh ta
<br /> I deiiver it ta ths"awne�'prior to cammencement.
<br /> COIdTRACTOR'S/OMIRIER'S AFFIDAVIT: 1 cer6fy that all the i►7formation in this appiication is accurate 8nd th�t af1 wrork �
<br /> will be dane in compliance wifh ail appiicable lawws regulatir,g cnrsstruc�ian.mnlru,�and land deue{aprrtEt'rtt. Application is
<br /> hereby made ta ab#ain a permft to do work and instailation as indica#e�cl. 1 t�tif}r thaf no wrark os insf�ilafian h�s
<br /> cammenced prior to issuance oi a permft and that ail work vitll be�rfom�ed to rr�et standards af all laws�gt�ating
<br /> canskruction, County and City codes, zoning regulations, and land de+r�lapmeni regulatians in the jurisdictlon, f also
<br /> � cert'riy#hat 3 understand that#he regulatians o#ather govemment agenc�may apply Eo the'sntended wark,anci tt�t it!s i
<br /> my responsibiiity to ider�kify what�ctions I must take to be in complian�. Sudi zgenaes irtdude bttt are nat tirnited�to:
<br /> Department af Environmental Protection-Cypress B�yheads, 4Vetiand Areas and Env'tronrtrer�tally 5ens:fiv8
<br /> Lartds,WaterMlastewafer Treatmer�t. ,
<br /> - Southwest Florida Water hAanagerrEent District-W211s, Cypress Bayheads, Wetlarxt Areas, Atierirtg
<br /> Watercourses. �
<br /> - Acmy Corps of Eng'sr�eers-Seaaralls,t�ocks,filavigable Wat�ways.
<br /> - Department of Heakth & Rehabititative Senrlces/Environm2ntaf F;�atih Urrik-Wells, VVast�uater Tt�airr�enY, ,
<br /> Septic Tanks.
<br /> - US EnuironmerEtai Prot�tian Agency-Asbestas aba#�rr�r�t.
<br /> - Federai Aviation Authority-Runways. "
<br /> I understand that the follawing restrictions appy to the use of filf:
<br /> - llse of filt is not aliowed In Fiood Zone"V'unless expt'essiy permitted.
<br /> - if the fiii materiat rs to be used in Ftood Zone "A", it is understood tha4 a drainag� }s�an a�dr�s3ng �
<br /> "compensating volume"wiil be submitted at time of pennitGng vJnich is preparetl by a prof�ssio�ai�rtg�rrr...�r
<br /> ticensed by the StaEe o#Fiorida
<br /> - if the fiii materiai is to be used in Ffood Zona"A"in cmnnuCtion�th a pennitted kr�itdirtg ttsictg s�err►wail
<br /> construction,I certify that fiil wili be used only to fi!I the area wit�hin the stem v+r�p.
<br /> - IT f1II fT18�8C13I iS t0 t}E tiSEC1 tTt any area, f certi€y thaf tsse of such ff!! wii! not aduersety af'ract atfja�
<br /> properties. Ifi use of fiil is faund to adversely af€ect adJace»2 propetties.the oumer t�tsay be c�3 far t�io!afi�
<br /> the conditior�s of the building permit issued tmder the attached pem�it application,for lots fess 4han ane(1)
<br /> acre which are elevafed by filt,an enginaered draEnage plan fs required.
<br /> ' !f 1 am the aGEtd'F FOit'ff�lE�O'IhiidER.I pror�i�e in good fdith to its�rnt tha oumer o#fhe perrni�ing cantii#�osts S�f for€�t in
<br /> this affidavit priar to cammencing construction. I understand tha#a sepaeate psmmiitt may bs reqtiff��a'�Sectri�al wor�, �
<br /> ptumbing, signs,wells, poais, air c4rsditionirrg. gas, or other insta4lations not spec�fca!{y ind� in the appiicat�an. A '
<br /> permit issued sha11 be construed ta be a tic�nse fo proceed wifh the woaic and nat as authari€y to via{a#e,car�t,a�ier,or
<br /> set aside arry provisions of the technical codes,nor shall issuance of a�it prev�nt the Building Offiaai from thereafter
<br /> requiring a comection of errors in plans,canstruction or vio}ations of any codes. Every per�rit fssued sh�it i�corr�}nvatid
<br /> an�ess the uvork authocized by such permit is cammenced within si�c months of�rmit issuance.or�f work authociz�d ts�+
<br /> the permit is suspended or abandoned for a period of si�c(6)manths afl�sr the 4me th�wot#c is aamm�nt�d. An�r�iast
<br /> may be requ�ted, in writing,fram the Building Uft'iaa!for a perfod not to exce�d ninety(30)days and wifl demt�sivat�
<br /> jus'tifisb#e cause for the extension. If work ceases fas ninefy{90}conssc��ve days��se job is consisfer�d abarrdar�ed� �
<br /> RWfAi�NIF3G TO CI�UPdL12: VOUFL FAILIIRE TO RECORID A@dC1'FEC�C1P C�E'�'9l�9�6dC�!!!'rEPdT R�Y E2�SUL'!'9!d 1POU� �
<br /> P�Yltdt'a'�tT�CE F{}Ft fl4�PRf}V'Eils9E!l�1TT'S'FQ Y{?t!�F�62C4P�FtTY. iF YCl�11�f'F��D 30 O$"�Aal@l Ftb+���1�,CC3l�SStDl�T
<br /> jfITH Y4UR Ll�i�tDER 4)G2 API ATTQR�l�1f BEFORE Fti�C�2R[3tl�9G YAt�R R�OTtCE O�CQ�3h+1��tC�E1dT. '
<br /> FLORIDA 3URAT(F.S.117.03) '
<br /> G, l/ �jI/�,���� �
<br /> {3Wi�fER4RAGEPIT CC's�1TRACYB� Q�'�l.�i� 1 �� '�'t
<br /> Wi�
<br /> Subsiribed snd swom to(or affimied)before me this sc�bed and awom 6o ior�:'mmed)betote me t2t�!
<br /> e,, ,,�,�,Y . -„� ,
<br /> Wtto lsfare persattr�fly Emown to me 4r h�awe ptoduced Is! persanalty tmavm to me or itasthave produc:ed
<br /> as identificcuition. as ideFttificatian.
<br /> �
<br /> NntaryPubtic ` �,v i�u���P2a#a�+Pub�c
<br /> � Comrresr�an No. �
<br /> :�'o�'4Y"°0���-, JAGQ13EL1NE HQRF�Ut3}NER
<br /> NemeafNotarytyped,p�ntodorstamped Nem2MNo �d �i!x�i��jMMISSiON#FF144817
<br /> '�� °'� EXPIRES Juty 2�4, 2018
<br /> �y�OF fL�``•
<br /> � (ap7)998-0153 FloridallotaryService.com
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