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. <br /> .� � � <br /> MOT�CE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed" restrictions" <br /> which may be more restrictive than Counry regulations. The undersigned assumes responsibility for compliance with any <br /> applicable deed restrictions. <br /> UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or <br /> cont�actors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the <br /> contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation <br /> unde�r state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the <br /> inten�ded work, they are advised to contact the Pasco County Building Inspection Division—Licensing 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 /> portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the <br /> cont�actor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco <br /> County. <br /> TR�4�ISPORTATION IMPACTIUTILITIES IMPACT i4ND RESOURCE RECOVERY FEES: The undersigned understands <br /> that �Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of <br /> use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and <br /> 90-0 as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of <br /> per itting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to <br /> recei ing a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or <br /> final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact <br /> fees,are due,they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances. <br /> CO STRUCTION LIEN LAW(Chapter 713, Florida Statutes, as amended): If valuation of work is$2,500.00 or more, I <br /> certi� that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's <br /> Prot ction Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone <br /> othe�than the"owner', I certify that I 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 /> COi�TFZ4CTOR'S/OWNER'S AFFIDAVIT. I certify that all the information in this application is accurate and that all work <br /> will e done in compliance with all applicable laws regulating construction, zoning and land development. Application is <br /> herei y made to obtain a permit to do work and installation as indicated. I certify that no work or installation has <br /> com�enced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating <br /> construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also <br /> certi�y that I understand that the regulations of other government agencies may apply to the intended work, and that it is <br /> my r sponsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: <br /> Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive <br /> Lands,Water/Wastewater Treatment. <br /> Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering <br /> Watercourses. <br /> Army Corps of Engineers-Seawalls, Docks, Navigable Waterways. <br /> Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment, <br /> Septic Tanks. <br /> US Environmental Protection Agency-Asbestos abatement. <br /> Federal Aviation Authority-Runways. <br /> I un erstand that the following restrictions apply to the use of fill: <br /> Use of fill is not allowed in Flood Zone"V" unless expressly permitted. <br /> If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a <br /> "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer <br /> licensed by the State of Florida <br /> If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall <br /> construction, I certify that fill will be used only to fill the area within the stem wall. <br /> If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent <br /> properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating <br /> the conditions of the building permit issued under the attached permit application, for lots less than one (1) <br /> acre which are elevated by fill, an engineered drainage plan is required. <br /> If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in <br /> this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, <br /> plurr�bing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application 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 /> set side any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter <br /> requ ring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become 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 or abandoned for a period of six(6) months after the time the work is commenced. An extension <br /> may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate <br /> justif able cause for the extension If work ceases for ninety(90)consecutive days, the job is considered abandoned. <br /> WA�NING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR <br /> PAY`NG TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT <br /> WITH YOUR LENDER OR AN ATTO BEFORE RECORDING Y UR NOTICE OF NCEMENT. ' <br /> FLOF'IDA JURAT(F.S.1 7 0 ) <br /> OWNER GENT , CONTRACTOR I <br /> Subscribe a wom to o affirme befase me this S bscribed nd snrom to(or affirmed)bef e this <br /> -�bY !.�!/u�/.�rn ', Cr2�.r� -,�/s�� by G✓ t�s <br /> ho is/are ersonall i <nov�n to me or has/have produced V�Iho's/are ersonally known to or haslhave produced <br /> as identification. as identification. <br /> I <br /> NotaryPublic Notary Public <br /> Comr�ission No Commission No <br /> Name of Notary typed,printed orstamped Name of Notary typed,printed orstamped � <br /> GAflY HICK3 "'" <br /> SiR�A"Y'P�e�,,� r n"�• GARY HICKS I <br /> ,qtiiF:..YP��•, <br /> �: MY COMMISSION#FF 16e587 ;t '';;-: MY COMMISSION#FF 16e587 <br /> ���','�; EXPIRES:January 10,2019 :�;�:;�; EXPIRES:January 10,2019 <br /> '•:,��,j��o�;�• Bondnd Thru Notary Public Underxriters •�'�,',�pd��'R' Bonded Thru Notary Publie Underxriters <br />