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<br /> NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions"
<br /> which may be more restrictive than County 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 /> contractors to undertake work,they may be required to be licensed in accordance with state and Iocai 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 /> under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
<br /> intended 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 /> contractor,that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
<br /> County
<br /> TRANSPORTATION IMPACT/UTILITIES IMPACT AND 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 /> 90-07, as amended. The undersigned also understands,that such fees, as may be due,will be identified at the time of
<br /> permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
<br /> receiving 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 /> CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes,as amended): If valuation of work is$2,500.00 or more,I
<br /> certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
<br /> Protection Guide"prepared by the Florida Department of Agricuiture and Consumer Affairs. If the applicant is someone
<br /> other 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 /> CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work
<br /> i will be done in compliance with all applicable laws regulating construction,zoning and land development. Application is
<br /> hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
<br /> commenced 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 /> certity 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 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 understand 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 certity 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 /> plumbing, 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 aside any provisions of the technical codes,nor shall issuance of a permit prevent the Building Official from thereafter
<br /> requiring 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 author¢ed 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 /> justifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned.
<br /> WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br /> PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
<br /> WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
<br /> FLORIDA JURAT(F.S.117.03)
<br /> OWNER OR AGENT".I�Y)kl A�Q� �'^t- CONTRACTOR � � �
<br /> u scrib d and swom to(Gr affirtned be ore me this scn d and swo to(or a(firtned)before me
<br /> by i�.hne� �r�Qds ���_bY�..dVe✓11C. L. A'LJ�Z.�
<br /> o is/ re persona known to me or h�s/hav,�iuced Q�i re personally known to me or haslhave produced
<br /> as identificaGon. K.1101�1►1 i-� fKe_ as identification.
<br /> Notary Public Notary Public
<br /> Commission No. � Commission No. ��yQ �y'p S
<br /> �V4 I�,�S�I l
<br /> nn e or s a pe Name of Notary typed,prinled or stamped
<br /> ;=o�'""'°'��:_EVA MARIE MARSHALL ..,..
<br /> .••'�1�r°�e"'
<br /> _� •a MY COMMISSION#FF080465 ,.-=o o�<.EVA MARIE MARSHALL
<br /> :7�'••........���f� -
<br /> '••'�oF�;o�;, EXPIRES April 11, 2018 `•� ' �"' MY COMMISSION#FF080485
<br /> (407)398-0153 FloridallotaryService.com •"�'oF�F;:o��f EXPIRES April 11, 2018
<br /> (ao7)398-0153 FloridallotaryService.com
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