II '
<br /> . ,I '
<br /> ��
<br /> i� 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 conVactor or
<br /> icontractors to undertake work,they may be required to be licensed in accordance with state and local regulations. If the
<br /> I 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 /> i� 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 /> ii� Caunty.
<br /> TRANSPORTATION IMPACTNTILITIES 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-o7, 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 Agriculture 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 /> 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 indlcated. I certify that no work or instaltation has
<br />� commenced prior to issuance of a permit and that all wrork 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 /> certify that I understand that the regulations of other govemment 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,WateNWastewater 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 8 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 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. I
<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 /> pertnit 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 lf 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 /> �Q � o 'ustifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned.
<br /> � �° � M ARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU Q � o
<br /> p o ;r~i � AYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSUL � 'o 0
<br /> 2 °? i',LL � ITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. � � � `"
<br /> ¢ 10 ,� � LORIDA JURAT(F.S.117.03) � � r~i '
<br /> �
<br /> Z .� 'I�o� UVNER OR AGENT � ��'"CONTRACTOR_��-s.,�.a.t.L> .'� ��^ � N u- L
<br /> a '� � ubscribed nd swom �t�for�� ' f�Subscribed and swom to(or affirmed)before me this a � g
<br /> wa ,�, � '� 1 b __ — , • '1 -�t • - .. •.�' �. - ' �l �, w u a ui
<br /> � � E � ho is/a ersona me or has/have produced Who is/are onalfy to me or has/have produced Z � '� o
<br /> d f6' � m as identification. as idenfification. J p. E •�
<br /> Q � U � � � o 0
<br /> � ,��e., �/�� d p U U
<br /> ;���6 i�'��; / ry Public - / � �' Nota�' ry Public Q Z �
<br /> :n• �: ' ' r re �% � �`s���.
<br /> :�.��_ ommissionNo,�=���`������ Com�m—is�-sionNo. ' ` � Sl� ��.;��•''b?�d�o,
<br /> '6.;. �I,���: J`"-�� 1V�� " j / ' I r� =� g.
<br /> �'.Ne '+:
<br /> "i,"� ame of Notary typed,printed or stamped Name of otary typ d�,printed or stamped ';�ro• .•��.�•
<br /> a
<br /> I� ' •.H� a��
<br /> i���
<br /> il
<br /> �I
<br /> I
<br /> i 1
<br />
|