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<br /> N()TICE: OIF DEED RESTt�iCTI�JNS: The undersignE�d understands that th(s permlt rnay be subject to�d�iad" rastric;tions"
<br /> whicYo m�y be.more�restric;tive than County regulations. The undersignecl assumes responsibllity for•compliance wi�th any
<br /> applic:able deed restrictions.
<br /> UNLI�CFCJSED CON'rRA(;TOR�i ANp CONTR/�f;TI�R RESPONSIBILITIES: If the owner has�:hired � .c�mtractor or
<br /> contr��ctors to undertake work, they may be required to be �Icensed in accordance with state and local rec�ulations, If the
<br /> contr��ctc�r is not licensed as required by law, botli the owner and contractor may be clted for a mfsdemeanor vlc�lation
<br /> under� state law. If the owner or intendod contractor are uncertafn as to what Iicensing requirements m�y apply f'or the
<br /> intencied work, they are acivised to cont�cQ the Pasco County Building Inspection Division—Licensing Sec:tlon at 727-847-
<br /> 8009, F�urthermore, if the owner has hired a cGntractor or contractors, he is advised to have the contractor(s) sign
<br /> portfons of the "contractor Block" of this application-fflr which they wiil be responsible. If you, as the owner sign �s the
<br /> contr��etc�r, that may be an indication th��t he is not properly Iic�nsed and is not entifled to permitting privileg�;s in �'asco
<br /> County.
<br /> TF�APJSF'ORTATION IMP�4CTIUTILITIE� INiPACT'AIVD RESOIJRCE REC�VERY FEES:' The uridersigned under:�tands
<br /> that 1"ransportation Impact Fees and Recourse Recovery Fees may apply to thE: construction of new buildings, change of
<br /> use in Axisting bufldings, or expansion c�f existing buoldings, as specified in Pa:�co County Ordinance number 89-07 and
<br /> 90-07', as �mended. The under•signed �Isv understands, that such fees, as m�y be due, wfll be identifi�d at the time of
<br /> permotfing. It is further uriderstc�od that Transport��tian Impact Fees and Resource f�ecovery Fees mus� be paid prior to
<br /> rE:cei�iinc� a "certificate of occup��ncy" or flnal powe�r r�lease. If the project doe;s not involve a certificate of oc:cupancy or
<br /> final ��ower release, the fe�es must be pafd prior tci permit (ssuance. Furtherm��re, if Pasco County Wat�r/Sewer Impact
<br /> fe�s ;are due, they must�6E3 paid.prior to permit issuanr,e In accordance with applicabl�: Pasco County ordin:�nc�:s,
<br /> Cf)NST'ItUCTION LI�N LAW (C:haptHr 7'13, Florli�a Statutes, as amended); If valuat(on of work is $2,;i()0.00 or more, I
<br /> certify tfiat I, the applicant, have been provide� with a copy of the "Florida Construction Lien Law�--Hc�meowner's
<br /> Protecticm Guide" prepared by the Floricia Departrnent of Agriculture and Gonsumer Affairs. If the applic�nt is sorneone
<br /> other th��n the"owner", I certify that I have obtained a copy of the above ciescribed document and promise in c�ood faith to
<br /> delivc:r It to the"owner"prior to c�mmoncement. ' � ' "
<br /> Ct�N'TR�GTOR'�IOWNER'S AF'F�DAV9T: I certif,y that all the informatfon in this appHcation is accurate and that all work
<br /> will�be done in compliance with all applicable law:� regulating construct(on, zoning and land developmerit. Application is
<br /> herek�y made to obtain �i permit to da work anci installatlon as indicated. I certify that no work or installation has
<br /> comrnenced prior to issu�nce of a perrnit and th��t all work will be performed to meet standards of all laws regulating
<br /> construction, County, and City codes, zoning reg�ala�ions, and land development r�gulations in the juri:�dicfion. I also
<br /> certify that I understand tf�at the regulations of other government agenciQs may apply to the intended work, cind that it is
<br /> m,y re:sponsibility to identify what actions I must take t� be (n compliance. Such agencies include but are nc�t lirnited to:
<br /> - Department of Environmontal Protection-Cypress �ayheads, 1Netl�nd Areas and Environmentally Sensitive
<br /> Lands, Water/Waste:water Treatment.
<br /> - � Southwest Florida Water Managernent District-Wells, (;ypress Bayheads, Wetland Areais, Altering
<br /> Watercourses,
<br /> - Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
<br /> - Department of Health & Rehabilitative �ervices/Environmental Health Unit-Wells, Wastewater Treatment,
<br /> Septic Tanks.
<br /> - US Environmental Protection Agency-l�s�estos abatement.
<br /> - Federal Aviatlon Aufhority-Runways,
<br /> I understarid that the following rEjstrictions apply to tho use of flll:�
<br /> - Use of fill is not allowed In Flood Zone"V"unless ex'ressly�ermitt�d.
<br />' - If the flll mai;erial is to be used in f=1o�d 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 professiorial engineer
<br /> Ifcensed by the Stata of Florida.
<br /> - If the fill mat�rial is to be used in Floo� Zone "A" (n conn�ction with a permitted building using stem wall
<br /> construcfiion, I certify that fill wlll be usE:d only to fill fhe area within tlie stom wall.
<br /> - If fill material is to be used In any s�rea, I certify tliat usa of such fill will not adversely affE3ct acljacent
<br /> properties. if use of ffll Is found to adversely affect adjacenk properties, the owner may be cited for vfolating
<br /> the condition:� of tha buiiding permit I:ssued under the attached permit s�pplication, for Iots less than c�ne (1)
<br /> � e uired.
<br /> acre which are elev�ted by ffli, an engineE,red drainage plan is r q
<br /> If I am the AGENT FOR YHE OWNER, I promise in c�ood faith to inform the owner of the permitting condition� set i�orth in
<br /> this ��fficlavit prior to commencing constructlon. I uncierstand that a separate permif may be required for• electrical work,
<br /> plumbing, signs, wells, pQols, �ir conditioning, gas, or other installations not :;pecifically included in thQ application. A
<br /> pE�rmft iasued shall be construed to be a Iicense tc� proceed wfth the work and not as authority to.violate, cancel, alter, or
<br /> sE:t aside any provis(ons c�f the technical codes, nar shall issuance of a permit prevent the Bufld(rig Officiaf from thereafter
<br /> requirin,y a correction of errors fn plans, constructfon �r violatfons of any codes. Every permit (ssued shall.ber,ome invalid
<br /> unle:�s th� work authorize:d by :�uch permit is commenced within six months of permit issuance, or if work authori:zed by
<br /> the �ermit (s suspended c►r abandoned for a periocl of�six (6) months after the time the work is commenc�:d. An extension
<br /> may be requested, In writing, from the Building,Official for a period not to excoed ninety (90) days and will demonstrate
<br /> justiflable cause for the eutension. If work ceases for ninety(90) consecutive days, th�)ob is considered abandoned.
<br /> - WAFtNING TO OWNER: YOUI� FAIL�URE TO F:EC;ORD A N0710E UF COMMENCEMENT MAY RE::3UL.T IN YOUFt
<br /> PAYIN(i TWICE FOf�IMIPROV�MEI�iT� �O Y�UR F'ROPERTI(. lF=YOU�lnlTl_ND_T_O-OBTAIN FINAN(I�NG, CONSULT
<br /> WIT&i YOUR LENDER O�t AN�P►TTOR�JE:Y BEFO�RE' RECORDING YOIJR O'fIC F MENCEMI=WT�-
<br /> FI.ORIDA JURAT(F.S. 117.03)
<br /> UWNIER OR AGENT CONTF�ACTORt —
<br /> Subsc:ribed and sworn to(or afflrmed)bofore me this Subscribed and s o afflrme )b f r e this
<br /> _by bY ---
<br /> Who islare personally known to me or heis/have produced Who is/are personally nown o mo or asalhave produced
<br /> as identiticatlon. ,•<:�s:;� DEBRA ELA�NE RUFFELL
<br /> � _;4��;:Commission#GG 045343
<br /> =s,r �,:Expires November 7,2020
<br /> Notary Public �%Q'"`g�� ���Thrt��py4S11F�Fdet�600'3857019
<br /> Comrnisslon No. _ Commisslon No. -- —
<br /> Name�of Notary typed,printed or stamped Name of Natary typed,printed or stamped
<br />
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