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<br /> (VQT1C��F D�ED_RE�.T.ItICT10�1�: �he undersign�d;unde�tands�,th�#;thl�kp.�rmlf�.may,�;b,e,subJectrto;"deed"�res�fct�oiis"�:r,.:_;_,.:,...,�
<br /> which mey'tie=more':reistti�tive`;th���Coun�`�r9agrllatfons `'The un��erslgrieds assumes respo'nsitilltty�=for.compliance'with`any'`��"�""'°�`��"
<br /> applicable:deed=rest�ictlons. ` - :r=;.:; •:::�.:; .. • _. ... - - _..-_.�___ __ v�:.,-,° .,,•.,.r_�.�>�;
<br /> -�:^�:' ' �_._...._...,:_... ...,. r. ._. ..:
<br /> UNLIClENSED��CONTRACTORS :AND CON�'RACTOR RESP,.ONSIB1tITiE�S:�=<If°the=�owner�Lhas"`htred�a�':cc�r�tiractor or
<br /> ,..
<br /> contractors.to undertake work;-tf�ey may�b_s,.r�iquiF-ed:sto.��tie�llcensed:Iny:aix_ordance.with:state�,and�local�regulallons:��ifrthe�>�•�-- - �t�
<br /> . . ...1.,>�___,. ..:....-_: ._. _ .,._ ; , :
<br /> contracto�:=ls��noE`�Ilaensed-as��te'qulred�:tiy law,�bothr�the ovdner a;nd-�conGacto�=��mejr��be��cltetl'.for�����ml�demeanor violation '
<br /> under state lau�r. If the ovvner.or Inte'nded,a{contra�torr�are;:uncertain as to.wfiat Itcenaing:requirements'�;;may::�appijr.��fo��*the+=�J���°���=�F'
<br /> �:..4� ,---:..�,.���..A. � �,... . _
<br /> tntended'iaork, tNey are�advlsed�to coritac't.the>>Pasco:Countyx:Bullding Inspectltin;;Dlvi�ion-L•tcensing Section at:727-847-
<br /> 8009. Furthermore, �If the owri�er'fias'Filred a coin'tracto�"o�µconfractors. he is advised to have�the contractor(,$)�,sign.,,r,,,,..:Y i
<br /> porNons�of the: conttactor,Block" of..fhis�appllcation�fo_r_.whlch,they wlll:.b.e-r,esp.onsible.>•IfMyou;:�as_.the biivner�aign as the"'`�
<br /> contractor,that�rnay�be an indtcation�tfiat°tie`=1s�nof:properly�licensed"and��i`s��not"en�tied�to pennitting priitileges (n Pasco
<br /> County. _ . _. _. . _. ... _......... �...__.... '��_,�Y�_.. I
<br /> �..:; =,:�:,
<br /> TRANSPORTATION�IMPACTIUTILCi'IES=rMI�AC��ANb�RE�AI�JItCE R@COVERY�FEE�:��The�undersi�ned understands .
<br /> thatTransportation Impact Fees.and,Recourse.Recovery.Fees may�,applyfi�.to�t�e'�,conatructlon.:of,new b.u.,ll.dings,�chan�e��of�p��'''°;;:�,���t -
<br /> use in existing buildings;or.,ezpar�si6rr�of�e�ii§�i`�i,g;'�bulliNngs, a§ spec�ted.tn P�sco Count�Ordinance number 89-07 and:
<br /> 90-07� as amended...::;,�h� undersigned also;urtderstands; th�t�suoh fees;:as�majr.�b:=due;Y�wllk.be.identified at the=time of'-���� •V�`°'��`'
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<br /> permitting. It Is turtlier understood that Tra�i�p�ortatlon Impacf'Fees art�`��Reaour,ceaReco�sry='Fees`:,mu�t be pald prior to
<br /> rece4ving�a'certi�cate-of�occupa�cy"�or flnal�.power;release:°4�:I��the.proJect::.does^not invclve�'a=certff_tcete of occupancy�o�#���=���`k'°'
<br /> final power.�release;�;.tFie�:fees=mus�t"tie peld,p�lo�,to,,permit Issu�hce. F�xthermore��if:Pascok;County"1NaterlSewer�lmpac[�=-���,�-��d��
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<br /> CONSTttUCTION'LIENbLA�II Cii'a�'te 713 i�lor da�tat t���ance witFt�:appilcatile:Pasco':County�ordtnances. •
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<br /> ( p `�� . � am�nd�d): If valuadon of work is a2,500:00}oc{more;:;l� �;. :��..
<br /> certify tFiat .I, �he::appllcant;:=have:.been_ prov[ded_�with-a~copy°r.of��thef�":Florida��ConstivEtion::Lien�-.:Law---Homeowne�'s ��.
<br /> Protection Guide" prepared by tHe Florida Department;of Agriculture and Consumsr�RfFairs. If the appllcant Is someone: :.., �.;•�-�_
<br /> other than 1he'owner", I cert�j+`�th�t I�.h�ve;:obtQ.ined"akcopy:of:th.e�abQve:descri�ed��loai�ent°and.p.rot�ise:`tn,good:�:faith•.to •. ;:,
<br /> deliver It to.tlie:'owner":'.piior��toycommencement:';,. ,. ' .` � -. . . ."��"' . � , _ ��.
<br /> CONTF�AACTOR'SIOVYNER'�AFFIDAVIT: I.ce,rtify;�,tfi�at,:ell:�th�;inf.ormatlotr�in�thia appllcatlon is accurat�and that all work
<br /> will'be done in compliance.wfth all.applicable (aws regulgting constructlon, zpning and:�land�developm�nt. Appticatlon.is
<br /> hereby made to obtain:a.pecm(t,�to:;do��w��h,and�:;ttistallation es indi�afetl:�-�.=1� certify that no work��:or tnstallatfon liasr �
<br /> commenced p�ior to iss�ance of.a�perm(E"and tha#�:all�r�rork will be pertormed�to meet=standards-of�all laws regula�ng-_
<br /> conshuctton, County and City codes, zoning regulatians, and land development regulatlons�In-tFie�:Jurisdlction:���`1-�a1'so.�
<br />,� certify that I understand that the regulatlons of other�government agencles may•apply..•;to,the�intended.work� and that it is
<br />� my respons(bllity to Identf(y•what.acttons I,mu.st�t�k,e�.to bedn;compliar�ca:_;.�Suc.h,{agencles^Include�'but�are.not Ilmited to::� �
<br /> - Depactment of E�lvtronmental=Protection Gypres�:'Beyliead�; WeNand Areas �nd Enylronmentaily Sensiti�e
<br /> Lands,WaterlWa9tewater Treatment. _ . - - �` � �� -
<br /> - Southwest FloNda Water Management�:bisfrlct-lNells; "Cypress•:�Bay�ead�,� Wedand� Areas. Altering
<br />� Watercourses. �,,,.. .--�� :_, ;.:;.::,.�.�:� �., .,...�,., � , . ,
<br /> - Army Corps of Englneers�Seawalls,'Docks, Navlgatile Weterways. .
<br /> - Department-�of:,Health.�&.,,Re�iabllltative�.,;Servlce.s'IEn�Pronmental,F�ealth=Unit:Well.si:�Ill�astewater�Tre�hnent; �
<br /> Septic Tanks:.��-� __ ' , _ - ' _ ' ' _ ... . ..
<br /> - US Environmental Protectlon Agency-Asbestos abatemen� �
<br /> - Federal Avlat[vn:Autho.�Ity�Runways:,
<br /> I understand.that�the.following:,'restrlctions apply to the use of flIL••
<br /> - Use of ftll Is not allowed 1niFlood:Zone"V"unless expressly permltted.
<br /> - If the-.�flll materlal=`Is��to;b.e used'�`'In ;Flood Zone. �A"� It Is underetood th'at`a dralnage plan addressing a
<br /> "compensating volume".wlll be submltted at#Ime of; ermittln whlch is re ared b a rof
<br /> . . P .9 P p y p e s s t o n a l e n g t n e e r �
<br /> Ilcensed by�tf;ie_State�of`.Flotlda: � . _ -
<br /> - If th� flll•materlal�:ts°`to be:used In Flood Zone 'A" Im connectton�wlth�a��permltted bullding using stem wall
<br /> � constiuction,.l'certify;:that-:flll:�iall:b.e�used only.to#111 the area wlthln�the�stem�wall: . � '
<br /> - If flll 'materlal�1s��to be used in�:any area; I �ce�tlf�r,�that .use. of-,such�flll wlll not adversely �ifect adjacent . _
<br /> propertles., .,If use:of.flll,;ls found�-to=advers�ly:.�ffect a�jacent�pcaipertles�.the owner may be clted for vlolating
<br /> the condl#ions:.of.the b�illdtngxpemilt�lssued�=under tlie`;�at�ached_pecmlt-appl(catlon;��for:lots�.les"s�than:one (1)
<br /> aare wFilch are elevated�6y:flll;a�-englneered dralnage plan Is requlred. •
<br /> If I am the AGENT FOR�.TNE OWNER,.Irpromfse In.good�falth to Inforrra�the owner of�the permltting conditlons'set torth In
<br /> thts aifidavit prlor to commer�cing constructlon. �1 unitl�rstand thet�_a_separate�permlt may be requlred for electrlcal:work, ., ..
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<br /> plumb(ng,,signs� wells;.pools;�alr'.cond(tioning;�.gas;�or:otMer Install�tloris not�spec�lc�lly Included-in.the applicatlon. .A -
<br />, permit Issued�shall be construe.d to'b'e'a`Ilcense`�to��p'oceed wlth"tNe wo�k and�:not�as:authoHly-:to:=vlolate;�acancel, alier, or
<br /> I set aslde any provtstons of ihe.technlcal_codes;�nor shall Issu�nce�of a.permtt.prevent the Bulldtrig Ofifctal irom thereaftec �
<br /> requlring a_coRectlon_af�errors in-.plans'; constiuctlon..or vlolatlons of-any codes:���very�p�ermlt=lssued`shall�tieaome-lnvalld
<br /> unless the work authortzed.by such perrtalt:is_commenced�wlthln,$fjc.,morxths of�permlt Issuance� or If work authoNzed by
<br /> the permlt Is:suspended�or;abar�doned�for:a:perlod;of:�six:(fl)�mon�s;,:efterthe-.tlme the�work�ts commenced._ An extenston
<br /> may be requested, In.,wdting,.from,the�Butlding,Offlctal for a perlod,�not_.to exceed'�ntnet�r-�(90)��days a�d�vii111�demonstrate
<br /> Justmable�cause for.•ihe extenslor�: If work ceas�s.for nlnety.(90)cons.ecutive:day.�,..the)ob�ts�consldered aba�doned.
<br /> lAIARNING TO OWNER: YO:UR.FAILURE:rT4,R�ECQ�tQ:AzlalOT�IGE:OF:•�COMMENCEMEI�T�:NtAY�RESULT IN:°YOUR �
<br /> PAYING TWICE:;FOF,t:IMPRO�IEMEN,�B�TflwX-fl.UR�:P�ORER-:TY:��I�:YO.U�I�F'iE�1D:�T0"�OHT�IN�F1N�Ct�E1N�;�ONBULT
<br /> �YFi Y��lR����ER���aPir A�ORP�E��fF�REtiR����Fi�`���i�`-�i��=�'�i'�-.'ciiiflWi�"��` .,. . .
<br /> FLORIDA JURA��(F.S::1.17:Q3}... . , ; .. , ...:. ._ .. .. , . - • --_, _
<br /> OWFIER OR A�3�NT�, COMTI3f1GTA �� ' .
<br /> Subsdlbed and�wom to(or aftlrtned)before me thl� Subsc►lbed end'auiom'to t�a rm -
<br /> bY /a�/.3//[0 .:,by... • • •G��
<br /> Who Islare personally known to.me.or:haalhave,produced . 1M�o.tslare p.ersonalyknown:to:.me.oc#laalhave:produced • �
<br /> -as Id'enBBcatl4n. - �J�/��C L/G�i(�50 as Identlflcadon. \
<br /> Notery Publlc . � !� ` ' �..
<br /> Nofary Publlc
<br /> Commisslon No•: Commiselon No. ' � �
<br /> EG-' �
<br /> Name ot Notary typed,printed o�atamped Name oi Not ...
<br /> • ,�"'�o�•,, DEBRAELAINE RUFFELL • •
<br /> .. _ }��' �. .. �� -
<br /> ,�:Commission#GG 045343
<br /> �:.�:o?Expires November 7,2020
<br /> ''•',A,po wo°'• Bonded Ttw Tioy Fa1n Insurance 8Uo-38�1019
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