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NO'flCI�.t3F DLED R�3TRiC11QI�S:_ Ttie.under�fgt�ed,under�tar�tds:;th�ttif�s�p�cm��rr�ay;ber,: b�, ..�,. tr#r �'.;:��..���'.v}��`�
<br /> l+� , su �c,#�to."d,�e,e,d"res �tiatis"
<br /> .;;s,. ' ,i!. _ r:��- _ »:r�Cri r�.nf;-. :f+...,,. S�i��J�ti-.'.s', ^t:a �:yk a,rv'�'Y'w'�-�'«''.y,., -cw» ts,t,..w..tk,a�✓'�
<br /> which may;tie'�mioiire:�res'trtctfv�..t#ia��C�unly�:re'��ilet�ons:•`�TtieSunde'.slgned��assumes,:re�p�'ns�tilltty:fiir:,cofnp�llan�e:viilth�any
<br /> applica6le'd�ed;re�tcicttons. �' :�:;> ,�.'°tiR-;�µ?:,��r� ` _ • __ . .._ -.�} � .�;��'M`"�,="��';
<br /> UNI.iCENS�D�=CGN�TRAC�:ORS:�AND .CCIN�RJ�►GTOR-RE�PQN�I�tCiY1�S:���tf=tiieYowner``lia.r�`�tiired��:�.co�tir�ctar vr
<br /> contractors to undectake work'�the�/.i�i;a�/:�6sirte'/�`utretl.sto:;�bealtcenseii;=lit;accor.dance:tiwtth;state.:•and;local,re ul #lans��:if��ther4:<:`a=����'
<br /> ,cy�, 1. .7_. .7 . ....,`a� k r^x�r;-F...- ...r .+..�.��.. .. . ,. . _ - •�;._:� � .
<br /> co�t�actor�=ls�-not�ltc�nse��as=>reqult�+�"by law;•.tiothtttie'owner arfnf=�c+a��a�itc`ramay��e��ctted'for�a"r�ilsdei�rie�ndr v[alatton
<br /> under state law. If the owner.ar Intendetl��contra�tor,ar,"e;xuncertaln as to what Itcenain r uiremenfs;(me, �e� t"`r��for�tl�ie',}�4.W�-�A--.'�
<br /> to t� ���eq..._..�. Y'�� �P_Y
<br /> F µ.r<.i. 3-�vs":.v f#�e+aw't»�
<br /> lnte�ded'�ni6rk�ttiey afei"advisei!`:toAc�iiitact`lhe��Pasco;C+�unty;8ulldliig�l�is�ectltin�,Qivl�li�n-l�tce.nsing Sectlon at.T27-847
<br /> ... rv+.;..�.v...5.3.i=,c-.v.•:'.
<br /> 8009. Furttiermore;`it+ttye aviiner=�'iias"fiired-a.coiiUacfo��or�co�itracfo's� he Is advi�ed b have��the contraator{s):sign,
<br /> ortlons•of.th.e.;.-contractor Black'.of:xt�is.,a Ilcatlanrfor�which�.,the will,;be�r,es onslble.:.•:,ff.:. ou� as��.'the�oviine���sl``n�"�a�s�t�ie`�`y`�'�`�"���''
<br /> r
<br /> P . .. .. .pp ..: ,... _ .._ . :: e�.y' �...p f�- y � � l�
<br /> eontrac#or,ttiat�naiy'��e an indica#1on�tQ�`af'fie�=fi`s��toE�rop�iEy"li�ensed"an��''1s not'en���i!'-to�piarmit#ii�g�p�llege:s in Pasco.
<br /> Counky. . . . ��P�r;., �,;.,
<br /> ,, �, e;C`;;;,��,::-.,..5 .<,�
<br /> TRANSPORTATION:IMRACT/UTIL6'�IE��1�'lRAC�l�N�?kE��l�l�tCE ItECQVEEtY-fEES;`Tl�e�under�t�t�e�urtderstands
<br /> that Transportation imp�ct Feias:and.�ecourse:Rec�very.�e��rrQti�y;apply:�#c�ti�e;�conatructlon:of nsw.b_uiidings,:schange�af�>'�:4u.'�:
<br /> use in.ezisting buildln8s, o�-expar�siGi��of�e�ite�i�i��taulldings� as spec�fied.tn Pascq County Or�dinance number 89-07 �nd.e
<br /> 90-07, as amended;,,,:�,Th� under�lgned�a1so:�nderstands, th�ifi�su�fees;ba��m�t�;b��due;,��+u�kctie�+�er�if�ed at t�te�tim��of;��`.-u���
<br /> s: , � t �.�--�r- � k
<br /> permitting. It Is fiirthe�+understood that Tra�g�oFtatfon Impac�'�Fees and�ftesour.ae�Reco�ery�Fees�,mt�st be pald priar to
<br /> reaeEving;a"cerf�tcate�-of�ocxupa�cy"�or`#1n�t�power�,�elease:'.:If`th�.prc����:does�not t�avo�rek�a�.certiftc�te af occuparicy�atr��-"-t���z�
<br /> final povuer.�retease;;tFie�fees��inusi.t�'be�`paid��pcl+�r to;permft iss�ia�ice. f..,�tthermore���lf:�Pasco;�CouMj�"1NatedSewer.;�:tmpacts ..��
<br /> �..�:
<br /> � -t� f"t �=. +^
<br /> );}t ' . ' v"'1..^. Y
<br /> fees ace due,,_they.must:be;:palii,_p�.ior_�o;pecnnithlssuance��n�acciardanaa..wlt�:apPllcatile�Pasco'yCountjiyari!lnanc:es. • .
<br /> COIYSTRUCTIAN�CIlEN"I.AY�{Ch�pter 715,FIoM'da�t��u#����m�ad�d): {f vsiva�on of wark is;�2,500.OQ;or.,more;;ji���.;. :�ro�z
<br /> certify that �I, the.- appllcant;:have;:be.en_ proVldeil�wlth���a-copy-;of-�thei�"Florida���onsiTucttan� Lieri=.:Lauv Homeqwner's
<br /> Protectbn Guide"pr�pared by�tl�e'F'to�ida D�p��r�fine�t;of Agrtculture and C�nsc�m�r,;�alrs. if the�pplEt�nt Is,someo�e:�.,..;-;...�,
<br /> other than#he`rnnmer"� I aert �:th�t l�liave:;o ineid"a�c'u .of..f e��ab v.e:�de� c"r '`'fgk ; `' , _
<br /> KY bta. PY:., h Q... s,.,,Itied�:�loau�ent'sand;P�nii�:e;iri;goad�:faith•to . ,i s
<br /> d�liver it to:.the�'ovimer"pi�o��trigccrt�tm'eni�men�;��. . . . , ... -. . ._.. : '_ . . . --
<br /> �ONTitACTOR'S70WNER'��IF�iDAViT: 1.cei��ty2#ti�t;.a)I:�th+��inf.oram�tlor��,l��thi�appltcatton is accurat�.�nd that aii work
<br /> r.��.
<br /> will'be done in compitance wfth all.appitcable laws.reguleting cons#naction, zontng and��land�tlevelo�m�nt. Appqcatlan Is
<br /> hereby made.�to ob#atn'�a.pecm.i#<<�tot;wdo�.vw��k;:�and:sl�isfell�tlon �s Ind#�a#�id�>=-.1� certify that no worlc�or Ins�altatlon lias=
<br /> ..,.� ,
<br /> .. �.,_., � . :...
<br /> coenmenced p�lor to IssWance of�a permit��ind that'.all work will be pertormed�ta meet;st�ndards-of„all laws regula�ing• ,
<br /> canstructEan, County and City codes, zonMgFregulatians� and tand devebpmer�t re�ttiia�ons�ln't1ie:Ji�rlsdtctiori:�°2`�l:�ai'so.=
<br /> aertify that 1 undersfand that th�regulaflons of�ather gavernment agencl�s may��apply�,#o:.the�.lntended.work, and that it ls
<br /> my responslblllty to Iden#tfy•wha�t.actlans I;must�teke:to be�in,co�lplianca_h�,3,u�,h agencles�lnclttde�bu#�aie,not Ilmlted:to:.� �.=
<br /> St�:, ..,.. z
<br /> - Department of Env6ronmental��Pro'tectlon=Cypress:'Bayhead�, V�letl"and Areas and Environmentally Sensitide
<br /> Lands�IAlaterNVastewater Treatmenk. , . - " "' " � �
<br /> - Sout#rwest Florlda W�#er Management��:0�strlct-lNelts,r'=Cyptes�.`�Bey�earl�� �,{t4►efland Areas� AtEertng
<br /> WBte�r'�V�sQ$. ,. ..,,j ,..:;.,''"S�.,iMu,:. ,��'.r_£� . .. , . , �
<br /> - Army Corps nf Engtne�rs�Seawalls;'�ocks,Navigatile Watermraiys. . .
<br /> - Depar#ment,;of;He,aitha:;�:;,Ret�abilitaHwe�>Se.ri►,ic�s/Enx�ronme�al;..Meaftt� -Unit:VVetts;:V�astewater�Tre�tm�nt, � '
<br /> Septic Tanks:.;.:, ; ,.. . , ...._ _ . , _. .,, , -. . � ,
<br /> - US Envlconmen�l�Pro#�ctlon Agency Asbestos�bateme.nt�:. �
<br /> - FederaFAviat�vn>Autho,�ity;�wRunways3'_� `.`� -� .
<br /> t undetst�nd.that.the:follrii�ting:�i�stcict�ans apply to�the use of fltl:�
<br /> - Use of fltl is not altowed in�Ftooc�'Zone"V"unless expressiy pemnitted. .
<br /> - If the:�flll"m�ite�lal'is��to'b.e used:In ,Flood�Zone: "A", Ik. is unde�etoad thaf-a drainage plan addre�s(ng a _
<br /> pcompe�sating vafiume"will be submltted a##ime af�permli#Ing wlilch ts prepared by a professlanal engineet: � -
<br /> � Ilcen�ed by�the��tate�of floi�ida: .� �;-, �:- - .
<br /> - If th��flH:materiail�:ts to:be..u�ed in Ftood �one 'A" 1n.�connec�inr��with:a���ermitted bulShcng usln� stem wa11., ..
<br /> aonstruction,,l;ce.rtify,�that fill:vuall:b:e�us�d only.to flll#he are�within�the�s#em�wall: -
<br /> - It fll! mate�af'1s�to be used 1�i�.any .area; I �ce�tity,th�t .uae. of:su�h fllf wNl no! adversely affect adJacent _
<br /> � praper.tles.F.iF..use;of fi11,,1s.�fot�ncF:to.,advets�Fy;.�ffectMa�lJacerit���prctperties�.the owner may be cited for viatattng.
<br /> the condi#lons�of.the bi�lli�ing�:perniit=�issyed��u�der tfie:;'�tt�icfied,_�ecmlt_�pplicatlon� for:lats�:less�tFian`one (1�_
<br /> �cre w1ili:ti�re e[evated`�by flll,a�t.engtneered dra6nag�plan is�requir�ed. .
<br /> if i�m the.A13ENT�OR:Tki�;,O..VYNER;;.IK.prom�se:ln,good,.f.alth#o informftP�a�awner of�the permitting condRlans set forth In
<br /> thts affidavit`p�tor fa commeracln�g constn�ctlon. ! uriderstani!thet azaeparatei pet�tnit may bs requlred for electrlca4'work. , ..
<br /> plumbing,,signs� welts.,,poats;.atr..canditioning,s:ga�s,,-.ac:ott�et Insfatt��i#�ions na���pec.�fiaatty included-in.the�apptication. .A
<br /> permit issuetl�hall be coFistiued to:`b'e_�a�licensei;ko�proce�ed wikh�tFi'e.k+uvork.and!nat-as:�authority;;to:violate;�car�cel��alter, ar
<br /> set aside any�provtslon�01`tFie:tecl��lcal�cod�;�nor sh�111ssa�nce�of a.petmlt.prever�t the Bulldirig CNt1da1 fram thecea#ter
<br /> requirtn.g a cor�ectlon:,af,eRors,in-,pians;:con�ifnictlan.or_ylalat(ons of-any codes: ��ery�p'ermtt��l.s'suetl'stiall�becom�r°invalid
<br /> unless the w�rk authorizecl.by suah p�rrr9lt:�{s�-connm�n�dvulChln st�c,,mon#hs �f�permlt Issuan�e, or It wrork�uthortzed by
<br /> fhe permif is suspended•ar,:abat�doned�for:a,perlod;of;�ix�:�)�montiis:`.after,the-tlnae the�work>is commenced.. M�utension -
<br /> may be requested,�ln.writing;vimm;tFie;Bullding,�fficlai�for a peirlod��not.to exceed'fiinet�r=(90)wiiays�a�id�wi�l~demongtrate
<br /> , jus#tflable�cause for.�#he extenslon: �f work ceas.es.for nlne#y.{90}cons.�cutive:dsy.�,..th��ab;ts.considered,ab�ador�ecl. �
<br /> WARNlNG Tt? QYMN�R: YOUR;�A!l.1JRE:.:TC�,.RE�O�ttQ.Ax1�Q�;IGE=QF.�CQMMEi�CGME�:MAY{RESUi�T`.iN�YOUR �
<br /> PAYING'iWICE;;FC1R�°iIWPRO�EMEN�`i��Tfl:Y�3U�t�:P�tOREiiTY:���1��Y0U;i�F'�E�i1U��T���B�A1N�FINAfi�E1N�;:CON9Ul.T
<br /> WIT AN� O FO' •R� t,. �, .} - __ .... -- -
<br /> - F10R10R J!!RA'i'{FsS::1.1 _ .._,. .- �, ; . , � �. - �..,, ._-_ - _
<br /> OWNER OR A0�1�1T •-, QqNTRAGTO - -�Yo '
<br /> Subscxibed and s�wm� m� �a 8tib�ibad�nd, ,#ii�
<br /> by .:by...:
<br /> Who Is/are pensanalty kna�wn b.me.or:has/have,prcducesi -Who.ls/sre;p.ersolnetly.�nrnlm•to;,me�or F1ae�lhav.e�p i�ced, •
<br /> � as td`eri�ftcat�in. . as[dent�ic�tion.
<br /> Notery Public . � Notary Pubfic
<br /> Commis�lan Na: Cam�isslon�Mo,
<br /> Name ot Notary typed,Printed or atamped Neme of t�otary typed.PrlMed or stamped
<br />
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