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�ov, 9, 201b 9:32AM GIBBS & PRRNtII No. 0444 P. 2
<br /> N079C�Op C1EED RESTRIC'fiONS: The unde�signed und��stsnds mat this permlt may be subjea to°deed°restrictions"
<br /> which may be more reslrie�lve than Counry regulatiorts. Tfte undersigned assum�s resperosiniGly fer eompl�anee wfth any ,
<br /> ap�lic�ble dead resfic6ons.
<br /> UNUGENSED CONTRACT4R5 AND CQrrrRACTOR RESpONS[BiLiTfES: If the oWner has hired a contract4r or
<br /> conlractors ta undertake woHc,lhey may be tequired fa be Ilce»se61n accordanes wlth state and local reguia�ans. if the
<br /> cor�tractor is nat f�censed as tequlred by law,b4th!he owner artd coMractcr mey be cited for a misdemeanor vfoladun
<br /> under state taw. IP th0 owner or inlended contracior are uncertain as to what licensing requlrementa mey epply for the
<br /> intended work,they are advised to copt�et me Paseo County Bu�ding Inspectian Division—Cicensiog Secdon at 727-647-
<br /> $009. Furiherm�re, iF the owrter has hir�d a r�ntractor or contractors,he is advFs�d io have the conlractor{e)sign
<br /> porCwns nf ihe"contractor B(odc"nf this appilcatian for�vt�ich thay w;0 he responsible, �f you,as the ou�mer�ign as the
<br /> conhactor,th�rt fnay be an indlcation Nat he fs not praperiy licensed and ia net e�tiqed to permithng privilages in Pasco
<br /> Caimty.
<br /> TRAMSPORTATION IMPACTNTILI'f1E5�MPACT ANQ it�SOURCE RECOVERY FEE$: The updersigned ur�derstand9
<br /> that Transportaflon Irnpact Fees and Recourse R�wvery Fees may app{y to the conswcttan of new bu�ldings,ahange af
<br /> uss in sx;sGng h�lldings,or expansion of existing buildings,as 8p�c�fied in Pasco Caunty Ordlnance number 89-p7 and
<br /> 90-07,a$Qmended. Tt�e undersigned also understands,ihat suoh fees,as may bs due,will be�dent'itted at the Gme oF
<br /> perm�lling, it is fuithe�understoad�riat Tran�partafion Impact Fees and Resource Recovery Fees must be paia pdor to ,
<br /> receiving a°certificate of aoaupancy'or final powsr relaase. )f Ihe proJeat does not involve a certiFicafe of occYrpancy or
<br /> (Inal powar relaasa,the fees must be paid priar te p�rmit issuance. Furth�rmar�,It Pasr:o Counry Water�server Irnpact '
<br /> faes are dua,tNey must 6e pafd prlor to pertnit issuance ln accp�danoe wim apppcab{e Paeco Caunty ordinances.
<br /> CONSTRUCrIow tI�N LAW(Chaptar 793,Florlda Statutes,as amended): If vslueiian ot warlc�s�2,540.00 ar mare,I
<br /> certify lhat I, I�e applie8nt, have baen provlded with a copy of the "Florida �onsUuction l.ieri L8w—Hom�wner's
<br /> Protec6on Guide"prepared by th�FWrida OepeRmsnt oP AgAculture and Consvmer Affairs. If lhe apptic�M is eomeene
<br /> other Ihan the"rnNner',(cerG[y lhat I have obtained�capy of tha ahova desMbed dacument and promise in good faith ta
<br /> del►ver ik to the°awne�'prior lo commeneemet►t.
<br /> COt�7RaCToR�S1oWb1ER�fi AFFIDAVIT: 1 certify that aii the in(ortnation in ihis apptica6an is axurste snd thst al!work
<br /> wlll be done in compllance with all applicabfa laws regulaNng cortstruciion,zoning artd Isnd developmenE. ApplicaUon is
<br /> herbby made tq obta(n a petmit tp do arork and inst�t(ation as Indicated. t certUy tf�ai no work or ir�staUation has
<br /> c4mmancgd prlor to issuance oF a permit end thaf all Work wi!(0e perfotmed lo maet stattdards of al(laxre re8ulaling
<br /> construction,Counly and Ciiy cndes, zontr� regufations,and land develapment re�ulatioqs in tne jurisdlCUon. I also
<br /> certify tf�at i underatand ihal Iha reguiallans af otl�er government agencies may appfy to Ehe intended wa�c,snd tltat it is
<br /> my responsibilifyto iderjtify what ectians I must take ta be In cornpG2nce. Such agencies include buf are not limited ta;
<br /> - Department of Environmenlal Pratectio�-Cypress 8ayhsads,Weiiand Areas and Environmenl�ify Sensitive
<br /> Lands,WaterlWssfewaterTreatment. �
<br /> - $o4tljwesl Ftanda Water Management Distrlct Wells, GyRress �ayheads, Wauand Ar�as, Altering
<br /> Wafefcouises.
<br /> - Army Corps oi EhgfieeTsSe�watls,Docks,Navlga6te Watenyays.
<br /> - • Department of Heatth &.RehablGtslive�Servicasl�vironmental"Heahh Unl[-WeAs, Wastewater Freatrnent, •
<br /> Septic Tanks. •
<br /> - US�nvirnnmental PeolacUon Agency-Ashestos abatement. , • , ,
<br /> - Fedetaf Aviatian A�thnrily-Runvrays. . . '
<br /> f understand that Ibe Following restricdor�appty to the usa of fill:
<br /> - Us�of TiU is not allawed in Fleod Zone"V"unless eXpressly parrnittad.
<br /> - if tha Bt1 materEal Is to be used fn Fbod Zone "A', iE ia u�da�stood t�at a drair�age plan addressing a
<br /> `compensat�ng vaf�nte°w1tl be su6mftted at tlme of permittmg which is prepared by a pm��ssla�►enginesr
<br /> Ilcen9ed by the State of�torida;
<br /> - (f lha fitl material is ta be used�n F(Qod�ane°A°tn conn�cdon wl�h a pertnitted building using sfem urall
<br /> , co�stnktlon,I certify Ihal fill will be used only to fl11 tha ar�a withln tha stem wall,
<br /> - �F fill materlal fs ta be used in any area, I cettify th�t s7se of such fi(1 wiU rn►t adversely affecx adJacet�t
<br /> propettiea. tf use ot till is faund to adversely atfeck adjaceM properties,the aWner may be c�ed fa►violsting '
<br /> lhe canditians oF fhe building p$rmif issued under the attached permii applicadan,for tols leas than a�re��) '
<br /> acre which are�levated by fill,an en�ir�eered drainage plan is raqutred.
<br /> tf 1 am�he AGENT FOR THE OWNER,1 promise in good Faith to intorm Ehe awner of the psrmftUng condlHons set forlh in
<br /> this�dav�priqr m aammanctng canstniclion. I vndersland that a�epa�te paimit m�y hs r�quirad for elechical work, •
<br /> plumbing,signs,wells,paa�s,ait conrlitloning,gas,or oiher instalfalioris no!specifically ir�eluded in 1fie epplication. A
<br /> pertnit issued shall be canatrusd to ba s licensa tn proc�ed wlth Ute work and nol as authority tu viofate,canc�l,alter,or
<br /> set astde any provlsions of ihe technicat codes,nor shall issuanes of a permlt prevent the Building O�icfa!from fheraafter
<br /> requiring a correctlon of ercurs in plans,conatrucGan ar Jolat�ons of any cad�s. Every permit Issued shalt became invalid
<br /> unless�he work authorized hy such pennit is commenced within six mon�hs ot permit issuance,or If work autho�lzed by
<br /> the pertnit is s�spended ar abandaned tor a perlod of sUc(6)months after th�6ma�he wo�k is commenced. M axtenston
<br /> may be requested,�in wn'ting,fram ths Hulldtng Of�clal for a period not to exceed ninety(9P)days and wi(I demanslrats
<br /> justlflabls caus�for the extension. If work ceaseg for ninety(90�consealtivs days,the job is considered abandatied.
<br /> wARHiN�70 owNeR: YOUR FAILURE TQ RE�QRQ A NO'nG�oF caMMENC�MEN7 MAY RE3ULT UY YQUEi
<br /> ' PAYINQ TWIGE FoR IMPROV�IENTS Tb YOUR PRQPERTY. tF YOU IN7�ND TO OB7AiN FtntANCM�,CONSUL'F
<br /> W17H 1'OUR I.�ND�R R AN A'i'TGRNEY BEFOR�RECORD1Ald Y N071C�OF CIJ ENCEM�NT. �
<br /> A�u t� . i, .o�f �
<br /> OWNER OR AGENT C4NTRAGTOK
<br /> subeatnea and�ewam ro(or e�sttaed)betore Mo tt�u substdaea�na� or amrm ore me is ���'�
<br /> WFW isl@ta RQl�UY�'"'�'la Mn cr h3sfi9Ye pY0CU4BQ Wh01916T9 Pe�4�81b'W14W+1 tP Rt0�h9eMsde proQuCed ++JJ�� �.�
<br /> , 86 IdBI11KtCAtlO)f. flE I(10MI11G81100. �
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