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<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 contractor or
<br /> � contractors to undertake work,they may be required to be licensed in accordance with state and local regulations. If the
<br /> 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 /> 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 /> County
<br /> TRANSPORTATION IMPACT/UTILITIES 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 /> 90-07, 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 indicated. I certify that no work or installation has
<br /> commenced prior to issuance of a permit and that all work 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 government 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,Water/Wastewater 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 & 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. i
<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.
<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, welis, pools, air conditioning, gas, or other installations not specifically included in the application. A
<br /> permit 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 I
<br /> unless the work authorized by such permit is commenced within six months of permit issuance, or if 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 /> justifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned.
<br /> WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br /> PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
<br /> WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. �
<br /> FLORIDA JURAT(F.S.117.03) //''�� '/ '
<br /> OWNERORAGENT ��` � q � CONTRACTOR �,/ � '
<br /> Sub 'be nd swom ro or a� d)before�[ne thy'� Sub cribe and swom to(or ffirmed before�me thi �
<br /> /� / by �t�Kl�%/II�H L'S��/L /V� 5' � by �1�"�/��/YUfI ��iC�i �
<br /> i .J(Vho is/are persona�lly kno n t e or haslhave produced o is/arer ersonayll�c noy�n��10 me or hasfiave produced
<br /> i l��-(C.SL�(�l lU�s identification. (-�(�1j0 10 f705�[�-`Gf✓ as identification.
<br /> I /����Ly(J(y. /l a;�/54'INbt�ey Public � ' Notary Public
<br /> Commission No.�'�(.�(�_��i�,� Commission No.�j�7bU���
<br /> �(%6�/I �,1/a/NE �Cl/�'-��Lc. ��82fJ PL/f"/NE �CJF�E�,�—•
<br /> I Name of Notary typed,prinled or stamped Name of Notary typed,printed or stamped
<br /> I
<br /> i ,Q���:¢q�,,DEBRAELAINE RUFFELL :�,;:��p¢�;I DEBRAELAINE RUFFELL
<br /> i :�� •.�:Commission#GG 045343 ,: :,:Commission#GG 045343
<br /> � '-;,�,�p;:Expires November 7,2020 ;��p,=Expires November 7,2020 '
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