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�lOTf�� ��9EE� ��STF�IGT606��: "�he und��sign�d und�rs�ands fiha�this permit may b�subj�ct�o°deed"r�striGtians" <br /> wk�ict�m�y b�more r��tric�iv��han County reg�l�tion�. 'The und�r�ign�d a�sumes res�n�ibility for complianc�wi4h�ny <br /> applicabl�do�d r�s�rictians. <br /> !��l�l���9��� ���l�'6'��'�'�R� A�1� ���lt�G�'E�R 63��P�&d�l�lLtYl�S: If �F�� own�r has hir�d a contractar or <br /> cvntrac�ors �a und�rta�:�wortc, �h�y may bg requir�d f� b� li�n��d ir� accard�nce with s��to and (�c�3 regula�lons, �f th� <br /> cantrac4or is no4 licensed a� rc�quired by iaw, both the owner and contractor may b� cit�d for a misdc�meanor viola4ion <br /> �ander state law. 1f�h� own�r or in��nctsd conYc�ctor ars unc�r�a{n a� to what iicen�9ng requir�rnen�s rnay apply�'or�F�e <br /> intended work, �hey are advis�d fio coni�ct fhe i°as�a County Building inspectian Divi�ion--l.ic�n�ing �ec6on at 727-847- <br /> 8008. Furthermor�, if the ownar ha� hir�d a contractor ar contracta�, h� is advised #o have the cantraator(s) sign <br /> �a�ior�� of th� "c�ntractor Blo�k" t�fi�hi� �ppllcaflon far which �hey w911 be r�spon�ible. �'you, �s �h� own�r�ign �� th� <br /> contrac�or, tha4 may be an indic�ation 4h�f he is no4 properly lic�ns�d and is nat entitl�d 2o p�rmi�ing privil�g�� in P�sco <br /> Cou�ty. <br /> �'��1�F'��'TA"TIO� 1M�AG�'ftl�"I�.iTi�� I�fi�,�CT 6�6!!�R���UF�CE R�C01l�ftY����: The undersigned undor�t�nd� <br /> that TranSPorta�ion Impact Fees�nd Recour�� Recovery F�es m�y�apply fio th� con�truc�ion of ne�r buiiding�, change of <br /> u�e in existtng buildings, or o�an�ia� af existir�g build�ngs, as sp�ci��d in P�sca�o�an#y t3rdirtanc� nt�mb�r�9-�7 and <br /> 90-07, as amend�d. T'he undePsigned �lso understands, that such fees, as may b� due, will be identffied �t th� #im� ofi <br /> {J�`P(Ttl�flftt„�. ��!'^a �E.t['t�t8f i�t1C�G�1"S�04� ��'121t !f�FIS�{}t��0Y1 �t7i�7�C� �@@S �Clt� ��SOUiC� �18COVt3C j �@�� [Y1LlS��lCs {3r'2lC� [3[�OF�O <br /> r�c�iving a "cer�ifiicat� of occup�ncy" or fin�i paw�r release. Ifi fihe proj�ct does not involv� � ceriific�te of occup�ncy or <br /> fin�i pow�r releas�, the fer�s mus�be paid priar to permit issuanc�. �ur�hermore, i�Pa�co County Vtl�i�rlS�uver Imp�ct <br /> f�es��du�,#h�y must bc�pald prior to permit(ssuance in accordance�rith applicai�le t'asco Gounty ordinanc�s. <br /> ��b@t1�Y���Td1�S� l,tE� �A!€!!(Ch�g��r�13� FErarld� �t��a�av, ���rcrcr�dE�B�: It valu�tion af work i�$2,500AQ or more, I <br /> cer�ify �hat i, the app€icanf, �I�VO b8@t't �C�Vlt��d WI�h � CO�� Of th{� "F3orsda Cons�ruction E.ien [.�w—Morfte�wn��'s <br /> Prot�ctian Guide° prepared by fihe Florida Departm�nt of Agricuiture and Con�um�r AfFairs. 1f�he applicant is someone <br /> oChar than the"own�r", 1 c�rfi�fy that E have obtain�d a copy of the abvve t���cribed�lacum�nt�nd prom�se in good f�i�h�o <br /> deliv�r i#�a th�"owner"'prior to commenc�ment. <br /> CQRDTRAC706�'S/�43tli��i�°� �,��ID�VIT: t certlfy that all the informatic+n in thts appNcatlon is accurate and that�II work <br /> wili be done irt compliance with all a�pli�able #aws reg�lating cartstruc�c�n, zor�ing and iand deveiapm�nt. App{9ca�imn is <br /> h�reby made �o ob�in a parmi4 fo do wariz �nd ins4�ila4ion as indicafed. ! csr�ify that no work ar insY�!lation has <br /> commenced prior ta issuance afi a pertr�it and that aU wor4c will be perform�d to rn�e4 st�ndards of a!! l�w� reg�al��ing <br /> car�sfructian, Coun4y and Clfy cadas, �oni»g regutafiorrs, �nd land develapment r�gulatior�s ie� fh� jurisdic#ion. 1 �lso <br /> c�rtify that I undorsfiand th�t the r�gulations of oth�r governm�nt agencies may appiy to th� intended work, and that it is <br /> r�y rgspons�b�lity to€dentify wha#acfions 1 must taEc��o�e in compliance. Such ag�nc'ses includ$�rat�re not Eimit�d to: <br /> - Dmp�rtm�n4 of Envir�nm�ntal Pro4Qction•Cypr�ss 6ayheads, Wetland Ar�as and EnvironmenfaNy Sen�itive <br /> Lands,Wa4erNVas4ewater 7'reafimen4. <br /> - �ouf�r��st Florida Water Managemenf �i�ft�c�-W�ils, Cypr��s �ayheads� VUe�(and Are�s, Ait�ring <br /> Watercaurses. <br /> - Army Cor�s of Ertgineers-Seawalls, Dac�s, i�avagabie Vlla�erways, <br /> - �e�ar�tr►ent of Heaith � R�habilitati��e &ervlceslEnvirQnmenta[ Health Unit-Well�, Wastew�ater Treatment, <br /> Septi�T�nlcs. <br /> - U��nvironm�nt�i Protection Ag�ncy-Asbestos abafiement. <br /> - FederalAvia�ion,r4uYhority-Runw�y�, <br /> 1 t�nd�rs�and tha#the fiv3lovuirtg r�s#ric#�ort�apply to fhe use of�ill: <br /> - UsQ af fiil is not a!lowc�d in Flaod Zorta"V"unless expressly permitted. <br /> - (f 4h� �II r�aterial is Yo be used In �'lood Zane "A'� i2 is und�r�fo�d 4haY a drainage �l�n addr�ssir�g a <br /> "cornp�nsating volum�" wi13 be submittcd af time of p�rmit�ing which is pr�parec� by a pr�fe�sionai engin�er <br /> licensed by fih�State af Florida. <br /> - 1�t�te �ll ma�eri�l is f4 i�e used in Fiood Zona "A" i11 G0I1f1�C�iDtt W1�FI � A$t?'Ytl$f�d ��t1It�I�i� tdSitt� StBPi"i U1t�I) <br /> cor►struction, I certify fihat filt will be used only fo fill th�area within the stem walf. <br /> - !� fi#! ma��ria! is to be us�d in any arQ�, ! c�rFi�y 4ha� usa of �uch �II vu�11 nc�t advers�#y aff�c� adj�c�n# <br /> proper�ies. If use of fill is found�a adver�eiy a�fioc�adjac�n4 properties, �h� ov►►n�r may b� cited ior violating <br /> 4h� condi4ions ofi fihe building p�rmiY issued under the attached pe�miY applicafion, for lo�s 1t�ss fh�n on� (9) <br /> acre rnrhich aEe elevated�y�II, an�ngineered drainage plan is�quired. <br /> �g I �m�M��G��1'T F�R TH� Oif#!'f��R, I promise in good faith to inform the owner af Yhe permitting canditions set farth in <br /> �his a�idavit pri�r �o commer�cfr�g canstrucfion. 1 understa�d that a separafie permit may be r�uired f�or etec�rical vuork, <br /> plumbing, signs, w�lEs, pooi�, �ir conditianing, gas, or ath�r insk�llations not specif.rcaily inc(uded in the �pplicafton. A <br /> permit is�ued �hail be cansfrued to be a licen�� to proceed with the woric and no�aS au4hari4y to violat�, cancel, alf�r, ar <br /> se�aside any provisiorts of the teahnicai codes, nor sh�fl issuance o�a p�rmifi prevent fhe BuE(ding Of�cial fram thereaft�r <br /> requiring a corrc�ction af errors in plan�, con�tru�tion or viot��ions o�a�ay codes. Every permiY issu�d sh►al{become invalid <br /> unless �he work auYhQrized by such p�rmit is commenced witihin six mar�ths o#permi�is�uance, or if work authorized E�y <br /> fhe p�rmif is susp�nc�ed or�toandoned for a period of stx(6)months after ths klme the vvorpc is commanaed. An�xten�ion <br /> may be requested, ln writ+ng, from the Buiiding Official for a periad not ta exceed ninety (90� days and wi!! demonstrate <br /> justi��bl�causc�for the exfension. 1fi worSt c��sc�s for nin�4y{90)consecutive d�ys, the job is consid�r�d abandoned. <br /> 4f�fB��6�Q6�� �'� �t��S�F�: �t`C?�6� FAtLU�� �'� 6���4R� A �@`�tC� �� ���t�������6t!`� �JI,�� �2��#1�.'�' t�f Y�JU� <br /> ��,�it��'i'li�iC� ��� ti1��8�+�i��ifi���i`��"���f4U�P'Rt7���TY. IPr YCII! t�'I'IT�N�'P�3 O�"PaAIW �9�9�i��1�§G,�COAlSULT <br /> @,�tl"P'@i Y�UR 6,��O�t eAi�AY"P'OR�t ,�V����R�RECQ�DING YOUR�901"IC� C9� �pi��lC���l� <br /> ��.o�to�,,su��{�.s.� s� <br /> OWtd�R QR AGEIU'i" c A �-=�[Z���d�� .��K..�LG:.L� <br /> F " GC7�IS�AC'CO�_ <br /> Subscribad end swom to{ar e�inned} r�me this Subsetibed and sworn ta{ar af��rn te me this <br /> by by <br /> Wha is/are person�Ily known to me or has/hava produoad Wha is/are personally known tn me or has/havo produced <br /> as identiflcatian. as identifica#i�n. <br /> ' � <br /> � Nqtery Pubiic !� -- Notar�r Publia <br /> Commission Rfa. Car»rnis 'on o. <br /> _;,_' e�k` Commission#FF 150422 <br /> Name of Natary typed,printed or stamped IVarne af Not i � §sr <br /> �y � , <br /> .,,oFF�°o` 8onded7 TrayFatnlnsuranaa8p0385d0t9 <br />