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<br /> NOTICE QF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed" restrictians"
<br /> which rnay be more restric#ive than County regulations. The undersigned assumes responsibility for cort�pliance with any
<br /> applicable deed restrictions.
<br /> UNL:IGEIVSED CQN'FRACTORS AND CONTRACTOR RESPOIVSlBILITIES: If #he owner has hired a contractor or
<br /> contractars to undertake work, they may be required to be licensed in accordance with state and Iocat reguiations. If the
<br /> contractor is nat (icensed as required by law, bath the owner and contractor may be cited for a misdemeanar violation
<br /> under state law. If the auvner 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—L.icensing Section at 727-847-
<br /> 8009. Furthermore, if the owner has hired a �ontractar or contractors, he is advised ta have the contractar{s) sign
<br /> portions af the "contractor Black" af this application far which they will be responsible. lf you, as the owner sign as #he
<br /> contractor, that may be an indication that he is not praperly licensed and is not entitled to permitting privileges in Pasco
<br /> Caunty.
<br /> TRANSPORTA710N IMPAC7IUTILITIES IMPACT AND RESOURCE RECOVERY F�ES: The undersigned understands
<br /> that Transpartati�on Impact Fees and Recourse Recovery Fees rnay apply to the construction of new buildings, change of
<br /> use in existing buildings, or expansion of existing buildings, es specified in Pasco County Ordinance number 89-07 and
<br /> 90-Q7, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of
<br /> permitting. (t is furkher understood tha#Transpo�Eation impact Fees and Resource Recovery Fees must be paid prior to
<br /> receiving a "cerkificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
<br /> final power release, the fees rrtust be paid prior to permit issuance. Furthermore, if Pasco County WaterlSewer Impact
<br /> fees are due,they must be paid priar to permit issuance in accordance with applicable Pasca County ordinances.
<br /> CQNSTRUCTIQN LlEN LAW(Chapter T13, Florida Statutes,as amended): !f valuation of work is$2,5QQA0 or more, 1
<br /> certify that I, the applicant, have been provided witM a copy af 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#han the"owner", 1 certify that t have ob#ained a copy of the above described document and pro►nise in good faith to
<br /> deliver it ta the"awner"prior#o commencement.
<br /> CONTRACTOR'SlOWNER'S AfFIDAVlT: ! certify thai all ihe infarmation En this application is accurate and that all work
<br /> will be done in compliance with alt appiicabie iaws regulating constructian, zoning and land develapment. Application is
<br /> hereby made to obtain a permit ta do work and installation as indicated. ! certify that no work or installation has
<br /> commenced prior ta issuance af a permEt and that alt work urill be pertormed to meet standards of all laws regulating
<br /> construction, County and City codes, zoning regulations, and land development regulations in the jurisdictian. I also
<br /> cer#ify that ! understartd that the regulations of ather government agencies may apply to the intertded work, and that it is
<br /> my respansibility to identify what actions� 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,WaterlUVastewater 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/Enviranmenta! Health llnit-Wells, Wastewater Treatment,
<br /> Septic Tanks.
<br /> - US Environmental Protection Agency-Asbestos abatement.
<br /> - FederaE Aviation Autharity-Runways.
<br /> I understand that the following restrictions apply to the use of fi11:
<br /> - Use of fill is not allowed in Flood Zone"V"unless expressly permitted.
<br /> - If the fill materiai is ta be used in Fioad Zone "A", it is understoad that a drainage ptan addressing a
<br /> "compensating valume" 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#hat fill wi!!be used only to f!!the area within the stem walt.
<br /> - If ftit materiai is to be used in any area, I certify fhat use of such fili wili 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 btailding permit issued under the attached permit appEication, for lots less than one (1}
<br /> acre which are elevated by fill, an engineered drainage plan is required.
<br /> If I arrt the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting condi#ions se#forth in
<br /> this affidavit priar to commencing construction. 1 understand that a separate permit may be required for electrical work,
<br /> plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
<br /> permit issued shall be construed to be a license#o proceed with the worK and not as authority to violate, cancel, atter, 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 correetion af errors in ptans, cons#ruction or violations of any cades. Every permit issued shall become Envalid
<br /> unless the work authorized by such permi# is cammenced within six months of permit issuance, or if wark 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 w�iting, fram the Building t�fficial for a period not to exceed ninety (90) days and wiii demonstrate
<br /> justifiable cause for the extension. If work ceases for ninety(90)cansecutive days,the job is considered abandoned.
<br /> WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br /> PAYING TWlCE FOR IMPRC?VEMENTS TO YOUR PROPER'TY. !F YOU INTEND TO OBTAIN FfNANCING, CONStlLT
<br /> WITN YOUR LENDER OR AN ATTORfVEY BEFORE RECORDiNG YOU NOTtCE OF COMMENCEMENT.
<br /> FLORIDA JURAT(F.S.117,03)
<br /> OWNEi2 OR AGENT CONTRACTO
<br /> Subscribed and sworn to(or affirmed)before me this Su cribed and sworn�o(�or„affrmed bef�oJ e me this
<br /> by !!? _bY_.�.[�t/S' �Ll.l'Jl,L�
<br /> Who istare personally known to me or hasli�ave produced Who i aj� ersonaity know to me ar haslhave p
<br /> as identification. L...�/V� i i .
<br /> Notary Public No Publia
<br /> Commission No. Commission No.
<br /> :ip!'• . AIEXANDRA MICt1E1,1,E WitSQN
<br /> ;.: `;:c
<br /> Name of Notary typed,printed or stamped Name of Notary typ d, a �,�r st���s���13 2020
<br /> v1G7t398 4"5's
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