|
_ . +q111��1 _
<br /> . ` L. I
<br /> � , x. ' t
<br /> • � W 'ti+t�
<br /> i �
<br /> ' _ .. � . . ..rii,'�i=;"i,t'>:
<br /> NOTtC{���D�EQ RE�'t'4�ICTIQ�fS:. Yhe.�nd�r�lgtaed;�ander�tands�=th�t�#hIs>��rm1E:may:.b,e..subJe.c#:ta gdeed",res,t�ctioris";`:;.�..,.,
<br /> which may`,tie�=�maire��resttictiVe`��fha�r`"Cour�t����g�ilsittons:�The�un�der�lgned-ass �. °�. t�i'' . . p '� ` ' � y"""` "'y�„'"
<br /> urriias'resPonsi�bift fair"coiai� Ilanuiai;with�ari
<br /> appAcable:daed=tias4�ictlona -,_.�:.,.::.::9: ,�.:.�.., �. '� . - ., h ,. ���
<br /> �:=�._ z:;. ...._. . _. . _. ..... -xY:....
<br /> .-.;�•^ . _
<br /> � ..< < ...�_..� __...... .
<br /> . _ . . -ry.�
<br /> �lNtt�CENSED��GONTRi4C�'C►RS-°AFfD:CC►NTRACTOR�RE$POFl�I�iLITi�S:°�•°if=t�e�aHmer`tias'�iiired�.`�".c�tirlttr�act�r or
<br /> <,.
<br /> contractors to undertake work,they;,may,bo:lre'quire:d�_to.��b�:llcenssd��in;aa:aedance:wieh•state�:and�loc�al':ragul,at8an_s.:X�if�the�����"�:��=u,��
<br /> f _...,,_ _,.T,�,.:_u
<br /> .��.v,.�,.,.�,.�:•._.,:r-..,�>_.�_;_w..,..�_...
<br /> cont�actor=1s--ricit'1{'censed�as-yrequlEed'6y law,•�tiot#�'#he awner atid=co�at�actor-�mey'tie'�ctted�:ftiir"a�mi�itemeanor vialatton
<br /> under state law. If the c�wner.ar Intended�,c,ontra�torrar;e,;,uncertaln�as�to�what Ilcensin c ulrements=�ma, �7a t�`'�ir'�"thes��==�:"�=;-�°.,
<br /> �.�....�,y��:-.9• eq_,.� .. Y�- PPY�.
<br /> t. . . _1_"'Ja� :.r!^J. t. _ . .1�.. . � ^�a, 'l,�°'a�`'w'^''.:,'
<br /> intended'work�tfiey arei`advls�►d to ciiritact�ttte�Pasica:County:,8ullding�lnspect#on alvlslon--L.icensfng Sect#on at:727-847-
<br /> 8009. Fur`thermore;if�the oiivrier`"has"`'tilr�d a Vccin"tracfor or coMrecfors, he is�advlsed to have �the cantrac#ohr(s}�:.,sign;:,�:}{i.,y:^t.;,
<br /> portians�of the contractor..Block"...of.this�applicekion_for:.whlcM;,they, wllt:;be.�,r,esponsible�-.�:It yau;e,as.�the own�e��"si�gn askthe
<br /> contrac#or,�thaf�rna3r..be an Mdica�oii tliat'fie is'not':prope�y Ilcensed��nd 1's'`i�iif'eri�#led to perml#ting�pri�liege.s in PascB..:t,,,: `..,
<br /> Counky. h . :_.._, . _ ' .__...,_...,�.-w.�:._..._...�n> 7.,.._.,.,.s.....�..-,.
<br /> TRWaNSPORTATlt?N��lMPACTlUTIlITlES�1�lE��CT��1��=l�E�QU�tCE RECAVEt�1��FEES;'T�te�uri�ersl��ied�understand� �
<br /> Ihat Transporta�on Impa�t Fees:and.Recaurse.R�cov�ey.F�es may�;appty�,#a•tfie�'+constructlon of.new_bulldtngs,schan�e�of�=t�''�°=�y�'�� ,
<br /> use In existing buildtngs;'��o�,;expansib�riof-eS�is�i��:�bulldings, as specffled In Pasco County Ot`dinance number 8�-07 and �
<br /> s0-U7, as amended:.,.,.'�he undec�lgned aiso:��iriderst�i�ds; �i�t��such fee�;;as�may.`��;due;,;..w.illx�be 3deriti�ed at#he�_�ime�af-::`:�,'•��`>}:'�
<br /> permitting. It is furthe�understaod that Trei��po�tation Impac�'Fees artd'�'Ftesourcea'Reco�sry�`Fees:,mus# be paid prlor to
<br /> recelvin •a cer#1ticat�-of�-occu a� '-
<br /> 9 " °� P GY'�"or=#tnat�.powe_r-=Felease.� :��the.prajec�;daes;no�I�voive,�a;+c�rt�fcatie of accupancy=ot't��'-�s'a�:��
<br /> flnal power�release;��tiie�.fees�inu�it''be p�id;prlor#o,:permR Issuaiice. Ft�tthermore;:,tf Fasco�;Countyrr;Water/Sewec��lmpact° .Y;��r;
<br /> ..,. : ,,�.:. . ,, :,�,_ �. �, . . ._�. 7.. ,
<br /> fees are due;;.they�tnust:,beFpald.:pclor�o:.permit�!'s�uance�:in,accardance wit�t:'appltaable,Pasco�County��anllnanaes. -
<br /> COMS�TRUGf10N't1@i�"E.A�f dCh�pter T13��1ar�d�Stra�ut��,��n��nd�dj: if valuatlon of work ls S2,SOO.OQ;or�moce;°}�•.:s. -��;:.
<br /> aertify that�1, #he�:applicent�:-have;:been pro�id�tl -with:�a�=copy-�:of=•ther�"�lo�ida����ons#ruction: Lien-�.Law Homeowner's
<br /> ProtectEan Gutde"prepared by=�the Fl�i�ida Depectme�it;af Agrlcuttcue and Canst�m�r.-,.�tftahs. 1f#he �ppltcant is,someone�:,..,,��_:�:,:�
<br /> ther an • er i cert x� ':
<br /> �,:.,......, ,.
<br /> a th the own ,, ify;th�t:l�liave:.opt�.tned�a��copy:of:#he�ab�ve.•�descrlbed;�locu�I�ent4and;prr.r�mi�e;:in;gcod'�faith�.to . a. .3.,
<br /> deliver It`ta�.ttie:"owaer'"`prloi:<toicoi�fniencemenf�:`,� ` . . ,., � . � . . .:. ' . _ . � _-, _,
<br /> COIVTitACTOR'�/OVYNER'S AFFfDAVIT: I.cei��fy,�#ti�at;ati:the�lnformaticm:,i��tht�appllcatton is accurat�.$nd that all wark
<br /> �,.9.,
<br /> will'b� done in compliance with all.appltcable 1aws regulating constnictlon� zontng and:�land`tlevelopm�nt. ApplCcation Is
<br /> hereby rrxade- tc cabtaln::�.petmit;,.#o,:,do�1wotl�;�and;"1�"staltatlon as ictcit�atetl:�:=.=�1�certiFy that na wark�or tnstaltation tias" �
<br /> oommenced p�lor to Issuance of'.a�peririif�nd that�:all��work wlll be perFo�med�to meet=standards�-af=:ell laws reguf�ting�
<br /> constnsctton, Gounty and Glty c�des, zaning regialat��ns, and land devetopmertt r.egtsta$oris�tri-tiie jt�r�sdlcttori:=�'•1`�.al'so:
<br /> certlfy that 1 understand th�t the regulatlons of othergovernment agencies may��apply:;#o.;the.-.intended work, and thet it Is �
<br /> my responsibillty#o Identlfy�what.acQons l.must_take,:tot be<41n�conlRl.lar�ce:t:S,uch:agencfes-lnclude`but-are:no!llmlted to: •
<br /> � ja5r•,, rp�,.,{P.,i;.,,,- rY ,t y.. .,._- .
<br /> - Depar`tment a� Efivironmentai>�Piotectlon=Cypre'ss:°8ayliead�; Wefiend Areas and Environmentally Sensitive
<br /> Lands,WateNWas#�water Treatment: ; � y �
<br /> - Southwest Flortda Water Management��:I�Is�ct-Welts;:``Cyptess:�`.8ay�ead�; �Vtlefiand` Area�. Altering
<br /> Watercourse�. •._,. -�-; '>�-; :,,.,,,_,,, �; ;,.�:;, . . ._ .
<br /> - Army Corps of Engineers»5eawa8s;�;Docics,Piavlgatile Watennrays. ; -
<br /> - Depac#ment r�of;Health,;,.�;.�Ret�ab,ItitafiveY�Servtcest�rwitanmen�tai�F�ealth�-Unit,Wetts;:VlFastevi�itec=�Tneafinent;
<br /> Septic Tantis:._. �- -�` . .- :
<br /> - US Env�ronrnent�l Protectlon AgencyAsbestos�baEemen#:
<br /> Federa6Avlat�vn.:Aulho�ity:,,Runiivays;:°- .
<br /> i understand.that the:foi#ouvliig:.`restcictlons aP.pfy fo tlie use of fllt.•
<br /> - �Use af flil is not ailowed in;FtoodsZone"V"untess expressty pernnitted.
<br /> - If the=flll-mate�lal-Yis���to�bs vsed:`7n.:F'lood�Zo�e. "A". tt Is understaod thaf-a dratnage plan addressing a
<br /> "compe�sating votume"w111 be submitted at#Ime of>perm3tting which is prepered by a professianaf engineer
<br /> Iloensetl:tiy'the;�tateof:flofida: ... - � -�� ��- .
<br /> - 1#fh� flll�;�materfal�ls�'to:be,.us�d in Ftoad �one 'A" in.f conn�c�ton�virlth�a���er.mltted bi�iiding using stem wali,, ,.
<br /> � aonstructton,,l certi,fy;that flll:wall:b'e.us�d only.to.fill the area H►ithln•the�stem�wall: • �
<br /> - !f fil! mate�laf��Is to tie used fri�any area; 1 �aeitlfy that .us� s�f;such fl!I will r�ot adversely affeat adJacent
<br /> properties., if:.use of flil�is�,found:ta-adverseFy:.�ffect adJa+�ent�;pr�perties,.th�ov�rner may be ci#ed fcr viota#ing ' -
<br /> the condt�ons:.:of�the bi�ilding�:perrritt•is'`s.ued�under tfietattacFied;..�ermit-applicatfon� for�lats�.less ttian,one (1)
<br /> acre wiitch`�re elevated`�by fllt,,a�t,ertglneered dr�inage pian ts required. • . ..
<br /> �,�.,
<br /> 1�I am the AC�ENT FOR�TIiE OWNER;,I�.prorriise_tn.._good,faith ta Inform•'the�awner of�the permitting condfttans set forth In
<br /> thls aftidavlt`prlor to commer�cing c:iinatructfon. �t understarid that:a;sgparate�permit may be requtred tor etectrEcai'work. . _
<br /> plumbing,,signs� wetfa�.poots,.•alr.condittoning,�.ga��;`:.or_otl�er. instail�i�tluns not�spec3ftaatly included-in.the�apPliaatlon. �A
<br /> permtt Issuetl�hail be coinshued to�b'e.�a�license"<to��proceed with`tFie.wwork and�:not-as:authoNty:;to:-.vtolate;�rcancel��alter� ar
<br /> seE aside any pravQslons of t�ie:tect�i�tcal-_c+ode�;;nor shall lssuance�af a.pe�tnit.pcevent the Bulldlrig t�dal fram thereafter
<br /> requfrin.g a ca�rectian<af,errors in-:plans,; con�#rvctian..oc irlolatlons of-any�codes. ��uery-p�rmit��l,gsued sliall�•tiecome�inval(d
<br /> un{ess the wo�k authohze�d�by such pe�rttlt:�ls.cat»tnenc+ad�wlthErt s�c,.�'tonths ot�perntlt issu�nce, or it work au#horized by
<br /> the permit is�suspended•or:sbandoned;for:a:perlod,of�six:�8)�monf�s:after`ti�e#irr�e ths�work�as commenced.. An e�ctension
<br /> , .
<br /> may be requested� in wri�ing�;:ir`om tNe;Bullding,Officl'a!-for a peirlod:nnt.to-�xceed'�ntnety=(90)Ydays e�id�-will�'demanstrate
<br /> 3ustlfiabie�c�,use tor.th�extension: If wock ceas,es>for niaety.{90}cons.ec�tive�day.��..th\Job�i�consldered abandaned.
<br /> WARMING T4 �Yti'tNEl�: YQUi�..�AIE.URE,:Tt1..R��CO�2D.�A,�lO'��GE>Q��COMMEMC�IMEl+�1'=NtAYFRE;Ztl�T IN YOUR �
<br /> PAYINC�TWICE;;FQR�iMPRQ�IENIEN'���T�►�YOUIt:�:PRC�#�?ER;T,Y.::,�I�-YOU�I�TEWD�T��i�BT�i'1N�FINiI�N1ENd�;'CONSULT
<br /> w�r �v A[� Tro F ;, .R�t �, �- � - , �, �
<br /> FtOR10.'9.ilIRA'��IF:S:•. �3j.,•• �. ., _ ` " .. ; � ;•::, . ;;__ .,,:��� � _ .. �;-: :� 1 ... _ _
<br /> - '�G��av�kZ��JK N�76R► � w-- - ���1-''✓�;, ��ONTFtf1CTA ��"l'-'�. ---- -- �---- --- - _ _
<br /> ub crlb and swwrar� r�Rirmed)b S e 1h��„ SubscrEbe/d ru!` =M{at afllrm�b ts mb'�it8
<br /> Wriolslare ersonallyknown .me.or:haalhave,produced , :Who.le/are . rsonally own• ,me:orhaa/have:prodix�d- •
<br /> �s Id"eii�fli�84n, as tdenilflca�on.
<br /> ,. > ' '
<br /> Notery Publlc . Nbtary Publlc
<br /> Gom sio . . . Co sion.t�o. � .�.
<br /> ,,*AQY'���`� � . . ._ � `��4�,RY Pv��� .
<br /> ,•}p `c�•r Nbfary Public-State'ot Florida �°, `�;,. Notary Public-5tate of Florida
<br /> Name ot No �r , ' tdame cf Nolery lyped,p .
<br /> "•,r Po�: Commission#Ff 034230 ��,,�,�� �c�.� Commission�FE�3A230
<br /> ��''%°;��°` Bonded Through National NOtary Assn. ''��°;;���`� Bonded Through National Notary Assn.
<br />
|