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<br /> IVOT9C�OF D�ED RES`TRECTION�: The undersigned undergtands;th�t,this.:p�rmlQ;may.be;subJecfi to"deed"restrlcQions" __ . �.
<br /> which maybe�more-testcictive-tfi�� County.�regulatlons: �The uiedersigned�'a§surine9��responsi611tty`fior�compliance witl�`any
<br /> applicabie.d�ed.restrictions. .. . , • _. � �
<br /> �1NL.IC�tdSED CANTI3AC1'ORS �;ND CONTi�ds►C'FOR RESPONSI�ILI41l�S: °If-the �wner�has-`hiced �a contractor or
<br /> contractors io undertake work, they may,b,e:r�quired�:to..be-:licens�d In accordance.writh �tate.and:local_regulatlons: If�the � ��
<br /> contractor is not l(censed as required`by laH►, botFi the oevner and-cont�actor-m�y be��c(ted for�a•misdemeanor violatlon
<br /> und�r state law. If the owner or intended,contr�ctor,;are,�uncertaln as to what Iicensing.requlrements;may apply:for the • �
<br /> intended work, they are advised to coritact tfie�Pasco County Bullding�Inspection D(vlslora—Licensing�Sectton at 727-84T-
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<br /> 8009. FurtFiermore, If the owmer�Fias hired-a conlracto� or contractors, he Is advised to have the contracto�(s); sign
<br /> po�tions of the "con4racto� Block" of..this application for,which.they, will„be-..r.esponsible.- If you,.as:#he ovimer sign as the ^ ��
<br /> contractor, that may be an indication that'he ts not properly Iicens�d and`�!s not entitled"to permitting pr6vlleges in Pasco ,
<br /> CounQy. ' `'`
<br /> °t'�1f��PARTAT'IOW-.IMPIQ,CTIUTILITIES�IMPI�C�'�ANb ltE30lJI�CE RECAVEI�Y FEES:� l'he undersigned�understands
<br /> that Transportatfon Impact F�es�nd.Fteco.urse R�covery:Fees may��apply�tv�Qhe_con�truction_of new bulldings,schange�of`� -
<br /> use in existing bulldi�gs, or_expansi�n��of�ezistin�g'�buildings, as specified.ln Pasco County Ordinance number 89-07 and
<br /> 90-07, as amended., The undersigned also;understands, that such fees,;,as�may:�be:<due;,.wlll:be (dentified at the.tiPrie`of• ��
<br /> permitting. It Is furtFier understood that Transport�tlon Impac[�Fees an.d'�Fiesource Recovery°�Fees.must be paid prior to
<br /> receiving a.'certffic�te of occupancy" or flnal-pow�c�rele�se. :If�the proj�ct:does�not:involve:a:certificate of o�cupancy�o� '_ -
<br /> flnal povver releas�,the.fees mu�t be paid,pclor to.permit Issuanc�. Fu�hermore�if Pasco,:.C.ounty`11Vater/Sewer�;lmpact - ,.
<br /> fees�re due,.they must be pald.prior to permit-issua+nce`In.accordance wlth applfcabte:Pasco�County ordinances. •
<br /> CAN�TRIIJCTION�1:1�IV-LAVIP(GFeapter 713s FIOP1d�$te�tUk����amend�d': If valuadon o#work is�2,500.00.or more;.f :.
<br /> certify that I, the -applicant, hav�-been provi.ded wtth a copy-of.the "Florida°Constnaction� Lien .Law�Homeowne�'s
<br /> Protection Guide" prepared by the Florida DepartmenQ�of Agrlc.ulture and ConsumerAffairs. If the appl(cant is someone
<br /> other ihan the'owner", I c�rtify that I have.obtaine�`a�copy,of.the:above..desceibed tlocui�ent�and.promise�In,good faith,to ,
<br /> deliver It to.the.`ownec".prioc::to�commencemerit: ' ' � � ,
<br /> �ONTRI�CTOR'S/OWNER'�AFPIDAVIT: I.ceiti�j+.tti�tall:th�,informatign.ln•thi��pplicatlon is accurate and that all work
<br /> will'be done in compliance wi4h all applicabte laws regulating constructlon, zoning and��land'�development. Appltcatlon is
<br /> hereby made to obtain .a permit;to do. work�,and�Inst�ll�tlora �s Ir�dicafed:.� .`I certify that no work or Inst�llatton has
<br /> commenced pr(or to Issuance of'a permif and that.all work wili be pertormed to meet.standards-�of �II laws �egulating�
<br /> constructlon, County and C1ty codes, zoning regulations, and land development regulations•tn the :jurisdlctlon.� I also
<br /> certlfy that I understand that the regulatlons of other gov�rnment agencies m�y�apply;to the int�nded work, and that it fs
<br /> my responsibility to identify�what.act(ons I must t�ke to be�in:.corrlpllance;.,�uch agencles�includ�but are.not Iimited to:
<br /> - Departrtoent of Environmental Prot�ction=Cypress. Bayfiead�,�WeHand Areas and Environmentally Sensitive
<br /> Lands,WaterlWasteu�ater Treatment.
<br /> - Southwest Florida VUater Management� .DBstrict-Welis, Cypress.���ayheads; Wetland Areas, Altering
<br /> Watercourses.
<br /> - Army Corps of Engineers-Se�walls,�Dock�, Navigable Watervuays.
<br /> - Department of Health:'& Rehabllltat�re.Seovices/Environmenfal Health Unit-Wells, Wastewater Trea4rment,
<br /> Se�tic Tanks:. _
<br /> - US Environmental Protection Agency-e4sbestos aba#ement.
<br /> - Federal Aviatton_Aut�orlty-�tunways.
<br /> I understand.that the follov�ing.:restrictions apply to the use of flll:�
<br /> - Use of�ill is not allowed in Flood;Zone"V"unless expressly permitted.
<br /> - If the fill m�terial is to be used. In.�Flood Zone. "A", It. is understood that � drainage plan addressing a
<br /> "compensating volume" will be suba�itted at time of permitting which Is prepared by a professional eng(neer
<br /> Iicensed by the State of Florida.
<br /> - If ih� �BI material fs to be used In Flood Zone "A" Ihs connec�fon�with�a permitted building using stem wall
<br /> construct(on., I certify that flll�:wall=b.e.used only.to.fill the area within the�stem�vvail. -
<br /> - If flll material is to be used in any area, I certify tfiat .use. of such flll wiil not adversely affect adJacent
<br /> propertles. If use of flll is fonnd to adversely,��fect adJaEent properti�s,.the owner may be cited for violating
<br /> the conditions of the b�ilding�,permtt Issued under the.attached:permit appllcation, for.lots-.less than one (1)
<br /> acre which are elevated�by f111; aet engtneered drainage plan is required. .
<br /> If 9 am th�AGEN7'FOR TIiE 01MNER; I,;proanis�in good faith to inform the owner of the permit�ing conditlons set forth In
<br /> this affidavlt�pr(or to commencing construction. I understand thet a�separate permft may be requlred for elecMcal work,
<br /> plumbing, signs, wells,.pools; alr conditloning,.gas, ar othec instali�tions nol.spec(fically Ineluded�in:the application. .A
<br /> permiE Issued shall be constcued to be a�I(cense to_proce�d with'the�rtiork and not�as,�uthor(ty to,violate,cancel, aiter, or
<br /> set aside any provisions of the technlcal.codes; nor shall issuance�of a.perrnit.prevent the Bulid6rig Offictalfrom thereafter
<br /> requiring�correction nf errors in•plans; constructlon or iriolat(ons of��ny codes. Every permlt Issued shall become invalid
<br /> unless the vvork authorized by such permit.ls.co�menced•withtn sfX cro.onQhs of permit E�suance. or if work authorized by
<br /> the permit is suspended or.abandoned-for.a:pertod ofsix�(6)montf�s.�fter the ti�e the�wotk is commenced. An extenslo�
<br /> may be requested, fn writing, from tNe��uilding,Offlci�l for a per(od-not-to exceed ninety�(90) days and-will demonstrate
<br /> justitiable cause ior.the extensioro�. If work cease�.for ninety.(g0)consecutive day.s,..th�job�Bs considered a,bandon�d. '
<br /> VdA1tt�IIVG YO OIIVMER: YOU�..FAILURE.T�..REC.ORD A.NOTIGE OF�CAMNlENC�MEMT.NFAY RESULT IN YOUR
<br /> Pr�YING TWICE:FOR�IIIA�OVEIdIEM�S TO YOU�;PR�PERTY: �IF�YO.�1�SIdTE�lD�T����TAIN�FItV�A1��1NG;�CANSUI�.T
<br /> WIT U D O AN A'TTO NEY� �ORE�i. E�OR� G�� AU ' �� �'O �� �•' � E E � T� �
<br /> __ FLORIbA JURA'�•(F.S. .03)_ ._, �- � ' ^ ' � - -
<br /> 01RItdER OR AOENT . CONTRACTO
<br /> Subs�bed and sarom r aHirtned)befor me thls Subscribed�and' -to(ow afflrm re,�ne ttits.
<br /> b �.�-►.n C, rn i s en j' - �-� '-' �� ,
<br /> Who Isfar ersonally known .me or has/have produced Who.ls/a ersonaily knowrt me or heslh�ve produced
<br /> as Identlwcetlon. as Idendflcadon.
<br /> � �
<br /> tdotery Publlc _ Nofary Publlc
<br /> Commis Co asion.No.
<br /> `�����y p���� SYLVIA A.CAMPBELL ����aV P���� SYWIA A.CAMPBELL
<br /> `.41J� f!Blii _ `�•O1P !/g��•'
<br /> , y�� Mame of Nolary type �d
<br /> Name of a�� S Jul 19,2017 ��omm.Expires Jul 19,2017
<br /> %�, �:� Commission#�FF 034230 �; �:� Commission�Ff 034230
<br /> �'��°������ Bonded Through National Notary Assn. �'��°������� Bonded Throuph National Notary Assn.
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