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<br /> N�"i'1��O��E��RE�TRgC°3l0�1�: Th���d,�r�i�ne��nder�iands�<tl�t�#�i3�;A�rrntt:m��_be:su�]ecf t�;�d�ed"_,rer�trtc#io�r�.. - ,.
<br /> which may��tie�inare=r.est�activ��tli��r'Gourity�+egwlat(on�:���'h���undei�'lgn�c�•�as�ume��re�s��n�ibiftty�.for�compliacice wit�i any
<br /> ..._..
<br /> appiicable deed restricQlona. � : � , . � .
<br /> UNi.I�ENSED�CONTRACTt�RS ANO CON�RACTdR �ES��N�i�IC�TIES: 4#=�� �wner h�s���hlr�d'�s`:€rorit�c�ar or
<br /> contractors to undertak�a work, they may;b,e:�requlr.�ed.ta�be-_Il�cen�ed in.a�cordanc�:with sfate�.and,�loc�l.regulations..�fif}the�� � °�
<br /> -- L. :.:.
<br /> c��tract�x t� �ot ilcei�sed as�requlred>.6y I�wt:botli th� own�r aric�'contiti�ctor�iiriay bi�°:cttecf�i�r�a►°a�ls�lemeanor u1a�lat��n
<br /> und�r state I�w. If the owrner or Intended;.<cor,9,tr;actor;;ere.�urt�ertalo� as t�a�nrhaf ilc:en�irag:requlrements�rinay:�:eipply��,for.��:the� •
<br /> tnQend�d work�they are�clvlsed to coritact�th�6�asco Gounty�uildlr�g'In�pectlon,D(iilsl�n.-Llcensing Sectlos�et 727��-
<br /> 8v09. Furttiermore, if the awn�r'haa"telred�e cont�acfo� or contractors� he is aclvlsed ta have �the a�ntractor(s);,sign. ,
<br /> portlans af th� "contractor �lock° of.this�appllcation..far:whtch.th�y vvill.be...r.esp.onslbie.� .If:yau; as�:th� avi►ner�'tgn'•'as�''tlie
<br /> contr�c#ar, that may°be an indlca#1�n th��°�ie-ts not properiy Ilcenssd a�tl�Q� not en�itled to pemitt�ng priul�eges 1n Pas�o ,
<br /> County. ' ` � .
<br /> T4�A�95PAftTA7'ION=lMPACTIUT�L:ITQES3IMPAG'C At��?RE�O��CE REI�OVE�tY�F�E3; T'he under�lgne�undePstarad�
<br /> thaQ Vrans�portation dmpact Fees and.Reco.urs�.F�ecove.ry.f�ees mey�*�ppiy;to�the:coe►sttuctit�n of a�ew.buildings,Ychange��mf°�� ` : �:
<br /> use In ex6sNng buildings, or,eicpar�'sio�r�of:�existtn,g-ibuildir�gs, as speclfled.in P�sco Caunty Ordin�nc� number 89-97 �nd.
<br /> 90-�7, as amended.;�'fh�undet�lgned atso�untlersta�ds; tha��such f�es;:as�snay�`t�e�due;;�wlil,}b� ld�nt6Fied at the=time-of�•'� - - °
<br /> permi�ting. It is iurther understood that T�nsp'b�tatlon 9�mp�cf Fees �nd�Resource�Recov.e�ry�Fees,_must be paid prbr to
<br /> rscelvfng-�_'cergificate:z�f o�c�par�cy°'.or�nal-•pawer�relea�e. :0f th�.proj�c�:.d�es;no�Invoive�a.cett�i��� �f occupanc�<<or�:�� - , .
<br /> �in�t p�wec release;t�ie�:fe�s mu�t`be paid,p��or to.perrroit i��uance. ���tk�ermore;-N`P�scar,.C�unty��VltaterlSewrer-impact � �• �
<br /> feesaredue�..they..must..be>p�ld:p�lorto.permit'�.Issu�nce:tn..acco¢�dancev�IQf�.:applic�ble-Pasca'�•County�or"dlnances. �
<br /> C��tSTRRlC3'��lN C1EN'E��(�t�apte��13� �I�t1tla Statu���o as am�n�e��: If v�lua�on ot'work Is�2�500.00ror mor�, 1 ._
<br /> certify that I, the: applfcant,. havs.been�.provid�d with a-cc�py- �f�the �"Flor(da� Constructian� Llen .Law—l-lomeowneP's
<br /> Protectlon Guide" prepared by tlie Floi�da Q�pattment'of Agrlcultur� and Gonsumer.:A'(falrs. If the appllc�r�t Is �am�ona .
<br /> �ther thaa�Qhe"owner", i c�eti�+th�t.l�have,�btalned�a=-copy;of:the:abpve.,d�scribe:d tiocu�ent°and..pror�l��;.0�,gaod:faith.to
<br /> deliver it to th�:"owne�=peior'to�co`rnm�ncgi�ent:` � - .
<br /> �C�N'fi�d0.C'POR'S/�tdVNER'S A�FIC�ANIi': 1.ce,rt3[j+�:t�rat,�I6.thesinf�rrn�ittrr�°:in•thi�appll�#ion is�ccurat��nd #hat atl uvork
<br /> �rill'be dons� in compiie�nce v�rith all.appii��ble lauvs regulatl�g constructlan, zoning and�•I�nd�development. Application is
<br /> hereby mad� ta obtain.�.pecm�t�:t�s_do-war.k:,and<In�italtatl�n �s 1ndt�at�d:.�..=1 r��t�'y that no wark�or Ins#sllatton has
<br /> commenced prior to issuance of a permiCand that�.all work will be perform�d�to meet standards-of all laws �egulating�
<br /> constructian, County and City codes, zoning a�egulatiQns, a�d land develapment regtalaUons�in the jurlsdlctlon: 1 �Iso
<br /> certify th�t I ur�dersf�nd that the r�gulatlons af other gmv�rnrotent�genci�� m�y�appiy�to th�a itttended�rork, and th�t it is
<br /> my responsibilEt�t�ideo�tif�.what,�ct(ons 1 musGt�ke:to,be,in:.coa�pllanc�.. �:uch:agencl�s In�lud�buQ�ar�.nmt Ilmited to:
<br /> - Departre�en# of Er�vironmenta�l=�Protec#ton-Cypjess.��ayh`ead�; 1tVe�and A�reas and Enviranmentally Sensi#ive
<br /> Lands, WetedlNas#ewater Tr��tment.
<br /> - Southw�st Florida V1��ter Management .Qistrlct iNeqs, Cypress.' Bay�eads,� Wetiand Areas, Altering
<br /> Watercours�s. .
<br /> - Army Corps of Engineers-Seawalls�Docks, N�vtgable Wateewa�ys.
<br /> - D�partment �f_Heal#�:"& ftet�abll�ta#iv��Servlc�i�l��vito�r�et��al=F�e��th lltti�Wells,�Wss���ntater-Treat�n�nt,
<br /> Septic Tanks:. � � .
<br /> - US Environment�l Protection Agency-Asbes4as abateme.nt.
<br /> Federal Avl�tion_Authority=_Runways.
<br /> I understand that the-following,restrlctlons apply'to the use of flil:•
<br /> - Use a�#filf is not allawed in Flood�Zone"V"unl�ss expressly pertnitted.
<br /> - If the 9ill material Is Qo be used. In.:Flood Zone. "A", It. Is a�r�derstood th�4 � drainage p0an addr�sstng a
<br /> °campe�s�tOng vol�rrae"uvlli b� �ubm6tted at tira�e of�perr�62#�r�g vfrhtch is prep�red b� a professf�na6 ee�gEn��r
<br /> Ilcensed by#he S�te of�Flotida;
<br /> - !f th� flA m�terlal�ts..to be �s.ed dn Flood ��n� "A" !n�conn�ctton�uvlth�� permitted bui{dlrag usfng st�m wall
<br /> ' conatnictton,, i�ertify th.a#�li:w�tl=b.e used only to..fili the area uerithin�the�s#em vvali.
<br /> - If flll maQerlal is to be used In any area, i ceitify that .use�. �f:such flll wlll not adversely a�fecQ adja��nt
<br /> pruperEle�. If use of�11 Is f�nn€�to adverseEy.��'ect ad�acent�p�pertfes�.th�awrner�tay b�cited fa�viofs�tl�g
<br /> the c�nditions.,of the b�iilding;permit issu�d under the attached.�rmit appdicatlon, for;lots less tha�n on� (1)
<br /> acre whiah a�e etev�ted�by t#tt���englneersd dr�lnage plaei is r�qulred. .
<br /> If i am the AGENT FOR.TH��it�N�R, t;.prcimtse tn gaod falth tm tnfarm the awner af�#h�permitting conditions set forth in
<br /> this aifidavft`prior to cabmmencin8 canstructlon. 9 undecstand thet a�aeparate permlt may be requlred for elect�icaP.work,
<br /> plu�nbing�_.slgns, weQl�,.Aa�fs;,�Ir coe�difioning�-.g��,-�r�t��r: Instai�l�tloris noQ.spec�l�Q�y 1nc#uded�in.#he�applica,tian. A
<br /> permlt lssued shall be canstru�d to b'�`a�Ita�ensekto`p�eed wlth tlie w►ork and o�ot•�s.�auQhority to.vlml�4�,�.canc�l, all�r, or
<br /> set asdde any provlston�a�the techailca#.caades;��or shal9lssuanc��o�a.perm�Q.pr.event th�Bulldirig t�filcfa!from 4hereafter � �
<br /> r�quiring a�orrection af err�rs i�:ptans;-cansttuc,tl�n ar violatlons of�anycodes. Eve•ry,-p�ermit[ssued�sh�ll become irnalld �
<br /> unlesa the work ai�thorized.by such perml�:�ls-co�rtm�nced•wlthfn s�Cxc.m.qnths of�permlk issuance, or If wark aukhorfzed by
<br /> #he perr�#t-i�suspend�d ar.sbandoned-foc�;pe�lod af�s�C=#$)m�rrths aft�r th��t#me the�wa�ie�s cammenced. An exten�ian
<br /> may be requested, In wrtting,:.from thie,�Bullding,Offlcla) for a per(od��not.tc� exceed�nlnetjf(90)-day_s and�vdill dernon��te �
<br /> Justlfi�bt�c�uss for the extensicsn: It'work ceas�as.for_nl�a��-�90;-�aaa��:��4��afay.s..QFi��ob�1"s constder�d�ba�doned.
<br /> !lEIAftNONG TO OWN@�: YOUR.�AILWR�,•TC�.,.R�EC:4l�Q.A.MOTICE:OF;�COMINEMC�APIEMT>M'AY RESULT�IN`Y011R
<br /> PAYINC:'fi�tlCErFOR IMPRQ�tE�AEN�'S�T�'!.Y�UEt::Pt�Q�E#�-Ttt:�I��YO.UxI���`�T�Q'��t'�B�'A�N�-FiNAA��1lrIG;'C.f3�N�URT
<br /> 111PIT U A Tfl� N t�'R�,, � -C'',:, ,611 `, `
<br /> F�oRiu�auw►�:t�:s:trr ua�- 4� � �: . . , . ..
<br /> OWNEIt OPt AO@PiT ����^��. CONI�RACTQR �
<br /> subsalbed and swrom M(�r atflrmed)Baetore thls Subacrlbed and'�wrom�ta(ow at9lrcned)'beto�Rie'ttil�
<br /> � by �by.- � -
<br /> ! Who Is/are personally knowm.to.me or has/have produr.ed lNho.ls/are.p.er�onellyknowmtt�.me or hes/have•produced •
<br /> ae lil"entlflcadpn, as ldenH�catton.
<br /> Notary Pubttc . � Notary Pnbtic
<br /> Comml�alon No:s Comr�Isslon.Plo.
<br /> Name ol'Notary typed,p�InQed ar stamped Name of Nolary q�ped,printed ar atamped
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