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4��'�°9��O�D���D��5�'Ft8C1'i��l�: '�`h� und�rsign�d und@rs�nds th�@ this�permi�may��subj�ct qo"d��d"restric4ions" <br /> whi�h m�y b�more ���tcic�v��h�n County r�gtal�tion�. Th� und�rslgn�d as�umes r�sp�n�ibil�ty for c�mp#ianc�wi4h any <br /> applicable deed restrictions, <br /> �l�9�d��6���� ���{T���'��� ��� ��&�"�'��"�5�� ���P�6��[�!LlTflE�; !f �4�� �wn�r has hired a c��tractor or <br /> c�nt�ac#ors�o und�r�#:�work, th�y m�y be r�qu(red fo b� i�c,�n�ed �� ac�ord�nce with�f�4�and ioc�i regutafiians. tfi#he <br /> aontrr�c�or fs nat licensed �s required by law, both the owner and contractar may b� cited for � mi�d�m�anor �iol�fiion <br /> ttnder s#afe #aw. 1��f��t�wt�r�r in�n�ied t�rr��r�ctor�r� unc�rf�in as #o�v�tat#�cen�ng r�qt�9r�rne��nay apply�'a�r fihe <br /> intended work, they�re advi�ed �a cont�c�4h�Pas�a County�ullding Inspec#ion Divi�ion�-Lic�n�ing S�c�on at 72'�-847- <br /> 8QQ9. Furth�rmor�, if #hc� ownar ha� hirc�d � contr�ctor c�r corttractors, f�e is ad�vised tZ► have th� contr�ac#or(�} sign <br /> porti�rr� of�i�e "cflntrac�ar Stoc�" of�his appiic�fiion for whieh th�y wiil be respa�sible. i�you, a�s th� owner sign a� ti�� <br /> confrac4or, tiia4 rr►�y be an indic�tion t�af !�e is no� prop�rly licen�ed ar�d is no4 snt��i�d to permitfi�g privileg�s in P�a�co <br /> Cour��t. <br /> 7'E�B�SF�ORYd�'T�0�3 INi�AI�TYU�'ILf�I�� 16��,�C7 6��D�3E�O�IRC� ��C046��Y l���S: Th� undersigned under�fl�r�ds <br /> �h�t$�ik�tlS�Of'Nra�ICCt IiS1p�Ct}�6C33�dt1d R@COU[�� R�COV@f}f F�BS tl1�Y'�D�IJt�4 4h@ GOt1S#rllG�jOit Of ti�U1!b�llld�fl��,Ch�Ptt��0� <br /> u�� in e�ast�ng bt�iidings, or expansian af exi�Ying buildings, as sp�cifi�d in Pasca Caun4y 4rdin�nc� num��r�9-0�' a�d <br /> 9q-07, as am�ndad. 1'he undQrsign�d �lso underst�nd�, that such f�es, �s may b� du�, wiH be identifred at�he time �F <br /> ���eniffing. It is furtkter unders�oad �hat Trans�or#a�o� tm�tact F��s and �e�ourc� Rscovery F��s mu�t�� paid prior�o <br /> rec�iving a "ce�i�ic�4e of c�ccupancy" or final pawer refeas�. if th� project d��s nat involve a c�rti�cate of ac�up�ncy or <br /> fi��l power rel�a�e, the f�c�s mus��e paid priar�a permi4 issuanc�, Furthermorc=, i��a�co Gouniy Wa�rlS�wer lmpact <br /> ft�e��r�du�,fihey mu�t��paid prior ta permifi issuance in accard�nc�wi4h applicabl�Pasco County ardinances. <br /> �5��9��`6�d8��'ltd�l�t��! L��9 dC����ee�?a 3, �l��dd���$ec��,���a��u�d��, If valu�tfon of wark Es��,500.p0 or r�ore, I <br /> c�r�f�r th�t 1, th� apptfcant, t�av� b�en proNd�d r�it� a copy ofi the "FIo�3da Cons�ctac�on �i�n l.aw F�omeawr�e�'s <br /> Protection Guideu prepar�d by th� �lorlda D�parfm�nt o#Agriculture ar�d Can�umer Affiair�. If fih� appiicant is som�one <br /> o�h�r than th�"ovun�r", !r,�r�►�j►ttt�t��a��obtain�d�cop�og the�bove�escribed�#oc�ment�nd promi�e�n�aod 5�aith�a <br /> d�liv�r it�o fihe"own�r"prior to commencemen�. <br /> Cf98�7'6�►C7't1�'�/Ol�i6�ER'� A�'�ID�VIT: f certify tha��li #he infarmatian in this appfic�ation is accur�te and that aH work <br /> wit[ be donc 1n campNancs wi#h �il a�plicabl� 1av�rs regulating canstruc#ion, �ctning and land d�v�icpra�nt. Application is <br /> h�reby m�de #o obf�ir� a p�rmi4 to do wori< and ins�all�Yion as indice4�d. I cerfify t0��fi no uvork or ins�altation ha� <br /> cornmenced �rior to is�uance ag � p�rrr►i� and 4f�a� al! w�rk �r�li be pe�rorm�d �o meet st�nd�rds of ait [��nrs regtalaiin� <br /> construction, County �nd Cify cad�s, ��ning regulations, �erd iand developmeng r�guiations in fhe jurisdicfion. I aiso <br /> c��ifiy thafi I undersfi�nd �hat the r�gulatian�of oth�r gov�r�ncnent agencies m�y apply#o th� intended wo�4c, and th�t it is <br /> my r�sponsibiC#y to iden#ify wh�#�ctions i rn�s#��e ta be in corrt�liance. Sucfs ag�ncies include bn�sre no�iimit�d to: <br /> - D�partm�n� of Envir�nmentai Pr�o��ction-Cypress 6�yheads, Weti�nd Ar�as �nd �nvironm�ntally Sen�itive <br /> l.ar�ds,WaterNil�s4ewaf�c Trea#m�nt. <br /> - Southwe�t Fiorida Wai�r M�n�gemertf Di�fric�Welt�, �ypr�ss B�yheads, U1/�t}a�rd Areas� Alkering <br /> W�tarcaurs�s. <br /> - Army Garps af Engin�er�S�a�all's, Qacks. 3�avigabie Wa�rways. <br /> - C�e��rtenent a� H.ealth &. Ft�h�bilGf�tiv� a�nt(cesl�n�iranmentat hleatth lin��-iN�[I�, V1tas%water Treatment, <br /> Sep�c Tanks. <br /> - US�nviranm�ntai Protectian Agency-Asbestas abatement. <br /> - Fedefat Aviat��r��u�hc�rity-Runw�y�, ' <br /> 1 sandQrs#and tha�the�allowing r���rictions apply to the us�of fi11: <br /> - Us�af�!1 ts na�allow�d tn�looci�'or�s"1�"ur►less�xpressly�ermit�ed. <br /> - if the �ilt mater#�I is f� b� used in Flood Z.��e `�A", i� is ur�d��sfo�d fih�� a drairtaga plan addre�sirtg a <br /> "compansafing voium�� wiit be �ubmitt�d at time of permitting which 1� prepareci by a professianai �ngin��r <br /> licensed by the St�t�o�Flarida. <br /> - t�tP�� fill material is fo be used 'rn F1ood Zane °A" in conn�cfian wiff� a p�rrrtiffar� buitding ��ing �tem waii <br /> cottstruction, I ce�ify�ha4 fiil wili b� used only ta fil the area within the s4�m wall. <br /> - I� fitl tna�eria! i� tv be used in any srea, ! cer�ify that tsse of such fiE( �ill no# adverseEy �ff�ct adj�c�n� <br /> prope�ies. ifr use of�Il is fiaund �o adv�rs�iy a�fiect adjacent prop�rties, the owner m�y b� cited for viola4ing <br /> the condiYions of the building perrni4 issued undc�r fha a44�ah�d permit applicatior�, for lofs lQss iF�n or�� (1) <br /> acr�which are ei�v�tarl by fill,an en�ineered dr�in�ge p1�n s`s t�cJuir�d, <br /> if I�m�hc�e4C��i�T�f�E��Ml� ���R, t promi��in good f�ith to fr�form the owner of th�permi�ting conditions s�t for�h in <br /> ��f18 ��It�BVtt�t1OC'�0 COittf11i3#1�li1� GOF}S�C'UGfI4Pi, � U11dG't'S�Qtld �31�C� S9�}aF'8�� �1@�172�4 t3'1�}� �� t'Gt�Uit'8d �OT�1@G#t1C�l WOC�t, <br /> piumbing, signs, welis, poois, �ir conditioninc�4 gas, or o�h�r in��ll�fic�n.S nat sp�cifica(ly inciuded tn th� spplication. A <br /> perm�t is�usd �hall b� con�fru�d t� be a ticer��e �o proc�ed wlth ths work and not as aughori�y�a viot�te, canc�l, aSi�r, or <br /> se�a��de�ny provisions ofi the technical codes, nor shati is�uance aF� permi�prevent#h� Building Of�ciai fram th�rea�f�r <br /> r�quiri�tg a carrecfion of errars ir�plans, constru�tion or viol�tions c��ar�y cod�s. Ev�ry p�rmifi i�sued sF�a{f becvme ir�vatid <br /> ur�less �e wor�C aufihori��d by sucF�permlt�� commenc�d w�ghin six man��s o#permi�i�sua�ce, �r if work autho�i�ed by <br /> the permit is susp�nded or�b�ndaned for a p�riod of stx(6)months af�er the klme 8he work is cammonc�d. An ext�nsion <br /> may be re�ue�ted, in wri#ing, firam tl�e k3uilding O€f�cia! �or a period not to exc�ed ninety {9Q} d�ys and wilt demons�ra�e <br /> justi�iabie cauee for�he extension. 1�work aeas�s fiar nin�4y{90}con�ecu4ive days, fihe jab i�considered abandoned. <br /> �9A�#���Zs �'C9 ��A���; Y�i�� �Ai�:t3�� "�'�'1 ���fi��l� a� ��`�1�� Q� �����i�����k�� �4Y ���Ui�°t [A� YC9E�� <br /> �AlPtidC�T!flli�� �0� if�lP�OlfE��1�7�T�1P'OUR PR�6��6�°f�t. I�Y�4! I�d`I"�I�D'PO 0�"�'Ali� �IPIAE9�1{�Gw CO�l�IlLY <br /> !N!'Y&�'�'� R L O� �► �RR Y 1� �R�R��'t��D 6�G Y�! F��40"Y6C� � CA E � � . <br /> ��ORiDA dURRT(F.S.1- 7.�3) � � <br /> -�-O'!!�ltV�t3�R2=AG�d1t'� - ����� -GC144�g1A."C'i � ^ - —_.. _ <br /> Subscribed and sv�m to�"ar aifirmed}bs � e this 8ubs 'b, r}��ey%a��na swom ta{or a#firnted}b me�his <br /> 7�ip_,,.E'� by `r/,� by <br /> Who Islare personaAy knowm to rna or hasthave praduoed Who Islar�personal4y known to ms or haslhave produced <br /> as iderrtiflcation. as 1den�flcation. <br /> , � <br /> -�o6��p�,( .� hJotary Pupiic � _- _ otar�r Public <br /> l r�-� /��� <br /> Co m�ss3on i�a.�����." ' .._ Ca rnission No. <br /> ..- � � <br /> ame af Na ry typed,printed ar ata ed Name a�A�o�ary typed,Ar'snted ac stamp�d <br /> r Y♦<au�as�i'ary„cr <br /> ;a�:::"` ►:'���, '::::iNE RUFFEL.L pRtR�.{i:VA�i, DEBRAEIAlNE Rt3FFEl.I <br /> -'� �''`s � r 53�� =" ��` Commisslon#GG 045343 <br /> Com,��!ssiun�:;.,;�?� �•� :- <br /> =�° ���Expltes Nuu��� . `� :,� 'a:=ExAires November 7,2424 <br /> ;,"F�a� �• :�'�¢ %/%o,�rio�`' BaidadTfwFmyFainlnsurance84D-385dOt9 , <br /> .g;,i,�R• 8onddThruTroyF •: :..::SOa38S7019 ' �"• <br />