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�90TiC�OE��ED RE3TI��CTIO1dS: The und�esign�d.undergtands�:���t:thf�.;p�aa;mit..may.b�,subJect,to,"deed":restricttons"..:F:r�,n <br /> which may°-tie��nor�=-resttic@ive��th���Courity���+�gr�latlon�:=�The'u�ide�lgn�d�assumes-re�p�n�lbill�':fo�"coniipli'�n�e'��+itFi'any ��' <br /> �pplicable.d�ed rest�ic4lons. ��`'-�� '-° "' <br /> �,. :d.�, :;_: �� � - <br /> _ - . _ . . <br /> 9J�LICENSED�CONT1tACT�R'S �RND COIV�t3�CTtDGt R�SPOPI�SfBILIYO�S: =1$°the��owner�has�hOr�:d��'ccn4��ctor or <br /> contractors to undertake work, they may;be„r�quir�d.�to,be;;llcens�d In.ac.�ordance.�rith;staf�.andylocal.r�gulatlons:<�IE the=� � •- <br /> contractor t§-not licen�ed as reyulred,'6y lew, botFr ttve own�r and�-con`Vecto��m�y�tiew�ited°.for��}ml��demeanor vtol�tlon <br /> u�der state law. If the owrn�r or Inteiided,�,co,ntractor,ar"��unc�rtain �s to whaf Ilcen�irog,r�quire�nents:m�ya.:apply-�ior:the�t°� - � �' <br /> - - ,__..,,__,_._,.._<�_:.�...-... <br /> int�nded�iark,"th�y a�e��dvis�d to co�it�ct the:Pasco.Coun4y�upldln�`Inspection_:D(vls(on-�Licensing Sectlon�t 727-647- <br /> 8009. FuetherQnore, If th� owmer`9ias'hdr�d a cont�acfor or contr�ctors. h� is advised to have�the contractor�s):.sign , <br /> portfons of.the "contcactor Block" of thlsl�pp0lcatlon.f�r.which..they,.wlll�,be-r.��pon�lble.-:If.you,a�s-:#he mvinier:sign�as'�the' � <br /> contractor, th�t may`b� an indication that''he 1s�not.progierly Ilcens�dr�ricl�i§�-no!`entitl�d�fo perrriltting privileg�s In Pascq _t <br /> County. . ; ;.:,:.,,;:�. -., <br /> �C3AIV�PAFlY�1T10N:IMPi4CTBl�JTILITIES 9MP14C'�A��b�ESOU�CE RECOVEtt1f�FEE3:�=The undeesigned�tinders�ands <br /> .. � � n6.G4H�ra a� . . . . .,:. .;. <br /> -�e���'�r�n� ��"����� 9��a�a..�� ..,.� �r��.�:�c�.���.�?�s�b��m.F��s rn�y'��g��lb:tv�ti��,cona@r�ectlonrof new buildings.a;chang�:of;; <br /> use in ex'isting buildings, or:,expansiarr��of�existi�i�:tbuipdings, �s �pecifi��.In Pascv Coun4y Ordlnance num�er 89=0�-an� <br /> , 90-07, a� �rr�ended._..Th� undersigned also:understa�d�, that:'such f�es;;:as�,�may;�e�-d�e;;_�aill�be id�ri`tlfted at the�'ti�e�of�=- ~ �_- <br /> , perm6tting. It Is fu'rther understood that'�ra�sryo�atlo� Imp�ct`'Fees �nct���Resou�„;Recovery'Fe�s::must be paid prior to <br /> ��e�Eving-�_'certiflcat� of�oQxupa�cy°�or�f�n�F-.power;,r�leas�:� :9f�the.proJ�ck:does=:not tnvolve��:�.c�rtffic�t� of occupancy=or�°'_��� � � <br /> , __:. .... <br /> fiEnal p�w�r r�lea�e;th'e�,fees'rr�u�t�ba paid�p�1or to.;p�rmit 6ssuanc�. .Fu�therrrmoce;�;If:P�sco,,Counly;Water/Sewec=:lmpact , :=��•�� <br /> fees are due,.dFoey�musQ.:be�p�id..prior.to.permit�,Issuance�in,�ccoedan�:violth��pplicable.Pasco��Counfy"ordir9ance�. - <br /> �ONSTRUCYI�N�LIEN'�LA�C"(Chaptee 7�3� FIoNd����fut��,as�r��raded): If valuadon of woPk is$2,500.00;or-rnore;.I=� � -� <br /> c�rtify that I, the applic�n4;• hav.e;been .pro�lded �vvfth- a=copy-og�4he��'Florida�°�ongtnictton �LB�n .Lav�Hom�owner's <br /> Protectfon Guide" prepared by the Flo�ida Dep�rtment�of AgPicaltur� and Con�um�r�.Aff�irs. If th� applEcant is sonneone�. <br /> .. .. <br /> > , <br /> �ther ihan thQ"owner�, i certify�Qhat.i h�ve,obt�in�d-a-�copy.of:fh�.abQve.:�e,scrlbed:�docu�ent�a�d.prqmBsein,good:�f�ith,.to - <br /> d�liver Et to�th�:"owrn�r"'p�ior'to:-commencem�nt:" • � � ' . � <br /> C�N4RACT��'S/OWNER'�A�FIDA!/17': I.cert6ty::th�t-.all'4he:lnf�rm�tior�:,tn�'thi��ppllcatlon is �ccur�,te and that�01 work '� <br /> v�ill'be done in compli�nce with all applicable laws re�ulating corastrt�ctlon, zoning �ntl�land`developrv►ent. �pplicatlon is � <br /> hereby rr�ade to� obt�in .a permit�=.to,;do,<rw.ork.�,and..in�felia�teon �s indl��t�d:�����31��c�rtify that no woPk�or Installation h�s' I <br /> commenced pPlor to Issuance of a perr�if"and� thal:all work wlll be p�rtormed to me�t:sQand�rds.�of all laws regul�ting� �I <br /> const�uctlon, County_ and City codes, zoraing regui�tia�ns, and land deve8oprnent eegula�lons`In�tfie jurisd(ctlon.- 1��1'so <br /> certi�y that I und��st�nd that the regulattons of other�ov�rnment a��r�cieQ m�y�appiy�:to.lh�.lntend�d work, and that it is <br /> my responsibili�r�to Id�ntify•what,acdons I�u�t•t�k�:to b��ln<.c�r�pliange,;,,�uch:ages�c9es tn�lude but=�re.not Ilmited to: <br /> - Departm�nt of EhvQronmentai='°Protecfton=�;jipr`ess:�ayFi�ad�, 1l�etl�nd Are�s �nd �nviroromentaliy Sen�itive <br /> Lands, Wa�terNV�stewrater Trea4�nent. ,_ - ��� <br /> - �outhw�st F{orida Vllat�r iVBanag�rv�en�: :Dis4rict-W�91s;' Cypr��s. �ey�ie�ds;� �W�tlan� Areas, .Alterfrag <br /> V��tercourses. � , " • <br /> - Army Corps of Eragtneers-Sea�alls, Dock�, N�vigabl�l�l�t�e�nrays. <br /> - D�parfm�nt of._.Eiealth:'�.,.Rehabllltativ�;�ervlcesLEraviro��n�r�t�h He�itt� iJntt-Well.s, UVasQewtat�r,7reatment, <br /> Septtc.�'anlis..� ' ' - . , <br /> - US Environmend�l Pretection Ag�ncy-Asb�stos�b�t�mente; ' <br /> ��dePal�Avlaticn��►uthority:�Runways. � . <br /> I unders4and that the..foliowing::restrlctlons apply�to the us�of flll:• <br /> - lDs�qf�ill Is not allowed 1n:Flood,,;Zone"V"unless expressly perrv9ltted. <br /> - If the filf mate�l�l Is to b.� u�ed::In.�Floo� �one. "A", Ik Is underetood'that a dra6nage plan addr��sing a I <br /> °compensating volume" will b� subr�ltted at 4ime of�.perrq�Ett)�g vuhlch is prep�red by a professional engln�er <br /> Ilcens�d�by'the�t�te�of`flocidra: � � , <br /> - If fh� flll-ma#erlal�6s�to be used In Flood ��n� "A� In�conneoQton�with�� �peemfFt�d build9�tg using ster� wall <br /> � con�QrucQlon, t c�rtify that fill�wlU.�b.e�used o�ly.to.f�ll the ar��writhln�fhe�stem�uu�ll. . <br /> - if fEll mate�lal Is to be u�ed In any area; I �certlfy th�t .use. of such �Blll vir111 not s�dvers�ly a�fect adJacent. <br /> pfopectles. If us�,of.flll Is found to adv�r�ely:�ffect adJ�certit��propeo#les,.the owner m�y b�clted for vEofating <br /> th� condl#ions.of the bullding�:permlt�ls"su�d�under the:�atfached_permit..�ppl(catlon,=for�:loQs•.le�s:than one (1) <br /> �cre vvNlcFi are�lev�ted'6y illl, a�t.englneered dralnag�plaa�Is requlr�d. •� <br /> Ig I am the AGE�IT.�013 T1i�AWNER;_I;.promiae,ln.gaod.falth to in$orm th��o.wn�r.of:the permltting conditlons set forth In <br /> thls af0idavlt`prtor to commencing coiastructYon. i und��tand that a�sep�rate permlt may be requlred for�I�ctrlcal.work, <br /> plumbing,.�,signs� wells�,poo0�;.-alr condltloning,�.g�s,_.o�.oth�� Instael�tlons noE•spec�lcally included�in.the��pplicat3on. .A <br /> p�rm6t Issued shall be cons�ued to:b��'a�Ilcense`-to•pr�ceed wlth`the,�iork.and.not��s.:�uthority.�to:vlol�t�,�carrc�l, alter, or , <br /> se@ aslde any�provtstons of the�eahnlcal_c�od��;�nor sh�ll Issu�nce�og a.p�rmi�.predent the Bulldi�ig�Iclal frmm thereafter . <br /> �equlrin,g a coer�ction af erroes;lre;plans;-co`e��.trucllon.or..vEolaUons of��ny cmdes.� Every�`.p�emttt;tssued si��ll�be�ome indalid <br /> unless the work au4hortzed.by such perrtalt:�9s.commenced•wrOthtn �c.:Pn�nth� of pem�lt issu�roc�, or If v�oek authorized by <br /> 4h�pe�mlt ls suspended��or;�bandoned�for:a;p�riod:of�BUt�;(�)•mon�f��,:���r th�tlm�the�vvoi`k�l�cortem�nced. An�xtenslon <br /> may be requ�st�d, Ip wrlting,,�f�om..th�.Bullding,Offlcl�il for a p�rfod=:rtot=to excged'=�nfi�ety°(90)��d��� and•willl �etnonstrate <br /> justffiable cause for.the extenslon�. If work-ceas�s:for nlnety.(90)cons.�cuQlm�d�y.s,..Ohe)ob��s consider�d aba�doned. <br /> �t9�1RNING TO�OIMfVER: �OUI�..�AILWRE„TQ.,R�EC.CI.RD,A�:.f�TIS��::.OF.�COMMENCEWIENT.N1�►Y:_RESULT�IN'YOUR <br /> ;. . . . . . <br /> .�AYING TMPICE;,FOR IlYIPIt011EMEN'�3�T�;YA.U��:P.�t�P:..ER'P•.;Y:��I��.YO.tJ{II�':�EpIDt�YO�-�BTA1NaF1�P1E1N�;'COIVSULT <br /> �4oT . D �1i�� Tf0 N OR ;. .O � G�? O ' E , � <br /> FL`ORIDA JURA'�(F:S:1:17:03).,.� - - , • - - � � <br /> OlMNER OR AOENT . COWT�CTQ ',• <br /> Subscrlbed and earom ta(oe afl9rmed)befar�me thls Sub�erlbed arsd'sudoen•4o or Rlemed)� �Pe me'tFil�: <br /> by �by ° <br /> b�o Is/are pe►son�tly knoNm to.me.or:he�lh�ve.produced Who.t�/�re.p.ersonel�y kii •t�me;oeha�/hav��produc�d • <br /> ' � -a�Id'entlflcatlon. " _ as IdentlBcaUon. <br /> Motery Publlc . � Nofary Publlc <br /> Commisslon P!lo:'• Com�I�slon�Pdo. <br /> Name of PVolary typed,print�d ar stamped Name of Notary lyped,printed or g�mped <br /> '� ; .. 5 � <br /> . .� • . <br />