|
i
<br /> . .
<br /> ��}'l�CE t��DE�R�RE:E'�R�CTEO�S: The a�d�r.s�gr��d uaui��t�nds�;�tl't�t�#�I�,���t;rrtit.rn�y;be.,sub�ectat�"dged".re�tr#c#to�is"_ -t A. .
<br /> which may�be_<�ore'.r:�st"r�ctiv�°thaa�'County,��egulafions�:The u�de�sigfled�-�"s�`ur�ea'r��ponslbility�for`�c�mpilance wltti"any"��"' ` " ��
<br /> �ppqcaale deed�restriatians. � :. • , '..
<br /> UWl.tCENSED=CANT1�CTt'�R� AN� CON�RA�'TOR RES��NSl�Q�;!'i��S:� tf��fh�e �wrn�r has°.:hir�rl.��'.ccintr�tctor or
<br /> contractors to undertake work, tFtey may;be:;r�quired..ta::�be;.11c�nsed:in,.accordance.with state�.and�local;u�egulaQl.o,ns:.w�if�the�� �
<br /> contr�c#or t� not��Oces��ed�=as�re�ulred'tiy law* botli the ow�ner and �nt�actoT���nay be��clted�f�r�a°mtsdemeanar vlolat#on
<br /> under stake law. if the owner or Intended;,c�ntr�ctor;�ar..e..;�ancertaln �s ta�wh�t Ilcenaing;r�quirement��may:=:e�pply��:foc�=the:� � • �
<br /> Intended w�rk,lhey are adiilsed t�e�irita�t tti��Paac�County B�Ilitling;9n�p�ction�D(vM�l�n�.--L(censirig Seotlon et 727-847-
<br /> 8�09. Fucttiermare, If the awr�er Fi�s"hlv�d�a canf�ac#br tit aoritractors, tie is �cJvt�ed to have �the cantrr��tor{s),..s1gn..
<br /> ,F;;..
<br /> porRiaans of the "contrector Black" of thls��pplicatfon_.far.whi�h th�y v�rlll be,.r.esp.o�sible.- If:.you;�as�:#he own�e�'`signYas tFie
<br /> contractor, th�t may be�r� indlcat4on lh�t'he is not:p�opetiy license� ���`1��tiot entit�ed tc perriiitting prtutleges in Pasco ,
<br /> County. • ::;; �.
<br /> '�'RANSPOiRT�►T1�DR1=IMPACTIl�TIL!'PIES�lMPA�'�AN�9°�E�OU�tCIE R��OYERY��EES: T'he unde�igne�uiiders#�nds
<br /> t�at'Tra��p�rtatlr�n Impact�ees�and.Reca�.ure�Recavery.��es m�y>;appiy�t��tf�e.�onstcuati�n of netiv..b¢aitd4ngs,Ych�nge�rof° � ,;'- ,
<br /> use In existing buildings, or,expar�'si��rrof-�eiiistin,g�bulltlings, �s sp�alfied.in P�sco Ca�unty Ordinanc� number �9-07 and.
<br /> 9o-OT, as �amended„�T:,he�andersigned a9s�:u�derstands, th�t�such fees;�,as��may�be�td��;,,wl�i:6e Ident�fed at the�:time�i�f�' � � `
<br /> permitting. It Is fiurther understood that Tr�anspor��tlon 1mp�ct Fees and��Resource.;Ftec�vsry$F�es�.must be paid prbr 40
<br /> f9C8IYIft��3�.'G@�EIEIG8�g:0��OCGU�?SflC�I" Of'�I118I^rJQW8f:F8I88$8: :If the.peej��k:daes�.not Involve<a:�a�rtificate of occupancy�or=.. ;:._ .'
<br /> final pawec retease;:thia:f�es mu�#be p�ii�,p`r'tor to.,p�rmi� iss4�ance, �W,k#hermr�re,-if:Pasca�;Co�ntyl'WaterlSewer..:lmpact :,,� .
<br /> fee�are du�,..they.:.must,.be.paid::prior t�.�.ermi2�:issu�nc�°:En.�ccordance arlRfi�.��ppllc�bl�:Pasca'��County�ortllnances, •
<br /> CONSTRt1CTf�rN��EN"t.�1t��(Cli�pt�r 715� �116�i�t���f��#tlf�8i as ar��n¢t�cf�: �f valua�on of work i�$2,504.OQ;or mor�,.l� .�
<br /> certify that 0, the. applicant, have.been provided-w6th a-copy of��the �"Flortda� Constructtan� Lien .La�v�—Homeown�r's
<br /> Proteotton Guide" prepared by ftie Fioi�d� Dep�rtment�of Agrfa�tture and Consr�m�r.:A#�1es. 1#4he �ppOfcan4 is someone . -.
<br /> ,.,..,
<br /> other than the`cawneN, l certt�+-thaf„1�h�v��eibtained�a�copy;�f:#he:above.;rl�scrik�e:d��lacu��nt�and,p�o�nts�..lc�,gaod;_faith�to
<br /> deliver It to.th�'awner�'pdor'ta�corirmencement;' � .
<br /> ��N'�i�CTQR'�lO�Nt�ER��%FFIDAVI�: �.cer•i;�r::���t>�11..the,inf�rrn�ttc�n::i�t�th1�appltc�tivn is accur�fie,�nd tha#al!work
<br /> will'b� done in compliance with all.app8�a�ble�aws regulating constructlan, zoning and�•land�devela�pm�nt. Appitcattan is
<br /> hereby made to abE�tn .a pecm�t=.io;dc�:w�rkv.and tnsQellation �� i�dlc�#�d:�=.-:! ceri�'y #h�t no worlt=°or Instalta#�on has
<br /> commenced prtar to i�suance of a p�rmlf`"and that�.all work will be performed�to me��t standards•of �Il laws �egula�ing�
<br /> constructiont County and City codes, zoning regula�lanst and land dev�iopmen# rega�latlons°tn #he jurisdlctlon:- ( also
<br /> cert�fy�hat 1 u�derstand tha�fh�regulat��ns of a#he�government a�encles may�appiy�to th�.intend�d wark, a��that it is
<br /> my responsibility to iderot(?y•uvhat,�ctlans 1 must•teke:ta be,in:.campl,lance:.�;uch.agencl�s tnclude btat-ar�.n�t Iimited ta:
<br /> - D�partment a� ��viranmental=�Pro#ection=C%Ypr�ss.Bayhtead�� �liie�and Ar�as a�rd Envl�anmentaity Sensitive
<br /> Lands,WatedWa�stewaker 7reahn�nt. �
<br /> - Southwest �lorida W�ter Man�gement- ..Distrlct W�Its! Gypress.'�Bay�e�ds;� Wetiand Areas� Atfer�ng
<br /> Watercourses. .
<br /> - Army Corps of Engiroe�t�s-Seawall�, Docks� IVavlg�ble IN�teru�r�ys.
<br /> - Depa�tment of_H�a�th;".�..Ret�ab0litativ�•Ser�►tc����r�vtro��n��.tta1 H��Ith 11�it�Vlells,�Vld��t�at�t�r-Tre�t�rtent,
<br /> Septic Tan1c�:. ,
<br /> - US Environment�9 Pro#ectl�n Ag�ncy Asbest�abatement.
<br /> Federa0 Avietton-�►uthority=�tunweys.
<br /> 1 under�tand tha#tMe.fallowing.xesirlctlons�pply�to the use of flll:•
<br /> - Use a�f f�lt Is na#allow�d in FloodtZ�ne"1�"unless expressiy per�tt#ed.
<br /> - If the 4ill materlal is ta bs used;,in.�Flo�d Zone. "A", If. i� understood th�t a drainage pl�n addres�ing �
<br /> "compensating volum�"wlll be subr�ltked �t�ime �f�per•►�itQ@ng whfah is prep�red by a professf�nal engin�e€�
<br /> ticens�d bythe State of Fiorida: � ,
<br /> - !f th� flll material-is to be used t� Flood �one "A" in�cannec#4or��wlth�a �aermitted bullding usfng stem wall
<br /> � construction, f c�ttify that fi�l:w111:b.e used o�tly.to t�f#fhe area within:the�•s#em�nra11.
<br /> - If fll! material is ta be u��d in .any area, I �c��tify tfiat .use. of such flll will not adv�ars�iy ��fect adJacent
<br /> propertles. #f use af fiP� is#ouns�to adverseFy:affect adJa���t�pro�erties�.tFre owner m�y be c1#ed for vioCa�ing.
<br /> the condl�ians:,of lh� b�ilding;p�rmit Ds"su�d under the at�ached,.�erm9Q applicatlon, for:lots�less 1han.one (1)
<br /> acre which are ePevated�by fllt;��t engineered dra�lnage plan I�requlred.
<br /> tf i am the AGENT FOR TM��WNER; I;�.pr`omis�,In good#at#h t�infarrra the awner afithe permitting condl#�ons set forth in
<br /> this a�idavtt-prlor to commencing con�tructlon. 1 underst�o�il thefia���pa�rate,permit m�y be requlred for elect�IcaPwork.
<br /> �,. .;.
<br /> plutv�bing, signs� wet�sF.P�ol�,,a9r.condit3onit��-.g�sa-.or ot��t Instatl�ftto�ts �o�.spec�(fa�atlPy irtclud�d�in.#he�apptfc.a#ian. -A
<br /> permit Issued shaii be construed to b'e a�li�nse�to prcaeed wlth tti�rnrork and not�as:e�utho�ity_:to,vlolate, c�nc�l, �Iter, or
<br /> set a�lde any provlsl�n�af th�.�echnical.ce�deis;�nor shall Essuance�og a.p�rmtt.peev�nt th��ulldl�ig Q�ici�!f�m thereafter �
<br /> r��ufring a cor�ec#lon of erc�rs in=.pl�ns;-car�strocQl�n ar vlc�lattons of-any code�. Every.;p�ermit�issued�h�IF bscome invalid
<br /> unless 4he uvark authortzed.by such perm(t>�s.commenaed•vvi�hfn stt�;¢nonths of�permit I�suance. r�r If onrark autharized by
<br /> �he perm{E is suspended ar,�bac�doned�•for:aperiod.af�sl�:#8)mont�is�fterthe•t€me the�wo�k��s co�rimenead, An extensian
<br /> may be requested, In writ(ng,;.ftom Qlie.�Building,Offici�l for a period:not-to exceed��ninehr(90)'�days and will demonstrate
<br /> •�ustifi�ble causs for�the extenslo�. If work ceases,for nlnety(90}cor�s.ecutib�:d�y.s�..th�Jcab�ts c�rnstdered aba�doned.
<br /> VVARNIfdG TO aWNER: YOUR.FAILIJRE�•TC1.,.R�,C��Q Aa�tOTIGE•:O�,�COMMEMG�IlA�M'P�aMAY-RE�ULT�IN�`YOl!!t
<br /> �1�Y1[dC TWICE;;�OR.IM�tC1V�MENT�-.td'��YQU�<P.�AER-TY: 1��1'A.U;IA��EHE�`�TQ��O�TAIN�FE1r6�`i�3��NG,�CONSUl.T
<br /> WIT�,;YOti,�R_�NCIER:I�R AI��,�'TORfdEI''�FO'R�+RECO�IW��YOUI�a�y,�,DT�iCEr�',,;_,�;QplMA�EN��E�IN��T' '
<br /> �-- FLORID/OJUFtA��(F.$:.1. ..03�- \ .� , . ;, . '. . . -
<br /> OWtdER OR AOENT �l'�-�i; C�f�'TRAGTQ - - � � � —
<br /> Subsalhad�nd�Ywom b(or a�irmed)betore me s Subscribed end'suu�tar•to(or at�tm�dpbef�re tPil�
<br /> � �,
<br /> ef
<br /> Who Is/are per3onelly knovm to.me or�has/hav�produced Who.te%ae p.e tSera�ly Itrr�own tty.me:or h�s/hav�•prodUced •
<br /> e�lii"entlflcatlpn. / i �s IdenBfls�Qan.
<br /> �
<br /> F '"
<br /> Notery�'ubttc a ,Z" - Natary Publta
<br /> Commisslon No:4 Gomrrtr�ealo . �.�,t�Y f�8�,, A Q E I E B0� S
<br /> =� �::- Commission#FF
<br /> Name ot Notary typed,p�inted ar stamped fdame at Nolary ' e��qri�Brpmedtber 12,201$
<br /> `'��},p���k°,�`�� 8onded TitH Troy Fain lnsurance 8W�385d6i3
<br />
|