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<br /> Na7tCE'��'D�ED f2E57RIGT'tONS: The undersigned understands that this permif may.be�:su6ject ta"deed"restrictions"
<br /> which,r�ay 6e c�nre r.estricfive than��oua�t�/r�g,uta#i�ns. Th�Wr�deGsigned,assur�es cespansibility fnrr complias�r.�withr sny
<br /> applicab!`e:deeri.cestcictios�s.
<br /> UNLICENSED CONTRACTORS.AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
<br /> contractors to undertake work,they may be required to 6e licensed in accordance with stafe and local regulations. If the
<br /> contractor is not licensed as required by law, both the.owner and contractor may be cited for a misdemeanor violation
<br /> under state law. If the owner or intended contractor are uncertain as to what licensing requirements may appty for the
<br /> intended work,they are advised to confact the Pasco County Building Inspection Division—Licensing Section at 727-847-
<br /> 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
<br /> portions of the"contractor Block"of this application for which they will be responsible. If you,as the owner sign as the
<br /> contractor,Yhat may b�art ir�di�ion YhaY Ele is r�af;pr.opecfjr flCerisec�.acu�'is cmY:�ecY Ya,permiYtiiirg.,pcivTeges in Pasca
<br /> {Couniy. ,
<br /> T,RJ'�hISRD'Rlf�4T10AI�;i�fP�1'CT1LiTiLITJES"Tfy�P.�CT�t�D RE90,l,iRCE�fJC}�tERN;F�ES: Th��c�ndersi�r�ed vndetstanc�,s
<br /> that Transportation lmpact Fees and Recourse Recovery fees may appty to fhe construction of new buiidings,change of
<br /> use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
<br /> 90-07, as amended. The undersigned also understands,that such fees,as may be due,will be identified at the time of
<br /> permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
<br /> receiving a"certificate of occupancy"or final power release. If the project does not involve a certificate of occupancy or
<br /> final power release,the fees must be paid prior to permit issuance. Furthermore, if Pasco County WateNSewer Impact
<br /> fees are due,they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
<br /> COIVSTRUCTION LIEN LAW(Chapter 793,Florida Stafutes,as amended): If valuation ofwork is$2,500.00 or more,I
<br /> certiiy thai i, the applicant. have�een�provided.vaiih,a�apy of.tiae"�lorida ConsVucticm,LiEn;i.zw—fiomeov�er's
<br /> Protection�Gc�ide"prepared by the Fforida Departm�nt of Agricultur�and Consumec affairs. If the applipnt i5 sameone
<br /> other than the"owner",I certify�.fhaf I have obt2in�a cop�of the atrove describad document a�d.promise in gaad faith,ta
<br /> deliver it to the"owner"prior to commencement.
<br /> CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that ali work
<br /> will be done in compliance with all applicable laws regulating construction,zoning and land development. Application is
<br /> hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
<br /> commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating
<br /> construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
<br /> certify that I understand that the regulations of other govemment agencies may apply to the intended work,and that it is
<br /> my responsihili�(to identifj(vuhat actions I'm�sttake_to be.in compliance. Such.ageqcies incLude:butace not limited to_
<br /> - DeparTrTient-of Envircirirrsentaf P,rotectimra-C7y;press.-Bayheads, V1�ettamti A�eas;and:=E�viro"nmeiitaAy Sen'siUve
<br /> Lands,�`Vaten�IWas��uuater TreatmeM.
<br /> - Snufhwest .FJorida �Nater =idlarr�cjemerrt ;.District-l�el{s, •Gy,press .Bayheacfs, Wetlantl �Areas, Attering
<br /> Watercourses.
<br /> - Army Corps of Engineers-Seawalls,Docks,Navigable Waterways.
<br /> - Department of Health & Rehabilitative Senrices/Environmental Health Unit-Wells, Wastewater Treatment,
<br /> Ssptic Tanks.
<br /> - US Environmental Protection Agency-Asbestos abatement.
<br /> - Federal Aviation Authority-Runways.
<br /> I understand that the following restrictions apply to the use of fill:
<br /> - Use.of.fill.�s�ot.allnw�d.ir�.Fdood;Zor�e"�/".un4ess expr�ssly;Pe�i�ted.
<br /> - lf th� fil1 maferial is ta be.used Cn Flaod �one "A", it is understoad.thaf a-drainage plar�°addressing_a•
<br /> "carnpensating vatc�me."will.6e submitted.at tirxae of per�utti�g,whieh�is pregar,ed t3y arprofessiarual ec�gi�eer
<br /> licensed,by t�e�State�otEla�rda:
<br /> - If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
<br /> construction,I certify that fill will be used only to fill the area within the stem wall.
<br /> - If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
<br /> properties. If use of fill is found to adversely affect adjacent properties,the owner may be cited for violating
<br /> the conditions of the building permit issued under the attached permit application,for lots less than one(1)
<br /> acre which are elevated by fill,an engineered drainage plan is required.
<br /> If I am the AGENT FOR THE OWNER,I promise in goad faith to inform the owner of the permitting conditions set forth in
<br /> this:a�davit priot ta eommen€ing eonstruction. !�ndersfa►x#tfra4.a separate��permit may�-f�requiretf far efeetrical wark,
<br /> •plur�6ir�g,�igns,welfs,,p�ols,sair xxxanditioning, gas, car-c3th�r ic�stallatitans rtot��pecificallyFi�cl�ided.in the applicafion. A
<br /> peraroit-iss�red shall:be,corrstr�ed>:to:be a,lice�s2:Yfl:;�sr�aceetl with•flae v�rk.aritl�nat-as authority to vjo}�fe,cancel,-�atter,.or
<br /> set aside any provisions o'f��he'techmcal codes,rior shaii issuance of a Fermit prevent�tie$ui�ding O#�+�iai,from�hereafter
<br /> requiring a correction of errors in plans,construction or violations of any codes. Every permit issued shall become invalid
<br /> unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
<br /> the permit is suspended or abandoned for a period of six(6)months after the time the work is commenced. An extension
<br /> may be requested, in writing,from the Building Official for a period not to exceed ninety(90)days and will demonstrate
<br /> justifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned.
<br /> WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEtNENT MAY RESULT IN YOUR
<br /> PAY1t�tG`171ti10E FORIMPR�Dl7EDftEL+i1'S TQ YQLiR:PR�PERTY. tE Y011 IQiTF1�iD Z'O°OHTAIAI fii�Y�tSCit�i�'a„C01178tlLT
<br /> W17 OUR LENDE 'Oft kN A1TOR EY BEFOf2 RE aRqIttIG YdUR h10TfC .OF G Pl MENT:
<br /> FLORIDPI JURAT(G$.'4.17.63)
<br /> OWNERORAGENT .:' � ��-�CONTRACTOR
<br /> Su scribed andsv�t o(or effirmed)before{ne thls ./filib g��b d a id b om ie or �a t s
<br /> �IO�I� by–�obc"�l V�l I�l tfltV / / �9
<br /> 1Nho is/are personally known to me or has/have produced � Who isle�e personally known to me or hasfiave produced
<br /> as iden'Uf'ication. as Identification.
<br /> l l �_ � ~
<br /> �d{ety-RS�bllc otary Public
<br /> 'Comcn'�ssiara No. C issian:iilo. (J
<br /> i���ti�-!a a- t����� P.,�/Z-� E/Q.�12 � �
<br /> Name stamped Name of Notary typed,printed or stamped �
<br /> IdOTAR P BLIC,STATE OF FLORIDA
<br /> MY COMIvIISSION#FF49813 .•<�:����, DEBRA ELAINE RUFFELL
<br /> EXPIRES '?'� ,:Commission#GG 045343
<br /> 8�9�17 =�r+��a:Expires November7,2020
<br /> BONDED THRU WESTERN SUR�TY CO. '�%�;;;°P'' Bonded Thru Troy Fain Insurance 8pQ-365�TDt3
<br />
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