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<br /> NO`T10E OF DEED B��STRIC'�'ION�: The und�csign�d und�Pgtand�:th�t#hi�.:p�rrroit.may,be..subJ�ct to"deed"rest�icttons�
<br /> which may be-more:rest�ictive�th��Coun�y�°r�g�latlons: �The underslgri�dassuii�es'responsibllttyfor�c��ipllance with ariy
<br /> applicable de�d restrictlons.
<br /> UNLIC@NSED CONTRACTORS AND CONT�C`TOR �E�POId�IB00:ITI�S: -Ifi-the owner has hir�d a contract�r or
<br /> contracto� to undertake work, th�y m�y be;r,e�qarEred•:to.�be-;Ilcensed In ar.�ordance.wtth state.and•local regulations. :If the
<br /> contractor is not licensed as�requlred-by I�w, both the own�r arad�conUactor=rri�y�be-ctted for a-misdenneanoP violatlon
<br /> under sQate law. If the owner or Intended.con4ractor are�unc���in as to what Itcensing.requirements m�y�apply�:�for�the
<br /> intended urork, they are advised to con@act�he Pa�co County�u9lding Insp�ctPon Division—Llcensing S�ction at 727-847-
<br /> 8009. Fu�thermore, If the oudraer has hired a conVactoc oP contractor�. he Is advised to have 4he a:ontractor(s), sign
<br /> poctions of the "contr�ctor Block° of thls appilcatfon for which 4hey wil�.be t�sponslble..if.you, as.#he oviirier'sign�as"the
<br /> contrac�or, that may be an indicatfon that�he Is not.properly licensed and��Os not entttled to p�rrv�it�ing pr6vileges In Pasco
<br /> County.
<br /> T�N�PORT�T�ON.IMPACTIIITOL1gIE��INfPAC'�Af�b RESOURCE RE�OVERY�FEES: Th�unders9gn�d�nderstands
<br /> that Tr�nsporQa6lon Irvepact F�es and.Rec�.ur�se Recove.ry.Fe�� may'�apply�to�the consQruction of n�w btaildtngs,•change°of
<br /> use in ex'ssting bulidi�gs, or:eRpansOon>of�existin,g:buildings, �s specifled.!n P�sco County Ordinance number �9-07 and
<br /> e0-07, as �mended. The urrdetsigned als��und�estands, Qha�:�such fees,��s,�n�y�tie�due,;wlli::b� Identl�ied at the�f6me°of-
<br /> permittia�g. It Is furtfier und�r�tood that�ransportatl�n Irrepact F�es and�Resource RecoverytiFees must be p�id prior to
<br /> receiving a "certiflcate ofi occupancy" or flnal powec:release. :6f�the proj�ct..does.not involve,a�.certiflcate of occupancy or
<br /> �inal pow�r rele�s�; the f�e§ must be paid prior to permit issuance. F��th�rmor�;ff Pasco_County�INated�ew�r Impact
<br /> fees are due,4hey_mcast be=pald_pnlor to permit�•Issuanc�-in accordance wtth��pplicable P�sca�.County ordinances. �
<br /> C06N�TRUCTSOPI LIEM L.AW(Cf��pder 713� Flmrltla S�a�ut�a�aa am�r�d�d�: If valuatlon of work is$2,500.00:�r more, I
<br /> c�rdify that I, �h� �pplicant, have been provlded wri�h. � copy of @he;"Florida Constructton L(en .Lav�Homeowner's
<br /> ProtecQion GuPde" pr�par�d by the Florlda Department ofi Agr9cultur� and ConsumerA6fairs. If the applecant is sotrneone
<br /> other than the°owne�", I certify-that I h�ve.ob.tain�d�a=copy,of.#he:above..descrlbed docure�ent�and.pro,rxalse�.in,good faith to
<br /> d�liver i�to the"owrner"_prioc to:�cornmeneem�nt.
<br /> COPd'P�ACTOR°S10{�IdER'�AF�IDAVIT: I.ceitify.Qhat al�.thg;inf.ormation:,in�thls appllc�tlon is accurafe and that atl work
<br /> will'be done in compliance with all appltcabi� I�w� regul�ting constn,oction, �ontng and land developrr�ent. Application is
<br /> hereby vr�ade to obtatn .a p�rmit .Qo do_w..ork:..�nd i�stallatio� as Indl��4�d:. 'I cectify th�t no work�or ins4�llatton has
<br /> commenced pr(or to Issuan� of a permlt and that.all work wiil b� pertorm�d�to meet standards of all laws r�gula�ing-
<br /> const�c2lon, County �nd City codes, zon0�g Pegulatians, and land dedelopment tegulations�in Qhe jurPsd(ction. I also
<br /> cer�lfy that I u�derstand thaR fhe r�gulatlons of other gov�Prtm�nt�g�ncies may�appiy�to the intended work, and fhat it is
<br /> my responsibility to id�ntity�what:�ct(ons I must tak�.M be=ln:.conlplianc�: Such ag�nci�s include but are.not Iimited to:
<br /> - Department of E�rov(ronm�ntal=l�rotecQibn-Cypre�s.0ayhead�, IPUetland Ar��� and Endironmentaily Sensitive
<br /> Lands,WaQeNWast�wat�r Treatment.
<br /> - Southwest Florid� 1Nate� IUlanagem�rrt .�istricQ-INells, Cypr�ss.� Bay.heads; iNetland Are�s, Altering
<br /> VV�tercourses.
<br /> - Army Corps of Engineers-S�awalls, Docks, Navtgatile VVat�Pwvay�.
<br /> - Department of H�alth � ReMabilitative Se�eices/Environrnent�l hlealth Unit WeIIs,.1Nastev�rater TP�atment,
<br /> Se�tic Tan�Cs. ,
<br /> - US Environmen�9 ProQ�cQion Ag�ncy-►4sbestos ab�tement.
<br /> - Federal Avlation_Authoclty=Runways.
<br /> I undeestand that the following.restriction�appBy to the use of flll:•
<br /> - Use of�ill es not alfowed i� Flood Zone�V"unless axpr�ss6y p�rmitted.
<br /> - If the flll mat�ria9 Is to b.e used: ir� �Flood Zone. "A", It. 9s understood that a drainage plan addr�sstng a
<br /> °compensating volum�p wiil be subr�ItSed at tirn� �f per:mif�lr�g v�hich is prepared by a profess6onal engfneer
<br /> licensed by th��fate of Florida:
<br /> - If�he fill materlai-(s to be used in Flood Zon� "A" in�connectfon wiQh�a permitted building using stem wrall
<br /> const�act6on, I certify that fiIl��Jll:b.e used QnOy.to#111 the ar�a wlthin�th��st���wall.
<br /> - If flll ma@erial is to b� aased in any are�� I �c�rtlfy th�t .uae. of auch fill wlll no4 advers�ly affect adjacent
<br /> properties. If use of flll Es found to adversely:�ffec4 adJac�nt�properti�s,.th� owner m�y be cited for viol�ating
<br /> the condi4ions of the bullding.permit Issued under Rhe at��ch�d ��rmit �ppllcatlon, for:IoQs less than.one (1)
<br /> acre which are�levat�d by fill,acr engineered dralnage plan is r�qulred. ,
<br /> If I am the AC;ENT FOFB THE OWNER, i;prorr�lse Bn good fatth to inform th�ov�rner of the perrnitttng conditlons s�t forth in
<br /> this affidavit�prior to cornme�cing consQructlon. I und�r�tand that a-separat� permit may ibe required for electrical wrork,
<br /> plurnbing, signs, wells,.pools;, alr cond(tioning, .gas� �r other lnstall�ttoros no�,�pecifi�lly included-dn.the application. .A
<br /> permlt 7ssued shall be consteued to be a°ilcens�to proce�d with the worBc�nd not as authorlty to,viol�te,�cancel, alter, or
<br /> set asid�any provistons of the Qecht�(cal codes;�raor shail Issuance�of a.p�rmit.peevenf the�ulldirig Oflficia!from ther�a�ter
<br /> requlr6ng a correcQion�f errors in plans, construction or violat(ons of�ny cod��. Every p�ertnit Issued shal!become indalid
<br /> unless th� wrork aulhor6zed by �ueh p�rmit:�ls.coanmenced•witFrin �fx m.onth� og permlt Issuance. or if wrark author6zed by
<br /> the per�it is suspend�d or.abandoned-for a:period of six f8)�montl�s.after the tintre th��wopk is cor►9menc�d. An extension
<br /> may be requested, In wrriting, fi�om th� �ullding,Offlciai for a period.root to exceed ninety�(90) days and-will demonstrate
<br /> justf�iable cause for the extension�. If work ceas��.for nin�ty.(90)consecutiv�day.s..th�job�is consider�d abandoned.
<br /> 4AIA�idBPIG TO OWR9ER: YOUR.FAI9.WRE•TO,.�E�.ORD A.I��YIGE�:OF C�NIMEMCEWI�(�T fOA�►Y�•RE�ULT 19d YOUR
<br /> PAYIRIG`I�IIICE:�OR ORAPR�VEAAERJ.T�T�-YOUR:PRt�P�R`PY. IF YO.�JrIR➢TEND�°Y6��87'AIN��FIP�►H�EtN�;�CONSUfLT
<br />- __WIT YO D a1R� `�'� OP�E��,�ECO �� �:' AIiR: ; �, �� . �
<br /> FLORIDA,iUFY�T(F.S.9.17 - - �—� - - -- - _
<br /> O�A/NER OR.A�iENT•�'_ � - �-�°---�.s- Si T� __m---�-- �_f - - .
<br /> "' � CON�'�ACTOR--�—ti. " �- .
<br /> Subsc7lbed and swrom �,a� e �ti o �t � Subscrlbed and'sv�com:4o( _ f t ` �t re I" �
<br /> by �.�• �, '1—.��,'�;1� .by�fU�,� " .. " /_0 i� ' ��
<br /> Who sla personatly�nowrn to.me or has/have produced Who.is/�e pey�onally knouyn to rRe or has/hav�•produced •
<br /> � �►ve�.S lrGP�n s�as IdentlBcatlqn. l—C, U'd�lv�rs !iCPvi s2 as IdentlBcafion.
<br /> �� 4.-�-_ Plotery Public "�— l� tdotary Public
<br /> BECKY L.TILLICH
<br /> Commisslon No: Comr�I�sion.Mo. BECKY L.TIL�.{CH
<br /> a �STATE OF FLORIDA � ���IVOTARY PUBLIC
<br /> o -
<br /> Name ol NoQary typed,printe � Name o�Moiary typed,printed or atam ����FF125685
<br /> � E�cpires 6/22/2018 � � �pires 6122l2018
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