|
W�IICi1 1Y18 D@�RIO�E�[esu�wtvnj�uarr.vwrn�,oa..•�•.••••••.. - -- - __ -
<br /> ...— — --•--o---- --- - - - _ - -- : - : : - . _..
<br /> applicable deed-restricttons. - .- � � - � ' � -�
<br /> U�11�ICE�NS�D�COMTtt�,CTORS �ND-CONT6tAC'i`OR!���SPONSI�IILI'FI��: If the ovimer has��hired"a�conti�ct�r or
<br /> contractors to undert�ke work,they may:be:ce�qulred��to-:�be:ltcensed In accordance.v�ith state�.and�local regulaHons. :If�the
<br /> conUactor (s not�licensed as requlred=:by lavv� both the oamer and.=contiacto�=may be�cited-for-a°mi�demeanor vlolation
<br /> und�r staQe Iaw. If the owner or Intended�:contractor�are•uncerteln as to what ticen�ing.requiremertts�may apply�for the
<br /> intended work,they are advised to contact the=Pasco Cotinty�uilding"Inspection Divislon--Ltcensing Sectton at 727-8�7-
<br /> 8009. Furth�rmore� ff th� ovmar has hired a contracfor or contractors; he Is advised to have the contractor(s). slgn
<br /> poHions of the "contractor �lock`' of this appltcation for_vbhich they will be.responslble. If you� as.the owrter sign�as the
<br /> contractor, that inay be an indication that he is not:prope�ly ticensed and'ts not entided to permittfng pridilege� fn Pa�co�
<br /> County.
<br /> T��l�PAItTATION�IIdIPACT1t�TS61TllES°rMRA�'��ANb RE�A�RCE RECOVE[�Y�FE@S: 'a'he�underslgned-understands
<br /> that'Pransportation Impact Fees:and.Recourse Recobe.ry.Fees may:apply�to:tfi�cons6vction of new bulidtngs,°change of
<br /> us� in existing buildings, or expansi��r�of'ezis�i�i�g.'�buildings. as sper.ified.in R��c� County Ordinance number 89-07 and
<br /> 90-07� as �mended. ..The�undersigned aiso:•und�rstand�; QhaiE:�such fees,:as�:may�bg due;rwlll:�be�dentffied at the�tim��of
<br /> permitting. It is further understood th�t Tra�sportation Impacf Fees and`Resource Recovery:Fees mu�t be paid prior to
<br /> Peceiving a°ce�Et�cate of-occupancy"ar final�.power�elease. :I��the.project�do�s no��indolv�.a certfficate of occupancy.o� �-
<br /> �inal power release;-the�fees.mu�t be paid�prior to p�rmOt issuance. F��thermore;�i�-P�scc:County Water/Sewer (mpact �
<br /> fees are due�they.must be paid p�ior to permit-lss4ancean accordance witlt�appllcabie.Pasco'.County ordinances. •
<br /> �O�d�TItUCTIOt�LIEN LAVb(Chapte�713� �lorlsla�t�tutu��s amended): Ifi daluadon of work is$2,500.00 or more, i
<br /> certify that I� the applicant, hade-been provided �with a copy of the�"Florida-�Constructton� Lien .Law—Homeowner's
<br /> Protection Guide" prepared by the Flo�lda DepartmenQ�of�,gric.ultnre and Consr�merAffair$.- If the appifcant Is sormeone
<br /> othar 4han the"owner", I certtfy.�hat I�h�ve.obta)n�d�a copy.of:the:aboved�scrlt��d-�focurr�ent-and:pr�mise in.good.faith to
<br /> d�li�er It to the."owner�prlor to•commencement: ' � ' - � .
<br /> �06dTFit�CTOR'�lOWNER'�AFFSDAIVIT: 1.certify:.tti�atall-the�,information In thl��ppllcation is accura�te.�nd that ail work
<br /> �rill�b� done in compliance wfth ail.appitcable laws regulating construction. zoning and land�development. Appltcation is
<br /> her�by made to obtain .a permit to do uuork.and Ihstallatlon as indl�efed:r��:t certify that no work or tnstallaHon has
<br /> comm�nced prlor to fssuance of a permit and 4hat.all work vutll b@ performed�to meet standards of ali laws regul�ting-
<br /> con�Qruction, County and City codes� zoning regulatians� and land development r.egt�laHons�tn the jarisdictlon. I�,al'so
<br /> cer�ify that I understand 4haQ ih�P�gula�lons of oth�r�governm�nQ agencies may�apply�to the intended.worlc, and that it is
<br /> my responsibility to identify.wh�t.actions I must•t€�k�:to be=ln:.compllance; 5.uch agencles includ�but-are.not iimited to:
<br /> - Dapartment of Environment�l�Protection-Cypr�ss.�Bayh�ad�, 41�eNand Areas and �nv(ronmentally Sensi�Iee
<br /> Lands��iNateNW�stewater Treatment.
<br /> - Southwe�t Florida Water Management:�is[rict Welis� Cypress-r�Bayheads; Wetland Areas� Alter�ng
<br /> Wat�r¢:ourses.
<br /> - Army Gorps of Engtneers-Seawalis�Docks,�lavigable V�lat�rwrays.
<br /> - Department of H�alth�'� ReF�abllltati�� Services/�nvironmental Heaith UnitVNells� Wastewat�r Treatment,
<br /> Septtc Tanks. � _
<br /> - US Environmenta0 Pro4ection Agency-Asb�stos abatemen�
<br /> Federai Adla�lon:A�alhoMty=Rur�ways.
<br /> i und�rsQand that the foll�inring�restrictions�apply to the use of flll:•
<br /> - �fs�o�fill is not allouved in Flood�Zone°V"unless expr�ss{y permitted.
<br /> - if the fill materl�l is to be u�ed_in �Flood Zone. °A', it. ts under�tood that�a drainage pl�n addressing a
<br /> "coenpens�ting eolum�"will be submitted �t time of p�rmitttng which ts prepared by a professional engineer�
<br /> Iicensed by the Sta�te of Flo�tda: � � � .
<br /> - If ih� fill mate�lal.ts to be u�ed tn Flood �one °A° In�connec�ion�t�vith-a �ermitted building using s4em wail
<br /> � constraaction, I certify th�t fill.ear111=t�e used only.to flll th�area withln�the�stem•wall.
<br /> - If flll material is to be used�in�any aree, I •cenify that .use of such flil will.not adve�sely affect adJacent
<br /> ' properties. If use�ofi�ill is found to adversely:�flfect adJacent�pcc�perties�.the owner may be cited for-viofating
<br /> 4he cond�ions of the building:permtt Issued�-under the at�acfied permit application. for:lots less than.one (1)
<br /> �cre whtch ere elevated�by flll;a�r engineersd dr�inage plan is r�quired. .
<br /> If I am 4he I�GENT�OR Tt1E_Ol�l1�t�R; I;promise In good faith to inform the owmer of�the.permitting conditions set forth in
<br /> �his �6fldavtt�pNor to commec9c(ng construction. i underst�nd thet�a=a�parate permtt may be requlred for efecMcal work.
<br /> pluro�btng, signs� w�lta�.pools;. air conditioning..g�s��or ot6�er install�tlons not.speciflcally inclu�ded-in.the application. .A
<br /> permlQ issued shall be construed to be a°Iicense-to�proceed�itt�ttie work and�not as:authoNty.to,violate,.cancel. alter, or
<br /> s�t aside anb provtsions of t�ie.technical codas;�nor shall issuance�of a.perrreit.prevent the Bulldirig Ofiicial from thereafter �
<br /> ee�uiring a correctioro af�Rors in��plans;consttuctlon or violatlons of any codes.� Evary�permtt issued shall-become inva(id
<br /> unies� the eaork authorized�by such permit ls_coanmenEed�ri�hin six mqnths of�pertnit 1s�uance, or if vHork authorized by
<br /> Qhe p�rmit i�suspended�or.abandoned-�fora:perlod�of:�sbc-�)�mont�s.aft�c the Nme the��nrot�k��s commenced. Q+n extension
<br /> �nay be�equested� in writing, from the.�Bufiding,Offlcial for a pertod.�not to exc�ed�nln�ty�(90)days a�d�v�ill demonst�ake
<br /> justifiabl��cause for.�the extension If work ceases:for ninet�(90)cons.ecutive days,_the Job�is consfder�d aba�doned.
<br /> @�I�R�I�C TO OHNNER: YOUP��FAILURE TCl_.R�E.GORQ A_�40T�GI� OF�C�MMEMCEMENT�.MAY R@S[�LT II��VOUR
<br /> (���f1�G'PlMICE.�OR�IMPRAVEMEN�S TO XO�UI�:PROP�R�T1F.-1�°.YO.U�Ii��EMD�I'a'�f8��11NfIMi�I�EiMG;'C.�MSIJLT
<br /> 4�GgFB Y U D �O TT�RNEX FOR� � -O I G�1f� '• �C ' . � � @ E '
<br /> FLORID4�JURA�•(F.S: .03) �' ' ' - '�
<br /> OYNNER OR AtiENT CONTRAETOPt - �
<br /> S bs dbe and swom (or a rtned)betore me this S��b¢cr�i�e�d� nd' m to(ot afflrmedrbefore me�ttiis�
<br /> .�� ._U1112_-b .
<br /> Wlio Is/alre pe�sGnalty known to.me ar�haslhave produced Who.ls/are p.eraonallyknoum•to nte or h�s/f�ave�produced •
<br /> as Id"entlflcatlon. as Identlfic�tlon.
<br /> . , , '
<br /> Notary Publlc _ Notary Public
<br /> Co misston No: D � Commission�ldo. �
<br /> ��,�G� �/.�/� ��� �.�t-i� ,P��� .
<br /> Name of(dolary typed,pflnted ar stamped Nam�of fVotary t�lped,printed or�tamped
<br /> 5:--��..�.�.o.�..A,t.�. •
<br /> �:��:;' DEBRAELAINERUFFELL �-'
<br /> :�. °�"•.. .;s��aa�-a:-�-s+t.:w�,... .._.:.s,�..�.
<br /> :,: ;�:Commission#GG 045343 ,.••�"�� pEgRp,EI,AINE RUFFELL
<br /> :=;,��;:Explres Nu��omber 7,2020 ;�'���'-Commission#GG 045343
<br /> ' �%$�;,�°�• 6anrkd Ft�rJ f�c;Fsc��n.ur.;;tco S0o-3�5-7ot9 ?r; °�s EXp�res November 7,2020
<br /> _ :�
<br /> _ �s,'k;ddi4°,:_�,,�ad'fffro7ioyFeinir.:�nce80a385�7019 -
<br />
|