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��b�'�,�� C►F���� ���1'R�CT���lS: 'The under�ign�d und�r�fiands that tihis�p�rmi4 may be subj�ct�o"d��d"r�stri�tionsp <br /> which m�ay��more rest�c�iv�#h�n Catan�y r�gu#�fions. T�� und�rsign�d���umss resp�nsEbifity for cQmpliartc�wi4h�ny <br /> applicabi�deed r�s�rictions. <br /> �1�6����,6���� ���'���5��� a��� ��d�'�4����� R��P���t�9�.!'�'s�S: If tF�� own�r has hired a cor�tr��tar or <br /> cantraotor� �o und�r�ai��wor�� fi��y may bc� r�qe�ir�d�fo b� {ic�ns�d in acc�rd�nce u�ith���and loc�i r�guta�#ans, if the <br /> cor�trac#or is not {ic�nsed �s required by law, bo4h tha owner and contractor may be cit�d for a misdeme�nor violafion <br /> undsr s��te �aw. 1�t�►�t�wn�r or in�nded �:cnfir�ctor ar� urtcar�in �s to v�hafi licer��ing r�quir�m��fs�rr�y �ppt�fior the <br /> intended work,th�y are adviscd ta cont�cf the Pasca Coun�y Building [n�p�c#ion Divi�ivn�-l.icen�ing S�c�on�t 727-547- <br /> $�3C?$. F'Ui'�hf3ftl"tOt�, tf fhL' OfitVti�TT h�� �ttfL'd � t;OtItC�C�Of t?C GQftfC�GGf�!"�, h� tS �G�N��B� �D Fk3V4' #{1� C[?Pl�f�CtOP(�} �1�1I <br /> po�ion� of the "contr�ctor �itock" of this �ppilcation �r whtch�hey will be r��pons�bl�. ig you, �s fh� awner�1gn�� ti�e <br /> can4rac4a�, �ha4 may b� an indic��lon th�f hg i� not prop�riy lic�n�ed and is no��n�#i�d � p�rmi�ing privileg�� in P�sc� <br /> Gauniy. <br /> ���lS�OR'P�'�1¢��9 li�P��7/f��"I1LlTI�� I�d��a�T�,6dD���OUFiC� ��C�!l��3Y�'���: 'The undersigned undQr�if�nd� <br /> 4ha��'rar���ortafiian lmpact�e�s�nd Recourse R�cavery F�es maY��pply f�2ht�consf�uc�ion o�new buildings, chang��# <br /> us� in existing buildings, or 0xpansion af existing buildings, as sp�cifl�d in Pa�co Gou�ty�rdinan�e nurn6er�9-07 and <br /> 90-Q7, as arn�nd�d. The und�fsigned also understand�, tMat such fee�, as may be du�, witl be idenfiified at the 4ime of <br /> �ermifiYing. 1�is fur��er undersfoad that Tr�ns�or#afiart Im�act ��es snd �eso�rc� �ec�very F��S mu�4 be pa�d prioc fo <br /> r�c�iving a "c�r�ifiic�fi�a of occupanay" or�nal pawer r�leasc�. If th� pro��at does not invoive a c.�rt�icmt� of occup�nay or <br /> �tn�! power rel����, the�es rraust be p�id prioe ta permiY issu�nce, Ft[rthsrmore, if(�asco County V1f�ter/Sewer #mpact <br /> fee$�r�due, th�y must b�p�id prior�o permit i�suance in accorclanc�with�ppiicabie Pasco Coun�y ardinances, <br /> ���l��'1�19CT"9��!!,l��4 L�'�R!4Ch�gz�r��3, F6�a�d� ���a��,�:���a����): If vafuation of uvork i��2,60�.00 or�ore, I <br /> c�rti�y fihat t, the appl[carrt, �tav� i���n provid�d vtt�th a copy c�f ��e "Fioritia Gan�trtsction Lien La�n�—I�ameowne�'s <br /> Prr,t�cti�n Guide" prepar�d by the Florida Deparfm�nt of�griculture ar�d Consum�r A►ffair�. If the �pp�icant is somcon� <br /> o�h�r�a�tha"tr�rn�r", t��tha�4 have trb#�in�d�copy ofi th�abovc�desccii��d dt�ciament and prorni�e in got�4�i4h fo <br /> d�liver it to th�`bwn�r"priar to commenc�men�. <br /> �d��T�C�1��'�/��9���'� e���8DA1l1'T: 1 certify that�11#he tnformati�an in this applicatton i�acaur�lt��nd that all vuort� <br /> vti+ili be done �n compliance�rvith a�i�appllca�le laws reguta�{ng cans#ruc4ian, �oning and land deve�[c�pm�n�, Applic��on is <br /> her�by made to ob��in a �ermi� to da work and insfali��ian as indic�ted. i cerfify �h�� no w�rk ar ins4ailafion h�� <br /> ��menced priar to issuance o�' a permig �r�d tha� �[I work will be p�r�orm�d �a mee� st�nd�rds of al# (a�vs regaalating <br /> cans4ruc#ion, Coun�r and C�ify cad�s, 2oning regutations, �nd i�nd developrn�nf r�guiations in the jurisdicfiion. I �i�a <br /> c�rtifiy that ! und�rstand that thQ r�gulations of oth�r gavernmen4 agencie� m�y apply to �he int�nd�d wor{c, and the�it is <br /> my re�ponsi�iii4y#o idenfi�r whafi acfians I mus�fialce 4c���in a�mp{iance. Such agencies inciude bu#�re not limit�d 4cr: <br /> - D��artm�n4 of Environmental Prat�ction-Gypr�ss Bayhead�, W�ff�nd Ar�as and Environmen�ally Sensitive <br /> �ar�ds,Wa��r1UV��few���r Trea�n4. <br /> - Sauthwest Flnride Wafier Man�gemen� C?i�teict-Weiis, Cyprass Q�yheads, W��iar�d Are�s, Altering <br /> Wrat�rcourses. <br /> - Army Carps of�rtgineers-Seawails, Docks, �t�vigabie 1Naferw{ays. <br /> - Dep�_rtm�nt of Mealtk� � R�h�bili�ative �enric�sl�ntrirQnm�ntat Health Un(t-INeDs, Wast�water Tre�tment, <br /> 3epfiic i'anic�. <br /> - U� Environm�ntai Protection Agency-Asbestos abafi�r�en�. <br /> - F�d�ra!�vta�nn�4uthority-R�anways. <br /> 1 undc�rsi�nd that the failawing re�trictians apply to fih�us�of fi�ll. <br /> - Us�ef fill ts na#alJow�d in Flood�or�e"U"unfs�s expressty permitted. <br /> - 1f the �ill rn�terial is Yo b� �sed In Flood Zor�e °�'", i# is und�rs�ood ��at a dr�ina�e plan add��ssing a <br /> "campen�afing volum�" wi11 be submitt�d �Y time of permitting which i� prepared by a prafessian�l �r�gin�er <br /> Iicen��d by fihe�fi�t�a�Florlda. <br /> - !f##�e �iti maf�tria! is fo b� usec# in Flood Zon� "A„ In cflnnecfion wi#h � permitfed bu�lding �asing �#�m vuall <br /> canstruction, I aertifiy fha#fiil will be used only fo fill th�area within the stem uvalC. <br /> - tf fii3 maf�rial 1� to be �assd in arty area, 1 cer�ify t�tafi use of ��cf� �II wi!! nt�# adv�r�ly �f�ect adj�c�nt <br /> properties. If use o�fill is faund to adverseiy aifect adjacen4 properties, �he own�r m�y b� ci4ed far violating <br /> the condt4ions c►f Yhe building p�rmi�issued under �he aYtach�d permit applica�ion, foe lofs t�ss than c�r�� (1) <br /> �cre cnrhich�re�ai�vated by fil1,�n engineered draEnage�I�n is req�sired. <br /> If I am tho AG�R�'T �OR i'�1E O�E�, I promise in good f�ith ta inform the owner o�fhe permitting ccmdifions set farph in <br /> thi� a�d�vif pric�r�o �m��nc��g construc�ian, 1 undersfiand fihat a s�paratc� permit rrxay b� ra,quired �or e�ect�ic�1�vorEc, <br /> �lumbing, sign�, wc�lis, pool�, air cortdifioning4 gas, or o�h.�r in�tall�_t�qrt� r�ot s�e�i�i.catly includ�d in �he applicatioc►. A <br /> p�rmiF issued sh��li be cans�r�ed �a be a licer��e to proce�d with �h�work and nat a��u�hori#y fo viala�e, c�nc�l, alfer, or <br /> se�aside any provisians of Yhe#echnicai codes, nor shaft issuance o�a permit preven�the �uifding O�icial fram thereafter <br /> requi�ir�g a correctior�of errors an plans, con�kruction or vidlafiions af any cod��. �v�ry permi�is�u�d sf�aN become invafid <br /> ur�less th�work authori�ed by auch permi�is commer�ced wi�l�ir� six mon�hs �f permit issuanc�, ��if war�c authori�ed by <br /> fihe permif is suspended or�bandoned for a p�rio�of six(6)months after the��m� the�vork�s cammenc�d. An�xt�nsion <br /> rrray be requested, 9n �vri#ing, fram the t3�ailding O�cia! for a periad nof 4a�xceed r�inety {80} ��ys and vui!! d�mon�rate <br /> jus�i�able cau�e far the exfen�ion. Ifi wor3c esas�s for nin�ty{90}can��cu4ive days, fhe job is can�id�re,d�bandoned. <br /> ����4��R� �'£� �@�f���: '�'��#� ��'ii$;iJ�'� �'������� A ���'��� R3��f�����#��fit��� ��s�Y R��l�l�.'�' #6�9 Y"t}@�� <br /> �d�Vl�lC�1'F4lfl�� FC1P� I�f1��0l���'1��45'�'�O YOLlR�R06���T�. I� Y�69 IMY�i�D�'0 08"Y�►16� C�16�l�i�Cli�t�,CO��U�.Y <br /> 9#1fB'��i 1f��R � t�� � �R � �E��� � d'� �N� t�L�E3 i1ld5YlC� �I�fl� � IEil9 . <br /> �LO€i1DA JUR�T�F.S.1 r i 03) <br /> �$M9PiV1�$�.G�AG�C11T � ..t-L/.C,'��� C�l'd63'RR4i'4 r • <br /> 3ubscribeti and swfom ta�or a�irmed) , thls t Subscribed and sworr�Fo(ar a�irm re me this - <br /> Who is/are personally known to me or aslhave pmduced Who lslare personally!<nawn to►ne ar haslhave pmduced <br /> as identification, as Eden#i�cation. <br /> Notary Publtc _ Natary i�ublic <br /> CommEss3on�So. Commissian Na. <br /> Nacne af Nai�ry 2yped,printed ar sfamped (�atn�of�ta#ary#yped,Acirtted or stamped <br /> � <br /> / <br />