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<br /> Nt3TtGE t)F QE�Q RE�TR1CTtCtN�: �'he understgs3ed under�tand�:t�t�t�{�:p�rml#�m�y.be�sub�ect to,�deed"tesUlctlo�s" --
<br /> which may be�more�rest�ictive-th�r�County.re�ul�tCons:=°The�und�rslgne��ssuimes.resp�nsitiiitiy'for c6itnpiiance with any
<br /> agpllcable deed restrtcftans. . .� .
<br /> UNLICENSED� CONTl�CTgRS�/bND CAM�CT+D���E�PAIN�l�i6;i�'IE�: -di the-avuner has°�hlred �a contiactar ar
<br /> coritraetors to und�rtake wrork, they may b�;r.�qulr�ed;to�be,llcens�d in a�cordance.with stat��.and�local regulations: �if the
<br /> contraotor is na# t�censed�as required:tiy Eaw. both-the owner_atid=cotitractoir msiy�be--c�ted�for��`misiiemesnar vlalatlon
<br /> under state law. If the owner or Intended�contra�tar;.�are�uncert�in as"to wrhat Itcenafng.requiremenfs�m�y-appty��for�the
<br /> tnfended wor�c,th�y a�re�dvtsed to coiitact ttie-Pasco Couttty Butldlrig lnsp�ctlon Dtvlslor�--L•tcensing Sectton at 727'-847-
<br /> 8009. Fu�Qhermore� it the� owner'has titred`a contractor ar cont'actors, h� is �iivised to have the canhactor(s).,sign
<br /> porttons of the°contractor.�lock" of t6�ls epplicatlon,for vdhich ihey_will be r.e�ponslble. �1�'you, as..the owner��ign�ss�4he - �
<br /> con#ract+n�, that may be an Ind��lon that he Is not�.pr�peri�licensed and-�ts not ent�#led ta pernilt�ing prtv3�e�ges In Patsco
<br /> County. �
<br /> TRAN�PAl�TATIQ�I�!l�PA�TIt�'�1l�1'�1E���1P��1�'�`�►N�}-�ESgURC���O!lE�Y�EES;7`he under�lgned understands
<br /> that Trar�sportatton Impact F�es:and.Reco.urse R�cave.ry.Fees may�:appiy•fo:tife_construction:of new buiidings��change of�
<br /> uss in exlsltr�g bu!!dings, or_e�anslo��of:eiiisti�i��buitdings, �s specNied.in PascQ County Ordinance number 89-Q7.and
<br /> 90-D7. as amended. 'Fhe undersigned also�ndersEands; that:�such fiees.;as�may�b�•-dn�;;wltl�.be ldent�[ed at the time of�''
<br /> permiNing. It is fu�tliea�understood th�t Tra�rsportallon Impact �ees�nd�Resource Recauery1Fees.rt�ust be paid prior to
<br /> rece�rl�eg a_°cert�icate-of-oa�upancyu ar flnal-powe.r.��etease. :1€the pro��ctysioes:no'��ievotv��a�c�rtiftcate of occup�r�cy.or-�- �
<br /> final power release� #he-fees mu�#ti� paid�.pc�ar to permft issuaince. F��th�rmore;i[.Pasco,�C�uniy"1Nater/Sewer (mpaat � I
<br /> fees ar8 due,.they must be,pstd-pr�or to.permtt..tssuance=ln.accordance wJth�apPltcabte=Pasco�County b�dina�►ces. •
<br /> COi�STRUCTiAN C1i�PI�V�(Ctee�rt�c 713� �tor�sta�tatutes�a�a amendedj: �fi valua�on of wark is$2,500.00 or m�re,l �
<br /> certify 4hat I� �he app8cant;_ have-beer� provided with_ a-copy of the�°Florida-Construction� Lien._Lawr—Homeowner'�
<br /> Protect6on Gutde"ptepared bythe Fiotltfa Departmen#"of�gdauittire atnd G�nsumer-A#fa[rs.- if the appt[cactt Is someone �
<br /> othar than the powner", 1 ceetif�r-th�t i�h�ve,obiained:a copy.of:the:abov�.r�esc�itied tlocu��ntand.promise�.tn,good;.faiift tc�
<br /> t�4311Y8T��tO.t�1Q,`�Vlt(119t'`.����1''.t0°t`+OtTiT[i8P1C8iF1@i"1t. ' . .
<br /> �9�NTR�CTAR'SI�WNER'�AFFiD�1�IiT: i.certtfy:.tiiat�ll-the�..inform�tion:in-tht�appltca#ton is�cc�rat�.and#hat all wor�
<br /> will'be done in compliance wfth all-appitcable laws reguleting ca�nstnac#lon, xoning and land�dedelopm�nt. Appii�atlon is �
<br /> i�ereby made to. obtain.a.perm�#<ta:do_wock:and Ifi�s#a11at1on a�s tndtceted;� .-1 cet�tt�y fhat nea wark�ar tnstsllatlan has ,
<br /> commen�ed-prfor ta Issuance of a pernnit"and that,alf wo�k wrill bo pertormed�to meet standards af all laws regufating- �
<br /> construcEton, Gounty and City c�des, zgntng F�guEattar�s� and land devetoprnent r.egtsla�ons�1n the Jurtsd#ot(on. 1-also �
<br /> ce�ify that i �a�derst�nd that the regul�ttons of oth�r�governm�nt ag�n�l�s may�apply�to the intanded work, and that it is i
<br /> eny responslbllllp ta ld�ntify.what,�cttons!must�take:to betln�corr�p!lanc+�: Such ag��o(es tnclude but��re.not Ilmited to: ,
<br /> - Department of Er�vlrmnm��ital°Priotectton-Cypress.�8ayhead�;+1�l+�Hand d�rea�.s,nd Environmentally Sensiti�re '
<br /> Lands,Water/lMastewater Treatment.
<br /> - Saut#y�rest Ftor�d�t Vllater �ulana�ement :��s#rdct-�!!ells, Cg�press.`8�ayheads; Wetla�td Areas, At�r3ng
<br /> 1Matercaurses.
<br /> - Army Garps af EngEneersweawatts� Do�ksf td��lgatile lNatetways.
<br /> - Departmen� �f �teal#h�:� ReMabii{#ativie ServicesJEatvir�nmenlai Meatth Un6t Wel[s�.1iVas#ewater-T►eatrnent, .
<br /> Septic Tariks: � � _ �
<br /> - �S Environmental Protec�on Agency Asbestos�batet�et�t. `
<br /> Federal.AdiaQonAulfaority=Rurnvays. �
<br /> 1 und�rstand t�iat the.(oEtowlr�g.resttictlons appiy to the use of flll:
<br /> - U�e of fiti is nrat af(oweci in.Ftood�Zone"V"untess expressty permitfsd. �
<br /> - !f the.�ilf material is to b.e used.�in �flood zone. °A", (t. is understood tha# a drainage plan addressing � I
<br /> °compe�sa#tng voiume"vriil be subr�itted af#ime af:.permiftlr�g wEiich Is prepared by � professlanal �ngineer
<br /> iicensed by the State�of Florida: . � - • � -
<br /> - . 1f th�filE mat�rlal.ls�t� be used in Flood Zone 'A° in�cnnnectto»-wlth:a`�ermi�ted bullding using stem waft �
<br /> canstruction, i certity that fili.wlll-be_t�sed onty-#o fli1 the area within�fhe�stem wali.
<br /> - !f fill mat�rial is to be used�In arry area; l cer#ify that .case of sucfi �fill will.not adverseiy affect �dJacent I
<br /> prope�tles. #f use af fl11 is fouctd ta advetsely=affecf adjai:ezrt=propert#es� the nwnsr may be c€fed for v1a�aQing
<br /> th� conditions�af the b�iiding:permit Issued-under#he.aftached perm(t apptica4lon� for:lats (ess ihan.c►ne (1) �
<br /> acr�which are etevated�by f�Ei;act engFneer$d dra�nage piari i�r�qulred. - .
<br /> Of i a��he�GENT��R,THE OWNER;.i,.promise In.good f.afth tv i�orm the awner of the permitt(ng canditions set forth in �
<br /> thts a�davit'pNor to commer�otng constructlan. � �na��t�na tn�t a-separate permlt►nay be requtr�d for el�ctrlcal work,
<br /> piumbi�tg, signs� wetls, poals;,alr conditicning�.g�s, or-ot�er: ins#atl��ons na�.�p�c�tcatiy inciuz#ed-in.#he�apptication. .A
<br /> permit Issued shall be construed�o be��itcense to�proceed wltt� ttie work�nd not-as:aulhoNty Qo.vlolate,�cancel� alter, �or
<br /> se#�stde atty provisions af the.t�chnlcal r�d�s;no�shall tssuance�of�.pecmit.p�evet�t t�Bultdt�ig Offlci�l#rom theteaf#er �
<br /> Pequiring a correction nf errors in�pians; consttuctton or vtalation�cf any codes.- Every�p�rmtt I.ssued s9ta11-becor�e indalid
<br /> unless the vk►oc�k authorized.by such p�rmit:�ls.co�menced�wtt4�En sf�c months of�permlt tssuanc�, or If v�ork authorized by
<br /> fi�re pe€mif is suspendeci�ar.abandaned fior:a:period of:-s�c�($)�mon#t�s.s�t#er th+��itft�#he�work�is commen�ed. An e�ctensian I
<br /> may be requested, in writing�i�om the�8uilding.Official for� pe�lod;nat-to-�xceed'Nnety�(90)�days a�id�-wili demanstrate i
<br /> just�iabl�c�ase far-the e�ensi�r� t#work c�as.�s_for nlnefy.{9Q}cons.ecutive da�s.-the�ab��s�onsldered aba�doned.
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<br /> 1�IfA�tM�NG TQ� ��4lNlEt�: Y�UQ�_FA!l.URE TCl_.R�.CQ�1�.E�► �lC1TlGl�;QF�Ct?MM�lGEI�lE�T�.NlAY�'tEStlkY tN�'X��102 j
<br /> I �c�Y1NG'iWiCE-FOR�tNtFROVEMEMT;�T�af'�UR:�.R�PER'iY. -1�°.Y�3U�t�"�'EEIVIDtT�'�IB'-�'�11N�FIPd�1�EiNG;�ON�t��.7'
<br /> I `#�liTH UR D ;O �Ald��, OGtNE1� FO.E� � �OR�1 �:'�Ip _ • C `O.�� u� . I
<br /> 1 �t,t?RfDA JilRt4�'(F,S: 7
<br /> �WlN�R pfd Af3ENT CO(�1Ti�IGTO � '�
<br /> �ubscrt6ed and swom (or a�i d)before m� s Stib�lbed'sr�d'suuvm-#o{ot rtttad}�b�te t�te#M� �
<br /> by .by... _ .
<br /> Who Is/ana personaliy knowm to•me or hasthave pwduced Who.ls/are person�llyknown•to mA or hasVhavaproduced • .
<br /> ae Ider��flc�#ion. as tdenti�cation»
<br /> Nofary Public _ H4tary Pubtic _
<br /> CommissEon No" ComtFEisston�fdo.
<br /> !�lame ot Natary typed.PrMted gr stamped tVame of Notarp tyPed.Printgd or statnped �
<br /> � :. �_ � �
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