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<br /> N()T'ICE: O� DEEC1 RE:STt:IC1'IONS: The undersignecl understands that this p�rmit rnay be subject to "dc;�:d'i restr•ic;tir.�ns"
<br /> whicru m;ay be more restric;tive than County r�gulations. '('he undersignecl assurnEs responsibility for compliaricE: with any
<br /> applic;able deed restrictions,
<br /> UNLI�CE�JSED CC)NTRA(;TOI�S �N� Ct)N7RACTOR I�ESPONSIBILITILS: If tFie owner has hired _�� cc�ntr��c,tor or
<br /> contr�ctors to und�rtake work, they may bEs required ta be Iicenseci in accordance� with state and local re�c3ulat.ions. If the
<br /> c�ntr��ctc�r is not licensed as requfred by I,�w, both the; c�wner ��nd contractor may be clted for a misdernear7or viol�tion
<br /> undE;r st�to law. If the ovvner or intend�d contractor ��r� uncerta(n as ta what Ifcenaing requirements rri��y ;apFily f�or the
<br /> inter�ciei� work, they ar� acivised to cont7cf the Pasco C;oiarity Biailding Inspection I�ivision—I_icenCing Sec;tian �t 7;?'T-E347-
<br /> 8009. F�urthermore, if the owner ha� hired a contractc�r or coniractor�, he is advised ta have the contr�ct��r(s) :�ign
<br /> portions of the "contractor Block" of this aF�pfication for which tG�ey will be resp�nsible, If you, a� the ovvn�r sfgn ;�s the
<br /> contractor, that may be an indicati��n th�at fie is not prapE;rly lici3nsed anci is no� enQikled to permittin� privilE�g�:;s ir� 4'asco
<br /> Counly,
<br /> TFtAI�JSF'ORTATION I�1P�CTIUTILIT�ES IMI�ACT APID RESOURCE RE!COVER'Y FEES; 'T'he undersigri�s����.in��er:�t�nds
<br /> th��t T'rar�sportation Impact Fees and Fte�cuiar:�e Recovery F�ees may apply to thf: con�truction of new builciing:Y, �;h�nge of
<br /> use in existing buildings, �r expansion c�f E�xisting builciings, as specified in Pa;�co County Ordin��nce number� Es9��a7 and
<br /> 90-07', as �mended. 'The undersigned ��I;��� understands, �hat ;�uch fees, as m��y be due, wili be identific��� ai; tfie time of
<br /> permmtting. It is further urider�tood th�t Tran�portation irnpact Fee:s and Resource f�ecovery Fe�;s rnust; h����:�aid prior to
<br /> rE;ceivinc� a "certiflcate of occupancy° or final power releeise. If the: project doe;� not involve a certificate c�f oc;cupancy or
<br /> final �aower releasis, the fE;es rnust be p�id prior to permit issuance. Furtherm��rE;, ii� Pasco County Wat��r/SE:�wer Im��act
<br /> fe�s t�re due, they mu:9t bf� paid prior to E�ermit fssuanc� in accordance with applic<�bl�: Pasco County ordiri��nc�:;s.
<br /> C()N�ST'I�UCTInN LIEN Ll�►W (Chapte�r 7�13, Florida Statutes, as ameneleci): Yf valuation-of worlc is $2,;�()C1.,0�0 or more, I
<br /> certify #f�at I, the applicant, have been pravided with a copy of fihe uFlorida Construction Lien Law�--�Hc:�meo�rvr�er's
<br /> Protocticrn Guide" prepar�d by the Fluric�a D�:partment of Agriculture ancl Gonsumer Affairs. If the appli�,�ant is sorneone
<br /> other th��n the "owner", I certify thaQ I have obtained a copy of the �bove described ciocument and promisE; in�,r;so��d faith to
<br /> delivr:;r ft to the"owner" prior to comme�nrernent, �
<br /> Cc�N'TFt��TOR'S10WNER'S AFFGDA,VtlT: I certify th�it �all the information in this apE�lication is ac;curate �:�nd, t.h��t �ael work
<br /> will�be done in coi�npliance with all applicablE3 laws regul�ting cons�tructian, zonin�a and lancl devElopmerit. AB�F�licatian is
<br /> herel:�y made to c�btain �i permit to da work and in.;tallation as indfcated. I cer�ify that no worlc or irist��llatian has
<br /> comr�nenced prior to issu��nce of a pE;rrnit and that all vvork will be peri�ormed ,tc� rrieet standarcis of all I��w:� re�a�,al�ting
<br /> con:�i:ruction, County and City codes, zoning regulatians, and land developmei�t r�sgulations in the juri:�clickion. I aiso
<br /> certify that I understarid tf�at the regulations of otfier government ��genci��s may �'pply to the intended wc�rk,;�:�n�� that it is
<br /> my rE::sponsibility to idf�ntify what actions I must take to b� in compliance. Such �genr,fes include but are riot lirnii!eci to:
<br /> - Department of Environme�ntal Protectlon-C;y��ress �ayheads, Wetl��nd Areas and Environm�:ntally Sensitive
<br /> Lands, W��ter/Wastewater Tre��tment,
<br /> - Southwest Florida WatE�r Management 171strict-Wells, (�ypress El��yheads, Wetland Are�:is, Altering
<br /> Watercourses.
<br /> - Army Cor��s of Enginee;rs-Seawalls, Docks, �lavigable Waterways. ;
<br /> - Qepartment of HE�alth & Refiabilitative Servlces/E:nvironmental He�dth Unit-Wells, Wastevvater 1'reatment,
<br /> Septic Tanks,
<br /> - US Eriviranm�sntal Protection AgEsncy-Asbesto;� abatement, �
<br /> - Federal Aviation Authority-Runw��ys, �
<br /> I understar�d that the foilowing restrictions ��pply to the �se of flll; '
<br /> - Use oFfill is not allowed in Fiood zone "V" unless exprE:ssly permitt�d, i
<br /> - If the flll mai;erial is to be u:�ed in Flood zone "A", it is urrder;�tood that a drairiage pl��n ar,idressing a
<br /> "compensating volume" will be: submitted af time of permitting whi�;h i:� prepared by a prof�ssiorial engineer
<br /> licensed k�y the State of Floridsi, �
<br /> - If the fill mat��rial is to bF: �ase;d in Flood Zane "A" in connection with � permitted t�uilding u:�i'ng st�wn wall
<br /> constr'uction, I certify that fill will I�e used only to fill fihe area within tlie sfe+m wall,
<br /> - If fill mat�rial is to bP used In any area, I certif,y tf�at us� of such fill will not adversely �iffr;c'1 ��cijacent
<br /> propertle�. If use of fill is found to adversely affect adJacenk properfie:�, the owner may be e;itE:d fo�r �iiolG�ting
<br /> the candition;� of the building p�rmit issuod under th� attaclied permit �applica4ion, for I�ts I w�ss!fh��n an�� (1)
<br /> acre which are elevated by fill, an engineereci drainago plan is requlred. '
<br /> If I ��m ti�e AGEN�' FC)R 1fHE OWNEF�, I promise in gaoci �faith to inform #he ownor of the pPrmitting conditic�n:,� ��el:i�orth in
<br /> this ��fficlavit prior to commenr,ing construc;tion. I undi;r:�t�nd that a separ�te ��errriit may be required far �:I;octirical work,
<br /> plumbing, signs, well,�, p�ols, a.ir conditioning, gas, or other inst��llations not ,speai�fically includE;d in th�: ,�p��lic��tion. A
<br /> pE:rrr�it i��sued shall be construed to b� �� Iicense to prc�cE;ed with the work �nd not as authority to violate, caricE:l, alter, or
<br /> sE:t aside �ny provisions c�f thE; technical cc�des, nor shall issuance of a permit prE;v�nt the� Ejuildirig Officia�f 1`r'om thereafter
<br /> requirinc� a correction of error:� in plans, con�truction or violations of any codes. E:very permit issued shall t�ecom�� invalid __
<br /> unl�;6>s the work authcxize:d by such permit is commencE�d within aix months oi` perrnit issuance,_or-�if-wi5rk=anflio�i:zed by
<br /> the F4ermit fs suspended c�r abandoned for a period of�ix_,(6,).mr�ntlls_-after-the-tim�-the Work is commenci;ci, �,hn extension
<br /> may be requested, in writing, from the Building-Offici�il�i'or a period not to exc��ed ninety (90) d�iys and will ��emonstrate
<br /> ,justifiable cause-f�r the-exten:�ion. If work ceases for ninety(90) consecutive d��y:�, the`)ob is con5idered abandcm���,
<br /> 41lAF�tNINC TO O�JNFR: YC7UR FAILVJf�:E TO RECbF�[) A fdOYICE UF COM�VIIENCENirNT MAY RE':3UE..T IP� Y4�UR
<br /> F�AYINC� TWICE 1=0F� IMIPROVEIVIE�9T� YO YOUR PIRUPERTI(. IF YOU IF1Tt:�ID 'TO OBTAI�! FIMAtdl;:IIP�C'i, I;C)���ULT
<br /> 1NI1'��i YOUR L�NDEt� �i AN ATTOIRNEEl( �EFORE RI=CORI)ING YOIJR NO ICE O� COMMEIJCEMI;:INT,.
<br /> Ft.ORIpA JURAT(F.�, 11'l.0 ) �
<br /> CONTFtACTOR,_ V"�� �
<br /> OWNIER�3R AGENT_---�:�� n o aCfir bef re e tl is ------
<br /> 5ubsr;rlbEd and sworn to(or afflrmed)before me lhls Subscrlbed and swor j �
<br /> ---by— — bY.����= � -------
<br /> Who Islare personally known to me or haslhavcz produced Who Is/are personally known tu mi3 or h�sas identifi ation.
<br /> as identlflcation, _ --
<br /> ,_Notary Public _ ___ _ Notaiy f'ublic
<br /> -- i
<br /> Comrnlssfon No.____ ___� Commicslon No._ __ --------�•
<br /> Namc�oF Nota eci rfnted or stamped Name of Notary typed,printed or stamped
<br /> ry�YP �P
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