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<br /> 1 u 1 ned unde�tands°:t �t<thl��. rmi��. ,sub c #�.dee e o.
<br /> NaT10E Ci�DEED RESTRICT ON�: The nd�g h . ..p� ... mayGbe r,Je t, d,:�!'. St[IC�I ,�lS
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<br /> which may:be�more°=r.�strlctNe=thai�Courity�regr�lafCons:-~TFie`under"slgnad��''sssumes-respon�ititltly.for aairipilance�v�iriitli`�any�M T'� ���`'�
<br /> appllcabte deed restrlctbns. .- ::. �:,� .. . - -;. , • . . _; ...,:: : _. � .1
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<br /> UNLICENSED�'°CONTRACTt�RS Afi�D CON�'RACTCiR RESPONSI�tL1T1�S: �ff-tlie°=owner has�'hired'a�:ctintr�c#or or
<br /> contractors to undertake work, they may;be:�r�quired�to-be„Ilcensed'In..accordance.wtth-state.andylocal�,regulatlonss,��If°the°��° =`�n��
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<br /> contractor ts-not ltcensedi'as'requlred,`tiy law, bo#tr�#he awner anil-t�ntractora�may�ba�'~cited �r°°a mi"s�emeanor violation
<br /> under state law. If the owner or Intended;;,co,ntr�ctvr;;arel�uncertaln as to what Iicens�ing.regulrements,;may�.applyf�fur='the`���=°�� �> '�
<br /> fntended"iniork�ltiejr aire�advlsed to coittact#he Pascn-�County Bullctlrig Irtspectio�i Qhrlslon-.-�fcensfng Sec#ion at 72?-847-
<br /> 8009. Ftirttiermore� if the ov+iiier"iias�Filred e contraic`tor o�contractors, he ls advised ta have the cantractor(s),.sign , ._ �
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<br /> porNons of the�,°contrector,81ack" af,this�appi(cation._far..whiQh they,.wiD.be�.r.e�ponslble.--.If;.you;-as:=,the owner,sign�as tlie''`"'�`�"`'�µ
<br /> con#t�ac#ar,_#hat�tnay be an I�ii�tion tha�t'i�e"Is`riot�ropetly llceiised arid'�is"n6t�entl�ed`fo perii`ilttfng pr�tlleges In Pasco.. . _
<br /> County. " _ . � .,w ... 4,;�_<,���. . .
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<br /> TRANSPt?RTA7iON:IMPACTIUTil:iTlES�lMPAC'�ANt?-1tESQU�tCE RECOVERY�FEES:�T�he unde�slgnediinde�starxds
<br /> that Transportatlon impact Fees�and.Recaurse,Recovery�Fees;may�:apply��:to:the;cons�truction.of new_buildtngs,<chan�e:�of'�"�� `��� "�'
<br /> use in exis8ng bulldings,°or�sexp`a�:i�i�n��of,�ezls#i�i�gabulldings� as sp�eclfled.ln Pascv County Onlinance number 89-07 and,.
<br /> 90-OT. as amended.,�,:,The undersigned also;�tinderstands, t�at:�such fees��,$s�tnajr:be�..due;�wi11.}be tdenfiffed at fhe�time`of��`v �u"� �'f
<br /> pe�mitting. It is fiirtFier understoo� that Transp'ort�tlan Impa�ct�Fees and Resource%Recovery=Fees:.must be paid prinr ta
<br /> recelvfng„a°cerflfiicate:.of occupat�ay"'�ar�flnalhpower;.�elease: :i�-the proj�ct:.does=.not:lnvolne;a::certrt#�cate of accupari�cy�ot:=�'t�-".�'_
<br /> flnal power release; the>fees'mu�t�'be'paid`;p�iar to�permit issuance. F�lthermore;-if.PascoYCounty�llVater/Sewer,.rslmpact� -� ., ..
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<br /> fees are due�,they�must.be;paid;prior,�o permlt.issuance=in-accordance wltt�:aPplicatilei-.Pasco�.County��rilinances. •
<br /> CONSTRUCTIC1i�'CIEN�LAW tC�iapter 713�FtoNda�tatut��,as amendedj: tf vatuaHon of work is$2,500.QO;or more;,l� :�- =;µ,#� �
<br /> certify tFiat I, !he -applicant;<-have.:been provlded:�wtth:-a-copy�,.of_they"Flor(da��Canstructlon�Lien.:Law�-�Hameowner's
<br /> Prot�cllor� Gulde" prep�red by tite`Flo�da Departmer�t�af Agr�cultctre and Gonsumer.;AfFalr's. If#he appltcant ts someone: . > : �2�
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<br /> other than the'owner", I certlfy_that:l�h��e,optatnedfa'c:opy,af..#he;aboye.�desc�ibied;tlocument;and::p..r.ori�i,s�in,goodu�fai�h t'o . ,�.:
<br /> deliver!t to.the:"owrier�:piior#o-co�ramencement:"': � ° �-• : . � - . - . : `� ., -
<br /> CONTRACTOR'S/OWNER'S AF�MDAViT. i.certitjr•,:tti�t:alb;the�{nformatla��n�.in'.thl�appltcatlan is accurate$nd that all�work
<br /> will'be done in compitance with all applicabfe laws��gulating constructlan. zoning and��land�'development. Appltca#lon,is
<br /> hereby made ta abtaln�.a.per.mit,to=do.work::;�nd�Iristalla#ion as Indt�ated:.;�.1� ceyY,tity 'tti�t no work.or instatlation t�as.
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<br /> commenced p�tor to Issuanae of'a permif"and that:allMwork will be performed to meet.standaTds�of:all laws �egulati�ig�
<br /> constructlon, County �nd C1ty codes, zoning regulaliQns, and land devetopmer�t r.egt�la�on��In`f�ie ;urtsdicfion.: I.;al'so:. . _
<br /> certtfy that I u�derstand that the regulatlons of athe�government agencies may�apply�to the._intended_work, and thak it is
<br /> my responsibility to ldent(fy.what.�ctlons 1 must�t�ke:to,be,ln�comp!larac�..Such;�gencles-include�bu#=are�.no#1lmited to. { -
<br /> - Departmen# of E�vironmentafi-�Protection�Cypre�s.`Bayh`ead�; We�and Areas and Envtronmental�y Sensitive m
<br /> Lands,WateNVl/�stewaater Treatment. � -
<br /> - Southwest Ftorida Water Mana�erz�ent�:D�strict:Vltetls, •Gypress.�Bayheads; Wetland Areas, Altering
<br /> Watercourses. a .
<br /> - Army Corps of Engtneers-Seawaiis�Docks,Navtgatile Watetways.
<br /> - Depar#ment af,Health�;& Rel�abilitathr.e;.,Servtces/Enviironmental�Health Unit Welis,.Wastewater=Treatimen;t, •
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<br /> Sepklc Tantis::� - � - -� - - .
<br /> - US Envlronmenta�Protection Agency-Asbestos abatemen�.. -
<br /> -FederaFAvfativn:Autk�orlty-Runways: �� ,� ��,
<br /> !understand that tF►e foilow�ng.�estrlotlons sapply�to tFie use of ftit:
<br /> • Use af fill is not aliowed in,Flaod;Zone"V"unless expressly permitted. �
<br /> - if the..fill�material�is #o�`b.e used_�`In::�Flood-Zone. "A", It. ts understood that a drain�ge plan addresstng '�
<br /> °'compensating votume"wiil be submltted a#�me of�permifting whlch is prepared by a professionai engineer ` �
<br /> Iicensed by°the State of-Flofida:� � �� � . _ _ ���
<br /> - If th� fill�material�.Is to�be�us.ed in Ffoad �one "A" tn>c+annec�io��ti�rlth�a���rml#ted btallding using stem wall_
<br /> construction, l certify_th.at ftll�:wJll.b.e-used only.to.fill the area within�the�stetn waq: '
<br /> - !f fil! material Is�to �be� use� ln any area, 1 �certt�jr that .uss. af such flif wll# not adversely affect adjacenf
<br /> propsrties. if use of,fill is foctnd to adversiaFy:�ffect ad)acei�#prctpe�ties,.the owner may be ctted for viol'�ting '
<br /> the candi#ians�:of..the bulld(ng;permit issued�u�der the�at�acFied,pecmit applicatlon,-for lots�.less=:than�one (1)
<br /> ar.re virtiict�'a�elevatecl�6y flli,��t engtneered d��tnage plan ts required, • . ;
<br /> If I am the AGENT FOFt THE OVIINER_, I;promise in good falth to inform the owner of�the permitting conditlons set farth in
<br /> this aKdavlk�prtor�to�commeracing constructlen. 1 uride�rstand tttet�anseparete permEt may be tequlted for etectrtcal�work,
<br /> ptumbtng, signs, wells,,poofs;, air.condfitianing,.gas.�;or..othec install�tions noE�spec�icaity lncluded�in.tMe appiicatian. .A
<br /> permit Issued shall be constn.ted ta'6e��a'license'�to�proceed wMth"tNe work�anil:.not°as~euthoNty,:to:.vlolate;ycancel. alter, o�
<br /> sei aside�ny'pmvlsfons of�t#te.technlcaf,c�de�;;nar shall tssuance nf a.permlt.prevent the Butldirig O#i�cta�from thereafter
<br /> requir(ng a correctlon af errors:in;:pians; canstructlon:or violatlons of�any-codes:�-.Every permlt�issued sfiall�becon�e Invalid
<br /> unless ihe work authort�ed.by such permtt:�is_ca�nmenced•wlthfn s�c�nonth� of�pe�rn!#lssuance, or If wark authorized Eiy
<br /> the permit is suspended>cr:aba�doned-for a;period;�of�six:E�)�montiis...after,the,tin�e.the�work��s commen�ed. An extensio�
<br /> may be requested� In writing;.�from the;�Building,Official-for a period�not=to exc"eed'=:nitiety�(90)�day� and�wily demonstrate
<br /> just�iableLLcause foc�the e�ctensio�: If work ceases:for nlnety.{90}cons.ecutive�days,..the��ob�is considered aba�daned. �
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<br /> WARNtIVG TO OWNE1�; YQ.Ul�aFA1LURE,,�'O�sR�E.CC�EtQ�A;NQTICE..CIF.�COMMEMCEMEI�T:�11tAY�R�SUlT1N��tC1UR
<br /> PAYING TW.i.CE..1=01�-iMPROVEMENT3�.T��YElUi�.:PItQPER�IY:?�,IF�.YO.U�iN'�EM�D'TEI�'�OBI�AIN�F1NAp�'iNG;'C.ONSULT
<br /> Wi7 -� , � � -A �A�'9'.. iV �� CA'@tL4.� O . :�, �49 � . E � . - � - --- _ __ ._
<br /> F�ORIDA.ltJRA�{F.S�1.17.03} .. , , , . ._ �
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<br /> OWNOER OR AOENT. CONTRAGTO �
<br /> Subscribed arni swom ta(or etRrmed)before me this Subscrf6ed and'suro �bo t afllrmed)• efore me`ttii�.' "
<br /> by �by-
<br /> Wlio Islare pe►�onalty knovm ta.me.or;hasihaae produced , Who.te/are p.ersonal own�kn me;or.heslhave:praduced
<br /> ;. , a�td'ent�RcaBon. as Identi�catlan.
<br /> Notery Pubila . Notary Publlc
<br /> Gommtssbn No: Gots��ts�ian Na, ,
<br /> Nar�e af lVota�ry typed�Printed or starnpad Name of Nalary ikped�Prin#ed ar st�niped
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