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�9�TIGE OF ���� ���TRIGTi�6�5, The und�r�ign�d und�rs�ands th��thi�permit may be subj�ct fo"de�d"r�stric�ons"
<br /> wf�ic�m�y bt�more restrictive�h��County regul�tion�. 1'he urtde��gned assucn�s respq�n�Eb�Ei#y fof c�tmpli�nc�wi2h any
<br /> applicable d�ed resfirictions. #�
<br /> �9�1�����l�E� ����'�,�"�'O�� a��b ����°[�A�'�C�� ���P�iV�t�9�.lYl��: if the ou+rn�r has hired � cantractor or
<br /> contractors�o und�r�he woric, #hey may�� required to be fic�n�ed xr� �ccardance with staf�and lac�i regufations. 1�the
<br /> contractor i� na4 Bcrnsed a� rQquired by law, both th� owner and contractor may b� cit�d for a misdameanor vial�tion
<br /> under s#ate iaw. 1f�#�� own�r or�n4t��d�d corttrac#or art� urtc�rfi�in as to vvhat {icen�i�g requ9remeni�s tnay app4y far�e
<br /> intanded work, th�y are advis�d ta cont.�ct fhe Pas�a County Building fn5p�c�ion Division—Licon�ing ��c�on at 72'�-847-
<br /> �QQB. Furthermore, if the own�t has hired a contractor ar contrat�iors, he is adv�s�d ta have the oontr�cfar(s} s9gc�
<br /> portio�s of#h� "c�ntractor Blac�" of this applicaffon for which fhey will be respor�sibie. i�yau, �s fh� owner sign �s th�
<br /> con�rac�or, 4ha4 may b� an indication 4hat he is no� prop�riy lic�r��ed and is not �n#��I�d to p�rmit#ing privileges in P�sco
<br /> Goun�y.
<br /> �'�,6��6�0�'fA'Pl06� If���C�'/BJ�'!U?'i�� IM�'�C��AI�D R�SOURC� ��COb��I����S: The under�ign�d undersfands
<br /> th�t�'r�n�portation impac4�'�e��and 4ecourse Rscovery F�es m�Y�aPply to the�onsfiruc�ion o�nevt+buiRdings,ch�ng�of
<br /> use in existing buildings, or oxpansion ofi existing buildings, as specifi�d in P�sco Caur�ty Ordinance numb�r 89-OT and
<br /> 9Q-07, as amend�d. The ur,der�ign0d also undersYands, that such fieos, as may b� du�, will b� identified at th� tim� of
<br /> �t�rmitting. It is f�rtFter unciors400d �hat Trans�or�afiior� Impact F�es ar�d Resaurcc i�ecavc�ry F��� must b� p�id prior�o
<br /> reaeiving a "certi�cate of occupancy" or fin�I power releasc. if#he proj�ct dn�s no�in�olve a certificatc� of occup�ncy or
<br /> �in�l povuer rel�a�e, th� ��s mus�be paid prior ta permit issuanc�, Fur�hermare, if Pasco Caunty Wat�rlSevtrer lmpacfi
<br /> fr��5�r�due, they must b�paid priar ta permit i�suance in accordanc�with appiicabi��asca Couniry ordinanc�s.
<br /> ���tl�'TE���"Cd��i L���9 L��!!(�'ha�a��N�'13, �'E��td� ��$tn�o.� ����ro��rod�s��: If v�luation of worl�is�2,50D,00 or more, I
<br /> c�r�ify tha� f, �hc� a�p[#cant, hav� �i�en provid�d w"ttE� � copy o# th� "�iorida Corts�ruction �ier� ��w Momeownec's
<br /> Pro�c�ction Guide" pr�par�d by th� Florida D�parfinent of Agricuiture �r�d Consumer Affairs. If the applicant is someono
<br /> o�hef that�the"ouvn�r", #r.�rfit�y th�+t! h�v�obtained a cop�o#th�above d�scrifaed do�us�ent and promi�e in good fai�h to
<br /> deliv�r it ta th�"awn�r"prior to commencamenfi.
<br /> �O�fTF�CYOR�'31C>'6RfN��"� A�C�ID�iIIT: I c��ttfy that a!I the tnformatian in this appllcatfon is a�curaYe�nd that all work
<br /> wili be done in compl�ance �ri4h all app3acable l�ws regulafing constr�cfian, �oning at�d 3and developmont. Applic�tion i�
<br /> hereby made 40 ob4�in a pormit to da worl< and ins4allation as indicatied. I cerfify th�t no work or insi�ilation has
<br /> co�nmenced prior #o is�uancc� of a perrni� ar►d tt�a4 a!! worlc wi!! be per�ormed �o meef s�andard� of a!i [�ws regul��ing
<br /> construction, Coun4y and City cod�s, 2oning regulafiions, and iand d�veiopmen# reguia4ior�s in the jurisdicfion. 1 aisa
<br /> certify that I undorstand tha4 the r�gula#ion� af ofh�r gov�rnmen#agenci�s may apply to �h� intended work, and th�t it is
<br /> my respor�sibili#y tc�€den#ifiy vuhat ac#ions 1 mus#taEcs#o be in com�liance. Such ag�ncies include but are not lim€��d to:
<br /> - Depar�m�n4 0�' Envira�nmanlal Prot�c4ian-Cypress �ayh�ads, Wetland A�as �nd Environm�nf�lly Sensitiv�
<br /> Lands,W,�4erM(astewater Trea#m�n4.
<br /> - Sout�w��t Florida UUafi�r M�n�gem�nfi �istric�We(i�, Cypr�ss Bayheads, Wet��nd Ar��s, Al�ering
<br /> Watercourses.
<br /> - Army Gorps aF Engirr�ers-S�auvalls, Dacks, �3avigabie Wafenn��ys.
<br /> - Depar�ment of Meal�h � f�ehabllitative �erviceslEnvirQnmeng�f Heal#h UnEt-We!!s, W�stewater Treatrnent,
<br /> Septi��'anic�.
<br /> - U5�nvironmenfial Prot�cfian Agency-Asbestos abat�ment.
<br /> - Federal Aviatian Authonty-Runw�ys.
<br /> 1 und�rsfand#hat the follawing restrictions apply to the use of fii1:
<br /> - Uso ar flll is not allowc�d in Fiood�'one"V"unless expressly p�rmftted.
<br /> - If 4he fiill materiai is fo be ussd �n FSoo� Z�ne "A„ i� is understood th�� a drairtage plan addr��sing �
<br /> "compen�ating volum�" wiil be submiit�d at time of pormitking which is prepared by a professianal �ngine�r
<br /> licensed by 4h�Sta#�o�Flarlda.
<br /> - If fhe fili material is fo be used in Fiood 2ane "A" in connec##a� with a psrmifted buiiding �sing stem waff
<br /> cansfruc#ion, I certify that fill will be us0d only�a fill the area within th�stem w�lt.
<br /> - €f fi14 maferia! is to be us�d in any are�, 1 c��tifiy 4ha� use o# such fil� will not adv�rsely �f#cct �djac�nt
<br /> proper�ias. (�use of fill is faund to adv�rs�ly a�fiac#adjacent properties, �he own�r m�y be cited for violating
<br /> the condifiions of the building perrniY issued under the a4t�ch�d permiY appllcafior�, for l�ts less 4h�n an� (1�
<br /> acr��rhich�rc,eCeva�ed by fill,an engineered drainage p(an is required.
<br /> i�I �m�he A4��6�Y��R�'0�E Olt�lf�R�R, I promise in good f�ith ta inform the owner of Yhe permitting canditior�s set forth in
<br /> thi� affid��ri� pr�or to commer�clr�g canstruction. 1 underst�nd t�tat a separa�e permit rs�ay be r�quired fior electr�cat wor€c,
<br /> piumbing, signs, w�Iis, poois, �ir conditioning, gas, or other ins#ailations not speGificaily included in th� application. A
<br /> permit issued shalt b� cans�ru�d to be a ficense to proceed with the worEz and not as authc�rity fo violate, cancel, �If�r, or
<br /> sef aside any provisions vf fihe#echnic�!codes, nar shafl isst►ance of a permit pr�v�n�the 8uitding Official fram 2hereafiter
<br /> r�quiring � correction of errars ir� plans, constiruction ar viol��ion�af any code�. Ev�ry permit issu�d si�alfi b�come it�vaiid
<br /> uniess the work auYP�ori�ed by sueh perm9t i� comm�naed wi�hirt six months oF p�rmit i�suance, or i�work authori�ed by
<br /> the permit is susponded or�to�n�oned far� p�riod oF s(x(�)months a�er the kime th�work is ccrmmonced. �in�xt�an�ion
<br /> may be requested, ln writing, fram Yhe �uilding O�cla! for a period not to �xcesd ninety {90} d�ys and wi!! demonstrate
<br /> jusfi�sbt�caus�for th�oxtension. Ifi wor3t ce�s�s for nin��y{90)can��ctafiiv�days, the�ob is consider�d abandoned.
<br /> ���d�3�t�tf� �'� �@�9i�S��: �fta�9J� FAPE.�1t�� "�'f� R��fi��t�S � t���f�� Q� ���t���R��€���t°� ��AY ���LJ�.�` 1�# ���lR
<br /> ��fi(i6Yt�'�tf�1C� �0�, (iIf1P��l/�k���i�'�'�O 1f0�lR IPROP�t�°TY. iF 1(C919 1�9T�i�D�'���'T�IP� F(6�e��9�CI�14�,COR'!:18�T
<br /> !4!lIT4i Yl� R L D� AR A OR �Y���OR�R��QRD�1�1ft�4J��c4C? !C� �GC9 � G�
<br /> F�.ORiDA Jt3Fi}�T{F.S.1 3�
<br /> U4f1f6�7�R CbR AG'�114T � CCF45T�P�'�O� % � y,,,r��
<br /> Sutsscsibed a�d swarrs ta(or affirme efar�me this Subsetibed and svfram fo{ar af�rme fo�hi
<br /> by by
<br /> Whn is/are personaliy knawn to e or has/have�rraduced Who islare personally known to m or haslhave produced
<br /> as idenfification. as identificafion.
<br /> Notary Pubiic Notar�r Public
<br /> Camtnission No. Comm3ssion No.
<br /> Name of Notary typed,printed or stamped Nama of Notary typad,printed or stamped
<br />
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