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N�'i'�I�IE QF QEE��tE�T.R1�TIf�NS: The underslgcaed.und�r�tands�th�t�thl�:p�rrr�if may.be.sub�ect to"deed"_rest[I�ttans" ,
<br /> which may be�:moce-r.esti�ictivertha�a County�raagula�lons:•�The�underslg��d�assurries-responsibillty"far`compllance'wilh �ny �
<br /> applicable deed restrlctlans. , -
<br /> UNLIGI�NSED Gd.�N'PRACTOR� I�tdD ��i11TiSACT�R RE�Pf3N�tBiL1T1�S: --if°the owner°has-fiired�a�contractor or
<br /> contr�ctors to under�ake work, th�y r��y:be�r.e�quir:ed�_to.be,:licensed In�ccordanae.wtth stat�.and�local:reguEatlons: ,�If the�
<br /> �ontractor ts-n�f IEc�ris�d-as�r�qulced��}r�l�tVir, b'otit the ovtmer and con#cactor=rriay�be��dted for a�enis�emesnc�r v1a�a�tion
<br /> under state lav�. If the owner or Intended;,cantra�tvrr ere.,un�ertain as to vbhat Ii�en�ing.requirements,:rnay apply��for.'the� �
<br /> intended wark,ttiey ara advfsei!to caritaci'tlie Pasca�Cou�tty SuNding'lrtspectlon DEvislon—L•Icensing Sectton at 727-847-
<br /> 8009. Furthermore, if the owner'fias tii�ed a ccin#racfor or contracfors, he ls acivtsed ta have the cantractar(s) sign
<br /> portions of the �contrackor Block" of.this applic�tian for vehich they v►till.b.e.�responslble. If you�; as.#he ovimer sig"n a� the '
<br /> contractor, that tn�y be an Indication that'�ie Is a�ot`.properiy la�:ensed arid ls nat enU�ed to per�nitting privlleges in Pasc�
<br /> �ounty. ' �` -
<br /> TItd�M�P�RTATIGN.INIP'i��T/UTll�ITIE�r�lllR�1�°��iNl��E�t�F�R�E RECQVERY���ES:. T�te underslgned understands
<br /> that Transpartatton impacf Fees and.Recourse Recover.,�.�ees may••a�pply�.to:the constnuction of new buildtngs,:change�of- ` `
<br /> use !n existing buildi�gs, o�.expar�si�n.•of-:exi�t3ng''�buildings, as speclfled.in Pasca County Ordinance number 89-07 and
<br /> 90-07, as arnended, The under�igned aiso,aund�rstands� that°-such#ee�;�as��may:5e:.due;�w311:=6e Identified aE the�tiivte�of:. �
<br /> permitting. It is ftirttier understood that Tr��spork�tion Impact Fees an.d�Resource Recovery�Fees�mu'sQ be pald pNar to
<br /> rece�ving�"ce�E#icate ot�oc�upancy"oi f��al-power:release: ;If�the pra�ect;,does,not lnvotve:a�.�e�ttficate of occ�pae�cy�or��.µ .
<br /> final power-release; the;fees mu�t 6e paid.prior#o permf4 tssga�nce. Fu�th�renoce;If Pasco,County�lNaterlSewer�lmpact ,
<br /> fe�s are due,.they�musQbe-paid�pelbr to pecmit_Issuance=in�ccordance with appltcabt�Pasco County ordinances, •
<br /> CO(dSTRUCI'10N"i�t�N'tmAW"(Chapteir 713, Elor��da Statut��,as�rnen€tec�: ��vatuation of work is�2,500,Op�ar more, }� .
<br /> certify that I, the appiicant,:-have�been provided �with �a copy- of_the.�"Elorida� Const�vction� Llen.:L�v�---Homeowner's
<br /> Pro#�c�to� Guide� prepared by the �at�da Depa�tme�f of Ag�lc.ultur� a�d Co�rsu�n�r-Aff�tr�. if the appitc�nt ts someot�e
<br /> �4her than the"owner", I certffy�-th�t.l h�ve::db#einetl�a copy;of.th�;abave..r�escrlbad document�and.promi�e.in,goad faith.to ,
<br /> deliver it ta.the.�owner"�.prioc to�corrimencement.:. � -
<br /> �O¢VT�C'P�JR'S/�WN�R'��,F�IDAdIT: I.certify:fti_at,�tt the;inf�rm�tion.l�thl�appiicatton is accurate.and that aH wark
<br /> wiA'be done in compU�nce wfth all.applicable laws regulating constructlon� zoning and land develapment. Applicatian is
<br /> hereby made #o ob#atn .a petmit;t� da work:,ao�d-installation a� IndE�afed:• `1 c�ctify #hat a�o urork ja� tnstaliatian has
<br /> comm�nced prior to Issuance of'a permit`and thaf.all work wlll be pertormed to meet standards of all laws regula�ing�
<br /> constructlor�, Gou�tfy and City cades, zoning regulatlans, a,nd Eand developrnettt r.egalations�in the j�cisdtction,- 'i�al'sa
<br /> certify khat 1 u�ders#and that the regulatlons of other gavernment agencies r�ay�apply�#o the.intended wark, and 4hat it is
<br /> my responslbll(ty to ldentify-what.acttarts!must take,:to,be,ln:.cx�cr�p!lance,. S,uch agencles•Include but-are..coat Iim{ted to:
<br /> - �epat#ment of E�vironmental��ot�ction-Cyp�"s�.'�ayfieai�s�, iNeNend Area� and Environmental#y Sensitive
<br /> Lands,VNaterNVastewater Treatment.
<br /> - Sautb�west Ftor�da �Vlater M�nag�ment :t�istrict We11s, Cypress.�"�ay.heads; Wetlae�d �ir�as, Aifer�ng
<br /> Watercourses.
<br /> - Arrny CoPps of Engineers-Seawallst Docks,Navigatile Waterv4rays.
<br /> - Depaa#ment of Heattfi�'& Reiiabllitafiv� Services/Envitonmenta9 HeatEh Unit W�lis, Wasfevuater�Treafinen#,
<br /> Septic Tank�. � .
<br /> - US Envi�oi�mentai Pro#ectiort Agenc�yr-Asbesto��bat�m�nt.
<br /> - Fede�a)Avlat(on.Authorlty-Runweys:
<br /> i understand that the�fvilouvfng.�restrictlons appiy'to the use aF flil:�
<br /> - Use of fili is na#aliowed in�Fiood�Zona"V"unless expressly permidted.
<br /> - If the fil0 material is to be used:ln.:Flood Zone. "A", it. is understood 4hat a dra(nage plan addresstng a
<br /> "comp�ansating voiume"will be submi#ted at ti�e of p�rmitting�rhich is pcepared by a prcp€esst�nal engineer
<br /> Ilcensed by 41ie State of�Fdorida. � �
<br /> - If the fill material is ta•.be► used 1� Flood �one °A" in�aonne�ti�r� uvlth�s�g�erm�tted bu3iding ttsing stem wa#1
<br /> � construct(on, I certif�►th�t RII<v�ap:b.e used only.to fill the area�vtthin the�stem vvall.
<br /> - If #ill materlal is to be used 1n any a�ea, 1 cer#Ify that use of such fill will not adversely affect adJacent
<br /> properties. if use of fill is found to adversely:�ffe�t adjaeent�propertie�,.the or�ner may be cited f��vloCating
<br /> the conditions_of_the building,permit issued under Qhe attached,permit appllcatian;for lots.9ess than.one (1)
<br /> acre whi�t�are elevated 5y flEl,art engtn�er�d draln�g�plac�is regulred, .
<br /> If I am the AGENT FOR TH�OVI4MER, I,�prorni�e In goad faith to inform the ownee of�the permitting condi#tons set forth tn
<br /> th�s afl�davtt`prio�to commeracing canstructlan. t understand that a�separete petmi! ratay be tequlred !or�lect�tca! work,
<br /> piumbing, signs, welts, poots;. air conditioning,.ga�s, or other. tn�tall�itions t�ot.spec�ftcally inctuded�in.the application. .A
<br /> permit lssued�shall be construad to be�a�Iicense'-ta,proaeed with tNe work arad nat�as:authoHty to.vlolate..cancel, alter, or
<br /> set aslde any provlslons of#h�techntcal code�;�nor shall iss��nc��of a.perm6t.prevent the�ulldlrig Clfficlal f�om therea�fter
<br /> requiring a correctlan af ercors in�-plans, construction or vlolat(ar�s of any codes. �very�permlt issued sfi�ll become inv�lid
<br /> unless the wro�k authorfzec! by suah perm{t:ls-commenced�wlthln sFX.m�nths of pem�tit lssuanc�, or If wark authori�ed by
<br /> the pe�mit is suspended or.aba�doned:�for:a:period,of sGc(6)m�ntiis..after the tim�the�vvopk�is cammenced. An exter�sion
<br /> may be requested� in writirig, from tFie Building.Official for a perlod.not#o exceed"niri�ty(90) days a�d uvill demonstra�te
<br /> �usfifiable��u�e for.the ext��tsio�: If work ceas�as.for nl�ety{90}cons.ecutive�day.sr..t�e�ab��s consider�d�ba�doned. i
<br /> MlARNtt�� TC� QWN�R; Y�1�R..�A1l.URE;T�..R�Cfl�tQ A,PlE}TIGE:O�����NIMi�NCEME�T=.�41lAY�RESt�l:TlN�YA1lR ,
<br /> PAYING TVVICE.FOR�I1VIPfZOVE1NENTS TO Y041R:PRL�PERTY.`�iF°.YO.U�IPI'F�MD'�TO'�OBTAIP1���i1�Ai��1�1G;'CON�UI.T
<br /> WirH uR ID � AN TTO N � F�RE� . ECOR�� �:}YOIJ :� O � . � E �E � � T� ��
<br /> FL�RICrA3i7PZAt3-{r.8.f.9T.ii3j_— ____ -- - -- – -- ----- -----.-- --- • _ ,
<br /> .
<br /> dVNNER Odt/�M3EN'� CONi'6t�CT0 �
<br /> Subs«ibed and swom M(or afllnned)beior�me this Subscdbed and'swom-to�at af�rmed)�baiore rtie ttii�
<br /> by
<br /> Who Is/are personally knovm to.me or haslhave produced Who.is/are .ers ally own• Ime or haslhave�produced
<br /> � aa idenUflc��on, as[dentlftcation.
<br /> Notery Pubiic . ; � Q�otary Publtc
<br /> Commtsslon No:` C m slan.N , ..,�{r�.
<br /> �*4� e':`__ Cpmmission#FF 150422
<br /> Name af Natary typed,ptinted or stamped Name of Nota t �� , 8
<br /> .,�F �� 8onded Thm Tmy ain tnsuranca 800.385-7019
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