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<br /> NC)1'IGE: OIF DE�[) RE:STFtIC1�lONS: Tfie; undersigneci understands that this permil rnay be subjoct to "d�3isd�' restric;tions"
<br /> whicru m�y be more r�stric;tive than Ccaunty r�gulations, 'T'lie undersigned assurness responsibility for compliaric�� vvith any
<br /> applic;able deed restric:tfons. �
<br /> UNLI�CE�VSED CUNTRA(�TORS �N[) C�z)�TRAC70R FtESPONSIBILITIES: If tf�e owner has hired �a c:��ritric;tor or
<br /> contr��ctors to undertal<e work, ihey may !7e required to be Iicenseci in accordancE; with state and local rec�ulai:ion�. 19 the
<br /> contr��ctc�r is not Ifcensed as r'equired by law, both thE; owner �nd contractor m�iy be cfted for 1 misdeme;ar�or viol�tion
<br /> under� stato law, if the ovvner or interid��c� contractor ��re; uncertain as to what lic;ensing requirements rri��y���pE�ly for• the
<br /> intencied work, fhey are acivise;d to corit�cf the Pasco (�ounty Building Inspectivn M�ivision—Licen:,ing Sec;fic�nI at 72�-ti47-
<br /> 8009. F�urthermore, if th� ovvner ha;s hired a contract��r or contractors, he (s acivised tc� havn the c��nt lactor(s) sign
<br /> portlons of the "contr<<ctor Block" of thiis <�pplication for vvhich they will be r•esporisible. If you, as the o�vne�r sigri ;�s the
<br /> contr��ctor, that m�y be an indfcation I;h�at he is not prop�rly lic�3nsed anci i;s not E:ntikled to permitting pri�vil�g�,s iri �'�asco
<br /> County. j
<br /> TF�AI�JSPORTATI(JN iMP�CTlUTILITVES IM9'ACT AND RESOIJRC� R�C�VERY FEES; The undersignisdr linder:�t�inds
<br /> that 1"ransportation ImpacQ FeE;s and Fte�c�aur��e Recove;ry f=ees may apply to thE: c;on�truction of rrew buil��ings�, change of
<br /> use iii existing buildings, ��r expansiori of existing buil��ings, as specified in Pa;�co County Ordin�nce numb'E�i• l39-07 and
<br /> 90-07', �s �3mended. The undersignec� s�lso �anderstands, that such fees, as m��y be due, will be identifi��rJ at tlie time of
<br /> permutting. It (s furthe;r urider;�tood th�t T'ransportatiori Impact Fee�s and Resourc;e f�ecovery Fe�s musi: he; ��aid pric�r to
<br /> rE;aei�rinc� a "certlficat� of��ccupancy" or f6nal power rele�ase, If the: project doe;s not involve a certificate c�f oc;cupanc;y or
<br /> finai ��ower release, the fE3es inust be p�ld prior to permit issuance. Furtherm��r�a, ii� Pascc� County Wate;r/S���n�er Impact
<br /> fe�;s ��re due, they must bE� paid prior to pE,rmit issuanc� in accordance with appiicabli� Pasco County ordin��n�r.�.s,
<br /> CUN'5T'I�UCTION LIE'N LR�W (ChaptE:r 7'13, Florida Statutes, as amended): �f valuatfon c�f work is $2,'i(l0;00 or mare, I
<br /> I certifi� that I, the ap��licant, F�ave bEen �rovided wil:h a copy af the NFlorida Construction Lien La�n��---Hc�meowrier's
<br /> Protoctic�n Guide" prepar�d by the FlGrici�� D�partmenl: of Agriculture anci Gonsurner Affairs. If the applic�ar�t is sorn�:one
<br /> other th��n the "owner", I certif,y tha4 I have3 obtained a ropy of the �bove c9e,scribed �c�cument and promis�m in c�ood faith to
<br /> deliv�;r it to the "owner° prior tc� comm�ncE�me�nt. i
<br /> Cc�N'TR��TOR'SIONJNER'S AFF9DAVd1': I certify that all the information in this a����lication is accurate and 1:h�t a91 work
<br />' will be done in compliance wikh all applicablc� laws rec�ulating con;�truction, zoning and land devE:lopmerit. F�p��lic;ation is
<br /> hErel:�y made to obteiin �i permit to da work and fn.�t�dlation as indic�ted, I ce:r�ify that no work or fnstallatian has
<br /> comrnenced prior to issu�ance� of a perrnit and that all �vc�rk will be peri�ormed t� meet standards of all I��ws reg�al��ting
<br /> consi;ruction, County and City codes, zo�ning regulations, and land devel�pment r�agulations in the juri.�dic�fian. I also
<br /> certify that I understand tf�at the regulatic�ns �f otfier government ��genci�:s may ��pply to the intended w��rk,! �ind �that it is
<br /> m,y rF�sp�nsibility to fd�ntify what actions I must take to bE; In compliance. Such �c�encles include l�ut are nc�t lirnited to:
<br /> - Department af Erivironmontal f'rotection-Cypress �ayheads, 1Netl�arid f�reas and Environm�;ntally Sensitive
<br /> Land�, Water(Wa:�tewater TrE;atrnent. �
<br /> - Southwest Florida WatPr Managemenl District-Wells, (�ypress E3�yheads, Wetland E�retis, Altc:ring
<br /> Watercourses. �
<br /> - Army Corps of Engineers••Se��w�lls, Docks, N�ivigable Waterways. �
<br /> - QepartmEnt c�f H�alth & Refiak►ilitative Services/E:nvironment�l He��ith Unit-Wells, Wastevv�ater 1-re:atment,
<br /> Septic Tanks. � • ` ',
<br /> - US Environm��ntal Protection Agdsncy-Asbesl:os abatement, i
<br /> Federal A,viatlon f�uthority-Runways. �
<br /> I undorstarid that the 1'ollowing restrictions apply to the use of fill:� !
<br />' - Use of fill is not allowed in Flaod Zone "V" unl�ss exprE�ssly permitted. ! j
<br /> If the flll mal;erial is to be �.ised in Flood Zone "A", It is urrder��tc�od that � drainage pl�n ;�i�clr�ssing a
<br /> "compen:�ating valume" will t�e :aubmftted a� time of permitting whi��h is prepared by a profe:ssional E;ngineer
<br /> Iicensed by the State of Fiorida. �
<br /> If the �II mat��rial fs to bQ �a;�ed in Flood Z��rie "A" in conn�cl:ion with a permitted building tasing sten� wall
<br /> e used onl� to fill fhe area within the st�m wali. �
<br /> construction, I certify that fill�vill b �
<br /> - If fill material ls to be used in any area, I certif,y tfiat us� of such fill will not adverselv s�ffe:ct ;�clj�cent
<br /> . �� ad acenk ro erties, the owner rnay be �it��d for v(olating
<br /> propertie;�. if use; of fill Is fc�iand to adver.,ely affect J p P
<br /> the condition;� of the buildinc� pE�rmit IssuE;d under the attaclied perrnit �application, for lots I�:ss lh;an ane (1)
<br /> acre which are elE;vated by fill, an engineered drainago plan is requfre�d. , ;
<br /> If I ain tl�e AG�NI' F�JR 1fHE OWNEI�t, I pramise in g��od faith to inform fihe ownE�r of the permitting concliCio�ri:� set i�orth in
<br /> this ��fficlavit prlor to c,ommencing construation. I understand that a separate permit may be required fc�r �I«ctriaal work, ,
<br /> plumbing, signs, wells, pools, air conditioning, gas, crr other installations not ;�pecifically included in th� a��plic�ation, A
<br /> pE;rmit i:�sued shall bE; constr�aed to b� �� IicEnse to proceE:d wfth the work and not as authority to vlolate, canc��l, altc�r, or
<br /> se;t aside any provisic�ns c�f th�technical codes, nor shall issuance of a permit prevent the Buildlrig Qfficial f�c�m tf�erEafter
<br /> requirinc,� a correction of error� in plans, c;on�truction or��i�lations of any codes. �very permit (ssued sh�all b;Fi;c�me irivalid
<br /> unle�,s the work �uthorize:d by such perrnit is commenced withfn uix months oi` permit issuance, or if wc�rk I��uthori:zE,d by
<br /> the Fnermit is suspended c►r ak�andoned far a period of six (6) munths after the time the work is commenc��ci,; liri extension
<br /> may be requested, iri writing, from if Work oc�fa eO orinirety (0)rconsecutive d��ys, ti,�job�S��a�sidee d kialyd�e�''trate
<br /> justifiabla cause for the exten�ion , �
<br /> WAF��NING TO aWNER: YOUR FAILVJiI�tE TO RECOI�i� A IdOYICE UF COMMENCEMENT WIAY Ri;::3lJl„1' IIV YOUR
<br /> F�AYIN(� TWICE FOFt IMIPRCIVEMEI�T� 'TCB YOUft PRI�IPERT'Y. IF YOU INTi:�JC) 'TO O�TAIN FINANQ��IVC;, Ct�t�::4ULT
<br /> WI_Pl�_YO.UR L�NDER O�t=QW-A-TI'ORNE"Y �EFORE-R��ORf?ING YCtJF�NO�ICE-OF-C�MIVI€'s�10EM9=1�fT'=�----`""
<br /> FI.OF�IDA JURAT(F.S, 117.03)
<br /> CONTFtACTOR_.._„_ _ _ •---�-•--
<br /> oWNIHR�JR AGENT�`_ �;ubscrlbed and sworn to(or affirmed)before ma thls I
<br /> Subsc;ribed and sworn to(or affirmecl)before me this _ , __
<br /> �bY�...— —by-- �
<br /> Who fs/are personally known to me c�r haslhavH produced Who Is/are personally known lo m�3 or hasas Iden�tiflc tion. ,
<br /> as Identlflcatlon, _ — --
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<br /> ____�Natary Public
<br /> Notary Public -- '
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<br /> (�ommission No.�._ _ ___ Commission No. __ •---'------�-
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<br /> Nam��of Notary�typed�Pr�nted or stamped Name of Notary typed,printed or stamped � i �
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