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<br />� �d3T��lE����E� ���'�'1����'�OI��: I he undersigned uncferstands that.this,permit rnay be subject ta deed„ restr,ict�ons
<br /> which may.be more:r;estrictive.than Calunty regulations. 'The�.wndersigned=assumes•responsibility�#or�compl'i'ance�viiitr5'�anyr "
<br /> applicable deed restrictions. �
<br /> �i�LE������ �C��I�R��T�D9�� �.�9U� ��8i��62��'�'�� i�����F��8��L9'�'B�S: If tfie ovvner has'-hired��a�-con#ractar or
<br /> contractors ta undertake work, they may be r.equired to be licensed in accardance with�state and local regulations. -�If the
<br /> contractor is nat licensed as r�quired Eiy law, both the ovuner and con#ractor�r�iay��ie cited-•for`�a rt�isdemeanar violation
<br /> under state law. lf the awner or intended contractor are uncertain as fio what licensing requirements��may�apply for::the
<br /> intended wor.lc,they are advised to contact the Paseo Caunty�uilding lnspection�Divisibn—Licensing Sectian at 727-847-
<br /> 8009. Furthermore, if the owner has hired`a caritractar or cantractors, he is advised to ;have the confractar(s}.,sign
<br /> portions of the "contrac#or Block" of this application for which they will be responsible. If you, as�;the owner s'ign as the ,
<br /> canfractor, that may be an indicatian that he is not properly licensed and is not �ntitled to permitting privileges in Pasco �
<br /> County. ,
<br /> '�'�e4R�a��@��'��'GCD�! 9Gl11R's���'/�9�"@�,9'�'@ES 9�fd����'��9�7 (�ES6?+U�C� B��C���RV���5: The undersigned understands
<br /> that Transportation lmpact Fees and R�ecourse Recovery�ees may:apply to the construction of new bvi(c3ings, change:df� "
<br /> use in existing buildings, or expansiorn of.exisfiing buildings, as specified in Pasco County Ordinance number 89-07 and
<br /> 90-07, as amended, The undersigned�also understands, that such fees, as may be dtte, will �e�itlentified at the tirr�e�of
<br /> permit#ing. I# is furkher understood that Transportation Impact Fees and Resource:Recavery Fees must be paid prior to
<br /> receiving a "certifEcate of occu�ancy" air final power release. !f the project does not invalve a certificate of occupancy or
<br /> f'snai power release, #he f�es must be paid prior ta permit issuance. Furthermore, if Pasco County WaterlSewer Impact �
<br /> fees are due, they must b�paid prior to�permit issuance in accordance with applicable Pasco Caunty ardinances. �
<br /> ����'CR�C3'��844 8���6� ��@�{�8���������, �I��a������ta����,�����¢�����: lf valuation af work is$2,500.00 or more,..l
<br /> certify that I, the applicanf, have been provided with a copy of fhe "�lorida Construction Lien Lawr---Homeowner"s
<br /> Proteckion Guide" preparec! by the Florida Deparkrnent o�Agriculture and Consurner Affairs. !�the�applicanfi:is someone ,
<br /> other than fihe"owner", 1 certify that I have obtained a copy of the abave described document and promise in good faith#o
<br /> deliver it to the"owner" prior to comm�ncemenf.
<br /> ���'8"6��'�'��'�l����Cl�'�������@��'�': I certify that all the information in th9s app('scation is accurate and thafi a!I work '
<br /> will be done in compliance wifh all applicable laws regulating construction, zoning and�land developmen#. Application is
<br /> hereby made to obtain a permit fa do uuork and instaEEafiort as irtdicatec#. 1 certify that no work or instaflaticin has
<br /> comm�nced prior to issuance ofi a per�mit and that all work will be performed to meet standards�of all laws regulating '
<br /> construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I alsa
<br /> certify that { understand that the regulatians af ofher government agencies may apply to the intended work, and tha# it is ,
<br /> my responsibility ta identify what actians I must take to be in compliance. Such.agencies include bufi are not limited to: �
<br /> - Department af Enviranm�n�taE Fratection-Cypress �ayEieads, Wetland Areas and Environmentally Sensitive
<br /> Lands,WaterNVastewater Trea#rnent.
<br /> - Southwesfi Florida Water Management District WelEs, Cypress �ayheads, Wetland Areas, Altering ; -
<br /> Watercourses.
<br /> - Army Corps af Engineers-Seawalls, Docks, Navigable Waterways.
<br /> - Department of Heaifh & Rehabilitative S�rviceslEnvironmen#at Health Unit Vtlells, Was#ewater Treatment, �
<br /> Sep.tic'fanks.
<br /> - US Environmental Protectio�n Agency-Asbestos abatement. -
<br /> - Federal Aviation Authorifiy-Runways. ;
<br /> I understand that the following restrictions apply to the us�of fill: '
<br /> - Use of fi11 is nat aliovired in FEaod Zone"V"urrless expressty permitted.
<br /> - If the fill material is to be� used in Flood Zone "A", it is understoad that a drainage plan addressing a ,
<br /> "campensa�[ng votume" wil! be submitted at time of permitting which is prepared by a professionai engineer
<br /> licensedby the State of Fiorida.
<br /> - If the fill material is to be ussd in Fload Zane "A" in connection with a permitted builtling using stem wal! ,
<br /> canstrucf€on, I c�rtify that�11 will be used only to fil!the area vuithin fhe sfierr�wa1L '
<br /> - If fill rnaterial is to .be usetl in any area, I certify that use af such'fill will not adversely afFect adjacent
<br /> prap�rties. If use af fi[I is found to adversely affect:adjacen# praper�ies, the owner rnay�be ci�ed far vialafing �
<br /> the canditions of the buildin;g permit issued under the attached permit application, for lots less than one (1) '
<br /> acre which are elevated by fll, an engin�ered drainage plan is required.
<br /> If t am the a���6�T��93'�����i�IER, 1 promise in good faith ta inform the owner of the permitting conditians se#forth in
<br /> this affidavit prior�a commencing const�uctian. I understand that a separate permit may be required for electrical work,
<br /> plumbing, signs, v�relts, pools, air cand�tioning, gas, or other �nstallations r►ot specifically included in fihe appl9cation. A
<br /> permit issued shall'be canstrued to be a license to proceed with the work and nofi as authority to vidlate, cancel, alter, ar �
<br /> s�t aside any provisions of the technical codes, nor shall issuance of a permit prsv�nt the Suilding G1,fficia!from thereafter
<br /> requiring a correctian of errors in pians, constructian ar vio(ations af any codes. Every permit issued�sha(1 become invaiid
<br /> unless the wor{c authoriz�d by such permit is commenced within six months of permit issuanc�, or if work authorized by
<br /> the permi#is suspended or abancloned for a periad of six{6}months after the tirrte the work is corrimenced. An exfension
<br /> may be requested, in wri#ing, from the Builditig Official for a period nat to exceed ninety (90) days and will demonstrate
<br /> justifiable cause for the extensian. !f worlc ceases for nin�ty(90)cons�cutive days,the job is conside'red abandon�d. .
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<br /> fiLORlDA JURAT(F.S. 17.03j l
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<br /> OWRIER 012.4GEf�T _ �,,, COPJT&2�4C70fR I
<br /> �Sub cri ed and sw o +ngd)b ore m � is Sub cri ed s m to(or �rme -this=-!
<br /> � t� 9 ti t by �
<br /> Who is/are personaf Imo or has/have produced Who is/are pe nall known or has have produced �
<br /> as identlfication. as identification.
<br /> �
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<br /> � �� �----- �� �
<br /> /''� /�'r " � ��—=---,vutary Pubtic � �� � i Notary Public ;
<br /> Commission No. Commission No. '�
<br /> �
<br /> �, �n,���� I ti �
<br /> Nam ot� �ped TERRY Name of Not . }ittec�r��SFa TERRY -
<br /> aa. a�: ldotary Public-Stale ot Flan,ta . - Y�btic-State o1 Florida
<br /> * ' ' �' ' " �c�mrnission #F�9580
<br /> -"; �+•= Cammission #PF 958064 ';'�.'��" v' 6q�
<br /> ,;f-, aP�`' My Comm.Expires Apr 4 202Q �"f%�;;;°'' My Comm Expires Apr 4.2020 .
<br /> "'����"" Bar,ded throogh Nattongl Notary Assn , gonded througq NaSfppa!Notary Assn
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