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<br /> NOTiCE OF 1}EED RE87'RICTIQNS: The undertslgr►ect;under�tands;th�#{#hts-��rmlf�rtay be,sub�ecE to,�deed°restrlctton',s"���,::-„.�;.:•..w
<br /> which majr-be',more�.restflctive�th�Fl County��regul�ittons.:��The�uiiders�l'gned�'a§`surries responsitiiltty�for�compllance with"'anj+� �
<br /> applicable d�ed'restrictlons. �. �_...�_,,�:� : � : , ' . .. _. .° ', - �_�
<br /> UNLiCENSED=CC?NTffACTQRS�AND CCINTRACTOR RESPONSIBICITIES:� �°tf-them owner has"�hired' a contfactar or
<br /> contractors to undertake work; they,may:b.e;r.eiqui�ed:_ta.;be;llcensed in;aacardance.with_state.and_,lacal�,regulati..a_ns:.-1f theT �� � �-'���
<br /> cor�tracto��ts rio#�1lcerised�-as�requlced`�`taHr,�both�ttie owner an�co�tcactor=may��t�e°°cited�for=anmtsdemeanar viofation
<br /> under state law. If the awner ar intended��contra�or,�ere„uncertaln as�to�what Ilcensing;requlrements�maysapply�:for:�tine=��•-° : ��.,:
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<br /> fntended w6rkr ttiey are'advlsei!'to ciiritao#the=Pasco•Gounly.Bulldl�lnspectionrDivtslon,-L.icensing Seatian at 727-847-
<br /> 8009. Fur#hermore, if the owner'iias'hti�ec!`'a�aantracfaT or;coritractors,�Fie is advised ta fiave the contractor{s),,sign.. ; 4
<br /> ,�.:t:i . y �..y f .
<br /> portions of the "contractor.Block".of..this_applica#lon.for.which.they wilt.be;:,i:esponsible.-=1f:you;:as.the oriuner"sign�as the " '`
<br /> contracto�; that�rnay.be an liidfcation that'fie=1s Kiiot:prope�jr-licerised�aritl��ls�iiot+an�tled to perriilEti"rig priv3legas In Pasco ;
<br /> TRANSPORTAT10N-1MPACTlUT1411'IES�;1�!lPAC'���AN�RE3t?URCE RECQVERY�FEES;�T�te underslgned�urtders�` . � .
<br /> h+• .
<br /> ` nds
<br /> that Transpartattan Impac#Fees�and.Recaurse.Racovery.Fees maj�;apply�:#o�tfie construction of new_bundings,°change�'of=="�`='�-�"
<br /> use In existing buildings,�o�._expar�si�n��of:�ei�istin,g°�fiuildings, a§ spec�ied.in.Pasco County Or'dinance number 89-OT.and �
<br /> 90-07, as amended:..°The undecs{gned also;�understands, fha��such fee"s,:,as��tnayrbe�:due;:�will�be Ideril�fted at tt�ett�me�~of>':- ...` '
<br /> permitting. It is �u'r'tFier understood that Tra�isp�ortatlon impact�Fees and Resou�ce�Reco�ery�`Fees.must be paid priar to
<br /> rece�ving-a.°cerfl�cate o#occupa�cy"�ar-finalrvpowerretiaase; :i€�lhe.pro��c#:,does,,no��involve;a:cert�ica#e of occupancy.�r-��:.°� , �;,
<br /> finai power_-release;:,,the�,fees rinu�f;be"paid;p�lor to,,permit iss�iance. Ft��tk�ermore;�lf Pasco:County"1NateNSewer•�Impect �.. �
<br /> fees are du�,:.theynmust:,be;pald,.prtoc to_per,mtt`,lssyance:in..accaedance wit�r<appltcable:Pasco'.County vrdlnances. �
<br /> CON�TRUCTiON'�lEN'�l:A�W(Cii�pter 713�Flar�d:$tatut�s,a�amendedy: If vaiva�on of wark�ls$2�500.00;or more;.i �� :s��
<br /> certify tFiat I, �he. applicant;:have.been :prov,i.ded-�with-�a,capy�of�the�"Flortda•��onsWction� Lien�:Law Homeowne�'s
<br /> Protectton Guide" prepared by�tlie�Flo��a Departmenf of Agrlcu[tu�e and Gonsum�ar;atialrs. If the applEcant Is someorie•�� � .
<br /> other than#he`owner", I certifji.th�t I,;h�ve,obtained�a�copy;of..the�abQve,described�iocui�ent=and_pro�iisi�;in,gaad�:faith to �{r
<br /> defiver It to.the.'owner":`.peior�to�aornmericement;`,:' •`� � , . • � �
<br /> CONIRACTOR'SIOVYNER'S AFFIDAViT: i.certify:�ttiat�.ali�the�ninf.ormatfon��;in•thi�appltcatlon is accurate.and that alliwork
<br /> will'be done in cam liance wf#h all a Iicable'laws re u�atin constructlon, zonin and�land�deyelo ment. A Ilcatton;is
<br /> P pP 9 9 9 ;. p PP
<br /> hereby made #a obtaln.a.permit,.ta�do_:wotk:�;and;insfalla#lor� as MdE�afed:��. �°I certify"that no work;ot Instaltatton has'
<br /> commenced pPior to I'ssuance of a permlf�and thaf`.all work will be perFormed�to meet standards-of ali laws regulating�
<br /> aonsbveEion, Gounty and City codes, zoning �egulatlanst and tand develapmer�t r.egulattons�ln the �urisdtctfon.-. !<<also
<br /> certify that I u�derstand #hat the regutatlons of o#her government agencles may�apply�#o the lntended work, and that it is
<br /> my responsiblHty to Identtfy•what.actlons 1 must take.to be�ln:,catrlpllanca.-,S,uch.agencles lncluds bwt�are.not Itmtted to: ��
<br /> - Dep�rtmen# af Et�vlranrnentafi��Prateatton=Cyp"r'ess.'Baytiead`�, 1NeNend Aress and Ernlronmentatly Sensithie
<br /> Lands, WatedWastewater Treatmenk. , ,
<br /> - Sauthwest Ftorlda Water IVtanagement�:aistrlct Vilelts� Cypress. Bsyheads; 1Nef#and Areas� Alteririg
<br /> Wateraourses. - . ' ` -
<br /> - Army Corps af Engineers-Seawalls,�ocks,Navigable Waterways.
<br /> - Department of,Health:.,&. Re�iabilitafhre;Setvices/Envitanmen#a1=.Fleaith Unit-Weti.s, IlKastewater�Tresfinent, ' '
<br /> Septic Tanks:_.�- -, , � � - , :
<br /> - US Envlronmental Pra#ection Agency Asbeatos abatement. �
<br /> � Federal Av.latlon_Authority-Runways. � '
<br /> !understand_thaE ttte fcllov+rlrig.:testrl'ctiohs 2ippfy'to tlie use of flli:
<br /> - Use of fitl is not atiowed in;Flood:Zone"V"uniess expressty permitted. `
<br /> - If the fill�material�-is to be�used.-'In-�:Flood,�Zone. "A°� Ik is understood that a�d�ainage plan addresstng ;a
<br /> "campe�sating-votume*will be subtititted at#ime af�.permifttng which is prepared by � professianat engineer
<br /> Ilcensed by�he S#ate�of`FMo�Hda: � � �'��-� ��;� - -
<br /> - !f th� fltF inatertal�:ls to-be used tn Fiood �one "A" fn�connec�ion�virlth:a {�ermttted baiidirtg using stem wa(i �
<br /> � co�atructlon, I ce�#ify.that fUl�:wall:be used only.to.fill the area:within�the�stem�wall: -� �
<br /> - If flll materia!-Is to be used !n any area, I �ce�klfy t#�at .usa af;such �iN wil! not adversely affect adJacent
<br /> properties. I#use,af.fill is found.to adversely:�ffect adja�eiit�praiperties�,th�owner may be cited for.uiola#irig. � ,
<br /> the-condi#Ions.of the.building:perrtiit Issued"under the.at�ached;�ermit applicatian-�for�:lots�less:than:one (1)
<br /> acre wliich ese ele"vated'by t�l#;��englneer�d drainage plan�requir�ed.
<br /> ff I am the AGENT FOR THE OWNER; I;.�rom(se In good fatth to Infarm-the��o.wner of.�the perniitting conditlons set forth in
<br /> thia affidavit`prtor ta cflmme�cing conatructlon. 1 uriderg�tand thst aRseparate permlt may be requlred for etectrlcal�work. ,,
<br /> -�-
<br /> ptumbing,_signs,.wetls,,.paols;.alr,canditioning�-.g�ts,:.vr.:o#her insfall�#ions not•spec�fcatly included�in.the�apptication. .A
<br /> permit Issued shall be consfived to<ae:'a�Iicense�.to��proceed with'the wo�k and:not�as:.authorl#y to:vlalate;�'aancel� alter, or
<br /> set aside anjr�provlsi�ns o€the teclinE`i�aades; nor shall fissuance�of a.permit.pr.event the 8uildlrig O#�cial from thereaiter
<br /> requfring a,coRectfon,af�eRo�s;in�:plans;-constnictlan.ocviolations of�anycodes:�-�very,permit�i.ssued siiall�become�invalid
<br /> unless the wrorlc authorized.by such perrnit:�ls-co�nmenced wlthin st�c..months of�permlt lssuanr�. or if work authorized by
<br /> the permit is suspendad,or.abandoned-foe-a:periatf;of s�C:�)montt�s.after,the tlme the�work as commenced. An extension
<br /> may be requested� In writing,,from th�e.:Building,Official for a pertod�not�-to.exceed'�ninety�(90)�days and-wllh demonstrate
<br /> just�iabte c�ause fior:�the e�enslon; If wor.lc ceas��far nlrte#y.{90}cons.ecutive:c3ay.s,._fhe�ob�ls consfdered aba�doneii. ±
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<br /> WARNING TQ OWNER: YOUR.FAII.URE.,Tt�1.RE.CO�tD�A,NQT�IGE.OF�•COMMEMGEMEI+tT�MAY=RESUE:T IN�YOUR
<br /> PAYING TWiCE�FOR iMRROVEMEI!t�$�,T;O�fOUI'�:PIiCC�PERTY:�:�IF°YOU�II!b�1D�TQ;OBTAIN•�FIN�`►I�1�1NG;'C.ON3lILT .
<br /> W�T -� -` - -�4- �O �El�'� FOEt�k, - -R� �� OC! ' : .;� _-� : �,� s� _� �^�� _____–
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<br /> F�ORIDA JURA;�{F.Ss.1.17.03j �` t � - -
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<br /> OWNER OR At3EPIT . CONTF�pCTO
<br /> Subscrlbed and svwm M(or aNfrmed)before me thts Stibs bed and'swom`#o �b�'to re me't�i1�
<br /> py a .by... y�ur�nrs�✓ - K.-�MI ��
<br /> Who Is/are persanally known to.me or:has/have produced Wh .I are .e onal�own�tr�me-or has/heve•produced = �
<br /> ' as Id'entl�ca@Pn.� ' as Iden��cafton. __ �
<br /> Notery Pubitc . � Notary Publlc
<br /> Ccmmisslon No: Co �isston�Na. � ,
<br /> � �
<br /> (Vame at I�otary typed�Pdnted or stamped Name of Nolary typed,prin#ed ar'stempsd ,
<br /> • �,,,, en"�,'��m.c,o�
<br /> :':,:"p�a���;, pEBRAELAINERUFFELL
<br /> . �,......
<br /> =t; i,:Commission#GG 045343
<br /> wN.�<`
<br /> �- ;, ;�,:Expires November 7,2p20
<br /> ( ` �'%�'�L;°•`'� BomiedThru7royFaialnsuranceBQQ-3385�14ie
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