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RF'E317LE CfF UEED`hESTFitC710"RS: The undersigned undersfands fF�at fF�is permif may be subject fo`deed°resfricGons"
<br /> which may be more restrictive than County regulations. The undersigned assumes responsibitity for compliance with any
<br /> applicable deed restrictions.
<br /> UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
<br /> contractors to undertake work,they may be required to be licensed in accordance with state and local regulations. If the
<br /> contrector is.not licensed.as required.by law, both the owner and contractor may be cited for a misdemeanor violation_ I
<br /> under state faw. ff"the owner or intended contractor are uncertain as to what iicensing requirements may apply for the
<br /> ir�fended work,they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
<br /> 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
<br /> portions of the"contractor Block"of this application for which they will be responsible. If you, as the owner sign as the
<br /> contractor,that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
<br /> County.
<br /> TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
<br /> that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings,change of
<br /> use in existing buildings, or expansion of existing 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 due,will be identified at the time of
<br /> permitting. it is further understood that Tr2nspottation tmpact•Fees and Resource Recovery Fees must be paid priar to
<br /> receiving a"certificate of occupancy"or final power release. If the project does not involve a certificate of occupancy or
<br /> final power release,the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water7Sewer'Impac3
<br /> fees are due,they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
<br /> CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes,as amended): If valuation of work is$2,500.00 or more,I
<br /> certify that 4, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowne�s
<br /> Protection Guide"prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
<br /> other than the"owne�",I certify that I have obtained a copy of the above described document and promise in good faith to
<br /> deliver it to the"owne�'prior to commencement.
<br /> CONTRACTOR'S10WNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work
<br /> will be done in compliance with all applicable laws regulating construction,zoning and land development. Application is
<br /> hereby mad"e to o6tain a permit to do work and"installation as indicated: I certify tfiat no work or installation has
<br />' commenced prior to issuance of a permit and that all work will be pertormed to meet standards of ail laws regulating
<br /> construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
<br /> certify that I understand that the regutat�ons of other government agencies may apply to the intended work,and that it i"s
<br /> my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
<br /> - Deparfittent nf Envimnmentat Proteotion-Cypress 8ayheads, WeHartd �ireas artd Envirortmentatty Sertsitive
<br /> Lands,Water/Wastewater Treatment.
<br /> - Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
<br /> Watercourses.
<br /> - Army Corps of Engineers-Seawalls,Docks,Navigable Waterways.
<br /> - Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
<br /> Septic Tanks.
<br /> - US Environmental Protection Agency-Asbestos abatemenL
<br />' - Federal Aviation Authority-Runways.
<br /> I understand that the following restrictions apply to the use of fill:
<br /> - Use of fill is not allowed in Flood Zone"V"unless expressly permitted.
<br /> - ff tfie fill materiaf is to 6e used in F(ood Zone °A°, it is understood tFiat a drainage pfan addressing a
<br /> "compensating volume"will be submitted at time of permitting which is prepared by a professional engineer
<br />, licensed by the State of Florida.
<br /> - If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
<br /> construction,I certify that fill will be used only to fill the area within the stem wall.
<br /> - lf fiU mat�rial is.to be used in.any area, l certify that use-of such,fill.will,.not adversely aff.ect adjacent.
<br /> properties. ff use of fill is found to adversely affect adjacent properties,the owner may be cited for violating
<br /> the conditions of the bui�ding permit issued under the attached permit application,for lots less than one (1)
<br /> acre which are elevated by fill,an engineered drainage plan is required.
<br /> If I am the AGENT FOR THE OWNER,I promise in good faith to inform the owner of the permitting conditions set forth in
<br /> this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
<br /> plumbing, signs, wells, pools, air conditioning, gas, or other installations not speciflcaily included in the application. A
<br /> permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel,alter,or
<br /> set aside any provisions of the technical codes,nor shall issuance of a permit prevent the Building O�cial from thereafter
<br />' requiring a correction of errors in plans,construction or violations of any codes. Every permit issued shall become invalid
<br /> unless the work authorized by such permit is commenced within six months of permit issuance,or if work authorized by
<br /> the pemiit�s suspended or abandoned for a penod of six(6Jtnonths after the time the work'is corrimenced. An extension
<br />, may be requested, in writing,from the Building Official for a period not to exceed ninety(90)days and will demonstrate
<br /> justifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned.
<br /> WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br /> PAYM66 TW{CE FOIi 4N{PROVEMEPFiS�'O YOUR PROPEI2TY. IF YOU 4WTEND TO OB�Al1�L F4PFA{�1GING,EONSULT
<br /> WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
<br /> FLORIDA JURAT(F.S.1 7 03
<br /> OWNER OR AGENT CONTRACTOR
<br /> b 'bed swom to or a m d)before me t is Subscribed and sworn to(or affirmed)before me this
<br /> by
<br /> o i arB e na1(y known f'o me ortias/F�ave produced Wfio is/are personaily known fo me or haslfiave p uced
<br /> asidentification, asidentification.
<br /> ,
<br /> Notary Public Notary Public
<br /> C miss'on No. Commission No.
<br /> ��t. ���,rn�e, uCG�ll
<br /> Name of Notary typed,printed or stamped l�- Name of Notary typed,printed or stamped
<br /> �pYP���i
<br /> :�,; •:�,-DEBRq ELqINE RUFFELL
<br /> :.; :4_Commtssion#GO 045343
<br /> :;� ��Explres Novemher 7,�,,;:q
<br /> ''•�.,;��4�'� Condod?hruTroy'rai��huuranco8
<br /> . Oa3�7019
<br /> '" - I
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