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<br /> i��T[CE O� D��D RE�TRI�Tit3�3S: The undersigned understands that this perrnit may be subject to-"deed"restrictions".
<br /> G which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
<br />� app(icabie deed restrictions.
<br /> UNLIGEiVS�D COt�'�'RACTORS AND C�NTRACTOR RESP�NSIBILITIES: if the awner has hired a cantractor ar
<br />` contractars to undertake work, they may be required to be licensed in accordance with state and local regufations. !f the
<br /> cantractor is not�(icensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
<br />' under state law. Ifi#he owner or intended cantractor are uncertain as tq what licensing requirements may appiy for ihe
<br /> intended uvork, they are advised to contact the Pasco County Buiiding 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 contractorts) sign
<br />� portions of the "cantractor Block" of fhis application for which they wil! be responsible. !f you, as the owner sign as the
<br /> contractor, that may be an indication that he is not properly licens�d and is nat entitled to permitting privileges�in P'asco
<br /> County.
<br /> TRANSPORTATtt'��! ttVfPACT/UTILiT1ES IMPACT A�ID RESOURCE RECt�VERY FEE�: The undersigned.understands
<br />� that Trar�sportation lmpa'ct Fses and Recourse Ftecavery Fees may apply to the canstruction of new buiidings, change af
<br /> use in existing buildings, or expansian of exis#ing buildings, as specifiied in Pasco County Ordinance number 89-07 anc!
<br /> 90-07, as amended. The undersigned also understands, that such fees, as may be due, wi!! be identified afi the time of
<br /> permitting. it is further understood that Transpartation Impact Fees and Resource Ftecove.ry Fees must be paid prior to
<br /> receiving a "certificate of occupancy" or final power reiease (f the projeet does not involve a certificate ofi occupancy or
<br /> , final power release, the fees must be paid priar ta permit issuance Furthermare, if Pasco Gounty Water/Sewer Impact
<br /> fees are due,they must be paid prior ta permit issuance ir� accordance with applicable Pasco Gounty ord[nances.
<br /> C(?PI�TRUCTUC?N LlE�! LAW (Ch�pter 713, Florida Statutes, as amended): !f vafuation of v�ork is $2,500.00 or more, i
<br /> certify that I, the applicant, have been provided with a copy af the "Florida Construction Lien Law—Homeowner's
<br /> Pratection Guide" prepared by the �lorida Department of Agriculture.and Consumer Affairs. lf the applicant is someone
<br /> other than the "owner", ( certify that I have obtained a copy of the above described dacument and promise in good faith to
<br /> deliver it to the"owne�' priar ta commencernent.
<br /> CONTRACTOR'S/�W�1CR'S AFFiDAVIT: ! certif}r that all the infarmatian in thls appiication is accurate and that al! work
<br /> will be done in compliance with al! applicable laws regulating construction, zoning and land development. Application is
<br /> hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
<br /> commenced prior to issuance of a permit and fhat al( work will be performed ta meet standards of a11 laws regulating
<br /> construcfiion, Caunty and City cades, zoning regulations, and Eand development regulations in the jurisdiction. 1 a{so
<br /> certify that l understand that the regulatians a# other government agencies may apply to the intended v+rork, and that it is
<br /> my responsibility to identify what actians ! must take ta be in compliance. Such agencies include but are not limited to:
<br /> - Department of Environmental Protection-Gypress Bayheads, Wetland Areas and Environmentally Sensiti�e
<br /> Lands,Water/Wastewater Treatment.
<br /> - Southwest Florida Water Management District-Wells, Cypress Bayheads, Wet(and Areas, Altering
<br /> ' � Watercaurses. .
<br /> I� - Army Corps of Er�gineers-Seawails, Dacks, Navigabie Waterways. �
<br /> � - Department of Health & Rehabilitative Services(Environmental Health Unit-Wells, Wastewater Treatment,.
<br /> Septic Tanks.
<br /> - US�Environmental Protection Agency-Asbestos abatement. •
<br /> - Federal Aviatian Authority-Runways.
<br /> ! understand that the foilowing restrictians apply to the use of fill:
<br /> - Use of fil! is not allowed in F{ood Zone "V" unless expressly permitted
<br /> - If the fill materiai is to be used in Fload Zone "A", it is understaod that a drainage .plan addressing a
<br /> "compensating volume" will be submitted at time of permitting which is prepared by a professional enginee'r
<br /> licensed by the State of F�larida.
<br /> - If the fill materia{ is to be used in Flood Zane "A" in connection with a,permitted buiiding using stem wa11
<br /> canstructian, l certify that fif!wili be used oniy to fil!the area within the st�m wail.
<br /> - lf fill material is to be used in any area, I certify that use of such fi1! wi{! not adversely aifect adjacsnt
<br /> properties. If use ofi fill is found to adversely affect adjacent properties, the owner may be cited for violating
<br /> ' the conditions of the building permit issued under the attached permit application, for lots less than one (1�
<br /> acre which are elevated by fil(, an engineered drainage plan is required. .
<br /> ifi i am the AG'�C�� F�IR THE C1INNER, I promise in goad faith ta inform the awner of the permitting conditions set forth in
<br /> this affidavit prior to cammencing canstruction. 1 understarrd that a separate permit may be.required far electrical wark,
<br /> � plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically 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 shai( issuance of a permit prevent the Buiiding Official from thereafter
<br /> requiring a correctian of errors in plans, construction ar vioiations of any codes Every permit issued sha(( became invalid
<br /> unless the work authorized by such permit is cammenced within six months of permit issvance, or if work authorized by
<br /> the permit is suspended or abandaned fbr a period;.of six (6) months after the time the wark is commenced. An extension
<br /> may be requested, In writing, from the Building Ofificiaf for a period not ta exceed ninety (90) days and will demonstrate
<br /> � justifiable cause for the extensian. (f work ceases for ninety (90) consecutive days, the job is considered abandanecl.
<br /> WARNING Tt� t�WI��R: 'YO�UR �AiLtJRE `('O RECORD A NOTICE OF COMMENCEMENT MAV RESULT 1N YOUR
<br /> ` PAYlNG TWlC� FQR lMPROV�MENTS TQ YOUR PROPERTY. IF YOU 1NTEND TU OBTAIN FtNANC1NG, CLINSULT
<br /> WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORQING YOUR NQTICE OF COMMENGEiNEt�1".
<br /> FLORIDAJURAT(F.S,Y77.03) ,,.�„� _ __
<br /> OWNER OR AGEFIT �• �`��'"` CONTRAGTOR
<br /> Sub cri ed and sw9�C�n to(or afflrmed}before me this Subscribed and sworn to(or affirmed) before me this
<br /> ���C�����y 2��'c-n•n��'�i,�•_c.�.a�.C�d--,c 5,,.-.w=, by
<br /> ' o is/are personally known to me or has/have�produned Who islare persona!!y known to me or has/have produced
<br /> as idenfification. as identification. •
<br /> ` � �
<br /> /r U, �� ' atary Pub(ic Notary Public
<br /> '^ ` `r
<br /> Commission Na. � �, Commiss(on No.
<br /> Name af Rlatary typed,printed or stamped Name of Notary typed,printed or stamped
<br /> 1'��"��'S�+�
<br /> ,�*��q� Notary Publfc Stete ot Ptar#aa -
<br /> ;r . Michelle Moyes
<br /> 4 Nty Commlaelan tig ob7321
<br /> �'o,w� Bftpiro��TJ2vha2o �
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