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g���i���������I��`��8�4���8�: ��und�r�ign�d und�r���nds°�.�h��Qhis:.��rml�.m�y.b�.saabject�m���ed°r�sVicQlons" <br /> which may b�<mor�rest�(ct6d�-gh�n Goaanty�isg�alatloris: �T�►�und��lgn�� �is�ur��s P�sp��slbliti�rfor�or�pllan�with�riy <br /> �pplic��9r�deed r��t�lc@Bons. , - <br /> 1���.BC������ ���9Y�tA�1���� ��9� ��R��'��T�6� �3��6��8��D�S�:1�B[�5�: I� �he ov�n�r h�s �hired �� a�nt�a�c@vr oP <br /> conQr�c�oPs�o und�r�a�k�wori�, th�y m�y b�.-c�qu6P�d�Qo.be;ltc�ns�d In�ccoPdawc�.vab2h�$at��.�nd•lo�l regulatlons. if @he <br /> con4racQoe t� no4 lic�:ns�d.�s r�qulP�d�by I�. bot7���he ovtre9�� an� con@iac�or er��y�b��clte� ffoP a misdem�anop diol�tlon <br /> �e�deP �4�Q� l�v�►. Of�h� �vua��r oP Int�nd�d contra��tor �P�-�ane�e2a9n �s to what 1t�nsing.P�quir��ents rna�r aPPiy=�for Qhe <br /> int�nd�d vuo�, they ar�ad�rfs�d to conQact t��P��c���unQg��ta6ldfng Insp�cQlo�Divislo�ic�nsing S�cQlon�2 727�47� <br /> �000. �uPt�o�rmor�, @� th� ovm�r h�s hl�d � aion�ractor or corifr�cto�. h� ls �dvised go h�ve the e�n�racQor(�) s�gn <br /> pvr�ion� of 4h� "�ont�ctor �loc�`° og�fils �ppBlca�lon �or�rhich 4h�y will b� r�sponsl�l�. I�yo�a�-as.#h� ow�ner sign �� Qh� <br /> eonQ�'�cB�P, 4B��t��y b� �n indie�4ior� 4hat h� !� ea�4 �rop�rly 91c�ns�d and ts nog�nt1Q9�d go �ecrrsitttng privil�ges bra Pasc� <br /> CounQy. <br /> �'���f������'I�R9..S�����'l��'8������`If�l��aE�'���,��-����@�f�������M�I����I��: T�h��und��(ge��d�anderst�nds <br /> QhaQ'Q'r�e��po�t�iQ6on I�npact F�es���.Recou�e R�cod�ry.F���m�iy'�pplb��o�46��cons�aa�ion o�n�w bulOd(ng�,°chang�o� <br /> �s� in �xasting beelldings, or �upan�lon�of��zi�ti�i�g`�uilding�� �� sp�cified.in P�sc� County Or�inanc� n�mbep �9-07 and <br /> 90-07, �s �m�nded....The unde€�igned ai�o�unders4ands, gha��saach���s,:�s�.�a�y_be�du�;:�►lil��� idenQffi�d at Qh�tinn�'og- <br /> ��r►rii9ti�ag. IQ Is��rth�r tand�est��d @h�Q Yran�por$�t(on ImPac� ��es �nd Reso�r� Recoe"etji Fees must be paid prior 40 <br /> Pec�iding � °�ee�i�iicate o�oecupancy" or�inal-power-r�le�s�. :If�h� peoj�c��do�s �04�ndoBv�.�:c�rti��t� of occup��cy oP <br /> fnal �o�r��P�I�as�, th�f�es mu�Q b� paid prioe to peemit iss�aanc�. Ft��h��rra�r�;i�Pa�cc� C�unty 1Nat�ri��wer Impac4 <br /> r��s��e du�,gh�y rvsus�b�=pald.p�lor t�p��mit�ls�u�nce�in accordanc�wlth��ppBicabl��asco�County oro1inances. � <br /> �O�I��'����'B���L���9 &��2f B�l���gr�a 79�� �I�rl�����t��������m�nd�d�: Ig v�lua�ion of�vork is�2,500.00 or anore, i <br /> certify 4hat i, Rh� �pplic�n�,. h�d�-b�en provided with a c:opy uf th� �FIor1��--Cons4ruc4ion� Lien .Law—@iomeo�vw�r'� <br /> Rrot�c�iota �uid�� pP��ared by the IFloPida D�paetmen��of Agrico�lh�r� and Con�umer-Aif�ies. If th� appl(cant is svrroeone <br /> o�hee 4han�he�owne�°, I ceeti�r�hat I�hav�..obtained a�py:o�.�h�abov�.���celbed�ocurr�ent°and.pr��oi�e�in gootl f�1Qh�o <br /> deliv�P I�R�Qhe.°ovi►n�r��prior to•commenc�ment. � . <br /> ��h�`���T�6�'�O��V6�1��°�A�FI�f�Y9Y: I.cer�ify.thep�II.Qh�Bae�orrv��ti�t�.le�thl� �ppllc��lon is accua�te.and that all u�orf� <br /> will�be done in cornpiianc� with all applicable lavbs Pegulating constructlon. �onfng and i�nd�d�v�lopment. Appl[eatio� is <br /> her�by made to obk�in .a permit Co do wrork_and inst�tl�4lon �s indicaf�d::• '� c��Qif� Qh�f no woPk or InstailaQior+ h�s <br /> commencsd pr(or �o I�suance of a permit and that.ali �nrork �(II b� pertorm�d�to me�� standaPds of ati laws r�gula�ing- <br /> construction, County and City codes, zoning r�gula4lons, �nd 9�nd d�d�B�pm�ra@ r.egaal��tons�In Qhe juri§d(ctton. @�al'so <br /> cer'cify tFr�t I u�d�Ps4�nd that the r�gulations of oth�P god�Pnm�n��g�nCies m�y�appEy�to Qh� intend�d work, and that i� is <br /> my re§ponsfbility fo id�ntffy�v�+hat,�ctlons I rnus4-t�k�4o b�,tn:.co�plianc�: �.aach�g�ncles Includ�btat are.noQ Ilnnitec9 40: <br /> - Departrrr9ent o9 Environm�nt�F ProtecQiora-CZrpr��s.��iyh�ad�; 1f!/etl�nd �r��,� �nd Environmen4ally Se�sitive <br /> L�eeds,�later/Vil�st�vva��r Tr�atm�nQ. <br /> - Southvue�t Florida W�teP Man�go�n�nt- :Dis�ricB-iN�lis, �pP��s.� ��yh��d�; We#i�nd Areas, AI@ering <br /> �I�$�PCOUPS�S. <br /> - Army Go�p�of�ngin�er�-Seawalis; Docks, �l�vig�bl�!l��tee�t►ay�. <br /> - D�par�m�n� of H��Igh� � Ref�abllitative Servlcesl��di�onr�nen��l �1��9t0� t1ni41N�lls, VVaste�rater T�e�trnenfi, <br /> Sep41c T��iE�s. � - <br /> - US Envl�onmental Pr�tection Agency-Asbestns abat�ment. <br /> , - �e��r�l Adi�Qon Aea9hority�Rurn�ys. <br /> t undors2arad tFiat�h��ollo�rlrig:P�stPistlons appiy fo th�use of flli:� <br /> - tl��of fil!Is nog allowed ln Flood�Zone°V'un±ess expressly p�Pm(tted. <br /> - 4g the filo m�Qerial is Qo �e used_In �Fload Zan� °A°, ft is undsrstood that a drainage pl�n addressing a <br /> ucomp�nsating dol�am�� a�riii b� submitt�d at#�ne c; �=rmttting which is prepar�d by a pr�essional enginesr <br /> Iicans�d by�h�Stag�q$FloPida: - - . <br /> - If ihe �ill m�terial is to b� us�d In Flood Zan� °A� in conne�ction-with-a �ermitt�:i bui�dina us�ra stem �vaN <br /> � constPuction, I c�rk3�j!�h���II ti�lll-be t�sed onty-fo�j the��ea within-�he stem�v�Il. - <br /> - Of fill ��t��ial is to be used�in �ny a�a, 1 cert�y fh�E u�e of suc�-► f� �� n�f a�v��e�y afrect adja�nE <br /> prop�r@i�s. I��as� 06�BB is�ound Qo �dverseiy=affet:t adj��ent �ra��es, ±i�� a��i�er may be cited for vlofia�ng <br /> @he-condtQions of frhe building.p�rrnit issued under t�e �€�s�ted,pe�rrtit ap�cat�er, fa� lots (ess than one (1) <br /> acr�wh6ch�r��Ied�Qed��}P 9ill, ���ngin�er�ed drainaga pian is requ:red. <br /> Ifi i arr�Qhe���P����93��f����1�[�, I�promis�(n good faith to Iz�arm the o�me�o�fi�ptrmitting condi�ons sef forth i� <br /> �his afifiidadtt�prior Q� cornmencie�g coetstetect6on. I undersfand fihat_a-�sparate permit msy b$ raqu3red #or efe�trica! vras�c, � <br /> clumbing, signs, wr�lls, pools; �Ir c�nditfoning, .g�s; or otk�er instalta�orts not_sp 's�r,'tca�iy in�vded-Pn f�te appltca�on. .� <br /> permit issued sh�ll b�constru�d to 9��a�lic�ns�to=proceed wtth ttts�rork and not as a�.�th�rity to.violate. carzcei, a�,er, c� <br /> s�t asid��ny provisfans o�th�4echnlcal�d��;�nor shall Issuar�ce of a permit_prevenf tin 8uf�dUig OfFiaa3 frorn th�ea:�,- <br /> requirfng a coPrection af ereor� in.pla�aas; cons@naction or vfolatfons of any codes. Every p=_rm�lssu�d stiall be�me invalyd , <br /> unless the wor�authorized by such ��rmi@:�is_coanrnenced��rithin sfx Fnonths of perm�# Essuanr,s, or if�vark authoriz$d by <br /> t3ie permit i� su�p�n¢&ed�oP.�ibae�done�for�:period of�six�) m�nths aft�r the tir�e �re��a�3c{s cammettc�d. An exfensi�n <br /> zay be Pequested, tn writing, frAm fih� �uilding.O�icial for a perlod rtot to ezc�e� t�ety(SO) days�a�� �n"Il demons�tp <br /> i�istffiabi�caus�for Qhe�xt�nsion. 9��►or�t c�as��:for ninefy(90)consecu�ive daysr-�e�ab 1s ca�sid��e�aba�dane�. . <br /> . _ <br /> �'���6�1�9� �°� �4�1�9��d: ����..f��iOL�l��-��,R�.C.A�� �.6V�"i���.�g ��i�'iPt��AlC�+9�i� NtAY�RESUi�T li� Y42�? <br /> �AV9�l�`�I��.����G�I�����1��➢�'�T�Y�UPk:����ER'�. 1�°_Y9�1-11��14d�_T'����AItSt Ft�EtNG, COhISUL i <br /> '�J1T��`(���6�N� � ��Gv�°b"V��l�� �A���_��0��1�1�-�� - -C�"�� C� �biT: <br /> =LORIDA JURAT(F.S.1.17.03) . �' �� - <br /> �WJNER OR d(�ENT COfd�C'T9R <br /> Subscribed and swam to(or afflrmed)baPore me this Subscrlbed and�stvam tn(cr afritmedrbsfote .e� _ <br /> �y 'by _ _ <br /> `?,no Is/are person�ily known to-me or haslhav�producad 1Nho Is/are persortally krtown ta me ar h��t•e:��� _ <br /> as id�ntlflcatlon. s:.3����� <br /> . I. <br /> Notary Public - ;�'=�� , � <br /> C:,r,-�-�s��t Ne:= ,��—�._:�;.��'��� <br /> !� =��.,��.'-�- ,�*�,�:"c�._'�"�.r:'?�= �'.�.,=���'�°+..r7�..?+:,°.`_��-Z':,.:2T'���`i3a�` . . <br /> ... - --- ___ _..�_ - � <br />