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<br /> � �!'�,�lG€O.�D��R RE&��C�l�i�S; The.ui�detsigt�ed;t�nde[sta�ds tb�t.t�is pe[m;+Laia�be s4l�e�Lto."�eed":restsi�ttwss"
<br /> v.i�4�;ci,i.;rr�a�±:h�,m�rer,�-strictive-tiian�GourrFyree�u}aFiarr� T.h�-urrder�qrtada��.trrr�tes�a�is:#ri�;�r,,`�F:cti�s�;�'��-w;;��-�.�
<br /> appti�l��deed restFt�l��s-
<br /> �t5[tICENSED CC}�tTElAC.T.QHS�,hN[� CO@LTKA6ZOEt"'RESPQLVStB1�t�{ES�: «the awner ha�hi�ed.a contiacfor oc
<br /> coe�t�actoes tv undexfake waFk,they��r be�r•eq,aired�Co be�lieenseck irr•acco�d'ance�w�i sfate and locaf regufations: ffi the-
<br /> corit�actor�s nof ficerise�as requi�ed by Faw, botlt tlie owner and cortfractor may be cifed for a mi`sdemear�"or'vfo(atiori'
<br /> under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
<br /> intended 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 /> £vuAS}�: �. ..� <. ...
<br /> -a'�'•�i'*�"��'�i?'�{�:?�P?�`�:��=a��?�?�:."`��.�������_�t3iY�y.�� �?te ttr:,eerss�+�+,`_�e;si2nc3s `
<br /> '�ii�t.Tra�spor3a�on.9m�ac�Fess_aratl�R.ecourse�cPsdv�?ry 1=�s rs��Y���a�9?:o�Yhe r,or�e�Hor�'ef�elx�l}din�s,r_.iaange�f a�
<br /> .�se yn•ezisS"srag'btaild'tng5,nr expansiara t�#�exisYir�g b�rlldings,as spea'�ed in�asco Ccnyn�y(3riiinance num�er B3-b7 and _ :'
<br /> 90.=07,as amended "ihe�undersignetl also�nderstands,'that.such.fees,as rr�ay'be due,wil! be�dentified at the Gme of
<br /> permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
<br /> receiving a"certificate of occupanc�'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 Water/Sewer Impact
<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 I, the applicant, have been provided with,a copy of the "Florida Construction Lien Law—Homeowner's
<br /> Protection Guid'e"pre�ated�6y the��r7da:-De{�artment of Ag�icGlfur�and'Consumei�Affairs: If th�applicant is:someane�
<br /> c:i��r:�an.ii��"o�i7�r",i�s��-irra�'i Rav��Sb�ir�ed"aco�y aF`irie��ve�'�scr}aed'�3��u�r��azrd c,-r�o�s�in•,aeod ia;i�•.id
<br /> �, deflver if to�tie"aw�iet"prioiio'corrifr�enceriieni.
<br /> COM7RACk'QR'S/CIWPCEf�'S-AFFIDAf�GT€ Ccerfity.thaYalt f[1e Cnformation i�:ttlis applicaCo�is accurate and=fhag all=work
<br /> will be done in compkiance with atf ap�lica6le laws•.regufating construction,zoning�and land devetopment. 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 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 also
<br /> certify that I understand that the regulations of other govemment agencies may apply to the intended work, and that it is �
<br /> my responsibiliry to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
<br /> - _pepartme�t of.Environmental Protection-Cypcess_Bayheads, Wetland Afeas,and.Environmentally Sensitive
<br /> L.�nClS.51VaLes�Laliast e�ter.Trseatm�nt_.
<br /> - 5�ok��w� Ftori� �fa�- 14'aragwr:erit .l�isb9ctalVells, �ypress 6ayh�ads, VVetand Pineas, Altsr�r�r,
<br /> Watercoucses.
<br /> - ,Artri,y.Cnrps of,Engineers-Seawalts,.Dncks,�f�avi,gahle�A/atera+vays.
<br /> - Department of Fieaifh & Rehabilitafive Servicesl�nvironmental Health Unit-Wells,-Wastewater Treatment,
<br /> Septic Tanks.
<br /> - US Environmental Protection Agency-Asbestos abatement.
<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 /> - If,tt;c;f��f,rna�ariaL;s to:5c;use�:'r:r:�loocl,,�o�te "A_, it_-�s Lndetstaad<Ghat.a dra�age.?lan.add�ess„r�:a
<br /> �Earnperasa��:v�feitrte"w�T€�s subm&�d.aF t��a€:p2cmttt€tr�r,u�`ti�h•i�•pr�aied��-arrrai�sir,�t=�y���E�
<br /> �ice��sed..by.�i�e.S�aie o�Floceda:
<br /> - lf.th�.fiif.mateciak�is.taFie;us�d in_Flood ZnR�-"A" in coac�ection witla..a;peun�ked 6oiTii"ing:us�ng.stem_wall, �
<br /> cortshvctiorr,{certify.that fi1x wi4F 6e:used�only ta�.fill.the area withirr tiie stesrr wa4i;
<br /> - ff filf material is to be used in any area, f certify thaf use of sucfi filf wilf not adversefy affect adjacent
<br /> properties. If use of 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 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 /> piumoi�,g; signs, wetis, paa7s, air cor�divariing,.�as, or o�er>lnsk2�iar�ons.�o't-specrn�aT'ry`.3nch)de6��ine ap�iifca�ion. �
<br /> "r�er�ii`s�:wsL�ci:stia.�'�_c�n.st.i�s�=�sa���T:icerase*.���r�sc�.v:;i:�:�;._,�r.�^a:=a�ai:ri�eri�;*'�:fl=v:e�i�,rzacP;=4N�,_�r
<br /> ��t aside,�y�znov��at�s�f.#�e�onritc�}codes,�rr�r�h�7l9r�u���df a p�rmlr�r�verS�.��:�u7jorng�nca1 fra7r+Phereatisr
<br /> requirirag a-�orrectican of errors`in�ilans,�nsYrucYion ur'viol�ioras;if ariy coi�es. '�very'perrr►it issuetl s�al'i�sscome 3r�valii7
<br /> �niess the�woric aut�hor.+zed by-s�oh:permi#�is commenced•t�uithin��six.months o'f pem�tit issuance,or ifi woric authorizeci�y
<br /> the permit is suspended or abandoned for a period of six(6)months after the time the work is commenced. 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 /> PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT �
<br /> WRH Y�l1R'LENDER Of2't�tV ATTOI'�NEY BEFQRE RECOR�ING=�CQ'�:�R;i.IC!'i'lCE OF GQI�AMENCEN[E{�4'C.
<br /> r+:.eRsa,;:�i�c,r��.s�•��4. �_'U V( U Il� - - -
<br /> UWNER OR AGENT CONiRAC�QEi
<br /> Subscri6ed andswom to.(oc a i betwe.me iis� SUbscn"bed a�i swom to(oraH d�betore:me: is ,
<br /> by 6y
<br /> Who is/are personally known to me or has/have produced Who is/are personally known to me or has/have produced
<br /> as identification. as identification.
<br /> i
<br /> Notary Public �� Notary Public
<br /> CoYnmissio»No. Co"issi N
<br /> ����„
<br /> .s.'°'*.Pva�,. �A F 150422
<br /> ameof�Notarytyped,�rinted.or.stamped ameofNo :Nd, �:o9r Xp�aDecember1 ,
<br /> ','�i� �,o;�`� BondadThNiroyFa�nlnsumnu800aB5•7019
<br /> i�
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