|
--- ��.�.�_.�,�.d.�.
<br /> � " • . _ .,. . ... . . ;.,r,
<br /> , ,;y.
<br /> . s :,;
<br /> y 'a•
<br /> =s.',:s"f;"a..;;:u,�,',,,;:�i
<br /> NOT.ICE OF bEED RESTRICTIONS: The undersigned.understands.that;this;permit.may:be:subject�to°d.e,ed�iresf�ictioris"��s,��
<br /> 3 r . ..- :�-�4� } x < , �. _ � � - �
<br /> wli�ch��may.bemor.eArestr9etive.�fhanµCourity.regulations Th��unders�gned��assumes=�respons�b�lrty.fbr`compliance'w�th.,any�'"';s
<br /> applic�6le.:deed restrictions. � '� ; >..>�>:�..�s:��f;:r;����f-''
<br /> UNLIGENSED_COIdTRACTt?RS AND`CONTRACTOR RESPONSIBICITIES: tf�flie�ovirner�=hasY'iiiretlx�ar;corttraetor ar "~;:
<br /> contractors to undertake+work;,they;mayj be.;reguired:ta be'�licensed in accordance with state-andFlocal;�egulatians;=:-lf�#he�.;"�����
<br /> . � ` ,w..—��re w.' ..:�t
<br /> contractor is not licensed�as•�required by law;bott��the owner:and�coritr�acfar=rnajr=;5e��cited-�for=a m�sdemeanor violatton �:
<br /> under state law. If the awner,�orzintended„c:ont[actor are�uncertain as to what.licensing�reguireme.nts.,rnay�appi,y.°:for fhe;:..°u�f �
<br /> `..:s.'w.'.,.�4�..14. 'Sm:� � kw.sr:. }'
<br /> intended work,-they-are=advised to conf'act�the.Pasco County-B;uilding;lnspecfion`Division-Licensing Section at'727:847= �:
<br /> . . .. _�
<br /> 8009. Furtherrnore, if the ovirner tias`F�ireii'�`a coritracto� or cont�acfors, he is advised�#o`ahave};the,contractor(s^){sign;y,�.:,y;��:
<br /> portians of the cantractar Block of this application,for which they.wll be�respansible. llf,_yau, as,the.owner signras.the �,
<br /> con#ractoc, tt�at rnay be an 9ndicatian�that he-is not properly li�:ensed�arict'`is no#en`ti#ted to pecm�tEing privileges:,inAPasco�.,:.u;�
<br /> Caunty. .. .... . _ . __. . ...: ....� __ �.£��i�- M,��.
<br /> TRANSPORTATION-lMPACT/.UTILITIES�IMPACT AND RESClURCE RECQVERY FEES: Ttie'undersigned understands _ �ir�.
<br /> tha#Transportatiort lmpac#Fees and Recaurse Recovery Fe:es�:may�apply to.the construction of:new;buildings,.�change�of'"��`.':,;�
<br /> use in existing'buildings,;o�;expansion:�.of,�.;exisfing build'ings, as specified in Pasco County Ordinance number'89=07`:anii �``r�
<br /> 90-07, as amended. The-undersigned also understands,°#hat such::fees,;as:may:;b.e.dt�ae, wi1i,..be:identified">at=tF�e�t'i►Y"te�of��':`��y`�
<br /> permitting.��it is further�understaod thaY"Transportation"Impact�Fees�•and Resource`�Recove 'ry'<.Fees°must be paid pcior to '�,
<br /> receiving a °certificate.of accupancy° or final,.;power release. if.the.{�r.ojec#does not�,involve,a.certiftca#�af occupancyrior?�4��`;:;
<br /> final:power reie_ase, the„fees�must be.-paid prior,to perrriit`issuance,..�%Furttiermore,..if4Pasco�County Wa�erlSewer4[mpacf:��--� '4
<br /> fe.es are due, tliey must be paid prior#a permit issuance;in�°accordance,.with'.applicable.Pasco:County ordinances. �
<br /> CONSTRUCTtON �IEN�1�AW(Chapter 718, F1or`ida Statutes,as amended): tf valuatiort of work is$2,�00:OO..at more;��1.,:�,� ;
<br /> certify that I, the applicant,. have .been..provided with-a copy.:;of-;fifie "Florida• Construetian::Lien. Law:Homeowner`'s��
<br />� Frotection Guide"'prepared by�ttie Florida Depa�tment of AgricuEture and Consume�Affairs. !f the applicant is,,someone�,�:. :�
<br /> i other than the"owner�,:I,ce�tity„that�l:have.abfained a copy�of the above descri6ed document�and pramise�in,goo,d`,faith'to,',;,r
<br /> deliver.it,to<the�','_owner":prior:to::commerieement.' " " � � �� � � � ' ' -
<br /> CONTRACTt3R'Sl`OWNER'S�AFF1DAViT:,=�i_cer#ify,that.ali�the information in this application is accurate and that�alt�wark
<br /> will be done in compliance wi#h all applicakrle�laws regulating construction, zoning�ancl land development. Application_is
<br /> hereby rnade to obtain�.�a,.pe�mit�to;Fdo.,wark"-and installation.as indicated. t�certify that na work ar=-:insfa!latianµhas
<br /> commenced prior`ta issuan`ce of�a permit and that all work will be performed to,.meet.standards of all laws regulating
<br /> constru�tion, County and City codes, zoning regulatians, and land deve�opment regulations�in;-the jurisdiction: �i1:�aEso
<br /> certify#hat I understand that the reguiations of other government agencies may apply ta the intended work, and #Fiat it is
<br /> my responsibility to identify what actions ! must take to be in compliance. Such agencies include.but are not�lirnited�to: :
<br /> - b.Departrrtent af Enviranrriental:`Rrotection-Cypress Baylieads, Wetland Areas and Environrrientaliy Sensi#ive '.
<br /> Lands,WaterMlastewater Treatment. ;
<br /> - Sauthwest Florida Water Management Dist�ict Wells, Cypress Bayheads, Wetland Areas, Altering
<br /> , Watercourses. ,
<br /> - Army Corps af Engineers-Seawalls, Docks, IVavigable Waterways. � �
<br /> - Depar#ment of Heaith & Rehabi(itative ServicesJEnvironmental Health Unit Wells, 1Nastewater Treatment; �
<br /> Septic:Tanks: � �
<br /> - US Enviranmental Protec#ion Agency-Asbestas abatement. � „
<br /> - Federal Aviation Authority-Runways. !
<br /> !understand that_the�:following res#rictions apply#o the use of�li:
<br /> - Use of fill is not atlowed in Ftood Zane"V"unless expressly permitted. '
<br /> - If the fill materiaF is to be used in Flood Zone °A", it is understood that a-drainage plan addressing a
<br /> ucampensating volume" wil! be submifted at time of permifting which is prepared by a prafessionai engineer "
<br /> licensed by the State of Flarida. � x'
<br /> - lf the fll mater�af is�ta be used in Fload Zone "A" in cannection with a permitted building using sfern wall
<br /> construction, I certify that-fiil4will be used only to fill the area within the stem wall. �
<br /> - If fi!! mater'ial is to .�e used in any area, ! certify that use of such�'fill wiH no# adversely ai`fect adjacent ��
<br /> properties. if use of fitt is found to adversely affect�adjacent properties, the owner may be cited for violating �
<br /> the conditions ofa:the building;per.mif issued under the attached pecmit.application, for lots less than one (1) ' � I
<br /> acre�nrhich are elevated by fill,an engineered drainage plan is requiced. �
<br /> If I am the AGENT FOR THE OWNER,��I promise in good faith to inform the owner of.the permitting:candi#ions set forth in :
<br /> this affidauit prior to commencing cartsfruction. _I understand #hat a separate permit may be required for electrical€work, `
<br /> plumbing, signs, wells, pools,air conditioning, gas,. o�•otlier installation`s nat specifically included in the application�. A
<br /> permit issued shall'be consfrued°to�6e a license'ta proceed�with tfie work and not as authority.ta vialate, cancel, al'ter, or �
<br /> set aside any pravisions of the`fechnical cades, nar shall issuartce of a permit prevent the Building 4fficial fram thereafter •
<br /> requiring a carrectian of errors in plans;Lconstructian or violations of�any codes. Every permit issued sfiall become invalid
<br /> untess the worlc authorized by such permit Is commenced.within si�c months of permit issuance, or if work authofrzed by
<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 Buildirig Official for a periad.not to exceed riinety {90) days and will demonstrate '
<br /> justifable cause for ttie extension. If wark ceases for ninefy(90)consecutive days,the job is considered abandoned?.
<br /> i
<br /> WARNtNG TC? QWNER:� YO,UR.PAI�URE:TO RECORD<A Nt3TlCE OF COMMENCEMENT MAY`RESUI�T EN YBUR
<br /> PAYING TWICE'FOR_IMP�20VEMENTS.TO XO,UR:�PRCIPERTY.: IF YOU=INTEND TO�OBTAIN�FINANCING, CONSULT
<br /> -1MlTH Y011R`L'ENDElt OR AR9 ATfORWEY��EF�RE-`REG�RDINGY4'3UR��90T1�E'�Ff�C?MMEitifCE�f1ENT: _____;. _..._ - ---- —";
<br /> FI.t�RIDAdURAT(F,S.1S7.03) . , � �
<br /> ._-- � �
<br /> OWNER QR AGENT G�� CQNTRACTOR
<br /> Subscribed and swam ta(or affirmed}before me this Subscribed and swom to(or affirmed}.before me this �� `
<br /> r �
<br /> bY 1-2.�C'� b I
<br /> Who islare personally known to me or haslhave produced � Who islare ona no.wn to me or has/have produced
<br /> as t�entifica6on. as identlfipBpn. "
<br /> Notary Public N[/ Notary Publlc
<br /> Cammission No. Cam s Na. �
<br /> ,��`"��"°i�''-., JACQUELINE BQGE �
<br /> Name af IVatary typed,pr#nted or sEamped 1Vame of Notary type �{i bt�s sfon#FF'150422 ;
<br /> ,, - -.�,�,h, •`= xpires pecember 12,2p18 �
<br /> , `'7�p;,��„°�� Bonded tlw 7roy Fain Insarance 800,185d018 '
<br /> -ti`:
<br />
|