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A. NOTICE OF DEED RESTRICTIONS
<br /> The undersigned understand that this permit may be subject to"deed restrictions"which may be more restrictive than County regulations.The
<br /> undersigned assumes responsibility for compliance with any applicable deed restrictions.
<br /> B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br /> If the owner has hired a contractor or contractors to undertake work,he may be required to be licensed in accordance with State and local
<br /> regulations. It the contractor is not licensed as required bylaw,both the owner and contractor may be cited for a misdemeanor violation under
<br /> State law. If the owner or intended contractor is uncertain which licensing requirements may apply for the intended work he is advised to
<br /> contact the Pasco County Building Inspections Division,Contractor Licensing Section,at(727)847-8009.
<br /> Furthermore,if the owner has hired a contractor or contractors,he is advised to have the contractors sign portions of the"Contractor Block"of
<br /> this application for which he will be responsible. If you as the owner sign as the contractor,you are indicating that you,rather than the
<br /> contractor,are responsible for the work If the contractor wishes you to sign as contractor,that may be an indication that he is not properly
<br /> licensed and is not entitled to permitting privileges in Pasco County.
<br /> C. IMPACT FEES/UTILITIES IMPACT AND RESOURCE RECOVERY FEES
<br /> The undersigned understands that Impact Fees and Resource Recovery Fees may apply to the construction of new buildings,change of use
<br /> in existing buildings,or expansion of existing buildings. The undersigned also understands that such fees as may be due will be identified at
<br /> the time of permitting. It is further understood that Impact Fees and Resource Recovery Fees must be paid prior to receiving a"Certificate of
<br /> Occupancy'or final power release. If the project does not involve a Certificate of Occupancy or final power release,the fees must be paid
<br /> prior to permit issuance. Furthermore, it Pasco County Water/Sewer Impact Fees are due, it must be paid prior to permit issuance in
<br /> accordance with applicable Pasco County ordinances.
<br /> D. CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes,as amended)
<br /> If valuation of work is$2,500.00 or more,I certify that I,the applicant,has been provided with a copy of the Florida Construction Lien Law-
<br /> Homecwnees Protection Guide prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other
<br /> than the owner,I certify that I have obtained a copy of the above-described document and promise in good faith to deliver it to the owner prior
<br /> to commencement
<br /> E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br /> I certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating
<br /> construction,zoning,and land development
<br /> Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced
<br /> prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction,County codes,zoning
<br /> regulations,and land development regulations in the jurisdiction.I also certify that I understand that the regulations of other government
<br /> agencies may apply to the intended work and that it is my responsibility to identify which actions 1 must take to be in compliance. Such
<br /> agencies include,but are not limited to:
<br /> • Department of Environmental Protection: Cypress bayheads,wetland areas,environmentally sensitive lands,and water/wastewater
<br /> treatment
<br /> pe
<br /> • Southwest Florida Water Management District Wells,cypress bayheads,wetland areas,and altering watercourses.
<br /> • Army Corps of Engineers: Sea walls,docks,and navigable waterways.
<br /> • Florida Department of Children and Family Services,Environmental Health Unit Wells,wastewater treatment,and septic tanks.
<br /> • U.S.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."
<br /> • If fill material is to be used in Flood Zone"A,"it is understood that a drainage plan addressing a"comApee''nsating volume"coil be
<br /> submitted at the time of permitting which is prepared by a professional engineer licensed by the state of Ffonda.
<br /> • If fill material is to be used in Flood Zone"A"in connection with a permitted building using stem-wall construction,I certify that fin will
<br /> be used only to fill the area within the stem well.
<br /> • If fill material is to be used in any area,I certify that use of such fin will not adversely affect adjacent properties. If use of fill is found
<br /> to adversely affect adjacent properties,the owner may be cited for violating the conditions of the Building Permit issued under the
<br /> attached permit application. For lots less than one(1)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 this affidavit prior to
<br /> commencing construction.
<br /> I understand that a separate permit may be required for electrical work,plumbing,signs,wells,pools,air conditioning,gas,or other installations not
<br /> specifically included in the application.
<br /> A permit issued shall be construed to be a license to proceed with the work and not as authority to violate,cancel,after,or set aside any provisions of
<br /> the technical codes nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans,construction,or
<br /> violations of any codes.Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit
<br /> issuance,or if work authorized by the permit is suspended or abandoned for a period of six months after the time the work has commenced. An
<br /> extension in writing,may be requested from the Building Official for a period not to exceed ninety(90)days and will demonstrate justifiable cause for the
<br /> 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 PAYING TWICE FOR IMPROVEMENTS
<br /> TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANONG,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
<br /> YOUR NOTICE OjFQCOMMENCEMENT.
<br /> SIGNATURE: _/_/ r' 'y b �(�/A SIGNATURE
<br /> OWNER OR AGENT CONTRACTOR
<br /> STATE OF- STATE OFO IDA
<br /> COUNTY Y ,ryCOUNTY
<br /> The foregoing instrument was ackno% ed ed before me this Mg . dlhe foregoin rnstrumentwas acknowledged before me this M�S 2011
<br /> (date),by V0,1.0A�YVlfr�ttT- d �� ��-CtrLlrg Q (date),by t J�f1 f�0 P�
<br /> (name of person acknowtedgin},who is pe nally knovm to-fi-or who (name of person acknowledging),who is personally known to me or who
<br /> has produced has produced
<br /> (type (type of
<br /> n rca on as rden' tion. identification)as identification.
<br /> �►*v►u.�.., KATRINA M.BARDEN
<br /> eal �Of P0ei��, MICHEM IAMY
<br /> +.� ea
<br /> Notary Pub�c State of Florida vu&I 4 NOTARY e
<br /> CommiUAL
<br /> ssion C * * IL "`•'"�
<br /> °F My Comm.Expires Oct 30,2022 5 , aQ WIRES.March 7,2w
<br /> rFOFF%-O, 9onded7Ml®IIdpMNobryt;NrY�
<br /> wpdata/bcsfforms/buildingpermitapplication_pc93043032 Rev.6110/15
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