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<br /> �Q�!�� (�� [3E�O ���Fl1�Tl(���� The permit
<br /> which may bemore restrictive than County regulations. The undersigned assumes responsibility for compliance with any
<br /> applicable deed restrictions.
<br /> UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
<br /> contractors to undertake work, they may be required tobaUoanoedineonondanoovvithota1eand|ocdregu|sdiona. |�tho
<br /> contractor is not-licensed as required by |ow, both the owner and contractor may be cited for a misdemeanor violation
<br /> understate !cmv. If the owner or intended contractor are uncertain auto whet 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. |fyou. oa 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 /> County.
<br /> TRANSPORTATION I88PACT/QTILQ-|ESlK0PACT AND-RESOURCE RECOVERY FEES: The undersigned.understands
<br /> that Transportation Impact Fees and Recourse Recovery Fees may apply tothe construction of new buildings, change of
<br /> use in existing bui|dinga, or expansion of existing bVi|d|ngs, as specified in Pasco County Ordinance number 8A-O7and
<br /> 00'07' as amended. The undersigned also understands., that such faes, as may be due, will be identified at the time of
<br /> permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
<br /> receiving m "certUioateof occupancy" or final povverrelease. |f the project does not involve aco�J\na1eof occupancy or
<br /> final power re|a�ae' the fees must be paid prior to permit issuance. Furthermore' if Pasco County Water/Sewer Impact
<br /> Ufenaareduo.theyrnuatbepaidprior10 '� ernn�issuance in accordance vv�happlicable Pasco County ordinances.
<br /> ��QNSTRO��TU{]0 LIEN ��LAWCbapteramended):713, Florida Statutes, as oond�d\� If valuation ofxVork is $2.500.00 or more, |
<br /> certify that |, the applicant, `axe been provided with a copy of the 'Florida Construction, Lien Law—Homeowner's
<br /> Protaution Guid�'' prepared by the Florida Department ofAgr\cu|ture.and Consumer Affairs. If the applicant is someone
<br /> rthan the"owner", ! certify that ) have obtained a copy of the above described document and promise in good faith to
<br /> deliver itto the"owner' prior tucommencement.
<br /> CONTRACTORS/OWNER'S AFFIDAVIT: | certify that all the information in this application is accurate and that all work
<br /> will be done in compliance with all applicable laws regulating oonetruc±ion, zoning and. land development. Application is
<br /> hereby made to obtain a permit to do work and installation as indicated. { certify that no work or installation ha's
<br /> commenced prior to iee�anoe of permit and that all work will be performed to meet standards of all laws regulatingcdnatnuotion. County and,Citv codes,, zoning regu\edone, and land deve\opnnent regulations. (n the juhad|ctinn. 1 aleo
<br /> corUh/that | pnde `ndthat ' erogu|ationoofotherQovernmontagencioomoya �p\ytotheintendadvvoik. andtho1 � io
<br /> my responsibility
<br /> ponsibi|ityto |dentifv vvhet actions | must take tobeinnonnp||ance. Such agencies ino|udebut are not Urn�ed�t
<br /> ' Department of' Environmental Protection-Cypress Bayheoda, Wetland Areas and Environmentally Sensitive
<br /> Lands, Water/Wastewater Treatment.
<br /> ' Southwest Florida Water Management District-Wells, Cypress. BaykeadS, Wetland Areas. Altering
<br /> Watercourses. '
<br /> Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
<br /> - Department of Health & Rehabilitative 8en/icea/Environnnen¢a| Health Unit-VVeUs, Wastewater Trep1meot'.�
<br /> Septic Tanks.
<br /> ' US-Environmental Protection Agency-Asbestos abatement.
<br /> ' Federal AviationAuthohty-Runways.
<br /> | understand that the following restrictions apply to the use offill:
<br /> ' Use of fill ia not allowed in Flood Zone"V'' unless expressly permitted. `
<br /> - If the fill, material is to be used in Flood Zone ^A''. it is understood thata drainage plan addressing a
<br /> "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
<br /> licensed by the State ofFlorida.
<br /> - If the fill nneteha\ is to be used in Flood Zone "N' in connection with a permitted building using stem wall
<br /> construction, I certify that fill will be used only to fill the area within the stem wall.
<br /> ' If fill material is to be used in any area. | certify that use Of-Such fill will not adversely 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 |Vte |eoo than one (1)
<br /> acre which are elevated by fill, an engineered drainage plan iarequired.
<br /> |f \ amthe 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.. | undeistand that a separate permit may be.required for electrical vvork,
<br /> p|umbing, signs, xve!\s, pno|o, air oondhioning, gas,'or other installations not specifically included in the application. A
<br /> permit issued s*hall 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 shall issuance of a permit prevent the Building Official from thereafter
<br /> requiring aoonecb* nof errors-in plans, cono�ocbonor violations of any codes. Every permit issued shall become inveUd
<br /> un}oaa the work authorized by such permit is commenced within six months of permit isouance, or if work authorized by
<br /> the permit ia suspended or abandoned for a period,of six (8) months after the time the Work \acommenced. 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. |f work ceases for ninety (9O) 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 013TAl0 FlN/\0CjNCS, C[}0SD[T
<br /> WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
<br /> FLORIDA Ju*A/ (F.u.11r.0u)
<br /> OWNER OR AGEN CONTRACTOR
<br /> yuu unu u d swqM to (or affirmed Subscribed and sworn*o(or affirmed)before me this '
<br /> by by
<br /> . Who/sl^unper vnal`v known mmeu,oas/onveproouoeo Who is/are personally known mmoo,has/have produced
<br /> as identification. as identification. '
<br /> N ary Public Notary puuUu `
<br /> Comm�o�n No. Commission No.------ - — m���
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