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<br /> Building Department
<br /> NOTICE OF DEED RESTRICTIONS:The undersigned understands that this permit may be subject to"deed"restrictions"which may be more restrictive
<br /> than County regulations.The undersigned assumes responsibility for compliance with any applicable deed restrictions.
<br /> UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES:If the owner has hired a contractor or contractors to undertake work,they
<br /> may be required to be licensed in accordance with state and local regulations.If the contractor is not licensed as required by law,both the owner and
<br /> contractor may be cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements
<br /> may apply for the intended work,they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-8009.
<br /> Furthermore, if the owner has hired a contractor or contractors,he is advised to have the contractor(s)sign portions of the"contractor Block"of this
<br /> application for which they will be responsible. If you,as the owner sign as the contractor,that may be an indication that he is not properly licensed and is
<br /> not entitled to permitting privileges in Pasco County.
<br /> TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
<br /> that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings,change of use in existing buildings,or
<br /> expansion of existing buildings,as specified in Pasco County Ordinance number 89-07 and 90-07,as amended.The undersigned also understands,that
<br /> such fees,as may be due,will be identified at the time of permitting.It is further understood that.Transportation Impact Fees and Resource Recovery
<br /> Fees must be paid prior to receiving a"certificate of occupancy"or final power release.If,the project does not involve a certificate of occupancy or final
<br /> power release,the fees must be paid prior to permit issuance.Furthermore,if Pasco County Water/Sewer Impact fees are due,they must be paid prior
<br /> 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 certify that I,the applicant,
<br /> have been provided with a copy of the"Florida Construction Lien Law—Homeowner's Protection Guide"prepared by the Florida Department of
<br /> Agriculture and Consumer Affairs.If the applicant is someone other than the"owner", I certify that I have obtained a copy of the above described
<br /> document and promise in good faith to deliver it to the"owner"prior to commencement.
<br /> CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work will be done in compliance with
<br /> all applicable laws regulating construction,zoning and land development.Application is hereby made to obtain a permit to do work and installation as
<br /> indicated.I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all
<br /> laws regulating construction,County and City codes,zoning regulations,and land development regulations in the jurisdiction. I also certify that I
<br /> understand that the regulations of other government agencies may apply to the intended work,and that it is my responsibility to identify what actions I
<br /> must take to be in compliance.Such agencies include but are not limited to:
<br /> - Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br /> Lands, Water/Wastewater Treatment.
<br /> - Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
<br /> Watercourses.
<br /> - Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
<br /> - Department of Health & Rehabilitative Services/Environmental 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 W" unless expressly permitted.
<br /> - If the fill material is to be used in Flood Zone "A", it is understood that a 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 of Florida.
<br /> - If the fill material is to be used in Flood Zone "A" 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, I 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 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 this affidavit prior to
<br /> commencing construction. I understand that a separate permit may be required for electrical work,plumbing,signs,wells,pools,air conditioning,gas,or
<br /> other installations not specifically included in the application.A permit issued shall be construed to be a license to proceed with the work and not as
<br /> authority to violate,cancel,alter,or set aside any provisions of the technical codes,nor shall issuance of a permit prevent the Building Official from
<br /> thereafter requiring a correction of errors in plans,construction or violations of any codes.Every permit issued shall become invalid unless the work
<br /> authorized by such permit is commenced within six months of permit issuance,or if work authorized by the permit is suspended or abandoned for a
<br /> period of six(6)months after the time the work is commenced.An extension may be requested, in writing,from the Building Official for a period not to
<br /> exceed ninety(90)days and will demonstrate justifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered
<br /> abandoned.
<br /> WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br /> PAYING TWICE FOR IMP RO MENTS TO YOUR PROPERTY. IF YOU INTEN TAIN FINANCING, CONSULT
<br /> WITH YOUR LEND - MMENCEMENT.
<br /> FLORIDA JURAT(F.S. 117.03)
<br /> OWNER OR AGENT CONTRACTOR
<br /> Sus ribe a d sw rn to(or affi ed)before mg th' Subscrib d a , worn.t .( ffirmed)befor a this
<br /> by / gihG�d y � �-f�1� .G/�i'/LO�� �
<br /> hhoLis/are personally known to me or has/have produced W o is/are ersonally.known to me or has/have produced
<br /> as identification. �— as identification.
<br /> J &_.,jrejj:�tNotary ryPublic J� Notary Public
<br /> Com i si n No. ' n Commis N�o./�� ✓u /
<br /> r /I `GGFif�
<br /> Na e f Notary typed,pri ted or stamped Name 4Ntry typed,printed br stampe
<br /> PATRICIA BURCHETT
<br /> a �o MY COMMISSION#GG365171 Q1,RYPV� PATRICIASURCHEIT
<br /> EXPIRES:AUG 13,2023 =�� My COMMISSION#GG365171'
<br /> �^ Bonded through 1st State Insurance ?,F�s EXPIRES:AUG 13,2023
<br /> Bonded through 1st State Insurance
<br />
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