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<br />NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions';
<br />which may be more 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 to be licensed in accordance with state and local regulations. If the
<br />contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
<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 Sedion 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 />County. ' '
<br />TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: Theundersigned understands
<br />that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
<br />use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance humber 89-07 and
<br />90-07, as amended. The undersigned also understands, that such fees, 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 a "certificate of occupancy" 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 LaVif-Homeowner's
<br />Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
<br />other than the "owner", I certify that I have obtained a copy of the above described document and promise in good faith to
<br />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
<br />will be done in compliance with all applicable laws regulating construction, zoning and land development. 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 government agencies may apply to the intended work, and that it is
<br />my responsibility to identify what actions I 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, WaterlWastewater 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 "V" 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 thah 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 />plumbing, signs, wells, pools, air conditioning, gas, or other installations hot specifically included in the application. A
<br />permit issued shall 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 a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
<br />unless the work authorized by such permit is commenced within six months of permit issuance; or if work authorized 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 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 consider~d abandoned.
<br />
<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 />WITH YOUR LENDER OR AN A1TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
<br />FLORIDA JURAT (F.S. 117.03>1 /' <:.
<br />OWNER OR AGENT ---70.. ~ fivJ-- CONTRACTOR / f) IJ ,if--
<br />.SuqscriPE!.d. and sworn to (or affirmed) before m.J) this subscril1ed and sworn to (or affirmed) before me this
<br />~bY (2v:~~ L'OJ1.......;.~ Gp...U\ V'I \ 215 L6v by 1Z\c1~~ L"'L'..h- c":"'A'l\ Y"'\
<br />Who isfare personally known 0 me or haslhave produced Who is/are personally known to me or haslhave produced
<br />?L, -S~ . '"iX \~ L-\ c... as identification. c: L- ~ 'lX \ ~ L.. (' as Identification.
<br />
<br />Commission No. ~~V'4f!tt, Karel} L. Miller
<br />-~ .~c '"
<br />:.~ i.: ommtsslon ,.
<br />Name of Notary ty . J8tt0ber 29,2010
<br />Bond.. TIOy FIln. Inoura_, Ino. lIQO.JN.1Il1e
<br />
<br />Name of Notary typed, prln
<br />
<br />
<br />F.," . ._..... ,... __7011
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<br />
<br />Notary Public
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<br />Commission No.
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