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<br />tl..~~~~,~~EDRESTRICTIONS: The undersigned understands that this permit may b~ subjectto.9~e9';it~~tflqti(jH~k'iy
<br />fj,'m,~M;q~,fJ1ore restrictive than County regulations. The undersigned assumes resp(jhsibilityfofbbm~lianGe.WHHi:i~Y,<"
<br />qa"""'" 'r~strictions. , , ,.,.','.. " · ... ," ",..,xi .....i:.ir.::':?~ ',~
<br />',I~':tiNTRACTORS AND qONTRACTOR RESPONSiBILITIES: If theoW{1er:basNr~#~c6Bfr~()tc)" hi;
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<br />ItW~~:dw~:;~~r.e~a6ybl~~~t~~ ~~:n:~ ~:~~:a~y~~;l~!~aJ~11Il~a~~II'\mn l~
<br />'::~~ =~~~n~:~:';: ~n~~: ~:~~~:7n:S,:';~~~~~~::?~;~~\~I~~~flj~f\licf~
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<br />~e, if the owner has hired a contractor or contractors, he is advised fOhavetliecofjlra.91~r(s):3r
<br />,",tractor' Block" of this application for which they will be responsible;, if you,ss f~eo,^,il~ris.igh~sm~ , 'r'
<br />;'ay be an indication that he Is not properly licensed and is not entitled to pefmittihgprivile~e~.iniBas~o 'I
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<br />GoJi'ilV;
<br />,."ftAN~.i "heN IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned uhderstands
<br />, tb~ttratls tion Impact Fees and Recourse Recovery Fees may apply to the construction of new buiidings, change of
<br />:;H~~i.llexis.,., ,;buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
<br />'r" ,:pptOnl:lS,~i'f1~p~~~: The uhdersigned al~o understands, that such fees, as may be due, will be identi~ed at the time of
<br />,R~trnifting:I~,<i,~,~lJrther understood thatT;ransportation Impact Fees and Resource Recovery Fees must be paid prior to
<br />regelvingail9~~ific:ate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
<br />finfil power rel~~~e, the fees must be paId prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
<br />fe~s are due",l~~xmust be paid prior to p~rmit 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 Law-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; 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 "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 "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, 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 ~f the permittin~ conditions s~t forth in
<br />this affidavit prior to commencing construction. I understand ~hat a s.eparate perm~t. may ~e reqUlr~d for elect~lca.' work,
<br />plumbing, signs, wells, pools, air conditioning, gas, or other Installations not speCifically 1n~luded.1n the application. A
<br />permit issued shall be construed to be a license to proceed with the work a~d not as authorl~y !o v'ol~t~, cancel, alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a permit prevent the B~II.dlng OffiCial from the~eaft~r
<br />requiring a correction of errors in plans, construction or violat~o~s o~ any codes. Every ~ermlt Issued. shall become, invalid
<br />unless the work authorized by such permit is commenced Within SIX months o.f permit Issu~nce, or If work authOrized. by
<br />the permit is suspended or abandoned for a period of six (6) months after the time th~ work IS commenced: An extension
<br />may be requested, in writing, from the Building Official for a period not t~ exceed nrn~ty (,90) dars and Will demonstrate
<br />justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the Job IS conSidered 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 ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. ,.
<br />
<br />FLORIDA JURAT (F.S. 117.03)
<br />
<br />CONTRACTOR
<br />Subscribed and sworn to (or affirmed) before me this
<br />by
<br />Who Is/are personally known to me or has/have produced
<br />as identification.
<br />
<br />OWNER OR AGENT
<br />Subscribed and sworn to (or affirmed) before me this
<br />by
<br />Who Is/are personally known to me or haslhave produced
<br />as Identification.
<br />
<br />Notary Public
<br />
<br />Notary Public
<br />
<br />Commission No.
<br />
<br />Commission No.
<br />
<br />Name of Notary typed, printed or stamped
<br />
<br />Name of Notary typed. printed or stamped
<br />
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