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<br />:'.~'~\t'.~.'.'.;:T.:AA.< . . -ON IMPACT/UTILITIES,' IMPACT AND RESOURCE RECOVERY FEES: The undersigned Uhderstands
<br />ii; .......dh~tT Impact Fees and Recourse Recovery Fees may apply to the construction of new buiidings, ~hahge of
<br />.., 't.ls~.jn. '.' ...... , ings, or expansion of existing buildings, as specified in Pasco County Ordinance number ~9-07 and
<br />'90:-o7Ia8.",..", ....' The uhderslgned al~~ understands, that such fees, as may be due, will be identified at tfie time of
<br />pe'tmitting:'m;I~:'4i~her understood that 1;ransportatlon Impact Fees and Resource Recovery Fees must be paid prior to
<br />rebei"lrig.a,,~~EiHifjpate of occupancy" or final power.release. If the project does not involve a certificate of occupancy or
<br />finfil power I'el~~se, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
<br />fe~s are dUe;J~~y.f1lUst be paid prior to p~rmlt Issuance In accordance with applicable Pasco County ordinances.
<br />CONSTRUCTi~N 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 Guldeir 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 "An, 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
<br />this affidavit prior to commencing construction. I understand that a separate perm~t may be requir~d for elect~ica.1 work,
<br />plumbing, signs, wells, pools, air conditioning, gas, or other Installations not specifically in~luded.ln the application. A
<br />permit issued shall be construed to be a license to proceed with the work a~d not as authOrity !o vlolat~, cancel, alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a permit prevent the B~i1.dlng OffiCIal from the~eaft~r
<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 th~ work is commenced: An extension
<br />may be requested, in writing, from the Building Official for a period not to exceed nJn~ty ~90) da~s 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 I END TO OBTAIN FINANCING, CQNSULT
<br />WITH YOUR LENDER OR AN ATTORNEY B FORE RECORDING YO TICE OF COMMENCEMENT.
<br />FLORIDA JURAT (ES. 117.03)
<br />
<br />"PEEDRESTRICTIONS: The undersigned understands that this permit may be subjedtolid~ed~f~
<br />~'9.re restrictive than County regulations. The undersigned assumes respdn~lblilty fort:()~~1
<br />'estrictions. . ,.>..<<
<br />'(!)NTRACTORS AND CONTRACTOR RESPONSIBILITIES:. If the6Wner/hashlredA
<br />.M~rtake work, they may be required to be licensed In accordanceWit~st~i~,aJ:!~.I()~I~~f'"
<br />i!\~nsed as required bylaw, both the owner and contractor maYb~~I~e~Jqfafljis'
<br />f~Jf;the owner or Intendecl contractor are uncertain as to whCltU~nsln~.,t~~~lf~m~nt~
<br />. 'It are advised to contaqt the Pasco County Building Inspectiqn piYi$lo"*1I6@rsiijg. .. .' .....),//L,
<br />'fe, if the owner has hired a contractor or contractors, he il3ad~ise~, to ha~e ~~E!, .,~I~fl'i"(;
<br />.... 'tractor Block"'of this ~pplicatlon for which they will be responsible; .If you; . as~liebWij~r'~;igfi ~s iHe'" i.'
<br />'~y be an hldlcatlon that he is not properly licensed and is hot entitled to permitting prlyli@~esln,Basco . f
<br />
<br />
<br />
<br />OWNER OR AGENT
<br />Subscribed and swom 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 />
<br />Notary Public
<br />
<br />~<C~ c-,,~
<br />
<br />Notary Public
<br />
<br />Commission No.
<br />
<br />Commission No.
<br />
<br />.....t K
<br />_"W... aren L. Mill
<br />
<br />Name of Notary typed, ~t r:~ . ssion # 00609664
<br />~1."".~ Expires October 29,2010
<br />,Sf, r,\ Bonded Troy Fa," ' Insurance. Inc 800-385-7019
<br />
<br />Name of Notary typed, printed or stamped
<br />
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