|
<br />
<br />8"
<br />9,.,,;;,
<br />pdm9tlS,...
<br />cbfttfaclph
<br />OdUh\y'h'
<br />"ltA.~S.~'" ION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
<br />r"nt~~~;:rt~l}~-~ Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
<br />ii,:.l'FQ~~.in.~~i ". . .,' .ildings, or" expansion of existing buildings, as specified in Pasco County ordinancen.umdber 89-07 and
<br />...~B-9h~s~m~I'!~~~~ The undersigned als~ undei'stan.ds, that such fees, as may be due, Will be iderHitie,. at the time of
<br />.p,~trniUiri9,}ltis,.f~fther understood that1;ransportation Impact Fees and Resource Recovery Fees must be paid prior to
<br />. re~eiVinga~f~~i[l6ate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
<br />fini'il pQwer rel~~se, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
<br />fe~s are due;W$lyrnust 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 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 "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 till 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 ~hat a s.eparate perm~t may ?e requir~d for elect~ica.1 work,
<br />plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically In~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 vlol~t~, cancel, alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a permit prevent the B~II,dIn9 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 n1n~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 INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. -
<br />
<br />FLORIDAJURAT(F,S'Vf~)A /I II^ .. ~ ~
<br />
<br />OWNER OR AGENT ~~ CONTRACTOR
<br />Subscribed and swo~(or affirmed.'tbefore me thi Subscribed and swomja.,(or affirmedJ.before me t
<br />'2-(5-01 b leJeJ\a.. ~gb '2..-{.("-{)7 by te~€A.A';:X~~~::::::
<br />Who Isfare pers~nallY known to me or haslhave produced Who Isfare personally known to me or has~:~~:rit[~:a~~oen~
<br />L as Identification. ~
<br />
<br />I
<br />i
<br />I ....
<br />NT.I~~.~f!~.~EDRESTRICTIONS: The undersigned understands that this permit may bl:l sUtJjedt?jid~.~d;'~esffiRH(jns;'
<br />W,IQI1.,;m~~.~~t,",ore restrictive than County regulations. The undersigned assumes i"espdn~ibiUty forcompli~fic~Wit~~HY.>.
<br />"'''llca'le<lj~El~.rlll~trictions. . .. .. . i. . ......i.. "/'."
<br />.'.....r:O.tURACTORS AND CONTRACTOR RESPONSI-BILlTIES: If theo",nerh.asNf~(re!9qntfaqlof.6f..:
<br />t:l~Hake work, they may be required to be licensed in accordancewlt~st~te~9dl~p~liC.' '.. 'ti6f1stidtfhi:l r '.,
<br />Hicensed as required bylaw, both the owner and contractor m~yb(:)~i~~~fq~~W.i~n?r,~.Ic:iIi:HI~ii i
<br />1',lfthe owner or Intende~ contractor are uncertain.as to what.li9~nsin~,t.~~Mil-~j1l~fit~;:~~Yi~~p!,y{arI~~ 'f'
<br />-~y are advised to contact the Pasco County Building Inspection DiyisioilTLic~~Si.flg?~8UpH.~t'iX?7;'B4.1../ I
<br />i'~, if the owner has hired a contractor or contractors, he isadvisedJdhElyett1e96~lfablorts)sigH '
<br />r"ltractor Block" of this application for which they will be responsible.. if .you;asthe()w~~rsi9,~ aslhe
<br />fay be an indication that. he is not properly licensed and is hot entitled to pertnlttihQ privilegeS. iii. Pasco
<br />
<br />
<br />\.;:-L':h"
<br />
<br />,'./....
<br />
<br />
<br />. _ ~E~INE BOG~$ary Public
<br />':. >""?o,!i Expires December 12, 2010
<br />.:,.,) .' B"".d...drtll" nvyn..illlll~rdln.;CO\N~/l,Il~
<br />
<br />Notary Public
<br />
<br />,1111.,
<br />,i\r!':v.r~. JACQUELINE BOGES
<br />Commission No. ;<A>~ C6fl'ImissiuII 00 521833
<br />%.~.....~~. Expires December 12, 2010
<br />I ~ W"lItt ,," c............. 'nln. lre) F~" 1..__.llUlVl;; "M-~/unf
<br />Name of Notary typed. printed or stamped
<br />
<br />
<br />Name of Notary typed, printed or stamped
<br />
<br />JS~D--~llo~ (01-01+-0
<br />
|