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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 Section 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 A~D RESOURCE RECOVERY FEES: The undersigned understands
<br />that Transportation Impact Fees and Recourse Reco~ery 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 number 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 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 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 adven:;ely affect adjacent properties, the owner may be cited f!Jr violating
<br />the conditions of the building permit issu.ed 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, pr other ~nstallatlons not specifically In~luded. In the application. A
<br />permit issued shall be construed to be a license to proce~d with the work a~d not as authorl~y !o, vlolat~, cancel, alter, or
<br />set aside any provisions of the technical codes, n?r shall.lss~ance of a permit prevent the B~II.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 the work is commenced: An extension
<br />may be requested, in writing, from the Building Official for a period not t~ exceed nin~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 />
<br />OWNER OR AGENT
<br />SUBScribed and sworn t~ or
<br />4- 3/D7 by ~ (:
<br />Who Is/are personally known to
<br />~L,De-.J.?5 t.--Ie.
<br />
<br />CONTRACTOR
<br />Su~sc1bed and sworn or e efore l1}e is .
<br />413 0, by ::5e: ~ e S.trc. D 'T"
<br />WhQ Islare personally known to me or haslhave produced
<br />R- 1) (20 12. L-L ~ as identification.
<br />
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<br />Notary Public
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<br />
<br />Notary Public
<br />
<br />Commission NO.~'.I~ K L M'
<br />.:-~ .... '" aren. lIer
<br />W Commission # nl'lMQAAA
<br />Name of Nota ~29,2010
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<br />Commission No.
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