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<br />N~TICE OF DEED RES~R.ICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions"
<br />which may be more restrlctrve 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 locall'egulations. 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 AND RESOURCE RECOVERY FEES: The undersigned 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 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 instaliation 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 "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 ~all. .
<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 properti~s, the.ow.ner 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 permlttln~ conditions s~t forth In
<br />this affidavit prior to commencing construction. I understand that a s.eparate perm~t may ~e reqUlr~d for elect~lca.1 work,
<br />plumbing, signs, wells, pools, air conditioning, gas, or other installatrons not speCifically In?luded. In the appllcatron. A
<br />permit issued shall be construed to be a license to proceed with the work a~d not as authorl~ !o vlolat~, 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 violations of any codes. Every permit Issued, shall become. Invalid
<br />unless the work authorized by such permit is commenced within six months ~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 trme 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) days 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 RECO~D A NOTICE OF COMMENCEMENT MAY RESULT INYOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR ATTORNEY BEFORE RECORDING YOUR NO E OF COMMENCEMENT.
<br />FLORIDA JURAT (F.S. 117.03)
<br />
<br />OWNER OR AGENT
<br />SUbScri7., ed and sworn t fflnned) before mlUhls
<br />.....!.~ 07 by Ch.n~Clf~ Al~ DA~.hS
<br />Who is/are personally known to me or haslhave produced
<br />(:7L p (20 IL Ll r as Identification.
<br />
<br />
<br />CONTRACTOR '.
<br />sUb1c~d and s . 0 (or afflnned) befi>re me this
<br />Cot I 0, bY('~~ p..1~\)IPIV\S
<br />Who is/are personally known to e or has/have produced
<br />~ 1:> 12 v Q. Ll C ' as Identification.
<br />
<br />
<br />~~ ~ ~'l'.'_ Notary Public
<br />
<br />Commission No. .('~~.. Kant.. L. Miller
<br />i~ \~ C . '
<br />:.. f*- 0
<br />Name of Notary . _~ber 29, 2010
<br />, .ff.., 8enHtI Tra, FIIin. ,.........nc., 'n* _.....7018
<br />
<br />~~~ ~.~
<br />
<br />Notary Public
<br />
<br />Commission No. I~~',r~ K"rAn L MillAr
<br />:~ .~ Commission # OD609664
<br />:*: ;*- .
<br />
<br />Name of Notary typed, p , n' Iloniled Tilly Fein _1_,lne ~-:l85-7019
<br />
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