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<br />:,~~Ji,"~t1~J,~f~D RESTRICTIONS: The undersigned understands that this permit may ~o/ $u~jeclJ~ t#[~#7,\~,~~ip6?~~' .', ,.
<br />Wiqf\ '!ppre restrictive than County regulations. The undersigned assumes responsibility fOrb?illpl.i~flp~;Wifh~h~>
<br />, . , ,relStrictions. '.. ..'. .. .'i<'::'
<br />C(jNTRACTORS AND CONTRACTOR RESPONSIBILITIES:.. If..the.t>,^,rerhashif~d~~()qtf~~~ofpt.
<br />genake work, they may be required to be licensed In accordancewi,thst~t~,~i;ldl~~~lf~g4i~ti6fisl,..IHH~ '
<br />'jjpensed as required bylaw, both the owner and contractor maybepit~~Jotahii$~~m~.~116fyi9IaH()1i
<br />'Ii the owner or intended contractor are uncertain as to what licensing fe~lIlrenienls }naYapply' faf tHer
<br />. " are advised to contact the Pasco County Building Inspection Divisloti~Licensing Section at 727-847-
<br />,Pi}",'f~G~", if the owner has hired a cohtractor or contractors, he isiadvised,fohfiyeJh~c89ft~~lar(s)Si9fi,
<br />""tti9r~'(jf.;..,htractor Block" of this application for which they will be responsible; . IfYou,asthe.?wri~rsig~ as the
<br />fraQt(jh;th~t!tnay be an indication that he is not properly licensed and is hot entitled to permitting priviieges ih. Pasco
<br />yhty.?'/";"j';i;" .. .' . .' .. · . . .... . ..
<br />.,..",.'N~i;>>~~f~TI~N IMPAGT/UTILlTIESilMPACT AND RESOURCE RECOVERY FEES: Theuhdersigned Understands
<br />Jh~tTr~i'\~M~~,ti?tl'mpact F-res and Recourse Recovery Fees may apply to the construction of new bUiidihgs, change. of
<br />j,y~~,Jn~*isti~~;)~~i.laings, or.: expansion of existing buildings, as specified in Pasco County Ordinance niJ.mberf39~07 and
<br />>~d-07;as ~m~~~,~~. The undersigned al,so understands, that such fees, as may be due, will be identitied at the time of
<br />,pe~trnlttihg.,I!tl.s(lI,rther understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
<br />.. reteiving ail.qerti~pate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
<br />fin~1 powerreiease, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
<br />fees are dLie,th~y,Jl1ust 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. 1 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 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 permit may be required for electrical work,
<br />plumbing, signs, wells, pools, air conditioning, gas, or other ~nstallations 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 vlol~t~, cancel. alter, or
<br />set aside any provisions of the technical codes, nor shall Issuance of a permit prevent the BUilding OffiCial from the~eaft~r
<br />requiring a correction of errors in plans, construction or violat~o~s o! any codes. Eve~ ~ermit issued. shall become. Invahd
<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) mo~ths 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 nJn~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.
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<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 />FLORIDA JURAT f'
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<br />CONTRACTOR
<br />S scribed and swo to (or affirmed) before me this
<br />I b by Ro~( -\. \ pr'"'7ht rn~ I r1l ~A')hl\ ()
<br />Who Is are personally known to me or has/h ve produced
<br />~ \:)c u L\ c: ~ nse as identification.
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<br />Notary Public
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<br />~~ d"'~"\.'l.Q~L
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<br />Notary Public
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<br />Commission No.
<br />
<br />Karen L. Miller
<br />Ion
<br />pires October 29, 2010
<br />Bcnded Tmy F... . I_neo, In" 8QO.38I.70111
<br />
<br />Commission No. ~
<br />~~ Karen L. Miller
<br />::! '\~ .,
<br />Name of Notary type , r,;,.. IWfJ'INl' October 29, 2010
<br />, 'Ii,tl\ _ Tn>y Flln .I.."",nco, InC. 8QO.38I.7018
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