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<br />NOTICE OF OEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions"
<br />which may be more restrictive than Counly regulations. The undersigned assumes responslbllily for compliance wilh 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 stale 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 edvised to contact the Pasco County Building Inspection Division-Licensing Section at 727-847-
<br />8009. Furthermore, II the owner has hired a contractor or contractors, he Is advised to have the conlractor(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 IMPACTIUTILITIES 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 Counly Ordinance number 89-07 and
<br />90-07, as amended. The undersigned also underslands, 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 ocoupancy" 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, II Pasco Counly Water/Sewer Impacl
<br />fees are due, they must be paid prior to permil issuance in accordance with applicable Pasco County ordinances
<br />CONSTRUCTION LIEN LAW (Chapler 713, Flortda statutes, as amended): If valuation of work is $2,500.00 or more, I
<br />certlly 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 />olher than the "owner", I certify that I have oblalned 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 permil to do work and Inslallatlon 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, Counly 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 Ihe intended work, and that il is
<br />my responsibillly to identify what actions I must take to be in compliance. Such agencies Include but are not limited to:
<br />Department of Environmental prolection.cypress Bayheeds, 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 SeNlces/Envlronmental 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 matenal is to be used in Flood Zone "A", iI is underslood that a drainage plan addressing a
<br />"compensaling 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 slem 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 till will not adversely affect adjacent
<br />properties. If use of fill Is found 10 adversely affect adjacent properties, the owner may be ciled for violating
<br />the conditions of the building permil 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 lhe 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 installations not speciflC8l1y included in the application. A
<br />permit issued shall be construed to be a license to proce~d with the work and not as authonty 10. violate, cancel, alter, or
<br />set aside any provisions of the technical codes, nor shall Issuance of a permit prevent the BUilding OfhClat from thereafter
<br />requiring a correction of errOTS in plans, construction or violations of any codes. Every ~ermit issued. shall become. invalid
<br />unless the wort< authorized by such permit is commenced wlthm SIX months of perm II Issuance, or II work authoozed. by
<br />lhe permit is suspended or abandoned for a period of six (6) months after the time the wort< is commenced.. An extenSion
<br />may be requested, in writing, from the Building Official for a period not 10 exceed ninely (90) da~s and WIll demonstrate
<br />justifiable cause for the extension. If work ceases for ninely (90) consecutive days, theJob IS conSidered abandoned.
<br />
<br />
<br />CONTRACTOR
<br />Subscribed. iHld swO
<br />~2i:J _O~ by
<br />o Is/are pe
<br />
<br />wn to me or has/have produced
<br />_as identification.
<br />
<br />Notary Public
<br />
<br />
<br />Notary Public
<br />
<br />.
<br />800-385-7019
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