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<br />NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "d~ed" restrictions"
<br />which may be more restrictive than County regulations. The ufdersigned assumes responsibility for compliance with any
<br />applicable deed restrictions.
<br />UNLICENSED CONTRACTORS AND CONTRACTOR RESf,ONSIBILlTIES: If the owner has hired a contractor or
<br />contractors to undertake work, they may be required to be lice sed 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 unctjlrtain 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 li~ensed and is not entitled to permitting privileges in Pasco
<br />County. I
<br />TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
<br />that Transportation Impact Fees and Recourse Recovery Fee~ may apply to the construction of new buildings, change of
<br />use in existing buildings, or expansion of existing buildings, ab specified in Pasco County Ordinance number 89-07 and
<br />90-07, as amended. The undersigned also understands, thatl such fees, as may be due, wilt be identified at the time of
<br />permitting. It is further understood that Transportation Impac~ 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 acc6rdance 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 CO~y of the "Florida Construction Lien Law-Homeowner's
<br />Protection Guide" prepared by the Florida Department of Agri ulture and Consumer Affairs. If the applicant is someone
<br />other than the "owner", I certify that I have obtained a copy of he 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 th 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 installatiolil as indicated. I certify that no work or installation has
<br />commenced prior to issuance of a permit and that all work iIt be performed to meet standards of all laws regulating
<br />construction, County and City codes, zoning regulations, an land development regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governm nt agencies may apply to the intended work, and that it is
<br />my responsibility to identify what actions I must take to be in c mpliance. 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 Distritt-Wells, cypres.s Bayheads, Wetland Areas, Altering
<br />Watercourses.
<br />Army Corps of Engineers-Seawalls, Docks, Navig ble Waterways.
<br />Department of Health & Rehabilitative Services IEnvironmental Health Unit-Wells, Wastewater Treatment,
<br />Septic Tanks. I
<br />_ US Environmental Protection Agency-Asbestos a~]atement.
<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 ~xpressly 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" wilt 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" " in connection with a permitted building using stem wall
<br />construction, I certify that fill will be used only to fil the area within the stem wall.
<br />If fill material is to be used in any area, I cert fy that use of such fill wilt not adversely affect adjacent
<br />properties. If use of filt is found to adversely affe t adjacent properties, the owner may be cited for violating
<br />the conditions of the building permit issued unde the attached permit application, for lots less than one (1)
<br />acre which are elevated by fill, an engineered drairage plan is required.
<br />If I am the AGENT FOR THE OWNER, I promise in good faitl to inform the owner of the permitting conditions set forth in
<br />this affidavit prior to commencin~ cons~r~ct!on. 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 Included In the application. A
<br />permit issued shall be construed to be a license to proce?d '^lith the work a~d not as authori~y !o viol~t~, cancel, alter, or
<br />set aside any provisions of the technical codes, nor shall Issuance of a permit prevent the BUilding OffiCial from thereafter
<br />requiring a correction of errors in plans, construction or violatibns of any codes. Every permit issued shall become invalid
<br />unless the work authorized by such permit is commenced wi hin six months of permit issuance, or if work authorized by
<br />the permit is suspended or abandoned for a period of six (6) onths after the time th~ work is commenced: An extension
<br />may be requested, in writing, from the Building Officia~ for a eriod not t~ exceed nln~ty (,90) da~s and Will demonstrate
<br />justifiable cause for the extension. If work ceases for ninety ( 0) consecutive days, the)ob IS conSidered abandoned.
<br />
<br />
<br />OWNER OR AGEN
<br />l!~it~ed an~~w~n t~ (~r ~ffir~~d! be.fore~e ~h\i~" ; .
<br />
<br />Whp Is/are personally known to me or has/have produced
<br />'l -;-:, ,_ as identification.
<br />
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<br />l ). ......'..~ Notary Public
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<br />Notary Public
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<br />commll isslon No.
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<br />Name of Notary typed, t
<br />! ~..... Expires October 29, 2010
<br />I ,.~ I I IoNIecI Trov~" ~ lftWt.nao., Ino 100-38&-7019
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<br />commisslon..J~~'f.~, Karen L. Miller
<br />i~~ ..f: Commission # 00609664
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<br />Name of N ~ "';'385-7019
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