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<br />ci;!)>;:.Nt=n~~,~~cR~ED RESTRICTIONS: The undersigned understands that this permit may. be slibjedto'id~~d;if~stfl~{j6Hsli '..
<br />;';;i',i~;'Y:'~~~1i~~~abie~;~r~:t~~~~~:~ve than County regulations. The undersigned assumes responsibility forCOfnPliafi6a..~ItM~~~
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<br />~~LI9:e~.$.~~"Loo~TRACTORS AND CONTRACTOR RESPONSI'BILlTIES: If the.o~ner.has.hife~Jt..bantfab~r6f{!T'
<br />.:'t?O!f~~tg~~t9,~t'gertake work, they may be required to be licensed in accordancewithstafefjiid J()9alf~~yi~tlpl1s,if l.tJK~,'!'i
<br />btt~ctcjt'i~,;n9tlicensed as required by. law, both the owner and contractor m~ybe (;il~.aJo~ a.iJjl~d~tri~.~fii:lr\i191~HtiB
<br />elf the owner or intended contractor are uncertain as to whgtli9~iisihQte~~ir~hi~M~.ma~~ppIY,t()rj~~' I
<br />'.~Yare advised to contaot the Pasco County Building Inspeotl()~ Di"i$ion"'LiCehSitiQ~~ctlp~~ti?7::.84f:: ! ...
<br />k~re, if the owner has hired a contractor or contractors, he Isadvlsed.Jd h~~e thecOptfaqI6f(s)slgfl';
<br />BPptractor Block" of this application for which they Will be responsible.. if youi8sthebwnefsign a,stMa
<br />cOihtract~tl,f11ay be an indication that he is not properly licensed and is hot entitled to permittihg prrVii@ges in. Pasco
<br />olJnty.;......, .. . .."
<br />"?\.. RA~~e~RX~tl~N IMPAqT/UTILlTIESIMPACT AND RESOURCE RECOVERY FEES: The ~nderslgned.Uhderstahds
<br />.-.th~t:rra~spg.~~tiqnlmpactF~es and Hecburse Hecovery Fees may apply to the construction of new bUiieJings, chahgeof
<br />.~~~in~xistiAg'lJ~il9ings, o~,.expansion of existing buildings, as specified in Pasco County Ordinance number89~07 ahd
<br />. 9q..07,~s~m~D(fe~. The uhdersigned also understands, that such fees, as may be due, will be identified at the time of
<br />pe:riniUih9..)tl~~~rther understood that 1;ransportation Impact Fees and Hesouroe Hecovery Fees must be paid prior to
<br />reteiving a"~~~ificate of occupancy" or final powerrelease. If the project does not involve a certificate. of occupancy or
<br />final. power re'~~~e, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
<br />fees are due;;th~ymust 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 oertify 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 />oonstruction, 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, Dooks, Navigable Waterways.
<br />Department of Health & Hehabllitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
<br />Septic Tanks.
<br />US Environmental Protection Agency-Asbestos abatement.
<br />Federal Aviation Authority-Hunways.
<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 />"oompensating 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 oonnection 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 attaohed 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 oonstruction. I understand that a s.eparate perm~t. may ?e requir~d for elect.rica.1 work,
<br />plumbing, signs, wells, pools, air conditioning, gas, or other ~nstallatlons not speCifically 1n~luded.ln the application. A
<br />permit issued shall be oonstrued 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 teohnical oodes, nor shall Issuance of a permit prevent the BUilding OffiCial from the~eaft~r
<br />requiring a oorreotion of errors in plans, construction or violat~o~s o~ any codes. Every ~ermit 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 th~ work is oommenced; An extension
<br />may be requested, in writing, from the Building Official for a period not t~ exceed n1n~ty ~90) da~s and Will demonstrate
<br />justifiable oause for the extension. If work ceases for ninety (90) consecutive days, the Job IS conSIdered abandoned.
<br />
<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.
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<br />FLORIDA JURAT (F.S. 11 ~3h, " .. /),1 A /I ,. _
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<br />OWNER OR AGENT ~JtLeL, CONTRACTOR ~~
<br />Subscribed and sworn to (or affirmed) before me thi Subscribed and sworn to (or affirmed) before me thi
<br />by by
<br />Who Is/are personally known to me or has/have produced Who is/are personally known to me or has/have produced
<br />asldenUfication. asidentiflcation.
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<br />Notary Public
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<br />Notary Public
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<br />Commission No.
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<br />CommIssion No.
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<br />Name of Notary typed, printed or stamped
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<br />Name of Notary typed, printed or stamped
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<br />J5~O~ fila -0/-01f-D
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