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NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions"
<br /> which may be more restrictive 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 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 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, 1
<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 clone 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 .city codes, zoning regulations, and land development regulations in the jurisdiction. I also
<br /> certify that I ynderstand that the regulations of other government agencies may apply to the intended work, and that it is
<br /> my respons 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 installations not specifically included in the application. A
<br /> set aside an y p i s io ns of the construe technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
<br /> set asde any provisions
<br /> unless t a correcti he work au thorized by of error s s u such permit srcotmmenced violations
<br /> within six any
<br /> months of permit issuance, permit
<br /> or issued
<br /> if work authorized by
<br /> unless tty sch pe
<br /> m a pb r is es ed, pend
<br /> in d or writing, from abandoned
<br /> the Build Building Official (6) months after the time
<br /> a period not to exceed ninety days and will demonstrate
<br /> may be requested, in g, from te 9
<br /> ob is considered abandoned.
<br /> justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the j
<br /> WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT N MENT MAY RESULT IN YOU ULR
<br /> PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
<br /> WITH YOUR LENDE : OR AN ATTORNEY BEFORE RECORDING YOU - L OTICE OF COMMENCEMENT.
<br /> FLORIDA JURAT (F. 11 o3) i
<br /> / t.tiL ` CONTRACTOR w. r
<br /> OWNER OR AGENT f cribgd and swo to or/ tfjrmed) e t r - "me this a �'
<br /> Subscribe and swor •r affirmed) se or; me this . > AL sZ0 /0 by /((lA�
<br /> A J is by LLt Who is /are eersonally known to me or has/ - e p c?d
<br /> Who is/are ersonally known to me i enti have produced
<br /> as identifica ion. L as identification.
<br /> c L - i ' " Notary Public
<br /> ., (ie CR- &idAi/6 Notary Public X�
<br /> NOTARY P • r •r 1
<br /> Commission No. • StaCl Hartwig
<br /> Commission No. , 0 ,r ' TE OF FLORIDA
<br /> Stacie Hartwi •, ■ •
<br /> # DD926164 Name of Notary typed, pr o - - , Expires: OCT C.16, 2013
<br /> Name of Notary typed; Expires: OCT. 16, 2013 BONDED THRU ATLA_\ IC BONDLVG CO., M..
<br /> BONDED THRU ATLANTIC BONDLSG CO., ENC.
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