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���,� ��33 �R��t�S. '"he unders�gned understands that this permit may be subject to "deed" restrictians" <br /> ,��, �, �e r�e re�re tlt� Cauniy regulat�ons. The undersigned assumes responsibility for compliance with any <br /> fteed - - <br /> � ��g � CONTf�CTOR RESPONSlBtLITtES: If the owner has hired a contractor or <br /> ��n��c�s te i�lre�k, t�y rtrY 1a� �� b0 ���ns� m accordance with state a�d local regulations. If the <br /> ����, ������ ��,,, ��t, the c�er and contr�r may be citad for a misdemeanc�r violation <br /> �„�, d° ��. �; �e oa�►�r �r ireta�ed c;�actcx aTe e�ncertaia as to what Ncensing requ�rements may apply for the <br /> r �� ',= rk. �rey ar� a�s�i 4o contact the P2sco County Buiiding Inspection Divisian--Licensing Section at 727-847- <br /> �x�,r�c �#y,��e ;t th� o�r�e� i�as hired a contractor or contractors, he is advised to have the contractor(s) sign <br /> �;� gt�� ' �c�c,' o� ��s �pt�at�cn for which they wi{I be responsible. If you, as the owner sign as the <br /> ���F�� .;,ai r�,av �e a� irx�ca#ion that ne �s ��c property licensed and is not entitled to permitting privileges in Pasco <br /> �c�s� . . . <br /> ��q,-np� �,���{�ACT AND RE�OI�tCE RE�OVERY FEES: The undersigned understands <br /> �� -��,�� � p� �.#�,�c�trse {�ecv�r5r Fees rnay appty to the construction of new buildings, change of <br /> �se tr ex� � hei�dr�. cr e�-of e�a'sti��9 buikNa9s� � gP��fied in Pasco Co�nty Ordinance number 89-07 and <br /> ��,�? � =j'�,e • .a1�o �d�ersta�fs, that such fees, as may be due, will be iden�fied at the time of <br /> �e�„�r��,n� ,t is fwther � that`Tr�ortabon Impact Fees and Resource Recovery Fees must be paid prior to <br /> .��,�„ a •' ,� �cy° crr fina{ power release. If the project does not involve a certificate of occupancy or <br /> =,n�t ��� re�a�se, �e �s ma�t be paid prior to permit issuance. Furfhermore, if Pasco County WatedSewer Impact <br /> t; <br /> iees are+�, �+ ��e p�icd pri�r tc� P�ermit issuance in accordance with applicable Pasco County ordinances. <br /> �� � L�f t� �pter 713, Florida Statutes, as amended}: If valuation of work is $2,500.00 or more, <br /> ���, tt�t i, � � t, hau� been provideC with a copy of the "Florida Construction Lien Law—Homeowner's <br /> *'fflFB{�tt)t� ��ild� p�i bY the F1or�da DePartme�t of Agriculture and Consumer Affairs, If the applicant is someone <br /> y ��r ���`, 1 c�r � 1 h�ve �tained a copy of the above described document and promise in good faith to <br /> � it 1D i�►e ° 4�+�'� P� � ��i. <br /> �"� � g!�l�1k'�"iT; i oertify that a!! the information in this application is accurate and that all work <br /> ,,,,,�� ��� c�r�n� v�h a{I ap}�iicab4e laws regulating canstruction, zoning and land deveiopment. Application is <br /> heretjy� made � obt�n a P�mit to do work and ins#alla�ion as indicated. I certify that no work or installation has <br /> �arnmenced prior to issuac►ce af a permit and that all work will be performed to meet standards of all laws regulating <br /> cons�ruetion C�rsry anci City cades, zoning regu#at'tons, and land development regulations in the jurisdiction. I also <br /> cerzi#y tt��t i understand that the regulations of other government agencies may apply to the intended work, and that it is <br /> t my re�p�lAsibitiry io ident�fy what actions I must take to be in compliance Such agencies include but are not limited to. <br /> - Dep�rtment af Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive <br /> Lands, WateclWastewater Treatment. <br /> _ Southwest Fbrida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering <br /> - `�' 1�Rla�cour�e,s. <br /> - Army Corps af Engirreers-5eawalis, Docks, Navigabfe Waterways. <br /> _ �epartfnent af Heatth & Rehabilitative Services/Environmental Heatth Unit-Wells, Wastewater Treatment, <br /> Sep#ic Tar�cs. <br /> _ t1g Envi�ta► pro�ectsor� Agency-Asbestos abatement. <br /> - Fec�eri# Rvia�licm A�rity-Rurnvays. <br /> � understand that the fotlo�wirig �es�rrctians apply to the use of fill: <br /> - Use of fill is not albwed in Flaod Zone "V" unless expressly permitted <br /> i# the fill materia! is to be used in Ffood Zone "A", it is understood that a drainage plan addressing a <br /> "compensatir� voEume" will be submitted at time of permitting which is prepared by a professional engineer <br /> ` �rs�ci b the Stabe � Florida. <br /> � Y <br /> !f the ftlt material is to be used in Flood Zone "A" in connection with a permitted building using stem wall <br /> ' constructian, I certify that fi11 will be used only to fill the area within the stem wall. <br /> ' - If fifl material is to be u:�ed in any area, I certify that use of such fill will not adversely affect adjacent <br /> r properties. If use of fi11 is found to adversely affect adjacent properties, the owner may be cited for violating <br /> ` the conditlons of the buiiding permit �ssued under the attached permit application, for lots Iess than one {1) <br /> acre which are elevated by fill, an engineered drainage plan is required. <br /> ir � am the AGENT FOR TtiE OWNEI�, ! prom�se ;n good faith to inform the owner of the permitting conditions set forth in <br /> m�s affidavit pr�or to commencing construction � understand that a separate permit may be required for electrical work, <br /> plurr�bi s�gns, wells, poois, air conditioning, gas, or other installations not specifically ine�uded in the application. A <br /> � perr�it ' sha►! be canstr�red to be a license to proceed with the work and not as authority to violate, cancel, alter, or <br /> "' set a� y prov+sions of ttte technical codes, nor shall issuance of a permit prevent the Building Official from thereafter <br /> requ�i `carrectiQn of errors in ptans, construction or violations of any codes. Every permit issued shall become invalid <br /> unless work authorized by such permit is commenced within six months of permit issuance, or if work authorized by <br /> � the per �s st�spended or at�andoned for a period of six (6) months after the time the work is commenced. An extension <br /> ;� may be rsquested, in writing, from the Building Official for a period not to exceed ninety (9�) days and will demonstrate <br /> � justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned. <br /> WARNING TO OWNER: YOUR AILURE TO RECORD A NOTICE OF GO ENCE ENT AY RESULT iN YOUR <br /> PAYING TWtCE FOR {MPR V TS TO YOUR PROPERTY. IF YOU INTE INANCING, CONSULT <br /> WITH YOUR LENDER O Y BEFORE RECORDING YOUR N F M EMENT. <br /> FLORIDA JURAT (F.S. 117 <br /> z <br /> " OWNER OR AGENT CONTRACTOR <br /> Subscribed'and sworn to (or this Subscribed and swom to (or a med} before me this <br /> by ✓o �t t b Y <br /> Wh i personafly known to me or has/have produced Wh� perso known to me or ha ave produced <br /> � as identificatic�n. as identificabon. <br /> i <br /> � � <br /> � -� ~-- Notary P�blic .�-- Notary Public <br /> I • --- <br /> �� ) � <br /> Commissi n No. � o�� Commission Na D D _�Pc� <br /> Name of l�otary typed, printed or stamped � Name of Notary typed, printed or stamped <br /> •�'�""�� KRISTEN P. JOSEPH '""""""'" <br /> '"��"�' KRISTEN P. JOSEPH <br /> �' '�.:= Commiss�on # DD 882627 '��'� � � " D 882627 <br /> :� '" Expires April 21 20�3 =*• .*: Commission # D <br /> '%�'� ���aQar � yFaminsurance80' 385-7019 �+�P; ExpiresApri1�1,2013 <br /> " ��A,i,�"t "�ded i � y Fa� Insurance&n 385-701b <br />