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�� g� p�p ���: 'he un�ers�gned understands that this permit may be subject to "deed" restricti�ns"
<br /> ���,r�x�e �awe � Co�uety ragulatiar�.s. The undersigned assumes responsibiiity for compliance with any
<br /> � �pi�� J� CO�tTRACTOR RESPaNStBILiTtES: {f the owner has hired a contractor or
<br /> ���, �y �,y be se�uired bo l� }icensed in accordance with state a�d local regulations. If the
<br /> � �� by law, bQCh the awmer and contrac�or may be cited for a misdemeanflr violation
<br /> �� ��� ���yr � c��ractor a�e uncertaia as tts what licensirtg requifements may apply for the
<br /> ,� .�ey ane ,advised to c�tact the Pasco County Building inspeetion Division—l.icensing Section at 727-84'7-
<br /> gr,�yg .;fi �e tw��er tta� �ired a contractar or contractors, he is advised to have the contractor(s) sign
<br /> �� ^ �te °e�rnractc�r �c" a€ +.hts ap�p►�cat�on for which they will be responsible. lf you, as the owner sign as the
<br /> �� = ,�,a� snav �e ar ,ncf�ccatror, ��;a: ne is � properiy licensed and is not entitled to permitting privileges in Pasco
<br /> �s�. "`
<br /> � ��,p� �s,q,�T��#� �QACT ANL1 RESOURCE REEOVERY FEES: The undersigned understands
<br /> .-�a� � i,�n�ract Fees a�ci Recourse Recovery Fees may apply to the construction of new buildings, change of
<br /> ,�5e ,� �- �� � c,r ex�ar,s�on of existing buitdings, as specified in Pasco County Ordinance number 89-07 and
<br /> ��_;�� � , T� ��iso und�rst�ds, that such fees, as may be due, wilf be identified at the time of
<br /> ;�� #t �� tfi�t Transportation Impact Fees and Resource Recovery Fees must be paid prior to
<br /> =,��g a•c�e,� oecupar�cy'� c�r ftnai pflwer rebease. If tfie pro�ect does not involve a certificate of occupancy or
<br /> =,na� �r r+�ea�e, � i�ses must b,e paid prior to aermit issuance. Furthermore, if Pasco County WaterlSewer Impact
<br /> f� �e �, �ey mu�t be pa�ic� pri�u � perrr�t issvance in accordance with appiicable Pasco County ordinances.
<br /> ' CpW,�'ll�O�t flQt t�1� 713, Fior�da Statutes, as amendsd}: If valuation of work is $2,500.00 or more, I
<br /> �y �;, �e a�pi�� t�e b�aen provuied +r�ith a copy of the "Florida Construction Lien Law—Homeowner's
<br /> pr�ry G�e° prepa��ed !xy �he Fbrida �nt of Agriculture and Cansumer Af�airs, If the applicant is someone
<br /> o�er t�n t�e ow��', I c�r�fy � I E�ve �tained a copy of the ahvve described document and promise in good faith to
<br /> � � kj � "i3�' PFitx �t7' t�A��ntent.
<br /> �p7T: I csrtify that all the information in this apptication is accurate and that all work
<br /> �{� ����e y� � a�ble laws regutating canstruction, zoning and land development. Application is
<br /> t�ere�ay s�nacie �es obtain a perrrrit to do wark and i�s#allatlon as indicated. I ce�ify that no work or installation has
<br /> �,c�r� p� �o is�nr,�e of a pe►mit and that all work will be performed to meet standards of all laws regulating
<br /> �ans�, Coc�ty and C�ty oorf�s, zaning regul�#ons, and land development regulatlons in the jurisdiction. I also
<br /> ; cer#�j ' I un�e�d tha# the regukations of other govemment agencies may apply to the intended work, and that it is
<br /> � my " i4ity to iden#rfy what actic�ns I must taKe to be in compliance. Such agencies include but are not limited to.
<br /> € - � Department of Environrr;ental Protecuon-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br /> �.ands, Water/Wastewate� Treatment
<br /> - Scx►tnwest F�orida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
<br /> :�'� WaRter'cou�ses.
<br /> _ �= A,rrr►�r Corps o# Engineers-aeawalls, Docks, tVavigable Waterways.
<br /> . _ �, :D�nt of Health & Rehabi{itative ServiceslEnvironmental Health Unit-Wells, Wastewater Treatment,
<br /> � Se�c Tantcs.
<br /> _ �{S �nviro�ta4 pcc�t�tion Agency-Asbestos abatement.
<br /> " ��at Av�ort �eor�ty-Runvuays.
<br /> e' ' uncter�ed that the fd#a� t�ric�ions apply to the use of fill:
<br /> - Use of fill +s not a#aowed in FMood 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 /> "compensaiir� voiume" will be submitted at time af permitting which is prepared by a professional engineer
<br /> licensed by tl�e S#aEe afi Fl�rida.
<br /> - If the fifi material is to be used in Flood Zone 'A" in connection with a permitted building using stem wall
<br /> construction, { certify that fill will be used only to fill the area within the stem wall.
<br /> - If fiEl material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
<br /> praperties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
<br /> the canditions �f the building permit issued under the attached permit application, for lots less than one (1)
<br /> acre which are eEevated by fill, an engineered drainage plan is required
<br /> if i am the AGENT FOR THE OWNER, ! promise �n good faith to inform the owner of the permitting conditions set forth in
<br /> th;s aff�davit prtor to commencing construction �,nderstand that a separate permit may be required for electrical work,
<br /> plumb� �_�igns, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
<br /> a perr�it '' " shalE be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
<br /> set �s' y p�y�s+ons of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
<br /> requiri correcUon of errors in plans, construction or violatians of any codes. Every permit issued shall become invalid
<br /> uniess ` work autharized by such permit is commenced within six months of permit issuance, or if work authorized by
<br /> the per�s s�speRded or abandoned for a period of six (6) months after the time the work is commenced. An extension
<br /> may be �ested, in writing, fram the Building Official for a period not to exceed ninety (90) days and will demonstrate
<br /> �ustifiable �ause for the extension. If �nrork ceases for ninety (90} consecutive days, the job is considered abandoned.
<br /> WARNING TO OWNER: YOUR F,�I URE TO RECORD A NOTICE OF COM � MAY RESUL7 IN YOUR
<br /> , PAYING TINiCE FOR IMPROVE TO YOUR PROPERTY. IF YOU INTE D T TAIN FINANCING, CONSULT
<br /> WiTH YOU LENDER OR BEFORE RECORDING YOUR NOTI CEMENT.
<br /> f' =LORIDA JtJRAT (F.S 117.03
<br /> �,:
<br /> �
<br /> OWNER OR AGENT CONTRACTOR —
<br /> Subscribed and swom to (or affi e this Scbs:ribed and swem to {cr affir cJ) before me this
<br /> �by _ ✓o v t by _ o
<br /> Wh i aee personalfy known to me or has/F�ave produced Wh __�ersonallv known to me or ha �ave produced
<br /> as identification. as identification.
<br /> J �
<br /> "" _� Notary Pubhc - �---- NOtary PubliC
<br /> Commissio No Y� � O o�-� Commission Na JJ D _`P �
<br /> Name of �latary typed, printed or stamped Name of Notary typed, printed or stsmped
<br /> " " ",; KRISTEN P. JOSEPH .,,,�„"„
<br /> k �� ��� ��" KRISTEN P. JOSEPH
<br /> � ,,� .
<br /> � _*. ';:: Commissbn # DD 882627 -����"
<br /> �; `o; Expires April 21, 20'!3 �; *a Commission # DD 882627
<br /> �r . Expires April 21, 2093
<br /> � ;nnded7' , .�yFaminsutance80 385-70'lU
<br /> n°,�,�,,. ��dedi �FaulnsuranceNU 385-7U1;i
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