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pi���F p�ttt qEST1liC'flOI�1S: �"he undersagned understands that this permit may be subject to "deed" restrictions"
<br /> �,r� b� nsa+e ��an Caxery regulatians. The undersigned assumes responsibiiity for compliance with any
<br /> �� � ` � Cf?NTRACTOR RESi�OFt51BlLtTIES: If the owner has hired a contractor or
<br /> �� #� w�c, t#� rr�,y tse requ�red ro be iicensed in accordance wi� state and local reguietions. If the
<br /> �? �� �of ��sed as rec�uirec :.;� !aw x:~ the awner and contractor may be cited for a m4sdemeanor violation
<br /> �` „��r I�r r= ;��e o�ef o� :r,c�.��ed concraccor are uncertaic► as to what licensing requirements may apply for the
<br /> . t�,�eti aa� �sec :c c7�tacz ;he Pasco County Bui4ding Inspectian Division—Licensing Section at 727-847-
<br /> �,�g� �, �; c� c�t+� �r�s nired a cantractor or contractors, he is advised to have the contractor(s) sign
<br /> ;, • -�� �" a# '�,s ap#�l�cat;on for which tney will be responsible. tf you, as the owner sign as the
<br /> � i� r�say t� a� t�ca�ior thac ne �s nct properly licensed and is not entitled to permitting privileges in Pasco
<br /> .a .�.
<br /> � AT�p�i �'p��CT�l�&�i�-lMPACT AN� RESC)�tJRC� RE€OVERY FEES: The undersigned understands
<br /> r��, �r�� �at F�es as��i,�cse Recovery Fees may apply to the c�nstruction of new buildings, change of
<br /> „se ;� e� or e�.�f axisting buikiings, as specified in Pasco County Ordinance number 89-07 and
<br /> �:�._�- �` . T� -akso un�ersta�ds, that such fees, as may be due, wilt be identlfled at the time of
<br /> �er;,�,rt;n�. ,t is �,,� u�d fftat Tramsportation Impact Fees and Resource Recovery Fees must be paid prior to
<br /> �pc��v;ng a°ce�1e �f o�x,�ar�cy' c,r final �wer r�ease. If the pra�ect does not involve a certi�cate of occupancy or
<br /> Fr�aq ua�er r�e, �e i�ses must be paid prior to permit issuance. FurEhermore, if Pasco County WaterlSewer Impact
<br /> ;ees a�$,�e, �ey rt�t baa p�eidpria �o perrrrit iss�rance in accordance with applicable Pasco County ordinances.
<br /> t� 'T1011 t,Elt�� 7t3, Ficrit�a Statutas, as amended): If valuation of work is $2,500.00 or more, I
<br /> c�y � F, ti�e a�p�c�, t� been provicied v,rith a capy of the "Flarida Construction Lien Law--Homeowner's
<br /> pr Guid�e' � by the Fbr�la D�'►ent of Agriculture and Consumer Affairs, If the applicant is someane
<br /> c� t�t� �re °o�`, i ae�lify tlr� t have obtained a copy af the above described document and promise in good faith to
<br /> d�rrer it � rie °o+�et" P�ioF � c�a�n'�stu�mertt.
<br /> � q�lEtA�T: I oertify that all the information in this application is accurate and that all work
<br /> ,vi�� ae ���ce with a#I applicable laws regulating construction, zoning and land development Application is
<br /> ner,et�y rnad�e � obt�n a perm�t to do work and installation as indicated. I certify that no work or installation has
<br /> � , pti�r t� issuance of a�ermit and that all work will be performed to meet standards of all laws regulating
<br /> ' Cc�ty anci City c�es, zoning regulat�ns, and land development regulations in the jurisdiction, I also
<br /> ce� un�tand that the regulatio�s of other government agencies may apply to the intended work, and that it is
<br /> �y � ity io ide�tiifiy what actions I must take to be in compliance. Such agencies include but are not limited to.
<br /> - =Dep�trnent o# Envtronmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br /> ' � '�'Larsds, Water,'Wastewate:r Treatment.
<br /> - Southwest Fioriaa Wate�r Managernent District-Wells, Cypress Bayheads, Wetland Areas, Altering
<br /> ' Watereourses
<br /> . . Army Corps of Engineers- Dacks, Navigable Waterways
<br /> - �artment af Health & Rehabi{itative Services/Environmental Health Unit-Wells, Wastewater Treatment,
<br /> Sep�tOC Tanlcs.
<br /> _ Ug En�tal pso�tion Agency-Asbestos abatement.
<br /> F� Arvo�ott A�y-Re�nways.
<br /> 1 under�tand that the foNvwdrtg �ic�fons apply to the use of fill:
<br /> - Use of fill is not a�wed itt Fiood Zane "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 /> "cx3mpe�s�atir�g v�ume" will be submitted at time of permitting which is prepared by a professional engineer
<br /> ticer►sed by the SYafie ofi Florida.
<br /> If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
<br /> constructian, f certify that fill wi11 be used only to fill the area within the stem walf.
<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. !f use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
<br /> the conditions of the builaing permit �ssued 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 /> t, if � am tt�e A�ENT FOR THE OWNE�, ! prom�se �n good faith to inform the owner of the permitting conditions set forth in
<br /> mis affic�it pnor to commencing cor�suuct�on , understand that a separate permit may be required for electrical work,
<br /> plur�i ' ns wells, pools, air cor��itioning, gas, or other installations not specifically included in the application. A
<br /> perrsaii '` shall be canstrued to t�e a license to proceed with the work and not as authority to violate, cancel, alter, or
<br /> set y pravisions of the technic.al codes, nor shall issuance of a permit prevent the Building Official from thereafter
<br /> req�r�ri ��orrection of errors in plans, construct�on or violations of any codes. Every permit issued shall become invalid
<br /> unfess work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
<br /> the per��s suspended or abandort�;d for a period of six (6) months after the time the work is commenced. An extension
<br /> may be Fec�uested, in wri�ing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
<br /> �ustifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned.
<br /> WARNlNG TO OWNER: YOUR FAt URE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br /> PAYING TWlGE FOR IMPROVE E O YOUR PROPERTY. IF YOU INTEND BTAIN FINANCING, CONSUL7
<br /> WITH YOUR LENDER OR AN FORE RECORDING YOUR NOTI MENCEMENT.
<br /> FLORIDA Jl1RAT (F.S 117.03)
<br /> OWNEP. OR AGEt�T _ :QNTRAC:TOP. —
<br /> Subscribed and swom Yo (or afftrmed me this Subscribed and swom to (or a ) fore me this
<br /> by ✓oHN L�v�t�l bY
<br /> Wh i are personaUy known to me or has/have produced Wh personallv known to me or ha ave produced
<br /> as identification. as identification.
<br /> �� � --- '� ".
<br /> otary Publ�c Notary Public
<br /> Commission Na D D �� c�__� Commission No � D� _�P� �i
<br /> t Name of 9�� �ry typed, printed or stamped Name of Notary typed, printed or Stamped
<br /> ;
<br /> � ••` I � ,��,+ KRISTEN P. JOSEPH
<br /> =�: .:. ,r Commiss�� # DQ 882627 ..:�:�"'" °�,. KRISTEN P. JOSEPH
<br /> -�^� o, Expires April 21, 20'�3 =*: � Commission # DD 882627
<br /> �:;�. �' � ExpiresApri121,20'�3
<br /> ��°�`� ;�ndedT�_ cyFa�rinsurance80� 385-70'19
<br /> �'rPf���, a�dedi' yFawlnsuranceBU' 385-701!i
<br /> .. ..,..W:...m�Wa.
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