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<br /> � �� i�'T'ii�C'f�t�1S. '"he unrlers�gned understands that this permit may be subject to "deed° restrictions"
<br /> ,�t� � �► ��e1C�ae �t Cous�ty regulations. The undecsigned assumes responsibiiity for compliance with any
<br /> � ° ��7+GRS !�#D CONTRACTOR RESPON31BtLt'fiES: lf the owner has hired a contractor or
<br /> ��' ��.��, ���, �y �;y � requared to be licensed in accordance witM siate and local regulations. If the
<br /> ;�� �• ��� ���xed �y faw, k�otr� the c�wner and contractar may be cited for a misdemeanor violation
<br /> �. �►,. �_ ;fi� c� or ;nc�er��e�d can�actar are uncertai� as to what licensing requirements may apply for the
<br /> ��c� ' K. t�eti a�� a�rise�; tc co�tact :t�e Pasco County Building Inspection Division—Licensing Section at 727-847-
<br /> 3^,,�� �t�re ;r th�e awrner nas Rired a contrac#or or contractors, he is advised to have the contractor(s) sign
<br /> ���r,c��q�:�e �cc�irae�ar Bk3ck� of �rs applicat�on for which they wiil be responsibie. ff you, as the owner sign as the
<br /> ;,���� �taf r�,ay �e an +rgcficatra� mac tte is n��t prope�ly licensed and is not entitled to permitting privileges in Pasco
<br /> �. ��`- "_ .,
<br /> q-�p� �r��� �Ip RESOURCE EtE�OVERY FEES: The undersigned understands
<br /> � ��� � ;,�n, � F�S a�R�coexse Reco3o�y Fees rn�y appiy to the canstru�tion of new buildings, change of
<br /> ,,� ,n bu� ac ,�-s�f ea�cisisting buiki�ngs, as specified in Pasco County Ordinance number 89-07 and
<br /> ��-�;; �, .'T#�e ��.�iso unders�ands, that suc� fees, as may be due, wiit be identified at the time of
<br /> �er�.,�ztin�. �c is ��d that Transpwtatian Impact Fees and Resource Recovery Fees must be paid prior to
<br /> .�ce a� � o�ncy�' pr final power release. if the project does not involve a certificate of occupancy or
<br /> :,na; a�er ��se. �e fees m�st be paid pnor to Permit issuance. Furthermore, if Pasco County Water/Sewer Impact
<br /> ��es ar� �e, �ey rr�st be �icipr�x to permit issuance in accordance wtth applicable Pasco County ordinances.
<br /> C��C'�#0� t�lfl.�M�r 713, Florids Statutes, as amended): If valuation of work is $2,500.00 or more, I
<br /> �y t� �, �e a�i�, t�e been provideci �vitti a copy of the "Flarida Construction Lisn Law—Homeowner's
<br /> pi �e�paneci by �e Fbrida Depa�t�ent of Agriculture and Con�umer Affairs. If the applicant is someone
<br /> �, ����w�'', ! c�fy � 1 t�ave abt�ined a copy of the above described document and promise in good faith to
<br /> ; � � �,� "q�rn�" �' � ��ce�rient.
<br /> �'�1"C: 1 certify that all the inforrnation in this application is accurate and that all work
<br /> 4,�i#; �e dt�ne �n cornp�anc� witt� a#1 appticable laws regulating construction, z�ning and land development. Application is
<br /> �` herei�y � to obtain a permit to cio work and instai4atian as indicated. I certify that no work or installation has
<br /> �pmt€t�C+�if ptior :o issuance of a��rmit and that all work will be performed to meet standards of all laws regulating
<br /> �onst,ru�ti�r�, Cavnry ar►cl City codes zoning regula�ons, and land development regulations in the jurisdiction. I also
<br /> � cert�#�+ f urtders�and tttat the reguiations of other government agencies may apply to the intended work, and that it is
<br /> � my '�liry to iclentify what acticros I must take to be in compliance. Such agencies include but are not limited to:
<br /> _ - Depertment of Envsronm�ntal Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br /> � i.ands, WaterlWastewater Treatment.
<br /> ' - i,, S�aeihwest Fborida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
<br /> C* YyCliiTWYiJrv•
<br /> �
<br /> , - Army Co�rps o# Eng�eers-Seawalis, Docks, Navigable Waterways.
<br /> - 7�epartment of Heatth & Rehabilitative ServiceslEnvironmental Health Unit-Wells, Wastewater Treatment,
<br /> Septic Tanks.
<br /> - US Environment4d Pro�ec�an Agency-Asbestos abatement.
<br /> fe�,y qv�o¢t p�dxx't#y-Runways.
<br /> 1 understand that ��oNowirig �ic�ions appty to tt�e use of fill:
<br /> - Use of filt is r►o� a�owed in Flaod Zone "V" unless expressly permitted.
<br /> ff the fill rru�rial is to be used in Flood Zone "A", it is understood that a drainage ptan addressing a
<br /> "cornpensating volume" will be submitted at time of permitting which is prepared by a professional engineer
<br /> i�eensed by t#�e Stat+e of Florida.
<br /> � k - lf the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
<br /> 5 construction, { certify that fill will be used only to fill the area within the stem wall.
<br /> � - If fill material is to be �ased in any area, I certify that use of such fill will not adversely affect adjacent
<br /> properties. If use of fill i.s found to adversely affect adjacent properties, the owner may be cited for violating
<br /> the canditions af the builaing permit �ssued under the attached permit application, for lots less than one {1)
<br /> acre which are etevated by fill, an engineered drainage plan is required.
<br /> if ; am the �4GENT FOR THE OWNEA:, ! prom�se in good faith to inform the owner of the permitting conditions set forth in
<br /> `x� this affidavit pr�or io commencing construction. I understand that a separate permit may be required for electrica) work,
<br /> � plurnb+ signs, wells, poois, air con�itioning, gas, or other installations not specifically included in the application. A
<br /> perr�i� "� shaki be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
<br /> � set as+ y pFOVisions af the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
<br /> requirt correction of errors in plar,s, constructron or violations of any codes. Every permit issued shall become invalid
<br /> uniess�t�work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
<br /> m tne per��s suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension
<br /> � may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
<br /> �4,
<br /> justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned.
<br /> WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMM CEMENT MAY RESULT IN YOUR
<br /> PAYING TWtCE FOR IMPR E S TO YOUR PROPERTY. IF YOU INTEN TAIN FINANCING, CONSULT
<br /> WITH YOUR LENDER OR Y BEFORE RECORDING YOUR N C MENCEMENT.
<br /> FLORIDA JURAT (F.S. 117 0
<br /> OWNER OR AGENT GON?RACTOR_
<br /> Subscribed and swom to (or me this � Subscribed and swom to ore me this
<br /> by ✓o v t by �Lo ,�
<br /> Wh _�r,sonatiy known to me or has/have produced Wh personallv knnwn to me or ha �ave produced
<br /> as identification. as identification.
<br /> � �,
<br /> __Notary Public Notary Public
<br /> 4 D � _��-
<br /> Commi ion No. D �� o�-__� Commission No.
<br /> �.
<br /> Name of �lotary typed, printed or stamped Name of Notary typed, printed or stamped
<br /> �
<br /> """' KRISTEN P. JOSEPH
<br /> � _=���'�- '"��""' KRISTEN P. JOSEPH
<br /> _,.. � Commiss�on # DD 882627 =�'�� Commission # DD 882627
<br /> ' H� o;' Expires April 21, 20'!3 ;�• •
<br /> d „R��;;,�� ���ar a myFa�nlnsurarca80� 385d019 H o:= ExpiresApri121, 20'�3
<br /> _ . ��Pimo?c nnded i' �.y Fain Insurance80 385•7019
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