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l+t+C}T� pF pE�p RESTa1CT1C)NS The undetsigned understands that this permit may be subject to "d�ed" s"
<br /> y be more restrictive thari County reguiations The undersigned assumes responsibility for comptian ��i any
<br /> t�d r�ons.
<br /> C(IF�"#'RAC'i'� A#�FD C4hiTRACTOR RESPONSBlLITIES: If the owner has hired a contractor or
<br /> � unciertaice wo�ic, they may be required to be kicensed in accordance with state and local regulations If the
<br /> �s not #i+censed as required by law both the owner and contractor may be cited for a misdemeanar violation
<br /> e tav✓ If the owner ar intended contractor are uncertain as to what licensing requirements may apply for the
<br /> irrte� �+ork. they are advised :c contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
<br /> 80(3�.� rurthermore. if tne owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
<br /> aor#i�ns of the "cantrac;tor Biock" of this application for which they will be responsible. If you, as the owner sign as the
<br /> cantractar, t�at may be an indicat+on that he is not properly licensed and is not entitled to permitting privileges in Pasco
<br /> Gounty.
<br /> 'tRA1�P0►f�T/�TK�1 iMPA�CTftRILIT7ES lMPACT AND RESOURCE RECOVERY FEES• The undersigned erstands
<br /> that Transp�arta�on (rr�act Fees and Recourse Recovery Fees may apply to the construction of new bu�in "�' �. �ge of
<br /> �se in existing l�klings, or e�tsion of existit►g buildings, as specifted in Pasco County Ordinance numb '-f37 and
<br /> �-07, as ame�ded. The emdersigned also understands, that such fees, as may be due, wiN be identified at tFie time of
<br /> �err�itting. It is furt�er understood ttaat Transpo�ta�ion lmpact Fees and Resource Recovery Fees mus# be paid prior to
<br /> secetving a"certficate of occupancy" or final power release. If the project cfoes not invofve a certificate of occupancy or
<br /> finai power release, the fees must be paid pnor to permit issuance Furthermore, if Pasco County Water/Sewer Impact
<br /> #ees are du�, they must be paid prior to permit issuance in accordance with applicabls Pasco County ordinances.
<br /> C{3i�f�iRt�C't70fi�f LfEAI l.AW (Ch2�pter 713, Ftarida Statutes, as amended): If valuatian of work is $2,500.Q0 t�r more, I
<br /> certi�y that I, ttre appticant, have bEer+ provideci with a copy of the "Florida Canstru�ion Lien Law—ti s
<br /> Probection G�ide" prepared by the �lorida Uepartment of Agriculture and Consumer Affairs. I# the a�tiean# �s� '
<br /> oi#ter than t�re "awrre�', 1 certiify that I have obtained a copy of the above described document and ptomise in g� ff� to
<br /> ii to the "awrre�" pri� to com�ncement. k.
<br /> S�R'S AF�K}AViT� 1 certify that all the informatio�� in this application is a�tt+rate and �ralc
<br /> e in c�mpiiance with aH applicabie laws regula�ing construct+on zoning ar�d land dev�lo��t. A t� Fs
<br /> #� made to obta+r a permii: t� do work and instaltation as indica;ed. 1 ce�fy that nc wor� e� insta�.la�ian nas
<br /> `' cet; priar to issuance of a permit and that all work will be performEd to meet stanciarcis o� a## la�s r�gu�atFne
<br /> " n. County and City ccxies zoning regulations, and land develaprnent regulat�ans in t�re juriscf�ctio� � a#so
<br /> t f ua�ders#ar+d that the r�guiations of other gflvemment agencies may app�y to the +ntendec� ��k. arad that +t =s
<br /> r�y r�srbiiitv ta identify what acfions I must take to be in compliance. Sudi agenc�es indude txJt a�'e !�t E's�ed t�a:
<br /> � - Department af Envirorimental Protection-Cypress Bayheads, Wetland Areas and Envfronmen� Serrset#w�
<br /> ' Lancis, WaterlWasteuwater Treatment.
<br /> - Southwest Florida Water Management D�strict-Wetls, Cypress Bayheads, Vd�fl�d As� �
<br /> Water+co�tses.
<br /> - Army Corps of Enginesrs-Seawa!!s, Docks, Navigabie Waterways.
<br /> - Departmen; of Health & Rehabilitative Servi�es/Environmentai Hea�th Unit-Welis. �rVas#eu�xate� T�ni.
<br /> S�:ptic T�ks.
<br /> - �tS Emrisvnme�t�a! Protsction Agency-Asbestos abatement.
<br /> - Fede� Aviation Authority�ways.
<br /> i ur�arid tf�at the � restric�iorrs �ply to the use of fiil •
<br /> - ilse of fifl is nat afiow�! in Flood Zone "V" unless express#y permitted.
<br /> - !f the f�ll rnateria! is to be used in Flood Zone "A", it is understood tha# a dr�nage pi� a�ssi� a
<br /> "comper�sating volume" will be submitted at time af permitting which ts �r�ed by a pro� ,
<br /> f�ense� by tt� Sta�e of Flaida.
<br /> - 1f the fifi materiai is to be used in Flood Zone "A° in connectian with a �a� twiiding us�ng �t �
<br /> construction, 1 certify that f+ll wiH be used only to fill the area w�thin tt� stem vv�1.
<br /> - If fill materiai �s to be used i^ any area. I certify that use o# such fi�i vas� r�ot ad�y
<br /> .� ' properties If use of fill is found to adversely affect adjacen, praperti�, the aw►� s�+ be c�d
<br /> � the condi,ions of the �uilding permit issued under the attached pern�i a��pl�ca�on f� �ats kess f` '�" {ij
<br /> " acre which are elevated by fiil, an engineered drainage pian is requi�e�.
<br /> ff C AGENT FOR THE OV1fi�ER, I promise in good faith to inform El�� owr�er af tt� p� � sez fi� in
<br /> this vit prior to cammencing c�struction. I understand that a separate permi} may be reqe�red �ar w�x�c.
<br /> pt�r , signs, weils, pooEs, air condifioning, gas, or other ins#allations not sp�cii'ica�y inG�at#e� in t�e ��ra. {�
<br /> permi# issued shall be construed to be a license to proceed with the work and rx>t as a�,�xit}r tt7 veoia�e, c�. ��, a�
<br /> � set aside any provisions of the tecr�nical codes, nor shall issuance of a permit preuent the &t�g flffiaal f� �r��s
<br /> � requiring a correction of errors in p(ans, construction or violations of any codes. Euery pem�t issueci st� bec�x�e i���
<br /> unless the work authorized by such permit is commenced within six months of permi# i��, or i� a�k a�iz�t ��
<br /> the permit is suspended or abandoned for a period of six (6) months after the time tl� wo�#c is c€r��c�rd. Aaa �c�a
<br /> may be requested, in writing, from the Building Official fo� a period not to exceed E3ir�ety (9U} da�s ar�ti ��,�r�
<br /> justifiable cause for the extension. !f work ceases for ninety (90) eonsecutive days, the jo� is c�s�rsd at�n , .
<br /> ;,,.:
<br /> WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTiCE O� C M11Y �� �f Y�l�
<br /> PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. If YOU iPtTEi�i� Al�l RNANCN06, C+�T
<br /> WITH YOUR LENDER OR AN A Y BEFORE RECC)RQ1NG YOUR NOTICE
<br /> FLORIDA JURAT (F S. � 17 p3) �
<br /> �, ,
<br /> OWNER Of2 AGENT CONTRACTQit
<br /> Subscribed and swom To (or affirtned) re me this Subscribed and swom to (o afiote me #ris
<br /> by �eNN Lx ✓E�� _ b} �of,��a! ttol���
<br /> V�is/�g personalry known to me or hasR�ave produced Who isl�e personaNy kna�m to me �#�tra+re prode�ed �
<br /> as identification. '°°' � i�ion. °;���
<br /> f ; I , �- ,
<br /> _ ~--� _�„_NOtary Public r
<br /> Commi�ipn No ��✓ �L� Commission No �r� 2.�0 �
<br /> ,
<br /> Name ota t ed, rinted or stam e � Name o: Notary typed, printed or stamped
<br /> a;��gY A� KftISTEN P. JOSEPF�
<br /> O: B(•�� y���U��
<br /> :* ' .�. Comrrnssaon # D� 882ti27 �:�°s�. KRISTEN P. JOSEPN
<br /> =�a• oe EYp'tres P,pril 21, 2013 ��.. .-
<br /> *; ..: Commiss�on # DD 882627
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<br /> ;���dedT' ;Fan�InsuranceBU 365-7U1:r '
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