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<br /> �►lOTtCE Of DEE[! RESTRICTI4NS� The unctersigned understands that this permit may be subject to "d�ed". ` i s
<br /> wfi� rnay be rnare restrictive than Caunty regulations. The undersigned assumes responsibility for complian ,,:tki any
<br /> d�ed re�idio�s.
<br /> C(I�TRACTORS AND CO�fTRACTOR RESPONSIBILITtES: If the owner has hired a contractor or
<br /> ca�ctors to undert�ake w�o�ck, they may be required to be licensed in accordance with state and local regulations If the
<br /> � na# {�sed as required by law, both the owner and contractor may be cited for a misdemeanor violation
<br /> u ` state iauv. !f the owtner or irrtended contractor are uncertain as to what iicensing requirements may appiy for the
<br /> int� w+o�c. tl�ey are ad�n�i tc ccmtact the Pasco Counfy Building Inspection Division—Licensing Section at 727-847-
<br /> 80t�9 F�sr�nr�are, if �te owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
<br /> �ortions af the "c�rtra�ctor Blodc� af this application for which they will be responsible. If you, as the awner s�gn as the
<br /> contractor, that may be an indication that he is not proper{y licensed and is not entitled to permitting privileg� in Pasco
<br /> Couniy.
<br /> �RAl�S�t3�TAT�ON tlIAPACTNT1LITlES IMFACT AND RESOURCE RECOVERY FEES: The undersigned ,,erstands
<br /> that Trarrspasta#ion {�act Fees and Recourse Recovery Fees may apply to the construction of new bui�din ' a�ge of
<br /> use in existing buiidings, ar expansion of existing buildings, as specified in Pasco County Ordinance numb -07 a�d
<br /> 90-07, as amer�ded. The undersigned a�so understands, that such fees, as may be due, wiN be identified at ttj'e tirtte of
<br /> ' permii��g It is further untierstoad that Transportafion fmpact Fees and Resource Recovery Fees mus# be paid prior to
<br /> rea�i� a"cert�ficate of occupan+:y' or final power release. If the project does not involve a certificate of occupancy or
<br /> �` fma� pcf�rer re�ease, ��ees rrtust be paid prior to permit issuance. Furthermore, if Pasco Co�n#y Water/Sewet' fmpa�t
<br /> #ees are c3ue, tl�ey rru►st be paid priar to pe,�mit issuance in accordance with applicable Pasco County ordinar�ces.
<br /> � UEN UlW (Ch�ter 713, Ftorida Statutes, as amended): If vatuation of work is $2,500.(30 r�� more, I
<br /> ��tat I, the a�pC�cant, have been provided with a copy of the "Florida Gons� Lien Law—H s
<br /> .�' �rot�;ction Guide' prepared by tt�e Flarida Department of Agriculture and Consumer Affairs. ff the a�fican# �s� ;"
<br /> i o�er than the "ou�me�'. I certify that I have obtained a copy of the above described documen# and �omis+e i� g� fss� tfl
<br /> deliver it to the "awnet" prior to con�mencement.
<br /> � , CTOR'S,�OYY'I�fER'S AFFtDAV1T: 1 certify that all the information in this apptication is a�axarate and tl'r�`� r�c
<br /> w�i i��done in compiiance with all appticabie laws regulating construct'ron zoning ar�d land deYe�pmerst. Ap�at�arr Es
<br /> her�y ma�e to obtain a permit to do work and installation as indica#ed. I ce�ifiy tttat no wror9c ar in has
<br /> ced pn�r t� �ssuance of a permit and that ali work wilf be perfarmed to meet sfiand�tls �' a� laws re��lafirig
<br /> "on, Gounty arrd City ct�fes, zoning. r�ula#ons, and tartd develaprnent regulations i� ihe juri�n � a�so
<br /> ` ce�y tha# I ut►derstand Uiat the regr�kations of other govemment agencies may appiy to the inter�eCi work, � ttt�t it is
<br /> my responsibit�ty to iden6fy what actions I must take to be in compfiance. S+�ch agerrcaes indude t�ut are r� 1i�r�wted ie�:
<br /> - De�artment of Environm�ntal Protection-Cypress Bayheads, Wetland Areas and Envir�rr�en� S�iv�
<br /> Lands, Water�M1Nasteq,vater Trea�r►ent.
<br /> - Southwest Florida Water Management District-Weils, Cypress �3ayheads, Vd� A��,
<br /> Wa#ercaurses.
<br /> - Army Corps of Engineers-Seawalls, Docks, Navigab4e Waterways.
<br /> - Department of Health & Rehabilitative Servi�es/Environmental hieakth Unit-1+�ells, Wastews#�r�'��t,
<br /> Se�c T2nics.
<br /> - U8 Ernriroc�rr�ental Protection Agency-Asbestas abaternent.
<br /> ` F� Awiation Auttrority-R�ways.
<br /> ` ( un�r�d ithat the fol�g restrictiorts apply to the use of fi11:
<br /> t - Use of fiil is not aPlaweci in Fload Zone "V" unless expressly �rmatted.
<br /> - If the fill material is tfl be used in Flood Zone "A", it is understoed tha# a cfra�nage �f� �ng a
<br /> ' "compensating volume" will be submitted at time of permifting w{�ich is �repared by a Exo#essi�ai
<br /> � t+r;ensed by the S#ate of Flarida.
<br /> ' - If the fi{{ material is to be used in Flood Zone "A° in connection with a�em�aEted bu�iirog c�i�+g �S a�
<br /> cortstruction, I certify that fitl wilf be used only to fill the area within tkre stem +�i.
<br /> - If fili material is to be used in any area, I certify that use o� such fi� w� r�at advecsely
<br /> �' properties. If use of fifl is found to adversely affect adjacent �ro{�ties, the c�mef rrray be ta�Cf
<br /> the conditions of the building permit issued under the a#�ched perrr�t a�s��an, f� �c�s 6ess � �"fi�
<br /> acre which are elevated by fill, an engineered drainage plan +s required.
<br /> I` I a� kfie AGEM#" FOR Thf� OVIf1�ER, I promise in good faith to inform the ow,rr�er of the �t�g sez ;rarC#� ir�
<br /> ' this 2�davit prior to commencing construction. I understand that a separate permit may be reqc�red i� �c.
<br /> , pfum�ing, signs, weils, pools, air conditioning, gas, or other ins#aUations not speci#rca�ty �s�cluded i� t� �o�?. �,
<br /> permit issued shall be construed to be a license to proceed with the warlc and nat as aut#�ity t� v�otate c�. ��, ar
<br /> set aside any provisions of the technical codes, nor shall issuance of a permit prevent tlie 8�g C�iciiat ��er�
<br /> requiring a correction of errors in p(ans, construction or violations af any cocfes, Every permit is.s+.�ed s#�a� b�
<br /> unless the work autr�orized by such permit is commenced within six months of per�� i�ce, c�r �f v,�r#c �ibr�z�et# �jr
<br /> the permit is suspended or abandoned for a period of six (6) months after the time the �fc �s ct��. A�a
<br /> may be requested, in writing, from the Building Official for a period not to excee.tl nir►�ty {94) � a�ti wi� �e
<br /> justifiable cause for the extension. If work ceases for ninery (90} consecutive days, #he }ob is ai�a�nc�ec#.
<br /> �• :,
<br /> WARNtNG T� OWNER: YOUR FA►ILURE TO RECORD A NOT1C� O� C W4Y ��' ai �
<br /> � PAYIN:G TWICE Ff?R 1MPR0 ENTS TO YOUR PRO#�ERTY. IF YOU INTE�iD T AIN F�tA11CN1�, C�T
<br /> " WITH � UR LENDER OR NEY BEFORE RECORDING YQUR P{OT
<br /> � FLOR)�A URP.T ;F S; �,' 03}
<br /> OWNBii� �!2 AGENT CONTRACTOR
<br /> �; Subscrilyed and swam to (or affi fore me this Subscribed and sworn to (or } bedore me �
<br /> °.� aY � � by ToNai �.avf�+�/
<br /> V i is/�g personalry known to m� or has/have produced Who is/�e �e�on�y knam tO me a#�e�e prod�
<br /> as identification. "'°"' °-�----"— � �. .'�;
<br /> t�
<br /> � ,�,� 1 _ Notary Public �
<br /> Commission No. �� ��- 1 Commission No. � 2.(p �
<br /> , Name t5f ota ed, or stam�ed Name of ivotary typed, prirsted or starnped
<br /> �.����„ ,r
<br /> = ��� K Cotnmis�on # DD 8'LG27 � � �"
<br /> - ; �� .�.,. KRISTEN P. JOSEPH
<br /> �; •�; Expires April 21, 20'I� _*. ;:_ Commission # DD 882627
<br /> , '.�,',p �;F;°� �na�a r� � r-an� �nsurance en ba5au,y "'.� N�� Expires April 21, 2093
<br /> c.
<br /> ^ ' , nded i Fau��nsurenceBU ,185=/61:�
<br /> �� ��f �i�
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