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<br /> hFQT'�C� C}F [yEED RESTRiCTtOWS: "fhe undersigrted understands that this permit may be subject to "d�ped" ` s"
<br /> ,r�ay be more restr+c#ive tfian Caunty regulations. The undersigned assumes responsibiliry fo� complianC }-. itfi any
<br /> � f�7�bQItS.
<br /> D CONTRACTORS AFfD CONTRACTOR RESPONSIBILITIES• if the owner has hired a contractor or
<br /> #� ur�ce work, they may be required to be licensed in accordance with state and local regulations If the
<br /> � r�at i�d as requireci by law, both the owner and contractor may be cited for a misdemeanor violation
<br /> �!aw if the owner or intent{ed coritractor are uncertain as to what licensing requirements may apply for the
<br /> ir��ed w!ork. tl�y are advis� ta contact the Pasco County Buifding Inspection Division—Licensing Section at 727-847-
<br /> 80t?�. Furth�Ore, if the owner has hired a contractor or contractors, he is advised to have the cflntractor(s) sign
<br /> �or�ons af the °coretractor Bbck" of th'ts application for which they will be responsible. If you, as the owner sign as the
<br /> cont�actor, that may be an indication that he is not properly licensed and is not entitled to permitting privileg�s in Pasco
<br /> Co�nty.
<br /> TRI�S�TATION tMPACTitlT1L1TIES fMPACT AND RES4URCE RECOVERY FEES: The undersigned erstands
<br /> thai Trartsp�tation Empact Fees and Recoursa Recovery Fees may apply to the canstruction of new b�din '�an�s of
<br /> u�e it� e�sting bctiEdings, or expansion of existing buildings, as specified in Pasco County Ordinance numb `-07 a�d
<br /> #�' 94-0T, a�s arrr�c�d. The undersigned also understands, that such fees, as may be due, will be identified at tne time of
<br /> ' p�. lt is fvrthe� understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
<br /> � a"cert�ficate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
<br /> �aet pp� rewease, ttse fees must be paid prior to permit issuance Furthermore, if Pasco County Water/Sewer Impact
<br /> �' �es ana t�e, they rr�.st be �d priw to permit issuance in accordance with appiicable Pasco County cxdinances.
<br /> fi�� L�+f LAW (Ctiapter 713, FEorida Statu#es, as amended): If valuatian o€ wor#c is $2,5U0 00 �r mare, I
<br /> ce►fi#y tha# I, ttre �pEicant, havs been provided with a copy of the "FloRda Constnx�ion Lien Law—H s
<br /> Pra�ectian Guide° prepared by the Florida Department of Agriculture and Consumer Atfairs. ifi tfte �iieant bs ' ne
<br /> ath�r than the "awner", I cer�fy that I have obtained a copy of the above descr+bed docurnent and pramise in g�d faith to
<br /> defi+rer it to the "ownei" priar to commencement.
<br /> <,,,,
<br /> C"tiaR'SJ�MYI�IER'S AF�tDAVtT: I certify that a11 the information in this a�ptication is �rate a�td �orfc
<br /> r�tl �re 'rn comp{'rance v,�th ali appiicabfe laws regulating construction zoning and land de+velopment. Ap�a#iaa� Es
<br /> h� mac�e fo obtain a permit to do work and instaAation as indica#ed. I ceftify ihat no waric or in �as
<br /> priar to +ssuance af a permit and that all work will be performed to rr�eet st�nda►ds af aN ian�+s re�#at�s�
<br /> 'an, County and City codes, zoning regulations, and larrd devefoprnent re�.�lations in the j�.tr�or� � a3�o
<br /> ce that ! understand #�at th� reguiations of other govemment agencies may appty to the intended �ork, aar� tha# i# s
<br /> my responsiGiii#y to �d�ntify what actians I must take to be in compiiance Such agencies indude but a�e +� €�ed t��
<br /> - Department of Enviranmental Protection-Cypress Bayheads, Wetiand Areas and Envir�srr�ent�y Se�rr��e
<br /> Lands, Water/W�stewater Treatment.
<br /> - Sau#hwest Florida Water Management D�strict-Welis, Cypress E3ay�ie�.s, VV�#tand A,re�
<br /> Wa#ercot�r�s.
<br /> - Army Corps of Engineers-SeawaAs, Docks, Navigable Waterways.
<br /> - Department of Health & Rehabilitative Servi�es/Environmental Health Unit-Welts, Wastewater��;�,
<br /> S�c T�tks.
<br /> -�{ �� US Ernircxtrr�^rtal PrQtection Agency-Asbestos abatement.
<br /> . _ F� Aviation Au#horitj+-R�nways.
<br /> 1�de�s�and t#�at the folio�ng testiictions aPpIY to the usQ of fiA�
<br /> ;� - Use af fiit is not attoweci in Fload Zone "V" unless expressiy p�em��.
<br /> �" - If the fiE! material is to be used in Flood Zone "A", it is understood that a dr�riage pt� a
<br /> "compensating volume" will be submitted at 4me of permitting wflich is �re{�ed by a profie�io�a# �
<br /> f�censed by the S#a�e ofi Florida.
<br /> - If the fi!I material is to be used in Flood Zone "A° in connection with a pem�ritted tw'siding using ��
<br /> construction, ! certify that fill will be used only to fiil the area within the stem waii.
<br /> - If fill material is to be used in any area, I certify that use � such fi� wr�N rtat azi+ee,�se�r
<br /> ; praperties. If use of fiff is found to adversely affec# adja�ent praper#ie.., the awFr�er �ray be �d
<br /> the conditions of the bui{ding permit issued under the attactted pem�t a#�ca�ot�, ��o�;s 6� y '�'�)
<br /> acre wfiach are elevated by fill, an engineered drainage ptan is required.
<br /> If f arrt the RGEN7 FOR TFiE OWNER, I promise in good faith to inform t�e awner af the �rmi#f�g � s�z f� in
<br /> this a�avit prior to commenang construction I understand that a separate pefmit may be rec�trirecf far a,+�r�c,
<br /> pturnbir�g, s�gns, weils, pools, air conditioning, gas, or other instalfations not speci#icahly inGud�d i� �e " fiurra. A
<br /> permit Rssued shall be construed to be a license to proceed with the work and nflt as auth�or�ity to v�oiake, car�c�et, a��, or
<br /> set aside any provisians of the technicai codes, nor shall issuance of a permit prev�at the B�g C?ff'�ia1 ��#�
<br /> requiring a correction of errors in pians, construction or violations of any codes. Every p�rrr�# tssueti s� b�e �nwa#ti.
<br /> unless the work authorized by such permit is commenced within six months ofi permit is��e, t� i# urc�t#c �,;
<br /> the permit is suspended or abandoned for a period of six (6) months after the tirr�e the v�c �s cx�x��. A�
<br /> may be requested, in writing, from the Building Official for a period not to ex� nir�ty ($f?) � ar�d r�k �,�e
<br /> justifiable cause for the extension. ;f work ceases for ninety (90) consecutive days, the � is co�sicf�ed abant�ed,
<br /> t
<br /> WARN1�iG TO OWNER: YOUR F'AtLURE TO RECORD A NOTiCE OF C p�4Y ��' �
<br /> PAYlNG TWICE FOR 1MPROVE YOUR PROPERTY. IF YQU fNl'E�dD TtD OBT �C��T
<br /> WITN � UR LENDER OR B FORE RECORDING YOUR Af0'i10E
<br /> FLORIt7i0. JURAT (F S 117 03) ,
<br /> (SWNER OR AGENT CONTRACTOR
<br /> `�-� Subscribed and swom to (or affirtned) fore me this Subscribed and swan to (or affam �s
<br /> ' by e N by ToH �. t
<br /> Vyj�s1� personalry known to ms or has/have produced Who i s/�e personaqy known to une or t�na produo�
<br /> as identification. "— —"�"' � �, ;`!�:
<br /> i -
<br /> �
<br /> Notary Pubhc
<br /> Commiss� No �D �J� �-� Commissian No � �.�
<br /> `� Name t� �o�ry typed �te�r stam e Name of Notary typed, prin#,ed or stamped
<br /> ' �,�.Y "'�.,, KRISTEN P. JOSEPH
<br /> ;�,. ,,,���,.,
<br /> _*. .,� Comrr�.ssaon # DD 882G27 ; �;�:^s:�.,, KRISTEN P. JOSEPH
<br /> � a' Expites April 21, 2053 :�: .; Commission # DD 882627
<br /> :�p ��N� �, , � 5-�u,y �,�Q � Expires April 21 2093
<br /> d nded . v f-a r Insurence8 'Jd � �
<br /> ' �ii ��`� tl , �0`�ed'i' '�a����fnsuranced;�� e85•f01'. '
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