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t�TtCE pF p�D : The undersigned understands that this permit may be subject to °deed" restrictions"
<br /> wtric� rna�y be mare �e than Counry regulations. The undersigned assumes responsibility for compliance with any
<br /> � f�96�t� �IC�•
<br /> V�,�; qdD CONTRAC70R RESPONStBtLITfES: If the owner has hired a contractor or
<br /> co� b nn�i� a�ck, riey may be required to be ticensed in accordance with state and local regulations. If the
<br /> n�ot N� � required by law, both the o�+vner and conttactor may be cited for a mESdemeanor violation
<br /> �nci�r 1a�+�r, tf the owner or intended contractor are unceRaiR as to what licensing requirements may apply for the
<br /> ,n . They ar� advised to cantact the Pasco County Building inspeetion Division—Licensing Section at 727-847-
<br /> gE}pg, e if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
<br /> �he `c�on€ra�r B�adc° af !h�s applicat�on for which ihey wiil be responsible. If you, as the owner sign as the
<br /> cor��,� �tat may be an indecation that he is not properly licensed and is not entitled to permitting privileges in Pasco
<br /> �' ;'
<br /> T��TATiON lYPACT!lJTtL�1�S-�MRACT AND RESOURC� RE�OVERY FEES: The undersigned understands
<br /> c#►at T�a�epoNe�►-� � a�R�c�u�se Recovery Fees may apply to the construction of new buildings, change of
<br /> �se in e�siia� buiid'�, a�rrsion-of eaas�ing buildirags, as specified in Pasco County Ordinance number 89-07 and
<br /> g0-p7 as �. '�he rndee�gned-�sa understar�ds, that such fees, as may be due, wilt be identified at the time of
<br /> �rr€�s�g. 1t is fiuther urx3erslood that Tr�sportation Impact Fees and Resource Recovery Fees must be paid prior to
<br /> {ecee�g a°o�e +�# oce�paracy' or finat power retease. If the pro�ect does not involve a certificate of occupancy or
<br /> fina� pa�€ r+�se, the fiees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
<br /> iee.s are �e. �ey must be paid pri� to permit issuance in accordance with applicable Pasco County ordinances.
<br /> LI@N t.11DMlf � 713, Florid� Statutes, as amended): If valuation of work is $2,500.00 or more, I
<br /> c�y that t, �e .a�t, haLre been provided with a copy of the "Flarida Construction Lien Law—Homeowner's
<br /> Pra�nn Cxiide' p� by the Flori�a DepartFnent of Agriculture and Consumer Affairs. If the applicant is someone
<br /> otl� �ran �e `o�wne�', 1 c�rtiiy �rat 1 have �btained a copy of the above described document and promise in good faith to
<br /> delir+er it b 1he `0�' Prior � Qp�n�cement.
<br /> C S,�fEVlT: I certify that all the information in this application is accurate and that atl work
<br /> wi41 be dc�r�e in � wifh aN appticabie laws regulating construction, zoning and land development. Application is
<br /> hereby rnacie to ab�+n a pertnit to do work and installation as indicated. I certify that no work or installation has
<br /> com�nenoed p�r to i�oe af a permit and that all work will be performed to meet standards of all laws regulating
<br /> cons�ru�n. County and City �s, zoning regulations, and land development regulations in the jurisdiction, I also
<br /> � ce�y ' 1 understand that the regulations of other government agencies may apply to the intended work, and that it is
<br /> my �{ity to itientiiy what actions I must take to be in compliance. Such agencies include but are not limited to:
<br /> ; - ��, Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br /> ! }�` Lands, Water/Wastewater Treatment.
<br /> � - Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
<br /> � �� Wa�rcours�s.
<br /> � - Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
<br /> - Departrt�ent of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
<br /> Septic TaMcs.
<br /> - US Envirorx�entat Protection Agency-Asbestos abatement.
<br /> - Fed� Aviatiort Pw�ority-Rcinways.
<br /> I understand that ihe fdbw� e�ic�ions apply to the use of fill:
<br /> - Use of filt is not a�owed in Fkood Zone "V" unless expressly permitted,
<br /> - If the fill materia! is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
<br /> "compensating voiume" will be submitted at time of permitting which is prepared by a professional engineer
<br /> fic:ensed by the State ofi Florida.
<br /> - If the fitl material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
<br /> construction, I certify that fill will be used only to fill the area within the stem wall.
<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. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
<br /> the conditions of the buiiding permit issued 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 /> If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
<br /> this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
<br /> plur�+ �igns, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
<br /> � pern�it ' shak! be canstrued to be a license to proceed with the work and not as authority to violate, cancel, alter, or
<br /> • set as� _ y pcovisions of the technical codes, nor shall issuance of a permit prevent the Building O�cial from thereafter
<br /> � requiri correction of errors in plans, construction or violations of any codes, Every permit issued shall become invalid
<br /> . unless wark authorized by such permit is cornmenced within six months of permit issuance, or if work authorized by
<br /> � the per�+s suspe�ded or abandoned for a period of six (6) months after the time the work is commenced. An extension
<br /> may be rec}uested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
<br /> justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned.
<br /> WARNING TO OWNER: YOUR AILURE TO RECORD A NOTICE OF COMME EMENT MAY RESULT IN YOUR
<br /> PAYING TWICE FOR IMPROV O YOUR PROPERTY. IF YOU INTEND AIN FINANCING, CONSUL7
<br /> WITH YOUR LENDER OR O BEFORE RECORDING YOUR NO C ENCEMENT.
<br /> FLORIDA JURAT (F.S. 117.03
<br /> OWNER C'R AGENT G7tdTRF�.CTOR
<br /> Subscribed and swom to (or a re me this Subscribed and swom to e) fot'e me this
<br /> "1 2p• 11 by ✓o v �• \� by
<br /> Wh ' personally known to me or has/have produced Wh personallv known to rrLe or ha ave produced
<br /> as identification. as idenbfication.
<br /> .� Notary Public ' ° Notary Publlc
<br /> Commission Na � ���o�� Commission No. D D _�P �
<br /> Name of qi�tary typed, printed or stamped Name of Notary ryped, printed or stamped
<br /> � •," „';,,' KRISTEN P. JOSEPH ,,,,,,,,,,�
<br /> � -�i���c : : �` P -, KRISTEN P. JOSEPH
<br /> :*. °�; Commission # DD 882627 '
<br /> � � := Commission # DD 882627
<br /> � .� r � - ExpiresApri121,20'!3 ``' � �
<br /> 'F" ����~ QnndedT!ir,� ,pyFy�nUqW3nce80i-385-7019 �o�� ExpiresApri121
<br /> , ��r°�j��';i� onded T' y Fain InSUrenCe 80' 385-7015
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