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�T�� p�p q�11p�iS; The undersigned understands that this permit may be subject to "deed" restrictjons"
<br /> ������n C�nty regulations. The undersigned assumes responsibiiity for compliance with any
<br /> ���'��g � CpNTRACTOR RESPONStBfLiTlES: If the owner has hired a contractor or
<br /> � tr-e� to be ticensed in accordance with state and locai re�}ulations. If the
<br /> oarr�.itt � �, �Y �►ay be requ
<br /> ����red by taw, both the owner and contractor may be cited for a misdemeanor violation
<br /> I for the
<br /> ��� � rf �� c�r intended con�aetor are uncertain as to what licensing requirements may app y
<br /> E� ,�ey are adv+sed to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
<br /> �pg. rn�e, if the oumer has hired a contractor or contractors, he is advised to have the contractor(s) sign
<br /> , �• =�e "ountrac�or �dc° of �is appl►cauon for which they will be responsible. If you, as the owner sign as the
<br /> �hat may be an in�ation that he is not properiy licensed and is not entitled to permitting privileges in Pasco
<br /> ' ����f/�TMpip I�pCTAfI�{Lt�i�SS-iMPACT AND RESOURCE RE�OVERY FEES: The undersigned understands
<br /> �# ,��_� � a�c� t��oouFSe Recovery Fees may apply to the construction of new buildings, change of
<br /> ;�,� m e� b�r�s,, or e�r�on. of existing bui�ings, as specified in Pasco County Ordinance number 89-07 and
<br /> � �� ���SO und,erstands, that such fees, as may be due, will be iden�fied at the time of
<br /> p�r�tting It ss �er unde�s�sd that Transpartation Impact Fees and Resource Recovery Fees must be paid prior to
<br /> ��,�;,,;,� a 4�e �f o�upranc�' or final power release. If the project does not involve a certificate of occupancy or
<br /> f,�� p� �e, �e iees m� be paid prior to permit issuance. Furtttermore, if Pasco County Water/Sewer Impact
<br /> f� � ��� p�i�pr�r to pefmit issuance in accordance with applicable Pasco County ordinances.
<br /> �,w�{�G��pp LiLNi,�llff�' 713, Ftcrida Statutes, as amended): If valuation of work is $2,500.00 or more, I
<br /> � t�t t, i� .appi�. E�e been provided with a copy of the "Florida Construction Lien Law--Homeowner's
<br /> pro�edi,an Guicie' prepared by the Fbrida Depart�►ent of Agriculture and Consumer Affairs. If the applicant is someone
<br /> ��rr �e o�",1 c�t g�rat t have obtained a copy of the above described document and promise in good faith to
<br /> � i�i� U�e `0�' P� � ��
<br /> �'T: { oertif}r that all the information in this application is accurate and that all work
<br /> �,y}#� � dane in c�►oe wwith aN applicab4e laws regulating construction, zoning and land development. Application is
<br /> ��y m�e ta o�in a pe�mit to do work and installation as indicated. I certify that no work or installation has
<br /> �� p�eor to i�ce af a permit and that all work will be performed to meet standards of all laws regulating
<br /> ;fl ��, Co�rrty aru3 City c�odes, zoning regulations, and land development regulations in the jurisdiction. I also
<br /> ' certi�y `� i understand that the regu{ations of other government agencies may apply to the intended work, and that it is
<br /> � rrr�r �tity to ident�fy what act+ons I must take to be in compliance. Such agencies include but are not limited to:
<br /> _ "�; pepartment of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentaily Sertsitive
<br /> t �" �ar�ds, Water/Wasstewater Treatment.
<br /> Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
<br /> � .� Vda�urses.
<br /> - Army Corps a# Engineers-Seawalls, Docks, Navigable Watenruays.
<br /> _ Departinnent of Health & Rehahilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
<br /> Se#� Tanks.
<br /> - US Envicocxoenral Protection Agency-Asbestos abatement.
<br /> Feclera! Aviatiort A�writy-Runways.
<br /> ��„��rs�nc} that �e fai�ing+�ic�ons apply to the use of fill:
<br /> Use of fli E is not a�owed in Flood Zone "V" unless expressly permitted.
<br /> I# the fill materia! is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
<br /> °compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
<br /> iice�sed by the 3#abe ofi Florida.
<br /> If the fitl matefial is to be used in Flood Zone A in connection with a perrnitted building using stem wall
<br /> �� �� •
<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 /> properaes. If use of filf is found to adversely affect adjacent properties, the owner may be cited for violating
<br /> the conditions of the building permit issued 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 I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
<br /> th�s afFidavit prior to commencing construction I understand that a separate permit may be required for electrical work,
<br /> p�ur�,bi �igns, we14s, pools, air conditioning, gas, or other installations not specifically included in the application. A
<br /> � perr�it ' styall be construed to be a ficense to proceed with the work and not as authority to violate, cancel, alter, or
<br /> • set y y provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
<br /> requiri correction of errars in plans, construction or violatians of any codes. Every permit issued shall become invalid
<br /> unless authorized by such permit is commenced within six months of permit issuance, or if work authorized by
<br /> � the per+�is 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 ninery (90) days and will demonstrate
<br /> , justifiable cause for the e�ension. If work ceases for ninety (90} consecutive days, the job is considered abandoned.
<br /> WARNING TO OWNER: YOUR AtLURE TO RECORD A NOTICE OF COMMENCEM NT MAY RESULT IN YOUR
<br /> PAYING TW10E FOR IMPROV TS TO YOUR PROPERTY. IF YOU INTEND TO IN FINANCING, CONSULT
<br /> WITH YOUR LENDER OR EY BEFORE RECORDING YOUR NOTIC ENCEMENT.
<br /> FLQRIDA JURAT (F.S 117.03
<br /> OWNER OR AGENT CONTRACTOR ,
<br /> �ubsc� it�ad and sworn to (ar affirtn �ore me :i�is Subscribeu �rd swom to (or affrm ) before me� ihis
<br /> �'I 7�t`+ • 1 � by ✓o t �bY
<br /> Wh ' personally known t me or hasfiave produced Wh personallv kno�ro_tQma or ha ave produced
<br /> as identification, as identificatlon.
<br /> __��`�� - -- ' Notary Public Notary Publlc
<br /> Commission No. D D �O�[�a� Commission No � � ���
<br /> Name of �lotary typed, printed or stamped Name of Notary typed, printed or stamped
<br /> • ""tr�. KRISTEN P. JOSEPH
<br /> .:�a� '''"" "�•., KRISTEN P. JOSEPH
<br /> � :,. :,� Commission # DD 882627 *��''..
<br /> :�a a: Expires April 21, 2013 � ;�: Commission # DD 882627
<br /> ,;�, ,, o� Expires April 21, 20'13
<br /> ��f��'� BnndedThn, royFainlneuair.e80�-38
<br /> �'�rP����'� ,nndedT! ., �.yFainlnsurence80� 385-7019
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