|
�p�E p� p�p R�1'i�Ti4NS: The unders�gned understands that this permit may be subject to °deed" restrictions"
<br /> �ic� �y be ��Iripi�re �ran Couniy regulations. The undersigned assumes responsibiiity for compliance wi�h any -
<br /> �y �� A�ip CONTRACTOR RESPONSIBILITiES: If the owner has hired a contractor or
<br /> ��, ���r1C, �ey ►�ay be regc»recf to be ticensed in accordance with state and local reguiations. if the
<br /> � n�t �� re�ec� by taw, both the�c�wn8r and contractor may be cited for a misdemeanor violation
<br /> �� ya�r,,, tf the ow�ar o� int�ded con#ractar are uncertaiA as to what licensing requirements may apply for the
<br /> „� , t�r ar�e ac�rtsed to carttact the Pasco County Buitcling Inspection Givision--Licensing Section at 727-847-
<br /> �qpg, e, if the owmer has hired a contractor or contractors, he is advised to have the contracto�(s) sign
<br /> , �ie `contractor Bk�C#c" af this applicat�on for which they will be responsible. If you, as the owner sign as the
<br /> s �n��;�at ma,y pe an in�cation thac he is not properly licensed and is not entitled to permitting privileges in Pasco
<br /> � � �- '�.; .
<br /> �q, 1��T�lTii.ti�S-#�ACT AND RESOURC� REfAVERY FEES: The undersigned understands
<br /> � t�a# fsa�q�ien-I�x T�es an�R�cse Recovery Fees may apply to the consVuction of new buildings, change of
<br /> J � m e,�g � or e�orE.of existing bui�dings, as specified in �asco County Ordinance number 89-07 and
<br /> gp_p� a�s a�. Tbe �e�#�iso understands, that such fees, as may be due, witt be identffied at the time of
<br /> pe�r�;ng. �t is �ttrer � that`Trartspartation Impact Fees and Resource Recovery Fees must be paid prior to
<br /> r�esv;ng a°�e�e a# o�up�an�' or final power release. If the pro}ect does not involve a certificate of occupancy or
<br /> T,na� �ow� reiaese, t�e fee.s must be paid prior to permit issuance. Furthermore, if Pasco Caunty WaterlSewer Impact
<br /> fe� are c�e. �ey m�st be paidprior to permit issuance in accordance with applicable Pasco County ordinances,
<br /> CO��7'#�GTIp�1 t!� tl�W � 713, Flarida Statutes, as amended): If valuation of work is $2,500.00 or more, I
<br /> �#t� �, f�e a�, t�e been provided with a copy of the "Florida Construction Lien Law—Homeowner's
<br /> pr�yion C��ide� pr� tiy tt►e Fbrida E�art�nent of Agricultu�e and Co�nsumer Affairs. If the applicant is someone
<br /> o�e�r th�► �e `oianer, l�fy �at i have �tained a copy of the above described document and promise in good faith to
<br /> delever it b the `0�' P� ��nt.
<br /> C A�tiq�i9T: ( oertify tt�at all the information in this application is accurate and that all work
<br /> u,;t� be ti�e � c:amQl�ce wilh aN a�ticabie laws regufating canstruction, z�ning and land development. Application Is
<br /> t��y rtrade t�o obt�n a pefrmt to do work and installation as indicated, I certify that no work or installation has
<br /> G�r+�c�ed pricx to issu�►ce af a permit and that all work will be performed to meet standards of all laws regulating
<br /> cons��. Coc�nty ar�d Cit�r codes, zaning regula�ons, and land development regulations in the jurisdiction. I also
<br /> ' cer�y " i und�stand tttat the regulations of other government agencies may apply to the intended work, and that it is
<br /> � my �lity to i�}entiiy what actians I must take to be in compliance. Such agencies include but are not limited to:
<br /> ; - � D�ep�artment of Environmental Protection-Cypress Bayheads, Wstland Areas and Environmentally Sensitive
<br /> ; : l.a�s, Water/Wastewater Treatment.
<br /> � _ s Souihwest F#orida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
<br /> � � Wa�'cout�ses.
<br /> - Army Corps a# Engineers-Seawalls, Docks, Navigable Waterways.
<br /> - Departrnent of Heatth & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
<br /> Septic Tar►4ccs.
<br /> - US Environrnenta! Prat�ection Agency-Asbestos abatement,
<br /> Feder� A+ria�ost A�ority-Runways.
<br /> � understand that the foiiowir�g re�ict�ons apply to the use of fill:
<br /> - Use of filf is nat a�owed in Flood Zone "V" unless expressly permitted.
<br /> If the fill materiat is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
<br /> °compensatirig volurne" will be submitted at time of permitting which is prepared by a pr�fessional engineer
<br /> ticensed by tl�e State of 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 fiU 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 af the burlding permit issued under the attached permit application, for lots less than one (1)
<br /> acre which are eievated by fill, an engineered drainage plan is reguired.
<br /> If I am the AGENT F�R THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
<br /> this affidavit prior to cammencing construction I understand that a separats permit may be required for electrical work,
<br /> plur�u �igns, welis, poois, air conditioning, gas, or other installations nat specifically included in the application. A
<br /> � pern�it ' shall be cortstrued to be a license to proceed with the work and not as authority to violate, cancel, alter, or
<br /> . Set y provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
<br /> requiri ` carrection of errars in ptans, construction or violations of any codes. Every permit issued shall become inva�id
<br /> . unless work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
<br /> �. the pera�is susper�ded 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 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: YOU FAILURE TO RECORD A NOTICE OF COMMENC ENT MAY RESUL7 IN YOUR
<br /> PAYiNG T1N10E FOR IMPRO S TO YOUR PROPERTY. IF YOU INTEND FINANCING, CONSULT
<br /> WITH YOUR LENDER O EY BEFORE RECORDING YOUR N M NCEMENT.
<br /> FLORIDA JURAT (F.S. 117.0
<br /> OWNER OR AGENT CONTRACTOR
<br /> Subscribed and swom to (or affirtne before me this Subscribed and swom to (or a d) before me this
<br /> °1 1 by ✓o v t� ` •�' 11 by e
<br /> Wh ' personally known to me or haslhave produced Wh� personaUv kn��rn_ta�e or ha ve produced
<br /> as identification, as idenGfication.
<br /> �' — _�otary Public r ` �'`� Notary Pubtic
<br /> Commission No. D D �OL-��o�� Commissi4n No iJ D _� �
<br /> Name of RJ�,tary typed, printed or stamped Name of Notary typed, printed or stamped
<br /> .. �� . ���;,, �� -
<br /> � , ,��x� KRISTEN P. JOSEPH "'""" KRISTEN P. JOSEPN
<br /> _*. :� �ommission # DD 882627 ����� CQmmission # DD 882627
<br /> o; Expires April 21, 20'f3
<br /> �''� ��t�,�'�' BnndedThru �oyFa�nlnauance80i385-7019 � �: ExpiresApril21,?0`43
<br /> , ' �P„„�;t��� ��ndedT' yFainlnsurance50 385-7019
<br /> � - - .,_ ...,„�
<br />
|