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<br /> NOfiiCE OF DEED R�STRICTtC�NS: The undersigned understands that this permit may be subject to "d�ed° ' s"
<br /> �i#� be more restrictive than County regulations. The undersigned assumes responsibility for compfian� �t�' any
<br /> �ble deed restrictions.
<br /> UAI�1S`ED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
<br /> a�rs to undert�ake wcxic, they may be required to be licensed iri accordance with state and local regulations. If the
<br /> �r is not iicensed as required by law, both the owner and contractor may be cited tor a misdemeanor viofation
<br /> urx�ar state iaw. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
<br /> �nteEided wak, they are �vised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
<br /> 80Q9. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
<br /> portions of the "contractor Blodc" of this application for which they wiil be responsible. If you, as the owner s�gn as the
<br /> cantractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileg�s in Pasco
<br /> County.
<br /> TRANSPOitTATiOAI IMPACTNT1LITlES IMPACT AND RESOURCE RECOVERY FEES• The undersigned ,,erstands
<br /> that Transportation Irr�act Fces and Recourse Recovery Fees may apply t5 the construction of new bu�rfi� � �e of
<br /> use in e�asting buiklings, or expansion of existing buildings, as specified in Pasco County �rdinance numb + '-ff�� ar�d
<br /> 90-07, as amended. The undersigned also understands, that such fees, as may be due, will be iden#ified at the time of
<br /> pertrr�'tting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
<br /> receiving a"certificate of occupancy" or final power release. 1f the project does not involve a certificate of occupancy or
<br /> final power re{ease, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
<br /> fees are due, they must be �aid prior to permit issuance in accordance with appiicable Pasco Counry ordinances.
<br /> CONSTRUCTiON LlEN LAW (Chapter 713, Florida Statutes, as amended). If valuation o# work is $2,500.00 �r more, I
<br /> certify that I, the applicant, have been provided with a copy of ths "Fiorida Construc�on Lien Law—H , s
<br /> Protection Guide° prepared by the F{orida Department of Agriculture and Consumer Affairs. if the appl+cant is' �'re
<br /> other than the "owner", I certiy that I have obtained a copy of the above described document and promise in go�pd �aith to
<br /> �c it to the "owne�' prior to commencement.
<br /> �, R'SlOYV�iER'S AFFIDAViT: I certify that a11 the infoRnation in this appfication is accurate and � �tc
<br /> � vr+�( e m compliance with all applicable laws regulating construction, zoning and land devebpment. �dorx fs
<br /> here� made to abtain a permit to do work and instaltation as indicated. I certify tt►at no w�ar�c or Ensta�a�cx�+ has
<br /> , prior to issuance of a permit and that all work will be perfomied to meet stand�cfs o€ a11 laws reg�ulai�ng
<br /> co 'on, County and City codes, zoning regulations, and land developmen# reguiations in ihe juri�n � a�so
<br /> � cert�y that i understand that the regulations of other govemment agencies may appiy to the in#encieci avork, a� fha# it 1s
<br /> my responsibility to identify what actions I must take to be in compliance. Such agencies indude but are r� lirr�it�d to:
<br /> - Department of Environmental Protection-Cypress Bayheads, We�and Areas and Environmen#aily Ser�ive
<br /> Lands, WaterllNastev+rater Treatment.
<br /> - Southwest Florida Water Management District-Wells, Cypress Bayheac�, We#iand Area�, �
<br /> Watercourses. j
<br /> - Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
<br /> - Department of Health & Rehabilitative Servi�es/Environmenta! Health Unit-We�#s, W�tewate+r;�'�t.
<br /> S�tic Tanks.
<br /> - US Eriv'sronmenta! Protection Agency-Asbestos abatement.
<br /> - Federai Aviation Authority-Runways.
<br /> I understand tha# the fdlo�ring restrictions apply to the use of fill:
<br /> - Use of fill is not allowed in Ffood Zone "V" unless expressly perrr�tted.
<br /> - If the fill material is to be used in Flood Zone "A", it is understood that a drainage pian � a
<br /> °compensating volume" will be submitted at time of permitting which is pre�ared by a professro� �er
<br /> Jicensed by the State of Florida. �
<br /> - If the fi1{ material is to be used in Flood Zone "A" in connection with a pern»ited buildin�g usi�g �'p�n waN
<br /> construcction, I certify that fill will be used only to fill the area within the stem w�l.
<br /> - If fil( material is to be used in any area, I certify that use a# such fitl uv� rtat a�d�r
<br /> properties. If use of fifl is found to adversely affect adjacent praperties, t#ie cwmer may be c�Cf
<br /> ' the conditions of the building permit issued under the a#ached permit appi�catron, t�ur k�s i� `_ ��'f)
<br /> acxe which are elevated by fill, an engineered drainage pian is r�uired.
<br /> If I am the AGENT FOR TNE OWNER, I promise in good faith to inform the owner of the pernrimng cor�d�c�s set f�x#t in
<br /> this �iffi�avit prior to commencing construction. I understand that a separate perml# rnay be reQuired fiar eiect�cat wo�,
<br /> plum�ing, signs, wells, pools, air conditioning, gas, or other installations not specif+ca�ly ind� �n the a�or�. A
<br /> permit issued shall be construed to be a license to proceed with the work and nat as au#hority tc� vrola�e, c�, �es, or
<br /> set aside any provisions of the technical codes, nor shall issuance of a permit prever�t the B�ng O#�aai �r
<br /> requiring a correction of errors in pfans, construction or violations of any codes. Ev�y pemut isstied st►a� Uec�xa�e �d
<br /> unless the work authorized by such permit is commenced within six months of permit issuar►ce, c� if worlc � by
<br /> the permit is suspended or abandoned for a period of six (6) months after the time #he wo�c is ca��. ��
<br /> may be requested, in writing, from the Building Official for a period not to exc�ed ►�inety {9f}) da�ys and �t der�sac�s�ate
<br /> justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the jo� is r�s�ed aaar��ed.
<br /> WARNING TO OWNER: YOUR FAILURE TO RECORD A NOT}CE 4f WlY �f IM lt'►f�UR
<br /> PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU tNTEi�lD i'O OBTANi RNANCM�G, CO�T
<br /> WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUi2 NOTICE
<br /> FLORIDA JURAT (F.S. 117.03)
<br /> OWNER OR AGENT CONTRACTOR
<br /> Subscribed and swom to (or affirttt this Subscribed and swom to (or e@rs
<br /> '� 2C � by o "( 2C`, • 1 i by To H�t 1 vP��+
<br /> Vyhq:sl�g Personally known to me or has/have produced Who isl�e persortal#y knovm to rna a t�e produoec# w�
<br /> as identification. "�' �' — as iden�ion, °�
<br /> r 6� ! —
<br /> Notary Public ,
<br /> Commission Na � D ��a- _ Commission tVo. Z)D 2.Cc _
<br /> Name di ota ed, printed or stamoed _ Name of Notary typed, prirtted or stamped
<br /> �;ai:':"' KRiSTEN P. JOSEPH
<br /> ;�: �,,, ,,,,�,.,,
<br /> _*. :� Commission # DD 882627 ; �;�:°s��,. KRISTEN P. JOSEPH
<br /> �.,� o: Expires April 21, 20�3 �.. .*__ Commission # DD 882627
<br /> ��ps a�°, �nded T' �, .y Fain Insurance8l 385-7019 0. Expires Aanl 21 � 2��.�
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<br /> '���" ' � ,-aided �' � Fa�r�InsWenCeB�� 3B5-7U7�
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