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<br /> N4'�4CE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "d�Ged" � s"
<br /> whi�#�rnay be more restrictive than County regulations. The undersigned assumes responsibility for complian tti any
<br /> " deed resfic�ons.
<br /> U' SEd CdNTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
<br /> c�n�ors to underkake work, they may be required to be licensed in 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 for a misdemeanor violation
<br /> - unc� shate taw If the owner or intended contractor are uncertain as to what licensing requirements may appiy for the
<br /> iRt�ded wak, they are �ivised to contact the Pasco County Building Inspection Qivision—Licensing Section at 727-847-
<br /> 8�9. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
<br /> portiflns of the "cantr�etor Block" of this application for which they will be responsible. If you, as the owner sign as the
<br /> contra�or, that may be an indication that he is not properly licensed and is not entitled to permitting privileg� in Pasco
<br /> County.
<br /> ;RANSPOi�i'ATfON IMPACTNTiLlTIES tMPACT AND RESoURCE RECOVERY FEES� The undersigned erstands
<br /> tha# TranspoRation Impact Fees and Recourse Recovery Fees may apply to the construction of new bu�9din ' �mge of
<br /> use in e�dsting buildings, ar expansion of existing buildings, as specified in Pasco County Ordinance numb -47 and
<br /> 90-07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of
<br /> perrr�tting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid pr+or to
<br /> receiving a"certfiCCate of occupancy' or final power release. If the project does not invalve a certificate of occupancy or
<br /> fi�ai power release, the fees must be paid pnor to permit issuance. Furthermore, if Pascv County Water/Sewer Impact
<br /> fees are due, they must be paid prior to permit issuance in accordance v✓ith appiicable Pasco County ordinances.
<br /> CQNSTRUCTiE3N L1EN LAW (Chapter 713, Ftorida Statutes, as amended). �f valuatian of wark is $2,500.00 t�E rrx�re, I
<br /> certify that I, the applir,ant, have been provided with a copy of the "Florida Cortstru�ion Lien Law—H , s
<br /> Pro#e�tion Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. 1# the a�iicant �s' ' rt�
<br /> o�er than the "owner', I certify that I have obtained a copy of the above described documen# and promise in g�d faii'fi to
<br /> deli� it to the "owner' prior to canmer�cement.
<br /> � CE'4R'Sl01A�R'S AFFIDAViT• I certify that all the informatian in this application is accxarate and � wcxk
<br /> v�l e in compliance with all applicable laws regulating construction, zoning and land dew�o�nt, � is
<br /> her . made to obtain a permit to do work and installation as indicated. I ce� that no wrork at 'sn� has
<br /> : priw to issuance af a permit and that all work will be performed to meet standaFds ofi aH ia�rs r+�,�iating
<br /> 'on, Coeanty and Cify cades, zoning regulations, and land development regulations in the ju�. I a#�o
<br /> � certi�y that 1 understand that the regufations of other govemment agencies may ap�y to the inter►cied a+vrk, a�td ttsat it is
<br /> my re�n�bility to identify what actions I must take to be in compliance Such agencies indude twt are r�t fimite�i to:
<br /> - Department of Ertvironmental Protection-Cypress Bayheads, We#land Areas and EnvironrnerttaMy S�we
<br /> Lands, WatedW�te�nrater Treatment.
<br /> - Southwest Florida Water Management District-Wells, Cypress 8ayh�c4s, WeUand Are�,� A�g
<br /> Watercourses.
<br /> - Army Corps of Engineers-Seawalls, Docks, Navigab+e Waterways.
<br /> - Department of Health & Rehabilitative Services/Environmental Heafth Unit-We!#s, WasteMrater���r�er�t.
<br /> Septic Tanks. � �
<br /> - US Enviro�mental Protsction Agency-Asbes#os abatement.
<br /> - F�al Aviation A,uthority-Ru�ways.
<br /> I undersCand that the fioNrn+ving restrictions apply to the use of fill:
<br /> - Use of fill is not a!lowed in Flood Zone "V" unless expressiy perrr�tted.
<br /> - If the fiil material is to be used in F1ood Zone "A", it is understoQd tha# a drair�age p�an �g a
<br /> "compensating volume" wi�l be submitted at 6me of permitting which is ;>repared by a pro� �
<br /> licensed by the State of Florida.
<br /> - If the fi8 material is to be used in Flood Zone "A° in connection with a permitted buiiding using �t e+ra�
<br /> construction, I certify that fill will be used onfy to fiil the area within the stem w�l.
<br /> - If f�lf material is to be used in any area, I certify that use o# such fi{I wili tiat ad►re�seiy
<br /> K ' properties. If use of fifl is found to adversely affect adjacent properties, thP a+ivner may be e�lecf
<br /> ` the conditions of the building permit issued under the attached pem�it ap��cai�an, �cx E�,s �ss �''fig
<br /> acre whic�h are e{evated by fill, an engineered drainage pfan is required.
<br /> If l am the AGENT FOR THE OWNER, I promise in good faith to inform the owr�r of the p�rrr�ng � se� ��n
<br /> this �davit prior to commencing construction. I understand that a separate permit rr�ay be re�Q�red fior � wra#c,
<br /> piumC�ing, signs, weils, poois, air conditioning, gas, or other ins#allations na# specific�ly i�Guded �t t�e . A
<br /> permit issued shal! be construed to be a license to proceed with the work and nat as au#hority ta �, c�, aN�s, or
<br /> set aside any provisions of the technical codes, nor shall issuance o# a permit prevent the $u�g {�ia1 ��
<br /> requiring a correction of errors in pfans, construction or violations of any codes. Every p�rmi# isst� st�a� �e �
<br /> unless the work authorized by such permit is commenced within six months of permit isse�ce, or if a�ric �rized t�y
<br /> the permit is suspended or abandaned for a period of six (6) mon#hs after the time tlze wcuic i� cuxr��c+�d. �
<br /> may be requested, in writing, from the Building Official for a period not to exceed ninsty {90� �yrs ar�,1 y�► d�te
<br /> justifiable cause for the extension. If work ceases for ninety (90) conse�utive days, the yo�b is ct�si�d .
<br /> WARNING TO OWNER: YOUR FAtLURE TO RECORD A NOTICE OF C4�CElI�NT 11�1Y �7'�� '�R
<br /> PAYING TWICE FOR IMPROVE S TO YOUR PROPERTY. fF YOU INTEN TO OBTAMt RNANCENG, �!l�.T
<br /> WITH YOU.R LENDER OR A Y BEFORE RECORDING YOUR
<br /> FLORIOA JURAT (F.S. 117.03)
<br /> OWNER OR AGENT CONTRACTOR
<br /> Subscribed and swom to (or affirmed) fore me this Subscribed and swom vmed) be(ore me B�is
<br /> `( ZO by o '1 � t� bY H�+J �.1iIE�v
<br /> V�(�Q,^s/�g persona{ly known to me or has/have produced Who isl�e QersotlaNy known to me a i�asltfave produoed °:
<br /> as identification. — � �. ,
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<br /> � ' � �� Notary Public � I � �_ C�„__._
<br /> �ommission No. � D g�a--� Commission No. �Z7 �'1,(c ZZ
<br /> �.
<br /> � „
<br /> I�!, Name c!f° ota ed rinted or�� Name of Nota
<br /> rY tYPed, Prir►ted or stam�d
<br /> , �ai� P' KRISTEN P. JOSEPH
<br /> • � �'= ���Y e' KRISTEN P. JOSEPH
<br /> = � ..� Commission # DD 88'L627 *�' �;. �mmission # DD 882627
<br /> � ,�:a_ Expires April 21, 2013
<br /> '�,p;; �ndedT �, aaaauis � ,; ExpiresAprii21,2013
<br /> �qf���'� . ,Fau�NSUrancs80�;185•701:;
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