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E OF DEED RESTRiCTIO�s� rne undersigned understands that this permit may be bibJe{or �mpl'ance w'i h any
<br /> NOTtC � �� ���ry �egulations The undersigned assumes respo �Y
<br /> which rt�ay be more restric�
<br /> applicable deed� �� � CpNTRqCTOR RESPONStBILITIES: If the owner has hired a contractor or
<br /> UNLICENSED be required to be licensed in accordance with state and local regulations. if the
<br /> ���� ��� W �' � � law, both the owner and contractor may be cited for a misdemeanor violation
<br /> uired by a I for the
<br /> contractor is nat licensed as req
<br /> under state law• ►f tt►e owner °r ���� ��Pasco County Buading D Ssion cens ng Section at 727-847-
<br /> intended work, they are advised to contact
<br /> which the will be responsible. If you, as the owner sign Pasco
<br /> 009. Furthe�m�e, if the owner has hired a contractor or co yractors, he is advised to have the contracsor(s sign
<br /> $ IicaUon fo nvilege
<br /> portions of the "contradof ��°�� °f ��S aPp �►icensed and is not entitled to permitting p
<br /> � that maY be an indication that he is not prope y
<br /> County. ��CT AND RESOURCE RECOVERY FEES: The undersigned understands
<br /> T�gpp�tTpT10N I�PACTIUTIU�� F�s ma a I to the construction� a � nu 89 0 ga d
<br /> that Transp�a� �� F� a � R�� R�very Y PP Y
<br /> use in ex+stiAB buildinSs, °� expans1O� of e�tisting buildings, as specified in Pasco Counry
<br /> 7 as amended• The �9^� �� �de��ds, that such fees, as may be due, W��� Fees must be pand p oe to
<br /> �� that Transportation Impact Fees and Resource Recovery
<br /> permitting. It is furtt►er unde�stood WaterlSewer Impact
<br /> receiving a"certficate �f occuPa��'" or final power release. If the pr�ject does not involve a certificate of occupancy o
<br /> final power re�ease, the fees must be Paid prior to permit issuance, Furthermore, if Pasco County ordinances.
<br /> or to permit issuance in accordance with applicable Pasco Counry
<br /> fees are due, theY m�st be paid p� If valuation of work is $2,500.00 or more, I
<br /> CONSTRUCTION tJEN lAW (ChaPtg+' 713, Florida Statutes, as amended):
<br /> t, have been provided with a copy of the "Ftorida Construction Lien Law—Homeowner's
<br /> ce � � ��� p I�cant is someone
<br /> Protection Guide" prepared by the Florida Department of A�gf I the t above descr bed document and prom se in good faith to
<br /> thai I have abtained a copy
<br /> other than the "owr�e�', i ce����
<br /> deliver it to the "pwne�' Pri� that all the information in this application is accurate and that a�l work
<br /> CONTRACTQR'S'�OW��S p`�DAYIT� � ���Y lication is
<br /> icable taws regulating construction, zoning and ��a no work or has
<br /> will be done in compliance with aU appl�
<br /> hereby made to obtain a permit to do work and installation as indicated. I certify
<br /> m � n �d p� to issuance of a permit and that all�n o�a d��land developmeM egulationsan the jur ction. also
<br /> CO zoning regulag ,
<br /> constructio�, Cou�tY an� City c�des, I to the intended work, and that it is
<br /> certify that I understar�d that the regulations of other government agencies may app y
<br /> m res sibifdY to ►der►tt(Y wha� a�Ons I must take to be in compl� heads SWetland a Env ronmentally Sensitive
<br /> y _ � pepartment of Environmental Protection-Cypress Bay
<br /> Lands, WaterMlastewater TreaVnent• ress Bayheads, Wetland Areas, Altering
<br /> _ �OUthwest Florida Water Management District-Wells, Cyp
<br /> Watercourses•
<br /> _ p�rmy Corps of Engineers-Seawalls, Docks, Navigable Waterways.
<br /> _ Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
<br /> Sep6c Tanks. enc Asbestos abatement.
<br /> US Environme�►taI Pro��O� A y
<br /> Federal Aviation AuthoritY-Runways.
<br /> �stricgons apply to the use of fill:
<br /> I understand that the fd1owin9 lan addressing a
<br /> Use of fill is not allowed in Flood Zone "V" unless expressly permitted. a rofessional engineer
<br /> If the fil! material is to be used in Flood Zone "A", it is un W?� ch is p epared a p P
<br /> ' u� volume" wi ll be submitted at time of permitting
<br /> 4i�� by the State of Florida. usin stem wall
<br /> _ If the fttl material is t° b� �� �n used only to filAthe a ea w th n the w mitted building 9
<br /> construc tion, I c e r t i f y th a t fi l l w i l l b e t ha t use o f s u c h f i l l w i l l n o t a dverset y affect adjacent
<br /> area, I certify be cited for vio la ting
<br /> If fill material is to be used in any ro erties, the owner may
<br /> properties. If use o f f i l l is f o u n d t o a d v e r s e l y a ff e ct ad jacent p p
<br /> conditions of the building permit issued under the a aa�c se equ f a aPP li c a ti o n, f o r l o t s l e s s t h a n onen
<br /> the fill, an engineered drainage p
<br /> acre which are elevated by ermitting conditions set ort
<br /> romise in good faith to inform the owner of the p be required for electrical work,
<br /> If I am the AGENT FOR THE OWNER, I p ii�ation. A
<br /> this affidavit prior to commencing construction. �asn o instaltatonsrnot specifically includ � ed io�ateecancel, alter, or
<br /> plumbing, signs, wells, pools, air conditioning, g
<br /> permit issued shall be construed to bea clodesenor shaleessuancehof a pe rnitpreventthehrBuil ss ed shall become inval d
<br /> set aside any provisions of the technic
<br /> rmit issuance, or if work authorized bY
<br /> requiring a correction of errors in plan er�I� ss�cotmmenced within six months �' Pe t e work is commenced. An extension
<br /> unless the work authorized by such P eriod of six (6) months after the �gp da s and will demonstrate
<br /> the permit is suspended or abandoned for a p
<br /> may be requested, in writin9, from the Building Official for a �c a secut��ive da s, he job is cons'dered abandoned.
<br /> justifiable cause for the extension. If work ceases for ninety ()
<br /> Y
<br /> Y. IF YOU INTEND TO AIN FINANCING, CONSULT
<br /> TO OWNER: YOUR FAILURE TO RECORD A T OTICE OF COMMENCEMENT MAY RESULT IN YOU
<br /> W A R N I N G T O Y O U R P R O P E R N C E M E N T.
<br /> PAYING T1N�CE FOR IMPRO V E M Y gEFORE RECORDING YOUR NOT I C E O
<br /> WITH YOUR LENDER OR AN
<br /> FLORIDA JURAT (F.S. 117 03) CONTRACTOR
<br /> � ftle thlS Sf�'���'���'
<br /> OWNER OR AGENT is S,c��,v�fn Subscribed and swom to (or affirm
<br /> Subscribed and swom to (or affirme /I by
<br /> b �/o L v � Wh ersonall or ha ave produced
<br /> roduced as identification.
<br /> Wh i� pe�onally known to m as denti cation.
<br /> NoEary Public
<br /> Notary Public T� 1 r1h � �?_�
<br /> mmission No. D D 7 7� 0 2 3
<br /> Commission No. +�
<br /> Name of Notary typed. Pnnted or stamped �
<br /> Name of Notary tyPed, Printed or stamped ++�-----
<br /> ��;i,� � , ELI95A M. HOLLERAN
<br /> :� • �� ,s�o�, oa rrao�
<br /> � EI.ISSA M. HOLLEFiAN �• �,= E�i es June 6, 2012
<br /> ��'�� ''
<br /> �'� �; Commission DD 774023 n�t�,F�'�noi°°
<br /> :.: ��,R,",�,� eaaa
<br /> �= Expires June 6, 2012
<br /> �'a' BaiGd ll+iu?ro�l Foin Ireunnce 800.18310
<br /> /' n.,•.
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