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NdTICE OF DEEf3 RESTRIC i iONS. Tne undersignea unciers,ands i�ai inis perr;Sii riay h2 subje�i�o cie�� �esticiians <br /> which may be mpre restrictive than County regulations. The undersigned assumes responsibility for compliance with any <br /> applicable deed restrictions. <br /> UNLICENSED CONTRqCTORS AND CONTRqCTOR RESPONSIBILITIES: If the owner has hired a contractor or <br /> contractors to undertake work,they may be required to be licensed in accordance with state and local regulations. If the <br /> contractor is not licensed as required by faw, both the owner and contractor may be cited for a misdemeanor vioiation <br /> under state iaw If the owner or intended contractor are uncertain as to what licensing requirements may apply for the <br /> intended woryc.they a�advised to contact the Pasco County Building Inspection Division—�Licensfng S��ion at 727-847- <br /> 8009. Furthermore, if the ovmer has hired a contractor or contractors, he is advised to have the contractor(s) sign <br /> portions of the"corrtractor Block"of this application for which they yvi��be resPonsible. if you, as the owner sign as the <br /> contractor, that may be an indication that he is not properly licensed and is not entitled to pertnifti� <br /> County, g privileges in Pasco <br /> TRANSPORTATION IMPAC7/UTILITIE3IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands <br /> that Tra�sportation Impact Fees and Recourse Recovery Fees may appty to the consUuction of new buildin <br /> use in existing buildings, or expar�sfon of existing buildings, as specified in Pasco County Ordinance number 89-07 and <br /> 90-07, as amended. The undersigned also understands,that such Tees, as may be due,wi11 be identified ethe time of <br /> permitting. It is further understood that Transportation Ir�pact Fees and Resource Recovery Fees must be paid prior to <br /> receiving a"certificate of occupan�y^or final power release. if the <br /> final power release,the fees must be paid prior to permit issuance�urtherrnore�if asco County W ter/Sev�r trnpac�t <br /> fees are due,they must be pe�prior to permit issuance in accordance with app�fcabl�pasco County ordinances. <br /> CONSTRUCTION LIEN WW�Chapter 713,FloHda Statutes,as arr�ended): If valuation oiwork is$2,r,p0.00 or more, I <br /> certify that I, the applicant, have been provided wit� a � <br /> Protection Guide^pr�epe�ed by the Florida Departmenf of Agriculture andYConsumer A a rs�If the appl,'ca^H s so�� <br /> other than the°owne�',I certi{y that I have obtained a co of the above described document and <br /> deliver it to the"owner�prior to commencement. py <br /> CONTRACTOR'S/pWNER'S AFFIDAVIT• I certi{y that all the information in this application is accurate anc!9 aa�a'N,o�k <br /> wi��be done in compfiance with all applicable laws regulating construction,zoning and land development. <br /> hereby made to obtain a permit to do work and installation as indicated. I certi{y that no work or installation has <br /> commenced prior to issuance of a APP���ation is <br /> construction, County and C' Permit and that ail work will be perFortned to meet standards of all laws reguiating <br /> rty codes, zoning regulations, and iand development regulations in the jurisdiction. I also <br /> certify that I understand that the regulations of other gpvemrnent agencies ma a <br /> my responsibility to identify wF�at actions I must take to be in compliance, Such agencies indude but are not limited to: <br /> Y PPN to the intended work, and that it is <br /> Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive <br /> Lands,WaterlWastewater Treatment. <br /> � Southwest Florida Water Management District-Wefls, Cypress Bayheads, WeUand Areas, Altering <br /> Watercourses. <br /> - Army Corps of Engineers-Seawalls,Docks,Navigable Waterways. <br /> - Department of Health & Rehabilitative Services/Environmental Health Unit-Weils, Wastewater Treatment, <br /> Septic Tanks. <br /> - US Environmental Protection Agency-qsbestos abafement. <br /> i understand that the following ts nrcryt�'ns app ysto the use of fill: <br /> Use of fill is not allowed in Flood Zone"V"unless expressly permitted. <br /> If the flB material is to be used in Flood Zone "A°, it is understood that a drainage plan addressing a <br /> "compensating volume"wip t�e submitted at time of permitting which is prepared by a professional engineer <br /> licensed by the State of Florida. <br /> If the fill material is to be used in Fiood Zone "q"in connection with a permitted building using stem wati <br /> construction,i certi{y that fill will be used only to fili the area within the stem wall. <br /> ►f fi�� materiat 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 adverseiy affect adjacent properties,the�,y�er may be cited for violating <br /> the conditions of the buiiding permR issued under the attached permit application,for lots Iess than one(1) <br /> acre which are elevated by flll,an engineered drainage plan is required. <br /> If i am the ACENT FOR THE OWNER, I promise in good faRh to inform the owne�of the <br /> this affidavit prior to commencing construction. I understand that a separafe peRnit ma be <br /> plumbi permitting conditions set forth in <br /> �9� s�9�� ►�ve��s, pools, air conditioning, gas, or other installations not s y �����fOf electrical work, <br /> Permit issued shall be construed to be a license to proceed with the work and not as authority to violate,cancel,alter,or <br /> set aside an �fi���Y+ncluded in the appflcation. A <br /> requiring a c orArrection of errorse neplans,af,ro�n�,�tN�ion orav�iolation of an codes, Ev <br /> pe►mit prevent the Building Official from thereafter <br /> uniess the work authorized by such p��i=is�����thin six onths of �pe��t issued shail become inyalid <br /> the pertnit is suspended or abandoned for a period of six(6)months after the time the oyorl,5���a���bY <br /> 1�fi b�eecau et for the eMens onmlfhwor}c�cease�r��r a�riod not to exceed ninety(gp�days and wi11 demonsUate <br /> An extension <br /> h'( )consecuGve days,the job is considered abandoned. - <br /> WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR <br /> PAYING 11MCE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT <br /> �TH 1' LENDER OR AN ATTaRNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. <br /> FLORIDA JURAT f.S.11 03) �/ <br /> ` � p � OWNERO GENT_ ��-- (`9OD �� <br /> � � �.,i � Subacribed a ��or afirmed before ryie th� CON7'RACTOR t�'�. (C <br /> 0 °� � � ----__bY r'=C�l+,�qJlLJ.P Subs=ped=_�db�om orafirtned)befqrQ�this � �'N <br /> � z = Who is/are perso��fo me a�hasThave roduced i'��1+�� <br /> � '~ z Who is/are persona K —�_ jt� <br /> � -�r � o as idenlification. r ti�own w me or hasfiave produced •. <br /> 'D: <br />-`� � � � ^ � as identifiCation. .�O•.,,,�y,��.� <br /> 1 2 �- �/�����/ ������r���� <br /> � � � Notary Pubhc `� � ; <br /> �.H°'r,'•,. Commissiun No. C�t-•��`' � <br /> ,a'r�:,m'yay NotaryF'ublic � m � a�.� <br /> s�a:' �� CommissionNo. �' v, �," -^, <br />�.��'�� Nam ��,�,,typed z° G g � <br /> i••..•�ur.'� ;4�r6p-"+Y g �tl — � Z v �. <br /> �����`'�� :r°.' �%��CAMA�1S5iDN#DD89741 H Name of Notary typed,printed or stamped -- Q ° O <br /> �•':- ..i��,,.,,, 'i. . � � � ^l <br /> ,J�. R' ��2�13 � , , -� ^�'Z O a� <br /> :9'C�'��F.tPIRES: <br /> JUN -' �i' � ^� `. � <br /> �'•���b���` YPNN.Q44pNPi0.�k1'rnm R ' � c.� � <br /> ��..•` r� . , <br />