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NOTICG 01=DCCD R[STPICTIONS: The•undersigned understands ihai:tl-�is permit may be subject to "deed" resfiricfiions"
<br /> which may be more restrictive fihan Counfiy regulafiions. The undersigned �ssum�s responsibility for compliance with any
<br /> applic�ble deed restrictions.
<br /> UNL(CCNSCD CONTRACTORS AND CoN"fRACTOR RCSI'ONSIRILITICS: If lhe owner has hired � contractor or
<br /> contractors io und�rtake work, they may be required to be licensed in �ccordance with st�te �nd local regulatians. If the
<br /> contracior is nol licensed as required by I�w, bo�lh ihe owner and coniraclor m�y�be cited �for a misdemeanor violaEion
<br /> under state I�w. IF the owner or intended confir�clor are uncerCain as lo wh�fi licensing requirements may apply �for fihe
<br /> intencled worlc, filiey are advisecl fio�contacfi fihe P�sco County f3uilding Inspeciion Division—Licensing Section ai?27-8�7-
<br /> 8009. 1=urlhermore, i� the owner has hired � coniractor or confracfiors, he is �dvise.d to have the coniractor(s) sign
<br /> porlions o�f'ihe "coniractor Rlocic" o�f fihis applicafiion �For which lhey will be resnonsible. IF you, as the owner sign as the
<br /> contractor, that m�y be an indication that he is not properly licensed and is nofi enfiitled to permiiting privileg�s in P�sco
<br /> Couniy.
<br /> TRANSPORTATIOIV IMI'ACTIUTILITIGS [MI'ACT AND RCSOUI�CC RCCOVCRY rCCS: Th� undersigned undersiands
<br /> that Tr�nsporfiafiion Impact Fees �nd Recourse Recovery Fees may �pply to the construction of new buildings, change of
<br /> use in existing buildings, ar expansion of exisfiing I�uildings, �s specified in P�sco Counfiy Ordinance number 89-07 �nd
<br /> 90-07, as amended. The undersigned �lso unclerstands, th�t such �Fees, as m�y be due, wilf be identified �fi fihe fiime of
<br /> permilfiing. It is �Further unclerstoocl fih�t Tr�nsportation Impact (=�es and Resource Recovery Fees musi be paid prior to
<br /> receiving a "cerCi(icate of occupancy" or•�inal power refe�se. l�( the project does nol• involve a certi�Fic�fie of occupancy or
<br /> �final power release, the �Fees musfi be paid prior fio permit issu�nce. Furthermore, if P�sco Counly Water/Sewer Impact
<br /> �fees �re due, they musi be paid prior to permit issuance in accordance wifih applic�ble P�sco Co�mly ordinances.
<br /> CONSTRUCTION LICN LAW(Chapter7l�, 1=torida Si:�tutes, as amended): IFvaluafiion o��worlc is $2,500.00 or more, I
<br /> certify that I, the applicanfi, have been provided with � co�y o�� fihe "Florid� Construci:ion Lien Law—Homeowner's
<br /> Proiection Guide" prep�recl by the Fforida De�arimenL of Agriculturc and Consumer Af(airs. ff tl�e applic�nt is someone
<br /> ofiher than the "owner", I certify fihat I h�v�.obi�ined � copy o�F fihe above described document�nd promise in good�Faifih fio
<br /> deliver ii to ihe owner nrior to commencemenl.
<br /> « ��
<br /> CONTRACTOR'SIOWNER'S AFI=IQAVIT: I cerLiFy fihal�If Cl�e information in fihis appficafiion is accurate and tliat all worlc
<br /> will be done in compliance wiih �II applicablc laws reguf�ling consfiruction, zoning ancl land developmenl. Apnlicaiion is
<br /> I�ereUy made to obtain a permifi to do worlc and install�fiion as indic�ted. I cerfii�y lh�fi no worlc or installation h�s
<br /> commenced prior i:o issu�nce of � permit and Lh�l �II worlc will be perFormed to meefi sfiandards of all laws regulating
<br /> consfirucfiion, County �nd Cifiy codes, zoning regulalions, �ncl Iancf development regulaiions in the jurisdiciion. I also
<br /> certify that I und�rsfiand fih�t fihe regul�tions o�F other government agencies m�y apply to the infiended worlc, and tha[ il is
<br /> my responsibiliiy fio ideniiFy wh�l�ctions I musl t�lce to be in compliance. Such agencies inciude but�re nofi limited io:
<br /> - Dep�rlmenL oF-Cnvironmental Proiecfiion-Cypress f3�yh�ads, Welf�nd Areas and Enviranmenfially Sensitive
<br /> Lands, W�terlWastew�ter Tre�fiment.
<br /> - Southwest Florida Water M�nagement Districfi-Wells, Cypress 13ayheads, Wetl�nd Are�s, Alkering
<br /> Wafiercourses.
<br /> - Army Corps o�F Engineers-Se�walls, Docks, Navigable W�terways.
<br /> - Deparlment of I-leallh & Reh�biliCative ServiceslEnvironmental 1-le�lth Unit-Wells, W�sfiewater Treatment,
<br /> Septic Tanics.
<br /> - US En�.ironmenfial Protecfiion Agency-Asbeslos abalement.
<br /> Feder�l Aviation Authoriiy-f-�unw�ys.
<br /> I undersfiand th�fi lhe following resfiricfiions apply Lo lhe use of�Filf:�
<br /> Use o�f�fill is not�Ilowed in Flood Zone "V"unless expressly permi[ted.
<br /> IF lhe �fill material is fio f�e used in Flood Zone "A", iC is underslood that � dr�inage pl�n addressing a
<br /> "compensating volume will be submitted at timc of permifiLing which is prep�red by a professional engineer
<br /> licensed by ihe Siate oF Florid�.
<br /> I� the �(ill m�terial is to be �used in Flood Zone "A" in connecfiion with � permitfied building using stem wall
<br /> � consfirucfiion, I certify lh�fi�fill will b� used only to�fill the area wifil�in fihe si:em wall.
<br /> (f.�fill rnaterial is fio be usecl in any are�, I certify i:hat use o�f such �fill will nofi adversely afFecl adjacenfi
<br /> properties. If.use o�f�(ill is �found lo �dversefy ��f-Fecl• �djacen[ properties, fihe owner m�y be cited �for violating
<br /> ihe conditions of the building permiL issuecl under �lhe �fitached permit applic�tion, �For lots less than on� ('I)
<br /> �cre which are elevated by�(ill, �n engineered drainage plan is requirecl.
<br /> fF I am the AGCNT FOR TI-IC OWIVGR, I promise in good�faifih to in�form fihe owner o�(the permitting conditions set forth in
<br /> fihis aFFidavil nrior to commencing construction. I underst�nd t1i�L a separ�ite permifi may Ue required �for elecfiric�l worlc,
<br /> plumbing, signs, welfs, pools, air conditioning, g�s, or other insiall�tions noi speciFically included in the application. A
<br /> �ermit issued sh�ll be construed to be � license to proceed with the worlc�nd nol as �uihorifiy fio.viol�fie, cancel, alfier, or
<br /> sefi aside �ny provisions o�f the fiechnical cocles, nor shall issu�nce oF a permil prevenfi the f3uifding OFfici�l�from thereafler
<br /> requiring a correction o�f errors in plans, consfiruction or violations o�F�ny codes. Gvery nermit issued shall become inv�lid
<br /> unless ihe worlc authorized by such permit is commencecl within six monlhs oF �ermil issu�nce, or if work authorized by
<br /> the permit is suspended or aUandoned�(or� period of six(6) months a�Ffier i:he iime the worlc is commenced. An extension
<br /> may be requested, in writing, �From the L3uilding'O�fficial for � period not fio exceed ninefiy (90) days �nd will demonstrale
<br /> jusfiiFiable cause�for the extension. IFworl<ce�ses�for ninefiy (90) consecul:ive d�ys, fihe job is considerecl abandoned.
<br /> WARNING TO OWNER: YOUR 1=./a[LURC TO PCCOI�.D A N�TICC OI= COMMCNCEMCNT MAl° I�CSULT iN�YOUR
<br /> PAYING TWICCNDG�OR AN ATTORNGY GI=aR� I�oCOPDING YO R NOT�I pG- O�' C MM�NCCMCNT.' CONSULT
<br /> WITW YOUR L
<br /> �LORIDA JURAT(�:S.117.03) , ^ �� r �//� �
<br /> C�st,�„ ��(/Zr",."� CONTRACTORI�Y�Q'�i" Y��—
<br /> OWNCR OR AGCNT 5ubscribed and sworn to(o tirmed)befqrorr�th�s
<br /> Subspnbed and sworn to(or�fy'med�befgr�me f is . ��_6�y �Y ��QC/e I��E/�f�//j
<br /> /�t-'�t �eZ- by �-C!C �Gf►- !)
<br /> Who is/are personally I<nown to me or has/have produced Who is/are personally icnown to me or ha�leaden it fi alc n.
<br /> as identificafion.
<br /> Notary Public
<br /> Notary Public
<br /> Commission No. Commission No.
<br /> NOTARY PLBLIGSTATE OF FLORIDA NOTARY PtiB(.;C•5'1.�1iF OF FLORTDA
<br /> Name of Notary typed,printed or s�a ;Cotnrl�ss`��I:#EE044504
<br /> Name oF Notary typed,printed c�Y� : oinmission#EE044504 ,-;;�
<br /> - : ,'E�Gi�; • ,� 22,2014
<br /> '--, .,° Ex�ire� :�OV 22,2014 �''�� •�' , _ , �,�;co,r�c
<br /> BO?�'D ED THR i':17
<br /> a`,-�'l \I:7GCO,INC. BO?iDEDTkn'.:1'I • .
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