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<br /> permitting. It is further understood that Transpo�tation Impact Fees and Resource Recovery Fees must be paid prior to
<br /> receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
<br /> final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
<br /> fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
<br /> CONSTRUCTION LIEN LAW(Chapter 713, Florida Statutes, as amended): if valuation of work is $2,�00.00 or more, I
<br /> certify that I, the appticant, have been provided with a copy of the "Florida Construction Lien Law—Horrieowner's
<br /> Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the �pplicant is someone
<br /> other than the"owner", I certify that I have obtained a copy of the above described document and promise in good faith to
<br /> deliver it to the"owner" prior to commencement.
<br /> CONTRACTOR'SIOWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work
<br /> will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is
<br /> hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
<br /> commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating
<br /> construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
<br /> certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is
<br /> my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
<br /> - Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Enviconmentally Sensitive
<br /> Lands, Water/Wastewater Treatment.
<br /> - Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
<br /> Watercourses.
<br /> - Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
<br /> - Department of Health 8� Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
<br /> Septic Tanks
<br /> - US Environmental Protection Agency-Asbestos abatement.
<br /> Federal Aviation Authority-Runways.
<br /> I understand that the following restrictions apply to the use of fill:
<br /> Use of fill is not allowed in Flood Zone"V" unless expressly permitted.
<br /> If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
<br /> "compensating volume" will be 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 Flood Zone "A" in connection with a permitted building using stem wall
<br /> construction, I certify that fill will be used only to fill the area within the stem wall.
<br /> If fill material is to be used in any area, 1 certify that use of such fill will not adversely affect adjacent
<br /> properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
<br /> the conditions of the building permit issued under the attached permit applica#ion, for Iots less than one (1)
<br /> acre which are elevated by fill, an engineered drainage plan is required.
<br /> If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting�conditions set forth in
<br /> this a�davit prior to commencing construction. I understand that a separate permit may be required for electrical work,
<br /> plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
<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 any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
<br /> requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
<br /> unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
<br /> the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension
<br /> may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and wil� demonstrate
<br /> just�able cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned.
<br /> WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MArY RESULT IN YOUR
<br /> PAYING TWICE FOR �MR AN ATTORNEY BEFORE RECORDING O Rf NOTICE OF C M'N �' ENCNT' CONSULT
<br /> WIT YOUR L NDER O
<br /> FLORIDA JURAT(F.S. 117.03) ��� � J�-�
<br /> .i�' ,.�/,�A,ot/'>"� CONTRACTOR ��
<br /> OWNER OR AGENT ���
<br /> Subscr(bed and swom to(or afftrmed)before e is
<br /> Subscribed and sworn to(or affir ed fore me this by
<br /> by Who is/are perso
<br /> Who is/ar �Fqpr��Y�f+1D'�OV+.�a�"0�°�°`� �d
<br /> �-�--N�p„�55���• ? o Micheb Swenson
<br /> a��`� M�q�e{e SwBnso�1 c My Commission EE082369
<br /> My Commission EE082389 ���� Expirea 05/2?/2015
<br /> �il,a�� Expire�p5122/2016 Notary Public
<br /> Public
<br /> Commission No.
<br /> Commission No.
<br /> ��e �J a,`f��Y�) rc1 ;c �+a.1�. S l��Cl �1 S�'n1 —
<br /> �1� Name of Notary typed,printed or stamped
<br /> Name of Notary typed,pnnted or stamped
<br />
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