NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions"
<br /> which may be more resfictive than County regulations. The undersigned assumes responsibility for compliance with any
<br /> applicabte deed restrictions.
<br /> UNLICENSED CONTRACTORS AND CONTRACTOR RE3PONSIBILITIES: If the ovmer has hired a coMractor 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 law, both the owner and contractor may be ated for a misdemeanor violation
<br /> under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
<br /> intended work,they are advised to corrtact the Pasco County Building Inspection Division--Licensing Section at 727-847-
<br /> 8009. Furthermore, if the owner has hired a contrador or coMradors, he is advised to have the contractor(s) sign
<br /> portions of the"contrador Block"of this application for which they will 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 eMitled to permitting privileges in Pasco
<br /> County.
<br /> TRANSPORTATION IMPACTNTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
<br /> that Transportation Impact Fees and Recourse Recovery Fees may appy to the consUvction of new buildings,change of
<br /> use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
<br /> 90-07,as amended. The undersigned also understands,that such fees,as may be due,will be idendfied at the time of
<br /> permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
<br /> receiving a"certificate of occupancy'or final power refease. If the project dces not involve a certificate of occupancy or
<br /> final power release,the fees must be paid prior to pertnit issuance. Furthermore, if Pasco County Water/Sewer Impact
<br /> fees are due,they must be paid prior to permit issuance in accordance with appticable Pasco County ordinances.
<br /> CONSTRUCTION LIEN LAW(Chapter 713,FloNda Statutes,as amended): If valuation of work is$2,500.00 or more,I
<br /> certify that I, the applicant, have been provided with a copy of the "Florida ConstrucUon Lien Law—Homeowner's
<br /> Protection Guide'prepared by the Florida Department of Agricutture and Consumer Affairs. If the applicant is someone
<br /> other than the"ovmer",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'S/OYVNER'S AFFIDAVIT: I oertify 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 certiTy that no work or installation has
<br /> commenced prior to issuance of a permit and thffi 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 ideMify what actions I must take to be in compliance. Such agenaes indude but are not limited to:
<br /> - Department of Environmerrtal Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br /> Lands,WateNVNastewater 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 Heatth Unft-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 /> ticensed by the State of Florida.
<br /> - If the fill material is to be used in Fload Zone "A" in connection with a pertnitted building using stem wall
<br /> construction,I certify that fill will be used ony 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 application,for lots 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 OVYNER, I promise in good faith to inform the owner of the permitting conditions set forth in
<br /> this affidavit 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 induded 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 pr�everrt the Buildirg Offiaal 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 pertnit issuance, or'rf 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 will demonstrate
<br /> justifiable 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 MAY RESULT IN YOUR
<br /> PAYING 7WICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
<br /> WITH YO R LE D R AN A7T RNEY BEFORE REC RDIN Y R T1C F C M ENCE EN .
<br /> FLORIDA JURAT(F.S.117.
<br /> OWNER OR AGENT CONTRACTOR
<br /> b bed nd swom to(o )before this � !be nd swom (or ffi ed)before�s
<br /> _ -/� by " f/�/ �' bY
<br /> Who is/are personaly known to me or AasThave produced Who is/are personaly known to me or has/have produced
<br /> ' as identification. as iderrtifica6on.
<br /> �
<br /> �IG " `-'"�� / t�C�
<br /> , Notary PuWic �. Z.. 1�'� Notary Public
<br /> Commission No. ��� 9 '`
<br /> Ca ' 'on No. — �
<br /> � , S'� ELA MARIE SLEMP
<br /> �� � a!/r/� Pvd� ARYPUBUC
<br /> Name�of Nofary h�P�.PriMed or Name of otary tYPed.Prirrted or stamped
<br /> ANGELA MqR1E SLEMP STATE OF FLORIDA
<br /> NOTARY PUBLIC Comm#EE153979
<br /> STATE OF FLORIDA � ��P�1'�'/1�/i30�'
<br /> . Comm#EE153979
<br /> E�IIMI�1�'/16/2015
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