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<br /> Si�s 6GC OF ��E� RES7RICT90R9S: The undersigned understands that this permit may be subject to"deed" restrictions"
<br /> wl-�ich may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
<br /> a��plicable deed restrictions.
<br /> l�h�9LS����1�CD COf�TRACTOf2S AND CO�1'fRACTOR RESPOfVSIBILITIES: If the owner has hired a contractor or
<br /> con��racto�-s to undertake work, they may be required to be licensed in accordance with state and local regulations. If the
<br /> con�iracior is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
<br /> under siaze law. If the owner or intended contractor are uncertairi as to what licensing requirements may apply for the
<br /> i;�iendec� work, they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
<br /> 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
<br /> po�ions oi fhe "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the
<br /> con�tractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
<br /> County.
<br /> 1��lSPO�TA'f90N 9MPACT/U71�LI1'IES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
<br /> fhat Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
<br /> use in exisring 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 identified at the time of
<br /> permitiing. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
<br /> !-eceiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
<br /> final �ower 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 /> Ge'�&t9�7RLB�'�10�9 �IEN LAW(Chapter 713, Florida Statutes, as amended): If valuation of work is$2,500.00 or more, I
<br /> cerii�`y that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
<br /> Proieciion Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
<br /> oiher than ihe "owner", I certify that I have obtained a copy of the above described document and promise in good faith to
<br /> . d�liver it�o the"owner" prior to commencement.
<br /> �.�C�{T�ACTOR'S/OWI�ER'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 /> consfiruction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
<br /> cer'iiiy ihai 1 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 /> - Deparfiment of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally 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 & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
<br /> Sepfic Tanks.
<br /> - US Environmental Protection Agency-Asbestos abatement.
<br /> - Federal Aviation Authority-Runways. �
<br /> ! unclersiand 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 /> - Ir' fhe 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, I 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 /> ii�i am ihe AG�lV� FOR 7F1E OWi�ER, I promise in good faith to inform the owner of the permitting conditions set forth in
<br /> this affidavii prior to commencing construction. I understand that a separate permit may be required for electrical work,
<br /> piumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
<br /> permifi issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
<br /> set�side 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 /> in� permif is suspended or abandoned for a period of six(6) months after the time the work is commenced. An extension
<br /> rnay be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
<br /> jus�ifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned.
<br /> ��l';�:&�9�r9� �'O O!l�IIi�E9�: YOl1R FAELURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br /> fi-'!1'Yi�1� �W9CE FOR INiPROV��fIEPlTS TO YOUFZ PROPER7Y. IF YOU INTEND TO OBTAIN F tdCING, CO T
<br /> �tt���'i�YC)�3E2�.��1DE O A�9�4TTORN Y RE REC DING Y R NOTICE OF CO IIIiE C MENT.
<br /> �LORIDA JURAT(F.S.11 . )
<br /> �l.N�f�P. ,.fiGENT � CONTRACTOR
<br /> ubscrib o o a irmed) fJo�me t�' Subscribed af�d swom to(or ffirmed)be rej�e thi �
<br /> by GcJi �r�vr ,��CY�.�/i",v� y-�s-/�f by � ' CY%'
<br /> Who is�sonally known to me or has/have roduced Who is/are personally known to me or has/have produced
<br /> as identification. as identification.
<br /> � �ZL ,_,�•�� a Public G�� Nota Public
<br /> ry ry
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<br /> Commi on No. Commission N
<br /> Name of Nota � � , a e Name of Notary typed,printed or stamped
<br /> :oa�'��q�� Notary Public State of Florida
<br /> � . Toni J Sherman
<br /> � My Commission FF o45864 go�*n`w�^ Notary Public Stete of Flontle
<br /> ��p.� Expires 08I23/2017 . Toni J Sherman
<br /> � My Comm��eian Ff 045@Bq
<br /> ��n°� Expires 081�3/�d17
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