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09109/2�13 03:00 FAX 86�5334586 C�N-SUR INC �I005
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<br /> Np710E OF DE�b RE37RICTiONS: The undet5igl�etl und�rstands that this permit msy be subje�t to"deed"restrictions"
<br /> whicn m�y�e more rest�letiva than Caunty regulatlans. T1t�understgned assumes responsibllity fo�Campttance wlth any
<br /> applicabte dsed restrictians.
<br /> UHLIC6NSED CONTRAGTORS AND CONTRACTOR R�SPQNRIBWTIE3: If ihe owner ft8s itired a �+DntraCtor or
<br /> �o+�tract4rs ta underiaEu�work,they may be�equi�ed ta b2 IiCensQd in accordance with state and Iocal regul�tionb. If the
<br /> car�a�tor�s not rcens��as r��uired�y�w,both ttre oumer and cor►t{'aCtOr may be ci�ed for a mistlerr�anor viat�ti6n
<br /> under state law. If tne owner or Intended contractor are unoertain as to what Ilcensing requirements may appty far the
<br /> intended wo�ic,they a�1d�lsed ko contact the Pasco County Building InspeCtion Pivisior�Llcensing Section at 727�&37-
<br /> 8009. FurttGen»ore, if ttZe owner has hlted s cantrados or c�nntracta�s, rie is adulsed to have the contrector{s) slgr�
<br /> portions of the"contractGr�toCk"of this appifcailon for which they will be responsi4le. If you,as ihe owner sign as ihe
<br /> . contractor,that rnay be an indication tnat hB is no#propedy licensed and is not entitled to p��mitting prlWleges in Pasco
<br /> Coutrty-
<br /> TRANSPORTATtON IMPACTIUTIt�T1E51Mt�ACT'AND RESBURCE RECOVERY FEES; Tne untl�rs(gned understands
<br /> that Transportation Impact Fees and Recourse Recovery Faes may appry to the construction af new builtlings,change of
<br /> use in ex�sting buitdiags,ar exp�ns�an af existing buitdings,as specified in Pesco County Orqin�nCe numhar 89-fl7 and
<br /> 90-07,as amended. 1'hre undetSigned a►Bd umterstands,that such fees,as tnsy 6e dae,wili be id2tat+fi8p ai ths tlms af
<br /> permitting. It is iurther unde�stoad tF1at T�6�nepoKBtlon lmpact Fees and Resource Recovety Fees rtlust be p81d prlar to
<br /> r�CeE►ring�"CBrtif�cate of occupancy"or final power rele8s�, if tne prajeet does not involve a certificate oi acaupanGy or
<br /> flne{pow�r rete&se,ti7@ fE2S tY}tlSt I')8�l2lt�p(i8t t0�8ITliit I8SU8RCw. Furthe�s►tGr�,if PasCa Caunty WatertSewer Imp�ct
<br /> f�es are due,they mu6t be pald p�or to permit issuance in accordance with applicable I'asco Counry ordinances.
<br /> CON3TRUCTION 11�N I.AW(Chapter 718,Flodda Ststubas�as amended�: If valuaUon of work is$2,500.00 or more,I
<br /> certiiy that 1, the applicant, hav& b�ers pravld�d w� a co=sy of the"Ftorida CansEructl4» Li�n �aw—Hameowner's
<br /> Protectian Guide"prepared by th�e FlOritld C1ep2�tment of Agdculture and Consumer Affai�s, If tne 2�pplYCan�Is someane
<br /> ather th�n the"owner",I pertify that 1 hev�vbtaineq 8 oppy ot tne above described document and pYOmise in g0od fallh to
<br /> dallver It to the"owner"ptior ta comrsencemet�t.
<br /> CONTRACTOR'SIOWNER'3 AFFIQAVIT: i Cerlify that all the Information in ihis applicatio�s is aCCUr�te and that aii work
<br /> will b�done in compliance with all applicable lauv�regulating conslructfon,zoning and land development. ApANptlan Is
<br /> h$repy made to obtain a pezmit to do wotk dR4 insta�laf�ori as indtcated. i certify that no war4c ar in9tditaGon has
<br /> commettCed pripr to issuanoe of a permi#and that all work wiA b�perfatm9d ta meet statutards of ali lavvs regul0ting
<br /> construCtipn, Cqunty and Clty cades,zoning regulations, and land devetppmenl regulations in the jurisdiction. I also
<br /> certify that!undetstanG tt'�0t the regutaticyns ot cathet govemme�t agencies mey apply to ths�Intended work,and khat it is
<br /> my nespans�bility ta idenGfy what aCtions t must take to be in comp3iance. Such ag�nCiBS In�tude�ut are nat limited to:
<br /> - Department of Errviror�mental Protectlon-Cypress Bayheads,Wetlend Areas dn0 Envlranm�ntally Sensitive
<br /> Lands,WaterMlasteweter Tre2tment. �
<br /> - Southwest Florids Water Manag�rnent bi&trlct Wells. Gypress 8ayt�eads, Wetlantl �e85, Altaring
<br /> Watercoucses.
<br /> - Artny Corps of Engineers•Seawalls,Po�ks,Navigabl�Waterways.
<br /> - Depatiment of HealEh & Rehabiiitafve $�rviCe�t�nvimr►mentai Me�ith Unit Welis, Wasfew�fier Treatment,
<br /> Septic Tanks.
<br /> - US Environmental ProtecGon Agency Asbestos abatem0n4
<br /> - Fecl�td�Avi�tlon Autho�ty-Ruriways.
<br /> I understand Ut�t tne toUpwtng restrtcllons appty to the use of filh
<br /> - Use af fill is not dllowed in Flpod Zone"V"unless expressly permilted,
<br /> - If the fiii material is !o Ge usad in Ftcod Zone"A", it +s unde�stocd tnat a Brainaga pian addressing a
<br /> "compenseting volume"will b�Supmitted at time of permitting which is prepaC�tl by a prOf85sionat engMeer
<br /> licensed by ihe State bf Florida. •
<br /> - If ttte fili material is to Ge used in Fla�tl�one"A"kn c�nnnectlon with�permitked buildir�g usiRg stem wdll
<br /> conswctian,!certiiy that fitl wiii b�vsed onsy M ftq ih$area wtthin the stem wai(,
<br /> - If tlll material is to be used in airy area, I �nify lhat usa of such flll wil4 not adversety affect adjdCent
<br /> properties. If use of fiU is faund to�dversely ai'ffect adJacent properties,the owner may be cik�d for violaGng
<br /> the cond(tions oi the bailding percnit issv�tl untler th�attached Qsrmlt applicstion,far lats Iess than ors+�(1}
<br /> acre whlch are elevated by fill,an engineered dr�ineg8 plan is requlred.
<br /> If I am ttle AG�Nt FOR 1'HE OUYNER,1 promise in good fsith to infartn the owner pf tha permltting canditions set fndh in
<br /> t�is afl'�davtt p�ior ta cam�»an�ing construaion. 1 understend thst a seperdie permit may oe requir�d far�lectrical v�ork.
<br /> plumbing,signs,weils, pools, air oontlitipning, gas, or other instalia6ons not specifiC�ily inCiuded in the appllcation. A
<br /> permit issued shall be annsvaed tp be a liq0nse ta prooee+d with the work and nvt as duthorlty to v1412�te,cancel,alter,or
<br /> set aside ar�y provisions af the technit�I c4des,nor shall lssuance of a persnit psevent the Builtling 0lficaa��ram tt�ereafter
<br /> requiring a correcfion of errars in ptans,c4n8truc.tiion or vlofations of any codes. Every permit issued 8he�i 4�C4me inval(d
<br /> uniess the work�uthorized by such permit is co�menced within Si�t months of permit issuance,or if work authori�ed by
<br /> the Agrmlt is suspended or sbandoned tor a period of six(6)mortiths after the tlme the work is eommen�ed. An extension
<br /> rtiay be reques�ed,In wri8ng,from the Buifding UFfici��fpr�peripq noi te e�cceed nlneiy{90)days and will demo�strate
<br /> jusllAable cause for the e�ension. If work ceases for ninety(90)c�n6ecuqv�days,the job is considered abandoned,
<br /> WARNIN�r TO t)WNER: YOUR FAEIURE TO RECORD A NOTtCE OF CiaMNlENCEMEtd'T MAY RESU�T tN YOUR
<br /> PAYING TWIGE FOR IMpROVEMENT3 T4 YOUR PROPERTY. IF Ypt1 INTEND TO OBTAIN FINANCINC�,CONSULT
<br /> WITH YUUR LENDER OR AN ATTORNEY BEFORE RECQ DING YOUR NQTICE bF CbMMENCEMENT.
<br /> �LORII?AJURAT{E.S.t17.03) J�
<br /> OWNER OR AGENT CQNTRACTOR_( -�N"�lA����aL..
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<br /> SuQacqDed antl�wom ta(or afflrmed)before me thta sub d antl ewo—m*,t�o(or e rme bvforo e th�a
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<br /> Who is�a�personally knovm to me or hea�heve D�educed tsr�,ne p�fl�(��yn to ma or haatAave pro ucect��
<br /> as IdentiliCetlen. as idenGfieStion.
<br /> Not6ry PuDtlC � NMery PuEIIC
<br /> CommSSalan Ha. mmisswn No.�„��,���cj g
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<br /> Nnme o(Natery typetl,pnnteu or atempeo NarM�e of Nofa iypea, ' tea o�etamped ,�;:;� ,�,�,`'rppy p�p��'
<br /> * *�i'tCQt�iMIS910N#��;7898
<br /> EXRtflES:Apt(112,20ZS
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