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<br /> I6�OY'ICE O� DE�� Rf�S�'RfCTIOW�: The undersigned understands that this permit may be subject to udeed"restric�ions°
<br /> which may be more restrictive than Caunfy regulatians. The undersigned assumes �esponsibility for compEiance with any �
<br /> applicable deed restrictions.
<br /> iJ�lLIC��9��� CU�1T���Yt�R� �R�D COR4�@��T�I� ���P��9S1�1l.�Y�(��: #f the av�+ner has hired a cantractor or
<br /> contractors #o undertake work, they may be required 4a be licensed in accordance with state and (ocal regulations. If fhe
<br /> contractor is not licensed as required by lavv, both the owner and contractor may be cited for a misd�meanor violation
<br /> under state law. If the owner ar intended cantracfor are �ncertain as to what licensing requirements rnay appiy far the
<br /> intended work, they are advised to contact the P'asco Gounty �uilding Inspectian Division—Licensing Section at 727-847-
<br /> , 8008. �urthermore, if the awner has h9red a cae�tractor or contracfars, he is advised ta have the contractor{s} sign
<br /> portians of the "contractar Block" of #his application far wrhich they vvill be responsible. If you, as the awner sign as the
<br /> contraetar, that may be an indication that he is nat praperly licensed and 4s no� enti#Eed �o permitting privileges in Pasco
<br /> Counfy.
<br /> YI�iV����Y�►TIQN I�IQ�AC�'IUYILIYIf�� IiWP�►��'�R➢�7 �E�OII��� �f�CO!l��tY F���: The undersigned unders#ands
<br /> that Transportation Impact Fees and Recourse Recovery �ees rnay apply to the cansfruction of new buildings, change of
<br /> use in existing buildings, or expansian of existing buildings, as specified in Pasco County Ordinance number 89-0? and
<br /> 90-07, as amended. The undersigned also understands, that such f�es, as rnay be due, will be identified at the time of
<br /> permitting. It is further understood that Transpartation Impact Fees and R.esource Ftecovery Fees must be paid prior to
<br /> receiving a °certificate of occupancy" or#inal pauv�r release. !f th� project do�s not involve a cer#ificate of occupancy or
<br /> final power release, fhe fees must be paid prior ta permit issuance. Furthermore, if Pasco Count}r W�fer/Sewer Impacf
<br /> fees are due, they must be paid priar fo perrnit issuance in accordance�nrith applicable Pasca County ordinances.
<br /> COR��YRk�CT�QN iL���! LAl�(C�a��4�r�9�, (Floecc��S�a�e����, �s �i��nt�eei�: tf�raEuation of work is$2,500AQ ar more, 4
<br /> certify that I, the applicant, have been provided with a capy of the uFlorida Construction Lien Law—Homeowner's
<br /> Protectian Guide° prspared by the Florida Department of Agriculture and Consumer Affairs. If the app}icant is someone
<br /> other than the°owner", I certify#hat 1 have abtained a capy of the above described document and promise in good faifh to
<br /> deliver it to the"owner"prior to commencement.
<br /> CQi�T�lC1'UR'S/O�ilW��t'S A���lD,fi�VI�': I certify that all the infarmation in this application is accurate and that ai1 vvork
<br /> vuill be done in campliance with all applicable laws regulating construction, zoning and land development. Applicakion is
<br /> hereby made to ob#ain a perrr�it ta do wrork and installation as indicated. 1 cert4fy fhat no work or installatian has
<br /> commenced prior to issuance of a permit and that all work vuill be performed to meet standards of all laws regulating
<br /> construction, County and City codss, zoning regulations, and land development regulations in the jurisdEction. 1 also
<br /> certify #hat 1 undersfand that the reguiafions of other governmenf agencies may apply to the intended work, and that it is
<br /> my responsibility#a identify what actions I must take to be in compliance. Such agencies include but are not limited to:
<br /> - Departmenf af Environmental �ratection-Cypress �ayheads, Wetland A�eas and EnvironmentaSly Seetsitive
<br /> Lands, WaterNVastewater Treatmen#.
<br /> - Southwesf Florida V�later �Ranagement District-Wells, Cypress Bayheads, VVetland Areas, flltecing
<br /> 1Natercours�s.
<br /> - Army Corps of Engineers-Seav+ralls, Docks, Navigable V�laterways.
<br /> - Department of Hea{fh & Ftehabilitative Services/Environmenta! Nealth Unit-We11s, Waste�ntater Treatrrtent,
<br /> Septic Tanks.
<br /> - US Environmenta3 Protection Agency-Asbestos abatement.
<br /> - Federal Aviation Authority-Runways.
<br /> t understand that#he follovuing restrictians apply to the use of fill:�
<br /> - Use of fill is not allowed in Ffood 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 permifting wrhich is prepared by a professional engineer
<br /> licensed by 4he State of Florida.
<br /> - If the �11 material is to be used in Flaod �one "A" in connecfiios� v�r'sth a permitted btailding using s#ern wrall
<br /> construction, I certify that fill will be used only to fill the area wi#hin the stem wall.
<br /> - If fill ma#erial is ta be used in any area, 1 certify that use of sttch fill will nat adversely affect adjacent
<br /> properties. If use of�li is found to adversely affect adjacent properties, the ovvner may be eifed fo�violating
<br /> the canditions of the building permit issued under fhe attached permit applicatian, for Iots less than one (1)
<br /> acre which are elevated by ftl, an ertgineered cfrainage plan is�equired.
<br /> If I am the AG�PdT' FOR�'lil� Ci1RlP��9t, I promise in good faith to inform #he owner of the permitting conditions set farth in
<br /> this affidavit prior to commencing construction. 1 understand thaf a separate permit may be required far elect�icaf v�rork,
<br /> plumbing, signs, wells, pools, air canditianing, gas, or other installations not specificaliy included in fhe appiicatian. A
<br /> permit issued shall be construed to be a license 4o proceed with the work and not as authority to violate, cancel, alter, or
<br /> set aside any provisions of the#echnical codes, nor shall issuance af a permit prevent the �uilding OfficiaE from thereafter
<br /> requiring a correc#ion of errors in plans, construction or violatians of any codes. Every permit issued shall become invalid
<br /> uniess the work au#horizec3 by such permiE is commenced vtirithin six months of permit issuance, or if vuork autharized 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 /> rt�ay be r�quested, in v�triting, from fhe Building t7�cia! for a period not ta exceed ninety (90) days and �nril! demonstrate
<br /> justifiable cause far tF�e extension. (f work ceases for ninety(90)consecutive days, fhe job is considered abandoned.
<br /> i�1l�RPlift9fy 30 O{n/Pl��Z: YQt1R �I�,ILl7�l� TCl (��C�J�D � ��TICg Cil� C�}�f#�V�i't9C�i��P�T i�d�,�' �21��UL.'�" lilt Yd3t1�
<br /> 7�AYIPIG `fVVICE �OR Y[M1HPR01/Eflfl�iUTS Y'f�YOII� P�20PE�Y1f. Y(�S(OU IYVY�NID Y"O O�'v',�I� �'IhYP►Rl�CI�lC, COY��IJ�.li'
<br /> N�l1T'Fi YQUIR ���IL��1�Q�t��I t��i'Ql�P1�Y�IE�'O�t� �2��C)��1�lC�YOUgt�4C}TIG�QF�Oii��iEWCi��1�EVT.
<br /> FLORIpA JURA`T(F.S�11 03) - -- -
<br /> O�t1tYd�R Oft iiG�A�7� Dr�_....��_•�.�,�. CORlT�CTC}R�r�-�--�.�[.�%`�
<br /> Subscribed and sworn to(or affirmed)before me this Subscribed and swom to(or affirmed)before me fhis
<br /> by bY
<br /> VVtio istare personatly known to me or haslhave produced Wf�a tslare persanally known ta me ar hasthave procluced ,
<br /> as Identlfication. as identi�cation.
<br /> Nokary Public Notary Public
<br /> Commission No. Commission No.
<br />�,�
<br />' Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
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