|
�--�---
<br /> - - �
<br /> PIOTiC�C11F �EED RESTRICYI�IdS: The undersigned understands#hat this permif may be subject fo"deed"resfricfions"
<br /> which may be more restrictive than Caunfy regtalations. The undersigned assumes responsibiiity for compliance with any
<br /> ; applscable deed restrictions.
<br /> U�lL.lCfEN�ED CONTR�IC7'ORS A�l1D COPl��A��'Ot� RESPOPl�1�lLITIES: If the owner has hired a contractar or
<br /> contractors to undertake work,�they may be required to be licensed in accordarice with state and lacal regulatians. If the
<br /> contractor is not licensed as required by law, both the owner and con#racfor may be cited for a misdemeanor vioiation
<br /> under sfate law. if the o�ner or intended contracfor are uncertain as #o wrhat iicensing requirements may appfy far the
<br /> intended rn�ork, they are adVised to con#act the Pasco County Building Inspection Division—Licensing Section at 727-847-
<br /> 8QQ9. Furthermare, sf the owner has hired a contractar or contractars, he is advised ta have the cantractor(s) sign
<br /> portions of the "contractor Block" af this application for which they will be responsible. If yau, as the owner sign as the
<br /> cont�actor, that rnay be an indicatian that he is not properly licensed and is not entitled to permitting privileges in Pasca
<br /> Counfy.
<br /> TRAIVS�ORTATION IP4�FA�'�JU7iLITli�� IiW��►��'�ii�D Ri�St�UIRC� R(�GO��RY F�i�S: The undersigned understands
<br /> thaf Transportatian Impacf Fees and Recau�'se Ftecovery Fees may appiy to the construction of new buildings, change of
<br /> use in existing buifdings, ar expansion af existing buiidings, as specified in f�asco Coun#y Ordinance number 89-07 and
<br /> 90-07, as amended. The undersigned also understands, that such fees, as may be due,.wil! be identified at the time of
<br /> permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must:be paid prior ta
<br /> receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
<br /> finai pawer release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impac#
<br /> ! fees are due, #hey must be paid prior ta permit issuance in accordance with applicable Pasco Caunty ordinances.
<br /> CON�T'Rt1GTiUN i.4IEN1 L.A�1l(Ch��atee�'�3, f�la�id��tatutes, as arrt�nded?: if valuation a#work Rs$2,500.00 or more, !
<br /> certify that I, the applicant, have been provided �ntith a copy of'the "Florida Constcuction l.ien Law—Homeowner's
<br /> F�rotection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If#he applicant is someone
<br /> ather than the"owner", I certify that I have obtained a copy of the above described document and promise in good faith ta
<br /> deliver if to the"owner"prior to commencemen#.
<br /> CONTRACTt3R'S/O{AIN�R'��,iFF1DAVIY: 1 certif}r that alt fhe informafion in #his application is accurate and that ait work
<br /> wrilE be done in compliance with a!1 applicabte (ar�rs regulatirtg construction, zoning and land develapment. ApplEcatiorr is
<br /> hereby made to obtain a permit to do wrork and installation as indicated. ! certify that no vuork or installatian has
<br /> commenced prior to issuance of a permit and that all work v�rill be performed to meet standards of all laws regula#ing
<br /> construction, Caunty and City codes, zaning regulations, and tand development regulations in the jurisdicfian. Q also
<br /> certify thaf I undersfand fhaE the regulatians of other government agencies may apply to the intended worfc, and fhat if is
<br /> my responsibility to identify what actions 1 must take to be in campliance. Such agencies include but are nat limited to:
<br /> - Department of Environmental Protectian-Cypress Bayheads, Wetland Areas and Enviranmentally Sensitive
<br /> l.ands, WaterNVastewater Treatment.
<br /> - Southvue'st Flvrida Water il�anagement District-Wells, Cypress Bayheads, Wetland Areas, Altering
<br /> Watercourses.
<br /> - Army Corps af Engineers-Seawalls, Docks, IVavigable Wafervvays.
<br /> - Department of Neaifh & Rehabifitative Services/Enviranmental Heafith Unit-Wells, Wastewater Treafinent,
<br /> Septic Tanks.
<br /> - US Environmenta{Protection Agency-Asbestos abatement.
<br /> - Federa!Aviation Autharity-Runuvays. ' .-
<br /> ! understand thak the following restrictions apply ta the use of fill:� ,
<br /> - Use of fill is not allowed in Flaod Zane"V"unless expressly permitted.
<br /> - If the fili material is #o be used in �load Zone "/�", it is understaod that a drainage plan addressing a
<br /> "cornpensating volume" will be submi#ted at tiene af permifting vwhich is prepared by a professional engineer
<br /> iicensed by the State of Florida. �
<br /> - If the fill material ss ta be used in Flood Zone "N" in connection v�ith a permitted building using stem v�rall
<br /> construc#ion, !certify that fill wi!! 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 far vioiating
<br /> the condifions of the bui(ding permit issued under the affached permit applicatian, far lats �ess than one (1}
<br /> � acre which are elevated by fiil, an engineered drainage plan is required.
<br /> � tf!am the AG�NT FOR�'H�O1fifYVEi�, f pramise 4n good faiEh to inforrr�the owner of the permitting conditians set forth in
<br /> this affidavit prior ta commencing construction. ! understand that a separate permit may be required for electrical work,
<br /> plumbing, signs, wells, pools, air conditioning, gas, or other ins#allations 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 authori#y ta.violate, cancei, alfer, or
<br /> set aside any provisions of the technical codes, nar shall issuance of a permit prevent the �uilding C}fficial fram thereafter
<br /> requiring a correction of errors in plans, canstruction or violations of any cades. Every petmit issued shall become invaiid
<br /> uniess #he work authorized by such permit is commenced within six mortths of permit �ssetance, or if work authorizec! by
<br /> the permit is suspended ar abandoned far 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 vvill demonstrate
<br /> justifiable cause for the extension. If work ceases for ninery(90)consecutive days, the job is considered abandoned.
<br /> WARiVt(d+� �"t3 OWP1�R: YOIIR �AILU E TCl R�C�RD A PIOTICE OE COM14��NG�H1fEWT ti�A ESULT tPl YC?U�2
<br /> PAYBiVCs TW10E FCtR 1�11PRC?`tE14��H1 TC!YOUR�f�O�ERTY, t�YOU lP11'EN T4 QBTAIN F A..1+1ClNG,CONSl1LY
<br /> tfi�tT'H`YQtlR�END�R O P►�1,�iY�" � W�Y�E�C1��f��CUR�Dl�IG YQllR ~.C�Oi�COf�I 'CEf�iIEPlT.
<br /> - --- ---- -----�--
<br /> FLORIDA.IURAT(F.S. 117 0 '
<br /> j�f0l�lPdER 4R . �� '--- �',-�--�..� �QPlTRA Q!� '
<br /> - Subscrtbed an bswarn or a �d)bg re me t� 1 ubscribed an bY med be me this
<br /> Who fslare personally kna o me or hasJha�e praduce � Wt�o Istare personalty k own ta e or haslhave pro uced
<br /> as IdenUfication. as identlfication.
<br /> ,,,��, ' '��s��� Notary Pubtic .•.•'"Y P,,,., Nofary Pubfic
<br /> — �L. .��,� :,-, I�ELI�€�9�E`� � ,
<br /> Com I�sI� "� ���mmission#EE tk�{}520 =*: �' Commission#
<br /> " � Commission No :f: :�. E�040520
<br /> �=
<br /> ��'�P��.�P� I+�rcic:i°hNTroyFaUlnsurance800�385-7019 ' +y'�R��ii�e�~, Bunded7lwT F , 4
<br /> i r
<br /> �°��"���7US9
<br /> Name o(Notary typed,printed or stamped Name of Natary typed,printed or stamped •
<br />
|