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<br /> NOTICE OF L1EED RESTRICTlONS: The undersigned understands that this permit may be subject to"deed" restric#ions"
<br /> which rnay be more restrictive than Caunty regulations. The undersigned assumas responsibility far compliance with any
<br /> applicable deed res#rictions.
<br /> llNL10ENSED CONTRAGTORS AND CONTRACTOR RESPQNSiSi�iTIES: lf the awner has hired a contractar or
<br /> contractors to undertake work, they may be required to be licensed in accordance with state and (ocal regulations. lf tfie
<br /> contractar is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
<br /> under sfate iaw. If the owner or intended cantractar are uncertain as ta what licensing requirements may apply for the
<br /> intended work, they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
<br /> 80Q9. Furthermare, if the awner has hired a contractor or contractars, he is advised ta have the contractor(s) sign
<br /> portions of the "contractor Block" of this application for which they will be responsibfe. If you, as the owner sign as tF�e
<br /> cantractar, that may be an indication that he is not properly licensed and is not entitled ta permitting privileges in Pasco
<br /> County.
<br /> TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
<br /> that Transportation Impact Fees and Recourse Recovery Fees may apply to the construc#ion of new buildings, change of
<br /> use in existing buildings, ar expansion of existing buildings, as specified in Pasco County Ordinance number 89-q7 and
<br /> 90-07, as amended. The undersigned alsa understands, that such fees, as may be due, will be identified at the time of
<br /> permitting. It is further understoad that Transportation impact Fees and Resource Recovery Fees must be paid priar to
<br /> receiving a "certificate of accupancy" ar final power release. If the praject daes not involve a certificate of accupancy or
<br /> finai power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County WaterJSewer lmpact
<br /> fees are due,they must be paid prior to permit issuance in accordance with applicable Pasco County ardinances.
<br /> C�NSTRUCTiON �fEN �AW(Chapter 713, Florida Statutes, as amended}: lf valuatian of wark is$2,504.00 ar more, !
<br /> certify that 1, the applicant, have been provided with a copy of the "Florida Construction l�ien Law—F{omeowner's
<br /> Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
<br /> ofher than the"awner", 1 certify that I have abtained a copy af the abave described document anci promise in gaod faith ta
<br /> deliver it to the"owner" prior to commencement.
<br /> CONTRAC70R'S/OWNER'S AFFlDAV1T: l cerkify that all the informatian in this application is accurate and that all work
<br /> will be done in compliance with all applicable laws regulating consfruction, zoning and iand development. Application is
<br /> hereby made to obtain a permit to do work and installation as indicated. I certify that no work or ins#allatian has
<br /> camrnenced priar ta issuance of a permit and that a11 work will be performed ta meet standards of ali laws regulating
<br /> construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
<br /> certify that 1 understand that the regulations of other government agencies may app{y ta the intended wark, and that it is
<br /> my responsibility ta identify what actions � must take to be in compliance. Such agencies include buf are not limited to:
<br /> - Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br /> Lands,WaterlWastewater Treatmenf.
<br /> - Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
<br /> Watercourses.
<br /> - Army Corps of Engineers-Seawalls, Dacks, Navigable Waterways.
<br /> - Department af Health & Rehabilitative Setvices/Environmental Health Unit-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#he use of fill:
<br /> - Use of fill is not allowed in Flood Zone"V"unless expressly permitted.
<br /> - If the fi11 material is ta be used in Fioad Zane "A", it is understoad that a drainage plan addressing a
<br /> "compensating volume" will be submitted at time af permitting which is prepared by a professianal engineer
<br /> licensed by the State of Flarida.
<br /> - If the fill material is to be used in Flaod Zone "A" in connection with a permitted building using stem wall
<br /> construction, 1 certify that fil!will be used only to fill the area within the stem wall.
<br /> - If fiiE maferiai is to be used in any area, 1 certiiy fhat use af such fill wi11 nat adversely affecf adjacent
<br /> properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
<br /> the conditians of the building permit issued under the attached permit applicatian, far lats Sess #han one (1}
<br /> acre which are elevated by fill, an engineered drainage plan is required.
<br /> !f I am the AGENT FOR 7HE OWNER, ! promise in good faith to inform the owner of the permitting conditians set farth in
<br /> this a�davit prior fa commencing construction. 1 unc3erstand that a separate permit may be required far electrical work,
<br /> plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
<br /> permit issued shali be cans#rued #o be a license to proceed vuith #he wark and not as autharity ta violate, cancel, alter, ar
<br /> set aside any provisions af the technical codes, nor shall issuance of a permi#prevent the Building Official from thereafter
<br /> requiring a correction ot errors in plans, construction or violations of any codes. Every permit issued shall become invalid
<br /> j unless the work aufhorized by such permit is commenced within six manths of permit issuance, or if work authorized by
<br /> the permit is suspended ar abandoned for a period of six (6) months after the time the wark is commenced. An extension
<br /> may be requested, in writing, from the Building Offcial for a period not ta exceed ninety {90} days and will demonstrate
<br /> justifiable cause for the extension. If work ceases for ninety(9Q)consecutive days,the jab is considered abandoned.
<br /> WARNiNG TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMEN7 NfAY RESULT 1N YOUR
<br />, PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br /> Wi3H YOUR LENDER CtR AN AT3 N BEFORE RECORDING YtJUR NOTICE OF C CEMENT.
<br /> FLORIDA JURAT(F.S.117.0
<br /> OWNER QR AGENT CONTE2ACTOR �
<br /> Sub rib d and sworn to(o ffirmed before me this Su,b s ri d and sworn to(or affirmed)before me this
<br /> Z- / by_�,F727�"✓�7`"t..-�2�f i1/G k� ?i/ by /�7,:�42T�'✓ .�?"u'n-Lin/6�
<br /> W a i�sonally known to me or hasthave produced Who islare personally known to me or E�aslhave praduced
<br /> as identification. as identification.
<br /> �
<br /> Notary Public Natary Public
<br /> C ission No. C%2�t7l�Z�t� Commis o No. �L''�D��2.'7�
<br /> f�+1 t As✓Hlir� t/o(� C�"�Z./J"�''rr�v.Iirr/
<br /> Name of o a f ped pri�nfedq`o�r s�t��ped Name of Notary t� ed, rinted r t ed
<br /> Qt�Y°Ua� i�okary Public Stata of Flarida etP4Y pveG Ivotary Public State a!Flodda �
<br /> � = s�� ; John H Christia��son ,� ? �� : John H Christiansan
<br /> '2�=r�_, a My Commission EE017274 �?G o My Commission EE017274
<br /> 9jFa��o°� Expires 10/15/2014 4�'q�p�oo- Expir?s 10/15/2014
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