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<br /> NOTICE O� DEED RESTRICTIONS: The undersigned understands that#his permit may be subject to"deed" restrictions"
<br /> which may be more restrictive than County reguEations. The undersigned assutt�es responsibilify for campliance with any
<br /> applicable deed restrictions.
<br /> UNLICENSEQ CONTRACTURS AND CO�ITRACTOR RESPONSlBtLl1'IES: !f the owner has hired a cantractor or
<br /> contractors to undertake work, #hey may be required to be licensed in accordance wifh state and local regulations. If the
<br /> contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
<br /> under state taw. if the awner or intended cont�aetor are uncertain as ta wFtat licensing requ'rremenfs may apply for the
<br /> intended work, they are advised to contack#he 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 cantractor(s) sign
<br /> portians of the "contractor Black" of #his appfication far which they will be responsible. If you, as #he owner sign as the
<br /> contractor, that may be an indication that he is not properly licensed and is not entitled to permit#ing privileges in Pasco
<br /> County.
<br /> TRANSPORTATIOfV IMPACT/UTILI7'IES IMPA�Y AND RESOURCE RECOVERY FEES: The undersigned underskands
<br /> that Transparta#ian Impact Fees and Recourse Recovery Fees may apply to fhe construction af new buildings, change of
<br /> use in existing buildings, or expansian of existing buildings, as specified in Pasco County Ordinance number 89-07 and
<br /> 90-Q7, as amended. The unders4gned a4so understands, that such fees, as may be due, wii! be identified a# the time of
<br /> permit#ing. It is further understood thaf Transporfafion Impact Fees and Resource Recovery Fees must be paid prior to
<br /> receiving a "ce�tificate of occupancy" or final pawer release. (f the project does not involve a certificake of occupancy or
<br /> finat powrer release, the fees must be paid prior ta permit issuance. Furthermore, if Pasca Caunty V1/aterlSewer Impact
<br /> fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
<br /> CQN5TRUGTION lIEN 1.AW{Chapter 713, �larida Statutes, as amended): !f valuation of work is$2,500.00 ar more, i
<br /> certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
<br /> Protectian Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. lf the applicant is someane
<br /> other than the"owner", I certify that I have obtained a copy of the above described ciocumen#and promise in good faith to
<br /> deliver it to#he"owner"prior to commencement.
<br /> CONTRACTOR'SIOWN�R'S AF�IDAV1'T: 1 certify that all the 'tnformation in this appEication is accurate and that al4 work
<br /> will be done in campliance with all applicable laws regulating construction, zoning and land develapment. Application is
<br /> hereby macfe Eo obtain a permit ta do work and installation as tndicated. 1 ceetify that no uvork or installation has
<br /> commenced prior fo issuance of a permit and that all work will be performed to meet standards of all faws regulating
<br /> construction, County and City codes, zoning regulations, and land development regutations in the jurisdictian. 1 also
<br /> certify that I understand #haf the regu(ations of other government agencies may apply to the intended work, and that it is
<br /> my responsibility to iden#ify what actions I must take to be in compliance. Such agencies include but are not limited to:
<br /> - Department af Environmental Protecfion-Cypress Bayheacis, Wetland Areas and Enviranmentally Sensitive
<br /> Lands, WaterNVastewater Treatment.
<br /> - Southwest Florida Water �anagement District-Wells, Cypress Bayheads, Wetland P�eas, Altering
<br /> Watercourses.
<br /> - Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
<br /> - Depar#ment af Heaifh & Rehabilitative Services/Env�ronmentat Flealth Unit-Wells, Wastewater Treafinent,
<br /> � Septic Tanks.
<br /> � - US Environmental Protection Ag�ncy-Asbestos abatemen#.
<br /> - Federal Avia#ion Authority-Runways. �
<br /> !understand that the following restric#ians apply to the use of fiR:�
<br /> - Use of fi11 is nof allowed in F1ood Zone"V"unless expressly permitted.
<br /> - If the fill material is ta be used in Flood Zone "A", it is understood that a drainage plan addressing a
<br /> "campensating volume" will be submi#ted at time of permitting vuhich is prepat�ed by a professional engineer
<br /> licensed by the State of Florida.
<br /> - If fhe fill material is to be used fn Flaad Zone "A" in connectian with a permitted building using s#etn wall
<br /> construction, I cettify that fill will be used only to fill the area wifhin the stem wall.
<br /> - If fill ma#erial is to be used in any ar�a, 1 certify that use of such ftll will not adversely affect adjacent
<br /> properties. if use af fii( is found ta adversely affect adjacent properties, fhe owner may be cited for vioiafing
<br /> i the conditions of #he building permit issued under the attached permit applica#ion, for lots less than one (1)
<br />; acre which are elevated by.fiEl, an engineered drainage plan is required.
<br /> If I am the AGENT FOR THE OWN�R, I promise in gaad faith to inform the owner of the permitting conditions set farth in
<br /> fhis affidavit priar to commencing constructian. I understand that a separate permit may be required for electrical work,
<br /> plumbing, signs, wells, pools, air conditioning, gas, or ofher installations not specifically inciuded in the applicatian. A
<br /> permit issued shall be construed to be a license #o proceed with the work and not as authori#y to violate, cancel, alter, or
<br />_ se#aside any proyisions_of the#echnical codes, nor shali issuance of a permit prevent the Building tJfficial frorn thereafter
<br /> requiring a correction of errors�in plans, canstruction or violations of any codes:��very permit"issued sh�all became�invaiid- --- �� �-
<br /> un[ess the work authorized by such permit is commenced within six months of permit issuance, ar if vtrork authorized 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 /> may be requested, in wri#ing, from the Building Q�ciai #or a psriod not to exceed ninety (90) days and wil! demonstrate
<br /> justifiabie cause far the extension. If work ceases for ninety(90j consec�tive rfays, the job is considered abandoned.
<br /> WARNING TO CIWNEE2: Y{?UR FAILURE TO RECCIRD A NOTICE CtF COMIVIENCEMENT �tiAY R�SULT IN YC?UF2
<br /> PAYIIWG TWICE FUR IIYIPROVEM�NTS TO YOUR PROPERTY. IF YOU INTEND TO OBYAIN FINANCING, CONSl1LT
<br /> WtTN YOUR LENDEFt C1R AN ATTORN�Y��FORE �ECORQlNG YOUR NOTICE C1E COMIV�ENCEtV1ENT.
<br /> FLORIDA JURAT(F.S.117.03)
<br /> OWhlEROi2AGENT GONTRACTOR ��.�('lGt` Jti(d� 11'�YIOfI L1(�•
<br /> Subscrlbed and swom to(or affirmed)before me thls Su1bscr`b-ed and swom to(or affirmed)before me this
<br /> by ,�1..���'�!by
<br /> Wi�o isJare personalty known to me or haslhave produaed � Who fslare personally known ta me or haslhave produced
<br /> as(dentlficaGon. "'— as identification.
<br /> ry ,.,'"�°0� JACQI���RUITINER
<br /> Nota Public :•'i°`' "°4r:
<br /> Commfssion No, Ission No. `*y �*# �Y CO(V1iY11SSIQN#FF1448i7
<br /> '� ���e� 4. 2018
<br /> ° aQ -0153 FloridallotaryService.com
<br /> Name of Notary typed,printed or stamped Name of ry typed,printed or stamped
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