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<br /> NoTlGC OI=D��D RCSTPICTIONS: Th�.undersigned underst7ncls i:f�ai:�:(�is permit m�y b�subject�o "dceci"reslrictions"
<br /> w1�Ich may!�� more r��tricfiive il��n County regulations. TI�� undQrsign�d �ssumes respansii�ility�For com�iianc�wifih any �
<br /> appiic�tbfe cieed r�stricl:ions.
<br /> UNLtC�NS�i� C�t�TI�AGTORS AI�tD CaI�TI�AGTOI�. I��SS�n1�1S1BI1.ITICS: 1�( Ll�e owner izas l�ircd � contr�ctor or
<br /> contractors i:o under[�Ice woric, �Iiey m�y i�� r�quirecf to b� fic�ns�ci in �ccord�tnce wifii} st��e and lac�l rec�ula�ions. 1�!lhe
<br /> conir�efior is nofi lic�ns�c! �s r�quired Jay I�rw, f�a�[I� the owner �nd confiractor m�y�i�e citeci �Tor � misdem��nor violation
<br /> under si�te law. I�f�1�� own�r or int�nded contracL•or �re LincerL•ain �s fio wl�at lic�nsing rcquirem�nts may appiy�rar ihe
<br /> infiencieci woric,ti7�y are�dvis�d to�cant�cf tl�e f'�sca Coun�y Building Ins�ec�:ion Division—Lic�nsing S��tian at 727-S�I.T-
<br /> 800J. rurfif7�rmore, i� i:l�e owner lias hir�ci � contractor or confiraciors, !�� is �c�vis�d Lo h�ve fihe contractor(s) sign
<br /> �orlians a�F'fihe "contr�ctar 13(ocic" o�F�Li�is appiic�tion �For which ti�ey wilf i�e r�sponsii�ie. .if you, �s th� own�r sign as fi7�
<br /> conir�ctor, tli�1 may bc �n incficaLion �l��i he is riot properiy iic�nseci anci is not'�r�fiiLleci to permit[ing privil�g�s in P�sco
<br /> COL111tJt. �
<br /> Tf�ANSi'�I�TAT[t�N 1MI'ACTIUTI�.ITI�S IMl'AGT A�lI� P�50UPGC I�.CCaV�1�.Y r��5: The unclersic�ned understal7cls
<br /> tl�al-Transportafiion imp�cfi F��s �nd Recourse t�ecovery Fees m�y�pply�:o il�e const�•ucl:ion'o�C n�uv bui(clings, cll�nge af
<br /> us� in �xisting buiidings, or �xp�nsion o�F�xisting i�uiidings, �s s�eciFi�d in P�sco Coun{y Ordinance numb�r 89-07 �nd
<br /> �0-07, as am�ncled. Th� undcrslc�n�ci also undors�t•ands, �[l��t sucl� •Tees, as m�y 1�e d«�, wili i�e icienfii�ied �t fhe�ime oF
<br /> perm#Ctfng. !fi is �fur(l��r und�rs�aacl �:hal Tr�nsporka��ion lmp�ck �'e�s ancl I��so��rc� l�c�;avery Fe�s must b� paid prior ta
<br /> rec�iving � "cerEi(ic�te o�F accu��ncy" ar�fin�l pow�i� i•e[�ase. I�F�ll�e praject cloes not involv� � certl�fic�fic a�f accup�ncy or
<br /> �(in�l pow�r rele�se, fhe �F��s must b� �aid prior fio �ermit isscT�nc�. 1=urlh�rrnor�, iF 1'�sco County 1N7fierl�ew�r lmp�cl•
<br /> •F��s�r� c[u�,1:h�y must bo pnici prior•[o�p�rmit issu�nce in accorci�tnce witi� appiic�i�i� f��sco Caunty ardinanc�s.
<br /> C01�57'RUCTION LICN L/�W(Chapl�r 7�1�, 1=larid�5t��tut�s, �s �m�nd�ci): i�Fv�lu�tion a�Frivoric is ;�2,500.00 or mor�, I
<br /> c�rtiFy �fi�t I, th� a��(icanfi, have i�e�n provided wi�Ll� �t co�y o•C �LI�e "�larid� Construc�:ion L.i�n Law—i-iomeawnor's
<br /> Profoc[ion Guicie" pr�p�r�ci f�y�(he Florid� be�ar[m�nt o�f Agrict�ll:ure ancl Gons�tmer ACf�irs. I�C i:l�e a�plicant ls someana
<br /> ot1��r fi1��n t1��"awner", 1 certify thaG I h�ve.oi���in�ci a copy a�F�:l�� above cf�scrib�c! docum�nt�nc! pramise fn good�f�i�l�io
<br /> deliver ii ta th�"owner"prior fio commenc�menfi.
<br /> CON'TRACTQR'S�OW�iCP'S A.I=1=1J�.�VIT: ! c�rti�Fy th��l�Ii•ti�� 1n��ormaiion in t1�is anplic�fiion is accur�tc anci thafi�11 worlc
<br /> wiiE f�� done in compliance wit1� a!! ap�lic�l�le l�ws rec�ul�ting canstrucfiian, zoning and land dev�lopmen�t. Applic�tion is
<br /> iiere�iy m�de fia obtain � p�rmifi to do worlc �ncf inst�ll�fio� ns indic�fi�d. 1 cerLily �L•h�t no warlt ar insf�!lation has
<br /> aommenceci �arior to issu�nce o�� � �ermfit �nd �tii�t �fi woric wiil i�e per�arm�cl io m��l sfanclarcis ofi �il l�ws regulating
<br /> consfirucfiion, County �nc( Cii:y cad�s, zoning r�guiations, �nd tand dev�topm�nfi r�gui�fiions in fii�e jt�riscficiian. I aiso
<br /> c�rkify�l�a� 1 undersfi�nd lh�i th� r�gulaLions o'f atl�er governme��t �genci�s m�y appiy�[o [i�e intended woric, �ne( fii��t it is
<br /> my r�sponsibifify to id�nti�Fy wl��t�clians ( m�zs�[i�ke fio i�e in campli�na�. Such ac�enci�s includ� (�ut�ro nofi Iimifi�d{o:
<br /> - D�p�rtmenfi o����nvironm�nfiai �Protection-Cy�sress B�yh��ds, VlfefiI�nd Ar��s �nd �nvironm�nta!!y Sen�itive
<br /> Lancis,W�t�rlWasfiew�[�rTr�atm�nt.
<br /> - Sot�filiv�r�st C=loric(a W�1:er M�nagem�n[ Dis�Lricfi-Wells, Cypress B�y1���tcis, W�tiand Ar��s, Altering
<br /> W�fiercot�rses.
<br /> - Army Cor�s o��Engin�ers-Se�walls, �ocIcs, N�vigal�Ie W�fierw�ys.
<br /> - D�par(menfi o�� 1-ieaith & i�.ei�ahifi[�tiv� Servic�siCnvir.onrr�enla{ 1-le�ltl� Unit-�!I(ells, W�stew�l�r Treafiment,
<br /> Septic Tanlcs.
<br /> - US Cnvaronmenfi�l Prot�cl:ian Agency-Asb�sios �i���Cem�nt.
<br /> - F�derai Avi�tion Aufliorcly-f��tnw�ys. �
<br /> 1 unc(orsf�nci fih�fi fih�following r�strictions�pp1y�ta��[ho us�o�f�ffll:
<br /> - Uso o�r•�iii is nofi�1lowecl in 1=looci�one"V"unless �xpress(y�ermit-t�d.
<br /> - [�f lh� fii!! materin! is to I�e used in i=lood Zone "A", ifi is und�rsfiaoc( ti���l � cfr�inage pf�n acCdressing �s
<br /> "comp�rts�fiing vofume° wi!! 1�� submii�:�d ai:fiimc o�f p�rmifi[ing wt�ich i5 prep�red by a pro�ession�l engin��r
<br /> iicensecl by tf�e St�te o�f rforida. _
<br /> - i��fii�e �(iii m�fieri�i is fio I�e�tTSeci in Ffoacf Zon� "A" in connec�:ian Srvith n permiLfi�d I�u3lcling using stom wa!!
<br /> � canstruction, I c�rti•�y fihafi�Fi11 wi1( be used•oniy fio fii11 fhe �re�within th�sfi�m w�if.
<br /> - l�f..•fill mal�ria! is to !ae us�d in �ny �ren, I�c�rfii�Fy tha�t use o•r sucii �till wiil nofi adv�rs�iy a�FFocfi adj�cent
<br /> ' prap�rti�s. f�f.�us� o�f�fill is��ot�ric( lo adv�rsely a�PCecfi adj�cenfi properties, fih� own�r m�y be cifieci�Cor vioi�iting
<br /> ih� conc(itions of fii�r� buiiciing permit issu�c!•unciez•�Ch� �til:�ch�c! p�rmif �tp��lic�l:ian, 'far (ol's less fil�an ono ('!)
<br /> �cre wi�ich �r� elev�t�d i�y'�11, �n �nginecr�d drafn�gc pla�7 is reqt�ir�d.
<br /> !�C 1 am ili�A�CNT rOP TI-IC OWN�I�, 1 promis� in good�F�it1�fio in�Form ti�e owner o�r�h� p�rmiti:ing conditions s�t�fortl� in
<br /> �his a�ffidavi� (�rior to commencIng consfiruciion. I unc(ersfi�nd ih�fi a s�p�r�fi� �ermifi m�y 1�� r�quired�For el�ctric�f wori<,
<br /> �iumi�in�, signs, w�lis, paa}s, air col-�c(iiioning, gas, or oth�r inst�Il�fii�ns nat�specific�lly incluci�d in fi1�o apptia�tion. A
<br /> �ermit issuecl s1i�i( I�e consfiru�cf to be � fic�ns�to proceed wi�I� tl��worlc�nd no1:as �uiharity fiqviolai�, cancel, �It�r, ar
<br /> set•�sicle any provisions o�F ti�e tecimicai coc(es, nor shaf( issu�nc� or� permi�pr•�v�ni ll�e L�uilciing Ofifici�l�from ther��fler
<br /> r�q«iring a correcti�n o�(crrors in plans, construcfiion or vial�tions o�F any cod�s. Cvery permiL tssueci sl��il becomc� inv�lid
<br /> un(�ss �i��worlc�ufihorizec! by sucl� ��rmifi is commerrcecl wifil�in six monfil�s o��permit issu�nce, or i�woric a�tfii�oriz�d Gy
<br /> fihe permit is susp�nc(�ci ar�tE��nclon�cl°For� period o�f six(6) montl�s a�fi:er i;he{im�fihe worlc is commene�ci. An extension
<br /> may 6e request�cl, in writing, �'rom ti�� BL�iiciing'��Ffici�! for � {�eriod nai:fio �xcee�l nin�ty (�JQ) d�ys and wil! demonsfra[e
<br /> Justifi�tble c�use�For�the �xtension. i�Fworic ce�s�s��ar nincty. (90) cons�cu�ive days,l:f-�e jo(� is consId�r�c! a�andoned.
<br /> 1NAi�NIN� TO t?11111V�R: YOUI�..rAILU1�C TO l���OPD .�1. N�TICC 01= COIVfM�NCCI111�t�IT Nf�IY I��SULT 1N•1f�0Ur
<br /> PAYiNC TWIC� �Ot�INIi'I�t?VZNI�NT�TO YCJUR P13�l��T�TY. II=YOCJ INT�NI7 TO OBT.�IIN rIN.�NCiNG, CONSULT
<br /> WITI-I YOUP L.�N13CP Oi�.A�i 1�TTORN�Y 13�FCtR� PGGORDJNG Y�I:JI� NC?TIGC t��' CONJM�NCCMZN`f.
<br /> 1=LORIDA JURAT(f-.S.1'17.03� '
<br /> �WNCR OR AGGNT C�='--�.-�Ci<--�w����2�/,fr GQNTI'�1.CTCIR ��� �/'�C
<br /> SubscriGed� d sworn to or afPirmed e re me fhis SttbscriU�d nd sworn ts r afifCmod)b tora o i�s ,
<br /> P 1�3-15��y �,�.�-L� C���/c .�,���� - �3-1 �y t! �e ,� �
<br /> Who is/are ers I�isaauuu.ta me or hasihave�roduce�i 1Nho Islare�ersonally lmaw�to me or l�aslhave producec!
<br /> as iclonfiiication. ---'—"�"—' as idenETcation.
<br /> �_L�c='���c°`.� Notary Public GZ't-�t— Notary Pub(ic•
<br /> Commiss on No. Commission o.
<br /> NOTARY pi'BLIC-STATE OF FLORIDA
<br /> ,.� '��; �tiizanne Bahr
<br /> t�lame oF Nofiary typed,pt�rr " 's �s-'ar: EE044504 Name of Nolary typed,pr'tnted or si�m�eri' �_�• " � '°
<br /> ` �', van^7::,�5�.�7#EE�44544
<br /> Ex�����:> '�'OV.22 2Q14 =.��,;
<br /> �.,, � �.�- � Exgi:�:s. ti 0V.22,2014
<br /> BOi`DEDTARL'P.ii..' l rOSnLtiGCO.,INC. BO\17F�THRL';11.;`.'e';: o;i�D(VGCO,INC.
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