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�1O'��CE pF p�Ep RI�,��OCYIOPI�: The undecsigned understands that this permit may be subject to°deed" restrictions" •
<br /> which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
<br /> applicable deed restrictions.
<br /> l3NLICENS�D COP17Rf�C70K�� �,R9� CONY�C�'�� �f���OR��I��L��'i��: If the o�vner has hired a contractor or
<br /> contractors to undertake work, they may be required to be licensed in accordance writh state and locai 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 law. If the owner or intended contractor are uncertain as fo 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 /> 8009. Furfhermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
<br /> portions of the "contractor Block" of this application for uvhich they will be responsible. If you, as the owner sign as the
<br /> contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
<br /> County.
<br />' 1fR�f�SPO�TAT10�1 I�i1��CYlU�'IL9�'91�� �Rfl��►CY�R9� ���0�9��� �f�COlY��Y fF���: The undersigned understands
<br /> that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
<br />� use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
<br /> 90-07, as amended. The undersigned also understands, that such fees, as may be due, w�ill be identified at the time of
<br /> permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
<br /> receiving a "certificate of occupancy" or final pouver release. If the project does not involve a certificate of occupancy or
<br /> final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
<br /> fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
<br /> �OIVSY�tlJC710�1 LI�R� L��VV(Chap�er 7�3, �loric➢���a�4ut��, �s ��rend�d): If valuation of work is $2,500.00 or more, I
<br /> certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Lavv—Homeowner's
<br /> Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
<br /> other than the "owner", I certify that I have obtained a copy of the above described document and promise in good faith to
<br /> deliver it to the"owner" prior to commencement.
<br /> �OWT�kiC°f0�'SlOWR41��'� 6�f��1��VV�': i certify that all the information in this application is accurate and that all work
<br /> will be done in compliance uvith all applicable laws regulating construction, zoning and land development. Application is
<br /> hereby made to obtain a permit to do v�rork and installa4ion as indicated. I certify that no work or installation has
<br /> commenced prior to issuance of a permiY and that all work �vill be performed to meet standards of all laws regulating
<br /> construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction_ I also
<br /> certify that I understand that fhe regulations of other government agencies may apply to the intended work, and that it is
<br /> my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
<br /> - Department of Environmental Protection-Cypress Bayheads, Wetland preas and Environmentally Sensitive
<br /> Lands, VVaterNVastevuafer Treatmenf.
<br /> - Southwest Florida Water Nlanagement Districf-Wells, Cypress �ayheads, Wetland Areas, Nltering
<br /> Watercourses. •
<br /> - Army Corps of Engineers-Seawalls, Docks, Navigable Waterways. -
<br /> - Department of Health � FZehabilitative Services/Environmental Fiealth Unit-VVells, Wastewater Treatmen4,
<br /> Septic Tanks. _.,
<br /> - US Environmentai Protection Agency-Asbestos abatement. _ �
<br /> - Federal Aviation Authority-Runways. �
<br /> I understand that the follovving restrictions apply to the use of fill:�
<br /> - Use of fill is not allowed in Flood Zone"V"unless expressly permitted. '
<br /> - If fhe flll 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 fime of permitting uuhich is prepared by a professional engineer
<br /> licensed by the State of Florida. � �
<br /> - If the fill matePial is to be used in Flood Zone "A" in connecfion with a permitted�building using stem wall
<br /> construction, I certify that fill will be used only to fill the area withiri�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 owiner may be cited for violating
<br /> the conditions of the building permif issued under the atfached permit application, for lots less than one (1)
<br /> acre which are elevated by fill, an engineered drainage plan is required. �
<br /> If I am the�C�IENT �OR THIE OWl�1fE�, I promise in good faith to inform the owner of the permitting conditions set forth in
<br /> this affidavit prior to commencing construction. I understand fhat a separate permit may be required for electrical work,
<br /> plumbing, signs, wells, pools, air conditioning, gas, or other installations 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 authority to_violate, cancel, alter, or
<br /> set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Buildirig Official from thereafter
<br /> reguiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
<br /> unless the work authorized by such permit is commenced within six months of permit issuance, or if work 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 writing, from 4he �uilding Official for a period not to exceed ninety (90) days and uvill demonstrate
<br /> justifiable cause for the exte sion. If work ceases for ninety(90)consecutive days, the job is considered abandoned.
<br /> �f!lARNIRIG TO Olfl9R���• V011�t IF�AIL�1�� TO �f����2D � Y�OYYC� OF COfifl�flE E�fl�i��f �AY f1��Sl9l.T 9i� YOI��
<br />�. 6��YIP9G�iliC� IFO� d ��Vl��fil�6�lf� Y 1(O�Dff�I��Of�Eialflf. If�l�Ol1 INEY�FI O 0�1�l�9Pl �IPI�RI IRl2�, Ct7�7SLBfL�'
<br /> U�[TH YOl9� LE�1D�. O��W�1fYO�i�9 f��f�O�YI� �f�COl�l�lh��YOIJR R➢O'�° �C OF COf�Vf�iiEYVC ��llf.
<br /> FLORIDA JURfiT(F.S. 1 .03)
<br /> OlRIRlER OR AGEPd CORIT�tACYOR
<br /> S ,_s�cr�bed or a�rm d)before m this �G 1�91'L'L �d d o o( r a irmed)before me ' e, �,3g122
<br /> '�"`�'1
<br /> Who is/are nally nown to or has/h c ��� o Is/ar r ally no to e s/ha �Zp,
<br /> as Ide c,�6� .�55\0��y�e�'�' + as'�.�p s� �,
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<br /> fVo Public Notary Public
<br /> Commission PJ �� Commission fV . ��
<br /> � ' � L
<br /> Name o(Notary typed,printed or s amped Name of Notary typed,printed or stamped
<br />
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