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<br /> �!O'TICI� O� DE�D RES'�RICl"IOR9�: The undersigned understands that this permit may be subject to"deed" restrictians" •
<br /> uvhich may be more �estrictive than County reguiations. The undersigned asstttnes responsibility for compliance rrvifh any
<br /> applicable deed restrictions.
<br /> t3NLlCENSED CONTR��C1F��t� �P1D �C9NY�C�'O!� M�f���OP1�8�9���'Y��: !f the owner has hired a contractor ar
<br /> confractors ta undertake v�ork, #hey may be required ta be licensed in accordance with state and loca{ regulations. If the
<br /> contractor is not licensed as required by law, both the ouvner and contractor may be cited for a misdemeanor violation
<br /> uncfer state law. !f the ovuner ar intended contractor are uncertain as ta vtirhaf licensing r�quiremenfs may apply far the
<br /> intended work, they are advised to contacf the Pasco County �uilding Inspection Division—Licensing Section at 727-847-
<br /> 8009. Furthermore, if the awner has hired a cantcactar or contractors, he is advised to havs the contractor(s} sign
<br /> � portions of the "contractar 81ock" of #his application for which they will be responsible. tf you, as the awner sign as the
<br /> contractflr, thak may be an +ndication that he is noY properly licensed and is not �ntitled to permitting privileges in Pasco
<br /> � County. �
<br /> � T92d�NSi�OR�'�7'ION iM�AGY/IUTILIYIE� i���►C"�'�,�C� �E�d�U��f� Rf��O@l��21(��E�: The undersigned undersi`ands
<br /> � thaf Transportation lmpact Fees anc# Recourse Recovery Fees may apply�o the construction af new buildings, change af
<br /> use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
<br /> 9Q-07, as amended. The undersigned also understae�ds, that such fees, as may be due, will be identified at the time of
<br /> permitting. It is further understood that Transpor#ation Impact �ees and Resource Recovery Fees must be paid priar to
<br /> receiving a "certificate of occupancy'" or final powrer release. If the project does not involve a certificate of occupa�icy or
<br /> final pawer release, the fees must b� paid prior #a permit issuance. Furthermare, if Pasca County WaterlSevfrer Impact..
<br /> fees are due, they rnust be paid prior to permit issuance in accordance with applicable F'asco County ordinances.
<br /> GQNS"fE�t1CT1�N 1.���4 �.�1f�1{CF�ap��r 713, �1ae�ic9��t��ut��, �s acnend�e�): Ef valuation of work is$2,540.00 or mare, 1
<br /> certify that I, the applicant, have been provided with a copy of the "Florida Constructian Lien Law—Homeowrner's
<br /> �rotection Guide" prepared by the �lor4da Depar#ment of Agriculture and Consumer/-1ffa�rs. !f the applicant is someone
<br /> other than the"owner", I cert+fy fhat i itav�obtained a copy of the above described document and promise in goad faith ta
<br /> deliver it to the "owner" prior to commencement.
<br /> �O�IT�2�GYO�t'Slt}t�IP���'��A�IFIID�VIIf: 1 certify that ail the infarmation in this application is accurate and that all tnrork
<br /> will be done in compliance with all applicable laws regulating construction, zoning and land develapment. Applicatian is
<br /> hereby made to obta'sn a p�rmit to do uvork and installation as indicated. 1 certify that no work or installation has
<br /> commenced prior to issuance of a permit and that ail work wili be perfarmed to meet standards of afl laws regula#ing
<br /> construction, County and City codes, zoning regulations, and land development regulations in khe jurisdictian_ I also
<br /> cerfify that I understand fhat the regulafions of ather gavernment agencies may apply to the intended uvark, and that it is
<br /> my responsibility to identify what actians I must take to be in compliance. Such agencies include but are not limited to:
<br /> - Depa�tment of Environmenta} Protectian-Cypress Bayheads, VVetland Areas and Environmentally Sensitive
<br /> Lands, WaterNVastewater Treatment.
<br /> - 5authuvest �lorida Water �r4anagement District-Wells, Gypress 6ayheads, Wetland Areas, Altering
<br /> tlVatercourses.
<br /> - Army Corps af Engineers�Seawalls, C�ocks, Navigable Waterways.
<br /> - Deparfinent af Flealth � Ret�abilitative Services/�nvironme�tal Nealth Uni#-�1Vells, Waste�nrater Treatment,
<br /> Septic 7anks. -
<br /> - US Environrrtentai Protection Agency-Asbestos abatement. -
<br /> - Federal Aviation Authority-Runvvays.
<br /> I understand thaf the follovving�estrictions apply to the use of fill:
<br /> - Use of fill is not allavved in Flood Zone"V"unless expressly permitted.
<br /> - If the �II material is to be used in Flood Zone "p", it is understood that a drainage plan addressing a
<br /> "campensating volume" will be subtnitt�c3 at time of permitting vuhich is prepared t�y a professiona! engir�eer
<br /> licensed by the State of Florida.
<br /> - If fhs fill material is ta be usecS in Ffiood �ane "A" in cannection v�riEh a permifted building using stem vtirall
<br /> construction, I certify that fill�nrill be used only to fill#he area within th�stem wrall.
<br /> - If fiN material is fo be used irt any area, 1 certify that use of such fil! wr911 not adversely affect adjacent
<br /> properties. !f use of fiit is faund to adversely affect adjacent properties, the owner may be cited for viola#ing
<br /> the conditions of ihe building permit issued under the attached permit application, for lots less than one (1)
<br /> acre which are elevated by�iN, an engineerecf drainage plan is required.
<br /> If I am the�G�P9�' �OR 1'HE OWlNE�, I promise in good faith to infarm the owner of the permitting conditions set forth in
<br /> fhis affidavit prior to commencing construction. I understand that a separate permit may be requsred for electricaf work,
<br /> plumbing, signs, wefls, paols, air conditioning, gas, or other insfalfations not specificatiy included in fhe app(ication. A
<br /> permit issued shal! be construed to be a license to proceed with the work and nat as aukhority to.violate, cancel, alter, or
<br /> set aside any provisions of the technical cades, nor shall issuance of a permit prevent the�uilding tJfFicial from the�eaffer
<br /> requiring a correction of errors in plans, construction or violations of any codes. Every permi# issued shall become invalid
<br /> un(ess the work au#horized �y such permit is commenced uvithin six months of permit issuance, or if worfc authorized by
<br /> the permit is suspended or abandoned for a periad of six(6) months after the time the work is commenced. An extension
<br /> may be requesEed, in writing, from_the 8uilding Official for a_period not to exceed ninety {90) days and �nril! demonstrate
<br /> justifiabie cause far fhe extension. If work ceases for ninety(90)cons�cutive days, the job is considered abandoned. - � -
<br /> 1f�ARR1M�� T4 �1�tRl��: Y�U�Z ����UR� TQ IR�C�(R� � 1��Y9C� O� �t��fl�il��C��il�l��' ��iY I�I��f�C,Y 11� VC3¢�R
<br /> F'd�Y1NC �i1PIC� �OY� If�II��OVE�1iiE�Y1(� TCE YO�DI� f��OfPER7Y. ��YOl1 O�T��1D li'�1 0�7',�I�l 1�9P1�►�l�IR9C°s, �OF1��J�.�'
<br /> �tittYH Y�t1�2 L�N�E�t OI� �iTY��t�1�Y'���'Cd�� ��CO(R�i�IC V�IJR�lOY#C(E C►F�t�11�iVl�EVCIEWI�NT.
<br /> FLORIDA JURf1T(F.S. 117.03)
<br /> OVY�t�Ft OF�AG�N'� C�RITF2�iC'PO�t
<br /> Subscribed and swom ta(or affirmed}before me this Subscribed and sworn to(or affirmed)before me this
<br /> by by
<br /> Who 3stare personally known to me or hasl�ave prodctced Wha Is/are personally known to me or haslhave produced
<br /> Identification. as idenGfication.
<br /> .
<br /> �'� `'� �'i%'•• ry Public Notary Public
<br /> '*� :: Commissian#Ffi 137073
<br /> Com fo � �o: Ex ' Commission PJo.
<br /> ���11F„h°`'� eor�dee r '
<br /> �uu Troy F�n Insurancs gpQ,g85.74f8
<br /> Name of Notary typed,printed or stamped " Name of Notary typed,printed or stamped
<br />
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