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YVOT'I�C� O� H7EEI� R�S�'�IC7"ION�: The undersigned undersiands that this permit may be subject to"deed" restrictians"
<br /> which may be more restric#ive than Gounty regulations. The undersigned assumes respansibility for compliance vuith any
<br /> applicable deed restrictians.
<br /> t9NLlCENSE� CC?h!'TFt��GY��� A�D G�N7'�#i�T�9� f�f�S�4?N�lf��L.Y'Ytf�S: If ths owner has hired a cantractor or
<br /> confractors ta under#ake work, #hey may be required to be licensed in accordance writh state and iocal regu{ations. !f the
<br /> contrackor is not licensed as required by law, bath th� o�nrner and contractor may be cited for a misdemeanar violation
<br /> under sfa#e law. if fhe ownee ar in#snded contractor are uncerfain as #o v�rhaf licensing requirements may apply far th�
<br /> intended work, they are advised to cantact the Pasco Caunty Building Inspection Division—Licensing Section a#727-847-
<br /> 8009. Fu�thermare, if the owrner has hired a cont�actar or contractors, he is advised to have the contractor(s) sign
<br /> partio�s of the "contractor Biock" of this application for which fhey wiil be responsible. if you, as the ovvner sign as the
<br /> cantractor, that may be an indication that he is nat properly licensed and is not entitled to permitting priY�ileges in 6'asco
<br /> County
<br /> T�NSPO�t"fA'�IQP� IAfi�'ACTIIJYILITIE� IfiflP�C1f l�Pl� i�E�OU��� R�COV�RY F���: The undersigned undersfands
<br /> ( that Transpor#ation Impact F�es and Recourse Recovery �ees may apgly to the construction af nevtir buildings, change of
<br /> use in existing buildings, or expansion of existing buildings, as specified in Pasco Caunty Ordinance number 89-07 and
<br /> 9Q-Q7, as amend�d. The undersigned also understands, that such fees, as may be due, wil! be identified at the time of
<br /> ' permitting. lt is further understood thaf Transportation (mpact Fees and Resource Recovery Fees must be paid prior fo
<br /> receiving a "certificate of occupancy" or final pov�er release. If the project does not involve a certificate �f occupancy or
<br /> final power release, the fees must be paid prior to permif issuance. �urthermore, if Pasco County WaterlSewer Impacf
<br /> fees are due, they must be paid prior to perrnit issuance in accordance with applicable F'asca County ordinances.
<br /> ��N��'�t]GT��}M �.�lE� �.�lfitt(�F���f��7�3, �Ic��oef��t��ut��, �� ��t�e�d+�c9}: If valuation of wrork is$2,500.00 or more, !
<br /> certify #hat I, the applicant, have been provided with a copy of the "Florida Constructian Lien Law—Homeowrner's
<br /> Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If ths applicant is sameone
<br /> other fhan the"owner", 1 certify that 1 hav�obtained a copy of#he above described document and promise in good faifh to
<br /> deliver it to the "ovuner" prior to commencement.
<br /> C�Nl'R�GTt3R'S101iV�9i�R'�I�iiF�l�}t�11[1': ! certify that alE the information in this application is accurate and that all work
<br /> �vill be done in compliance with all applicable lawrs regulating construction, zoning and land dev�lopment. Applica#ian is
<br /> hereby made to obtain a permit to do worlc and instaflation as indicated. 1 certify that no wor4c ar instaNation has
<br /> commenced prior to issuance of a permit and that all work �ill be performed to meef standards of all laws regufating
<br /> construction, County and Ciky codes, zoning regulations, and land dev�lopment regulations in the jurisdiction. I also
<br /> certify that t undersfand thaf the regulations af ofher govarnment agencies may apply ta the intertded rn�ork, and that it is
<br /> my responsibility to iden�'tfy what actions I must take to be in campliance. Such agencies include but are not limited to:
<br /> - Departmen# of Enviranmenfal Protectior�-Gypress Bayheads, Wettand Areas and Environmentally Sensitive
<br /> l..ands, WaterNVastewater Trea#ment.
<br /> - Sauthvuest �iorida ltVat�r Management District-1tVells, Cypress �ayheads, V�(etland Areas, Altering
<br /> Watercourses.
<br /> - Army Corps of Engineers-Seauvalls, Docks, Navigable Waterways.
<br /> - C7epartment of Health � Rehabilifative ServicesJEnvironmental Nealth Unit-WelEs, 'UVastewater Treatment,
<br /> Septic Tanks.
<br /> - US Environmental Protectiort Agency-Ashestos abatem�nt.
<br /> - Federal Aviation Authority-Ftunways.
<br /> I understand that the foflawing resttictions apply to the use of fill:�
<br /> - Use of fill is not allowed in F1ood Zone"V"unless expressly permitted.
<br /> - If the �Il material is to be used in Flood Zone "A", it is understooci that a drainage plan addressing a
<br /> "compensating volume" vuitl be submit#ed at time of permittirtg vuhich is prepared by a professional engineer
<br /> licensed by the State of Florida.
<br /> - If the fill material is ta be used 'tn Flood Zone "A° in connectEon uvith a permitted building usRng stem �nrall
<br /> construction, I certify thak fill will be used only to fill the area within the sfem wali.
<br /> - If fill material is to be used in any area, 1 certify that use o# such fill will not adversely affect adjacent
<br /> proper#ies. If use of fill is found to adversely affect adjacent properties, the owner may be cifed far violating
<br /> the conditions of the building permi# issued under the attached permit applicatian, far lots less than one (1)
<br /> acre which are elevatecf by fill, an engineered drainage plan is required.
<br /> If I am the�,GIEIVT �OF21fFVL Olf��lEl�, I promise in goad faith to inform the owner of the permitting conditions set forth in
<br /> this affidavit prior fo cammencing constructRan. 1 understand that a separate perrnit may be required for electricaE work,
<br /> plumbing, signs, wells, pools, air condifioning, gas, or ofher installations not specifically included in t�e appiicafion. A
<br /> permit issued sha!! be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
<br /> set aside any provisians of tha technical cades, nar shall issuance of a permit preven##he �uilding O�cial from the�eafter
<br /> requiring a correction of errors in plans, construction or violations of any cades. Every permit issued shall become invalid
<br /> unless #he work authorized by such permit is camrnenced w�ithin six manths of permit Essuance, or if uvork aufhorized by
<br /> khe permit is suspended ar abandoned for a periad of six(6) months after the time the work is commenced. An extension
<br /> may be requested, in writing, from the Building Officia! for a period nak #o exceed ninety (90) days and wi!! demonstrate
<br /> justifiab(e cause far#he �xfension. It work ceases fior ninefy t90)consecutive ciays, fhe job is considered abandaned.
<br /> �ARtd9Fd� "f0 Qi�IN��: ��t3� i�6�1�17�� T� ��Ct3�� � �9�TpC�C U�F �:�ii���PlC��d�i�Y ��l' ��E sUi..'T 1i�1 'Y�}U�
<br /> �'WYING TV11iCfE �'CDR If�i�'�tOV�I1N�Gd7S �'KJ YOl9� �'V�C16'E�tYY. I�YOU YN1YENfD T�D 0�7WIN FINA�ICIPIfs°, C��I�l1�Y
<br /> Vitt7H Y{}lJl� L�NC}IE��?I�d��1 Al�t'QIRi�1EY����I����COi�fD1�1G Y�tJR�IOTIG�C?F CO�II�EP1C��ti�W1�.
<br /> FLORIDA JURAT(F.S. 117.03
<br /> C11flt�tCf2 Ogt�G�TdT • CORITE�AGTOFt
<br /> Subscribed and sworn or med efore me this Subscribed and sworn to(or affirmed)before me this
<br /> by by
<br /> Who isJare personally known to me oe haslhave produced Who;slare personally known ta me or haslhave produced
<br /> as Identification. as identificaGon.
<br /> •.Y���r
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<br /> �mssio�13707�Nota Public Notary Publia
<br /> r�°�:Ilf�t;a�`�'�� amawnwr�fl8 ,2(}'18
<br /> Com iss n `°'"F""1°'�°^Geooaes�o�o Commission P�lo.
<br /> Name of Notary typed,printed or stamped IVame of Notary typed,printed or stamped
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