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td�T'IC� �� G1�ED R��'�RECTlO�1�: The undersigned understands that this permit may be subject to"deed" restrictians"
<br /> which may be more restrictive than County regulatEons. The tandersigned assumes responsibility far compEiance v�rith any
<br /> applicable deed restrictians. �
<br /> UN�.ICEMSED �ON'TR�C'�OIiZ� �I�� �C�i�°��C�'O� f�f��F't)N5�f�1�1'fl��: If the owner has hired a cantractor or
<br /> contrackors to undertake work, #hey may be required to be licensed in accordance wtith sfate and iocai eegulations. if fhe
<br /> contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanar violation
<br /> under stafe iarrv. If fhe or�vner ar intended contractoc are uncertain as ta vuhat licensing requirements may appty for the
<br /> intended work, they are advised to cantact the Pasco Counfy Building Inspection Division—Licensing Section at 727-847-
<br /> 80Q9. Fur#her�are, if the owner has hired a contractor or confiractors, he is advised to have the contractor{s} sign
<br /> portions of the "conkractor Block" of this application for which they vvill be respansible. If ,you,�as the owner sign as the
<br /> eantractor, thak may be an indication that he is naY properly licenssd and is not entitled to permitting privileges in Pasco
<br /> County.
<br /> �'E�N��OR�'A7'ION IBfi�AC�'1lI�ILI'YIfE� �iifl�A��'A�9� ����U��� R��OV�RY f�E�S: The undersigned understands
<br /> fhat Transportation tmpact Fees and �tecourse Recovery Fees may apply to the constructian of nevsr buifdings, change of
<br /> use in existing buildings, or expansian 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, v�rill be identified at #he time of
<br /> permitting. It is further understood thaf Transportafion (mpact Fees and F2esource Recovery Fees rnust be paid prior to
<br /> receiving a "'ce�tificate of occupancy"' or final povuer release. If khe projec# does not involve a cer#iflcate of occupancy or
<br /> final povver reiease, the f�es must be paid prior fo p�rmit issuanee. Furthermore, if Pasco�County �NaferlS��nrer lmpac�
<br /> fees are due, they rnust be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
<br /> C�}W�7Rl1CT90N �1�� �11�i1(Chap���7'�3, �1�ci�����t�ta�+��, �s ��end�d}. !f valuatian of v�rork is $2,500.00 or more, !
<br /> certify that I, the applicant, have been provided with a capy of the "Florida Constructian Lien Law—Hameowner's
<br /> Profectian Guide" prepared by the Flarida Department of Agriculture and Consumer l�ffairs. !f the applicant is someone
<br /> other than the °owner", 1 certify#hat I have obtained a copy of the above described document and promise in good faith to
<br /> deliver it to the "ovvner"prior to commencement.
<br /> Ct��17"�2��7�R'�lO���R'� k�i��llD.�iV�Y: 1 certify fha# all the infarmation in this applicatEor� is accurate and #hat al! work
<br /> will be done in compliar�ce with all applicable laws regulating cons4ructian, zoning and land development. Applicatian is
<br /> hereby made to abtain a permit ta do uvork and installation as indicated. 9 certify thaf no vuork or installation has
<br /> commenced prior to issuance of a permit and that all work wilf be performed to meet standards of aU laws regulaking
<br /> constructian, Counky and City codes, zoning regulatians, and land developmenk regulations in the jurisdictian. ! also
<br /> certify that 1 understand that the regulations of ather governrnent agencies may apply ta fhe infended rtvork, and that it is
<br /> my responsibility#a iden�ify whaf actians I must take fo be in compliance. Such agencies include but are not limited ta:
<br /> � - Depa�tment of Environmer�tal Protection-Cypress �ayheacls, 1�lefiland Areas and Environmentally Sensitive
<br /> Lands, VVaterNVas#ewater Tre�tment.
<br /> - Sauthutrest Florida Water �!lanagem�nt District-Wells, Gypress Bayheads, Wetland Areas, Rltering
<br /> Watercourses.
<br /> - Nrmy Corps of Engineers-SeawaUs, C)ocks, iVavigable Watenrvays.
<br /> - t�epartment o� Hea1fF► � �tehabilitative Services/�nvirortmental F��a1th Unit-V1le11s, V�astewrater Treatment,
<br /> Septic Tanks.
<br /> - US Enviranmenfal Prafection Agency-Asbestos abatement.
<br /> - Federal Aviation Authority-Runways.
<br /> C understand that the Following restrictions apply ta the use af fill;
<br /> - Use of fill is not allowed in Fiood Zone"V" unless expressly permitted.
<br /> - If the fill materia! is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
<br /> "compensating volume" wi11 be submifted a� time o� permitting vvhich is prepared by a professional engineer
<br /> licensed by khe State of Florida.
<br /> - If fhe fill material is to be used in Fiood Zone `"A" in connection vtirith a permifted building using stem v�raEl
<br /> construction, I certify that fill will be used only to fill the area within the stem wall.
<br /> - !f fill material is to be used in any area, I certify that use o# such fil! wrill not adversely affect adjacent
<br /> properties. If use of�ii is found to advers�ly affect adjacent properties, the owner may be citec3 for violating
<br /> the conditions of the building permit issued under the attached permit applicatian, for lots less than one (1)
<br /> acre which are eievated by fill, art engineered drainage plan is required.
<br /> If I am the Af��IVT �OFt�'HIE OWlY��i�, I promise in good faith to inform the owner of the permitting conditions set forth in
<br /> this affidavit prior to commencing construction. ! ursderstand #hat a separate permit may be required for etectrical v�rork,
<br /> plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the appiication. A
<br /> permit issued shal! be construed to be a license to procesd uvith the woek and not as authority to.violate, cancel, alter, or
<br /> set aside ar�y provisions af the technical codes, nar shaH issuance of a permit prevent the Buiiding �fficial frorn thereafter
<br /> requiring a correction of errors in plans, construction or violations of any codes. Every permi# issued shall become invalid
<br /> unless the wark autharized by such permit is cammenced �nrithin six manths of permit issuance, or if uvork authorized by
<br /> the permit is suspended or abandoned for a periad of six(6) months after the time the work is cornmenced. An extension
<br />( rnay be requesEed, in vtrriting, from th� Building Clfficial for a period not to exceed ninety {90) days and tnril! demonstrate
<br /> justifiable cause for ihe �xtension. If work ceases for ninefy(90)consecutive days, the job is considered abandaned.
<br /> 6�iA�WIRI� T�3 �{�Jtd��: 1(Clt1� i��►1��3R� �� �Z��O�D � f��l'QC� O� �Q�Fii�ii�N�(�fi�iEP1T iil9�►Y R��llL,T 1�1 �ft�LD@2
<br /> f�d�YlfdG 7�filICE �OR Ifi��'G�OVI�fW��➢�"� 1�01(0�0� �ff�flfPER'Y�. IfF YOU 9WY��IU YO O�Y,k11�1 �16V�►iV�CIPIG, COi1i�UL.�'
<br /> ViflT�i'Y�t1F2 �ENDIEIf� If��1�!�i71� CY������$2�COY2I�INIC�Y��9� f��YlG�Gl�C{���EMC1E�tli��1�.
<br /> FLORIDA JURf1T(F.S. 117 3�
<br /> t71R►P}�F2 4F2�G��17 CO�E7'�tACT't?F2
<br /> Subscribed and swom to(or affirmed)before me this Subscribed and sworn to(or a�rmed)before me this
<br /> by by
<br /> Who islare personaMy kn n to me or haslhave produrec! Who(slare persanally knowtn to me ar haslhave produced
<br /> as Identification. as identification.
<br /> ,��Y„ , �o � .a N
<br /> -�" �°_ om ' o PV ary Public Notary Public
<br /> " :;; Expires,lune 29,
<br /> .�'.OfT1R1�SS� f,,;r�'4°•`'�, ��d�ThruTroyFainlnsurance80U�95d01B CommfssionNo.
<br /> r u�a��
<br /> Name oC Notary typed,printed or stamped Name of Flotary typed,printed or stamped
<br />
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