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fN0'�'IC� O� �I��f� R�S"T�iC�'IOPI�: The undersigned understands that this permit may be subject to"deed" re:,trictior�.s"
<br /> which may be more restrEctive than County regulations. The undersigned assumes responsibifity for campliance with any
<br /> applicable deed restricfions.
<br /> U�iL.IC�N�iED CC?IdT�f��1f�F�� �PJ� G�PI�'���'�� ��S�Ot�SGl�IL.17l��: if the owner has hired a contrac#or ar
<br /> contractors to undertake uvork, they may be required to be licensed in accordance writh sfate and iocal regula�ians. If the
<br /> contractor is not licensed as requir�d by law, bath the ovuner and contractor may be cited for a misdemeanor violation
<br /> under state lavv. !f the owner or in#�nded contracfar are uncertain as ta r�vhat licensing requir�ments may apply for the
<br /> in9ended work, they are a�dvised to confacf the I'asco County Building Inspection Division—Licensing Section at 727-847-
<br /> 80Q9. FurEhermore, if the owner has hired a contractor ar confractors, he is advised 4o have the contractor�s} sign
<br /> portions of the "contractar Block" of this application for�nrhich they will be responsible. tf you, a� the o�vner sign as the
<br /> conkractor, khat may be an indication that he is not properly licensed and is not �ntitled to permitting privileges in Pasco
<br /> County.
<br /> 'Y�fV�F�O��'ATIOPI Infl�ACY/l1TBLl�"OfE� 9flii��►C1'��� f��S�1U�t�� R��Oi/f�F�Y FE��: T'he undersigned understands
<br /> thaf Transportation tmp�ct Fees and Recourse Recavery Fess may appiy to the construction af new buildings, change af
<br /> use in existing buildings, or expansion of existing buildings, as specified in Pasco Caunty Ordinance number 89-07 and
<br /> 9Q-07, as amended. The undersigned a(so unders�ands, tha� such fees, as may be due, �rill be iden4ified at the time of
<br /> permitting. It is fur#her unders#ood thaf Transportation Impact Fees and Reso�rce Recovery Fees musf be paid priar to
<br /> receiving a "certificate of occupancy" or final pov+rer release. !f the p�ojec# does not involve a certificate of occupancy or
<br /> finai po�rver release, fhe fees mttst be paid prior #a permit issuance. �urthermore, if Pasca County WaterlSetnrer lmpact
<br /> fees are due, they rnust be paid prior to permit issuance in accardance v�rith applicable Pasco Coun#y ordinances.
<br /> C�N�7�l�C`1"ION �.l�i� 1..Atfit(Cha���e�7'13, �1��6d�����t�t��, �s ��tn�e�e0e�): lf valuation af uvork is $2,500.00 or mare, 1
<br /> ' certify that I, the applicant, have been provided with a capy of the "Florida Constructian Lien Law—Hameo�rner's
<br /> Prateckian Guide" prepared by the Florida Departmen# of P�griculture and Consumer Affairs. If the applicant is someone
<br /> other than the "owner", I certify that i have obtainad a copy of the above described document and promise in good fai#h to
<br /> deliver it to the "owner"prior to commencement.
<br /> C�}tdT'�t�C70�t'Slt3�V�1�R'S�i�F1�d�V1�': I certif}r that all #he information in �his apptication is accurate and that all work
<br /> �rvill be done in compliance with all applicable laws regulating construction, zoning and land development. Application is
<br /> hereby made to obtain a permit to da wrarlc and installatior� as ind'tcated. 1 certify that �o work ar instaltation has
<br /> commenced prior #o issuance of a permif and th�t all work vuill be performed to meet s@andards of alI laws regulating
<br /> construction, Counky and City codes, zoning regulations, and land development regulatians in the jurisdictian. ! also
<br /> cer#ify that I understand thaf the regulations of ofher gavernrnent agencies may apply ta the intended uvork, and fhat it is
<br /> riny responsibility to identify what actians I must take to be in compliance. Such agencies include but are not limited to:
<br /> - Departrt�ent of Environmental Protecfion-Cypress Bayheads, 1l�etland Areas and �nviranmen#aily Sensifive
<br /> Lands, WaterNVas#ewrater Treatment.
<br /> - Sauthwest Florida Vlfater �Vlanagement District-V1(eEls, Cypr�ss �ayheads, Wetland Areas, Altering
<br /> Vifatercaurses.
<br /> - Army Corps of Engineers-Seawalls, l7ocks, Navigable Waterways.
<br /> - C7epartment of Fieaith � �tehabilitative S�rvices/�nvironmen�aM H�alth Unit-Wetis, Wastewater Treatm�nt,
<br /> 5eptic l"anks. �
<br /> - US Environmen#ai Profectior�Agency-Asbestos abafi�ment.
<br /> - Federal Aviation Authority-Runways. - -
<br /> t understand that the following restric4fons apply ta the use of fi!!:� �
<br /> - Use of fill is not a1lo�ved in Flood Zone"V" unless expressly permitted.
<br /> - If the fill material is to be used in Flood Zone "A", ifi is understaod that a drainage plan addressing a
<br /> "compensating volume" wiil be submitted a# time of permifting usrhich-is prepared by a professional engineer
<br /> licensed by#he State of Florida. - �
<br /> - If the ftll ma#erial is to be used in Flood Zone "A" in connectio� vtri#h a permi#ted building using stem wall
<br /> construction, I certify thak fill will be used only to fill the area within the stem wall.
<br /> - If fN materia! is to be used in any area, I certify thaQ use of such fill will not adversely affect adjacent
<br /> properties. If use of fili is found to advers�ly af�ect adjacent properties, the orn+ner may be cited for viala#ing
<br /> the conditions of the building permit issued under the attached permit applicatian, for lots less than one (1)
<br /> acre which are elev�tecf by fill, an engineered drainage plan is required.
<br /> If I am the AC�N�' (FOR�'HfE O'�il�1fE�, I pramise in good faith to inform the owner of the permitting conditions set forth in
<br /> this affidavEt prior to commencing construction. I understand 4hat a separate permit rr�ay be required for elecfrical uvaric,
<br /> plumbing, signs, wells, pools, air conditioning, gas, or ofher insfalfations not specifically included in the app(ication. A
<br /> pe�mik issued shall be canstrued to be a license 4o proceed with khe wrork and not as authority to violate, cancel, alter, or
<br /> set aside any pravisions of the technical cades, nar shall issuanc�af a permit prevenf the Building qfficia!from thereafter
<br /> requiring a correction of errors in plans, construction or violatians of any codes. �very permit issued shall became invalid
<br /> unless #he wark authorized by such permif is commenced within six manths of permit issuance, or if vuork aufhorized by
<br /> khe permit is suspended or abandoned for a period of six(6) nnonths after the Qirrie the work is commenc�d. Nn exYension
<br /> may be requested, in vuri#it�g, from the �uilding Clfficia! far a period not ta exceed ninety (9Q) days and v�riH demonstrate
<br /> justifiable cause for the �xtension. If work c�ases for ninety(9q)consecutive days, the job is considered abandoned.
<br /> !iil�RtdlN� 'T� t�1�iP1(�t�: Y�U�t ��IILU�� Y� ��CO�� � �lQT@C� {}i� �fl�ii�HgNC��'I�AIT �d�Y iE��.�'sU�T 1�i Yt3�lR -
<br /> �'�YIPI� T�f1110E IFOR II�I�'�OVP��ii��llf� YC1 YOl9� i�d70�E�tYY. If�YOU IRIYI�WID TC! O�Y,�►IPV FIN��1�1�9(9, �COiV�tlJL.V
<br /> �ilQYO-{'1(�U�t �ENC1���Ft��9��'7'O (������ ���E}E'��?Ik�iC 1r�1!(F�A101�'1C�{)I�C���Li����ili��ttT.-
<br /> FLORIDA JURAT(F.S. 1,17.03) � �_,
<br /> Q�fPlEFL QFt AGERtT� �OFlTf2AC7{?i��" `'� �3.GG�_ �--�
<br /> Subscribed���d swo o r aff ed) ef e me th�s SubI�s r�i�jed a d swo 'to'or ffirmed before me this �
<br /> 6� ~--�.bY �' I �' G�G�-1L�r'�bY r����.7 i C °� �C�Q.c
<br /> Who�are p ana1C knqwn to me or haslhave produced Wha Is�are pe o y�Ily knp n ta me or haslhave produced
<br /> o ' C.P�,c S,..9 a s'fiientification. �~'�-� ��(1�.�'L�C¢,�..�2� as identification.
<br /> � ptary Public � t� Notary Public
<br /> Commis ' ����:*='Commission#EE � �t� ,,�;� �-.
<br /> � . '. Commis� iv . �°�•. JACQUELI
<br /> %;;�.••••''�BondedTtwTroyFanlnstuanceB,ryP:ft5.7015� =' �;►_ OIT1R11SS1O(1#EE Q4Q52O
<br /> P.F,s,,, � ;o: FJ{ it£S��+Cem
<br /> Name of o ary typed,printed or stamped Name of Nota L�FP�� l�l�t���j'�{38�nsurarwe8p(}3gs.�p�g,:
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