|
i
<br /> PI�T1C� O� CII�(�D Rf���'RiC�'IOiV�: The undersigned understands that fhis permit may be subject to"deed" r'astrictiGns"
<br /> which may be m4re restrictive than County regulatians. The undersigned assumes responsibilify for compEisnce wifh any
<br /> applicable d��d restrictio�s.
<br /> �J�9L.iCI�FiSEID �ONYf���YOR� �iRf� ���1T�1��'�� Ii�f���'flR����1�.9Y'9f�5: If the owner has hired a contractor or
<br /> I contracfors to undertake�vork, fhey may be required to be (icensed in accordaRCe writh state and bcal regulations. If the
<br /> � contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanar violation
<br /> under state law. If fhe ouvner ar intended canfractor are uncerfain as #o uvhat licer�sing requirements may apply for the
<br /> intended work, they are advised to contact the Pasco County �uilding Inspection Division—Licensing Seckion at 727-847-
<br /> 8009. FurEhermc�re, if the auvner has hired a contractor or contractors, he is advised to have the cantractar(s} sign
<br /> portions of the "conkractor Block" of this application for which they will be r�spo�sible. (f you, as #he ovvner sign as the
<br /> contractar, that may be an indication #hat he is not �roperly licensed and is not �entitled to permitting privileges in Pasco
<br /> i Counfy. ' • '
<br /> �'B�Pd��Oi�T'ATIOIV I�i��CYlU1'�'ILI�'IfE� I�i��►C7�Rl� �E�t�U�C� Rf�Gt�VE�3Y F��S: 'The undersigned understands
<br /> ' thaf Transportafior� (mpacE �ees and Recourse Recovery Fees may apply to the canstruction af newr builciings, 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 suctt fees, as may be due, wil! be idenEified at the time of
<br /> permitting. It is further unders400d that Transpo�#ation Impact Fees and Resource Recovery Fees must be paid prior to
<br /> receiving a "certificate of occupancy" ar fina) povuer rel�ase. !f the project does not involve a certi�cate of occupancy or
<br /> finai po�nrer release, the fees must be paid prior fa permit issuance. Furthermc�re, if Pasco Gaunty Waterl5auver Impact
<br /> fees are due, they rnust be paid prior ta permit issuance in accordance with applicable Pasco County ordinances.
<br /> C�Pd�T�tF1C`C1O� �.IIE�I �.�i�{�h��4�r 7'�d�, �t��o+������u���, �� a�m�nd�e�}: !f valuation of work is $2,500.00 or mare, 4
<br /> certify lhat I, 9he applicant, have been provided vvith a capy of tlie "Florida Constructian Lien Law—Homeowner's
<br /> �'rotection Guide" prepared by the Florida Qepartment of pgriculture and Consumer Affairs. !f the applicant is someone
<br /> ather than the "owner°, t certify that 1 have obtained a eopy of the above described document and promise in good faifh to
<br /> deliver it to the"owner" prior to commencement.
<br /> C4�PdT'�2��TO�t'S/0Vi«3�F�'��l���C}�,�/IY: 1 ce�fify that all the information in this apptication is accurate and #hat all work
<br /> will b� done in compliance with all applicable lawrs regulating construction, zoning and land develapment. Application is
<br /> hereby made to abtain a permit ta do �nrark and instatlation as indicated. i cerlify .Ehat no work ar instaflation has
<br /> commenced prior to issuance of a permit and that all work vvill be perfarmed to meet standards of all laws regulaking
<br /> constructian, County and City cod�s, zoning regulations, and land development regulations in the jurisdictian. I also
<br /> cerfify that 1 unders#and thaf the regu{ations of other government agencies may apply to the intended wark, and that it is
<br /> my responsibility fo idenkify vvhat actions I must take to be in compliance. Such agencies include but are nat limited to:
<br /> - Department of Environmental Protec#ion-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br /> Lands, Water/Wastewat�r Treatment.
<br /> - Southwest Florida Wafer �l}anag�ment District-Welis, Cypress Bayheads, Wetland Areas, Altering
<br /> Watercourses.
<br /> - Army Corps of Ensineers-Seawalls, Docks, Navigable Watentvays.
<br /> - Department af Health � Rehabilitative 5ervices/Environmental Heaffh Unit-1Nells, Wastewater Treafinent,
<br /> �eptic T'anks.
<br /> - US Environmental F'totecfiion Agency-Asbestos abatem�nt.
<br /> - Federal Aviation Authority-Runways.
<br /> ! understand that the follov�ring r�estric#3ons apply to the use af fill:
<br /> - Use of fill is not allowed in �lood Zone"V"unless expressly permitted.
<br /> - If the fill material .is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
<br /> "compensatirig vblume"vvii4 be submifted at fime of perm3fting �nrhich is prepared 6y_ a professional engineer
<br /> licensed by the State of Florida.
<br /> - If fhe �11 material is to be used in Flood Zone "A" in connection;tnriEh.a permitfed build9ng using stem wrafl
<br /> construction, I certify that fill will be used only to fill the area within tfie°stem watl. � '
<br /> - If filf material is to be used in any ar�a, ! certify that use of such fil! wrill not adversely affect adjacent
<br /> properties. if use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
<br /> the conditions of the building permit issued under the attached permit applicatian, for lots less than one (1)
<br /> aere which are elevated by fil[, an engineered drainage plan is required.
<br /> If I am the�4��IV�' �O�1f�Yf� ¢��`ll�l�l�, I promise in good faith to inform the owner of the permitting conditions set forth in
<br /> this affidavit priQr to commencing construction. I understand that a separate permit may be required for eEectrical work,
<br /> plumbing, signs, we(Is, pools, air conditioning, gas, or ofher installa#ions not specifically included in the application. A
<br /> permit issued shal! be construed to be a licepse ta proceed uvith the work and not as authority to.violate, cancel, alter, or
<br /> set aside any provisions of the technica{ codes, nar shall issuance af a permif prevent the Building Official from thereafter
<br /> requiring a correction of errors in plans, construction or violations of any cades. Every permit issued shall become invalid
<br /> unless the work autharized by such permif is commenced v�ithin six months af permi# issuance, oe if work authorized by
<br /> the permit_is suspended or abandoned for a periad of six(6) months after#he time the work is commenced. An extension
<br /> may be requested, in �,rriting, from the �uilding �fficia! far a period tiof to euceeci-ninety (90) days and vui11-demonstrate –
<br /> justifiabls cause for the extension. If�vork ceases for ninefy(90}consecutive cfays, fhe job is considered abandaned.
<br /> �l��2R1d�9� i'C9 �liill���t: Y�L�(i� (��1���� �O ��fCt��ID � f�#��'i�� Q�F ��ii��H�i��E�ii�F19�' Iit�1r�Y 92��11LY It�# lCCD41R
<br /> B�AYING 'T1iiIIC� �C1� Ii�1�fftOVf�f�i�l�'�� TO YOIY�t �'f�O�ER7Y. YfF YOU IP➢Y�PI� YO O��'f�IN i=1PlaifVtCiP1G, tCOW�43�.Y
<br /> VittYH YQ�R ��N�EFt��.a►N��0��1(EY�tE�C7�� G���O�ID�(�C�lf�[!�2�O�'IC�O�r COIVft�i(ENGIE�f1�E�tY.
<br /> FLORIDA JURAT(F.S, 117 03
<br /> ouv���t o���� �,�_.V��� ca�T�acrS� ��
<br /> Subscribed and swom to(or affirmed)before me this S bscribed d sworn to(or affirmed)before me�
<br /> by ���x:�'�by
<br /> Who islare personally known ta me ar haslhave produced Who IsJar per n krtawn to me or ttaslhave produced
<br /> as Identification. as identification.
<br /> /
<br /> Notary Public :�. G��=��� PJotary Public
<br /> ( �IttiE �
<br /> Commisslon No. CommPssi n PJo. ,.�oti��P�:e4., JACG2UELiN OGES
<br /> �h: :k' t�t .!
<br /> :,y ta�,^' ��1«S L�'r����t 12,2414
<br /> Name of PJotary typed,printed or stamped fVame of Notery typ "r�i ar
<br />
|