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PlOTIC� OF CIE�� R�S'�'�I��'➢OV��: The undersigned understands that this permit may be subject to"deed" restrictions"
<br /> +n�hich may be more �estrictive than Counfy regulations. The undersigned assumes responsibifi�y for compliance with any
<br /> applicable deed restrictions.
<br /> �!�l�.4�IE���C} C�C�TR�►�C7'��2� �.A11C� ���1���T�� (E�����t�S1�1l.i�'t��: If the own�r has hired a cantractor or
<br /> contrackors ta undertake work, #hey may be required to be licensed in accordance with state and focal reguiatians. If fhe
<br /> contractor is not licensed as required by lew, both the owner and contractor may be cited for a misd�meanor violation
<br /> under stat� law. If fhe owr�er ar int�nded cantrac#or are uneertain as fo �nrhat [icensing requirements may appty for the
<br /> intended vvork, they are advised to contac#the Pasco Caunty Building Inspection Division—Licensing Sec#ion at 727-847-
<br /> 8009. Furfhermore, if the ov�rner has hired a contractor ot contractors, he is advised to have the contractor(s) sign
<br /> portions of the "contractar 81ock" of this application for which fhey wili be�responsible. (f yau, as the ovvner sign as #he
<br /> contractor, that may be an indication fhat he is nat properly licensed and 9s not �ntitled to �ermit#ing privileges in Pasco
<br /> County,
<br /> '�97IA����R'T�►T'I�N i�il�°��GY11J�'IL9YV�� �fl���C'� 1�6�f� ���CIU�C� ��ICO�fEG�Y����: 7'he undersigned understands
<br /> that Transpartatian tmpact Fees and t2ecourse Recouety Fees may apply to fhe construction af neuv buildings, change of
<br /> use in existing buildings, or expansion of existing buildings, as specified in Pasco Caunty Ordinance number 89-07 and
<br /> 90-07, as amended. 7�he unders9gned a{so understae�ds, thak such fees, as may be due, v�i1E be iden4ified af the tirne of
<br /> permit#ing. (t is further undersfood that Transportation Impact Fees and R.esource Recovery Fees must be paid priar to
<br /> receiving a "certificate of occupancy" or final power release. !f Qhe proj�ct does no4 involve a certificate of occupancy or
<br /> finai power re(ease, the fees must be paid prior fa permit issuanc�. �urfherm�re, if Pasco County 1lVaterlSe�nrer lmpac#
<br /> fees are due, they musl be paid prior to permit issuance in accardance with applicable F'asco County ordinances.
<br /> , C��t��'�t1C710i� �.�IER9 �.�if��������r 7�3, �I�r�c����������, � �e��e�c���}: tf valuation of tnrork is$2,500.00 or mare, 4
<br /> certify that I, the applicant, have b�en provided with a copy of the "Florida Construction Lien Law—Homeovuner's
<br /> F'rateckion Guide° prepared by th� Flo�ida Departm�nk of Agriculture and Consumer flffairs. If the applicant is someone
<br /> other than the Nowner", i certify fhat I have obtained a eapy of the abave described document and promise in gaod faith fo
<br /> deliver it to fhe"owner"prior to commencement.
<br /> �C}�T'�1�iC'gOIR'�/t���1��'��S�1FInl�a�l1�': 1 certify that all the information in this applicatior� is accurate and #hat a!I �nrork
<br /> �+vill be done in compliance uvith all applicable laws regulating construction, zoning and land development. Applicatian is
<br /> her�by made ta abtain a permit to da �nrork and installa#ion as indicated. , 9 certify �hat no �rork or 9nstalEa#ion has
<br /> commenced prior #o issuance of a permiY and that all vuork vvill be performed to me�t standards of all laws regulaking
<br /> construcEion, County and City codes, zanir�g regulations, and land developmenk regulations in fhe jurisdiction_ I also
<br /> e�rtify #hat i unders#and that the regu(ations of other gavernm�nt agencies may apply to th� intended work, and that i# is
<br /> my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited ta:
<br /> - Department af Environm�nta] Protection-Cypress �ayheads, V1l�tland Areas and Environmentally Sensitive
<br /> Lands, UVater/Wastewater Treatment.
<br /> - Southwest Flarida 1�(a�er (�ianagement Districf-Wells, Gypress �ayheads, 11Vetland Areas, Altering
<br /> Watercourses.
<br /> - f�rmy Corps af Engineers�Seawalls, Docks, IVavigable Watenrvays.
<br /> - C}eparfinenf of Hea!#h & Ftehabilitative Services/�nvironmental Fiealth Unit-Weils, Wastewater Treafinent,
<br /> Septic 7'anks.
<br /> - US �nviror�mental Protection Agency-Asbestos abatement.
<br /> - �ederal Aviation Authority-F2unvvays.
<br /> I understand that the follovving restric#ions apply to fh�use of filf:
<br /> - Use of fill is not allowed in Flood Zone"V"uniess expressly permifted.
<br /> - If the �II mat�rial is to be used in Flood �one "A", ik is understood that a drainage plan addressing a
<br /> "compensating volume"' will be submitt�cf a# time af pertnifting which is prepared by a professional engineer
<br /> licensed by the Sfat�of Florida.
<br /> - If the fill material is to be used in Fload Zar�e "A" in connection vtrith a permitted building using sfem vuall
<br /> construcfion, I certify tha#fill will be used only to flll the area within the stem wall.
<br /> - If fill materiaR is to be used in any area, ! certify that use of such fill v�rill nat adversely a#fect adjacent
<br /> properfies. Pf 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 /> acre which ar�elsvated by fill, an�ngin�ered drairtage plan is r�quirecf.
<br /> If I am the Wta�R1Y �OR�'0i1� CilYil�IlE9�, I promise in good faith to infarm the owner of the permitting condi#ions set forth in
<br /> fhis affidavit prior to commencing canstruction. I understand that a separat� permit rraay be required fpr etecfrica# vvark,
<br /> plumbing, signs, wrefls, paols, air condifioning, gas, or other installations not specifically incfuded in the application. A
<br /> permit issued sha!! be construed to be a license to proceed with khe uvork and not as authority to.violate, cancel, alter, or
<br /> set aside any provisions of the techr�ical codes, nor shal) issuanc�of a permit prev�nf the Buiiding Official from thereafter
<br /> requiring a correction of errors in plans, constructian or violatians of any codes. IEvery permit issued shall became invalid
<br /> unless the work authorized by such permit is commenced uvithin six tnonths of permit issuance, or if v,rork aufhorized by
<br /> the permit is suspended ar abandoned for a period of six(fi) monfhs after the time the work is commenced. An extension
<br /> rr�ay be requested, in vuriting, from the �uilding �fftcial far a period not to exceed ninety {�O) days and will demonstrate
<br /> jusfifiable cause for�he �xtension. If work ceases for ninefy(90)consecutiv�days, the job is considered abandoned.
<br /> 11i!lARRt�R9� YCl ��il�l��2: ��UiR ��1l,U�� TO �2����2� � �l�YlC� �(� ���H6���lC�6i���!'� �iif�Y ���ULI' ti�! Y�U�
<br /> �aiY1iVC� T1filMCE t�ia�t i��fR09/IE�lfi��9`V'� T'�►YO�p�t ��td)�'f��tYY. O�YOU YR9YEiVl� TO O�li'�IPI �IPIANICE�(�, �OFISIll..7
<br /> ��rc�va�c��z �.���►�t�e�����r������'���t��� �t�������������� �c���cc��r��t������vr.
<br /> FLORIDA JURAT(F.S. 117.03)
<br /> pW��ft t}�2 kdG��tY ��i�l'(RAGTt}�
<br /> Subscribed and swom to(or affirmed)before me this Subscribed and sworn to(or affirmed)before me this
<br /> by by
<br /> Who islare persanalty known to me or hasJhave produced Who�sJare personally knawrn to me or haslhave produced
<br /> as idenkification. as idenUfication.
<br />�
<br /> Notary Public ``-- �i��"'� " `— Notary Public
<br /> Commisslon No. Commiss o No.
<br /> Name of Notary typed,printed or stamped fVame af Notary typed,printed or stamped
<br />
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