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��YIC� OF ��ED �E�T�IC'T90P1�: T'he undersigned undersfands that fhis permit may be subjecf to"deed°restric#ions"
<br /> which may be more restrictive than County reguiations. The undersigned assum�s responsibility for campNance�nrifh any,
<br /> applicable deed resfricfions.
<br /> 11Rd�.lC�NSED Ct}�ITR��Y�R� �PlfD C4�PJ'�'�►�"�'C�� i�i���(�R�Sl�ILIYI��: !f the owner has hirsd a contrac#or or
<br /> contractors ta undertake uvork, they may be required ta be licensed in accordance with state and local regulations. If the
<br /> contracto� is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
<br /> under stat� law. If#he owner or intended contrackor are uncerfain as to what ticensing requiremen#s may apply for Qhe
<br /> intended work, th�y are advised fo con�acf the Pasco Counfy �uilding Inspectian C�ivision—Lieensing Section at 727-847-
<br /> 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor{s) sign
<br /> portions of the "contractar Blocic" of fhis applEcation for which they v�rill be responsible. If you, as the owrner sign as the
<br /> contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
<br /> County.
<br /> YC�PVSpORY�TIOIV IflAi�P�.CYItt"6'ILI'Ti�� IfifiY��►�1f 1��9D 9Z���UF�C� �EC�1/f��Y i����: The undersigned understands
<br /> thaf Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of nevu buildings, change of
<br /> use in existing buildings, or expansion of exis4ing bui4c4ings, as specified in Pasco County Ordinance r�umber 89-07 and
<br /> 90-07, as amended. The undersigned a{so u�derstar�ds, that such fees, as may be due, will be identifisd a4 the time of
<br /> permikting. It is further und�rstood that Transportafion lmpact Fees and Resource Recovery Fees must be paid prior to
<br /> receiving a "certificate af occupancy" or final power release. If th� project does not involve�a certi�cate of occupancy or
<br /> final pow�er re(ease, the fees must be paid prior to permit issuance. Furthermore, if Pasca County Wa#erlSerrver (mpac#
<br /> fees are due, �hey mus#be paid prior ta permit issuance in accordance wifh appHcable Pasco County ordinances.
<br /> Ct}FtSTF2UCTtOW C.9��1 L�1fii(Gfia��Yerr?'�@3, �I�r�z#��4��u���, �s a�r�re��d�dj: !f valuation of work is $2,5Q0.00 or more, 1
<br /> certify that 1, the applicant, have been provided �nrith a copy of the "Flarida Const�uction Lien Lavu Homeowner's
<br /> � Protectfon Guide" prepar�d by the Florida Department of Agriculture and Consumer Affairs. !f the applicant is someane
<br /> ; other than khe"ov�rner", I certify that I have obtained a copy af the above described dacument and pramise in goad faith to
<br /> ; deliver it to the"owner" priar to commencement.
<br /> ,' Ct3iVTR�iC'f�ER'S/Ci�lR11E�t'� �ii�IFIC3�iVIY: { certify that ali the infarmatian in this application is accurate and that a11 wrork
<br /> vvill be dane in campliance v�ith all appiicabie la�vs Pegulating construction, zoning and larid deve4opment. AppEication is
<br /> hereby made to obtain a perrnit to do �nrork and ir�stallatian as indicated, I certify that na worlc or instatlatian has
<br /> commenced prior to issuance of a p�rmit and that all vvork will be performed ia meet standards of all lauvs regulating
<br /> ; construction, County and City codes, zoning regulations, and land develapment regulations in the jurisdiction. I also
<br /> ' certify that I undersfand 4hat the regulations of other government agencies may apply to the intended work, and fhat ik is
<br /> ;� my responsibi(ify to identify whaf actions i must take to b� in compliance. Such agencies inciude but are nat limited to:
<br /> - Department af Enviranrrtentai Protection-Cypress Bayheads, Vtletland Areas and �nviranmenfal)y Sensitive
<br /> Lands, V1/a�erMlasfeuvater Treatment.
<br /> � - Southuves4 �Eorida WaEer Management C7istrict-We!!s, Cypress Bayheads, Wetland Areas, AlEering
<br /> I Watercourses.
<br /> ; - Army Corps of Engineers-Seawalls, Docks, Navigable Waterwrays.
<br /> ' - Departmen# of Health � Rehabi(itative ServiceslEnvironmental Heafth Unit-Weils, Wastewater Treatment,
<br /> � Septic Tanks.
<br /> - US �nvirantnentai Protectio�Agency-Asbestos abat�mertt.
<br /> - Federal Aviatian Authority-Runways. ,
<br /> I understand that the following restrictions apply to the use of fill:�
<br /> - Use of fill is not allowed in Flood Zone"V" unless expressly permitted.
<br /> - tf the fill mat�rial is ta be used in Flood Zone "A", it is understood that a drainage plan addressing a
<br /> "compensating va(ume" vviil be submitted at time af permifting uvhich is prepared by a professiona! engineer
<br /> , iicensed by the State of Fiorida.
<br /> I - tf fhe fili maEeria! is to be used in Ftood Zone "A" in cannection with a permitted building using stem v+ral!
<br /> constructior�, I certify thak fill wrill�be used only to fill th�area writhln fhe s#em wall.
<br /> - If fil! matecial is to be used in any area, ! certify that use af such fill will not adversely affect adjacent
<br /> properties. If use of fill is found to adversely affec� adjacen# properties, the own�r may be ci#ed for violating
<br /> the conditions of the building permit issued under th� aftached permit appiication, for lots less #han one (1)
<br /> acre which are e(evated by fill, an engineered drainage plan is required.
<br /> � tf I am the AG��►T��FZ TN� �1i�ff�l�i�, 1 promise in good faifh#0 9nform the ar�vner of the permitting conditians set for�h in
<br /> thEs affidavit prior to comrnencing constructian. ! understand that a separa4e permit may be required for electrical v+rork,
<br /> plumbing, signs, wells, pools, air conditioning, gas, or other insta!lakions not specifically included in the application. A
<br /> permit issued shall be construed to be a license to proceed with the vvork and not as authority ta vialate, cancel, alter, or
<br /> set aside any provisions of the technical codes, nor shall issuance of a permit prevent fhe Buifding Official fram thereafter
<br /> requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shati became invalid
<br /> uniess the work authorized by such permit is commer�ced vtirithin six months of permit issuance, or if work authorized by
<br /> the permit is suspended or abandoned for a period af six{6) months after the time the uvork is comrnenced. An extension
<br /> may be requested, in vuriting, from fhe Building OfFicia! for a periad not #o exceed ninety (90) days and wi!! demonstrate
<br /> justifiable cause far the extension. If work ceases far ninety (90)consecutiv�e days, the job is considered abandoned.
<br /> 1Al�RidtR9Cy TC6 OIiiIN�F�: �C�CI� i��ILUR� TO RIE��3Rt3 �, G�PJ�'ICi� CDi� COii�flflEiV��iifi�EN'T fl�ii�Y �2���}LT �iV '�CILY�
<br /> �'�YiPiC�ViC� IFOi7�4�i���3V1E6�ilER1�'S TO YCYU�2�(f�0�RTlf. �6=Yt3t1 Qi�Y��II�TO O�iT�1G�i �li�1�61PCt�C�, G���UL�"
<br /> itUl��i YC.}UR �.EN���E���k��'1�Y�1'��9�Y��lF CQ�tIDl��VOtl�i�Q��'!G�CaF CC?Hf�6i�E�ICElif�E�►T.
<br /> FI.ORIDA JURrqT{F.S. 917 03) _ ..._-- --- — _".��.,_
<br /> - a
<br /> OliVRt�R OFt�GEP77 �OPI'TRAGI'Qgt
<br /> Subscribed and s n to{o a�r "� t Subscribed and sworn ta(or affirmed)before me this
<br /> �- by M 4, ����'���� by
<br /> Who islare personally known to e or haslhave produced Who isJate personally known fo rne or haslhave produced
<br /> a fdenGfcaGon. as identification.
<br /> �
<br /> Notary Public PJotary Public
<br />' '�r r�g�, JOEL E.BACON
<br /> Gommfs i r��t5 F: Commission Na.
<br /> _.. t�rmissrefl-�4-3�
<br /> :;, ��: Expires Ju�e 29,2418 �
<br /> �,:
<br /> ritarn of ' � PJame of Notary typed,printed or stamped
<br />
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