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iVOTiC� O� �EED RE5"TRiC'TIOFd�: The undersigned understands that this permit may be subject to "deed" re�trictions"
<br /> which may be more restrictive than Caunty regulatians. The undersigned assetmes responsibility for compEiance with ar'ry
<br /> applicable deed restrictians. �
<br /> tINLEC��iS1ED CtJNT�AC7��� fil(V� CCt�'��i�T��t f�f��i�ON�l1�IL11'IES: !€ the owner has hired a contractor or
<br /> contractors to undertake work, #hey m�y be required to be lieensed in accordance with state and tocal reguiations. If fhe
<br /> contractor is not licensed as required by la�, both the owner and contractor may be cited for a misdemeanor violation
<br /> under state la�nr. {f the arn�ner or intended contrac4or are uncertain as ta what licensing requirements may apply for the
<br /> , intended work, they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
<br /> $OQ3, Furthermore, if the ovuner has hirecf a con#ractor or contractors, he is advised to have fhe con#ractor{s} sign
<br /> portions of the "can#ractor Block"' of this appficafion for wi�ich #hey �vili be responsible. tf you, as the awner sign as the
<br /> contractor, that may be an indieat4on #hat he is nat properly licensed and is not entitled to permitting privileges in Pasco
<br /> County. - '
<br /> �'�tV�POR�'�►�'ICDN 9Afl�ACYll1�ILVYI�� 9G�l�A�T�P9C8 �E�IDl1��� R��OVf�RI( ����: 7'he undersigned underskands
<br /> fhat Transpartation Impact Fess and Recourse Recovery Fees may apply to the cons#ructian af new 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. The csndersigned also understae�ds, that such fees, as may be due, vuil4 be identified at #he time of
<br /> permit#ing. It is fur#her understood that Transpo�#afion Impact�Fees and Resource Recovery Fees must be paid prior to
<br /> ' receiving a "certificate af occupancy" or final po�rer release. If the praject does not involv� a cerkificate of occupancy or
<br /> frnai pawer re(ease, the fees must be paid prior to permit issuance. Furthermore, if Pasco Courtty 111/aterlSetnler Impact
<br /> fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
<br /> CQA1STi�l�C71�N L1��1 �.�►1fV{Cha�g��713, �1�e�i��St�fe�f��, a�� ��n�nd�e�): tf valuatian of v�rork is$2,500.OQ os rnore, 1
<br /> certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Lavv—Hameornrner's
<br /> Protection Guid�° prepared by the Ftorida Department of Agriculture and Consumer flffairs. !f the applicant is someor�e
<br /> other than fhe °OWTIEP°� I certify thaf I have abtained a copy of fhe above described document and promise in good faith to
<br /> � deliver it to the"owner"prior to commencement.
<br /> C4?N'T�t�G'F't}�'�1{�VNW(Ei�'���iF1(D6�1liY: 1 certify that a41 the informafion in this application is accttrate and #hat all vvork
<br /> will be done in compliance with all applicable laws regulating constructian, zoning and land development. Applicatian is
<br /> ', hereby made to obtain a permit to do v�rork and installation as indicated. 1 certify that no work or instaltation has
<br /> commenced prior to issuance of a permit and that all work wiil be performed to meet standards of all taws regulating
<br /> constructian, County and Ciky codes, zoning regulations, and land developmenk regulations in the jurisdictian. I also
<br /> c�rtify #haf I undersfand thaf the regulatians of c�ther gov�rnmen# agencies may apply #o fhe infended work, and fhat it is
<br /> my responsibility to identify what actions I must take to be in compliance. �uch agencies include but are not limited to:
<br /> - Depar�ment of �nvironmental Protection-Cypress Bayheads, Wetland Areas artd Environmentally Sensitive
<br /> Lands, WaterNVastewater Treatment.
<br /> - Sauthwest Florida Water IVlanagement District-Wells, Cypress Bayheads, Wetland Areas, Altering
<br /> Watercourses.
<br /> - Army Corps of Engineers-Seawralls, Docks, Navigable 1fVaterways.
<br /> - Depar#ment of Nealth & Rehabilitafive ServiceslEnv"tronmental }iealth Unit-1lVells, Wastewater Treatment,
<br /> Septic�'anks. , -
<br /> - US Environmental Protection Agency-Asbestos abatem�nt. - _ . � - .
<br /> - Federal Aviakion Authority-Runways.
<br /> ! und�:rstand that the foilowing restrictions apply to the use of fill:
<br /> - Use of fill is not aliavued in Fioad 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 /> "compensating volurr�e" vuill be submitfed at time of permitting �nrhich is prepared t�y a professional engineer
<br /> licensed by the State of Florida.
<br /> - If the �11 material is to be used ttl FI40d ZOtI@ "A" in connection with a permitted building using stem uvall
<br /> construction, I certify that fill will be used only to fil(fhe area within the stem wall.
<br /> - If f€II material is to be used in any area, ! certify that use of such fill will not adversely affect adjacent
<br /> properties. If use of fill is found to adverseiy affect adjacent properties, fhe owner may be cited for vialating
<br /> the conditions of the building permit issued under the attached permit application, far lots less than one (1)
<br /> acre which are elevated by fill, an engineered drainage plan is required.
<br /> If I am the AGERIT fFOR 7FI� O1�iIIV�I�, I promise in good faith to inform #he owner of#he permitting conditions set forth in
<br /> this affidavit prior to camrnena'sng construction. 1 understand that a separate permit may be requfred for electrical vuork,
<br /> plumbing, signs, wells, pools, air conditioning, gas, or ofher insfallations nof specifically inciuded in the application. 1�
<br /> permit issued.shall be coristrued to be a license tp proceed with khe uvork and not as authori#y to violate, cancel, alter, or
<br /> set aside any pravisions of the technical cades, nar shail issuance of a permit prevenf fhe �uiiding Offieial from thereafter
<br /> requiring a correction of errors in plans, constructian or violatians of any codes. Every permit issued shall become invalid
<br /> unless the work authorizecf by such permif is commenced within six rnonths of permit issuartce, or if work authorizecf by
<br /> the permit is suspended or abandoned for a periad of six (6) months after the time the work is commenced. An extension
<br /> may be requested, in wri#ing, from fhe Building Official for a period not to exceed ninety (90) days and will demonstrate
<br /> jusfifiable cause far#he extension. If rrvork ceases for ninefy(90)consecutive days, the job is considered abandoned.
<br /> 1AlARlVIN� 7"� �WN�R: Y�UFZ iF�IL�1�� T� �t�C��t� �, �QTICE C11� ��iVl11�ENC���PtT 1V��,Y RiEsi1LT I�l YOt1R
<br /> fP�I�IPdG T�ii/ICE �'C7R IYVI�ROV�fVI��'�S �'O YOU�t �'fRf7�'EF�"fl(. I(�YOU IPITEfVD 1'�1 O�7AIN FIIV�►�JCIPIG, COiV!SULY
<br /> �1���--1 Y�U�t�.�N�D1EIEt Oi��1N�1T'TC1�t��1(�(E�t,���E (FtE����Ii�C YOII��IQYIC�E C1F �t1i4�i�CdCIE�f#��IT.
<br /> FI.ORIQA JURAT(F.S, 117.03)
<br /> _ _..�___..,_`�
<br /> O1tVPl�@2 OFt A�E�lY GQftI'f��
<br /> Subscribed and swom to or a(flrmed before me this Subscribed nd sworn to o aY'rmed b fore me th's
<br /> by ( ) �o.-g-l� by� r���.- �1C./-�.�
<br /> Who istare personally known to me or haslhave produced Is! e personal�y nown to me ar haslha ev produced
<br /> as IdenUficakion. __i__�,1 �5 .�+ Cer...B..g-- as iden6ficaGon.
<br /> �
<br /> Notary Public �� Notary Public
<br /> Commissian No. C mm( ion "'�'"��.
<br /> _*:� �'::= Commission#EE Q40520
<br />! ��: _
<br /> Name oC fVotary typed,printed or stamped IVame of No �Ajnp�;`pr� roYF� @r , 014
<br /> . "��ce&10-3&57019
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