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<br /> NOTICE OF DEED RESTRICTIONS: The undersigned unde stands that this permit may be subject to"deed"restrictions" ,
<br /> which may be more restrictive than County regulations. The ndersigned assumes responsibility for compliance with any
<br /> applicable deed restrictions.
<br /> UNLICENSED CONTRACTORS AND CONTRACTOR RE PONSIBILITIES: if the owner has hired a contractor or
<br /> contractors to undertake work,they may be required to be li nsed in accordance with state and local regulations. If the
<br /> contractor is not licensed as required by law, both the own r and contractor may be cited for a misdemeanor violation
<br /> under state law. If the owner or intended contractor are un ertain as to 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 /> 8009. Furthermore, if the owner has hired a contractor o contractors, he is advised to have the contractor(s) sign
<br /> portions of the"contractor Block"of this application for whic they will be responsible. If you, as the owner sign as the
<br /> contractor,that may be an indication that he is not properly icensed and is not entitled to permitting privileges in Pasco
<br /> County.
<br /> TRANSPORTATION IMPACT/UTILITIES IMPACT AND RE OURCE RECOVERY FEES: The undersigned understands
<br /> that Transportation Impact Fees and Recourse Recovery Fe s may apply to the construction of new buildings,change of
<br /> use in existing buildings,or expansion of existing buildings, s specified in Pasco County Ordinance number 89-07 and
<br /> 90-07, as amended. The undersigned also understands,th t such fees, as may be due,will be identified at the time of
<br /> permitting. It is further understood that Transportation Impa t Fees and Resource Recovery Fees must be paid prior to
<br /> receiving a"certificate of occupancy"or final power release. If the project does not involve a certificate of occupancy or
<br /> final power release,the fees must be paid prior to permit is uance. Furthermore, if Pasco County Water/Sewer Impact
<br /> fees are due,they must be paid prior to permit issuance in ac ordance with applicable Pasco County ordinances.
<br /> CONSTRUCTION LIEN LAW(Chapter 713,Florida Statut ,as amended): If valuation of work is$2,500.00 or more,I
<br /> certify that I, the applicant, have been provided with a c py of the "Florida Construction Lien Law—Homeowner's
<br /> Protection Guide"prepared by the Florida Department of Ag iculture and Consumer Affairs. If the applicant is someone
<br /> other than the"owner",I certify that I have obtained a copy o the above described document and promise in good faith to
<br /> deliver it to the"owne�'prior to commencement.
<br /> CONTRACTOR'S/OWNER'S AFFIDAVIT. I certify that all t e information in this application is accurate and that all work
<br /> will be done in compliance with all applicable laws regulatin construction,zoning and land development. Application is
<br /> hereby made to obtain a permit to do work and installati n as indicated. I certity that no work or installation has
<br /> commenced prior to issuance of a permit and that all wor will be performed to meet standards of all laws regulating
<br /> construction, County and City codes, zoning regulations, a d land development regulations in the jurisdiction. I also
<br /> certify that I understand that the regulations of other govern ent agencies may apply to the intended work,and that it is
<br /> my responsibility to identify what actions I must take to be in ompliance. Such agencies include but are not limited to:
<br /> - Department of Environmental Protection-Cypre s Bayheads, Wetland Areas and Environmentally Sensitive
<br /> Lands,Water/Wastewater Treatment.
<br /> - Southwest Florida Water Management Dist ict-Wells, Cypress Bayheads, Wetland Areas, Altering
<br /> Watercourses.
<br /> - Army Corps of Engineers-Seawalls,Docks,Navi able Waterways.
<br /> - Department of Health & Rehabilitative Service /Environmental Health Unit-Welis, Wastewater Treatment,
<br /> Septic Tanks.
<br /> - US Environmental Protection Agency-Asbestos batement.
<br /> - Federal Aviation Authority-Runways.
<br /> I understand that the following restrictioris apply to the use o fill:
<br /> - Use of fill is not allowed in Flood Zone"V"unles expressly permitted.
<br /> - If the fill material is to be used in Flood Zon "A", it is understood that a drainage plan addressing a
<br /> "compensating volume"will be submitted at tim of permitting which is prepared by a professional engineer
<br /> licensed by the State of Florida.
<br /> - If the fill material is to be used in Flood Zone 'A" in connection with a permitted building using stem wall
<br /> construction,I certify that fill will be used only to ill the area within the stem wall.
<br /> - If fill material is to be used in any area, I ce ify that use of such fill will not adversely affect adjacent
<br /> properties. If use of fill is found to adversely a ect adjacent properties,the owner may be cited for violating
<br /> the conditions of the building permit issued un er the attached permit application,for lots less than one (1)
<br /> acre which are elevated by fill,an engineered dr inage plan is required.
<br /> If I am the AGENT FOR THE OWNER,I promise in good fai h to inform the owner of the permitting conditions set forth in
<br /> this affidavit prior to commencing construction. I understan that a separate permit may be required for electrical work,
<br /> plumbing, signs, wells, pools, air conditioning, gas, or oth installations not specifically included in the application. A
<br /> permit issued shall be construed to be a license to proceed ith the work and not as authority to violate,cancel,alter,or
<br /> set aside any provisions of the technical codes,nor shall iss ance of a permit prevent the Building Official from thereafter
<br /> requiring a correction of errors in plans,construction or viola ions of any codes. Every permit issued shall become invalid
<br /> unless the work authorized by such permit is commenced ithin six months of permit issuance,or if work authorized by
<br /> the permit is suspended or abandoned for a period of six(6)months after the time the work is commenced. An extension
<br /> may be requested, in writing,from the Building Official for period not to exceed ninety(90)days and will demonstrate
<br /> justifiable cause for the extension. If work ceases for ninety 90)consecutive days,the job is considered abandoned.
<br /> WARNING TO OWNER: YOUR FAILURE TO RECORD NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br /> PAYING TWICE FOR IMPROVEMENTS TO YOUR PROP TY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
<br /> WITH YOUR LENDER OR AN ATTORNEY BEFORE REC RDING YOUR NOTICE OF COMMENCEMENT.
<br /> FLORIDA JURAT(F.S.117.03)
<br /> OWNER OR AGENT C0IITRACTOR ./��C .�1'��� 1
<br /> Subscribed and swom to(or affirmed)before me this Sub rib d and sworn to(or af(irmed)before me this '/ n � crn�—f j"�
<br /> bY `-� by �C�YJL�i� ���`� � F—�V� l�1 c� /
<br /> Who is(are personally known to me or has/have produced Wh i areg ergona k wn t0 me or ha have produced
<br /> as identification. Ll ✓ V �[.QrL. s Identification.
<br /> Notary Public ' ' �'�"�� Notary Public
<br /> Commission No. Co mission No. � 1 �� 1��
<br /> Name of Notary typed,printed or stamped Na e of No ry t� v �or stamp�HLYN ACKERMAN
<br /> �r�� ���'.
<br /> _ . . ? Notary Public-State ot Florida
<br /> ;,g' :a�;My Comm.Expires Mar 12,2oie
<br /> ,,� �''.'„o����•' Commission # FF 100996 '
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