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@V�TICf� O� I��EC112ES'Y'�ICYIOR9�: The undersigned understands that this permit may be subjeck to"deed" restrictians"
<br /> vvhich may be more restrictive than County regulations. The undersigned assumes responsibility far compCiance writh any
<br /> applicable deed restrictions.
<br /> UNL.1C����D GO�IT1t��C�fQR� �►�S� G��T�i�'���t �d(���t}�St(�1L1'Y'���: !f the a�nrner has hired a cantractor or
<br /> contractors #o undertake �nrork, #hey may be required to be licensed in accardance v�rith state and locai regulations. If fhe
<br /> contractor is nof licensed as required by law, bakh the o�nrner and contractor may be cited for a misdemeanor violation
<br /> � under state law. If th� awner or infended con#rac#or are uncertain as to wFtat licensing requirements may apply far the
<br /> intended work, they are advised to contacf#he Pasco County Building Inspection Division—Licensing Sec#ion at 727-847-
<br /> 8049. Fu�thermore, if the ar�vner has hired a contractor ar contractors, he is advised to have fhe cantractor{s} sEgn
<br /> portions of the "con#ractor Block" of this application for which they vvill be responsible. If yau, as the avvner sign as the
<br /> eontractor, that rr�ay be an indieation that he is not properly licens�d and i� n�t entitled to permitting privileges in Pasco
<br /> County.
<br /> ( 1f6�►1V,POR�'�YI(7Yd I�iI�,�C�IIJT'IL6�'I�S ��I��CY G�R�� f�f��OU�C� ��G��'��1(f�EfE�: The undersigned understands
<br /> � that Transpar#atiort Impact Fees and Recourse Recover}r Fees may apply to the cans#ructiort 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. 7h� urtdsrsign�d also understands, that such fees, as may be due, vuill be identified at the time of
<br /> permitting. It is further understood that Transportafion Impact Fees and Ftesource Recovery Fees must be paid prior to
<br /> receiving a "certificate of occupancy" or final po�nrer release. If th� project do�s no# involve a certificate of occupancy or
<br /> finai pawer release, fhe f�es must be paid prior ta permi# issuance. Furthermare, if F'asco Counfy �ltate�/Sevtirer lmpact
<br /> fees are due, they must be paid prior#o perrnit issuance in accordance with applicable Pasco Coun#y ordirrances.
<br /> �Q�IST�IlCTI�� �IIEP� ��V{Gha��f��793, �I�ric�����gta���, �s ��rn�nd��d�: If valuation of wor�C is$2,500.00 or more, 1
<br /> certify lhat I, the applicant, have been provided with a copy of #he "Florida Constructian Lien Lavu—Hameowrner's
<br /> Pratectior� Guide" prepared by the Florida Department of Agriculture and Cansumer flffairs. Ef the applicant is someone
<br /> ather than the "ovirner", I certify that I have obtained a copy of the above described document and promise in good faith to
<br /> deliver it to khe"owner"prior to commencement.
<br /> GU�T��►�TL7�'SJt��itR��(�'��i�[�11�,d�V1�': ! certify that a!E the information in this applicafion is accurate and fhat ail vvork
<br /> will be done in compliance with all applicable lav�s regulating construction, zoning and land development. Application is
<br /> hereby made ta obtain a permit ta da �ntork and installafson as indicated. 1 certify that �o vtirork or 9nstallation has
<br /> �� cammenced prior ta issuance of a permit and that all work will be performed to meet standards of all laws regula#ing
<br /> construction, County and City codes, zoning regulatians, and land development regulations in the jurisdiction. I also
<br /> certify #haf I undersfand that fhe regu{ations of other gavernment agencies rrtay appiy #o the intended work, and fhat it is
<br /> ' my responsibility to identify uvhat actians I must Yake fo be in compliance. Such agencies include but are not limited to:
<br /> - Deparfinent of Environmental �rotection-Gypress Bayheads, Wetfand Areas and �nvironmentally Sensitive
<br /> Lands, V�later/Was#ewater Treatment.
<br /> - 5outhwest Fiorida Water [Vlanagemen# Districf-VUells, Cypr�ss Bayheads, Wetland Areas, A1#ering
<br /> Watercourses.
<br /> - Army Carps of Enginesrs-Seawalls, Docks, Navigable lAfatervvays.
<br /> - Depertment of Health � Rehabilitafive Services/�nviron►nental Nealth Unit-Weils, Wastewafer Treatrrrenf,
<br /> �eptic�Tanks.
<br /> - US Environmental Peotection Agency-Asbestas abatem�nt.
<br /> - Federal Aviation Authority-Runways.
<br /> I understand that the fallowing restrictions apply ta the ease of f�lf:
<br /> - Use of fill is not allowed in Flood Zone"V"unless expressly permifted.
<br /> - !f the fill mat�rial is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
<br /> "compensating voiume" rn�i}{ be submitt�d at time of permifting uvhich is prepared by a professiona! engineer
<br /> licensed by the State of Florida.
<br /> - If fhe fi11 material is ta be used in F1oad Zane "A" in connection vtrith a permitted building using stem wraEl
<br /> construction, I certify tha�fill will be used only to fill fhe area within the stem wall.
<br /> - If fill material is to be used in any area, I certify that use of such fil! will not adversely affect adjacen#
<br /> properties. If use of�II is found to adversely affect adjacent proper#ies, fhe ovvner may be cited for violating
<br /> the conditions of the building permit issued under the aktached permit applicaQion, for Iots I�ss than one (1)
<br /> acre vuhich are efevated by fi11, an engineered drainage plan is required.
<br /> (f I am the AG�IVT FOI�T�9� OWIPIfEI�, I promise in good faith to infarm the owner of#he permitting conditions set forth in
<br /> this affidavit prior to commencing construcfion. I undersfand Ehat a separafie permit may be required for electrical vvork,
<br /> plumbing, signs, wells, pools, air conditioning, gas, or other insfalla#ions not specifically included in the appficaQion. A
<br /> permit issued shafl be construed to be a license to proceed with the work and not as authority to.violate, cancel, alter, or
<br /> set aside any provisions af the technical codes, nor shall issuanc� af a permit prevent fhe 8uilding Officia!from thereafter
<br /> requiring a correction of errors in plans, construction or violations of any codes. �very permit issued shall became invalid
<br /> unless the w�ork authorized by such permit is commenced �nrifhin six rr�onths of permit �ssuance, or if vvork aufhorized by
<br /> the permit is suspended or abandoned for a periad of six(6) months after the time the work is cornmenced. pn extension
<br /> may be requested, in vuriting, from fhe �uilding Official far a period not to exceed nineEy {90) days and v�ri11 demonstrate
<br /> justifiable cause for the extension. If work ceases for ninety(90)cons�cufive days, the job is considered abandoned.
<br /> r��►��r�� Tm owr���: v�u�z ��i�u�� �� ��co�� � ������ c�� �o�w���c����� ��v �����.� �� �cru�
<br /> �'�YIMC �'�'l41C� FC�@3 II��'ROVI��IifE�llf� T�D YOI�R �97CD�ERY'Y. IF�OU YC�YEGVD TO O�TAI�I Fl�d�►f�CIWG, (GOPI��I�.�'
<br /> �'iti�0i Y�t1� �.��Cl�F��}iR,�ip[tdi�TT�ii���Y��IF��IE �2��Q�1L�I�G YQt1�2 I�t]��'IC�CI�COC��IE�CE��k�i�.
<br /> FLORIDA JUR�"f(F.S. 117.03)
<br /> t?lfitft4Ef2 QFt�G�PIT COlVT�3AGTO�t
<br /> Subscrlded and sworn to(or affirmed)before me thls Subscribed and sworn to(or affirmed)before me this
<br /> by by
<br /> �JVho�stare personalty known to me or haslhave produced Who istare persanalEy lcnown to me or haslhave produced
<br /> as identification. as identification.
<br /> PJotary Public Notary Publia
<br /> Commission No. Commission No.
<br /> i
<br /> i
<br /> Name af tVotary typed,printed ar stamped Name pf Notary typed,printed or stamped
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