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<br /> �O'TI�� O� CDE�D M2���'�IC7'IfJPl�. The undersigned understands that this permit may be sub�ect to deed restrictians
<br /> wthich may be more r�strictive than County reguEatior�s. The undersigned assumes responsibility for compliance v+rith any
<br /> applicable deed res#rictions.
<br /> U�L[C(E�4��D CC)NTR�C7�R� ��� C�P1�'��CTO�t ���F���1�I�IL1�"!{��: if the owner has hired a cantractor or
<br /> contractors ta underkake work, #hey may be requir�d fo be licensed in accardance with state and iocal regulations. if the
<br /> contractor is not licensed as required by lav+r, both the awner and contractor may be cited for a misdemeanor violation
<br /> und�r sfate law. If#he ovuner or intended cantractor ar� uncertain as �o what ticensing requirements may apply far the
<br /> intended work, they are advised to contact the Pasco County Building Inspection Divisian—Licensing Section at 727-847-
<br /> 8009. Furthermore, if fhe o�nrner has hirecf a contractor or contractors, he is advised �a have the contractor(s} sign
<br /> portions of the "cpntractor Block" of this applicatian for which they vvili be responsible. (f you, as the avdner sign as khe
<br /> eont�actor, that rnay be an indication khat he is not properly Gcensed and is not �nkitled to permittiog privileges in Pasco
<br /> Counfy. �
<br /> �"p�N�9�O�t1'/�TIOiV IflH��CTIUTILY'�"I�S 9�fi��,C'Y l�R9fl� ����9Uf�C� R�C�V��Y I�I��S: �'he undersigned understands
<br /> that Transpoctation tmpact Fe�s and Ftecourse Recovery Fees may apply to the construction of nst�t buildings, change of
<br /> use in existing buildings, ar expansion of �xisting buildings, as specified in 6�asco Caunty Ordinance number 89-07 and
<br /> 94-Q7, as amended. The undersigned also unders#ands, that such fees, as may be due, v+till be identified at the time of
<br /> permitting. It is further understood that Transportation Impack Fees and Resource Recovery Fees mus# be paid prior to
<br /> receiving a "certificate of occupancy" or fin�l powrer release. If khe project does no# involve`a certificate af occupancy or
<br /> final power r�lease, the fees must be paid priar to permit issuance. �urtherrr�are, if Pasco Count}r WaterlSewer Impac�
<br /> fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
<br /> CtJNS�'�2t1C�'IOP] E.��� �.�1�i���harp�����30 4�lcsris��S���u���, �� ���r��#+���: If valuation of u�ork is$2,5QO.Q0 or more, 1
<br /> certify that I, the applicant, have been pravided with a capy of the "�lorida Construction Lien Lavu—Hameovvner's
<br /> Protection Guide" prepar�ed by fhe Flarida Degartment of Agricultur� and Consucner Affairs. lf the applicant is sameone
<br /> ofher than the "owner", I certify#hat 1 have obtained a eopy of fhe above described document and promise in gaod iaith to
<br /> deliver it to the"owner" prior to commencement.
<br /> CO(VT���TOI�'�/�3�itP1�(�'� ��1F1�1���1': 4 certify fhat all fh� irrformatio� ir� this applica�ior� is accurate and that all work
<br /> will be done in compliance with all applicabte laws regulating construction, zoning and land developmen#. Application is
<br /> hereby made to obtain a permit to do vuork and ins#alEatian as indicated. t certify that no v�rorfc or 4nsta1la#ion has
<br /> commenced prior #o issuance af a permit and that all work will be performed to meet standards of all laws regula#ing
<br /> construction, Courtty and Ciky codes, zoning regulatians, and land development regulations in the jurisdictian_ I also
<br /> certify that 1 understand that the regul�tions of other government �gencies may appty #o the infended vuork, and that i# is
<br /> my responsibility to identify what actions I must take fo be in compliance. Such agencies incluiie but are not limited ta:
<br /> - Departrnent of Enviranm�ntal Protection-Gypress Bayheads, Wefland Areas and Environmentally Sensifive
<br /> Lands, VVat�r/Wastewater Trea#ment.
<br /> - �outhv+test Fiorida Water �anagement Distric�-1n(elis, Cypress �ayheads, l�letfand Areas, Altering
<br /> VVatercours�s.
<br /> - Army Corps of Engineers-Sea+ntaUs, Docks, kVavigable V1(afenrvays.
<br /> - Department of Heaifh � �ehabiiitative Services/�nviranmentai F�ealth Unit-VVells, Wastetnrater Treatrrtent,
<br /> Septic Tanks.
<br /> - US Environmen#a! Pratec#ior��lgency-Asbestos abatement.
<br /> - F'ederal Aviation Authority-Runways.
<br /> ! understand that the foflov+ring restrictions apply to#he use af filh
<br /> - Use of fill is not allawed in �iood Zone"V"unless expressly permitted.
<br /> - If the fill rnat�rial is to be used in Flood Zone °N", it is understood that a drainage plan addressing a
<br /> "compensafing voiume" wi11 be submitfed at time of permitting �nrhich is prepared by a professional �ngineer
<br /> licensed by the State of Florida.
<br /> - If fhe fill material is #o be used in Flood Zone "A" ie� connection uvith a pe�rnitted building using sfem uvall
<br /> construction, I certify that fill will be used only to fill the ar�a wi#hin the stem wall.
<br /> - !f filf materia! is ta be used in any ar�a, I certify that use of such ftl! v�ril! not adversely affect adjacent
<br /> properties. If use of fiH is found to advers�ly affect adjacenf properties, the ouvner may be cifed for viola#ing
<br /> the conditions of the building permit issued under the attached permit application, far Iots less than one (1)
<br /> acre v�thich are elevated by till, an engineered drainage plan is required.
<br /> If I am the�►CEiV�' FOI�7'B�IE CDFW�fE�t, I pramise in good faith to inform tfie owner of the permitting conditions set forth in
<br /> this afiidavit prior to commencing cortstruction. 1 understand that a separate permit may be'cequired for electrical work,
<br /> plumbing, signs, wells, paols, air conditioning, gas, or other instalfa#ions not specificalfy included in the application. A
<br /> permit issued shal! be constr.ued to be a licsnse to proceed with the vuork and nat as authority ta_violate, cancel, altec, or
<br /> set asid� any provisions of the technical cod�s, nar shall issuanc� af a permit prevent fhe Building �fficial from thereafter
<br /> requiring a correctian of errors in plans, construction or violations of any codes. �very permi# issued shall became invalid
<br /> tanless i�te uvork authorized by such permit is cammenced tinrithin six months of permit issuance, or if wark aufhorized by
<br /> the permit is suspended or abandon�d for a period of six(6) months after the time the work is commenced. An extension
<br /> may be requested, in writing, frorn the �uilding Official for a periad not to exceed ninefy (90} days and uvil! demonstrate
<br /> justifiabfe cause for the extensian. If work ceases for ninety(90)consecutive days, the job is considered abandoned.
<br /> 1fll�►RNIF�� 7't3 �1ltiilRl�9�: 1'�t162 ��HLt�R� T� �tI�C�+Ri3 A �QTICiE �iF �t}�I�idERiC�i�i�l�'T �I�iY R��l9L'�' 1�1 YOU�
<br /> �'�AYIRI� �4111�E �Cd�t B�'1�920V��i�R9�'S v�YOLJ���.OI��R`�'1�. I�YOtJ VWYfEP9�YC2 OBI��I�I FIPI�►W�NPIG, CO�S�I�.T
<br /> itil��F@-1 Y��� �.�6V�lEFt�Y��i��'�T�}�(��1�(�����I� �����t(01(��Y��f�2 i�01'1����C�Ii���6�CE�d��4�'.
<br /> FLORIDA JURAT(F.S. 117 0
<br /> Q�flt�lEit Oft AG�i�7 �OP1�'�tA�TO�
<br /> Subscribed and swom ta(or a�rm efore me this Subscribed and swo to(or affirmed)before me this
<br /> by by
<br /> Who istare personally known 4o me ar haslhave produced Wha islare sanally knourn#o me or haslhaue�trocfuced
<br /> as Ident(fication. s identificakion.
<br /> ry Public P�otary Public
<br /> �q1�:��a,y�; JflE�E.BACON _ ��"' Commissian#FF 137073
<br /> Cammissl . Commission#F Commfs � ��= •
<br /> :;�EXpires June 29,2018 '%,�f N;fi•' Bonded Ttuu Tray Fain tnsuance 8043B5d019
<br /> ''�+sf(�„��,°.��` 8wideditw7ray+Fsinlnsuazrceg�p�3gS.7tl19
<br /> Name o No ary pe , Name o otary typed,printed or stamped
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